Characterization of longitudinal transformation of T2-hyperintensity in oligodendroglioma.

BACKGROUND: Oligodendroglioma (ODG) are CNS resistant tumors characterized by their unique molecular signature, namely a combined deletion of 1p and 19q simultaneously to an IDH1/2 mutation. These tumors have a more favorable clinical outcome compared to other gliomas and a long-time survival that ranges between 10 and 20 years. However, during the course of the disease, multiple recurrences occur and the optimal treatment at each stage of the disease remains unclear. Here we report a retrospective longitudinal observation study of 836 MRI examinations in 44 ODG patients. METHODS: We quantified the volume of T2-hyperintensity to compute growth behavior in dependence of different treatment modalities, using various computational models. RESULTS: The identified growth pattern revealed dynamic changes, which were found to be patient-specific an did not correlate with clinical parameter or therapeutic interventions. Further, we showed that, surgical resection is beneficial for overall survival regardless the WHO grad or timepoint of surgery. To improve overall survival, an extent of resection above 50% is required. Multiple resections do not generally improve overall survival, except a greater extent of resection than in previous surgeries was achieved. CONCLUSIONS: Our data aids to improve the interpretation of MRI images in clinical practice.

Trauma Informed Interventions to Reduce Seclusion, Restraint and Restrictive Practices Amongst Staff Caring for Children and Adolescents with Challenging Behaviours: A Systematic Review.

Engaging with children and adolescents in mental health settings who are exhibiting behaviours that challenge can often result in the use of seclusion, restraint and coercive practices. It is recognised that more therapeutic ways to engage this population are needed, adopting trauma informed interventions may provide a solution. The aim of this systematic review is to synthesize the evidence in relation to the effect of trauma-informed interventions on coercive practices in child and adolescent residential settings. The review is guided by elements of the Cochrane Handbook for Systematic Reviews of Interventions and reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist. Results were synthesized and reported narratively. Nine studies met the eligibility criteria for this review. There was a lack of homogeneity amongst the studies. The trauma-informed interventions used were typically multi-faceted, underpinned by a variety of approaches and sought to bring about changes to clinical practice. Most studies (n = 8) reported significant reductions in the use of restrictive practices following the implementation of a trauma informed approach. The use of a trauma-informed approach, underpinned by an organisational change or implementation strategy, have the potential to reduce coercive practices with children and adolescents. However, the included interventions were insufficiently described to draw strong conclusions.

Mental Health and Wellbeing at Schools: Health Promotion in Primary Schools with the Use of Digital Methods.

Mental health disorders among primary school children remain a crucial issue. Early health promotion interventions can positively affect and prevent the onset of mental disorders. Promising digital mental health methods have been implemented for adolescents and youths with scarce evidence among younger ages. Therefore, the aim of the current systematic review was to identify health promotion interventions on mental health and wellbeing, with the use of digital methods, delivered in primary school settings. Six digital interventions have been identified, three of which were targeting teachers and the others students. Regardless of the limited number of studies, the effectiveness of the web-based interventions upon teachers' knowledge and attitudes and the positive impact on children's behavioral improvements has been documented. The lack of adequate evidence highlights the need for further research in the field. The current review provides information for professionals working in primary schools useful for the design and implementation of effective mental health and wellbeing interventions.

Teaching methods in the healthcare management major.

INTRODUCTION: Organisation and management are factors of paramount importance in higher education for achieving higher quality of training, better professional adaptation, and more effective career pursuance of the students. AIM: The present study analyses the use of various teaching methods for the students in the major of Healthcare Management as they are employed in two medical universities. MATERIALS AND METHODS: We conducted a detailed questionnaire survey which included the students in the Healthcare Management major in the Faculty of Public Health (FPH) at Sofia Medical University (SMU) and the Medical Faculty of Plovdiv Medical University (PMU). The students were surveyed for two consecutive academic years (2004/2005 and 2005/2006). The logical units of study were 198 students completing their baccalaureate programs in Healthcare Management: 145 (73.23+/-3.15%) in the FPH, SMU and 53 (26.77+/-3.15%) in the PMU (the greater number of students from the SMU was due to the greater number of students admitted into the Sofia Medical University). The technical units of study were the Faculty of Public Health in the Medical University in Sofia and the Medical faculty in the Medical University in Plovdiv. The survey was carried out using our own questionnaire form comprising 51 questions (open and closed), some of them allowing more than one answer. The collected sociological data were analysed using SPSS v. 13.0, and the diagrams were made using Microsoft Excel' 97. We used the alternative, non-parametric and graphic analyses to illustrate the processes and events at a level of significance P < 0.05. RESULTS: The most frequently used teaching method in both Medical Universities is the lecture (30.43+/-3.63% for PMU and 26.32+/-1.91% for SMU). This format of teaching is also considered to be the easiest with regard to learning the study material by 22.75+/-3.25% of the PMU graduates and 27.56+/-2.38% of the SMU graduates. The PMU students regard seminars, individual work and discussions as the format that afford the easiest way to acquire knowledge (22.16+/-3.21%, 21.56+/-3.18%, (18.56+/-3.01%, respectively). The most frequently used teaching method is the lecture; for the SMU student, it is used in 91.67+/-5.64% of all cases, while for PMU it is 8.33+/-5.64%. CONCLUSION: Students prefer the classical teaching methods. They are the most familiar and the most frequently used formats by lecturers, although they do not require a higher level of activity on the part of the students, who in T. Popov's view "...demonstrate passive attitude towards the educational process".

Characteristics and tendencies in development of the higher education in the sphere of public health.

INTRODUCTION: The faculties of social health care have been established in response to the growing social demand for highly qualified managerial staff at all levels of the health care system. The mission of these faculties is to train specialists who will have the necessary knowledge so that they can join in the reforms in the field of social health care to support the changes in the medical and paramedical sector in Bulgaria. AIMS: To determine the specific features of the directions and tendencies in the development of the higher education in Public Health Care. MATERIALS AND METHODS: A cross-section sociological survey was carried out over a five-year period. The opinions of 208 graduate students from all medical colleges in the country were examined in 2000/2001 academic year. A second survey was carried out in 2005/2006 academic year including another sample of 219 graduates in their final third year of study. The sample was recruited from graduates in various majors with an even faculty number. The Medical College (MC) in Bourgas was not included in the second survey as it was outside the system of the medical university. SPSS v. 15.0 was used to analyse the data. Statistical analysis was performed using the analysis of variance, alternative and non-parametric analysis. RESULTS: After graduating from the MC, 62.25 +/- 3.29% of the respondents in 2000/2001 wanted to pursue their bachelor's degree in Healthcare Management. Five years later, in 2005/2006, the number of student wishing to continue their education was almost the same (59.72 +/- 3.38%). The major motives of the MC graduates in academic year 2000/2001 to continue their education were: acquisition of new knowledge (45.36 +/- 5.05%); by continuing their education the students make a beneficial investment in their future career (26.80 +/- 4.50%); the higher educational degree will allow them to be more competitive in finding a job (14.43 +/- 3.57%). Five years later the motives of the MC graduates were different apparently under the influence of the new social and economic situation in the country. The major motives this time were the perspectives of making a career, especially noticeable with nurses (34.78 +/- 5.23%) and midwives (12.90 +/- 6.02%). CONCLUSIONS: The greatest number of the respondents wanted to continue their education for baccalaureate degree in Health Care Management. Also worth noting is that their motives for continuing their studies changed in that five-year period.

Prerequisites for the occurrence of burnout syndrome in oncology nurses.

BACKGROUND: The burnout syndrome, as defined in literature, is the ultimate result of prolonged stress in the professional life of nurses characterised mainly by emotional exhaustion, depersonalization and reduced personal accomplishment. AIM: The purpose of the present study was to investigate and analyse those factors of the work environment that have an effect on the development of burnout syndrome in nurses working in an oncology in-patient clinic. MATERIAL AND METHODS: The study was designed as a questionnaire survey. Our study sample consisted of 70 nurses representing 78% of the medical nursing staff in the Plovdiv Oncology In-patient Clinic. Descriptive statistics and the analysis of proportions were used in the statistical analysis of data. Calculations and graphical presentation were done using MS Excel 97 and SPSS 11.0. RESULTS AND DISCUSSION: Most of the respondents (98.5%) said that the pain experienced by patients was the most significant factor contributing to their emotional exhaustion. The following factors were ranked by the respondents given in ascending order of strength: strong pain--100%, fear of death--59.4%, the thought that the patients leave their relatives for good--55.1%. Most of the respondents (56.5%) reported that it was the everyday encounter with pain and lack of hope that depressed them most; 67% of them said they were demotivated by the everyday encounter with death. We should also note the fact that more than half of the respondents said that their professional life affected their social life and the relations within their families. CONCLUSION: Our results are consistent with those reported by Haberman MR according to whom the care for a dying cancer patient is the most difficult aspect of nursing as a profession.