The EUROASPIRE surveys : lessons learned in cardiovascular disease prevention

The Joint European Societies (JES) guidelines on cardiovascular disease (CVD) prevention published in 1994, 1998, 2003, 2007, 2012 and 2016 defined lifestyle and risk factors targets for patients with coronary or other atherosclerotic disease and people at high risk of developing CVD. Guideline implementation in Europe has been evaluated with four cross-sectional EUROASPIRE surveys starting in mid-1990s. The results showed poor lifestyle and risk factor management in patients with CHD and in high CVD risk people with high prevalences of smoking, obesity, central obesity and diabetes. The control of blood pressure, lipids and glucose was far from optimal. A comparison across the recent three surveys provided a unique description of time trends for secondary prevention over a period of 14 years. The results showed adverse lifestyle trends, a substantial increase in obesity, central obesity and diabetes. Despite significant improvement of blood pressure and lipid control many patients were not reaching the risk factor goals and there was no change in glucose control. Comparing the most recent two surveys, there were no major differences in lifestyle and risk factor management in people at high risk of developing CVD. A new approach to CVD prevention integrating primary and secondary prevention into a modern preventive cardiology programme, focusing on lifestyle and risk factor management is required, in order to reduce the risk of CVD events and improve quality of life in patients with CHD and those at high risk of developing CVD

How to Elaborate a Demonstrator in Inspiring Science Education Platform

Report published in the Proceedings of the National Conference on "Education and Research in the Information Society", Plovdiv, May, 2016Inquiry based approach in the classroom is the modeling of the real scientific research skills of investigation, critical thinking, imagination, intuition, playfulness, and thinking for a real world problem. For the realization of an ISE Demonstrator, we adhere to the scenario template and step-by-step guidance for planning the lesson using the five step scenario template. Today, because of the Rosetta Stone, we can interpret many ancient texts and inscriptions of Egyptian hieroglyphic and demotic scripts found on sheets of papyrus and monuments throughout Egypt. The Rosetta Stone Demonstrator enables teachers to use in their lessons factual material that is related to Egyptian culture. The purpose of this demonstrator is students to become aware of the interactions between different languages and their structure.Association for the Development of the Information Society, Institute of Mathematics and Informatics Bulgarian Academy of Sciences, Plovdiv University "Paisii Hilendarski

Cost-effectiveness of a European preventive cardiology programme in primary care: A Markov modelling approach

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.OBJECTIVE: To investigate the longer-term cost-effectiveness of a nurse-coordinated preventive cardiology programme for primary prevention of cardiovascular disease (CVD) compared to routine practice from a health service perspective. DESIGN: A matched, paired cluster-randomised controlled trial. SETTING: Six pairs of general practices in six countries. PARTICIPANTS: 1019 patients were randomised to the EUROACTION intervention programme and 1005 patients to usual care (UC) and who completed the 1-year follow-up. OUTCOME MEASURES: Evidence on health outcomes and costs was based on patient-level data from the study, which had a 1-year follow-up period. Future risk of CVD events was modelled, using published risk models based on patient characteristics. An individual-level Markov model for each patient was used to extrapolate beyond the end of the trial, which was populated with data from published sources. We used an 11-year time horizon and investigated the impact on the cost-effectiveness of varying the duration of the effect of the intervention beyond the end of the trial. Results are expressed as incremental cost per quality-adjusted life-year gained. RESULTS: Unadjusted results found the intervention to be more costly and also more effective than UC. However, after adjusting for differences in age, gender, country and baseline risk factors, the intervention was dominated by UC, but this analysis was not able to take into account the lifestyle changes in terms of diet and physical activity. CONCLUSIONS: Although the EUROACTION study achieved healthier lifestyle changes and improvements in management of blood pressure and lipids for patients at high risk of CVD, compared to UC, it was not possible to show, using available risk equations which do not incorporate diet and physical activity, that the intervention reduced longer-term cardiovascular risk cost-effectively. Whether or not an intervention such as that offered by EUROACTION is cost-effective requires a longer-term trial with major cardiovascular events as the outcome.This study is sponsored solely by AstraZeneca through the provision of an unconditional educational grant

Vision for the Engagement of the e-Facilitator in School in the Inspiring Science Education Environment

The Inspiring Science Education project is all about elaborating a learning environment using an inquiry based learning (IBL) approach. The Inspiring Science Education portal as a main part of the environment is the place where a registered user can find (create) eLearning Tools and digital educational resources, which can be used in class and as a place to connect with like-minded teachers and schools around Europe to share experiences and collaborate on projects. On the other hand, starting from 2009 in various EU countries, including Bulgaria, research was done to describe and categorize the professional profile of the e-facilitator, carrier of the mission to overcome digital divide between the generations, through implementing ICT knowledge. Our team worked on the requirements and explored the need for an e-facilitator in school as a major ICT expert and consultant, who empowers access to the electronic services in the e-education space, facilitates links with virtual libraries, acts as initiator and architect of social communication by forming communities involving all participants in the learning process—students, teachers, parents, administration, etc. This paper expresses the author’s projection of the roles and functionalities of the e-facilitator in school in the Inspiring Science Education environment. ACM Computing Classification System (1998): K.3.1

Nekotorye osobennosti slavianskikh psaltyrei na materiale XI-XVI vv.

Elena Kotseva, Ivona Karachorova, Asen Atanasov - BulgariaEach of the three authors presents a section describing certain characteristics of Slavic Psalters from the 9th to the 16th centuries. Ivona Karachorova (26-38) focuses on lexical features and the possible redaction of the Psalter text on which they are based. The most noteworthy result is the isolation of a group of manuscripts that arose in the 13th cent. Elena Kotseva (39-50) examines the codicological and "grapho-linguistic" features of the Psalter as well as comparing its contents to the calendar/synaxarion of the Typikon of the Great Church of Constantinople, 9th-10th cent. Music specialist, Asen Atanasov (51-71) provides tables indicating the psalm-based hymns according to the calendars/synaxaria of the oldest Slavic Cyrillic and Glagolitic monuments. A bibliography (71-75) is included. Polata 14-15: 25-26

Determinants of participation and risk factor control according to attendance in cardiac rehabilitation programmes in coronary patients in Europe : EUROASPIRE IV survey

Aim: The purpose of this study was to describe the proportions of patients referred to and attending cardiac rehabilitation programmes in Europe and to compare lifestyle and risk factor targets achieved according to participation in a cardiac rehabilitation programme. Methods: The EUROASPIRE IV cross-sectional survey was undertaken in 78 centres from 24 European countries. Consecutive patients aged <80 years with acute coronary syndromes and/or revascularization procedures were interviewed at least six months after their event. Results: A total of 7998 patients (24% females) were interviewed. Overall, 51% were advised to participate in a cardiac rehabilitation programme and 81% of them attended at least half of the sessions; being 41% of the study population. Older patients, women, those at low socio-economic status or enrolled with percutaneous coronary intervention and unstable angina, as well as those with a previous history of coronary disease, heart failure, hypertension or dysglycaemia were less likely to be advised to follow a cardiac rehabilitation programme. People smoking prior to the recruiting event were less likely to participate. The proportions of patients achieving lifestyle targets were higher in the cardiac rehabilitation programme group as compared to the non-cardiac rehabilitation programme group: stopping smoking (57% vs 47%, p < 0.0001), recommended physical activity levels (47% vs 38%, p < 0.0001) and body mass index<30 kg/m(2) (65% vs 61%, p=0.0007). However, there were no differences in the blood pressure, lipids and glucose control. Patients who attended a cardiac rehabilitation programme had significantly lower anxiety and depression scores and better medication adherence. Conclusions: Only half of all coronary patients were referred and a minority attended a cardiac rehabilitation programme. Those attending were more likely to achieve lifestyle targets, had lower depression and anxiety, and better medication adherence. There is still considerable potential to further reduce cardiovascular risk by increasing uptake and fully integrating secondary prevention and cardiac rehabilitation to provide a modern preventive cardiology programme

Gender differences in the implementation of cardiovascular prevention measures after an acute coronary event

Objective To compare gender-related lifestyle changes and risk factor management after hospitalisation for a coronary event or revascularisation intervention in Europe. Method The EUROASPIRE III survey was carried out in 22 European countries in 2006-2007. Consecutive patients having had a coronary event or revascularisation before the age of 80 were identified. A total of 8966 patients (25.3% women) were interviewed and underwent clinical and biochemical tests at least 6 months after hospital admission. Trends in cardiovascular risk management were assessed on the basis of the 1994-1995, 1999-2000 and 2006-2007 EUROASPIRE surveys. Results Female survey participants were generally older and had a lower educational level than male participants (p<0.0001). The prevalences of obesity (p<0.0001), high blood pressure (BP) (p=0.001), elevated low-density lipoprotein (LDL)-cholesterol (p<0.0001) and diabetes (p<0.0001) were significantly higher in women than in men, whereas current smoking (p<0.0001) was significantly more common in men. The use of antihypertensive and antidiabetic drugs (but not that of other drugs) was more common in women than in men. However, BP (p<0.0001), LDL-cholesterol (p<0.0001) and HbA1c (p<0.0001) targets were less often achieved in women than in men. Between 1994 and 2007, cholesterol control improved less in women than in men (interaction: p=0.009), whereas trends in BP control (p=0.32) and glycaemia (p=0.36) were similar for both genders. Conclusion The EUROASPIRE III results show that despite similarities in medication exposure, women are less likely than men to achieve BP, LDL-cholesterol and HbA1c targets after a coronary event. This gap did not appear to narrow between 1994 and 2007

Venets: The Belogradchik Journal for Local History

Abstract. This article explores first results of fieldwork in villages Slaveyno and the neighboring village Vievo, Rhodop Mountains. People in Slaveyno are Orthodox Christians; Vievo is populated by Bulgarian Muslims (Pomaks). Acquainted with the peculiarities of the villages raised many questions but continued interest emerged because of constant construction and operation of identity, seen locally. Initially, my attention was caught by more &quot;visible&quot; markers of identity and collective memory, which can be distinguished in the surface layer of the local culture. In this layer falls the yearly repetition of the heroic past of the village with the celebrating of the anniversary of Ilinden-Uprising (1903), on the one hand and the celebration of s