Globalization had a significant impact on project management, especially on its structure and the working environment of project teams, because of the increased connectivity due to technology innovations, offering the international project managers the possibility to access high quality human resources across country frontiers, at reduced prices. Internet communication transformed traditional teams in virtual teams, which activity is based on the electronic collaboration tools. The high diversity degree characteristic to virtual teams, from culture to technical tools, can be overwhelming for the international project manager which has to lead its virtual team to success. One of the key processes which lead to a high effective team is the team building process, based on motivation and trust. Even if this seems similar to traditional teams, the path of achieving them is very different and it involves more variables and one of them is the national culture, which we consider one of the most important. This article aims to highlight the importance of understanding each dimension of the national culture so that international managers choose to establish the motivational practices and tools accordingly. We also proposed the profile of the national culture most suitable to work in a virtual environment.
Systemic thinking is an instrument used in any field to understand the complexity of the changes and challenges that take place, and to discover the reciprocal links and conditions between the internal elements that determine the functioning of the system. Understanding how the international project with virtual project teams works as a system can help us better address the issues that arise in managing it, helping to increase the success rate. The international project with teams in the virtual environment, due to the diversity it embraces, in various aspects, especially at the cultural level, is considered a complex system, and can be seen as a system of systems. This term applies to systems in which interactions that could appear between different elements and deliverables are difficult to represent by a mathematical model or to be anticipated. In order to highlight the complexity of the international project system, we chose to represent project management in the virtual environment as a subsystem through the subsystems that compose it. This graphic representation can be used as a theoretical model of how to manage an international project with teams in the virtual environment
The leadership style and the thereof oriented behavior pattern represents the basic attitude in which a person exercises its leadership tasks. There are a series of different leadership styles with numerous explanation attempts aiming to present a model for a successful leadership behavior. The worldwide trend leads in the direction of Management by Delegation with clear operating principles which is nowadays the central point of all general interests concerning this topic but a thorough documentation regarding the different leadership styles is the starting point for each manager when trying to build a good relation with the employees. A well-defined and applied leadership style will influence the working behavior of the employees and in turns lead to a better functioning of the whole organization. The knowledge-based organization needs to be up to date with both the oldest and the newest theories concerning leadership so it can create a working relationship with its employees. The present paper aims to present the main aspects concerning leadership, leadership styles and concepts in order to find the best way of creating a successful relationship between leadership and employees by strengthening the individual responsibility of each employee and hence improving the functioning of an organization.
Numerous studies have pointed out direct positive impacts of Information Communication Technology (ICT) on education quality. From just tool, ICT is being viewed in itself as quality or as catalyst for quality improvement. These findings have led universities worldwide to adopt ICT regardless of uncertainties. Consequently, not all of them succeeded. Proofs from cases around the world show that ICT produces positive impact only in the environment that fits. Such environment is fostered by an effective change management approach. The main aim of this paper is therefore to present the symbiotic relationship between ICT and change management, zeroing on how changes are managed to attain a proper ICT ecosystem for education quality improvement. It also aims to understand, through the conducts of extensive bibliographical research, along with critical content analyses, the roles of ICT in education, its design and impacts, and what constitutes effective change management approach for ICT inclusion. Key findings include: that the integration of ICT alone does not necessarily produce direct positive impact on teaching and learning, but its design; that a good design requires a proper change management process, driven by ICT, and that the involvement of all stakeholders, particularly functional managers, is critical to attain better performances.
Risk assessment is one the key activities of any project. The unexpected situations can have catastrophic consequences. Risk assessment tries to estimate to potential known unknowns, but there is no guarantee to foresee all circumstances around a project. In this situation the project team must be adaptive and find solutions by cooperation, creativity and abductive reasoning. In the paper we tried to analyse on what extent a project and a project team can be handled as a complex adaptive system. More precisely, how the scientific and practical achievements of the theory of complex adaptive systems (CAS) can be used in project management. More exactly, we analyse the applicability of the Holonic Multi-Agent Systems in risk management of the projects. We consider the way in which holons handle the unexpected situations can be a model in project management.
Our study aims to provide a global picture of good sustainable practices and initiatives in the field of Technical and Vocational Education and Training (TVET). In order to outline the major positive practices worldwide, a document analysis was performed on international relevant documents (reports, academic studies, guides, rules and regulations, work papers). This method was complemented by discussions with local representatives of school administration, who provided specific evidence on curricular and extracurricular activities conducted locally. Our findings confirm that various sustainable initiatives in TVET took place at an international level, mostly involving multiple stakeholders in the public sector, private sector and civil society. However, it is difficult to assess the effectiveness of these initiatives due to the unequal cooperation of several countries in responding to the UNESCO questionnaires, and to the targets they address. Many of the initiatives outlined in our study appear to have a strong cultural and ethnical dimension. The organization of such examples of good practices according to the different types of learning systems (formal, non-formal and informal education) provides a large framework for different Education actors at international, national and local level, allowing them to inspire when making policies decisions to integrate Sustainable Development in Technical educational courses.
Background and aims. The incidence of Barrett’s Esophagus (BE) is increasing worldwide, thus diagnosis is becoming a major key of interest in preventing esophageal adenocarcinoma. Because the status of BE in Romania is unclear, we performed a narrative review to comprehensively evaluate all published articles on BE from Romania.
Methods. We conducted a systematic literature search of PubMed data base and of all Romanian medical journals. The abstracts and the titles of the identified studies were reviewed to exclude the studies that did not answer the search question. In addition we performed a manual search to identify articles on this topic published earlier in local journals or not indexed on internet.
Results. A total of 17 articles were found. 8 studies and 9 reviews were identified, with a total of 8,829 participants enrolled. The results showed that the median age ranges between 54–59 years, with a predominance for male sex, the main risk factors, such as gastroesophageal reflux disease, obesity, smoking, hiatal hernia, are also present in Romania and infection with H. pylori has a protective effect. The diagnosis of Barrett’s esophagus in Romania is established in agreement with international guidelines.
Conclusions. There are not many publications on BE in Romania. However the data in this country are similar to those reported in other countries. The management is carried out according to standard guidelines. Diagnosing BE relies on endoscopic techniques and classification systems. Risk factors such as gastroesophageal reflux, hiatal hernia, obesity and Helicobacter pylori are considered in Romanian articles. More studies are welcome on this matter in our country.
There is little data on the long term evolution of patients with irritable bowel syndrome (IBS) and of associated conditions. We therefore studied the evolution of IBS patients in a single tertiary center during a long interval of time.
Methods. We carried out a retrospective study based on the survey of patients records. We analyzed the records of symptoms, therapy, associated diseases, as consigned at follow-up visits for an interval of 4 years in average (2008-2011).
Results. A cohort of 114 patients with IBS diagnosed based on Rome III criteria were included (29 men and 85 women), age 19-85 years (mean age: 43.45 years). Urban patients were predominant. The main three symptoms were: abdominal pain, bowel disorders (constipation, diarrhea) and bloating. IBS - constipation (IBS - C) is associated with a favorable course of symptoms (increasing the number of stools, decrease intensity of abdominal pain and bloating) after treatment and IBS - diarrhea (IBS - D) is associated with variable symptoms after treatment (p = 0.031). Using trimebutin or mebeverin in association with other drugs for one month correlates with a favorable evolution of symptoms after treatment and monotherapy is associated with fluctuating symptoms ( p< 0.001). Favorable symptoms are associated with the use of probiotics in combination, but not in monotherapy (p< 0.001). Favorable evolution of symptoms is also associated with the use of anxiolytics in combination. Persistence of symptoms after treatment was correlated with the presence or absence of depression. The absence of depression was correlated with a favorable evolution of symptoms (p = 0.005). IBS-C is associated at limit (marginal significance) with hemorrhoidal disease (p = 0.56). 33 patients (29%) - received monotherapy (trimebutin or mebeverin or probiotics); 81 patients (71%) - received combined therapy: (trimebutin or mebeverin or probiotics) + anxiolytics or proton pump inhibitors (PPI) or nonsteroidal anti-inflammatory (NSAI) or spasmolitics. The most common associated diseases observed in patients with IBS were: depression (27.19%), dyslipidemia (25.43%), hemorrhoidal disease (22.80%) and fibromyalgia (21%).
Conclusions. The highest response rate was obtained with trimebutin or mebeverin + anxiolitics + probiotics. The most frequent disease associated with IBS was depression. Other diseases with a high incidence: dyslipidemia, hemorrhoidal disease and fibromyalgia. Further studies are needed to analyze the link between IBS and some associated diseases.
Cardiovascular and digestive diseases frequently share the same risk factors such as obesity, unhealthy diet, or several social behaviors, and the increasing prevalence of patients with overlapped cardiovascular and digestive symptoms is a challenging problem in the daily practice. Patients with gastro-esophageal reflux disease can exhibit various forms of chest pain that can be very similar to angina. Furthermore, antithrombotic therapies used for preventive or curative purposes in patients with cardiovascular diseases are frequently associated with gastrointestinal side effects including bleeding. At the same time, in patients with coronary stents presenting to the emergency department with chest pain, angina triggered by stent thrombosis or restenosis should be differentiated from angina-like symptoms caused by a gastrointestinal disease. The aim of this review was to present the complex inter-relation between gastroesophageal diseases and angina in patients on dual antiplatelet therapy following an acute coronary syndrome, with a particular emphasis on the role of anemia resulting from occult or manifest gastrointestinal bleeding, as a precipitating factor for triggering or aggravating angina.
The irritable bowel syndrome (IBS) is the most common chronic gastrointestinal disorder referred to gastroenterologists. One of the most common manifestations of IBS is bloating. Abdominal bloating is defined as subjective sensation of abdominal distension associated with girth increment. Therefore, it is described in the Rome IV criteria as bloating/abdominal distension. Bloating symptoms are reported by 10-30% of the general population and it was rated as the most bothersome symptom by 60% of IBS patients; the lack of specificity of this complaint prevented bloating to be included between the diagnostic criteria for IBS. Indeed, bloating may be reported also in healthy people or in other functional conditions. This paper looks to the evolutions of the concepts on bloating according to the Rome working groups from the beginning until now and it represents a comprehensive review on the prevalence and pathogenesis of bloating.