Chlamydiaceae and Chlamydia-like organisms in free-living small mammals in Europe and Afghanistan.

Few data are available on the occurrence of chlamydial infections in wild small mammals. We investigated the significance of free-living small mammals as reservoirs or transmission hosts for microorganisms of the phylum/class Chlamydiae. We obtained 3,664 tissue samples from 911 animals in Switzerland, Germany, Austria, the Czech Republic, and Afghanistan. Samples included internal organs (n = 3,652) and feces (n = 12) from 679 rodents (order Rodentia) and 232 insectivores (order Soricomorpha) and were tested by three TaqMan® real-time PCRs specific for members of the family Chlamydiaceae and selected Chlamydia-like organisms such as Parachlamydia spp. and Waddlia spp. Only one of 911 (0.11%) animals exhibited a questionable positive result by Chlamydiaceae-specific real-time PCR. Five of 911 animals were positive by specific real-time PCR for Parachlamydia spp. but could not be confirmed by quantitative PCR targeting the Parachlamydia acanthamoebae secY gene (secY qPCR). One of 746 animals (0.13%) was positive by real-time PCR for Waddlia chondrophila. This result was confirmed by Waddlia secY qPCR. This is the first detection of Chlamydia-like organisms in small wildlife in Switzerland. Considering previous negative results for Chlamydiaceae in wild ruminant species from Switzerland, these data suggest that wild small mammals are unlikely to be important carriers or transport hosts for Chamydiaceae and Chlamydia-like organisms.

Geographic variation in the frequency of isolation and fluconazole and voriconazole susceptibilities of Candida glabrata: an assessment from the ARTEMIS DISK Global Antifungal Surveillance Program.

Geographic differences in frequency and azole resistance among Candida glabrata may impact empiric antifungal therapy choice. We examined geographic variation in isolation and azole susceptibility of C. glabrata. We examined 23 305 clinical isolates of C. glabrata during ARTEMIS DISK global surveillance. Susceptibility testing to fluconazole and voriconazole was assessed by disk diffusion, and the results were grouped by geographic location: North America (NA) (2470 isolates), Latin America (LA) (2039), Europe (EU) (12 439), Africa and the Middle East (AME) (728), and Asia-Pacific (AP) (5629). Overall, C. glabrata accounted for 11.6% of 201 653 isolates of Candida and varied as a proportion of all Candida isolated from 7.4% in LA to 21.1% in NA. Decreased susceptibility (S) to fluconazole was observed in all geographic regions and ranged from 62.8% in AME to 76.7% in LA. Variation in fluconazole susceptibility was observed within each region: AP (range, 50-100% S), AME (48-86.9%), EU (44.8-88%), LA (43-92%), and NA (74.5-91.6%). Voriconazole was more active than fluconazole (range, 82.3-84.2% S) with similar regional variation. Among 22 sentinel sites participating in ARTEMIS from 2001 through 2007 (84 140 total isolates, 8163 C. glabrata), the frequency of C. glabrata isolation increased in 14 sites and the frequency of fluconazole resistance (R) increased in 11 sites over the 7-year period of study. The sites with the highest cumulative rates of fluconazole R were in Poland (22% R), the Czech Republic (27% R), Venezuela (27% R), and Greece (33% R). C. glabrata was most often isolated from blood, normally sterile body fluids and urine. There is substantial geographic and institutional variation in both frequency of isolation and azole resistance among C. glabrata. Prompt species identification and fluconazole susceptibility testing are necessary to optimize therapy for invasive candidiasis.

Why do differences in the degree of fiscal decentralization endure?

A notable difference between the U.S. and many countries in Europe is in the degree of fiscal decentralization. Regional (and local) governments in the U.S. have significant autonomy in setting their own taxes and determining how to spend their revenues. This is not true of their counterparts in Spain, France, the United Kingdom, Czech Republic and many other European countries. In recent years, many countries formerly subject to dictatorshipsor communism have been considering decentralizing fiscal responsibility to sub-national governments as part of the process of democratization (see Bird and Ebel, forthcoming). Yet, much of Europe remains immune to adopting effective decentralization in which sub-national units have true taxing authority.

Bortezomib(Velcade (R))-Thalidomide-Dexamethasone (VTD) Is Superior to Thalidomide-Dexamethasone (TD) In Patients with Multiple Myeloma (MM) Progressing or Relapsing After Autologous Transplantation.

Introduction: The Thalidomide-Dexamethasone (TD) regimen has provided encouraging results in relapsed MM. To improve results, bortezomib (Velcade) has been added to the combination in previous phase II studies, the so called VTD regimen. In January 2006, the European Group for Blood and Marrow Transplantation (EBMT) and the Intergroupe Francophone du Myélome (IFM) initiated a prospective, randomized, parallel-group, open-label phase III, multicenter study, comparing VTD (arm A) with TD (arm B) for MM patients progressing or relapsing after autologous transplantation. Patients and Methods: Inclusion criteria: patients in first progression or relapse after at least one autologous transplantation, including those who had received bortezomib or thalidomide before transplant. Exclusion criteria: subjects with neuropathy above grade 1 or non secretory MM. Primary study end point was time to progression (TTP). Secondary end points included safety, response rate, progression-free survival (PFS) and overall survival (OS). Treatment was scheduled as follows: bortezomib 1.3 mg/m2 was given as an i.v bolus on Days 1, 4, 8 and 11 followed by a 10-Day rest period (days 12 to 21) for 8 cycles (6 months) and then on Days 1, 8, 15, 22 followed by a 20-Day rest period (days 23 to 42) for 4 cycles (6 months). In both arms, thalidomide was scheduled at 200 mg/Day orally for one year and dexamethasone 40 mg/Day orally four days every three weeks for one year. Patients reaching remission could proceed to a new stem cell harvest. However, transplantation, either autologous or allogeneic, could only be performed in patients who completed the planned one year treatment period. Response was assessed by EBMT criteria, with additional category of near complete remission (nCR). Adverse events were graded by the NCI-CTCAE, Version 3.0.The trial was based on a group sequential design, with 4 planned interim analyses and one final analysis that allowed stopping for efficacy as well as futility. The overall alpha and power were set equal to 0.025 and 0.90 respectively. The test for decision making was based on the comparison in terms of the ratio of the cause-specific hazards of relapse/progression, estimated in a Cox model stratified on the number of previous autologous transplantations. Relapse/progression cumulative incidence was estimated using the proper nonparametric estimator, the comparison was done by the Gray test. PFS and OS probabilities were estimated by the Kaplan-Meier curves, the comparison was performed by the Log-Rank test. An interim safety analysis was performed when the first hundred patients had been included. The safety committee recommended to continue the trial. Results: As of 1st July 2010, 269 patients had been enrolled in the study, 139 in France (IFM 2005-04 study), 21 in Italy, 38 in Germany, 19 in Switzerland (a SAKK study), 23 in Belgium, 8 in Austria, 8 in the Czech republic, 11 in Hungary, 1 in the UK and 1 in Israel. One hundred and sixty nine patients were males and 100 females; the median age was 61 yrs (range 29-76). One hundred and thirty six patients were randomized to receive VTD and 133 to receive TD. The current analysis is based on 246 patients (124 in arm A, 122 in arm B) included in the second interim analysis, carried out when 134 events were observed. Following this analysis, the trial was stopped because of significant superiority of VTD over TD. The remaining patients were too premature to contribute to the analysis. The number of previous autologous transplants was one in 63 vs 60 and two or more in 61 vs 62 patients in arm A vs B respectively. The median follow-up was 25 months. The median TTP was 20 months vs 15 months respectively in arm A and B, with cumulative incidence of relapse/progression at 2 years equal to 52% (95% CI: 42%-64%) vs 70% (95% CI: 61%-81%) (p=0.0004, Gray test). The same superiority of arm A was also observed when stratifying on the number of previous autologous transplantations. At 2 years, PFS was 39% (95% CI: 30%-51%) vs 23% (95% CI: 16%-34%) (A vs B, p=0.0006, Log-Rank test). OS in the first two years was comparable in the two groups. Conclusion: VTD resulted in significantly longer TTP and PFS in patients relapsing after ASCT. Analysis of response and safety data are on going and results will be presented at the meeting. Protocol EU-DRACT number: 2005-001628-35.

New considerations on the management of osteoporosis in Central and Eastern Europe (CEE): summary of the "3rd Summit on Osteoporosis-CEE", November 2009, Budapest, Hungary.

INTRODUCTION: In November 2009, the "3rd Summit on Osteoporosis-Central and Eastern Europe (CEE)" was held in Budapest, Hungary. The conference aimed to tackle issues regarding osteoporosis management in CEE identified during the second CEE summit in 2008 and to agree on approaches that allow most efficient and cost-effective diagnosis and therapy of osteoporosis in CEE countries in the future. DISCUSSION: The following topics were covered: past year experience from FRAX® implementation into local diagnostic algorithms; causes of secondary osteoporosis as a FRAX® risk factor; bone turnover markers to estimate bone loss, fracture risk, or monitor therapies; role of quantitative ultrasound in osteoporosis management; compliance and economical aspects of osteoporosis; and osteoporosis and genetics. Consensus and recommendations developed on these topics are summarised in the present progress report. CONCLUSION: Lectures on up-to-date data of topical interest, the distinct regional provenances of the participants, a special focus on practical aspects, intense mutual exchange of individual experiences, strong interest in cross-border cooperations, as well as the readiness to learn from each other considerably contributed to the establishment of these recommendations. The "4th Summit on Osteoporosis-CEE" held in Prague, Czech Republic, in December 2010 will reveal whether these recommendations prove of value when implemented in the clinical routine or whether further improvements are still required.

Graduate labor mismatch in Central and Eastern Europe

[cat] Utilitzant l’enquesta REFLEX/HEGESCO, aquest article explora la probabilitat de desajustament entre educació i treball a l’Europa de l’Est i Central. Classifiquem els països en dos grups segons la transparència dels títols educatius al mercat de treball. Polònia, la República Txeca i Eslovènia formen el grup amb més transparència, i Hongria, Lituània i Estònia formen el grup amb més opacitat. Analitzem tres tipus de desajustaments: el vertical (infra‐, sobre‐educació), l’horitzontal (desajustament del camp d’estudi) i el desajust en habilitats. Focalitzem l’anàlisi en l’efecte dels camps d’estudi i les competències dels individus en el desajustament del mercat laboral en aquests països. Els resultats mostren importants diferències entre els dos grups de països estudiats.

Graduate labor mismatch in Central and Eastern Europe

[cat] Utilitzant l’enquesta REFLEX/HEGESCO, aquest article explora la probabilitat de desajustament entre educació i treball a l’Europa de l’Est i Central. Classifiquem els països en dos grups segons la transparència dels títols educatius al mercat de treball. Polònia, la República Txeca i Eslovènia formen el grup amb més transparència, i Hongria, Lituània i Estònia formen el grup amb més opacitat. Analitzem tres tipus de desajustaments: el vertical (infra‐, sobre‐educació), l’horitzontal (desajustament del camp d’estudi) i el desajust en habilitats. Focalitzem l’anàlisi en l’efecte dels camps d’estudi i les competències dels individus en el desajustament del mercat laboral en aquests països. Els resultats mostren importants diferències entre els dos grups de països estudiats.

La juventud ante la ciudadanía

En este artículo se presenta los resultados de un trabajo por encuesta realizado para el estudio de la ciudadanía con alumnado de educación secundaria obligatoria. Trata, en concreto, de la elaboración de un cuestionario para identificar los elementos que constituyen el concepto de ciudadanía del alumnado de secundaria. En primer lugar se presenta la fundamentación teórica y el modelo de ciudadanía del que se parte, en base a la cual se concretan los objetivos, el contenido, y la estructura interna del cuestionario. Tras un estudio piloto del mismo y, una vez realizadas las modificaciones oportunas, se construye el cuestionario a aplicar. El cuestionario, que aparece en el anexo del articulo, se ha aplicado a una muestra de 333 personas de seis centros de educación secundaria obligatoria con población multicultural. Finalmente, se presentan los resultados obtenidos en el estudio, así como las evidencias de las características técnicas del instrumento elaborado.

La juventud ante la ciudadanía

En este artículo se presenta los resultados de un trabajo por encuesta realizado para el estudio de la ciudadanía con alumnado de educación secundaria obligatoria. Trata, en concreto, de la elaboración de un cuestionario para identificar los elementos que constituyen el concepto de ciudadanía del alumnado de secundaria. En primer lugar se presenta la fundamentación teórica y el modelo de ciudadanía del que se parte, en base a la cual se concretan los objetivos, el contenido, y la estructura interna del cuestionario. Tras un estudio piloto del mismo y, una vez realizadas las modificaciones oportunas, se construye el cuestionario a aplicar. El cuestionario, que aparece en el anexo del articulo, se ha aplicado a una muestra de 333 personas de seis centros de educación secundaria obligatoria con población multicultural. Finalmente, se presentan los resultados obtenidos en el estudio, así como las evidencias de las características técnicas del instrumento elaborado.

Cap a una ciutadania intercultural. Un tema emergent a la recerca educativa

En aquest article oferim una aproximació a l'estudi de la ciutadania intercultural des de l'investigació educativa. Per això, hem resumit en primer lloc, els nous plantejaments de la ciutadania que fonamentnen la investigació realitzada pel GREDI en aquests darrers anys. El nostre model recull, com trets claus de la ciutadania que pretenim es desenvolupi des de l'educació, el fet de ser, alhora, activa i responsable, crítica i intercultural; desenvolupada en l'àmbit local però oberta a nivells més amplis. Posteriorment, l'article sintetitza algunes de les investigacions dutes a terme en aquest camp. La segona part d'aquest article ofereix un resum d'una de les investigacions realitzades pel GREDI i que ha permès diagnosticar els elements que configuren el contepcte i la pràctica de la ciutadania en els joves de 14 a 16 anys a Barcelona. Es conclou assenyalant els elements significatius que poden trobar-se en les invesetigacions presentades i que permeten dibuixar les línees de progrés per a qui desitja endinsar-se en la investigació en aquesta àrea temàtica.

Risc i seguretat en el context educatiu: un debat necessari en el marc d'una educació orientada al desenvolupament de la ciutadania

En aquest article se profunditza en torna a les repercusions dels nous escenaris teòrics relacionats amb el desenvolupament del concepte de risc en la segona modernitat. Les tradicions d'anàlisi de la violència escolar o de la gestió positiva del conflicte, han constituït-del fet encara avui dia constitueixen- referents importants per a l'anàlisi de la seguretat en els centres educatius, però el desenvolupament d'un nou concepte de seguretat humana sorgit a partir dels Programes de les Nacions Unides pel Desenvolupament (PNUD) proporciona un marc de reflexió més ampli. Partint d'aquesta perspectiva, se pretèn operativitzar un model que permeti comprendre com es construeix la percepció de risc en el context escolar.