The effective reduction of tourniquet application time after minor modification of the CLSI H03-A6 blood collection procedure

Introduction:

The phlebotomists’ procedures are a still source of laboratory variability. The aim of this study was to verify the efficacy of minor modification in procedure for collection of diagnostic blood specimens by venipuncture from CLSI H03-A6 document is able to reduce the tourniquet application time.

Materials and methods:

Thirty phlebotomists were invited to participate. Each phlebotomist was trained individually to perform the new venipuncture procedure that shortens the time of tourniquet release and removal. The phlebotomy training program was delivered over 8h. After training, all phlebotomists were monitored for 20 working days, to guarantee the adoption of the correct new procedures for collection of diagnostic blood specimens. After this time frame the phlebotomists were evaluated to verify whether the new procedure for blood collection derived from CLSI H03-A6 document was effective to improve the quality process by decrease in tourniquet application time. We compared the tourniquet application time and qualitative difference of phlebotomy procedures between laboratories before and after phlebotomy training.

Results:

The overall mean ± SD tourniquet application time before and after this intervention were 118 ± 1 s and 30 ± 1 s respectively. Minor modifications in procedure for blood collection were able to reduce significantly the tourniquet application time (−88 s, P < 0.001).

Conclusions:

The minor modifications in procedure for collection of diagnostic blood specimens by venipuncture from CLSI H03-A6 document were able to reduce the tourniquet application time. Now the proposed new procedure for collection of diagnostic blood specimens by venipuncture could be considered usefulness and should be put into practice by all quality laboratory managers and/or phlebotomy coordinators to avoid preanalytical errors regard venous stasis and guarantee patient safety.     

Quality Impact on Diagnostic Blood Specimen Collection Using a New Device to Relieve Venipuncture Pain

A new device called Buzzy^® has been recently presented that combines a cooling ice pack and a vibrating motor in order to relieve the venipuncture pain. The aim of this study was to evaluate the impact of Buzzy^® use during diagnostic blood specimen collection by venipuncture for routine immunochemistry tests. Blood was collected from 100 volunteers by a single, expert phlebotomist. A vein was located on the left forearm without applying tourniquet, in order to prevent any interference from venous stasis, and blood samples were collected using a 20-G straight needle directly into 5 mL vacuum tubes with clot activator and gel separator. In sequence, external cold and vibration by Buzzy^® was applied on the right forearm—5 cm above the chosen puncture site—for 1 min before venipuncture and continued until the end of the same procedure already done in the left forearm. The panel of tests included the following: glucose, total cholesterol, HDL-cholesterol, triglycerides, total protein, albumin, c-reactive protein, urea, creatinine, uric acid, alkaline phosphatase, amylase, AST, ALT, g-glutamyltransferase, lactate dehydrogenase, creatine kinase, total bilirubin, phosphorus, calcium, magnesium, iron, sodium, potassium, chloride, lipase, cortisol, insulin, thyroid-stimulating hormone, total triiodothyronine, free triiodothyronine, total thyroxine, free thyroxine and haemolysis index. Clinically significant differences between samples were found only for: total protein, albumin and transferrin. The Buzzy^® can be used during diagnostic blood specimens collection by venipuncture for the majority of the routine immunochemistry tests. We only suggest avoiding this device during blood collection when protein, albumin and transferrin determinations should be performed.     

Work-family conflict and facilitation among teachers in Israel and Switzerland

In this paper, we examine the attitudes toward integrating work and family in a sample of 247 teachers in Switzerland and Israel. More particularly, we focus on the national context’s role in mediating the relations between professional and private spheres. The data were collected by a questionnaire implemented and administered in the two countries. The analysis reveals differences between Israeli and Swiss teachers regarding the importance of attribution to life roles and their attitudes toward conflict and facilitation. Findings suggest new insights into the consideration of cultural elements in shaping the teachers’ attitudes toward the integration of family and work.

     

CLAIRE: A combinatorial visual analytics system for information retrieval evaluation

Information Retrieval (IR) develops complex systems, constituted of several components, which aim at returning and optimally ranking the most relevant documents in response to user queries. In this context, experimental evaluation plays a central role, since it allows for measuring IR systems effectiveness, increasing the understanding of their functioning, and better directing the efforts for improving them. Current evaluation methodologies are limited by two major factors: (i) IR systems are evaluated as “black boxes”, since it is not possible to decompose the contributions of the different components, e.g., stop lists, stemmers, and IR models; (ii) given that it is not possible to predict the effectiveness of an IR system, both academia and industry need to explore huge numbers of systems, originated by large combinatorial compositions of their components, to understand how they perform and how these components interact together.We propose a Combinatorial visuaL Analytics system for Information Retrieval Evaluation (CLAIRE) which allows for exploring and making sense of the performances of a large amount of IR systems, in order to quickly and intuitively grasp which system configurations are preferred, what are the contributions of the different components and how these components interact together.The CLAIRE system is then validated against use cases based on several test collections using a wide set of systems, generated by a combinatorial composition of several off-the-shelf components, representing the most common denominator almost always present in English IR systems. In particular, we validate the findings enabled by CLAIRE with respect to consolidated deep statistical analyses and we show that the CLAIRE system allows the generation of new insights, which were not detectable with traditional approaches.     

Modular exaptation: A missing link in the synthesis of artificial form

Exaptation, the cooption of existing technologies for emergent functions, is an important but neglected mechanism for innovation. Exaptation may enable an existing technology to (a) construct a new technological niche, (b) enter into a preexisting niche, or (c) transform the internal architecture of an artifact without changing its function.     

Cardiac troponins and physical exercise. It's time to make a point

The timely diagnosis of acute coronary syndrome (ACS), in particular myocardial infarction (MI), is still one of the most challenging issues in medicine. The introduction into routine laboratory practice of assays for measuring the cardiospecific troponins has dramatically revolutionized the diagnostic approach and the recent development of methods with improved analytical sensibility (i.e., highly sensitivity [HS] assays), has further contributed to improve the negative predictive value of troponin testing but, contextually, has substantially lowered the clinical specificity of these markers. In particular, clinical studies have demonstrated the existence of an exercise-related increase of HS-troponins, with measurable values detectable in up to 94% of athletes undergoing endurance sports. This measurable amount oftroponin in blood would mirror an increased membrane permeability and early troponin release rather than reflecting a clinically threatening myocardial injury. As such, the measurable amount of cardiac troponins as assessed with the novel HS assays requires major clinical focus (i.e., serial measurement of cardiac biomarkers, detailed clinical history-taking, integration with ECG and imaging findings) to prevent misdiagnosis of ACS and/or MI in otherwise healthy persons.     

Intra- and inter-session reliability of vertical jump performance in healthy middle-aged and older men and women

Despite its widespread use in performance assessment, the reliability of vertical jump in an ageing population has not been addressed properly. The aim of the present study was to assess intra- and inter-day reliability of countermovement jump in healthy middle-aged (55-65 years) and older (66-75 years) men and women. Eighty-two participants were recruited and asked to perform countermovement jumps on two different occasions interspersed by 4 weeks. The middle-aged groups exhibited excellent absolute reliability for flight height, jump height, peak force, peak power, peak force/body mass, and peak power/body mass, with coefficients of variation ranging from 2.9% to 7.2% in men and from 3.6% to 6.9% in women and moderate-to-high intraclass correlations (0.75 to 0.97 in men; 0.77 to 0.95 in women). The older groups displayed good coefficients of variation (4.2% to 10.8% in men and 3.4% to 9.5% in women), but the intraclass correlations were low-to-high (0.43 to 0.84 in men; 0.42 to 0.93 in women). Overall, intra-session reliability was higher than inter-session reliability. Peak power was by far the most consistent variable, whereas flight and jump height had the most marked variability. The minimum detectable change varied from 10.5% to 33%, depending on the variable examined, suggesting important implications for intervention studies.     

The value of neurosurgical and intraoperative magnetic resonance imaging and diffusion tensor imaging tractography in clinically integrated neuroanatomy modules: A cross‐sectional study

Neuroanatomy is considered to be one of the most difficult anatomical subjects for students. To provide motivation and improve learning outcomes in this area, clinical cases and neurosurgical images from diffusion tensor imaging (DTI) tractographies produced using an intraoperative magnetic resonance imaging apparatus (MRI/DTI) were presented and discussed during integrated second‐year neuroanatomy, neuroradiology, and neurosurgery lectures over the 2008–2011 period. Anonymous questionnaires, evaluated according to the Likert scale, demonstrated that students appreciated this teaching procedure. Academic performance (examination grades for neuroanatomy) of the students who attended all integrated lectures of neuroanatomy, was slightly though significantly higher compared to that of students who attended these lectures only occasionally or not at all (P=0.04). Significantly better results were obtained during the national progress test (focusing on morphology) by students who attended the MRI/DTI‐assisted lectures, compared to those who did so only in part or not at all, compared to the average student participating in the national test. These results were obtained by students attending the second, third and, in particular, the fourth year (P≤0.0001) courses during the three academic years mentioned earlier. This integrated neuroanatomy model can positively direct students in the direction of their future professional careers without any extra expense to the university. In conclusion, interactive learning tools, such as lectures integrated with intraoperative MRI/DTI images, motivate students to study and enhance their neuroanatomy education. Anat Sci Educ 6: 294–306. © 2013 American Association of Anatomists.     

Introduction to the Special Issue “Beyond Industrial Robotics: Social Robots Entering Public and Domestic Spheres”

Industrial and domestic robotics provide fascinating and relevant perspective insights into current and possible trajectories for the development of contemporary societies. While industrial robotics has found its place since the 1960s, domestic robotics wherein humans interact with social robots is still an unsettled area. After reviewing data on the diffusion of social robots and on their use, the historical tradition from which social robots come is discussed. This discussion is followed by an analysis of the penetration of social robots in everyday life and the importance of interdisciplinary research is highlighted.