HEALTH MANAGEMENT AT THE THRESHOLD OF THE NEW MILLENNIUM

Socio-economic, demographic, and political changes in Europe create new challenges facing the organization and management of public health. These issues were interpreted during the conference of the European Health Management Association held in June, 1998, in Dublin (Ireland). Over 250 participants from 30 countries discussed the problems of health care reforms, health policy and management, new information technologies and their application in public health and quality management. A special attention was paid to the reforms in Central and Eastern Europe as well as to the university education in health management. Through a specially performed questionnaire-based investigation, the participants outlined the profile of health care systems in the beginning of the new millenium. It was expected that the relative share of the taxes provided for public health financing would be of approximately 29 per cent, that one of the insurance money - of about 33 per cent, but of co-payment financing - of about 38 per cent. Experts' opinion was united around the statement that on the background of the tendency towards continuous increasing of public health expenditures one should look for the way out in resource redistribution (according to 84 per cent of the interviewed experts). An enhancement of the state financing was not expected as the future role of the state would mainly consist in the regulation (according to 69 per cent of the experts). More than 80 per cent of them considered the competition capable to find the proper way for co-work and collaboration facing both professional and institutional borderlines

REHABILITATION AFTER STROKE: TRADITION AND FUTURE

The measurement of the structural disorders after stroke can be carried out by estimating the personal deficit and then generalized as a degree of invalidity. The present study focused on 65 stroke patients. They were follow е d-up and underwent an early neurorehabilitation course. The analysis of an extensive body of literature and the results obtained from our clinical investigations enabled to discuss the relationship between the elements, e. g., diagnosis, planning, intervention and assessment involved in the management of the neurorehabilitation process. Based on the combination of standardized indices and scales the authors suggest a unified rehabilitation profile enabling them to evaluate and monitor the motor and cognitive deficit. Thus, objective prerequisites are established for determining the priorities, monitoring the efficacy and the possibilities for prognosis of terms and outcome of the conducted rehabilitation training

AWARENESS AMONG PATIENTS IN OUTPATIENT CARE IN NORTHEAST BULGARIA

Medical activities to be performed after the patient fully informed about upcoming treatments. He must be aware of the many factors that influence medical treatments and laboratory results. It is important to consult medical professionals for the conditions to be met by the patient before the research. The article is an analysis of the views of patients, laboratory physicians, laboratory and general practitioners for the level of awareness among patients of an impending investigation. The research was conducted in northeastern Bulgaria among 1039 respondents. There is a high degree of awareness among the urban population, unlike poor awareness among patients of smaller settlements.Medical activities to be performed after the patient fully informed about upcoming treatments. He must be aware of the many factors that influence medical treatments and laboratory results. It is important to consult medical professionals for the conditions to be met by the patient before the research. The article is an analysis of the views of patients, laboratory physicians, laboratory and general practitioners for the level of awareness among patients of an impending investigation. The research was conducted in northeastern Bulgaria among 1039 respondents. There is a high degree of awareness among the urban population, unlike poor awareness among patients of smaller settlements

INTERACTIONS AND RELATIONSHIPS OF MEDICAL LABORATORY ASSISTANTS IN TEAMWORK AT UNIVERSITY HOSPITAL „ST. MARINA – VARNA“

The relationship of medical staff raise many important issues in medical practice, which must include not only professional competence but also the implementation of effective professional communication, observation and interaction. Good professional communication in medical practice is achieved through the strict observance of the established rules of medical ethics. Compliance with both the universal and the specific rules for medical professionals to communicate. Creating an atmosphere of trust, support and empathy in the process of working with medical staff from different departments in the hospital environment. The article is an analysis of opinion on the interaction between technicians, nurses and doctors in a hospital environment. The study was conducted among 66 respondents in the University Hospital „St. Marina – Varna“The relationship of medical staff raise many important issues in medical practice, which must include not only professional competence but also the implementation of effective professional communication, observation and interaction. Good professional communication in medical practice is achieved through the strict observance of the established rules of medical ethics. Compliance with both the universal and the specific rules for medical professionals to communicate. Creating an atmosphere of trust, support and empathy in the process of working with medical staff from different departments in the hospital environment. The article is an analysis of opinion on the interaction between technicians, nurses and doctors in a hospital environment. The study was conducted among 66 respondents in the University Hospital „St. Marina – Varna

DIVISION OF THE ROLES AND CONTRACTING IN PRIMARY HEALTH CARE

The introduction of market mechanisms into the public health sphere necessitates a clear distinction of the roles of main participants in medical service accomplishing. The processes of contracting between vendors and customers of health services are based on this distinction. This communication presents the end product of seminars supported by the "H+" Swiss hospital association in Bulgaria entitled "A contract for providing primary health care for the citizens of municipality X". The basic and secondary elements of the contract contents as well as the essence and importance of the contracting as a component of public health reform in Bulgaria are discussed. It is emphasized that the introduction of contracting relations into the public health system will ensure a better control on the amount and quality of the health services and on financial means` movement. The contracting will favourably influence on the public and private health sectors thus representing an important component of introducing the market economics, especially in the health sphere

APPLICATION OF MANAGEMENT PROGRAMS FOR CHRONIC DISEASES - INTERNATIONAL EXPERIENCE AND SITUATION IN BULGARIA

Disease management programs (DMPs) are successful in different regions of the world and there are possibilities for their application in Bulgaria. A retrospective approach is used in the analysis of 11 articles, for the period 2002 – 2011. The data shows that the disease management programs improve the coordination between the different participants in the system and ensure comprehensiveness and continuity of the health care and, at the same time, early diagnostics, therapy and rehabilitation.Disease management programs (DMPs) are successful in different regions of the world and there are possibilities for their application in Bulgaria. A retrospective approach is used in the analysis of 11 articles, for the period 2002 – 2011. The data shows that the disease management programs improve the coordination between the different participants in the system and ensure comprehensiveness and continuity of the health care and, at the same time, early diagnostics, therapy and rehabilitation

ANALYSIS OF THE ABORTIONS IN BULGARIA FOR 2014

Every year, in Bulgaria nearly half of the pregnancies end up with an abortion. It is well known that every abortion hides a risk for every woman that had this kind of medical intervention. Also lowers the ability of having another pregnancy, having a healthy carrying and giving a natural childbirth. On other side, abortions are associated with being a significant factor which regulates the demografic features of the population. There is a tendency that most of the Bulgarian women use the abortion like alternative method for contraception. This is due to the fact that since 1956 there isn`t a law that prohibit the performing of abortion by choice of the pregnant woman. For the period from 1967 to 1998, many statistics show that the number of the abortions is significantly higher than the number of the actual childbirths. However, through out the next few years there is a stable tendency of dropping the number of abortions. Overall, in 2014 there is a solid tendency for the decreasing numbers of the abortions in Bulgaria between the period of 2000-2013.Every year, in Bulgaria nearly half of the pregnancies end up with an abortion. It is well known that every abortion hides a risk for every woman that had this kind of medical intervention. Also lowers the ability of having another pregnancy, having a healthy carrying and giving a natural childbirth. On other side, abortions are associated with being a significant factor which regulates the demografic features of the population. There is a tendency that most of the Bulgarian women use the abortion like alternative method for contraception. This is due to the fact that since 1956 there isn`t a law that prohibit the performing of abortion by choice of the pregnant woman. For the period from 1967 to 1998, many statistics show that the number of the abortions is significantly higher than the number of the actual childbirths. However, through out the next few years there is a stable tendency of dropping the number of abortions. Overall, in 2014 there is a solid tendency for the decreasing numbers of the abortions in Bulgaria between the period of 2000-2013

Tuberculosis and HIV — Doubling the Fatality

Tuberculosis (TB) and HIV/AIDS infection are one of the most ubiquitous and deadliest communicable diseases in the world. They cause millions of deaths each year and are recognized as major threats for public health worldwide. The corresponding pathogens (Mycobacterium tuberculosis and HIV) share overlapping epidemiology—they affect low-income countries and place an immense burden on their feeble health care systems. Over the last decades, the natural history of both diseases has changed; in addition to devastating single HIV and TB infections, the coinfection with both pathogens has emerged and has spread in pandemic scale. When present as dual infection in an individual, Mycobacterium tuberculosis and HIV potentiate each other and kill in cooperation the host. TB is the leading cause of death in HIV-positive patients and in turn HIV infection is the strongest risk factor for the development of new or reactivation of dormant TB disease. Both pathogens (as single or dual infection) provoke a robust immune response in the infected host but the immune system does not achieve to eliminate the infectious agent(s). The failure of immune defense results in vulnerable immune balance between the micro- and the macroorganism and often ends up in a fatal outcome

Effect of cluster size of chalcogenide glass nanocolloidal solutions on the surface morphology of spin-coated amorphous films

Amorphous chalcogenide thin film deposition can be achieved by a spin-coating technique from proper solutions of the corresponding glass. Films produced in this way exhibit certain grain texture, which is presumably related to the cluster size in solution. This paper deals with the search of such a correlation between grain size of surface morphology of as-deposited spin-coated As33S67 chalcogenide thin films and cluster size of the glass in butylamine solutions. Optical absorption spectroscopy and dynamic light scattering were employed to study optical properties and cluster size distributions in the solutions at various glass concentrations. Atomic force microscopy is used to study the surface morphology of the surface of as-deposited and thermally stabilized spin-coated films. Dynamic light scattering revealed a concentration dependence of cluster size in solution. Spectral-dependence dynamic light scattering studies showed an interesting athermal photo-aggregation effect in the liquid state.Comment: 15 pages, 8 figure