Patient Blood Management (PBM) as a multidisciplinary practice and a standard of care for the anemic surgical patient is playing an increasingly important role in reducing transfusions and optimizing both clinical outcomes and costs. The success of PBM implementation depends on staff awareness and involvement in this approach. The main objective of our study was to explore physicians’ perceptions of the conditions for implementing PBM in hospitals and the main obstacles they face in detecting and treating anemic patients undergoing elective surgery. This cross-sectional descriptive study includes 113 Romanian health units, representing 23% of health units with surgical wards nationwide. A 12-item questionnaire was distributed to the participants in electronic format. A total of 413 questionnaires representing the perceptions of 347 surgeons and 66 anesthesia and intensive-care specialists were analyzed. Although a lack of human resources was indicated by 23.70% of respondents as the main reason for not adhering the guidelines, the receptiveness of medical staff to implementing the PBM standard was almost 90%. In order to increase adherence to the standard, additional involvement of anesthesia and intensive-care physicians would be necessary from the perception of 35.70% of the responders: 23.60% of surgeons and 18.40% of hematologists.

Background/Objectives: Private dental markets operating under fee-for-service arrangements lack the structural accountability mechanisms that typically drive quality governance adoption in publicly funded systems. In Romania, where no private dental office currently holds formal accreditation, accreditation-seeking reflects a genuine behavioral choice rather than a regulatory compliance. This study examined whether financing structure and Professional Governance behavior operate as distinct determinants of accreditation-seeking intention among private dental practitioners and which pathway offers a more tractable entry point for quality policy intervention. Methods: A cross-sectional survey was conducted among 98 licensed private dental practitioners in Romania (November 2025–January 2026). Three domain composites were derived from a 31-item de novo instrument anchored in JCI, ANMCS, and EN ISO 9001:2015 standards: Professional Governance, Patient Rights and Ethics, and Patient Safety Behaviors. The financing profile was operationalized as engagement with the national public insurance system (CNAS). Binary logistic regression modeled high accreditation-seeking intention (Q31 ≥ 4) against standardized domain scores and financing engagement, with bootstrap confidence intervals from 2000 replicates. Results: Two predictors independently and significantly predicted high accreditation-seeking intention. CNAS engagement showed the strongest association (OR = 5.05, 95% bootstrap CI [1.87–17.91], and p = 0.003), while the Professional Governance score remained independently associated (OR = 2.68, 95% bootstrap CI [1.63–5.63], and p = 0.003). The Patient Rights and Ethics score was not significant. Practitioners actively exploring CNAS contracting showed the highest accreditation-seeking intention (exceeding that of established contractors), suggesting a possible transitional accountability dynamic during financing transition, though this interpretation requires prospective longitudinal validation. Model performance was good (AUC = 0.788; Nagelkerke R² = 0.339). Conclusions: Both financing engagement and governance behavior predicted accreditation-seeking intention after mutual adjustment, representing distinct pathways to voluntary quality adoption in private dental practice. Policy interventions aligned with entry into public contracting and with practice-level governance development are more likely to support accreditation uptake than normative appeals to professional ethics alone.

Background and Objectives: Gambling disorder (GD) is a behavioral addiction associated with distress, comorbidity, and functional impairment. This exploratory cross-sectional study examined associations between DSM-5-TR symptom burden, personality dimensions, cognitive emotion regulation, quality of life, and sociodemographic variables in a Romanian clinical sample. Materials and Methods: The sample included 122 adults with psychiatrist-confirmed pathological gambling/GD recruited from “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, Bucharest. Personality was assessed with the Personality Clinical Form (PCF; 109 valid profiles), cognitive emotion regulation with the Cognitive Emotion Regulation Questionnaire, and quality of life with the Quality of Life Inventory. Symptom burden was measured using a nine-item binary DSM-5 symptom burden index. Results: The symptom burden index showed a pronounced ceiling effect: median = 9.00 (IQR = 9.00–9.00; range = 4–9), with 91.0% classified as severe and 77.9% meeting all nine criteria. In PCF analyses, symptom burden was positively associated, after Benjamini–Hochberg correction, with broad personality pathology, including maladaptive personality dimensions, personality-functioning indicators, and personality-disorder feature scales; the strongest association involved borderline features. Catastrophizing and Blaming Others were positively associated with severity, whereas Positive Reappraisal, Putting into Perspective, and Positive Refocusing were negatively associated. Quality of life was very low overall and associated with personality and coping variables, but not directly with symptom burden. Criterion-count rank distributions differed by marital status and perceived social support; occupational status showed an omnibus distributional difference, but no pairwise contrast survived correction. Conclusions: GD was characterized by severe symptom burden and restricted score variability. Findings support multidimensional assessment of personality functioning, emotion regulation, quality of life, and social–contextual vulnerability.

Background/Objectives: Healthcare systems increasingly rely on standardized diagnostic information to support clinical decision-making, reimbursement, and public health governance. Although accreditation of medical laboratories underpins trust in diagnostic services, in practice, it is encountered primarily through the way in which accredited status is communicated in routine healthcare documentation. This study examines national rules that govern the communication of accreditation-related information and their relevance for healthcare management and policy. Methods: A descriptive, document-based comparative analysis was conducted across all 42 national accreditation bodies participating in the European Co-operation for Accreditation Multilateral Agreement (EA-MLA). Official regulations and policies governing the use of accreditation symbols and references in medical laboratory documentation were analyzed. Only documents confirmed as valid and in force as of January 2026 were included. The analysis focused on report-level identification, differentiation of accredited and non-accredited results, use beyond reports, and consequences of misuse. Results: Across countries, accreditation communication rules define how laboratory results are recognized, reimbursed, and operationally used within healthcare systems. While regulatory detail varies, common requirements exist regarding clear identification of accredited results and safeguards against misinterpretation, which directly influence administrative processes and financing mechanisms. For example, in some healthcare systems, accredited reporting determines eligibility for public reimbursement, while in others, it constitutes a legal prerequisite for providing laboratory services. Conclusions: Accreditation-related communication functions as an element of healthcare information governance rather than a purely technical marker. National variations reflect healthcare policy and management priorities, with implications for efficiency, transparency, and access to care.

In proficiency testing (PT), a consensus assigned value is an estimate whose uncertainty can affect participants’ performance classifications. This study evaluated the relationship between formula-based assigned-value uncertainty, empirical sampling variability and classification discordance under limited participation. Using gravimetric calibration of a 100 µL micropipette, 147.2 million Monte Carlo PT rounds were simulated across 1472 scenarios combining participant numbers (N = 5–50), two dispersion levels referenced to ISO 8655-2:2022 and outlier contamination (0–30%). The arithmetic mean and ISO 13528 Algorithm A were compared regarding assigned-value variability, uncertainty calibration, stability and classification. The 95th percentile of the assigned-value uncertainty ratio frequently exceeded the ISO 13528 threshold of 0.3, particularly under contamination and limited participation. This ratio was strongly associated with scenario-level decisional discordance (Spearman ρ = 0.97–0.99). Formula-based uncertainty exceeded empirical Monte Carlo variability for Algorithm A in all 1472 scenarios (calibration ratios of 1.044–1.301), whereas the arithmetic mean’s ratios ranged from 0.856 to 0.998. Although Algorithm A generally improved empirical stability under contamination, this advantage did not consistently translate into lower participant-number requirements under the combined acceptance criterion. These findings demonstrate that estimator robustness and uncertainty-formula calibration are distinct properties requiring separate evaluation when designing PT schemes with limited participation.