E-ServEval: a system for quality evaluation of the on-line public services

This paper describes the objectives, the general architecture and the components of the web-based system for quality evaluation of the on-line public services developed using the framework of the complex research project “System for quality evaluation of the on-line public services for citizens and business environment (e-ServEval)â€. The paper also presents the technological options regarding the design and development of the system, the functions of the components and the aspects regarding the interface between user and e-ServEval system. Finally, the stage of the project and the conclusions are presented.e-government, e-government services quality, quality evaluation

MODELE CONCEPTUALE ALE CALITATII SERVICIILOR ON-LINE

Cele mai multe studii si cercetari efectuate in domeniul calitatii serviciilor evidentiaza faptul ca baza evaluarii calitatii serviciului este experienta individuala a clientului cu un anumit serviciu. Cercetarile care promoveaza aceasta idee se regasesc atat in "scoala europeana" (mai exact, "scoala nordica") reprezentata de Grönroos, Gummensson, Lethinen si Olsen, cat si in "scoala americana" reprezentata de Parasuraman, Zeihaml si Berry. In cercetarea calitatii serviciilor, specialistii au Incercat sa defineasca dimensiunile calitatii serviciilor si sa conceptualizeze calitatea serviciilor. Rezultatele principale ale cercetarilor s-au concretizat in "modele conceptuale ale calitatii serviciilor" (Dotchin si Oakland, 1994b) . Articolul prezinta o serie de modele conceptuale ale calitatii serviciilor on-line cu aplicabilitate la evaluarea calitatii serviciilor urbane.modele, calitate, servicii on-line

Prosthetic Reconstruction of the Upper Digestive Tract

In cases of locally advanced cancers involving the junction between the hypopharynx and cervical oesophagus, the curative surgical treatment is total circular laryngo-pharyngectomy with resection of the upper cervical oesophagus, coupled with modified radical neck dissection. Techniques used to re-establish the continuity of the digestive tract have been pectoral transposition flap, gastric pull-up, jejunum or colon transposition and free pedicled fascial-cutaneous flap reconstruction. Prosthetic reconstruction was thought of and used only as a temporary solution. In our clinic, we adapted the Montgomery oesophageal prosthesis as more than just a temporary solution and used it in 63 patients operated from 2004 to 2014 with advanced (stages III and IV) cancer involving most of the hypopharynx or extending towards the upper cervical oesophagus. Following total circular laryngo-pharyngectomy with bilateral modified radical neck dissection, prosthetic reconstruction was performed using the Montgomery oesophageal tube. Patients were followed up on, and their status was monitored. Favourable results encouraged the authors to further develop a new active prosthesis, with advanced design and materials that better mimic the anatomy and physiology of the replaced segment. Prosthetic reconstruction of the upper digestive tract following radical oncologic surgery is a viable option, with advantages compared to other laborious plastic techniques. The new active model is under development, hopefully offering soon a safe and more cost-effective alternative to the other techniques

Particularităţile homeostazei hormonale şi ale statutului imun la bolnavele de cancer al glandei mamare în menopauză

Studiul homeostazei hormonale şi imunologice la 556 de bolnave de CGM în menopauză a evidenţiat că pentru acestea sunt caracteristice dereglări complexe ale homeostazei hormonale şi imunologice, manifestate prin hiperprolactinemie, hiperestrogenemie, imunosupresie secundară de tip T şi dezechilibru al indicilor imunităţii umorale

HPV-Positive Oral Squamous Cell Carcinoma

Head and neck malignancies represent the sixth most frequent type of cancer currently in worldwide statistics. Of these, oral and pharyngeal cancers have steadily increased, being linked with the increase in HPV infection pandemic. This rise is not due to one cause, but rather multiple factors such as lifestyle and sexual behavior pattern changes and globalization. Because of the anatomy of the oral cavity and oropharynx, the proper diagnosis is easily delayed, and patients present with advanced stage disease, which requires aggressive and extensive surgery along with neck dissection and chemoradiotherapy. Patients with advanced stage disease have a high recurrence risk with a low 5-year survival rate. Preventing the HPV infection is of course desirable, but right now, for adults which already are infected and have a higher risk of developing HPV-related neoplasias, as well as for our head and neck cancer patients, alternative treatment algorithms are necessary

Lamboul interosos posterior antebrahial

Background. The posterior interosseous forearm flap appeared as an option for upper limb reconstruction with priority on the hand. Being vascularized by the posterior interosseous vessels of the forearm, this flap can be used even when the ulnar or radial vessels are damaged. Objective of the study. To improve the results of the treatment of tissue defects in the hand by using the posterior antebrachial island flap. Material and Methods. In 12 patients treated using this flap, we studied the following items: age, sex, morphological component, size, direction of migration, location of defects and functional outcomes. Results. Using the posterior interosseous forearm flap, a complete regeneration was obtained, total recovery of the function of the forearm and the hand with the movements in a complete volume. Depending on the sex, we had 8 men and 4 women, aged between 28-71 years. The flaps covered defects with an average area of about 35 cm2 and were migrated on the forearm from one patient to the remaining 11 patients in the hand regions. In all cases they were harvested in the fasciocutaneous composition. The registered complications were manifested by transient local infections in 3 patients. Conclusion. The posterior interosseous flap can be migrated with fasciocutaneous components to different parts of the forearm and hand to cover soft tissue defects, with satisfactory surgical and functional outcome and minimal complications. Introducere. Lamboul interosos posterior antebrahial a apărut drept o opțiune pentru reconstrucția membrului superior cu prioritate la nivelul mâinii. Fiind vascularizat de vasele interosoase posterioare ale antebrațului, acest lambou poate fi utilizat chiar când vasele ulnare sau radiale sunt lezate. Scopul lucrării. Îmbunătățirea rezultatelor tratamentului defectelor tisulare la nivelul mâinii prin utilizarea lamboului insular antebrahial posterior. Material și Metode. La 12 pacienți tratați prin utilizarea acestui lambou am studiat următorii itimi: vârsta, sexul, componenta morfologică, dimensiunile, direcția de migrare, localizarea defectelor și rezultatele funcționale. Rezultate. Utilizând lamboul interosos posterior antebrahial, s-a obținut o regenerare completă, recuperare totală a funcției antebrațului și a mâinii cu mișcările într-un volum complet. În funcție de sexe am avut 8 bărbați și 4 femei, cu vârste între 28-71 ani. Lambourile au acoperit defecte cu o suprafață medie de cca 35 cm2 și au fost migrate pe antebraț la un pacient, la restul 11 pacienți pe regiunile mâinii. În toate cazurile au fost recoltate în componența fasciocutanată. Complicațiile înregistrate s-au manifestat prin infecții locale tranzitorii la 3 pacienți. Concluzii. Lamboul interosos posterior antebrahial poate fi migrat cu componente fasciocutanate, în diferite părți ale antebrațului și mâinii pentru acoperirea defectelor țesuturilor moi, cu rezultat chirurgical și funcțional satisfăcător și complicații minime

Revascularization impact: quality of life enhancement in chronic limb-threatening ischemia

Introduction. Globally, over 230 million people have peripheral artery disease, often undiagnosed, leading to chronic limb-threatening ischemia. Revascularization is vital for preventing amputation and improving quality of life. While specific questionnaires for severe ischemia are lacking, the SF-36 questionnaire is widely used to assess quality of life, with variations like SF-12 and SF-8 for larger cohorts. Objectives. Our aim was to assess how different lower limb revascularization methods affect the postoperative quality of life in patients with chronic limb-threatening ischemia. Methods. This study was conducted at the St. Pantelimon Emergency Hospital of Bucharest, Romania. It included 166 adult patients with chronic limb-threatening ischemia who were monitored for 12 months. Quality of life was assessed using the SF-36 questionnaire. The patients were categorized into two groups: 112 underwent conventional surgery, and 54 had hybrid procedures. Data analysis involved t-tests, Mann-Whitney U tests and assessment of data reliability. Results. In the Conventional Surgery group, the average age was 70.5 years, predominantly male, with similar risk factors as the second group. The Hybrid Surgery group had an average age of 73 and exhibited more extensive distal arterial lesions, higher rates of ulcer/gangrene, and a higher occurrence of postoperative minor amputations. The SF-36 questionnaire showed low data reliability for the General Health and Social Functioning domains. Additionally, the Hybrid Surgery group had poorer preoperative perception in the Body Pain category. However, significant postoperative improvements in quality of life were observed in all domains for both groups with similar results. Conclusions. Revascularization improves the quality of life for patients with chronic limb-threatening ischemia, including those that also require minor amputations. SF-36 has good assessment for most QoL aspects, but reliability declines in severe ischemia