(HealthDay News) -- A growing number of American children are developing infections caused by a worrisome type of antibiotic-resistant bacteria, a new study reports.

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Updated CDC recommendations for overseas tuberculosis (TB) screening of immigrants and refugees have identified hundreds of cases that otherwise would have gone undetected until after arrival in the United States, saving taxpayers an additional $15 million in medical costs.

In 2012, the most recent year for which data are available, overseas physicians identified more than 1,100 cases of tuberculosis, including 14 cases of multidrug-resistant (MDR) TB, according to a report published in CDC’s MMWR today.  Due to screening changes that require newer, more sensitive sputum-culture tests, about 60 percent of the cases – about 660 cases plus the 14 MDR TB cases - would not previously have been identified and treated prior to coming to the United States.

The $15 million cost savings estimate is a rough estimate based on the cost of treating TB cases that would not have otherwise been identified and treated prior to the immigrants’ and refugees’ arrival in the United States. Those costs are primarily borne by U.S. public health departments, both federal and state, that provide care and treatment for TB patients diagnosed after their arrival. Additional economic analyses are under way.

“This program has been one of the largest and most successful interventions in U.S. tuberculosis control during the past decade,” said Martin Cetron, M.D., director of CDC’s Division of Global Migration and Quarantine. “In addition to creating major savings in health care costs, is the program ensures that immigrants and refugees get prompt care and correct treatment, which is vital to their health, the health of their loved ones, and the U.S. communities where they settle.”

More than one-third of the world’s population is thought to be infected with Mycobacterium tuberculosis, the bacterium that causes TB. In 2012, nearly 9 million people around the world became sick with TB disease. Since the early 1900s, immigrants and refugees applying for a visa to come to the United States undergo a medical examination that includes TB screening. Prior to 2007, applicants received a chest X-ray and microscopic sputum smear test to identify persons with active TB. Those who had a positive smear test received TB treatment prior to arriving in the United States. However, these tests often missed persons with mild cases of TB. In 2007, CDC began implementing new requirements, which require people suspected of having tuberculosis to receive a much more sensitive sputum culture test to confirm TB so that patients receive treatment prior to arriving in the United States. These requirements have now been completely rolled out to all countries with U.S.-bound immigrants.

During the past 20 years, people born abroad have made up a larger and larger proportion of U.S. TB cases. Currently, 65 percent of people in the United States with TB are foreign-born. The change in screening procedures is estimated to have decreased the percentage of immigrants and refugees who tested negative for TB, while abroad, but who developed TB after their arrival from 7 percent to 1 to 2 percent.

In addition to requiring sputum cultures, the 2007 guidelines require testing of children ages 2-14 who are coming to the United States from countries with high rates of TB since TB often goes undetected in children. The 2007 guidelines also require the use of directly observed therapy (DOT), the gold standard for treatment. DOT is a practice where health care professionals administer and document each dose of medicine throughout the entire course of treatment.

For more information on immigration and testing overseas, please visit: https://www.cdc.gov/immigrantrefugeehealth/index.html.

What sort of leader are you? Do you think leading is all about a laser-like focus on the task, watching the bottom line and making sure everyone is doing what they should? Or is it about listening to your team, being open to ideas and perspectives, and inspiring them to find their own niche?

Distinctions between a task-oriented leader and a social-emotional leader have filled the pages of academic literature for more than a half-century. But recent research strongly suggests the distinction has a foundation in our brains—which allows us to be either analytical or empathetic, but not both at the same time—researchers at Case Western Reserve University report.

The managerial world has long held that a leader must be either one type or the other. But the presence of both capabilities in a normal brain suggests the opposite is true, the researchers argue in a study published online in the journal Frontiers in Human Neuroscience, at https://journal.frontiersin.org/Journal/10.3389/fnhum.2014.00114/full.

The failure of management and graduate schools and the business world at large to value and develop both capabilities results in damage ranging from inefficient operations to unethical decision-making, the researchers contend.

"In the '70s, business became focused on the return-on-investment and cash-flow, and this led to the elevation of financial wizards to demigod status in the '90s and resulted in the financial meltdown in 2007," said Richard Boyatzis, professor of organizational behavior at Case Western Reserve's Weatherhead School of Management and a study author.

"Those are the consequences of too narrow a focus by organizations on only the financial side," he said.

Boyatzis worked on the study with Anthony Jack, assistant professor of cognitive science at Case Western Reserve, and Kylie Rochford, a PhD student in organizational behavior.

A balanced leader

"The balanced leader switches fluidly between focusing on operations and the bottom line at one moment, and fostering a positive work environment and ethical insight the next," Jack said. "What the science is telling us is that the brain naturally supports this switching, but doesn't function so well when we blend the two modes."

Researchers found the brain contains what's called the "Task Positive Network (TPN)," which is analytical and task-oriented, and the "Default Mode Network (DMN)," which is empathetic and social.

Using functional magnetic resonance imaging (MRI) on dozens of subjects, Jack has shown the two networks tend to suppress one another when presented with technical or social problems to solve. The brain constantly cycles between the two networks while the subject is at rest. This see-sawing activity is stronger in people who are psychologically healthy and have higher IQ.

Jack also found that, when subjects employed both networks at the same time, the subject was typically being manipulative or anti-social rather than a more balanced thinker.

"Every normal brain contains both modes, with the flexibility to go to the right mode at the right time," Jack said. "In the business world right now, the emphasis is more on the task orientation of leaders rather than cultivating empathy. That is partly because it easier to assess task-oriented leadership."

But the long-term consequences of this cultural bias are damaging. "Emphasizing one side over the other is not the best way to promote good leadership," Jack said,

One-way thinking

Management research over decades shows each mode of thinking has advantages and downsides.

Being task-oriented leads to focus, solving problems and efficient execution of clearly defined objectives. That is desirable, Jack points out, when a surgeon is focused on being precise with an incision rather than on the pain the incision will cause.

But research has shown that focusing solely on completing tasks—or on the bottom line—squashes creativity, hinders ethical insight, openness and new ideas, and harms employee morale.

Being an empathetic leader can increase employee motivation and engagement, encourage creativity and is essential for ethical decision-making.

"Leaders are always trying to get things done through people, so it's important to pay attention to the relationships," Rochford said.

But a social-only focus results in a lack of attention to objectives, which is inefficient when the task requirements are clear and the goal is to execute them, Jack said.

Further, workers' perceptions of a leader swing with the circumstances. Past management studies show that workers perceive task-oriented bosses as effective when they have a clear job to get done, and poor leaders when they appear to focus only on short-run output.

Workers perceived bosses focused on work relationships as effective when they showed trust in the workers and were primarily concerned with developing workers' talents. But these same leaders were seen as ineffective when they seemed to be passive about a task at hand.

Historically off-target

"Since the 1940s, people have demonstrated the need in families, teams and management for two types of leaders: those task-oriented and the social/emotional/relationship leader," Boyatzis said.

But most approaches used to identify and develop effective leaders are misguided, he said, because "we confuse the ability to be effective in both by focusing on one."

Boyatzis said, for example, the usual step to becoming a school principal is to first be an assistant principal.

"The assistant principal focuses on tasks and operations and discipline within the school, which are often lousy preparation for relationship development," Boyatzis said. "But the role of the principal is to develop relationships with the parents and community."

Split leadership roles are common, from parenting to CEOs. "But the problem is, who covers both when one leaves?" Boyatzis said.

Finding a leader who is outstanding at both is rarer, but it is possible, Boyatzis said. "The fact we have these two distinct neural domains suggests it is possible to cultivate both sides, and we do see that in individuals," he said.

Cultivating both networks

The researchers say the challenge for education and leadership training is to help people cultivate both skill sets, so leaders can cycle fluidly between the two networks and better perceive when each mode of thinking is appropriate.

They suggest that organizations provide management candidates with coaching and training in both domains. They advise using simulations to allow leaders-in-training to practice moving back and forth between task-focused and social networks.

The candidates should also be required to follow a career path that invokes these networks differentially. For example, candidates may develop the DMN by splitting time on marketing projects and on training and developing people; and TPN by spending time in finance, information technologies and quality assurance.

In higher education, especially in graduate professional programs, coursework should be modified to insure teamwork in class assignments, field projects, service learning and internships, and there should be more integration of personal reflection on one's own behavior, values and impact on others, Boyatzis said.

The researchers are now devising experiments to investigate how people switch back and forth between the networks, according to analytical or social tasks they're presented. They are also investigating personality factors which relate to the individual differences in the tendency to use one network or the other for specific situations.

OSAP is looking for volunteers to help draft a response to NIOSH on behalf of OSAP and dental safety. NIOSH is seeking public comment on the desirability of adding requirements and tests in its 42 CFR 84 respirator approval process to parallel protections in the FDA clearance process. All comments must be received by April 14, 2014. Please refer to the Federal Register Notice issued on March 14, 2014, for more information.

If you are interested in volunteering on behalf of OSAP, please contact tlong@osap.org ASAP.

OSAP has some updates regarding its upcoming symposium, held June 5 to June 8.

(1) Dr. Harold Jaffe from the US Centers for Disease Control and Prevention (CDC) is returning! The most popular speaker from the 2013 symposium is coming back and will spearhead a panel presentation addressing “Infection Control in Dentistry – Then, Now and What Next”. He will share a clip from the 60 Minutes interview about the Florida dentist and discuss risk communication. Dr Mary Chamberland, also from CDC, will speak about early efforts to assess the risk of HIV transmission in healthcare settings before and immediately after the Florida investigation. Dr. John Molinari will describe the founding of OSAP at this pivotal time 30 years ago and what has transpired since and Dr. Don Marianos will focus on the future with lessons learned.

(2)  Attendees will have the opportunity to tour the 3M Innovation Center. The Center features dynamic displays and interactive, hands-on demonstrations designed to stimulate creative solutions to challenging issues. The tour will be on Thursday, June 5 from 9 am – 12 pm and is limited to 50 people.

Click here for more information. Early-bird registration ends April 30.

Dona Ana Community College in New Mexico is seeking a dental assistant instructor or professor to prepare and teach 30-32 credit hours over the fall and spring semesters. Teaching assignment may include day, evenings, weekends, and/or multiple campus locations. An Associate Degree (preferably in Dental Assisting or related field) is required.

For more information, click  here.