DOCSLIB.ORG

Pancreatic Cancer: Multicenter Prospective Data Collection and Analysis by the Hungarian Pancreatic Study Group

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Pancreatic Cancer: Multicenter Prospective Data Collection and Analysis by the Hungarian Pancreatic Study Group View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by SZTE Publicatio Repozitórium - SZTE - Repository of Publications original paper Available from: http://www.jgld.ro/wp/archive/y2016/n2/a15 DOI: http://dx.doi.org/10.15403/jgld.2014.1121.252.pcr Pancreatic Cancer: Multicenter Prospective Data Collection and Analysis by the Hungarian Pancreatic Study Group Gábor Lakatos1, Anita Balázs2, Balázs Kui2, Szilárd Gódi3, Ákos Szücs4, Andrea Szentesi2, Zsolt Szentkereszty5, Richárd Szmola6, Dezső Kelemen7, Róbert Papp7, Áron Vincze3, József Czimmer3, Gabriella Pár3, Judit Bajor3, Imre Szabó3, Ferenc Izbéki8, Adrienn Halász8, László Leindler9, Gyula Farkas Jr.9, Tamás Takács2, László Czakó2, Zoltán Szepes2, Péter Hegyi2,10, 11*, Zsuzsanna Kahán12,* 1) Dept. Oncology, St. Istvan Abstract and St. Laszlo Hospital and Out- Patient Department, Budapest; Background & Aims: Pancreatic cancer is a devastating disease with poor prognosis. There is very limited 2) 1st Dept. Medicine, University information available regarding the epidemiology and treatment strategies of pancreatic cancer in Central of Szeged; 3) 1st Dept. Medicine, Europe. The purpose of the study was to prospectively collect and analyze data of pancreatic cancer in the University of Pécs; 4) 1st Dept. Hungarian population. Surgery, Semmelweis University, Methods: The Hungarian Pancreatic Study Group (HPSG) organized prospective, uniform data collection. Budapest; 5) Institute of Surgery, Altogether 354 patients were enrolled from 14 Hungarian centers. Clinical Center, University of Results: Chronic pancreatitis was present in 3.7% of the cases, while 33.7% of the patients had diabetes. Debrecen; 6) Dept. Interventional Family history for pancreatic cancer was positive in 4.8%. The most frequent presenting symptoms included Gastroenterology, National pain (63.8%), weight loss (63%) and jaundice (52.5%). The reported frequency of smoking and alcohol Institute of Oncology, Budapest; consumption was lower than expected (28.5% and 27.4%, respectively). The majority of patients (75.6%) were 7) Dept. Surgery, University diagnosed with advanced disease. Most patients (83.6%) had a primary tumor located in the pancreatic head. of Pécs; 8) 1st Dept. Medicine, The histological diagnosis was ductal adenocarcinoma in 90.7% of the cases, while neuroendocrine tumor Szent György University was present in 5.3%. Biliary stent implantation was performed in 166 patients, 59.2% of them received metal Teaching Hospital of County stents. Primary tumor resection was performed in 60 (16.9%) patients. Enteral or biliary bypass was done Fejér, Székesfehérvár; 9) Dept. in 35 and 49 patients, respectively. In a multivariate Cox-regression model, smoking status and presence of Surgery, University of Szeged; gemcitabine-based chemotherapy were identified as independent predictors for overall survival. 10) Hungarian Academy of Conclusion: We report the first data from a large cohort of Hungarian pancreatic cancer patients. We identified Sciences, University of Szeged, smoking status and chemotherapy as independent predictors in this cohort. Momentum Gastroenterology Multidisciplinary Research Group; Key words: pancreatic cancer – Hungarian cohort – acute pancreatitis – chronic pancreatitis – diabetes mellitus. 11) Institute for Translational Medicine & 1st Department of Abbreviations: EBM: evidence-based medicine; EPI: exocrine pancreatic insufficiency; FNAB: fine needle Medicine, University of Pécs; 12) aspiration biopsy; HPSG: Hungarian Pancreatic Study Group; MDCT: multi-detector computed tomography; Dept. Oncotherapy, University of OS: overall survival; PC: pancreatic cancer; RPP: Registry for Pancreatic Patients Szeged, Hungary Address for correspondence: Prof. Dr. Peter Hegyi Introduction the seventh, and the mortality rate is the fifth among all cancers University of Pécs; Centre for [2]. In Hungary both the incidence and mortality are one of Translational Medicine; Pancreatic cancer (PC) is the highest in Europe. There were 2,373 newly diagnosed PC Pécs, Hungary one of the most aggressive types patients in Hungary in 2010, and 1,837 died due to the disease [email protected] of human malignancies and a [3]. major health problem. Pancreatic The number of patients with PC is increasing globally. It Received: 11.12.2015 cancer is a relatively rare type is estimated that in 2012 there were 103,773 newly diagnosed Accepted: 26.02.12016 of tumor, but due to its high cases and 104,463 fatal outcomes in Europe [4]. There are mortality rate it is one of the most no screening tests for early detection of PC. By the time of *the last two authors equally frequent causes of cancer death diagnosis, less than 15% of patients can be offered a potential contributed to this work in the world.[1] In developed curative treatment, and up to 30% of the patients die within countries the incidence of PC is 12 months [5]. J Gastrointestin Liver Dis, June 2016 Vol. 25 No 2: 219-225 220 Lakatos et al Data suggest that the onco-epidemiological situation the number of patients enrolled by each center are summarized related to pancreatic cancer in Central European countries in Table I. is even worse compared to that in the Western world [6]. An Demographic data, data of possible risk factors, symptoms, epidemiologic analysis from 51 countries across the world has diagnosis, staging, therapy and survival were assessed. Data shown the highest mortality rates in Central Europe with trends collection was performed using a web-based electronic data towards increasing mortality in Romania, along with Albania, collection method as part of the Registry for Pancreatic Patients Spain and Croatia [7]. An epidemiologic study conducted in (RPP). Serbia between 1991 and 2010 demonstrated high mortality Demographic data included age and gender of patients. rates with increasing mortality trend in both genders and in Information about alcohol consumption and smoking most age groups [8]. (frequency and total amount of daily consumption), body mass There is only limited information available on the index (BMI), history of acute and chronic pancreatitis, diabetes management of PC from Central Europe including Hungary. mellitus and familial PC has been collected as possible risk In order to improve outcome of PC, it is essential to determine factors. Frequency of symptoms and clinical signs, such as fever, which factors contribute to the unfavorable trends seen in less pain, diarrhea, jaundice and weight loss were also evaluated. developed countries. The main purpose of our study was to Cancer related data included the date of diagnosis, extension collect information regarding the diagnosis, management and of the disease, location of the primary tumor, histological type, outcome of pancreatic cancer in Hungary. Here we present the method used to obtain histological diagnosis and the level the first large prospectively collected and analyzed data of of CA 19-9 at the time of diagnosis. Diagnosis and staging pancreatic cancer in the Hungarian population. of pancreatic cancer was based on imaging tests including multi-detector computed tomography (MDCT), magnetic Patients AND Methods resonance imaging (MRI), endoscopic retrograde cholangio- pancreatography (ERCP) and endoscopic ultrasonography The Hungarian Pancreatic Study Group (HPSG) was (EUS). Primary resectable tumor, locally advanced and established in 2011 in order to improve the care of patients metastatic disease were distinguished. Histological diagnosis suffering from pancreatic diseases. To achieve our aims we was performed using brush cytology during ERCP, fine needle (i) developed an electronic data registry for patients (www. aspiration biopsy (FNAB) or surgical biopsy/resection. pancreas.hu), (ii) published the currently available evidence- The database included information on endoscopic, surgical, based medicine (EBM) guidelines [9-13], (iii) established oncological and supportive therapy performed. The proportion specific study sessions including the pancreatic cancer one, of plastic or metal stents used for biliary drainage was (iv) and organized multicenter clinical trials [14-17]. determined. Information on the frequency of duodenal stent For this study the HPSG collected data from patients implantation was also recorded. Data on surgical resection diagnosed with PC between September 2012 and March (including margin status; R0, R1, R2) has been collected for 2014 using uniform questionnaire and clinical data sheets. patients with a resectable primary tumor. Palliative biliary Patients were enrolled from 14 Hungarian centers including and enteral bypass were recorded as well. If a patient received endoscopy units, gastroenterological, oncological and surgical oncological treatment (radiation therapy or chemotherapy) departments. The characteristics of the single departments and for PC, the type and intent (neo-adjuvant, adjuvant, palliative) of therapy and the name of the chemotherapeutic agent used Table I. Characteristics of the participating centers Name of institution Type of institution Department profile Number of patients enrolled (n) Borsod-Abaúj-Zemplén County General Hospital, Miskolc General Hospital Gastroenterology 2 Bács-Kiskun County Municipality Hospital, Kecskemét General Hospital Gastroenterology 2 Pándy Kálmán Békés County Hospital, Gyula General Hospital Gastroenterology 11 Department of Interventional Gastroenterology, National National Institution Endoscopy Unit 27 Institute of Oncology, Budapest Institute of Surgery,
Load more

Recommended publications
  • What Have EU Countries Done to Support Low-Wage Workers in an Era of Downward Wage Pressures?
    IZA DP No. 9390 Stemming the Tide: What Have EU Countries Done to Support Low-Wage Workers in an Era of Downward Wage Pressures? Sarah Marchal Ive Marx September 2015 DISCUSSION PAPER SERIES Forschungsinstitut zur Zukunft der Arbeit Institute for the Study of Labor Stemming the Tide: What Have EU Countries Done to Support Low-Wage Workers in an Era of Downward Wage Pressures? Sarah Marchal Herman Deleeck Centre for Social Policy, University of Antwerp Ive Marx Herman Deleeck Centre for Social Policy, University of Antwerp and IZA Discussion Paper No. 9390 September 2015 IZA P.O. Box 7240 53072 Bonn Germany Phone: +49-228-3894-0 Fax: +49-228-3894-180 E-mail: [email protected] Any opinions expressed here are those of the author(s) and not those of IZA. Research published in this series may include views on policy, but the institute itself takes no institutional policy positions. The IZA research network is committed to the IZA Guiding Principles of Research Integrity. The Institute for the Study of Labor (IZA) in Bonn is a local and virtual international research center and a place of communication between science, politics and business. IZA is an independent nonprofit organization supported by Deutsche Post Foundation. The center is associated with the University of Bonn and offers a stimulating research environment through its international network, workshops and conferences, data service, project support, research visits and doctoral program. IZA engages in (i) original and internationally competitive research in all fields of labor economics, (ii) development of policy concepts, and (iii) dissemination of research results and concepts to the interested public.
    [Show full text]
  • Budapest Vs. the Countryside
    american chamber of commerce in hungary VOICEVol III. Issue 11, march 2013 BuDa pest vS. thE cOuNtRyside And thE demogRaphIc time bomb MORE INSIDE: Education that serves society Innovation – you can’t do it alone 3 contents 4 introduction 15-19 COVEr STORY 30 AmchAm nEwS Dear Members and Friends… capital vs. countryside New board, new president 5 PEoPLE 31 AmchAm nEwS the glass half full 20-21 COVEr STORY hungarian tax system: 6 PEoPLE the demographic time bomb Swedish taxes with traveling at the speed Ethiopian wages of google 22-23 Lifestyle AmchAm nEwS 7 PEople andrás török’s Budapest 32 adding value, boosting Innovation – you can’t confidence do it alone 24-25 focuS 8 AnALYSiS Education that serves society 33 chAmbEr cornEr Will the largest grow larger? providing a reasoned voice 26 AmchAm nEwS 91-11 AnALYSiS Business news roundup hungary ‘not an island’ 36-37 AmchAm nEwS New members on board 12-13 AnALisys AMCHAm NewS hungary moves deeper 27 38-41 AmchAm nEwS into recession Shifting toward growth photo coverage 14 AnALYSiS 28-29 AmchAm NewS BSE saw a drastic drop in 42 AmchAm nEwS turnover in 2012 a cooperative approach to tax cEO’s note Voice is published on behalf of the American Chamber of Commerce by Absolut Media Zrt., Madách Trade Center, 1075 Budapest, Madách Imre út 13-14., Building A, 8th floor Editor-in-chief: ROBIN MARSHALL ([email protected]) • Contributors: GABRIELLA LOVAS, ROBIN MARSHALL, ANDRÁS TÖRÖK Photography: András HAJnal, LÁZár TodoroFF • Design: ABSOLUT DESIGN STÚDIÓ ([email protected]) • Art director: Tamás TárCZY • CEO: TAMÁS BOTKA Advertising: ABSOLUT MEDIA Zrt.
    [Show full text]
  • EU Mapping of Child Protection Systems Lot 16
    Report of Various Sizes (FRANET) EU mapping of child protection systems Lot 16 – Hungary 2 April 2014 Contents I. Legislative framework and policy developments ................................................... 2 II. Structures and Actors ...................................................................................... 41 III. Capacities ...................................................................................................... 77 IV. Care ........................................................................................................... 91 V. Accountability ............................................................................................... 118 References ........................................................................................................ 166 Annex – Terms and definitions ............................................................................. 183 1 I. Legislative framework and policy developments 1. Overview of the normative framework of the national child protection system. 1. Normative framework: The United Nations Convention on the Rights of the Child (UN CRC) was ratified in 1991 in Hungary1. The new Child Protection Act in accordance with the CRC came into force in November of 19972. Its main goal is to promote the best interests, the protection and wellbeing of children. The normative framework ensures the well- being and the protection of children from violence, exploitation, abuse, neglect, trafficking, child labour, and child separation. The children’s’ rights approach
    [Show full text]
  • The Case of the 2011 Hungarian Higher Education Policy Reforms
    MULTIPLE DIMENSIONS OF HIGHER EDUCATION POLICY: IS THERE A COMMON GOAL? The Case of the 2011 Hungarian Higher Education Policy Reforms by Aniko Toth Submitted to Central European University Department of Political Science In partial fulfillment of the requirements for the degree of Master of Arts in Political Science (2-year) CEU eTD Collection Supervisor: Professor Matteo Fumagalli Budapest, Hungary (2014) ABSTRACT Higher education has been shaped by the effects of globalization, internationalization, and massification. As a result, there are various stakeholders in higher education and there are shifting relations among their interests, which can generate different takes on what direction higher education should head towards. The thesis focuses on the case of the 2011 Hungarian higher education reforms applying a structural approach to reveal the different dimensions the reforms are linked to and to assess the effectiveness of the policies. The macro (global and European patterns of higher education policy), meso (social, political, legal, and economic aspects of Hungarian higher education) and micro levels (students and higher education in Hungary) are revisited keeping the reforms the recurring reference point. The main proposition states that there is a mismatch between the Hungarian policies and the European and global patterns of higher education policy suggesting the existence of a policy-gap that remains unresolved by the reforms. The thesis reveals the gap, and based on the combined assessment of the three-levels of the analysis, it suggests recommendations on the advancement of the policy. ACKNOWLEDGMENTS First of all, I would like to thank my thesis supervisor Professor Matteo Fumagalli for his support, guidance, and important suggestions on my work.
    [Show full text]
  • The Road to Flexibility? Lessons from the New
    THE ROAD TO FLEXIBILITY? LESSONS FROM THE NEW PROEF 1e HUNGARIAN LABOUR CODE T"-/3 G678":/#'* and N'%;8&<< H=3** Abstract As a result of a general revision, a new Labour Code entered into force on 1 July 2012 in Hungary. One of the determining objectives of the recent labour law reform was ‘ exibilisation’, and ensuring that regulation by labour law should be kept to a minimum. e new rules increased the contractual freedom of parties, and particularly the role of collective agreements in the regulation of employment relationships. While maintaining the basic structure of Hungarian labour law, the new Labour Code introduced conceptual changes in several key areas, such as the termination of employment relationships, liability for damages and collective rights. ese changes were justi ed by the government on the grounds that the current labour law regulation was too rigid and that did not re ect the private law foundations of this eld of law su ciently. e article puts this statement under critical review and gives an overview of the most important elements of the labour law reform. In particular, a er a short introduction we will examine what changes the new Labour Code introduced in the hierarchy of legal sources, and what attempts were made to extend the scope of the Labour Code to other forms of employment. Further, we will analyse to what extent the changes introduced by the new Labour Code modi ed the balance between the interests of employees and employers. Finally, we will also give an overview of the relationship between the new Labour Code and EU labour law.
    [Show full text]
  • Immigration Or Emigration Country? Migration Trends and Their Socio-Economic Background in Hungary: a Longer-Term Historical Perspective
    A Service of Leibniz-Informationszentrum econstor Wirtschaft Leibniz Information Centre Make Your Publications Visible. zbw for Economics Gödri, Irén; Soltész, Béla; Bodacz-Nagy, Boróka Working Paper Immigration or emigration country? Migration trends and their socio-economic background in Hungary: A longer-term historical perspective. Working Papers on Population, Family and Welfare, No. 19 Provided in Cooperation with: Hungarian Demographic Research Institute, Budapest Suggested Citation: Gödri, Irén; Soltész, Béla; Bodacz-Nagy, Boróka (2014) : Immigration or emigration country? Migration trends and their socio-economic background in Hungary: A longer-term historical perspective., Working Papers on Population, Family and Welfare, No. 19, ISBN 963-7109-92-7, Hungarian Demographic Research Institute, Budapest This Version is available at: http://hdl.handle.net/10419/226462 Standard-Nutzungsbedingungen: Terms of use: Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Documents in EconStor may be saved and copied for your Zwecken und zum Privatgebrauch gespeichert und kopiert werden. personal and scholarly purposes. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle You are not to copy documents for public or commercial Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich purposes, to exhibit the documents publicly, to make them machen, vertreiben oder anderweitig nutzen. publicly available on the internet, or to distribute or otherwise use the documents in public. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, If the documents have been made available under an Open gelten abweichend von diesen Nutzungsbedingungen die in der dort Content Licence (especially Creative Commons Licences), you genannten Lizenz gewährten Nutzungsrechte. may exercise further usage rights as specified in the indicated licence.
    [Show full text]
  • Schult, Tanja, a Hero's Many Faces: Raoul
    Page 1 of 6 Biro, Ruth. Schult, Tanja. A Hero’s Many Faces: Raoul Wallenberg in Contemporary Monuments. The Holocaust and Its Context Series. New York: Palgrave Macmillan, 2012. Pp. 425. Notes, Illustrations, Bibliography, Index. AHEA: E-journal of the American Hungarian Educators Association, Volume 5 (2012): http://ahea.net/e-journal/volume-5-2012 Schult, Tanja, A Hero’s Many Faces: Raoul Wallenberg in Contemporary Monuments. The Holocaust and Its Context Series. New York: Palgrave Macmillan, 2012. Pp. 425. Notes, Illustrations, Bibliography, Index. Reviewed by Ruth G. Biro, Duquesne University This book by Swedish scholar Tanja Schult details 31 monuments in 12 countries on five continents dedicated to Raoul Wallenberg, Swedish diplomat rescuer of Jews in Budapest, Hungary in 1944-1945. The 2012 paperback edition contains some recent additions to her 2009 hardcover volume of the same title, which was a slightly revised version of her doctoral dissertation at Humboldt University, Berlin in 2007. Schult was educated in art history and Scandinavian studies in Erlangen and Lund and is currently a researcher at Stockholm University. The publisher’s series promotes international research on the Holocaust, Holocaust remembrance and interpretation, relevance of the Holocaust issues to contemporary society, and dissemination of innovative Holocaust scholarship in the English-speaking world. Schult presents an interdisciplinary socio-historical approach to Wallenberg monuments that represents the viewpoint of art history and how artists of the works expressed their ideas of Wallenberg’s deeds, fate, and legacy. She examined the dynamics of Wallenberg’s activities, the artistic interpretations of memorials to him, ways in which individuals, groups, and nations have honored Wallenberg, and how his humanitarian actions have come to symbolize moral courage against oppression, resistance to injustices, and the struggle for human rights.
    [Show full text]
  • Download Article (PDF)
    Südosteuropa 63 (2015), no. 2, pp. 249-271 HUNGARY’S PATH TOWARD AN ILLIBERAL SYSTEM ANDRÁS VÉRTES The Hungarian Economy. On the Wrong Trajectory Abstract. Hungary’s economy has lost the past decade. Since the country acceded to the European Union, it has not been able to converge towards the EU average in per capita GDP, whereas the majority of the countries in the Central and East European region have come much closer to it. The general government and the current account balance improved markedly, but in every other field (consumption, investment, competitiveness, attraction of capital, etc.) Hungary’s performance has lagged behind the majority of the countries in the CEE region. This is due both to the former socialist-liberal and the present national-conservative govern- ments. The irresponsible fiscal and unsuccessful reform policy of the former government contributed to the increase of the state debt. The latter government constrained democracy as well as the functioning of a market economy. Nationalisations, market reorganisations, and the deployment of a tax system as a means of punishment have undermined the rule of law and the security of property. As a result, a low growth potential and the widening of inequalities are economic characteristics of Hungary. András Vértes is Chairman of GKI Economic Research Co., Budapest. Introduction For the past decade and a half, analysts of the Hungarian economy, abroad and at home, have been examining the state of affairs with growing surprise. For a long time, they thought that unintended factors coincided, unfavourable trends were temporary in nature, policy decision-makers had bad luck, or some individual wrong decisions led to negative consequences.
    [Show full text]
  • Hungarian Gerontology
    HUNGARIAN GERONTOLOGY Year 4. No. 14. 2012 HUNGARIAN GERONTOLOGY Editorial Board: Editor-in-Chief: Imre Semsei Imre, PhD, DSc Editors: Social Gerontology: Laszlo Ivan, MD, Experimental Gerontology: Miklos Szekely, MD Geriatrics: Bela Szekacs, MD Education: Gyula Bako MD Gerontopsichology: Peter Molnar, MD Life Style: Maria Figler, MD Prevention: Istvan Kiss, MD Társadalomgerontológia: Gergely Fabian, PhD Members of the Board: Laszlo Vertes, MD, Budapest, President Balint Boga, MD, Budapest Erzsebet Csernathné Karandi, Hajduboszormeny Laszlo Dobos, PhD, Miskolc Bela Halmos, MD, Eger Klara Hazafi, MD, Pecs Jozsef Jaszberenyi, PhD, Budapest Karoly Nemeth, MD,Veroce Gyozo Pek, PhD, Debrecen Laszlo Patyan, Nyíregyháza Andrea Ruszwurm, MD, Nagykanizsa Jean S. Szilagyi, Nyiregyhaza Istvan Toth, MD, Miskolc Zita Zekany, MD, Gyula Magdolna Zollei, MD, Szeged Publisher: Faculty of Health, University of Debrecen, 2-4 Sostoi Str., H-4400 Nyiregyhaza Imprint: Imre Semsei, PhD, Gerontology Science Coordination Center, Faculty of Health, University of Debrecen Period of appearance: quarterly On-line version: ISSN: 2062-3690 Technical data: “HUNGARIAN GERONTOLOGY” is a member of the electronic system of the National Library of University of Debrecen (http://magyargerontologia.lib.unideb.hu) Printed version: ISSN: 2062-3682 Press: University Press of Debrecen. 1 Egyetem Sqr., H-4032 Debrecen. Liability: Marta Viragos, PhD HUNGARIAN GERONTOLOGY Year 4, No 14. (2012) CONTENTS EUROPEAN YEAR 2012 „ACTIVE AGING – SOLIDARITY BETWEEN GENERATIONS” oldal Editorial (Imre Semsei, PhD) 1 EUROPEAN YEAR 2012 5 THE EUROPEAN YEAR 2012 IN HUNGARY 33 AGE PLATFORM EUROPE 52 AGE PLATFORM EUROPE IS 10 YEARS OLD 68 ACTIVE AGING 80 Subscription 124 Instruction for Authors 125 EDITORIAL Dear Readers, Year 2012 has been declared by the European Union as the year for “Active Aging – Solidarity between Generations”.
    [Show full text]
  • Cohesion Policy and Perceptions of the European Union in Hungary
    CELINE CANTAT Cohesion Policy and Perceptions of the European Union in Hungary A Cultural Political Economy Approach 2017/8 WORKING PAPER SERIES ABOUT THE PROJECT This study was prepared in the framework of the project “The Impact of Cohesion Policy on EU Identification - COHESIFY” (http://www.cohesify.eu). COHESIFY is a research project funded by the European Union under the Horizon 2020 Program (Grant Agreement nº 693427), running from February 2016 through April 2018. The project investigates whether the performance of the EU’s flagship development policy – Cohesion Policy - influences how people see the EU. The project compares regions in ten countries in the EU to test the importance of the visibility in spending, the extent of local control over selecting priorities and beneficiaries, the significance of political affiliations and the impact of weak performance such as the low absorption rates. The project compares the positions of insiders, such as program designers and administrators, with applicants and beneficiaries, such as local authorities, private companies and civic groups. These attitudes are compared with the views of the general public in the respective regions. These views are gathered through analysis of national and local media reports, social media discussions, and complemented with representative surveys, interviews and focus groups. This paper explores the ways in which a range of actors became involved in negotiating and implementing cohesion funds in Hungary during the two project periods of 2007-13 and 2014-20. ABOUT THE PAPER SERIES Working Papers reflect the on-going work of academic staff members and researchers associated with the Center for Policy Studies/CEU.
    [Show full text]
  • The Role of the Formula 1 Grand Prix in Hungary's Tourism
    BULCSÚ REMENYIK1 – CSILLA MOLNÁR2 The role of the Formula 1 Grand Prix in Hungary’s tourism Abstract Formula 1’s business model is unlike that of any other sports series. F1 is the world’s most-watched annual sports series and attracts more than 400 million television view- ers on every occasion. Hosting an F1 race puts a country on the sporting map and stimu lates curiosity. Income from ticket sales comes to an average of around $33 mil- lion a year and has large influence on the economy, especially on tourism by generating income in the HORECA sector, transportation and other services. Formula 1 races reach a global audience and are keenly followed by avid fans. It is considered to be the most frequented sports event in the world after the Summer Olympic Games marked by high travel numbers. The Formula 1 Hungarian Grand Prix marks an important period for Hungarian tourism, as almost 2 million visitors have visited the Hungaroring during the last 25 years. This sports event attracts international visitors with increased tourist spending, which means a regular and calculable income for hotels and restaurants. The Budapest – Central Danube tourist region, where the Formula 1 Hungarian Grand Prix takes place, is a well-developed and easily accessible area close to the capital city. Keywords: Formula 1, Hungaroring, sports tourism, tourism development, hotel industry JEL codes: Z3, Z2 1 Dr. Bulcsú Remenyik PhD, Budapest Business School, associate professor, [email protected]. 2 Dr. Csilla Molnár PhD, Szent István University, associate professor, [email protected].
    [Show full text]
  • 1 WATER and HEALTH in HUNGARY Report to the 3 Meeting
    WATER AND HEALTH IN HUNGARY Report to the 3rd Meeting of the Parties PART ONE 1. Provide brief information on the process of target-setting in your country, e.g. which public authority(ies) took the leadership and coordinating role, which public authorities were involved, how coordination was ensured, which existing national and international strategies and legislations were taken into account, how cost-benefit analysis of target sets was performed. Hungary ratified the Protocol on Water and Health in 2001, and it came into force by the Government Decree 213/2005 (X. 5.) in October 2005. Implementation of the Protocol began in 2007, coordinated by the Minister of Health and the Minister of Environment and Water. In 2010, the new Government of National Cooperation established major alterations in the government structure and the legal framework, which affected the implementation of the Protocol. The areas covered by the Protocol are shared - on the national level - between the Minister of Human Resources, the Minister of Administration and Justice, the Minister of National Development, the Minister of Rural Development and the Ministry of Interior. The ministers act through the ministries (legal framework) and their national and regional institutional system (implementation). The health related aspects of the Protocol on the local level belong to the National Public Health and Medical Officer’s Service, which was previously (until 2010) under the Ministry of Human Resources. After the governmental reorganization, the national institutions of the Service (National Institute for Environmental Health, National Centre for Epidemiology) remained at the Ministry, while the regional infrastructure was integrated into the capitol and county government offices as public health professional administrative bodies, at the level of districts (capitol districts) they operate as district-level public health institutes.
    [Show full text]