Becoming a therapist in Bulgaria: A grounded developmental model

Introduction:  The relative novelty of psychotherapy as practice and profession in Bulgaria allows for a therapist-centered study of the beginnings of psychotherapist careers. The existing models of psychotherapist career development focus on career factors or personal professional transformation. The current study builds upon developmental career models by examining closely the early stages of becoming a psychotherapist through the perspectives of therapists themselves.Aim: This qualitative study explored how psychotherapists and counselors in Bulgaria choose their career path and how their experiences and interaction with context shape their professionalization.Materials and Methods: Ten therapists were purposefully sampled to represent a diverse gamut of experiences and therapy modality. Data were collected through in-depth interviews and analyzed via a phenomenological and a grounded theory approach.Results: A developmental model with seven elements was produced: Early Influences, The Passage to Therapy/Encounter with Therapy, Creating One’s Own Concept of Therapy, Choice of Therapy, Training, The Responsibility of the Tutor, and The Self-Awareness as a Therapist.Conclusion: The grounded model is compared to a factor model and a personal-professional development model for psychotherapy career choice. Compared to their Western colleagues, Bulgarian psychotherapists follow similar pathways into the profession, but are more likely to engage in life-long learning

Knowledge Management in Pharmaceutical Organizations: Theory and Practice

Introduction: The development of information technologies and the growing significance of intellectual capital compel managers to rethink the use of knowledge in business today. Knowledge management has been introduced into managers’ work and so has begun a search for models to guide that work. The purpose of this article is to analyze the practice of knowledge management in pharmaceutical organizations in Bulgaria and to familiarize the audience with the most significant theoretical models for creating knowledge management strategies for companies in the pharmaceutical business.Materials and Methods: The article draws on scholarly literature on knowledge management with an emphasis on theoretical models of knowledge management strategy formation suitable pharmaceutical organizations. A content analysis was conducted with class papers written by students in the Knowledge Management for Pharmaceutical Organizations class from the master’s program in Pharmaceutical Management and Care at Medical University Varna.Results and Discussion: Two theoretical models are examined – the Knowledge Codification strategy, stressing codification, preservation and reuse of knowledge by means of organizational data bases, and the Knowledge Personalization strategy, focused on interpersonal dialogue, knowledge transfer via brainstorming and group reflection among co-workers. The competition on the pharmaceutical market is intense and the companies need to improve their knowledge management strategy in order to stay competitive. The managers of pharmacies from our sample fully understand the necessity of increasing the intellectual capital of their firms by the accumulation and transfer of knowledge. They widely practice the transfer of knowledge through direct face-to-face contact among the company workers. Simultaneously, they actively seek forms of disseminating product knowledge among clients and wider audiences. After engaging with the codification and personalization strategies for knowledge management the majority of the master’s program participants who work in pharmacies think that the codification strategy would be very effective in their practice. The creation of a data base with organizational knowledge all employees would have access to the knowledge, know-how and experience of the whole collective, which will accelerate the professionalization of each employee. Such a process is especially important for new and inexperienced workers as it will allow them to reduce their time-to-competence and become fully productive. In addition, the employee knowledge data base would mitigate the loss of knowledge for pharmacies when employees with precious practical experience leave the company. In comparison, big pharmaceutical companies (as represented by the students) involved in research and development work find more promising the knowledge personalization strategy.Conclusions: Master’s students from the Knowledge Management for Pharmaceutical Organizations class propose their visions for knowledge management strategies in the pharmaceutical business as they combine new knowledge obtained in class, their study of scholarly sources and their practical work experience

A femtoscopic Correlation Analysis Tool using the Schr\"odinger equation (CATS)

We present a new analysis framework called "Correlation Analysis Tool using the Schr\"odinger equation" (CATS) which computes the two-particle femtoscopy correlation function $C(k)$, with $k$ being the relative momentum for the particle pair. Any local interaction potential and emission source function can be used as an input and the wave function is evaluated exactly. In this paper we present a study on the sensitivity of $C(k)$ to the interaction potential for different particle pairs: p-p, p-$\mathrm{\Lambda}$, $\mathrm{K^-}$-p, $\mathrm{K^+}$-p, p-$\mathrm{\Xi}^-$ and $\mathrm{\Lambda}$-$\mathrm{\Lambda}$. For the p-p Argonne $v_{18}$ and Reid Soft-Core potentials have been tested. For the other pair systems we present results based on strong potentials obtained from effective Lagrangians such as $\chi$EFT for p-$\mathrm{\Lambda}$, J\"ulich models for $\mathrm{K(\bar{K})}$-N and Nijmegen models for $\mathrm{\Lambda}$-$\mathrm{\Lambda}$. For the p-$\mathrm{\Xi}^-$ pairs we employ the latest lattice results from the HAL QCD collaboration. Our detailed study of different interacting particle pairs as a function of the source size and different potentials shows that femtoscopic measurements can be exploited in order to constrain the final state interactions among hadrons. In particular, small collision systems of the order of 1~fm, as produced in pp collisions at the LHC, seem to provide a suitable environment for quantitative studies of this kind.Comment: 16 pages, 13 figures, submitted to EPJ

Game theory framework for MAC parameter optimization in energy-delay constrained sensor networks

Optimizing energy consumption and end-to-end (e2e) packet delay in energy-constrained, delay-sensitive wireless sensor networks is a conflicting multiobjective optimization problem. We investigate the problem from a game theory perspective, where the two optimization objectives are considered as game players. The cost model of each player is mapped through a generalized optimization framework onto protocol-specific MAC parameters. From the optimization framework, a game is first defined by the Nash bargaining solution (NBS) to assure energy consumption and e2e delay balancing. Secondy, the Kalai-Smorodinsky bargaining solution (KSBS) is used to find an equal proportion of gain between players. Both methods offer a bargaining solution to the duty-cycle MAC protocol under different axioms. As a result, given the two performance requirements (i.e., the maximum latency tolerated by the application and the initial energy budget of nodes), the proposed framework allows to set tunable system parameters to reach a fair equilibrium point that dually minimizes the system latency and energy consumption. For illustration, this formulation is applied to six state-of-the-art wireless sensor network (WSN) MAC protocols: B-MAC, X-MAC, RI-MAC, SMAC, DMAC, and LMAC. The article shows the effectiveness and scalability of such a framework in optimizing protocol parameters that achieve a fair energy-delay performance trade-off under the application requirements

Carfilzomib-lenalidomide-dexamethasone vs lenalidomide-dexamethasone in relapsed multiple myeloma by previous treatment

Carfilzomib, a proteasome inhibitor, is approved as monotherapy and in combination with dexamethasone or lenalidomide-dexamethasone (Rd) for relapsed or refractory multiple myeloma. The approval of carfilzomib-lenalidomide-dexamethasone (KRd) was based on results from the randomized, phase 3 study ASPIRE (NCT01080391), which showed KRd significantly improved progression-free survival (PFS) vs Rd (median 26.3 vs 17.6 months; hazard ratio (HR)=0.690; P=0.0001). This subgroup analysis of ASPIRE evaluated KRd vs Rd by number of previous lines of therapy and previous exposure to bortezomib, thalidomide or lenalidomide. Treatment with KRd led to a 12-month improvement in median PFS vs Rd after first relapse (HR 0.713) and a 9-month improvement after 2 previous lines of therapy (HR 0.720). Treatment with KRd led to an approximate 8-month improvement vs Rd in median PFS in bortezomib-exposed patients (HR 0.699), a 15-month improvement in thalidomide-exposed patients (HR 0.587) and a 5-month improvement in lenalidomide-exposed patients (HR 0.796). Objective response and complete response or better rates were higher with KRd vs Rd, irrespective of previous treatment. KRd had a favorable benefit-risk profile and should be considered an appropriate treatment option for patients with 1 or 2 previous lines of therapy and those previously exposed to bortezomib, thalidomide or lenalidomide