Search

The widespread use of case method around the world, coupled with conflicting evidence about its effectiveness compared to the traditional lecture method, motivated this study. We meta-analyzed 22 investigations that report 86 effect sizes aggregated in two types of outcomes: cognitive (i.e., knowledge and skills), and affective (i.e., motivation and attitudes). For case method, meta-analytic results were significant for cognitive outcomes, but not for affective outcomes. Furthermore, the case method demonstrated a higher effect than lecture method in the teaching of cognitive outcomes. We also evaluate the effect of two moderators on these relationships, reporting significant effects in undergraduate students and non-significant moderation in cultural values. We discuss and interpret these findings considering different learning theories and propose both theoretical and practical implications.

The purpose of this study was to examine the influence of the individual characteristics of students and teachers in the effectiveness of the case method in a sample of Colombian business students. The results from two studies indicated that the case method is as effective as the lecture method in respect of learning outcomes (i.e. declarative knowledge and situation analysis) and is related to the higher satisfaction of students (i.e. pedagogic strategies and the relation between students and the professor); however, its effects can be mediated and moderated by some personality traits of the teachers and students (conscientiousness, openness to experience, and extroversion) and by the students’ motivation (social motivation). Case method is effective for promoting educational outcomes, and its usage is not just recommended for senior students but, as we have found, it is also recommended for junior students who can improve both their declarative knowledge and situation analysis skills with this method.

The purpose of this study is to validate the Spanish version of the Work Design Questionnaire (WDQ; Morgeson & Humphrey, 2006). Employees from three Colombian samples completed the questionnaire (N=831). Confirmatory factor analyses revealed a 21-factor structure (χ2/dfratio = 2.40, SRMR = .06, RMSEA = .04, CFI = .90) with adequate levels of convergent and discriminant validity. Additional support for construct validity was found from significant differences among different occupational groups (professional and nonprofessional, health-focused, commercial, and manufacturing workers). Furthermore, knowledge, social, and work context characteristics showed incremental validity over task characteristics on job satisfaction and perceived performance. Possible interpretations of these relationships are offered. It is concluded that the study provides evidence for the validity of a Spanish version of the scale, and presents further support for the generalization of the 21-factor structure of work design characteristics in different cultural settings.

Sputum culture conversion is often used as an early microbiological endpoint in phase 2 clinical trials of tuberculosis treatment on the basis of its assumed predictive value for end-of-treatment outcome, particularly in patients with drug-susceptible tuberculosis. We aimed to assess the validity of sputum culture conversion on solid media at varying timepoints, and the time to conversion, as prognostic markers for end-of-treatment outcome in patients with multidrug-resistant (MDR) tuberculosis.

The tuberculosis burden in children exposed at home to multidrug-resistant tuberculosis (MDR-TB) is unquantified. With limited access to MDR-TB treatment, likely millions of children share the experience of chronic exposure to an infectious patient.

Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis have emerged as major global health threats. WHO recommends contact investigation in close contacts of patients with MDR and XDR tuberculosis. We aimed to assess the burden of tuberculosis disease in household contacts of such patients.

Although progress has been made to reduce global incidence of drug-susceptible tuberculosis, the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis during the past decade threatens to undermine these advances. However, countries are responding far too slowly. Of the estimated 440 000 cases of MDR tuberculosis that occurred in 2008, only 7% were identified and reported to WHO. Of these cases, only a fifth were treated according to WHO standards. Although treatment of MDR and XDR tuberculosis is possible with currently available diagnostic techniques and drugs, the treatment course is substantially more costly and laborious than for drug-susceptible tuberculosis, with higher rates of treatment failure and mortality. Nonetheless, a few countries provide examples of how existing technologies can be used to reverse the epidemic of MDR tuberculosis within a decade. Major improvements in laboratory capacity, infection control, performance of tuberculosis control programmes, and treatment regimens for both drug-susceptible and drug-resistant disease will be needed, together with a massive scale-up in diagnosis and treatment of MDR and XDR tuberculosis to prevent drug-resistant strains from becoming the dominant form of tuberculosis. New diagnostic tests and drugs are likely to become available during the next few years and should accelerate control of MDR and XDR tuberculosis. Equally important, especially in the highest-burden countries of India, China, and Russia, will be a commitment to tuberculosis control including improvements in national policies and health systems that remove financial barriers to treatment, encourage rational drug use, and create the infrastructure necessary to manage MDR tuberculosis on a national scale.

Objectives. Tuberculosis (TB) case detection remains low in many countries, compromising the efficacy of TB control efforts. Current global TB control policy emphasizes case finding through sputum smear microscopy for patients who self-report to primary health centers. Our objective was to assess the feasibility and yield of a simple active case finding strategy in a high incidence population in northern Lima, Peru.Methods. We implemented this pilot strategy in one health center's catchment area. Health workers visited household contacts of new TB case subjects to identify symptomatic individuals and collect sputum for screening. Neighboring households were screened in the same manner. Secondary analyses measured risk of TB by (1) sputum smear status of the index case subject, (2) compliance with testing, and (3) risk factors for disease detected through active contact tracing in contrast to self-report.Results. The TB prevalence detected through combined active and passive case finding among 1,094 household contacts was 0.91% (914 per 100,000), much higher than with passive case finding alone (0.18%; 183 per 100,000; p=0.02). Among 2,258 neighbors, the combined strategy detected a TB prevalence of 0.22% (221 per 100,000) in contrast to 0.08% (80 per 100,000) detected through passive case finding alone (p=0.25). Risk factors for being diagnosed through active case finding in contrast with self-report included age >55 years (odds ratio [OR]=5.5; 95% confidence interval [CI] 1.2, 22.8) and female gender (OR=3.9; 95% CI 0.99, 22.3).Conclusions. Risk of active TB among symptomatic household contacts of active case subjects in this community is very high. Results suggest that contact tracing in such settings may be a powerful means of improving case detection rates for active TB disease.

We conducted a case-control study among children in Lima, Peru to identify factors associated with tuberculosis disease. Known close contact with someone with tuberculosis disease, prior hospitalization, and history of anemia were associated with a higher tuberculosis disease rate. Consumption of fruitsvegetables ≥5 daysweek was associated with a lower rate. Isoniazid uptake was low among children with a known contact.

ObjectiveTo measure the association between phenotypic drug resistance and the risk of tuberculosis infection and disease among household contacts of patients with pulmonary tuberculosis.Setting106 district health centers in Lima, Peru between September 2009 and September 2012.DesignProspective cohort study.Participants10 160 household contacts of 3339 index patients with tuberculosis were classified on the basis of the drug resistance profile of the patient: 6189 were exposed to drug susceptible strains of Mycobacterium tuberculosis, 1659 to strains resistant to isoniazid or rifampicin, and 1541 to strains that were multidrug resistant (resistant to isoniazid and rifampicin).Main outcome measuresTuberculosis infection (positive tuberculin skin test) and the incidence of active disease (diagnosed by positive sputum smear or chest radiograph) after 12 months of follow-up.ResultsHousehold contacts exposed to patients with multidrug resistant tuberculosis had an 8% (95% confidence interval 4% to 13%) higher risk of infection by the end of follow-up compared with household contacts of patients with drug sensitive tuberculosis. The relative hazard of incident tuberculosis disease did not differ among household contacts exposed to multidrug resistant tuberculosis and those exposed to drug sensitive tuberculosis (adjusted hazard ratio 1.28, 95% confidence interval 0.9 to 1.83).ConclusionHousehold contacts of patients with multidrug resistant tuberculosis were at higher risk of tuberculosis infection than contacts exposed to drug sensitive tuberculosis. The risk of developing tuberculosis disease did not differ among contacts in both groups. The evidence invites guideline producers to take action by targeting drug resistant and drug sensitive tuberculosis, such as early detection and effective treatment of infection and disease.Trial registrationClinicalTrials.gov NCT00676754.