Avoidance to wipe alcohol before venipuncture is not a source of spurious hemolysis

Background

It is still uncertain whether or not avoidance to let disinfectant alcohol dry at the site of venipuncture is a source of spurious hemolysis when drawing venous blood.

Methods:

In a consecutive series of 52 outpatients referred for routine laboratory testing, venous blood was drawn by direct venipuncture with (odd group) or without (pair group) wiping 70% isopropyl alcohol at the site of venipuncture. A 3.5 mL evacuated tube with clot activator and gel separator was drawn from a vein of the upper limb, serum was immediately separated with standard centrifugation and tested for potassium, lactate dehydrogenase (LD), aspartate aminotransferase (AST) and hemolysis index (HI) on Roche Cobas.

Results:

No specimen was discarded for unsatisfactory venipuncture. No differences for age and gender were observed between groups. As regards the four parameters investigated, no significant differences could be observed between patients in whom blood was drawn with or without letting the alcohol dry. It is also noteworthy that no sample in both groups exceeded the conventional sample rejection threshold of cell-free hemoglobin.

Conclusions:

The results of our prospective, randomized study attest that failure to wipe alcohol at the site of venipuncture should not be considered as a potential source of spurious hemolysis when drawing blood.     

Teacher Training for Change in Italy: experiences and critical reflections

The idea of ‘innovation’ refers most of all to a research‐experiment situation, where the idea of “Reform” has to do mainly with a political‐administrative approach.

In the Italian experience, reform situations prevail on innovation situations in the sense that significant changes tend to be introduced through reform interventions rather than through innovation processes. The prevailing trend is that the innovations follow the reforms instead of preparing them.

This implies that initial teacher preparation has very little to do with a positive attitude towards innovation processes, while the in‐service training endorses a paramount relevance as the most effective strategy of diffusing, supporting and sustaining the passage from the reforms to the innovations.

In‐service activities can reflect three main models: content centred, technique centred, and relation centred. The implications and the developments of the three models are analysed in order to identify the approaches and the strategies put into effect by the most significant agencies active in this field.

The conclusions point at four final perspectives: to realise a sound initial preparation; to connect the innovative processes with the enhancement of the professional quality within the schools; to support the continuous growth of the school personnel qualifications and to make a correct use of the professional avant‐garde.     

Learning to read: Evidence on the distinction between decoding and comprehension skills

The paper focuses on the importance of distinguishing between decoding and comprehension skills in reading. This distinction can also be applied to the study of precursors of reading and of the first phases of reading acquisition. The reconsideration of a 15-year research program shows evidence and implications of such a dissociation. In particular, the paper reviews psychometric research concerning reading performance in first and second grade, research on precursors of reading, the effects of early programs devoted to develop reading abilities. Decoding and comprehension reading components appear at least partially separated, related to different underlying cognitive abilities, differently sensitive to enrichment programs.     

Physiology in the Journal of Sports Sciences

Abstract

Doping in sports is commonplace. The prevention of harm to the athlete, the guarantee of fair play, and a level playing field for all competitors are the basis of the current anti-doping strategies. As healthcare systems are forced to allocate increasing resources to prevent and treat the prevailing pathologies worldwide, funding for anti-doping campaigns will necessarily be restricted. Ideally, additional resources should be devoted to increasing the number of athletes tested, the panels of tests used, and the frequency of out-of-competition controls. Since doping prevention cannot be considered a priority for most healthcare systems, such an approach is unaffordable and an alternative framework should be devised, focused primarily on harm reduction rather than fair play. The identification of abnormal deviations from reference values, regardless of pathological or artificial causes, would allow the athlete to be followed and tested using conventional laboratory tests, which are affordable to governments and healthcare systems and available to clinical laboratories. Although this strategy would not detect cheating, it would safeguard athletes' health.     

Patent examiner specialization

We study the matching of patent applications to examiners at the U.S. Patent and Trademark Office. The distribution of technology classes is more concentrated than would occur under random matching and F-tests reject the hypothesis that family size and claim scope are randomly distributed across examiners. Using the application text, we show that examiner specialization persists even after conditioning on technology sub-classes. Specialization is less pronounced in computers and software than other technology fields. More specialized examiners have a lower grant rate. These findings undermine the idea that random matching justifies instrumental variables based on examiner behaviors or characteristics.     

Contamination of lithium heparin blood by K2-ethylenediaminetetraacetic acid (EDTA): an experimental evaluation

Introduction:

The contamination of serum or lithium heparin blood with ethylenediaminetetraacetic acid (EDTA) salts may affect accuracy of some critical analytes and jeopardize patient safety. The aim of this study was to evaluate the effect of lithium heparin sample contamination with different amounts of K₂EDTA.

Materials and methods:

Fifteen volunteers were enrolled among the laboratory staff. Two lithium heparin tubes and one K₂EDTA tube were collected from each subject. The lithium-heparin tubes of each subject were pooled and divided in 5 aliquots. The whole blood of K₂EDTA tube was then added in scalar amount to autologous heparinised aliquots, to obtained different degrees of K₂EDTA blood volume contamination (0%; 5%; 13%; 29%; 43%). The following clinical chemistry parameters were then measured in centrifuged aliquots: alanine aminotranspherase (ALT), bilirubin (total), calcium, chloride, creatinine, iron, lactate dehydrogenase (LD), lipase, magnesium, phosphate, potassium, sodium.

Results:

A significant variation starting from 5% K₂EDTA contamination was observed for calcium, chloride, iron, LD, magnesium (all decreased) and potassium (increased). The variation of phosphate and sodium (both increased) was significant after 13% and 29% K₂EDTA contamination, respectively. The values of ALT, bilirubin, creatinine and lipase remained unchanged up to 43% K₂EDTA contamination. When variations were compared with desirable quality specifications, the bias was significant for calcium, chloride, LD, magnesium and potassium (from 5% K₂EDTA contamination), sodium, phosphate and iron (from 29% K₂EDTA contamination).

Conclusions:

The concentration of calcium, magnesium, potassium, chloride and LD appears to be dramatically biased by even modest K₂EDTA contamination (i.e., 5%). The values of iron, phosphate, and sodium are still reliable up to 29% K₂EDTA contamination, whereas ALT, bilirubin, creatinine and lipase appear overall less vulnerable towards K₂EDTA contamination.     

Could light meal jeopardize laboratory coagulation tests?

Background:

Presently the necessity of fasting time for coagulation tests is not standardized. Our hypothesis is that this can harm patient safety. This study is aimed at evaluating whether a light meal (i.e. breakfast) can jeopardize laboratory coagulation tests.

Materials and methods:

A blood sample was firstly collected from 17 fasting volunteers (12 h). Immediately after blood collection, the volunteers consumed a light meal. Then samples were collected at 1, 2 and 4 h after the meal. Coagulation tests included: activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fbg), antithrombin III (AT), protein C (PC) and protein S (PS). Differences between samples were assessed by Wilcoxon ranked-pairs test. The level of statistical significance was set at P < 0.05. Mean % differences were determined and differences between and baseline and 1, 2 and 4h samples were compared with reference change value (RCV).

Results:

A significantly higher % activity of AT was observed at 1 h and 4 h after meal vs. baseline specimen [113 (104–117) and 111 (107–120) vs. 109 (102–118), respectively; P = 0.029 and P = 0.016]. APTT at 2 h was found significantly lower than baseline samples [32.0 (29.9–34.8) vs. 34.1 (32.2–35.2), respectively; P = 0.041]. The results of both Fbg and PS tests were not influenced by a light meal. Furthermore, no coagulation tests had significant variation after comparison with RCV.

Conclusion:

A light meal does not influence the laboratory coagulation tests we assessed, but we suggest that the laboratory quality managers standardize the fasting time for all blood tests at 12 hours, to completely metabolize the lipids intake.     

Improving expressive writing skills of children rated for ADHD symptoms

The present study examines the expressive writing abilities of children described by their teachers as having Attention Deficit Hyperactivity Disorder (ADHD) symptoms and of matched controls and the effects of two types of facilitation. A group of 35 ADHD children and matched controls are given the task of composing a letter either under standard instructions or with facilitation (a guide scheme), preceded by a brief training on how to use the facilitation. Results show that both groups drew benefit from the guide scheme. Despite the fact that differences between groups were maintained after the training for the case of spelling errors, the poorer performance of ADHD children vanished. It is concluded that ADHD children have poor expressive writing skills, but this can be improved through the help of a guide scheme preceded by brief training.