Hristina Stoynova

Background/Objectives: Pediatric clinical trials require decisions that balance the need for evidence with treatment safety, informed participation, and the burden of trial procedures. This study aimed to explore physicians’ perspectives on the ethical and practical challenges of pediatric clinical trials and on opportunities for improvement, with particular attention to informed family decision-making, ethical acceptability, and practical feasibility. Methods: Semi-structured, in-person interviews were conducted with 13 physicians involved in pediatric care. Responses were typed by the interviewer during each interview and subsequently confirmed by participants. Open-ended questions addressed recruitment, informed consent, children’s participation in decisions, ethical concerns, and trial procedures. The responses were analyzed using reflexive thematic analysis to identify recurring themes and divergent points of view. Results: Three overarching themes were identified: (1) building an informed family decision; (2) judging whether a trial is acceptable for a child; and (3) making pediatric trials feasible in practice. Physicians reported parental concerns about investigational treatments, difficulty explaining complex information, and limited time for consent discussions. They supported involving children according to their ability to understand, although views differed on when children should take a more active role. Assessments of trial acceptability focused on potential benefit, adverse effects, placebo use when established treatment is available, and additional procedures. Recruitment challenges, restrictive eligibility criteria, frequent visits, and administrative workload affected feasibility. Suggested improvements included clearer information for families, simpler protocols, flexible visit schedules, and administrative support. Conclusions: Physicians viewed informed family decisions, careful assessment of benefit and risk, and manageable trial procedures as interrelated considerations for pediatric trial participation. These findings identify practical priorities for trial design and communication with families.

Virtual patients (VPs) and artificial intelligence (AI) are being implemented in pharmacy education across various countries in order to learn different techniques to improve communication skills, identify drug-related problems, assess the pharmacist’s role in the self-medication process or assess students’ knowledge acquisition. The objective of this study was to assess the benefits of integrating VPs and AI in pharmacy education, particularly their impact on pharmacy students’ knowledge and skills in self-medication counselling. A literature search was conducted across PubMed, Scopus and Web of Science databases. Studies focused on the integration of VPs and AI tools in pharmacy education and their impact on students’ knowledge, counselling and communication skills related to self-medication, were evaluated. Eligible studies were full-text, peer-reviewed research articles published in English. No restrictions were applied regarding publication year. A total of 857 articles were identified through electronic databases and 9 met the inclusion criteria. Six studies were conducted in the USA and one each in Portugal, Sweden and Indonesia. Most studies employed a pre–post-study design. Six studies utilized VP simulations, while the remaining three implemented AI-based tools. Key outcomes covered in analyzed articles included improvements in knowledge score, communication, and consultation skills, along with positive perceptions, including increased student satisfaction and confidence levels. Using VP simulations and AI tools in pharmacy education could positively impact students by enhancing their knowledge as well as their confidence and counselling skills.

Background and Objectives: Turner Syndrome (ORPHA:881) is a rare genetic disorder characterized by complete or partial loss of one of the X chromosomes (monosomy X). In addition to specific somatic features and hormonal imbalances, affected individuals often face challenges related to quality of life (QoL). The aim of this review is to analyze the available scientific literature on the QoL in patients with Turner Syndrome. Materials and Methods: A systematic literature review was conducted using the databases Scopus, PubMed, and Web of Science, using specific key words. The search was performed from the date of inception of each database through July 2025. Only full-text articles in English assessing the QoL in individuals with Turner Syndrome were included. Results: The search identified 843 records, of which 12 studies met the eligibility criteria and were included in the final analysis. These studies consistently reported significant differences in the QoL between patients with Turner Syndrome and healthy controls. Factors such as hormone replacement therapy, social support, and comorbid conditions were highlighted as key determinants of QoL. Conclusions: Assessing the QoL in patients with Turner Syndrome is essential for understanding their overall adaptation and the need for a multidisciplinary approach to care. The findings highlight the necessity of additional long-term studies to better understand the impact of various therapeutic strategies on the QoL. The systematic review of the literature underscores the importance of a multidisciplinary approach in the care of patients with Turner Syndrome and the need for individualized therapeutic strategies aimed at improving their health-related quality of life.