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PubMedDate not supplied

Visually impaired (VI) education in Romania and the United Kingdom: special education in Romania since 1990 for blind and partially sighted children and young people, with comparisons drawn from similar experiences of legislative and educational changes in England and Wales since 1981.

This article reviews the educational facilities available in the last decades of the 20th century for blind and partially sighted children and young people in Romania and the UK. A turning point in England and Wales came with the Education (Special Educational Needs) Act 1981. For Romania, the turning point came in 1990 with the overthrow of the Ceaucescu regime in late 1989. Romania is seeking entry to the European Union in 2007. This has provided an incentive to bring special educational philosophy and facilities quickly into line with other countries in the European Union. Similar problems regarding inclusion are encountered in both countries. Differentiating features are their different demographic characteristics and the educational resources and assets available at the time of the major changes. Finally, there is a brief review of the number of people with sight loss in paid employment as the next logical focal point for a national inclusion strategy. The UK has been able to develop and advance further than Romania in this sphere, but the legal framework is in place in Romania. The generic terms visually impaired (VI) and sight loss are both used throughout when referring to blind and partially sighted people.

Blindness↗
PubMed2005

Mentoring a developing health technology assessment initiative in Romania: an example for countries with limited experience of assessing health technology.

OBJECTIVES: The aim of this study was to assist and facilitate introduction and development of a health technology assessment (HTA) program in Romania. METHODS: Mentoring of an initiative group in Romania was provided by an HTA program in Canada. Mentoring activities included provision of HTA materials, participation in local seminars, facilitating contact with HTA and funding organizations, and in-house training of a professional from Romania. RESULTS: Since 1998, when the relationship was initiated, the Romanian group has been successful in developing an understanding of HTA and awareness of its utility among various decision-makers in the health system. Currently, although the need for HTA in Romania exists and interest in developing this activity has been officially expressed, HTA is still early in its development phase. The mentoring support helped to identify and define the need for HTA in Romania. Continuation of the existing relationship can be expected to strengthen the expertise in this country. However, while mentoring has been a valuable activity, it is not, by itself, sufficient to ensure development of an HTA program in Romania. The actions and decisions that could lead to implementing HTA in Romania depend on the local context. CONCLUSIONS: Mentoring services assisted the initiative group in promoting HTA in Romania. The implementation of HTA in Romania has not happened yet, and efforts need to continue to sustain the existing momentum. However, success in implementing an HTA program will depend on essential factors such as local political, economical, and educational support for this initiative and others like it.

Alberta↗
PubMed2000

Genetic evidence of multiple transmissions of HIV type 1 subtype F within Romania from adult blood donors to children.

We studied the phylogeny of HIV-1 subtype F viruses from children and adults in Romania in order to (1) clarify whether the Romanian subtype F epidemic was caused by one or several virus introductions and (2) gain insight into the route of spread of the HIV-1 subtype F virus among children and adults in Romania. env (V3), gag (p17/half p24), and pol (prot/half RT) sequences were obtained from three districts in Romania: Tirgu Mures (n = 9, children), Craiova (n = 15, children), and Bucharest (n = 13, adults). Of 37 HIV V3 sequences from Romania, 35 belonged to the genetic subtype F in the neighbor-joining tree, whereas 2 sequences from adults clustered with subtypes A and C. Within the subtype F cluster, no bootstrap-supported subclusters were observed according to geographic area in Romania. Two of the adult V3 sequences that clustered with the children were obtained from individuals who tested HIV seropositive in 1989 and 1990, showing that the subtype F virus was present among adults when the HIV epidemic began among children in Romania. The HIV-1 subtype F viruses obtained from children showed a mean pairwise V3 nucleotide distance of 7.9% and maximum distances of between 18 and 19%; both are higher than previously described. The mean V3 distances (overall, synonymous, and nonsynonymous) were significantly higher for adults than for children. One V3 sequence from the Democratic Republic of Congo clustered within the Romanian sequences, suggesting that the subtype F virus in Romania may originate from this area. Our data also suggest that HIV-1 subtype F was present among Romanian adults before it appeared in 1989 among institutionalized children. The juvenile population was most likely infected with the HIV-1 subtype F virus on more than one occasion, presumably through HIV-contaminated blood (products) obtained from adults.

Adolescent↗
PubMed1994

Paralytic poliomyelitis in Romania, 1984-1992. Evidence for a high risk of vaccine-associated disease and reintroduction of wild-virus infection.

Although poliomyelitis due to wild-virus infection has virtually disappeared from Romania, with no cases having been documented between 1984 and 1989, vaccine-associated paralytic poliomyelitis has been reported at very high rates for over two decades. In November 1990, to decrease the risk of vaccine-associated paralytic poliomyelitis, oral poliovirus vaccine produced in Romania was replaced by imported oral vaccine made by a Western European manufacturer. To better quantify the risk of vaccine-associated paralytic poliomyelitis and the impact of the change in vaccine manufacturer, the authors reviewed clinical, epidemiologic, and laboratory data on poliomyelitis cases that occurred in Romania from 1984 to 1992. Poliovirus isolates were characterized at the US Centers for Disease Control and Prevention. During the period 1984-1992, 132 confirmed cases of paralytic poliomyelitis were reported in Romania, of which 13 were classified as wild-virus-associated, 93 as vaccine-associated, and 26 as "of unknown origin." Wild type 1 poliovirus was isolated during 1990-1992 from nine of 13 (69%) cases in an outbreak that occurred primarily among undervaccinated gypsy children. Vaccine-associated cases were epidemiologically and virologically distinct from wild-virus cases. Of the 93 vaccine-associated cases, 45 children were recipients and 48 were contacts. The overall risk of vaccine-associated paralytic poliomyelitis in Romania (1 case per 183,000 doses of oral poliovirus vaccine distributed) was 14-fold higher than the risk in the United States. The risks of recipient vaccine-associated paralytic poliomyelitis related to the first dose of oral vaccine were similar for Romanian and imported vaccine (1 case per 95,000 doses and 1 case per 65,000 doses, respectively), as were the total risks of vaccine-associated paralytic poliomyelitis. These findings definitively demonstrate a substantially elevated risk of vaccine-associated paralytic poliomyelitis in Romania which was not affected by a change in oral poliovirus vaccine manufacturer.

Child, Preschool↗
PubMed2006

The survey on the practice of gastroenterology in Romania.

AIM OF THE STUDY: To get data on the current practice of Gastroenterology in Romania. MATERIAL AND METHOD: We obtained data regarding the number of gastroenterologists in Romania from the Centre of Statistics of the Ministry of Health and Family (CSMHF) and the National Centre of Training for Medical Personnel (NCTMP). We sent a questionnaire to all the Centers of Gastroenterology in Romania inquiring about the number of gastroenterologists and fellows, and about the gastroenterological procedures performed. We compared these data to that of 17 European countries. RESULTS: The total number of gastroenterologists in Romania on January 1, 2005 was 175 (123 specialists and 52 senior consultants), and the total number of fellows in training was 133. Romania has a small number of gastroenterologists - 0.83/100,000 inhabitants, expected to reach approximately 1.4/100,000 inhabitants in 2010. Regarding the abilities in gastroenterological procedures, we obtained data from 98 gastroenterologists. They have good performances in diagnostic gastroscopy (97%), colonoscopy (81.6%), abdominal ultrasound (79.6%), but a poor performance in ERCP (10.2%). Less than half of the gastroenterologists (46.9%) perform proctologic procedures. Data regarding the training program of the Romanian fellows are disappointing: only 69.1% of them perform gastroscopy, 33.8% colonoscopy, 2.9% ERCP, 64.7% abdominal ultrasound and 14.7% proctology. CONCLUSIONS: The number of gastroenterologists in Romania seems low compared with most European countries. They do not acquire a uniform satisfactory mastering of gastroenterological procedures during their training program. This should be improved according to the guidelines of the European Diploma of Gastroenterology.

Digestive System Surgical Procedures↗
PubMed2002

An epidemiological and surveillance overview of brucellosis in Romania.

This article reports epidemiological investigations on the occurrence of brucellosis in Romania. Like in other former communist countries, data concerning epidemiology of brucellosis and published articles are very few. The epidemiology and control of brucellosis in Romania was analyzed using data made available by the Office International des Epizooties and Veterinary Service of Romania. Romania, like many other developed countries, has eradicated Brucella abortus from cattle since 1969. Brucellosis caused by Brucella melitensis has never been reported. The incidence of brucellosis in swine and sheep is very rare but still there are a few outbreaks in some regions. In 2000, the number of cases was 47 in swine and 270 cases in sheep. Vaccination against brucellosis is prohibited in Romania.

Abattoirs↗
PubMed2002

Changing life expectancy in Romania after the transition.

BACKGROUND: While Poland, Hungary, and the Czech Republic have seen impressive gains in life expectancy in the 1990s, Romania has not. In contrast with the other countries, there has been very little research on the causes of the pattern of mortality seen in Romania. OBJECTIVES: To describe the trends in life expectancy at birth in Romania after the political transition in 1989 and to evaluate the contribution of deaths from different causes and different ages to these changes. METHODS: Decomposition of life expectancy by age and cause of death using routine data on mortality for the years 1990, 1996, and 1998; comparison of death rates by age, sex, and cause of death. RESULTS: Romania has experienced an overall decline of 1.71 years of life expectancy at birth from 1990 to 1996 in men and 0.54 years in women. The major contribution to this decline was an increase in mortality from cardiovascular diseases and diseases of the digestive system, in particular cirrhosis, among the middle aged and elderly. The recovery observed in 1998, of 1.12 years in men and 0.89 years in women, was mainly caused by a reduction in deaths from cardiovascular disease in the middle aged and elderly. Infant and early childhood mortality fell throughout the period but there was an increase of approximately 40% in mortality at age 5-9 that was almost entirely attributable to AIDS. CONCLUSION: This is the first Romanian study that describes the evolution of life expectancy after transition. Romania may at last be beginning to follow the path of improving adult mortality seen in the early 1990s in some of its neighbours. It has, however, been unique in eastern Europe in experiencing increasing childhood mortality. This is attributable to an epidemic of paediatric AIDS, consequent on the tragically inappropriate policies adopted in the 1980s.

Acquired Immunodeficiency Syndrome↗
PubMed2001

The epidemiology of childhood-onset type 1 diabetes mellitus in Romania. ONROCAD Study Group. National Romanian Organisation for the Care of Diabetic Children and Adolescents.

The ONROCAD Study group was established to provide descriptive epidemiological information on type 1 diabetes mellitus (DM) in Romania. Data on all new patients with type 1 DM with onset before age 15 years during the four-year period 1992-1995 in Romania were submitted from all members of the ONROCAD Study Group, representing all doctors and clinics that manage children with DM in Romania. Age- and sex-specific incidence rates were estimated, using available demographic data. A total of 706 new patients with type 1 DM and onset 0-14 years was registered. The overall completeness of ascertainment was estimated at 93.5%. For all Romania, the incidence of childhood-onset type 1 DM was estimated at 3.57/100,000/year. The incidence in the three regions was statistically significantly different (p = 0.002), with high rates in Transylvania and low rates in Muntenia. Girls had a significantly higher incidence than boys for each of the age groups 0-4, 5-9 and 10-14 years. Between these age groups, the incidence increased significantly with age. The incidence of childhood-onset type 1 DM is among the lowest recorded in Europe. Significant, but unexplained, geographical variation exists within Romania. Searches for factors to explain this heterogeneity may provide clues to the etiology of childhood-onset type 1 DM.

Adolescent↗
PubMed2005

Colonoscopy in Romania.

BACKGROUND: To date, colonoscopy is considered the gold standard for the investigation of the colon and also the gold standard method for colorectal cancer screening. AIM of this paper was to assess if and how is Romania prepared to cope with screening of colon cancer by means of colonoscopy. METHOD: We sent a study-type questionnaire addressed to all the centers in Romania known to perform digestive endoscopy and we inquired about the total number of colonoscopies and flexible sigmoidoscopies performed in 2003 (the questionnaire was sent to 43 centers). RESULTS: Thirty-eight centers responded to the question-naire. The total number of colonoscopies performed in Romania in 2003, obtained by collecting the data from the study centers, was 22,324. The number of sigmoidoscopies performed during the same period was 12,349. The ratio between the number of colonoscopies and sigmoidoscopies was 1.8/1. There were 106.3 colonoscopies /100,000 inhabitants. CONCLUSION: Considering the population of Romania (about 21 million inhabitants), the number of colonoscopies performed is insufficient for our country. The number of centers performing colonoscopy in Romania is also insufficient.

Colonic Neoplasms↗
PubMedDate not supplied

[The incidence of tuberculosis in Romania in 1993].

The situation of tuberculosis in Romania has been progressively deteriorated since 1986. Using the data from the TB notification forms and demographic data for the number of inhabitants by sex and age groups in various districts in 1993, there have been calculated the main TB epidemiometric indicators for 1993. TB notification rate in 1993 in Romania (89.4%000) is plotted against values in other countries of the Europe Region WHO in figure 1 and against the mean values for in the six WHO regions in figure 2; the dynamic of the annual values 1991-1994 in the 41 districts of Romania are presented in figure 3 and a comparison of the annual values 1985-1993 in Romania versus other countries with rising values (USA, Denmark and Lithuania) in figure 4. Data concerning TB notification rate in children (20.7%000 in 1993) and its dynamic during the last 8 years is presented in table II, high values districts in table III, the prevalence of sources in tables IV and the TB mortality (10.1%000 in 1993) and its trend during the last 11 years in table V. A series of 8 annexes presents 1993 data on TB notification number and rate by disease localisation, bacteriologic confirmation and sex, for each of the 41 districts of the country. All data are meant to reveal the magnitude of "TB problem" in Romania, to allow optimisation of the main control actions and planning of the necessary means.

Adolescent↗
PubMed2004

A strategic assessment of abortion and contraception in Romania.

The history of fertility regulation in Romania illustrates the complex interactions between politics, women's reproductive health and rights and access to high quality care. This paper describes the current situation of abortion and contraception in Romania, based on national statistics, recent reproductive health surveys and the findings of a strategic assessment led by the Ministry of Health in late 2001. This rapid assessment employed a participatory, qualitative methodology. Over 500 people were interviewed from 145 institutions in 25 cities, towns and villages in Romania, about the range of actions needed to prevent unwanted pregnancies, reduce abortion-related morbidity and mortality and improve the quality, accessibility and availability of abortion and contraceptive services. Although much progress has been made in contraceptive services over the past ten years, improvements in abortion care have lagged considerably The assessment played an important role in raising team members' awareness and motivation to take action. Some of the issues identified are already being addressed by the institutions that took part. National standards and guidelines for comprehensive abortion care have been developed, contraceptive services have been expanded at primary health care level, sexual and reproductive health education provided by classroom teachers has been introduced in schools, and a study to test a model of comprehensive abortion care services for Romania is planned.

Abortion, Induced↗
PubMedDate not supplied

[The prevalence of viral hepatitis B in pregnant women in an area of southern Romania].

In Romania, the acute hepatitis B virus (HBV) infections are considered to be a public health problem. One of the most effective routes of transmission is from infected mothers to newborns both perinatal and in early childhood. That for, this study objective was to estimate the prevalence of hepatitis B în pregnant women. We used the cluster sampling method with a sample size of 1356 pregnant women. Finally our study was based on 1298 blood samples coming from 19 clusters (obstetrics wards/hospitals) selected from those 108 obstetrics wards/hospitals in the south of Romania. Overall, 31.8% (95% C.I. 27.3%-36.4%) of pregnant women admitted for birth in southern Romania had the evidence of past or current HBV infection (anti HBc, AgHBs). In a study done in 1990, Bradley A. Woodruff et al. has reported a prevalence of past or current HBV infection of 36.7% among pregnant women in northeastern Romania.

Adult↗
PubMed2003

The prevalence of coeliac disease at endoscopy units in Romania: routine biopsies during gastroscopy are mandatory (a multicentre study).

UNLABELLED: The incidence and prevalence of coeliac disease vary internationally. In Eastern Europe little is known about the prevalence of coeliac disease. THE AIM: of this study was to evaluate the prevalence and the clinical features of coeliac disease in adults biopsied during upper endoscopy in Romania. This is the first incidence study of the coeliac disease in Romania. METHODS: The study was initiated by the Romanian Society of Digestive Endoscopy for the period 1 January 2002 - 31 May 2002. It was carried out in 9 Academic Centres in Romania, which ensured an even geographical distribution and therefore significant statistical results at a national level. The study included 2436 patients according to following criteria: age over 16 years, with no known history of coeliac disease, visiting the participating upper endoscopy units or patients with documented coeliac disease presenting for follow-up check or recurrence of clinical symptoms. At least two bioptic samples were obtained from the distal duodenum, as distally as possible, which were submitted to histopathological examination and scored according to the modified UEGW Marsh criteria (2001). A database was set up to include all the patients with data regarding sex, age, urban or rural background, full clinical diagnosis, clinical symptoms, history of the coeliac disease. RESULTS: Of the 2436 patients studied, 54 (2.22%) were diagnosed with coeliac disease. Their demographic features: 48.15% men, 51.85% women, 68.52% living in urban areas, 31.48% in rural ones, mean age 42 +/-17.0 years. The most frequent reasons for performing upper digestive endoscopy were: dyspeptic syndrome - 15.93%, anemia - 24.07%, and chronic diarrhoea - 22.22%. The most frequently recorded clinical manifestations were: chronic diarrhoea in 46.3%, asthenia in 29.63%, anemia in 24.07%, aphthae in 24.07%. Histopathological results according to Marsh classification were: Marsh III- 64.81 %, Marsh II-35.19%. CONCLUSIONS: The prevalence of the coeliac disease in Romania is 2.22%: its sex distribution is fairly equal, the age distribution includes two peaks, at 30-40 and 50-60 years respectively, and patients from urban areas predominate. The most frequent (over 50% of the cases) histological type was M III. The most common clinical symptoms were diarrhoea, asthenia, anemia, aphthae, while the most frequent associated diseases were diabetes mellitus and Duhring-Brocq dermatiti

Adult↗
PubMedDate not supplied

Foster care and adoption policy in Romania: suggestions for international intervention.

Building an effective child welfare system is a monumental task facing postrevolution Romania. Following revelations on American and Western European television about the large number of "orphans" in Romania, many couples flocked to that country to adopt children. A significant number of adopted Romanian children were brought to the United States. Some of these children are now evidencing problems that are bringing them to the attention of health and social service agencies. This article examines the macroeconomic policies that led to the institutionalization of a large number of children in Romania. Although institutional care is the current norm, a legal basis exists for building family foster care as an alternative. Romania's new adoption law replaces private adoptions with agency-based work. International adoption agencies are involved in developing community-based foster care and permanency planning as part of their work. This article challenges international adoption agencies to use clinical assessments of developmental delays and more rigorous health examinations for children released for adoption.

Adolescent↗
PubMed1991

Acquired immunodeficiency syndrome in Romania.

After the initial description of acquired immunodeficiency syndrome (AIDS) in Romania in late 1989, national AIDS case surveillance was established with a modified version of the World Health Organisation (WHO) clinical case definition. This modified case definition requires that AIDS cases have both clinical and serological evidence of human immunodeficiency virus (HIV) infection. Before December, 1989, Romania had reported 13 AIDS cases to WHO. By Dec 31, 1990, 1168 AIDS cases were reported to Romania's Ministry of Health, of which 1094 (93.7%) occurred in children less than 13 years of age at diagnosis. Of these, 1086 (99.3%) were in infants and children less than 4 years of age, and 683 (62.4%) in abandoned children living in public institutions at the time of diagnosis. By Dec 31, 1990, 493 (45.1%) mothers of children with AIDS had been located and tested, and 37 (7.5%) were positive for HIV; 423 (38.7%) cases were in children who had received transfusions of unscreened blood, and 6 (0.5%) were in children with clotting disorders. HIV transmission through the improper use of needles and syringes is strongly suspected in most of the remaining 628 (57.4%) children with AIDS, most of whom had received multiple therapeutic injections. This outbreak demonstrates the serious potential for HIV transmission in medical facilities that intensively and improperly use parenteral therapy and have poor sterilisation technique.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Organohalogenated pollutants in human serum from Iassy, Romania and their relation with age and gender.

Human serum samples (n=142) from Iassy county (Eastern Romania) collected in 2005 were analyzed for p,p'-DDT and its metabolites, hexachlorobenzene, hexachlorocyclohexane (HCH) isomers, chlordane and metabolites and 14 polychlorinated biphenyl (PCB) congeners. In all samples, p,p'-DDE (principal metabolite of p,p'-DDT) and beta-HCH (most persistent HCH isomer) were the most abundant organochlorine pesticides (OCPs) with median concentrations of 1975 and 923 ng/g lipid weight (lw), respectively. Hexachlorobenzene and p,p'-DDT were also detected in all samples, but at a lower median concentration of 30 and 340 ng/g lw, respectively. The large variation of the ratio p,p'-DDT/p,p'-DDE (range between 0.02 and 0.80) suggests various degrees of exposure to DDT, including recent exposure, at least to some subgroups of the population. Chlordane and its metabolites were in most cases close to the limit of quantification suggesting a very low use of chlordane formulations in Eastern Romania. Unexpectedly, PCBs were present in all samples at sometimes considerable levels (up to 4970 ng/g lw for sum of 14 PCB congeners) indicating a higher exposure of the Romanian population than previously reported. The PCB profile consisted of persistent congeners such as 138, 153, 170 and 180 which contributed for approximately 75% to the sum PCBs. Concentrations of most pollutants correlated significantly with age (r>0.86, p<0.01). Except for p,p'-DDT and gamma-HCH, the mean levels of OCPs in females were statistically higher than in males, while, except for octa-CBs, no gender differences were found for PCBs. Levels of p,p'-DDE, penta-CBs, hexa-CBs and hepta-CBs were significantly higher in individuals with a rural main residence. In a pooled serum sample, 6 polybrominated diphenyl ether (PBDE) congeners were measured at a level of 1.04 ng/g lw. Compared to results available from Central and Eastern European countries, human serum samples from Romania contained higher levels of contamination. This emphasizes that an extensive and rigorous program for the monitoring of OCPs and PCBs in Romanian population is highly needed in the light of possible adverse health effects acknowledged for these pollutants.

Adolescent↗