Healthcare-seeking of medical students: the effect of socio-demographic factors, health behaviour and health status - a cross-sectional study in Hungary.

BACKGROUND: Medical students are more likely to have various physical and psychological issues, but less information is available about the healthcare-seeking behaviour for physical and mental health issues. The aim of this study is to determine the factors affecting medical students' healthcare-seeking when visiting a general practitioner (GP) and/or psychologist. METHODS: 688 medical students (326 International and 362 Hungarian,) participated in a cross-sectional study. The information was gathered using a self-administered online questionnaire and covered socio-demographic background, health behaviour, general and mental health status and healthcare-seeking. For analysing adjusted associations, multivariable logistic regression models were used. RESULTS: Overall, 56.8% of medical students visit the GP; and 17.2%, the psychologist. Hungarian medical students visited the GP with chronic diseases, International medical students were more likely to visit a GP when they encountered sexual activity and had chronic diseases. Moreover, there was a significant correlation between sex, alcohol consumption, and perceived stress in the total sample of psychologist visits. When Hungarian medical students were in their clinical years and had a poor self-rated mental health, they were more likely to visit a psychologist. Whereas female international medical students and those who had poor self-rated mental health were more likely to seek psychological help. CONCLUSION: Students visit a GP and/or psychologist is associated with a variety of factors, including socio-demographic background, health behaviours, and health issues. Medical schools should encourage help-seeking behaviours and early disclosure of medical students. Their ability to grasp healthcare attitudes and designing treatments will be important for both their academic success and future profession.

Effect of osteoarthritis and its surgical treatment on patients' quality of life: a longitudinal study.

BACKGROUND: Osteoarthritis (OA) is one of the primary causes of pain and disability worldwide leading to patients having some of the worst health-related quality of life (QOL). The purpose of our study was to investigate the progression of the generic and disease-specific QOL of osteoarthritic patients going through total hip or knee replacement surgery and the factors that might alter the effect of surgery on QOL. METHODS: A longitudinal study was performed based on data collected from 120 OA patients who filled in the short version of the WHO's generic measure of quality of life (WHOQOL-BREF) and the disease-specific Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and after surgery. RESULTS: Domains related to physical health status showed relatively lower scores in patients before surgery. Patients reported a significant increase of QOL after surgery in the WHOQOL-BREF physical domain, especially if they were from the younger group (< 65 years, p = 0.022) or had a manual job (p = 0.008). Disease-specific QOL outcome results indicate that overall patients gained significantly better QOL in all domains of the WOMAC score. Patients with hip OA seemed to have the most benefit of their operation as they reported better outcome in WOMAC pain (p = 0.019), stiffness (p = 0.010), physical function domains (p = 0.011) and total score (p = 0.007) compared to knee OA patients. CONCLUSION: There was a statistically significant improvement in all domains concerning physical functions in the study population. Patients also reported significant improvement in the social relationship domain, which indicates that OA itself as well as its management might have a profound effect on patients' life beyond the reduction of their pain.

[Knowledge and attitudes about vaccinations among medical students during the COVID-19 pandemic]. / A védooltásokkal kapcsolatos ismeretek és attitudök orvostanhallgatók körében a COVID­19-pandémia alatt.

INTRODUCTION: In Hungary, regarding the age-related mandatory vaccinations, the population is almost 100% vaccinated. In the case of recommended vaccinations, however, the situation is less favourable, and during the COVID-19 pandemic, anti-vaccination sentiment has also appeared in some groups to a greater extent than before. Reducing this is the task of all health professionals. OBJECTIVE: The exploration of knowledge and attitudes about vaccinations, and the analysis of the characteristics of these factors according to gender, year and vaccine willingness/hesitancy among medical students at the University of Szeged. METHOD: The cross-sectional study was conducted among first and fourth year medical students of the University, using an online questionnaire, which examined, in addition to sociodemographic characteristics, the administration of influenza and COVID-19 vaccinations, the self-assessment of knowledge about vaccinations, the importance of vaccinations, and student opinions about recommended vaccinations. RESULTS: Based on the definition of the WHO Strategic Advisory Group, 88.6% of the students belonged to the "vaccine willingness" group, who administered the vaccine against COVID-19 as soon as it became available, while the "vaccine hesitancy" group (11.4%) only asked for the vaccine when vaccination was made mandatory or not even then. According to the model adjusted to gender and year, those who showed willingness to vaccinate were more likely to consider the use of vaccinations, counselling, etc. important than those who were hesitant, while there was no correlation with the self-rating of knowledge. On the basis of the odds ratio of the statements related to the recommended vaccinations, it was possible to identify the opinions associated with vaccine willingness or hesitancy. DISCUSSION: Overall, student knowledge and attitudes showed a positive picture. On the other hand, it should be emphasized that the misconceptions identified among students showing vaccine hesitancy are the same as the anti-vaccination sentiments found among the general population. CONCLUSION: During university training, more emphasis should be placed on monitoring the willingness of students to be vaccinated, and on developing knowledge and communication. Orv Hetil. 2023; 164(21): 803-810.

Female Sexual Dysfunction in Association with Sexual History, Sexual Abuse and Satisfaction: A Cross-Sectional Study in Hungary.

Female sexual dysfunction (FSD) has a negative impact on women's quality of life, self-esteem, and physical health. The aim of the present study was to explore the prevalence and the factors associated with FSD using an online questionnaire. A cross-sectional survey was conducted among young adults (18-35 years old) in Hungary using the DSM-5 criteria. The participants (n = 5942) were divided into three major groups: FSD (20.3%), an intermediate group (43.9%), and a control group (35.6%). Most of the women showing FSD were affected with female orgasmic disorder (9.2%) and genito-pelvic pain/penetration disorder (4.6%), while female sexual interest/arousal disorder was found in altogether 100 women (1.7%); 4.8% of women were affected by more than one definite disorder. The occurrence of female sexual dysfunction was related to the women's previous sexual history (first sexual experience, sexual education, early encounter with pornographic content, and sexual abuse), their self-satisfaction (with their own body, genitalia, and sexual attraction), and their sexual orientation. Sexual dysfunction showed a strong association with abuse, sexually transmitted diseases, and self-esteem. The present study identified the relationship between sexual dysfunctions and other health conditions, which can be the basis for some form of screening and early assistance programs for FSD.

International medical students' acculturation and self-rated health status in Hungary: a cross-sectional study.

BACKGROUND: Over the past few decades, the number of international students has increased dramatically. These students have to adjust to unfamiliar social, cultural, and educational environments. The concept of acculturation has been applied in multiple studies on various health outcomes. This study investigated the relationship between acculturation and self-rated health (SRH) among international medical students. METHODS: A cross-sectional study was conducted among international medical students at the University of Szeged, Hungary between April and October 2021. A total of 326 participants filled out questionnaires about sociodemographic characteristics, acculturation, and SRH. The modified Stephenson multigroup acculturation scale (SMAS) was used to assess the acculturation status; the scale defined acculturation as the degree of dominant society immersion (DSI, 12 items) and ethnic society immersion (ESI, 16 items). To measure SRH, participants were asked to rate their current general health and mental health. The data were analyzed by using descriptive statistics and the multiple logistic regression model. RESULTS: 32.5% of the students reported having poor general and 49.7% poor mental health. We have found that acculturation was associated with SRH in multivariable logistic regression models controlling for sociodemographic characteristic. Bidimensional acculturation, such as ESI and DSI significantly influenced SRH as the likelihood of poor general health decreased (OR = 0.50; 95% CI = 0.31-0.81, P = 0.005), when the ESI was higher, whereas the likelihood of poor mental health decreased (OR = 0.52; 95% CI = 0.35-0.79, P = 0.002) if students had a greater DSI. CONCLUSION: Both types of immersion can affect the students' SRH. If the student could integrate better into their own ethnic group, their general health was better, and if they could strongly integrate into the Hungarian society, their mental health was more favorable. Acculturation measures should be promoted by academics and public health professionals in order to better understand their role in the behaviors, health outcomes, and health care use of medical international students. These findings will help professionals shape culturally sensitive prevention and counselling strategies for international student populations.

Association between sociodemographic, obstetric, and lifestyle factors among Hungarian pregnant women-A cross-sectional study.

AIM: To learn the association between sociodemographic and obstetric factors and lifestyle characteristics of pregnant women, and to identify factors that can influence pregnant women's health consciousness. METHODS: A cross-sectional, questionnaire-based study was performed among women who gave birth in Szeged in 2014-2015. Data collection was based on a self-administered questionnaire and health documentations. Overall maternal health promoting behavior (MHPB) index was defined by summarizing the scores obtained from diet, physical activity, smoking status, and alcohol consumption. RESULTS: The final analysis included 1548 mothers; 41.3% (n = 602) of the sample had healthy diet, 9.0% (n = 134) were physically active and attended special pregnancy exercise classes, 84.4% (n = 1279) did not drink alcohol, and 93.5% (n = 1447) were nonsmokers. Regarding the MHPB index, 0.8% (n = 11) of the women reached the maximum score (20), while the average was 14.8 (SD = 2.58). Advanced maternal age (p < 0.001), having a spouse or partner (p < 0.001), higher educational level (p < 0.001), planned pregnancy (p < 0.001), and early visit at pregnancy care (p = 0.046) were significantly associated with higher MHPB index. CONCLUSION: The lifestyle of pregnant women can have a great impact on the developing fetus, either in a positive or negative way. In order to evaluate maternal lifestyle, overall health behavior should be considered. Lifestyle of the included women was not satisfactory, an improvement in health consciousness is needed at every social level; however, the differences between the various social classes may suggest the importance of further promotion and improvement of pregnancy planning and pregnancy care among younger and lower educated women.

Healthcare Professionals' Compliance with the Standard Management Guidelines towards the Use of Biological Disease-Modifying Anti-Rheumatic Drugs in Rheumatoid Arthritis Patients.

Treatment of rheumatoid arthritis (RA) is complicated, with numerous aspects influencing decision-making, including disease severity, comorbidities, and patient preferences. The present study aimed to evaluate healthcare professionals' (HCPs) knowledge of biological disease-modifying anti-rheumatic drugs (bDMARDs) and their compliance with the standard management guidelines for assuring optimal RA therapy. The cross-sectional, survey-based study was performed in various healthcare and academic settings in Karachi, Pakistan to probe HCPs' knowledge of bDMARDs and their compliance with the European League against Rheumatism (EULAR) recommendations for the management of RA patients. Overall, n = 413 questionnaires were included in our study (response rate: 82.6%). The physicians were further well-informed about the indications (n = 276, 91.3%, p = 0.001) and monitoring requirements (n = 258, 85.4%, p = 0.004). The pharmacists were more knowledgeable about the drug targets (n = 96, 86.4%, p = 0.029) and their mechanisms of action (n = 80, 72.0%, p = 0.013). Male respondents as compared with females (41.3% vs. 35.6%, p = 0.04), and physicians as compared with pharmacists (40.7% vs. 37.8%, p = 0.012), were more confident in using bDMARDs than conventional treatment in RA patients. Our findings show that the respondents were familiar with the attributes of bDMARDs and the standard management guidelines for RA care. Our results may be relevant in creating new methods, guidelines, and treatments to enhance RA treatment adherence, satisfaction, and health outcomes.

Factors Influencing Pain Management of Patients with Osteoarthritis: A Cross-Sectional Study.

BACKGROUND: Osteoarthritis (OA) is a complex disease associated with chronic pain. Many patients treat their joint pain at a symptomatic level with over-the-counter (OTC) pain medications, often without the knowledge of their physicians. The aim of this study was to provide physicians with data about osteoarthritic patients' habits of pain management and to examine the explanatory factors of various ways of self-treatment. METHODS: A cross-sectional study involving 189 patients with hip or knee OA and scheduled for joint replacement surgery was carried out. Participants filled out a self-administered questionnaire consisting of the Western Ontario and McMaster Universities Osteoarthritis Index and questions about their methods of alleviating pain. RESULTS: 2.6% of patients did not use anything to alleviate their pain, while 63% practiced a non-pharmacological method. Diclofenac was the most frequently used drug, followed by ibuprofen. Profession had the greatest impact on medication habits; patients doing manual work were significantly more likely to take OTC non-steroidal anti-inflammatory drugs and use topical analgesics. CONCLUSIONS: Patients utilized a wide variety of pain management techniques. They seemed to use well-known painkillers, even if their side effects were less desirable. Such patients require comprehensive pain management, including educational and behavioural interventions, complemented by topical and oral medication.

Suicide Attempts among School-Attending Adolescents in Mongolia: Associated Factors and Gender Differences.

Attempting suicide is an important risk factor that can lead to suicide death. The aim of the current study was to examine the prevalence of suicide attempts and to identify the gender-specific predictors of suicide among adolescents in Mongolia. We analyzed data from the 2019 Mongolian Global School-Based Health Survey (GSHS) conducted nationwide among 13-18-year-old students. Univariable and multivariable analyses were performed to assess the correlates of suicide attempts. Overall, 32.1% of the adolescents reported to have had suicide attempts. Multivariable analysis showed a significant association in the total sample of suicide attempts with lack of close friends, anxiety, injury and violence, smoking and alcohol drinking, and sexual intercourse. Male suicide attempters were less likely to have close friends and more likely to have injuries, been physically attacked, been bullied, smoke, drink alcohol, and have had sexual intercourse. Within the female subgroup, anxiety, injury and violence, smoking and alcohol drinking significantly increased the odds of reporting suicide attempts. Increase of the student's age by one year decreased the odds ratio of suicide attempts. Nearly one in three students had had a suicide attempt. Several factors, including mental distress, violence, and risky behaviors were found to be associated with suicide attempts. These can aid in designing intervention strategies for preventing suicidal behaviors among adolescents.

Students in Danger: Binge Drinking Behaviour and Associated Factors in Hungary.

INTRODUCTION: Among young adults, high rates of binge drinking were observed in certain European countries. Binge drinking is associated with several health problems (unplanned pregnancy, HIV infections, problems with memory, and injuries). The aim of this questionnaire-based study was to measure the frequency of binge drinking and its association with sociodemographic, familial, lifestyle factors and school performance among secondary and university students (n=2449) in Csongrád County, Hungary. METHODS: In this cross-sectional study the students' sociodemographic data, parents' educational and economic level, and students' academic performance and self-reported use of tobacco, drugs, and alcohol were collected by a questionnaire. Descriptive statistics and multivariable binary logistic regression analyses were applied using SPSS 24.0 software. RESULTS: Altogether 2449 Hungarian secondary school students and university students participated in the study. Nearly one-third of the students were classified as binge drinkers, significantly more male university students. Tobacco or illicit drug use resulted in higher odds of being a binge drinker in both subgroups. Poor school performance and binge drinking were significantly correlated especially among secondary school students. CONCLUSIONS: Targeting alcohol, tobacco, and illicit drug use together, including education, parent interventions, and public health policies, are crucial in the prevention of possible serious consequences.

Exploring the effort-reward structure of university work focusing on perceived overall stress, self-reported health, and musculoskeletal disorders.

BACKGROUND: The effort-reward imbalance (ERI) model by Siegrist encouraged numerous scientific investigations that reported particular ties between psychosocial risks and poor self-reported health (SRH), while psychosocial work-related stress has also been linked to musculoskeletal disorders (MSDs). The aim of this study was to examine the health status and the perceived levels of occupational stress of university employees and to analyse the findings according to the employees' effort and reward structure of work, perceived overall stress, SRH and the presence of MSDs.   Design and methods: 398 employees - including healthcare professionals, academic personnel and workers with administrative or other jobs - employed at the University of Szeged, Faculty of Medicine were investigated with a self-administered questionnaire including the Effort-Reward Imbalance Questionnaire (ERI-Q) and Perceived Stress Scale 4 (PSS-4). RESULTS: More than half of the investigated subjects (54.8%) reported some forms of MSDs. Low self-reported health (p<0.001) and presence of MSDs (p=0.015) were significantly associated with the level of perceived stress and effort-reward imbalance (ERI), moreover increased level of perceived stress was independently associated with the likelihood of MSDs (AOR=1.13) and low self-reported health (AOR=1.30). ERI well predicted low self-reported health (AOR=2.05) as well. Increased level of perceived stress positively correlated with high work-related effort (r=0.247, p<0.001) and over-commitment (r=0.387, p<0.001) while with work-related reward (r=-0.181, p=0.011) perceived stress showed a negative connection. CONCLUSION: Our results suggest that addressing the burden of effort-reward imbalance and MSDs would likely lessen employees' perceived level of overall stress and affect their self-reported overall state of health.

Diabetic Retinopathy Screening in Patients with Diabetes Using a Handheld Fundus Camera: The Experience from the South-Eastern Region in Hungary.

PURPOSE: Diabetic retinopathy (DR) is the leading cause of vision loss among active adults in industrialized countries. We aimed to investigate the prevalence of diabetes mellitus (DM), DR and its different grades, in patients with DM in the Csongrád County, South-Eastern region, Hungary. Furthermore, we aimed to detect the risk factors for developing DR and the diabetology/ophthalmology screening patterns and frequencies, as well as the effect of socioeconomic status- (SES-) related factors on the health and behavior of DM patients. METHODS: A cross-sectional study was conducted on adults (>18 years) involving handheld fundus camera screening (Smartscope Pro Optomed, Finland) and image assessment using the Spectra DR software (Health Intelligence, England). Self-completed questionnaires on self-perceived health status (SPHS) and health behavior, as well as visual acuity, HbA1c level, type of DM, and attendance at healthcare services were also recorded. RESULTS: 787 participants with fundus camera images and full self-administered questionnaires were included in the study; 46.2% of the images were unassessable. T1D and T2D were present in 13.5% and 86.5% of the participants, respectively. Among the T1D and T2D patients, 25.0% and 33.5% had DR, respectively. The SES showed significant proportion differences in the T1D group. Lower education was associated with a lower DR rate compared to non-DR (7.7% vs. 40.5%), while bad/very bad perceived financial status was associated with significantly higher DR proportion compared to non-DR (63.6% vs. 22.2%). Neither the SPHS nor the health behavior showed a significant relationship with the disease for both DM groups. Mild nonproliferative retinopathy without maculopathy (R1M0) was detected in 6% and 23% of the T1D and T2D patients having DR, respectively; R1 with maculopathy (R1M1) was present in 82% and 66% of the T1D and T2D groups, respectively. Both moderate nonproliferative retinopathy with maculopathy (R2M1) and active proliferative retinopathy with maculopathy (R3M1) were detected in 6% and 7% of the T1D and T2D patients having DR, respectively. The level of HbA1c affected the attendance at the diabetology screening (HbA1c > 7% associated with >50% of all quarter-yearly attendance in DM patients, and with 10% of the diabetology screening nonattendance). CONCLUSION: The prevalence of DM and DR in the studied population in Hungary followed the country trend, with a slightly higher sight-threatening DR than the previously reported national average. SES appears to affect the DR rate, in particular, for T1D. Although DR screening using handheld cameras seems to be simple and dynamic, much training and experience, as well as overcoming the issue of decreased optic clarity is needed to achieve a proper level of image assessability, and in particular, for use in future telemedicine or artificial intelligence screening programs.

Prevalence and Correlates of Poor Oral Hygiene among School-Going Students in Mongolia.

Brushing at least twice a day is one of the most effective methods for the prevention of dental caries and oral diseases. The aim of the present study was to determine the prevalence and correlates of poor oral hygiene in Mongolian school-going students. A secondary analysis of nationally representative data from the 2013 Mongolian Global School-based Health Survey (GSHS) was performed. In the survey, a questionnaire was completed by 5393 students aged 12-16 years old. The prevalence of poor oral hygiene and its association with some independent variables were analyzed by frequency distribution, chi-squared test, and logistic regression. The overall prevalence of poor oral hygiene was 33%. In the multivariate analysis, male students, inadequate fruit and vegetable intake, parents' smoking, being exposed to second-hand smoke, poor parental supervision and connectedness, physical inactivity, and sedentary behavior were significantly associated with poor oral hygiene. Meanwhile, students who ate fast food and drank carbonated soft drink were found to be less likely to be poor tooth-brushers in 2013. Various determinants were identified in connection with poor oral hygiene. Based on these findings, it is recommended that an oral health promotion program should be combined with general health promotion and lifestyle intervention programs for this target population.

Knowledge, Attitude and Practice of Community Pharmacists Regarding Antibiotic Use and Infectious Diseases: A Cross-Sectional Survey in Hungary (KAPPhA-HU).

One of the key drivers for the emergence and spread of antimicrobial resistance (AMR) is non-prudent antibiotic (AB) use, which results in selection pressure towards relevant bacteria. Community pharmacists have pivotal roles in facilitating the prudent use of ABs that have been demonstrated by several studies worldwide. The aim of our present study was to evaluate the knowledge, attitude and practice of community pharmacists related to AB use and infectious diseases in Hungary. A descriptive cross-sectional survey was performed among community pharmacists in Hungary with the use of an anonymous, structured and pilot-tested questionnaire. Data collection ran between January 2016 and January 2018; n = 339 community pharmacists nationwide were approached with our questionnaire, out of which 192 filled out our survey. Hungarian pharmacists have appropriate knowledge regarding ABs and antimicrobial therapy, and they realize the public health impact of the growing AMR. Twenty-five percent of participants admitted to giving out non-prescription ABs at least once in the last year. The age and presence of board-certified specializations were shown to be significant factors of self-perceived knowledge and professional attitudes. Educational strategies and interventions specifically aimed at focusing on identified shortcomings and changing certain attitudes could substantially improve AB dispensing and AB use, in addition to minimizing resistance.

Psychosocial Work Environment Risk Factors Among University Employees - A Cross-sectional Study in Hungary.

INTRODUCTION: National and international research results have highlighted the fact that workplace stress causes mental and somatic problems. The aim of the present paper is to define exposure to workplace-related risk factors, with special focus on psychosocial risk factors, and the way they interconnect with workplace conditions, relationships with superiors and colleagues, and moral, professional and financial appreciation. METHODS: Cross-sectional research with the help of an anonymous online self-administered questionnaire was carried out among 261 higher education employees (67% women, 33% men, mean age 43.4 years) from 12 faculties of the University of Szeged, Hungary. Statistical analysis was performed using IBM SPSS 22.0. RESULTS: The primary workplace stress factors for university employees were strict deadlines (80.4%), frequent overwork (64.2%) and difficulty in meeting requirements (56.7%). Communication problems with colleagues and superiors were also highlighted (47.5%). Job strain was higher for women than for men. With regard to low financial, professional, and moral appreciation, employees were characterised by the existence of work requirements impossible to meet, as well as by low autonomy. Experience of anxiety and aggression came along with low financial and moral appreciation (p<0.001). CONCLUSIONS: Our data suggests that employees at the university were subject to several psychosocial risk factors, and worked under considerable mental stress, leading to a higher prevalence of mental health problems. The results highlight the need for a health-focused policy-making in higher education to reduce health expenditure and increase efficiency at work.

Adolescent smoking and the social capital of local communities in three counties in Romania / El consumo de tabaco en adolescentes y el capital social de las comunidades sociales en tres condados de Rumania

Objective: To identify the effect of social capital on adolescent smoking. Method: A stratified random sample of 1313 7th and 8th grade students from three counties in Transylvania, Romania, completed a self-administered questionnaire on smoking-related knowledge, attitudes and behaviours. The impact of social capital was measured (personal and community activities, school achievements and smoking-related knowledge). Multivariate multinomial logistic regression models were used to measure the association between social participation and smoking. Results: Experimenting with smoking was mostly related to knowledge about smoking, academic performance and second-hand tobacco smoke exposure at home. The strongest risk factor of adolescent smoking was the smoking behaviour of classmates: those who reported a significant proportion of smokers among their classmates were nine times more likely to smoke themselves than in other cases (adjusted odds ratio [aOR]: 9.05). Those who considered smoking to be harmless were 4 times more likely to be smokers than those who considered this behaviour to be dangerous (aOR: 4.28). Poor academic results increased adolescents' smoking (aOR: 3.22 and 2.66). The odds were significantly higher for smoking, if they had an active social life (aOR: 2.54). Regular church attendance proved to be a protective factor (aOR: 0.45). Conclusions: Several social capital factors can play a role in adolescent smoking. The organization and the development of community activities aimed at prevention must strengthen the factors related to the community's social capital to reduce the likelihood of teenage smoking

Objetivo: Evaluar el efecto del capital social sobre el consumo de tabaco en adolescentes. Método: El estudio se realizó en un grupo aleatorizado y estratificado compuesto por 1313 estudiantes de séptimo y octavo grado de tres municipios en Transilvania (Rumanía). Los participantes contestaron un cuestionario autocumplimentado en relación con el consumo de tabaco y sobre actitudes y comportamientos respecto a este. El impacto del capital social, entendido como actividades personales y comunitarias, así como el desarrollo académico y la información sobre el consumo de tabaco, fueron algunas de las medidas. Resultados: Experimentar con el hábito de fumar se relaciona principalmente con el conocimiento sobre dicha adicción, el rendimiento académico y la exposición al consumo de tabaco en el hogar. El mayor riesgo para el consumo se deriva de la interacción con compañeros de clase que incurren en el consumo de tabaco. En tal caso, la probabilidad de consumo aumenta nueve veces (odds ratio ajustada [ORa]: 9,05). Quienes consideraron que fumar es inofensivo tuvieron cuatro veces más probabilidades de ser fumadores que quienes consideraron este comportamiento como peligroso (ORa: 4,28). En cuanto a los/las estudiantes con bajo rendimiento académico se observa un mayor incremento del consumo (ORa: 3,22 y 2,66). Al mismo tiempo, dicho patrón también se observa entre aquellos/as con un entorno social activo (ORa: 2,54). La asistencia a la iglesia de manera regular es un factor protector (ORa: 0,45). Conclusiones: Diferentes aspectos relacionados con el capital social se asocian al consumo de tabaco en adolescentes. La organización de actividades y el desarrollo comunitario deberán tener en cuenta estos aspectos para prevenir el consumo de tabaco. Hay que prestar especial atención a la clase social con el fin de reducir las probabilidades de consumo en adolescentes

Abdominal obesity increases metabolic risk factors in non-obese adults: a Hungarian cross-sectional study.

BACKGROUND: The prevalence of abdominal obesity is increasing worldwide. Adults with abdominal obesity have been reported to have increased risk of cardiometabolic disorders. The aim of this study was to examine whether non-obese subjects (body mass index (BMI) < 25 kg/m2) with abdominal obesity examined in the framework of the Swiss-Hungarian Cooperation Programme had increased metabolic risk compared to participants without abdominal obesity. METHODS: A cross-sectional study was carried out in 5228 non-obese individuals. Data were collected between July 2012 and February 2016. Descriptive statistics, Pearson's correlation analysis and multiple logistic regression models were applied, odds ratios (OR) with 95% confidence interval (CI) being the outcomes. RESULTS: 607 (11.6%) out of the 5228 non-obese individuals had abdominal obesity. The correlation analysis indicated that the correlation coefficients between BMI and waist circumference (WC) were 0.610 in males and 0.526 in females. In this subgroup, the prevalence of high systolic blood pressure, high fasting blood glucose, and high total cholesterol and triglyceride levels were significantly higher. The logistic regression model based on these data showed significantly higher risk for developing high systolic blood pressure (OR = 1.53; 95% CI = 1.20-1.94), low HDL cholesterol (OR = 2.06; 95% CI = 1.09-3.89), and high trygliceride level (OR = 1.65; 95% CI = 1.27-2.16). CONCLUSIONS: There was a very high, significant, positive correlation between WC and BMI. Abdominal obesity was found to be strongly related to certain metabolic risk factors among non-obese subjects. Hence, measuring waist circumference could be recommended as a simple and efficient tool for screening abdominal obesity and related metabolic risk even in non-obese individuals.

[Medical aspects of sexual education according to national and international guidelines]. / A szexuális nevelésrol orvosi szemmel a hazai adatok és a nemzetközi irányelvek tükrében.

INTRODUCTION: The prevention of early sexual life and its unwanted consequences is a worldwide problem. National and international surveys have shown that adolescents have their first sexual intercourse at a younger age. AIM: The study aimed to determine the way of sexual education of young people provided by physicians - general practitioners, paediatricians, obstetricians, gynaecologists etc. - in accordance with the results of a questionnaire-based study, the experiences gained during the interactive education and the suggestions of international guidelines dealing with sexual education. METHOD: Self-administered questionnaire-based study was performed among 13-18-year-old girls attending primary or secondary school (N = 868) between 2009 and 2016. The sexual activity of adolescent girls, their knowledge related to contraception and sexually transmitted infectious diseases, gynaecological (e.g., cancer screening) experiences were measured before sexual education performed by a gynaecologist. RESULTS: Every 4th girl had the first sexual act at the age of 14 or before, but at the same time their sexual knowledge was incomplete and there was a significant proportion of those who already have had sex but have never had a gynaecological examination. CONCLUSION: The results highlighted the educational deficiencies of reproductive life, which is a complex task to solve, to address the changing approach of national healthcare and education systems, to adopt and follow scientific evidence-based guidelines. All health-care workers who are in contact with adolescents during their work must be involved in the sexual education. It is essential to continue incorporating sex education into education from early childhood to young adult age. Orv Hetil. 2019; 160(13): 494-501.

Adolescent smoking and the social capital of local communities in three counties in Romania.

OBJECTIVE: To identify the effect of social capital on adolescent smoking. METHOD: A stratified random sample of 1313 7th and 8th grade students from three counties in Transylvania, Romania, completed a self-administered questionnaire on smoking-related knowledge, attitudes and behaviours. The impact of social capital was measured (personal and community activities, school achievements and smoking-related knowledge). Multivariate multinomial logistic regression models were used to measure the association between social participation and smoking. RESULTS: Experimenting with smoking was mostly related to knowledge about smoking, academic performance and second-hand tobacco smoke exposure at home. The strongest risk factor of adolescent smoking was the smoking behaviour of classmates: those who reported a significant proportion of smokers among their classmates were nine times more likely to smoke themselves than in other cases (adjusted odds ratio [aOR]: 9.05). Those who considered smoking to be harmless were 4 times more likely to be smokers than those who considered this behaviour to be dangerous (aOR: 4.28). Poor academic results increased adolescents' smoking (aOR: 3.22 and 2.66). The odds were significantly higher for smoking, if they had an active social life (aOR: 2.54). Regular church attendance proved to be a protective factor (aOR: 0.45). CONCLUSIONS: Several social capital factors can play a role in adolescent smoking. The organization and the development of community activities aimed at prevention must strengthen the factors related to the community's social capital to reduce the likelihood of teenage smoking.