Larger differences in utilization of rarely requested tests in primary care in Spain

Introduction

The study was performed to compare and analyze the inter-departmental variability in the request of rarely requested laboratory tests in primary care, as opposed to other more common and highly requested tests.

Materials and methods

Data from production statistics for the year 2012 from 76 Spanish laboratories was used. The number of antinuclear antibodies, antistreptolysin O, creatinine, cyclic citrullinated peptide antibodies, deaminated peptide gliadine IgA antibodies, glucose, protein electrophoresis, rheumatoid factor, transglutaminase IgA antibodies, urinalysis and uric acid tests requested was collected. The number of test requests per 1000 inhabitants was calculated. In order to explore the variability the coefficient of quartile dispersion was calculated.

Results

The smallest variation was seen for creatinine, glucose, uric acid and urinalysis; the most requested tests. The tests that were least requested showed the greatest variability.

Conclusion

Our study shows through a very simplified approach, in a population close to twenty million inhabitants, how in primary care, the variability in the request of laboratory tests is inversely proportional to the request rate.Key words: primary care, laboratory proficiency testing, clinical laboratory services, test requesting, preanalytical phase     

Education and communication is the key for the successful management of vitamin D test requesting

Introduction

Pre-preanalytical and post-postanalytical phases are steps where the laboratory professional may play a crucial role. Measuring the serum circulating 25 hydroxyvitamin D level (25(OH)D) is recommended to evaluate vitamin D status in patients at risk for vitamin D deficiency while 1,25 hydroxyvitamin D (1,25(OH)₂D) is only recommended to monitor several particular conditions (chronic kidney disease, hereditary phosphate-losing disorders, and some other) clearly defined by the current clinical guidelines of Endocrine Society.
Our research hypothesis was that through education and communication through comments in the Laboratory Information System (LIS), we could improve appropriateness in the request vitamin D tests.

Materials and methods

A retrospective observational cross-sectional study was conducted from January 2005 to December 2014. Each 1,25(OH)₂D request was reviewed individually by a member of the laboratory staff. Starting in November 2011, each inappropriate 1,25(OH)₂D request was registered in LIS and 25(OH)D was measured instead of 1,25(OH)₂D. We counted the overall number of 1,25(OH)₂D requests and the number of inappropriate requests which then were marked with a comment.

Results

The request of 25(OH)D increased along years. However, 1,25(OH)₂D requests increased until 2012 when demand began to diminish.

Conclusions

Education and communication through comments in the LIS, corrected the inappropriate request of 1,25(OH)₂D and promoted the use of 25(OH)D to study vitamin D deficiency.Key words: clinical laboratory services, utilization, vitamin D, communication, education     

Role of maturity timing in selection procedures and in the specialisation of playing positions in youth basketball

This study investigated the role of maturity timing in selection procedures and in the specialisation of playing positions in youth male basketball. Forty-three talented Dutch players (14.66 ± 1.09 years) participated in this study. Maturity timing (age at peak height velocity), anthropometric, physiological, and technical characteristics were measured. Maturity timing and height of the basketball players were compared with a matched Dutch population. One-sample t-tests showed that basketball players were taller and experienced their peak height velocity at an earlier age compared to their peers, which indicates the relation between maturity timing and selection procedures. Multivariate analysis of variance (MANOVA) showed that guards experienced their peak height velocity at a later age compared to forwards and centres (P < .01). In addition, positional differences were found for height, sitting height, leg length, body mass, lean body mass, sprint, lower body explosive strength, and dribble (P < .05). Multivariate analysis of covariance (MANCOVA) (age and age at peak height velocity as covariate) showed only a significant difference regarding the technical characteristic dribbling (P < .05). Coaches and trainers should be aware of the inter-individual differences between boys related to their maturity timing. Since technical characteristics appeared to be least influenced by maturity timing, it is recommended to focus more on technical characteristics rather than anthropometric and physiological characteristics.     

Gender, politics, and radioactivity research in interwar Vienna: the case of the Institute for Radium Research

This essay explores the significance of political and ideological context as well as experimental culture for the participation of women in radioactivity research. It argues that the politics of Red Vienna and the culture of radioactivity research specific to the Viennese setting encouraged exceptional gender politics within the Institute for Radium Research in the interwar years. The essay further attempts to provide an alternative approach to narratives that concentrate on personal dispositions and stereotypical images of women in science to explain the disproportionately large number of women in radioactivity research. Instead, the emphasis here is on the institutional context in which women involved themselves in radioactivity in interwar Vienna. This approach places greater importance on contingencies of time and place and highlights the significance of the cultural and political context in a historical study while at the same time shedding light on the interrelation between scientific practices and gender.     

Community Technology and Democratic Rationalization

The objective of this paper is to explore questions of human agency and democratic process in the technical sphere through the example of "virtual community." The formation of relatively stable long-term group associations--community in the broad sense of the term--is the scene on which a large share of human development occurs. As such it is a fundamental human value mobilizing diverse ideologies and sensitivities. The promise of realizing this value in a new domain naturally stirs up much excitement among optimistic observers of the Internet. At the same time, the eagerness to place hopes for community in a technical system flies in the face of an influential intellectual tradition of technology criticism. This eagerness seems even more naive in the light of the recent commercialization of so much Internet activity. Despite the widespread skepticism, we believe the growth of virtual community is significant for an inquiry into the democratization of technology.We show that conflicting answers to the central question of the present theoretical debate--Is community possible on computer networks?--generalize from particular features of systems and software prevalent at different stages in the development of computer networking. We conclude that research should focus instead on how to design computer networks to better support community activities and values.     

The tragedy of the digital commons

In the paper it is argued that bridging the digital divide may cause a new ethical and social dilemma. Using Hardin's Tragedy of the Commons, we show that an improper opening and enlargement of the digital environment (Infosphere) is likely to produce a Tragedy of the Digital Commons (TDC). In the course of the analysis, we explain why Adar and Huberman's previous use of Hardin's Tragedy to interpret certain recent phenomena in the Infosphere (especially peer-to-peer communication) may not be entirely satisfactory. We then seek to provide an improved version of the TDC that avoids the possible shortcomings of their model. Next, we analyse some problems encountered by the application of classical ethics in the resolution of the TDC. In the conclusion, we outline the kind of work that will be required to develop an ethical approach that may bridge the digital divide but avoid the TDC.     

The girl with the garden gloves: researching the affordances of sensual materialities in the school garden

ABSTRACT

This article uses vignettes and photographs taken from ethnographic research to reframe the methodological assumptions within school garden research. New theoretical perspectives are applied to previous empirical school garden research that provides deeper understandings of both the teaching and the learning of ecoliteracy in such material contexts. Actor Network Theory and Social Semiotics further highlight the affordance of school garden spaces. We make public the conversations of a small research group about a perceived ethnographic turn towards materiality, aesthetics and agency.     

Context and quantitative dimension of social conventional transgressions: Is it more serious at home or at school?

The aim of this experiment was to know whether the same transgressions were judged of different seriousness depending on their context of occurrence, and whether subjects’ judgements varied according to age. Sixty subjects participated in the experiment, 20 4-year-olds, 20 8-year-olds, and 20 adults. Four cases of transgression of social conventional rules were examined. Each transgression occurred in four contexts. Subjects compared the contexts of each transgression in pairs in all combinations. For each age group, data were analyzed by means of Kruskal’s scaling in order to rank the contexts of each transgression, and by means of correspondence analysis to relate transgressions and contexts with each other. Results show that children of both ages are quite consistent in their ranking of contexts. They differ from adults who, instead, consider transgressions to be more context-specific. Results are discussed for their theoretical value and in relation to the concept of context.     

Academic anxieties: which type contributes the most to low achievement in methodological courses?

Students’ academic achievement in courses with a high mathematical content can be affected by their levels of trait, math and test anxiety. In this study, 180 university students were assessed on these types of anxiety and the relationships between them and students’ performance were evaluated. Higher levels of math anxiety were related to a low academic achievement, but a high level of test anxiety was related only to an increase in the number of errors. Moreover, although women reported higher levels of trait, math and test anxiety than their male peers, their academic achievement was similar. We conclude that math anxiety is the main emotional factor that can affect students’ performance in these courses and some proposals to help highly math-anxious students are discussed.     

The prevention of emotional and behavioural difficulties in schools: Teachers’ suggestions

Teachers are highly concerned about students with Emotional and Behavioural Difficulties (EBD). Lately, much emphasis has been given to the field of prevention in schools, through the Competence‐Enhancement Perspective. Emotional Intelligence (EI) and Social and Emotional Learning (SEL) provide the necessary skills to be acquired by students. The current study explored Greek in‐service teachers’ perceptions of the most important cognitive, emotional and social skills students should possess, in order to prevent the occurrence of EBD. It was found that teachers emphasised the importance of emotional skills. The study acknowledges teachers’ significant role in children’s social and emotional learning and advocates their involvement in the design of skills programmes for EBD pupils.