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Interviews and other interesting materials
Interviews and other interesting materials

Contraception does not affect the country's birth rate

Dr Ivan DikovINTERVIEW OF BFPA'S LONG-TERM CONSULTANT DR. IVAN DIKOV FOR WORLD CONTRACEPTION DAY (in Bulgarian)

 

PECULIARITIES IN THE SPECIFIC DIAGNOSTICS AND INTERPRETATION IN HIV INFECTION

Prof. Radka ArgirovaПроф. д.м.н. Радка Аргирова, вирусолог, Аджъбадем Сити Клиник ДКЦ и Токуда Болница, София

Преди да  опишем особеностите в специфичната диагностика на HIV-инфекцията,  ще дефинираме някои основни понятия от областта HIV/СПИН. HIV-инфекцията се определя като периодът от момента на заразяване с HIV до смъртта при естествен ход на инфекцията. СПИН е последната фаза на HIV инфекцията, като съществуват ясно определени критерии – клинични и лабораторни -  за поставяне на диагнозата  СПИН. Симптомите на остра/ хронична HIV инфекция при възрастни и деца са описани в Приложение 1 към чл.10,т.1 на Наредба N 47 на МЗ, обнародвана в ДВ, бр.103/29.12.2009 г.  В Приложение 2 към чл.10,т.2 на същата Наредба са описани индикаторните заболявания за СПИН.
Прозоречен период е времето между заразяването с HIV и появата в кръвта на биохимично измерими маркери на инфекцията (най-често  антитела, но като маркери могат да бъдат използвани и вирусспецифични антигени, както и вирусна РНК). Сероконверсия е моментът, в който се откриват биохимично измеримите маркери (най-често антитела към HIV, които най-вероятно се формират по-рано, отколкото се откриват). Практически, прозоречният период е времето между заразяването и откриването на антивирусните антитела. HIV антителата се откриват най-рано 2 седмици след заразяването, в 60-65% от случаите се откриват след 4 седмици, в 80% - след 6 седмици, в 90% - след 8 седмици и в 95-98% - след 12 седмици. При съвременните тестове от 4-то поколение освен анти-р24 антителата, се открива и р24 антигена – около 4-5 дни преди появата на антителата. Най-ранно определимият лабораторен маркер е HIV РНК, която пък се открива около 6-7 дни преди р24 антигена. Следователно, няма никакъв смисъл да се търсят специфични маркери на HIV преди началото на втората седмица след заразяването.

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CYTOMEGALOVIRUS AND PREGNANCY

Prof. Radka ArgirovaПроф. ДМН Радка Аргирова, вирусолог, Аджибадем СитиКлиник Токуда Болница, Клинична Лаборатория

Цитомегаловирусът (CMV) е член на семейството на херпесните вируси. В това семейство влизат около 200 вируса, но осем от тях причиняват заболявания у човека – херпес симплекс типове 1 и 2 – HSV-1, HSV-2, херпес зостер вирус – VZV, Епщайн-Бар вирус – EBV, както и неотдавна изолираните човешки херпесни вируси – типове 6,7 и 8 – HHV-6, HHV-7 и HHV-8. Инфекциите с тези вируси се характеризират със следните отличителни черти:
- Масовост и  най-често субклинично протичане, особено когато засягат детската възраст;
- Инфекцията с тях остава доживотна, обикновено латентна при нормално функционираща имунна система, като отделните представители на семейството се различават по начина и мястото на установяване на латентност;
- Показват постоянна тенденция за увеличаване честотата и тежестта на клиничната манифестация при реактивация;
- Реактивират се при имуносупресивни състояния, като н тези случаи се превръщат в сериозен и трудeн за  лечение клиничен проблем.
С цитомегаловирус (CMV) са заразени около 85% от възрастните хора у нас. Те носят IgG антитела.Вирусът се предава особено добре чрез слюнката, поради което бременните жени и близките им трябва да бъдат съветвани да не целуват новородените по устата, както и да бъдат с повишено внимание към личната си хигиена. Прясно заразяване на бременната с вируса води до пренасянето му и заразяване на развиващото се бебе, а по време на  раждане заразяването става чрез урина, цервикални и вагинални екскреции. Глобалните  данни показват, че 0.2% -  2%  от новородените в световен мащаб се раждат заразени с CMV. Инфекцията е по-честа в развиващите се страни и при лоши условия на живот. Вродената CMV инфекция е най-важната инфекциозна причина за вродена глухота, малформации, микроцефалия, забавено умствено развитие и способности за учене и запаметяване у децата. В по-късна възраст децата с вродена CMV инфекция имат проблеми с функционирането на имунната система, изразяващи се в повишена заболяемост.

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Telling a personal story is an effective way of communicating an idea or a message

Sofia, December 2018 

It is through stories that people can relate to one another as fellow human beings
                                                                    Paul Browde, MD, psychiatrist and storyteller

Listening shapes telling. We have to want to understand people and listen openly without prejudgments and assumptions
                                                                                                                                   Murray Nossel, PhD, psychologist and story teller

Recently by invitation of BFPA in the frame of our project “Changing the narrative. The story tellers” Paul and Murray were in Bulgaria and conducted training on listening and storytelling. For all participants meeting them both was extremely useful not only from professional point of view, but also in personal perspective. These three days were a life changing experience that unlocked new senses and changed our sensibility and worldview. Via this interview we want to give you an opportunity to have a glimpse at their way of thinking and to feel them as people.

Murray Nossel

 

Murray Nossel, PhD, is the founder and director of Narativ, a company with offices in New York and London that specializes in storytelling training. Originally a clinical psychologist, Murray is an Academy Award® nominated filmmaker, trainer, and motivational speaker. Murray is on the teaching faculty of the Program of Narrative Medicine at Columbia University. He is the founder of the World Mother Storytelling Project.

 Paul Browde

 

Paul Browde, MD is a psychiatrist, storyteller and couples’guide, trained as an actor at the Drama Studio London. He has led several projects, teaching listening and storytelling for advocacy purposes in Africa and Eastern Europe. He has taught in the Columbia University Narrative Medicine Masters' Program.
 

 

If you have to present yourself in one sentence or in 3 words, by choice, how would it sound?
Paul: A spirit, a human being, with a story.
Murray: I am a listener and storyteller.

You are conducting trainings and work in different parts of the world, touching different cultures. Are there differences in the way people are telling stories and communicating and to what degree they understand each other?
Paul: People have very different ideas and beliefs about the world. People also have many different opinions about the way things should be. However, once people are able to tell a story, without commentary or adding their opinion, then stories are stories, and people connect to one another. It is through stories that people can relate to one another as fellow human beings.
Murray: Only on the most superficial level, people’s stories have different content. Some live in hot places, others cold, some are rich, others are poor, some are educated, others are not. People have different positions on the axes of power, education, wealth, health etc. In my work I encounter people who have lives of comfort and apparent ease. Others are subjected to wars, natural disasters, epidemics, extreme poverty   and serious illness. 
I am not minimizing these differences, but underneath it all, we are all the same. We all want the same thing – to be happy – and our lives are governed by the same themes: Love, rage, valor, compassion …. We all have the same destiny – we are born and we are going to die. No being can escape this inevitable fate.
I define story as an account of what happened.  When people simply give a sensory account of their experience, i.e. what they have seen, smelled, tasted, touched, they are able to cut across divides. We have even been able to teach our method to people across the world, in multiple languages, even those with intellectual disabilities.

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Latest news

Youth Аdvocacy Тeams for Better Access to Health Services and Information

Banya, August 22-24, 2022

Together with 14 young people from Blagoevgrad, Dupnitsa and Sofia, we worked on implementation of  two campaigns - in Blagoevgrad and Dupnitsa - to support vulnerable communities and improve young people's access to SRH  information and services. The main topics of the training focused on advocacy skills, organizing and conducting local campaigns and how to use “photovoice” method. Examples of already developed campaigns from the previous training in Dolna Banya were also presented.  The idea was to involve new participants in various activities in different locations, as well as to connect young people to help and learn from each other in the process of preparing and implementing advocacy campaigns.
The young people with the help of the health mediators, defined as a problem the poor access to information and health services, ensuring a healthy and fulfilling way of life for the young people from the Roma community in Blagoevgrad. They have the ambition to contribute for raising the public awareness towards these problems in Blagoevgrad, and also to draw the attention of the institutions to the problem.

 
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Dolna Banya, July, 11-13, 2022

Talks, questions, sharing about the huge gap between how young people define health care problems and how adults see them; about the lack of trust in the institutions regarding their reaction in cases of violence, even for registered ones! We discussed that deep in our national psychologyit is stated that talking about mental health and "shameful" illnesses is not good, when it happens at all it is hidden, superficial and stigmatizing, and thus leads to dramatic complications for people in personal plan. We also talked about the nuances of "advocacy" and "lobbying."
We from the BFPA team think that we are really lucky for working with a group of wonderful young people - from the youth clubs in Pernik and Breznik and from the American University in Blagoevgrad (AUBG). The workshop was held July 11-13, 2022, in Dolna Banya. Our work topics are advocacy and campaigning.

 
How Health Knowledge to Get to Roma Communities

Dolna Banya, July 5-7, 2022

After two days fulfilling work on leadership and advocacy with unbelievable roma young people from Lom, Dupnitsa and Byala Slatina problems in respective communities were identified. Discussions in searching the best decisions were led; image of the target groups and stakeholders was created and the needed communication skills on leading a successful campaign were discussed. Role plays, practical cases and individual video presentations with messages were commented.
The health mediators Tanya Kirilova from Lom, Daniela Ljubenova from Dupnitza and Mirena Bocheva from Byala Slatina are real mentors for the young people from the communities they work for. The three of them, together with Dr. Rada Stamenkova, Pavlina Filipova and Ralitsa Zgalevska from BFPA team actively contributed to support the motivated and well-prepared young people, enthusiastic to advocate for better health of people from their communities. In the coming months the team will continue to work on building their capacity as leaders and to help them with expertise and guidelines.

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Interviews and other interesting materials