15 research outputs found
ASPECTE CHEIE ALE INTRODUCERII EVALUĂRII TEHNOLOGIILOR MEDICALE ÎN ROMÂNIA
No full textRegarding Health Technology Assessment (HTA) represents a form of policy research which considers the short and long term consequences of health technologies. The first steps towards HTA were taken in Romania more than 15 years ago, but the effects seem insignificant even though they have never been measured. After 2011 HTA re-entered on the Romanian health care reforms’ agenda and it started the design of the legal framework in order to develop the HTA system.The scope of this article is to briefly present some key principles and aspects which could represent the fundamentals of a quick development of HTA in the following years. This article is not meant to present an evaluation of the HTA steps which have been done so far.In order to develop a HTA system there is a need for the involvement of key policy making stakeholders who have to express their willingness and demand for the usage of data generated by the HTA system for the decision-making process. Also, there is a need of resources (human, financial, organisational) and for capacity-building of institutions who will offer the ground to develop the HTA. In Romania, the willingness to develop the HTA system is expressed in the health policies (specifically in the Government Program for 2013-2016), but there is still a lot to do in terms of designing the legal framework and the development of required institutions for an HTA system.In this context, there are four key aspects which could facilitate the introduction and functioning of the HTA in Romania, grouped under the „Four P” (Partnership, Pragmatism, Predictability and Praise), aspects detailed in the context of Romanian health care system. The application of these „Four P” has to be coupled with the health policies in order to integrate the HTA system with the continuous reform of the health services: public financing, basic package, evaluation of quality etc. And to all these aspects there is a need to associate change champions, leaders who believe in HTA and who could become pioneers and development catalysts of HTA in Romania if they get support from the political environment. Keywords:HTA - Health Technology Assessment, health policy, health reform, resources allocation.Evaluarea Tehnologiilor Medicale (ETM) reprezintă o formă de cercetare în politicile de sănătate în care se examinează consecinţele pe termen scurt şi lung ale tehnologiilor din sănătate. Primii paşi în direcţia ETM în România au fost făcuţi cu peste 15 ani în urmă dar efectele par nesemnificative, deşi nu au fost niciodată măsurate. După anul 2011, ETM a reintrat pe agenda reformei sistemului de sănătate din România şi a început realizarea cadrului legislativ în vederea dezvoltării sistemului de ETM.Scopul articolului este de a prezenta, pe scurt, câteva principii şi aspecte cheie care să stea la baza unei dezvoltări rapide a ETM în anii ce urmează şi nu de a realiza o evaluare a paşilor făcuţi, până în acest moment, privind ETM în România.Pentru construirea unui sistem de ETM este nevoie de implicarea decidenţilor politici care să-şi exprime dorinţa şi să lanseze cererea de utilizare a informaţiilor generate de ETM în luarea deciziilor. Pe de altă parte, trebuie să existe resursele (umane, financiare, organizaţionale) şi să fie dezvoltate capacităţile insituţionale care să ofere baza realizării ETM. În România, la nivelul politicilor de sănătate se exprimă dorinţa de dezvoltare a ETM (specific şi în Programul de Guvernare 2013-2016), dar se lucrează, încă, la realizarea cadrului legislativ adecvat şi la creşterea capacităţii instituţionale de a face un sistem de ETM.În acest context sunt identificate 4 aspecte cheie ce ar facilita introducerea şi funcţionarea ETM în România, grupate sub sintagma cei „Patru P” (Parteneriat, Pragmatism, Predictibilitate şi Premiere), aspecte prezentate detaliat în contextul sistemului de sănătate din România. Punerea în practică a celor „Patru P” trebuie cuplată la politica de sănătate, astfel încât să integreze ETM cu reforma continuă a celorlalte sectoare ale sistemului de sănătate: modalitate de finanţare, definirea pachetului de servicii, evaluarea calităţii îngrijirilor etc. Iar la toate aceste aspecte cheie e nevoie de asociat campioni ai schimbării, lideri care cred în funcţionarea ETM şi care sprijiniţi de mediul politic pot devenii pionieri ai sistemului şi catalizatori ai introducerii şi dezvoltării ETM în România.Cuvinte chei: Evaluarea Tehnologiilor Medicale (ETM), politici de sănătate, reforma sănătăţii, alocarea resurselor
Implementation of spatial variability in PLAXIS
No full textAs a consequence of the difficulty to obtain complete direct information about the subsurface, and the importance of heterogeneity of soil properties in geotechnical design, a desire exists in the geotechnical community for a smarter use of the available data in common practice. The objective of this thesis is to provide a potential solution for this, by implementing the Random Finite Element Method (RFEM) in PLAXIS, a well-known geotechnical calculation software package, allowing users to stochastically model engineering problems while accounting for the spatial variability of soil properties. As a result of this project, practitioners can use the upside of stochastic analysis using RFEM to derive new insights about the behavior of their system, such as potential soil-related asymmetries, all while obtaining a better picture of the risks associated with a certain design. As with any technological advancement, responsible use of the framework is required to ensure the upside is attained and computational concerns do not hinder the use of the model, feature which still requires further research and improvement.Geo-Engineerin
Dietary Disruptors in Romania: Seasonality, Traditions, and the COVID-19 Pandemic
No full textBackground: The global rise in obesity has been significantly influenced by shifts in dietary habits that have been exacerbated by external factors such as the COVID-19 pandemic. This study aims to analyze the trends in Romanian dietary habits from 2015 to 2023, focusing on the impact of the COVID-19 pandemic and the role of socio-economic factors, seasonality, and cultural practices. Methods: For dietary habits, we used nationally representative data from the Romanian Household Budget Survey provided by the Romanian National Institute of Statistics. The survey includes 30,000 households annually. From the same provider, we downloaded data about potential drivers of food consumption, such as income, the consumer price index, and the unemployment rate. The analysis mixes descriptive statistics and panel data analysis. Among the main drivers, the econometric models include seasonality and regional factors, ensuring a comprehensive understanding of the changes in dietary behavior. Results: During the COVID-19 pandemic, daily calorie consumption increased to over 3000 calories per person, representing a 20% increase compared to the pre-pandemic period. Post-pandemic, food consumption remains elevated, averaging 2500–2600 calories per person daily. The pandemic also led to a shift in dietary composition, with significant changes. Thus, we mark an increase in fat (p < 0.001) and carbohydrate intake (p < 0.01) and a decrease in protein intake (p < 0.001). Beyond the presence of health disruptors, we confirm the significant impact of income (p < 0.001) and seasonality (p < 0.001). Other factors like unemployment, the consumer price index, and hidden regional factors have a minor role. Conclusions: The COVID-19 pandemic has had a lasting impact on Romanian dietary habits, reinforcing unhealthy eating patterns that were already prevalent. The sustained increase in calorie consumption, particularly of nutrient-poor, energy-dense foods, poses a significant public health challenge. The study also highlights significant seasonal variations, with a marked increase in food intake during the last quarter of the year, driven by cultural and religious traditions. These findings underscore the need for targeted public health interventions and policies that address economic factors and cultural and regional influences to promote healthier dietary behaviors in Romania
E-education, information investors in people for relaunch economy
Get PDFThe paper addresses the issue of modern concepts of "e-education and e-learning", plus the models and the recovery of investment. The following are educational approach focusing on e-learning, using principles androgogic system E-learning, models for implementation of e-learning, plus a comparative analysis of standards and norms of global e-learning. Insertion peculiarities of international standards for e-learning(defining the standards and norms of international e-learning, the use of e-learning on the job market and the realization of e-learning focused on the correlation between strategic business objectives, infrastructure and evaluation system preparing staff). End of paper plays Six-Sigma methodology and the recovery of investment specific e-learning, the level of competence of the actors in the e-learning paradigm and implementation and benefits of online learning.e-education, web-based learning, open and distance learning, androgogic model of e-learning
Burden of Influenza in Romania. A Retrospective Analysis of 2014/15–2018/19 Seasons in Romania
No full textIntroduction: Influenza is a seasonal epidemic with a heavy negative impact both on population health, and healthcare system utilization; until now, there are only two burden of disease studies in the Romanian context. This study aims to quantify the burden of influenza for the Romanian population for the seasons 2014/15 to 2018/19, using health administrative databases. Methods: Incidence, hospitalization and mortality rates attributable to influenza as well as total number of influenza cases and deaths were estimated, for each season in the analyzed period, by combining the new cases reported by General Practitioners, Emergency Department presentations, hospitalizations, number of deaths, positivity rate of influenza, and probability to be consulted by a physician. Years of life lost due to premature death attributable to influenza complications were also computed. Results: On average, 591,151 cases/season attributable to influenza were estimated during the period 2014/15–2018/19. The highest rates for incidence, hospitalization and presentation to emergency department were found in the age groups 0–4 years and 65 years and above. Influenza mortality rate was estimated at 3 per 100,000 persons and the 65 and above age group had the highest rate. Conclusions: About 3% of the total Romanian population is estimated to develop an influenza attributable disease in a non-pandemic season. An overall increasing trend of the mortality rate attributable to influenza may be also underlined. On average, a person loses 12 years due to premature death caused by complications of influenza
Research on the Influence of the Light and Compound Feed on Growth Performance into Young Quail Mixed Eggs-meat Population of Balotesti During 28-56 Days
No full textAbstractIn order to study the influence of the light and compound feed on growth performance into young quail mixed-population of Baloteşti was organized an experiment on 400 chicken quails. It has studied the impact of a illumination program with asymmetrical hourly intervals (10L+2N+6L+6N) compared with a program of continuous lighting in day period (16L+8N). It was used 3 types of compound feed: for growth, finishing and for adult quails. The growth performance of young quails during the period 28-49 days were superior in the case of lots of female animals (B1) and male (B2) compared with the consignments of female (A1) and male (A2). The average live weight at the age of 49 days was higher with 9.67% at the females from the lot B1 compared with females from lot A1, while to male this was higher with 6.95% at the males of the lot B2 compared with males from the lot A2. In the period 49-56 days the weight gain at males from the lot A2-2 has been with 6.30g/head higher than to male from the lot of A2-1, and feed consumption rate has been reduced by 19.10g c.f./g weight gain to the consignment A2-2 from the consignment A2-1. Increase of growth to male from the lot B2-2 has been with 6.88g/head higher than to male from the lot B2-1 and feed consumption rate has been reduced by 17.60g c.f./g weight gain to lot B2-2 compared the lot B2-1. Considering the superior performance recorded in the case of lots A2, B2, A2-2 and B2-2 during the periods concerned, it is recommended to use the illumination program with the hourly intervals asymmetrical with a duration of 16hours in growth young quail still from the age of 28 days, the management of the finishing compound feed to male for meat in the period 49-56 days and the feed for adult quail females from the age of 49 days
Analiza Cost-Eficacitate R-CHOP VS. CHOP în limfoamele agresive non-Kodkin (NHL)
No full textThe CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone) is the standard treatment for younger and elderly patients with diffuse large-B-cell lymphoma, but it induces complete responses in only 40 to 50 percent of elderly patients. The benefit of adding Rituximab (R) – a chimeric anti-CD20 IgG1 monoclonal antibody, to CHOP was observed among patients with relatively low risk disease or high risk disease. In comparative studies of CHOP and R-CHOP, the rate of complete response was significantly higher in the group that received R-CHOP than in the group that received CHOP alone. In several EU countries there are cost-effectiveness studies regarding the treatment of aggressive NHL with CHOP vs. R-CHOP, but in Romania there is no such a study done.The authors used a cost-effectiveness model where they compared the costs of both type of treatments and the benefits expressed in gained years of life, in order to have the Romanian perspective for the economic evaluation of treatment of aggressive NHL with CHOP vs. R-CHOP. The Romanian cost-effectiveness analysis is based on a model developed by Best et al. which calculates the cost-effectiveness ratio of R-CHOP vs. CHOP over time horizon of 10 years for patients with diffuse large B-cell lymphoma DLCL. The analysis was done based on local Romanian costs and the clinical benefits from the GELA study. Rituximab administered together with CHOP gives patients an increased chance of cure, a significantly superior survival and represents a cost-effective therapy compared to standard treatment with CHOP. When costs and survival benefits are considered over 10 years, the additional cost per patient on R-CHOP is 12,929 Euro. Over a 10 years time frame, the estimated survival benefit of R-CHOP compared to standard CHOP treatment alone in this group of patients is on average 0.60 extra years of life gained per patient. The estimated additional cost per extra year of life gained for the combination therapy is 21,549 Euro. Using the same cost-effectiveness model we observed that using R-CHOP vs. CHOP we obtained in Romania the lowest cost per additional year of life gained compared with France or United Kingdom.Keywords: cost-effectiveness analysis, cost per life year gained, NHL non-Hodgkin lymphoma Tratamentul cu CHOP (Cyclophosphamide, Doxorubicin, Vincristine şi Prednisone) reprezintă tratamentul standard pentru limfomul difuz cu celule B mari (forma cea mai frecventă a limfoamelor non-Hodgkin) la pacienţii tineri sau vârstnici, dar acesta induce un răspuns complet doar la 40-50% dintre pacienţii vârstnici. Beneficiul adăugării Rituximab (R) – un anticorp IgG1 chimeric monoclonal anti-CD20, la CHOP a fost observat la pacienţii cu risc mare sau redus de boală. În studiile comparative de eficacitate între CHOP şi R-CHOP, rata de răspuns complet a fost semnificativ mai mare la grupul ce a primit R-CHOP faţă de grupul ce a primit CHOP simplu. Studii economice de cost-eficacitate a CHOP vs. R-CHOP în tratamentul limfoamelor agresive non-Hodgkin au fost efectuate în mai multe ţări ale Uniunii Europene, dar în România nu s-au efectuat astfel de studii până în acest moment.Autorii au utilizat un model de analiză economică de tip cost-eficacitate în care au comparat costurile ambelor tipuri de tratament şi au exprimat rezultatele în ani de viaţă câştigaţi, pentru a avea o perspectivă locală a evaluării economice a tratamentului cu CHOP vs. R-CHOP a limfoamelor agresive non-Hodgkin. Analiza românească a cost-eficacităţii se bazează pe un model dezvoltat de Best et al. care a calculat raportul cost-eficacităţii pentru R-CHOP vs. CHOP la pacienţii cu limfoame agresive non-Hodgkin pentru un orizont de timp de 10 ani. Analiza a fost făcută pe baza datelor de cost din România şi a datelor privind beneficiile din studiul GELA. Rituximab administrat împreună cu CHOP oferă pacienţilor o şansă mai mare la vindecare, supravieţuire mai mare, semnificativă şi reprezintă o terapie cost-eficace în comparaţie cu tratamentul cu CHOP. În momentul în care luăm în considerare costurile şi beneficiile pe o perioadă de studiu de 10 ani pentru pacienţii vârstnici cu limfoame difuze cu celule B mari, rezultatele arată un cost adiţional pe pacient tratat cu R-CHOP de 12.929 Euro. De-a lungul a 10 ani, beneficiul suplimentar în supravieţuire al tratamentului cu R-CHOP faţă de tratamentul cu CHOP la aceşti pacienţi este de 0,6 ani de viaţă câştigaţi per pacient. În acest fel, costul adiţional al tratamentului cu R-CHOP faţă de CHOP pentru un an de viaţă câştigat este de 21.549 Euro.Utilizarea aceluiaşi model de analiză cost-eficacitate în Franţa şi Marea Britanie ne arată că în România se obţine cel mai redus cost per an de viaţă câştigat adiţional prin tratamentul cu R-CHOP faţă de tratamentul cu CHOP.Cuvinte cheie: analiză cost-eficacitate, cost pe an de viaţă câştigat, limfoame non-Hodgki
Real-world evidence: the low validity of temperature screening for COVID-19 triage
Get PDFBackground: The COVID-19 pandemic forced health-related organizations to rapidly launch country-wide procedures that were easy to use and inexpensive. Body temperature measurement with non-contact infrared thermometers (NCITs) is among the most common procedures, both in hospital settings and in many other entities. However, practical hospital experiences have raised great doubts about the procedure's validity. Aim: This study aimed to evaluate the validity of the body temperature measured using NCITs among oncological and transplant patients who took the polymerase chain reaction test for SARS-Cov-2 PCR+ and PCR- in a Romanian Hospital. Methods: Body temperature was measured for 5,231 inpatients using NCITs. The cutoff point for fever was equal to or above 37.3 degrees C. Patients then completed a questionnaire about their symptoms, contact, and travel history. Findings: Fever was detected in five of 53 persons with PCR+, resulting in a sensitivity of 9.43% (95% CI, 3.13-20.66%). No fever was verified in 5,131 of 5,171 persons with PCR-, resulting in a specificity of 99.15% (95% CI, 98.86-99.38%). A defensive vision of NCIT procedure (maximum standard error only in favor) had a sensitivity of 15.09% (95% CI, 6.75-27.59%). Conclusions: The use of NCITs in a triage provides little value for detection of COVID-19. Moreover, it provides a false sense of protection against the disease while possibly discriminating individuals that could present fever due to other reasons, such as oncologic treatments, where fever is a common therapeutical consequence. The consumption of qualified human resources should be considered, especially in the context of the shortage of healthcare professionals worldwide.info:eu-repo/semantics/publishedVersio
Determining the influence of dynamic balance in the technical training in football game at U13 level
Get PDFBackground and Study Aim. Technical training in football plays an important part in scoring goals. Precise movements can become the key to victory in a match. Among the principal factors determining the accuracy of shooting or kicking the ball is balance. The study aims to determine the influence of dynamic balance on technical training in U13 football.
Material and Methods. A group of 26 football players from Otopeni Sports Club (Romania), aged 12-13 years, in the U13 category, participated in this study. Dynamic balance was assessed using the Sensamove MiniBoard platform with tests including: Lateral bipedal balance (LBB), Vertical bipedal balance (VBB), and Vertical unipedal balance for both right (VBRL) and left (VBLL) legs. Technical training was evaluated using tests recommended by the Romanian Football Federation: instep kick from 9 m (Test 1, points), outside kick in 30 sec. (Test 2, points), and 20 m long pass (Test 3, points). Pearson’s correlation coefficient was used to analyze the relationship between dynamic balance (lateral and vertical bipedal, and vertical unipedal for both legs) and technical training in U13 footballers.
Results. The analysis of the comparative results between LBB and VBB variables reveals better performances by 9.2% at VBB. There are lower values of the vertical deviations mean by 2.9 degrees forward at LBB and by -2.8 degrees backward. The mean of lateral deviations is lower by -2.7 degrees to the left at VBB and by 3.3 degrees to the right. The comparative results between VBRL and VBLL variables show better performances by 0.3% at VBRL. The values of the vertical deviations mean are lower by 0.5 degrees forward at VBRL and 0.3 degrees backward. The mean of the lateral deviations (left-right) have equal values. Analyzing the performances obtained in technical tests highlights 22.2% (estimated maximum score) at instep kick, 62.5% (individual maximum value) at outside kick and 34.5% (estimated maximum value) at 20 m long pass. The influence of dynamic balance on technical training shows 60.7% positive connections and 39.3% negative ones between LBB and VBB variables. As for VBRL and VBLL variables, there are 67.9% positive connections and 32.1% negative connections between them.
Conclusions. The weighting of values at performance and maintaining in space was highlighted. The mean of front-back and left-right deviations in bipedal and unipedal balance has lower values. The technical performances obtained were compared with the estimated maximum score and the individual maximum value. An increased number of positive connections to balance performance variables and of negative connections to the mean of deviations was noticed. This fact contributed to determining the degree of influence on the investigated variables. The findings can serve as a recommendation for future research
Genetic contributions of the serotonin transporter to social learning of fear and economic decision making
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