Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations

Summary Points Brucellosis remains the commonest anthropozoonosis worldwide, and its treatment remains complex, requiring protracted administration of more than one antibiotic. In November 2006, a consensus meeting aimed at reaching a common specialist statement on the treatment of brucellosis was held in Ioannina, Greece under the auspices of the International Society of Chemotherapy and the Institute of Continuing Medical Education of Ioannina. The author panel suggests that the optimal treatment of uncomplicated brucellosis should be based on a six-week regimen of doxycycline combined either with streptomycin for 2–3 weeks, or rifampicin for six weeks. Gentamicin may be considered an acceptable alternative to streptomycin, while all other regimens/combinations should be considered second-line. The development of a common global therapeutic language for human brucellosis, and future, properly conducted clinical trials would definitely solve controversies regarding the disease.

The encouragement of the open access movement: an essential realm for health information professionals in the 21st century

According to the Bethesda Statement on Open Access Policy for libraries and the recommendations of the BOAI10, libraries and librarians have an important role to fulfil in the encouragement of open access. Taking into account the Competencies for Information Professionals of the 21st Century, elaborated by the Special Libraries Association, and the Librarians’ Competencies Profile for Scholarly Publishing and Open Access, we shall identify the competencies and new areas of knowledge and expertise that have been involved in the process of the development and upkeep of our institutional repository (Repositorio SSPA).

Profile of European radiotherapy departments contributing to the EORTC Radiation Oncology Group (ROG) in the 21st century.

PURPOSE: Since 1982, the Radiation Oncology Group of the EORTC (EORTC ROG) has pursued an extensive Quality Assurance (QA) program involving all centres actively participating in its clinical research. The first step is the evaluation of the structure and of the human, technical and organisational resources of the centres, to assess their ability to comply with the current requirements for high-tech radiotherapy (RT). MATERIALS AND METHODS: A facility questionnaire (FQ) was developed in 1989 and adapted over the years to match the evolution of RT techniques. We report on the contents of the current FQ that was completed online by 98 active EORTC ROG member institutions from 19 countries, between December 2005 and October 2007. RESULTS: Similar to the data collected previously, large variations in equipment, staffing and workload between centres remain. Currently only 15 centres still use a Cobalt unit. All centres perform 3D Conformal RT, 79% of them can perform IMRT and 54% are able to deliver stereotactic RT. An external reference dosimetry audit (ERDA) was performed in 88% of the centres for photons and in 73% for electrons, but it was recent (<2 years) in only 74% and 60%, respectively. CONCLUSION: The use of the FQ helps maintain the minimum quality requirements within the EORTC ROG network: recommendations are made on the basis of the analysis of its results. The present analysis shows that modern RT techniques are widely implemented in the clinic but also that ERDA should be performed more frequently. Repeated assessment using the FQ is warranted to document the future evolution of the EORTC ROG institutions.

Research Priorities for seabirds: Improving seabird conservation and management in the 21st century

Seabirds are facing a growing number of threats in both terrestrial and marine habitats, and many populations have experienced dramatic changes over past decades. Years of seabird research have improved our understanding of seabird populations and provided a broader understanding of marine ecological processes. In an effort to encourage future research and guide seabird conservation science, seabird researchers from 9 nations identified the 20 highest priority research questions and organized these into 6 general categories: (1) population dynamics, (2) spatial ecology, (3) tropho-dynamics, (4) fisheries interactions, (5) response to global change, and (6) management of anthropogenic impacts (focusing on invasive species, contaminants and protected areas). For each category, we provide an assessment of the current approaches, challenges and future directions. While this is not an exhaustive list of all research needed to address the myriad conservation challenges seabirds face, the results of this effort represent an important synthesis of current expert opinion across sub-disciplines within seabird ecology. As this synthesis highlights, research, in conjunction with direct management, education, and community engagement, can play an important role in facilitating the conservation and management of seabird populations and of the ocean ecosystems on which they and we depend.

Des bio-objets pour la bioéthique. Compte rendu de Bio-Objects: Life in the 21st Century

Compte-rendu / Review

Work and economic security in the 21st century

In recent decades there has been a transformation of two central concepts of modernity – labour and the household. Ela Bhatt – the founder of the Self-Employed Women’s Association of India (SEWA), has made an important contribution to this transformation. Through the emergence of unions such as SEWA, the notion of who represents labour is being broadened; the marginalised are finding an institutional voice. Increasingly, the household is being recognised as a site of both production and reproduction. SEWA is not a traditional trade union that aims, through collective bargaining with an employer, to improve its members’ wages and working conditions as sellers of their labour power. Instead, it aims to empower women economically in the informal economy by bringing them into the mainstream economy as owners of their labour. The union dimension of SEWA builds their collective power through struggle; the cooperative dimension translates their bargaining power into the economic and social development of its members and their community. Besides, Bhatt’s approach to the self-employed was a direct challenge to the ILO’s tripartism when it was established in the early seventies. The first part of the paper provides a short biography of Ela Bhatt, describes the origins of SEWA, analyses a ‘classification struggle’ over how and who is to define what a worker is. In the second part the author considers SEWAs innovative organizing strategy and is rethinking modernity in the labour context. In the conclusion the paper discusses the lessons that can be learnt from Ela Bhatt.

Climate change in the 21st century.

La preocupación por el cambio climático y por cómo afecta a nuestras comunidades, ecosistemas y vidas, ha aumentado mucho durante los últimos años del siglo XX y principios del siglo XXI. Este libro analiza la situación tanto desde aspectos científicos como sociales y nos facilita una descripción de los problemas y de lo que se puede hacer para contrarrestarlos local y globalmente. Los autores explican diferentes formas de estudiar el cambio climático con métodos interdisciplinarios para medir y preveer sus efectos futuros y adaptar nuestra sociedad, y analizan las conexiones entre el cambio climático y la salud de diferentes ecosistemas, el crecimiento económico y social, y el discurso global sobre el desarrollo sostenible.

Challenges and opportunities for intelligent buildings in the 21st Century

Intelligent buildings should be sustainable, healthy, technologically aware, meet the needs of occupants and business, and should be flexible and adaptable to deal with change. This means the processes of design, construction, commissioning and facilities management including post occupancy evaluation are all equally important. Buildings comprise many systems devised by many people and yet the relationship between buildings and people can only work satisfactorily if there is integrated team with a holistic vision. The address will discuss some trends in the design and management of intelligent buildings for this century.