Search

In this paper, by applying a feminist bioethical perspective, we identify a new form of medical paternalism that still shapes contemporary legal policies on human egg cryopreservation performed without medical reasons. The fear of negligent, careless women who opt to delay their pregnancy for mere convenience is a widely known gender biased stereotype. Nevertheless, the opinions and judgments of medical professionals on this issue have not yet been sufficiently explored by in-depth research. In this essay, therefore, first we look at the broader bioethical, legal, and social aspects of human egg cryopreservation. In the second part of the paper we discuss a unique qualitative study conducted with professionals working at Hungarian IVF clinics. We argue, based on a bioethical analysis of the collected data, that when new reproduction technologies provide opportunities for women to widen their range of reproductive choices, the traditional forms of medical paternalism can be reinforced by gendered paternalism, as well. We identify several elements of gendered paternalism that characterized the attitudes of the IVF staff and discuss the professionals' resistance to elective egg freezing and vitrification of eggs for the future. We conclude by suggesting directions for future policy. Although we focus on the Hungarian case in this paper, we are aware that similar attitudes can be observed in some other countries where this technology has become available and requested by women, but where they also face difficulties in their access to it. [ABSTRACT FROM AUTHOR]

Background: The objective of this paper is to explore unmet health care needs in Hungary in ambulatory care due to costs and difficulties in travelling, and to analyze how unmet needs relate to socio-demographic characteristics.Methods: The quantitative analysis is based on a national, representative online survey carried out in Hungary on a sample of 1000 respondents in early 2019 using a proposed set of questions developed by the OECD. We present and compare unmet medical needs in different socio-demographic groups, and we use multivariate logistic regression analysis to identify the main determinants of unmet medical needs.Results: Among responders who had medical problems in the last 12 months, 27.3% reported forgone medical visit due to difficulties in travelling, 24.2% had unfilled prescription for medicine due to costs, 21.4% reported forgone medical visit or follow-up visit due to costs and 16.6% reported skipped medical test, treatment or other follow-up due to costs. These shares are much higher than presented previously in international databases. The logistic model indicates that respondents were significantly more likely to report unmet needs if they were women, younger or belonged to first and second income quintiles.Conclusions: Policy makers need to address the issue of high prevalence of forgone medical care among the Hungarian population to avoid deterioration of population health and inequalities in access. As a first step, policies should try to decrease financial burden of vulnerable groups to improve access. [ABSTRACT FROM AUTHOR]

In situ U–Pb analyses were performed on SEM-BSE, SEM-CL and Raman mapped zircons from the Variscan granitoids exposed in the Mórágy pluton, Hungary. However, the routinely used LA-ICP-MS could result only in reliable age constraints if the system was not overprinted by multiple geological processes that affect the isotope system of zircons. To overcome the ambiguities the new zircon U–Pb age data were evaluated carefully, first using simple statistical models, then a zircon internal texture related complex approach was applied. This method demonstrates that the U–Pb age in overprinted systems correlates with the structural state; the worse structural state zones showing younger, but still concordant ages. Individual zircon internal texture and structural state based evaluation made it possible to select the least overprinted age components of the system and identify five steps in the evolution of the studied intrusive rock. The two melts (granitoid and mafic) passed the zircon U–Pb isotope closure temperature ~ 355 ± 3 Ma ago during their cooling. Crystallization of the two mingled magmas overarched the 350–340 Ma period, including two intense zircon crystallization peaks (~ 347 Ma, ~ 333 Ma). The cessation of melt crystallization (~ 650 °C) happened ~ 334 ± 4 Ma ago, as indicated by the age of the "normal and long prismatic" zircons. Further confirming this statement, they are embedding in their rims the eutectic mineral assemblage. A Cretaceous post-magmatic event was identified according to slightly discordant U–Pb ages for the Mórágy pluton. [ABSTRACT FROM AUTHOR]

Background: EQ-5D-3L population data are available only from Hungary, Poland and Slovenia in Central and Eastern Europe (CEE). We aimed to compare the accessible studies and estimate a regional EQ-5D-3L population norm for CEE.Methods: A combined dataset using patient-level data of 8850 respondents was created. Based on the European Census of 2011, regional population norm estimates were calibrated by gender, age and education for the joint citizenry of 11 CEE countries.Results: EQ-5D-3L health states were available for 6926 and EQ VAS scores for 6569 respondents. Demographic characteristics of the samples reflected the recruitment methods (Hungary: online; Slovenia: postal survey, Poland: personal interviews). Occurrence of problems differed significantly by educational level in all the five dimensions (p < 0.001). The inter-country differences persisted after controlling for demographic variables. The estimated EQ-5D-3L index CEE norms with UK tariffs for age groups 18-24, 25-34, 35-44, 45-54, 55-64, 65-74 and 75 + were 0.911, 0.912, 0.871, 0.817, 0.762, 0.743 and 0.636 for males and 0.908, 0.888, 0.867, 0.788, 0.752, 0.68 and 0.584 for females, respectively. Estimates were provided also using Polish, European and Slovenian value sets.Conclusions: Besides gender and age, education should be considered during the design and interpretation of quality-of-life studies in CEE. The estimated regional EQ-5D-3L population norm may be used as a benchmark by CEE countries with lack of local dataset. However, the substantial inter-country differences in health status and scarcity of data over age 65 call for harmonized country-specific EQ-5D-3L population norm studies in the CEE region. [ABSTRACT FROM AUTHOR]

Background: We adapted the eHealth Literacy Scale (eHEALS) for Hungary and tested its psychometric properties on a large representative online sample of the general population.Methods: The Hungarian version of eHEALS was developed using forward-backward translation. For the valuation study, 1000 respondents were recruited in early 2019 from a large online panel by a survey company. We tested internal consistency, test-retest reliability and construct and criterion validity using classical test theory, as well as item characteristics using an item-response theory (IRT) graded response model (GRM).Results: 55% of respondents were female, and 22.1% were ≥ 65 years old. Mean eHEALS score was 29.2 (SD: 5.18). Internal consistency was good (Cronbach's α = 0.90), and test-retest reliability was moderate (intraclass correlation r = 0.64). We identified a single-factor structure by exploratory factor analysis, explaining 85% of test variance. Essential criteria for GRM analysis were met. Items 3 and 4 (search of health resources) were the least difficult, followed by items 5 and 8 (utilisation of health information), and then items 1 and 2 (awareness of health resources). Items 6 and 7 (appraisal of health resources) were most difficult. The measurement properties of eHEALS were not affected by gender, age, education or income levels. Female gender, older age, intensity of health information seeking, formal health education and visit at the electronic health-record website were associated with higher eHEALS scores, as well as best and worst self-perceived health states, BMI < 25 and participation at health screenings over the past year.Conclusions: The Hungarian eHEALS is a useful and valid tool for measuring subjective eHealth literacy. [ABSTRACT FROM AUTHOR]

Background Emergency contraceptive pills (ECPs) are used to prevent unintended pregnancy. There is a worldwide intention to improve access to ECPs; therefore, identifying potential barriers to introducing over-the counter (OTC) access is of utmost importance. As pharmacists are the key personnel to convey accurate drug information, their knowledge and attitude on ECPs is important. Objective We aimed to conduct a nationwide study to assess pharmacists' knowledge on ECPs and to survey their opinion on sales category change of ECPs (i.e. to introduce OTC access in pharmacies). Setting Registered pharmacists in Hungary. Method A prospective cross-sectional study was conducted with an anonymous, web-based questionnaire. Univariate analysis (Mann-Whitney U test and Fischer's exact test) was used to identify factors associated with supportive opinion toward OTC provision. Main outcome measure Knowledge level of pharmacists, proportion of pharmacists with supportive opinion on OTC access. Results 357 out of 2019 pharmacists completed the questionnaire, yielding a 17.7% response rate. Almost 30% of pharmacists (N = 99) agreed that ECPs should have an OTC availability in Hungary. More than 40% of pharmacists (N = 145) considered ECPs as contraceptives. On average, 55.18% (standard deviation: ±12.40%) of the answers were correct, showing moderate knowledge of the pharmacists. Age and rating ECPs as contraceptives were significantly associated with supportive opinion toward OTC provision (p < 0.001). The effect of knowledge on the pharmacist's opinion was significant in young pharmacists (p = 0.02). Conclusion Pharmacists' knowledge and opinion on ECPs should be improved, especially that of the young ones. Currently the attitude of pharmacists does not favor sales category changes of ECPs in Hungary. [ABSTRACT FROM AUTHOR]

Insecure attachment can contribute to various psychological problems including body dissatisfaction. It is not clarified which attachment quality, anxiety or avoidance predict lower body satisfaction, and the relationship of maternal and paternal patterns has not been distinguished yet. Our aim was to test these aspects in adolescents. Participants of the large cross-sectional survey were Hungarian children and adolescents ( N = 5214, 51.6 % boys, mean age 14.8 years, SD = 2.6 years). Measures included self-reported body weight and height data, body satisfaction scale, the Experience in Close Relationships Scale-Relationship Structures, and the Child Depression Inventory. Boys had significantly higher body satisfaction, and worse maternal attachment than girls, who showed worse paternal attachment and higher depression. Higher paternal anxiety and avoidance, and maternal avoidance predicted lower body satisfaction in both genders adjusted for age and BMI ( R = 6.1-12.5 %). Depression fully mediated the relationship between dysfunctional maternal attachment and lower body satisfaction in both genders, between dysfunctional paternal attachment and lower body satisfaction in girls, while only partially mediated between dysfunctional paternal attachment and lower body satisfaction in boys. Dysfunctional parental attachment was associated with adolescents' lower body dissatisfaction, mediated by the level of depression. The importance of paternal attachment was highlighted in boys' body concerns. Results suggest that handling negative moods, parental anxiety and avoidance may be useful in the case conceptualizations and treatments related to adolescents' body dissatisfaction that requires further assessment. [ABSTRACT FROM AUTHOR]