The Jews of Eastern Europe

by J. H. Adeney

Major challenges in clinical management of TB/HIV co-infected patients in Eastern Europe compared with Western Europe and Latin America.

INTRODUCTION Rates of both TB/HIV co-infection and multi-drug-resistant (MDR) TB are increasing in Eastern Europe (EE). Data on the clinical management of TB/HIV co-infected patients are scarce. Our aim was to study the clinical characteristics of TB/HIV patients in Europe and Latin America (LA) at TB diagnosis, identify factors associated with MDR-TB and assess the activity of initial TB treatment regimens given the results of drug-susceptibility tests (DST). MATERIAL AND METHODS We enrolled 1413 TB/HIV patients from 62 clinics in 19 countries in EE, Western Europe (WE), Southern Europe (SE) and LA from January 2011 to December 2013. Among patients who completed DST within the first month of TB therapy, we linked initial TB treatment regimens to the DST results and calculated the distribution of patients receiving 0, 1, 2, 3 and ≥4 active drugs in each region. Risk factors for MDR-TB were identified in logistic regression models. RESULTS Significant differences were observed between EE (n=844), WE (n=152), SE (n=164) and LA (n=253) for use of combination antiretroviral therapy (cART) at TB diagnosis (17%, 40%, 44% and 35%, p<0.0001), a definite TB diagnosis (culture and/or PCR positive for Mycobacterium tuberculosis; 47%, 71%, 72% and 40%, p<0.0001) and MDR-TB prevalence (34%, 3%, 3% and 11%, p <0.0001 among those with DST results). The history of injecting drug use [adjusted OR (aOR) = 2.03, (95% CI 1.00-4.09)], prior TB treatment (aOR = 3.42, 95% CI 1.88-6.22) and living in EE (aOR = 7.19, 95% CI 3.28-15.78) were associated with MDR-TB. For 569 patients with available DST, the initial TB treatment contained ≥3 active drugs in 64% of patients in EE compared with 90-94% of patients in other regions (Figure 1a). Had the patients received initial therapy with standard therapy [Rifampicin, Isoniazid, Pyrazinamide, Ethambutol (RHZE)], the corresponding proportions would have been 64% vs. 86-97%, respectively (Figure 1b). CONCLUSIONS In EE, TB/HIV patients had poorer exposure to cART, less often a definitive TB diagnosis and more often MDR-TB compared to other parts of Europe and LA. Initial TB therapy in EE was sub-optimal, with less than two-thirds of patients receiving at least three active drugs, and improved compliance with standard RHZE treatment does not seem to be the solution. Improved management of TB/HIV patients requires routine use of DST, initial TB therapy according to prevailing resistance patterns and more widespread use of cART.

The jews of eastern Europe

by Arnold D. Margolin. Foreword by James W. Gerard

The Role of Corruption in Explaining the Electoral Success of New Political Parties in Central and Eastern Europe

More than 20 years after the collapse of the Soviet Union, the electoral volatility in Central and Eastern Europe (CEE) is still remarkably high. A considerable part of the volatility derives from the votes for new political parties, since they are very often on the winning side of elections. This paper examines corruption as potential determinant of their electoral success. It argues that the effect of corruption is twofold: On the onehand, the historically-grown corruption level reduces the electoral success of new political parties due to strong clientelist structures that bind the electorate to the established parties. On the other hand, an increase of the perceived corruption above the traditional corruption level leads to a loss of trust in the political elite and therefore boosts the electoral success of new competitors. A statistical analysis of all democratic elections in CEE between 1996 and 2011 confirms these two counteracting effects.

Dry grasslands of Central-Eastern and South-Eastern Europe shaped by environmental heterogeneity and human land use – Editorial to the 10th Dry Grassland Special Feature

Der diesjährige 10. Trockenrasen-Sonderteil von Tuexenia beginnt mit einem Bericht über die aktuellen Aktivitäten der European Dry Grassland Group (EDGG). Zunächst geben wir einen Überblick über die Entwicklung der Mitgliederzahl. Dann berichten wir vom letzten European Dry Grassland Meeting in Tula (Russland, 2014) und vom letzten European Dry Grassland Field Workshop in Navarra (Spanien, 2014) und informieren über künftige Veranstaltungen der EDGG. Anschließend erläutern wir die Publikationsaktivitäten der EDGG. Im zweiten Teil des Editorials geben wir eine Einführung zu den fünf Artikeln des diesjährigen Trockenrasen-Sonderteils. Zwei Artikel beschäftigen sich mit der Syntaxonomie von Trockenrasen in Ost- bzw. Südosteuropa: der eine präsentiert erstmalig eine Gesamtklassifikation der Trockenrasengesellschaften Serbiens und des Kosovo während der andere Originalaufnahmen sub-montaner Graslandgesellschaften aus den bislang kaum untersuchten ukrainischen Ostkarpaten analysiert. Zwei weitere Artikel behandeln Trockenrasen-Feuchtwiesen-Komplexe im ungarischen Tiefland: Der eine behandelt den Einfluss der Landnutzung auf die Phytodiversität von Steppen und Feuchtwiesen, der andere den Einfluss von Niederschlagsschwankungen in einem Zeitraum von drei Jahren auf die Ausbildung salzbeeinflusster Steppen-Feuchtwiesen-Komplexe. Der fünfte Artikel analysiert landnutzungsbedingte Veränderungen des Graslands des Tsentralen-Balkan-Nationalparks in Bulgarien über einen Zeitraum von 65 Jahren

Corruption and the Electoral Support of New Political Parties in Central and Eastern Europe

More than 20 years after the collapse of the Soviet Union, the electoral volatility in Central and Eastern Europe (CEE) is still remarkably high. A considerable part of the volatility derives from the votes for new political parties, since they are very often on the winning side of elections. This article examines corruption as a potential determinant of their electoral support. It argues that the effect of corruption is twofold: on the one hand, the historically derived corruption level reduces the electoral support for new political parties due to strong clientelist structures that bind the electorate to the established parties. On the other hand, an increase in perceived corruption above the traditional corruption level leads to a loss of trust in the political elite and therefore boosts the electoral support for new competitors. A statistical analysis of all democratic elections in CEE between 1996 and 2013 confirms these two counteracting effects.

Major Challenges in Clinical Management of TB/HIV Coinfected Patients in Eastern Europe Compared with Western Europe and Latin America.

OBJECTIVES Rates of TB/HIV coinfection and multi-drug resistant (MDR)-TB are increasing in Eastern Europe (EE). We aimed to study clinical characteristics, factors associated with MDR-TB and predicted activity of empiric anti-TB treatment at time of TB diagnosis among TB/HIV coinfected patients in EE, Western Europe (WE) and Latin America (LA). DESIGN AND METHODS Between January 1, 2011, and December 31, 2013, 1413 TB/HIV patients (62 clinics in 19 countries in EE, WE, Southern Europe (SE), and LA) were enrolled. RESULTS Significant differences were observed between EE (N = 844), WE (N = 152), SE (N = 164), and LA (N = 253) in the proportion of patients with a definite TB diagnosis (47%, 71%, 72% and 40%, p<0.0001), MDR-TB (40%, 5%, 3% and 15%, p<0.0001), and use of combination antiretroviral therapy (cART) (17%, 40%, 44% and 35%, p<0.0001). Injecting drug use (adjusted OR (aOR) = 2.03 (95% CI 1.00-4.09), prior anti-TB treatment (3.42 (1.88-6.22)), and living in EE (7.19 (3.28-15.78)) were associated with MDR-TB. Among 585 patients with drug susceptibility test (DST) results, the empiric (i.e. without knowledge of the DST results) anti-TB treatment included ≥3 active drugs in 66% of participants in EE compared with 90-96% in other regions (p<0.0001). CONCLUSIONS In EE, TB/HIV patients were less likely to receive a definite TB diagnosis, more likely to house MDR-TB and commonly received empiric anti-TB treatment with reduced activity. Improved management of TB/HIV patients in EE requires better access to TB diagnostics including DSTs, empiric anti-TB therapy directed at both susceptible and MDR-TB, and more widespread use of cART.

Innovation in Eastern Europe : a case study of Czech Republic

In this study we evaluate innovative performance of the economies of Central and Eastern Europe (CEE) based on the available statistics of innovation processes. We compare such country-level indicators as educational levels, investments in R&D, FDI, trade and licensing flows, patents and scientific articles, and find that the most developed CEE economies are also the most innovative. At the same time, as supported by the results of the interviews in Czech Republic, one of the top performers in the CEE region, its economy is facing a number of challenges that are similar to other middle-income countries around the world. We suggest addressing these challenges from the prospective of the Middle Income Trap, when a middle-income economy to sustain growth must learn to compete with advanced economies in high-skill innovation. Development of effective innovation policy should be a priority for the CEE countries to escape from the middle income trap.

Post Roads, Central and Eastern Europe Regions, 1802 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: A new map of the post roads of Germany and Hungary with the adjacent kingdoms, republics and states : from the large map published at Vienna, with additions and improvements by J. Enouy, geogr. It was published by Laurie & Whittle, 53 Fleet Street in 1802. Scale [ca. 1:2,500,000]. Covers the Central and Eastern Europe regions. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Europe Lambert Conformal Conic coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, postal roads, territorial and administrative boundaries, shoreline features, and more. Relief shown pictorially.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.