A survey of practice in the management of haemolysis, icterus, and lipaemia in blood specimens in the United Kingdom and Republic of Ireland

2021 ◽  
pp. 000456322110597
Author(s):  
Sean Costelloe ◽  
Natividad Rico Rios ◽  
Nicola Goulding ◽  
Hema Mistry ◽  
Adam Stretton ◽  
...  
Keyword(s):  
Quality Control ◽  
Clinical Care ◽  
Laboratory Medicine ◽  
Cross Reactivity ◽  
Public Hospitals ◽  
Internal Quality ◽  
The United Kingdom ◽  
Blood Specimens ◽  
The Uk ◽  
Control And Management

Background Haemolysis, icterus and lipaemia (HIL) are common interferants in laboratory medicine, potentially impacting patient care. This survey investigates HIL management in medical laboratories across the UK and ROI. Methods A survey was sent to members of key professional organisations for laboratory medicine in the UK and ROI. Questions related to the detection, monitoring, quality control, and management of HIL. Results In total, responses from 124 laboratories were analysed, predominantly from England (52%) and ROI (36%). Most responses were from public hospitals with biochemistry services (90%), serving primary care (91%), inpatients (91%), and outpatients (89%). Most laboratories monitored H (98%), I (88%), and L (96%) using automated indices (93%), alone or in combination with visual inspection. Manufacturer-stated cut-offs were used by 83% and were applied to general chemistries in 79%, and immunoassays in 50%. Where HIL cut-offs are breached, 64% withheld results, while 96% reported interference to users. HIL were defined using numeric scales (70%) and ordinal scales (26%). HIL targets exist in 35% of laboratories, and 54% have attempted to reduce HIL. Internal Quality Control for HIL was lacking in 62% of laboratories, and just 18% of respondents have participated in External Quality Assurance. Laboratories agree manufacturers should: standardise HIL reporting (94%), ensure comparability between platforms (94%), and provide information on HIL cross-reactivity (99%). Respondents (99%) showed interest in evidence-based, standardised HIL cut-offs. Conclusions Most respondents monitor HIL, although the wide variation in practice may differentially affect clinical care. Laboratories seem receptive to education and advice on HIL management.

scholarly journals Uncertainty of Measurement in Laboratory Medicine

2018 ◽  
Vol 37 (3) ◽  
pp. 279-288 ◽  
Author(s):  
Neda Milinković ◽  
Svetlana Ignjatović ◽  
Zorica Šumarac ◽  
Nada Majkić-Singh
Keyword(s):  
Quality Control ◽  
Good Clinical Practice ◽  
Laboratory Medicine ◽  
Internal Quality ◽  
Uncertainty Of Measurement ◽  
Laboratory Practice ◽  
Iso 15189 ◽  
Diagnostic Uncertainty ◽  
Measurement Results ◽  
Reliable Interpretation

SummaryAn adequate assessment of the measurement uncertainty in a laboratory medicine is one of the most important factors for a reliable interpretation of the results. A large number of standards and guidelines indicate the need for a proper assessment of the uncertainty of measurement results in routine laboratory practice. The available documents generally recommend participation in the proficiency schemes/ external quality control, as well as the internal quality control, in order to primarily verify the quality performance of the method. Although all documents meet the requirements of the International Standard, ISO 15189, the standard itself does not clearly define the method by which the measurement results need to be assessed and there is no harmonization in practice regarding to this. Also, the uncertainty of measurement results is the data relating to the measured result itself, but all factors that influence the interpretation of the measured value, which is ultimately used for diagnosis and monitoring of the patient's treatment, should be taken into account. So in laboratory medicine, an appropriate assessment of the uncertainty of the measurement results should have the ultimate goal of reducing diagnostic uncertainty. However, good professional laboratory practice and understanding analytical aspects of the test for each individual laboratory is necessary to adequately define the uncertainty of measurement results for specific laboratory tests, which helps to implement good clinical practice. Also, setting diagnoses in medicine is a decision with a certain degree of uncertainty, rather than statistically and mathematically calculated conclusion.

scholarly journals Inpatient suicide death in Ireland: challenges and opportunities for clinical care

2015 ◽  
Vol 32 (3) ◽  
pp. 233-236
Author(s):  
K. M. Malone ◽  
E. Cleary ◽  
A. Lane
Keyword(s):  
United Kingdom ◽  
Clinical Care ◽  
The Past ◽  
The United Kingdom ◽  
Community Psychiatric ◽  
Psychiatric Units ◽  
Stigma Of Mental Illness ◽  
Challenges And Opportunities ◽  
Inpatient Suicide ◽  
The Uk

Rates of admissions and residency in Irish psychiatric units and hospitals have decreased significantly over the last 30 years. Through this period national suicide rates have increased, with Ireland currently having the 17th highest suicide rate of the 27 EU countries and the fourth highest rate in males aged 15–24 years. Suicide deaths among inpatients in psychiatric care are rare but tragic occurrences. At present, little is known about the incidence, prevalence or profile of inpatient suicide in Ireland and in comparison with other European countries. Addressing a similar deficit, the United Kingdom established a National Confidential Enquiry in 1992, which over the past two decades has used a standardized research methodology to comprehensively investigate all suicide deaths of, and homicides committed by, people in contact with the mental health services. This inquiry, using a no-fault and confidential approach with all clinicians has informed and improved services and policies and possibly impacted on suicide reduction efforts in the United Kingdom. Suicide prevention efforts in Ireland are negatively influenced by an ongoing stigma of mental illness and suicide, which sustains the knowledge gap in relation to inpatient suicide. A similar method of enquiry to that of the UK confidential approach blended with current demographic and clinical data sources and including family input (from those bereaved by inpatient suicide) could inform a tailored policy and provide a valuable model for studying suicide across all inpatient and community psychiatric services.

İngiltere’den Türkiye’ye ‘Düzensiz’ Göçmen Dövizi Gönderme Davranışının Nedenleri Üzerine Nitel Bir İnceleme

2019 ◽  
Vol 6 (2) ◽  
pp. 173-190
Author(s):  
Fethiye Tilbe
Keyword(s):  
Cultural Values ◽  
Host Country ◽  
Regulatory Framework ◽  
Face To Face ◽  
Migrant Communities ◽  
The United Kingdom ◽  
Main Determinants ◽  
Money Transfers ◽  
The Uk ◽  
Migrant Groups

Bu makale, göçmen dövizi  akımlarında “düzensizlik” olarak ifade ettiğimiz, Türkiye’ye resmi kanallar dışında gönderilen enformel  göçmen dövizlerini, Birleşik Krallık’ta (özellikle Londra’da) yaşayan Türkiye kökenli göçmenler açısından incelemektedir. Her göçmen grubu, gerek ev sahibi ülkedeki düzenleyici çerçeve ve sosyo-ekonomik koşullar, gerek göçmen topluluğunun sosyo-kültürel değerleri tarafından belirlenen biçimde, farklı göçmen dövizi transfer biçimlerine eğilim sergilemektedir. Dolayısıyla farklı ülkelerdeki aynı kökenden göçmen toplulukları, ev sahibi ülkedeki dinamikler nedeniyle göçmen dövizlerinin formel ya da enformel (düzenli ya da düzensiz) gönderiminde farklılaşabilirken, aynı ülkedeki farklı ülke kökenli göçmen grupları da pek çok örüntünün etkisiyle farklı eğilim gösterebilmektedir. Nitel araştırma tasarımı kapsamında 27 göçmen ve 7 anahtar statüdeki katılımcıyla gerçekleştirilen yüz yüze görüşmelere dayalı olan bu çalışma, Birleşik Krallık’tan Türkiye’ye göçmen dövizi gönderimindeki düzensizlik olgusunu, her iki ülkenin sosyal, ekonomik ve kültürel dinamikleriyle ilişkilendirerek incelemeyi ve nedenlerini ortaya çıkarmayı amaç edinmektedir. Elde edilen sonuçlar, göçmenlik statüsü, gönderilen para miktar ve sıklığı ile geleneksel ilişki ağlarına olan güvenin yanında, Birleşik Krallık’taki sosyal yardım ve çalışma biçimine ilişkinin düzenleyici çerçevenin ve göçmenlerin sosyo-ekonomik durumlarının Türkiye’ye enformel göçmen dövizi gönderiminde temel belirleyici olduğunu ortaya koymaktadır.ABSTRACT IN ENGLISHA Qualitative Examination of Determinants of Remittances Sending Behaviour Among Immigrants from Turkey in the UKThis article examines the causes of irregularity in remittances flows from the United Kingdom (UK) to Turkey, from the perspective of migrants from Turkey living in the UK. Each group of migrants prefers different types of remittance sending methods, as determined by the regulatory framework and socio-economic conditions in the host country and the socio-cultural values of the migrant community. Therefore, migrant communities of the same origin in different countries may differ in using formal or informal sending methods of remittances due to the dynamics in the host country. Similarly, migrant groups of different nationalities in the same country may show different tendencies due to the influence of many patterns. Similarly, migrant groups of different nationalities in the same country may show different tendencies due to the influence of many patterns. This study aims to examine the phenomenon of irregularities in sending remittances by associating with the social, economic and cultural dynamics of both countries. For this purpose, face-to-face in-depth interviews were conducted with 27 immigrants and 7 key status participants by using qualitative research method. The obtained results reveal that the regulatory framework relating to social assistance and labour market in the UK, immigration status, the frequency and the amount of money sent and confidence in traditional relationship networks is the main determinants of informal money transfers to Turkey.

TBE in United Kingdom

2020 ◽  
Keyword(s):  
United Kingdom ◽  
Clinical Disease ◽  
England And Wales ◽  
Probable Case ◽  
The United Kingdom ◽  
South West ◽  
Louping Ill ◽  
The Uk ◽  
North And South ◽  
South West England

Until 2019, TBE was considered only to be an imported disease to the United Kingdom. In that year, evidence became available that the TBEV is likely circulating in the country1,2 and a first “probable case” of TBE originating in the UK was reported.3 In addition to TBEV, louping ill virus (LIV), a member of the TBEV-serocomplex, is also endemic in parts of the UK. Reports of clinical disease caused by LIV in livestock are mainly from Scotland, parts of North and South West England and Wales.4

Science, Politics, and the Pandemic

2020 ◽  
Vol 119 (820) ◽  
pp. 303-309
Author(s):  
J. Nicholas Ziegler
Keyword(s):  
United States ◽  
Biomedical Research ◽  
Scale Up ◽  
Political Leadership ◽  
The United States ◽  
Scientific Advice ◽  
The United Kingdom ◽  
Effective Policy ◽  
Scientific Expertise ◽  
The Uk

Comparing the virus responses in Germany, the United Kingdom, and the United States shows that in order for scientific expertise to result in effective policy, rational political leadership is required. Each of these three countries is known for advanced biomedical research, yet their experiences in the COVID-19 pandemic diverged widely. Germany’s political leadership carefully followed scientific advice and organized public–private partnerships to scale up testing, resulting in relatively low infection levels. The UK and US political responses were far more erratic and less informed by scientific advice—and proved much less effective.

Risk Transferin Public Private Partnership/Private Finance Initiative Procurement Documents:The Differencebetween The United Kingdom and Malaysia

2016 ◽  
Vol 4 (4) ◽  
pp. 30
Author(s):  
Nooriha Abdullah ◽  
Darinka Asenova ◽  
Stephen J. Bailey
Keyword(s):  
United Kingdom ◽  
Public Procurement ◽  
Research Question ◽  
Public Private Partnership ◽  
Private Finance Initiative ◽  
Private Partnership ◽  
Risk Transfer ◽  
Private Finance ◽  
The United Kingdom ◽  
The Uk

The aim of this paper is to analyse the risk transfer issue in Public Private Partnership/Private Finance Initiative (PPP/PFI) procurement documents in the United Kingdom (UK) and Malaysia. It utilises qualitative research methods using documentation and interviews for data collection. The UK documents (guidelines and contracts) identify the risks related to this form of public procurement of services and makeexplicittheappropriateallocation of those risks between the public and the private sector PPP/PFI partners and so the types of risks each party should bear. However, in Malaysia, such allocation of risks was not mentioned in PPP/PFI guidelines. Hence, a question arises regarding whether risk transfer exists in Malaysian PPP/PFI projects, whether in contracts or by other means. This research question is the rationale for the comparative analysis ofdocumentsand practicesrelatingtorisk transfer in the PPP/PFI procurements in both countries. The results clarify risk-related issues that arise in implementing PPP/PFI procurement in Malaysia, in particular how risk is conceptualised, recognised and allocated (whether explicitly or implicitly), whether or not that allocation is intended to achieve optimum risk transfer, and so the implications forachievement ofvalue for moneyor other such objectivesinPPP/PFI.

EVALUATION OF THE UNITED KINGDOM NATIONAL EXTERNAL QUALITY ASSESSMENT SERVICE 2008 (UK NEQAS 2008) GUIDELINES FOR THE DIAGNOSIS OF SUBARACHNOID HEMORRHAGE USING SPECTROPHOTOMETRIC XANTHOCHROMIA: A RETROSPECTIVE STUDY

2009 ◽  
Vol 32 (6S) ◽  
pp. 5
Author(s):  
A Gangloff ◽  
L Nadeau
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Viral Encephalitis ◽  
Objective Evaluation ◽  
Final Diagnosis ◽  
Amyloid Angiopathy ◽  
The United Kingdom ◽  
Cerebral Amyloid ◽  
The One ◽  
The Uk

Objective: Evaluation of the UK NEQAS 2008 guidelines for the interpretation of spectrophotometric xanthochromia. Method: A search of the laboratory database for all the xanthochromia test results between May 1st 2008 and May 1st 2009 was performed. Medical charts were reviewed for patients of Hôpital de l’Enfant-Jésus (HEJ) that had at least one detectable pigment (bilirubin, oxyhemoglobin, or methemoglobin). Xanthochromia results obtained with 4 different criteria (Chalmers original, Modified Chalmers, Duiser and UK NEQAS 2008) were compared. Results: We reviewed 41 medical charts (2 patients with duplicate lumbar punctures (LP) for a total of 43 LP). For these 41 patients there were 11 positive xanthochromia results, 5 of which were in concordance with a final diagnosis of subarachnoid hemorrhage (SAH). The diagnosis of the 6 other positive xanthochromia results were as follow: meningeal spread of a lymphoma, cerebral amyloid angiopathy, exertional headache, viral encephalitis with a possibility of petechiaes on the cerebral CT and second LP. Interpretation (negative/positive) of 40/43 LP was identical for the 4 methods. 2 LP were positive with Duiser and UK NEQAS 2008 but negative with Chalmers approaches (final diagnosis: SAH and cerebral amyloid angiopathy). 1 LP was positive only by the Duiser method (viral encephalitis). Conclusions: UK NEQAS 2008 guidelines identified all SAH but are sensitive to traumatic and pathologic meningeal lesions. Except for a case of viral encephalitis with a suspicion of cerebral petechiaes on CT, UK NEQAS 2008 gave xanthochromia results similar to the one in use at HEJ (Duiser). Chalmers original and Modified Chalmers methods missed one of the five SAH.

HIV and other STIs in the United Kingdom: further increases

2003 ◽  
Vol 7 (48) ◽  
Author(s):  
◽  
Keyword(s):  
United Kingdom ◽  
Disease Surveillance ◽  
Communicable Disease ◽  
People Living With Hiv ◽  
Health Protection Agency ◽  
Protection Agency ◽  
England And Wales ◽  
The United Kingdom ◽  
The Uk ◽  
Living With Hiv

The Health Protection Agency Communicable Disease Surveillance Centre for England and Wales and others have reported that the number of people living with HIV in the UK has increased

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