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Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective. [ABSTRACT FROM AUTHOR]

In order to become known and attract consumers, a health care organization has to develop suitable external communication campaigns. Consequently, management instruments are employed to effectively evaluate the success of a campaign. The BCG Matrix, SWOT analysis and the Gantt Diagram were used in this paper to ensure the consistency and accuracy of the external communication process at an empirical level. [ABSTRACT FROM AUTHOR]

Oligo-anovulation, hyperandrogenism and insulin resistance characterizes polycystic ovary syndrome (PCOs). Metformin is the oldest insulin sensitizer used in the management of type 2 diabetes mellitus. In PCOs, metformin decreases the serum lipids, androgen and insulin; induces ovulation and regular menstrual cycle; increases the pregnancy rate. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOs) is a public health important disease, affecting one in five women at reproductive age. The clinical implications include reproductive, metabolic and psychological features. This article reviews the literature data related to the new metabolic and hormonal mechanisms in PCOs. Recognizing the real diagnostic of PCOs, using the right criteria, is a challenge in current practice. [ABSTRACT FROM AUTHOR]

Orthopedic surgery is among the top 5 medical specialties with an increased risk of facing a lawsuit. A large part of medical malpractice claims are due to poor communication between physician and patient; therefore, by addressing this issue and implementing psychological methods as well as IT solutions, a reduction in the incidence of medical lawsuits can be achieved. Some of these solutions include implementing and applying psychometric tools such as the SF-36 and SCL-90R tests, creating virtual information hubs for the patient, and establishing efficient communication methods by using IT technology between physician and patient. [ABSTRACT FROM AUTHOR]

The purpose of health care marketing is to learn and understand the needs and desires of prospective patients in order to be able to meet those necessities at the highest standards. A big advantage is the targeting capability of the electronic media that has led to its being used by managers of marketing in medical institutions as means of advertisement when they develop the marketing strategies. Regarding social media, it is safe to say that there are communication platforms that can promote certain behaviours thus influencing decision-making. Through social media, people stay in touch with other people and they can provide a mean for medical institutions to permanently communicate with the existing patients or with the potential ones. In addition, social media can be used in advertising and promoting strategies, by posting information about discounts, offers and advantages of accessing the products provided by a certain institution. A study was conducted on 126 patients of a dental clinic in Bucharest. 126 new patients were selected on a period of 22 months from January 2015 until October 2016. The patients never had any treatment in this clinic and were influenced by the Internet to seek for dental care services. The purpose of this study was to evaluate the digital methods of promoting medical services, bringing new patients to a clinic. The results of the study demonstrated the need for digital methods of promoting medical care services in order to expand a business. A strategic way of thinking in this case implied attracting new patients and offering them quality health care services, which ensured their satisfaction and the probability of their recommending the health facility further. This study revealed an important role of social networking sites in promoting. This high response was probably responsible due to targeted promoting services. Almost all the new patients who completed the form will remain patients of this clinic in future. [ABSTRACT FROM AUTHOR]

From the three Eustachian tube (ET) functions: middle ear protection, secretion clearance and middle ear ventilation, the ventilatory function is unanimously considered the most important one, because proper hearing is established only when tympanic membrane compliance is normal. This requires equilibrium between the middle ear and ambient gas pressure, which makes the normal functioning of active ET opening of critical importance. There are several methods and tests that can assess such a complex and variable mechanism. Sonotubometry is one such method; despite the fact that it has been continuously improved in the last 20 years, it is not yet systematically used to evaluate the ET ventilatory function, because its measurement pattern, context mapping (patient, clinic data, medication, treatment), validation, reproducibility and value for clinic practice, have not yet been fully consolidated and integrated in a knowledge-based, service-oriented system, that can provide decision support or even diagnostic. The paper reviews the role of tubal sonometry as a non-invasive, physiologic and easy to use method in assessing the ventilatory function and investigates the validity and reproducibility of a measuring pattern and test in a group of children. The paper describes the test pattern used, and the computer-based platform based on: (1) Digital Signal Processing (DSP) for sound acquisition and lowlevel processing; (2) Artificial Intelligence techniques to extract significant sound features from sonotubograms and learn a manifold context database. Results are reported from test series carried out in healthy children; a similar study between tests is included in the final Discussions section. [ABSTRACT FROM AUTHOR]

Part of the large group of nutritional and toxic optic neuropathies, tobacco-alcohol optic neuropathy is a disease often underdiagnosed or detected at a stage when the full recovery of vision is not possible. This article summarizes its signs and symptoms, describes the pathophysiological processes involved and provides the necessary information for diagnosis and treatment of the entity previously known as tobacco-alcohol amblyopia, reporting in the end, a challenging case along with its findings. [ABSTRACT FROM AUTHOR]

Nowadays, consumers use the computer mediated communication to make purchase decisions on a large variety of products and services. Since health care services are archetypal by nature, consumers in this field are one of the most encountered users of electronic word-of-mouth. The objective of this paper is to explain and support the necessity of adopting a different qualitative method when electronic word of mouth is harnessed on health care dedicated forums, that is, netnography. [ABSTRACT FROM AUTHOR]

Chronic pulmonary diseases represent a segment of pathology with an Increasing prevalence worldwide, this requiring joint efforts from specialists In this field to (a) identify those factors Insufficiently explored so far, but critical for their evolution and (b) address them via new therapies. This study alms to explore the existing data regarding the psychological factors Involved In the dynamics of chronic pulmonary diseases and the main possibilities of psychological intervention, as a distinct part of pulmonary rehabilitation (PR). 49 articles published on this topic in peer-reviewed journals between 1979 and 2010, Indexed in PubMed, ProQuest and EBSCO databases, were examined for evidence. Among psychological factors considered Important by study authors were the following: 1) the deficient Instruction of the patient, 2) decreased treatment motivation, 3) a marginal social role, 4) a disadaptive cognitive style and 5) psychiatric comorbidity (especially anxiety and depression). Efficient interventions were, for physicians, 1) patient education and 2) designing a personalized self-management plan, and for the clinical psychologists, 1) cognitive-behavioral therapy, 2) biofeedback, 3) family therapy, 4) relaxation and 5) hypnosis. Despite the undeniable effect of these methods In selected cases, the high heterogeneity of designs and personal affiliations of researchers do not allow new generalizations about their efficacy or their routine implementation Into PR. Further research Including larger samples, more uniform designs, construction of consensual International standards regarding the objectives of PR, and assessments done by experts from multiple study domains could contribute to a better understanding of the role psychological Interventions could play In PR. [ABSTRACT FROM AUTHOR]

Background: Assessment of efficiency of amniotic membrane covering in the improvement of bullous keratopathy symptoms. Material and method: The paper represents a clinical prospective study, which includes 42 patients diagnosed with bullous keratopathy and operated between January 2009 and November 2013 in the Department of Clinical Ophthalmology from “Dr. Carol Davila" Central Military Emergency Hospital. Follow up between 6 and 48 months, with an average of 22 months. Subject to research: corneal re-epithelisation, epithelial bullae, pain and photophobia relapse. Results: In 37 cases, the symptoms improved, in 8 cases the minimum symptoms persisted and in 29 cases the symptoms completely disappeared. In 5 cases, there were no significant improvements, symptoms reappeared briefly after membrane resorption. Conclusions: Amniotic membrane covering represents an efficient palliative care means in oedematous keratopathy. [ABSTRACT FROM AUTHOR]

The global assessment of the evolution of a disease in a certain geographical area or a specific domain is useful in the medical research for the preparation of practice guidelines/protocols used in the hospitals. Cirrhosis is one of the most common disorders seen today, occupying a significant place in the gastrointestinal pathology. The disease is the final stage of various affections in terms of etiology and morphology. The most frequent subjects treated on this topic are those related to the etiopathology and early diagnosis. Given the current interest in this matter and considering that UGS (upper gastrointestinal bleeding) in liver cirrhosis is a common complication and potentially fatal, the medical research found some very useful conducting retrospective studies in this area. The purpose of our study was to create an IT system implemented with Sentinel WebDashboard, which could increase the medical performances in diagnosis, monitoring and treatment of a disease. We tested our solution on a medical data set containing information about the patients with liver cirrhosis. The solution facilitates the access of the physicians to the databases containing complete information about the patients, offers the possibility to monitor the evaluation of their health and also aids physicians in optimizing the medical procedures and improve the diagnostic methods. It also offers the advantages of a web application: it does not require the installation on the client side, being accessible anytime, anywhere via a web browser, laptop, Smartphone or tablet. [ABSTRACT FROM AUTHOR]

The paper discusses the methods to apply OLAP techniques for multidimensional databases that leverage the existing, performance-enhancing technique, known as practical pre-aggregation, by making this technique relevant to a much wider range of medical applications, as a logistic support to the data warehousing techniques. The transformations have practically low computational complexity and they may be implemented using standard relational database technology. The paper also describes how to integrate the transformed hierarchies in current OLAP systems, transparently to the user and proposes a flexible, "multimodel" federated system for extending OLAP querying to external object databases. [ABSTRACT FROM AUTHOR]

COPD is a chronic disease that has not only a high prevalence and social costs, but is tightly connected to a significant decrease of health-related quality of life (HRQoL). The aim of this study was to evaluate the comparative impact on HRQoL of two psychological factors (self-efficacy, optimism) vs. classical medical determinants (forced expiratory volume in 1 second (FEVi), peak expiratory flow (PEF), functional impairment). 26 women and 28 men, aged 45-64 years old (mean = 58.1; standard deviation = 9.7), diagnosed with COPD and with self-reported dyspnea requiring medication were administered COPD Self-Efficacy Scale, LOT-R (Life Orientation Test - Revised) to evaluate optimism, Quality of Well-Being (QWB) Scale, as an accepted measure of HRQoL and Functional Impairment Scale (FIS), used to assess the deterioration of functionality in respiratory diseases. Their respiratory parameters (FEV1, PEF) were also measured, via spirometry. Results showed that self-efficacy and optimism were positively correlated to HRQoL (r= .34 (p < .05) and r= .29 (p < .05), respectively). A reduced model that eliminated the direct influence of respiratory parameters on HRQoL proved to be equally satisfactory in terms of predictor value, compared to the full model (that contained all studied variables) (X2 = 0.067, ns). The functional impairment (Fl) scores were inversely correlated with HRQoL (r= -.46, p < .01). These results have implications in considering self-efficacy and optimism as important factors when aiming HRQoL improvement in COPD, and for the inclusion of psychological interventions in the treatment plan of COPD patients. [ABSTRACT FROM AUTHOR]

Modern marketing puts the consumer and not the manufacturer in the center, the essence of the marketing approach being the conception, the projection and the making of the product, starting from the consumer towards the manufacturer; this resulting in the fact that the product's marketing approach seems strikingly similar to the semiotic approach of the message. In the semiotic approach, the message is a construction of signs, which, by interacting with the receiver, produces the meaning. The transmitter (the message transmitter) becomes less important. The focus is centered to the „text” and the way this is „read”, the sense being born when the „reader” negotiates the „text”. The negotiation takes place when the „reader” filtrates the message through the sieve of his cultural loading. A „target public” is a group which is specific to a certain Cultural Loading, a loading which deals with linguistic, logical, psychological and symbolic structures, which get out to meet the message and „negotiates” with the structures similar to it. When we are thinking in terms of the semiotic approach, we are handling the cultural determinism of communication, using the concepts of Kuhn and Gonseth (paradigm and referential). They open a new path in the market research, in the market segmentation and knowledge of the „target audiences”. [ABSTRACT FROM AUTHOR]

The article focuses on the international conference of Health-Nutrition-Fitness-Wellbeing, that was held in Falticeni, Suceava, during 19-21 of October 2012. It mentions about the impact of the metabolic affections on the affective disorders; and the influences of healthy nutrition on the harmonious psychical development of the youngsters.

Recent years have seen an "explosion" in the abilities of scientists to use neuroscience in new domains. Unfortunately, it is little known and reported on how advertising companies make more effective pharmaceutical drugs commercials. The purpose of this paper is to analyze how neuromarketing techniques may impact the consumer response to pharmaceutical advertising campaigns. The result shows that using neuromarketing methods a pharmaceutical company can better understand the conscious and unconscious consumer's thoughts and tailor specific marketing messages. [ABSTRACT FROM AUTHOR]

Objective: the optimization of a diagnosis process and fluency in the Health Care sector in Romania. A key to discover this complex process was to determine a correlation between the physicians and the use of information technology, on one side and the patients' perspective on the other. Hypothesis: Integrating information technology in a physician's activity will lead to lower costs and less time spent while diagnosing patients. Using the electronic medical records and introducing a unified database with the patients' medical histories will make the process of diagnosis easier. Methods: We studied the diagnosis from the point of view of 304 patients in a public hospital and 320 physicians working there. Results: We believed that time and accessibility to different physicians makes the diagnosis process a burden for a patient and implicitly lead to dissatisfaction with health care services. We supposed that the burden of diagnosis for physicians comes from the lack of Internet connection and computer usage knowledge. We have found out that most physicians know how to use the computer at an intermediate level and have access to Internet, online journals and databases and do not use emails to a higher extent to communicate to other specialists, but do not rely entirely on the electronic medical records. Most physicians think that it is not technology, which stands in the way of proper and fast diagnosis but the financing and the paper work from the Romanian health system. Solutions that might be taken into account to entirely motivate physicians to use electronic medical records are: 1. Adjustments can be made to the computer software interface in order to make the design more consistent (to eliminate the paper forms) and user friendly. 2. Physicians can be provided with more training and knowledge. Discussion: After some statistical tests have been applied to find a correlation between the chosen variables, we have reached the conclusion that the results are encouraging and there is no correlation between the degree of the impact of Preventive Medicine and the healthy behavior of the respondents. [ABSTRACT FROM AUTHOR]

Rationale. The development of IVF techniques has diminished the importance of tubal infertility but recent discoveries shed a new light on reproductive tubal surgery prior to any IVF cycle. Objective. To adapt current state of the art recommendations concerning tubal factor infertility to actual possibilities in Romanian healthcare system and to grow the awareness of fellow fertility specialists and general practitioners to the improved outcomes of novel management and treatment modalities. Methods and results. 67 free full text articles centered on the subject of management in tubal infertility were identified in international databases. Four articles described general diagnosis using data from medical history, 21 works approached the diagnosis through hysterosalpingography, 14 papers introduced the use of different sonographic procedures, 8 files analyzed the importance of exploratory laparoscopy and 20 articles reviewed different treatment modalities. Discussions. Current data show that active implementation of the large scale use of tubal surgery prior to any IVF cycle will reduce up to 30% the costs associated with obtaining a viable pregnancy in cases with tubal factor sterility. [ABSTRACT FROM AUTHOR]

Rationale. Around 30% of the infertile women worldwide have associated Fallopian tubes pathology. Unfortunately, for a long time, this aspect of infertility has been neglected due to the possibility of bypassing this deadlock through IVF. Objective. Up to date free full text literature was reviewed, meaning 4 major textbooks and around 100 articles centered on tubal infertility, in order to raise the awareness on this subject. Methods and results. The anatomy of the Fallopian tube is complex starting from its embryological development and continuing with its vascular supply and ciliated microstructure, that is the key to the process of egg transport to the site of fertilization. There are many strongly documented causes of tubal infertility: infections (Chlamydia Trachomatis, Gonorrhea, and genital tuberculosis), intrauterine contraceptive devices, endometriosis, and complications after abdominal surgery, etc. Discussions. Although there are still many controversies about the etiology of tubal sterility with the advent of molecular diagnosis of infections there has been cleared the pathway of infection through endometriosis or through ciliary immobility towards the tubal obstruction. [ABSTRACT FROM AUTHOR]

The purpose of the study is to give the rising incidence of Salmonellosis and the continuous decrease of sensitivity of Salmonella to a range of antibiotics, the prime importance of the choice of optimal anti-infective chemotherapy in order to prevent the selection of multidrug-resistant strains (MDR). We have studied 54 strains of Salmonella sent for further investigation to “Cantacuzino” NIRDMI Bucharest. The statistical analysis was based on the interpretation pathogen susceptibility and analyzed according to CLSI recommendations 2009, which revealed that 8 (14,81%) identified as S. enterica serovar Typhimurium group, presented a phenomenon of MDR. S. Typhimurium strains producing ESBL showed resistance mechanisms associated with beta-lactam resistance to aminoglycosides, quinolones, sulfonamides and tetracyclines. [ABSTRACT FROM AUTHOR]

The article focuses on various events attended by the Romanian Society for Diabetes, Nutrition and Metabolic Diseases (RSDNMD) including the 39th National Congress of the Romanian Society of World Day of Diabetes, breakfast meeting on the World Day of Diabetes and International Congress of the International Federation of Diabetes (IFD). It further focuses on Florian Bodog, Secretary of the Health Commission of the Senate of Romania who has signed the Declaration as a Romanian Senator.

The objectives of the reforms in the EU healthcare systems are based on the implementation of the marketing concept in the health systems, which are, among other things: • efficient management of the financial resources and control costs of the rendered health services; • increased satisfaction of the clients of health care services; • broad accessibility to health services; • effective implementation of modern technologies; • rational stimulation of medical services consumption; • achievement of a fair and neutral competition between the public/ private providers and health insurance companies; • introduction of performance criteria in order to increase the incomes of the medical staff and hierarchy in hospitals; • implementation of modern management methods in health services management; • decentralization of the public healthcare system. Product policy in the medical system of healthcare - the most important component of the marketing mix - is the attitude that addresses a medical organization to the volume, structure, and diversity of services subject to their own activities in relation to the requirements of the services market and the competitive actions of other medical institutions.

An inflammatory, proliferative condition with chronic evolution and systemic response, psoriasis, is positioned today among the most common inflammatory skin diseases affecting the Caucasian population worldwide. With a significant incidence, psoriasis has been increasingly defined as a disease with a major impact on the patient's life and the society to which he/she belongs. This paper conducts an analysis of the currently available therapies for the treatment of moderate and severe psoriasis, therapies with biological agents obtained through sophisticated genetic engineering technologies. Recent research and the increasing interest in therapeutic methods as complete and efficient as possible make us optimistic and confident in the future.