István Vingender

A needle in the haystack – the dire straits of needle exchange in Hungary

BackgroundThe two largest needle exchange programs (NEPs) in Hungary were forced to close down in the second half of 2014 due to extreme political attacks and related lack of government funding. The closures occurred against a background of rapid expansion in Hungary of injectable new psychoactive substances, which are associated with very frequent injecting episodes and syringe sharing. The aim of our analysis was to predict how the overall Hungarian NEP syringe supply was affected by the closures.MethodsWe analyzed all registry data from all NEPs in Hungary for all years of standardized NEP data collection protocols currently in use (2008–2014) concerning 22 949 client enrollments, 9 211 new clients, 228 167 client contacts, 3 160 560 distributed syringes, and 2 077 676 collected syringes.ResultsWe found that while the combined share of the two now closed NEPs decreased over time, even in their partial year 2014 they still distributed and collected about half of all syringes, and attended to over half of all clients and client contacts in Hungary. The number of distributed syringes per PWID (WHO minimum target = 100) was 81 in 2014 in Hungary, but 39 without the two now closed NEPs.ConclusionsThere is a high probability that the combination of decreased NEP coverage and the increased injection risk of new psychoactive substances may lead in Hungary to a public health disaster similar to the HIV outbreaks in Romania and Greece. This can be avoided only by an immediate change in the attitude of the Hungarian government towards harm reduction.

onColoGiCAl pAtients’ KnoWledGe oF pAtients’ riGhts And onColoGiCAl heAlth CAre orGAniZAtion

Introduction. neoplastic diseases are the leading cause of death in hungary nowadays. the number of oncological patients have been increasing for the last decades. in spite of that, the organization of oncological care is still a difficult subject. Aim. the primary aim of our innovative study was to explore the scope of knowledge of oncological patients and their families about patients’ rights and health care organization. additionally, our goal was to assess patient’s behaviors and attitudes towards the studied subjects. Material and methods. 271 patients and family members from two big, outpatient oncology departments (one in Budapest, and another one in the town in the countryside) were enrolled in our study. the participants took part in verbal interview that was based on a pre-set questionnaire. the statistical analysis was conducted with spss statistica 23 software. Results. patients with higher level of education tended to know more details concerning their disease and treatment, as well as their rights as patients. in general, the knowledge of health care organization of the participants was poor. Only 39.7% of the respondents indicated that pathologist played an important role in the diagnosis of type of cancer, whereas the same answer was chosen in 89.3% of cases in question inquiring about the role of the oncologist. these results were not influenced by the level of education of the participants. 44.2% of the participants thought that pathologists perform exclusively the postmortem examinations, while 16.8% of the participants could not indicate at all what role pathologists had in diagnosing a neoplasm. Conclusions. although all our respondents had active neoplastic disease or their family member was diagnosed with cancer, it has been revealed that: (1) a high percentage of them are not aware of patients’ rights, (2) they are not familiar with the oncological health care organization, which is independent of their level of education. depending on the level of education, there is a group that does not want to learn patients’ rights at all. in our opinion, better education of patients in these fields would contribute to higher quality of oncological care, and consequently, to better quality of life and health status of oncological patients.

Migration Potential of Hungarian Healthcare Professionals – Dynamics of Attraction and Repulsion@@@Das Migrationspotential von ungarischem, medizinischem Fachpersonal – Die Dynamik von Anziehung und Abstoßung

The reason why the migration of healthcare professionals has not been described and analyzed yet in Hungary can obviously be found in the authenticity and the lack of this of the Hungarian society. There are several theoretical approaches to the migration processes. Each and every one of them analyzes and defines migration from a different point of view. Our goal was to find out the nature of the migration willingness and activity of Hungarian healthcare specialists. We intended to concentrate primarily on the sociological, cultural-anthropological and social-psychological aspects of this complex phenomenon. This sub-cultural phenomenon can be derived form numerous factors: (a) the family background of Hungarian healthcare specialists, (b) their typical, modal system of values when choosing a profession, (c) the fact that they are typically women, (d) the lack of former experience and knowledge of inspirations in mobility. At the Semmelweis University Faculty of Health Sciences we have already carried out several research projects and their synthesis might lead to the description of the migration trends of healthcare specialists. Four years ago, when we did a study about migration to work abroad, the number of those who predicted leaving the country for sure was the same as today. But the number of those who rejected the whole idea was far higher than nowadays. At that time 20% of healthcare specialists considered a career like this impossible, while now their number is less than 5%. When taking into consideration the fact that the recruiting processes are far more intensive and organized than they used to be, we can expect that a larger number of people can be convinced than ever before. However, the migration intentions are not definite, homogenous or final. The interventions, aiming to keep healthcare specialists in Hungary, still have a chance.The reason why the migration of healthcare professionals has not been described and analyzed yet in Hungary can obviously be found in the authenticity and the lack of this of the Hungarian society. There are several theoretical approaches to the migration processes. Each and every one of them analyzes and defines migration from a different point of view. Our goal was to find out the nature of the migration willingness and activity of Hungarian healthcare specialists. We intended to concentrate primarily on the sociological, cultural-anthropological and social-psychological aspects of this complex phenomenon. This sub-cultural phenomenon can be derived form numerous factors: (a) the family background of Hungarian healthcare specialists, (b) their typical, modal system of values when choosing a profession, (c) the fact that they are typically women, (d) the lack of former experience and knowledge of inspirations in mobility. At the Semmelweis University Faculty of Health Sciences we have already carried out...