Cristina Claudia Rotea

The transformation of healthcare systems presents a key challenge for EU Member States, as they face growing population needs, resource pressures, and ongoing health disparities among communities. Using a systems-thinking approach provides a suitable framework for analyzing how healthcare resources, behavioral and social health determinants, and overall population outcomes are interconnected. This study aims to explore these relationships from a systemic viewpoint within health communities across the European Union. The research employs a cross-sectional approach, utilizing aggregated data from all 27 EU Member States. It involves descriptive and factor analyses to create composite indices of healthcare resources, positive health determinants, and health outcomes. Furthermore, it uses a univariate Generalized Linear Model (GLM) and multilayer perceptron neural networks to model nonlinear relationships among variables. Cluster analysis is also conducted to classify Member States into different health performance typologies. The results emphasize connections between healthcare system resources and population health outcomes, illustrating how positive determinants impact health status and highlighting structural differences across European communities. The results indicate relevant associations between healthcare system resources and population health outcomes, whereas the analysis of positive health determinants suggests more complex, partly nonlinear patterns. The findings also highlight structural differences across European health communities.

Background: Physical activity is essential for public health, yet disparities in access to exercise opportunities and institutional support remain significant across European regions. Objectives: This study examines how locally available physical activity options and support from local authorities relate to exercise participation, life expectancy, and healthy life years within the European Union. Methods: Using artificial neural networks and cluster analysis, the research identifies patterns across EU countries and explores associations between exercise behaviors and public health outcomes. Results: The MLP analysis showed that moderate regular physical activity had the most decisive influence on predicting healthy life years (100%), followed by regular activity (44.7%). In comparison, inactivity had a notable negative impact (40.5%). Life expectancy was most closely associated with the model’s strongest predictive pathway (weight = 2.395). Access to physical activity opportunities (100%) and the presence of supportive community providers (90.8%) were the most influential factors in encouraging active lifestyles. Conclusions: Populations with greater access and engagement in physical activity tend to enjoy longer life expectancies and more years of good health. While the study’s observational nature limits causal interpretations, the findings highlight the potential of community-level strategies and infrastructural investment to foster active lifestyles and enhance population health across varied local contexts.

In an era characterized by rapid changes and uncertainty, organizational resilience emerges as a critical factor for the survival and prosperity of businesses. Confronted with a progressively volatile and unpredictable organizational landscape, an organization’s capacity to swiftly and effectively address challenges and adapt to changes becomes indispensable. This paper investigates the role of strategic human resource management (SHRM) practices and organizational culture (OC) in enhancing organizational resilience (OR). The research employed a questionnaire distributed to 501 employees within public institutions, with data analysis conducted using structural equation modeling. The study assesses the direct effects of SHRM practices on organizational resilience while also investigating the mediating effects of organizational culture on the relationship between these practices and resilience. The primary findings highlight both the direct and indirect impacts of SHRM practices on organizational resilience. The study underscores the importance of adopting an integrated approach, wherein SHRM practices and organizational culture are strategically aligned to bolster organizational resilience and secure sustainable success in a dynamic and turbulent organizational landscape.

The role of human resources as a change agent in the organizational change process holds great importance. Hence, it is crucial to identify ways human resources can support change. This paper investigates the direct and indirect relationships between human resource management (HRM) practices and organizational performance, as well as the mediating role of the organizational change process in these relationships. The proposed model integrates primary HRM practices, organizational change components, organizational performance, employee retention, and organizational abandonment. We collected data to evaluate the relationships between the model variables through a survey questionnaire applied to 441 Romanian employees in the healthcare industry. The paper used structural equation modeling to test the model’s validity and hypotheses. The results show that HRM practices directly impact organizational performance and have a mediated impact through the organizational change process. Additionally, the direct and mediating effects are consistent, and healthcare employers consider appropriate HRM practices and effective management of the organizational change process as essential drivers to achieve superior performance. The empirical findings provide valuable insights for government policymakers, stakeholders, and health managers on how suitable HRM practices can influence organizational performance.

Healthcare managers consider the rewards and performances of employees as central elements of their activities due to the challenges caused by the phenomenon of healthcare employees’ emigrating to higher-income countries, which has reduced patient satisfaction and led to a negative image of hospitals. In this context, this paper analyzes how employee rewards influence the employees’ self-perceived performances in the hospital units of the emergency medical system in Romania. Using structural equation modeling, we analyzed the relationships between the investigated variables, showing that financial motivation and the recognition of employees’ merits are central to employees’ self-perceived performances. Ensuring equity also has a positive impact on how the reward package is established and managed. While financial rewards are the most important incentives to increase efforts to exhibit higher performances, recognition has a long-term motivational effect.

The last decades have seen continuous increases in electronic commerce (e-commerce) and particularly mobile commerce (m-commerce). These sharp increases, especially during the COVID-19 pandemic, have led companies to become aware of the potential of this trade channel. This paper investigates the effects of antecedents on behavioral intention in m-commerce and the role of consumer satisfaction in the buyer decision process. In our investigation, we used the modified technology acceptance model (TAM). The research was conducted through a survey based on a self-administered questionnaire, with the data being analyzed by structural equation modeling and cross-tabulation. Following the investigation, we found that perceived usefulness (PU) and perceived ease of use (PEU) positively influence behavioral intention. Consumer satisfaction also plays a significantly positive role in m-commerce actual use, influencing future behavioral intention. The results also showed that generational and gender differences strongly affect behavioral intention, with younger generations and male respondents being more inclined to use m-commerce.

Intestinal/enteric heterotopia of the vulva is an extremely rare disease with only 3 cases described in the literature. We report here an unusual case of this disease occurring in a 26-year-old patient in a context of Crohn’s disease. To the best of our knowledge, such type of association has not been previously described. The potential origins of these lesions including metaplastic transformation, dysontogenetic changes, or epithelial colonic displacement/implantation are discussed.