Romanian public administration reform 2.0: using innovative foresight methodologies to engage stakeholders and the public

Purpose: The purpose of this practice-oriented paper is to look at a recent, late-phase development in public administration (PA) reform in Romania, specifically the drafting of the recently adopted national Strategy on Strengthening the Efficiency of Public Administration (2014-2020). In particular, the paper focuses on the opportunities and limits of outsourcing the building of the vision underlying the strategy and the prioritization of strategic objectives. The article’s story is also placed in the broader context of agencification literature and, more specifically, the involvement of executive agencies in policymaking. Design/methodology/approach: The paper describes the vision-building exercise, developed according to a script already tested in several sectoral strategy-making processes, and the objectives and procedure of the online participatory consultation by using an adapted real-time Delphi format (similarly tested in the recent past). Findings: The paper reports on the ways in which the output of the visioning process and of online consultations may be used to enhance a strategic process already underway. Originality/value: PA reform in post-communist countries has been among the most hotly debated, intensely pursued, yet seemingly elusive policy objectives of the transition and post-transition periods. Among pre-accession and then European Union (EU) member states, the need to get in and then to get involved in European policymaking provided some impetus for such reforms and also set substantial constraints, without however always adding much predictability or significantly streamlining the public sector. The paper contributes to this debate by proving an innovative method of devising a reform strategy by outsourcing the strategy-building process to an agency with the necessary know-how and experience.</p

First Case of COVID-19 Treated with Monoclonal Anti-Spike Antibodies in a Patient with Cystic Fibrosis in Romania

Patients with chronic lung conditions, including cystic fibrosis, may be prone to severe COVID-19. Therefore, therapeutic intervention should be prompt and tailored to all associated comorbidities. We report the case of a 17-year-old male adolescent with cystic fibrosis and multiple chronic conditions (bronchiectasis, exocrine pancreatic insufficiency, chronic multidrug resistant Pseudomonas aeruginosa colonization, nasal polyposis, chronic sinusitis, ventricular extrasystoles and multiple drug allergies), who presented with an acute episode of productive cough, and was confirmed with moderate COVID-19 based on positive RT-PCR for SARS-CoV-2 and lung imaging showing isolated foci of interstitial pneumonia. Intravenous treatment with the monoclonal antibody cocktail casirivimab and imdevimab was administered. The evolution was favorable, with rapid remission of the inflammatory syndrome and gradual decrease of cough, without progression to severe or critical COVID-19, but with complications such as repeated hemoptysis, which was due to the patient’s underlying conditions, and which required close monitoring for timely adjustment of the patient’s chronic treatment

Integrating Artificial Intelligence in Pediatric Healthcare: Parental Perceptions and Ethical Implications

Background: Our study aimed to explore the way artificial intelligence (AI) utilization is perceived in pediatric medicine, examining its acceptance among patients (in this case represented by their adult parents), and identify the challenges it presents in order to understand the factors influencing its adoption in clinical settings. Methods: A structured questionnaire was applied to caregivers (parents or grandparents) of children who presented in tertiary pediatric clinics. Results: The most significant differentiations were identified in relation to the level of education (e.g., aversion to AI involvement was 22.2% among those with postgraduate degrees, 43.9% among those with university degrees, and 54.5% among those who only completed high school). The greatest fear among respondents regarding the medical use of AI was related to the possibility of errors occurring (70.1%). Conclusions: The general attitude toward the use of AI can be considered positive, provided that it remains human-supervised, and that the technology used is explained in detail by the physician. However, there were large differences among groups (mainly defined by education level) in the way AI is perceived and accepted