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Une société en désolation et de déliaison attaque d'abord les sciences humaines et sociales et fait encourir le risque de rupture du lien intersubjectif et de solidarité. Le renoncement à celui-ci est à l'origine de la perte du sens et du retour de la peur de la folie. Les soignants subissent l'impact de ce monde nouveau et saisis par l'urgence, agissent sur le présent, plus que n'élaborent des prospectives d'avenir tenant compte de l'histoire, et médicalisent puis psychiatrisent des problématiques humaines de vie et de mort. La rationalisation des démarches diagnostiques et thérapeutiques dictée plus par l'économisme d'aujourd'hui, qui n'est pas une science humaine et sociale mais une idéologie, menace de balayer les acquis de le Pédopsychiatrie institutionnelle, et de l'indispensable éthique de la rencontre interhumaine au cœur du soin. A society where desolation and delirium reigns attacks first and foremost the human and social sciences, and runs the risk of breaking the bonds of intersubjectivity and solidarity. The renunciation of the latter is at the root of the collective loss of meaning and the return of fear of madness. Mental health caregivers feel the impact of this new world and, seized by the urgency of the situation, act in the present rather than looking to the future, taking history into account, medicalizing and then subjecting human problems of life and death to psychiatric analysis and treatment. The rationalization of diagnostic and therapeutic approaches dictated more by today's economism, which is not a human and social science but an ideology, threatens to sweep away the achievements of institutional child psychiatry, and the indispensable ethic of inter-human encounter that lies at the heart of care. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Health care facilities are responsible for preventing and controlling diseases and must be resilient enough to deal with crises. The Iranian health care facilities have faced challenges in managing COVID-19 pandemic. The purpose of this study was to identify the challenges faced by the Iranian health care facilities during the Covid-19 epidemic and to provide solutions. Methods This qualitative study was conducted with a phenomenological approach and using semi-structured interviews with 59 healthcare policy makers, managers, and employees, and medical university faculty members. The participants were selected through purposive and snowball sampling. Thematic analysis was used to analyze the data. Results Overall, 43 challenges to the resilience of health care facilities during the Covid-19 pandemic were identified and grouped into 8 themes (i.e., leadership and management, planning, organizational culture, organizational learning, employee management, customer management, resource management, and process management. The most important resilience challenges were: fragmented management system; poor leadership; incompatible health network structure; lack of a national holistic plan; poor case detection; insufficient resources; inefficient information system; negative attitude of managers and employee; organizational inertia; failure to build on lessons learned from crises; low workforce preparedness; lack of community-based management; and improper monitoring and evaluation. Managers should use community-based, evidence-based, and integrated management to build health system resilience against COVID-19, have sufficient knowledge and experience to organize operations, use appropriate and effective coordination models, develop a creative and participatory culture, reengineer processes, and provide necessary resources. Conclusion The Iranian health care facilities face challenges that prevent them from becoming resilient, responsive, and efficient in managing COVID-19. Policy makers and managers should increase the resilience of health care facilities to shocks and crises by using the suggested measures.

IntroductionVascular anomalies (VAs) are rare conditions and affected patients often experience a difficult patient journey. Timely diagnosis is only possible if primary caregivers are aware of the anomalies and are connected with dedicated specialists. Aim of our survey was to investigate the knowledge about diagnostic and therapeutic possibilities for children with VAs, and the existing networking among primary pediatric caregivers in Austria.MethodsPrimary care pediatricians in Austria were invited to complete an online questionnaire consisting of 28 questions focusing on pediatric VAs.ResultsOut of 373 invited pediatricians 93 (25%) returned the questionnaires, 86 of which were complete. Most physicians (39/93 42%) answered that they see between 15 and 30 patients with infantile hemangiomas per year. Vascular malformations are rarely treated in the primary care setting; most primary care pediatricians (58/86, 67%) reported that they currently treat fewer than 5 patients with such type of VAs. There was unequivocal agreement among the participants (84/86, 98%) on the need to establish a network of specialists and a registry dedicated to pediatric VAs.ConclusionsThis survey represents the first study shedding light on the awareness of VAs among Austrian pediatricians and can serve as a basis for future investigations and advances in the management of these conditions in Austria and other countries with a similar healthcare setting.

Background: Health care facilities are responsible for preventing and controlling diseases and must be resilient enough to deal with crises. The Iranian health care facilities have faced challenges in managing COVID-19 pandemic. The purpose of this study was to identify the challenges faced by the Iranian health care facilities during the Covid-19 epidemic and to provide solutions. Methods: This qualitative study was conducted with a phenomenological approach and using semi-structured interviews with 59 healthcare policy makers, managers, and employees, and medical university faculty members. The participants were selected through purposive and snowball sampling. Thematic analysis was used to analyze the data. Results: Overall, 43 challenges to the resilience of health care facilities during the Covid-19 pandemic were identified and grouped into 8 themes (i.e., leadership and management, planning, organizational culture, organizational learning, employee management, customer management, resource management, and process management. The most important resilience challenges were: fragmented management system; poor leadership; incompatible health network structure; lack of a national holistic plan; poor case detection; insufficient resources; inefficient information system; negative attitude of managers and employee; organizational inertia; failure to build on lessons learned from crises; low workforce preparedness; lack of community-based management; and improper monitoring and evaluation. Managers should use community-based, evidence-based, and integrated management to build health system resilience against COVID-19, have sufficient knowledge and experience to organize operations, use appropriate and effective coordination models, develop a creative and participatory culture, reengineer processes, and provide necessary resources. Conclusion: The Iranian health care facilities face challenges that prevent them from becoming resilient, responsive, and efficient in managing COVID-19. Policy makers and managers should increase the resilience of health care facilities to shocks and crises by using the suggested measures. [ABSTRACT FROM AUTHOR]

Cyber security attacks evidence has shown that many sectors and industries are still at an insufficient level of readiness to counter these threats, including healthcare organizations and the entire healthcare industry. The COVID19 pandemic has additionally launched the issue of cyber protection of healthcare systems and connected medical and other devices as well as modern IT components, which are often the entry point for attackers against healthcare organizations. With the aim of a systematic approach to cyber security in healthcare organizations, this article comprehensively presents cyber risks and possible consequences of attacks in the context of healthcare organization services, as well as identifies the five most important cyber security challenges and provides recommendations for establishing protection mechanisms in line with best practices. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cancer is a chronic disease with long-term consequences for health and quality of life and is more prevalent among older people. Therefore, comorbidity among cancer patients is commonly observed. Several data indicate that 40% of cancer patients have at least one other chronic condition recorded, and of these, 15% have two or more medical conditions, including cardiovascular disease, obesity and metabolic disease, mental health problems, and muscle-skeletal conditions. There is no gold-standard approach for measuring comorbidity in the context of cancer, especially in recent years, when health systems have dealt with a pandemic emergency that has negatively impacted the management of cancer patients. The purpose of this narrative review is to clarify and provide the necessary insights to optimize the care of cancer patients. Ensuring the continuum of care for cancer patients is of vital importance and is considered a top priority. It is necessary to overcome the model that considers neoplastic pathology as a single morbid condition. Instead, the complexity of a cancer patient's problems must be considered and related to complex medical conditions. Addressing the problem of comorbidity in cancer more decisively will be a central challenge if we are to avert a crisis in the models of diagnosis and treatment of cancer patients. [ABSTRACT FROM AUTHOR]

Copyright of Challenges of the Future / Izzivi Prihodnosti is the property of Fakulteta za Organizacijske Studije v Novem mestu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Originality: The subject of the research is the definition and analysis of the organization's process in a health organization, as well as the perception of employees in terms of the performance of the organization. The research aims to determine the manner of organizing, ie the phase in the process of designing the organizational structure in the health organization, as well as to assess the level of perception of organizational performance of employees in that organization. Method: The subject research was conducted through a standardized questionnaire (Griffithsetall, 2006), which contains 8 questions related to the primary demographic data of employees and 30 questions related to the subject of the research. Results: Proving special hypotheses in the research leads to the conclusion that clearly defined roles and responsibilities, the existence of an appropriate pace of work, a deep understanding of the wishes and needs of patients by employees, and employee motivation to work affect the success of a health organization, that is, the manner of organizing affects its business success, while the work environment is not one of the factors that affect the success of a health organization. Society: Considering the impact on society, through the defined measures proposed above, this research paper proposes a way to preserve the functioning of a health organization, meet the wishes and needs of patients and preserve one of the basic human needs, and that is the right to adequate treatment. Limitations / further research: The proposal for future research is reflected in increasing the sample of examinees and repeating research in health organizations across the country.

Purpose: The burden of chronic obstructive pulmonary disease (COPD) is high in rural America. Few studies, however, have examined urban/rural differences in health care access, or racial/ethnic and income disparities stratified by urban/rural residence, among persons with COPD. Methods: We studied individuals age ≥ 40 years with COPD from the 2018 Behavioral Risk Factor Surveillance System. The primary exposure was "urban" or "rural" county of residence. We examined multiple health and health care access/services outcomes using logistic regressions adjusted for age and sex, and performed analyses stratified by rural/urban county that included additional adjustment for race/ethnicity or income. Findings: Our sample included 34,439 individuals. COPD prevalence was 8.6% in rural counties versus 5.4% in urban counties. Rural residents with COPD were poorer, had less education, worse health, and more disability. Of the rural population with COPD, 12.6% were uninsured, versus 10.4% in urban areas (AOR 1.26; 95% CI: 1.00–1.58). Rural residents with COPD were more likely to have not seen a doctor due to cost (AOR 1.18; 95% CI: 1.02–1.36). Differences in other outcomes were mostly nonsignificant. We observed large access disparities by race/ethnicity and income among individuals in both urban and rural counties, with the highest rates of forgone care among minorities in rural counties. Conclusion: Patients with COPD in rural areas experience greater morbidity and obstacles to care than those in urban areas. Racial/ethnic minorities and those with low incomes—particularly in rural areas—are also at greater risk of forgoing doctor visits due to cost. Expanded access to health care could address respiratory health inequities. [ABSTRACT FROM AUTHOR]

Communication is a crucial component in all steps of the health care process. Therefore, it is important to have knowledge about the communication skills of the whole health organization. From the socio-cognitive perspective, collective efficacy beliefs are the main indicators of the capacity of functioning of the system. This work aimed to contribute to the validation of the English version of Health Profession Communication Collective Efficacy Scale (HPCCE scale) a self-report questionnaire measuring hospital doctors’ beliefs to succeed as a group to meet the needs of internal and external communication and of communication with patients, examining the structure, reliability and convergent validity. This study was a cross-sectional investigation conducted using snowball sampling. The participants were 287 doctors working at different hospitals in UK. Explorative factor analyses and Rasch analysis confirmed the one-factor solution. Results revealed high internal reliability. The HPCCE scale correlated positively with Social Self-Efficacy. The English version of HPCCE is a valid instrument to measure communication efficacy beliefs in hospital, involving different type of doctors. It can contribute to the implementation and evaluation of management interventions in a health organization aimed at its optimization.

Introduction: Access in France to early diagnosis and care for the most severe, but infrequent, Neurodevelopmental Disorders (NDD), autism spectrum disorder and global developmental delay, in children aged 0–7 was improved through measures implemented in 2019. However, there are no such measures for specific learning disorders (SLD), attention, motricity and language disorders (SLDD), despite their annual incidence of between 5 and 8%.Method: We describe the design of a new type of organization and financing of care for SLDD including evaluation procedure, as well as other factors, mainly at the prevention level that will contribute to local and national policy for this frequent health problem. This in response to a national call for projects, commonly called Article 51, targeted innovation in healthcare delivery and funding in the context of medium-term national reform. This provides project stakeholders with the opportunity to set up and implement “bottom-up” projects, mainly using local professionals. A joint initiative by the regional Health Authorities of the Occitanie region, the French Social Security system and a non-profit Association (Occitadys) proposed an experimental new structure of NDD care and funding.Discussion: We here discuss the design of this experiment that aims, over two to three years, to alleviate families' financial burden of care and establish a regional three-tier care system with respect to evaluation, re-education and rehabilitation care. Our approach may benefit SLDD health-care planning, and addresses the questions of prevention, early detection and care-design for families, taking local and socioeconomic disparities into account.

Medical institutions operate in an extremely dynamic environment, in accordance with the legal framework, through the organization and management of resources and processes, often in an emergency situation. The main element of a health organization is its human resources. Health facilities operate in an extremely dynamic environment, in accordance with the regulatory framework, through the organization and management of resources and processes, often in an emergency situation. The main element of a health organization is its human resources. The development of staffs, their motivation, and training in a number of competencies are also developed by the organization itself. For its stability, the organizational structure, communication channels and people, as well as their capabilities (knowledge and skills), are important. The selection and development of personnel depends on the management. For a specific field, such as health care, the competence of employees is important. Through various methods, management must constantly emphasize its personnel (selection, development, certification, audit) in order to be able to adequately perform its activities. This study aims to analyze the importance of human resources audit in the health organization and to find out its need for each medical institution to fulfill its mission and provide quality services. The questions concerning motivation of work, workload, problems accompanying the working process are considered. The main conclusions relate to the necessity and advantages of using audit in healthcare organizations. [ABSTRACT FROM AUTHOR]

In the Circular Flow model, a firm or business institution is one of the four factors forming the economic system in society. This section discusses the hospital as a firm because the hospital can be thought of as a place that produces health services from a variety of inputs. Thus, the concept of production can be used in hospitals because the managers are faced with the fact that to produce service products, the hospital can be said to be a production place that carries out the process systematically. The factory is very complex with complicated processes and is in an ever-changing environment. To understand this process can be seen in the case handling cases of Sectio Caesaria (SC) in a teaching hospital. Sectio Caesaria case handling is considered as a production line in the hospital. With medical names, these production lines are referred to as clinical pathways. [ABSTRACT FROM AUTHOR]

This study aims to describe the impact of COVID-19 on internship activities at health organizations in Saudi Arabia. The study is a secondary analysis of data set that was collected from 101 health science interns from different health organizations. The majority of interns were trained or started their internships at public health organizations (64.29%), while 6.12% and 29.59% were at private and other health organizations, respectively. During the COVID-19 pandemic, most health organizations chose to continue the internships (76.53%), while others (23.47%) decided to suspend trainings. Health organizations have taken different actions to overcome the internship issues during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Purpose – to demonstrate the links between social exclusion and the higher costs of treating customers depending on this social sector, unlike other customers who are neither unemployed nor live in poverty. Design/Method/Approach of the research. In the external study, a survey method was used, supplemented with a method of observation at the study site. The authors of the publication carried out research using the qualitative method, formalized interview with medical staff. This research was done in University Hospital in Wroclaw in 2018. Findings. Any health organization must create good relations inside the organization and mostly from outside. One of them is a patient that the author calls a "customer" as every person spends money on health organization leading to the proper hospital functioning. Decision-makers within the system continuously must make choices and seek alternative ways to measure illness costs. One of the factors that harm the optimization of the health services' scale is the social exclusion phenomenon, which is significantly affecting society. Socially isolated people's problems are deprivation, as a lack of access to the necessary level of high-quality, safe, and effective medical services, and cultural competence to provide such medical services. The ex-post analysis conclusions show that relationships between the analyzed areas and the social exclusion phenomenon have a medium and even large dependency and demonstrate cause-effect relationships. Management of customers with the disfunction of medical personnel social requires using other means of communication and building relationships on facts. The communication model between medical personnel and the customer should be founded on a moderate paternalistic model, which is based on facts and documents. The result will be a reduction in service time, which will affect consultation time, financial savings, and an increase in medical personnel efficiency. Originality/Value. In the research of socially isolated people's health problems, three aspects was distinguished: health problems caused by social isolation, health problems that cause social exclusion, and health conditions that are difficult to treat due to social isolation. Paper type – empirical.

In today's modern information society, the success of organizations and managers is increasingly dependent on factors such as attachment, loyalty, communication, leadership and trust that are a circumstance for staff motivation. By loyalty we mean the desire to do the best work, striving for compliance with the principles of the organization. The purpose of the study is to derive indicators that determine respondents' connectedness with the healthcare organization and to clarify the interaction between various aspects of loyalty to the organization and job satisfaction. We proceed from the understanding that occupational satisfaction and staff loyalty to the healthcare organization are key indicators of managerial competence in the field of human resources development and organizational behavior. The study was conducted among 55 health managers and 145 medical specialists from the hospital care in Sofia. Methods: documentary method; questionnaire method; a questionnaire for assessing loyalty to the organization (Organizational Commitment Questionnaire), adapted to the Bulgarian organizational environment and the specifics of health care activity; statistical methods. Results: We tracked the interdependencies between different aspects of loyalty and job satisfaction. The emotional component of loyalty was found to have a positive effect on staff efforts and negatively on their tendency to leave the healthcare facility. Payment satisfaction increases the emotional and rational components of loyal behavior. Older employees have a higher degree of loyalty to the healthcare organization, with its value increasing significantly in the group of over 45 years. Conclusions: Job satisfaction and loyalty to the organization are interdependent variables. Conclusion: It is necessary to create and maintain such an organizational culture in the healthcare facility, which creates a strong emotional and rational connection of the staff with the healthcare institution. [ABSTRACT FROM AUTHOR]

The coronavirus disease-19 (COVID-19) pandemic is imposing an extraordinary threat to global health. Consequently, fear has been raised in that the COVID-19 pandemic could disproportionately affect lowincome countries. Low-income countries are mainly concentrated in the Global South of the tropics with a high diversity of pathogens, and a considerable proportion of people living under chronic poverty. All these risks might have made Southern people develop a sort of herd immunity and resilience against a broad range of infections. The analysis of the COVID-19 Worldometers data by using country-, territory-, or conveyance-wise summarized in Global North (64 countries) and Global South (147 countries) suggested the high incidence of COVID-19 infection in the North world countries. However, this should be treated with caution given the low testing and contact tracing, and presumably reporting capacity, by the South World countries. Nevertheless, Southern people are living under minimal healthcare, consequently, their relative wellness amidst the COVID-19 crisis could not be overlooked. The observed differences in infectivity, however, might not be ethnically-biased but most likely they could be due to the differences in the living standard, healthcare systems as well as the lifestyle of Global North versus Global South countries.

Introduction:Social media is used as a tool for both information providers and information consumers to disseminate and receive health information. There is a dearth of research that compares the differences between different types of health provider  Twitter® (Twitter, Inc., San Francisco, CA) posting styles, specifically regarding the ways in which they communicate health information with the public. This is particularly true for more localized studies that focus on small data sets. Methods:Our study seeks to help fill this gap through an exploration of emergent trends of social media use of small, but specific, stakeholders in Texas, in the United States. Results:A content analysis of health information providers' (individual, organizational, and governmental groups) Tweets based on digital, ethnographic, and grounded theory methods was performed to provide quantitative and qualitative findings in terms of purpose, sentiment, visual features, tone of the Tweets, and public engagement. Conclusions:The findings indicate how individual or organizational users differentially use their Twitter accounts and open up a discussion of what factors might influence effective communication with the public. [ABSTRACT FROM AUTHOR]

The article considers problems of assessment of the quality of human resource capacity of health organizations. The analysis of existing methods of an estimation of personnel potential. Describes the main components of the system of personnel policy of the medical organization. Developed graphical representation of personnel potential of the employee.

This article aims to verify if the innovations institutionalized in a health organization can be considered as sustainable innovations. To meet this objective, a qualitative case study was carried out, with descriptive characteristics, the object of which was a large private hospital, located in the city of Porto Alegre-RS. Data were collected through nine semi-structured interviews with the leaders indicated by the Institution and data were analyzed through qualitative content analysis. The main results show that the health organization studied develops innovation practices that contribute to sustainability, such as: acquisition of equipment, innovation in the management model, innovation in the organizational structure and the introduction of the School of Health. Occurred in a systematized manner according to the sustainability pillars and, rather, from a strategic conception with significant economic and social benefits aligned with the management model.

Background Several health organizations have adopted the 5A’s brief intervention model (Ask, Advise, Assess, Assist, Arrange), based on evidence-based guidelines for smoking cessation. We examine individual, cognitive, behavioral, and organizational factors associated with the 5A’s performance among clinical healthcare workers in Catalonia. We also investigate how these factors interact and potentially predict the implementation of each component of the 5A’s. Material and Methods A cross-sectional survey was conducted among clinical health workers enrolled in an online smoking cessation training course (n = 580). The survey included questions about individual characteristics as well as cognitive, behavioral, and organizational factors previously identified in research. We assessed self-reported performance of the 5A’s, assessed on a scale from 0 to 10, and used Multivariate regression to examine factors associated with its performance. Results The performance means (standard deviation) were moderate for the first 3A’s [Ask: 6.4 (3.1); Advise: 7.1 (2.7); Assess: 6.3 (2.8)] and low for the last 2A’s [Assist: 4.4 (2.9); Arrange: 3.2 (3.3)]. We observed a high correlation between Assist and Arrange (r = 0.704, p < 0.001). Having positive experiences and feeling competent were positively associated with performing the 5A’s model and having organizational support with Assist and Arrange. Personal tobacco use among healthcare workers was negatively associated with Advice and Arrange. Conclusions Our study found that clinical healthcare workers do not perform the 5A’s completely. The main barriers identified suggest the need of training and making available practical guidelines in healthcare services. Organizational support is essential for moving towards the implementation of Assist and Arrange.

В настоящее время, рассматривая вопрос о распространенности бронхиальной астмы и хронической обструктивной болезни легких, мы вынуждены говорить о социально значимых заболеваниях, которые наносят урон человечеству мирового масштаба с высоким уровнем инвалидизации и смертности населения. Так же важным аспектом является экономическая составляющая данной проблематики. Достаточно большая статья расходов отводится на лечение больных данной категории больных из федерального и регионального бюджета. В связи с этим, стал остро вопрос о совершенствовании алгоритма динамического наблюдения и реабилитационных мероприятий для больных хронической обструктивной болезнью легких и бронхиальной астмой. Достижения в области медицины позволяют практическому врачу применять лекарственные препараты, направленные на достижение полного контроля заболевания. Но как показывает реальная практика важным является и тот факт, каков достигнут комплаинс между врачом и пациентом. Какие методы еще могут применяться в лечении больных БА и ХОБЛ могут применяться? Конечно это психокоррекция. Большое многообразие клинических проявлений у пациентов с данными патологическими состояниями позволяет нам задуматься о формировании определенного психостатуса больных. Всестороннее изучение БА и ХОБЛ представляет научный интерес для практической медицины, что и явилось актуальным вопросом в нашем исследовании.В проводимом нами исследовании участвовало всего 330 человек. Из них 185 чело-век – больных бронхиальной астмой. Из них – 50 человек легкой степени тяжести заболевания, 110 человек – средней степени тяжести и 25 – тяжелой степени тяжести. Средний возраст пациентов составил 38-56 лет. Средний возраст составил 57-63 года.Пациенты были включены в исследование путем случайной выборки на этапе диспансерного наблюдения в условиях БУ «Сургутская окружная клиническая больница» консультативно-диагностической поликлиники. Наблюдение проводилось на протяжении 2012-2014 гг.Проводя многостороннее исследование личности больных бронхиальной астмой и хронической обструктивной болезнью легких, мы воспользовались методикой, предлагаемой стандартизированным и адаптированным Миннесотским опросником (MMPI).Для статистической обработки материала применен пакет прикладных программ STATISTICA 6.0 (Stat Soft Inc). Использовали: критерий Стьюдента (t); критерий Вилкоксона для оценки значимости различий количественных переменных в двух связанных выборках; U-критерий Манна-Уитни для оценки значимости различий количественных переменных в двух независимых выборках; критерий Мак Немара % (для связанных выборок) и двухсторонний точный критерий Фишера (для независимых выборок) для сравнения переменных, представленных в виде частот; корреляционный анализ путем вычисления коэффициента корреляции Спирмена [Гланц С., 1995; Гельман В.Я., 2002; Реброва О.Ю., 2002].В группу больных хронической обструктивной болезнью легких (ХОБЛ) вошли 145 человек. Из них 95 человек – больные II стадии тяжести заболевания и 50 человек – III стадии заболевания.

Introduction: Vascular anomalies (VAs) are rare conditions and affected patients often experience a difficult patient journey. Timely diagnosis is only possible if primary caregivers are aware of the anomalies and are connected with dedicated specialists. Aim of our survey was to investigate the knowledge about diagnostic and therapeutic possibilities for children with VAs, and the existing networking among primary pediatric caregivers in Austria., Methods: Primary care pediatricians in Austria were invited to complete an online questionnaire consisting of 28 questions focusing on pediatric VAs., Results: Out of 373 invited pediatricians 93 (25%) returned the questionnaires, 86 of which were complete. Most physicians (39/93 42%) answered that they see between 15 and 30 patients with infantile hemangiomas per year. Vascular malformations are rarely treated in the primary care setting; most primary care pediatricians (58/86, 67%) reported that they currently treat fewer than 5 patients with such type of VAs. There was unequivocal agreement among the participants (84/86, 98%) on the need to establish a network of specialists and a registry dedicated to pediatric VAs., Conclusions: This survey represents the first study shedding light on the awareness of VAs among Austrian pediatricians and can serve as a basis for future investigations and advances in the management of these conditions in Austria and other countries with a similar healthcare setting., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Gasparella, Senica, Singer, Banfi, Flucher, Beqo, Till and Haxhija.)

The human resources management of the Romanian healthcare organizations is deficient under the conditions where compared to other European countries, the provision of the Romanian population with doctors and healthcare staff is lower than the European environments. Apart the irregular territorial distribution of the medical staff, it is to notice also the insufficient specialized personnel particularly for preventive, medico-social, public health sectors and healthcare management. Other issues refer to the missing incentives to choose the medical career and the missing support for young specialists, the poor organization of the continuous and postgraduate training for physicians, the low level of the remuneration and the missing connection between the medical performance and the officially earned incomes etc. All these aspects reveal major dysfunctions on the planning and training of the medical staff, aspects related to several institutions that have no coordinated coherent policies in the field. The causes of the missing professionalism entail sometimes serious problems of patients due to the poor training that such persons have, due to the indifference that patients are subject to nowadays and due to the low incomes. Sometimes the effects are serious, both patients and the organization management have to suffer. Therefore, the medical staff should be motivated and last but not least we have to make it be more capable, more responsible, and more efficient. The training and skill upgrade of the auxiliary medical staff (nurses and caregivers) with medium education within the Romanian public healthcare organizations should be opportune and a project should be implemented as soon as possible both for the proper conduct of the organization management and the patients and medical staff well-being. Also by implementing this project, we should reach a major decrease of the medical staff receiving bribe from patients; this is quite serious and actions should be taken as soon as possible in order to avoid a decrease of the patient satisfaction degree. [ABSTRACT FROM AUTHOR]