Achievement motivation and attitude of medical laboratory assistants to continuing education

Introduction. The problem of improving competence by means of continuing education of health specialists is not sufficiently discussed and studied, especially in terms of medical laboratory assistants. The emphasis of the present study is on the ability to update achievement motivation of laboratory assistants through new opportunities and forms of continuing professional education. Their interest in continuing education indicates an aspiration for improving their professional competence with respect to innovative professional practices including dynamically changing methods, technologies and devices facilitating health examinations that reflect the highly significant results of their work for the health and life of their patients. The aim of the present research is to study the achievement motivation of students and medical laboratory technicians and its influence on the main variables and descriptors of the attitude towards continuous learning. Materials and research methods. The studied persons represent three target groups involved in continuing professional education - in-service medical laboratory assistants, heads of medical laboratories and students enrolled in the programme of Medical Laboratory Assistant at Bulgarian medical colleges. The methodological tools comprise standardised psychological tests, as well as questionnaires developed for the purposes of the specific study. Results and scientific novelty. The main results support the thesis that motivation for achievement is updated in activities and situations where professional success is subjectively important and there are clear criteria of success or failure. The interest in continuing education depends on the motivation for achievement as a tendency in various individuals. The higher achievement motivation determines a stronger need to improve professional competences, aspiration to acquire a graduate degree in their professional field, preferences to specialisations as a form of continuing learning and understanding of continuing education as a manifestation of the desire for new knowledge. The results from the study may enrich the existing research data on the application of achievement motivation theory as an explanatory model of life-long learning behaviour, which may become an effective way to tackle the rapidly ageing and half-life of knowledge in medicine and technology. Practical significance. The applicability of the results is very clearly visible in the formulated thesis of the necessary change in the educational policy in the country through new forms of continuous education of medical laboratory assistants which would update their achievement motivation and would result in increase in the efficiency of their professional functioning.Введение. Проблема повышения компетентности путем непрерывного обучения специалистов здравоохранения, в частности медицинских лаборантов, недостаточно изучена. Основное внимание в настоящем исследовании уделяется возможности актуализировать мотивацию достижений лаборантов посредством новых методов и форм непрерывного профессионального образования. Интерес лаборантов к непрерывному обучению является индикатором стремления к повышению их профессиональной компетентности в условиях инновативности профессии с ее динамически меняющимися методами, технологиями и аппаратурой для медицинских исследований и при высокой значимости результатов их работы для здоровья и жизни людей. Цель работы - исследовать мотивацию достижений у студентов и медицинских лаборантов и ее влияние на основные переменные и дескрипторы отношения к непрерывному обучению. Материалы и методы. Респонденты являются представителями трех целевых групп, имеющих отношение к непрерывному обучению в профессии: практикующие медицинские лаборанты, руководители медицинских лабораторий и студенты специальности «Медицинский лаборант» в болгарских медицинских колледжах. Методический инструментарий включает в себя стандартизированные психологические тесты, а также вопросники, разработанные для целей конкретного исследования. Результаты и научная новизна. Основные результаты работы обосновывают тезис о том, что мотивация достижений становится актуальной в действиях и ситуациях, когда успех в профессии субъективно значим и существуют четкие критерии успеха или неудачи. Готовность к непрерывному обучению зависит от мотивации достижений как личностной тенденции. Более высокая мотивация достижений обуславливает более сильную потребность в повышении профессиональных компетенций, стремление получить ученую степень в своей профессиональной области, предпочтение специализации как формы непрерывного обучения и понимание непрерывного образования как проявление стремления к новым знаниям. Результаты исследования могут обогатить существующие данные по применению теории мотивации достижений в качестве объяснительной модели поведения при непрерывном обучении, что может стать эффективным способом решения проблемы быстрого старения и периода полураспада знаний в медицине и технологиях. Практическая значимость. Применимость результатов выражается особенно четко в сформулированном тезисе о необходимом изменении образовательной политики страны посредством новых форм непрерывного обучения для медицинских лаборантов, которые смогут актуализировать свою мотивацию достижений и в результате повысить эффективность их функционирования в профессии.The article is supported by the Medical College of the Trakia University, Stara Zagora, Bulgaria.Статья выполнена при поддержке Медицинского колледжа Тра-кийского университета - Стара Загора, Болгария

Spectrokinetic characterization of photoactive yellow protein films for integrated optical applications

In this paper, the photocycle of the dried photoactive yellow protein film has been investigated in different humidity environments, in order to characterize its nonlinear optical properties for possible integrated optical applications. The light-induced spectral changes of the protein films were monitored by an optical multichannel analyser set-up, while the accompanying refractive index changes were measured with the optical waveguide lightmode spectroscopy method. To determine the number and kinetics of spectral intermediates in the photocycle, the absorption kinetic data were analysed by singular value decomposition and multiexponential fitting methods, whose results were used in a subsequent step of fitting a photocycle model to the data. The absorption signals of the films were found to be in strong correlation with the measured light-induced refractive index changes, whose size and kinetics imply that photoactive yellow protein may be a good alternative for utilization as an active nonlinear optical material in future integrated optical applications. © 2019, The Author(s)

Mechanical properties of materials for 3D printed orthodontic retainers

Aim: The purpose of this study was to compare the mechanical properties of materials used for orthodontic retainers made by direct 3D printing and thermoforming. Materials and methods: Twenty-one specimens (n=7) from 3 different materials (Formlabs Dental LT Clear V2 - Formlabs Inc., Somerville, Massachusetts, USA; NextDent Ortho Flex - Vertex-Dental B.V., Soesterberg, The Netherlands, and Erkodent Erkodur - ERKODENT, Germany) were manufactured and their mechanical properties were evaluated. Two of the specimen groups were 3D printed and the other one was fabricated using a material for thermoforming. The statistical methods we applied were descriptive statistics, the Kruskal-Wallis and Dunn’s post-hoc tests. Results: With respect to Young’s modulus (E), the Kruskal-Wallis test (df=2, χ2=17.121, p=0.0002) showed a significant difference between the materials for direct 3D printing of orthodontic retainers (E=2762.4 MPa±115.16 MPa for group 1 and 2393.05 MPa±158.13 MPa for group 2) and thermoforming foils (group 3, E=1939.4 MPa±74.18 MPa). Statistically significant differences were also found between the flexural strength (FS) (Kruskal-Wallis test, df=2, χ2=17.818, p=0.0001) and F(max) (Kruskal-Wallis test, df=2, χ2=17.818, p=0.0001). Conclusions: The materials tested in the current study showed statistically significant differences in their Young’s modulus, flexural strength, and F(max)

Factors influencing the decision to start renal replacement therapy: results of a survey among European nephrologists

Background: Little is known about the criteria nephrologists use in the decision of when to start renal replacement therapy (RRT) in early referred adult patients. We evaluated opinions of European nephrologists on the decision for when to start RRT. Study Design: European web-based survey. Predictors: Patient presentations described as uncomplicated patients, patients with unfavorable clinical and unfavorable social conditions, or patients with specific clinical, social, and logistical factors. Setting & Participants: Nephrologists from 11 European countries. Outcomes & Measurements: We studied opinions of European nephrologists about the influence of clinical, social, and logistical factors on decision making regarding when to start RRT, reflecting practices in place in 2009. Questions included target levels of kidney function at the start of RRT and factors accelerating or postponing RRT initiation. Using linear regression, we studied determinants of target estimated glomerular filtration rate (eGFR) at the start of RRT. Results: We received 433 completed surveys. The median target eGFR selected to start RRT in uncomplicated patients was 10.0 (25th-75th percentile, 8.0-10.0) mL/min/1.73 m(2). Level of excretory kidney function was considered the most important factor in decision making regarding uncomplicated patients (selected by 54% of respondents); in patients with unfavorable clinical versus social conditions, this factor was selected by 24% versus 32%, respectively. Acute clinical factors such as life-threatening hyperkalemia refractory to medical therapy (100%) and uremic pericarditis (98%) elicited a preference for an immediate start, whereas patient preference (69%) and vascular dementia (66%) postponed the start. Higher target eGFRs were reported by respondents from high-versus low-RRT-incidence countries (10.4 [95% CI, 9.9-10.9] vs 9.1 mL/min/1.73 m(2)) and from for-profit versus not-for-profit centers (10.1 [95% CI, 9.5-10.7] vs 9.5 mL/min/1.73 m(2)). Limitations: We were unable to calculate the exact response rate and examined opinions rather than practice for 433 nephrologists. Conclusions: Only for uncomplicated patients did half the nephrologists consider excretory kidney function as the most important factor. Future studies should assess the weight of each factor affecting decision making. Am J Kidney Dis. 60(6): 940-948. (C) 2012 by the National Kidney Foundation, In

The association between older age and receipt of care and outcomes in patients with acute coronary syndromes

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Supplemented ERA-EDTA Registry data evaluated the frequency of dialysis, kidney transplantation, and comprehensive conservative management for patients with kidney failure in Europe

The aims of this study were to determine the frequency of dialysis and kidney transplantation and to estimate the regularity of comprehensive conservative management (CCM) for patients with kidney failure in Europe. This study uses data from the ERA-EDTA Registry. Additionally, our study included supplemental data from Armenia, Germany, Hungary, Ireland, Kosovo, Luxembourg, Malta, Moldova, Montenegro, Slovenia and additional data from Israel, Italy, Slovakia using other information sources. Through an online survey, responding nephrologists estimated the frequency of CCM (i.e. planned holistic care instead of kidney replacement therapy) in 33 countries. In 2016, the overall incidence of replacement therapy for kidney failure was 132 per million population (pmp), varying from 29 (Ukraine) to 251 pmp (Greece). On 31 December 2016, the overall prevalence of kidney replacement therapy was 985 pmp, ranging from 188 (Ukraine) to 1906 pmp (Portugal). The prevalence of peritoneal dialysis (114 pmp) and home hemodialysis (28 pmp) was highest in Cyprus and Denmark respectively. The kidney transplantation rate was nearly zero in some countries and highest in Spain (64 pmp). In 28 countries with five or more responding nephrologists, the median percentage of candidates for kidney replacement therapy who were offered CCM in 2018 varied between none (Slovakia and Slovenia) and 20% (Finland) whereas the median prevalence of CCM varied between none (Slovenia) and 15% (Hungary). Thus, the substantial differences across Europe in the frequency of kidney replacement therapy and CCM indicate the need for improvement in access to various treatment options for patients with kidney failure.Peer reviewe

Disruption of PTH Receptor 1 in T Cells Protects against PTH-Induced Bone Loss

Hyperparathyroidism in humans and continuous parathyroid hormone (cPTH) treatment in mice cause bone loss by regulating the production of RANKL and OPG by stromal cells (SCs) and osteoblasts (OBs). Recently, it has been reported that T cells are required for cPTH to induce bone loss as the binding of the T cell costimulatory molecule CD40L to SC receptor CD40 augments SC sensitivity to cPTH. However it is unknown whether direct PTH stimulation of T cells is required for cPTH to induce bone loss, and whether T cells contribute to the bone catabolic activity of PTH with mechanisms other than induction of CD40 signaling in SCs.Here we show that silencing of PTH receptor 1 (PPR) in T cells blocks the bone loss and the osteoclastic expansion induced by cPTH, thus demonstrating that PPR signaling in T cells is central for PTH-induced reduction of bone mass. Mechanistic studies revealed that PTH activation of the T cell PPR stimulates T cell production of the osteoclastogenic cytokine tumor necrosis factor alpha (TNF). Attesting to the relevance of this effect, disruption of T cell TNF production prevents PTH-induced bone loss. We also show that a novel mechanism by which TNF mediates PTH induced osteoclast formation is upregulation of CD40 expression in SCs, which increases their RANKL/OPG production ratio.These findings demonstrate that PPR signaling in T cells plays an essential role in PTH induced bone loss by promoting T cell production of TNF. A previously unknown effect of TNF is to increase SC expression of CD40, which in turn increases SC osteoclastogenic activity by upregulating their RANKL/OPG production ratio. PPR-dependent stimulation of TNF production by T cells and the resulting TNF regulation of CD40 signaling in SCs are potential new therapeutic targets for the bone loss of hyperparathyroidism

The European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2016 : a summary

Background. This article summarizes the ERA-EDTA Registry's 2016 Annual Report, by describing the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2016 within 36 countries. Methods. In 2017 and 2018, the ERA-EDTA Registry received data on patients undergoing RRT for ESRD in 2016 from 52 national or regional renal registries. In all, 32 registries provided individual patient data and 20 provided aggregated data. The incidence and prevalence of RRT and the survival probabilities of these patients were determined. Results. In 2016, the incidence of RRT for ESRD was 121 per million population (pmp), ranging from 29 pmp in Ukraine to 251 pmp in Greece. Almost two-thirds of patients were men, over half were aged >= 65 years and almost a quarter had diabetes mellitus as their primary renal diagnosis. Treatment modality at the start of RRT was haemodialysis for 84% of patients. On 31 December 2016, the prevalence of RRT was 823 pmp, ranging from 188 pmp in Ukraine to 1906 pmp in Portugal. In 2016, the transplant rate was 32 pmp, varying from 3 pmp in Ukraine to 94 pmp in the Spanish region of Catalonia. For patients commencing RRT during 2007-11, the 5-year unadjusted patient survival probability on all RRT modalities combined was 50.5%. For 2016, the incidence and prevalence of RRT were higher among men (187 and 1381 pmp) than women (101 and 827 pmp), and men had a higher rate of kidney transplantation (59 pmp) compared with women (33 pmp). For patients starting dialysis and for patients receiving a kidney transplant during 2007-11, the adjusted patient survival probabilities appeared to be higher for women than for men.Peer reviewe

The ERA-EDTA Registry Annual Report 2017 : a summary

Background. This article presents a summary of the 2017 Annual Report of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry and describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 37 countries. Methods. The ERA-EDTA Registry received individual patient data on patients undergoing RRT for ESRD in 2017 from 32 national or regional renal registries and aggregated data from 21 registries. The incidence and prevalence of RRT, kidney transplantation activity and survival probabilities of these patients were calculated. Results. In 2017, the ERA-EDTA Registry covered a general population of 694 million people. The incidence of RRT for ESRD was 127 per million population (pmp), ranging from 37 pmp in Ukraine to 252 pmp in Greece. A total of 62% of patients were men, 52% were >= 65 years of age and 23% had diabetes mellitus as the primary renal disease. The treatment modality at the onset of RRT was haemodialysis for 85% of patients. On 31 December 2017, the prevalence of RRT was 854 pmp, ranging from 210 pmp in Ukraine to 1965 pmp in Portugal. The transplant rate in 2017 was 33 pmp, ranging from 3 pmp in Ukraine to 103 pmp in the Spanish region of Catalonia. For patients commencing RRT during 2008-12, the unadjusted 5-year patient survival probability for all RRT modalities combined was 50.8%.Peer reviewe