Do Instructional Videos on Sputum Submission Result in Increased Tuberculosis Case Detection? A Randomized Controlled Trial.

OBJECTIVE We examined the effect of an instructional video about the production of diagnostic sputum on case detection of tuberculosis (TB), and evaluated the acceptance of the video. TRIAL DESIGN Randomized controlled trial. METHODS We prepared a culturally adapted instructional video for sputum submission. We analyzed 200 presumptive TB cases coughing for more than two weeks who attended the outpatient department of the governmental Municipal Hospital in Mwananyamala (Dar es Salaam, Tanzania). They were randomly assigned to either receive instructions on sputum submission using the video before submission (intervention group, n = 100) or standard of care (control group, n = 100). Sputum samples were examined for volume, quality and presence of acid-fast bacilli by experienced laboratory technicians blinded to study groups. RESULTS Median age was 39.1 years (interquartile range 37.0-50.0); 94 (47%) were females, 106 (53%) were males, and 49 (24.5%) were HIV-infected. We found that the instructional video intervention was associated with detection of a higher proportion of microscopically confirmed cases (56%, 95% confidence interval [95% CI] 45.7-65.9%, sputum smear positive patients in the intervention group versus 23%, 95% CI 15.2-32.5%, in the control group, p <0.0001), an increase in volume of specimen defined as a volume ≥3ml (78%, 95% CI 68.6-85.7%, versus 45%, 95% CI 35.0-55.3%, p <0.0001), and specimens less likely to be salivary (14%, 95% CI 7.9-22.4%, versus 39%, 95% CI 29.4-49.3%, p = 0.0001). Older age, but not the HIV status or sex, modified the effectiveness of the intervention by improving it positively. When asked how well the video instructions were understood, the majority of patients in the intervention group reported to have understood the video instructions well (97%). Most of the patients thought the video would be useful in the cultural setting of Tanzania (92%). CONCLUSIONS Sputum submission instructional videos increased the yield of tuberculosis cases through better quality of sputum samples. If confirmed in larger studies, instructional videos may have a substantial effect on the case yield using sputum microscopy and also molecular tests. This low-cost strategy should be considered as part of the efforts to control TB in resource-limited settings. TRIAL REGISTRATION Pan African Clinical Trials Registry PACTR201504001098231.

Composition Space Analysis in the Development of Copper Molybdate Hybrids Decorated by a Bifunctional Pyrazolyl/1,2,4-Triazole Ligand

A bitopic ligand, 4-(3,5-dimethylpyrazol-4-yl)-1,2,4-triazole (Hpz-tr) (1), containing two different heterocyclic moieties was employed for the design of copper(II)–molybdate solids under hydrothermal conditions. In the multicomponent CuII/Hpz-tr/MoVI system, a diverse set of coordination hybrids, [Cu(Hpz-tr)2SO4]·3H2O (2), [Cu(Hpz-tr)Mo3O10] (3), [Cu4(OH)4(Hpz-tr)4Mo8O26]·6H2O (4), [Cu(Hpz-tr)2Mo4O13] (5), and [Mo2O6(Hpz-tr)]·H2O (6), was prepared and characterized. A systematic investigation of these systems in the form of a ternary crystallization diagram approach was utilized to show the influence of the molar ratios of starting reagents, the metal (CuII and MoVI) sources, the temperature, etc., on the reaction products outcome. Complexes 2–4 dominate throughout a wide crystallization range of the composition triangle, while the other two compounds 5 and 6 crystallize as minor phases in a narrow concentration range. In the crystal structures of 2–6, the organic ligand behaves as a short [N–N]-triazole linker between metal centers Cu···Cu in 2–4, Cu···Mo in 5, and Mo···Mo in 6, while the pyrazolyl function remains uncoordinated. This is the reason for the exceptional formation of low-dimensional coordination motifs: 1D for 2, 4, and 6 and 2D for 3 and 5. In all cases, the pyrazolyl group is involved in H bonding (H-donor/H-acceptor) and is responsible for π–π stacking, thus connecting the chain and layer structures in more complicated H-bonding architectures. These compounds possess moderate thermal stability up to 250–300 °C. The magnetic measurements were performed for 2–4, revealing in all three cases antiferromagnetic exchange interactions between neighboring CuII centers and long-range order with a net moment below Tc of 13 K for compound 4.

Emerging arboviruses in Harris County, Texas

Harris County, which includes Houston, Texas, is an endemic and epidemic area for two viruses transmitted by arthropods (arboviruses). These viruses are maintained in cycles involving mosquitoes and wild birds, and transmission to humans is accidental. The majority of human infections is asymptomatic or may result in a flu-like syndrome. However, some infections can result in meningitis or encephalitis. These neuroinvasive infections may cause death, and those who survive may experience serious neurological complications requiring costly and lengthy medical care. The most important arboviruses in terms of morbidity are St. Louis encephalitis (SLEV) and West Nile (WNV) viruses. In fact, Harris County reports more SLEV encephalitis cases than any other county in the U.S. Most arboviral human cases occur from July through September, when mosquitoes are most active. Those at risk for encephalitis and death are the elderly and those with a history of hypertension or immunosuppresion. There is no specific treatment and no human vaccines are commercially available in the U.S. The approach for control of arboviruses in Harris County during epidemics is multidisciplinary and executed by several agencies. It includes surveillance, vector control, and educational messages for the population. Prevention of outbreaks consists of elimination of the vector and its breeding grounds, and practicing personal protective measures to prevent exposure to mosquitoes. ^ Current findings indicate that mosquito-borne viruses other than SLEV and WNV could pose an additional threat for the population. Eastern equine encephalitis virus (EEEV) activity has been detected in dogs and sentinel chickens in Houston and surrounding areas. Several serotypes of dengue virus have caused recent outbreaks in south Texas, and some locally-acquired cases have been detected in Houston. Since the clinical presentation of all arboviruses that cause encephalitis is very similar, and current surveillance is focused on detecting SLEV and WNV, there is a possibility that other arboviruses could be present in the area but are not being detected. Additionally, Harris County's ample annual rainfall and flooding problems, warm weather, multiple mosquito species, local and migrating birds that are susceptible to arboviral infection, and a constant flow of goods and travelers from many parts of the world could favor the emergence or re-emergence of other arboviruses. ^ The aims of this project were to determine if other arboviruses were circulating in the county, to assess the knowledge and attitudes about mosquito-borne viruses in a sample of the population, and to conduct an analysis of the initial WNV epidemic in Harris County. Through the retrospective analysis of clinical specimens collected during the 2002-2005 epidemic seasons, serologic evidence of dengue infection was detected suggesting the possibility that this virus may be co-circulating with SLEV and WNV. A cross-sectional survey revealed high awareness about arboviruses but not a consistent use of protective measures to avoid mosquitoes. The third component for this project included a retrospective review and geographical analysis of the 2002 WNV epidemic. ^ Overall, this study documented valuable information about the dengue virus, a potentially emerging arbovirus in Texas, revealed the need for more educational preventative programs, reinforced the value of mosquito and avian surveillance, and indicated the importance of continuing to investigate the factors that contribute to the development of outbreaks. ^

Commentary on "When Policy Opportunity is not Enough: College Access and Enrollment Patterns among Texas Percent Plan Eligible Students"

Invited commentary on "When Policy Opportunity is not Enough: College Access and Enrollment Patterns among Texas Percent Plan Eligible Students" by Catherine Horn and Stella Flores.

The Children’s Bureau’s Role in Promoting Parent Engagement and Family Support: A Brief History and Current Efforts

Over the years, federal child welfare policy has supported parent engagement and family support strategies through various Children’s Bureau funded state formula grant programs, research and demonstration discretionary grants, and technical assistance. This article highlights programs funded by two federal laws, Promoting Safe and Stable Families and the Child Abuse Prevention and Treatment Act, and Children’s Bureau’s efforts to test innovations and disseminate knowledge about promising and evidence-based practices regarding parent engagement and family support. The article begins with a brief legislative history and then describes several grant programs that are supported by the legislation. The article concludes with lessons learned and a discussion of the new opportunities for system changes through the Title IV-E Waiver Demonstration projects.

Metropolitan Observatory for Street Children and Youngsters: A Chilean Experience of an Innovative Model

In Chile, street children and youngsters' situations have changed significantly over the last decades. The Metropolitan Observatory is an innovative organization that makes it possible to follow this velnerable group. The Observatory is becoming a pioneering actor in the subject, thanks to the participative work and agreed consensus of different institutions involved. The aim of this paper is to introduce the innovative cross-sectoral work done by the Metropolitan Observatory for street children and youth.

Memoria escrita de las lenguas en Misiones: Un análisis discursivo. 16H297

Reuniones mensuales de discusión de lecturas y procesos conceptuales. Agenda de las reuniones: a) Puesta en balance de las tramas conjeturales en torno del objeto Memoria–Lenguas–Escritura; b) Intensificación del trabajo con la instancia enunciativa (Autoría), las modalidades genéricas y estrategias del gesto memorioso; c) Ponderación de la configuración del archivo en base al acervo documental encontrado hasta el momento; d) Vinculación del proyecto con el proceso de cursado de la Maestría en Semiótica Discursiva del Lic. Di Iorio.

Del libro didáctico a la secuencia de formación: propuestas de intervención pedagógica

Esta nueva propuesta se constituye como una continuidad del proyecto El libro didáctico como material para la enseñanza de portugués LE - Perspectivas políticas: industria editorial y trabajo simbólico, culminado en 2011 y al mismo tiempo como una nueva etapa de investigación y producción de los materiales de estudio del PLE. El trabajo de análisis de los libros didácticos de portugués LE nos proporcionó bases teóricometodológicas para la reflexión sobre las configuraciones textuales, discursivas y semióticas en torno de la enseñanza del portugués como lengua extranjera en la Argentina y en nuestra región. Sin embargo, consideramos que nuestra tarea de investigación debe avanzar hacia una propuesta de intervención pedagógica que ayude a explorar nuevas estrategias y prácticas de comprensión y producción, a partir de materiales que favorezcan aprendizajes significativos. En esta instancia se propone profundizar las confrontaciones críticas entre las matrices discursivas de los LD y las experiencias educativas posibles de desplegarse en las aulas, tratando de eludir los modos estereotipados de abordar la enseñanza del PLE esto es, reelaborar y resignificar series de ejercitación gramaticales automatizadas y repetitivas; revisar y reinventar las modalidades de mediación narrativa y de sus lazos con otros universos discursivos que den cuenta de las identidades culturales de la brasilidad; cuestionar y poner en tensión la relación entre la lengua nacional, internacional y extranjera, las formas estandarizadas y locales con las producciones discursivas sociales disponibles; y los modos discursivos y genéricos en los cuales las autorías y las figuras de lectores se inscriben en los materiales de estudio. El punto de vista del AD, en relaciones transdisciplinarias con la glotopolítica, la semiótica y otras perspectivas críticas de la cultura y la educación, permitirá resituar, e interpretar alternativas didácticas para reorientar tanto los procesos de formación docente cuanto las experiencias áulicas en el contexto regional del Mercosur. En términos programáticos se expandirán los recorridos por diversos archivos discursivos y de tecnologías de la información y la comunicación vinculados a la LP; en este sentido, se deja abierta la posibilidad de incluir libros didácticos de reciente edición y archivos textuales en diferentes soportes tecnológicos que contrasten significativamente con el corpus ya analizado. Se trabajará en la elaboración de propuestas de intervención para la enseñanza de PLE que ponderen críticamente los posicionamientos ideológicos respecto de la lengua y las textualidades y propicien la condición dialógica del quehacer educativo. Dichas propuestas serán consideradas como secuencias de formación, entendidas como focos del proceso semiótico y polisémico de los saberes implicados en el aprendizaje de una lengua extranjera. Se discutirán criterios selectivos y operativos UNaM – FHyCS – SInvyP Acreditación de Proyectos de Investigación 5 de construcción de dichas secuencias en su dimensión curricular pedagógica y en escalas graduales e integradas de prácticas con el PLE.

Territorios literarios e interculturales: despliegues críticos, teóricos y metodológicos. 16H347

En este proyecto nos proponemos continuar profundizando y reflexionando en torno a dos conceptos claves: el de autor y el de territorio, a los que incorporaremos una tercera dimensión, la de la interculturalidad; por lo tanto, esta tríada nos permitirá la complejización de los planteos con los que veníamos trabajando la literatura y otras prácticas significantes en Misiones. Las actividades desarrolladas en las etapas anteriores nos permiten, hoy, operar con estos conceptos como posibilidad para instalar una práctica interpretativa de las múltiples significaciones; además, propicia el despliegue de una diversidad de líneas de investigación generadas a partir de las iniciativas de los integrantes del equipo. Desde esta posición nos permitirá configurar una cartografía de la literatura y de otras discursividades sociales de la cotidianeidad misionera, no sólo desde las últimas tres décadas, territorio temporal en el que se produjeron múltiples manifestaciones que entretejieron la urdiembre del campo cultural misionero, sino que será interesante abordar otras constelaciones territoriales. La enunciación de esta trama problemática compleja brinda la posibilidad de un diálogo con prácticas, y juegos de lenguaje. Las lecturas críticas responderán a criterios y segmentaciones en torno a categorías teóricas: formaciones, instituciones, pulsiones y tensiones en el campo cultural y el campo intelectual, juegos de lenguaje, constelación de diálogos con autores de la literatura universal, dispositivos de inscripción en la memoria cultural, los autores/escritores/productores y los lectores. Literatura regional y literatura territorial. Los diversos géneros literarios, testimoniales y conversacionales sus condiciones de producción, la escritura y la Genética, arqueología, archivos, colecciones y bibliotecas. Proyectos autorales -estéticos, artísticos, políticos e ideológicos- grupos, formaciones, instituciones. Representaciones y esferas culturales e identitarias, otras voces, tramas y texturas de discursividades sociales; territorios interculturales y discursos fundadores. Su inclusión en el Programa de Semiótica responde a la posibilidad que esta disciplina brinda tanto desde lo teórico como desde lo metodológico para el análisis de los procesos de semiosis infinita y en particular, para la lectura crítica de un territorio en el que las prácticas lingüísticas, intelectuales y sociales, propias de un contexto de relaciones interculturales le otorgan un matiz especial.