Molecular nutrition in life course perspective: Pinpointing metabolic pathways to target during periconception.

Lifecourse nutrition encompasses nourishment from early development into parenthood. From preconception and pregnancy to childhood, late adolescence, and reproductive years, life course nutrition explores links between dietary exposures and health outcomes in current and future generations from a public health perspective, usually addressing lifestyle behaviours, reproductive well-being and maternal-child health strategies. However, nutritional factors that play a role in conceiving and sustaining new life might also require a molecular perspective and recognition of critical interactions between specific nutrients and relevant biochemical pathways. The present perspective summarises evidence about the links between diet during periconception and next-generation health and outlines the main metabolic networks involved in nutritional biology of this sensitive time frame.

Teaching cards as low-cost and brief materials for teaching basic life support to 6-10-year-old primary school children - a quasi-experimental combination design study.

AIM: Teaching Basic Life Support (BLS) in schools is a key initiative to improve the survival rates after out-of-hospital cardiac arrest. Low-cost training materials can reach a wider population. Our aim was to compare the effectiveness of using teaching cards with the traditional instructor-led and combined methods on BLS skills and attitude and to evaluate the long-term effects after two months. METHODS: A quasi-experimental combination design study. Two hundred sixty-three schoolchildren aged 6 to 10 years were assigned to three groups with different methods to teach BLS: teaching card group (n = 100), traditional instructor-led teaching group (n = 91), combined teaching group (n = 72). BLS skills and attitude were measured and compared before the training (T0), after the training (T1), and two months later (T2). RESULTS: BLS skills improved in every group at T1 compared to T0 (p < 0.001) and remained higher at T2 than at T0 in almost all cases (p < 0.001). Skill performance was similar in most of the skills between the three groups at T1. The best skill scores acquired were calling the ambulance and the correct hand position by chest compression. Positioning the head during check the breathing was more effective in the traditional group (48.4%) and combined group (61.1%) than in the teaching card group (19.0%) (p < 0.001) at T1. However, some skills improved significantly in the teaching card group at T2: check breathing for 10 s (p = 0.016); positioning the head by check breathing (p < 0.001); and positioning the head by ventilation (p = 0.011). Attitude did not change significantly in any of the groups (p > 0.05). Furthermore, the level of attitude was inferior in the teaching card group compared with the traditional (p = 0.005), and the combined groups (p = 0.049). CONCLUSION: Using low-cost materials for teaching BLS for young schoolchildren can improve their skills, however, could not improve attitudes. Teaching cards were not inferior compared to traditional and combined methods in some skills but inferior in others. Therefore, hands-on training opportunity is still important. Teaching cards are useful for long-term learning. To learn correctly the whole sequence of BLS is difficult for 6 to 10 years-old children, however, they are able to learn more BLS-related skills separately.

How effective are chest compressions when wearing mask? A randomised simulation study among first-year health care students during the COVID-19 pandemic.

BACKGROUND: The resuscitation guidelines provided for the COVID-19 pandemic strongly recommended wearing personal protective equipment. The current study aimed to evaluate and compare the effectiveness of chest compressions and the level of fatigue while wearing two different types of mask (surgical vs. cloth). METHODS: A randomized, non-inferiority, simulation study was conducted. Participants were randomised into two groups: surgical mask group (n = 108) and cloth mask group (n = 108). The effectiveness (depth and rate) of chest compressions was measured within a 2-min continuous chest-compression-only CPR session. Data were collected through an AMBU CPR Software, a questionnaire, recording vital parameters, and using Borg-scale related to fatigue (before and after the simulation). For further analysis the 2-min session was segmented into 30-s intervals. RESULTS: Two hundred sixteen first-year health care students participated in our study. No significant difference was measured between the surgical mask and cloth mask groups in chest compression depth (44.49 ± 10.03 mm vs. 45.77 ± 10.77 mm), rate (113.34 ± 17.76/min vs. 111.23 ± 17.51/min), and the level of fatigue (5.72 ± 1.69 vs. 5.56 ± 1.67) (p > 0.05 in every cases). Significant decrease was found in chest compression depth between the first 30-s interval and the second, third, and fourth intervals (p < 0.01). CONCLUSION: The effectiveness of chest compressions (depth and rate) was non-inferior when wearing cloth mask compared to wearing surgical mask. However, the effectiveness of chest compressions decreased significantly in both groups during the 2-min chest-compression-only CPR session and did not reach the appropriate chest compression depth range recommended by the ERC.

Country-level mentoring for advanced practice nursing: A case study.

AIM: To describe the mentoring process between the ICN Advanced Practice Nurse Network practice subgroup and the University of Pécs to support the emerging advanced practice role in Hungary, and explore the creation of a mentoring algorithm for faculty and other key stakeholders worldwide who wish to develop advanced practice nursing programs. BACKGROUND: Advanced practice nurses provide comprehensive clinical care and expand access to care in more than 70 countries. In March of 2017, a representative of the Faculty of Health Sciences of the University of Pécs requested assistance in curricula development for the inaugural advanced practice nursing program in Hungary. METHODS: A mixed-methods single case study was undertaken. The sources of evidence include interviews, e-mails, review of the literature, and related documents. Qualitative data were analyzed for content, and frequencies were calculated for quantitative indicators. FINDINGS AND DISCUSSION: The findings highlight the importance of clear communication, development of shared goals, and determination to see the project through. Enriching information was provided by colleagues from diverse global settings. Credibility was gained in Hungary from the support of national and international experts. CONCLUSION: The mentoring foundation and process facilitated the role development in Hungary and contributed to an increased understanding of advanced practice nurses' scope of practice. The intentional approach and the careful ongoing reflection may lead to future successful endeavors. Multinational engagement and collaborations will promote advanced practice nursing contributions globally. IMPLICATIONS FOR NURSING POLICY: Mentoring can effectively empower nurses and advanced practice nurses to work to their full capacity. The shared experiences of international mentoring colleagues can contribute to and support the development and acceptance of national policies for the advanced practice nursing roles.

Comparative analysis of sports consumption habits in Hungary, Poland and Germany.

BACKGROUND: The so-called sports consumption models are looking for the factors that influence the sports spending of households. This paper aims to examine the Hungarian, Polish and German households' sports expenditures which can be an important indicator of physical activity and sporty lifestyle. METHODS: Surveying of households in three countries (Hungary, Poland and Germany) has been conducted with a self-designed questionnaire. We have used descriptive and bivariate non-parametric and parametric statistical methods: (1) χ2 test, Mann-Whitney test and Kruskal-Wallis test for checking the relationship between sociodemographic and physical activity variables and (2) independent sample t-test and ANOVA for checking the differences in sports expenditures. RESULTS: Our research concluded that men, especially previous athletes, exercise more than women and those who have no history as registered athletes. The choice of sports venues is obviously different between the countries in the sample. Members of the study population spend the most on sports services while they spend the least on sports equipment. German households have the highest spending rates compared to the other two countries. CONCLUSIONS: Results are in line with our previous research findings and with other literatures. The difference in preferences of sports venues could have the reason of different supply of sports clubs or the different living standards too. It needs further researches to clear it. Material wealth, income level and sport socialisation can be a determining factor regarding the level of sports spending.

Hydrotherapy with hydrogen-rich water compared with RICE protocol following acute ankle sprain in professional athletes: a randomized non-inferiority pilot trial.

We analysed the effects of an experimental novel protocol of intensive hydrotherapy with hydrogen-rich water (HRW) on injury recovery in athletic men who suffered an acute ankle sprain (AAS) and compared it with a RICE protocol (rest, ice, compression, elevation). Professional athletes (age 23.7 ± 4.0 years; weight 78.6 ± 5.7 kg, height 182.5 ± 4.3 cm; professional experience 5.9 ± 3.9 years) who incurred AAS during a sport-related activity were randomly assigned immediately after the injury to either hydrogen group (n = 9) or a conventional RICE treatment group (n = 9). Hydrogen group received six 30-min ankle baths with HRW throughout the first 24 h post-injury, with hydrotherapy administered every 4 hours during the intervention period. RICE group stood off the injured leg, with ice packs administered for 20 min every 3 hours, with the injured ankle compressed with an elastic bandage for 24 hours and elevated at all possible times above the level of the heart. HRW was equivalent to RICE protocol to reduce ankle swelling (2.1 ± 0.9% vs. 1.6 ± 0.8%; P = 0.26), range of motion (2.4 ± 1.3 cm vs. 2.7 ± 0.8 cm; P = 0.60), and single-leg balance with eyes opened (18.4 ± 8.2 sec vs. 10.7 ± 8.0 sec; P = 0.06) and closed (5.6 ± 8.4 sec vs. 3.9 ± 4.2 sec; P = 0.59). This non-inferiority pilot trial supports the use of HRW as an effective choice in AAS management. However, more studies are needed to corroborate these findings in other soft tissue injuries.

Guanidinoacetic acid deficiency: a new entity in clinical medicine?

Guanidinoacetic acid (GAA, also known as glycocyamine or betacyamine) is a naturally-occurring derivative of glycine and a direct metabolic precursor of creatine, a key player in high-phosphate cellular bioenergetics. GAA is found in human serum and urine, with circulating GAA likely reflects an equilibrium between its endogenous production and utilization/excretion. GAA deficiency (as indicated by low serum GAA) has been reported in various conditions yet this intriguing clinical entity appears to be poorly characterized as yet, either as a primary deficit or a sequel of secondary disease. This minireview article summarizes the inherited and acquired disorders with apparent GAA deficiency and discusses a possible relevance of GAA shortfall in clinical medicine.

Health literacy among participants from neighbourhoods with different socio-economic statuses in the southern region of Hungary: a pilot study.

BACKGROUND: Health literacy (HL) has a deep impact on people's decisions about their health and health care system. Measurement and improvement of HL level is essential to develop an appropriate health care system. The aim of the study was to (1) conduct a pilot study among the population of Baranya County in Hungary with different socio-economic statuses, (2) evaluate the HL level and (3) found the correlations between socio-economic data, emergency departments' visits, medical history and HL. METHODS: In a cross-sectional study conducted in 2019 with 186 participants, socio-economic status, health status, HL level and knowledge about the triage system were measured. The questionnaire included questions on socio-economic status, previous chronic diseases, and satisfaction with the emergency care system as well as the standardised European Health Literacy Survey Questionnaire (HLS-EU-Q47). Descriptive statistical analysis (mean, SD, mode) and mathematical statistical analysis (ANOVA, chi2 test, Pearson Correlations, Two sample t-test) were applied. SPSS 24.0 statistical software was used to analyse the data. Relationships were considered significant at the p < 0.05 level. RESULTS: One hundred and eighty-six people were involved in the research, but 45 of them were excluded (N = 141). The participation rate was 75.8%. There were significant differences in HL levels by gender and educational level (p = 0.017), health education (p = 0.032) and presence of children in the household (p = 0.049). Educational level (p = 0.002) and type of settlement (p = 0.01) had strong impacts on economic status. We found that 46.1% of the participants had limited comprehensive HL (cHL) level. This proportion was slightly lower for the disease prevention sub-index (33.3%). The average cHL index score was 34.8 ± 8.7 points, the average health care sub-index score was 34.6 ± 9.7 points, the average disease prevention sub-index score was 35.8 ± 9.9 points, and the average health promotion sub-index score was 34.2 ± 9.4 points. 46.1% of the examined population in Hungary had limited HL level. CONCLUSIONS: Socio-economic status has a strong influence on HL level. It is not enough to improve awareness but we need to improve knowledge and cooperation with the doctors and health care system.

Measurement of public health benefits of physical activity: validity and reliability study of the international physical activity questionnaire in Hungary.

BACKGROUND: To ensure accurate measurement of the health benefits of habitual physical activity in large sample epidemiological studies, physical activity questionnaires (PAQs) are the most feasible methods. Therefore, the purpose of this study was the validation and cultural adaptation to the Hungarian population of the International Physical Activity Questionnaire (IPAQ-HL). METHODS: A cross-sectional study among Hungarian healthy adults (age 21.375 ± 1.940 years, n = 120) was performed comparing measures of last 7 days IPAQ-HL self- administered questionnaire and obtained accelerometer (Actigraph GT3X) data for concurrent validity, reassessed by a random subsample (n = 33) to measure reliability. RESULTS: Our results indicate acceptable criterion validity for total physical activity, moderate to vigorous physical activity (R = 0.387, p < 0.001; R = 0.331 p < 0.001 respectively) and moderate physical activity (R = 0.193, p = 0.034). The ICC scores revealed moderate to good correlations (ICC = 0.744-0.942, p < 0.001). Moderate Kaiser-Meyer-Olkin measure (0.531, p < 0.001) and good reproducibility for vigorous, moderate to vigorous and moderate activities was found for IPAQ-HL in the studied population. Nevertheless, like analogous self-reports in other languages, it overestimates the time spent on physical activity. CONCLUSIONS: IPAQ-HL proved to be a reasonably valid measure for population prevalence epidemiological studies and is suggested for use to develop public health policy recommendations or to optimize public health interventions. However, the results on vigorous activity should be interpreted with caution, the questionnaire showed moderate validity for this particular intensity.

Association with subjective measured physical activity (GPAQ) and quality of life (WHOQoL-BREF) of ageing adults in Hungary, a cross-sectional study.

BACKGROUND: It is well known that physical activity (PA) has health benefits. This study aimed to examine physical activity carried out by the senior (over 50) participants and its relation to their quality of life (QoL). METHODS: Surveillance of PA and QoL was measured by using questionnaires (GPAQ, WHOQoL-BREF) in this study. Descriptive data were presented as means and standard deviations (SD) for continuous variables and as percentages for categorical variables. Multivariate linear regression analysis was conducted. The significance level was set at p ≤ 0.05. RESULTS: Overall, 250 participants were recruited, the mean age of the study population (n = 243) was 70.2 (SD 7.1) years. The results clearly showed that the Hungarian participants aged over 50 years were more likely to do PA if they had university degree and lower age (p ≤ 0.001) and used more active transportation (p = 0.035) if they had low education. The results of WHOQoL-BREF showed that the Hungarian individuals have better QoL if they have university degree (p ≤ 0.001) and lower age (p ≤ 0.001). Using multivariate linear regression analysis to examine the effect of PA patterns on QoL adjusted for demographic variables (age, education, BMI, place of living), the result showed significant correlation between WHOQoL-BREF dimensions and GPAQ (p ≤ 0.001). CONCLUSION: Higher amount of PA among aging population can result in better QoL in all dimensions.

Cross-cultural adaptation and validation of the Global Physical Activity Questionnaire among healthy Hungarian adults.

BACKGROUND: Physical activity (PA) is an important factor among the determinants of health due to it's protective factor and preventive role. Self-reported measures such as questionnaires are most commonly used in public health studies, but may over- or underestimate actual patterns of PA. Therefore, accelerometers are widely used to assess concurrent validity. The aim of the present study was to adapt and validate the self-administered GPAQ - Hungarian version (GPAQ-H) against accelerometer data and IPAQ-Hungarian long version (IPAQ-HL) in Hungarian healthy young adults. METHODS: A cross-sectional comparative study was conducted to examine the last 7 days PA by GPAQ-H, comparing with IPAQ-HL and Actigraph GT3X accelerometer to measure concurrent validity and reliability. A convenient sample of 300 young adults was recruited in January - July 2018 at the University of Pécs, in South-Hungary, 120 participants (age 21.53 ± 1.75 years, 46.66% male) were included in the validity and reliability study. RESULTS: Significant differences between the three instruments were found (p < 0.001) in all scores, except PAQs vigorous activities (p = 0.332) and GPAQ-H and accelerometer MVPA score (p = 0.424). A moderate KMO measure was found (0.538) with a significant Barlett's test of Sphericity (279.51; p < 0.001). The total variance was explained as 81.10%. The reliability of the GPAQ-H instrument with all domain's scores was 0.521 (CI 0.371-0.644). We found in all intensity scores and sitting time good reliability scores (R = 0.899-987, p < 0.001) between the baseline and follow-up (N = 33 random subsample). The Bland-Altman plots were showed that GPAQ-H overestimates vigorous activities by 212.75 min/week (331.82-757.42) and MVPA by 104.93 min/week (- 1016.98-807.11). A high difference, 6336.79 min/week (CI 3638.18-9035.40) was revealed regarding sitting, as GPAQ-H largely underestimated the time spent sedentary. CONCLUSIONS: The Hungarian GPAQ self-administered form showed fair to moderate validity with correlation coefficients similar to other European studies. Based on our study's results it could be claimed that the GPAQ-H measurement tool is a valid and reliable questionnaire to measure the healthy Hungarian population's physical activity patterns. However, our results also proved that GPAQ-H alone is not a valid and reliable questionnaire to measure sitting time.

The effect of a community-based e-health program to promote the role of physical activity among healthy adults in Hungary.

BACKGROUND: Physically active lifestyle can prolong the years spent without chronic diseases and is strongly associated with good mental and physical health. The goal of the study was to examine the physical activity patterns of the healthy adults and the effectiveness of a community-based e-health program. METHODS: The study sample comprised of 633 participants. Analyses were based on the E-Harmony health program that was conducted in Hungary in 2014-2015. The longitudinal study measured the physical activity patterns of the healthy adult population, and a 12-month community-based internet and media program was evaluated for the target group to improve the physical activity level and related knowledge. We examined the effectiveness of the program by the International Physical Activity Questionnaire - Hungarian validated long version adjusting for socio-demographic parameters, also across multivariate linear regression analysis using SPSS 24.0 software. Confidence interval of 95% was used and the level of significance was p < 0.05. RESULTS: The total physical activity of the study sample was 5129.9 (SD = 4488.1) MET min/week. Male participants scored higher in total activity but the results showed no statistical significance. Our participants were sitting 2211.6 (SD = 1592.8) min /week on average (daily average was 315.9 (SD = 227.6) minutes); the results showed no statistically significant difference by gender. We found weak but significant relationship between the active lifestyle and anthropometric data, especially according to leisure time activities and sedentary behaviour (p < 0.001). Based on the multivariate linear regression models the socio-demographic parameters significantly affected the physical activity level of participants. After the 12-month community-based e-health program, 10.34% changes occurred in the total physical activity level (p < 0.001). CONCLUSIONS: To our knowledge, ours was the first community-based e-health program in Hungary to improve the physical activity level of the healthy adult population. Based on our results this web-based e-health program can be an adequate tool to promote healthy lifestyle. The study could provide appropriate information for the further health interventions and policy making. Further research is necessary to determine the special risk groups and to develop an applicable e-health program for such specific subgroups.

'The (second) year of first aid': a 15-month follow-up after a 3-day first aid programme.

AIM: First aid education in early childhood can be an effective method to increase the number of trained bystanders. Our aim was to evaluate the long-term effects of a 3-day first aid programme for all primary school-age groups (7-14 years old). METHODS: This study was a 15-month follow-up of our previous investigation. Five-hundred and twenty-four primary school children were involved in this study. Measurements were made on the following topics: adult basic life support, using an automated external defibrillator (AED), handling an unconscious patient, managing bleeding and calling the ambulance. Data collection was made with a self-made questionnaire and skill test. RESULTS: Knowledge and skills were significantly higher after 15 months than before training (p<0.01). However, these results were significantly worse than immediately and 4 months after training (p<0.01). Based on the questionnaire, more than three-quarters knew the emergency phone number 15 months after training. Approximately two-thirds of the children could use the correct hand position in cardiopulmonary resuscitation, the correct compression-ventilation ratio and an AED, and half of them could perform correct recovery position at 15 months. Correct assessment of breathing was similar in a situation game than before training. Self-efficacy improved significantly after training (p<0.01) and remained improved after 4 and 15 months when compared with before training (p<0.01). CONCLUSION: Participants could remember some aspects of first aid long term. However, knowledge and skills had declined after 15 months, so refresher training would be recommended. Self-efficacy towards first aid improved after training and remained high after 15 months.

ECG alterations suggestive of hyperkalemia in normokalemic versus hyperkalemic patients.

BACKGROUND: In periarrest situations and during resuscitation it is essential to rule out reversible causes. Hyperkalemia is one of the most common, reversible causes of periarrest situations. Typical electrocardiogram (ECG) alterations may indicate hyperkalemia. The aim of our study was to compare the prevalence of ECG alterations suggestive of hyperkalemia in normokalemic and hyperkalemic patients. METHODS: 170 patients with normal potassium (K+) levels and 135 patients with moderate (serum K+ = 6.0-7.0 mmol/l) or severe (K+ > 7.0 mmol/l) hyperkalemia, admitted to the Department of Emergency Medicine at the Somogy County Kaposi Mór General Hospital, were selected for this retrospective, cross-sectional study. ECG obtained upon admission were analyzed by two emergency physicians, independently, blinded to the objectives of the study. Statistical analysis was performed using SPSS22 software. χ2 test and Fischer exact tests were applied. RESULTS: 24% of normokalemic patients and 46% of patients with elevated potassium levels had some kind of ECG alteration suggestive of hyperkalemia. Wide QRS (31.6%), peaked T-waves (18.4%), Ist degree AV-block (18.4%) and bradycardia (18.4%) were the most common and significantly more frequent ECG alterations suggestive of hyperkalemia in severely hyperkalemic patients compared with normokalemic patients (8.2, 4.7, 7.1 and 6.5%, respectively). There was no significant difference between the frequency of ECG alterations suggestive of hyperkalemia in normokalemic and moderately hyperkalemic patients. Upon examining ECG alterations not typically associated with hyperkalemia, we found that prolonged QTc was the only ECG alteration which was significantly more prevalent in both patients with moderate (17.5%) and severe hyperkalemia (21.1%) compared to patients with normokalemia (5.3%). CONCLUSIONS: A minority of patients with normal potassium levels may also exhibit ECG alterations considered to be suggestive of hyperkalemia, while more than half of the patients with hyperkalemia do not have ECG alterations suggesting hyperkalemia. These results imply that treatment of hyperkalemia in the prehospital setting should be initiated with caution. Multiple ECG alterations, however, should draw attention to potentially life threatening conditions.

Short-term H2 inhalation improves running performance and torso strength in healthy adults.

In this randomized, double-blind, placebo-controlled, crossover pilot trial, we evaluated the effects of 7-day H2 inhalation on exercise performance outcomes and serum hormonal and inflammation profiles in a cohort of young men and women. All participants (age 22.9 ± 1.5 years; body mass index 23.4 ± 2.5 kg m-2; 10 women and 10 men) were allocated to receive either gaseous hydrogen (4%) or placebo (room air) by 20-min once-per-day inhalation for 7 days, with a wash-out period of 7 days to prevent the residual effects of interventions across study periods. The primary treatment outcome was the change in running time-to-exhaustion in the incremental maximal test from baseline to day 7. Additionally, assessment of other exercise performance endpoints and clinical chemistry biomarkers was performed at baseline and at 7 days after each intervention. The trial was registered at ClinicalTrials.gov (ID NCT03846141). Breathing 4% hydrogen for 20 min per day resulted in increased peak running velocity (by up to 4.2%) as compared to air inhalation (P = 0.05). Hydrogen inhalation resulted in a notable drop in serum insulin-like growth factor 1 (IGF-1) by 48.2 ng/mL at follow-up (95% confidence interval [CI]: from -186.7 to 89.3) (P < 0.05), while IGF-1 levels were elevated by 59.3 ng/mL after placebo intervention (95% CI; from -110.7 to 229.5) (P < 0.05). Inhalational hydrogen appears to show ergogenic properties in healthy men and women. Gaseous H2 should be further evaluated for its efficacy and safety in an athletic environment.

'The year of first aid': effectiveness of a 3-day first aid programme for 7-14-year-old primary school children.

AIM OF THE STUDY: Bystanders can play an important role in the event of sudden injury or illness. Our aim was to evaluate the effects of a 3-day first aid course for all primary school age groups (7-14 years old). METHODS: 582 school children were involved in the study. Training consisted of three sessions with transfer of theoretical knowledge and practical skills about first aid. The following most urgent situations were addressed in our study: adult basic life support (BLS), using an automated external defibrillator (AED), handling an unconscious patient, managing bleeding and calling the ambulance. Data collection was made with a questionnaire developed for the study and observation. Students were tested before, immediately after and 4 months after training. Results were considered significant in case of p<0.05. RESULTS: Prior to training there was a low level of knowledge and skills on BLS, management of the unconscious patient, use of an AED and management of bleeding. Knowledge and skills improved significantly in all of these categories (p<0.01) and remained significantly higher than the pre-test level at 4 months after training (p<0.01). Younger children overall performed less well than older children, but significantly improved over the pre-test level both immediately and 4 months after training (p<0.01). Prior first aid training was associated with knowledge of the correct ambulance number (p=0.015) and management of bleeding (p=0.041). Prior to training, age was associated with pre-test knowledge and skills of all topics (p<0.01); after training, it was only associated with AED use (p<0.001). There was a significant correlation between the depth of chest compression and children's age, weight, height and body mass index (p<0.001). Ventilation depended on the same factors (p<0.001). CONCLUSION: Children aged 7-14 years are able to perform basic life-saving skills. Knowledge retention after 4 months is good for skills, but thinking in algorithms is difficult for these children.

[At what age can children perform effective cardiopulmonary resuscitation? - Effectiveness of cardiopulmonary resuscitation skills among primary school children]. / Hány éves kortól képesek a gyermekek újraéleszteni? ­ A hatékonyság felmérése általános iskolás gyermekek körében.

INTRODUCTION: In cardiac arrest life can be saved by bystanders. AIM: Our aim was to determine at what age can schoolchildren perform correct cardiopulmonary resuscitation. METHOD: 164 schoolchildren (age 7-14) were involved in the study. A basic life support training consisted of 45 minutes education in small groups (8-10 children). They were tested during a 2-minute-long continuous cardiopulmonary resuscitation scenario using the "AMBU CPR Software". RESULTS: Average depth of chest compression was 44.07 ± 12.6 mm. 43.9% of participants were able to do effective chest compressions. Average ventilation volume was 0.17 ± 0.31 liter. 12.8% of participants were able to ventilate effectively the patient. It was significant correlation between the chest compression depth (p<0.001) and ventilation (p<0.001) and the children's age, weight, height and BMI. CONCLUSIONS: Primary school children are able to learn cardiopulmonary resuscitation. The ability to do effective chest compressions and ventilation depended on the children's physical capability. Orv. Hetil., 2017, 158(4), 147-152.

Direct effects of physical training on markers of bone metabolism and serum sclerostin concentrations in older adults with low bone mass.

BACKGROUND: Both gravitational loading and the forces generated by muscle contraction have direct effects on serum markers of bone metabolism. The object of this study was to examine the direct effects of a single session of resistance exercise or walking on biochemical markers of bone metabolism in participants with low bone mass. METHODS: A total of 150 otherwise healthy female subjects (mean age = 59.1 ± 7.1 years) diagnosed with osteoporosis or osteopenia were randomly allocated to either a resistance exercise group (RG; n = 50), walking group (WG; n = 50), or control group (CG; n = 50). Changes in bone-specific alkaline phosphatase (BALP), carboxy-terminal cross-linked telopeptide of type I collagen (CTX), and serum sclerostin concentrations were measured before and immediately after a single exercise intervention. RESULTS: There was no significant change in BALP values in any of the groups. Sclerostin levels increased in the RG and WG, and there was significant difference between the WG and CG after the exercise intervention (P < 0.01). In contrast, the changes in CTX concentrations from baseline were significant in the RG (P < 0.01) but not in the WG (P = 0.11), and there was a significant difference between resistance exercise and walking (P < 0.01). CONCLUSIONS: In participants with low bone mass, resistance exercise influenced the serum concentrations of CTX, a marker of bone resorption, but walking did not. TRIAL REGISTRATION: Current Controlled Trials ISRCTN16329455 ; retrospectively registered on 05/05/2016.

[Adult advanced life support knowledge among ambulance officer/paramedic students in Hungary]. / Mentotiszthallgatók felnott emelt szintu újraélesztéssel kapcsolatos ismeretei Magyarországon.

INTRODUCTION: Resuscitation knowledge is necessery for emergency care workers. AIM: The aim of the authors was to investigate the advanced life support knowledge of paramedic students in Hungary. METHOD: The research has been executed at University of Pécs - Faculty of Health Sciences, Semmelweis University - Faculty of Health Sciences, and University of Debrecen - Faculty of Health Care. 97 students (n = 97) were involved in the study from third and fourth grades. Data were recorded with a self-fill-in questionnaire. RESULTS: Average scores were 67.79%. There was no significant difference between women and men (p = 0.725). Younger age improved significantly scores (p = 0.003). Full-time students completed the test significantly better than part-time students (p = 0.004). There was no significant difference between the students from different locations (p = 0.254). CONCLUSIONS: It would be appropriate to increase the number of resuscitation courses and to tighten the exams. The authors propose that it would be reasonable to examine the students' practical skills. Orv. Hetil., 2016, 157(37), 1476-1482.