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Background Early reports indicate that COVID-19 may require intensive care unit (ICU) admission in 5–26% and overall mortality can rise to 11% of the recognised cases, particularly affecting the elderly. There is a lack of evidence-based targeted pharmacological therapy for its prevention and treatment. We aim to compare the effects of a World Health Organization recommendation-based education and a personalised complex preventive lifestyle intervention package (based on the same WHO recommendation) on the outcomes of the COVID-19. Methods PROACTIVE-19 is a pragmatic, randomised controlled clinical trial with adaptive “sample size re-estimation” design. Hungarian population over the age of 60 years without confirmed COVID-19 will be approached to participate in a telephone health assessment and lifestyle counselling voluntarily. Volunteers will be randomised into two groups: (A) general health education and (B) personalised health education. Participants will go through questioning and recommendation in 5 fields: (1) mental health, (2) smoking habits, (3) physical activity, (4) dietary habits, and (5) alcohol consumption. Both groups A and B will receive the same line of questioning to assess habits concerning these topics. Assessment will be done weekly during the first month, every second week in the second month, then monthly. The composite primary endpoint will include the rate of ICU admission, hospital admission (longer than 48 h), and mortality in COVID-19-positive cases. The estimated sample size is 3788 subjects per study arm. The planned duration of the follow-up is a minimum of 1 year. Discussion These interventions may boost the body’s cardiovascular and pulmonary reserve capacities, leading to improved resistance against the damage caused by COVID-19. Consequently, lifestyle changes can reduce the incidence of life-threatening conditions and attenuate the detrimental effects of the pandemic seriously affecting the older population. Trial registration The study has been approved by the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (IV/2428- 2 /2020/EKU) and has been registered at clinicaltrials.gov ( NCT04321928 ) on 25 March 2020.

Psoriasis is a chronic inflammatory skin disease with well-documented psychological comorbidities, yet the mechanisms linking early life experiences to its psychosocial impact remain underexplored. This cross-sectional study examined the associations between childhood trauma, early maladaptive schemas (EMSs), and psychological distress in adults with psoriasis (n = 85), other chronic illnesses (n = 85), and healthy controls (n = 85). Participants completed validated self-report measures assessing childhood maltreatment (Childhood Trauma Questionnaire–Short Form), EMSs (Young Schema Questionnaire–Short Form), and symptoms of depression, anxiety, and stress (Depression Anxiety Stress Scale). Statistical analysis revealed that, relative to healthy controls, the psoriasis group endorsed higher Emotional Deprivation, Insufficient Self-Control, and Emotional Inhibition schemas, consistent with enduring emotion regulation difficulties. Psoriasis patients also reported greater depression symptoms than healthy controls, and higher anxiety and stress than both healthy and chronically ill controls. Although no between-group differences emerged in retrospectively reported childhood trauma, the pattern of schema elevations suggests that difficulties in early emotional development, such as unmet emotional needs or subtle forms of neglect, may have contributed to later vulnerability, reflected at the schema rather than the trauma-report level. Overall, the findings highlight schema-level vulnerabilities in psoriasis that may underlie psychological distress and potentially contribute to symptom maintenance. Clinically, brief screening for EMSs and emotion-regulation problems in dermatological settings may support risk stratification and referral. Integrating schema-focused and stress-reduction interventions into routine psoriasis care could improve well-being and disease management.

The aim of our study was to compare typical Thai and Hungarian personality profiles of the Zuckerman–Kuhlman–Aluja Personality Questionnaire (ZKA-PQ). 672 Thai and 647 Hungarian were included in our study. The distribution of age, gender and education level were matched. The ZKA-PQ was administered that measures Aggression, Extraversion, Activity, Sensation Seeking and Neuroticism. We tested reliability, the structural invariance and analyzed aggregated mean profiles for cultures as well as typical profiles by cluster analyses. Reliability of factors were acceptable in both cultures, but some facets (especially AC3 Restlessness) showed low reliability. The global Tucker’s coefficient of congruence (TCC) for cross-cultural factorial invariance was 95. We have also run a Multigroup Confirmatory Factor Analysis, but fit indices were not adequate. Cross-cultural neural network invariance was not met either. Hungarians scored significantly higher on Extraversion, Sensation Seeking, Aggression and Activity. Cluster-analyses revealed six typical profiles: Introverted impulsive, Reserved, Resilients, Overcontrolled, Aggressive impulsive and Positive sensation seeker. Majority of first two clusters were Thai respondents, majority for last two clusters were Hungarians. In sum, there were some cross-cultural congruence in factor structure, but strict invariance was not fulfilled. Comparison of mean profiles remain tentative, but cluster analysis revealed cross-cultural differences in typical profiles.

Medical students are a vulnerable group for harmful health behaviours due to academic stress. Increased screen time is associated with adverse health behaviour, particularly delayed bedtime, shorter sleep duration and poorer sleep quality. This possible relationship has not yet been examined among medical students in Europe. Medical students at the Technical University of Dresden were invited to participate in an online questionnaire based cross-sectional study. To analyse correlations between screen time and sleep parameters, correlation coefficients, linear regression and mixed-model analysis were calculated. 415 students (average age 24 years, 70% female) were included in the analysis. The students reported an average of 7 h screen time per day and 7.25 h sleep duration per night. Approximately 23% (n = 97) reported sleeping less than 7 h per night and 25% (n = 105) reported fairly to very poor sleep quality. Students who reported more screen time for leisure went to bed significantly later (r = 0.213, p < 0.001). Students who spent more screen time for study/work tended to sleep shorter (r = − 0.108, p < 0.015). There was no significant association between screen time and sleep quality (p = 0.103). The results show a need for educational interventions to promote healthy sleep behaviour and to limit screen time.

Background Socioeconomic disadvantages in the childhood environment might strongly influence beliefs and behavior characterizing the adult years. When children experience unpredictable and adverse situations, they develop an unpredictability schema with the core belief that situations are unpredictable. Methods In two studies, we examined the association of childhood socioeconomic disadvantages with self-reported pain sensitivity, pain catastrophizing, and pain-related fear. Multidimensional survey measures were used to assess environmental conditions experienced in childhood. In addition, participants completed the Pain Catastrophizing Scale, Pain Sensitivity Questionnaire, Body Awareness Questionnaire, Unpredictability Schema Questionnaire, and Fear of Pain Questionnaire. In Study 1 (N = 252), in separate models, we examined pain sensitivity and pain catastrophizing of a community sample of pain-free young individuals in association with their childhood experiences. In Study 2 (N = 293), in a new sample, but with a wider age range, we examined the association of early life socioeconomic disadvantages with pain-related fear. In both studies, the predictions were tested with Structural Equation Modeling. Our models constituted a path from childhood socioeconomic status and household unpredictability to pain variables via the factors of family resources, unpredictability schemas, and body awareness. Results and conclusions The findings converged on the conclusion that individuals experiencing disadvantageous early life conditions tended to have an elevated level of pain catastrophizing, higher perceived sensitivity to pain, and higher level of pain-related fear. These associations were mediated by an unpredictability schema and body awareness.

Adult individuals frequently face difficulties in attracting and keeping mates, which is an important driver of singlehood. In the current research, we investigated the mating performance (i.e., how well people do in attracting and retaining intimate partners) and singlehood status in 14 different countries, namely Austria, Brazil, China, Greece, Hungary, Italy, Japan, Peru, Poland, Russia, Spain, Turkey, the UK, and Ukraine (N = 7,181). We found that poor mating performance was in high occurrence, with about one in four participants scoring low in this dimension, and more than 57% facing difficulties in starting and/or keeping a relationship. Men and women did not differ in their mating performance scores, but there was a small yet significant effect of age, with older participants indicating higher mating performance. Moreover, nearly 13% of the participants indicated that they were involuntarily single, which accounted for about one-third of the singles in the sample. In addition, more than 15% of the participants indicated that they were voluntarily single, and 10% were between-relationships single. We also found that poor mating performance was associated with an increased likelihood of voluntary, involuntary, and between-relationships singlehood. All types of singlehood were in higher occurrence in younger participants. Although there was some cross-cultural variation, the results were generally consistent across samples.

Acute recurrent pancreatitis (ARP) due to alcohol and/or tobacco abuse is a preventable disease which lowers quality of life and can lead to chronic pancreatitis. The REAPPEAR study aims to investigate whether a combined patient education and cessation programme for smoking and alcohol prevents ARP. The REAPPEAR study consists of an international multicentre randomised controlled trial (REAPPEAR-T) testing the efficacy of a cessation programme on alcohol and smoking and a prospective cohort study (REAPPEAR-C) assessing the effects of change in alcohol consumption and smoking (irrespective of intervention). Daily smoker patients hospitalised with alcohol-induced acute pancreatitis (AP) will be enrolled. All patients will receive a standard intervention priorly to encourage alcohol and smoking cessation. Participants will be subjected to laboratory testing, measurement of blood pressure and body mass index and will provide blood, hair and urine samples for later biomarker analysis. Addiction, motivation to change, socioeconomic status and quality of life will be evaluated with questionnaires. In the trial, patients will be randomised either to the cessation programme with 3-monthly visits or to the control group with annual visits. Participants of the cessation programme will receive a brief intervention at every visit with direct feedback on their alcohol consumption based on laboratory results. The primary endpoint will be the composite of 2-year all-cause recurrence rate of AP and/or 2-year all-cause mortality. The cost-effectiveness of the cessation programme will be evaluated. An estimated 182 participants will be enrolled per group to the REAPPEAR-T with further enrolment to the cohort. The study was approved by the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (40394-10/2020/EÜIG), all local ethical approvals are in place. Results will be disseminated at conferences and in peer-reviewed journals. NCT04647097.

ObjectivesThe current global health crisis of the COVID-19 pandemic has drastically affected the whole population, but healthcare workers are particularly exposed to high levels of physical and mental stress. This enormous burden requires both the continuous monitoring of their health conditions and research into various protective factors.DesignCross-sectional surveys.Setting and participantsSelf-administered questionnaires were constructed assessing COVID-19-related worries of health workers in Hungary. The surveys were conducted during two consecutive waves of the COVID-19 pandemic (N-first wave=376, N-second wave=406), between 17 July 2020 and 31 December 2020.Primary and secondary outcome measuresCOVID-19-related worry, well-being and distress levels of healthcare workers. We also tested whether psychological resilience mediates the association of worry with well-being and distress. Multiple linear regression analyses were performed.ResultsThe results indicated that healthcare workers had high levels of worry and distress in both pandemic waves. When comparing the two waves, enhanced levels of worry (Wald’s χ2=4.36, p=0.04) and distress (Wald’s χ2=25.18, p<0.001), as well as compromised well-being (Wald’s χ2=58.64, p<0.001), were found in the second wave. However, not all types of worries worsened to the same extent across the waves drawing attention to some specific COVID-19-sensitive concerns. Finally, the protective role of psychological resilience was shown by a mediator analysis suggesting the importance of increasing resilience as a key factor in maintaining the mental health of healthcare workers in the burden of the COVID-19 pandemic.ConclusionsOur results render the need for regular psychological surveillance in healthcare workers.RegistrationHungarian Scientific and Research Ethics Committee of the Medical Research Council (IV/5079-2/2020/EKU).

The present study developed a brief version of the Hungarian Why Sex? questionnaire (Meskó et al., 2022). The study was in part based on previously reported data obtained from several samples ( N  = 6193; 1976 men, 4217 women). Using Mokken Scaling Procedure, Item Response Model and redundancy analysis indicated that retaining three summary scales comprising five items each was the optimal solution for the brief version. The validity of the brief scale was tested with the Sexual System Functioning Scale (SSFS), the Experiences in Close Relationships Scale–Short Form (ECR-S) and, the Hungarian version of the Attachment Style Questionnaire (ASQ-H; n  = 297, 127 men, 170 women). In addition, correlations between the long and brief versions of YSEX? with sociosexual orientation (SOI-R) and the five-factor personality construct (BFI-S) were compared ( n  = 1024, 578 women, 446 men). The results suggest that the three summary scales of the Hungarian 15-item Form of the Why Sex Questionnaire (YSEX?-15H) provide reliable and valid measures of the previously affirmed three broad sexual motives (Personal Goal Attainment, Relational Reasons, Sex as Coping). The Relational Reasons summary scale was associated with secure emotional and sexual attachment. The Personal Goal Attainment and Sex as Coping summary scales showed coherent patterns of associations with the emotional and sexual aspects of secondary attachment strategies (over- and under-functioning). The YSEX?-15H offers both researchers and practitioners a concise and useful instrument for the assessment of sexual motivation.

Introduction: Prehospital emergency care is critical to saving lives. Facilitating bystander involvement and increasing the likelihood that people will provide first aid can reduce the time to treatment and increase the chances of survival and recovery. One possible solution to increasing people's willingness to provide first aid is to identify the barriers that may prevent them from doing so. One such barrier could be Blood Injury Injection (BII) phobia, which is a very common condition with up to 20% of people experiencing mild to severe fear and 3-5% experiencing phobic levels of fear. Methods: In the absence of a psychometrically sound measure of the probability of giving first aid, we developed a brief six-item questionnaire (Probability of Giving First-aid Scale; PGFAS) and tested its performance with the Polytomous Rasch Model. We demonstrated that the questionnaire had adequate reliability and validity. We then used the PGFAS measure to test how anxiety and disgust sensitivity related to BII phobia may act as barriers to providing medical assistance. Results: Our results show that fear of injection and blood draw, blood and mutilation significantly reduced the likelihood of giving first aid. In contrast, fear of sharp objects, medical examinations, people showing symptoms of illnesses and disgust sensitivity, and fear of contamination did not have a significant effect. Conclusion: In conclusion, the PGFAS could be a useful as a screening tool to identify people who are less likely to help. It may also be used to assess the effectiveness of first aid training, but this was not addressed in this study. Our results emphasize the importance of preparing the person who is to give first aid, and of incorporating activities that support helper identity into training that teaches technical knowledge.