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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.
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Agotamiento Profesional , Aprendizaje Automático , Calidad de Vida , Maestros , Humanos , Hungría , Masculino , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Femenino , Adulto , Calidad de Vida/psicología , Persona de Mediana Edad , Encuestas y Cuestionarios , Maestros/psicología , Maestros/estadística & datos numéricos , Trastorno de Adicción a Internet/psicología , Trastorno de Adicción a Internet/epidemiologíaRESUMEN
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.
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Introduction: Low socioeconomic status affects not only diagnosis rates and therapy of patients with diabetes mellitus but also their health behavior. Our primary goal was to examine diagnosis rates and therapy of individuals with diabetes living in Ormánság, one of the most deprived areas in Hungary and Europe. Our secondary goal was to examine the differences in lifestyle factors and cancer screening participation of patients with diagnosed and undiagnosed diabetes compared to healthy participants. Methods: Our study is a cross-sectional analysis using data from the "Ormánság Health Program". The "Ormánság Health Program" was launched to improve the health of individuals in a deprived region of Hungary. Participants in the program were coded as diagnosed diabetes based on diagnosis by a physician as a part of the program, self-reported diabetes status, and self-reported prescription of antidiabetic medication. Undiagnosed diabetes was defined as elevated blood glucose levels without self-reported diabetes and antidiabetic prescription. Diagnosis and therapeutic characteristics were presented descriptively. To examine lifestyle factors and screening participation, patients with diagnosed and undiagnosed diabetes were compared to healthy participants using linear regression or multinomial logistic regression models adjusted for sex and age. Results: Our study population consisted of 246 individuals, and 17.9% had either diagnosed (n=33) or undiagnosed (n=11) diabetes. Metformin was prescribed in 75.8% (n=25) of diagnosed cases and sodium-glucose cotransporter-2 inhibitors (SGLT-2) in 12.1% (n=4) of diagnosed patients. After adjustment, participants with diagnosed diabetes had more comorbidities (adjusted [aOR]: 3.50, 95% confidence interval [95% CI]: 1.34-9.18, p<0.05), consumed vegetables more often (aOR: 2.49, 95% CI: 1.07-5.78, p<0.05), but desserts less often (aOR: 0.33, 95% CI: 0.15-0.75, p<0.01) than healthy individuals. Patients with undiagnosed diabetes were not different in this regard from healthy participants. No significant differences were observed for cancer screening participation between groups. Conclusions: To increase recognition of diabetes, targeted screening tests should be implemented in deprived regions, even among individuals without any comorbidities. Our study also indicates that diagnosis of diabetes is not only important for the timely initiation of therapy, but it can also motivate individuals in deprived areas to lead a healthier lifestyle.
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Detección Precoz del Cáncer , Estilo de Vida , Humanos , Estudios Transversales , Hungría/epidemiología , Femenino , Masculino , Persona de Mediana Edad , Detección Precoz del Cáncer/estadística & datos numéricos , Detección Precoz del Cáncer/métodos , Adulto , Anciano , Diabetes Mellitus/epidemiología , Diabetes Mellitus/diagnóstico , Neoplasias/epidemiología , Neoplasias/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/uso terapéuticoRESUMEN
INTRODUCTION: Problematic usage of the internet (PUI) is perhaps one of the most frequently studied phenomena of the 21st century receiving increasing attention in both scientific literature and the media. Despite intensive research there have been relatively few meaningful studies among elementary school students in Hungary and worldwide, who may be considered as a high-risk population with regard to problematic internet use. The aim of our study was to carry out a complex research focusing on the prevalence and risk factors of PUI among elementary school children aged 10-15 years (Grade 5-8). METHODS: Demographics included were gender, age, place of stay, type of residence, family type, parental education, start of internet use, used devices, daily internet use, purpose of internet use, internet accounts, ways of keeping in touch with friends and sporting activities. PUI was evaluated using the paper-based version of the Potentially Problematic Use of the Internet Questionnaire. RESULTS: Overall, 2000 paper-based questionnaires were successfully delivered and the final analysis included 1168 responses (overall response rate 58.4%). Mean age was 12.55 ± 1.24 years. Female gender (OR = 2.760, p = 0,006, CI 95% 0.065 to 0.384), younger age (11-12 years) (OR = 3.812, p < 0.001, 95% CI: 1.747-4.731), early exposure to the internet (OR = 3.466, p = 0.001, 95% CI 1.535-5.446), living in a small village (OR = 1.081, p = 0.002, 95% CI 1.041-1.186) urgency to answer online (OR = 4.677, p < 0.001, 95% CI: 2.714-6.639), decreased frequency of personal contact with friends (OR = 2.897, p = 0.004, 95% CI: 1.037-1.681), spending more than 6 h online (OR = 12.913, p < 0.001, 95% CI: 10.798-14.892), morning and nighttime internet use (OR = 3.846, p < 0.001, CI 95% 1.886-5.810) and never doing any sports (OR = 2.016, p = 0.044, 95% CI: 1.050-3.354) were independently associated with problematic internet use. CONCLUSIONS: Based on the results of our questionnaire survey more than 10% seemed to be problematic users in our study population, which is a relatively high rate. Early exposure to the internet as well as younger age were strongly related to this phenomenon. Duration of being online as well as daily time interval of internet use are important predisposing factors. Scarcely studied social factors such as being online at the expense of personal relationships and the lack of physical activity should be payed more attention to prevent the development of PUI.
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Conducta Adictiva , Instituciones Académicas , Niño , Humanos , Femenino , Adolescente , Estudios Transversales , Hungría , Estudiantes , Encuestas y Cuestionarios , Internet , Conducta Adictiva/epidemiologíaRESUMEN
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.
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Conducta Adictiva , Agotamiento Profesional , Trastornos del Inicio y del Mantenimiento del Sueño , Masculino , Femenino , Adolescente , Humanos , Adulto Joven , Adulto , Depresión/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Calidad de Vida , Estudios Transversales , Hungría/epidemiología , Conducta Adictiva/epidemiología , Agotamiento Psicológico , Estudiantes , InternetRESUMEN
BACKGROUND: Occupational accidents are rising, but there is little evidence on the outcomes of patients who received case management during Return to work (RTW) programs. This study examined the case management-based on RTW program features that improve the work ability index (WAI) and quality of life (QoL). METHODS: This cross-sectional research involved 230 disabled workers due to an occupational injury in Indonesia, 154 participated in RTW, and 75 did not participate in RTW (non-RTW) during the COVID-19 pandemic. Sociodemographic and occupational factors were used to examine the RTW results. We used the Finnish Institute of Occupational Health's WAI questionnaires to measure the work ability index and World Health Organization Quality of Life Brief Version (WHOQOL-BREF) for quality of life. RESULTS: The study found a statistically significant difference in working duration and preferred treatment for RTW between the groups (p-value = 0.039). Furthermore, the quality of life in the domain of environmental health and work ability index score also demonstrated a significant difference between the groups (p-value = 0.023 and 0.000, respectively). CONCLUSIONS: During the COVID-19 pandemic, this study found that the RTW program improved the quality of life and work abilities of disabled workers.
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COVID-19 , Reinserción al Trabajo , Humanos , Estudios Transversales , Calidad de Vida , Pandemias , Evaluación de Capacidad de TrabajoRESUMEN
Peripheral artery disease (PAD) is a progressive atherosclerotic disease significantly impacting functional status and health-related quality of life (HRQoL). This study aimed to investigate HRQoL among PAD patients in Hungary using the validated Hungarian version of the PADQoL questionnaire. Patients with symptomatic PAD were consecutively recruited from the Department of Angiology, Clinical Center, University of Pécs, Hungary. Demographics, risk factors, and comorbidities were registered. Disease severity was measured by Fontaine and WIFI stages. Descriptive statistical analysis, Chi-square test, and non-parametric tests were performed (p < 0.05). Overall, 129 patients (mean age 67.6 ± 11.9 years, men 51.9%) participated in our study. The Hungarian PADQoL demonstrated good internal consistency (α range: 0.745-0.910). Factors on intimate and social relationships gave the best (89.15 ± 20.91; 63.17 ± 26.05) and sexual function (28.64 ± 27.42), and limitations in physical functioning (24.68 ± 11.40) the worst scores. PAD had a significant negative impact on the social relationships of patients aged 21-54 years (51.6 ± 25.4). Fontaine stage IV patients experienced significantly lower HRQoL due to fear and uncertainty (46.3 ± 20.9) and limited physical functioning (33.2 ± 24.8). The Hungarian PADQoL identified central aspects of HRQoL. Advanced PAD was found to impact several areas of HRQoL, primarily physical functioning and psycho-social well-being, drawing attention to the importance of early diagnosis and management.
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Enfermedad Arterial Periférica , Calidad de Vida , Masculino , Humanos , Persona de Mediana Edad , Anciano , Hungría , Enfermedad Arterial Periférica/epidemiología , Comorbilidad , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
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.
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Agotamiento Profesional , Calidad de Vida , Masculino , Humanos , Femenino , Estudios Transversales , Hungría/epidemiología , Prevalencia , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Agotamiento Psicológico , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
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.
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Conducta Adictiva , Trastorno de Adicción a Internet , Ansiedad , Trastornos de Ansiedad , Relaciones Familiares , Humanos , Relaciones Interpersonales , Factores de RiesgoRESUMEN
Past decades have witnessed a major epidemiologic transition with a considerable increase in the disease burden associated with atherosclerotic cardiovascular diseases (CVDs), with low-income and middle-income countries (LMICs) experiencing substantial increase in CVDs. As the global population is aging and peripheral artery disease (PAD) is strongly age-related, it is estimated to become increasingly prevalent in the future. PAD shares risk factors with coronary and cerebrovascular risk factors, particularly diabetes mellitus and smoking, and is associated with significant CVD morbidity and mortality. Despite advances in therapeutic modalities, 236 million people were estimated to be suffering from PAD worldwide in 2015, and numbers have been rising since. The prevalence of asymptomatic PAD has remained high; PAD prevalence seems higher among women and is related to ethnicity. Although several epidemiological studies have been published on PAD during the past decades, data from LMICs are scarce. Besides providing up-to-date epidemiological data retrieved from the literature and the Global Burden of Disease (GBD) study database, this narrative review also intends to draw attention to the substantial disease burden of PAD manifesting in more Years of Life Lost (YLL), age-adjusted mortality and amputation rates, with a special focus on some European countries and especially Hungary, i.e., the country with the highest amputation rate in Europe.
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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.
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Conducta Adictiva , Juegos de Video , Adolescente , Adulto , Conducta Adictiva/epidemiología , Niño , Femenino , Humanos , Hungría/epidemiología , Internet , Uso de Internet , Masculino , Prevalencia , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) is the second most common cause of optic nerve-related permanent visual loss in adults. AIM: We aimed to analyze the efficacy of the noninvasive and minimally invasive therapeutic options of NAION. METHODS: We performed a systematic literature search in MEDLINE, EMBASE, and CENTRAL from inception to 10 June 2019 to identify the studies that report on the effect of different therapies on visual acuity (VA) and visual field (VF). Weighted mean difference (WMD) with 95% confidence interval (CI) was calculated for these outcomes. The efficacy of steroids was investigated in quantitative, oxygen, steroid plus erythropoietin (EPO), levodopa/carbidopa, memantine, and heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP) therapies and other therapeutic modalities in qualitative synthesis. RESULTS: Thirty-two studies were found to be eligible. We found that steroid therapy compared to control did not improve VA (p = 0.182, WMD = 0.14, 95% CI: -0.07, 0.35) or VF (p = 0.853, WMD = 0.16, 95% CI: -1.54, 1.86). Qualitative analysis could be performed for oxygen, steroid plus EPO, and HELP as well, however, none of them showed VA and VF benefit. Two individual studies found memantine and levodopa beneficial regarding VA. CONCLUSION: Our systematic review did not reveal any effective treatment. Further investigations are needed to find therapy for NAION.
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Neuropatía Óptica Isquémica , Adulto , Humanos , Levodopa/uso terapéutico , Memantina/uso terapéutico , Neuropatía Óptica Isquémica/tratamiento farmacológico , Neuropatía Óptica Isquémica/cirugía , Oxígeno , Esteroides/uso terapéutico , Agudeza VisualRESUMEN
Diabetes mellitus influences several important hemorheological parameters including blood viscosity, erythrocyte aggregation and deformability. In the present study, 159 type-2 diabetic patients and 25 healthy controls were involved. Patient's age, body weight, body mass index (BMI), smoking habits, physical activity, history of cardiovascular diseases, current antidiabetic therapy and concomitant medication were recorded. Patients were grouped according to their antidiabetic treatment with insulin, or with one or more of the following antidiabetic drugs: metformin, sulfonylureas, acarbose, or no antidiabetic therapy. Hemorheological measurements (hematocrit, erythrocyte aggregation, plasma fibrinogen, whole blood and plasma viscosity), von Willebrand factor activity, and platelet aggregation measurements were performed. Platelet aggregation was investigated with the method of Born. Plasma viscosity and red blood cell aggregation were significatly higher in diabetes. No significant difference was found in hemorheological parameters between different antidiabetic regimens. Whole blood and plasma viscosity and red blood cell aggregation correlated with glucose levels but not with HbA1C levels. In conclusion, plasma and whole blood viscosity, as well as red blood cell aggregation appear to be associated with concurrent hyperglycemia, but not with the quality of glycemic control or the applied antidiabetic treatment. Platelet aggregation induced by ADP or epinephrine does not seem to be associated with diabetes even at subthreshold doses.
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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.
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Agotamiento Profesional , Salud Laboral , Horario de Trabajo por Turnos , Adulto , Trastornos de Ansiedad , Agotamiento Profesional/epidemiología , Humanos , Encuestas y Cuestionarios , Compromiso LaboralRESUMEN
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.
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Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/tratamiento farmacológico , Isquemia Encefálica/epidemiología , Femenino , Fibrinolíticos/uso terapéutico , Humanos , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/tratamiento farmacológico , Accidente Cerebrovascular/epidemiología , Terapia Trombolítica , Resultado del TratamientoRESUMEN
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.
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Agotamiento Profesional , Adulto , Agotamiento Profesional/epidemiología , Personal de Salud , Humanos , Persona de Mediana Edad , Factores de Riesgo , Apoyo Social , Encuestas y CuestionariosRESUMEN
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.
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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.