Evaluation of a WHO-Validated Serotype-Specific Serological Assay for the Diagnosis of Pneumococcal Etiology in Children with Community-Acquired Pneumonia.

BACKGROUND: The etiologic diagnosis of community-acquired pneumonia (CAP) remains challenging in children because blood cultures have low sensitivity. Novel approaches are needed to confirm the role of Streptococcus pneumoniae. METHODS: In this study, pneumococcal aetiology was determined by serology using a subset of blood samples collected during a prospective multicentre observational study of children <15 years of age hospitalised in Belgium with X-ray-confirmed CAP. Blood samples were collected at admission and 3-4 weeks later. Pneumococcal (P)-CAP was defined in the presence of a positive blood or pleural fluid culture. Serotyping of Streptococcus pneumoniae isolates was done with the Quellung reaction. Serological diagnosis was assessed for nine serotypes using World Health Organization validated IgG and IgA serotype-specific enzyme-linked immunosorbent assays (ELISAs). RESULTS: Paired admission/convalescent sera from 163 children were evaluated by ELISA (35 with proven P-CAP and 128 with non proven P-CAP). ELISA detected pneumococci in 82.8% of patients with proven P-CAP. The serotypes identified were the same as with the Quellung reaction in 82% and 59% of cases by IgG ELISA and IgA ELISA, respectively. Overall, ELISA identified a pneumococcal aetiology in 55% of patients with non-proven P-CAP. Serotypes 1 (51.6%), 7F (19%), and 5 (15.7%) were the most frequent according to IgG ELISA. CONCLUSIONS: In conclusion, the serological assay allows recognition of pneumococcal origin in 55% of CAP patients with negative culture. This assay should improve the diagnosis of P-CAP in children and could be a useful tool for future epidemiological studies on childhood CAP etiology.

Health networks: Actors, professional relationships, and controversies

In recent years international policies have aimed to stimulate the use of information and communication technologies (ICT) in the field of health care. Belgium has also been affected by these developments and, for example, health electronic regional networks ("HNs") are established. Thanks to a qualitative case study we have explored the implementation of such innovations (HN) to better understand how health professionals collaborate through the HN and how the HN affect their relationships. Within the HNs studied a common good unites the actors: the continuity of care for a better quality of care. However behind this objective of continuity of care other individual motivations emerge. Some controversies need also to be resolved in order to achieve cooperative relationships. HNs have notably to take national developments into account. These developments raise the question of the control of medical knowledge and medical practice. Professional issues, and not only practical changes, are involved in these innovations. © 2008 The authors and IOS Press. All rights reserved.

Early cellular immune response to a new candidate mycobacterial vaccine antigen in childhood tuberculosis

The search for novel vaccines against tuberculosis (TB) would benefit from in-depths knowledge of the human immune responses to Mycobacterium tuberculosis (Mtb) infection. Here, we characterised in a low TB incidence country, the immune responses to a new candidate vaccine antigen against TB, the heparin-binding haemagglutinin (HBHA), in young children in contact with an active TB case (aTB). Children with no history of BCG vaccination were compared to those vaccinated at birth to compare the initial immune responses to HBHA with secondary immune responses. Fifty-eight children with aTB and 76 with latent TB infection (LTBI) were included and they were compared to 90 non-infected children. Whereas Mtb-infected children globally secreted more interferon-gamma (IFN-γ) in response to HBHA compared to the non-infected children, these IFN-γ concentrations were higher in previously BCG-vaccinated compared to non-vaccinated children. The IFN-γ concentrations were similar in LTBI and aTB children, but appeared to differ qualitatively. Whereas the IFN-γ secretion induced by native methylated and recombinant non-methylated HBHA were well correlated for aTB, this was not the case for LTBI children. Thus, Mtb-infected young children develop IFN-γ responses to HBHA that are enhanced by prior BCG vaccination, indicating BCG-induced priming, thereby supporting a prime-boost strategy for HBHA-based vaccines. The qualitative differences between aTB and LTBI in their HBHA-induced IFN-γ responses may perhaps be exploited for diagnostic purposes.

Espaces d’interdépendance entre action publique et experts: Etat réflexif dans le champ du sida

info:eu-repo/semantics/published

Inductive reasoning in the justification of the result of adding two even numbers

In this paper we present an analysis of the inductive reasoning of twelve secondary students in a mathematical problem-solving context. Students were proposed to justify what is the result of adding two even numbers. Starting from the theoretical framework, which is based on Pólya’s stages of inductive reasoning, and our empirical work, we created a category system that allowed us to make a qualitative data analysis. We show in this paper some of the results obtained in a previous study.

Health Interreg Sante, un projet qui fait bouger...

Newsletter outlining the project objectives and updates.

Las familias "Baeomycetaceae" e I"Icmadophilaceae" en la Península Ibérica

Se aportan datos morfológicos, químicos y de distribución de seis especies de las familias Baeomycetaceae (Baeomyces) e Icmadophilaceae (Dibaeis, Icmadophila, Thamnolia) presentes en la Península Ibérica. Se publican numerosas nuevas citas de Baeomyces rufus y de Dibaeis baeomyces, que constituyen las especies más frecuentes y abundantes en la península.

First report of "Cotoneaster pannosus" Franch. ("Rosaceae") in Tarragona Province, and updated distribution area in Spain

Cotoneaster pannosus (Rosaceae), an ornamental shrub native to China, is reported for the first time in Tarragona Province (Catalonia, Spain). Data on demography and accompanying species for the new locality are provided, in addition to a chrorological update at nation level.

Contribution to the knowlegde of Galician xenoflora (NW Iberian Peninsula, Spain).

Information on 12 exotic plants of diverse interest for the Galician flora are presented. All of them were collected in Ribeira council (SW of the A Coruña province). The total includes 8 novelties at a regional level (Aeonium haworthii, Aloe mitriformis, Brugmansia × candida, Nephrolepis cordifolia, Osteospermum ecklonis, Pelargonium capitatum, Sedum mexicanum, Sparaxis tricolor), and 2 provincial novelties. In addition, information on two taxa hardly mentioned in the literature on Galician vascular flora is also included. All the cited specimens are deposited at the SANT Herbarium.

Sistema integrado para empresas de construcción en Cusco

Actualmente las empresas requieren estrategias innovadoras, que permitan gestionar de forma integral, optimizando los recursos y maximizando los resultados. Siendo el objetivo del presente trabajo de investigación, diseñar un instrumento de gestión integral (gestión de la calidad, ambiental, seguridad y salud ocupacional) para el sector construcción en Cusco. Se realizó un análisis actual de la actividad de construcción, se planteó a diferencia de otras propuestas, el diseño que inicia con el diagnóstico, planificación, organización, ejecución, supervisión y optimización del sistema integral. Los resultados están expresados en el diagnóstico de los 3 sistemas, información clave, para el planteamiento y propuesta de las etapas posteriores; estructurando el planteamiento de los subprogramas basados en el diagnóstico integral, para finalmente determinar los lineamientos estratégicos, de implementación, evaluación y verificación del sistema, teniendo en cuenta la norma ISO 9001: 2008, ISO 14001:2004 y OSHAS 18001:2007; así como la legislación vigente para el Perú.

Conditional cash transfer programs and the representations of poverty in Bolivia and Peru

Bolivia and Peru adopted the same instruments of social policy —conditional cash transfer programs— to solve the same public problems under different political regimes. By means of the qualitative methodology of discourse analysis, this paper studies the representations of poverty and State made by key actors of those social programs. Underlying more differences than similarities, one demonstrates that the same social policy is linked to opposite social representations of poverty and the State role in every country. The main explanation for this is, far from being imposed by international organizations, those programs are adopted and adapted by each political regime.

A delphy study of the cooperativisation of the social services in the historical territory of Gipuzkoa

This article shows the main results obtained from the Delphi study, which was made of politicians and technicians from the Department of Social Policy in the County Council of Gipuzkoa, concerning the possibility of cooperativizing the provision of social services in this historical territory. With this in mind, the structure of this article is in two different parts. The first part develops the theoretical framework which serves as inspiration for the empirical work, where note is made of the main theoretical proposals that have a bearing on the collective dimension of citizen participation in the management of public services. Among the various models, those which prioritise public participation through social and solidarity economy entities stand out. The second part concerns itself with the presentation of the field research results. To this end, the methodological notes concerning the preparation process for the Delphi analysis are presented first and this is immediately followed by a synthesis of the main results obtained in this study. The article ends with a section of conclusions and future lines of action.

Recepción e influencia de la literatura hispanoamericana en Corea

A medida que el concepto de "nación" se ha debilitado en estos últimos años, y de forma muy rápida, el límite convencional de la cultura se está desvaneciendo y el mundo se mueve hacia un orden cultural integrado, a través de intercambios constantes entre las culturas, a pesar de las barreras discriminatorias. La literatura, en este sentido, no es una excepción y es necesario discutir la relación entre la literatura coreana y la hispanoamericana desde la perspectiva de la literatura comparativa. El presente estudio ofrece una mirada más cercana al proceso y a los distintos aspectos del modo en que las obras de los escritores hispanoamericanos han sido aceptadas en Corea del Sur. La literatura hispanoamericana se ha introducido en Corea desde principios del siglo XX y se extendió rápidamente a partir de los ochenta, cuando la controversia literaria del posmodernismo se desató y las obras de Borges y García Márquez fueron presentadas a los lectores coreanos. Sería interesante examinar los aspectos sobre cómo los escritores hispanoamericanos como Neruda, Borges y García Márquez se han integrado en la literatura coreana. En esta etapa, sin embargo, es difícil determinar si su influencia es suficientemente permanente como para convertirse en un linaje, o simplemente se trata de un fenómeno temporal. No obstante, la literatura hispanoamericana seguirá expandiendo interrelaciones crecientes con la coreana más allá de las fronteras, ejerciendo una gran influencia entre sí.

Leopoldo Panero and his antology of the Spanish American Poetry. A “personal” reading of America

El presente artículo trata de ofrecer una lectura estética y política de la Antología de la poesía hispanoamericana que publicara Leopoldo Panero entre 1944 y 1945 bajo protección gubernamental. Para ello se parte de la particular biografía del escritor astorgano, su relación en los años treinta con los poetas hispanoamericanos –especialmente Vallejo y Neruda– y su gira por América ya como supuesto prohombre del régimen franquista en 1949 y 1954. La lectura sistemática de sus prólogos y selección de poetas revela la particular visión de Panero sobre Hispanoamérica, mediatizada por el concepto imperial de Falange pero formulada bajo su propia visión de lo que la lírica americana representa para la lengua castellana. Se sostiene así en estas líneas la tesis de que los postulados de Panero representan, a pesar de todo, una opción mucho más compleja de lo que se suele considerar.