Karolina Kosa | University of Debrecen (original) (raw)
Papers by Karolina Kosa
<sec> <title>BACKGROUND</title> <p>Patient experiences constitute an inde... more <sec> <title>BACKGROUND</title> <p>Patient experiences constitute an independent dimension of health care quality that can be solicited by structured surveys or at dedicated online platforms. Unsolicited spontaneous patient narratives are much less used but potentially valuable means for gauging patient experiences.</p> </sec> <sec> <title>OBJECTIVE</title> <p>Our aim was to explore patient experiences in spontaneous patient blogs submitted during one decade to an online health forum.</p> </sec> <sec> <title>METHODS</title> <p>1662 non-solicited individual blogs on patient experiences posted between 2009 and 2018 on a Hungarian internet forum were randomly sampled. 20% (n=346) of the blogs were used for qualitative content analysis. A coding framework was constructed based on previous research and taxonomies to analyse content, including specific experiences or episodes. Major categories and subcategories were constructed within the three major dimensions (structure, process, outcome) of Donabedian's framework for health care quality.</p> </sec> <sec> <title>RESULTS</title> <p>Majority of blogs described a specific experience (94.2%) in healthcare; almost 40% occurred in tertiary care; 29.5% of the blogs even identified a specific hospital or department. 55.2% of the bloggers were patients themselves, and the majority (92.7%) were dissatisfied with the reported experience. Issues were most frequently related to physicians (65.2%). In terms of Donabedian's dimensions, problems with human resources dominated "Structure" (74.1%) such as not enough or incompetent staff. Waiting time and access to care (69.19%) comprised the most frequent complaints of material resources within "Structure". Within "Process", episodes related to examination (42.86%) accounted for most of the complaints. Outcomes were identified in 60% of the blogs, and deterioration, complication, readmission, or death was reported in 62% of these episodes.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>Donabedian's model of healthcare quality was appropriate for the categorization of patient experiences. Regular monitoring of spontaneous patient reports is recommended to utilize them for healthcare quality improvement especially if reports provide specific details.</p> </sec>
Frontiers in Public Health, Nov 30, 2021
Background: Health literacy, a recently determined construct plays an important role in how indiv... more Background: Health literacy, a recently determined construct plays an important role in how individuals are able to manage their health. A useful approach for the assessment of health literacy is to measure the comprehension of available patient education materials (PEMs). Objective: We aimed at assessing the usefulness of PEMS available in Hungarian by testing comprehension of selected PEMs in different groups of users. Methods: Comprehension of patient education materials in the domain of healthcare was tested by selecting PEMs and creating questions based on their text in 3 dimensions of health literacy: understand, process/appraise, apply/use. Twenty questions were created that could be answered without pre-existing knowledge by reading the appropriate text taken from PEMs. Comprehension was examined in four groups: laypersons, non-professional healthcare workers, 1st year healthcare students, and 5th year medical students. Readability indices were calculated for the same texts to which questions were created. Results: Laypersons answered <50% of the PEMs-based questions correctly. Non-professional healthcare workers performed better with 57% of right answers but significantly worse than healthcare students or medical students. Those with at least high school qualification (maturity exam) showed significantly higher comprehension compared to those with lower educational attainment. Persons in good or very good health also had significantly better comprehension than those in less favorable health. All readability indices showed that comprehension of the tested PEMs required at least 10 years of schooling or more. Therefore, these PEMS are difficult to understand for persons with less than high school level of education. Conclusion: Rephrasing of the investigated patient educational materials would be recommended so that they better fit the educational attainment of the Hungarian population. Evaluation of the readability and comprehensibility of other PEMs also seems warranted.
BMC Pediatrics, Feb 12, 2022
Intoduction: Childhood intelligence is an important predictor of later outcomes in life such as s... more Intoduction: Childhood intelligence is an important predictor of later outcomes in life such as socioeconomic status or health. Hence, a deeper understanding of predictors of child intelligence should suggest points of intervention for children facing adversities. Objectives: The purpose of this study is to examine the predictive value of demographic, perinatal and neonatal variables after birth and developmental characteristics at age 2 for 4-year intelligence as outcome among low birth weight children. Methods: We designed a panel study with a 2-year follow-up with 114 child-mother pairs. The outcome variable was IQ intelligence quotient at 4 years of age of LBW low birth weight children measured by the Wechsler Primary and Preschool Scales of Intelligence. Potential predictors were maternal education, family wealth, ethnic identity; sex, twin pregnancy, gestational age, birth weight, Apgar scores, maternal smoking during pregnancy; diagnosis of intravetricular haemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia after birth and cognitive, language and motor development at age 2 measured by one composite score of the three Bayley Scales of Infant and Toddler Development aggregated. Results: Stepwise backward regression was carried out including significant variables from the bivariate analysis. The best model included 4 predictors which accounted for 57% of the variance of the full IQ intelligence at 4-years of age. Maternal higher education was significant positive, below average family wealth and neonatal diagnosis of bronchopulmonary dysplasia were significant negative predictors in the model after birth. 2-year developmental characteristics such as cognitive, motor and language skills were positive predictors of the IQ intelligence at age 4. Conclusion: Sociodemographic assessment at birth and developmental assessment at two years of age are of crucial importance to recognize children at high risk for delayed cognitive development. High-risk children should be directed to supportive interventions and their development should be regulary monitored.
BACKGROUND The high risk for mental health problems among medical students has been compounded by... more BACKGROUND The high risk for mental health problems among medical students has been compounded by the Covid-19 pandemic which greatly reduced formal and informal social contacts. In order to help students, the mental health support service of the medical school of one Hungarian university was not only transferred to the online learning management system but was expanded by self-help materials in three domains: improving study skills, stress management techniques, and reducing stress related to the Covid-19 pandemic. Separate portals were developed for medical students at Hungarian and English courses. OBJECTIVE Our objective was to investigate the pattern of access to the online self-help materials among medical students and the characteristics of those who used the portals. METHODS Access to the online materials between April 2020-April 2021 among Hungarian and international medical students was analyzed using the logging data of the system. RESULTS 15% (n=458) of medical students entered the portal. Women were more likely to visit the site than men among both Hungarian (female: 72%) and international students (female: 59%). Fifth-year students (27%) among Hungarians and first-year students (24%) among internationals comprised the largest proportion of visitors. Of all students who logged in at any time during the examined period, 36.6– 40.4% viewed materials for improving study skills, 23-29% viewed stress management materials of which short-duration techniques in audio format were preferred. The access rate of content targeting coping with mental health effects of Covid-19 was 9.5-24%. CONCLUSIONS The pattern of access can be used for the development of interventions that are of most interest to medical students. Support to improve study skills and brief stress management techniques were the most preferred types of self-help materials.
Magyar tudomány, Nov 1, 2019
Mentálhigiéné és pszichoszomatika, Jun 1, 2018
health strategy by presenting major conceptual and methodological dilemmas arising when represent... more health strategy by presenting major conceptual and methodological dilemmas arising when representative mental health surveys are designed. The most frequently used tools to measure mental disorders, generic mental status and mental health at the population level are also summarized. The mental status of the Hungarian population should be regularly monitored using internationally comparable methodology so as not only to produce valid data for the development of a strategy to improve mental health but also to enable the follow-up of the effectiveness of policy interventions.
Biochemical and Biophysical Research Communications, Mar 1, 1997
found that the application of TPA markedly inhibited In contrast to most other systems, TPA induc... more found that the application of TPA markedly inhibited In contrast to most other systems, TPA induced TG C the increase of TG C caused by RA in mouse epidermal activity and protein in SW620 human colon carcinoma cells. Our own results also show that the activation of cells. This induction was accompanied by cell growth PKC inhibits induction of TG C by RA in NIH3T3 cells inhibition and increased apoptosis. The general pro-(manuscript in preparation). However, Keogh et al (13) tein kinase-C inhibitor GF-109203X blocked the inducrecently reported that in a human colon tumor cell line, tion of TG C by TPA, whereas the specific inhibitor of SW620, TPA induced TG C enzyme activity. Induction the PKCa isoform, the indocarbazole Go6976, reduced of transglutaminase C by TPA is quite intriguing since,
BMC Family Practice, Oct 17, 2020
Background: A Primary Care Model Programme was implemented in Hungary between 2013 and 2017 in or... more Background: A Primary Care Model Programme was implemented in Hungary between 2013 and 2017 in order to increase access of disadvantaged population groups to primary care and to offer new preventive services for all clients. In a country with single-handed practices, four group practices or GP clusters were created in the Programme. Six GPs comprised one cluster who together employed nonmedical health professionals and nonprofessional health mediators, the latter recruited from the serviced communities, many of them of Roma ethnicity. Health mediators were tasked by improving access of the local communitiesincluding its vulnerable Roma membersto existing and new services. Health mediators were interviewed about their work experiences, motivation, and overall opinion as members of the clusters as part of the Programme evaluation. Methods: As part of the Programme evaluation, structured interviews were conducted with all 40 health mediators employed at the time in the Programme. Interviews were transcribed and content analysis was carried out. Results: Three themes emerged from the transcripts. The first focused on the health mediators' personal characteristics such as motivation to join the Programme, the way their job increased their self-esteem, social status and health consciousness. Domains of the second theme of their work included importance of on-the-job training and of their insider knowledge of local communities, as well as their pride to have become members of the primary care team. The third theme covered overall functioning of the Programme of which they had mostly positive opinions, notwithstanding some criticism regarding procurement. Conclusions: Health mediators had earlier worked in various European countries specifically to improve access of Roma ethnic groups to health services but the Hungarian Model Programme was globally the first in which health mediators as non-professional workers became equal members of the primary care team as employees. Their contribution and overwhelmingly positive experiences, along with their useful insights for improvement call for the establishment and funding of health mediator positions in primary care especially in areas with large numbers of disadvantaged Roma populations.
Egészségfejlesztés /, Sep 26, 2022
Válogatás korábbi lapszámok kapcsolódó cikkeiből Egyetemi hallgatók egészségműveltségének vizsgál... more Válogatás korábbi lapszámok kapcsolódó cikkeiből Egyetemi hallgatók egészségműveltségének vizsgálata Ismertetés: Az egészségműveltség iskolákban történő fejlesztésének etikai alapjai: érvek ("miért"), irányok ("mit") és hangszínek ("hogyan") A fiatalok kockázati viselkedésének és mentális egészségének szűrése-a YouthCHAT program Az egészségműveltség definíciói
Human Resources for Health, Feb 7, 2022
Objectives : A Primary Care Model Programme had been implemented in Hungary between 2013 and 2017... more Objectives : A Primary Care Model Programme had been implemented in Hungary between 2013 and 2017 in which group practices were established that employed-among others-nonprofessional health workers (health mediators, similar to community health workers) to facilitate access for the most disadvantaged population groups. The health of mediators, themselves mostly disadvantaged ethnic Roma, was monitored every odd year of the Programme. Methods : A repeated cross-sectional health interview survey had been implemented inviting all health mediators who were employed at the time of the survey. The same questionnaire was used in all 3 surveys with items from the European Health Interview Survey 2009 and validated versions of other scales. Results: Positive changes occurred in the health status of mediators during 5 years of follow-up. Significant improvement in mental health occurred among those who completed on-the-job vocational training. By 2017, significant increase in sense of coherence was observed among those who obtained vocational qualification as opposed to those who did not. The proportion of highly stressed mediators showed a significant increase among those with no vocational training. Improvement was detected in all mediators in health awareness, dysfunctional attitudes, psychological stress and smoking prevalence. Conclusions : Significant improvement in mental status among those who obtained on-the-job vocational qualification were observed during follow-up of ethnic Roma health mediators in the programme in which they were equal members of the primary health care team. Employment of health mediators in primary care teams not only contributed to improving access to care for disadvantaged groups, but also improved the mental health of mediators themselves.
Acta Polytechnica Hungarica, 2023
Due to healthcare systems increased focus on healthcare quality and patientcentered care, the pat... more Due to healthcare systems increased focus on healthcare quality and patientcentered care, the patients' perspective of delivered healthcare, has become an important part of healthcare service evaluations. Patient experiences can be used to improve the quality of care, as they reveal important information about health care encounters. An increasing number of organizations systematically collect and analyze patient experience data. The aim of our study was to identify major topics in narratives of patients' healthcare related experiences and analyze the reactions of readers of patient experiences. 1663 blogs and 298806 textual comments were extracted on non-solicited patient experiences from a Hungarian online forum during a 10-year period. Topic modeling with state-of-the-art BERT embeddings were used to analyze the data and extract meaningful patterns and concepts. Sentiment analysis was utilized to categorize the emotional valence of the narrative writings. The huBERT and HIL-SBERT models identified 326 and 200 topics in terms of patient experiences and 508 and 728 topics regarding the reactions to these experiences without human supervision. Conceptually similar topics were integrated into major categories with manual analysis. 94.4% of the experiences and 77.5% of comments were classified as negative, reflecting the same annual tendency over the decade. Our study uses a data-driven approach for extracting patterns of healthcare related patient opinions, in Hungary. Topic modeling, based on BERT embeddings, could provide useful information on patient perceptions and perspectives, that could improve healthcare quality and safety.
Orvosi Hetilap, Jun 18, 2006
The rapid development of public health and medicine started in the second half of the 19th centur... more The rapid development of public health and medicine started in the second half of the 19th century leading to a massive decline or disappearance of previously deadly communicable diseases. However, almost parallel to this process, chronic non-communicable diseases appeared and have become widespread in the populations of developed countries presenting a new challenge for public health. &amp;amp;amp;amp;amp;#39;New public health&amp;amp;amp;amp;amp;#39; and health promotion emerged representing new ways of thinking and approaches as a societal answer to population health problems. The Ottawa Charter, the decisive document of health promotion laid the ground for health promoting activities, naming healthy public policy, supporting environments, community actions, personal skills and and reoriented health services as major fields of action towards improving population health. The article describes examples for these actions and how they are related to health, and provides ideas as to how medical practitioners can contribute to the global common goal of health promotion and medicine.
Mentálhigiéné és pszichoszomatika, Dec 13, 2022
Elméleti háttér: Manapság a videójátékok számos ember életének fontos részét képezik. 2020-as haz... more Elméleti háttér: Manapság a videójátékok számos ember életének fontos részét képezik. 2020-as hazai adatok szerint a videójátékosok száma legalább 3,8 millió fő, a jellemző játékidő hétköznapokon 2-3 óra. A játékosok (angolul "gamers" vagy magyarosan gamerek) egy része profi módon, szervezett versenyeken játszik, napjában több órát fordítva játékra és képességei fejlesztésére; őket e-sportolóknak nevezik. A videójátékokkal való rendszeres időtöltés-mint minden szokás-befolyással van a játékosok lelki működésére. Cél: kvalitatív módszertannal, valós időben, strukturált online interjúkkal feltárni a videójátékkal rendszeresen játszók pszichés jellemzőit. Módszerek: A 18 éven felüli interjúalanyok hólabda módszerrel kerültek azonosításra (n = 22; 77% férfi, átlagéletkor: 24,9 [SD = 3,8] év). Eszközök: az alanyok 5 témakörbe tartozó kérdésekre válaszoltak: 1. demográfiai adatok, 2. általános játszási szokások, 3. a játék (gaming) jelentősége az alany számára, 4. a játékra való motivációk, 5. a játékos társas kapcsolatai. A hangrögzített interjúk átgépelésével kapott szövegeket tartalomelemzésnek vetettük alá. Eredmények: Összesen 22 fővel készült interjú, amelyek teljes időtartama 598 perc (átgépelés után 51 193 szó) volt. Az interjúalanyok többségükben húszas éveik elején járó fiatalok voltak, akik átlagosan 10,7 éves (SD = 5,5 év) korban kezdtek el játszani. A válaszadók átlagosan napi 5,2 órát (SD = 2,3 óra) töltenek játékkal; nagy részük (91%) gamernek vallja magát, de többségük az ellenőrző kérdések eredményei alapján e-sportolónak tartható. A tevékenység kialakulását vizsgálva 64% vallotta, hogy társas kapcsolatai hatására, illetve 41% az unaloműzés miatt kezdett játszani, és ezek, valamint a fejlődés lehetősége ösztönözte a tevékenység folytatására. A motivációk közül kiemelt jelentőségű a győzelem és a vereség, valamint a fejlődés igénye. A válaszadók 32%-a problémásnak ("toxikusnak") vélte saját játékát, habár ezt a viselkedést másnál elítélte. Az alanyok barátainak java része a gamerek szubkultúrájából kerül ki; a játéktevékenységet nem végző környezetük pedig többségében negatívan vélekedik a játékos hobbijáról vagy általában a videójátékokról. Következtetések: A káros következményekkel járó videójátszás legfontosabb megelőzési lehetősége a társas készségek fejlesztése, a valóságos társas kapcsolatok minél korábban kezdődő építése és erősítése.
Frontiers in Public Health
European Journal of Mental Health, 2018
Background: The prevalence of postpartum anxiety is high and its negative consequences are signif... more Background: The prevalence of postpartum anxiety is high and its negative consequences are significant. Most research studies have aimed at exploring the demographic and psychosocial risk factors while neglecting factors of intrapsychic vulnerability. The aim of our study is to examine postpartum anxiety from this aspect, that is, uncovering the early relational experiences of mothers, specifically regarding their early maladaptive schemas. Methods: 125 women participated in online data collection in the first year after giving birth. Maternal anxiety was measured with the postpartum version of STAI-S, while early maladaptive schemas were assessed with the Schema Questionnaire. Results: In terms of demographics, most of the mothers in our sample had middle-class characteristics, but 21.6% had clinical, and 34.4% had subclinical levels of anxiety. Our results confirmed a significant, direct effect of maladaptive schemas on postpartum anxiety in case of 13 of the 15 measured schemas. Discussion: This study draws attention to the intrapsychic vulnerability of mothers as a highly neglected etiological aspect of postpartum anxiety. Further research of intrapsychic and, especially, attachment-related vulnerability should be carried out to identify at-risk women and treat postpartum anxiety more adequately. Limitations: The sample consisted of highly educated, married women with planned children, so the results are not representative for mothers in general.
Supportive Care in Cancer, 2022
Introduction Nowadays, more than 80% of newly diagnosed classical Hodgkin lymphoma (HL) patients ... more Introduction Nowadays, more than 80% of newly diagnosed classical Hodgkin lymphoma (HL) patients can be cured and become long-term survivors due to risk and response-adapted treatment strategies. A well-known side effect is cognitive dysfunction that appears in HL patients after chemotherapy. In the present study, we aimed to measure cognitive dysfunction in our HL patients in this study and to find potential correlations between patient-related factors, the signs and symptoms of their diseases, or therapeutic factors. Methods We carried out a computer-assisted assessment (CANTAB) of cognitive dysfunction in 118 patients. We examined the domains of visual memory, attention, working memory, and planning. Results The median age of 64 females and 54 males at diagnosis was 29 (13–74) and 41 (21–81) years at the completion of CANTAB. Fifty-two percent of all patients showed cognitive impairment. Attention was impaired in 35% of patients, the working memory and planning were impaired in 2...
Sustainability, 2021
Background: COVID-19 has changed the world and strongly affected the health of the people and the... more Background: COVID-19 has changed the world and strongly affected the health of the people and the quality of their life. These changes might impact employees’ physical activity (PA) and sedentary behavior (SB). This study aimed to summarize the literature focusing on the COVID-19-caused changes in physical activity and sedentary behavior among the adult working population. Methods: Literature searches were conducted in June 2021 using multiple electronic databases. The following keywords and synonyms were used during the searching process: physical activity, sedentary behavior, COVID-19, employee. After the data cleaning process (duplicates, inclusion criteria), the title and the abstract of all manuscripts from the searches were screened independently by two reviewers. Results: Thirty-nine manuscripts were selected as a result of the searching process. Of these, 5 were SB related, 15 were PA related and 19 addressed both PA and SB. There were longitudinal (10), cross-sectional (28)...
Orvosi hetilap, Jan 27, 2002
The status and problems of the roma (gipsy) population have been in the forefront in Hungary and ... more The status and problems of the roma (gipsy) population have been in the forefront in Hungary and have called for numerous benevolent interventions. Successful planning and implementation of programs aimed at the improvement of their health status must be based on solid facts regarding their problems and the causes behind. The authors give a literature review on research papers discussing the health (disease) status of the Hungarian roma population published between 1980 and 2001. They give a summary on the demography of gypsies, an overview of publications on pregnancy, delivery and infant mortality, on adult morbidity and mortality, on genetic investigations among roma people, as well as on their health behaviour and relations with the health care system, and finally, they give a brief overview of their socio-economic status. The authors sum up the major difficulties of research aimed at roma people, express their concern regarding health research papers published on gypsies; and o...
The present working document aims to provide support to and additional background for the Europea... more The present working document aims to provide support to and additional background for the European Commission in its process of reviewing the health components of the National Roma Integration Strategies during the first quarter of 2012. It is for a targeted audience (specifically, DG SANCO technical staff working on Roma health). This document contains an expanded and adapted version of the “criteria for the evaluation of the health component of the National Roma Integration Strategies” that were presented at the “Roma health resource workshop” in Istanbul on 26-27 October 2011. The workshop, which was co-organized by UNFPA and WHO, provided input and facilitated country-to-country exchange for developing or revising the health component of National Roma Integration Strategies or related sets of policy measures. The aforementioned criteria were presented in plenary and subsequently reviewed in breakout groups that comprised more than 40 representatives from governments, NGOs/civil ...
<sec> <title>BACKGROUND</title> <p>Patient experiences constitute an inde... more <sec> <title>BACKGROUND</title> <p>Patient experiences constitute an independent dimension of health care quality that can be solicited by structured surveys or at dedicated online platforms. Unsolicited spontaneous patient narratives are much less used but potentially valuable means for gauging patient experiences.</p> </sec> <sec> <title>OBJECTIVE</title> <p>Our aim was to explore patient experiences in spontaneous patient blogs submitted during one decade to an online health forum.</p> </sec> <sec> <title>METHODS</title> <p>1662 non-solicited individual blogs on patient experiences posted between 2009 and 2018 on a Hungarian internet forum were randomly sampled. 20% (n=346) of the blogs were used for qualitative content analysis. A coding framework was constructed based on previous research and taxonomies to analyse content, including specific experiences or episodes. Major categories and subcategories were constructed within the three major dimensions (structure, process, outcome) of Donabedian's framework for health care quality.</p> </sec> <sec> <title>RESULTS</title> <p>Majority of blogs described a specific experience (94.2%) in healthcare; almost 40% occurred in tertiary care; 29.5% of the blogs even identified a specific hospital or department. 55.2% of the bloggers were patients themselves, and the majority (92.7%) were dissatisfied with the reported experience. Issues were most frequently related to physicians (65.2%). In terms of Donabedian's dimensions, problems with human resources dominated "Structure" (74.1%) such as not enough or incompetent staff. Waiting time and access to care (69.19%) comprised the most frequent complaints of material resources within "Structure". Within "Process", episodes related to examination (42.86%) accounted for most of the complaints. Outcomes were identified in 60% of the blogs, and deterioration, complication, readmission, or death was reported in 62% of these episodes.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>Donabedian's model of healthcare quality was appropriate for the categorization of patient experiences. Regular monitoring of spontaneous patient reports is recommended to utilize them for healthcare quality improvement especially if reports provide specific details.</p> </sec>
Frontiers in Public Health, Nov 30, 2021
Background: Health literacy, a recently determined construct plays an important role in how indiv... more Background: Health literacy, a recently determined construct plays an important role in how individuals are able to manage their health. A useful approach for the assessment of health literacy is to measure the comprehension of available patient education materials (PEMs). Objective: We aimed at assessing the usefulness of PEMS available in Hungarian by testing comprehension of selected PEMs in different groups of users. Methods: Comprehension of patient education materials in the domain of healthcare was tested by selecting PEMs and creating questions based on their text in 3 dimensions of health literacy: understand, process/appraise, apply/use. Twenty questions were created that could be answered without pre-existing knowledge by reading the appropriate text taken from PEMs. Comprehension was examined in four groups: laypersons, non-professional healthcare workers, 1st year healthcare students, and 5th year medical students. Readability indices were calculated for the same texts to which questions were created. Results: Laypersons answered <50% of the PEMs-based questions correctly. Non-professional healthcare workers performed better with 57% of right answers but significantly worse than healthcare students or medical students. Those with at least high school qualification (maturity exam) showed significantly higher comprehension compared to those with lower educational attainment. Persons in good or very good health also had significantly better comprehension than those in less favorable health. All readability indices showed that comprehension of the tested PEMs required at least 10 years of schooling or more. Therefore, these PEMS are difficult to understand for persons with less than high school level of education. Conclusion: Rephrasing of the investigated patient educational materials would be recommended so that they better fit the educational attainment of the Hungarian population. Evaluation of the readability and comprehensibility of other PEMs also seems warranted.
BMC Pediatrics, Feb 12, 2022
Intoduction: Childhood intelligence is an important predictor of later outcomes in life such as s... more Intoduction: Childhood intelligence is an important predictor of later outcomes in life such as socioeconomic status or health. Hence, a deeper understanding of predictors of child intelligence should suggest points of intervention for children facing adversities. Objectives: The purpose of this study is to examine the predictive value of demographic, perinatal and neonatal variables after birth and developmental characteristics at age 2 for 4-year intelligence as outcome among low birth weight children. Methods: We designed a panel study with a 2-year follow-up with 114 child-mother pairs. The outcome variable was IQ intelligence quotient at 4 years of age of LBW low birth weight children measured by the Wechsler Primary and Preschool Scales of Intelligence. Potential predictors were maternal education, family wealth, ethnic identity; sex, twin pregnancy, gestational age, birth weight, Apgar scores, maternal smoking during pregnancy; diagnosis of intravetricular haemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia after birth and cognitive, language and motor development at age 2 measured by one composite score of the three Bayley Scales of Infant and Toddler Development aggregated. Results: Stepwise backward regression was carried out including significant variables from the bivariate analysis. The best model included 4 predictors which accounted for 57% of the variance of the full IQ intelligence at 4-years of age. Maternal higher education was significant positive, below average family wealth and neonatal diagnosis of bronchopulmonary dysplasia were significant negative predictors in the model after birth. 2-year developmental characteristics such as cognitive, motor and language skills were positive predictors of the IQ intelligence at age 4. Conclusion: Sociodemographic assessment at birth and developmental assessment at two years of age are of crucial importance to recognize children at high risk for delayed cognitive development. High-risk children should be directed to supportive interventions and their development should be regulary monitored.
BACKGROUND The high risk for mental health problems among medical students has been compounded by... more BACKGROUND The high risk for mental health problems among medical students has been compounded by the Covid-19 pandemic which greatly reduced formal and informal social contacts. In order to help students, the mental health support service of the medical school of one Hungarian university was not only transferred to the online learning management system but was expanded by self-help materials in three domains: improving study skills, stress management techniques, and reducing stress related to the Covid-19 pandemic. Separate portals were developed for medical students at Hungarian and English courses. OBJECTIVE Our objective was to investigate the pattern of access to the online self-help materials among medical students and the characteristics of those who used the portals. METHODS Access to the online materials between April 2020-April 2021 among Hungarian and international medical students was analyzed using the logging data of the system. RESULTS 15% (n=458) of medical students entered the portal. Women were more likely to visit the site than men among both Hungarian (female: 72%) and international students (female: 59%). Fifth-year students (27%) among Hungarians and first-year students (24%) among internationals comprised the largest proportion of visitors. Of all students who logged in at any time during the examined period, 36.6– 40.4% viewed materials for improving study skills, 23-29% viewed stress management materials of which short-duration techniques in audio format were preferred. The access rate of content targeting coping with mental health effects of Covid-19 was 9.5-24%. CONCLUSIONS The pattern of access can be used for the development of interventions that are of most interest to medical students. Support to improve study skills and brief stress management techniques were the most preferred types of self-help materials.
Magyar tudomány, Nov 1, 2019
Mentálhigiéné és pszichoszomatika, Jun 1, 2018
health strategy by presenting major conceptual and methodological dilemmas arising when represent... more health strategy by presenting major conceptual and methodological dilemmas arising when representative mental health surveys are designed. The most frequently used tools to measure mental disorders, generic mental status and mental health at the population level are also summarized. The mental status of the Hungarian population should be regularly monitored using internationally comparable methodology so as not only to produce valid data for the development of a strategy to improve mental health but also to enable the follow-up of the effectiveness of policy interventions.
Biochemical and Biophysical Research Communications, Mar 1, 1997
found that the application of TPA markedly inhibited In contrast to most other systems, TPA induc... more found that the application of TPA markedly inhibited In contrast to most other systems, TPA induced TG C the increase of TG C caused by RA in mouse epidermal activity and protein in SW620 human colon carcinoma cells. Our own results also show that the activation of cells. This induction was accompanied by cell growth PKC inhibits induction of TG C by RA in NIH3T3 cells inhibition and increased apoptosis. The general pro-(manuscript in preparation). However, Keogh et al (13) tein kinase-C inhibitor GF-109203X blocked the inducrecently reported that in a human colon tumor cell line, tion of TG C by TPA, whereas the specific inhibitor of SW620, TPA induced TG C enzyme activity. Induction the PKCa isoform, the indocarbazole Go6976, reduced of transglutaminase C by TPA is quite intriguing since,
BMC Family Practice, Oct 17, 2020
Background: A Primary Care Model Programme was implemented in Hungary between 2013 and 2017 in or... more Background: A Primary Care Model Programme was implemented in Hungary between 2013 and 2017 in order to increase access of disadvantaged population groups to primary care and to offer new preventive services for all clients. In a country with single-handed practices, four group practices or GP clusters were created in the Programme. Six GPs comprised one cluster who together employed nonmedical health professionals and nonprofessional health mediators, the latter recruited from the serviced communities, many of them of Roma ethnicity. Health mediators were tasked by improving access of the local communitiesincluding its vulnerable Roma membersto existing and new services. Health mediators were interviewed about their work experiences, motivation, and overall opinion as members of the clusters as part of the Programme evaluation. Methods: As part of the Programme evaluation, structured interviews were conducted with all 40 health mediators employed at the time in the Programme. Interviews were transcribed and content analysis was carried out. Results: Three themes emerged from the transcripts. The first focused on the health mediators' personal characteristics such as motivation to join the Programme, the way their job increased their self-esteem, social status and health consciousness. Domains of the second theme of their work included importance of on-the-job training and of their insider knowledge of local communities, as well as their pride to have become members of the primary care team. The third theme covered overall functioning of the Programme of which they had mostly positive opinions, notwithstanding some criticism regarding procurement. Conclusions: Health mediators had earlier worked in various European countries specifically to improve access of Roma ethnic groups to health services but the Hungarian Model Programme was globally the first in which health mediators as non-professional workers became equal members of the primary care team as employees. Their contribution and overwhelmingly positive experiences, along with their useful insights for improvement call for the establishment and funding of health mediator positions in primary care especially in areas with large numbers of disadvantaged Roma populations.
Egészségfejlesztés /, Sep 26, 2022
Válogatás korábbi lapszámok kapcsolódó cikkeiből Egyetemi hallgatók egészségműveltségének vizsgál... more Válogatás korábbi lapszámok kapcsolódó cikkeiből Egyetemi hallgatók egészségműveltségének vizsgálata Ismertetés: Az egészségműveltség iskolákban történő fejlesztésének etikai alapjai: érvek ("miért"), irányok ("mit") és hangszínek ("hogyan") A fiatalok kockázati viselkedésének és mentális egészségének szűrése-a YouthCHAT program Az egészségműveltség definíciói
Human Resources for Health, Feb 7, 2022
Objectives : A Primary Care Model Programme had been implemented in Hungary between 2013 and 2017... more Objectives : A Primary Care Model Programme had been implemented in Hungary between 2013 and 2017 in which group practices were established that employed-among others-nonprofessional health workers (health mediators, similar to community health workers) to facilitate access for the most disadvantaged population groups. The health of mediators, themselves mostly disadvantaged ethnic Roma, was monitored every odd year of the Programme. Methods : A repeated cross-sectional health interview survey had been implemented inviting all health mediators who were employed at the time of the survey. The same questionnaire was used in all 3 surveys with items from the European Health Interview Survey 2009 and validated versions of other scales. Results: Positive changes occurred in the health status of mediators during 5 years of follow-up. Significant improvement in mental health occurred among those who completed on-the-job vocational training. By 2017, significant increase in sense of coherence was observed among those who obtained vocational qualification as opposed to those who did not. The proportion of highly stressed mediators showed a significant increase among those with no vocational training. Improvement was detected in all mediators in health awareness, dysfunctional attitudes, psychological stress and smoking prevalence. Conclusions : Significant improvement in mental status among those who obtained on-the-job vocational qualification were observed during follow-up of ethnic Roma health mediators in the programme in which they were equal members of the primary health care team. Employment of health mediators in primary care teams not only contributed to improving access to care for disadvantaged groups, but also improved the mental health of mediators themselves.
Acta Polytechnica Hungarica, 2023
Due to healthcare systems increased focus on healthcare quality and patientcentered care, the pat... more Due to healthcare systems increased focus on healthcare quality and patientcentered care, the patients' perspective of delivered healthcare, has become an important part of healthcare service evaluations. Patient experiences can be used to improve the quality of care, as they reveal important information about health care encounters. An increasing number of organizations systematically collect and analyze patient experience data. The aim of our study was to identify major topics in narratives of patients' healthcare related experiences and analyze the reactions of readers of patient experiences. 1663 blogs and 298806 textual comments were extracted on non-solicited patient experiences from a Hungarian online forum during a 10-year period. Topic modeling with state-of-the-art BERT embeddings were used to analyze the data and extract meaningful patterns and concepts. Sentiment analysis was utilized to categorize the emotional valence of the narrative writings. The huBERT and HIL-SBERT models identified 326 and 200 topics in terms of patient experiences and 508 and 728 topics regarding the reactions to these experiences without human supervision. Conceptually similar topics were integrated into major categories with manual analysis. 94.4% of the experiences and 77.5% of comments were classified as negative, reflecting the same annual tendency over the decade. Our study uses a data-driven approach for extracting patterns of healthcare related patient opinions, in Hungary. Topic modeling, based on BERT embeddings, could provide useful information on patient perceptions and perspectives, that could improve healthcare quality and safety.
Orvosi Hetilap, Jun 18, 2006
The rapid development of public health and medicine started in the second half of the 19th centur... more The rapid development of public health and medicine started in the second half of the 19th century leading to a massive decline or disappearance of previously deadly communicable diseases. However, almost parallel to this process, chronic non-communicable diseases appeared and have become widespread in the populations of developed countries presenting a new challenge for public health. &amp;amp;amp;amp;amp;#39;New public health&amp;amp;amp;amp;amp;#39; and health promotion emerged representing new ways of thinking and approaches as a societal answer to population health problems. The Ottawa Charter, the decisive document of health promotion laid the ground for health promoting activities, naming healthy public policy, supporting environments, community actions, personal skills and and reoriented health services as major fields of action towards improving population health. The article describes examples for these actions and how they are related to health, and provides ideas as to how medical practitioners can contribute to the global common goal of health promotion and medicine.
Mentálhigiéné és pszichoszomatika, Dec 13, 2022
Elméleti háttér: Manapság a videójátékok számos ember életének fontos részét képezik. 2020-as haz... more Elméleti háttér: Manapság a videójátékok számos ember életének fontos részét képezik. 2020-as hazai adatok szerint a videójátékosok száma legalább 3,8 millió fő, a jellemző játékidő hétköznapokon 2-3 óra. A játékosok (angolul "gamers" vagy magyarosan gamerek) egy része profi módon, szervezett versenyeken játszik, napjában több órát fordítva játékra és képességei fejlesztésére; őket e-sportolóknak nevezik. A videójátékokkal való rendszeres időtöltés-mint minden szokás-befolyással van a játékosok lelki működésére. Cél: kvalitatív módszertannal, valós időben, strukturált online interjúkkal feltárni a videójátékkal rendszeresen játszók pszichés jellemzőit. Módszerek: A 18 éven felüli interjúalanyok hólabda módszerrel kerültek azonosításra (n = 22; 77% férfi, átlagéletkor: 24,9 [SD = 3,8] év). Eszközök: az alanyok 5 témakörbe tartozó kérdésekre válaszoltak: 1. demográfiai adatok, 2. általános játszási szokások, 3. a játék (gaming) jelentősége az alany számára, 4. a játékra való motivációk, 5. a játékos társas kapcsolatai. A hangrögzített interjúk átgépelésével kapott szövegeket tartalomelemzésnek vetettük alá. Eredmények: Összesen 22 fővel készült interjú, amelyek teljes időtartama 598 perc (átgépelés után 51 193 szó) volt. Az interjúalanyok többségükben húszas éveik elején járó fiatalok voltak, akik átlagosan 10,7 éves (SD = 5,5 év) korban kezdtek el játszani. A válaszadók átlagosan napi 5,2 órát (SD = 2,3 óra) töltenek játékkal; nagy részük (91%) gamernek vallja magát, de többségük az ellenőrző kérdések eredményei alapján e-sportolónak tartható. A tevékenység kialakulását vizsgálva 64% vallotta, hogy társas kapcsolatai hatására, illetve 41% az unaloműzés miatt kezdett játszani, és ezek, valamint a fejlődés lehetősége ösztönözte a tevékenység folytatására. A motivációk közül kiemelt jelentőségű a győzelem és a vereség, valamint a fejlődés igénye. A válaszadók 32%-a problémásnak ("toxikusnak") vélte saját játékát, habár ezt a viselkedést másnál elítélte. Az alanyok barátainak java része a gamerek szubkultúrájából kerül ki; a játéktevékenységet nem végző környezetük pedig többségében negatívan vélekedik a játékos hobbijáról vagy általában a videójátékokról. Következtetések: A káros következményekkel járó videójátszás legfontosabb megelőzési lehetősége a társas készségek fejlesztése, a valóságos társas kapcsolatok minél korábban kezdődő építése és erősítése.
Frontiers in Public Health
European Journal of Mental Health, 2018
Background: The prevalence of postpartum anxiety is high and its negative consequences are signif... more Background: The prevalence of postpartum anxiety is high and its negative consequences are significant. Most research studies have aimed at exploring the demographic and psychosocial risk factors while neglecting factors of intrapsychic vulnerability. The aim of our study is to examine postpartum anxiety from this aspect, that is, uncovering the early relational experiences of mothers, specifically regarding their early maladaptive schemas. Methods: 125 women participated in online data collection in the first year after giving birth. Maternal anxiety was measured with the postpartum version of STAI-S, while early maladaptive schemas were assessed with the Schema Questionnaire. Results: In terms of demographics, most of the mothers in our sample had middle-class characteristics, but 21.6% had clinical, and 34.4% had subclinical levels of anxiety. Our results confirmed a significant, direct effect of maladaptive schemas on postpartum anxiety in case of 13 of the 15 measured schemas. Discussion: This study draws attention to the intrapsychic vulnerability of mothers as a highly neglected etiological aspect of postpartum anxiety. Further research of intrapsychic and, especially, attachment-related vulnerability should be carried out to identify at-risk women and treat postpartum anxiety more adequately. Limitations: The sample consisted of highly educated, married women with planned children, so the results are not representative for mothers in general.
Supportive Care in Cancer, 2022
Introduction Nowadays, more than 80% of newly diagnosed classical Hodgkin lymphoma (HL) patients ... more Introduction Nowadays, more than 80% of newly diagnosed classical Hodgkin lymphoma (HL) patients can be cured and become long-term survivors due to risk and response-adapted treatment strategies. A well-known side effect is cognitive dysfunction that appears in HL patients after chemotherapy. In the present study, we aimed to measure cognitive dysfunction in our HL patients in this study and to find potential correlations between patient-related factors, the signs and symptoms of their diseases, or therapeutic factors. Methods We carried out a computer-assisted assessment (CANTAB) of cognitive dysfunction in 118 patients. We examined the domains of visual memory, attention, working memory, and planning. Results The median age of 64 females and 54 males at diagnosis was 29 (13–74) and 41 (21–81) years at the completion of CANTAB. Fifty-two percent of all patients showed cognitive impairment. Attention was impaired in 35% of patients, the working memory and planning were impaired in 2...
Sustainability, 2021
Background: COVID-19 has changed the world and strongly affected the health of the people and the... more Background: COVID-19 has changed the world and strongly affected the health of the people and the quality of their life. These changes might impact employees’ physical activity (PA) and sedentary behavior (SB). This study aimed to summarize the literature focusing on the COVID-19-caused changes in physical activity and sedentary behavior among the adult working population. Methods: Literature searches were conducted in June 2021 using multiple electronic databases. The following keywords and synonyms were used during the searching process: physical activity, sedentary behavior, COVID-19, employee. After the data cleaning process (duplicates, inclusion criteria), the title and the abstract of all manuscripts from the searches were screened independently by two reviewers. Results: Thirty-nine manuscripts were selected as a result of the searching process. Of these, 5 were SB related, 15 were PA related and 19 addressed both PA and SB. There were longitudinal (10), cross-sectional (28)...
Orvosi hetilap, Jan 27, 2002
The status and problems of the roma (gipsy) population have been in the forefront in Hungary and ... more The status and problems of the roma (gipsy) population have been in the forefront in Hungary and have called for numerous benevolent interventions. Successful planning and implementation of programs aimed at the improvement of their health status must be based on solid facts regarding their problems and the causes behind. The authors give a literature review on research papers discussing the health (disease) status of the Hungarian roma population published between 1980 and 2001. They give a summary on the demography of gypsies, an overview of publications on pregnancy, delivery and infant mortality, on adult morbidity and mortality, on genetic investigations among roma people, as well as on their health behaviour and relations with the health care system, and finally, they give a brief overview of their socio-economic status. The authors sum up the major difficulties of research aimed at roma people, express their concern regarding health research papers published on gypsies; and o...
The present working document aims to provide support to and additional background for the Europea... more The present working document aims to provide support to and additional background for the European Commission in its process of reviewing the health components of the National Roma Integration Strategies during the first quarter of 2012. It is for a targeted audience (specifically, DG SANCO technical staff working on Roma health). This document contains an expanded and adapted version of the “criteria for the evaluation of the health component of the National Roma Integration Strategies” that were presented at the “Roma health resource workshop” in Istanbul on 26-27 October 2011. The workshop, which was co-organized by UNFPA and WHO, provided input and facilitated country-to-country exchange for developing or revising the health component of National Roma Integration Strategies or related sets of policy measures. The aforementioned criteria were presented in plenary and subsequently reviewed in breakout groups that comprised more than 40 representatives from governments, NGOs/civil ...