INSTITUTIONS AND VALUES OF ROMANIANS – COMPARATIVE ANALYSIS OF HISTORICAL REGIONS

Starting from the results of a national survey, a questionnaire on the values of Romanians was applied in April 2008 which was used for a comparative analysis of historical regions of Romania: Moldova, Bucharest, Dobrogea, Transilvania and Muntenia.instrumental values, formal institutions, informal institutions, culture, regions

SUPPLY CHAIN OUTSOURCING: MANAGEMENT ACCOUNTING AND CONTROL SYSTEMS USED IN INTER-ORGANISATIONAL RELATIONSHIPS

Inter-organisational relationships created through outsourcing have become popular in recent years. Researchers have shown increased interest in management accounting and control systems used in such relationships, however previous studies identify potential areas for future research. The purpose of this research is to build on previous studies and to identify what management accounting and control systems organisations implement when they enter into an inter-organisational relationship following an outsourcing decision, in order to mitigate potential risks and maintain control over the supplier’s performance and activities. The methodology chosen is a case study conducted in an IT company that outsourced part of its supply chain function to a third party logistics provider. Data were collected through semi-structured interviews conducted with members of the Supply Chain and Procurement Teams. Findings show that risks are mitigated through partner selection criteria, contractual agreements and frequent meetings. The supplier’s performance is controlled through performance measurement tools, integrated information systems and cost models. The implementation of these management accounting and control systems enabled the partners to achieve a collaborative relationship. Keywords: outsourcing, inter-organisational relationships, management accounting and control system

LARS-like symptoms in the general population may suggest the significance of postoperative functional problems and emotional implications of rectal surgery

Background & Aim. Sphincter-saving rectal surgery is prone to cause changes in bowel function associated with Low Anterior Resection Syndrome (LARS). Our aim was to assess LARS-like symptoms within a population of 50-80-year old in order to understand the functional disturbances and emotional impact of LARS. Materials and methods: We used a questionnaire to evaluate LARS with the following categories of symptoms: flatulence control, anal incontinence, frequency, clustering and urgency of the stools, and the psycho-emotional impact created by the presence of these symptoms. We calculated the severity of LARS on 343 responders. Results. The average age of the responders (57.4% females) was 60 years. Overall, 48.1% of those questioned had no LARS-associated symptoms, while the rest presented either minor (39.9%) or major (12%) LARS-like symptomatology according to the assessment scale. Women have a higher relative risk (1.32) of having minor or major LARS. The frequency of stools did not correlate with the overall LARS score. The psycho-emotional impact was mostly influenced by the presence of incontinence (p=0.001) and urgency (p=0.05). Discussions. The study highlights the need to integrate the initial status of patients into the overall quantification of the effects of surgery on the quality of life. Age does not influence the prevalence of LARS, but symptoms seem more prevalent in women. The psycho-emotional impact is relevant to the general population, so explanations given during the informed consent and accurate description of potential consequences of surgical intervention increase compliance to ensure better post-operative control of the symptomatology. Conclusions. Deriving a normative LARS-like score may alter the interpretation and discussion of LARS scores for future rectal cancer patients, and it also provides a better understanding of the emotional impact of such symptoms on certain population subsets or cultural groups

LARS-like symptoms in the general population may suggest the significance of postoperative functional problems and emotional implications of rectal surgery

Background & Aim. Sphincter-saving rectal surgery is prone to cause changes in bowel function associated with Low Anterior Resection Syndrome (LARS). Our aim was to assess LARS-like symptoms within a population of 50-80-year old in order to understand the functional disturbances and emotional impact of LARS. Materials and methods: We used a questionnaire to evaluate LARS with the following categories of symptoms: flatulence control, anal incontinence, frequency, clustering and urgency of the stools, and the psycho-emotional impact created by the presence of these symptoms. We calculated the severity of LARS on 343 responders. Results. The average age of the responders (57.4% females) was 60 years. Overall, 48.1% of those questioned had no LARS-associated symptoms, while the rest presented either minor (39.9%) or major (12%) LARS-like symptomatology according to the assessment scale. Women have a higher relative risk (1.32) of having minor or major LARS. The frequency of stools did not correlate with the overall LARS score. The psycho-emotional impact was mostly influenced by the presence of incontinence (p=0.001) and urgency (p=0.05). Discussions. The study highlights the need to integrate the initial status of patients into the overall quantification of the effects of surgery on the quality of life. Age does not influence the prevalence of LARS, but symptoms seem more prevalent in women. The psycho-emotional impact is relevant to the general population, so explanations given during the informed consent and accurate description of potential consequences of surgical intervention increase compliance to ensure better post-operative control of the symptomatology. Conclusions. Deriving a normative LARS-like score may alter the interpretation and discussion of LARS scores for future rectal cancer patients, and it also provides a better understanding of the emotional impact of such symptoms on certain population subsets or cultural groups

Leczenie akromegalii w Rumunii. Jak blisko jesteśmy uzyskania kontroli nad chorobą?

Introduction: In Romania, no nationwide data for acromegaly treatment and control rate are available. Our objective was to assess the acromegaly control rate in a tertiary referral centre, which covers an important part of Romanian territory and population of patients with acromegaly. Materials and methods: We reviewed the records of all 164 patients (49 males and 115 females; median age 55 [47, 63.5] years) with newly or previously diagnosed acromegaly, who have been assessed at least once in our tertiary referral centre between January 1, 2012 and March 31, 2016. This sample represents 13.6% of the total expected 1200 Romanian patients with acromegaly and covers 82.9% of the counties in Romania. Control of acromegaly was defined as a random serum growth hormone (GH) < 1 ng/mL and an age-normalised serum insulin-like growth factor-I (IGF-I) value. The GH and IGF-I values used for calculation of the control rate were those at the last evaluation. The same assays for GH and IGF-I measurement were used in all patients. Results: There were 147 treated and 17 untreated patients. Of the 147 patients assessed after therapy, 137 (93.2%) had pituitary surgery, 116 (78.9%) were on medical treatment at the last evaluation, and 67 (45.5%) had radiotherapy. Seventy-one (48.3%) had a random GH < 1 ng/mL, 54 (36.7%) had a normalised, age-adjusted IGF-I, and 42 (28.6%) had both normal random serum GH and IGF-I. Conclusions: In Romania, acromegaly benefits from the whole spectrum of therapeutic interventions. However, the control rate remains disappointing.Wstęp: W Rumunii nie są dostępne ogólnokrajowe dane dotyczące leczenia akromegalii ani wskaźnika kontroli choroby. Badanie przeprowadzono w celu oceny wskaźnika kontroli akromegalii w ośrodku referencyjnym trzeciego stopnia, który obejmuje opieką zdrowotną znaczną część obszaru Rumunii i populacji pacjentów z akromegalią. Materiał i metody: Autorzy dokonali przeglądu danych medycznych wszystkich 164 chorych [49 mężczyzn i 115 kobiet; mediana wieku 55 lat (47; 63,5)] z noworozpoznaną lub wcześniej zdiagnozowaną akromegalią, których przynajmniej jednokrotnie zbadano w ośrodku referencyjnym trzeciego stopnia (miejsce pracy autorów) w okresie od 1 stycznia 2012 roku do 31 marca 2016 roku. Ta próba stanowiła 13,6% całej rumuńskiej populacji chorych na akromegalię szacowaną na 1200 osób i reprezentowała 82,9% okręgów administracyjnych w Rumunii. Kontrolę akromegalii definiowano jako stężenie przygodne hormonu wzrostu (growth hormone, GH) w surowicy wynoszące poniżej 1 ng/ml oraz normalizacja odpowiednio do wieku stężenia insulinopodobnego czynnika wzrostu 1 (insulin-like growth factor-1, IGF-1) w surowicy. Do obliczenia wskaźnika kontroli choroby stosowano wartości GH i IGF-1 z ostatnich pomiarów. U wszystkich pacjentów używano tych samych testów do pomiarów GH i IGF-1. Wyniki: Badanie obejmowało 147 chorych poddanych leczeniu i 17 chorych nieleczonych. Spośród 147 chorych ocenianych po terapii, u 137 (93,2%) zastosowano leczenie chirurgiczne, 116 (78,9%) w momencie ostatniej wizyty kontrolnej stosowało leczenie farmakologiczne, a 67 (45,5%) poddano radioterapii. U 71 chorych (48,3%) przygodne stężenie GH w surowicy wynosiło poniżej 1 ng/ml, u 54 (36,7%) uzyskano normalizację stężenia IGF-1 skorygowanego względem wieku, a u 42 chorych (28,6%) uzyskano normalizację obu parametrów — GH i IGF-1. Wnioski: W Rumunii u chorych na akromegalię stosuje się szerokie spektrum interwencji terapeutycznych, jednak wskaźnik kontroli choroby nadal pozostaje niezadawalający