Daniela Taneva

Background: Nursing education in Europe has undergone substantial reform over the past two decades, primarily driven by the Bologna Process and European Union directives aiming to harmonise educational standards and facilitate professional mobility. However, growing evidence indicates that structural alignment has not fully translated into equivalent educational outcomes and competencies across countries. Methods: A scoping review was conducted following the Arksey and O’Malley framework and PRISMA-ScR guidelines. Three databases (PubMed, Scopus, and Google Scholar) were systematically searched for studies published between 2010 and 2025. A total of 1,492 records were identified, with 11 studies included in the final qualitative thematic analysis. Results: Significant heterogeneity was observed in curriculum structure (180–240 ECTS), clinical training requirements, and competency frameworks across European countries. Disparities were particularly evident in the implementation and quality assurance of clinical practice. In Bulgaria, key challenges include workforce shortages, limited clinical training capacity, underfunding, ageing student populations, and high emigration rates. Additionally, gaps were identified in the integration of evidence-based teaching, digital competencies, and interprofessional education. Conclusions: While progress towards harmonisation has been achieved, persistent systemic and functional disparities continue to limit educational quality and workforce mobility. Addressing these gaps requires integrated reforms combining educational innovation, health system investment, and targeted national workforce strategies, particularly in countries such as Bulgaria.

Background/Objectives: Maternal overweight and obesity are critical factors increasing the risk of various pregnancy complications. Maternal obesity can lead to fetal macrosomia and a heightened risk of intrauterine death, with long-term implications for the child’s health. This study aimed to analyze the incidence of obesity and its impact on pregnancy outcomes in women who delivered by cesarean section at the University Hospital “St. George”, Plovdiv. Methods: A single-center retrospective cohort study was conducted. The documentary method was used for gathering data. Records were randomly selected. The statistical methods used included mean values, confidence intervals (of mean), frequency, and the Kolmogorov–Smirnov test for normality of distribution. Data comparisons were performed using the Mann–Whitney test. Mean values of numerical variables were compared using the independent samples t-test. Results: In total, 46.36% of women in this study were affected by obesity to varying degrees, and the proportion of women who were overweight at the end of their pregnancy was 37.85%. In the studied cohort, 15.99% of women were affected by hypertensive complications. This significant prevalence of obesity highlights concerns regarding body weight among women of reproductive age. This study emphasized a strong correlation between maternal obesity, particularly severe obesity, and the occurrence of preeclampsia. Conclusions: In this study among women who delivered by cesarean section, a significant proportion of them were affected by overweight and obesity. Data for our country are insufficient, and a more in-depth study of this problem is needed. Future research should explore the long-term impacts of maternal obesity on the health of the mother and the newborn.

Background/Objectives: Maternal overweight and obesity are critical factors increasing the risk of various pregnancy complications. Maternal obesity can lead to fetal macrosomia and a heightened risk of intrauterine death, with long-term implications for the child’s health. The study aimed to analyse the incidence of obesity and its impact on pregnancy outcome in women delivered by caesarean section from 2021 to 2023 at the University Hospital "St. George", Plovdiv. Methods: This retrospective cohort study examined the prevalence of obesity and its effects on pregnancy outcomes among 494 women undergoing caesarean sections between 2021 and 2023. The documentary method was used for gathering data. Inclusion criteria were applied. Data were statistically analysed with SPSS v.23. Results: A significant prevalence of obesity in the studied cohort was revealed, highlighting concerns regarding body weight among women of reproductive age. The presence of preeclampsia in these mothers was associated with increased risks to newborns, including prematurity and low birth weight. The study emphasized a strong correlation between maternal obesity, particularly severe obesity, and the occurrence of preeclampsia. Conclusions: There is a noticeable trend towards increasing rates of pregnancy complications associated with maternal obesity. A substantial proportion of women delivered by caesarean section is affected by obesity and overweight. This study indicated a clear trend towards a rise in the frequency of preterm births linked to preeclampsia, as well as an increased incidence of hypertensive disorders in women with elevated BMI. Future research should explore the long-term impacts of maternal obesity on health.

Background/Objective: The priority task of each country is to ensure the protection of and improvement in its people’s health. One of the key aspects of health is related to food culture, consuming foods that ensure growth and normal development in a person and also prevent diseases. The consumption of foods that contain essential nutrients and functional foods, which include those containing probiotics, is the basis of a healthy diet. Methods: A structured anonymous interview was conducted with 90 parents from the Roma minority group to assess the nutritional culture of children from these families. The knowledge of Roma parents about probiotics, as well as their attitudes to apply them to their children, was examined. The survey was based on a questionnaire that was distributed among the respondents, Roma students, under the guidance of a mentor. Roma students study health specialties and are also participants in a Scholarship Programme. Results: We have established that the daily diet of children from this minority group consists of foods containing hydrogenated fats and sugar, which was indicated by 53.3% of respondents, and only 28.9% of respondents noted that their children consume fresh fruit every day. We have established that less than half of the children (35.6%) consume yoghurt daily as a source of valuable probiotics. We applied a nonparametric Kruskal–Wallis test and found statistically significant differences in the respondents’ knowledge of probiotics (χ² = 16.186, p = 0.001): those receiving secondary specialized education were better informed, but education has not affected their knowledge of the health benefits of probiotics (χ² = 5.462, p = 0.141). Children from minority groups tend to eat unhealthy foods. Conclusions: The role of Roma students studying health specialties as participants in the Scholarship Programme is to assist parents in forming a nutritional culture in their children. Roma students, due to their ethnic and cultural proximity and potential to be health professionals, contribute to sustainable health improvements among the Roma community as a whole.

Background: The integration of robotic surgery into modern medical practices has transformed operative methodologies, necessitating an evolution in the roles of operating room nurses. Methods: The method of literature review through deductive content analysis was used for the study. Three databases were selected according to criteria scale and possibility of free access – Science Direct, PubMed (Medline), Scopus. Keywords/phrases corresponding to MeSH terminology (Medical Subject Headings) have been defined - ''robot surgery'', ''nurses'', ''robot assisted surgery'', ''nursing care'', ''laparoscopic surgery'', ''nurse's role'' Results: The literature review yielded 10 selected publications for analysis. These publications covered diverse topics such as nurses' experiences in robotic-assisted surgery, perioperative nursing roles, and evaluations of nursing interventions in robotic procedures. Conclusion: Nurses play main roles in robotic surgery across preoperative, intraoperative and postoperative phases. As technology advances, nurses need continuous training and updated protocols to meet the specific demands of robotic procedures. The study emphasizes the wide-ranging responsibilities of nurses and calls for ongoing research to enhance their contribution to the evolving field of robotic surgery.

Introduction: The advancement of nursing science and practice necessitates the documentation of information, which is increasingly being recorded in electronic mediums due to the progress of information technology. Various countries around the world have implemented electronic nursing records (ENRs) or are in the process of implementing them. This study aims to ascertain the significance of electronic nursing records and consolidate their primary benefits for nursing. Methods: The study utilized an established scoping review methodology (Arksey and O‘Malley protocol; JBI method; PRISMA ScR (2018)). Results: Out of 6970 initial articles extracted from four databases, 36 were included in the study. Several essential elements for structuring, introducing, and emphasizing the importance of ENRs have been recognized, including the availability of standardized terminology, enhancement of nursing care quality, advancement of research activity, integration with electronic systems, optimization of healthcare, and conditions for ENR integration. Conclusions: Electronic nursing records are indispensable and beneficial for enhancing care quality, improving patient safety, and affirming the autonomy of the nursing profession.

Introduction: The advancement of nursing science and practice necessitates the documentation of information, which is increasingly being recorded in electronic mediums due to the progress of information technology. Various countries around the world have implemented electronic nursing records (ENRs) or are in a process of implementing it. This study aims to ascertain the significance of electronic nursing records and consolidate their primary benefits for nursing. Methods: The study utilized an established scoping review methodology (Arksey and O‘Malley protocol; JBI method; PRISMA 2020). Results: Out of 6970 initial articles extracted from 4 databases, 36 were included in the study. Several essential elements for structuring, introducing, and emphasizing the importance of ENRs have been recognized, including the availability of standardized terminology, enhancement of nursing care quality, advancement of research activity, integration with electronic systems, optimization of healthcare, and conditions for ENR integration. Conclusion: Electronic nursing records are indispensable and beneficial for enhancing care quality, improving patient safety, and affirming the autonomy of the nursing profession.

Over the past two decades, biologics (Bs) have been widely used in the treatment of patients with inflammatory joint diseases (IJD). The treatment of IJD aims at reducing disease progression, improving patients’ physical health and well-being, and achieving long-lasting remission or, at least, minimal disease activity. The introduction of Bs in rheumatology practice has significantly improved patients’ outcomes and prognosis. Their use, however, involves undertaking significant risks and challenges for both patients and medical teams. The purpose of this article is to provide a brief overview of the biological therapies currently approved for this group of diseases in Bulgaria and the indications for administration and monitoring of the most common side effects. The optimal administration of Bs is determined by treatment efficacy, discussion of benefits and risks, prevention of the possible development of severe adverse effects, administration regimens, and routes of administration of Bs. The analysis of major issues during treatment helps summarize the information on the use of Bs, thus increasing the possibility of managing the risks associated with their use by strengthening the engagement of healthcare experts and patients in the process of monitoring the impact of biological agents.

Introduction: The consequences of osteoporotic fractures are extremely detrimental to the individual as well as to society. Adopting effective preventative measures is a top public health priority. Aim: This paper deals with the development and validation of an osteoporosis knowledge measurement tool. Materials and methods: The study sample included 335 healthy women aged between 25 and 51 years. The osteoporosis knowledge measurement tool is an adapted version of the osteoporosis knowledge assessment tool (OKAT). To determine the validity and reliability of the tool, we examined the psychometric properties. Nonparametric methods were used for the statistical analysis. Results: Flesch reading ease index was 55.14. The Cronbach’s α value was 0.884. The corrected item-total correlations varied between 0.340 and 0.611. The items’ mean difficulty was 0.46. The mean discrimination index was 0.61. The mean score of the sample was M=12.64±5.164, a little bit higher than 50% of the success rate. Conclusion: The tool can be used in different settings to assess educational needs and plan interventions. The results indicate a need for educational and preventive initiatives.

Background: The aim of this review is to explore the role of artificial intelligence in the diagnosis of colorectal cancer, how it impacts CRC morbidity and mortality, and why its role in clinical medicine is limited. Methods: A targeted, non-systematic review of the published literature relating to colorectal cancer diagnosis was performed with PubMed databases that were scouted to help provide a more defined understanding of the recent advances regarding artificial intelligence and their impact on colorectal-related morbidity and mortality. Articles were included if deemed relevant and including information associated with the keywords. Results: The advancements in artificial intelligence have been significant in facilitating an earlier diagnosis of CRC. In this review, we focused on evaluating genomic biomarkers, the integration of instruments with artificial intelligence, MR and hyperspectral imaging, and the architecture of neural networks. We found that these neural networks seem practical and yield positive results in initial testing. Furthermore, we explored the use of deep-learning-based majority voting methods, such as bag of words and PAHLI, in improving diagnostic accuracy in colorectal cancer detection. Alongside this, the autonomous and expansive learning ability of artificial intelligence, coupled with its ability to extract increasingly complex features from images or videos without human reliance, highlight its impact in the diagnostic sector. Despite this, as most of the research involves a small sample of patients, a diversification of patient data is needed to enhance cohort stratification for a more sensitive and specific neural model. We also examined the successful application of artificial intelligence in predicting microsatellite instability, showcasing its potential in stratifying patients for targeted therapies. Conclusions: Since its commencement in colorectal cancer, artificial intelligence has revealed a multitude of functionalities and augmentations in the diagnostic sector of CRC. Given its early implementation, its clinical application remains a fair way away, but with steady research dedicated to improving neural architecture and expanding its applicational range, there is hope that these advanced neural software could directly impact the early diagnosis of CRC. The true promise of artificial intelligence, extending beyond the medical sector, lies in its potential to significantly influence the future landscape of CRC’s morbidity and mortality.