Mental issues, internet addiction and quality of life predict burnout among Hungarian teachers: a machine learning analysis.

BACKGROUND: Burnout is usually defined as a state of emotional, physical, and mental exhaustion that affects people in various professions (e.g. physicians, nurses, teachers). The consequences of burnout involve decreased motivation, productivity, and overall diminished well-being. The machine learning-based prediction of burnout has therefore become the focus of recent research. In this study, the aim was to detect burnout using machine learning and to identify its most important predictors in a sample of Hungarian high-school teachers. METHODS: The final sample consisted of 1,576 high-school teachers (522 male), who completed a survey including various sociodemographic and health-related questions and psychological questionnaires. Specifically, depression, insomnia, internet habits (e.g. when and why one uses the internet) and problematic internet usage were among the most important predictors tested in this study. Supervised classification algorithms were trained to detect burnout assessed by two well-known burnout questionnaires. Feature selection was conducted using recursive feature elimination. Hyperparameters were tuned via grid search with 10-fold cross-validation. Due to class imbalance, class weights (i.e. cost-sensitive learning), downsampling and a hybrid method (SMOTE-ENN) were applied in separate analyses. The final model evaluation was carried out on a previously unseen holdout test sample. RESULTS: Burnout was detected in 19.7% of the teachers included in the final dataset. The best predictive performance on the holdout test sample was achieved by random forest with class weigths (AUC = 0.811; balanced accuracy = 0.745, sensitivity = 0.765; specificity = 0.726). The best predictors of burnout were Beck's Depression Inventory scores, Athen's Insomnia Scale scores, subscales of the Problematic Internet Use Questionnaire and self-reported current health status. CONCLUSIONS: The performances of the algorithms were comparable with previous studies; however, it is important to note that we tested our models on previously unseen holdout samples suggesting higher levels of generalizability. Another remarkable finding is that besides depression and insomnia, other variables such as problematic internet use and time spent online also turned out to be important predictors of burnout.

The prevalence and risk factors of burnout and its association with mental issues and quality of life among hungarian postal workers: a cross-sectional study.

BACKGROUND: Burnout is one of the most extensively studied phenomena of the twenty-first century; which has been extensively studied among helping professions, although it can be broadened to several other types of occupation. Based on our knowledge and literature search, no similar studies have been carried out among postal workes to date. METHODS: This cross-sectional questionnaire-based epidemiological study was carried out between May 2021 and January 2022 in five counties in Hungary with the recruitment of postal delivery workers focusing on (1) the prevalence of burnout among postal delivery workers; (2) including the role of demographic parameters, duration of employment as well as the presence of secondary employment; (3) and also analyzed the role of several risk factors and medical conditions; (4) and we also examined the possible association between depression, insomnia and quality of life and burnout. RESULTS: Overall 1300 questionnaires were successfully delivered and 1034 responses received (response rate of 79.5%). Three hundred sixty-eight males (35.6%) and six hundred sixty-six females (64.4%) participated in our study. The prevalence of burnout was 50.8% (525/1034) in this study population (mean score 2.74 ± 0.33). Logistic regression analysis showed that female gender [OR = 2.380, 95% CI: 1.731 to 2.554], first workplace [OR = 1.891, 95% CI: 1.582 to 2.162] and working more than 30 years [OR = 1.901, 95% CI: 1.608 to 2.326] have significantly increased the likelyhood of burnout as well as the history of muscoskeletal pain [OR = 1.156, 95% CI: 1.009 to1.342], current quality of life [OR = 1.602, 95% CI: 1.473 to 1.669] and the presence of sleep disturbance [OR = 1.289, 95% CI: 1.066 to 1.716]. CONCLUSION: This is the first study in Hungary to investigate the prevalence of burnout among postal workers and to explore the relationship between burnout and mental health problems. Our study underlines the clinical importance of burnout and draws attention to the need for appropriate prevention and treatment strategies.

[The examination of burnout among healthcare workers]. / A kiégés vizsgálata egészségügyi dolgozók között.

BACKGROUND AND PURPOSE: Health reforms in recent decades have been largely based on economic considerations and have led to a significant problem in the sector today, with the issue of human resources being pushed back, which is exacerbated by burnout syndrome. The aim of this questionnaire-based study was to examine the complex background of burnout among health care workers in the cities of Komló, Pécs and Kecskemét. METHODS: Baseline demographic data were recorded. Burnout was assessed by the Maslach Burnout Inventory (MBI), and the intensity of dysfunctional attitudes were also studied. Depression was detected by the Beck Scale and social supports, and effort-reward dysbalance were also examined. RESULTS: Overall 411 employees participated in our study. Age group distribution was middle aged access, vast majority of the workers was between 36 and 55 years. Mean burnout scale was 58.6 (SD = 16.3), 63 workers had mild (14.2%), 356 had moderate (80.7%) and 22 had severe (5.1%) burnout. In a multivariate analysis the type of work (OR = 1.018), age (OR = 2.514), marital status (OR = 1.148), job type (OR = 1.246) the lack of social support (OR = 1.189) and allowance (OR = 9.719) were independently associated with burnout (p < 0.05 in all cases). There was a significant association among burnout, depression and dysfunctional attitudes. CONCLUSION: The vast majority of our social workers suffered from moderate and a small, but significant proportion suffered from severe burnout. Our work draws attention to the modifiable and unmodifiable risk factors of burnout in this population, which may help in the development of preventive strategies.

Early seizures after ischemic stroke: focus on thrombolysis.

INTRODUCTION: Stroke is a significant underlying cause of epilepsy. Seizures due to ischemic stroke (IS) are generally categorized into early seizures (ESs) and late seizures (LSs). Seizures in thrombolysis situations may raise the possibility of other etiology than IS. AIM: We overtook a systematic review focusing on the pathogenesis, prevalence, risk factors, detection, management, and clinical outcome of ESs in IS and in stroke/thrombolysis situations. We also collected articles focusing on the association of recombinant tissue-type plasminogen activator (rt-PA) treatment and epileptic seizures. RESULTS: We have identified 37 studies with 36,775 participants. ES rate was 3.8% overall in patients with IS with geographical differences. Cortical involvement, severe stroke, hemorrhagic transformation, age (<65 years), large lesion, and atrial fibrillation were the most important risk factors. Sixty-one percent of ESs were partial and 39% were general. Status epilepticus (SE) occurred in 16.3%. 73.6% had an onset within 24 h and 40% may present at the onset of stroke syndrome. Based on EEG findings seizure-like activity could be detected only in approximately 18% of ES patients. MRI diffusion-weighted imaging and multimodal brain imaging may help in the differentiation of ischemia vs. seizure. There are no specific recommendations with regard to the treatment of ES. CONCLUSION: ESs are rare complications of acute stroke with substantial burden. A significant proportion can be presented at the onset of stroke requiring an extensive diagnostic workup.

Platelet Aggregometry Testing: Molecular Mechanisms, Techniques and Clinical Implications.

Platelets play a fundamental role in normal hemostasis, while their inherited or acquired dysfunctions are involved in a variety of bleeding disorders or thrombotic events. Several laboratory methodologies or point-of-care testing methods are currently available for clinical and experimental settings. These methods describe different aspects of platelet function based on platelet aggregation, platelet adhesion, the viscoelastic properties during clot formation, the evaluation of thromboxane metabolism or certain flow cytometry techniques. Platelet aggregometry is applied in different clinical settings as monitoring response to antiplatelet therapies, the assessment of perioperative bleeding risk, the diagnosis of inherited bleeding disorders or in transfusion medicine. The rationale for platelet function-driven antiplatelet therapy was based on the result of several studies on patients undergoing percutaneous coronary intervention (PCI), where an association between high platelet reactivity despite P2Y12 inhibition and ischemic events as stent thrombosis or cardiovascular death was found. However, recent large scale randomized, controlled trials have consistently failed to demonstrate a benefit of personalised antiplatelet therapy based on platelet function testing.

[Clopidogrel resistance in cerebrovascular disease -- results of one-year follow-up]. / Clopidogrelrezisztencia vizsgálata cerebrovascularis betegségben -- egyéves utánkövetés.

INTRODUCTION: In an earlier study the authors reported short-term benefits of clopidogrel treatment in patients with cerebrovascular disease. AIM: The aim of the authors was to analyze findings during a 12-month follow-up period. METHOD: 100 patients with a history of acute stroke or transient ischaemic attack have been included in the study. The efficacy of the therapy was assessed 7 and 28 days as well as 3, 6 and 12 months after initiation of medical therapy. Patients were divided into two parts (clopidogrel responder and resistant) based on their initial laboratory findings. Risk profiles, medical therapy, laboratory parameters and vascular events were compared between the two patient groups. RESULTS: After 7 days of treatment, clopidogrel seemed to be ineffective in 11 patients (11%). Strong, clinically significant correlations were found among blood pressure values, blood glucose and lipid parameters, serum C-reactive protein levels and platelet aggregation levels. An aggressive secondary preventive therapy resulted in a decrease of clopidogrel resistance and improvement in laboratory parameters. Patients who were clopidogrel resistant at baseline had significantly higher rate of vascular events compared to those who were clopidogrel responders (18.1 vs. 4.5%, p<0.01), although clopidogrel resistance was not an independent risk factor of unfavourable vascular outcome using a multivariate analysis. No adverse events or hemorrhagic complications were observed. CONCLUSIONS: Clopidogrel resistance and unfavourable outcome seems to be associated with "classical" risk factors underlying the importance of aggressive secondary prevention.

Internet Addiction and COVID-19 Misbeliefs Among Hungarian Online Gamers: A Cross-Sectional Study.

Introduction: The internet has become a part of everyday life, and during the COVID-19 pandemic the rate of internet use has raised even higher, which increases the possibility of compulsive and problematic use leading to the acceptance of online misbeliefs and conspiration theories. This cross-sectional study aimed to explore the relationship between COVID-19-related misconceptions and internet addiction among adult recreational online gamers. Methods: A sample of 1671 recreational video game users completed the online survey (male: n = 1522 (91.08%), mean age = 21.83, SD = 4.18; female: n = 149 (8.91%), mean age = 24.33, SD = 8.38). Demographic questions, risk factors and health-related questions, internet use and addiction were measured alongside a short questionnaire about common COVID-19-related topics, such as its origin and risk of infection. Results: Out of all participants 248 (14.8%) answered all the COVID-19-related questions properly, thus having no misconceptions, while 545 (32.6%) had one wrong answer, 532 (31.8%) had 2 wrong answers, 251 (15.0%) had 3 wrong answers, 78 (4.7%) had 4 wrong answers and 17 (1.0%) had 5 wrong answers. Significant factors to a higher number of COVID-misconceptions were time spent studying (χ2 (35,1671) = 63.86, p = 0.002), marital status (χ2 (15,1671) = 30.65 p = 0.01) and secondary employment (χ2 (51,671) = 14.88, p = 0.01). Although 17.1% of the participants reached the threshold score for internet addiction, the predictors of COVID-19 misconceptions were marital status (ß = -0.06, p = 0.01) and time spent studying (ß = 0.05, p = 0.03), while neither daily internet use, internet addiction scores or risk factors predicted these misconceptions in a linear regression model. Discussion: Our study concludes that Internet addiction did not directly influence misconceptions about the COVID-19 pandemic in this population despite the surprisingly high rate of problematic users.

The association of problematic usage of the internet with burnout, depression, insomnia, and quality of life among Hungarian high school students.

Introduction: The extensive availability of the internet has led to the recognition of problematic usage of the internet (PUI) or so called internet addiction (IA), probably mostly involving adolescents. Aim: Here we present a study focusing on the incidence and consequences (including burnout, which is relatively rarely studied) of internet addiction among high school students using a questionnaire-based non-random sampling cross-sectional survey. Included questionnaires were the Problematic Internet Use Questionnaire, the Maslach Burnout Inventory General Survey for Students MBI-GS (S), the 9-item short version of Beck Depression Inventory (BDI-SF), the Athens Insomnia Questionnaire and the EQ-5D (quality of life) questionnaire. Data were evaluated the exertion of Student's t-test, chi square test and Pearson's rank-order correlation. Logistic regression analysis was used to determine the significance of the different parameters as independently associated with PUI. Results: Overall 3,000 paper-based questionnaires were successfully delivered and 2,540 responses received (response rate of 84.6%). 1,309 males (mean age 17.6 ± 1.43 years) (51.5%) and 1,231 females (mean age 17.5 ± 1.4 years) (48.5%) took part in our study. Problematic usage of the internet was detected in 486 (19.1%) students (232 males, mean age 17.6 ± 1.35 years and 254 females, mean age 17.34 ± 1.37 years). In a logistic regression analysis sleep disturbance (OR: 1.84, 95% CI: 1.83-2.03), depression (OR: 1.97, 95% CI: 1.77-2.02) and burnout (OR: 1.8, 95% CI: 1.16-1.94) were significantly associated with PUI. Conclusion: Nearly one fifth of our study population suffered from PUI, which was strongly associated with school burnout, insomnia and depression, which underlines the importance of this phenomenon.

Prevalence and Risk Factors of Problematic Internet Use among Hungarian Adult Recreational Esports Players.

Background: Esports are highly prevalent in modern culture, particularly among young people, and are a healthy hobby for the majority of users. However, there is a possible link between video gaming (including esports) and problematic internet use (so-called internet addiction, IA), mostly involving adolescents. Methods: Here we present an online survey focusing on the prevalence and risk factors of internet addiction among adult esports players. Demographics included age, gender, family type, type of work, working years and daily internet use. Medical conditions associated with IA such as smoking, alcohol and drug intake, hypertension, diabetes, ischemic heart disease, musculoskeletal pain and history of depression were also recorded. Results: Overall, 2313 players including 176 females (7.6%) and 2137 males (92.4%) participated in our online survey. Age distribution was the following: 18−25 years 90.3% (2088/2313), 26−35 years 7.95% (184/2313), 36−45 years 0.86% (20/2313), 46−55 years 0.82% (19/2313), 56−62 years 0.04% (1/2313) and 62 years or older 0.04% (1/2313). Internet addiction was detected in 19.9% of players (461/2313) based on the Problematic Internet Use Questionnaire. In a multivariate analysis internet addiction was significantly associated with age between 18 and 25 (OR: 1.675, p = 0.002), being single (OR = 1.505, p = 0.014), internet use > 6 h daily (OR = 4.338, p < 0.001), having < 3 children (OR: 2.037, p = 0.023) and having secondary employment (OR = 1.789, p = 0.037). Regular alcohol intake (OR = 18.357, p < 0.001) and history of depression (OR= 5.361, p = 0.032) were also strongly correlated with IA. Conclusion: This is the first study from Hungary investigating the prevalence and risk factors of internet addiction among adult esports players. One out of five adult gamers suffered from IA. Our study also draws attention to increased risk within this group and risk factors such as younger age, family status and type of employment.

Internet addiction: the medical challenge of the 21st century? br / Internetfüggoség: a 21. század orvosi kihívása?

As a result of digitalisation and the increasing use of the internet, its problematic use is on the rise in the 21st cen-tury, with a predominant impact on minors and a potentially increasing challenge for health care systems in the fu-ture. The main risk factors for this phenomenon are age, inadequate social and family relationships, and can be as-sociated with mental problems such as depression and anxiety, somatic illnesses, often with additional dependencies. Imaging studies can detect abnormally functioning brain areas in the affected individuals, however, there is a signifi-cant heterogeneity among them. Similar to other addictions, extensive internet use negatively affects the individual in all areas of life. We do not have a high level of evidence for treatment yet, but it appears that treatments used in other (classic) addictive diseases may be effective.

The Impact of Shift Work on Occupational Health Indicators among Professionally Active Adults: A Comparative Study.

The analysis of the impact of shift work on occupational health still needs further contributions. Therefore, we developed this research with the purpose of assessing the impact of shift work on occupational health indicators, namely burnout, work-engagement, occupational self-efficacy, and mental health functioning (symptoms of depression and anxiety), by comparing workers who did shift work (44.2% of participants) with workers who did not (55.8% of participants). A total of 695 Portuguese professionally active adults between 18 and 73 years of age (Mage = 37.71; SD = 12.64) participated in this study and completed a survey containing a sociodemographic questionnaire and four occupational health measures: The Burnout Assessment Tool, The Work-Engagement questionnaire (UWES), The Occupational Self-Efficacy Questionnaire, and the BSI-18 for mental health symptoms. Results showed statistically significant differences (p < 0.05) for all indicators, demonstrating that participants who worked shifts presented lower scores of work-engagement and occupational self-efficacy, and higher scores of burnout, depression, and anxiety when compared to participants who did not work shifts. Linear regressions showed that shift work explained significant but low percentages of anxiety symptoms, low work-engagement, depression symptoms, low occupational self-efficacy, and burnout. We concluded that non-standard working hours (by shifts) are detrimental to employee occupational health, by increasing the risk of anxiety and depression levels, and burnout, and by reducing work-engagement (as a well-being indicator) and occupational self-efficacy perceptions.

Mediating Effect of Burnout on the Association between Work-Related Quality of Life and Mental Health Symptoms.

The purpose of this study was: (1) to assess levels of burnout, work-related quality of life (WRQoL) and mental health symptoms among a sample of active workers living in Portugal; (2) to analyze differences in burnout, WRQoL and mental health symptoms by gender and shift work; (3) to analyze association levels among all variables under study; (4) to determine the predictive effect of burnout and WRQoL on mental health symptoms; and (5) to assess the mediating effect of burnout on the association between WRQoL and mental health symptoms. Eight-hundred and forty-one Portuguese active workers between 18 and 67 years of age participated in this study (Mean = 37.23; SD = 11.99). Results showed that women participants scored higher in burnout and mental health symptoms, and lower in overall WRQoL, than men; additionally, participants who worked in shifts presented higher mental health symptoms. Significant correlations were found for all variables and regression analysis demonstrated that 56% of the overall variance of mental health symptoms was explained by older age, shift work, lower WRQoL, and burnout (exhaustion and cognitive impairment). Finally, the mediation effect of burnout on the association between WRQoL and mental health symptoms was statistically significant. These findings are useful for health professionals and health managers who work in the field of occupational health in identifying variables affecting burnout, WRQoL and mental health symptoms.

The Impact of Internet Addiction and Job Satisfaction on Mental Health Symptoms among a Sample of Portuguese Workers.

Not many studies assessing the impact of internet addiction (IA) and job satisfaction (JS) on mental health symptoms (MHS) among active workers exist. Therefore, the purpose of this study was as follows: (a) to assess the presence of criteria for IA among a sample of active workers; (b) to analyze differences in IA, JS and MHS, by gender; (c) to analyze association levels among IA, JS, and MHS; and (d) to determine the predictive effect of IA and JS on MHS. In total, 1064 participants (Mage = 40.66; SD = 12.02) completed a survey containing four categories of measures: demographic information, internet addiction, job satisfaction, and mental health symptoms (anxiety and depression). Results showed a presence of 13.3% for IA among the sample. Male participants showed higher scores of IA and JS but lower scores of overall MSH than female participants did. Significant positive correlations were found between overall IA and MHS, and significant negative correlations were found between IA and JS, and MHS and JS. Hierarchical linear regression analysis showed that strong predictors of MHS were age (being older), gender (being female), not having enough economic funds, being unsatisfied with the leadership in the job, being unsatisfied with the nature of the job, and having higher scores in salience and excessive use regarding IA. In conclusion, addiction to internet technology is a risk factor with implications for occupational satisfaction and mental health.

Ischemic stroke mimics: A comprehensive review.

BACKGROUND: Ischemic stroke is the leading cause of disability and one of the leading causes of death. Ischemic stroke mimics (SMs) can account for a noteble number of diagnosed acute strokes and even can be thrombolyzed. METHODS: The aim of our comprehensive review was to summarize the findings of different studies focusing on the prevalence, type, risk factors, presenting symptoms, and outcome of SMs in stroke/thrombolysis situations. RESULTS: Overall, 61 studies were selected with 62.664 participants. Ischemic stroke mimic rate was 24.8% (15044/60703). Most common types included peripheral vestibular dysfunction in 23.2%, toxic/metabolic in 13.2%, seizure in 13%, functional disorder in 9.7% and migraine in 7.76%. Ischemic stroke mimic have less vascular risk factors, younger age, female predominance, lower (nearly normal) blood pressure, no or less severe symptoms compared to ischemic stroke patients (p < 0.05 in all cases). 61.7% of ischemic stroke patients were thrombolysed vs. 26.3% among SMs (p < 0.001). (p < 0.001). Overall intracranial hemorrhage was reported in 9.4% of stroke vs. 0.7% in SM patients (p < 0.001). Death occurred in 11.3% of stroke vs 1.9% of SM patients (p < 0.001). Excellent outcome was (mRS 0-1) was reported in 41.8% ischemic stroke patients vs. 68.9% SMs (p < 0.001). Apart from HINTS manouvre or Hoover sign there is no specific method in the identification of mimics. MRI DWI or perfusion imaging have a role in the setup of differential diagnosis, but merit further investigation. CONCLUSION: Our article is among the first complex reviews focusing on ischemic stroke mimics. Although it underscores the safety of thrombolysis in this situation, but also draws attention to the need of patient evaluation by physicians experienced in the diagnosis of both ischemic stroke and SMs, especially in vertigo, headache, seizure and conversional disorders.

The Association of Internet Addiction with Burnout, Depression, Insomnia, and Quality of Life among Hungarian High School Teachers.

The extensive availability of Internet has led to the recognition of problematic Internet use (so called Internet addiction, IA) mostly involving adolescents. There are limited data about the prevalence and consequences of IA in adults especially among high school teachers. Here, we present a cross-sectional prospective study focusing on the association of Internet addiction with burnout, depression, insomnia, and lower quality of life among high school teachers taking many co-variates into account. Overall, 623 males (34.3%) and 1194 females (65.7%) participated in our study. Internet addiction was detected in 5.2% (95/1817) based on the Problematic Internet Use Questionnaire. Internet addiction was associated with severe burnout (10.5 vs. 2.7%, p < 0.001), moderate (36.8 vs. 1.7%, p < 0.001), and severe (6.3 vs. 0.1%, p < 0.001) depression, insomnia (23.1 vs. 11.4%, p < 0.001), and severe sleep disturbance (severe insomnia, 27.4 vs. 3.8%, p < 0.001) and lower quality of life in all domains (p < 0.001). There was also a significant correlation of the severity of the above-mentioned parameters and the severity of IA (overall scores, p < 0.001 in all cases). In a multivariate analysis including demographic criteria, risk factors medical conditions and the above-mentioned parameters as co-variates internet addiction was significantly associated with depression (OR = 3.836, CI: 2.92-5.44, p = 0.03), and insomnia (OR: 3.932, CI: 3.6-5.69, p = 0.002). This is the first study from Hungary and is one of the first studies showing the association of IA with mental issues, burnout, and lower quality of life among adults. It underlines the clinical importance of problematic Internet use among adults.

Internet Addiction and Burnout in A Single Hospital: Is There Any Association?

The extensive availability of the internet has led to the recognition of problematic internet use, the so-called Internet Addiction (IA), mostly involving adolescents. Burnout can lead to substance abuse or addictive behaviour (such as internet addiction) as a coping method. There are insufficient data about internet addiction and its possible association with burnout in adults, especially among healthcare workers. The aim of our present study was to focus on prevalence and the risk factors of internet addiction and its possible association with burnout among healthcare workers in a single hospital applying a questionnaire-based survey. In total, 49 doctors (10.1%), 198 nurses (40.9%), 123 medical assistant (25.4%), 73 other healthcare workers (15.1%), and 42 (1.7%) healthcare associated workers (cleaning, laundry, etc.) have completed our survey. In a multivariate analysis, IA was associated with age between 18 and 25 (OR: 2.6, p = 0.024), surfing on the internet >5 h daily (OR 25.583, p < 0.001), being single (OR: 4.275, p = 0.006), being childless (OR: 3.81, p = 0.011), working less than five years (OR 2.135, p = 0.048) and job type (being healthcare associated worker, OR: 2.907, p = 0.009). Illicit drug intake (OR 52.494, p < 0.001), and diabetes (OR: 4.122, p = 0.043) were also significantly associated with internet addiction. No association of burnout and IA could be found. A small but significant proportion of our healthcare workers suffered from IA, which was associated with substance abuse and diabetes in multivariate analysis. Our study also draws attention to the risk factors of IA such as younger age, family status, working type and working hours internet use. The possible association of burnout and IA merits further investigation.

Prevalence and Risk Factors of Internet Addiction among Hungarian High School Students.

INTRODUCTION: The extensive availability of the internet has led to the recognition of problematic internet use (so-called internet addiction-IA) mostly concerning adolescents. AIM: Here, we present a study focusing on the prevalence and risk factors of internet addiction in Hungarian high school students, using a questionnaire-based survey. RESULTS: Overall, 3000 paper-based questionnaires were successfully delivered and 2540 responses were received (response rate of 84.6%). A total of 1309 males (mean age 17.6 ± 1.43 years) (51.5%) and 1231 females (mean age 17.5 ± 1.4 years) (48.5%) took part in our study. Internet addiction was detected in 486 (19.1%) students (232 males, mean age 17.6 ± 1.35 years, and 254 females, mean age 17.34 ± 1.37 years) based on the Problematic Internet Use Questionnaire. In a multivariate analysis, age (age of 17, OR = 3.688, p < 0.001), family status (living without parents) (OR = 2.091, p = 0.034), the size of the household (more than five people per household) (OR = 2.546, p = 0.026), spending more than 6 h online (OR = 5.457, p < 0.001), and daily time interval (OR = 84.316, p < 0.001) were significantly associated with internet addiction. Alcohol use (OR = 10.341, p = 0.001), drug intake (OR = 6.689, p = 0.001) and musculoskeletal disorders (OR = 3.966, p = 0.047) were also strongly associated with IA. CONCLUSION: A significant proportion of our students suffered from IA, which is associated with substance intake (possible abuse) and musculoskeletal pain in the multivariate analysis. Our study also draws attention to the preventable risk factors of IA, such as working hours or nighttime internet use, number of hours spent online and family surroundings.

Prevalence and Risk Factors of Internet Addiction among Hungarian High School Teachers.

The extensive availability of internet has led to the the recognition of problematic internet use (so called internet addiction, IA) mostly involving adolescents. There is limited data about the prevalence of IA in adults. Here we present a study focusing on the prevalence and risk factors of internet addiction among high school teachers. Overall 2500 paper-based questionnaires were successfully delivered and 1817 responses received (response rate of 72.7%). In our study 1194 females (65.7%) and 623 males (34.3%) participated. In a multivariate analysis including of all factors (demographic data, internet habits, comorbidity etc.) age <35 years (OR: 6.098, CI: 5.09-7.08, p < 0.001), male gender (OR = 5.413, CI: 4.39-6.18, p = 0.002), surfing on the internet > 5 h daily (OR 2.568, CI: 2.03-3.39, p < 0.001), having no children (OR: 1.353, CI: 1.13-1.99, p = 0.0248), and having secondary employment (OR = 11.377, CI: 8.67-13.07, p = 0.001) were significantly associated with internet addiction. This is the first study from Hungary showing the prevalence and risk factors of internet addiction among high school teachers. A small, but significant proportion suffered from IA. Our study also draws attention to the risk factors of IA such as younger age, family status and working type.

Neuropathic Low Back Pain and Burnout among Hungarian Workers.

Burnout is an increasingly prevalent syndrome mainly involving those working in human services. Although it is categorized as an occupational phenomenon and not as a medical condition, it seems to be strongly associated with several diseases such as pain syndromes. However, no studies examined the association between neuropathic low back pain and burnout. This questionnaire-based study was carried out between April 2019 and March 2020 in three main sites among teachers, social workers and healthcare workers. Demographic criteria included age, gender, marital status, number of children, type of work, years spent with work, work schedule, legal relation, secondary employment. Included diseases were diabetes, hypertension, ischemic heart disease, generalized pain (pain involving more than one area of the body) and depression. Low back pain was assessed by the painDETECT questionnaire, burnout was measured with the Maslach Burnout Inventory (MBI) and depression was measured by the Beck Depression Inventory. Dysfunctional attitudes were also recorded. Overall, 1500 questionnaires were successfully delivered and 1141 responses received (response rate of 76%). Three hundred social workers, 399 teachers, 339 paramedics, 35 doctors and 68 medical attendants have completed our survey. In a multivariate analysis including of all factors (demographic criteria, burnout, depression, dysfunctional attitudes, comorbidity etc.) neuropathic low back pain was associated with age > 62 (OR = 3.981, p = 0.01), number of children ≥ 2 (OR = 2.638, p = 0.003), job type (being a social worker) (OR = 6.654, p < 0.001), burnout (OR = 2.577, p < 0.001), current depression (OR = 2.397, p < 0.001), and suffering from generalized pain (OR= 4.076, p < 0.001). This is the first study showing the association of burnout and neuropathic low back pain, which is the most common cause of disability. Based on our results neuropathic low back pain and burnout have similar risk factors and consequences which raises the possibility of similar pathophysiology.

Characteristics of Patients Referred To A Specialized Headache Clinic.

Headache is a common problem with great effect both on the individual and on the society. Recent studies raised the possibility of increasing rate of specialty referrals, inappropiate treatment and advanced imaging for simple headache. The aim of our study was to analyze the characteritics of patients (including duration of symptoms, headache type, brain imaging, treatment) referred to our specialized headache clinic between 01/01/2014 and 01/01/2015 by their general practitioners and primary care neurologists due to chronic/treatment-resistant headache syndromes. 202 patients (mean age 53.6 ± 17.6 years) were evaluated in our clinic (102 females, mean age 50.14 ± 16.11 years and 100 males, mean age 57 ± 18.1 years). Migraine (84/202) and tension-type (76/202) were the most common syndromes. 202 plain brain CT, 60 contrast-enhanced CT and 128 MRI were carried out by their general practitioners or other healthcare professioners including neurologists before referral to our headache centre. Despite of extensive brain imaging appropiate treatment was started less than 1/3 of all patients and significant proportion received benzodiazepines or opioid therapy. Furthermore, more than 10% of referred patients presented with secondary headache including one meningitis. The management of headache is still a challenge for primary care physicians leading to medical overuse. Vast majority of our patients should not be referred to our specialized headache clinic as they had uncomplicated headache or other underlying conditions than pain.