Varna Medical University Press: Journals
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A research on offshore operations safety
No full textThis report represents a continuation and final synthesis of the report “Analysis of Safety and Risks in Offshore Operations.”It integrates verified data (GWEC, G+ / Energy Institute, GWO, IEA) and the results of regression and time-series analysis (2015–2024), oriented toward practical future application. The text constitutes a secondary (descriptive-analytical) review of publicly available data from GWEC, the Energy Institute / G+, GWO, and the IEA; it does not claim to be a primary empirical study. The report supplements the initial study with a quantitative verification of key dependencies. No statistically significant linear relationship is found between the annually installed offshore GW capacity and the number of recordable injuries. A much stronger positive correlation is observed between the number of injuries and total worked hours (R² ≈ 0.71)[1]. This confirms that risk management should focus on exposure (work hours) and high-risk processes (TR/CTV/SOV transfers, cargo-handling operations, etc.).Graphs, tables, interpretations, and recommendations for unified KPIs and digital monitoring are presented.[1] Model: OLS of annual number of recordable injuries (G+) versus worked hours (G+), 2015–2024
Antimicrobial therapy: general principles and recommendations for good medical practice. A review
Full text linkINTRODUCTIONThe terms antimicrobial and antibiotic refer to various therapeutic agents, including antibacterial, antiviral, antifungal, and antiparasitic drugs. Many factors should be considered before prescribing any of these pharmaceutical agents. Some factors are related to the etiologic agents and their behavior, while others are patient-related and depend on individual characteristics.AIMThis review aims to identify the critical aspects of antimicrobial drug therapy, such as appropriate timing, duration, regimens, interpretation of antimicrobial susceptibility testing (AST) results, patient-related factors, and antimicrobial resistance (AMR).MATERIALS AND METHODSAn electronic search was performed in PubMed, Scopus, Web of Science, and Google Scholar, using the following keywords: (((antimicrobial) OR (antibiotic)) AND ((treatment) OR (therapy)) AND (principles) AND ((antimicrobial) AND (resistance))). After evaluation and analysis of the obtained data, 33 articles were included in this study.RESULTS The first step in antimicrobial therapy is selecting an appropriate drug and regimen. The diagnosis is determined by careful analysis of the site of infection, the patient’s general and immune status, and the establishment of the microbial agent. The timing of the antimicrobial therapy depends on the urgency. In high-risk patients, empiric treatment should start immediately after collecting specimens for culture and sensitivity testing. Patient-related factors that should be considered when selecting antimicrobial therapy are hepatic and renal function, age, genetic susceptibility, allergies, pregnancy, lactation, and prior antibiotic use.CONCLUSIONAntimicrobial therapy should be based on selecting appropriate pharmaceutical agents and doses, route of administration, timing, and duration of the treatment. Numerous etiological and patient-related factors should be considered during the treatment. The growing risk of AMR requires more cautious behavior and strict following of the recommendations for good medical practice
Childbirth preparation and postpartum period from the perspective of women who have given birth
Full text linkIntroduction: The psycho-emotional state of women who have given birth is a crucial component of their overall health status, which directly depends on the timely care provided and their satisfaction with it. Preparation for childbirth and the postpartum period is often focused on the physical aspect of the process, but emotional support and the provision of information remain not fully studied.Aim: Analysis of the perceptions, sources of information, and level of preparedness of women regarding childbirth and the postpartum period.Materials and Methods: The following methods were used: a sociological method, by anonymously and voluntarily surveying 76 women; a statistical method, applied throughout the result analysis in the conducted study; and a documentary method, as literary sources examining the subject of this study were analyzed.Results: According to the respondents' answers, 94.7% consider it important to receive additional information during pregnancy. The most common forms of preparation include familiarization with the childbirth process (88.2%), breastfeeding training (82.9%), and choosing a medical team (76.3%). The main sources of information are social media (75%) and parenting schools (56.6%). At the maternity ward, 51.3% did not receive sufficient support for breastfeeding. After childbirth, 60.5% reported having experienced anxiety, and 63.2% reported irritability. Only 5.3% sought professional psychological support.Conclusion:• The study shows a significant need for accessible and structured information.• A woman's psycho-emotional well-being remains a key but often overlooked element.• More systematic support is needed during the labor and postpartum period.• Educating expectant mothers about the period of childbirth and afterwards would guarantee a sense of security and peace of mind for the woman in her new role as a parent
The Social Gradient of Depression: Why Economic Insecurity Has a Stronger Impact than Social Isolation among Older People in Bulgaria
Full text linkIntroduction: Mental health among older adults constitutes an increasingly important public health concern in the context of population ageing and widening socio-economic inequalities. While social relationships are commonly conceptualized as protective factors, the relative contribution of socio-economic conditions compared with social network characteristics to depressive symptomatology in later life remains insufficiently examined in the Bulgarian context.Aim: The aim of the present study is to examine the relative impact of socio-economic factors (income and educational attainment) in comparison with social network characteristics on mental health and depressive symptomatology among older adults in Bulgaria.Materials and Methods: A secondary cross-sectional analysis was performed using data from the seventh and eighth waves of the Pan-European Survey of Health, Ageing and Retirement in Europe (SHARE), including respondents aged 50 years and older in Bulgaria. Depressive symptomatology was measured using the EURO-D scale. Net household income, educational attainment (ISCED classification), and social network size were included as key independent variables. Descriptive statistics, non-parametric tests, and correlation analyses were employed.Results: Statistically significant negative associations were observed between income and depressive symptomatology, as well as between educational attainment and depression. Lower income and lower levels of education were associated with higher EURO-D scores, indicating a pronounced social gradient in depressive symptomatology. No statistically significant association was identified between social network size and depressive symptomatology. Higher levels of depression were observed among women and among respondents aged 80 years and older.Conclusion: The findings indicate that socio-economic factors, particularly income and educational attainment, have a stronger association with mental health outcomes among older adults in Bulgaria than quantitative measures of social networks. These results underscore the role of structural socio-economic inequalities in shaping the social gradient of depression in later life
Psycho-neuroendocrine, immunological, and systemic effects of romantic love: A systematic review and integrative model
Full text linkLove—and in particular, romantic and partner intimacy—constitutes a multifaceted psycho-biological process that integrates neural reward mechanisms, hormonal and neuroendocrine regulation (oxytocin, vasopressin, dopamine, serotonin, cortisol, among others), as well as changes in immune activity and behavior. Accumulating experimental and clinical evidence suggests that love may act as a form of “eustress” during the early stages of relationships, characterized by arousal and uncertainty, but in stable and long-term partnerships, it is associated with enduring beneficial effects on stress reactivity, immune competence, and overall health outcomes. The present review summarizes and analyzes findings from neuroimaging studies, endocrine and immunological research, as well as clinical observations, and further provides methodological guidelines and interdisciplinary perspectives for future investigations into the interaction between intimate relationships and medical science
Pediatric Tracheotomy: Risks and Complications
Full text linkIntroduction: Pediatric tracheotomy, like any surgical procedure, is associated with a certain percentage of complications, and their occurrence is not directly related to the surgical technique used. Depending on the time of onset, complications are classified as intraoperative, early postoperative (within the first 7 days after the intervention), and late postoperative (after the 7th day following the surgery). In terms of type, complications show great variety, and although it is difficult, they can generally be categorized by severity into mild, moderate, and severe (life-threatening).Aim: This paper aims to provide a comprehensive overview of the complications associated with pediatric tracheotomy, categorized by the timing of their onset, and to discuss their pathophysiology, clinical presentation, preventive measures, and current approaches to managementDiscussion: In contemporary practice, pediatric tracheotomy is increasingly performed as an elective procedure due to severe systemic, chronically progressive diseases in young patients. This allows for thorough preoperative preparation; however, the presence of significant comorbidities complicates the surgical process and contributes to a higher incidence of complications across all three postoperative periods.Conclusion: The incidence of complications associated with tracheostomy is much higher and more threatening in children than in adults. Tracheotomized children have a high overall mortality according to the literature, however deaths are usually related to the underlying disease, not the tracheotomy itself
Assessing healthcare quality in Bulgaria: The role of medical practitioners' professional and contextual characteristics
Full text linkIntroduction: Medical practitioners are the backbone of health systems. Professionals' assessment of the quality of healthcare varies depending on the type of healthcare system, their place in it, their professional experience, and their specialty.Aim: The aim of the study is to investigate the relationships between the professional and contextual characteristics of medical specialists, and their assessment of the quality of healthcare in Bulgaria.Materials and Methods: Data from a national sociological survey of 282 medical professionals conducted online in November 2021 were used. A χ2-test of independence was used to determine the existence of significant differences in the assessment of professionals according to their profession, length of their work experience, type and location of the medical facility in which they work. Independent-sample Student's t-test and one-factor analysis of variance (One-Way ANOVA) were conducted to test for statistically significant differences in assessment and defined contextual and professional characteristics.Results: The majority of medical specialists assess the quality of healthcare in Bulgaria as satisfactory. An association was found between professionals with little work experience in healthcare and negative assessment of quality, ꭓ2 = 4.81, p = 0.028 < 0.05, N = 282. A statistically significant effect was observed between specialists who work in medical facilities in regional center towns, who assessed the quality as satisfactory ꭓ2 = 4.33, р = 0.037 < 0.05, N = 282, and specialists who work in Sofia, who assessed the quality of healthcare as bad ꭓ2 = 5.10, р = 0.024 < 0.05, N = 282.Conclusion: The results of our study indicate that professional and contextual characteristics have some, but not significant, relationships with medical specialists’ assessment of the quality of healthcare in Bulgaria