The impact of disease and sociodemographic background on children suffering from cerebral palsy / A betegség és a szociodemográfiai háttér hatása a cerebralis bénulásban szenvedo gyermekek életminoségére.

Összefoglaló. Bevezetés: A kutatócsoport 99 fo, cerebralis paresisben (CP) szenvedo gyermek (8-18 éves) önállóan közölt életminoségét értékelte, és az eredményeket összehasonlította egy 237 fos kontrollcsoport adataival, amelyek hasonló életkorú, egészséges általános populációhoz tartozó gyermekektol származtak. Célkituzés: A kutatás célja annak megismerése volt, hogy a CP-ben szenvedo gyermekek hogyan vélekednek egészségi állapotukról és társadalmi helyzetükrol. Módszer: Életminoség-kérdoív alkalmazása. Betegségspecifikus és társadalmi-demográfiai mutatók mérése, kiértékelése. Eredmények: Az CP-ben szenvedo gyermekek és szüleik az egészséggel kapcsolatos életminoséget rosszabbnak ítélték meg, mint társaik. Eredményeink azt mutatják, hogy a noi nem, a rosszabb motoros funkció és a komorbiditások (epilepszia, incontinentia és intellektuális károsodás) negatív hatású. A szüloi vélemény alkalmas volt proxyjelentésként a korreláció mért erossége miatt. Figyelemre méltó, hogy az agyi bénulás típusai közül az egyoldali spasticus CP-ben szenvedo gyermekek életminoség-értéke a legalacsonyabb. A válaszadók valószínuleg a test két oldala között lévo funkcionális különbséget érezték. A szellemi fogyatékosság a betegpopuláció több mint felénél fordult elo. Testvéreik között a mentális betegség 5,7-szer gyakoribb. A CP-s gyerekek családi környezete sokkal hátrányosabb volt, mint az egészséges gyermekeké. A kutatás eredményei alapján megállapítható, hogy a szülo alacsonyabb iskolai végzettsége és munkaeropiaci inaktivitása, valamint az egyszülos család a CP-s gyerekeknél szignifikánsan magasabb arányban fordult elo, és ezek a tényezok negatív hatást gyakoroltak az életminoségre. Következtetés: A fogyatékkal élo gyermekek életminoségét a betegség és a szociodemográfiai környezet egyaránt befolyásolja. Orv Hetil. 2021; 162(7): 269-279. INTRODUCTION: Self-reported health-related quality of life (HRQoL) of 99 children (8-18 years) with cerebral palsy (CP) was assessed and compared with 237, age-matched healthy control children from the general population. OBJECTIVE: The aim was to find out the opinions of children with CP about their health status and social condition. METHOD: Assessment of quality of life questionnaire was carried out. Measurements of disease-specific and sociodemographic variables were done. RESULTS: Children with CP and their parents rated HRQoL poorer than their counterparts. Our results show that female sex, worse gross motor function and comorbidities (epilepsy, incontinence and intellectual impairment) had negative impact. The parental opinion was suitable as proxy report because of the measured strength of the correlation. Among the types of CP, interestingly, children with unilateral spastic CP had the poorest HRQoL. They were likely to feel a functional difference between the two sides of the body. Intellectual disability occurred in more than half of our patient population. Among their siblings, mental illness is 5.7 times more common. The family environment was much more disadvantageous than in the case of healthy children. As our study shows, lower education, inactive status in the labour market and single-parent family occurred at a much higher rate and worsened the quality of life. CONCLUSION: Quality of life of children with disability was influenced by both the sociodemographic background and the disease. Orv Hetil. 2021; 162(7): 269-279.

Risk of eating disorders in university students: an international study in Hungary, Poland and Ukraine.

OBJECTIVE: In this international study, the prevalence of Eating disorders (EDs) was determined among university students and identified associated demographic and behavioral factors predicting disorders using data from three European countries. METHODS: The survey was conducted in Hungary, Poland, and Ukraine in 2018. Registered full-time students completed an online anonymous questionnaire. Students provided data about socioeconomic characteristics, body mass index (BMI), EDs, physical fitness and sport practice, psychological distress (stress, anxiety, depression), life orientation, alcohol, tobacco, and cannabis use. Data were analyzed using SPSS 24.0 software. RESULTS: From the 1965 returned questionnaires 1950 were analyzed, because of the missing data (67.3% female, mean age of the total participant's 21.40 ± 3.83 years old). EDs were observed in 26.3% of students. In logistic regression, EDs were predicted by female sex, higher BMI, single marital status, elevated psychological distress and limited access to health care. CONCLUSION: EDs are relatively common in university students especially in females. Students with higher distress and BMI, limited access to health care and living without partner are at risk for EDs. This result highlights the need for a public health approach. Universities are the last chance where students can be screened in an organized setting and offer interventions early when treatment is likely to be most effective.

Exercise addiction and its related factors in amateur runners.

BACKGROUND AND AIMS: This study examines exercise addiction (EA) in amateur runners from a multidimensional approach, including demographics (age, sex, educational attainment, and financial situation), training factors (duration of running activity, weekly time spent running, mean workout distance per session, other sports activities, and childhood physical activity), psychological features (perceived health, life satisfaction, loneliness, stress, anxiety, depression, body shape, and eating disorders), and anthropometrics (body mass index) that might predict EA. METHODS: The well-validated Exercise Dependence Scale (EDS) was applied to evaluate the prevalence of EA in amateur runners. A multinomial logistic regression was performed to find explanatory variables of risk of EA using the SPSS 24.0 statistical software. RESULTS: A total of 257 runners (48.9% females, Mage = 40.49, SD = 8.99 years) with at least 2 years running activity participated in an anonymous questionnaire survey. About 53.6% of respondents were characterized as non-dependent symptomatic and 37.8% as non-dependent asymptomatic. About 8.6% had prevalence of being at risk of EA. The logistic regression model displayed five variables that significantly predicted the risk of EA: (a) anxiety, (b) loneliness, (c) weekly time spent running, (d) childhood physical activity, and (e) education level. DISCUSSION AND CONCLUSIONS: Findings indicate that loneliness and anxiety may lead to withdrawal and uncontrolled behavior that in turn leads to increased amount of exercise in amateur runners. Lower level of education attainment is also a likely risk of EA development, and childhood sports activity is a predictor.

[Epidemiology, cost and economic impact of cerebral palsy in Hungary]. / A cerebralis paresis epidemiológiája, költségei és közgazdasági hatásai Magyarországon.

BACKGROUND AND PURPOSE: The purpose of our communication was to determine the total cost of cerebral paretic patients in Hungary between 0 and 18 years and to assess their impact on the national budget. METHODS: Based on the data of Borsod county we calculated the CP characteristics. The cost of CP was determined by routine care of individuals. Lost Parental Income and Tax were calculated on the basis of average earnings. The ratio of GDP, Health and Social Budget and Health Budget to CP is based on CP annual average cost and frequency. We have developed a repeatable computational model. RESULTS: Of the risk groups, premature birth (30.97%), low birth weight (29.64%), perinatal asphyxia (19.47%) were the most common. Source is unknown of 37.61% of the cases. CP prevalence was 2.1‰. The two-sided (59.7%) and the one-sided (19.0%) spastic pareses dominated. The most serious form is the two-sided spastic paresis (42.5% GMFCS 3-5 degrees). Epilepsy was 22.0%, incontinence was 27%, mental involvement was 46%. Care for one child up to 18 years of age costs an average of 73 million HUF (€ 251,724). The lost family income was 27.36 million HUF (€ 94,345), and lost tax and health care contributions were 14.46 million HUF (€ 49,862). Additionally, 0.525% of the GDP, 0.88% of the full health and social budget and 1.83% of direct medical costs were spent for CP families. CONCLUSION: The cost of CP disease is significant. Costs can be reduced by improving primary prevention. From the perspective of the family and government, it is better to care for families so they can take care of their disabled children.

Factors influencing the diabetes-specific health-related quality of life in children and adolescents with type 1 diabetes mellitus.

This study aimed to investigate the association of the anthropometric, clinical variables and maximal oxygen uptake (Vo2max) with diabetes-specific health-related quality of life (HRQoL) in youths with type 1 diabetes mellitus (T1DM) and to find the predictors of HRQoL and blood glucose control. A total of 239 youths with diabetes (124 boys and 115 girls) were recruited from diabetes-based summer camps. HRQoL assessment was carried out with the Pediatric Quality of Life Inventory 3.0 Diabetes Module (Information Resources Centre, Mapi Research Trust, France); Vo2max was evaluated by conducting the 20-m shuttle run test. Higher Vo2max and the insulin pump therapy were significant predictors of the HRQoL in the multiple regression analysis; other clinical and anthropometric variables had no effect. The better blood glucose control was explained only by the higher Vo2max. The good cardiorespiratory fitness (expressed by Vo2max) has clinical and QoL benefits for paediatric patients with T1DM.

Benefits of continuous subcutaneous insulin infusion on quality of life.

PURPOSE: The aim of this study was to compare the general health-related quality of life (HRQoL), the metabolic control (HbA1c), the anthropometric measurement, and the cardiorespiratory fitness (expressed by VO2max) in youths with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) to those receiving multiple daily injections (MDI). We looked for factors influencing the HRQoL and metabolic control. METHODS: A total of 239 patients treated with CSII (51 girls and 53 boys) or MDI (64 girls and 71 boys) between ages 8 and 18 years were assessed with the Pediatric Quality of Life Inventory, Generic Core Scales, and Diabetes Module. VO2max was evaluated using the 20-meter shuttle run test. RESULTS: CSII group had significantly better HRQoL according to both child self-report and parent proxy-report. Youths with CSII reported better physical, emotional, and school-related functioning, and had less diabetes-related fear and symptoms than the MDI group. There were no significant differences in body mass index z-scores, insulin doses, HbA1c, and VO2max between the groups. HRQoL was predicted by the CSII therapy (ß = -0.220; p = .000) and the VO2max (ß = 0.386; p = .000), other clinical and anthropometric parameters had no effect; the HbA1c was predicted only by VO2max (ß = -0.353; p = .000). CONCLUSIONS: Diabetic youths treated with CSII therapy have better HRQoL than those treated with MDI. There are no differences between the investigated groups in anthropometric data, glycated hemoglobin, and physical fitness. Moreover, good physical fitness has an important role in achieving better metabolic control and HRQoL, which underlines the importance of regular aerobic exercise in the treatment and care of type 1 diabetes in childhood.

Reduced physical fitness in children and adolescents with type 1 diabetes.

AIMS: To evaluate motor performance and cardiorespiratory function in youths with type 1 diabetes in comparison with age-matched control groups and to analyze the influence of physical activity level, anthropometric and physical fitness parameters on long-term metabolic control. METHODS: 106 youths with diabetes and 130 healthy youths aged 8-18 were assessed by the Eurofit test regarding motor performances, cardiorespiratory fitness (VO2max), skinfold thickness, and body mass index. Physical activity level was assessed through the use of questionnaires. Predictors of physical fitness and metabolic control were determined with regression analysis. RESULTS: There were no differences either in body composition or in physical activity level, but younger girls with diabetes had impaired results in speed of upper limb movement, abdominal muscle strength, upper body strength, running speed, and VO2max ; older girls with diabetes had poor results in speed of upper limb movement, abdominal muscle strength, upper body strength and VO2max . Younger boys with diabetes had impaired results in speed of upper limb movement, flexibility, static strength of hand, and abdominal muscle strength; and older boys with diabetes had poor results in speed of upper limb movement, flexibility, abdominal muscle strength, upper body strength, and VO2max compared with control groups. Older age, female gender, lower physical activity level, and higher HbA1c were significant independent predictors of poorer VO2max. Better VO2max proved to be the single predictor of favorable HbA1c . CONCLUSIONS: Youths with diabetes have reduced fitness parameters. Efforts should be carried out to improve physical fitness as part of treatment and care of children and adolescents with type 1 diabetes.

[Hungarian adaptation of the Pediatric Quality of Life Inventory™ 3.0 Diabetes Module]. / A Pediatric Quality of Life Inventory™ 3.0 Diabetes Moduljának magyarországi adaptálása.

UNLABELLED: Due to the lack of validated age- and disease-specific instruments, there are limited health-related quality of life measurements in type 1 diabetes youths in Hungary. OBJECTIVE: To culturally adapt the Pediatric Quality of Life Inventory™ 3.0 Diabetes Module. METHOD: Feasibility, internal consistency reliability, reproducibility, convergent, discriminant and concurrent validities were evaluated in 134 type 1 diabetes youths. RESULTS: Low scale-level mean percentage of missing item responses, minimal floor and moderate ceiling effects supported the feasibility. Cronbach α exceeded the internal consistency reliability standard of 0.70. Concordance between the children's and the parents' reports was strong. The instrument differentiated between the quality of life of patients having acceptable and poor metabolic control. Intercorrelations between the Generic Module and Diabetes Module had moderate to large effect sizes. CONCLUSIONS: The results demonstrate the feasibility, reliability and validity of the instrument, but further research should be carried out for generalization for Hungarian population.