Evidence-Based Alignment of Pathology Residency With Practice II: Findings and Implications

This article presents findings from a 4-year series of surveys of new-in-practice pathologists, and a survey of physician employers of new pathologists, assessing how pathology graduate medical education prepares its graduates for practice. Using the methodology described in our previous study, we develop evidence for the importance of residency training for various practice areas, comparing findings over different practice settings, sizes, and lengths of time in practice. The principal findings are (1) while new-in-practice pathologists and their employers report residency generally prepared them well for practice, some areas—billing and coding, laboratory management, molecular pathology, and pathology informatics—consistently were identified as being important in practice but inadequately prepared for in residency; (2) other areas—autopsy pathology, and subspecialized apheresis and blood donor center blood banking services—consistently were identified as relatively unimportant in practice and excessively prepared for in residency; (3) the notion of a single comprehensive model for categorical training in residency is challenged by the disparity between broad general practice in some settings and narrower subspecialty practice in others; and (4) the need for preparation in some areas evolves during practice, raising questions about the appropriate mode and circumstance for training in these areas. The implications of these findings range from rebalancing the emphasis among practice areas in residency, to reconsidering the structure of graduate medical education in pathology to meet present and evolving future practice needs.

Assessing the Current Standing of Hamad Medical Corporation Blood Donor Center in Qatar and Developing a Forecast Model for the Blood Stock Needs during the 2022 World Cup Event

Background: In two years from now, Qatar will host the 2022 World Cup competition, which requires high level of preparedness and readiness in different sectors including healthcare. Among different subsections of health, the blood bank and the Blood Donor Center will have a major role in this event especially in case of unforeseen incidences. Accordingly, a proper assessment of the current blood resource availability and a prediction of future blood needs helps in overcoming any obstacle that could be faced during the event. Objectives: (1) Highlight the process of the blood supply chain, with a detailed delineation of the needed amount of blood components for both routine and emergency situations services, and outline the proper measures taken to deliver the safest and most appropriate blood units and reduce wastage of blood component. (2) Assess the current standing of the Blood Donor Center and corresponding units in Qatar. (3) Develop a forecast model that predicts the number of blood donors in the next four years as a method to evaluate the readiness of the Blood Donor facility to host the world cup event. (4) Explore the potential challenges that could be faced when meeting the benchmark of donation and established an action plan to overcome these anticipated challenges. Materials and methods: Both qualitative (interviews) and a quantitative (data collection and analysis) approaches have been implemented in our study. We also established a time series forecast model using Autoregressive Integrated Moving Average (ARIMA). Results: The number of donors in the next four years, which is predicted to increase by 26%, will not be able to be accommodated in the current Blood Donor Center facility. Therefore, the established blood stock benchmark will not be met despite that the Center and its corresponding units are fully equipped with high standard equipment and follow international guidelines in the process of blood withdrawal. Conclusion: Infrastructure improvements and logistics support for Hamad Medical Corporation Blood Donor Center are required to support the continuously increasing numbers of blood donors for daily demand and during mega events.

Role of the paramagnetic donor-like defects in the high n-type conductivity of the hydrogenated ZnO microparticles

The magnetic and electronic properties of the hydrogenated highly conductive zinc oxide (ZnO) microparticles were investigated by electron paramagnetic resonance (EPR) and contactless microwave (MW) conductivity techniques in the wide temperature range. The EPR spectra simulation allowed us to resolve four overlapping EPR signals in ZnO microparticles. The Lorentzian EPR line with isotropic g-factor 1.9623(5) was related to the singly ionized oxygen vacancy. Another Lorentzian line with g|| = 1.9581(5), g⊥ = 1.9562(5) was attributed to the zinc interstitial shallow donor center, while EPR signal with g|| = 1.9567(5), g⊥ = 1.9556(5) and Gaussian lineshape was assigned to the hydrogen interstitial shallow effective-mass-like donor. The EPR signal with g|| = 1.9538(5), g⊥ = 1.9556(5) and Lorentzian lineshape was tentatively attributed to the shallow donor center. The charge transport properties in ZnO microparticles have been investigated by the contactless MW conductivity technique at T = 5–296 K. Two conduction mechanisms, including ionization of electrons from the shallow donors to the conduction band and hopping conduction process, have been distinguished. The hopping conduction process follows Mott’s variable-range hopping T−1/4 law at T = 10–100 K. The evaluated values of the average hopping distance (15.86 Å), and hopping energy (1.822 meV at 40 K) enable us to estimate the donor concentration in the investigated ZnO microparticles as ~ 1018 cm−3.

Implementing of Active Brain-Dead Donor Identification Strategy in a Single Donor Center: One Year Experience

Background and objectives: Organ shortage is considered to be a major limitation for increasing transplantation rates. Brain-dead donors (DBDs) are an important source of organs, but up to 50% of potential DBDs might not be identified. An active brain-dead donor search could potentially increase a deceased donor pool. The aim of this study was to evaluate the effectiveness of an active potential DBD identification program and to evaluate one year impact on the potential organ donor pool in Lithuania‘s biggest medical institution. Materials and Methods: An organ donor coordinator service was established and active DBD search strategy was implemented in the hospital of LSMU Kauno Klinikos, and retrospective data analysis was performed between December 2016 and December 2017. Collected data was compared to the available data of the previous year in the same center and to the donation dynamics of the whole country. Results: A total of 6734 patients were treated in all intensive care units (ICU), and 234 (3.5%) of them were identified as possible donors. No increase in potential donor’s number was observed in study year (n = 34) compared to remote year (n = 37). No significant difference in potential donor’s demographic data, cause of death, family refusals and medical contraindication rates. Cerebral angiography (CA) repeated in 20% of potential donors in order to confirm brain death diagnosis. More potential donors for whom CA was repeated had decompressive craniectomy done (66.7% vs. 33.3%, p = 0.018). Decompressive craniectomy statistically significantly increases the rate of repeated CA (OR 12.7; 95% CI, 1.42–113.37; p = 0.023). Active search strategy increased length of hospital stay of potential donors comparing to previous year (3.97 ± 4.73 vs. 2.51 ± 2.63, p = 0.003). An optimal time of the first four days of hospitalization to identify a potential donor was observed during our study (OR 10.42; 95% CI, 4.29–25.34; p = 0.001). Conclusions: We were not able to demonstrate active donor identification strategy superiority over the passive strategy during a short one year period; nevertheless, valuable knowledge was gained in brain death diagnostics, new terminology was implemented, and the stability of actual donor numbers was observed in the experimental donor center in the light of decreasing national results. Long-term strategy is required to achieve sustainable results in organ donation.

The Impact of an Undergraduate Biology Class on Donor Recruitment at a Hospital-Based Blood Donor Center

Objectives A biology class, BIOL 294H, taught undergraduates about platelet donation while partnering with the University of North Carolina’s (UNC’s) hospital-based Blood Donation Center to recruit apheresis platelet donors. We identified our platelet donors’ demographics and learned how BIOL 294H affected recruitment. Methods Every platelet donor presenting to the UNC Blood Donation Center from February 7, 2017, to March 10, 2017, was asked to complete an electronic 10-question survey. Results A total of 159 unique donors completed the survey; 64% were female and 75% were between ages 18 and 25 years. Overall, 70% were UNC undergraduate students. Over half (56%) reported first learning about platelet donation through word of mouth, and 22% cited specific efforts associated with BIOL 294H. Conclusions Recruitment of undergraduate platelet donors primarily included BIOL 294H peer interactions and deliverables from the class, such as social media updates and events on campus. The sustained recruiting efforts of our students over many years contributed to recruitment of a majority of our platelet donors.