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References
1
EAPC Taskforce on the Development of Palliative Care in Europe (2005) A Map of Palliative Care Specific Resources in Europe. 4th Research Forum of the European Association for Palliative Care, Venice, Italy, 25th-27th May 2006
2
http://www.odci.gov/cia/publications/factbook/geos/ro.html
3

Report of the United Nations Development Programme 2005 (HDI 2003). Launched by the United Nations in 1990, the Human Development Index measures a country's achievements in three aspects of human development: longevity, knowledge, and a decent standard of living. It was created to re-emphasize that people and their lives should be the ultimate criteria for assessing the development of a country, not economic growth. Current (2003) values range from 0.963 (Norway, 1/177 countries) to 0.281 (Niger, 177/177 countries). Countries fall into one of three groups: countries1-55=high development; 56-141=medium development; 142-177=low development:

http://hdr.undp.org/statistics/data/indicators.cfm

http://hdr.undp.org/statistics/data/country_fact_sheets/cty_fs_ROM.html

4
EAPC Palliative Care Facts in Europe Questionnaire, 2005
5

The charity ‘Children in Distress’ explain reasons behind the major problem of HIV/AIDS for children in Romania, and the focus of their supportive work. ‘Romania has 54% of Europe's Aids children. Why? Ceausescu in an effort to turn Romania from an agricultural based economy to an industrial economy decreed that women should have at least four children. Due to extreme poverty couples would register the birth to satisfy the authorities then simply abandon the child often at one of the many state orphanages. The orphanages themselves could not cope. In an effort to overcome overcrowding and malnutrition the authorities decided to give the children a micro-transfusion of blood. The blood was brought in from abroad and was contaminated with the HIV virus. Medical shortages caused needles to be re-used and the infection spread rapidly through the orphanages. These children, abandoned, malnourished, neglected and infected with the HIV virus were left to die in conditions of appalling squalor. It was this sight that caused Children in Distress to be founded and continues to be the main focus of our work to-day.’

http://www.children-in-distress.org/aboutrom.html

6
IOELC interview with Melinu Dumitrescu (Poina Brasov, Romania) – 14th September 2001
7
EAPC (East) Questionnaire 2001
8
EAPC Palliative Care Facts in Europe Questionnaire, 2005
9
Romanta Lupsa (2000) Advanced course of Palliative Care in Puszczykowo, Poland, 2000, (see 1st edition of National Standards in Palliative Care, 2002, a collaborative publication by Romanian American Sustainable Partnerships (RASP), Hospice Casa Sperantei, and NHPCO)
10

EAPC Palliative Care Facts in Europe Questionnaire, 2005. For further details about Hospice Sf.Irina see website (NB in Romanian):

http://www.formula-as.ro/reviste_676__133__sunt-invatatoare-pensionara.html

11

IOELC interview with Melinu Dumitrescu (Poina Brasov, Romania) – 14th September 2001

12
IOELC interview with Melina Dumitrescu (Brasov, Romania) – 1st October 2004
13
EAPC Palliative Care Facts in Europe Questionnaire, 2005
14

IOELC interview with Mariana Pernea (Poina Brasov, Romania) – 14th September 2001

15
IOELC interview with Daniela Mosoiu (Budapest, Hungary) – 25th February 2002
16
EAPC (East) Questionnaire.
17
IOELC interview with Gabriela Baila (Brasov, Romania) – 5th February 2002
18
Mosoiu, D., Ryan, K. M., Joranson, D. E., and Garthwaite, J. P. 2006. Reform of drug control policy for palliative care in Romania. Lancet, 367: 2110-2117
19
Karen Ryan, Senior Policy Analyst, Pain and Policy Studies Group, University of Wisconsin Comprehensive Cancer Center. EAPC Newsletter, vol. 1, no. 4, May 2005
20
IOELC interview with Mariana Pernea (Poina Brasov, Romania) – 14th September 2001
21
IOELC interview with Gabriela Baila (Brasov, Romania) – 5th February 2002
22

EAPC Palliative Care Facts in Europe Questionnaire, 2005

23
Mosoiu, D., Ryan, K. M., Joranson, D. E., and Garthwaite, J. P. 2006. Reform of drug control policy for palliative care in Romania. Lancet, 367: 2110-2117
24
Mosoiu, D., Ryan, K. M., Joranson, D. E., and Garthwaite, J. P. 2006. Reform of drug control policy for palliative care in Romania. Lancet, 367: 2110-2117
25
EAPC East Newsletter, no. 28, January 2005
26
Mosoiu, D., Ryan, K. M., Joranson, D. E., and Garthwaite, J. P. 2006. Reform of drug control policy for palliative care in Romania. Lancet, 367: 2110-2117
27
Karen Ryan, Senior Policy Analyst, Pain and Policy Studies Group, University of Wisconsin Comprehensive Cancer Center. EAPC Newsletter, vol. 1, no. 4, May 2005
28
Mosoiu, D., Ryan, K. M., Joranson, D. E., and Garthwaite, J. P. 2006. Reform of drug control policy for palliative care in Romania. Lancet, 367: 2110-2117
29
EAPC East Newsletter, no. 28, January 2005
30
Daniela Mosoiu. EAPC Newsletter, vol. 2, no. 4, April 2006
31
Mosoiu, D. (2006) Palliative care and pain control in Romania, International Journal of Palliative Nursing, 12(3): 110
32
The term defined daily doses for statistical purposes (S-DDD) replaced the term defined daily doses (DDD), which had previously been used by the Board. The defined daily doses for statistical purposes are technical units of measurement for the purpose of statistical analysis and are not recommended prescription doses. Their definitions are not free of a certain degree of arbitrariness. Certain narcotic drugs may be used in certain countries for different treatments or in accordance with different medical practices and therefore a different daily dose could be more appropriate. The defined daily doses for statistical purposes indicated should be considered approximate and subject to modification if more precise information becomes available. The defined daily doses for statistical purposes for ethylmorphine, hydromorphone, ketobemidone, morphine, opium, oxycodone, phenazocine and tilidine were modified in 2003. The modifications followed the recommendations made in 2002 by an expert group that reviewed the defined daily doses for statistical purposes used by the Board for the analysis of the consumption of narcotic drugs, taking into account the developments in the most common dosages, indications and methods of administration of the narcotic drugs listed above. For example, in the case of morphine, the defined daily dose for statistical purposes was changed from 30 mg to 100 mg in order to reflect its increased consumption by oral administration, instead of by parenteral administration. International Narcotics Control Board. Narcotic Drugs: estimated world requirements for 2006. Statistics for 2002-2004.
33
International Narcotics Control Board (2005) Narcotic Drugs: estimated world requirements for 2006. Statistics for 2002-2004. New York: United Nations, 2005
34

EAPC Palliative Care Facts in Europe Questionnaire, 2005

35
Estimated monthly income in euros of an average worker in Romania in 2005 is 201 euros (695 Romania New Lei -RON)
36
Palliative Care in Eastern Europe: Open Society Institute Project (2001) – Questionnaire completed by Dr. Maria Lungu
37

Palliative Care in Eastern Europe: Open Society Institute Project (2001) – Questionnaire completed by Dr. Daniela Mosoiu

38
Clark, D., and Wright, M. 2003. Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia. Buckingham: Open University Press, Romania, pp. 93-103
39

IOELC interview with Daniela Mosoiu (Budapest, Hungary) – 25th February 2002

40

EAPC Palliative Care Euro-Barometer 2005

41

Personal communication, Dr. Lupsa Romanta, September 4th 2000

42

EAPC Palliative Care Euro-Barometer 2005

43

EAPC Palliative Care Euro-Barometer 2005

44

EAPC Palliative Care Facts in Europe Questionnaire, 2005

45
www.childrenindistress.org
46

IOELC interview with Graham Perolls (Poina Brasov, Romania) – 15th September 2001

47

IOELC interview with Graham Perolls (Poina Brasov, Romania) – 15th September 2001

48

IOELC interview with Gabriela Baila (Brasov, Romania) – 5th February 2002

49
Andrews C (1996) Changing the face of the dying: first Romanian Hospice Education Centre, Hospice Bulletin 3 Issue 3
50
Internal report on the Balkan Conference
51

IOELC interview with Daniela Mosoiu (Budapest, Hungary) – 25th February 2002

52
EAPC Palliative Care Facts in Europe Questionnaire, 2005
53
Palliative Care in Eastern Europe: Open Society Institute Project (2001) – Questionnaire completed by Dr. Maria Lungu
54
Mosoiu, D. (2006) Palliative care and pain control in Romania, International Journal of Palliative Nursing, 12(3): 110
55
http://www.soros.org/initiatives/pdia/focus_areas/a_international_palliative/intlpubs
56
PACARO information brochure, 2004
57
IOELC interview with Wim van den Heuvel and Luminita Dumitrescu (Bucharest, Romania) – 30th September 2004
58
EAPC Palliative Care Euro-Barometer 2005
59
EAPC Palliative Care Euro-Barometer 2005
60
Clark, D., and Wright, M. 2003. Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia. Buckingham: Open University Press, Romania, pp. 93-103
61
IOELC interview with Mariana Pernea (Poina Brasov, Romania) – 14th September 2001
62

Perolls, G. (2002) Setting up a Hospice Service: The Experience of Hospice Casa Sperantei, Brasov, Romania, Hospice Information, Help the Hospices: London.

http://www.eapceast.org/upload/F04%20Setting%20up%20a%20Hospice%20Service.rtf

63

IOELC interview with Daniela Mosoiu (Budapest, Hungary) – 25th February 2002

64
http://www.eapceast.org/shownews.asp?newsId=78
65
IOELC interview with Melina Dumitrescu (Brasov, Romania) – 1st October 2004
66
http://www.sah.org.uk/annualreview/rotationalpost.htm
67
Clark, D., and Wright, M. 2003. Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia. Buckingham: Open University Press, Romania, pp. 93-103
68
CASA is the Christian Agency for Social Action, linked with Emanuel Baptist Church. Other projects include a centre for single mothers, foster care for abandoned babies and a vocational training centre for disadvantaged teenagers.
69

See the Emanuel Hospice website: http://www.emanuelhospice.org/

70

Hospice of Hope Romania, Annual Report, 2005

71
Hospice of Hope Romania newsletter, 29th June 2004
72
Hospice of Hope Romania, Annual Report, 2005
73

IOELC interview with Daniela Mosoiu (Sheffield, England) – 5th September 2003

74
Hospice of Hope Romania newsletter, September 2005
75

http://www.cia.gov/cia/publications/factbook/geos/mi.html

76
http://www.who.int/countries/rou/en/
77
This refers to adult mortality risk, which is defined as the probability of dying between 15 and 59 years
78

http://www.who.int/countries/rou/en/

79
Clark, D., and Wright, M. 2003. Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia. Buckingham: Open University Press, Romania, pp. 93-103
80
http://www.unaids.org/en/
81

UNAIDS (2004) The changing epidemic HIV/AIDS epidemic in Europe and Central Asia, Geneva: Joint United Nations Programme on HIV/AIDS (UNAIDS)

 http://data.unaids.org/Publications/IRC-pub06/JC1038-ChangingEpidemic_en.pdf

82
http://www.unaids.org/en/Regions_Countries/Countries/romania.asp
83

Bara, A. C., van den Heuvel, W. J. A., and Maarse, J. A. M. 2002. Reforms of Health Care System in Romania. Croatian Medical Journal, 43(4): 446-452

84
Health Care Systems in Transition: Romania(2000);  Copenhagen: The European Observatory on Health Care Systems: 3
85
Bara, A. C., van den Heuvel, W. J. A., and Maarse, J. A. M. 2002. Reforms of Health Care System in Romania. Croatian Medical Journal, 43(4): 446-452
86
Health Care Systems in Transition: Romania(2000);  Copenhagen: The European Observatory on Health Care Systems: 3
87
IOELC interview with Melina Dumitrescu: Poina Brasov – 14th September 2001
88
Health Care Systems in Transition: Romania(2000);  Copenhagen: The European Observatory on Health Care Systems: 3
89
Total health expenditure per capita is the per capita amount of the sum of Public Health Expenditure (PHE) and Private Expenditure on Health (PvtHE). The international dollar is a common currency unit that takes into account differences in the relative purchasing power of various currencies. Figures expressed in international dollars are calculated using purchasing power parities (PPP), which are rates of currency conversion constructed to account for differences in price level between countries.
90
http://www.who.int/countries/rou/en/
91
Tandon, A., Murray, C. L. J, Lauer, J. A, and Evans, D. B. Measuring overall health system performance for 191 Countries. GPE Discussion Paper Series: No 30; WHO
92

http://www.who.int/countries/rou/en/

93
Health Care Systems in Transition: Romania(2000);  Copenhagen: The European Observatory on Health Care Systems: 3
94
Dumitrescu, L., van den Heuvel, W. J. A., and van den Heuvel-Olaroiu, M. 2006. Experiences, Knowledge, and Opinions on Palliative Care among Romanian General Practitioners. Croatian Medical Journal, 47: 142-147
95

Paper by Dr Romanta Lupsa for the Puszczykowo advanced course, 4th September 2000

96
IOELC interview with Mariana Pernea (Poina Brasov, Romania) – 14th September 2001
97

IOELC interview with Daniela Mosoiu (Budapest, Hungary) – 25th February 2002

98
Mosiou, D Andrews, C Perolls, G (2000) Palliative care in Romania.  Palliative Medicine 14: 65-67
99
IOELC interview with Daniela Mosoiu (Budapest, Hungary) – 25th February 2002
Further Reading

Andrews, C. 1996. Changing the face of dying: first Romanian Hospice Education Centre. Hospice Bulletin, 3(3).

 

Bogdan, C. 1994. Romania. Eur. J. Palliat Care, 1(2): N2.

 

Clark, D., and Wright, M. 2003. Transitions in End of Life Care.  Hospice and related developments in Eastern Europe and Central Asia.  Buckingham: Open University Press, 2003, pp. 93-103, Romania.

 

Cowling, K., and Fowler Kerry, S. 2004. Developing a paediatric hospice programme in Romania. European Journal of Palliative Care, 11:2.

 

Dumitrescu, L., van den Heuvel, W. J. A., and van den Heuvel-Olaroiu, M. 2006. Experiences, Knowledge, and Opinions on Palliative Care among Romanian General Practitioners. Croatian Medical Journal, 47: 142-147.

 

Mosoiu, D., Andrews, C., and Perolls, G. 2000. Palliative care in Romania.  Palliative Medicine, 14: 65-67.

 

Mosoiu, D. 2002. Romania: Cancer pain and palliative care. J. Pain Symptom Management, Aug; 24(2): 225-7.

 

Mosoiu, D. 2006. Palliative care and pain control in Romania, International Journal of Palliative Nursing, 12(3): 110.

 

Mosoiu, D., Ryan, K. M., Joranson, D. E., and Garthwaite, J. P. 2006. Reform of drug control policy for palliative care in Romania. Lancet, 367: 2110-2117.

 

Perolls, G. (2002) Setting up a Hospice Service: The Experience of Hospice Casa Sperantei, Brasov, Romania, Hospice Information, Help the Hospices: London.

 

Stjernswärd, J., and Clark, D. 2003. Palliative medicine – a global perspective. In: D. Doyle, G. Hanks, N. Cherny, and K. Calman (Eds.) Oxford Textbook of Palliative Medicine. Oxford: Oxford University Press.

 

Wright, M., and Clark, D. 2002. The development of palliative care in Brasov, Romania. European Journal of Palliative Care, 9(5): 202-205


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