The EUROPEP questionnaire for patient’s evaluation of general practice care: Bulgarian experience

Aim To validate the Bulgarian EUROPEP-questionnaire and its implementation to measure patient evaluation of general practice care in Bulgarian population. Methods A multicenter cross-sectional study was conducted at twenty five primary care practices from South-Central Region of Bulgaria. A total of 1000 adult patients aged over 18 years and visiting the practice for more than a year were approached consecutively to take part in the study. The internal consistency and test-retest reliability of the EUROPEP questionnaire were evaluated. To confirm the construct validity of the questionniare, еxplanatory factor analysis was performed. Results Cronbach’alpha for “clinical behaviour” is 0.95 and for “organisation of care” 0.81. Factor analysis identifed two factors, which accounted for 77.0% of the total variation in these items. On average, 58.7% of respondents rated the level of care received as excellent. The waiting time in the waiting room was the item most poorly rated (33.8%). The item “keeping patients’ records and data confidential” was the most highly rated (88.8%). Patients were less satisfied with “providing quick services for urgent health problems” (78.5% excellent or good) and “getting an appropriate for them appointment” (76.2% excellent or good). Conclusion Two scales with satisfactory psychometric properties were established in the Bulgarian version of the EUROPEP-questionnaire. The study identified areas requiring improvement in general practice, such as reduction in waiting times and obtaining patient’s convenience appointment

Academic Staff Satisfaction with their Work: A Cross-Sectional Study in a Medical University

BACKGROUND: Employees' work satisfaction, combined with democratic management, are important predictors of future productivity in any organisation. AIM: The aim of this study is to investigate job satisfaction in academic staff as well as the associated working environment factors, using an original self-administered questionnaire. METHODS: A cross-sectional survey was conducted using an original standardised questionnaire. It involved 370 academic staff members at one of the five medical universities in Bulgaria. The questionnaire consists of 17 items (including occupational hazards, management style, conflict solving and demographic characteristics) rated on a 5-point Likert scale. RESULTS: The results revealed that the majority of academic staff (71.7%) works in a risky environment. Employees indicate that “mental strainâ€, “work with chemical agents and dust†and “work with biological hazards†are the most common risk factors. Democratic leadership and cooperation are most commonly applied management styles. CONCLUSION: The instrument for the measurement of job satisfaction revealed high values of psychometric characteristics for reliability and validity. The study found a high level of satisfaction of academics with their working conditions. It is necessary to conduct similar studies periodically to detect more precisely the decrease in academic staff work satisfaction and take timely and adequate measures to improve it

The Role of Vaspin in the Development of Metabolic and Glucose Tolerance Disorders and Atherosclerosis

In recent years, most research efforts have been focused on studying insulin-sensitizing adipokines. One of the most recently discovered adipokines is vaspin, a visceral adipose tissue-derived serine protease inhibitor. Vaspin levels have been found significantly increased in mice with obesity and insulin resistance. It has been assumed that vaspin serves as an insulin sensitizer with anti-inflammatory effects and might act as a compensatory mechanism in response to decreased insulin sensitivity. Most studies in humans have shown a positive correlation between vaspin gene expression and serum levels, and metabolic syndrome parameters. Vaspin gene expression is influenced by age and gender, and the administration of insulin sensitizers enhances it in mice, whereas the use of metformin decreases serum vaspin levels in humans, probably due to different regulatory mechanisms. Presumably vaspin plays local and endocrine role in the development of initial and advanced atherosclerosis in obese subjects and might be used as a predictor of coronary and cerebrovascular disease. It is believed that vaspin could be regarded as a new link between obesity and related metabolic disorders, including glucose intolerance. The entire understanding of vaspin intimate mechanism of action might enable the development of novel etiology-based treatment strategies, targeting metabolic and glucose tolerance disorders

The Survey of Health Care Managers’ Attitude towards the Implementation of Information and Communication System for the Registration of Medical Errors

The aim of the study has been to examine attitude and motivation of managers of Health Care Establishments for the implementation of information and communication system for the registration and reporting of medical errors. A sociological method: anonymous inquiry sent by e-mail or by post has been used to register the initial information. More than half of the health care managers (59.6% (62)) are willing to implement an information system for the registration of medical errors in their respective health care establishments

Perception of patient safety culture among hospital staff

A patient safety culture (PSC) is a complex phenomenon, representing an essential part of the organizational culture and refers to the shared values, conceptions and beliefs which contribute to the formation and encouragement of safe behavioural models in a health organization. With this study, the authors wanted to delineate the attitude of hospital staff in Bulgaria regarding PSC and to document to whether attitudes differ between physicians and other healthcare professionals (HCPs)

COVID-19 Mortality and Related Comorbidities in Hospitalized Patients in Bulgaria

Until now, the COVID-19 pandemic has resulted in at least 27 million cases and over 900,000 deaths worldwide. Bulgaria is one of the countries that is the most severely affected by the COVID-19 pandemic, and the mortality rate is among the highest registered in the world. The aim of this study is to investigate and analyze mortality rates due to the fact of COVID-19 in addition to the most common related underlying medical conditions in those hospitalized to outline the factors that have an impact on the mortality rate due to the fact of COVID-19. A descriptive cross-sectional research design with a retrospective analysis was used to collect data from a total of 128,269 hospitalized patients during the period from April 2020 to November 2021. During the study period, the number of hospital admissions due to the fact of COVID-19 was 5200. The patients’ mean age was 67.34 (SD ± 19.65), and 51.7% (2689) of the patients were men. Only 10% of out of a total of 5200 patients did not test positive for COVID-19 upon admission based on the antigen or PCR test. Out of all patients, 41.5% had no underlying medical conditions upon presentation, and the remaining 58.5% had diagnosed comorbidities, varying from one to five. One-third (1470) had a lethal outcome, and the remaining 71.7% recovered from the infection and were discharged from the hospital. Based on the analysis of our results, there is definite evidence that the CFR and susceptibility to symptomatic COVID-19 were higher in the elderly, men, and patients with more comorbidities, especially chronic cardiovascular, metabolic, and respiratory disorders, as well as in those admitted to hospital within 6 h after an emergency ward visit and who had a shorter mean hospital stay

Insulin secretion and action affect glucose variability in the early stages of glucose intolerance

Aims Since it is unknown whether glucose variability (GV) is increased and whether this is related to worsening of insulin secretion and action in prediabetes, we have assessed insulin secretion and sensitivity, and daily GV in early stages of dysglycemia. Materials and Methods Twenty subjects with normal glucose tolerance (NGT; age 45.0 +/- 9.5 years; BMI 31.1 +/- 6.4 kg/m2), 25 with NGT and 1hrOGTT>8.6 mmol/L (1hrOGTT; 45.7 +/- 8.5 years; 32.4 +/- 7.0 kg/m2), and 59 with isolated impaired glucose tolerance (iIGT; 47.7 +/- 11.2 years; 31.3 +/- 6.1 kg/m2) underwent OGTT and MMTT. CGM was performed with blinded FreeStyle Libre Pro for 24 h under standard conditions. Parameters of beta-cell function, insulin sensitivity and GV were calculated. Results Overall insulin secretion and action as well as GV progressively worsened across glucose tolerance categories. On a matrix analysis, GV parameters were inversely related to ISSI-2; r = -0.37 to -0.52; p r = -0.28 to -0.48; p < 0.0001 for CV, SD, J-index, LI, HBGI and MAGE. Insulin secretion (IGI) and b-cell function (ISSI-2) emerged as independent contributors to GV in early stage of dysglycemia accounting for about 16%-38% of its variability. Conclusions Our results show that daily GV worsens already with mild impairment of glucose tolerance. The increase in GV is inversely related to insulin secretion and action