Donka Dimitrova

Donka Dimitrova
Medical University of Plovdiv · Department of Health Management and Health Economics, Faculty of Public health

PhD

About

102
Publications
30,117
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2,356
Citations
Additional affiliations
September 1993 - December 2014
Medical University of Plovdiv
Position
  • Professor (Associate)

Publications

Publications (102)
Article
Full-text available
Background: Online education became mandatory for many students during the Coronavirus disease 2019 (COVID-19) pandemic and blurred the distinction between settings where processes of stress and restoration used to take place. The lockdown also likely changed perceptions of the indoor acoustic environment (i.e., soundscape) and raised its importan...
Article
Background: The COVID-19 pandemic has profoundly changed people’s ability to recreate in public green spaces, which is likely to exacerbate the psychological impacts of the pandemic. In the current study, we seek to understand whether greenery can support mental health even with insufficient outdoor exposure in times of physical isolation from the...
Article
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Context: Traffic noise may contribute to depression and anxiety through higher noise annoyance (NA). However, little is known about noise sensitivity (NS) and mental health status as contextual factors. Objective: We tested three hypotheses: (1) Traffic noise is associated with mental ill-health through higher NA; (2) Mental ill-health and NS mo...
Article
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Background: In recent decades, many studies are focused on different training modalities comparison in patients with cardiac diseases. High intensity aerobic interval training (HIAIT) has been considered as an alternative approach to moderate-intensity continuous training (MICT) in rehabilitation of patients with chronic heart failure (CHF). Aim:...
Chapter
Hospital noise pollution is rising worldwide. The psycho-social stress caused by noise can lead to higher incidence of hypertension in nurses. The aim of this chapter was to explore the association between perceived occupational noise exposure and hypertension among hospital nurses. A cross-sectional questionnaire survey was carried out among 96 ho...
Article
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Background: The Ruminative Thought Style Questionnaire (RTSQ) is a multifaceted measure of general trait rumination. However, there is no instrument for measuring rumination in Bulgarian, which limits progress in the field. Aim: We aimed to validate the RTSQ in Bulgarian and examine its psychometric properties and contribution to several mental hea...
Article
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Together with the epidemic prevalence of diabetes mellitus (DM), the burden of this chronic metabolic disorder has serious impact on the quality of life of patients and reduces their life span. The objective of this study was to assess the impact of type 2 diabetes mellitus (T2DM) on the Quality of Life (QoL) by Audit of Diabetes-Dependent Quality-...
Chapter
To our knowledge, there has been no longitudinal study testing the direction of the causal relationships between mediators linking residential greenness and mental health. We carried out a questionnaire survey in the city of Plovdiv, Bulgaria. A group of students from the Medical University in Plovdiv were followed from October to December 2017. Me...
Chapter
Community pharmacies are one of the venues for promotion of healthy lifestyle among the general public. In Bulgaria, this subject still lacks adequate scientific grounding. The aim of this study was to investigate the involvement of Bulgarian community pharmacists in promotion of healthy lifestyle and hygiene in the context of the international mov...
Chapter
Due to the nature of their work, nurses are at risk of developing health anxiety, which has been observed in other populations involved in medical treatment. The association between occupational factors and health anxiety among Bulgarian nurses has not been investigated previously. The aim of this chapter was to identify associations between some d...
Chapter
Noise annoyance is arguably the most prevalent non-auditory outcome of residential noise exposure. Research on the subject in Bulgaria has suggested that annoyance is associated with considerable socioeconomic costs. At the same time, common intervention strategies fail to achieve sufficient reduction in environmental noise in major agglomerations,...
Article
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Growing amounts of evidence support an association between self-reported greenspace near the home and lower noise annoyance; however, objectively defined greenspace has rarely been considered. In the present study, we tested the association between objective measures of greenspace and noise annoyance, with a focus on underpinning pathways through n...
Article
Aims The study aimed to investigate the impact of different factors on health-related quality of life of patients with diabetes mellitus type 2 (DM) in primary care. Design and methods A cross-sectional multicentre study was conducted in a 540 random sample of adults with type 2diabetes mellitus. Social and demographic data, habits, cardiovascular...
Article
Background: Recent years have seen growing, but still tentative, evidence of the potential associations of environmental noise and air pollution with mental disorders. In the present study, we aimed to examine the associations between residential noise and air pollution exposures and general mental health in young adults with a focus on underlying...
Article
Background: A growing body of scientific literature indicates that urban green- and bluespace support mental health; however, little research has attempted to address the complexities in likely interrelations among the pathways through which benefits plausibly are realized. Objectives: The present study examines how different plausible pathways be...
Conference Paper
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Urban vegetation may have the potential to buffer both sound wave propagation and the negative psychological reactions to residential noise (i.e., noise annoyance). In the present study, we aimed to examine the association between greenspace and combined noise annoyance due to different sources, and to determine to what extent the effect of objecti...
Article
Multiple cross-sectional studies indicated an association between hypertension and road traffic noise and they were recently synthetized in a WHO systematic review. However, recent years have seen a growing body of high-quality, large-scale research, which is missing from the WHO review. Therefore, we aimed to close that gap by conducting an update...
Article
Background: Urban greenspace can benefit mental health through multiple mechanisms. They may work together, but previous studies have treated them as independent. Objectives: We aimed to compare single and parallel mediation models, which estimate the independent contributions of different paths, to several models that posit serial mediation compo...
Article
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Multiple risk factors for rheumatoid arthritis (RA) have been studied, but there is a dearth of research on occupational noise, which is highly prevalent in the United States (US). This study aimed to determine whether occupational noise exposure was associated with an elevated risk of prevalent RA in the US general population. Data from the 2011 -...
Article
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Голяма част от населението на Земята обитава градове, което, от една страна води до повишена експозиция на редица рискови фактори за здравето, а от друга – ограничава контакта с природата. Тъй като в България има оскъдни проучвания върху ползите от градските зелени площи, настоящият обзор има за цел да представи основните постановки на темата пред...
Article
Background: In a rapidly urbanizing world, many people have little contact with natural environments, which may affect health and well-being. Existing reviews generally conclude that residential greenspace is beneficial to health. However, the processes generating these benefits and how they can be best promoted remain unclear. Objectives: Durin...
Article
Given the ubiquitous nature of both noise pollution and mental disorders, their alleged association has not escaped the spotlight of public health research. The effect of traffic noise on mental health is probably mediated by other factors, which have not been elucidated sufficiently. Herein, we aimed to disentangle the pathways linking road traffi...
Article
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Introduction: Occupational noise exposure has been linked to work-related injuries. Strategies to control occupational hazards often rely on dose-response relationships needed to inform policy, but quantitative synthesis of the relevant literature has not been done so far. This study aimed to systematically review the epidemiological literature and...
Conference Paper
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Occupational noise has been linked to occupational injuries, with the underlying mechanisms being cognitive impairment, poor information processing, disturbed intelligibility of sounds and communication, etc. Strategies to control occupational hazards often rely on dose-response relationships needed to inform policy, but, to our knowledge, quantita...
Conference Paper
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This study aimed to explore the association between greenspace " exposure " and road traffic noise annoyance. We sampled 652 participants (15 – 25 years of age) at two randomly selected high schools and three universities in the city of Plovdiv, Bulgaria. Data on sociodemographic factors, road traffic noise annoyance (0 – 10 scale), noise sensitivi...
Article
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Introduction Occupational noise exposure and chronic obstructive pulmonary disease (COPD) are common in the United States, but so far their association has not been explored. Given the neuroimmunological effects of noise, such an association seems plausible. Thus, the present study aimed to explore the association of occupational noise exposure wit...
Article
Background Primary and synthetic research on road traffic noise (RTN) and blood pressure (BP) is abundant for adults, but not for children and adolescents. Given the conflicting evidence from primary studies, this study aimed to conduct an up-to-date systematic review with meta-analysis of the association between RTN and children’s BP, by using ad...
Chapter
Road traffic noise is an established risk factor for hypertension but little is known about ethnic differences in this effect. Ethnic minorities suffer environmental health disparities and may have higher environmental vulnerability. The aim of this chapter was to explore the risk of prevalent hypertension associated with road traffic noise exposur...
Article
Background: Evidence is emerging about the risk of obesity associated with traffic noise. The present study aimed to explore the association between self-reported occupational noise exposure and body mass index (BMI)-defined obesity in the US general population. Methods: This study is based on the 2014 National Health Interview Survey. Informati...
Article
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Noise exposure might be a risk factor for ischemic heart disease (IHD). Unlike residential exposure, however, evidence for occupational noise is limited. Given that high quality quantitative synthesis of existing data is highly warranted for occupational safety and policy, we aimed at conducting a systematic review and meta-analysis of the risks of...
Article
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Background Cardiovascular disease (CVD) is the main mortality cause worldwide. Noise and vibration are considered to be occupational risk factors, but little is known about their effects in Bulgaria, and among women and white-collar workers, globally. The aim of this study was to investigate the risk of prevalent CVD, associated with occupational n...
Article
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Background Noise pollution is considered a risk factor for ischemic heart disease (IHD). Both are highly prevalent in Bulgaria, but their association has not been studied sufficiently. Aim The aim of the present study was to examine the risk of IHD associated with road traffic (Lden) and lifetime occupational noise exposure (LONE) in a Bulgarian sa...
Article
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Traffic noise is an established risk factor for some cardiovascular diseases such as hypertension and ischaemic heart disease, but the evidence regarding stroke is still limited. In this study we aimed to systematically review the related epidemiological data and make a meta-analysis of the risk of stroke morbidity associated with road and air traf...
Article
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Type 2 diabetes mellitus (T2DM) is a growing public health problem in Bulgaria. While individual and lifestyle determinants have been researched, up to date there has been no study on environmental risks such as road traffic, noise and air pollution. As a first step towards designing a large scale population-based survey, we aimed at exploring the...
Article
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Background Sleep disturbance is a risk factor for somatic, psycho-social and spiritual dysfunction. It is also arguably the most deleterious effect of traffic noise pollution. Quantification of its burden is an anchor element of environmental policy making but no data are currently available for Bulgaria where the preponderance of dangerous nightti...
Article
Introduction Various neighbourhood features such as safety, green spaces, aesthetics and maintenance of the build environment, etc. are correlates of health-related behaviours and outcomes. Assessment of neighbourhood quality by raters using audit tools is objective way to obtain reliable information about those features, and the Irvine-Minnesota I...
Article
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Background: There has been increasing interest regarding the effects of air pollution on the risk of rheumatoid arthritis. Unfortunately , epidemiologic research on air pollution effects remains scant and offers conflicting results.
Article
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Introduction: In Bulgaria there is an epidemic of diabetes mellitus type2. This disease affects almost every aspect of the life of the patient. The available literature indicates that self-assessment of quality of life (QoL) has proved to be a powerful predictor of mortality and morbidity. The aim of the study was to assess the quality of life in p...
Article
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New epidemiological evidence is starting to emerge about the association between road traffic noise (RTN) exposure and markers of obesity, but results have been controversial. This study aimed to determine the association between RTN exposure and self-reported body mass index (BMI) in the city of Plovdiv, Bulgaria. A cross-sectional non-probabilist...
Article
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Background Dog guardianship (DG) is a novel behavioral preventive intervention against arterial hypertension (AH) based on increased opportunities for physical activity, positive neuroendocrine response to stress and improved social capital. Current biomedical mindset in Bulgaria, however, is mostly focused on treatment rather than prevention throu...
Article
Physical reduction of noise exposure is no longer considered the only preventive approach towards noise mitigation. Urban green spaces constitute an important factor in ameliorating the negative perception of noise in cities. The aim of this study was to explore the associations between several objective and self-rated indicators of interaction wit...
Article
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Physical reduction of noise exposure is no longer considered the only preventive approach towards noise mitigation. Urban green spaces constitute an important factor in ameliorating the negative perception of noise in cities. The aim of this study was to explore the associations between several objective and self-rated indicators of interaction wit...
Article
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BACKGROUND: Noise annoyance (NA) contributes considerably to the cumulative burden of disease from environmental noise in Europe. Exposure-response functions are the basis for assessment of its socioeconomic impact which is essential for environmental health policy. These functions have not been implemented in Bulgaria. AIM: In order to determine t...
Article
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Colorectal carcinoma (CRC) is the second most common cancer in Europe. Screening guidelines recommend a range of screening options that include faecal occult blood tests (FOBTs). The efficacy of FOBT-based CRC screening is dependent on the participation rate, thus emphasizing the importance of the latter. This study aimed at analysing the feasibili...
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There is now compelling evidence that screening for colorectal cancer may result in significantly reduced mortality. Screening tests for colorectal cancer are not systematically performed in Bulgaria. Aim. This article explores the effect of an educational intervention on the willingness of patients to participate in the screening for colorectal ca...
Article
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Road traffic noise is a widely studied environmental risk factor for ischaemic heart disease and myocardial infarction in particular. Given that myocardial infarction is a leading disability and mortality cause in Bulgaria and that a significant proportion of the urban population is exposed to high noise levels, quantification of the burden of dise...
Article
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Background: Given the prevalence of noise pollution in the Modern World and the large percentage of pregnant women exposed, considerable body of evidence has accumulated exploring the biological mechanisms and epidemiological risk for noise-attributed adverse birth outcomes. The findings are, however, discordant not only between primary studies, bu...
Article
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BACKGROUND: Self-medication with antibiotics is a major concern worldwide because of the high risks of antimicrobial resistance which may result in complicated courses of treatment, increased risk of death and excess costs to the healthcare systems. AIM: The aim was to study the attitudes and self-medication patterns as related to the use of antibi...
Article
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Ethoprofiles development is important for the successful and effective management of human resources. In this study, we investigated how medical professionals’ perceived the work-related requirements and their need for healthcare management education. Materials and methods: Qualitative interview study (N = 15). Consenting on group profiles health c...
Article
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BACKGROUND: Self-medication with antibiotics is a major concern worldwide because of the high risks of antimicrobial resistance which may result in complicated courses of treatment, increased risk of death and excess costs to the healthcare systems. AIM: The aim was to study the attitudes and self-medication patterns as related to the use of antib...
Article
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The Noise Sensitivity Scale Short Form (NSS-SF), developed in English as a more practical form of the classical Weinstein NSS, has not to date been validated in other cultures, and its validity and reliability have not yet been confirmed. This study aimed to validate NSS-SF in Bulgarian and to demonstrate its applicability. The study comprised test...
Article
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The aim of this work is to present a demonstrative project for general practitioners (GPs) advanced training on the risky problems, related to air pollution and health. For the project implementation we chose the second largest city in Bulgaria - typical urban environment. To participate in the project we invited GPs from 10 practices, located in d...
Article
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Introduction Chronic psychological distress can cause suppression of the hypothalamic-pituitary-testicular axis and thus lead to male hypogonadism, which is associated with psycho-social dysfunction, chronic diseases, and as a result, considerable economic costs. Conversely, noise is a prototypal environmental stressor with ever-growing importance,...
Article
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Background: Many women are exposed daily to high levels of occupational and residential noise, so the effect of noise exposure on pregnancy should be considered because noise affects both the fetus and the mother herself. However, there is controversy in the literature regarding the adverse effects of occupational and residential noise on pregnant...
Article
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Birth weight is extensively investigated as an outcome of interacting with greenery in mothers’ living environment, because it is one of the major causes for neonatal and infant mortality, as well as a correlate of some adverse effects in childhood and beyond. Conversely, in modern urban-ecological systems the access to greenery is limited. The aim...
Article
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Noise pollution is one of the four major pollutions in the world. In order to implement adequate strategies for noise control, assessment of traffic-generated noise is essential in city planning and management. The aim of this study was to determine whether space syntax could improve the predictive power of noise simulation. This paper reports a re...
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Background: Noise sensitivity (NS) is a key construct in the fields of hygiene, planning and occupational medicine. It refers to a personality trait representing the reactivity to noise and is associated with various psycho-physiological health outcomes. This study aimed to develop a shorter version of the original Noise Sensitivity Questionnaire (...
Article
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There is increasing evidence of a positive relation between green spaces in people's living environment and self-reported indicators of physical and mental health. However, to this moment health anxiety has not been contextualized in the light of the restorative and anxiolytic experiences of urban nature nor has it been studied in reference to the...