Three-weekly doses of azithromycin for Indigenous infants hospitalized with bronchiolitis: a multicentre, randomized, placebo-controlled trial

Background: Bronchiolitis is a major health burden in infants globally, particularly among Indigenous populations. It is unknown if 3 weeks of azithromycin improve clinical outcomes beyond the hospitalization period. In an international, double-blind randomized controlled trial, we determined if 3 weeks of azithromycin improved clinical outcomes in Indigenous infants hospitalized with bronchiolitis.Methods: Infants aged ≤24 months were enrolled from three centers and randomized to receive three once-weekly doses of either azithromycin (30 mg/kg) or placebo. Nasopharyngeal swabs were collected at baseline and 48 h later. Primary endpoints were hospital length of stay (LOS) and duration of oxygen supplementation monitored every 12 h until judged ready for discharge. Secondary outcomes were: day-21 symptom/signs, respiratory rehospitalizations within 6 months post-discharge and impact upon nasopharyngeal bacteria and virus shedding at 48 h.Results: Two hundred nineteen infants were randomized (n = 106 azithromycin, n = 113 placebo). No significant between-group differences were found for LOS (median 54 h for each group, difference = 0 h, 95% CI: −6, 8; p = 0.8), time receiving oxygen (azithromycin = 40 h, placebo = 35 h, group difference = 5 h, 95% CI: −8, 11; p = 0.7), day-21 symptom/signs, or rehospitalization within 6 months (azithromycin n = 31, placebo n = 25 infants, p = 0.2). Azithromycin reduced nasopharyngeal bacterial carriage (between-group difference 0.4 bacteria/child, 95% CI: 0.2, 0.6; p < 0.001), but had no significant effect upon virus detection rates.Conclusion: Despite reducing nasopharyngeal bacterial carriage, three large once-weekly doses of azithromycin did not confer any benefit over placebo during the bronchiolitis illness or 6 months post hospitalization. Azithromycin should not be used routinely to treat infants hospitalized with bronchiolitis.Clinical trial registration: The trial was registered with the Australian and New Zealand Clinical Trials Register: Clinical trials number: ACTRN1261000036099

Reconsidering graduate students' education as scholar-teachers: Mind your language!

This contribution argues that the education of the future professoriate must be based on a comprehensive view of the work of FL professionals. That requires the FL field to develop a coherent intellectual foundation and educational philosophy capable of assuring the validity and value of the range of its contributions—in teaching, scholarship, and service. The paper proposes a reimagined shared knowledge about language as that necessary foundation, substantiating the argument from several perspectives: investigation of the conceptualization of language underlying the MLA Report; a projection of future demands on faculty with regard to knowledge about language; the possibilities of systemic functional linguistics to provide suitable conceptual constructs and educational proposals; a critique of the current situation in core areas of the field; features of a reconceptualized TA education; and reflections on future steps that might enable language professionals to “mind our language” while we “mind the store.

The Privilege of the Less Commonly Taught Languages: Linking Literacy and Advanced L2 Capacities

When, in 2001, Laurel Rasplica Rodd, president of the Association of Teachers of Japanese, invited me to participate in a roundtable discussion at the Association for Asian Studies annual meeting, I was delighted to accept, inasmuch as the topic, ''An integrated curriculum for the foreign language classroom," had occupied me for quite some time, most recently with the extensive curricular revision in my own home department, the German Department at Georgetown University (Developing multiple literacies, 1997-2000; Byrnes, 2001). My observations and experiences had convinced me that the foreign language profession, particularly faculty in institutions of higher education, needed to rethink a number of theoretical constructs and reshape many praxes in curriculum, pedagogy, and assessment in order to meet both the challenges and the promises of a multicultural and globalized society. That conviction was also a troubled conviction, inasmuch as I saw few signs that the profession was able or even willing to set out on that journey, despite its unmistakable urgency (Byrnes, 1998, 2005a)