Bologna Process Implementation in Romania: Policy Implementation Lessons

Romania is one of the signatories of the Bologna Process Declaration in 1999.Following this decision, Romania made efforts for the alignment of its higher education system to the objectives and the policies promoted by the Bologna Process. In this process different action lines have received different attention, as the understanding of the policy problems and the national priorities were not always in line with the EHEA ministerial agreements. The current article looks at the main commitments Romania has made within the Bologna Process by analysing the overall national implementation, the associated funding policies and institutional practices. The article focuses on three Bologna Process action lines: social dimension, quality assurance and internationalization of higher education, due to their complexity (beyond legal changes), impact at the grassroots level and their various understandings by the stakeholder community. The article ends with a short overview of the policy lessons that can be drawn regarding Bologna Process and its national translation for other countries which found themselves in policy transitions in the past two decades

Evidence-Basing the Future of the EHEA

The EHEA has been launched in 2010 with the wider goal of ensuring more comparable, compatible and coherent systems of higher education in Europe. This initiative, deemed by many observers as one of the most successful regional cooperation process in the field of higher education policies, relies on soft-coordination mechanisms grounded on the principle of evidence-based policy making (Deca, 2013). The present article aims at illustrating the way in which European level policy decisions have so far been grounded on evidence, while making the case for potential additional tools that could contribute to achieving the EHEA goals: data analytics, semantic analysis and ‘big data’ approaches

Condiloma gigante

O condiloma gigante está altamente associado à infecção pelo Papiloma Vírus Humano (HPV), uma das doenças sexualmente transmissíveis mais prevalentes no mundo. Paciente de 54 anos, com aparecimento de lesão vegetante em região suprapúbica de crescimento progressivo há 20 anos. Realizou tratamento prévio de condiloma peniano com cauterização com sucesso. A lesão teve crescimento significativo e foi, então, submetido à biópsia com diagnóstico histológico de condiloma acuminado. A terapia eleita foi a exérese completa da lesão. A terapia invasiva se torna opção terapêutica de eleição, indicada por todos os estudos analisados. No caso em questão, a opção terapêutica foi a retirada completa da lesão devido à recorrência do quadro após terapias de cauterização química e térmica. Apesar de a abordagem cirúrgica ser uma conduta mais agressiva, no paciente em questão foi adequada por conta do tamanho e da falha de terapias anteriores

Wealth and demography in Ottoman probate inventories: a database in very long-term perspective

This article introduces a database of Ottoman probates and examines some of the methodological difficulties in very long-term analysis. Wealth statistics, spanning from 1460 to 1920 in the longest subsample, indicate an inverted U-shaped pattern that may signal the limits of extensive growth or “decline” as per the former Decline Paradigm. This pattern does not entirely match recent scholarship on the Ottoman Empire, however. Examining the effect of biases and changes in probate demography on wealth, we explore how real the observed wealth pattern is. We employ descriptive statistics, linear regression and Oaxaca-Blinder decomposition, and find that demographic composition matters but does not alter the shape of the wealth curve. Explanation for the gap between probate findings and current historiography, therefore, must lie elsewhere

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease