Detection of preanalytical errors in arterial blood gas analysis

IntroductionBlood gas analysis (BGA) is an essential test used for years to provide vital information in critically ill patients. However, the instability of the blood gases is a problem. We aimed to evaluate time and temperature effects on blood gas stability.Materials and methodsArterial blood was collected from 20 patients into syringes. Following BGA for baseline, syringes were divided into groups to stand at 4°C and 22°C for 30, 60, 90, 120 minutes. All were tested for pH, partial pressure of carbon dioxide (pCO₂), partial pressure of oxygen (pO₂), oxygen saturation (sO₂), oxyhemoglobin (O₂Hb), sodium, potassium, glucose, lactate, oxygen tension at 50% hemoglobin saturation (p50), and bicarbonate. A subgroup analysis was performed to detect the effect of air on results during storage. Percentage deviations were calculated and compared against the preset quality specifications for allowable total error.ResultsAt 4°C, pO₂ was the least stable parameter. At 22°C, pO₂ remained stable for 120 min, pH and glucose for 90 min, lactate and pCO₂ for 60 min. Glucose and lactate were stable when chilled. Air bubbles interfered pO₂ regardless of temperatures, whereas pCO₂ increased significantly at 22°C after 30 min, and pH decreased after 90 min. Bicarbonate, sO₂, O₂Hb, sodium, and potassium were the unaffected parameters.ConclusionsCorrect BGA results are essential, and arterial sample is precious. Therefore, if immediate analysis cannot be performed, up to one hour, syringes stored at room temperature will give reliable results when care is taken to minimize air within the blood gas specimen.     

Comparing Numerical Methods to Estimate Vertical Jump Height Using a Force Platform

ABSTRACT

Males (n = 29) and females (n = 34) performed vertical jumps. Jump height was estimated from force platform data using five numerical methods and compared using intraclass correlation (ρ), and linear and rank regression standard error of estimate (SEE). Take-off velocity plus center of mass height at take-off and mechanical work methods were identical (ρ = 1.000) with small linear (SEE < 0.0001 cm) and rank order (SEE = 0) error. Integrating acceleration to displacement was nearly identical (ρ > 0.999), with small linear (SEE = 0.1 cm) and rank order (SEE < 1) errors compared to the above methods. Take-off velocity (ρ = 0.517) and flight time (ρ = 0.573) estimates were less than all other methods and had large linear (SEE ≥ 2.1 cm) and rank order (SEE > 4) errors. Take-off velocity and flight time methods should be avoided due to systematic and random error.     

The Cost-effectiveness of Preventive Conservation Actions

ABSTRACT

Two historic house museums, a municipal art gallery, and a provincial archive have had comprehensive risk and option assessments done by the Canadian Conservation Institute. For each institution, an average of 60 options addressing 40 risks was analyzed in terms of risk reduction, cost, and cost-effectiveness. A meta-analysis found that cost-effectiveness follows a strong economy of scale within each institution. By estimating valuation of each collection, cost-effectiveness was converted into benefit–cost ratio of dollar spent per dollar value saved and was found not to follow an economy of scale between small and large institutions. Optimization software was applied to see if precise maximization of risk reduction gave significantly different recommendations than those in the original reports which relied on the Pareto rule of addressing the largest risks first.     

User Experiences with Editorial Control in Online Newspaper Comment Fields

This article investigates user experiences with editorial control in online newspaper comment fields following the public backlash against online comments after the 2011 terror attacks in Norway. We analyze data from a survey of online news consumers focusing on experiences and attitudes towards editorial control set against a spectrum between “interventionist” and “noninterventionist” positions. Results indicate that interventionist respondents rate the quality of online comments as poor, whereas noninterventionist respondents have most often experienced being the target of editorial control measures and feel that editorial control has intensified after the terror attacks. We conclude that newspapers should pay attention to the different needs of participants when devising strategies for editorial control. Media professionals should also consider changes to increase the transparency of moderation practices.     

Beyond “J-Tweeters”

Based on a survey (N?=?1613) directed to members of the Norwegian Journalist Association (NJ), this paper presents an extensive overview of the ways in which comparably older and newer online platforms have been incorporated into the professional lives of Norwegian journalists. While plenty of research is available that explores the uses of Twitter by journalists, the results presented here suggest that Facebook is by far the most frequently used platform throughout the journalistic process—from collecting information, distributing content and engaging with readers. Statistical analyses provide further insights into which variables appear to influence certain modes of usage across the studied platforms. Based on the results, the argument is made that the advantages of using Facebook as a platform for journalistic practices are obvious due to its popularity among the general public, but that this utilization of one platform over others also could be problematic. As Facebook continues to gain leverage towards the newspapers they host, questions of journalistic practices need to come to the fore.     

Low energy availability in exercising men is associated with reduced leptin and insulin but not with changes in other metabolic hormones

Low energy availability, defined as low caloric intake relative to exercise energy expenditure, has been linked to endocrine alterations frequently observed in chronically energy-deficient exercising women. Our goal was to determine the endocrine effects of low energy availability in exercising men. Six exercising men (VO_2peak: 49.3 ± 2.4 ml · kg^?1 · min^?1) underwent two conditions of low energy availability (15 kcal · kg^?1 fat-free mass [FFM] · day^?1) and two energy-balanced conditions (40 kcal · kg^?1 FFM · day^?1) in randomised order. During one low energy availability and one balanced condition, participants exercised to expend 15 kcal · kg^?1 FFM · day^?1; no exercise was conducted during the other two conditions. Metabolic hormones were assessed before and after each 4-day period. Following both low energy availability conditions, leptin (?53% to ?56%) and insulin (?34% to ?38%) were reduced (P < 0.05). Reductions in leptin and insulin were independent of whether low energy availability was attained with or without exercise (P > 0.80). Low energy availability did not significantly impact ghrelin, triiodothyronine, testosterone and IGF-1 (all P > 0.05). The observed reductions in leptin and insulin were in the same magnitude as changes previously reported in sedentary women. Further research is needed to understand why other metabolic hormones are more robust against low energy availability in exercising men than those in sedentary and exercising women.     

Policy on ethnic segregation in a system of choice: the case of The Netherlands

This paper examines the implications of the uneven distribution of minority pupils and the Dutch system of choice for policies on ethnic segregation at both the local and school level. The analysis is based on a sample of 27 municipalities serving 23% of all Dutch primary school pupils. Segregation to a large extent can be found in The Netherlands as elsewhere, and the constitutional freedom of education is precisely the factor that places important restrictions on solving this problem adequately. At the local level more than one‐third of all municipalities, for various reasons, do not take any action. Of the others that do take action the majority saddles the schools with the responsibility since the problems are mainly seen as of an educational nature. According to the school principals a percentage of minority pupils exceeding 50‐60% causes ‘white’ parents to leave and they are given every opportunity to do so by the Dutch system of free parental choice. Therefore a radical reorientation is required in the Dutch system of choice in order to address the challenges of ethnic segregation.     

Education policy in an era of neoliberal urbanisation: a case study of Istanbul’s school relocations

This article examines an effort to spatially re-organise urban public schools in the largest city in Turkey. Recently, the Turkish government has made an effort to relocate inner-city public schools in Istanbul to less desirable parts of the city. Analysing how education policy in the country is tied to wider political mechanisms and considering the results of the studies carried out in various parts of the world, this article argues that the interaction between education and urban life in Turkey displays unique characteristics in terms of the populations implicated in the policy change and the spaces transformed as a result. Two salient characteristics are the involvement of the secular middle class and the perception by them that school relocations entail de-secularisation of the city and the education system. The article argues that these characteristics should be conceptualised in the context of particular conjunctures of forces driven by different contradictions.     

The Dutch policy of integration put to the test: differences in academic and psychosocial development of pupils in special and mainstream education

After several failed attempts to rein in the growth of special education, the Dutch government made a start in 1991 with a policy to accommodate pupils with problems in regular education and to put a stop to the growth of special education. This paper examines a large-scale study conducted by our research group at the University of Amsterdam which attempted to answer the question whether pupils with problems are better off in special education where there are more resources and they can get more attention than in mainstream schools. It was expected that the pupils in special education would do better due to the specialist care and individual attention. However, with a few exceptions, few differences were found when comparable at-risk pupils in regular schools were compared with their counterparts in both types of special schools. There was a conspicuously large measure of variability in both regular and special education. All school types had both at-risk pupils who were doing well from an academic and/or psychosocial perspective and pupils whose progress left much to be desired. There is little evidence to support the idea that at-risk pupils make less progress, in either their academic or psychosocial development, in regular schools compared with pupils in special schools. The general assumption that at-risk pupils will do better in special education does not seem to account for its attractiveness. Contrary to the policy theory, the dual system, as it exists in The Netherlands, does not appear to be an obstacle to the provision of adequate care for pupils with special educational needs. However, the policy to equip regular schools to accommodate this category of pupils appears not to be realized as simply as that. It has not proved possible to demonstrate the effects of the varying levels of specialist help provided by regular schools on the development of at-risk pupils.