Small scale agriculture as a resilient system in rural Romania

A brief overview of rural Romanian phenomena and processes in modern history reveals that rural areas and small rural households were highly stable systems, providing social and economic security. In all history, except during the communist period, small-scale agriculture was and continues to be the main provider of jobs in the rural labour market in the absence of other non-agricultural employment opportunities. In all times, consumption of self-produced food, supported by small farms, has had a leverage effect against poverty. More than that, the statistical information shows that small farms achieve higher levels of economic performance compared to large farms by diversifying their production structure and, through that, they make an important contribution to national food security. In the post-communist period (i.e. after 1989) in Romania, these functions and roles of the small farms have been restored and are widely recognised. If the meaning of ‘socio-economic resilience’ is the ability of an individual, of a household, community, region or country to resist, to adapt and to recover quickly after a crisis, shock or change, the economic and social functions and roles assumed in the transition period by small Romanian rural farms give them the attributes of a resilient answer of the entire Romania to the post-communist changes and shocks

Agriculture role in social-economic resilience to major economic crises in Romania

The objective of this analysis is to investigate the capacity of agriculture to actively contribute to reducing vulnerabilities and the degree of exposure of Romania’s economy to shocks caused by major economic crises. The role of agriculture, as economic and social resilience factor, is analyzed from the perspective of primary sector contribution to the attenuation of shock and to the recovery following the economic-financial crisis that started in 2008. The primary sector contribution to counterbalancing the negative effects on GDP and labour employment generated by the recent economic crisis, by increasing the turnover in agriculture and reasserting the role of occupational outlet, in the conditions of shortage on the labour market, represent a few arguments in favour of the assertion that Romania’s agriculture is a system with relatively high resilience to shocks and at the same time a supplier of economic and social resilience for the entire economy

The irrigation system in Brăila – a farmer economic focused approach

In the present context marked by ever increasing global climate changes, the use of irrigations in agriculture represents not only an option but more and more a necessity for ensuring a higher yield of agricultural products whose demand increases every year based on population growth. The present paper focuses on the specific elements of the irrigation systems from Brăila County, the way the farmers have access to and the different implications derived by using these systems. The paper turns to quantitative analysis of available statistical data and qualitative analysis of the interviews with local farmers focused on economic efficiency of the water used for irrigations. 

Agriculture role in social-economic resilience to major economic crises in Romania

The objective of this analysis is to investigate the capacity of agriculture to actively contribute to reducing vulnerabilities and the degree of exposure of Romania’s economy to shocks caused by major economic crises. The role of agriculture, as economic and social resilience factor, is analyzed from the perspective of primary sector contribution to the attenuation of shock and to the recovery following the economic-financial crisis that started in 2008. The primary sector contribution to counterbalancing the negative effects on GDP and labour employment generated by the recent economic crisis, by increasing the turnover in agriculture and reasserting the role of occupational outlet, in the conditions of shortage on the labour market, represent a few arguments in favour of the assertion that Romania’s agriculture is a system with relatively high resilience to shocks and at the same time a supplier of economic and social resilience for the entire economy

PERCEIVE project - Deliverable D4.5 "Report on the comparative analysis of experts' and citizens' perceptions and views"

This report is a comparative analysis of nine regional case-studies selected in our project, based on original data collected through the PERCEIVE field survey that was conducted during the summer of 2017 and on the reports on regional case studies written by Perceive’s partners. Each report was based on the analysis of the focus group’s section that addresses the assessment of Cohesion Policy. The general objective of this report is to synthesize the citizens’ and practicioners’ views on EU Cohesion Policy and to compare them in order to understand if there are different perceptions of this policy and its implementation. For each region included in the study, the identification of the relevant regional needs are considered, followed by an assessment of the EU policy effectiveness in responding to the revealed issues. Both have been pursued at the level of citizens and of Cohesion Policy practitioners, and are followed by a comparative analysis that helps to understand whether the EU Cohesion Policy is perceived and understood by citizens in the same way as it has been conceived by practitioners. The comparative analysis helped shed light on the convergence and divergence points between citizens and experts with regard to the public intervention needs through Cohesion Policy and in the evaluation of the effectiveness of these interventions, thus contributing to a better understanding of the general perception of the EU by the large public

Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores

BackgroundThe risk of liver fibrosis increases over time in HIV and HIV-HBV individuals even under antiretroviral treatment (ART), warranting a rigorous and periodic monitorization. Given the lower availability of transient elastography, we aimed to assess the longitudinal variation of two non-invasive liver fibrosis scores, APRI and Fib-4, in cases with HIV monoinfection, HIV-HBV co-infection and individuals with HBsAg-seroclearance.MethodsWe performed an observational retrospective study between 2013 and 2019 on 212 HIV patients including 111 individuals with HIV mono-infection, 62 individuals with HIV-HBV co-infection and positive HBsAg and 39 cases with HIV-HBV infection and HBsAg-loss. The groups were followed at 36, 48, and 60 months. Liver fibrosis was indicated by an APRI >0.5 or Fib-4≥1.45 score and advanced fibrosis by an APRI score >1.5 or Fib-4 >3.25. Logistic regression with generalized estimating equations (GEE) was used to assess the predictors for the presence of liver fibrosis over time.ResultsDuring a median follow-up of 58.5 months the prevalence of liver fibrosis in all patients increased with 0.5% reaching 11.3% using an APRI score and with 0.9% reaching 10.8% using the Fib-4 score. At the visit corresponding to 60 months the prevalence of liver fibrosis was higher in all HIV-HBV patients compared with individuals with HIV mono-infection, namely: 16.1% on APRI and 12.9% on the Fib-4 score in HIV-HBV/HBsAg-positive individuals, 12.8% on both APRI and Fib-4 scores in HIV-HBV/HBsAg-negative individuals vs. 8.1 and 9%, respectively in HIV mono-infection. The presence of liver fibrosis over the study period was independently associated with plasma HIV RNA, CD4+T cell counts, HIV-HBV co-infection (for APRI >0.5) and ART non-adherence (for Fib-4 >1.45). At the final visit, non-adherence to ART and CD4+T cell counts remained associated with liver fibrosis.ConclusionsThe study found a slow progression of APRI and Fib-4 scores over time in young PLWH with extensive ART. Liver fibrosis scores continued to increase in patients with HIV mono-infection yet remained lower than in HIV-HBV patients irrespective on the presence of HBsAg. The periodic follow-up using non-invasive scores on the long-term could help improve the surveillance in low-income settings and high scores should be followed by additional diagnostic methods

Fifth European Dirofilaria and Angiostrongylus Days (FiEDAD) 2016

Peer reviewe

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

Background: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97\ub71 (95% UI 95\ub78-98\ub71) in Iceland, followed by 96\ub76 (94\ub79-97\ub79) in Norway and 96\ub71 (94\ub75-97\ub73) in the Netherlands, to values as low as 18\ub76 (13\ub71-24\ub74) in the Central African Republic, 19\ub70 (14\ub73-23\ub77) in Somalia, and 23\ub74 (20\ub72-26\ub78) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91\ub75 (89\ub71-93\ub76) in Beijing to 48\ub70 (43\ub74-53\ub72) in Tibet (a 43\ub75-point difference), while India saw a 30\ub78-point disparity, from 64\ub78 (59\ub76-68\ub78) in Goa to 34\ub70 (30\ub73-38\ub71) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4\ub78-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20\ub79-point to 17\ub70-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17\ub72-point to 20\ub74-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view-and subsequent provision-of quality health care for all populations