Liviu Oprea | University of Medicine and Pharmacy "Gr. T. Popa", Iasi (original) (raw)

Papers by Liviu Oprea

International Journal of Environmental Research and Public Health, Nov 25, 2021

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

South African Journal of Economic and Management Sciences, May 29, 2014

Nowadays, a third generation of ethics has come to the fore, whereby ethical issues are approache... more Nowadays, a third generation of ethics has come to the fore, whereby ethical issues are approached in an integrated manner, emphasising the management of ethics, which entails a cause-effect relation. One of its evaluation instruments is the ethical audit. This paper presents the findings of research focused on 47 executives involved in the management of quality in Romanian hospitals. The research concerns, in particular, the relevance and the opportunity for an ethical audit and the assessment of its possible effects. The data were gathered using a questionnaire. The research shows that Romanian managers consider the introduction of the ethical audit within the accreditation process as being relevant and pertinent. They believe that ethical monitoring is beneficial for the activity of healthcare institutions, but also that these institutions are as yet not sufficiently prepared to implement ethical audits. This study might be useful for sounding an alarm bell or for suggesting a direction for the qualitative and quantitative improvement of accreditation criteria and for the management of change in healthcare institutions worldwide.

The international recruitment of health personnel appears to be lately an usual practice for some... more The international recruitment of health personnel appears to be lately an usual practice for some countries to cover their needs in health care. That is possible due to income differences between countries that motivate physicians to migrate. Now this is an unavoidable fact, but the resulting ethical problems cannot be ignored, like the unbalance in the developing countries healthcare systems by losing physicians. The whole practice became morally questionable with international ongoing efforts to solve it one as the recruitments codes. We will to discuss the WHO Global Code of Practice on the International Recruitment of Health Personnel from an original perspective inspired from Rawls theory of justice. The rawlsian principles we will focus on are: a. the veil of ignorance, b. the maximin strategy. With this, we offer a better look inside the code and the practice it tries to regulate.

Social Research Reports, 2013

This paper aims to analyse several inequalities in the Romanian healthcare system at regional lev... more This paper aims to analyse several inequalities in the Romanian healthcare system at regional level and to highlight the resemblances and the differences, taking into account the socioeconomic development, the population health status and the material and human resources allocated to healthcare, in different Romanian regions. We use secondary data registered at NUTS 2 level for eight Romanian regions collected from Eurostat (2009-2010). The results show large discrepancies between Romanian regions in most of analysed variables. Bucharest, NorthWest and West regions are characterized by a higher level of resources allocated to healthcare, a higher level of education and a lower poverty rate, unlike NorthEast , SouthWest and South regions, which display the opposite situation.

Revista Romana De Bioetica, Apr 29, 2013

ABSTRACT This study presents a psychotherapeutic intervention with a young man. The main complain... more ABSTRACT This study presents a psychotherapeutic intervention with a young man. The main complaints refer to the separation from his girlfriend and stress at work. The patient had identified his dysfunctional automatic thoughts and had tested them by confronting them with realistic alternatives. The main interventions targeted small behavioral changes, cognitive restructuring, clinical hypnosis and the empty-chair technique for ambivalence. The therapist took into account a virus B infection as a favoring factor for depression; the patient was properly informed. Therapeutic objectives were achieved thanks to the multiple resources available to the patient.

Journal of Affective Disorders

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

International Journal of Environmental Research and Public Health

Healthcare accessibility and equity remain important issues, as corruption in the form of informa... more Healthcare accessibility and equity remain important issues, as corruption in the form of informal payments is still prevalent in many countries across the world. This study employs a panel data analysis over the 2006–2013 period to explore the role of different institutional factors in explaining the prevalence of informal payments. Covering 117 countries, our findings confirm the significant role of both formal and informal institutions. Good governance, a higher trust among individuals, and a higher commitment to tackling corruption are associated with diminishing informal payments. In addition, higher shares of private finance, such as out-of-pocket and domestic private health expenditure, are also correlated with a lower prevalence of informal payments. In policy terms, this displays how correcting institutional imperfections may be among the most efficient ways to tackle informal payments in healthcare.

The purpose of this study is to explore whether socioeconomic variations exist in the prevalence ... more The purpose of this study is to explore whether socioeconomic variations exist in the prevalence of chronic diseases in Romania. To evaluate the level of variations, this article reports a European Quality of Life Survey (EQLS) conducted in Romania. Using logistic regression analysis, results suggest that while some weaker and more vulnerable socioeconomic groups are significantly more likely to report a chronic illness or disability (e.g. women, older people, retired or unable to work), others are not (e.g. people with low educational level, living in rural areas or in poorer regions). Showing a disproportionately prevalence of chronic conditions amongst socioeconomic groups, the study emphasises the need for a policy that takes into account socioeconomic variations when addressing the impact of chronic diseases.

Adherence to antiretroviral therapy is one of the main focuses regarding HIV/ AIDS in the world a... more Adherence to antiretroviral therapy is one of the main focuses regarding HIV/ AIDS in the world at the present time. Numerous studies have identified a wide arrange of factors influencing adherence, from psychological aspects such as depression or poor self-efficacy, to medical aspects such as treatment fatigue, pill burden, side-effects, and also social support, stigma, discrimination, lack of knowledge or lack of access to medical care. The research aims to highlight the main reasons HIV-positive patients from Moldova have for non-adherence to anti-retroviral therapy. After studying retrospectively psychological evaluation records of patients hospitalized in the HIV/AIDS Regional Center Iasi, between January 2013 and January 2015, we identified the main reasons invoked for non-adherence: fear of disclosure, related to the posibility of being rejected and stig-matized; "treatment fatigue", manifested through forgetfulness, postponing, due to the emotional impact of taking...

There have been made polygraphic registrations for 20 patients believed to be suffering from brea... more There have been made polygraphic registrations for 20 patients believed to be suffering from breathing disorders during sleep. The patients were also subjected to a detailed ENT clinical exam and nasal endoscopy. The patients filled a form for the polygraphic laboratory and a questionnaire for ESS auto-evaluation. Breathing problems during sleep, including sleep apnea, are a common pathology being diagnosed through the adverse effects it has on the quality of life. These effects can be quantified by the sleep deprivation index on the Epworth Scale (ESS). The risk of the patients to fall asleep during the daytime has a great implication on the quality of life. The values range between 0 and 24 and can be correlated with the index of apnea-hypopnea characterizing sleep apnea. This paper wants to synthesize a study on a group of patients with sleep apnea. This study correlated the data obtained from the polysomnography registration to the ones given by the specific form filled with the...

Revista De Cercetare Si Interventie Sociala, 2017

Today, the protocols for “donation after cardiac death” allow clinicians to harvest viable vital ... more Today, the protocols for “donation after cardiac death” allow clinicians to harvest viable vital organs as soon as cardiopulmonary arrest is deemed to be irreversible, typically several minutes after diagnosing a loss of circulatory and respiratory function. Although these patients are not brain dead, the irreversibility of circulatory death make these patients suitable donors for organ donation, provided that organ harvesting will take place as soon as possible. In the neurologic definition of death, a person is dead when the whole-brain is dead. The continued circulation of blood helps to prevent the organs from deteriorating, making this method superior. Brain dead patients still display some residual functions of life, making non-health professionals wondering if they are really dead. However, the brain death criteria focus on an event, which can be precisely timed and detected with enough certainty to justify an irrevocable action, such as organ procuring. In this paper we anal...

Revista de Cercetare si Interventie Sociala, 2021

The objectives of this study are assessing of internet use among Romanian patients from general p... more The objectives of this study are assessing of internet use among Romanian patients from general practitioners as well as their intention to use or recommend the first computer tailored program for smoking cessation from Romania. The study involved 200 patients from general practitioners from Cluj-Napoca, Romania. A cross-sectional study was performed in 2014 through anonymous questionnaires. More than 80% of the patients declared using internet, while half were searching on internet in the last month information regarding healthy lifestyle. The prevalence of smoking was 29.5%. One out of two smokers declared intention to try the program for smoking cessation, this intention being higher among smokers with a stronger intention to quit smoking in the next 6 months, having email-address and searching healthy lifestyle information on internet in the last month. Two thirds of the participants agreed that they would inform other persons about the smoking cessation program; this intention ...

The Informal Economy in Global Perspective, 2017

This chapter explores the prevalence of informal payments in public healthcare services in Greece... more This chapter explores the prevalence of informal payments in public healthcare services in Greece. To evaluate the relationship between extra payments or valuable gifts (apart from official fees) and the level of acceptability of corruption, as well as the socio-spatial variations in the tendency to offer informal payments, data from a 2013 Eurobarometer survey is reported. Using logistic regression analysis, the finding is that patients with a high acceptability of corruption, those considering corruption as a very widespread phenomenon and those located in rural areas are more likely to offer, apart from official fees, extra payments or valuable gifts for healthcare services. The chapter concludes by discussing the health policy implications.

Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i

This paper aims to uncover what patients really expect form ART, and also what infectious disease... more This paper aims to uncover what patients really expect form ART, and also what infectious diseases doctors expect from a patient's ART regime, thus exploring an important side of adherence to ART. From July to November 2014 we have conducted a qualitative study regarding both patients' and doctors' expectations form the ART. We interviewed 30 patients and 4 doctors. We used semi-structured interviews that were conducted in the Psychosocial Compartment of the HIV/AIDS Regional Center in Iasi. The patients we interviewed came from all 6 counties in the Moldova area. Age varied from 16 years to 59 years; 55% were female and 45% male. 30% came from a rural area. The most common expectations that patients have regarding ART are: "to help me live", "not to make me feel sick", "to be easy to take (not to big, not a lot)", "not to show on the outside what I have on the inside". The infectious diseases doctors that we interviewed work in th...

Iranian journal of public health, 2013

We aimed to verify the issue of the ethics audit and its use in the system of accreditation of ho... more We aimed to verify the issue of the ethics audit and its use in the system of accreditation of hospitals. It presents the results of a survey conducted among hospital managers from Romania. Our article highlights the results of the second part of a research carried out in 2012 on the pertinence and the structure of the ethics audit integrated within the accreditation process of hospitals, according the opinion of the 47 executives and managers involved in the quality management of Romania hospitals. The data have been gathered with the aid of the online questionnaire. An ethics audit integrated within the accreditation process of hospitals should include primarily the respect of the patients' rights, the good relations of the institutions with its patients and the respect of the moral rights of the employees. The usefulness of this study is due to the fact that it consults precisely those who should really contribute to the creation, application and monitoring of ethical policie...

Revista românǎ de bioeticǎ

An analysis of the effects of migration of health professionals may often reveal the negative con... more An analysis of the effects of migration of health professionals may often reveal the negative consequences of this phenomenon on health systems in the source countries. At the same time, especially in the case of the temporary migration, there are positive effects from the foreign professional practice, one of which being the development of professional competencies. The aim of this presentation is to highlight the doctors’ perception of the "doctor-patient" relationship after practicing abroad. The methodology which was used in this study was qualitative. The data were therefore obtained after conducting 22 interviews. The study participants were 10 doctors who had at least one year of practicing abroad and returned to Romania and 12 doctors working in EU countries (France, Belgium, UK). To gather the information we used semi-directive interview guides and the analysis was thematic, using the QsrNvivo program. The results showed that one of the main benefits felt by Roman...