The comparative study of chronically ill and healthy children and adolescents in the light of their general mental health.

Children's hospitalisation is difficult for the family and the immediate environment. In these cases, the provision of psychological support is particularly important. Chronically ill children who are regularly hospitalised are in a particularly difficult situation, often feeling vulnerable. Our research aims to explore and analyse in detail the psychological state, attitudes and mental health of chronically ill children and to compare patient groups (children receiving care in pulmonology, gastroenterology, onco-haematology and rehabilitation) to understand the interacting factors, which may be of great importance for quality patient care and for measures to improve patient care in the future. We studied chronically ill children (N = 107) aged 10 to 18 years (M = 14.3; SD = 2.0), cared for by the Department of Paediatric Rehabilitation, Paediatric Psychiatry and Psychosomatics of the University of Debrecen Clinical Centre, the second largest paediatric institution in Hungary. In our survey, sociodemographic questions, the Connor-Davidson Resilience Scale, the Satisfaction With Life Scale, the Cantril Ladder, the Non-Productive Thoughts Questionnaire, the Problematic Internet Use Questionnaire, the Drawing version of Pictorial Representation of Illness Self-Measure (PRISM-D), the Beck Depression Inventory-Shortened Scale, the Illness Intrusiveness Ratings Scale, the Spielberger State-Trait Anxiety Questionnaire-Child Version and the Strength and Difficulty Questionnaire were applied. One-way analysis of variance (ANOVA) was used to examine differences between groups, and Pearson rank correlation analysis was used to measure the relationships between individual variables. The results show significant differences between patient groups in terms of resilience, depression, nonproductive thoughts, problematic internet use, anxiety and coping, but no consistent pattern in the development of scores. In addition, for some psychological correlates, the role of sociodemographic background also showed significant results. The practical utility of our study is that using questionnaire methods to map patient satisfaction, compliance, and patient attitudes will provide regarding the factors that influence the mental health status of children living with chronic illnesses. In the light of this, additional methods and tools can be included to improve the quality of healthcare and to develop a set of procedures that will serve the intended purpose.

The role of animal-assisted programs in physical health improvement of children and adolescents with special education needs - a systematic review.

Programs involving animals in therapeutic programs are becoming increasingly prevalent. These programs can vary greatly in their approach, scope, and objectives, and they can significantly impact the development of healthy children and those with various disorders. In this systematic review, we sought to investigate the psychological ramifications of animal-assisted activities (AAA), therapies (AAT), and interventions (AAI). We searched for relevant studies using the EBSCO Discovery Service search engine across 85 databases, utilising appropriate keywords. Our search generated 262 results, of which 21 were selected for inclusion after title and abstract screening, as well as full-text analysis. Our findings indicate that dogs and horses are animal-assisted programs' most commonly used animals. Additionally, autism, cerebral palsy, and ADHD were found to be overrepresented in these programs. Furthermore, the length of sessions and overall program duration exhibited considerable variation, regardless of patient age or disease type. The principal measures centred on the physiological variables related to the nervous system and motorium-related indicators. The studies were generally of exceptional methodological soundness. Frequently, the studies narrowed their scope to a single segment or just the child or adolescent, but the outcomes lacked contextual interpretation. Expanding the range of studies by comparing psychological and physiological indicators and conducting follow-up analysis with a longitudinal design would be beneficial.

Use of intraoperative haemoadsorption in patients undergoing heart transplantation: a proof-of-concept randomized trial.

AIMS: The aim of this trial was to compare the clinical effects of intraoperative haemoadsorption versus standard care in patients undergoing orthotopic heart transplantation (OHT). METHODS AND RESULTS: In a randomized, controlled trial, OHT recipients were randomized to receive intraoperative haemoadsorption or standard care. Outcomes were vasoactive-inotropic score (VIS), frequency of vasoplegic syndrome (VS) in the first 24 h; post-operative change in procalcitonin (PCT) and C-reactive protein (CRP) levels; intraoperative change in mycophenolic acid (MPA) concentration; frequency of post-operative organ dysfunction, major complications, adverse immunological events and length of in-hospital stay and 1-year survival. Sixty patients were randomized (haemoadsorption group N = 30, control group N = 25 plus 5 exclusions). Patients in the haemoadsorption group had a lower median VIS and rate of VS (VIS: 27.2 [14.6-47.7] vs. 41.9 [22.4-63.2], P = 0.046, and VS: 20.0% vs. 48.0%, P = 0.028, respectively), a 6.4-fold decrease in the odds of early VS (OR: 0.156, CI: 0.029-0.830, P = 0.029), lower PCT levels, shorter median mechanical ventilation (MV: 25 [19-68.8] hours vs. 65 [23-287] hours, P = 0.025, respectively) and intensive care unit stay (ICU stay: 8.5 [8.0-10.3] days vs. 12 [8.5-18.0] days, P = 0.022, respectively) than patients in the control group. Patients in the haemoadsorption versus control group experienced lower rates of acute kidney injury (AKI: 36.7% vs. 76.0%, P = 0.004, respectively), renal replacement therapy (RRT: 0% vs. 16.0%, P = 0.037, respectively) and lower median per cent change in bilirubin level (PCB: 2.5 [-24.6 to 71.1] % vs. 72.1 [11.2-191.4] %, P = 0.009, respectively) during the post-operative period. MPA concentrations measured at pre-defined time points were comparable in the haemoadsorption compared to control groups (MPA pre-cardiopulmonary bypass: 2.4 [1.15-3.60] µg/mL vs. 1.6 [1.20-3.20] µg/mL, P = 0.780, and MPA 120 min after cardiopulmonary bypass start: 1.1 [0.58-2.32] µg/mL vs. 0.9 [0.45-2.10] µg/mL, P = 0.786). The rates of cardiac allograft rejection, 30-day mortality and 1-year survival were similar between the groups. CONCLUSIONS: Intraoperative haemoadsorption was associated with better haemodynamic stability, mitigated PCT response, lower rates of post-operative AKI and RRT, more stable hepatic bilirubin excretion, and shorter durations of MV and ICU stay. Intraoperative haemoadsorption did not show any relevant adsorption effect on MPA. There was no increase in the frequency of early cardiac allograft rejection related to intraoperative haemoadsorption use.

Local laboratory-run donor-derived cell-free DNA assay for rejection surveillance in heart transplantation-first six months of clinical experience.

INTRODUCTION: Donor-derived cell-free DNA (dd-cfDNA) is a blood biomarker detecting graft injury with high negative predictive value. While non-invasive strategies for heart transplant (HTx) rejection surveillance are widely adopted in the United States with centralized testing, data on the feasibility of dd-cfDNA assay at the local level are lacking. Here, we report the first 6 months of experience with a local laboratory-run dd-cfDNA assay in the routine clinical surveillance setting. METHODS: Twenty-six HTx patients with stable graft function were transitioned from endomyocardial biopsy-based (EMB) to dd-cfDNA-led rejection surveillance using a commercially available next-generation sequencing-based assay. RESULTS: In the 90 samples analyzed, dd-cfDNA fraction remained continuously low in most patients, thus 88% of surveillance EMBs could be safely avoided. In the case of ≥.25% dd-cfDNA, EMB was performed. There was no missed rejection. CONCLUSION: Our data show the feasibility to analyze dd-cfDNA at the local level and successful implementation of this non-invasive surveillance method into clinical practice, thus considerably reducing the frequency of invasive surveillance EMBs.

Cardiac sarcoidosis completely mimicking biventricular arrhythmogenic cardiomyopathy.

Cardiac sarcoidosis (CS) is a chameleon of cardiology, and it can mimic different cardiac diseases; among them is arrhythmogenic cardiomyopathy (ACM). We admitted a 70-year-old female patient with heart failure symptoms in 2015, who fulfilled all major ECG and non-invasive imaging criteria of biventricular ACM. She was well with the recommended medications for 3 years, showing only isolated cardiac involvement, but in 2018, cervical and mediastinal lymphadenopathy appeared and cervical lymph node core biopsy histology, bronchoalveolar lavage flow cytometry strongly suggested extracardiac sarcoidosis. Therefore, our suspicion was that sarcoidosis is responsible for the cardiac involvement, which was not confirmed by PET-CT and gallium scintigraphy examinations. At the end of 2018, she died in septicaemia with multiorgan failure, and only autopsy verified her CS. A new ECG algorithm published in 2021 for the differential diagnosis of CS and biventricular ACM, when applied on her ECGs recorded in 2015, suggested the diagnosis of CS.

Effect of medically assisted reproduction (MAR) and pregnancy planning on Bayley-III Screening Test subscales in preterm infants at 12 months of corrected age: a cross-sectional study.

BACKGROUND: The association between medically assisted reproduction and pregnancy planning on overall developmental outcomes of infants has been studied in relatively few studies. The availability of accurate tools for the early detection of developmental delays is a major issue. The purpose of this study is describing the average neurodevelopment of preterm infants and assessing the association between medically assisted reproduction, pregnancy planning and neurodevelopmental outcomes among Hungarian preterm infants. METHODS: Cross-sectional study of preterm infants with gestational age < 37 weeks (N = 171) who underwent developmental assessment using Bayley-III Screening Test (Bayley Scales of Infant and Toddler Development Screening Test - Third Edition) in five developmental domains (cognitive, receptive and expressive language, fine and gross motor) at 12 months of corrected age. We examined the developmental pattern of infants and the potential associations between medically assisted reproduction, pregnancy planning and Bayley-III Screening Test subscales. Information on the mode of conception and pregnancy planning was obtained through parental anamnesis. RESULTS: Concerning the risk for developmental delay, the language and motor subscales were the most affected. Examination of the mode of conception and developmental outcomes revealed higher neurodevelopmental skills in infants who were conceived through medically assisted reproduction. Significantly lower cognitive, receptive and expressive language skills were found to be associated with unplanned pregnancies. Multi-way analysis of variance was conducted in order to assess the impact of the mode of conception and pregnancy planning on subscales. CONCLUSIONS: We cannot unambiguously conclude that MAR and pregnancy planning had a solely positive effect on the development of preterm infants at 12 months of corrected age, but our results are vital for the design and implementation of further research.

Perinatal, neonatal, developmental and demographic predictors of intelligence at 4 years of age among low birth weight children: a panel study with a 2-year follow-up.

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.

A new perspective: Establishing developmental profiles of premature infants based on Bayley-III scores at age 2.

Longitudinal and cross-sectional studies in early childhood generally focus on different developmental areas separately. The aim of this study is to identify the most common developmental profiles regarding cognitive, language and motor skills among low birthweight (LBW) children. Our sample included 208 LBW children examined at 24-28 months. We used cluster analysis to identify developmental profiles based on the scores of the Bayley-III Cognitive, Language and Motor scales. We found three consistent profiles (High, Mildly Delayed and Severely Delayed) and three inconsistent, average profiles (with High Expressive Language, with Mildly Delayed Expressive Language and with Severely Delayed Language). Socioeconomic status, maternal education, in vitro fertilization, plurality and chronic morbidities were significantly related to the clusters. Cluster analysis might be an effective method to identify developmental profiles of preterm (and other at-risk) children, which might result in a more complex understanding of cognitive and psychomotor development in early childhood.

Blood-filled cyst of the tricuspid valve: Multiple cardiac disorders, one surgical case.

BACKGROUND: Intracardiac blood cysts are an exceedingly rare occurrence in adulthood. Detailed imaging modalities aid in the diagnosis of such incidental lesions and procedure planning. METHODS: We report the case of a 51-year-old male accusing dyspnea on exertion as a sole symptom which led to the discovery of multiple cardiac anomalies, namely, severe aortic valve insufficiency on a bicuspid aortic valve, ascending aortic aneurysm, a cystic mass on the tricuspid valve, patent foramen ovale, and an occluded right coronary artery. RESULTS: The disorders were managed in a single surgical intervention, the resected mass being confirmed as a blood cyst. CONCLUSIONS: Our case presents a unique association of cardiac disorders, including a highly uncommon intracardiac blood-filled cyst, and underlines the importance of multimodality imaging and interdisciplinary approach in the successful management of such complex cases.

Behçet's disease: successful aortic root reconstruction in severely dilated aortoventricular junction after aortic valve replacement with novel surgical method - case report.

BACKGROUND: Behçet's disease is an auto-inflammatory disorder categorized as a primer systemic vasculitis of unknown aetiology. Genetic factors, infectious agents and the irregularity of T-cell homeostasis are presumed to be responsible for the emergence of Behçet's disease. Characteristic symptoms are multisystemic. Although cardiovascular involvement is rare, it should be noted due to the difficulty of surgical treatment options. CASE PRESENTATION: Our 44-year-old male patient underwent aortic valve replacement due to aortic regurgitation. At the 15-month follow-up, echocardiography showed detachment of the prosthetic valve and in the aortic root, multiple pseudo-aneurysms were identified. We performed an aortic root reconstruction with a Bentall procedure using a special "skirted" conduit to reduce strain in the suture line between the conduit and the extremely dilated left ventricular outflow tract. CONCLUSIONS: The surgical treatment of cardiovascular manifestations of Behçet's disease remains challenging. This new technique may be beneficial in well-selected cases where the annulus of the aorta is extremely dilated or annular tissue disorder is present.

Adaptive Behavioral, Social-Emotional, and Neurodevelopmental Outcomes at 2 Years of Age in Hungarian Preterm Infants Based on Bayley III.

AIM:  This study aimed to assess cognitive, language, and motor development as well as social-emotional and adaptive behavior skills of low birthweight (LBW) children. METHODS: Our cohort contained 305 two-year-old LBW children. Developmental functioning was assessed by the Bayley Scales of Infant and Toddler Development, 3rd Edition. RESULTS: Performance in language, particularly in expressive communication was the poorest. Extremely low birthweight (ELBW) children were found to be at increased risk of developmental delay: 12.73 times in motor (95%CI = 2.8-57.5), 9.81 times in cognitive (95%CI = 3.2-29.6) and 3.91 times in language (95%CI = 1.6-9.4), and social-emotional skills (95%CI = 1.6-9.5). Parents of children with lower birthweight reported poorer social and practical adaptive skills. Self-care domain seemed to be the least developed. CONCLUSION: Additionally, the screening for developmental delays, monitoring the adaptive behavior skills may also be useful - especially among ELBW children - in order to identify the specific areas, situations, and functions that are most in need of interventions. ABBREVIATIONS: AB: Adaptive Behavior; ABAS-II: Adaptive Behavior Assessment System-II; BPD: Bronchopulmonary Dysplasia; BSID-III: Bayley Scales of Infant Development 3rd Edition; BW: Birthweight; CI: Confidence Interval; CS: Composite Score; ELBW: Extremely Low Birthweight; GA: Gestational Age; IVF: In Vitro Fertilization; IVH: Intraventricular Hemorrhage; LBW: Low Birthweight; NEC: Necrotizing Enterocolitis; OR: Odds Ratio; ROP: Retinopathy of Prematurity; SE: Social-Emotional Development; VLBW: Very Low Birthweight.

Factors Influencing Adherence Among Youth with Type-1-Diabetes Mellitus - The Hungarian Case.

Background and Introduction: Due to the increasing prevalence of type-1-diabetes, an increasing number of studies have drawn attention to its psychological effects and long-term consequences. As Type 1 Diabetes Mellitus is a chronic, non-curable, yet maintainable condition, with the affected children and their families facing a lifelong challenge, our research focuses on the factors influencing adherence. METHODS: The adherence of youth was examined in a sample involving 114 patients treated in the Medical and Health Science Centre at the University of Debrecen by employing a new adherence questionnaire (DAQ abbreviated version, Munkácsi et al. 2019) (DAF 2017; N=114). The influence of socio- demographic variables and those related to the disease (age at the time of diagnosis, the time elapsed since diagnosis, method of treatment, the time elapsed since the use of the pump) was measured by linear regression. Furthermore, the between-group comparisons were made by independent sample t-tests and variance analysis. The investigation was carried out between September 2017 and May 2018. RESULTS: The effect of using insulin pump as therapy turned out to be significant and positive (0.36. p=0.045). It was observed that the adherence of the patients using insulin pump was higher while the effect of the age at the diagnosis had a significantly negative effect (-.247, p=0.035). Thus, earlier detection of the disease may lead to a higher level of adherence. The effects of the socio-demographic variables (gender, family structure, educational level, type of the settlement, owning sibling and birth order) were not significant (p>0.05). Regarding the between-group comparisons, a significant difference could be pointed out concerning the siblings and birth-order as the adherence of those with siblings was higher (p=0.044). Moreover, concerning insulin pump therapy, the adherence of patients using pump was significantly better (p=0.048). Also, regarding the age of the diagnosis, the adherence of those diagnosed before 12 was seemingly higher (p=0.039). Concerning the other socio-demographical and disease-related variables, no significant differences could be detected. CONCLUSION: The results suggest that the treatment has an outstanding role in the adherence of the disease. Moreover, the role of the appropriate treatment, living conditions as well as the early diagnosis is relevant.

Evaluation of the performance of a human D-dimer test in dogs with neoplasia.

The goal of this study was to evaluate the suitability of a commercially available D-dimer assay as a diagnostic tool for testing dogs. This assay is an immunoturbidimetric diagnostic test, capable of determining the D-dimer levels in human plasma by using 2B9 monoclonal antibody. Plasma samples of clinically healthy (n = 20) and tumour-bearing (n = 50) dogs were measured. The tumours were grouped on the basis of histological type and aggressiveness, and then the measured D-dimer concentrations of these groups were compared to those of the control group. The differences were analysed statistically. For benign tumours, we did not find alterations in the D-dimer levels. However, in the case of malignant tumours (lymphoma, sarcoma, and carcinoma) and in the presence of metastases, significantly elevated D-dimer levels were measured. The assay proved to be suitable for measuring the D-dimer levels in plasma samples of dogs. The calculated reference range for dogs was confirmed to be between 0.06 and 0.69 µg/mL fibrinogen equivalent unit.

[The influence of emotional state and coping ability on the outcome of the assisted reproductive technology among infertile couples].

INTRODUCTION: Infertility and its treatment impose significant physical and emotional burden on infertile couples. The most commonly used assisted reproductive technology is the In Vitro Fertilization (IVF). Approximately one third of the treatments results in pregnancy. The aim of our study is to explore psychosocial factors that have an influence on the chance of IVF treatment success. METHODS: 104 infertile couples undergoing IVF treatment participated in our research, of which 49 couples achieved pregnancy after treatment and 55 couples did not. The emotional state was assessed by the Positive and Negative Affect Schedule, the short form of the Beck Depression Inventory and the Spielberger State-Trait Anxiety Inventory. The coping abilities were measured by the short form of the Ways of Coping Inventory, the Psychological Immune Competence Inventory and the Connor-Davidson Resilience Scale. The negative life events were assessed by the short and revised form of the Paykel's Life Events Scale. Data were collected at three occasions: at the beginning of the treatment (T1), before embryo transfer (T2), and before pregnancy test (T3). RESULTS: According to the most important results of the logistic regression analysis, the outcome of the treatment is negatively influenced by the female (p<0.01) and male age (p<0.05). For women, positive affectivity at T1, the Problem analysis coping strategy, the Sense of self-growth personality trait, the Personal competence and Tolerance of negative affect factors were found to be adaptive in respect of treatment success (p<0.05). For men, the IVF outcome was positively influenced by the lower level of depression at T1, the Problem analysis coping strategy and the Sense of control personality trait (p<0.05). CONCLUSION: Emotional attitudes of couples towards childbearing and treatment and their coping mechanisms have an influence on the treatment outcome. Therefore, assessment and conscious shaping of these factors may increase the chance of successful treatment.

Association between Emotional State Changes in Infertile Couples and Outcome of Fertility Treatment.

Aims Infertility and its treatment are associated with considerable psychological distress for infertile couples. The aim of our study was to explore to what extent positive and negative affectivity and a predisposition to depression and anxiety appear in infertile couples during in vitro fertilization (IVF) treatment. We also aimed to explore how the emotional state of couples changed during IVF in relation to treatment outcomes. Method In our longitudinal study, 174 people (87 couples) were followed up during treatment by means of questionnaires. Their emotional state was assessed with PANAS, BDI-R, and STAI at the beginning of treatment, before embryo transfer, and before taking a pregnancy test. Couples who achieved pregnancy after treatment were included in the successful group (n = 82), while those who did not were included in the unsuccessful group (n = 92). Results We found more favorable emotional states in IVF couples compared to patient populations and the average population. In successful IVF couples, positive affectivity decreased, and negative affectivity increased in women until the time of embryo transfer. This was accompanied by an increase in positive affectivity in men, which remained until the time of the pregnancy test and provided emotional support to their partner. These results were confirmed by changes in the levels of depression. Conclusion Our study suggests the importance of couples' emotional dynamics for having a child and an association between couples' emotional reactions during IVF cycles and treatment success.

[Psychomotor state of development of preterm children concerning chronic neonatal morbidities at the age of 2 years]. / Koraszülöttek kétéves kori pszichomotoros fejlettsége a leggyakoribb krónikus utóbetegségek tekintetében.

Introduction: Over the last few years, in the development of neonatology, the limits to which it is possible to sustain the lives of premature babies have been extended, and thus the proportion of survivors with chronic morbidities has increased. Retinopathy of prematurity (ROP), intraventricular haemorrhage (IVH) and bronchopulmonary dysplasia (BPD), all of which deeply influence the quality of life, life expectancy and social integration, are the most significant morbidities among premature newborns. Aim: Description of psychomotor development of low birth weight (<2500 g) premature infants at the age of 2 years, in relation to the most common chronic morbidities. Method: Psychomotor development (Brunet-Lézine scale, 1980) of low-birth-weight preterm infants at the age of 2 years (n = 200) was measured and the neonatal final reports were analysed retrospectively. Results: After age correction, birth weight positively correlated with the developmental quotient (DQ), while the length of stay in hospital correlated negatively. Grades I/II of neonatal IVH were not significant predictors of lower DQ, while the opposite was true for grades III/IV. We identified a similar relationship with the stages of ROP. According to the result of the homogeneity test, we can consider the independent effects of significant diseases. We also observed that the more diagnoses the premature baby received, the more they are at risk of later developmental delay at the age of 2 years. Conclusions: We recommend the early childhood interventions of the most vulnerable children of ≤1500 g birth weight with severe ROP and IVH - to reduce deficiencies in capabilities and prevent future mental and motor difficulties. Orv Hetil. 2020; 161(5): 183-192.

Women Underrepresentation in R&I: A Sector Program Assessment of the Contribution of Gender Equality Policies in Research and Innovation.

Despite decades of efforts to achieve gender equality in research and innovation (R&I), all EU member states still face remarkable difficulties in driving forward the development of their innovation system while at the same time improving gender equality by using all the available research potential. In this paper we focus on the development of the share of women researchers in four national innovation systems, i.e. in Austria, Denmark, Hungary and Spain in the time period 2005-2015. The four selected cases represent countries with significant differences in their innovation capacity, gender regimes and progress of gender equality in R&I. A qualitative comparative analysis (QCA) is carried out to conduct a sector program evaluation based on statistical data and qualitative studies to understand the dynamic development of the proportion of women researchers. The study aims to provide insights into the aggregated gender equality interventions and policies implemented in the four countries studied and their contributions to the development of the proportion of women scientists at the structural level. The analysis reveals that the development of the share of women researchers during the studied period has been particularly influenced by contextual factors, namely the relative size of the business enterprise sector and the share of women among holders of tertiary education. While this is the case, it is found that gender equality interventions need to be more widespread and more effectively designed to be a strong contributing factor to an increasing representation of women in R&I.

[Investigation of the adherence of children with diabetes through the validation of the child version of the Diabetes Adherence Questionnaire]. / Cukorbeteg gyermekek együttmuködésének vizsgálata a Diabetes Adherencia Kérdoív gyermekváltozatának validálása során.

Introduction: Most of the adolescents suffering from type 1 diabetes mellitus (T1DM) can be described with HbA1c values below the target level. Several research investigated the impact of diabetes on the quality of life, however, no complex questionnaire has been developed to examine each area of the disease. Aim: The aim of the present study is to create a Hungarian, reliable and valid questionnaire which can cover each aspect of the adherence related to type 1 diabetes mellitus. Method: In the present study, the attention was drawn to the introduction of a new questionnaire related to diabetes adherence which can be applied among children and adolescents as well. To test the questionnaire and to reduce the number of the items and to determine the scales, reliability analysis (Cronbach's α) and factor analysis was applied. Results: The new measurement, which was created through the translation of English language international questionnaires, their pre-test, and its reduction by factor and reliability analysis, containing 9 subscales with 58 items, is stated as reliable regarding the results of the Cronbach's α index. Conclusion: It can be stated that the created Diabetes Adherence Questionnaire can be reliably applied on child and adolescent population and it can be adapted for people suffering from other types of chronic diseases. Orv Hetil. 2019; 160(29): 1136-1142.

[Harmonization of cut-off values of commercially available D-dimer tests]. / Kereskedelmi forgalomban használt D-dimer-tesztek vágóértékének harmonizálása.

INTRODUCTION: The objective of the D-dimer tests is to exclude venous thromboembolic disorders. The characteristics of various D-dimer tests differ significantly and consequently, their results are difficult to compare. AIM: Our goal was to compare three D-dimer tests, analyse their correlation and harmonise their sensitivity and specificity through the optimisation of cut-off values. METHOD: At Semmelweis University, the D-dimer level was determined with three different reagents in 158 plasma samples, suspected with venous thromboembolism. INNOVANCE D-Dimer was selected as the referent, and in the case of the two other tests (STA-Liatest D-Di; Dia-D-Dimer), the cut-off values were changed between 0.2-1 µg/ml (fibrinogen-equivalent unit - FEU). The optimal cut-off values were estimated by diagnostic parameters and chi-square test. The correlation of the different tests was calculated by regression analysis. RESULTS: Based on the chi-square statistics, there is no significant difference between STA-Liatest D-Di and INNOVANCE D-Dimer tests using the cut-off values 0.3-1 µg/ml (FEU) (STA-Liatest D-Di). In the case of Dia-D-DIMER, there is a significant difference using 0.2-0.3 µg/ml (FEU) cut-off values, 0.4 µg/ml (FEU) is a border-line value and using 0.5-1 µg/ml (FEU) cut-off values, there is no significant difference. The sensitivity of STA-Liatest D-Di changed between 82.7-100% using 0.2-1 µg/ml (FEU) cut-off values, while the sensitivity of Dia-D-DIMER was 92.3-100%. Their specificities ranged between 50-96.3% and 35.2-87%. The optimal cut-off values were estimated as 0.5-0.6 µg/ml (FEU) for the STA-Liatest D-Di test and 0.7 µg/ml (FEU) for the Dia-D-DIMER test. CONCLUSION: Each diagnostic laboratory should determine the optimal cut-off value of the D-dimer test in use, considering the examined population of the area. Orv Hetil. 2019; 160(15): 585-592.

[Artificial abortus from the male partner's perspective]. / A muvi abortusz a férfi partner szemszögébol.

Induced abortion is an intervention that scientific research primarily addresses from the concerned women's point of view in terms of either the causes or the consequences of the abortion decision. Nevertheless, each case of abortion involves a man as much as a woman (in the same vein as conception), which calls for the better knowledge of male partners' needs, expectations and experiences related to induced abortion. The present summary addresses male partners' status and importance in abortion care in a practical approach based on professional considerations. Available empirical findings suggest that male partners' involvement in abortion care has importance both in protecting men's emotional balance and in providing support for women in adapting to the abortion process. Male partners' deeper involvement possibly includes roles such as seeing the female partner to the intervention, participation in pre-abortion counselling, presence during the intervention, and participation in post-abortion care. Related findings show that all of these forms of support are related to women's positive abortion-related experiences and thus to their better recovery (provided that the female partner expresses a need for her male partner's personal support). Furthermore, male partners' involvement in abortion care enables health care providers to tailor counselling (information on the intervention, on possible consequences, on contraceptive methods etc.) to men's specific needs. These practices facilitate partners' joint and informed decision making, joint responsibility for conception or contraception, and eventually contribute to reducing the incidence of induced abortion. Orv Hetil. 2019; 160(18): 694-699.