113 research outputs found
The role of the accounting and audit standards in the globalization process
The audit rules are necessary, they being able to be useful as much for the auditors and for the audit beneficiaries. For the auditors, the rules make first of all a support item, a guide or a support in applying the methods, techniques, procedures and second of all a support and justification item, for the case where difficulties show up. In what regards third-parties, these will be assured that the audit is made by unitary criteria, no matter by whom it is made.
Even if solicited by various firms, in order to raise the credibility of the financial situations they published, the audit process cannot take place at random, without the existence of legal regulations. Due to the increasing importance the audit gets in developing any business, in time imposing the necessity to make professional specific standards, that are to insure a minimum quality of the audit process an a certain performance to the auditor profession.peer-reviewe
The Synthesis and Analysis of Partial Discharges from Stator Winding Insulation of Hydro Generators
In this paper to perform the partial discharges which appear in stator
winding insulation, the main characteristic measures of these,
measurement and the results of partial discharges test
Fingerprints Identification using a Fuzzy Logic System
This paper presents an optimized method to reduce the points number to be used in order to identify a person using fuzzy fingerprints. Two fingerprints are similar if n out of N points from the skin are identical. We discuss the criteria used for choosing these points. We also describe the properties of fuzzy logic and the classical methods applied on fingerprints. Our method compares two matching sets and selects the optimal set from these, using a fuzzy reasoning system. The advantage of our method with respect to the classical existing methods consists in a smaller number of calculations
Ecotourism contribution to sustainable development of rural communities
Ecotourism has emerged as a form of tourism along with people's need to withdraw in nature and natural areas , to visit and know who enjoy or not a national or international protection status. In broad terms we can say that ecotourism means traveling most often in developing countries to relatively undisturbed natural areas for study, leisure or voluntary assistance (volunteer) who considers himself flora, fauna, geological forms and ecosystems from area and the people who live nearby, their needs, culture and their relationship with the earth. Along with the development of ecotourism worldwide recognition came and benefits of this form of tourism as a mechanism for optimal utilization of tourism resources and landscape. Ecotourism is a form of sustainable tourism, the main motivation of the tourists is the observation and appreciation of nature and local traditions related to nature, must fulfill the following conditions: conservation and nature protection, use of local human resources, character education, respect for nature, awareness of tourists and local communities minimum negative impact on the natural and socio-cultural environment. In the present context the contribution of ecotourism will be especially economical with great social and economic effects. Ecotourism paradigms - new existential philosophy of local communities and tourists arrived in these areas will be the starting point for generating new approaches to these activities, both in terms of economic development, and sustainable development. Deciphering them will help develop models of existence, to change the mentality and building foundations for the upward evolution of rural communities
Diagnostic analysis of ecotourism potential of Caras-Severin county
Sustainable tourism development is not just a concept discussed, supplemented or restated in the conferences held on this subject. Need to protect natural and cultural riches which is the common heritage of humanity and to meet the needs of tourists and local people led to the emergence in practice some form of sustainable tourism. Objectives, principles, sustainable tourism development requirements can be found in forms of tourism such as ecotourism, rural tourism or cultural tourism. These forms are an expression of desire for tourism to represent not only a positive factor and dynamic development and a practical solution for keeping unaltered the environment. Caras-Severin position in a natural setting, in a mainly mountainous area with a rich and varied forest and wildlife, with a representative hydrographic network, with great cultural-historical values encourage tourism development in various forms, these elements representing tourist destinations with a high degree of attractiveness. Tourism values are given by a natural setting rich and varied with many types of terrain, climate elements that are under the influences of ocean and southern, a representative of the hydrographic network, a rich and varied forest and wildlife, all representing tourist destinations with a high degree of attractiveness. Because of the exceptional features of the landscape and species diversity in the county were established more than 50 protected areas. Protected areas account for approximately 14.6% of the county, so almost three times more than the rest of the country. From total, three of the protected areas have the status of national park and a natural park
The use of the gravity model in forecasting the flows of emigrants in EU countries
Migration is a complex phenomenon with economic, social, political, cultural and human implications, and therefore, it is the locus of interest for many researchers from various fields. After 1989, migration in Romania became a social issue due to the large number of migrants searching for labour all around Europe. This paper focuses on investigating and forecasting labour migration from Romania and its geographical orientation. We analysed the gravity model, which simple and accurate, focused on the distance as a determinant of the length of the mobility and, thus, of the host country chosen by the migrant. Based on the proposed macroeconomic model, we discuss results for main destinations countries, i.e. Spain, Italy, Austria, Germany, as well as for EU as a whole
The importance of early arthritis in patients with rheumatoid arthritis
Rheumatoid arthritis (RA) is a systemic inflammatory disorder that manifests predominantly in the synovial joint, where it causes a chronic inflammatory process, leading to early osteoarticular destructions. These destructions are progressive and irreversible, generating a significant functional deficiency. During the last years, the diagnostic approach of RA has focused on early arthritis. Early arthritis can develop into established RA or another established arthropathy, like systemic lupus erythematosus or psoriatic arthritis. It can have a spontaneous resolution or may remain undifferentiated for indefinite periods of time.
The management of early arthritis has changed considerably in the past few years, under the influence of new concepts of diagnosis and new effective therapies. The treatment goal of early arthritis should now be the clinical remission and prevention of joint destruction. Methotrexate is the first line of therapy, used to treat early arthralgia and to reverse or limit impending exacerbation to RA. Biological treatment is used as a second line therapy in patients with severe disease who do not respond or have a contraindication to disease-modifying antirheumatic drugs (DMARDs). Patients with early arthritis should usually be identified and directed to rheumatologists to confirm the presence of arthritis, and to establish the correct diagnosis plus to initiate the proper treatment strategies
Vitamina D şi riscul cardiovascular: rolul medicului de familie în prevenţia cardiovasculară
Universitatea Ovidius, Constanţa, Universitatea de Medicină şi Farmacie
Carol Davila, Bucureşti, Institutul Naţional pentru Sănătatea Mamei
şi Copilului Alessandrescu-Rusescu, Bucureşti, Universitatea Bioterra, Bucureşti, cabinet medical individualIntroducere
Patologia cardiovasculară cunoaşte în ultimii
ani o creştere alarmantă a incidenţei, HTA fiind considerată cea mai frecventă afecţiune în acest context.
OMS consideră că bolile cardiovasculare constituie
prima cauză de mortalitate în lume. Statisticile arată
o creştere a incidenţei, astfel că ”în 2012 au existat
17,3 milioane decese, dintre care 7,3 milioane s-au
datorat bolii coronariene, 6,2 milioane au avut un
atac cerebral şi 9,4 milioane au avut drept cauză
directă HTA”. În acelaşi sens, o analiză a OMS şi a
Societăţii Internaţionale de HTA, realizată în 2014,
a scos în evidenţă faptul că HTA constituie ”cel mai
important factor de risc pentru deces şi dizabilitate
la scară mondială” şi ”cel mai răspândit factor de risc
cardiovascular de pe glob”.
În România, prevalenţa HTA este foarte mare –
aproximativ 7 milioane de persoane sau 40% din populaţia ţării. De asemenea, se constată apariţia bolii
la vârste tinere, sub 40 de ani, ceea ce constituie un
adevărat semnal de alarmă. Este important de precizat faptul că studiile au demonstrat că există o relaţie
de interdependenţă clară între HTA şi riscul cardiovascular, uneori chiar independent de alţi factori de
risc. Astfel, rolul medicului de familie este extrem de
important, HTA fiind practic cea mai frecventă formă
de boală cronică, monitorizată în cabinet.
Prevenţia este esenţială, medicina de familie
având un rol foarte important, fiind singura specialitate care are ca obiect de activitate şi prevenţia.
Depistarea la timp a valorilor crescute de TA şi a celorlalţi factori de risc cardiovascular, tratarea corecta,
prevenirea afectării organelor-ţintă şi a complicaţiilor, evaluarea corectă a riscului cardiovascular sunt
obiectivele pe care trebuie să le aibă medicul de
familie în abordarea şi managementul pacientului
cu HTA şi risc de boală cardiovasculară. Obiective
Există însă o multitudine de necunoscute încă
în această patologie, cu identificarea a ”noi” factori
de risc, ce ar putea avea rol în apariţia HTA şi a patologiei cardiovasculare, în determinarea unui risc
cardiovascular crescut. Unul dintre aceşti ”noi” factori
de risc cardiovascular este considerat, în ultimii ani,
deficitul de vitamina D. Relaţia dintre vit. D şi riscul
cardiovascular face obiectul mai multor studii în
ultimii ani, dovedindu-se faptul că există o legătură
directă între deficitul de vit. D şi un risc cardiovascular crescut.
Material şi metodă de cercetare
Am efectuat un studiu prospectiv, desfăşurat
între anii 2011 şi 2017, pe un lot de 316 pacienţi din
lista proprie de capitaţie, care au fost diagnosticaţi
cu HTA, după o monitorizare de trei luni de zile ale
valorilor TA (dintr-un lot total de 692 pacienţi). Parametrii monitorizaţi la toţi pacienţii incluşi în studiu
au fost: greutate, înălţime, circumferinţa abdominală,
indicele de masă corporala,Tensiunea arterială, frecvenţa cardiacă, colesterol total, HDL, LDL, non-HDL
colesterol, trigliceride, glicemie, uree, creatinina serică-RFG, acid uric, fibrinogen, VSH, hs-CRP (ca marker
al riscului cardiovascular), calciu seric, osteodensitometrie. La 146 de pacienţi din lotul de 316 (F-106 şi
B-40) s-a dozat şi vit. D (25-hidroxi vitamin D).
Criterii de includere pentru acest studiu au fost:
vârsta de 35-65 ani, prezenţa HTA+/-BCV, DZ, obezitate, depresie. Criterii de excludere: vârsta <35 ani
şi >65 ani, prezenţa osteoporozei/osteopeniei în
tratament, hipocalcemie sau afecţiuni tiroidiene în
tratament. Valoarea normală a vit. D (25 hidroxi) a fost
considerată >30 ng/ml (conform Societăţii Europene
de Endocrinologie).
Rezultate obţinute şi discuţii
Cercetările efectuate în studiu au elucidat mai
multe aspecte:
• Valori mici (<10 şi 10-20 ng/ml), respectiv deficitul sever sau moderat de vit. D, se atestă mai
frecvent la femei decât la bărbaţi.
• Grupele de vârstă 41-50 de ani şi 51-60 de ani
sunt cele mai expuse, mai ales la femei.
• Obezitatea (evaluatăprinIMC,CA) este înrelaţie
invers proporţională cu nivelul de vit. D (IMC şi
CA crescute – vit. D scăzută), IMC este mai crescut la femei decât la bărbaţi, grupele de vârstă
41-50 de ani şi 51-60 de ani fiind mai expuse.
• Relaţia dintre hs-CRP şi vit. D. Riscul cardiovascular moderat sau crescut (conform datelor şi
valorilor de laborator) este prezent la peste 50%
din pacienţii din lotul studiat. Se evidenţiază o relaţie invers proporţională între vit. D şi valoarea hs-CRP (vit. D scade, riscul cardiovascular
creşte).
• Corecţia deficitului de vit. D prin administrarea
acestei vitamine, conform ghidurilor Societăţii Europene de Endocrinologie, a arătat o
normalizare a valorilor – 25 (OH) vit. D, după 8
săptămâni de tratament.
• La pacienţii care prezentau variabilitate a TA
s-a obţinut o stabilizare a valorilor şi o scădere
a TA sistolice cu 10-15 mmHg la 82% din pacienţii cuprinşi în studiu şi a TA diastolice cu 5-10
mmHg la 35%.
Exista o seama de limite pe care studiile viitoare
ar trebui sa le depăşească: încă mai este nevoie de
dovezi care să explice relaţia dintre deficitul de vitamina D şi boala cardiovasculară, rolul suplimentării
cu această vitamină în protecţia cardiovasculară.
Concluzii
Astfel, se poate considera că vitamina D are un
rol important în organism, deficitul acesteia este
foarte frecvent în populaţie şi ar putea fi considerat factor ”nou” de risc cardiovascular, iar grupa de
vârstă 40-50 de ani are cele mai multe variabile şi
este cea care poate fi abordată cel mai bine pentru
prevenţie
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