REDUCE CHILD MORTALITY AS A MILLENNIUM DEVELOPMENI GOAL IN ROMANIA.

AIM: To assess the efforts made in Romania towards achieving the Goal 4 from MDGs--Reduce Child Mortality. MATERIALS AND METHODS: A descriptive study about the deaths among Romanian children under five, between 2002 and 2015, from the perspective of the MDGs. To help track progress toward this commitment, following specific targets and indicators were developed: Target 1-Halve the mortality rate in children aged 1-4 years between 2002-2015; Target 2--Reduce infant mortality by 40% between 2002 and 2015; Target 3--Eliminate measles by 2007. The comparison allows establish the status (achieved or not) for each target. RESULTS: From 2002, the under-five mortality rate recorded a continuous descendent trend till now (20.8 to 10.3 under five deaths per 1000 inhabitants in 2013). The infant mortality rates declined from 17.3 to 8.5 deaths per 1,000 live births (2002-2013). Eliminating measles by 2007--was achieved one year later, because of the measles epidemic in 2005 and 2006. High vaccination rates have been maintained, with the proportion of children 1 year old vaccinated against measles reaching and being maintained at between 94-98%. CONCLUSIONS: Substantial progress has been made in Romania, in achieving the Millennium Development Goal no. 4. All the three targets were achieved. However, infant mortality still remains above the average of European Union (4 infant deaths per 1,000 live-births).

A PRELIMINARY EVALUATION OF RESIDENTS' PERCEPTION OF THEIR TRAINING AND KNOWLEDGE ON THREE-DIMENSIONAL IMAGING.

UNLABELLED: The aim of this preliminary study was to assess the residents' perception on their training program and on their knowledge regarding the use and interpretation of three-dimensional imaging techniques in their clinical practice. MATERIAL AND METHODS: A multi-item questionnaire was distributed among 104 residents training in four medical specialties at the University of Medicine and Pharmacy "Grigore T. Popa" in Iasi. RESULTS: Fifty-five residents agreed to fill in the questionnaire, achieving a participating rate of 52.88%. The majority of the respondents (74.5%) declared to indicate classic CT scans to their patients. A significantly lower fraction of the participating residents (32.7%) affirmed to indicate CBCT scans. Electronic literature was the most common information source on the use of three-dimensional imaging (52.7%). Most of the residents declared that they cannot interpret correctly CT and CBCT scans (78.2%, respectively 83.6%). A significant percentage of the respondents considered that the level of training provided on the interpretation of CT and CBCT results is very low (49.1%, respectively 60.0%). CONCLUSIONS: The residents' perception of the quality of their education regarding 3D imaging modalities, along with their perception of their knowledge in this area, indicates the necessity to improve their didactic and practical training. A further extended survey will be conducted to evaluate the educational experience of residents from all medical specialties that use 3D imaging techniques in neck and head imaging.

Disparities in the access to primary healthcare in rural areas from the county of Iasi - Romania.

AIM: To identify the factors that may conduct to various forms of social exclusion of the population from the primary healthcare and to analyze health disparities as population-specific differences in the access to primary healthcare in rural compared to urban residence areas from Iasi, the second biggest county, situated in the North--East region of Romania. MATERIALS AND METHODS: This research is a type of inquiry-based opinion survey of the access to primary healthcare in rural compared to urban areas of the county of Iasi. Data were collected by face-to-face interviews. There were taken into account the socioeconomic status (education level in the adult population, employment status, family income, household size) and two temporal variables (the interval of time spent to arrive at the primary healthcare office as a marker for the geographical access and the waiting time for a consultation). The study group consisted of two samples, from rural and urban area, each of 150 patients, all ages, randomly selected, who were waiting at the family doctor's practice. RESULTS: The study has identified disparities related to a poor economic status assessed through the employed status ("not working" 15% in urban and of 20% in rural).The income calculated per member of family and divided in terciles has recorded significant differences for "high" (36.7% urban and 14.7% rural) and "low", respectively (14.6% urban and 56.6% rural). High household size with more than five members represented 22.6% of the total subjects in rural and 15.3% in urban areas. The assessment of the education level in the adult population (> 18 years) revealed that in the rural areas more than a half (56%) of the sample is placed in the category primary and secondary incomplete, whereas the value for secondary complete and postsecondary was 37.3%. The proportion of respondents in the urban areas who have post-secondary education is five times higher than those in rural areas (15.4% vs. 2.7%). The reduced geographical access assessed as the interval of time spent to arrive at the primary healthcare office revealed, on average, 25 minutes in urban versus 75 minutes in rural areas. CONCLUSIONS: The research outcomes highlight the fact that the population living in rural communities from the county of Iasi, are disadvantaged in accessing the primary health services, with negative consequences on the health status.

Variables of job satisfaction in medical assistant profession.

AIM: To identify the key favorable issues, showing a high degree of job satisfaction, and also the adverse issues that may affect the work performance among medical assistants. MATERIAL AND METHODS: This research is a type of inquiry-based opinion survey carried out by administering a self-managed, anonymous questionnaire, consisting of five sections with 25 items. The study group included 175 medical assistants from all specialties, working in public hospitals in the city of Iasi, who answered the questionnaires. A number of 167 subjects have responded, the return rate being of 95.4%. The respondents were asked to indicate the amount of agreement or disagreement on a typical five-level Likert scale. RESULTS: The study has identified some positive aspects: positive perception of the medical assistant profession (76.6%); concern about personal growth and career development (86.3%); good rel ationships established with other colleagues (71.2%), and some negative aspects: inappropriate work conditions and equipments (70%); the income compared to the volume of work was perceived by majority as an important source of dissatisfaction (80.8%); willingness to work abroad (53.9%). CONCLUSIONS: The findings of the present research focused on the variables of job satisfaction in the medical assistant profession and should be a real concern for managers, because the job dissatisfaction may affect the employee's productivity.

Occupational hazards in a public ambulance service.

AIM: To identify the occupational risks in an ambulance service and to assess their impact on the health of employees. MATERIAL AND METHODS: Two marched groups (number, sex, age, length of exposure) from two different work sectors were selected. A 60 item questionnaire was used. The 60 items were grouped into four categories related to work organization, work environment, neuropsychosensorial risk factors and health system and occupational safety-related risk factors and hazards. The data were statistically processed, significant correlations between the risk factors and the associated symptoms being found. RESULTS AND DISCUSSION: Compared to the control group, significantly higher values (p<0.001) for work complexity, work environment factors, and organizational risk factors (walking on uneven ground, carrying weight, vicious postures) were found in ambulance service staff; cervical and lumbar spine problems were the most common complaints of ambulance service staff. CONCLUSION: The specific risk factors for ambulance service employees directly related to musculoskeletal disorders have been established.

Profile of services provided by an accident and emergency care department in connection with road traffic injuries involving children, 2003-2005.

OBJECTIVE: To study profile of services provided by an accident and emergency care department (AECD) in connection with road traffic injuries involving children in "St. Maria" University Paediatrics Hospital, Iasi, Romania. METHODS: The survey represents a descriptive analysis of 2003-2005 data regarding the 538 injured children aged 0-18 years and allowed to design the request pattern based on: a) comparison between observed case distribution by weekday, month and season and hypothetical equal distribution using chi2 test; b) most common features of cases. RESULTS: Injuries ranged from 4.3% in March to 12.3% in August, being significantly higher in summer. Children aged 5-14 years represented 65.6%. The male : female and urban : rural ratios were 1.3 : 1 and 1.5 : 1, respectively. Two in three cases were found to suffer head injury, and one in two children suffered abdomen/pelvis contusions. CONCLUSION: More road traffic injuries attended the AECD during summer. The common case was male gender aged 5-14 years, urban area, with head injury and abdomen/pelvis contusions.