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@article{Kostadinov_2020,
title = {Epidemiology of Acquired Thrombotic Thrombocytopenic Purpura},
volume = {11},
issn = {1314-3581},
url = {https://journal.raredis.org/index.php/RBLS/article/view/122},
doi = {10.36865/2020.v11i3.122},
abstractnote = {Acquired Thrombotic Thrombocytopenic Purpura (aTTP) is a rare disease with diverse clinical manifestations, including fever, anemia, thrombocytopenia, neurological symptoms, and acute renal impairment. First identified and described in 1924, today the pathophysiological aspects that distinguish it from other thrombotic vasculopathies and serve as targets for innovative therapies are known. TTP is divided into inherited and acquired forms. The acquired form can be idiopathic or secondary. The current classification of the World Health Organization defines TTP in the category of thrombotic microangiopathies. Studying the epidemiology of aTTP is challenging due to several objective factors. The disease is characterized by a specific laboratory immunologic panel, which is often technically unavailable for many clinical centers. The presence of severe clinical presentations, often accompanied by comorbidities and rapid fatal progression, is also a barrier to establishing the true prevalence of the disease. This publication aims to analyze epidemiological data for aTTP and provide an assessment of the prevalence of this condition in Bulgaria.},
number = {3},
journal = {Rare Diseases and Orphan Drugs},
author = {Kostadinov, Kostadin and Stefanov, Georgi and Iskrov, Georgi and Stefanov, Rumen},
year = {2020},
month = {10},
pages = {36–44}
}
@article{Hubenova_2022,
author = {Hubenova, M. and Kostadinov, K.},
title = {Change in eating habits during the COVID-19 confinement},
year = {2022},
journal = {General Medicine},
volume = {24},
number = {1},
pages = {23 – 29},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85131335656&partnerID=40&md5=960321f2fcf677479ecd9d43d8f6d6d0},
type = {Article},
publication_stage = {Final},
source = {Scopus}
}
@article{Ignatova_2022,
doi = {10.3389/fpubh.2022.822909},
url = {https://doi.org/10.3389%2Ffpubh.2022.822909},
year = {2022},
month = {3},
publisher = {Frontiers Media {SA}},
volume = {10},
author = {Valentina Ignatova and Kostadin Kostadinov and Evguenia Vassileva and Naira Muradyan and Georgi Stefanov and Georgi Iskrov and Rumen Stefanov},
title = {Socio-Economic Burden of Myasthenia Gravis: A Cost-of-Illness Study in Bulgaria},
journal = {Front. Public Health}
}
@article{Rycheva_2022,
title = {HTA69 Delay of Innovative Oncology Treatments - Case From Bulgaria},
volume = {25},
issn = {1098-3015},
url = {http://dx.doi.org/10.1016/j.jval.2022.09.1529},
doi = {10.1016/j.jval.2022.09.1529},
number = {12},
journal = {Value in Health},
publisher = {Elsevier BV},
author = {Raycheva, R and Kostadinov, K},
year = {2022},
month = {12},
pages = {S309–S310}
}
@article{Garnier_2023,
title = {Genetic newborn screening and digital technologies: A project protocol based on a dual approach to shorten the rare diseases diagnostic path in Europe},
volume = {18},
issn = {1932-6203},
url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0293503},
doi = {10.1371/journal.pone.0293503},
abstractnote = {Since 72% of rare diseases are genetic in origin and mostly paediatrics, genetic newborn screening represents a diagnostic “window of opportunity”. Therefore, many gNBS initiatives started in different European countries. Screen4Care is a research project, which resulted of a joint effort between the European Union Commission and the European Federation of Pharmaceutical Industries and Associations. It focuses on genetic newborn screening and artificial intelligence-based tools which will be applied to a large European population of about 25.000 infants. The neonatal screening strategy will be based on targeted sequencing, while whole genome sequencing will be offered to all enrolled infants who may show early symptoms but have resulted negative at the targeted sequencing-based newborn screening. We will leverage artificial intelligence-based algorithms to identify patients using Electronic Health Records (EHR) and to build a repository “symptom checkers” for patients and healthcare providers. S4C will design an equitable, ethical, and sustainable framework for genetic newborn screening and new digital tools, corroborated by a large workout where legal, ethical, and social complexities will be addressed with the intent of making the framework highly and flexibly translatable into the diverse European health systems.},
number = {11},
journal = {PLOS ONE},
author = {Garnier, Nicolas and Berghout, Joanne and Zygmunt, Aldona and Singh, Deependra and Huang, Kui A. and Kantz, Waltraud and Blankart, Carl Rudolf and Gillner, Sandra and Zhao, Jiawei and Roettger, Richard and Saier, Christina and Kirschner, Jan and Schenk, Joern and Atkins, Leon and Ryan, Nuala and Zarakowska, Kaja and Zschüntzsch, Jana and Zuccolo, Michela and Müllenborn, Matthias and Man, Yuen-Sum and Goodman, Liz and Trad, Marie and Chalandon, Anne Sophie and Sansen, Stefaan and Martinez-Fresno, Maria and Badger, Shirlene and Olden, Rudolf Walther van and Rothmann, Robert and Lehner, Patrick and Tschohl, Christof and Baillon, Ludovic and Gumus, Gulcin and Gross, Edith and Stefanov, Rumen and Iskrov, Georgi and Raycheva, Ralitsa and Kostadinov, Kostadin and Mitova, Elena and Einhorn, Moshe and Einhorn, Yaron and Schepers, Josef and Hübner, Miriam and Alves, Frauke and Iskandar, Rowan and Mayer, Rudolf and Renieri, Alessandra and Piperkova, Aneta and Gut, Ivo and Beltran, Sergi and Matthiesen, Mads Emil and Poetz, Marion and Hansson, Mats and Trollmann, Regina and Agolini, Emanuele and Ottombrino, Silvia and Novelli, Antonio and Bertini, Enrico and Selvatici, Rita and Farnè, Marianna and Fortunato, Fernanda and Ferlini, Alessandra},
year = {2023},
month = {11},
pages = {e0293503},
language = {en}
}
@article{Guevara_2023,
place = {Sofia, Bulgaria},
title = {Neurological Soft Signs and Social Cognition in Patients with Schizophrenia: the Missing Link},
volume = {76},
url = {https://www.proceedings.bas.bg/index.php/cr/article/view/391},
doi = {10.7546/CRABS.2023.09.15},
number = {9},
journal = {Proceedings of the Bulgarian Academy of Sciences},
author = {Guevara, Kaloyan and Kostadinov, Kostadin},
year = {2023},
month = {10},
pages = {1440–1448}
}
@article{Kelly_2023,
title = {Trauma Informed Interventions to Reduce Seclusion, Restraint and Restrictive Practices Amongst Staff Caring for Children and Adolescents with Challenging Behaviours: A Systematic Review},
issn = {1936-153X},
url = {http://dx.doi.org/10.1007/s40653-023-00524-2},
doi = {10.1007/s40653-023-00524-2},
journal = {Journal of Child and Adolescent Trauma},
publisher = {Springer Science and Business Media LLC},
author = {Kelly, Peter and Saab, Mohamad M. and Hurley, Emma J. and Heffernan, Sinéad and Goodwin, John and Mulud, Zamzaliza A. and O Malley, Maria and O Mahony, James and Curtin, Margaret and Groen, Gunter and Ivanova, Svetla and Jörns-presentati, Astrid and Korhonen, Joonas and Kostadinov, Kostadin and Lahti, Mari and Lalova, Valentina and Petrova, Gergana and O Donovan, Aine},
year = {2023},
month = {3}
}
@book{Kevorkyan2023,
author = {Kevorkyan, Ani and Kostadinov, Kostadin and Rangelova, Vanya and Raycheva, Ralitsa},
title = {COVID-19 in Bulgaria: Epidemiological Analysis (in Bulgarian)},
publisher = {Paisii Hilendarski University Press (Университетско издателство „Паисий Хилендарски“)},
year = {2023},
isbn = {978-619-202-922-7},
note = {Reviewers: Prof. Dr. Y. Stoilova, MD; Prof. Dr. Oliyana Boykinova, MD}
}
@article{Kiani_2023,
doi = {10.3889/oamjms.2023.9749},
url = {https://doi.org/10.3889%2Foamjms.2023.9749},
year = {2023},
month = {1},
publisher = {Scientific Foundation {SPIROSKI}},
volume = {11},
number = {E},
pages = {53--58},
author = {Faik Kiani and Kostadin Kostadinov and Rumen Stefanov and Viktoriya Mandova},
title = {Dentophobia-latent Component Factor Analysis of Dental Concerns Assessment Scale},
journal = {Open Access Maced J Med Sci}
}
@article{Kostadinov_2023,
title = {Historical Overview of the Definition of Rare Tumors in the Context of Health Policies},
volume = {14},
rights = {Copyright (c) 2023 Kostadin Kostadinov, Nina Musurlieva},
issn = {1314-3581},
url = {https://journal.raredis.org/index.php/RBLS/article/view/182},
doi = {10.36865/2023.v14i2.182},
abstractnote = {Malignant diseases as a collective group of nosological entities represent a significant social and health problem. However, the inclusion of all types of cancer in a single category in health policy development has been criticized. Due to their clinical and epidemiological characteristics, patients with rare tumors face greater barriers in accessing innovative medications, combined with a lack of expertise in the diagnostic and therapeutic process. The development of separate policies for these patients requires a precise definition of the concept.
This review aims to present the chronological development of defining the concept of rare tumors in the context of building health policies in this area. For the purposes of the review, a search was conducted using keywords "rare cancers," "rare tumors," and "rare neoplasm" in the PubMed/MEDLINE and ScienceDirect databases, as well as Google Scholar. The articles found are organized into three main contexts of using the term "rare tumors" – clinically based definitions; definitions based on epidemiological criteria; and definitions used in pediatric oncology.},
number = {2},
journal = {Rare Diseases and Orphan Drugs Journal},
author = {Kostadinov, Kostadin and Musurlieva, Nina},
year = {2023},
month = {11},
pages = {6–12},
language = {bg}
}
@article{Kostadinov_2023a,
author = {Kostadinov, K. and Musurlieva, N.},
title = {Rare Tumors in the Context of Assisted Reproduction (in Bulgarian)},
journal = {Journal "Medical Law and Healthcare" (Списание "Медицинско право и здравеопазване")},
year = {2023},
volume = {4},
pages = {6--12},
isbn = {2748-7070-4-2023}
}
@article{Raycheva_2023a,
title = {Challenges in mapping European rare disease databases, relevant for ML-based screening technologies in terms of organizational, FAIR and legal principles: scoping review},
volume = {11},
issn = {2296-2565},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2023.1214766},
doi = {10.3389/fpubh.2023.1214766},
journal = {Frontiers in Public Health},
author = {Raycheva, Ralitsa and Kostadinov, Kostadin and Mitova, Elena and Bogoeva, Nataliya and Iskrov, Georgi and Stefanov, Georgi and Stefanov, Rumen},
year = {2023}
}
@article{Raycheva_2023b,
title = {HTA7 The Price of Innovation – Oncology Treatments Expenditures: Case from Bulgaria},
volume = {26},
issn = {1098-3015},
url = {http://dx.doi.org/10.1016/j.jval.2023.03.1436},
doi = {10.1016/j.jval.2023.03.1436},
number = {6},
journal = {Value in Health},
publisher = {Elsevier BV},
author = {Raycheva, R. and Kostadinov, K.},
year = {2023},
month = 6,
pages = {S260}
}
@article{Iskrov_2024,
title = {Are the European reference networks for rare diseases ready to embrace machine learning? A mixed-methods study},
volume = {19},
issn = {1750-1172},
url = {https://doi.org/10.1186/s13023-024-03047-7},
doi = {10.1186/s13023-024-03047-7},
abstractnote = {The delay in diagnosis for rare disease (RD) patients is often longer than for patients with common diseases. Machine learning (ML) technologies have the potential to speed up and increase the precision of diagnosis in this population group. We aim to explore the expectations and experiences of the members of the European Reference Networks (ERNs) for RDs with those technologies and their potential for application.},
number = {1},
journal = {Orphanet Journal of Rare Diseases},
author = {Iskrov, Georgi and Raycheva, Ralitsa and Kostadinov, Kostadin and Gillner, Sandra and Blankart, Carl Rudolf and Gross, Edith Sky and Gumus, Gulcin and Mitova, Elena and Stefanov, Stefan and Stefanov, Georgi and Stefanov, Rumen},
year = {2024},
month = {1},
pages = {25}
}
@article{Kostadinov_2024a,
title = {Navigating Gene Therapy Access: The Case of Bulgaria in the Context of the EU Regulatory Landscape},
volume = {12},
rights = {http://creativecommons.org/licenses/by/3.0/},
issn = {2227-9032},
url = {https://www.mdpi.com/2227-9032/12/4/458},
doi = {10.3390/healthcare12040458},
abstractnote = {Gene therapies (GTs) have recently emerged as revolutionary personalized therapeutic options. Despite their promising potential, challenges such as uncertainty regarding long-term health benefits and safety, along with extreme price tags, pose significant obstacles to patient access. Within the EU, the European Medicines Agency plays a pivotal role with regards to GT market authorization. However, national authorities are responsible for pricing and reimbursement, which results in fragment patient access within the EU. This study aimed to provide an overview of the complex landscape of post-market authorization accessibility for GT products in Bulgaria, comparing it with neighboring EU countries. We applied a mixed-methods approach, including desk research, public data requests, and list price comparisons. As of 1 April 2023, 14 GTs had a valid market authorization at the EU level. In Bulgaria, Kymriah® was the only GT included in the Positive Drug List (PDL), with an official list price of EUR 335,636.94. Similar results were found in Romania, whereas five GTs were included in Greece’s PDL. Additionally, Zolgensma® was found accessible in Bulgaria through an alternative individual access scheme at an estimated price of EUR 1,945,000.00. In conclusion, this study emphasized targeted policy interventions to address health inequalities and to ensure timely access to GTs within the EU.},
number = {4},
journal = {Healthcare},
author = {Kostadinov, Kostadin and Marinova, Yuliyana and Dimitrov, Kostadin and Hristova-Atanasova, Eleonora and Iskrov, Georgi and Stefanov, Rumen},
year = {2024},
month = {1},
pages = {458},
language = {en}
}
@article{Raycheva_2024,
title = {Landscape analysis of available European data sources amenable for machine learning and recommendations on usability for rare diseases screening},
volume = {19},
issn = {1750-1172},
url = {https://doi.org/10.1186/s13023-024-03162-5},
doi = {10.1186/s13023-024-03162-5},
abstractnote = {Patient registries and databases are essential tools for advancing clinical research in the area of rare diseases, as well as for enhancing patient care and healthcare planning. The primary aim of this study is a landscape analysis of available European data sources amenable to machine learning (ML) and their usability for Rare Diseases screening, in terms of findable, accessible, interoperable, reusable(FAIR), legal, and business considerations. Second, recommendations will be proposed to provide a better understanding of the health data ecosystem.},
number = {1},
journal = {Orphanet Journal of Rare Diseases},
author = {Raycheva, Ralitsa and Kostadinov, Kostadin and Mitova, Elena and Iskrov, Georgi and Stefanov, Georgi and Vakevainen, Merja and Elomaa, Kaisa and Man, Yuen-Sum and Gross, Edith and Zschüntzsch, Jana and Röttger, Richard and Stefanov, Rumen},
year = {2024},
month = {4},
pages = {147},
language = {en}
}
@article{Bechev_2024,
title = {Anatomical Features and Morphometric Characteristics of the Sphenoidal Sinus in MRI Studies},
issn = {2168-8184},
url = {http://dx.doi.org/10.7759/cureus.66764},
doi = {10.7759/cureus.66764},
journal = {Cureus},
publisher = {Springer Science and Business Media LLC},
author = {Bechev, Kristian and Yotova, Nina I and Kostadinov, Kostadin and Ilyov, Ilko and Markov, Daniel},
year = {2024},
month = 8
}
@article{Kostadinov_2024b,
title = {Mapping the Policy Alternatives for Rare Cancer},
volume = {34},
rights = {https://creativecommons.org/licenses/by-nc/4.0/},
issn = {1101-1262, 1464-360X},
url = {https://academic.oup.com/eurpub/article/doi/10.1093/eurpub/ckae144.2172/7844803},
doi = {10.1093/eurpub/ckae144.2172},
journal = {European Journal of Public Health},
author = {Kostadinov, K and Hristova-Atanasova, E and Musurlieva, N and Iskrov, G and Stefanov, R},
year = {2024},
month = nov,
pages = {842-843},
language = {en}
}
@article{Petrova_2024,
title = {Exploring Empathy Dynamics in Virtual Patient Training},
volume = {34},
rights = {https://creativecommons.org/licenses/by-nc/4.0/},
issn = {1101-1262, 1464-360X},
url = {https://academic.oup.com/eurpub/article/doi/10.1093/eurpub/ckae144.1139/7844712},
doi = {10.1093/eurpub/ckae144.1139},
number = {Supplement_3},
journal = {European Journal of Public Health},
author = {Petrova, G and Kostadinov, K and Lalova, V and Ivanova, S},
year = {2024},
month = nov,
pages = {444-445},
language = {en}
}
@article{Goodwin_2024,
author = {John Goodwin, Maria O'Malley, Aine O'Donovan, Stephanie Allen, Margaret Curtin, Ryan Goulding, Gunter Groen, Sinead Heffernan, Svetla Ivanova, Joonas Korhonen, Astrid Jörns-Presentati, Kostadin Kostadinov, Valentina Lalova, James O'Mahony, Gergana Petrova, Ville Vainio and Mari Lahti},
title = {Staff Experiences of Working with Children and Adolescents Engaging in Behaviours That Challenge in Mental Health and Paediatric Inpatient Environments: A Qualitative Exploratory Study across Four European Countries},
journal = {Child Care in Practice},
volume = {0},
number = {0},
pages = {1--21},
year = {2024},
publisher = {Routledge},
doi = {10.1080/13575279.2024.2407085},
url = {https://doi.org/10.1080/13575279.2024.2407085},
eprint = {https://doi.org/10.1080/13575279.2024.2407085}
}
@article{Kostadinov_2025a,
title = {An Evaluation of Rare Cancer Policies in Europe: A Survey Among Healthcare Providers},
volume = {17},
rights = {http://creativecommons.org/licenses/by/3.0/},
issn = {2072-6694},
url = {https://www.mdpi.com/2072-6694/17/2/164},
doi = {10.3390/cancers17020164},
abstractnote = {Rare cancers, defined as those with an annual incidence of fewer than six cases per 100,000 individuals, are associated with significant health inequalities. This study aimed to assess the knowledge, attitudes, and perceptions of healthcare providers with expertise in rare cancers regarding the effectiveness of enacted or planned rare cancer policies across Europe. Between 25 March 2023 and 5 March 2024, we conducted an online survey targeting 738 healthcare providers affiliated with the European Reference Networks and the Organization of European Cancer Institutes, yielding 92 complete responses from 28 European countries (response rate: 12.5%). While a significant portion of respondents were unaware of their country’s legal definitions for rare cancers, 67.4% acknowledged that national cancer plans prioritized rare cancers. These plans received the highest ratings for their evidence-based interventions and monitoring efforts. The integration of rare cancer policies into broader oncology frameworks was the preferred policy model. National cancer registries were highly rated for confidentiality and validity but scored the lowest for cost-effectiveness. Government funding was deemed crucial for cancer screening programs. The disease burden and unmet health needs primarily influenced reimbursement decisions in the field of rare cancers. Respondents rated palliative care as more effective in adults with rare cancers compared to in children, particularly regarding symptom management. We confirmed significant variability in rare cancer policy evaluations across Europe, the necessity for a common EU-level definition for rare cancers, and a shift in reimbursement and policy framework models, highlighting the importance of policy integration and enhanced collaboration. However, given the limitations of the study, such as small sample size and possible unstudied confounding factors, we should interpret our findings with caution. A systematic policy review and multistakeholder assessment in the future could complement our results.},
number = {2},
journal = {Cancers},
author = {Kostadinov, Kostadin and Iskrov, Georgi and Musurlieva, Nina and Stefanov, Rumen},
year = {2025},
month = jan,
pages = {164},
language = {en}
}
@article{Dzhambazova_2025,
title = {The Socio-Economic Burden of Spinal Muscular Atrophy: A Cost-of-Illness Study in Bulgaria},
volume = {13},
rights = {http://creativecommons.org/licenses/by/3.0/},
issn = {2227-9032},
url = {https://www.mdpi.com/2227-9032/13/4/401},
doi = {10.3390/healthcare13040401},
abstractnote = {Background/Objectives: The objective of our study was to quantify the annual costs, from a societal perspective, encompassing direct health care costs, direct non-health care costs, and labor productivity losses associated with spinal muscular atrophy (SMA) patients in Bulgaria and their caregivers. Methods: We applied a prevalence-based, bottom-up costing methodology to assess the socio-economic burden of SMA from a societal perspective. We evaluated and summed up all costs for health services (diagnosis, treatment, follow-up, and rehabilitation), educational and social services, and formal and informal care in the community, as well as indirect costs due to the loss of productivity and work capacity of the SMA patients’ caregivers. Results: Nine parents of SMA patients provided consent and completed the study’s questionnaire. Two children had SMA type III, and seven had SMA type II. The median annual socio-economic burden per SMA patient was EUR 254,968.80. The high direct costs, primarily driven by drug expenses, and the substantial indirect costs resulting from the loss of productivity among informal caregivers were the primary causes. We found no utilization of social care and educational services. Conclusions: We emphasize the need for careful consideration of long-term outcomes, real-world data collection, and performance-based reimbursement. An ideal scenario could achieve these objectives in synergy. A second layer of policy actions and measures must address the unmet needs of SMA patients and their families using a holistic approach. The indirect costs associated with SMA, particularly the productivity loss of informal caregivers, underscore the need for comprehensive support programs.},
number = {4},
journal = {Healthcare},
author = {Dzhambazova, Elizabet and Kostadinov, Kostadin and Tsenkova-Toncheva, Lilia and Galabova, Fani and Ezeldin, Fares and Iskrov, Georgi and Stefanov, Rumen},
year = {2025},
month = jan,
pages = {401},
language = {en}
}
@article{Kostadinov_2025b,
title = {‘It Felt Like Finding Hope Only to Lose It Again’: A Grounded Theory Study of Rare Cancer Policies in Bulgaria},
issn = {2213-5383},
url = {https://www.sciencedirect.com/science/article/pii/S2213538325000141},
doi = {10.1016/j.jcpo.2025.100570},
abstractnote = {Rare cancers, defined by an annual incidence of fewer than 6 per 100,000 cases, pose significant challenges due to their complexity, lack of expertise, and limited treatment options. In Bulgaria, these challenges are compounded by limited resources, fragmented care, and outdated policies. This study investigates policy stakeholder perspectives to identify gaps and propose policy alternatives for rare cancer care in Bulgaria, with implications for the broader European Union (EU) context. A grounded theory qualitative research design was employed to explore stakeholder insights. Eight key stakeholders, including policymakers, healthcare providers, patient advocates, and pharmaceutical representatives, participated in semi-structured interviews. Data was analyzed through thematic coding to map policy gaps and develop viable alternatives. Stakeholders highlighted significant gaps in funding, access to innovative therapies, and care organization. Four policy approaches emerged: Liberal, advocating for inclusivity and decentralized care; Conservative, emphasizing cost control and centralization; Balanced, integrating elements of both; and Status Quo, retaining the current system. While centered on Bulgaria, these findings address universal challenges in rare cancer care, offering a framework adaptable to other EU countries. Adopting tailored policies can reduce disparities, improve patient outcomes, and align national strategies with EU objectives, particularly under Europe’s Beating Cancer Plan and the EU Cancer Mission.},
journal = {Journal of Cancer Policy},
author = {Kostadinov, Kostadin and Iskrov, Georgi and Musurlieva, Nina and Stefanov, Rumen},
year = {2025},
month = mar,
pages = {100570}
}
@article{Korhonen_2025,
title = {Fostering Mental Health Literacy Among Primary School Professionals: Evaluating the Impact of an Online Training Program ‘Well@School’},
volume = {22},
rights = {http://creativecommons.org/licenses/by/3.0/},
issn = {1660-4601},
url = {https://www.mdpi.com/1660-4601/22/3/435},
doi = {10.3390/ijerph22030435},
abstractnote = {Mental health challenges among children and adolescents have become a pressing global concern, particularly in the wake of the COVID-19 pandemic and ongoing geopolitical instability. Addressing these issues requires innovative, cost-effective strategies, with schools serving as critical platforms for mental health promotion. This study evaluates the impact of an online training program, Well@School, designed to enhance Mental Health Literacy (MHL) among primary school professionals in Finland, Lithuania, Bulgaria, Slovenia, and Greece. Using a descriptive, cross-sectional design with pre- and post-test assessments, the study involved 223 health, education, and social care professionals. The revised Mental Health Literacy Scale (MHLS) was employed to measure changes in MHL. Results indicated a significant positive effect, with an average increase of 4 points (2.5%) in MHLS scores post-course. Bayesian analysis further confirmed this improvement, showing a high probability (99.92%) of a positive impact, with the most likely gain ranging between 3 and 5 points. The findings underscore the potential of online training programs to enhance MHL among school professionals, thereby improving their capacity to support students’ mental health. This study highlights the importance of equipping primary school staff with the necessary skills to recognize and address mental health challenges, reduce stigma, and foster a supportive school environment.},
number = {3},
journal = {International Journal of Environmental Research and Public Health},
author = {Korhonen, Joonas and Lahti, Mari and Kostadinov, Kostadin and Erjavec, Karmen and Istomina, Natalja and Ivanova, Svetla and Lagiou, Areti and Lalova, Valentina and Makutienė, Monika and Notara, Venetia and Ollikkala, Hanna and Petrova, Gergana and Sakellari, Evanthia and Sukyte, Daiva and Laaksonen, Camilla},
year = {2025},
month = mar,
pages = {435},
language = {en}
}