Social characteristics and their effect on self-rated health in persons over 18 years of age

Introduction: Social stratification of people results from differences in education occupation and income, and it exposes the people from lower social classes to different health risks and deprives them of ability to control their health. The aim of this study was to examine the effect of individual social status on self-rated health (SRH). Two hypotheses were tested. First, if some social factors (education, financial resources and monthly income per family member) have direct effects on SRH. Second, if these social factors influence the relationships of psychological stress and some behavioral factors to SRH.Material and methods: A cross-sectional study was carried out among 90 persons over 18 years of age in 2013. Self-rated health, psychological stress, social status (education, income, property ownership, and qualification) and some behavioral characteristics (body-mass index and fresh vegetable intake) were studied by a semi-structured interview. Data were processed by SPSS.v.19. Descriptive statistics, ANOVA and Kruskall-Wallis tests were used. Finally, Spearman rho test was applied to clarify the strength and direction of association between variables.Results: Most of the interviewees (47.8%) assessed their health as good. Stratification by some basic social characteristics showed that 5.6% of them had elementary education, 12.4% were unemployed. One third of the group under study existed on monthly income less than 310 BGN, 30% defined their financial resources as insufficient, 16.6% lived in rented accommodation. Every third person reported a disparity between the current job position and the owned professional competences. Education and financial resources were the variables significantly associated with self-rated health - those with elementary education and those who had insufficient financial resources perceived their health negatively more often (p=0.001). Symmetrical distribution of poor SRH among the groups with lower incomes explained partly the lack of significant differences between groups (p=0.469).Conclusion: Education and financial resources were significantly associated with self-rated health among all studied social factors

Comparative analysis of main clinical features in melanoma patients with and without sentinel lymph node biopsy

Introduction. Sentinel lymph node biopsy is fundamental in the treatment and prognosis of cutaneous malignant melanoma. This study aims to identify differences in baseline clinical characteristics and survival of patients with melanoma with and without a sentinel lymph node biopsy (SLNB) performed.  Material and methods. In 2018, a retrospective study of 151 patients with malignant melanoma (MM) was conducted. The patients were hospitalized at the Second Clinic of University Hospital — Pleven, from 2012 to 2017. The patients were divided into two groups: Group A included 58 (38.4%) patients with SLNB performed; Group B included 93 (61.6%) patients who did not undergo SLNB. A double-detection method was used while performing SLNB.  Results. The incidence of achromatic malignant melanoma is significantly higher in patients without SLNB (12 or 12.9%) than in patients with SLNB (2 or 3.4%) — c2 = 3.796, df = 1, p = 0.051. Of all 151 patients in the study, 46 died, representing 30.5% of patients with melanoma. The mortality rate was higher in the patients without SLNB (32.3% vs. 27.6% in Group A). However, the differences in the two groups are not statistically significant.  Conclusions. Patients with achromatic melanoma have significantly fewer sentinel lymph node (SLN) biopsies performed because of a late diagnosis. Most of our patients are diagnosed at a later stage when lymphatic metastases are already present, which leads to a significant increase in lymph node dissections performed. There is no significant difference in mortality and survival in the SLNB and non-SLNB groups

Evaluation of the current status of the value-added pharmacy services and pharmacists’ attitude in Bulgaria

Value-added pharmacy services (VAPS) are additional services to the traditional pharmacy activities, which do not include dispensing of medicinal products and professional consultation. Over 51% of the community pharmacies in Bulgaria offer VAPS but mainly measuring of blood pressure (67.4%) and blood glucose (12.9%). About 60% of community pharmacists in the country are willing to perform other VAPS. About 70% of them believe that patients would rate VAPS as useful. Younger pharmacists with professional experience less than 5 years (90.9%) tend to believe that VAPS would be positively rated by their patients. The study shows that VAPS different from consultation and dispensing of medicinal products have a potential for development in the community pharmacies in Bulgaria

Pilot Study of Pharmacists’ Attitudes towards and Expectations for Remuneration of Valueadded Pharmacy Services (VAPS) in Bulgaria

Introduction: Value-added pharmacy services (VAPS) are additional services to the traditional pharmacy activities, which do not in­clude dispensing of medicinal products and professional consultation. These services have cost reduction effect on the healthcare system and add value to the work of the pharmacist as a healthcare professional.Aim: To assess the pharmacists’ attitudes and expectations towards the remuneration of value-added pharmacy services (VAPS) in Bulgaria.Materials and methods: A cross-sectional study including pharmacists working in community pharmacies was carried out between August 2018 and October 2018. A web-based 15-item questionnaire was developed. The questionnaire was distributed to all members of the Bulgarian Pharmaceutical Union (n=5165). Two hundred thirty-three questionnaires were filled in and returned (response rate of 4.5%). Data were processed by SPSS v. 24.0.Results: Over 51% of the community pharmacies in Bulgaria offer VAPS, mainly measuring blood pressure (67.4%) and blood glucose (12.9%). Over two-thirds of the pharmacists considered charging a remuneration fee for blood pressure measurement irrelevant. About 30.5% of those who held the opposite opinion proposed that the fee charged should not be higher than EUR 2.56. Over 44% of the re­spondents proposed that the fee for blood glucose measurement should not be higher than the same amount. Most pharmacists (98.3%) supported the idea of charging a remuneration fee for injections and influenza vaccination in a pharmacy.Conclusion: The study shows that pharmacists in Bulgaria are ready to offer VAPS, but additional remuneration for the services should be provided

50 години Катедра „Социална медицина и организация на здравеопазването`

22 Май 201

Abstracts Of The Proceedings And The Posters From The Third Scientific Session Of The Medical College Of Varna

October 2-3, 201