Duration of cough, TB suspects' characteristics and service factors determine the yield of smear microscopy

Objective To determine the efficiency of routine tuberculosis (TB) case detection by examining sputum smear positivity for acid-fast bacilli in relation to duration of cough, characteristics of TB suspects examined and health service factors. Method We combined patient interviews with routine data from laboratory registers in 6 health care facilities in San Juan de Lurigancho district, Lima, Peru. A TB case was defined as a TB suspect with at least one positive sputum smear. We calculated adjusted odds ratios with 95% confidence intervals for the association between smear positivity and health service and patient's characteristics. Results Smear positivity was 7.3% (321/4376). Of the 4376 adults submitting sputa, 55.3% (2418) reported cough for 2 weeks, being referred by health care staff, attending a secondary-level health care facility, male sex and age between 15 and 44 years were independent determinants of smear positivity. Conclusions Routine case detection yields a low proportion of smear-positive cases because of the inclusion of a high proportion of patients without cough or coughing for <2 weeks. Adherence to the national TB control programme guidelines on the selection of TB suspects would have a positive impact on the smear positivity rate, reduce laboratory costs and workload and possibly improve the reading quality of smear microscop

Pedagogical Practices for Virtual Worlds

As a result from activities carried out within Module 2 of the MUVEnation programme about exploring active learning approaches, we have created a collection of practices for teaching and learning in Virtual Worlds, organised in 21 chapters, classified in the following categories of instructional methods: Presentation, Demonstration, Discussion, Drill-and-practice, Tutorial, Cooperative Learning, Gaming, Simulation and Discovery. The educational professionals who participated in the course worked in teams, but in some cases individually to map and describe the existing range of teaching practices in Second Life, and to draw a reflection about the elements for their success. Practices described include: lecture, multimedia presentation, demonstration, dialogic teaching and specifically debates and consensus building, but also other forms of discussion like seminars, symposia, syndicates, panel discussion, workshops and organized forums; brain storming, treasure hunts and virtual quests, learning by projects, self paced learning and self study, Labs (class/ fields), role play, virtual theatre and theatrical improvisation matches, peer tutoring and learning, Role playing, and simulation games