Home-based tuberculosis contact investigation in Uganda: a household randomised trial.

IntroductionThe World Health Organization (WHO) recommends household tuberculosis (TB) contact investigation in low-income countries, but most contacts do not complete a full clinical and laboratory evaluation.MethodsWe performed a randomised trial of home-based, SMS-facilitated, household TB contact investigation in Kampala, Uganda. Community health workers (CHWs) visited homes of index patients with pulmonary TB to screen household contacts for TB. Entire households were randomly allocated to clinic (standard-of-care) or home (intervention) evaluation. In the intervention arm, CHWs offered HIV testing to adults; collected sputum from symptomatic contacts and persons living with HIV (PLWHs) if ≥5 years; and transported sputum for microbiologic testing. CHWs referred PLWHs, children <5 years, and anyone unable to complete sputum testing to clinic. Sputum testing results and/or follow-up instructions were returned by automated SMS texts. The primary outcome was completion of a full TB evaluation within 14 days; secondary outcomes were TB and HIV diagnoses and treatments among screened contacts.ResultsThere were 471 contacts of 190 index patients allocated to the intervention and 448 contacts of 182 index patients allocated to the standard-of-care. CHWs identified 190/471 (40%) intervention and 213/448 (48%) standard-of-care contacts requiring TB evaluation. In the intervention arm, CHWs obtained sputum from 35/91 (39%) of sputum-eligible contacts and SMSs were sent to 95/190 (50%). Completion of TB evaluation in the intervention and standard-of-care arms at 14 days (14% versus 15%; difference -1%, 95% CI -9% to 7%, p=0.81) and yields of confirmed TB (1.5% versus 1.1%, p=0.62) and new HIV (2.0% versus 1.8%, p=0.90) diagnoses were similar.ConclusionsHome-based, SMS-facilitated evaluation did not improve completion or yield of household TB contact investigation, likely due to challenges delivering the intervention components

Urban football narratives and the colonial process in Lourenço Marques

Support for Portuguese football teams, in Mozambique as well as in other former Portuguese colonies, could be interpreted either as a sign of the importance of a cultural colonial heritage in Africa or as a symbol of a perverse and neo-colonial acculturation. This article, focused on Maputo, the capital of Mozambique – formerly called Lourenc¸o Marques – argues that in order to understand contemporary social bonds, it is crucial to research the connection between the colonial process of urbanisation and the rise of urban popular cultures. Despite the existence of social discrimination in colonial Lourenc¸o Marques, deeply present in the spatial organisation of a city divided between a ‘concrete’ centre and the immense periphery, the consumption of football, as part of an emergent popular culture, crossed segregation lines. I argue that football narratives, locally appropriated, became the basis of daily social rituals and encounters, an element of urban sociability and the content of increasingly larger social networks. Therefore, the fact that a Portuguese narrative emerged as the dominant form of popular culture is deeply connected to the growth of an urban community

Der Einfluss der Alters- und Familienstrukturen auf die Ausgaben der Länder und Gemeinden

Das Papier untersucht die Effekte des demographischen Wandels auf die öffentlichen Ausgaben, wobei ein besonderer Blick auf die föderalen Zusammenhänge gerichtet wird. Unter Verwendung von Paneldaten über die Pro-Kopf-Ausgaben der westdeutschen Bundesländer in 15 Aufgabenbereichen wird untersucht, ob von demographischen Einflussvariablen nachweisliche Effekte auf die Ausgaben ausgehen. Ökonometrische Tests zeigen einen signifikanten Einfluss der Altersstrukturen in nahezu allen Aufgabenbereichen, wogegen die Familienstruktur nur in einigen Aufgabenbereichen Einfluss zu haben scheint. Zusätzlich werden Prognosen berechnet, die Auskunft darüber geben, wie sich der in der Zukunft absehbare demographische Wandel auf die Pro-Kopf-Ausgaben der Länder und Gemeinden auswirkt. Hierbei zeigen sich durchaus quantitativ bedeutsame Effekte, die zwischen der Länder- und Gemeindeebene teilweise deutlich differieren

Diasporas and secessionist conflicts : the mobilization of the Armenian, Albanian and Chechen diasporas

This article examines the impact of diasporas on secessionist conflicts, focusing on the Albanian, Armenian and Chechen diasporas and the conflicts in Kosovo, Karabakh and Chechnya during the 1990s. How do diasporas radicalize these conflicts? I argue that despite differences in diaspora communal characteristics and the types of the secessionist conflicts, a common pattern of mobilization develops. Large-scale diasporic support for secessionism emerges only after independence is proclaimed by the local elites. From that point onwards diasporas become engaged in a conflict spiral, and transnational coalitions are formed between local secessionist and diaspora groups. Depending on the organizational strength of the local strategic centre and the diasporic institutions, these coalitions endure or dissipate. Diasporas exert radicalization influences on the conflict spiral on two specific junctures – when grave violations of human rights occur in the homeland and when local moderate elites start losing credibility that they can achieve the secessionist goal

The Quantity Theory of Money is Valid. The New Keynesians are Wrong!

We test the quantity theory of money (QTM) using a novel approach and a large new sample. We do not follow the usual approach of first differentiating the logarithm of the Cambridge equation to obtain an equation relating the growth rate of real GDP, the growth rate of money and inflation. These variables must then again be ‘integrated’ by averaging in order to obtain stable relationships. Instead we suggest a much simpler procedure for testing directly the stability of the coefficient of the Cambridge equation. For 125 countries and post-war data we find the coefficient to be surprisingly stable. We do not select for high inflation episodes as was done in most empirical studies; inflation rates do not even appear in our data set. Much work supporting the QTM has been done by economic historians and at the University of Chicago by Milton Friedman and his associates. The QTM was a foundation stone of the monetarist revolution. Subsequently belief in it waned. The currently dominant New Keynesian School, implicitly or explicitly denies the validity of the QTM. We survey this history and argue that the QTM is valid and New Keynesians are wrong

Practice characteristics of Emergency Department extracorporeal cardiopulmonary resuscitation (eCPR) programs in the United States: The current state of the art of Emergency Department extracorporeal membrane oxygenation (ED ECMO).

PURPOSE: To characterize the current scope and practices of centers performing extracorporeal cardiopulmonary resuscitation (eCPR) on the undifferentiated patient with cardiac arrest in the emergency department. METHODS: We contacted all US centers in January 2016 that had submitted adult eCPR cases to the Extracorporeal Life Support Organization (ELSO) registry and surveyed them, querying for programs that had performed eCPR in the Emergency Department (ED ECMO). Our objective was to characterize the following domains of ED ECMO practice: program characteristics, patient selection, devices and techniques, and personnel. RESULTS: Among 99 centers queried, 70 responded. Among these, 36 centers performed ED ECMO. Nearly 93% of programs are based at academic/teaching hospitals. 65% of programs are less than 5 years old, and 60% of programs perform ≤3 cases per year. Most programs (90%) had inpatient eCPR or salvage ECMO programs prior to starting ED ECMO programs. The majority of programs do not have formal inclusion and exclusion criteria. Most programs preferentially obtain vascular access via the percutaneous route (70%) and many (40%) use mechanical CPR during cannulation. The most commonly used console is the Maquet Rotaflow(®). Cannulation is most often performed by cardiothoracic (CT) surgery, and nearly all programs (\u3e85%) involve CT surgeons, perfusionists, and pharmacists. CONCLUSIONS: Over a third of centers that submitted adult eCPR cases to ELSO have performed ED ECMO. These programs are largely based at academic hospitals, new, and have low volumes. They do not have many formal inclusion or exclusion criteria, and devices and techniques are variable

The future impact of changes in rate parity agreements on hotel chains: the long-term implications of the removal of rate parity agreements between hotels and online travel agents using closed consumer group booking models

The Office of Fair Trading, a not-for-profit and non-ministerial government department of the United Kingdom (from April 2014 incorporated within the Competition and Markets Authority), investigated the legality of rate parity from 2012, particularly rate parity agreements made between Intercontinental Hotel Group, Booking.com, and Expedia. Consequently, these major hotel brands and agents have committed to remove rate parity for closed consumer groups. This article identifies confusion over such groups and longer term implications. Smaller agents will enter the market, leading to increased fragmentation and competition. Branded hotels will face tough challenges in protecting prices and value from aggressive agents suddenly facing a more competitive market and independent hoteliers able to establish effective relationships with the new, smaller agents. Keywords : Rate parity, pricing, closed consumer groups, hotels

1985: Abilene Christian College Bible Lectures - Full Text

WHAT THE CHURCH NEEDS TO HEAR Being the Abilene Christian University Annual Bible Lectures 1985 Published by A-C-U PRESS ACU Station Abilene, Texas 7969

Bartonella species detection in captive, stranded and free-ranging cetaceans

We present prevalence of Bartonella spp. for multiple cohorts of wild and captive cetaceans. One hundred and six cetaceans including 86 bottlenose dolphins (71 free-ranging, 14 captive in a facility with a dolphin experiencing debility of unknown origin, 1 stranded), 11 striped dolphins, 4 harbor porpoises, 3 Risso's dolphins, 1 dwarf sperm whale and 1 pygmy sperm whale (all stranded) were sampled. Whole blood (n = 95 live animals) and tissues (n = 15 freshly dead animals) were screened by PCR (n = 106 animals), PCR of enrichment cultures (n = 50 animals), and subcultures (n = 50 animals). Bartonella spp. were detected from 17 cetaceans, including 12 by direct extraction PCR of blood or tissues, 6 by PCR of enrichment cultures, and 4 by subculture isolation. Bartonella spp. were more commonly detected from the captive (6/14, 43%) than from free-ranging (2/71, 2.8%) bottlenose dolphins, and were commonly detected from the stranded animals (9/21, 43%; 3/11 striped dolphins, 3/4 harbor porpoises, 2/3 Risso's dolphins, 1/1 pygmy sperm whale, 0/1 dwarf sperm whale, 0/1 bottlenose dolphin). Sequencing identified a Bartonella spp. most similar to B. henselae San Antonio 2 in eight cases (4 bottlenose dolphins, 2 striped dolphins, 2 harbor porpoises), B. henselae Houston 1 in three cases (2 Risso's dolphins, 1 harbor porpoise), and untyped in six cases (4 bottlenose dolphins, 1 striped dolphin, 1 pygmy sperm whale). Although disease causation has not been established, Bartonella species were detected more commonly from cetaceans that were overtly debilitated or were cohabiting in captivity with a debilitated animal than from free-ranging animals. The detection of Bartonella spp. from cetaceans may be of pathophysiological concern