No abstract

Landfills continue to represent the most frequent managerial practice for municipal solid wastes and an increasing and complex problem globally. In certain countries, a transition to an open society and free market is superimposed on the transition to sustainability, resulting in even higher complexity of management. This paper proposes an approach for problem-structuring of landfills in complex transitions: sustainability or unsustainability of a management approach is determined by a set of sustainability filters that are defined by sets of indicators and prioritized according the systemic concept of sustainability, which says that economy is embedded in society, which is embedded in nature. The writers exercise this approach with an old landfill in Iasi, Romania, and conclude for unsustainability, because the ecological sustainability filter is not successfully passed. Social and economic sustainability filters are also discussed in relation with the ecological sustainability indicators. The described approach allows a coherent, transdisciplinary synthesis of knowledge scattered across various disciplines, a pervasive problem in landfill management. The case study helps distinguish between generally true and contextdependent aspects.

Heart failure is nowadays a common condition associated with high mortality and increased healthcare-related

Management of chronic illness implies significant changing the lifestyle, taking medication, watching the diet, introducing and maintaining exercise in daily life, etc. These actions represent elements of adherence to treatment and they reflect the responsibility of patient's participation to healthcare. The increase in adherence to treatment and in the quality of care, implicitly, may depend on allotting the resources necessary within therapeutic effort and on the effectiveness of the partnership between patient and doctor. Assuming the medical decision as a team may lead to solving the issue of non-adherence (Armstrong, 2014). Whereas the values of the functional parameters of the body represent an objective measurement of treatment efficiency and to some extent of adherence to it, implicitly, assessing the patient's lifestyle involves understanding his experience, which is governed by subjectivity. This article has the following objectives: (1) to analyze the definitions of adherence to treatment from a biomedical perspective and from the perspective of Chronic Care Model (CCM); (2) to identify the characteristics specific to the roles of acting participants to healthcare and to analyze the modifications of roles by the choice of theoretical model and (3) to identify the determining factors of adherence to treatment.

The necessity of empirical research in the field of medical services provision is highlighted both by the numerous modifications within the legislative framework (through which the medical system is organized and functions) and by the dysfunctionalities within its existence. The study proposes to pinpoint the factors that may influence the quality of the physician-patient relationship. We identified factors at the level of communication between physician and patient, of empowering and involving the patient, of understanding the patient, of the patient's way through the system, and of relating to a "second opinion." We also present solutions identified by physicians for optimising these relations. The study is based on the analysis of 12 interviews conducted with physicians within public and private institutions in Iaşi. The topics of discussion focused on the following aspects: physician-patient relationship, physician's trust in the patient, particularities of trust relationship, patient empowerment and involvement, level of patient's information, "the second opinion," physician's experience as a patient (or as caregiver). The paper brings attention to the difficulties pinpointed by physicians, in their relation with both the institutions and the patients. The main aspects identified are related to the way in which the physician-patient relationship is