Yordanka is responsible for the management of the Human Research Ethics Committee (HREC), Clinical Trials Sub-Committee, Animal Care and Ethics Committee (ACEC) and the Institutional Biosafety Committee (IBC). She provides strategic advice related to human ethics, animal ethics and biosafety areas. She is also responsible for developing and reviewing ethics policies, procedures and guidelines.
Dawson, AJ, Krastev, Y, Parsonage, WA, Peek, M, Lust, K & Sullivan, EA 2018, 'Experiences of women with cardiac disease in pregnancy: a systematic review and metasynthesis.', BMJ open, vol. 8, no. 9, pp. e022755-e022755.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE:Cardiac disease in pregnancy is a leading cause of maternal death in high-income countries. Evidence-based guidelines to assist in planning and managing the healthcare of affected women is lacking. The objective of this research was to produce the first qualitative metasynthesis of the experiences of pregnant women with existing or acquired cardiac disease to inform improved healthcare services. METHOD:We conducted a systematic search of peer-reviewed publications in five databases to investigate the decision-making processes, supportive strategies and healthcare experiences of pregnant women with existing or acquired cardiac disease, or of affected women contemplating pregnancy. Identified publications were screened for duplication and eligibility against selection criteria, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We then undertook a thematic analysis of the data relating to women's experiences extracted from each publication to inform new healthcare practices and communication. RESULTS:Eleven studies from six countries were included in our meta-synthesis. Four themes were revealed. Women with congenital and acquired heart disease identified situations where they had either taken charge of decision-making, lacked control or experienced emotional uncertainty when making decisions. Some women were risk aware and determined to take care of themselves in pregnancy while others downplayed the risks. Women with heart disease acknowledged the importance of specific social support measures during pregnancy and after child birth, and reported a spectrum of healthcare experiences. CONCLUSIONS:There is a lack of integrated and tailored healthcare services and information for women with cardiac disease in pregnancy. The experiences of women synthesised in this research has the potential to inform new evidence-based guidelines to support the decision-making needs of women with cardiac disease in pregnancy. Shared dec...
Luckett, T, Bhattarai, P, Phillips, J, Agar, M, Currow, D, Krastev, Y & Davidson, PM 2015, 'Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria', AUSTRALIAN HEALTH REVIEW, vol. 39, no. 5, pp. 552-560.View/Download from: UTS OPUS or Publisher's site
Frunza, M, Pascalev, A, Krastev, Y & Ilieva, A 2014, 'A Comparative Analysis of the Attitudes of Bulgarian and Romanian Stakeholders towards Living Organ Donation', Revista de Cercetare si Interventie Sociala, vol. 47, no. Decembrie, pp. 272-290.
Harris, MF, Lloyd, J, Krastev, Y, Fanaian, M, Davies, GP, Zwar, N & Liaw, S-T 2014, 'Routine use of clinical management guidelines in Australian general practice', AUSTRALIAN JOURNAL OF PRIMARY HEALTH, vol. 20, no. 1, pp. 41-46.View/Download from: Publisher's site
Harris, MF, Lloyd, J, Litt, J, van Driel, M, Mazza, D, Russell, G, Smith, J, Mar, CD, Denney-Wilson, E, Parker, S, Krastev, Y, Jayasinghe, UW, Taylor, R, Zwar, N, Wilson, J, Bolger-Harris, H & Waters, J 2013, 'Preventive evidence into practice (PEP) study: implementation of guidelines to prevent primary vascular disease in general practice protocol for acluster randomised controlled trial', Implementation Science, vol. 8, no. 1, pp. 1-10.View/Download from: UTS OPUS or Publisher's site
Background: There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD) and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession.
Comino, E, Davies, G, Krastev, Y, Haas, MR, Christl, B, Furler, J, Raymont, A & Harris, M 2012, 'A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care', BMC Health Services Research, vol. 12:415, pp. 1-9.View/Download from: UTS OPUS or Publisher's site
Background Although primary health care (PHC) is a key component of all health care systems, services are not always readily available, accessible or affordable. This systematic review examines effective strategies to enhance access to best practice processes of PHC in three domains: chronic disease management, prevention and episodic care. Methods An extensive search of bibliographic data bases to identify peer and non-peer reviewed literature was undertaken. Identified papers were screened to identify and classify intervention studies that measured the impact of strategies (singly or in combination) on change in use or the reach of services in defined population groups (evaluated interventions). Results The search identified 3,148 citations of which 121 were intervention studies and 75 were evaluated interventions. Evaluated interventions were found in all three domains: prevention (n?=?45), episodic care (n?=?19), and chronic disease management (n?=?11). They were undertaken in a number of countries including Australia (n?=?25), USA (n?=?25), and UK (n?=?15). Study quality was ranked as high (31% of studies), medium (61%) and low (8%). The 75 evaluated interventions tested a range of strategies either singly (n?=?46 studies) or as a combination of two (n?=?20) or more strategies (n?=?9). Strategies targeted both health providers and patients and were categorised to five groups: practice re-organisation (n?=?43 studies), patient support (n?=?29), provision of new services (n?=?19), workforce development (n?=?11), and financial incentives (n?=?9). Strategies varied by domain, reflecting the complexity of care needs and processes. Of the 75 evaluated interventions, 55 reported positive findings with interventions using a combination of strategies more likely to report positive results.
Christl, B, Lloyd, J, Krastev, Y, Litt, J & Harris, MF 2011, 'Preventing vascular disease Effective strategies for implementing guidelines in general practice', AUSTRALIAN FAMILY PHYSICIAN, vol. 40, no. 10, pp. 825-828.
Krastev, Y 2011, 'Institutionalisation of Bulgarian ethics committees: history and current status.', Indian journal of medical ethics, vol. 8, no. 3, pp. 148-151.
This paper provides an overview of the institutionalisation of the ethics review process in Bulgaria in accordance with the worldwide trend in establishment of ethics committees. Historical and current politico-legal changes influencing the work of ethics committees are analysed. The paper focuses on ethics committees which review biomedical research involving humans, with an emphasis on their composition, functions, training of members, and decision-making processes. Recent positive changes addressing insufficient training of ethics committees'members are highlighted. Recommendations are made for enhancement of the ethics review process and improved transparency.
Krastev, Y 2011, 'What role do research ethics committees play in Bulgarian clinical trial research?', Australasian Medical Journal, vol. 4, no. 8, pp. 461-462.
Krastev, Y, Grimm, M & Metcalfe, A 2011, 'Research governance and change in research ethics practices at a major Australian university.', Monash bioethics review, vol. 29, no. 4.
Recent revisions of the National Statement on Ethical Conduct in Human Research and the Australian Code for the Responsible Conduct of Research put a great emphasis on research governance. Institutional responsibility for the governance of the research is not limited only to the ethical review by the Human Research Ethics Committee (HREC), but also to the accountability for quality, safety, privacy, risk management and financial management of the research. Despite the development of proposed research governance frameworks, many Australian institutions do not have such structures in place and rely excessively on HRECs to perform administrative functions that are not their responsibility. In this paper we report on implementation of a research governance framework at University of New South Wales which led to reduced HREC workload and allowed more attention to its core functions. We present the approach undertaken by the university to separate the ethical review process by HREC from the research governance. We recommend that with proper research governance frameworks in place, the role of HRECs and the institutional responsibility of governance of the research can be defined clearly.