Effect of Pre-Analytical Errors on Quality of Laboratory Medicine at a Neuropsychiatry Institute in North India

Advances in instrument technology and automation have simplified tasks in laboratory diagnostics reducing errors during analysis thereby improving the quality of test results. However studies show that most laboratory errors occur in the pre-analytical phase. In view of the paucity of studies examining pre-analytical errors, we examined a total of 1513 request forms received at our laboratory during a 3 month period. The forms were scrutinized for the presence of specific parameters to assess the pre-analytical errors affecting the laboratory results. No diagnosis was provided on 61.20% of forms. Type of specimen was not mentioned in 61.60% of the forms and 89.25% of all forms were illegible. Critical results were encountered in 17.30% of patients, and of these 76.60% were not communicated due to incomplete forms. Thus, by following standard operating procedures vigorously from patient preparation to sample processing the laboratory results can be significantly improved without any extra cost.     

Teacher participation in the decision‐making process: reality and repercussions in Indian higher education

The study reported here focused on comparing teachers’ actual and desired participation in different decision‐making situations and examined how participation in decision making differs in Indian higher educational institutions. The paper provides a comparison of findings with similar studies conducted in Western settings regarding the relationship of participative decision making (PDM) with some selected organizational variables: teachers’ job satisfaction, organizational goal commitment, role ambiguity, and role conflict. Data were gathered through a survey of 281 faculty members of Banaras Hindu University, India. Results indicate that in the Indian context, teachers’ actual and desired participation was highest in institutional decisions and lowest in technical decisions. Among the personal variables, age, designation, teaching experience and span of service in present institution were found to be significantly related with decisional participation of university teachers. It is recommended that administrators evolve a mechanism for inviting participation of teachers in different decisional domains, based on the findings of this study.     

Program assessment and program improvement: closing the loop

Engineering Criteria 2000 (EC 2000), the recently revised set of accreditation criteria for engineering programs in the USA, places considerable stress on outcomes assessments. EC 2000 requires the assessment results to be used to identify program improvements and for such usage and the resulting improvements to be documented. While numerous assessment instruments have been developed and discussed in the literature, less attention has been paid to the question of how to use these to improve the programs or to document this usage. In this paper, we present an approach that serves both to identify possible improvements based on the results of assessments, as well as to provide high quality documentation. As an added bonus, it also helps incoming students and new faculty to get a good understanding of the structure and evolution of the program.     

‘Rape’ in children

‘Rape’ as a sexual offence has been existing since time immemorial. In a country like India with her conservative and traditional society, sex is not discussed freely and a sexual offence particularly in childhood is hushed up, for fear of the victimised girl's future. Here an attempt is made to study the relavent factors responsible for ‘rape’ in children. These individual cases were followed up, rescued and rehabilitated whenever possible. This paper deals with a prospective study of 130 cases, between the ages of 6 months to 18 years from Bombay, over a period of 15 months. Over 77.68% oases were more than 4 years of age and 6.15% were between the ages of 6 months and 6 years. Shockingly, 2 young infants were of 6 months of age. Majority of these girls belonged to various slums of Bombay. 34.5% of girls were illiterate, and 79.23% had some knowledge about sex. Surprisingly 36.16% were willing victims and the criteria for including these cases under ‘rape’ was their under age i.e. less than 18 years. Of these 130 victims, 23 conceived, of which 6 delivered after full term. The remaining 17 cases were medically terminated. Of the accused, neighbours were responsible in 51.53% of cases, the remaining being contributed by employer, relative, friend and known hooligans from the same area. Some of these girls were rehabilitated and some are still in the remand home. Few girls, though minor, were married to the accused and were still keen on accepting them as their husbands against the wish of their parents.     

A Synergistic Role of Myeloperoxidase and High Sensitivity Troponin T in the Early Diagnosis of Acute Coronary Syndrome

Aim of this study was to evaluate the role of Myeloperoxidase (MPO) and high sensitive Troponin T in the early diagnosis of acute coronary syndrome (ACS). This was a cross sectional study that comprised of 120 individuals of which 75 were cases and 45 healthy controls. On the basis of clinical history and 12 lead electrocardiogram initial diagnosis of ACS was made in the cases. MPO and high sensitive Troponin T (hs-cTnT) was measured in all the individuals. Levels of MPO were significantly higher in patients of ACS as compared to those in control group [medians: 15.40 (95 % CI 11.06–20.84) vs 5.84 (95 % CI 5.50–6.44)]. By taking the cut off as >11.87 U/mL for MPO, its sensitivity was 87 % (95 % CI 73.7–95.1), specificity was 97.3 % (95 % CI 90.6–99.7), positive predictive value was 94.6 % and negative predictive value was 92.6 %. Positive likelihood ratio was 33.0 while negative likelihood ratio was 0.13, whereas the corresponding values in case of hs-cTnT were 95.6 % (95 % CI 85.2–99.5), 61.3 % (95 % CI 49.5–72.6), 59.7 %, 95.8 %, 2.47 and 0.07 by taking cut off as >14 pg/ml. The area under the ROC curves (AUC) of MPO and hscTnT at 0–6 h were 0.971 (95 % CI 0.92–0.99, P < 0.001) and 0.797 (95 % CI 0.71–0.86, P < 0.001) respectively. The logistic model combining the two markers yielded sensitivity, specificity, positive predictive value and negative predictive value of 95.7, 97.3, 98.2 and 93.7 % respectively. It was concluded that MPO and hs-cTnT may be useful tools for risk stratification of ACS and can be used together with better accuracy in the early diagnosis of ACS.     

Against empathy: moving beyond colonizing practices in educational technology

Empathetic design is the ability for the designer to predict the cognitive and emotional experience of learners as they engage with the design product and process. It aims to center sensitivity toward learners, and the design process as a whole, which suggests potential application in educational settings. In the shift to digital, empathetic design may help instructors imagine learners’ thoughts and feelings engaged during the learning activity, and make iterative changes in response. Though empathetic design highlights sensitivity toward learners, by attempting to ‘be’ the other, it may unintentionally enact practices, and ideologies, of colonization. Recommendations for praxis via humanizing pedagogy are offered.