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.

Repair competence assay in studies of the influence of environmental exposure to c-PAHs on individual susceptibility to induction of DNA damage.

Previous results from studies performed in three European cities suggested a decrease in DNA repair efficiency observed in lymphocytes of subjects occupationally exposed to environmental carcinogenic polycyclic aromatic hydrocarbons (c-PAHs). The aim of this study was to investigate whether a relationship between exposure to environmental c-PAHs and cellular vulnerability to the induction of DNA damage and its repair is confirmed in a pooled group of subjects from Prague, Kosice and Sofia. The investigated pool consisted of 144 subjects occupationally exposed to environmental c-PAHs, who were municipal policemen or bus drivers. A control group of 115 matched individuals consisted of males unexposed at work to c-PAHs. The repair efficacy was evaluated by a comparison of the DNA damage detected by the single cell gel electrophoresis (SCGE) immediately after challenging the cells with X-ray irradiation, with residual damage (RD) being measured after an incubation period of 60min. A stochastic concept for a mechanism of the interaction between DNA and various genotoxic exposures, was applied to analyze a relationship between exposure and biological effect in the studied sample. The outcome of the study confirms that the exposure to environmental c-PAHs or smoking cigarettes, significantly decreases DNA repair efficiency (repair efficiency in the pooled group of exposed individuals was 61.8+/-11.8% versus 67.9+/-9.9 in control, p<0.001, and repair efficiency in group of smoking individuals was 63.0+/-11.5% versus 65.9+/-11.1 in nonsmokers, p<0.005). The repair efficiency can be affected by a genetic polymorphism, such as subjects with a homozygous mutation in polymorphic CYP1A1((Val/Val)) enzyme, or slow NAT2 acetylators, who showed a considerably lower DNA repair efficiency (i.e. average repair efficiency in subgroups of fast acetylators was for the control subgroup 68.1% versus 66.5% in exposed subjects, while in the case of subgroups of slow acetylators, for the control group was 68.0% versus significantly less in the exposed subjects, 60.6%, p<0.05). Smoking habits, or the diet's vitamin content, significantly affected the process. The results obtained confirm a potential value of the method as a biomarker of susceptibility in molecular epidemiology or preclinical studies, aimed at predicting susceptibility to various genotoxic exposures (environmental, occupational, therapeutic). To conclude, the research proved the influence of environmental c-PAHs, genotypes, and life styles on DNA damage and on its repair efficiency. Even low exposure to environmental c-PAHs altered DNA repair abilities of the subjects, which may result in an increased cancer risk. The findings confirm that c-PAHs should become pollutants that are subject to regulation.