Strategic investment in tuberculosis control in the Republic of Bulgaria

As Bulgaria transitions away from Global Fund grant, robust estimates of the comparative impact of the various response strategies under consideration are needed to ensure sustained effectiveness of the tuberculosis (TB) programme. We tailored an established mathematical model for TB control to the epidemic in Bulgaria to project the likely outcomes of seven intervention scenarios. Under existing programmatic conditions projected forward, the country's targets for achieving TB elimination in the coming decades will not be achieved. No interventions under consideration were predicted to accelerate the baseline projected reduction in epidemiological indicators significantly. Discontinuation of the 'Open Doors' program and activities of non-governmental organisations would result in a marked exacerbation of the epidemic (increasing incidence in 2035 by 6-8% relative to baseline conditions projected forward). Changing to a short course regimen for multidrug-resistant TB (MDR-TB) would substantially decrease MDR-TB mortality (by 21.6% in 2035 relative to baseline conditions projected forward). Changing to ambulatory care for eligible patients would not affect TB burden but would be markedly cost-saving. In conclusion, Bulgaria faces important challenges in transitioning to a primarily domestically-financed TB programme. The country should consider maintaining currently effective programs and shifting towards ambulatory care to ensure program sustainability

Mentaliseringsbasert psykoterapi - En mulig tilnærming til behandling av pasienter med unnvikende og paranoide personlighetsforstyrrelser?

The present thesis explores whether mentalization-based psychotherapy (MBT), on theoretical grounds, may be applicable in the treatment of patients with avoidant and paranoid personality disorders. We describe the development of mentalization and the principles of MBT. Characteristics of the two diagnostic groups in question are presented and compared with borderline personality disorder, for which the effectiveness of MBT has been empirically documented. We discuss whether patients with avoidant and paranoid personality disorders have mentalizing failures and whether MBT might be an applicable treatment alternative for such disorders. If so, we further explore weather modifications are needed in order to increase the effectiveness of MBT treatment for the relevant diagnostic groups. Our analyses indicate that both patients with avoidant and patients with paranoid personality disorders consistently manifest mentalizing failures. We therefore suggest that MBT might be useful for these patients, but in order to achieve optimal results, the treatment needs to be adapted. Finally, we provide some ideas for potential modifications for each personality disorder. As our conclusions are only tentative, there is a need of studies, empirically addressing the effect of MBT for avoidant and paranoid personality disorders

80-year Anniversary of Prof. Dr. Ec. Scs. Petko Dimitrov Petkov

80-year Anniversary of Prof. Dr. Ec. Scs. Petko Dimitrov Petkov