Sample records for laboratory services rates

  1. 9 CFR 391.4 - Laboratory services rate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Laboratory services rate. 391.4 Section 391.4 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.4 Laboratory...

  2. 9 CFR 391.4 - Laboratory services rate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Laboratory services rate. 391.4 Section 391.4 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES...

  3. 9 CFR 391.4 - Laboratory services rate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Laboratory services rate. 391.4 Section 391.4 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... dividing the Office of Public Health Science (OPHS) previous fiscal year's regular direct pay by OPHS...

  4. 9 CFR 391.4 - Laboratory services rate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Laboratory services rate. 391.4 Section 391.4 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... dividing the Office of Public Health Science (OPHS) previous fiscal year's regular direct pay by OPHS...

  5. 9 CFR 391.4 - Laboratory services rate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Laboratory services rate. 391.4 Section 391.4 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... dividing the Office of Public Health Science (OPHS) previous fiscal year's regular direct pay by OPHS...

  6. 7 CFR 91.37 - Standard hourly fee rate for laboratory testing, analysis, and other services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Standard hourly fee rate for laboratory testing... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.37 Standard hourly fee rate for laboratory testing, analysis, and other services. (a) The...

  7. 7 CFR 91.37 - Standard hourly fee rate for laboratory testing, analysis, and other services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 3 2014-01-01 2014-01-01 false Standard hourly fee rate for laboratory testing... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.37 Standard hourly fee rate for laboratory testing, analysis, and other services. (a) The...

  8. 7 CFR 91.37 - Standard hourly fee rate for laboratory testing, analysis, and other services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false Standard hourly fee rate for laboratory testing... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.37 Standard hourly fee rate for laboratory testing, analysis, and other services. (a) The...

  9. 7 CFR 91.37 - Standard hourly fee rate for laboratory testing, analysis, and other services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Standard hourly fee rate for laboratory testing... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.37 Standard hourly fee rate for laboratory testing, analysis, and other services. (a) The...

  10. 7 CFR 91.37 - Standard hourly fee rate for laboratory testing, analysis, and other services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Standard hourly fee rate for laboratory testing, analysis, and other services. 91.37 Section 91.37 Agriculture Regulations of the Department of Agriculture... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and...

  11. Calgary Laboratory Services

    PubMed Central

    2015-01-01

    Calgary Laboratory Services provides global hospital and community laboratory services for Calgary and surrounding areas (population 1.4 million) and global academic support for the University of Calgary Cumming School of Medicine. It developed rapidly after the Alberta Provincial Government implemented an austerity program to address rising health care costs and to address Alberta’s debt and deficit in 1994. Over roughly the next year, all hospital and community laboratory test funding within the province was put into a single budget, fee codes for fee-for-service test billing were closed, roughly 40% of the provincial laboratory budget was cut, and roughly 40% of the pathologists left the province of Alberta. In Calgary, in the face of these abrupt changes in the laboratory environment, private laboratories, publicly funded hospital laboratories and the medical school department precipitously and reluctantly merged in 1996. The origin of Calgary Laboratory Services was likened to an “unhappy shotgun marriage” by all parties. Although such a structure could save money by eliminating duplicated services and excess capacity and could provide excellent city-wide clinical service by increasing standardization, it was less clear whether it could provide strong academic support for a medical school. Over the past decade, iterations of the Calgary Laboratory Services model have been implemented or are being considered in other Canadian jurisdictions. This case study analyzes the evolution of Calgary Laboratory Services, provides a metric-based review of academic performance over time, and demonstrates that this model, essentially arising as an unplanned experiment, has merit within a Canadian health care context. PMID:28725754

  12. Service quality framework for clinical laboratories.

    PubMed

    Ramessur, Vinaysing; Hurreeram, Dinesh Kumar; Maistry, Kaylasson

    2015-01-01

    The purpose of this paper is to illustrate a service quality framework that enhances service delivery in clinical laboratories by gauging medical practitioner satisfaction and by providing avenues for continuous improvement. The case study method has been used for conducting the exploratory study, with focus on the Mauritian public clinical laboratory. A structured questionnaire based on the SERVQUAL service quality model was used for data collection, analysis and for the development of the service quality framework. The study confirms the pertinence of the following service quality dimensions within the context of clinical laboratories: tangibility, reliability, responsiveness, turnaround time, technology, test reports, communication and laboratory staff attitude and behaviour. The service quality framework developed, termed LabSERV, is vital for clinical laboratories in the search for improving service delivery to medical practitioners. This is a pioneering work carried out in the clinical laboratory sector in Mauritius. Medical practitioner expectations and perceptions have been simultaneously considered to generate a novel service quality framework for clinical laboratories.

  13. A comprehensive Laboratory Services Survey of State Public Health Laboratories.

    PubMed

    Inhorn, Stanley L; Wilcke, Burton W; Downes, Frances Pouch; Adjanor, Oluwatosin Omolade; Cada, Ronald; Ford, James R

    2006-01-01

    In November 2004, the Association of Public Health Laboratories (APHL) conducted a Comprehensive Laboratory Services Survey of State Public Health Laboratories (SPHLs) in order to establish the baseline data necessary for Healthy People 2010 Objective 23-13. This objective aims to measure the increase in the proportion of health agencies that provide or assure access to comprehensive laboratory services to support essential public health services. This assessment addressed only SPHLs and served as a baseline to periodically evaluate the level of improvement in the provision of laboratory services over the decade ending 2010. The 2004 survey used selected questions that were identified as key indicators of provision of comprehensive laboratory services. The survey was developed in consultation with the Centers for Disease Control and Prevention National Center for Health Statistics, based on newly developed data sources. Forty-seven states and one territory responded to the survey. The survey was based on the 11 core functions of SPHLs as previously defined by APHL. The range of performance among individual laboratories for the 11 core functions (subobjectives) reflects the challenging issues that have confronted SPHLs in the first half of this decade. APHL is now working on a coordinated effort with other stakeholders to create seamless state and national systems for the provision of laboratory services in support of public health programs. These services are necessary to help face the threats raised by the specter of terrorism, emerging infections, and natural disasters.

  14. 42 CFR 414.510 - Laboratory date of service for clinical laboratory and pathology specimens.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Laboratory date of service for clinical laboratory... AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.510 Laboratory date of service for clinical laboratory and pathology specimens. The date of service for either a...

  15. 42 CFR 494.130 - Condition: Laboratory services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Laboratory services. 494.130 Section 494... Patient Care § 494.130 Condition: Laboratory services. The dialysis facility must provide, or make available, laboratory services (other than tissue pathology and histocompatibility) to meet the needs of the...

  16. 42 CFR 494.130 - Condition: Laboratory services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratory services. 494.130 Section 494... Patient Care § 494.130 Condition: Laboratory services. The dialysis facility must provide, or make available, laboratory services (other than tissue pathology and histocompatibility) to meet the needs of the...

  17. Strengths of the Northwell Health Laboratory Service Line

    PubMed Central

    Balfour, Erika; Stallone, Robert; Castagnaro, Joseph; Poczter, Hannah; Schron, Deborah; Martone, James; Breining, Dwayne; Simpkins, Henry; Neglia, Tom; Kalish, Paul

    2016-01-01

    From 2009 to 2015, the laboratories of the 19-hospital North Shore-LIJ Health System experienced 5 threatened interruptions in service and supported 2 regional health-care providers with threatened interruptions in their laboratory service. We report our strategies to maintain laboratory performance during these events, drawing upon the strengths of our integrated laboratory service line. Established in 2009, the laboratory service line has unified medical and administrative leadership and system-wide divisional structure, quality management, and standardization of operations and procedures. Among many benefits, this governance structure enabled the laboratories to respond to a series of unexpected events. Specifically, at our various service sites, the laboratories dealt with pandemic (2009), 2 floods (2010, 2012), 2 fires (2010, 2015), and laboratory floor subsidence (2013). We were also asked to provide support for a regional physician network facing abrupt loss of testing services from closure of another regional clinical laboratory (2010) and to intervene for a non-health system hospital threatened with closure owing to noncompliance of laboratory operations (2012). In all but a single instance, patient care was served without interruption in service. In the last instance, fire interrupted laboratory services for 30 minutes. We conclude that in a large integrated health system, threats to continuous laboratory operations are not infrequent when measured on an annual basis. While most threats are from external physical circumstances, some emanate from unexpected administrative events. A strong laboratory governance mechanism that includes unified medical and administrative leadership across the entirety of the laboratory service line enables successful responses to these threats. PMID:28725768

  18. 7 CFR 91.16 - Order of a laboratory service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Order of a laboratory service. 91.16 Section 91.16..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Laboratory Service § 91.16 Order of a laboratory service. Laboratory...

  19. 7 CFR 91.16 - Order of a laboratory service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Laboratory Service § 91.16 Order of a laboratory service. Laboratory... 7 Agriculture 3 2011-01-01 2011-01-01 false Order of a laboratory service. 91.16 Section 91.16...

  20. 7 CFR 91.15 - Basis of a laboratory service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Basis of a laboratory service. 91.15 Section 91.15..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Laboratory Service § 91.15 Basis of a laboratory service. Analytical...

  1. 7 CFR 91.15 - Basis of a laboratory service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Laboratory Service § 91.15 Basis of a laboratory service. Analytical... 7 Agriculture 3 2011-01-01 2011-01-01 false Basis of a laboratory service. 91.15 Section 91.15...

  2. 75 FR 17281 - Changes in Hourly Fee Rates for Science and Technology Laboratory Services-Fiscal Years 2010-2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-06

    ..., residue chemistry, proximate analysis for composition, and biomolecular (DNA-based) testing. A user fee... provide greater clarity of reported test analyses and laboratory determinations. DATES: Effective April 7... analyses and laboratory determinations provided by AMS laboratory services apply only to the submitted...

  3. Patient satisfaction with clinical laboratory services at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

    PubMed Central

    Abera, Rodas Getachew; Abota, Boaz Arka; Legese, Melese Hailu; Negesso, Abebe Edao

    2017-01-01

    Background Monitoring patient satisfaction is an important and useful quality improvement tool for clinical laboratories in particular and health care organizations in general. Thus, this study aimed to assess patient satisfaction toward clinical laboratory services at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Methods A hospital-based cross-sectional study was conducted and a convenient sampling technique was applied to recruit study participants. A total of 210 patients who had received laboratory services were included. A self-administered predesigned, pretested, structured questionnaire was used, and data were collected through face-to-face interviews. A 5-point Likert scale with 1 and 5 indicating the lowest and highest levels of satisfaction, respectively, was used and their weighted average was used to categorize the satisfaction level of the patients. Chi square test was used (taking P≤0.05 as the statistically significant level) to find out if any association existed between the level of satisfaction and different attributes. Data were analyzed using SPSS version 20. Results The overall level of patient satisfaction toward clinical laboratory services in this study was 59.7% with a response rate of 210 (100%). The Likert scale results of patient satisfaction of the laboratory services revealed that the mean rating values ranged from 3.05 (±1.12) to 4.12 (±1.08) out of a possible 5. Among the different indicators, patients were highly satisfied with the cleanliness of facility (82%), maintenance of privacy and confidentiality (83.2%), and the cost of the laboratory service (86.5%), while they were dissatisfied with the location of the laboratory (56%), latrine accessibility and availability (58.4%), and latrine cleanness and comfort (63.8%). Conclusion The whole availability of requested tests, availability of place in blood drawing room to put personal things, and waiting time for specimen collection were found to have a

  4. 42 CFR 414.510 - Laboratory date of service for clinical laboratory and pathology specimens.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... and pathology specimens. 414.510 Section 414.510 Public Health CENTERS FOR MEDICARE & MEDICAID... Laboratory date of service for clinical laboratory and pathology specimens. The date of service for either a clinical laboratory test or the technical component of physician pathology service is as follows: (a...

  5. 42 CFR 414.510 - Laboratory date of service for clinical laboratory and pathology specimens.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... and pathology specimens. 414.510 Section 414.510 Public Health CENTERS FOR MEDICARE & MEDICAID... Laboratory date of service for clinical laboratory and pathology specimens. The date of service for either a clinical laboratory test or the technical component of physician pathology service is as follows: (a...

  6. 42 CFR 414.510 - Laboratory date of service for clinical laboratory and pathology specimens.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... and pathology specimens. 414.510 Section 414.510 Public Health CENTERS FOR MEDICARE & MEDICAID... Laboratory date of service for clinical laboratory and pathology specimens. The date of service for either a clinical laboratory test or the technical component of physician pathology service is as follows: (a...

  7. Physician satisfaction with clinical laboratory services: a College of American Pathologists Q-probes study of 138 institutions.

    PubMed

    Jones, Bruce A; Bekeris, Leonas G; Nakhleh, Raouf E; Walsh, Molly K; Valenstein, Paul N

    2009-01-01

    Monitoring customer satisfaction is a valuable component of a laboratory quality improvement program. To survey the level of physician satisfaction with hospital clinical laboratory services. Participating institutions provided demographic and practice information and survey results of physician satisfaction with defined aspects of clinical laboratory services, rated on a scale of 1 (poor) to 5 (excellent). One hundred thirty-eight institutions participated in this study and submitted a total of 4329 physician surveys. The overall satisfaction score for all institutions ranged from 2.9 to 5.0. The median overall score for all participants was 4.1 (10th percentile, 3.6; 90th percentile, 4.5). Physicians were most satisfied with the quality/reliability of results and staff courtesy, with median values of excellent or good ratings of 89.9%. Of the 5 service categories that received the lowest percentage values of excellent/good ratings (combined scores of 4 and 5), 4 were related to turnaround time for inpatient stat, outpatient stat, routine, and esoteric tests. Surveys from half of the participating laboratories reported that 96% to 100% of physicians would recommend the laboratory to other physicians. The category most frequently selected as the most important category of laboratory services was quality/reliability of results (31.7%). There continues to be a high level of physician satisfaction and loyalty with clinical laboratory services. Test turnaround times are persistent categories of dissatisfaction and present opportunities for improvement.

  8. 42 CFR 414.510 - Laboratory date of service for clinical laboratory and pathology specimens.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Laboratory date of service for clinical laboratory and pathology specimens. 414.510 Section 414.510 Public Health CENTERS FOR MEDICARE & MEDICAID... AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.510 Laboratory...

  9. Medical Services: Veterinary/Medical Food Inspection and Laboratory Service

    DTIC Science & Technology

    1997-11-06

    cosmetics. (2) Laboratory diagnosis of communicable and zoonotic diseases and conditions of military interest. (3) Management of laboratory animal...veterinary food inspection service. (b) Prevention and control of communicable diseases of animals and zoonotic diseases and conditions. (c...Development of command zoonotic disease control programs. (2) Advise the MACOM of sanitary defects or epizootics that may be detected through the laboratory

  10. 7 CFR 91.35 - Who shall perform an appealed laboratory service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.35 Who shall perform an appealed laboratory service. An appealed laboratory service shall be performed... 7 Agriculture 3 2010-01-01 2010-01-01 false Who shall perform an appealed laboratory service. 91...

  11. 42 CFR 440.30 - Other laboratory and X-ray services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Other laboratory and X-ray services. 440.30 Section 440.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... and X-ray services. Other laboratory and X-ray services means professional and technical laboratory...

  12. 42 CFR 440.30 - Other laboratory and X-ray services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Other laboratory and X-ray services. 440.30 Section 440.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... and X-ray services. Other laboratory and X-ray services means professional and technical laboratory...

  13. 42 CFR 440.30 - Other laboratory and X-ray services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Other laboratory and X-ray services. 440.30 Section 440.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... and X-ray services. Other laboratory and X-ray services means professional and technical laboratory...

  14. 42 CFR 440.30 - Other laboratory and X-ray services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Other laboratory and X-ray services. 440.30 Section 440.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... and X-ray services. Other laboratory and X-ray services means professional and technical laboratory...

  15. 42 CFR 440.30 - Other laboratory and X-ray services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Other laboratory and X-ray services. 440.30 Section 440.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... and X-ray services. Other laboratory and X-ray services means professional and technical laboratory...

  16. Perceptions of a medical microbiology service: a survey of laboratory users.

    PubMed Central

    Morgan, M S

    1995-01-01

    AIM--To ascertain the perception of laboratory users regarding the quality of the medical microbiology services in a district general hospital. METHODS--Detailed questionnaires were circulated to all clinicians in the locality, with headings covering the quality of medical advice provided, the availability of information on specimen collection, format of request forms, specimen transport arrangements, turnaround times, the quality and need for interpretative advice, and the overall impression of the quality of the services provided. RESULTS--Two hundred and thirty five replies were received, giving a response rate of 69%. Transportation of specimens and communication of reports were identified as priority areas for improvement. The overall quality of the service was perceived as satisfactory, although areas were identified where substantial improvements could be made, some at little or no cost to the laboratory. CONCLUSIONS--The survey focused clinicians' attention on the service, raised the profile of the laboratory, and resulted in improved communications and a better understanding of customer needs. Overall, the exercise was felt to be extremely useful, and worthwhile repeating to gauge the effect of the changes instituted as a result. PMID:8537489

  17. [Costs and prices of laboratory services].

    PubMed

    Magid, E; Bartels, P D; Brandslund, I; Christensen, M S; Fahrenkrug, J; Hørder, M; Olsen, H; Pedersen, K O; Riber, E

    1991-09-23

    Cost accounting is performed in private and public laboratories. Guidelines for these activities are required and with this objective in mind, the Board of the Danish Society of Clinical Chemistry commissioned a working group to produce a position paper which is presented now in this report. The report discusses the objectives, the principles and the general requirements for cost accounting. The significance of information on costs for the clinicians' rational use of the laboratory is also illustrated. The working group points out that prerequisites for lucid and appropriate costing guidelines are clarification of which purposes information on costs are meant to serve, identification of the relevant cost centers and quality assurance of laboratory services to a defined extent. It is common practice to express laboratory costs as costs per test. The report advocates calculation of the cost per patient contact, i.e. the overall costs for laboratory service in a given investigative situation.

  18. 7 CFR 94.5 - Charges for laboratory service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Charges for laboratory service. 94.5 Section 94.5 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS...

  19. 76 FR 4710 - Accreditation and Approval of Laboratory Service, Inc., as a Commercial Gauger and Laboratory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... Laboratory Service, Inc., as a Commercial Gauger and Laboratory AGENCY: U.S. Customs and Border Protection, Department of Homeland Security. ACTION: Notice of accreditation and approval of Laboratory Service, Inc., as a commercial gauger and laboratory. SUMMARY: Notice is hereby given that, pursuant to 19 CFR 151.12...

  20. 1990 National Water Quality Laboratory Services Catalog

    USGS Publications Warehouse

    Pritt, Jeffrey; Jones, Berwyn E.

    1989-01-01

    PREFACE This catalog provides information about analytical services available from the National Water Quality Laboratory (NWQL) to support programs of the Water Resources Division of the U.S. Geological Survey. To assist personnel in the selection of analytical services, the catalog lists cost, sample volume, applicable concentration range, detection level, precision of analysis, and preservation techniques for samples to be submitted for analysis. Prices for services reflect operationa1 costs, the complexity of each analytical procedure, and the costs to ensure analytical quality control. The catalog consists of five parts. Part 1 is a glossary of terminology; Part 2 lists the bottles, containers, solutions, and other materials that are available through the NWQL; Part 3 describes the field processing of samples to be submitted for analysis; Part 4 describes analytical services that are available; and Part 5 contains indices of analytical methodology and Chemical Abstract Services (CAS) numbers. Nomenclature used in the catalog is consistent with WATSTORE and STORET. The user is provided with laboratory codes and schedules that consist of groupings of parameters which are measured together in the NWQL. In cases where more than one analytical range is offered for a single element or compound, different laboratory codes are given. Book 5 of the series 'Techniques of Water Resources Investigations of the U.S. Geological Survey' should be consulted for more information about the analytical procedures included in the tabulations. This catalog supersedes U.S. Geological Survey Open-File Report 86-232 '1986-87-88 National Water Quality Laboratory Services Catalog', October 1985.

  1. 7 CFR 91.39 - Premium hourly fee rates for overtime and legal holiday service.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... overtime work. When analytical testing in a Science and Technology facility requires the services of... (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.39 Premium hourly fee rates for overtime and legal holiday service. (a) When analytical testing in a Science...

  2. 7 CFR 91.39 - Premium hourly fee rates for overtime and legal holiday service.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... overtime work. When analytical testing in a Science and Technology facility requires the services of... (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.39 Premium hourly fee rates for overtime and legal holiday service. (a) When analytical testing in a Science...

  3. 7 CFR 91.39 - Premium hourly fee rates for overtime and legal holiday service.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... overtime work. When analytical testing in a Science and Technology facility requires the services of... (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.39 Premium hourly fee rates for overtime and legal holiday service. (a) When analytical testing in a Science...

  4. 7 CFR 91.39 - Premium hourly fee rates for overtime and legal holiday service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... overtime work. When analytical testing in a Science and Technology facility requires the services of... (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.39 Premium hourly fee rates for overtime and legal holiday service. (a) When analytical testing in a Science...

  5. Patients satisfaction with laboratory services at antiretroviral therapy clinics in public hospitals, Addis Ababa, Ethiopia.

    PubMed

    Mindaye, Tedla; Taye, Bineyam

    2012-07-04

    Despite the fact that Ethiopia has scale up antiretroviral treatment (ART) program, little is known about the patient satisfaction with ART monitoring laboratory services in health facilities. We therefore aimed to assess patient satisfaction with laboratory services at ART clinics in public hospitals. Hospital based, descriptive cross sectional study was conducted from October to November 2010 among clients attending in nine public hospitals ART clinics in Addis Ababa Ethiopia. Patients' satisfaction towards laboratory services was assessed using exit interview structured questionnaire. Data were coded and entered using EPI info 2002 (Centers for Disease Control and Prevention Atlanta, GA) and analyzed using SPSS version 15 software (SPSS INC, Chicago, IL, USA). A total of 406 clients were involved in the study. Of these 255(62.8%) were females. The overall satisfaction rate for ART monitoring laboratory services was (85.5%). Patients were satisfied with measures taken by health care providers to keep confidentiality and ability of the person drawing blood to answer question (98.3% and 96.3% respectively). Moreover, the finding of this study revealed, statistical significant associations between the overall patients' satisfaction with waiting time to get blood drawing service, availability of ordered laboratory tests and waiting time to get laboratory result with (p < 0.05). Patients receiving blood drawing service less than 30 minute were 7.59 times (95% CI AOR: 3.92-14.70) to be more satisfied with ART monitoring laboratory services compared to those who underwent for more than 30 minutes. Overall, the satisfaction survey showed, most respondents were satisfied with ART monitoring laboratory services. However, factors such as improving accessibility and availability of latrines should be taken into consideration in order to improve the overall satisfaction.

  6. [Onsite microbiology services and outsourcing microbiology and offsite laboratories--advantage and disadvantage, thinking of effective utilization].

    PubMed

    Hosokawa, Naoto

    2011-10-01

    In recent years, budget restrictions have prompted hospital managers to consider outsourcing microbiology service. But there are many advantages onsite microbiology services. Onsite microbiology services have some advantages. 1) High recovery rate of microorganism. 2) Shorter turn around time. 3) Easy to communicate between physician and laboratory technician. 4) Effective utilization of blood culture. 5) Getting early information about microorganism. 6) Making antibiogram (microbiological local factor). 7) Getting information for infection control. The disadvantages are operating costs and labor cost. The important point of maximal utilization of onsite microbiology service is close communication between physicians to microbiology laboratory. It will be able to provide prompt and efficient report to physicians through discussion about Gram stain findings, agar plate media findings and epidemiological information. The rapid and accurate identification of pathogen affords directed therapy, thereby decreasing the use of broad-spectrum antibiotics and shortening the length of hospital stay and unnecessary ancillary procedures. When the physician use outsourcing microbiology services, should discuss with offsite laboratories about provided services. Infection control person has to arrange data of susceptibility about every isolate and monitoring multi-drug resistant organism. Not only onsite microbiology services but also outsourcing microbiology services, to communicate bedside and laboratory is most important point of effective utilization.

  7. National Water Quality Laboratory, 1995 services catalog

    USGS Publications Warehouse

    Timme, P.J.

    1995-01-01

    This Services Catalog contains information about field supplies and analytical services available from the National Water Quality Laboratory in Denver, Colo., and field supplies available from the Quality Water Service Unit in Ocala, Fla., to members of the U.S. Geological Survey. To assist personnel in the selection of analytical services, this catalog lists sample volume, required containers, applicable concentration range, detection level, precision of analysis, and preservation requirements for samples.

  8. 7 CFR 91.17 - Postponing a laboratory service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... scientist determines that it is not possible to accurately analyze or make a laboratory determination of a... replacement, or for any other substantial reason, the scientist may postpone laboratory service for such...

  9. 7 CFR 91.17 - Postponing a laboratory service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... scientist determines that it is not possible to accurately analyze or make a laboratory determination of a... replacement, or for any other substantial reason, the scientist may postpone laboratory service for such...

  10. Implementation of a new 'community' laboratory CD4 service in a rural health district in South Africa extends laboratory services and substantially improves local reporting turnaround time.

    PubMed

    Coetzee, L M; Cassim, N; Glencross, D K

    2015-12-16

    The CD4 integrated service delivery model (ITSDM) provides for reasonable access to pathology services across South Africa (SA) by offering three new service tiers that extend services into remote, under-serviced areas. ITSDM identified Pixley ka Seme as such an under-serviced district. To address the poor service delivery in this area, a new ITSDM community (tier 3) laboratory was established in De Aar, SA. Laboratory performance and turnaround time (TAT) were monitored post implementation to assess the impact on local service delivery. Using the National Health Laboratory Service Corporate Data Warehouse, CD4 data were extracted for the period April 2012-July 2013 (n=11,964). Total mean TAT (in hours) was calculated and pre-analytical and analytical components assessed. Ongoing testing volumes, as well as external quality assessment performance across ten trials, were used to indicate post-implementation success. Data were analysed using Stata 12. Prior to the implementation of CD4 testing at De Aar, the total mean TAT was 20.5 hours. This fell to 8.2 hours post implementation, predominantly as a result of a lower pre-analytical mean TAT reducing from a mean of 18.9 to 1.8 hours. The analytical testing TAT remained unchanged after implementation and monthly test volumes increased by up to 20%. External quality assessment indicated adequate performance. Although subjective, questionnaires sent to facilities reported improved service delivery. Establishing CD4 testing in a remote community laboratory substantially reduces overall TAT. Additional community CD4 laboratories should be established in under-serviced areas, especially where laboratory infrastructure is already in place.

  11. 42 CFR 405.515 - Reimbursement for clinical laboratory services billed by physicians.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Reimbursement for clinical laboratory services... Criteria for Determining Reasonable Charges § 405.515 Reimbursement for clinical laboratory services billed... limitation on reimbursement for markups on clinical laboratory services billed by physicians. If a physician...

  12. A cost benefit analysis of outsourced laboratory services.

    PubMed

    Bowers, J A

    1995-11-01

    As healthcare moves toward increased capitation, hospital administrators must be aware of all costs associated with patient services. This article describes the cost benefit analysis process used by northern Indiana hospital consumers during 1994-1995 to evaluate a local laboratory service outsource provider, South Bend Medical Foundation (SBMF). In an effort to meet the best interests of the community at large, three competing hospitals, medical leadership, and the local outsource provider joined forces to ensure that cost effective quality services would be provided. Laboratory utilization patterns for common DRGs were also analyzed. The team created a reconfiguration analysis to help develop benchmark figures for consideration in future contract negotiations.

  13. Helping You Identify Quality Laboratory Services

    MedlinePlus

    ... and then discuss specifics about the quality improvement processes the laboratory has in place. General questions  What ... like a printed copy, please call the Customer Service Center at (630) 792-5800. To report information ...

  14. Physician Satisfaction With Clinical Laboratory Services: A College of American Pathologists Q-Probes Study of 81 Institutions.

    PubMed

    McCall, Shannon J; Souers, Rhona J; Blond, Barbara; Massie, Larry

    2016-10-01

    -Assessment of customer satisfaction is a vital component of the laboratory quality improvement program. -To survey the level of physician satisfaction with hospital clinical laboratory services. -Participating institutions provided demographic information and survey results of physician satisfaction, with specific features of clinical laboratory services individually rated on a scale of 5 (excellent) to 1 (poor). -Eighty-one institutions submitted 2425 surveys. The median overall satisfaction score was 4.2 (10th percentile, 3.6; 90th percentile, 4.6). Of the 16 surveyed areas receiving the highest percentage of excellent/good ratings (combined scores of 4 and 5), quality of results was highest along with test menu adequacy, staff courtesy, and overall satisfaction. Of the 4 categories receiving the lowest percentage values of excellent/good ratings, 3 were related to turnaround time for inpatient "STAT" (tests performed immediately), outpatient STAT, and esoteric tests. The fourth was a new category presented in this survey: ease of electronic order entry. Here, 11.4% (241 of 2121) of physicians assigned below-average (2) or poor (1) scores. The 5 categories deemed most important to physicians included quality of results, turnaround times for inpatient STAT, routine, and outpatient STAT tests, and clinical report format. Overall satisfaction as measured by physician willingness to recommend their laboratory to another physician remains high at 94.5% (2160 of 2286 respondents). -There is a continued trend of high physician satisfaction and loyalty with clinical laboratory services. Physician dissatisfaction with ease of electronic order entry represents a new challenge. Test turnaround times are persistent areas of dissatisfaction, representing areas for improvement.

  15. 7 CFR 91.34 - When an appeal of a laboratory service may be refused.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.34 When an appeal of a laboratory service may be refused. An application for an appeal of a laboratory... 7 Agriculture 3 2010-01-01 2010-01-01 false When an appeal of a laboratory service may be refused...

  16. Competitive bidding for Medicare Part B clinical laboratory services.

    PubMed

    Kautter, John; Pope, Gregory C

    2014-06-01

    The traditional Medicare fee-for-service program may be able to purchase clinical laboratory test services at a lower cost through competitive bidding. Demonstrations of competitive bidding for clinical laboratory tests have been twice mandated or authorized by Congress but never implemented. This article provides a summary and review of the final design of the laboratory competitive bidding demonstration mandated by the Medicare Modernization Act of 2003. The design was analogous to a sealed bid (first price), clearing price auction. Design elements presented include covered laboratory tests and beneficiaries, laboratory bidding and payment status under the demonstration, composite bids, determining bidding winners and the demonstration fee schedule, and quality under the demonstration. Expanded use of competitive bidding in Medicare, including specifically for clinical laboratory tests, has been recommended in some proposals for Medicare reform. The presented design may be a useful point of departure if Medicare clinical laboratory competitive bidding is revived in the future.

  17. 7 CFR 91.31 - When an appeal of a laboratory service may be requested.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.31 When an appeal of a laboratory service may be requested. (a) An application for an appeal... 7 Agriculture 3 2010-01-01 2010-01-01 false When an appeal of a laboratory service may be...

  18. 7 CFR 91.31 - When an appeal of a laboratory service may be requested.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.31 When an appeal of a laboratory service may be requested. (a) An application for an appeal... 7 Agriculture 3 2011-01-01 2011-01-01 false When an appeal of a laboratory service may be...

  19. The Air Force's central reference laboratory: maximizing service while minimizing cost.

    PubMed

    Armbruster, D A

    1991-11-01

    The Laboratory Services Branch (Epi Lab) of the Epidemiology Division, Brooks AFB, Texas, is designated by regulation to serve as the Air Force's central reference laboratory, providing clinical laboratory testing support to all Air Force medical treatment facilities (MTFs). Epi Lab recognized that it was not offering the MTFs a service comparable to civilian reference laboratories and that, as a result, the Air Force medical system was spending hundreds of thousands of dollars yearly for commercial laboratory support. An in-house laboratory upgrade program was proposed to and approved by the USAF Surgeon General, as a Congressional Efficiencies Add project, to launch a two-phase initiative consisting of a 1-year field trial of 30 MTFs, followed by expansion to another 60 MTFs. Major components of the program include overnight air courier service to deliver patient samples to Epi Lab, a mainframe computer laboratory information system and electronic reporting of results to the MTFs throughout the CONUS. Application of medical marketing concepts and the Total Quality Management (TQM) philosophy allowed Epi to provide dramatically enhanced reference service at a cost savings of about $1 million to the medical system. The Epi Lab upgrade program represents an innovative problem-solving approach, combining technical and managerial improvements, resulting in substantial patient care service and financial dividends. It serves as an example of successful application of TQM and marketing within the military medical system.

  20. From customer satisfaction survey to corrective actions in laboratory services in a university hospital.

    PubMed

    Oja, Paula I; Kouri, Timo T; Pakarinen, Arto J

    2006-12-01

    To find out the satisfaction of clinical units with laboratory services in a university hospital, to point out the most important problems and defects in services, to carry out corrective actions, and thereafter to identify the possible changes in satisfaction. and Senior physicians and nurses-in-charge of the clinical units at Oulu University Hospital, Finland. Customer satisfaction survey using a questionnaire was carried out in 2001, indicating the essential aspects of laboratory services. Customer-specific problems were clarified, corrective actions were performed, and the survey was repeated in 2004. In 2001, the highest dissatisfaction rates were recorded for computerized test requesting and reporting, turnaround times of tests, and the schedule of phlebotomy rounds. The old laboratory information system was not amenable to major improvements, and it was renewed in 2004-05. Several clinical units perceived turnaround times to be long, because the tests were ordered as routine despite emergency needs. Instructions about stat requesting were given to these units. However, no changes were evident in the satisfaction level in the 2004 survey. Following negotiations with the clinics, phlebotomy rounds were re-scheduled. This resulted in a distinct increase in satisfaction in 2004. Satisfaction survey is a screening tool that identifies topics of dissatisfaction. Without further clarifications, it is not possible to find out the specific problems of customers and to undertake targeted corrective actions. Customer-specific corrections are rarely seen as improvements in overall satisfaction rates.

  1. Students' Satisfaction toward the Services of the Chemical Laboratory

    ERIC Educational Resources Information Center

    Lukum, Astin; Paramata, Yoseph

    2015-01-01

    Chemistry Laboratory serves all of the students that were programmed chemistry laboratory works. The satisfaction of the students was studied that involving 50 students. The study was conducted to measure the students' satisfaction towards the services offered by the laboratory. Measurement of the students' satisfaction was conducted using…

  2. Laboratory challenges in the scaling up of HIV, TB, and malaria programs: The interaction of health and laboratory systems, clinical research, and service delivery.

    PubMed

    Birx, Deborah; de Souza, Mark; Nkengasong, John N

    2009-06-01

    Strengthening national health laboratory systems in resource-poor countries is critical to meeting the United Nations Millennium Development Goals. Despite strong commitment from the international community to fight major infectious diseases, weak laboratory infrastructure remains a huge rate-limiting step. Some major challenges facing laboratory systems in resource-poor settings include dilapidated infrastructure; lack of human capacity, laboratory policies, and strategic plans; and limited synergies between clinical and research laboratories. Together, these factors compromise the quality of test results and impact patient management. With increased funding, the target of laboratory strengthening efforts in resource-poor countries should be the integrating of laboratory services across major diseases to leverage resources with respect to physical infrastructure; types of assays; supply chain management of reagents and equipment; and maintenance of equipment.

  3. The USDA Forest Service National Seed Laboratory

    Treesearch

    Robert P. Karrfalt

    2006-01-01

    The USDA Forest Service National Seed Laboratory has provided seed technology services to the forest and conservation seed and nursery industry for more than 50 years. This paper briefly traces the lab’s evolution from a regional facility concerned principally with southern pines to its newest mission as a national facility working with all native U.S. plants and...

  4. [Quality use of commercial laboratory for clinical testing services - considering laboratory's role].

    PubMed

    Ogawa, Shinji

    2014-12-01

    The number of commercial laboratories for clinical testing in Japan run privately has decreased to about 30 companies, and their business is getting tougher. Branch Lab. and FMS businesses have not expanded recently due to the new reimbursement system which adds an additional sample management fee, becoming effective in 2010. This presentation gives an outline of each role for hospital and commercial laboratories, and their pros & cons considering the current medical situation. Commercial laboratories have investigated how to utilize ICT systems for sharing test information between hospitals and our facilities. It would be very helpful to clarify issues for each hospital. We will develop and create new values for clinical laboratory testing services and forge mutually beneficial relationships with medical institutions. (Review).

  5. 14 CFR 1215.114 - Service rates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Service rates. 1215.114 Section 1215.114... (TDRSS) Use and Reimbursement Policy for Non-U.S. Government Users § 1215.114 Service rates. (a) Rates for TDRSS services will be established by the DAA for SCaN. (b) Per-minute rates will reflect TDRSS...

  6. 47 CFR 76.1603 - Customer service-rate and service changes.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 4 2012-10-01 2012-10-01 false Customer service-rate and service changes. 76.1603 Section 76.1603 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1603 Customer service—rate and...

  7. 47 CFR 76.1603 - Customer service-rate and service changes.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 4 2014-10-01 2014-10-01 false Customer service-rate and service changes. 76.1603 Section 76.1603 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1603 Customer service—rate and...

  8. 47 CFR 76.1603 - Customer service-rate and service changes.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 4 2013-10-01 2013-10-01 false Customer service-rate and service changes. 76.1603 Section 76.1603 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1603 Customer service—rate and...

  9. 47 CFR 76.1603 - Customer service-rate and service changes.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 false Customer service-rate and service changes. 76.1603 Section 76.1603 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1603 Customer service—rate and...

  10. 47 CFR 76.1603 - Customer service-rate and service changes.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Customer service-rate and service changes. 76.1603 Section 76.1603 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1603 Customer service—rate and...

  11. A calibration service for biomedical instrumentation maintenance laboratories.

    PubMed

    Barnes, A; Evans, A L; Job, H M; Laing, R; Smith, D C

    1999-01-01

    An in-house calibration laboratory for the Biomedical Instrumentation Maintenance Services of the hospitals in the West of Scotland was established in 1993. This paper describes the development of this calibration service in the context of an overall quality system and also estimates its costs. Not only does the in-house service have many advantages but it is shown to be cost effective for workloads exceeding 260 items per annum.

  12. 14 CFR 1215.114 - Service rates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... (TDRSS) Use and Reimbursement Policy for Non-U.S. Government Users § 1215.114 Service rates. (a) Non-U.S... user. These rates are subject to change. (e) The per minute charge for TDRSS service is computed by... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Service rates. 1215.114 Section 1215.114...

  13. Opinions of Pre-Service Classroom Teachers towards Laboratory Using in Science Instruction and Their Preferences Towards Laboratory Approaches

    ERIC Educational Resources Information Center

    Yildirim, Nagihan

    2016-01-01

    This study is a descriptive study that adopts relational screening model with the aim of determining pre-service classroom teachers' opinions about laboratory use in science teaching their preferences among laboratory approaches and identifying the reasons of the answers given by the pre-service teachers. The sample of the study is 236 pre-service…

  14. Geometry Laboratory (GEOLAB) surface modeling and grid generation technology and services

    NASA Technical Reports Server (NTRS)

    Kerr, Patricia A.; Smith, Robert E.; Posenau, Mary-Anne K.

    1995-01-01

    The facilities and services of the GEOmetry LABoratory (GEOLAB) at the NASA Langley Research Center are described. Included in this description are the laboratory functions, the surface modeling and grid generation technologies used in the laboratory, and examples of the tasks performed in the laboratory.

  15. Strategies of organization and service for the critical-care laboratory.

    PubMed

    Fleisher, M; Schwartz, M K

    1990-08-01

    Critical-care medicine requires rapidity of treatment decisions and clinical management. To meet the objectives of critical-care medicine, the critical-care laboratory must consider four major aspects of laboratory organization in addition to analytical responsibilities: specimen collection and delivery, training of technologists, selection of reliable instrumentation, and efficient data dissemination. One must also consider the advantages and disadvantages of centralization vs decentralization, the influence of such a laboratory on patient care and personnel needs, and the space required for optimal operation. Centralization may lead to workflow interruption and increased turnaround time (TAT); decentralization requires redundancy of instrumentation and staff but may shorten TAT. Minimal TAT is the hallmark of efficient laboratory service. We surveyed 55 laboratories in 33 hospitals and found that virtually all hospitals with 200 or more beds had a critical-care laboratory operating as a satellite of the main laboratory. We present data on actual TAT, although these were available in only eight of the 15 routine laboratories that provided emergency service and in eight of the 40 critical-care laboratories. In meeting the challenges of an increasing workload, a reduced clinical laboratory work force, and the need to reduce TAT, changes in traditional laboratory practice are mandatory. An increased reliance on whole-blood analysis, for example, should eliminate delays associated with sample preparation, reduce the potential hazards associated with centrifugation, and eliminate excess specimen handling.

  16. Customer satisfaction survey with clinical laboratory and phlebotomy services at a tertiary care unit level.

    PubMed

    Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi

    2014-09-01

    We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.

  17. Customer Satisfaction Survey With Clinical Laboratory and Phlebotomy Services at a Tertiary Care Unit Level

    PubMed Central

    Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L.; Lee, Eun Yup; Son, Han Chul

    2014-01-01

    We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level. PMID:25187892

  18. Comparison of microbiological diagnosis of urinary tract infection in young children by routine health service laboratories and a research laboratory: Diagnostic cohort study.

    PubMed

    Birnie, Kate; Hay, Alastair D; Wootton, Mandy; Howe, Robin; MacGowan, Alasdair; Whiting, Penny; Lawton, Michael; Delaney, Brendan; Downing, Harriet; Dudley, Jan; Hollingworth, William; Lisles, Catherine; Little, Paul; O'Brien, Kathryn; Pickles, Timothy; Rumsby, Kate; Thomas-Jones, Emma; Van der Voort, Judith; Waldron, Cherry-Ann; Harman, Kim; Hood, Kerenza; Butler, Christopher C; Sterne, Jonathan A C

    2017-01-01

    To compare the validity of diagnosis of urinary tract infection (UTI) through urine culture between samples processed in routine health service laboratories and those processed in a research laboratory. We conducted a prospective diagnostic cohort study in 4808 acutely ill children aged <5 years attending UK primary health care. UTI, defined as pure/predominant growth ≥105 CFU/mL of a uropathogen (the reference standard), was diagnosed at routine health service laboratories and a central research laboratory by culture of urine samples. We calculated areas under the receiver-operator curve (AUC) for UTI predicted by pre-specified symptoms, signs and dipstick test results (the "index test"), separately according to whether samples were obtained by clean catch or nappy (diaper) pads. 251 (5.2%) and 88 (1.8%) children were classified as UTI positive by health service and research laboratories respectively. Agreement between laboratories was moderate (kappa = 0.36; 95% confidence interval [CI] 0.29, 0.43), and better for clean catch (0.54; 0.45, 0.63) than nappy pad samples (0.20; 0.12, 0.28). In clean catch samples, the AUC was lower for health service laboratories (AUC = 0.75; 95% CI 0.69, 0.80) than the research laboratory (0.86; 0.79, 0.92). Values of AUC were lower in nappy pad samples (0.65 [0.61, 0.70] and 0.79 [0.70, 0.88] for health service and research laboratory positivity, respectively) than clean catch samples. The agreement of microbiological diagnosis of UTI comparing routine health service laboratories with a research laboratory was moderate for clean catch samples and poor for nappy pad samples and reliability is lower for nappy pad than for clean catch samples. Positive results from the research laboratory appear more likely to reflect real UTIs than those from routine health service laboratories, many of which (particularly from nappy pad samples) could be due to contamination. Health service laboratories should consider adopting procedures used in

  19. Comparison of microbiological diagnosis of urinary tract infection in young children by routine health service laboratories and a research laboratory: Diagnostic cohort study

    PubMed Central

    Birnie, Kate; Hay, Alastair D.; Wootton, Mandy; Howe, Robin; MacGowan, Alasdair; Whiting, Penny; Lawton, Michael; Delaney, Brendan; Downing, Harriet; Dudley, Jan; Hollingworth, William; Lisles, Catherine; Little, Paul; O’Brien, Kathryn; Pickles, Timothy; Rumsby, Kate; Thomas-Jones, Emma; Van der Voort, Judith; Waldron, Cherry-Ann; Harman, Kim; Hood, Kerenza; Butler, Christopher C.; Sterne, Jonathan A. C.

    2017-01-01

    Objectives To compare the validity of diagnosis of urinary tract infection (UTI) through urine culture between samples processed in routine health service laboratories and those processed in a research laboratory. Population and methods We conducted a prospective diagnostic cohort study in 4808 acutely ill children aged <5 years attending UK primary health care. UTI, defined as pure/predominant growth ≥105 CFU/mL of a uropathogen (the reference standard), was diagnosed at routine health service laboratories and a central research laboratory by culture of urine samples. We calculated areas under the receiver-operator curve (AUC) for UTI predicted by pre-specified symptoms, signs and dipstick test results (the “index test”), separately according to whether samples were obtained by clean catch or nappy (diaper) pads. Results 251 (5.2%) and 88 (1.8%) children were classified as UTI positive by health service and research laboratories respectively. Agreement between laboratories was moderate (kappa = 0.36; 95% confidence interval [CI] 0.29, 0.43), and better for clean catch (0.54; 0.45, 0.63) than nappy pad samples (0.20; 0.12, 0.28). In clean catch samples, the AUC was lower for health service laboratories (AUC = 0.75; 95% CI 0.69, 0.80) than the research laboratory (0.86; 0.79, 0.92). Values of AUC were lower in nappy pad samples (0.65 [0.61, 0.70] and 0.79 [0.70, 0.88] for health service and research laboratory positivity, respectively) than clean catch samples. Conclusions The agreement of microbiological diagnosis of UTI comparing routine health service laboratories with a research laboratory was moderate for clean catch samples and poor for nappy pad samples and reliability is lower for nappy pad than for clean catch samples. Positive results from the research laboratory appear more likely to reflect real UTIs than those from routine health service laboratories, many of which (particularly from nappy pad samples) could be due to contamination. Health service

  20. Technical Service Agreement (TSA) | Frederick National Laboratory for Cancer Research

    Cancer.gov

    Frederick National Laboratory for Cancer Research (FNLCR) scientists provide services and solutions to collaborators through the Technical Services Program, whose portfolio includes more than 200 collaborations with more than 80 partners. The Frederi

  1. An evaluation of clinical laboratory services in sub-Saharan Africa. Ex africa semper aliquid novi?

    PubMed

    Gray, I P; Carter, J Y

    1997-11-06

    Pathology services represent the rational, scientific basis of the practice of clinical care. It does not represent deus ex machina, an implausible solution to a complex plot, but rather the way in which clinical care can be audited, controlled, guided and kept appropriate to the funds and the skills available. Arguments are presented to support this statement as well as to analyse what is wrong with health care, from the point of view of laboratory medicine, in sub-Saharan Africa. In most African countries 'first world' technology has to be imported by economies barely able to sustain the basic requirements of human life. Badly needed foreign exchange is obtained by growing export crops at the cost of traditional lifestyle, disenfranchising communities, urbanisation, and even at the cost not being able to grow food. War, corruption, lack of accountability even in the Western sense of being able to go to the polls every so often, lack of empowerment, low literacy rate etc all debase the communities, with minimal exceptions, of Africa. Health care is under the same capricious rule as all other public services: investment in laboratories is poor and most have no access to a professional laboratory at all. More investment, not less; expansion of pathology services not restricting them, is needed throughout the continent.

  2. 14 CFR § 1215.114 - Service rates.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Service rates. § 1215.114 Section § 1215... SATELLITE SYSTEM (TDRSS) Use and Reimbursement Policy for Non-U.S. Government Users § 1215.114 Service rates. (a) Rates for TDRSS services will be established by the DAA for SCaN. (b) Per-minute rates will...

  3. 14 CFR 1215.114 - Service rates.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Service rates. 1215.114 Section 1215.114... (TDRSS) Use and Reimbursement Policy for Non-U.S. Government Users § 1215.114 Service rates. (a) Non-U.S. Government user rates will reflect TDRSS total operational and maintenance costs prorated to a per-minute...

  4. 7 CFR 91.32 - Where to file for an appeal of a laboratory service and information required.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.32 Where to file for an appeal of a laboratory service and information required. (a... 7 Agriculture 3 2010-01-01 2010-01-01 false Where to file for an appeal of a laboratory service...

  5. 7 CFR 91.32 - Where to file for an appeal of a laboratory service and information required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.32 Where to file for an appeal of a laboratory service and information required. (a... 7 Agriculture 3 2011-01-01 2011-01-01 false Where to file for an appeal of a laboratory service...

  6. 46 CFR 9.6 - Rate for night service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... OVERTIME SERVICES § 9.6 Rate for night service. The rate of extra compensation for authorized overtime services performed at night on any week day is hereby fixed at one half the gross daily rate of regular pay... 46 Shipping 1 2010-10-01 2010-10-01 false Rate for night service. 9.6 Section 9.6 Shipping COAST...

  7. Multiscale Laboratory Infrastructure and Services to users: Plans within EPOS

    NASA Astrophysics Data System (ADS)

    Spiers, Chris; Willingshofer, Ernst; Drury, Martyn; Funiciello, Francesca; Rosenau, Matthias; Scarlato, Piergiorgio; Sagnotti, Leonardo; EPOS WG6, Corrado Cimarelli

    2015-04-01

    The participant countries in EPOS embody a wide range of world-class laboratory infrastructures ranging from high temperature and pressure experimental facilities, to electron microscopy, micro-beam analysis, analogue modeling and paleomagnetic laboratories. Most data produced by the various laboratory centres and networks are presently available only in limited "final form" in publications. Many data remain inaccessible and/or poorly preserved. However, the data produced at the participating laboratories are crucial to serving society's need for geo-resources exploration and for protection against geo-hazards. Indeed, to model resource formation and system behaviour during exploitation, we need an understanding from the molecular to the continental scale, based on experimental data. This contribution will describe the plans that the laboratories community in Europe is making, in the context of EPOS. The main objectives are: • To collect and harmonize available and emerging laboratory data on the properties and processes controlling rock system behaviour at multiple scales, in order to generate products accessible and interoperable through services for supporting research activities. • To co-ordinate the development, integration and trans-national usage of the major solid Earth Science laboratory centres and specialist networks. The length scales encompassed by the infrastructures included range from the nano- and micrometer levels (electron microscopy and micro-beam analysis) to the scale of experiments on centimetre sized samples, and to analogue model experiments simulating the reservoir scale, the basin scale and the plate scale. • To provide products and services supporting research into Geo-resources and Geo-storage, Geo-hazards and Earth System Evolution. If the EPOS Implementation Phase proposal presently under construction is successful, then a range of services and transnational activities will be put in place to realize these objectives.

  8. Factors influencing variation in dentist service rates.

    PubMed

    Grembowski, D; Milgrom, P; Fiset, L

    1990-01-01

    In the previous article, we calculated dentist service rates for 200 general dentists based on a homogeneous, well-educated, upper-middle-class population of patients. Wide variations in the rates were detected. In this analysis, factors influencing variation in the rates were identified. Variation in rates for categories of dental services was explained by practice characteristics, patient exposure to fluoridated water supplies, and non-price competition in the dental market. Rates were greatest in large, busy practices in markets with high fees. Older practices consistently had lower rates across services. As a whole, these variables explained between 5 and 30 percent of the variation in the rates.

  9. A Laboratory Exercise with Related Rates.

    ERIC Educational Resources Information Center

    Sworder, Steven C.

    A laboratory experiment, based on a simple electric circuit that can be used to demonstrate the existence of real-world "related rates" problems, is outlined and an equation for voltage across the capacitor terminals during discharge is derived. The necessary materials, setup methods, and experimental problems are described. A student laboratory…

  10. The Effect of the Laboratory Specimen on Fatigue Crack Growth Rate

    NASA Technical Reports Server (NTRS)

    Forth, S. C.; Johnston, W. M.; Seshadri, B. R.

    2006-01-01

    Over the past thirty years, laboratory experiments have been devised to develop fatigue crack growth rate data that is representative of the material response. The crack growth rate data generated in the laboratory is then used to predict the safe operating envelope of a structure. The ability to interrelate laboratory data and structural response is called similitude. In essence, a nondimensional term, called the stress intensity factor, was developed that includes the applied stresses, crack size and geometric configuration. The stress intensity factor is then directly related to the rate at which cracks propagate in a material, resulting in the material property of fatigue crack growth response. Standardized specimen configurations and experimental procedures have been developed for laboratory testing to generate crack growth rate data that supports similitude of the stress intensity factor solution. In this paper, the authors present laboratory fatigue crack growth rate test data and finite element analyses that show similitude between standard specimen configurations tested using the constant stress ratio test method is unobtainable.

  11. Safety in the Chemical Laboratory: Laboratory Air Quality: Part II. Measurements of Ventilation Rates.

    ERIC Educational Resources Information Center

    Butcher, Samuel S.; And Others

    1985-01-01

    Part I of this paper (SE 538 295) described a simple model for estimating laboratory concentrations of gas phase pollutants. In this part, the measurement of ventilation rates and applications of the model are discussed. The model can provide a useful starting point in planning for safer instructional laboratories. (JN)

  12. 78 FR 70579 - Deluxe Laboratories, Inc., a Division of Deluxe Entertainment Services Group, Inc. Hollywood...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ...., a Division of Deluxe Entertainment Services Group, Inc. Hollywood, California; Notice of Revised... of Deluxe Laboratories, Inc., a division of Deluxe Entertainment Services Group, Inc., Hollywood... workers of Deluxe Laboratories, Inc., a division of Deluxe Entertainment Services Group, Inc., Hollywood...

  13. 7 CFR 91.33 - When an application for an appeal of a laboratory service may be withdrawn.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.33 When an application for an appeal of a laboratory service may be withdrawn. An... 7 Agriculture 3 2011-01-01 2011-01-01 false When an application for an appeal of a laboratory...

  14. 7 CFR 91.33 - When an application for an appeal of a laboratory service may be withdrawn.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.33 When an application for an appeal of a laboratory service may be withdrawn. An... 7 Agriculture 3 2010-01-01 2010-01-01 false When an application for an appeal of a laboratory...

  15. 14 CFR 1215.114 - Service rates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Service rates. 1215.114 Section 1215.114 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION TRACKING AND DATA RELAY SATELLITE SYSTEM (TDRSS) Use and Reimbursement Policy for Non-U.S. Government Users § 1215.114 Service rates. (a) Non-U.S...

  16. The effect of for-profit laboratories on the accountability, integration, and cost of Canadian health care services.

    PubMed

    Sutherland, Ross

    2012-01-01

    Canadian public health care systems pay for-profit corporations to provide essential medical laboratory services. This practice is a useful window on the effects of using for-profit corporations to provide publicly funded services. Because private corporations are substantially protected by law from the public disclosure of "confidential business information," increased for-profit delivery has led to decreased transparency, thus impeding informed debate on how laboratory services are delivered. Using for-profit laboratories increases the cost of diagnostic testing and hinders the integration of health care services more generally. Two useful steps toward ending the for-profit provision of laboratory services would be to stop fee-for-service funding and to integrate all laboratory work within public administrative structures.

  17. The role of veterinary research laboratories in the provision of veterinary services.

    PubMed

    Verwoerd, D W

    1998-08-01

    Veterinary research laboratories play an essential role in the provision of veterinary services in most countries. These laboratories are the source of new knowledge, innovative ideas and improved technology for the surveillance, prevention and control of animal diseases. In addition, many laboratories provide diagnostic and other services. To ensure the optimal integration of various veterinary activities, administrators must understand the functions and constraints of research laboratories. Therefore, a brief discussion is presented of the following: organisational structures methods for developing research programmes outputs of research scientists and how these are measured the management of quality assurance funding of research. Optimal collaboration can only be attained by understanding the environment in which a research scientist functions and the motivational issues at stake.

  18. A model for consolidation of clinical microbiology laboratory services within a multihospital health-care system.

    PubMed

    Carter, Elliot; Stubbs, James R; Bennett, Betsy

    2004-01-01

    To determine the cost-effectiveness of consolidating clinical microbiology services in a three-hospital health-care network while maintaining high-quality laboratory services, a retrospective review of the total costs of maintaining separate clinical microbiology laboratories within our health-care system was compared to the cost of providing these services after consolidation. Turnaround times before and after consolidation were compared to assess efficiency of the consolidated services. Input of clinicians was also solicited to ensure that quality of services and customer satisfaction remained high. The results of the consolidation project show that the net fiscal saving because of consolidation of clinical microbiology services within our health-care system will be approximately 100,000 dollars per fiscal year. This value includes increased courier charges as well as personnel savings. Although fiscal savings are an integral part of any laboratory consolidation plan, the financial considerations must be balanced by quality of service. The response to consolidation from clinicians was decidedly mixed before implementation of the plan because of fear of increased turnaround times and limited access to laboratory information. The consolidation process, however, was smooth with few physician complaints. The consolidation of our clinical microbiology services illustrates that significant financial savings can be achieved without compromise of efficiency or quality of service.

  19. 76 FR 7883 - Postal Service Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... POSTAL REGULATORY COMMISSION [Docket No. R2011-4; Order No. 663] Postal Service Rate Adjustment AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request concerning a Type 2 rate adjustment. This notice addresses procedural steps...

  20. Regional and supraregional biochemistry services in Scotland: a survey of hospital laboratory users.

    PubMed Central

    Murphy, M J; Dryburgh, F J; Shepherd, J

    1994-01-01

    AIM--To ascertain the views of Scottish hospital laboratory users on aspects of regional and supraregional biochemical services offered by the Institute of Biochemistry at Glasgow Royal Infirmary. METHODS--A questionnaire was circulated asking questions or inviting opinions under various headings, including current patterns of usage of the services provided, availability of information on specimen collection requirements and reference ranges, current arrangements for transport of specimens, turnaround times for delivery of reports, layout and content of request and report forms, quantity and quality of interpretive advice, potential changes in laboratory services, and overall impression of the services provided. Opportunities were provided for free text comment. The questionnaire was circulated in 1992 to heads of department in 23 Scottish hospital biochemistry laboratories. RESULTS--Twenty one replies were received. Services used widely included trace metals/vitamins (n = 20) and specialised endocrine tests (n = 19). Other services also used included specialised lipid tests (n = 13), toxicology (n = 12), thyroid function tests (n = nine), and tumour markers (n = eight). Fifteen laboratories used one or more of the services at least weekly. Most (n = 20) welcomed the idea of a handbook providing information on specimen collection and reference ranges. Nine identified loss of specimens as a problem. Other perceived problems included the absence of reference ranges from report forms, quantity and quality of interpretive advice, and turnaround times of some tests. Overall impressions of the service(s) offered were very good (n = 12); adequate (n = seven); poor (n = one). CONCLUSIONS--Useful information was obtained about patterns of use and transport arrangements. Areas identified as requiring follow up included provision of information, alternative ways of communicating reports, and improvement in quantity and quality of interpretive advice. PMID:8027390

  1. Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

    PubMed Central

    Osaro, Erhabor; Chima, Njemanze

    2014-01-01

    The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the “engine room” of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness. PMID:25182941

  2. Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England.

    PubMed

    Osaro, Erhabor; Chima, Njemanze

    2014-06-01

    The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

  3. 76 FR 80326 - 2012 Rate Changes for the Basetime, Overtime, Holiday, and Laboratory Services Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-23

    ..., plus the travel and operating rate, plus the overhead rate, plus the allowance for bad debt rate. The... and operating rate) + $16.68 (overhead rate) + $.02 (bad debt allowance rate) = $54.24. Overtime Rate... rate, plus the allowance for bad debt rate. The calculation for the 2012 overtime rate per hour per...

  4. Medical Laboratory Services. Student's Manual. Cluster Core for Health Occupations Education.

    ERIC Educational Resources Information Center

    Williams, Catherine

    This student's manual on medical laboratory services is one of a series of self-contained, individualized materials for students enrolled in training within the allied health field. It includes competencies that are associated with the performance of skills common to several occupations in the medical laboratory. The material is intended for use…

  5. Implementing and measuring the level of laboratory service integration in a program setting in Nigeria.

    PubMed

    Mbah, Henry; Negedu-Momoh, Olubunmi Ruth; Adedokun, Oluwasanmi; Ikani, Patrick Anibbe; Balogun, Oluseyi; Sanwo, Olusola; Ochei, Kingsley; Ekanem, Maurice; Torpey, Kwasi

    2014-01-01

    The surge of donor funds to fight HIV&AIDS epidemic inadvertently resulted in the setup of laboratories as parallel structures to rapidly respond to the identified need. However these parallel structures are a threat to the existing fragile laboratory systems. Laboratory service integration is critical to remedy this situation. This paper describes an approach to quantitatively measure and track integration of HIV-related laboratory services into the mainstream laboratory services and highlight some key intervention steps taken, to enhance service integration. A quantitative before-and-after study conducted in 122 Family Health International (FHI360) supported health facilities across Nigeria. A minimum service package was identified including management structure; trainings; equipment utilization and maintenance; information, commodity and quality management for laboratory integration. A check list was used to assess facilities at baseline and 3 months follow-up. Level of integration was assessed on an ordinal scale (0 = no integration, 1 = partial integration, 2 = full integration) for each service package. A composite score grading expressed as a percentage of total obtainable score of 14 was defined and used to classify facilities (≤ 80% FULL, 25% to 79% PARTIAL and <25% NO integration). Weaknesses were noted and addressed. We analyzed 9 (7.4%) primary, 104 (85.2%) secondary and 9 (7.4%) tertiary level facilities. There were statistically significant differences in integration levels between baseline and 3 months follow-up period (p<0.01). Baseline median total integration score was 4 (IQR 3 to 5) compared to 7 (IQR 4 to 9) at 3 months follow-up (p = 0.000). Partial and fully integrated laboratory systems were 64 (52.5%) and 0 (0.0%) at baseline, compared to 100 (82.0%) and 3 (2.4%) respectively at 3 months follow-up (p = 0.000). This project showcases our novel approach to measure the status of each laboratory on the integration continuum.

  6. 78 FR 283 - 2013 Rate Changes for the Basetime, Overtime, Holiday, and Laboratory Services Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-03

    ... rate, plus the allowance for bad debt rate. The calculation for the 2013 basetime rate per hour per...)) = $28.36 + $8.96(benefits rate) + $.70 (travel and operating rate) + $17.15 (overhead rate) + $.01 (bad... travel and operating rate, plus the overhead rate, plus the allowance for bad debt rate. The calculation...

  7. An audit of the laboratory service provided to the Health Service Executive Orthodontic Department, St James Hospital, Dublin.

    PubMed

    Al-Awadhi, E A; Wolstencroft, S J; Blake, M

    2006-01-01

    To evaluate the service purchased from contracted orthodontic laboratories used by HSE (SWA) regional orthodontic unit, St. James's Hospital, Dublin and identify deficiencies in the current service. A data collection questionnaire was designed and distributed to the departmental orthodontists for a period of three months (October-December 2004). Gold standards, drawn up based on the authors' ideal requirements and published guidelines, were supplied to grade the work returned. During the study period 363 items of laboratory work were requested. 20% of the laboratory work arrived late and most of the delayed work was delayed for more than 24 hours. Most laboratory delays occurred with functional appliances, retainers and study models. Prior to fit, 20% of the appliances required adjustments for more than 30 seconds. 65% of laboratory work returned to the department met all of the gold standards. 10% of appliances were considered unsatisfactory. Functional appliances were most often ill fitting accounting for almost half of the unsatisfactory laboratory work. The majority of the laboratory work returned to the department met our gold standards and arrived on time. Forty six percent of the appliances required adjustments. Functional appliances required the most adjustments; one in five of all functional appliances ordered were considered unsatisfactory.

  8. Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.

    PubMed

    Schroeder, Scott R; Salomon, Meghan M; Galanter, William L; Schiff, Gordon D; Vaida, Allen J; Gaunt, Michael J; Bryson, Michelle L; Rash, Christine; Falck, Suzanne; Lambert, Bruce L

    2017-05-01

    Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates. We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception and short-term memory of look-alike and sound-alike drug name pairs (eg, hydroxyzine/hydralazine). Laboratory test error rates (and other metrics) significantly predicted real-world error rates obtained from a large, outpatient pharmacy chain, with the best-fitting model accounting for 37% of the variance in real-world error rates. Cross-validation analyses confirmed these results, showing that the laboratory tests also predicted errors from a second pharmacy chain, with 45% of the variance being explained by the laboratory test data. Across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception. Regulators and drug companies seeking a validated preapproval method for identifying confusing drug names ought to consider using these simple tests. By using a standard battery of memory and perception tests, it should be possible to reduce the number of confusing look-alike and sound-alike drug name pairs that reach the market, which will help protect patients from potentially harmful medication errors. Published by the BMJ

  9. Service Quality and Patient Satisfaction: An Exploratory Study of Pathology Laboratories in Jaipur.

    PubMed

    Agarwal, Anuradha; Singh, Maithili R P

    2016-01-01

    One of the most important parts of healthcare system is diagnostics. Nowadays, Indians have become more aware of their health, due to improved and better availability of health related information, increase in medical tourism, and expanding health insurance. The demand for better diagnostic facilities have increased with the increase in lifestyle related diseases, excesses use of chemicals in agriculture practices and change in food habits. It is expected that the Indian diagnostic market will grow from USD $5 billion in the year 2012 to USD $32 billion by the year 2020 with 20% CAGR (India Brand Equity Foundation 2015 ). Today patients have easy access of information regarding the health services and they have become more concerned about it as they look forward to receiving the maximum value for their money. To win the confidence of the patients and to maintain that trust, it is required to deliver the right services to the right person at the right time. The purpose of this study was to develop a scale to measure the service quality at pathology laboratory. A thorough review of literature revealed that there are studies related to healthcare service quality but there is no such established scale to measure service quality of pathology laboratory. Thus, the authors strived to develop a reliable and valid instrument to measure the patients' perception toward pathology laboratory service quality. For this exploratory study was conducted on the sample of 80 patients of the laboratories in Jaipur city. The reliability and factor structures were tested to purify the scale. The findings revealed 13 items, comprising of three dimensions of service quality: responsiveness, tangibility, and reliability.

  10. 78 FR 18376 - Promotional Rates for Global Express Guaranteed Service

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... POSTAL SERVICE Promotional Rates for Global Express Guaranteed Service AGENCY: Postal Service\\TM\\. ACTION: Notice of Promotional Rates. SUMMARY: The Postal Service gives notice of promotional rates for Global Express Guaranteed[supreg] (GXG[supreg]) service consistent with Governors' Decision No. 12-02...

  11. About Region 3's Laboratory and Field Services at EPA's Environmental Science Center

    EPA Pesticide Factsheets

    Mission & contact information for EPA Region 3's Laboratory and Field Services located at EPA's Environmental Science Center: the Office of Analytical Services and Quality Assurance & Field Inspection Program

  12. Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia.

    PubMed

    Mesfin, Eyob Abera; Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

    2017-10-01

    Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system.

  13. A&M. Technical service laboratory in administration building (TAN602). Floor plan, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    A&M. Technical service laboratory in administration building (TAN-602). Floor plan, reception desk, door and finish schedules. Ralph M. Parsons 1480-12-ANP/GE-3-602-A-1. INEEL index code no. 033-0602-00-693-107488 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  14. Individual laboratory-measured discount rates predict field behavior

    PubMed Central

    Chabris, Christopher F.; Laibson, David; Morris, Carrie L.; Schuldt, Jonathon P.; Taubinsky, Dmitry

    2009-01-01

    We estimate discount rates of 555 subjects using a laboratory task and find that these individual discount rates predict inter-individual variation in field behaviors (e.g., exercise, BMI, smoking). The correlation between the discount rate and each field behavior is small: none exceeds 0.28 and many are near 0. However, the discount rate has at least as much predictive power as any variable in our dataset (e.g., sex, age, education). The correlation between the discount rate and field behavior rises when field behaviors are aggregated: these correlations range from 0.09-0.38. We present a model that explains why specific intertemporal choice behaviors are only weakly correlated with discount rates, even though discount rates robustly predict aggregates of intertemporal decisions. PMID:19412359

  15. Individual laboratory-measured discount rates predict field behavior.

    PubMed

    Chabris, Christopher F; Laibson, David; Morris, Carrie L; Schuldt, Jonathon P; Taubinsky, Dmitry

    2008-12-01

    We estimate discount rates of 555 subjects using a laboratory task and find that these individual discount rates predict inter-individual variation in field behaviors (e.g., exercise, BMI, smoking). The correlation between the discount rate and each field behavior is small: none exceeds 0.28 and many are near 0. However, the discount rate has at least as much predictive power as any variable in our dataset (e.g., sex, age, education). The correlation between the discount rate and field behavior rises when field behaviors are aggregated: these correlations range from 0.09-0.38. We present a model that explains why specific intertemporal choice behaviors are only weakly correlated with discount rates, even though discount rates robustly predict aggregates of intertemporal decisions.

  16. Pre-Service Chemistry Teachers' Competencies in the Laboratory: A Cross-Grade Study in Solution Preparation

    ERIC Educational Resources Information Center

    Karatas, F. O.

    2016-01-01

    One of the prerequisites for chemistry teacher candidates is to demonstrate certain laboratory skills. This article aims to determine and discuss the competencies of pre-service chemistry teachers in a chemistry laboratory context working with solution chemistry content. The participants in this study consisted of a group of pre-service chemistry…

  17. Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia

    PubMed Central

    Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

    2017-01-01

    Background Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. Methodology A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. Results A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). Conclusion In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system. PMID:29075171

  18. 47 CFR 76.922 - Rates for the basic service tier and cable programming services tiers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rates for the basic service tier and cable programming services tiers. 76.922 Section 76.922 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation...

  19. The U.S. Forest Service National Seed Laboratory and Fraxinus ex situ genetic conservation

    Treesearch

    Robert P. Karrfalt

    2010-01-01

    The U.S. Forest Service's National Seed Laboratory (NSL) has as part of its mission the conservation of genetic resources for the Forest Service and Forest Service cooperators through long-term seed storage. The Forest Service recognizes ash as one of four priority species for genetic conservation. The NSL is in charge of the Forest Service ash preservation plan...

  20. The Implementation of a Service-Learning Component in an Organic Chemistry Laboratory Course

    ERIC Educational Resources Information Center

    Glover, Sarah R.; Sewry, Joyce D.; Bromley, Candice L.; Davies-Coleman, Michael T.; Hlengwa, Amanda

    2013-01-01

    avenues for the implementation of service-learning into their curricula. A second-year undergraduate organic chemistry laboratory experiment, in which the undergraduate students make azo dyes, can provide a vehicle for a service-learning module in which university undergraduate…

  1. Specialist integrated haematological malignancy diagnostic services: an Activity Based Cost (ABC) analysis of a networked laboratory service model.

    PubMed

    Dalley, C; Basarir, H; Wright, J G; Fernando, M; Pearson, D; Ward, S E; Thokula, P; Krishnankutty, A; Wilson, G; Dalton, A; Talley, P; Barnett, D; Hughes, D; Porter, N R; Reilly, J T; Snowden, J A

    2015-04-01

    Specialist Integrated Haematological Malignancy Diagnostic Services (SIHMDS) were introduced as a standard of care within the UK National Health Service to reduce diagnostic error and improve clinical outcomes. Two broad models of service delivery have become established: 'co-located' services operating from a single-site and 'networked' services, with geographically separated laboratories linked by common management and information systems. Detailed systematic cost analysis has never been published on any established SIHMDS model. We used Activity Based Costing (ABC) to construct a cost model for our regional 'networked' SIHMDS covering a two-million population based on activity in 2011. Overall estimated annual running costs were £1 056 260 per annum (£733 400 excluding consultant costs), with individual running costs for diagnosis, staging, disease monitoring and end of treatment assessment components of £723 138, £55 302, £184 152 and £94 134 per annum, respectively. The cost distribution by department was 28.5% for haematology, 29.5% for histopathology and 42% for genetics laboratories. Costs of the diagnostic pathways varied considerably; pathways for myelodysplastic syndromes and lymphoma were the most expensive and the pathways for essential thrombocythaemia and polycythaemia vera being the least. ABC analysis enables estimation of running costs of a SIHMDS model comprised of 'networked' laboratories. Similar cost analyses for other SIHMDS models covering varying populations are warranted to optimise quality and cost-effectiveness in delivery of modern haemato-oncology diagnostic services in the UK as well as internationally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Implementation of Quality Management in Core Service Laboratories

    PubMed Central

    Creavalle, T.; Haque, K.; Raley, C.; Subleski, M.; Smith, M.W.; Hicks, B.

    2010-01-01

    CF-28 The Genetics and Genomics group of the Advanced Technology Program of SAIC-Frederick exists to bring innovative genomic expertise, tools and analysis to NCI and the scientific community. The Sequencing Facility (SF) provides next generation short read (Illumina) sequencing capacity to investigators using a streamlined production approach. The Laboratory of Molecular Technology (LMT) offers a wide range of genomics core services including microarray expression analysis, miRNA analysis, array comparative genome hybridization, long read (Roche) next generation sequencing, quantitative real time PCR, transgenic genotyping, Sanger sequencing, and clinical mutation detection services to investigators from across the NIH. As the technology supporting this genomic research becomes more complex, the need for basic quality processes within all aspects of the core service groups becomes critical. The Quality Management group works alongside members of these labs to establish or improve processes supporting operations control (equipment, reagent and materials management), process improvement (reengineering/optimization, automation, acceptance criteria for new technologies and tech transfer), and quality assurance and customer support (controlled documentation/SOPs, training, service deficiencies and continual improvement efforts). Implementation and expansion of quality programs within unregulated environments demonstrates SAIC-Frederick's dedication to providing the highest quality products and services to the NIH community.

  3. Rating maternal and neonatal health services in developing countries.

    PubMed Central

    Bulatao, Rodolfo A.; Ross, John A.

    2002-01-01

    OBJECTIVE: To assess maternal and neonatal health services in 49 developing countries. METHODS: The services were rated on a scale of 0 to 100 by 10 - 25 experts in each country. The ratings covered emergency and routine services, including family planning, at health centres and district hospitals, access to these services for both rural and urban women, the likelihood that women would receive particular forms of antenatal and delivery care, and supporting elements of programmes such as policy, resources, monitoring, health promotion and training. FINDINGS: The average rating was only 56, but countries varied widely, especially in access to services in rural areas. Comparatively good ratings were reported for immunization services, aspects of antenatal care and counselling on breast feeding. Ratings were particularly weak for emergency obstetric care in rural areas, safe abortion and HIV counselling. CONCLUSION: Maternal health programme effort in developing countries is seriously deficient, particularly in rural areas. Rural women are disadvantaged in many respects, but especially regarding the treatment of emergency obstetric conditions. Both rural and urban women receive inadequate HIV counselling and testing and have quite limited access to safe abortion. Improving services requires moving beyond policy reform to strengthening implementation of services and to better staff training and health promotion. Increased financing is only part of the solution. PMID:12378290

  4. 42 CFR 405.515 - Reimbursement for clinical laboratory services billed by physicians.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...'s bill, or a request for payment for a physician's services, includes a charge for a laboratory test... chapter): (a) If the bill or request for payment indicates that the test was personally performed or supervised either by the physician who submitted the bill (or for whose services the request for payment was...

  5. 42 CFR 405.515 - Reimbursement for clinical laboratory services billed by physicians.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...'s bill, or a request for payment for a physician's services, includes a charge for a laboratory test... chapter): (a) If the bill or request for payment indicates that the test was personally performed or supervised either by the physician who submitted the bill (or for whose services the request for payment was...

  6. 42 CFR 405.515 - Reimbursement for clinical laboratory services billed by physicians.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...'s bill, or a request for payment for a physician's services, includes a charge for a laboratory test... chapter): (a) If the bill or request for payment indicates that the test was personally performed or supervised either by the physician who submitted the bill (or for whose services the request for payment was...

  7. 42 CFR 405.515 - Reimbursement for clinical laboratory services billed by physicians.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...'s bill, or a request for payment for a physician's services, includes a charge for a laboratory test... chapter): (a) If the bill or request for payment indicates that the test was personally performed or supervised either by the physician who submitted the bill (or for whose services the request for payment was...

  8. Choosing the right laboratory: a review of clinical and forensic toxicology services for urine drug testing in pain management.

    PubMed

    Reisfield, Gary M; Goldberger, Bruce A; Bertholf, Roger L

    2015-01-01

    Urine drug testing (UDT) services are provided by a variety of clinical, forensic, and reference/specialty laboratories. These UDT services differ based on the principal activity of the laboratory. Clinical laboratories provide testing primarily focused on medical care (eg, emergency care, inpatients, and outpatient clinics), whereas forensic laboratories perform toxicology tests related to postmortem and criminal investigations, and drug-free workplace programs. Some laboratories now provide UDT specifically designed for monitoring patients on chronic opioid therapy. Accreditation programs for clinical laboratories have existed for nearly half a century, and a federal certification program for drug-testing laboratories was established in the 1980s. Standards of practice for forensic toxicology services other than workplace drug testing have been established in recent years. However, no accreditation program currently exists for UDT in pain management, and this review considers several aspects of laboratory accreditation and certification relevant to toxicology services, with the intention to provide guidance to clinicians in their selection of the appropriate laboratory for UDT surveillance of their patients on opioid therapy.

  9. 9 CFR 391.2 - Basetime rate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Basetime rate. 391.2 Section 391.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.2 Basetime rate. (a) For...

  10. 9 CFR 391.2 - Basetime rate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Basetime rate. 391.2 Section 391.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.2 Basetime rate. (a) For...

  11. 9 CFR 391.2 - Basetime rate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Basetime rate. 391.2 Section 391.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.2 Basetime rate. (a) For...

  12. The value-added laboratory: an opportunity to merge research and service objectives.

    PubMed

    McDonald, J M

    1997-01-01

    The changing health-care environment is creating a new opportunities for laboratory medicine professionals that correspond with the new health services research agendas. Proving cost-effectiveness and conducting outcomes assessment are becoming vital functions of laboratories in this era of managed care. Laboratorians must take advantage of the resulting opportunities to show how they add value and medical relevance to the health-care delivery system.

  13. Designing testing service at baristand industri Medan’s liquid waste laboratory

    NASA Astrophysics Data System (ADS)

    Kusumawaty, Dewi; Napitupulu, Humala L.; Sembiring, Meilita T.

    2018-03-01

    Baristand Industri Medan is a technical implementation unit under the Industrial and Research and Development Agency, the Ministry of Industry. One of the services often used in Baristand Industri Medan is liquid waste testing service. The company set the standard of service is nine working days for testing services. At 2015, 89.66% on testing services liquid waste does not meet the specified standard of services company because of many samples accumulated. The purpose of this research is designing online services to schedule the coming the liquid waste sample. The method used is designing an information system that consists of model design, output design, input design, database design and technology design. The results of designing information system of testing liquid waste online consist of three pages are pages to the customer, the recipient samples and laboratory. From the simulation results with scheduled samples, then the standard services a minimum of nine working days can be reached.

  14. The impact of automating laboratory request forms on the quality of healthcare services.

    PubMed

    Dogether, Majed Al; Muallem, Yahya Al; Househ, Mowafa; Saddik, Basema; Khalifa, Mohamed

    In recent decades, healthcare organizations have undergone a significant transformation with the integration of Information and Communication Technologies within healthcare operations to improve healthcare services. Various technologies such as Hospital Information Systems (HIS), Electronic Health Records (EHR) and Laboratory Information Systems (LIS) have been incorporated into healthcare services. The aim of this study is to evaluate the completeness of outpatients' laboratory paper based request forms in comparison with a electronic laboratory request system. This study was carried out in the laboratory department at King Abdulaziz Medical City (KAMC), National Guard Health Affairs, Riyadh, Saudi Arabia. We used a sample size calculator for comparing two proportions. We estimated the sample size to be 228 for each group. Any laboratory requests including paper and electronic forms were included. We categorized the clarity of the forms into understandable, readable, and unclear. A total of 57 incomplete paper forms or 25% were identified as being incomplete. For electronic forms, there were no incomplete fields, as all fields were mandatory, therefore, rendering them complete. The total of understandable paper-based laboratory forms was 11.4%. Additionally, it was found that the total of readable was 33.8% and the total for unclear was 54.8%, while for electronic-based forms, there were no unclear forms. Electronic based laboratory forms provide a more complete, accurate, clear, and understandable format than paper-based laboratory records. Based on these findings, KAMC should move toward the implementation of electronic-based laboratory request forms for the outpatient laboratory department. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  15. Performance of health laboratories in provision of HIV diagnostic and supportive services in selected districts of Tanzania.

    PubMed

    Ishengoma, Deus S; Kamugisha, Mathias L; Rutta, Acleus S M; Kagaruki, Gibson B; Kilale, Andrew M; Kahwa, Amos; Kamugisha, Erasmus; Baraka, Vito; Mandara, Celine I; Materu, Godlisten S; Massaga, Julius J; Magesa, Stephen M; Lemnge, Martha M; Mboera, Leonard E G

    2017-01-23

    Roll-out and implementation of antiretroviral therapy (ART) necessitated many countries in Sub-Saharan Africa to strengthen their national health laboratory systems (NHLSs) to provide high quality HIV diagnostic and supportive services. This study was conducted to assess the performance of health laboratories in provision of HIV diagnostic and supportive services in eight districts (from four regions of Iringa, Mtwara, Tabora and Tanga), after nine years of implementation of HIV/AIDS care and treatment plan in Tanzania. In this cross-sectional study, checklists and observations were utilized to collect information from health facilities (HFs) with care and treatment centres (CTCs) for HIV/AIDS patients; on availability of laboratories, CTCs, laboratory personnel, equipment and reagents. A checklist was also used to collect information on implementation of quality assurance (QA) systems at all levels of the NHLS in the study areas. The four regions had 354 HFs (13 hospitals, 41 Health Centres (HCs) and 300 dispensaries); whereby all hospitals had laboratories and 11 had CTCs while 97.5 and 61.0% of HCs had both laboratories and CTCs, respectively. Of the dispensaries, 36.0 and 15.0% had laboratories and CTCs (mainly in urban areas). Thirty nine HFs (12 hospitals, 21 HCs and six dispensaries) were assessed and 56.4% were located in urban areas. The assessed HFs had 199 laboratory staff of different cadres (laboratory assistants = 35.7%; technicians =32.7%; attendants = 22.6%; and others = 9.1%); with >61% of the staff and 72.3% of the technicians working in urban areas. All laboratories were using rapid diagnostic tests for HIV testing. Over 74% of the laboratories were performing internal quality control and 51.4% were participating in external QA programmes. Regional and district laboratories had all key equipment and harmonization was maintained for Fluorescence-Activated Cell Sorting (FACS) machines. Most of the biochemical (58.0%) and haematological

  16. The availability and functional status of focused antenatal care laboratory services at public health facilities in Addis Ababa, Ethiopia.

    PubMed

    Desalegn, Daniel Melese; Abay, Serebe; Taye, Bineyam

    2016-08-11

    Provision of quality laboratory services is an essential aspect of a promoting safe motherhood and better outcomes for newborn. Therefore; this study was intended to assess status of focused antenatal care (FANC) laboratory services at public health facilities in Addis Ababa, Ethiopia. Institution based, descriptive cross-sectional study was conducted from April to May 2015. The study included 13 randomly selected health facilities and 13 purposively selected laboratory service providers. The status of FANC laboratory service was assessed by using pre-tested structured questionnaire and observation checklist. The study supplemented with qualitative data through in-depth interview of laboratory service providers. The quantitative data were coded and analysed by using SPSS Version 20 software and qualitative data was transcribed, coded, categorized and thematically analysed by the principal investigator. Only 5 (38.5 %) out of 13 visited health facilities reported the availability of all types of basic FANC laboratory investigations. Comparing the availability of individual tests in the study facilities, urine dipstick, urine microscopy and stool examination were available in all institutions. However, only 7 (53.8 %) of the health facilities reported the availability of hepatitis B virus screening test. Rapid syphilis (RPR) test was found in 10 (76.9 %) facilities. All laboratory facilities had at least one or more basic FANC laboratory tests interruption for more than a day within the last 1 year due to shortage of reagent and electric power disruption. Majority of the health facilities reported incomplete provision of FANC laboratory investigations. Laboratory supply shortage and electric power disruption were the facilities' major challenge to screen pregnant women for pregnancy related health conditions. Since such conditions may affect the outcome of pregnancy, therefore extensive efforts should be targeted to avoid services interruption by taking

  17. 47 CFR 76.922 - Rates for the basic service tier and cable programming services tiers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation... changes in a cable operator's rates must be made from rate levels derived from data [that was current as... adjustment is made, except that the first annual inflation adjustment shall cover inflation from September 30...

  18. 47 CFR 76.922 - Rates for the basic service tier and cable programming services tiers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation... changes in a cable operator's rates must be made from rate levels derived from data [that was current as... adjustment is made, except that the first annual inflation adjustment shall cover inflation from September 30...

  19. 47 CFR 76.922 - Rates for the basic service tier and cable programming services tiers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation... changes in a cable operator's rates must be made from rate levels derived from data [that was current as... adjustment is made, except that the first annual inflation adjustment shall cover inflation from September 30...

  20. 47 CFR 76.922 - Rates for the basic service tier and cable programming services tiers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation... changes in a cable operator's rates must be made from rate levels derived from data [that was current as... adjustment is made, except that the first annual inflation adjustment shall cover inflation from September 30...

  1. A Mobile Service Robot for Life Science Laboratories

    NASA Astrophysics Data System (ADS)

    Schulenburg, Erik; Elkmann, Norbert; Fritzsche, Markus; Teutsch, Christian

    In this paper we presents a project that is developing a mobile service robot to assist users in biological and pharmaceutical laboratories by executing routine jobs such as filling and transporting microplates. A preliminary overview of the design of the mobile platform with a robotic arm is provided. Safety aspects are one focus of the project since the robot and humans will share a common environment. Hence, several safety sensors such as laser scanners, thermographie components and artificial skin are employed. These are described along with the approaches to object recognition.

  2. 42 CFR 416.171 - Determination of payment rates for ASC services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Determination of payment rates for ASC services... Determination of payment rates for ASC services. (a) Standard methodology. The standard methodology for determining the national unadjusted payment rate for ASC services is to calculate the product of the...

  3. [Unnecessary routine laboratory tests in patients referred for surgical services].

    PubMed

    Mata-Miranda, María del Pilar; Cano-Matus, Norberto; Rodriguez-Murrieta, Margarita; Guarneros-Zapata, Idalia; Ortiz, Mario

    2016-01-01

    To question the usefulness of the lab analysis considered routine testing for the identification of abnormalities in the surgical care. To determine the percentage of unnecessary laboratory tests in the preoperative assessment as well as to estimate the unnecessary expenses. A descriptive, cross-sectional study of patients referred for surgical evaluation between January 1st and March 31st 2013. The database of laboratory testing and electronic files were reviewed. Reference criteria from surgical services were compared with the tests requested by the family doctor. In 65% of the patients (n=175) unnecessary examinations were requested, 25% (n=68) were not requested the tests that they required, and only 10% of the patients were requested laboratory tests in accordance with the reference criteria (n=27). The estimated cost in unnecessary examinations was $1,129,552 in a year. The results were similar to others related to this theme, however, they had not been revised from the perspective of the first level of attention regarding the importance of adherence to the reference criteria which could prevent major expenditures. It is a priority for leaders and operational consultants in medical units to establish strategies and lines of action that ensure compliance with institutional policies so as to contain spending on comprehensive services, and which in turn can improve the medical care. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  4. Meeting the challenges of globalisation and miniaturisation in laboratory services.

    PubMed

    Melo, Murilo R; Rosenfeld, Luiz Gastão

    2007-12-01

    In the recent years, two trends emerged in the clinical laboratory: the miniaturisation of equipments to provide point-of-care testing (POCT) and a concentration of laboratories through mergers and acquisitions. New technology has expanded both opportunities. POCT provides the benefit of a convenient test where it is needed, i.e. near the patient. For companies, it is easier and cheaper to develop such tests, since technical requirements are somewhat less stringent, being an interesting area for start-ups. Nanotechnology is one of the most fascinating technical advances, with some advocating a US$1 trillion market-size for it by 2015. Laboratory tests and biomaterials will probably be greatly influenced by it, with new approaches for molecular diagnosis, with tests that can target both DNA and proteins in a process that eliminates PCR and allows multiplex analysis. On the other hand, there is a strong trend towards the globalisation of clinical laboratories and that occurs in four areas: a) Consumption of health services abroad; b) Movement of Health Personnel; c) Cross-Border delivery of trade; and d) Commercial presence. Each of these areas presents new challenges and opportunities for clinical laboratories, what will certainly shape the way we work today and in the future.

  5. 75 FR 3197 - Summer Food Service Program; 2010 Reimbursement Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-20

    ..., reimbursement has been based solely on a ``meals times rates'' calculation, without comparison to actual or... public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service... to the reimbursement rates for meals served in the Summer Food Service Program (SFSP). As required...

  6. Using fee-for-service testing to generate revenue for the 21st century public health laboratory.

    PubMed

    Loring, Carol; Neil, R Brock; Gillim-Ross, Laura; Bashore, Matthew; Shah, Sandip

    2013-01-01

    The decrease in appropriations for state public health laboratories (SPHLs) has become a major concern as tax revenues and, subsequently, state and federal funding, have decreased. These reductions have forced SPHLs to pursue revenue-generating opportunities to support their work. We describe the current state of funding in a sampling of SPHLs and the challenges these laboratories face as they implement or expand fee-for-service testing. We conducted surveys of SPHLs to collect data concerning laboratory funding sources, test menus, fee-for-service testing, and challenges to implementing fee-for-service testing. Most SPHLS receive funding through three revenue sources: state appropriation, federal funding, and fee-for-service testing (cash funds). Among SPHLs, state appropriations ranged from $0 to more than $6 per capita, federal funding ranged from $0.10 to $5 per capita, and revenue from fee-for-service testing ranged from $0 to $4 per capita. The tests commonly performed on a fee-for-service basis included assays for sexually transmitted diseases, mycobacterial cultures, newborn screening, and water testing. We found that restrictive legislation, staffing shortages, inadequate software for billing fee-for-service testing, and regulations on how SPHLs use their generated revenue are impediments to implementing fee-for-service testing. Some SPHLs are considering implementing or expanding fee-for-service testing as a way to recapture funds lost as a result of state and federal budget cuts. This analysis revealed many of the obstacles to implementing fee-for-service testing in SPHLs and the potential impact on SPHLs of continued decreases in funding.

  7. Impact of the London 2012 Olympic and Paralympic Games on demand for microbiology gastrointestinal diagnostic services at the Public Health Laboratory London.

    PubMed

    Williams, K; Sinclair, C; McEwan, R; Fleet, K; Balasegaram, S; Manuel, R

    2014-07-01

    Planning for the London 2012 Olympic and Paralympic Games at the Public Health Laboratory London was based on the requirement to meet potential increased demand with scalable capacity. The aim of this study was to determine the impact on demand for microbiology gastrointestinal diagnostic services during the Games period. Retrospective cross-sectional time-series data analysis was used to assess the number of gastrointestinal specimens received in the laboratory and the number of positive results. There was no increase in the number of gastrointestinal specimens received during the Games period, thus the Games had no impact on demand for microbiology gastrointestinal diagnostic services at the laboratory. There was a decrease in the number of public health specimens received for culture [incidence rate ratio = 0.34, 95% confidence interval (CI) = 0.13-0.86, P = 0.02] and a decrease in the number of culture positive community specimens (odds ratio = 0.59, 95 % CI = 0.40-0.85, P = 0.005), suggesting a decrease in gastrointestinal illness during the Games period. As previous planning assumptions were not based on actual specimen activity, the results of this study may modify the extent of additional planning for microbiological services required for mass gatherings. © 2014 The Authors.

  8. 48 CFR 252.239-7005 - Rates, charges, and services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... services. (d) For nontariffed services, the Contractor shall charge the Government at the lowest rate and... customer. (e) Recurring charges for services and facilities shall, in each case, start with the... Government may stop the use of any service or facilities furnished under this agreement/contract at any time...

  9. 76 FR 5328 - Summer Food Service Program; 2011 Reimbursement Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    .... Since January 1, 2008, reimbursement has been based solely on a ``meals times rates'' calculation... public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service... reimbursement rates for meals served in the Summer Food Service Program (SFSP). In accordance with sections 12(f...

  10. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT - U.S. POSTAL INSPECTION SERVICE FORENSIC & TECHNICAL SERVICES DIVISION - NATIONAL FORENSIC LABORATORY, DULLES, VIRGINIA

    EPA Science Inventory

    The United States Postal Service (USPS) in cooperation with EPA's National Risk Management Research Laboratory (NRMRL) is engaged in an effort to integrate waste prevention and recycling activities into the waste management programs at Postal facilities. This report describes the...

  11. Importance/performance analysis: a tool for service quality control by clinical laboratories.

    PubMed

    Scammon, D L; Weiss, R

    1991-01-01

    A study of customer satisfaction with clinical laboratory service is used as the basis for identifying potential improvements in service and more effectively targeting marketing activities to enhance customer satisfaction. Data on customer satisfaction are used to determine the aspects of service most critical to customers, how well the organization is doing in delivery of service, and how consistent service delivery is. Importance-performance analysis is used to highlight areas for future resource reallocation and strategic emphasis. Suggestions include the establishment of performance guidelines for customer contact personnel, the enhancement of timely delivery of reports via electronic transmission (computer and fax), and the development of standardized graphics for request and report forms to facilitate identification of appropriate request forms and guide clients to key items of information on reports.

  12. Current use of equations for estimating glomerular filtration rate in Spanish laboratories.

    PubMed

    Gràcia-Garcia, Sílvia; Montañés-Bermúdez, Rosario; Morales-García, Luis J; Díez-de Los Ríos, M José; Jiménez-García, Juan Á; Macías-Blanco, Carlos; Martínez-López, Rosalina; Ruiz-Altarejos, Joaquín; Ruiz-Martín, Guadalupe; Sanz-Hernández, Sonia; Ventura-Pedret, Salvador

    2012-07-17

    In 2006 the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC) and the Spanish Society of Nephrology (S.E.N.) developed a consensus document in order to facilitate the diagnosis and monitoring of chronic kidney disease with the incorporation of equations for estimating glomerular filtration rate (eGFR) into laboratory reports. The current national prevalence of eGFR reporting and the degree of adherence to these recommendations among clinical laboratories is unknown. We administered a national survey in 2010-11 to Spanish clinical laboratories. The survey was through e-mail or telephone to laboratories that participated in the SEQC’s Programme for External Quality Assurance, included in the National Hospitals Catalogue 2010, including both primary care and private laboratories. A total of 281 laboratories answered to the survey. Of these, 88.2% reported on the eGFR, with 61.9% reporting on the MDRD equation and 31.6% using the MDRD-IDMS equation. A total of 42.5% of laboratories always reported serum creatinine values, and other variables only when specifically requested. Regarding the way results were presented, 46.2% of laboratories reported the exact numerical value only when the filtration rate was below 60mL/min/1.73m2, while 50.6% reported all values regardless. In 56.3% of the cases reporting eGFR, an interpretive commentary of it was enclosed. Although a high percentage of Spanish laboratories have added eGFR in their reports, this metric is not universally used. Moreover, some aspects, such as the equation used and the correct expression of eGFR results, should be improved.

  13. Services of the CDRH X-ray calibration laboratory and their traceability to National Standards

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cerra, F.; Heaton, H.T.

    The X-ray Calibration Laboratory (XCL) of the Center for Devices and Radiological Health (CDRH) provides calibration services for the Food and Drug Administration (FDA). The instruments calibrated are used by FDA and contract state inspectors to verify compliance with federal x-ray performance standards and for national surveys of x-ray trends. In order to provide traceability of measurements, the CDRH XCL is accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) for reference, diagnostic, and x-ray survey instrument calibrations. In addition to these accredited services, the CDRH XCL also calibrates non-invasive kVp meters in single- and three-phase x-ray beams, and thermoluminescentmore » dosimeter (TLD) chips used to measure CT beam profiles. The poster illustrates these services and shows the traceability links back to the National Standards.« less

  14. A major employer as a health care services laboratory.

    PubMed

    Reeve, G R; Pastula, S; Rontal, R

    1998-12-01

    Health care management within the USA operations of the Ford Motor Company is a substantial and critical enterprise. The company provides health care coverage for a population of 636,000 active employees, retirees and their dependents at a cost of US$1.5 billion annually. The company realizes that effective management of health care resources requires continuous improvement in the services for which the company contracts and in the manner in which these services are provided to employees. In this context, the company's health care management department views the Ford employee population as a living health care sciences laboratory for the design, evaluation and improvement of health care services. The population, available data sources, and their advantages and disadvantages for use in the evaluation of disease and health utilization patterns are discussed in this paper from an epidemiological perspective. Two examples of preliminary evaluations are presented to illustrate use of data from this large employee population for improving care provided to persons with elevated risk of cardiovascular disease.

  15. High-Data-Rate Quadrax Cable Microwave Characterization at the NASA Glenn Structural Dynamics Laboratory

    NASA Technical Reports Server (NTRS)

    Theofylaktos, Onoufrios; Warner, Joseph D.; Sheehe, Charles J.

    2012-01-01

    An experiment was performed to determine the degradation in the bit-error-rate (BER) in the high-data-rate cables chosen for the Orion Service Module due to extreme launch conditions of vibrations with a magnitude of 60g. The cable type chosen for the Orion Service Module was no. 8 quadrax cable. The increase in electrical noise induced on these no. 8 quadrax cables was measured at the NASA Glenn vibration facility in the Structural Dynamics Laboratory. The intensity of the vibrations was set at 32g, which was the maximum available level at the facility. The cable lengths used during measurements were 1, 4, and 8 m. The noise measurements were done in an analog fashion using a performance network analyzer (PNA) by recording the standard deviation of the transmission scattering parameter S(sub 21) over the frequency range of 100 to 900 MHz. The standard deviation of S(sub 210 was measured before, during, and after the vibration of the cables at the vibration facility. We observed an increase in noise by a factor of 2 to 6. From these measurements we estimated the increase expected in the BER for a cable length of 25 m and concluded that these findings are large enough that the noise increase due to vibration must be taken in to account for the design of the communication system for a BER of 10(exp -8).

  16. Dioxins, Furans, PCBs, and Congeners Analytical Service within the Superfund Contract Laboratory Program

    EPA Pesticide Factsheets

    This page contains information about the DLM02.2 analytical service for the analysis of dioxins and furans at hazardous waste sites. The SOW contains the analytical method and contractual requirements for laboratories.

  17. 77 FR 12866 - Accreditation and Approval of Amspec Services LLC, as a Commercial Gauger and Laboratory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-02

    ... 151.13, Amspec Services LLC, 12154 B River Road, St. Rose, LA 70087, has been approved to gauge and...: February 22, 2012. Ira S. Reese, Executive Director, Laboratories and Scientific Services. [FR Doc. 2012...

  18. Pre-Service Science Teachers' Views on Laboratory Applications in Science Education: The Effect of a Two-Semester Course

    ERIC Educational Resources Information Center

    Harman, Gonca; Cokelez, Aytekin; Dal, Burckin; Alper, Umut

    2016-01-01

    The aim of this study was to examine pre-service science teachers' views about laboratory applications in science education and how their views changed through laboratory applications that were carried out for two semesters. 63 (52 females, 11 males) pre-service teachers participated in the study. The study was carried out by using pre-test and…

  19. CIEMAT EXTERNAL DOSIMETRY SERVICE: ISO/IEC 17025 ACCREDITATION AND 3 Y OF OPERATIONAL EXPERIENCE AS AN ACCREDITED LABORATORY.

    PubMed

    Romero, A M; Rodríguez, R; López, J L; Martín, R; Benavente, J F

    2016-09-01

    In 2008, the CIEMAT Radiation Dosimetry Service decided to implement a quality management system, in accordance with established requirements, in order to achieve ISO/IEC 17025 accreditation. Although the Service comprises the approved individual monitoring services of both external and internal radiation, this paper is specific to the actions taken by the External Dosimetry Service, including personal and environmental dosimetry laboratories, to gain accreditation and the reflections of 3 y of operational experience as an accredited laboratory. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. 49 CFR 40.329 - What information must laboratories, MROs, and other service agents release to employees?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... other service agents release to employees? 40.329 Section 40.329 Transportation Office of the Secretary... Confidentiality and Release of Information § 40.329 What information must laboratories, MROs, and other service agents release to employees? (a) As an MRO or service agent you must provide, within 10 business days of...

  1. Audit of laboratory mycology services for the management of patients with fungal infections in the northwest of England.

    PubMed

    Hassan, I A; Critten, P; Isalska, B; Denning, D W

    2006-07-01

    Fungal infection is increasingly recognised as an important cause of morbidity and mortality, especially in immunocompromised patients. Little information exists on laboratory services available and the methods used by general microbiology laboratories to diagnose these important infections. To investigate the services microbiology laboratories in northwest England provide towards the diagnosis and management of superficial and deep fungal infections. A questionnaire was sent to laboratories to get a holistic view of the support given to clinicians looking after patients with fungal infections. The aim was not to investigate details of each laboratory's standard operating procedures. The completed questionnaires, which formed the basis of this report, were returned by all 21 laboratories which were recruited. This study was conducted between March 2004 and September 2004. Services were provided to District General Hospitals and to six tertiary centres, including eight teaching hospitals by 16 laboratories. Their bed capacity was 250-1300 beds. Total specimens (including bacterial and viral) processed annually were 42 000-500,000 whereas fungal ones were 560-5400. In most microbiology laboratories of northwest England, clinicians were aware of the potential of fungal pathogens to cause infections especially in immunocompromised patients. Additional measures such as prolonged incubation of samples were introduced to improve fungal yield from patients at high risk. It is necessary to train and educate laboratory and medical staff about the role of serology and molecular methods in diagnosis and management of patients with fungal infection.

  2. Errors in clinical laboratories or errors in laboratory medicine?

    PubMed

    Plebani, Mario

    2006-01-01

    Laboratory testing is a highly complex process and, although laboratory services are relatively safe, they are not as safe as they could or should be. Clinical laboratories have long focused their attention on quality control methods and quality assessment programs dealing with analytical aspects of testing. However, a growing body of evidence accumulated in recent decades demonstrates that quality in clinical laboratories cannot be assured by merely focusing on purely analytical aspects. The more recent surveys on errors in laboratory medicine conclude that in the delivery of laboratory testing, mistakes occur more frequently before (pre-analytical) and after (post-analytical) the test has been performed. Most errors are due to pre-analytical factors (46-68.2% of total errors), while a high error rate (18.5-47% of total errors) has also been found in the post-analytical phase. Errors due to analytical problems have been significantly reduced over time, but there is evidence that, particularly for immunoassays, interference may have a serious impact on patients. A description of the most frequent and risky pre-, intra- and post-analytical errors and advice on practical steps for measuring and reducing the risk of errors is therefore given in the present paper. Many mistakes in the Total Testing Process are called "laboratory errors", although these may be due to poor communication, action taken by others involved in the testing process (e.g., physicians, nurses and phlebotomists), or poorly designed processes, all of which are beyond the laboratory's control. Likewise, there is evidence that laboratory information is only partially utilized. A recent document from the International Organization for Standardization (ISO) recommends a new, broader definition of the term "laboratory error" and a classification of errors according to different criteria. In a modern approach to total quality, centered on patients' needs and satisfaction, the risk of errors and mistakes

  3. Health laboratories in the Tanga region of Tanzania: the quality of diagnostic services for malaria and other communicable diseases.

    PubMed

    Ishengoma, D R S; Rwegoshora, R T; Mdira, K Y; Kamugisha, M L; Anga, E O; Bygbjerg, I C; Rønn, A M; Magesa, S M

    2009-07-01

    Although critical for good case management and the monitoring of health interventions, the health-laboratory services in sub-Saharan Africa are grossly compromised by poor infrastructures and a lack of trained personnel, essential reagents and other supplies. The availability and quality of diagnostic services in 37 health laboratories in three districts of the Tanga region of Tanzania have recently been assessed. The results of the survey, which involved interviews with health workers, observations and a documentary review, revealed that malaria accounted for >50% of admissions and out-patient visits. Most (92%) of the laboratories were carrying out malaria diagnosis and 89% were measuring haemoglobin concentrations but only one (3%) was conducting culture and sensitivity tests, and those only on urine and pus samples. Only 14 (17%) of the 84 people found working in the visited laboratories were laboratory technologists with a diploma certificate or higher qualification. Sixteen (43%) of the study laboratories each had five or fewer types of equipment and only seven (19%) had more than 11 types each. Although 11 (30%) of the laboratories reported that they conducted internal quality control, none had standard operating procedures (SOP) on display or evidence of such quality assurance. Although malaria was the main health problem, diagnostic services for malaria and other diseases were inadequate and of poor quality because of the limited human resources, poor equipment and shortage of supplies. If the health services in Tanga are not to be overwhelmed by the progressively increasing burden of HIV/AIDS, malaria, tuberculosis and other emerging and re-emerging diseases, more funding and appropriate policies to improve the availability and quality of the area's diagnostic services will clearly be required.

  4. The centrality of laboratory services in the HIV treatment and prevention cascade: The need for effective linkages and referrals in resource-limited settings.

    PubMed

    Alemnji, George; Fonjungo, Peter; Van Der Pol, Barbara; Peter, Trevor; Kantor, Rami; Nkengasong, John

    2014-05-01

    Strong laboratory services and systems are critical for delivering timely and quality health services that are vital to reduce patient attrition in the HIV treatment and prevention cascade. However, challenges exist in ensuring effective laboratory health systems strengthening and linkages. In particular, linkages and referrals between laboratory testing and other services need to be considered in the context of an integrated health system that includes prevention, treatment, and strategic information. Key components of laboratory health systems that are essential for effective linkages include an adequate workforce, appropriate point-of-care (POC) technology, available financing, supply chain management systems, and quality systems improvement, including accreditation. In this review, we highlight weaknesses of and gaps between laboratory testing and other program services. We propose a model for strengthening these systems to ensure effective linkages of laboratory services for improved access and retention in care of HIV/AIDS patients, particularly in low- and middle-income countries.

  5. The Effect of Simulation-Assisted Laboratory Applications on Pre-Service Teachers' Attitudes towards Science Teaching

    ERIC Educational Resources Information Center

    Ulukök, Seyma; Sari, Ugur

    2016-01-01

    In this study, the effects of computer-assisted laboratory applications on pre-service science teachers' attitudes towards science teaching were investigated and the opinions of the pre-service teachers about the application were also determined. The study sample consisted of 46 students studying science teaching Faculty of Education. The study…

  6. Enabling Data Intensive Science through Service Oriented Science: Virtual Laboratories and Science Gateways

    NASA Astrophysics Data System (ADS)

    Lescinsky, D. T.; Wyborn, L. A.; Evans, B. J. K.; Allen, C.; Fraser, R.; Rankine, T.

    2014-12-01

    We present collaborative work on a generic, modular infrastructure for virtual laboratories (VLs, similar to science gateways) that combine online access to data, scientific code, and computing resources as services that support multiple data intensive scientific computing needs across a wide range of science disciplines. We are leveraging access to 10+ PB of earth science data on Lustre filesystems at Australia's National Computational Infrastructure (NCI) Research Data Storage Infrastructure (RDSI) node, co-located with NCI's 1.2 PFlop Raijin supercomputer and a 3000 CPU core research cloud. The development, maintenance and sustainability of VLs is best accomplished through modularisation and standardisation of interfaces between components. Our approach has been to break up tightly-coupled, specialised application packages into modules, with identified best techniques and algorithms repackaged either as data services or scientific tools that are accessible across domains. The data services can be used to manipulate, visualise and transform multiple data types whilst the scientific tools can be used in concert with multiple scientific codes. We are currently designing a scalable generic infrastructure that will handle scientific code as modularised services and thereby enable the rapid/easy deployment of new codes or versions of codes. The goal is to build open source libraries/collections of scientific tools, scripts and modelling codes that can be combined in specially designed deployments. Additional services in development include: provenance, publication of results, monitoring, workflow tools, etc. The generic VL infrastructure will be hosted at NCI, but can access alternative computing infrastructures (i.e., public/private cloud, HPC).The Virtual Geophysics Laboratory (VGL) was developed as a pilot project to demonstrate the underlying technology. This base is now being redesigned and generalised to develop a Virtual Hazards Impact and Risk Laboratory

  7. Laboratory Services Guide

    DTIC Science & Technology

    1994-10-01

    dosimetry services using thermoluminescent dosimeters ( TLDs ) to meet 10 CFR 19, 20, 30-36, 40 and 70; to proNide dosimetry service for environmental...USAF Personnel Dosimetry Branch. Once it is determined that area or external dosimetry is necessary, request the number of TLDs required by FAX or letter... dosimetry , Request TLDs 2 - 4 weeks in advance and always designate a control badge. The Radiation Dosimetry Branch thanks you in advance for doing everything

  8. Improved Specimen-Referral System and Increased Access to Quality Laboratory Services in Ethiopia: The Role of the Public-Private Partnership

    PubMed Central

    Kebede, Yenew; Fonjungo, Peter N.; Tibesso, Gudeta; Shrivastava, Ritu; Nkengasong, John N.; Kenyon, Thomas; Kebede, Amha; Gadde, Renuka; Ayana, Gonfa

    2016-01-01

    Background. Nonstandardized specimen-transport logistics, lack of laboratory personnel to transport specimens, lack of standard specimen containers, and long turnaround time (TAT) hindered access to quality laboratory services. The objective of the Becton, Dickinson, and Company (BD)–US President's Emergency Plan for AIDS Relief (PEPFAR) Public-Private Partnership (PPP) was to support country-specific programs to develop integrated laboratory systems, services, and quality improvement strategies, with an emphasis on strengthening the specimen-referral system (SRS). Methods. In 2007, through the Centers for Disease Control and Prevention (CDC), the Ethiopian Public Health Institute (EPHI) joined with the BD-PEPFAR PPP to strengthen laboratory systems. A joint planning and assessment committee identified gaps in the SRS for prioritization and intervention and piloted the system in Addis Ababa and Amhara Region. Results. The PPP established standardized, streamlined specimen logistics, using the Ethiopian Postal Service Enterprise to support a laboratory network in which 554 facilities referred specimens to 160 laboratories. The PPP supported procuring 400 standard specimen containers and the training of 586 laboratory personnel and 81 postal workers. The average TAT was reduced from 7 days (range, 2–14 days) to 2 days (range, 1–3 days) in Addis Ababa and from 10 days (range, 6–21 days) to 5 days (range, 2–6 days) in Amhara Region. Conclusions. This study highlights the feasibility and untapped potential of PPPs to strengthen laboratory systems. This planned and structured approach to improving specimen referral enhanced access to quality laboratory services. PMID:27025700

  9. Improving Pre-Service Elementary Teachers' Education via a Laboratory Course on Air Pollution: One University's Experience

    ERIC Educational Resources Information Center

    Mandrikas, Achilleas; Parkosidis, Ioannis; Psomiadis, Ploutarchos; Stoumpa, Artemisia; Chalkidis, Anthimos; Mavrikaki, Evangelia; Skordoulis, Constantine

    2013-01-01

    This paper describes the structure of the "Air Pollution Course", an environmental science laboratory course developed at the Science Education Laboratory of the Faculty of Primary Education, University of Athens, as well as the findings resulting from its implementation by pre-service elementary teachers. The course proposed in this…

  10. Mechanisms and rates of strength recovery in laboratory fault zones

    NASA Astrophysics Data System (ADS)

    Muhuri, Sankar Kumar

    2001-07-01

    The life cycle of a typical fault zone consists of repeated catastrophic seismic events during which much of the slip is accommodated interspersed with creep during the inter-seismic cycle. Fault strength is regenerated during this period as a result of several time-dependent, fluid assisted deformation mechanisms that are favored by high stresses along active fault zones. The strengthening is thought to be a function of the sum total of the rates of recovery due to these multiple creep processes as well as the rate of tectonic loading. Mechanisms and rates of strength recovery in laboratory fault zones were investigated in this research with the aid of several experimental designs. It was observed that wet faults recover strength in a time-dependent manner after slip due to operative creep processes. Subsequent loading results in unstable failure of a cohesive gouge zone with large associated stress drops. The failure process is similar to that observed for intact rocks. Dry laboratory faults in contrast do not recover strength and slip along them is always stable with no observable drop in stress. Strengthening in laboratory faults proceeds in a manner that is a logarithmic function of time. The recovery is attributable to fluid mediated mechanisms such as pressure solution, crack sealing and Ostwald ripening that collectively cause a reduction in porosity and enhance lithification of an unconsolidated gouge. Rates for the individual deformation mechanisms investigated in separate experimental setups were also observed to be a non-linear function of time. Pressure solution and Ostwald ripening are especially enhanced due to the significant volume fraction of fine particles within the gouge created due to cataclasis during slip. The results of this investigation may be applied to explain observations of rapid strengthening along large, active crustal fault zones such as parts of the San Andreas Fault system in California and the Nojima fault in Japan. Presence of

  11. Reframing beliefs about work and change processes in redesigning laboratory services.

    PubMed

    Kelly, D L

    1998-03-01

    In 1996 a team started meeting to redesign care at Intermountain Health Care's (Salt Lake City) laboratory services on a fast track to dovetail with remodeling of the physical layout. The team reframed its current beliefs about using team processes--including use of a consultant/facilitator, team size, and decision making (by criteria instead of consensus). Although the lab was strong in technical measurements, the sole management measurement before redesign was financial data generated by the accounting department. A comprehensive measurement system, which was required for the lab to evaluate the impact of the redesign efforts and manage its operations over time, constituted the team's first steps toward implementing the redesign effort. PROCESS REDESIGN: Once the team understood the purpose, customer expectations, desired outcomes of the specimen flow process, and the reasons for current breakdowns, it was able to design an ideal high-level process (with a floor plan to support it). Multiple subprocesses were redesigned and implemented on the basis of reframed beliefs--for example, that the process starts and ends with the customer (clinician or patient) and that there is one standardized entry point into the lab to reduce variability in processing and assign priority for analysis of specimens. For example, the team identified opportunities for improvements in the manner in which laboratory test results were communicated to physicians' offices. The belief that appeared to have the most profound impact on the redesign effort was the clarification of the fundamental purpose of laboratory services and how it shapes every aspect of the business.

  12. 76 FR 28767 - Desert Southwest Customer Service Region-Rate Order No. WAPA-152

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-18

    ... Temporarily Extending Network Integration Transmission Service (NITS). SUMMARY: This action is to temporarily... Administration, Rate Extension for Desert Southwest Region Network Integration Transmission Service and WALC... Integration Transmission Service and Ancillary Services Formula Rates Section 302 of the Department of Energy...

  13. America's "undiscovered" laboratory for health services research.

    PubMed

    Gimbel, Ronald W; Pangaro, Louis; Barbour, Galen

    2010-08-01

    Debate over reforming the nation's healthcare system has stimulated a need for health services research (HSR) models that are nationally applicable. Toward this end, the authors identify the Military Health System (MHS) as America's "undiscovered" laboratory for HSR. Although many may confuse the MHS with the Department of Veterans Affairs (VA), the 2 systems vary dramatically with respect to their beneficiary populations, access to care, and other important attributes. In this article, the authors describe key characteristics of the MHS including its large beneficiary base, its direct care operating environment, its dedicated medical school and graduate education programs, and its fully operational integrated health information system. Although a few health systems (eg, Kaiser Permanente, Partners Healthcare, and Department of Veterans Affairs) possess some characteristics, no other has all of these components in place. This article sets the stage for contemporary HSR studies with broad applicability to current issues in American healthcare that could be performed within the MHS. Inclusion of the MHS environment in HSR studies of health services delivery modalities, adoption of health information technology, access to care, relationship of medical education to effective safe care delivery, health disparities, child health, and behavioral health would provide strong underpinnings for proposed changes in American healthcare delivery. Finally, the article highlights current regulatory barriers to research within the MHS whereas suggesting steps to minimize their impact in conducting HSR.

  14. Restriction of therapy mainly explains lower thrombolysis rates in reduced stroke service levels.

    PubMed

    Gumbinger, Christoph; Reuter, Björn; Hacke, Werner; Sauer, Tamara; Bruder, Ingo; Diehm, Curt; Wiethölter, Horst; Schoser, Karin; Daffertshofer, Michael; Neumaier, Stephan; Drewitz, Elke; Rode, Susanne; Kern, Rolf; Hennerici, Michael G; Stock, Christian; Ringleb, Peter

    2016-05-24

    To assess the influence of preexisting disabilities, age, and stroke service level on standardized IV thrombolysis (IVT) rates in acute ischemic stroke (AIS). We investigated standardized IVT rates in a retrospective registry-based study in 36,901 patients with AIS from the federal German state Baden-Wuerttemberg over a 5-year period. Patients admitted within 4.5 hours after stroke onset were selected. Factors associated with IVT rates (patient-level factors and stroke service level) were assessed using robust Poisson regression modeling. Interactions between factors were considered to estimate risk-adjusted mortality rates and potential IVT rates by service level (with stroke centers as benchmark). Overall, 10,499 patients (28.5%) received IVT. The IVT rate declined with service level from 44.0% (stroke center) to 13.1% (hospitals without stroke unit [SU]). Especially patients >80 years of age and with preexisting disabilities had a lower chance of being treated with IVT at lower stroke service levels. Interactions between stroke service level and age group, preexisting disabilities, and stroke severity (all p < 0.0001) were observed. High IVT rates seemed not to increase mortality. Estimated potential IVT rates ranged between 41.9% and 44.6% depending on stroke service level. Differences in IVT rates among stroke service levels were mainly explained by differences administering IVT to older patients and patients with preexisting disabilities. This indicates considerable further potential to increase IVT rates. Our findings support guideline recommendations to admit acute stroke patients to SUs. © 2016 American Academy of Neurology.

  15. 47 CFR 64.6040 - Rates for Telecommunications Relay Service (TRS) calling.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Rates for Telecommunications Relay Service (TRS) calling. 64.6040 Section 64.6040 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON....6040 Rates for Telecommunications Relay Service (TRS) calling. No Provider shall levy or collect any...

  16. 77 FR 36563 - Indian Health Service; Reimbursement Rates for Calendar Year 2012 Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service; Reimbursement Rates for Calendar Year 2012 Correction AGENCY: Indian Health Service, HHS. ACTION: Notice; correction. SUMMARY: The Indian Health Service published a document in the Federal Register on June 6, 2012, concerning rates for...

  17. 77 FR 34054 - Accreditation and Approval of Amspec Services LLC, as a Commercial Gauger and Laboratory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-08

    ... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Accreditation and Approval of Amspec Services LLC, as a Commercial Gauger and Laboratory AGENCY: U.S. Customs and Border Protection, Department of Homeland Security. ACTION: Notice of accreditation and approval of Amspec Services LLC, as a...

  18. 77 FR 50523 - Accreditation and Approval of Amspec Services LLC, as a Commercial Gauger and Laboratory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Accreditation and Approval of Amspec Services LLC, as a Commercial Gauger and Laboratory AGENCY: U.S. Customs and Border Protection, Department of Homeland Security. ACTION: Notice of accreditation and approval of Amspec Services LLC, as a...

  19. 77 FR 50522 - Accreditation and Approval of Amspec Services LLC, as a Commercial Gauger and Laboratory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Accreditation and Approval of Amspec Services LLC, as a Commercial Gauger and Laboratory AGENCY: U.S. Customs and Border Protection, Department of Homeland Security. ACTION: Notice of accreditation and approval of Amspec Services LLC, as a...

  20. Improved Specimen-Referral System and Increased Access to Quality Laboratory Services in Ethiopia: The Role of the Public-Private Partnership.

    PubMed

    Kebede, Yenew; Fonjungo, Peter N; Tibesso, Gudeta; Shrivastava, Ritu; Nkengasong, John N; Kenyon, Thomas; Kebede, Amha; Gadde, Renuka; Ayana, Gonfa

    2016-04-15

    Nonstandardized specimen-transport logistics, lack of laboratory personnel to transport specimens, lack of standard specimen containers, and long turnaround time (TAT) hindered access to quality laboratory services. The objective of the Becton, Dickinson, and Company (BD)-US President's Emergency Plan for AIDS Relief (PEPFAR) Public-Private Partnership (PPP) was to support country-specific programs to develop integrated laboratory systems, services, and quality improvement strategies, with an emphasis on strengthening the specimen-referral system (SRS). In 2007, through the Centers for Disease Control and Prevention (CDC), the Ethiopian Public Health Institute (EPHI) joined with the BD-PEPFAR PPP to strengthen laboratory systems. A joint planning and assessment committee identified gaps in the SRS for prioritization and intervention and piloted the system in Addis Ababa and Amhara Region. The PPP established standardized, streamlined specimen logistics, using the Ethiopian Postal Service Enterprise to support a laboratory network in which 554 facilities referred specimens to 160 laboratories. The PPP supported procuring 400 standard specimen containers and the training of 586 laboratory personnel and 81 postal workers. The average TAT was reduced from 7 days (range, 2-14 days) to 2 days (range, 1-3 days) in Addis Ababa and from 10 days (range, 6-21 days) to 5 days (range, 2-6 days) in Amhara Region. This study highlights the feasibility and untapped potential of PPPs to strengthen laboratory systems. This planned and structured approach to improving specimen referral enhanced access to quality laboratory services. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  1. 42 CFR 493.1355 - Condition: Laboratories performing PPM procedures; laboratory director.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing PPM procedures; laboratory director. 493.1355 Section 493.1355 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS...

  2. 42 CFR 493.1355 - Condition: Laboratories performing PPM procedures; laboratory director.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Laboratories performing PPM procedures; laboratory director. 493.1355 Section 493.1355 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS...

  3. National Laboratory Planning: Developing Sustainable Biocontainment Laboratories in Limited Resource Areas.

    PubMed

    Yeh, Kenneth B; Adams, Martin; Stamper, Paul D; Dasgupta, Debanjana; Hewson, Roger; Buck, Charles D; Richards, Allen L; Hay, John

    2016-01-01

    Strategic laboratory planning in limited resource areas is essential for addressing global health security issues. Establishing a national reference laboratory, especially one with BSL-3 or -4 biocontainment facilities, requires a heavy investment of resources, a multisectoral approach, and commitments from multiple stakeholders. We make the case for donor organizations and recipient partners to develop a comprehensive laboratory operations roadmap that addresses factors such as mission and roles, engaging national and political support, securing financial support, defining stakeholder involvement, fostering partnerships, and building trust. Successful development occurred with projects in African countries and in Azerbaijan, where strong leadership and a clear management framework have been key to success. A clearly identified and agreed management framework facilitate identifying the responsibility for developing laboratory capabilities and support services, including biosafety and biosecurity, quality assurance, equipment maintenance, supply chain establishment, staff certification and training, retention of human resources, and sustainable operating revenue. These capabilities and support services pose rate-limiting yet necessary challenges. Laboratory capabilities depend on mission and role, as determined by all stakeholders, and demonstrate the need for relevant metrics to monitor the success of the laboratory, including support for internal and external audits. Our analysis concludes that alternative frameworks for success exist for developing and implementing capabilities at regional and national levels in limited resource areas. Thus, achieving a balance for standardizing practices between local procedures and accepted international standards is a prerequisite for integrating new facilities into a country's existing public health infrastructure and into the overall international scientific community.

  4. National Laboratory Planning: Developing Sustainable Biocontainment Laboratories in Limited Resource Areas

    PubMed Central

    Adams, Martin; Stamper, Paul D.; Dasgupta, Debanjana; Hewson, Roger; Buck, Charles D.; Richards, Allen L.; Hay, John

    2016-01-01

    Strategic laboratory planning in limited resource areas is essential for addressing global health security issues. Establishing a national reference laboratory, especially one with BSL-3 or -4 biocontainment facilities, requires a heavy investment of resources, a multisectoral approach, and commitments from multiple stakeholders. We make the case for donor organizations and recipient partners to develop a comprehensive laboratory operations roadmap that addresses factors such as mission and roles, engaging national and political support, securing financial support, defining stakeholder involvement, fostering partnerships, and building trust. Successful development occurred with projects in African countries and in Azerbaijan, where strong leadership and a clear management framework have been key to success. A clearly identified and agreed management framework facilitate identifying the responsibility for developing laboratory capabilities and support services, including biosafety and biosecurity, quality assurance, equipment maintenance, supply chain establishment, staff certification and training, retention of human resources, and sustainable operating revenue. These capabilities and support services pose rate-limiting yet necessary challenges. Laboratory capabilities depend on mission and role, as determined by all stakeholders, and demonstrate the need for relevant metrics to monitor the success of the laboratory, including support for internal and external audits. Our analysis concludes that alternative frameworks for success exist for developing and implementing capabilities at regional and national levels in limited resource areas. Thus, achieving a balance for standardizing practices between local procedures and accepted international standards is a prerequisite for integrating new facilities into a country's existing public health infrastructure and into the overall international scientific community. PMID:27559843

  5. Management practices associated with conception rate and service rate of lactating Holstein cows in large, commercial dairy herds.

    PubMed

    Schefers, J M; Weigel, K A; Rawson, C L; Zwald, N R; Cook, N B

    2010-04-01

    Data from lactating Holstein cows in herds that participate in a commercial progeny testing program were analyzed to explain management factors associated with herd-average conception and service rates on large commercial dairies. On-farm herd management software was used as the source of data related to production, reproduction, culling, and milk quality for 108 herds. Also, a survey regarding management, facilities, nutrition, and labor was completed on 86 farms. A total of 41 explanatory variables related to management factors and conditions that could affect conception and service rate were considered in this study. Models explaining conception and service rates were developed using a machine learning algorithm for constructing model trees. The most important explanatory variables associated with conception rate were the percentage of repeated inseminations between 4 and 17 d post-artificial insemination, stocking density in the breeding pen, length of the voluntary waiting period, days at pregnancy examination, and somatic cell score. The most important explanatory variables associated with service rate were the number of lactating cows per breeding technician, use of a resynchronization program, utilization of soakers in the holding area during the summer, and bunk space per cow in the breeding pen. The aforementioned models explained 35% and 40% of the observed variation in conception rate and service rate, respectively, and underline the association of herd-level management factors not strictly related to reproduction with herd reproductive performance. Copyright (c) 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  6. 42 CFR 416.171 - Determination of payment rates for ASC services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... services. (d) Limitation on payment rates for office-based surgical procedures and covered ancillary... nonfacility practice expense relative value units under § 414.22(b)(5)(i)(B) of this subchapter multiplied by... payment rate for covered ancillary radiology services that involve certain nuclear medicine procedures...

  7. 42 CFR 416.171 - Determination of payment rates for ASC services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... services. (d) Limitation on payment rates for office-based surgical procedures and covered ancillary... nonfacility practice expense relative value units under § 414.22(b)(5)(i)(B) of this subchapter multiplied by... payment rate for covered ancillary radiology services that involve certain nuclear medicine procedures...

  8. 42 CFR 416.125 - ASC facility services payment rate.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false ASC facility services payment rate. 416.125 Section 416.125 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... connection with the performance of that procedure. (b) The payment must be substantially less than would have...

  9. 42 CFR 416.125 - ASC facility services payment rate.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false ASC facility services payment rate. 416.125 Section 416.125 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... connection with the performance of that procedure. (b) The payment must be substantially less than would have...

  10. 7 CFR 160.204 - Fees for extra cost and hourly rate service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Fees for extra cost and hourly rate service. 160.204... STORES REGULATIONS AND STANDARDS FOR NAVAL STORES Specific Fees Payable for Services Rendered § 160.204 Fees for extra cost and hourly rate service. The fees specified in §§ 160.201 and 160.202 apply to the...

  11. Plate-rate laboratory friction experiments reveal potential slip instability on weak faults

    NASA Astrophysics Data System (ADS)

    Ikari, M.; Kopf, A.

    2016-12-01

    In earthquake science, it is commonly assumed that earthquakes nucleate on strong patches or "asperities", and data from laboratory friction experiments indicate a tendency for unstable slip (exhibited as velocity-weakening frictional behavior) in strong geologic materials. However, an overwhelming amount of these experiments were conducted at driving velocities ranging from 0.1 µm/s to over 1 m/s. Less data exists for shearing experiments driven at slow velocities on the order of cm/yr (nm/s), approximating plate tectonic rates which represent the natural driving condition on plate boundary faults. Recent laboratory work using samples recovered from the Tohoku region at the Japan Trench, within the high coseismic slip region of the 2011 M9 Tohoku earthquake, showed that the fault is extremely weak with a friction coefficient < 0.2. At sliding velocities of at least 0.1 µm/s mostly velocity-strengthening friction is observed, which is favorable for stable creep, consistent with earlier work. However, shearing at an imposed rate of 8.5 cm/yr produced both velocity-weakening friction and discrete slow slip events, which are likely instances of frictional instabilities or quasi-instabilities. Here, we expand on the Tohoku experiment by conducting cm/yr friction experiments on natural gouges obtained from a variety of other major fault zones obtained by scientific drilling; these include the San Andreas Fault, Costa Rica subduction zone, Nankai Trough (Japan), Barbados subduction zone, Alpine Fault (New Zealand), southern Cascadia, and Woodlark Basin (Papua New Guinea). We focus here on weak fault materials having a friction coefficient of < 0.5. At conventional laboratory driving rates of 0.1-30 µm/s, velocity strengthening is common. However, at cm/yr driving rates we commonly observe velocity-weakening friction and slow slip events, with most samples exhibit both behaviors. These results demonstrate when fault samples are sheared at plate tectonic rates in the

  12. The revenue generated from clinical chemistry and hematology laboratory services as determined using activity-based costing (ABC) model.

    PubMed

    Adane, Kasaw; Abiy, Zenegnaw; Desta, Kassu

    2015-01-01

    The rapid and continuous growth of health care cost aggravates the frequently low priority and less attention given in financing laboratory services. The poorest countries have the highest out-of-pocket spending as a percentage of income. Higher charges might provide a greater potential for revenue. If fees raise quality sufficiently, it can enhance usage. Therefore, estimating the revenue generated from laboratory services could help in capacity building and improved quality service provision. Panel study design was used to determine revenue generated from clinical chemistry and hematology services at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Activity-Based Costing (ABC) model was used to determine the true cost of tests performed from October 2011 to December 2011 in the hospital. The principle of Activity-based Costing is that activities consume resources and activities consumed by services which incur the costs and hence service takes the cost of resources. All resources with costs are aggregated with the established casual relationships. The process maps designed was restructured in consultation with the senior staffs working and/or supervising the laboratory and pretested checklists were used for observation. Moreover, office documents, receipts and service bills were used while collecting data. The amount of revenue collected from services was compared with the cost of each subsequent test and the profitability or return on investment (ROI) of services was calculated. Data were collected, entered, cleaned, and analyzed using Microsoft Excel 2007 software program and Statistical Software Package for Social Sciences version 19 (SPSS). Paired sample t test was used to compare the price and cost of each test. P-value less than 0.05 were considered as statistically significant. A total of 25,654 specimens were analyzed during 3 months of regular working hours. The total numbers of clinical chemistry and hematology tests performed during

  13. 42 CFR 493.1441 - Condition: Laboratories performing high complexity testing; laboratory director.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Laboratories performing high complexity testing; laboratory director. 493.1441 Section 493.1441 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY...

  14. 42 CFR 493.1441 - Condition: Laboratories performing high complexity testing; laboratory director.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing high complexity testing; laboratory director. 493.1441 Section 493.1441 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY...

  15. Estimation of the Rate of Unrecognized Cross-Contamination with Mycobacterium tuberculosis in London Microbiology Laboratories

    PubMed Central

    Ruddy, M.; McHugh, T. D.; Dale, J. W.; Banerjee, D.; Maguire, H.; Wilson, P.; Drobniewski, F.; Butcher, P.; Gillespie, S. H.

    2002-01-01

    Isolates from patients with confirmed tuberculosis from London were collected over 2.5 years between 1995 and 1997. Restriction fragment length polymorphism (RFLP) analysis was performed by the international standard technique as part of a multicenter epidemiological study. A total of 2,779 samples representing 2,500 individual patients from 56 laboratories were examined. Analysis of these samples revealed a laboratory cross-contamination rate of between 0.54%, when only presumed cases of cross-contamination were considered, and 0.93%, when presumed and possible cases were counted. Previous studies suggest an extremely wide range of laboratory cross-contamination rates of between 0.1 and 65%. These data indicate that laboratory cross-contamination has not been a common problem in routine practice in the London area, but in several incidents patients did receive full courses of therapy that were probably unnecessary. PMID:12409381

  16. The Nature of Pre-Service Science Teachers' Argumentation in Inquiry-Oriented Laboratory Context

    ERIC Educational Resources Information Center

    Ozdem, Yasemin; Ertepinar, Hamide; Cakiroglu, Jale; Erduran, Sibel

    2013-01-01

    The aim of this study was to investigate the kinds of argumentation schemes generated by pre-service elementary science teachers (PSTs) as they perform inquiry-oriented laboratory tasks, and to explore how argumentation schemes vary by task as well as by experimentation and discussion sessions. The model of argumentative and scientific inquiry was…

  17. 78 FR 1277 - International Product Change-Global Expedited Package Services-Non-Published Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-08

    ... POSTAL SERVICE International Product Change--Global Expedited Package Services-- Non-Published...-- Non-Published Rates 4 (GEPS-NPR 4) to the Competitive Products List. DATES: Effective date: January 8... add Global Expedited Package Services-- Non-Published Rates 4 (GEPS-NPR 4) to the Competitive Products...

  18. 9 CFR 391.3 - Overtime and holiday rates.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Overtime and holiday rates. 391.3 Section 391.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.3 Overtime...

  19. 9 CFR 391.3 - Overtime and holiday rates.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Overtime and holiday rates. 391.3 Section 391.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.3 Overtime...

  20. 9 CFR 391.3 - Overtime and holiday rates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Overtime and holiday rates. 391.3 Section 391.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.3 Overtime...

  1. 9 CFR 391.3 - Overtime and holiday rate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Overtime and holiday rate. 391.3 Section 391.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.3 Overtime an...

  2. Laboratory-based maximum slip rates in earthquake rupture zones and radiated energy

    USGS Publications Warehouse

    McGarr, A.; Fletcher, Joe B.; Boettcher, M.; Beeler, N.; Boatwright, J.

    2010-01-01

    Laboratory stick-slip friction experiments indicate that peak slip rates increase with the stresses loading the fault to cause rupture. If this applies also to earthquake fault zones, then the analysis of rupture processes is simplified inasmuch as the slip rates depend only on the local yield stress and are independent of factors specific to a particular event, including the distribution of slip in space and time. We test this hypothesis by first using it to develop an expression for radiated energy that depends primarily on the seismic moment and the maximum slip rate. From laboratory results, the maximum slip rate for any crustal earthquake, as well as various stress parameters including the yield stress, can be determined based on its seismic moment and the maximum slip within its rupture zone. After finding that our new equation for radiated energy works well for laboratory stick-slip friction experiments, we used it to estimate radiated energies for five earthquakes with magnitudes near 2 that were induced in a deep gold mine, an M 2.1 repeating earthquake near the San Andreas Fault Observatory at Depth (SAFOD) site and seven major earthquakes in California and found good agreement with energies estimated independently from spectra of local and regional ground-motion data. Estimates of yield stress for the earthquakes in our study range from 12 MPa to 122 MPa with a median of 64 MPa. The lowest value was estimated for the 2004 M 6 Parkfield, California, earthquake whereas the nearby M 2.1 repeating earthquake, as recorded in the SAFOD pilot hole, showed a more typical yield stress of 64 MPa.

  3. E-commerce application study and complementary services in the sector of laboratory diagnostics based on consumers' opinion.

    PubMed

    Kontis, Alexios-Patapios; Siassiakos, Konstantinos; Kaimakamis, Georgios; Lazakidou, Athina

    2010-01-01

    The field of the Laboratory Diagnostics (in vitro), a sector of the field of health services, constitutes an industrial market that includes activities of research, development, production and products distribution that are designated for laboratory use. These products are defined as techno-medical products including various categories of products such as simple medicines, advanced technological systems, etc. Despite the high performance, the enlargement and the increasing trends of the field, it is not recorded the expected progress in the methods and the ways of promotion, trading and supporting of these products in the market. The present paper aims at the investigation of the consumers' opinion and the specification of those services that are possible to be implemented in electronic services and commerce for a strongly competitive advantage for the enterprises of the sector. The analysis of the findings from the Consumer Purchase Decision Centres (CPDC) shows how important it is to implement web-based applications in the proposed services.

  4. Gas hydrate formation rates from dissolved-phase methane in porous laboratory specimens

    USGS Publications Warehouse

    Waite, William F.; Spangenberg, E.K.

    2013-01-01

    Marine sands highly saturated with gas hydrates are potential energy resources, likely forming from methane dissolved in pore water. Laboratory fabrication of gas hydrate-bearing sands formed from dissolved-phase methane usually requires 1–2 months to attain the high hydrate saturations characteristic of naturally occurring energy resource targets. A series of gas hydrate formation tests, in which methane-supersaturated water circulates through 100, 240, and 200,000 cm3 vessels containing glass beads or unconsolidated sand, show that the rate-limiting step is dissolving gaseous-phase methane into the circulating water to form methane-supersaturated fluid. This implies that laboratory and natural hydrate formation rates are primarily limited by methane availability. Developing effective techniques for dissolving gaseous methane into water will increase formation rates above our observed (1 ± 0.5) × 10−7 mol of methane consumed for hydrate formation per minute per cubic centimeter of pore space, which corresponds to a hydrate saturation increase of 2 ± 1% per day, regardless of specimen size.

  5. 78 FR 41129 - Market Test of Experimental Product - International Merchandise Return Service-Non-Published Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ...--Non-Published Rates AGENCY: U.S. Postal Service\\TM\\. ACTION: Notice. SUMMARY: The Postal Service hereby gives notice of a market test for International Merchandise Return Service--Non-Published Rates in... Return Service (IMRS) Non-published Rate (NPR) experimental product on August 15, 2013. The Postal...

  6. Performance indicators and decision making for outsourcing public health laboratory services.

    PubMed

    Santos, Maria Angelica Borges dos; Moraes, Ricardo Montes de; Passos, Sonia Regina Lambert

    2012-06-01

    To develop performance indicators for outsourcing clinical laboratory services, based on information systems and public administrative records. In the municipality of Rio de Janeiro, Southern Brazil, the public health laboratory network comprised 33 laboratories with automated equipment (but no integrated information system), 90 primary care units (where sample collection was performed) and 983 employees. Information records were obtained from the administrative records of the Budget Information System for Public Health and the Outpatient and Hospital Information System of the Unified Health System. Performance indicators (production, productivity, usage and costs) were generated from data collected routinely from 2006 to 2008. The variations in production, costs and unit prices for tests were analyzed by Laspeyres and Paasche indices, which specifically measure laboratory activity, and by the Consumer Price Index from the Brazilian Institute of Geography and Statistics. A total of 10,359,111 tests were performed in 2008 (10.6% increase over 2006), and the test/employee ratio grew by 8.6%. The costs of supplies, wages and providers increased by 2.3%, 45.4% and 18.3%, respectively. The laboratory tests per visit and hospitalizations increased by 10% and 20%, respectively. The direct costs totaled R$ 63.2 million in 2008, representing an increase of 22.2% in current values during the period analyzed. The direct costs deflated by the Brazilian National Consumer Price Index (9.5% for the period) showed an 11.6% increase in production volumes. The activity-specific volume index, which considers changes in the mix of tests, showed increases of 18.5% in the test price and 3.1% in the production volume. The performance indicators, particularly the specific indices for volume and price of activity, constitute a baseline of performance potential for monitoring private laboratories and contractors. The economic performance indicators demonstrated the need for network

  7. Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors.

    PubMed

    Atay, Aysenur; Demir, Leyla; Cuhadar, Serap; Saglam, Gulcan; Unal, Hulya; Aksun, Saliha; Arslan, Banu; Ozkan, Asuman; Sutcu, Recep

    2014-01-01

    Preanalytical errors, along the process from the beginning of test requests to the admissions of the specimens to the laboratory, cause the rejection of samples. The aim of this study was to better explain the reasons of rejected samples, regarding to their rates in certain test groups in our laboratory. This preliminary study was designed on the rejected samples in one-year period, based on the rates and types of inappropriateness. Test requests and blood samples of clinical chemistry, immunoassay, hematology, glycated hemoglobin, coagulation and erythrocyte sedimentation rate test units were evaluated. Types of inappropriateness were evaluated as follows: improperly labelled samples, hemolysed, clotted specimen, insufficient volume of specimen and total request errors. A total of 5,183,582 test requests from 1,035,743 blood collection tubes were considered. The total rejection rate was 0.65 %. The rejection rate of coagulation group was significantly higher (2.28%) than the other test groups (P < 0.001) including insufficient volume of specimen error rate as 1.38%. Rejection rates of hemolysis, clotted specimen and insufficient volume of sample error were found to be 8%, 24% and 34%, respectively. Total request errors, particularly, for unintelligible requests were 32% of the total for inpatients. The errors were especially attributable to unintelligible requests of inappropriate test requests, improperly labelled samples for inpatients and blood drawing errors especially due to insufficient volume of specimens in a coagulation test group. Further studies should be performed after corrective and preventive actions to detect a possible decrease in rejecting samples.

  8. Pre-Service Teachers' Attitudes toward Use of Vee Diagrams in General Physics Laboratory

    ERIC Educational Resources Information Center

    Keles, Özgül; Özsoy, Sibel

    2009-01-01

    The purpose of this study is to determine pre-service teachers' attitudes toward use of Vee diagrams in general physics laboratory. The sample of the study consists of 29 (16 girls and 13 boys) freshmen students enrolling to elementary school science education program at one of the universities in Turkey. To gather the data of the study…

  9. CONDUCTIVITY PROFILE RATE OF CHANGE FROM FIELD AND LABORATORY DATA WITHIN BIODEGRADING PETROLEUM HYDROCARBON

    EPA Science Inventory

    We present the results of long term (500 days) measurements of the bulk conductivity in a field and laboratory experiment. Our objective was to determine the rate of change in bulk conductivity and whether this rate of change correlated with the petroleum hydrocarbon degradation...

  10. 47 CFR 76.930 - Initiation of review of basic cable service and equipment rates.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Initiation of review of basic cable service and...) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation § 76.930 Initiation of review of basic cable service and equipment rates. A cable operator shall file its schedule of...

  11. 76 FR 20220 - New Formulas for Calculating the Basetime, Overtime, Holiday, and Laboratory Services Rates; Rate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... calculating the rates that it charges meat and poultry establishments, egg products plants, and importers and... establishments. The Egg Products Inspection Act (EPIA) (21 U.S.C. 1031 et seq.) provides for mandatory inspection of egg products processed at official plants. FSIS bears the cost of mandatory inspection provided...

  12. 38 CFR 4.22 - Rating of disabilities aggravated by active service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... aggravated by active service. 4.22 Section 4.22 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... aggravated by active service. In cases involving aggravation by active service, the rating will reflect only the degree of disability over and above the degree existing at the time of entrance into the active...

  13. 38 CFR 4.22 - Rating of disabilities aggravated by active service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... aggravated by active service. 4.22 Section 4.22 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... aggravated by active service. In cases involving aggravation by active service, the rating will reflect only the degree of disability over and above the degree existing at the time of entrance into the active...

  14. 38 CFR 4.22 - Rating of disabilities aggravated by active service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... aggravated by active service. 4.22 Section 4.22 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... aggravated by active service. In cases involving aggravation by active service, the rating will reflect only the degree of disability over and above the degree existing at the time of entrance into the active...

  15. 38 CFR 4.22 - Rating of disabilities aggravated by active service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... aggravated by active service. 4.22 Section 4.22 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... aggravated by active service. In cases involving aggravation by active service, the rating will reflect only the degree of disability over and above the degree existing at the time of entrance into the active...

  16. 38 CFR 4.22 - Rating of disabilities aggravated by active service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... aggravated by active service. 4.22 Section 4.22 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... aggravated by active service. In cases involving aggravation by active service, the rating will reflect only the degree of disability over and above the degree existing at the time of entrance into the active...

  17. A laboratory-scale comparison of rate of spread model predictions using chaparral fuel beds – preliminary results

    Treesearch

    D.R. Weise; E. Koo; X. Zhou; S. Mahalingam

    2011-01-01

    Observed fire spread rates from 240 laboratory fires in horizontally-oriented single-species live fuel beds were compared to predictions from various implementations and modifications of the Rothermel rate of spread model and a physical fire spread model developed by Pagni and Koo. Packing ratio of the laboratory fuel beds was generally greater than that observed in...

  18. 78 FR 7750 - Summer Food Service Program; 2013 Reimbursement Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    .... Reimbursement is based solely on a ``meals times rates'' calculation, without comparison to actual or budgeted... public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service... adjustments to the reimbursement rates for meals served in SFSP. In accordance with sections 12(f) and 13, 42...

  19. The Contribution of Constructivist Instruction Accompanied by Concept Mapping in Enhancing Pre-Service Chemistry Teachers' Conceptual Understanding of Chemistry in the Laboratory Course

    ERIC Educational Resources Information Center

    Aydin, Sevgi; Aydemir, Nurdane; Boz, Yezdan; Cetin-Dindar, Ayla; Bektas, Oktay

    2009-01-01

    The present study aimed to evaluate whether a chemistry laboratory course called "Laboratory Experiments in Science Education" based on constructivist instruction accompanied with concept mapping enhanced pre-service chemistry teachers' conceptual understanding. Data were collected from five pre-service chemistry teachers at a university…

  20. Performance indicators for quality in surgical and laboratory services at Muhimbili National Hospital (MNH) in Tanzania.

    PubMed

    Mbembati, Naboth A; Mwangu, Mugwira; Muhondwa, Eustace P Y; Leshabari, Melkizedek M

    2008-04-01

    Muhimbili National Hospital (MNH), a teaching and national referral hospital, is undergoing major reforms to improve the quality of health care. We performed a retrospective descriptive study using a set of performance indicators for the surgical and laboratory services of MNH in years 2001 and 2002, to help monitor and evaluate the impact of reforms on the quality of health care during and after the reform process. Hospital records were reviewed and information recorded for planned and postponed operations, laboratory equipment, reagents, laboratory tests and quality assurance programmes. In the year 2001 a total of 4332 non-emergency operations were planned, 3313 operations were performed and 1019 (23.5%) operations were postponed. In the year 2002, 4301 non-emergency operations were planned, 3046 were performed and 1255 (29%) were postponed. The most common reasons for operation postponement were "time-barred", interference by emergency operations, no show of patients and inoperable anaesthetic machines. Equipment problems and supply and staff shortages together accounted for one quarter of postponements. In the laboratory, a lack of equipment prevented some tests, but quality assurance was performed for most tests. Current surgical services at MNH are inadequate; operating theatres require modern, functioning equipment and adequate supplies of consumables to provide satisfactory care.

  1. Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country

    PubMed Central

    Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

    2017-01-01

    Background It is believed that laboratory tariffs in Iran don’t reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. Objective This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. Methods This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. Results In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector’s tariffs in 2015. Conclusion This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories. PMID:28607638

  2. Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country.

    PubMed

    Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

    2017-04-01

    It is believed that laboratory tariffs in Iran don't reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector's tariffs in 2015. This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories.

  3. Data Services and Transnational Access for European Geosciences Multi-Scale Laboratories

    NASA Astrophysics Data System (ADS)

    Funiciello, Francesca; Rosenau, Matthias; Sagnotti, Leonardo; Scarlato, Piergiorgio; Tesei, Telemaco; Trippanera, Daniele; Spires, Chris; Drury, Martyn; Kan-Parker, Mirjam; Lange, Otto; Willingshofer, Ernst

    2016-04-01

    The EC policy for research in the new millennium supports the development of european-scale research infrastructures. In this perspective, the existing research infrastructures are going to be integrated with the objective to increase their accessibility and to enhance the usability of their multidisciplinary data. Building up integrating Earth Sciences infrastructures in Europe is the mission of the Implementation Phase (IP) of the European Plate Observing System (EPOS) project (2015-2019). The integration of european multiscale laboratories - analytical, experimental petrology and volcanology, magnetic and analogue laboratories - plays a key role in this context and represents a specific task of EPOS IP. In the frame of the WP16 of EPOS IP working package 16, European geosciences multiscale laboratories aims to be linked, merging local infrastructures into a coherent and collaborative network. In particular, the EPOS IP WP16-task 4 "Data services" aims at standardize data and data products, already existing and newly produced by the participating laboratories, and made them available through a new digital platform. The following data and repositories have been selected for the purpose: 1) analytical and properties data a) on volcanic ash from explosive eruptions, of interest to the aviation industry, meteorological and government institutes, b) on magmas in the context of eruption and lava flow hazard evaluation, and c) on rock systems of key importance in mineral exploration and mining operations; 2) experimental data describing: a) rock and fault properties of importance for modelling and forecasting natural and induced subsidence, seismicity and associated hazards, b) rock and fault properties relevant for modelling the containment capacity of rock systems for CO2, energy sources and wastes, c) crustal and upper mantle rheology as needed for modelling sedimentary basin formation and crustal stress distributions, d) the composition, porosity, permeability, and

  4. Field Measurements Indicate Unexpected, Serious Underestimation of Mussel Heart Rates and Thermal Tolerance by Laboratory Studies

    PubMed Central

    Tagliarolo, Morgana; McQuaid, Christopher D.

    2016-01-01

    Attempts to predict the response of species to long-term environmental change are generally based on extrapolations from laboratory experiments that inevitably simplify the complex interacting effects that occur in the field. We recorded heart rates of two genetic lineages of the brown mussel Perna perna over a full tidal cycle in-situ at two different sites in order to evaluate the cardiac responses of the two genetic lineages present on the South African coast to temperature and the immersion/emersion cycle. “Robomussel” temperature loggers were used to monitor thermal conditions at the two sites over one year. Comparison with live animals showed that robomussels provided a good estimate of mussel body temperatures. A significant difference in estimated body temperatures was observed between the sites and the results showed that, under natural conditions, temperatures regularly approach or exceed the thermal limits of P. perna identified in the laboratory. The two P. perna lineages showed similar tidal and diel patterns of heart rate, with higher cardiac activity during daytime immersion and minimal values during daytime emersion. Comparison of the heart rates measured in the field with data previously measured in the laboratory indicates that laboratory results seriously underestimate heart rate activity, by as much as 75%, especially during immersion. Unexpectedly, field estimates of body temperatures indicated an ability to tolerate temperatures considered lethal on the basis of laboratory measurements. This suggests that the interaction of abiotic conditions in the field does not necessarily raise vulnerability to high temperatures. PMID:26840775

  5. Customerizing the clinical laboratory. Repositioning for enhanced service and a competitive advantage.

    PubMed

    Schuler, R S

    1989-01-01

    The call for excellence has never been louder, especially in the health-care industry. This call typically means increased service, i.e., faster, more accurate and, of course, friendlier service--all easier said than done, but qualities that make enhanced customer service so powerful. The excellent companies are learning that because it is so difficult to customerize, few competitors do so. Therefore, by devoting the time and effort necessary for customerization, they can move ahead of their competitors. But surpassing competitors by excellent service can be done inside of companies as well as outside. All units and departments have customers. The key to customerization inside is finding out what your customers want and behaving accordingly. The results go beyond enhanced customer satisfaction. They also include enhanced energy levels, reduced turnover, increased pride, and greater creativity for the newly customerized department. All it takes is an understanding of and dedication to customerization. Repositioning the existing department is critical to the success of any attempt to customerize. This article thoroughly describes customerization and the entire process of repositioning the clinical laboratory. One will not occur without the other.

  6. An audit of Cryptosporidium and Giardia detection in Scottish National Health Service Diagnostic Microbiology Laboratories.

    PubMed

    Alexander, C L; Currie, S; Pollock, K; Smith-Palmer, A; Jones, B L

    2017-06-01

    Giardia duodenalis and Cryptosporidium species are protozoan parasites capable of causing gastrointestinal disease in humans and animals through the ingestion of infective faeces. Whereas Cryptosporidium species can be acquired locally or through foreign travel, there is the mis-conception that giardiasis is considered to be largely travel-associated, which results in differences in laboratory testing algorithms. In order to determine the level of variation in testing criteria and detection methods between diagnostic laboratories for both pathogens across Scotland, an audit was performed. Twenty Scottish diagnostic microbiology laboratories were invited to participate with questions on sample acceptance criteria, testing methods, testing rates and future plans for pathogen detection. Reponses were received from 19 of the 20 laboratories representing each of the 14 territorial Health Boards. Detection methods varied between laboratories with the majority performing microscopy, one using a lateral flow immunochromatographic antigen assay, another using a manually washed plate-based enzyme immunoassay (EIA) and one laboratory trialling a plate-based EIA automated with an EIA plate washer. Whereas all laboratories except one screened every stool for Cryptosporidium species, an important finding was that significant variation in the testing algorithm for detecting Giardia was noted with only four laboratories testing all diagnostic stools. The most common criteria were 'travel history' (11 laboratories) and/or 'when requested' (14 laboratories). Despite only a small proportion of stools being examined in 15 laboratories for Giardia (2%-18% of the total number of stools submitted), of interest is the finding that a higher positivity rate was observed for Giardia than Cryptosporidium in 10 of these 15 laboratories. These findings highlight that the underreporting of Giardia in Scotland is likely based on current selection and testing algorithms.

  7. Family-centred service: differences in what parents of children with cerebral palsy rate important.

    PubMed

    Terwiel, M; Alsem, M W; Siebes, R C; Bieleman, K; Verhoef, M; Ketelaar, M

    2017-09-01

    A family-centred approach to services of children with disabilities is widely accepted as the foundational approach to service delivery in paediatric health care. The 56 items of the Measure of Processes of Care questionnaire (MPOC-56) all reflect elements of family-centred service. In this study, we investigated which elements of family-centred service are rated important by parents of children with cerebral palsy by adding a question on importance to each item of the MPOC-56 (MPOC-56-I). In total, 175 parents of children with cerebral palsy completed the MPOC-56-I. For each MPOC item, parents were asked to rate the importance on a 5-point scale ranging from 0 (not important at all) up to and including 4 (very important). We used Spearman's rank correlation coefficient to further explore the variation in parents' importance ratings. Parents' importance ratings of the MPOC-56 items varied. The percentage of parents rating an item important (importance rating 3 or 4) varied between 43.8% and 96.8%. The percentage of parents rating an item unimportant (rating 0 or 1) varied between 0.0% and 20.3%, and the percentage of parents rating an item neutral (rating 2) varied between 3.0% and 36.0%. Most diverse importance ratings were found for five items concerning the provision of general information. Three correlations between these items and child and parent characteristics were found. Six items were rated important by almost all (≥95%) parents. These items concern elements of specific information about the child, co-ordinated and comprehensive care for child and family and enabling and partnership. Parents rate the importance of family-centred services for their situation in various ways. These findings endorse that family-centred services should recognize the uniqueness of families and should be tailored to what parents find important. © 2017 John Wiley & Sons Ltd.

  8. 42 CFR 493.1403 - Condition: Laboratories performing moderate complexity testing; laboratory director.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing moderate complexity testing; laboratory director. 493.1403 Section 493.1403 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION...

  9. 42 CFR 493.1403 - Condition: Laboratories performing moderate complexity testing; laboratory director.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Laboratories performing moderate complexity testing; laboratory director. 493.1403 Section 493.1403 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION...

  10. Building and Rebuilding: The National Public Health Laboratory Systems and Services Before and After the Earthquake and Cholera Epidemic, Haiti, 2009-2015.

    PubMed

    Jean Louis, Frantz; Buteau, Josiane; Boncy, Jacques; Anselme, Renette; Stanislas, Magalie; Nagel, Mary C; Juin, Stanley; Charles, Macarthur; Burris, Robert; Antoine, Eva; Yang, Chunfu; Kalou, Mireille; Vertefeuille, John; Marston, Barbara J; Lowrance, David W; Deyde, Varough

    2017-10-01

    Before the 2010 devastating earthquake and cholera outbreak, Haiti's public health laboratory systems were weak and services were limited. There was no national laboratory strategic plan and only minimal coordination across the laboratory network. Laboratory capacity was further weakened by the destruction of over 25 laboratories and testing sites at the departmental and peripheral levels and the loss of life among the laboratory health-care workers. However, since 2010, tremendous progress has been made in building stronger laboratory infrastructure and training a qualified public health laboratory workforce across the country, allowing for decentralization of access to quality-assured services. Major achievements include development and implementation of a national laboratory strategic plan with a formalized and strengthened laboratory network; introduction of automation of testing to ensure better quality of results and diversify the menu of tests to effectively respond to outbreaks; expansion of molecular testing for tuberculosis, human immunodeficiency virus, malaria, diarrheal and respiratory diseases; establishment of laboratory-based surveillance of epidemic-prone diseases; and improvement of the overall quality of testing. Nonetheless, the progress and gains made remain fragile and require the full ownership and continuous investment from the Haitian government to sustain these successes and achievements.

  11. A Six Sigma Trial For Reduction of Error Rates in Pathology Laboratory.

    PubMed

    Tosuner, Zeynep; Gücin, Zühal; Kiran, Tuğçe; Büyükpinarbaşili, Nur; Turna, Seval; Taşkiran, Olcay; Arici, Dilek Sema

    2016-01-01

    A major target of quality assurance is the minimization of error rates in order to enhance patient safety. Six Sigma is a method targeting zero error (3.4 errors per million events) used in industry. The five main principles of Six Sigma are defining, measuring, analysis, improvement and control. Using this methodology, the causes of errors can be examined and process improvement strategies can be identified. The aim of our study was to evaluate the utility of Six Sigma methodology in error reduction in our pathology laboratory. The errors encountered between April 2014 and April 2015 were recorded by the pathology personnel. Error follow-up forms were examined by the quality control supervisor, administrative supervisor and the head of the department. Using Six Sigma methodology, the rate of errors was measured monthly and the distribution of errors at the preanalytic, analytic and postanalytical phases was analysed. Improvement strategies were reclaimed in the monthly intradepartmental meetings and the control of the units with high error rates was provided. Fifty-six (52.4%) of 107 recorded errors in total were at the pre-analytic phase. Forty-five errors (42%) were recorded as analytical and 6 errors (5.6%) as post-analytical. Two of the 45 errors were major irrevocable errors. The error rate was 6.8 per million in the first half of the year and 1.3 per million in the second half, decreasing by 79.77%. The Six Sigma trial in our pathology laboratory provided the reduction of the error rates mainly in the pre-analytic and analytic phases.

  12. Medical Service Clinical Laboratory Procedure--Hematology.

    ERIC Educational Resources Information Center

    Department of the Army, Washington, DC.

    Presented are laboratory studies focusing on blood cells and the complete scheme of blood coagulation. Formed is the basis for the following types of laboratory operations: (1) distinguishing the morphology of normal and abnormal blood cells; (2) measuring the concentrations or number of blood cells; (3) measuring concentration and detecting…

  13. 48 CFR 52.241-7 - Change in Rates or Terms and Conditions of Service for Regulated Services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Change in Rates or Terms and Conditions of Service for Regulated Services. 52.241-7 Section 52.241-7 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND...

  14. 75 FR 47650 - International Product Change-Global Expedited Package Services-Non-Published Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... POSTAL SERVICE International Product Change--Global Expedited Package Services-- Non-Published...-Published Rates to the Competitive Products List pursuant to 39 U.S.C. 3642. DATES: August 6, 2010. FOR...-Published Rates to the Competitive Products List, and Notice of Filing (Under Seal) of Contract and Enabling...

  15. 76 FR 80987 - International Product Change-Global Expedited Package Services-Non-Published Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... POSTAL SERVICE International Product Change--Global Expedited Package Services-- Non-Published... request with the Postal Regulatory Commission to add Global Expedited Package Services-- Non-Published... Package Services--Non- Published Rates 3 (GEPS--NPR 3) to the Competitive Products List and Notice of...

  16. 42 CFR 416.171 - Determination of payment rates for ASC services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... payment rates for office-based surgical procedures and covered ancillary radiology services... relative value units under § 414.22(b)(5)(i)(B) of this subchapter multiplied by the conversion factor... ancillary radiology services that involve certain nuclear medicine procedures will be the amount determined...

  17. Modeling the Endogenous Sunlight Inactivation Rates of Laboratory Strain and Wastewater E. coli and Enterococci Using Biological Weighting Functions.

    PubMed

    Silverman, Andrea I; Nelson, Kara L

    2016-11-15

    Models that predict sunlight inactivation rates of bacteria are valuable tools for predicting the fate of pathogens in recreational waters and designing natural wastewater treatment systems to meet disinfection goals. We developed biological weighting function (BWF)-based numerical models to estimate the endogenous sunlight inactivation rates of E. coli and enterococci. BWF-based models allow the prediction of inactivation rates under a range of environmental conditions that shift the magnitude or spectral distribution of sunlight irradiance (e.g., different times, latitudes, water absorbances, depth). Separate models were developed for laboratory strain bacteria cultured in the laboratory and indigenous organisms concentrated directly from wastewater. Wastewater bacteria were found to be 5-7 times less susceptible to full-spectrum simulated sunlight than the laboratory bacteria, highlighting the importance of conducting experiments with bacteria sourced directly from wastewater. The inactivation rate models fit experimental data well and were successful in predicting the inactivation rates of wastewater E. coli and enterococci measured in clear marine water by researchers from a different laboratory. Additional research is recommended to develop strategies to account for the effects of elevated water pH on predicted inactivation rates.

  18. Estimating Pesticide Effects on Fecundity Rates of Wild Birds Using Current Laboratory Reproduction Tests

    EPA Science Inventory

    The manuscript reviews the issues concerning the use of results on pesticide effects from laboratory avian reproduction tests for estimating potential impacts of pesticides on fecundity rates in avian population models.

  19. The total laboratory solution: a new laboratory E-business model based on a vertical laboratory meta-network.

    PubMed

    Friedman, B A

    2001-08-01

    Major forces are now reshaping all businesses on a global basis, including the healthcare and clinical laboratory industries. One of the major forces at work is information technology (IT), which now provides the opportunity to create a new economic and business model for the clinical laboratory industry based on the creation of an integrated vertical meta-network, referred to here as the "total laboratory solution" (TLS). Participants at the most basic level of such a network would include a hospital-based laboratory, a reference laboratory, a laboratory information system/application service provider/laboratory portal vendor, an in vitro diagnostic manufacturer, and a pharmaceutical/biotechnology manufacturer. It is suggested that each of these participants would add value to the network primarily in its area of core competency. Subvariants of such a network have evolved over recent years, but a TLS comprising all or most of these participants does not exist at this time. Although the TLS, enabled by IT and closely akin to the various e-businesses that are now taking shape, offers many advantages from a theoretical perspective over the current laboratory business model, its success will depend largely on (a) market forces, (b) how the collaborative networks are organized and managed, and (c) whether the network can offer healthcare organizations higher quality testing services at lower cost. If the concept is successful, new demands will be placed on hospital-based laboratory professionals to shift the range of professional services that they offer toward clinical consulting, integration of laboratory information from multiple sources, and laboratory information management. These information management and integration tasks can only increase in complexity in the future as new genomic and proteomics testing modalities are developed and come on-line in clinical laboratories.

  20. Understanding patient satisfaction ratings for radiology services.

    PubMed

    Lang, Elvira V; Yuh, William T C; Ajam, Amna; Kelly, Ronda; Macadam, Luke; Potts, Richard; Mayr, Nina A

    2013-12-01

    Under the Hospital Value-Based Purchasing Program of the Centers for Medicare & Medicaid Services, patient satisfaction accounts for 30% of the measures of and payments for quality of care. Understanding what drives patient satisfaction data and how the data are obtained, converted into scores, and formulated into rankings is increasingly critical for imaging departments. The objectives of this article are to describe the potential impact of patient satisfaction ratings on institutions and individuals, explain how patient satisfaction is rated and ranked, identify drivers that affect the ratings and rankings, and probe the resulting challenges unique to radiology departments. Research results indicate that training providers to make simple modifications in their language and behavior during patient care can significantly impact patient satisfaction, which, in turn, can impact both quality-of-care ratings and the bottom line of hospitals. Training providers is a simple and cost-effective way to potentiate the clinical expression of compassion into improvement of patient satisfaction and financial reward, a national trend that no one in the game can afford to ignore.

  1. The instantaneous rate dependence in low temperature laboratory rock friction and rock deformation experiments

    USGS Publications Warehouse

    Beeler, N.M.; Tullis, T.E.; Kronenberg, A.K.; Reinen, L.A.

    2007-01-01

    Earthquake occurrence probabilities that account for stress transfer and time-dependent failure depend on the product of the effective normal stress and a lab-derived dimensionless coefficient a. This coefficient describes the instantaneous dependence of fault strength on deformation rate, and determines the duration of precursory slip. Although an instantaneous rate dependence is observed for fracture, friction, crack growth, and low temperature plasticity in laboratory experiments, the physical origin of this effect during earthquake faulting is obscure. We examine this rate dependence in laboratory experiments on different rock types using a normalization scheme modified from one proposed by Tullis and Weeks [1987]. We compare the instantaneous rate dependence in rock friction with rate dependence measurements from higher temperature dislocation glide experiments. The same normalization scheme is used to compare rate dependence in friction to rock fracture and to low-temperature crack growth tests. For particular weak phyllosilicate minerals, the instantaneous friction rate dependence is consistent with dislocation glide. In intact rock failure tests, for each rock type considered, the instantaneous rate dependence is the same size as for friction, suggesting a common physical origin. During subcritical crack growth in strong quartzofeldspathic and carbonate rock where glide is not possible, the instantaneous rate dependence measured during failure or creep tests at high stress has long been thought to be due to crack growth; however, direct comparison between crack growth and friction tests shows poor agreement. The crack growth rate dependence appears to be higher than the rate dependence of friction and fracture by a factor of two to three for all rock types considered. Copyright 2007 by the American Geophysical Union.

  2. Validity of a heart rate monitor during work in the laboratory and on the Space Shuttle

    NASA Technical Reports Server (NTRS)

    Moore, A. D. Jr; Lee, S. M.; Greenisen, M. C.; Bishop, P.

    1997-01-01

    Accurate heart rate measurement during work is required for many industrial hygiene and ergonomics situations. The purpose of this investigation was to determine the validity of heart rate measurements obtained by a simple, lightweight, commercially available wrist-worn heart rate monitor (HRM) during work (cycle exercise) sessions conducted in the laboratory and also during the particularly challenging work environment of space flight. Three different comparisons were made. The first compared HRM data to simultaneous electrocardiogram (ECG) recordings of varying heart rates that were generated by an ECG simulator. The second compared HRM data to ECG recordings collected during work sessions of 14 subjects in the laboratory. Finally, ECG downlink and HRM data were compared in four astronauts who performed cycle exercise during space flight. The data were analyzed using regression techniques. The results were that the HRM recorded virtually identical heart rates compared with ECG recordings for the data set generated by an ECG simulator. The regression equation for the relationship between ECG versus HRM heart rate data during work in the laboratory was: ECG HR = 0.99 x (HRM) + 0.82 (r2 = 0.99). Finally, the agreement between ECG downlink data and HRM data during space flight was also very high, with the regression equation being: Downlink ECG HR = 1.05 x (HRM) -5.71 (r2 = 0.99). The results of this study indicate that the HRM provides accurate data and may be used to reliably obtain valid data regarding heart rate responses during work.

  3. Three-year customer satisfaction survey in laboratory medicine in a Chinese university hospital.

    PubMed

    Guo, Siqi; Duan, Yifei; Liu, Xiaojuan; Jiang, Yongmei

    2018-04-25

    Customer satisfaction is a key quality indicator of laboratory service. Patients and physicians are the ultimate customers in medical laboratory, and their opinions are essential components in developing a customer-oriented laboratory. A longitudinal investigation of customer satisfaction was conducted through questionnaires. We designed two different questionnaires and selected 1200 customers (600 outpatients and 600 physicians) to assess customer satisfaction every other year from 2012 to 2016. Items with scores <4 were considered unsatisfactory, and corrective actions should be taken. The completion rates of physicians were 96.8% in 2012, 97% in 2014 and 96.5% in 2016, whereas the rates of patients were 95.3%, 96.2% and 95.2%, respectively. In 2012, the most dissatisfaction items were test turnaround time (3.77 points) and service attitude (3.87 points) from physicians, whereas waiting time (3.58 points) and examination environment (3.64 points) were the most dissatisfaction items from patients. After corrective actions were taken, the result of satisfaction in 2014 was better, which illustrated our strategy was effective. However, some items remained to be less than 4, so we repeated the survey after modifying questionnaires in 2016. However, the general satisfaction points of the physicians and patients reduced in 2016, which reminded us of some influential factors we had neglected. By using dynamic survey of satisfaction, we can continuously find deficiencies in our laboratory services and take suitable corrective actions, thereby improving our service quality.

  4. Optimising the laboratory supply chain: The key to effective laboratory services

    PubMed Central

    Williams, Jason; Smith, Peter; Kuritsky, Joel

    2014-01-01

    Background The Supply Chain Management System (SCMS) is a contract managed under the Partnership for Supply Chain Management (PFSCM) consortium by the United States Agency for International Development (USAID). SCMS procures commodities for programmes supported by the US President’s Emergency Plan for AIDS Relief (PEPFAR). From 2005 to mid-2012, PEPFAR, through SCMS, spent approximately $384 million on non-pharmaceutical commodities. Of this, an estimated $90m was used to purchase flow cytometry technology, largely for flow cytometry platforms and reagents. Objectives The purpose of this paper is to highlight the cost differences between low, medium and high utilisation rates of common CD4 testing instruments that have been procured though PEPFAR funding. Method A scale of costs per test as a function of test volume through the machine was calculated for the two most common CD4 testing machines used in HIV programmes: Becton Dickinson (BD) FACSCount™ and BD FACSCalibur™. Instrument utilisation data collected at the facility level in three selected countries were then used to calculate the onsite cost-per-test experienced in each country. Results Cost analyses indicated that a target of at least 40% utilisation for FACSCount™ and 15% utilisation for FACSCalibur™, respectively, closely approach maximal per-test cost efficiency. The average utilisation rate for CD4 testing instruments varies widely by country, level of laboratory and partner (0% − 68%). Conclusion Our analysis indicates that, because cost-per-test is related inversely to sample throughput, the underutilisation of flow cytometry machines is resulting in an increase in average cost-per-test for many instruments. PMID:29043175

  5. 78 FR 78809 - Rates for Interstate Inmate Calling Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 64 [WC Docket No. 12-375; DA 13-2379] Rates for Interstate Inmate Calling Services AGENCY: Federal Communications Commission. ACTION: Proposed rule... Communications Commission's Web site: http://fjallfoss.fcc.gov/ecfs2/ . Follow the instructions for submitting...

  6. Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains

    PubMed Central

    Schroeder, Scott R; Salomon, Meghan M; Galanter, William L; Schiff, Gordon D; Vaida, Allen J; Gaunt, Michael J; Bryson, Michelle L; Rash, Christine; Falck, Suzanne; Lambert, Bruce L

    2017-01-01

    Background Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates. Objectives We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. Methods Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception and short-term memory of look-alike and sound-alike drug name pairs (eg, hydroxyzine/hydralazine). Results Laboratory test error rates (and other metrics) significantly predicted real-world error rates obtained from a large, outpatient pharmacy chain, with the best-fitting model accounting for 37% of the variance in real-world error rates. Cross-validation analyses confirmed these results, showing that the laboratory tests also predicted errors from a second pharmacy chain, with 45% of the variance being explained by the laboratory test data. Conclusions Across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception. Regulators and drug companies seeking a validated preapproval method for identifying confusing drug names ought to consider using these simple tests. By using a standard battery of memory and perception tests, it should be possible to reduce the number of confusing look-alike and sound-alike drug name pairs that reach the market, which will help protect patients from potentially

  7. 76 FR 2930 - International Product Change-Global Expedited Package Services-Non- Published Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... POSTAL SERVICE International Product Change--Global Expedited Package Services-- Non- Published... request with the Postal Regulatory Commission to add Global Expedited Package Services-- Non-Published...--Non-Published Rates, to the Competitive Products List, and Notice of Filing (Under Seal) the Enabling...

  8. Quality in the molecular microbiology laboratory.

    PubMed

    Wallace, Paul S; MacKay, William G

    2013-01-01

    In the clinical microbiology laboratory advances in nucleic acid detection, quantification, and sequence analysis have led to considerable improvements in the diagnosis, management, and monitoring of infectious diseases. Molecular diagnostic methods are routinely used to make clinical decisions based on when and how to treat a patient as well as monitor the effectiveness of a therapeutic regime and identify any potential drug resistant strains that may impact on the long term patient treatment program. Therefore, confidence in the reliability of the result provided by the laboratory service to the clinician is essential for patient treatment. Hence, suitable quality assurance and quality control measures are important to ensure that the laboratory methods and service meet the necessary regulatory requirements both at the national and international level. In essence, the modern clinical microbiology laboratory ensures the appropriateness of its services through a quality management system that monitors all aspects of the laboratory service pre- and post-analytical-from patient sample receipt to reporting of results, from checking and upholding staff competency within the laboratory to identifying areas for quality improvements within the service offered. For most European based clinical microbiology laboratories this means following the common International Standard Organization (ISO9001) framework and ISO15189 which sets out the quality management requirements for the medical laboratory (BS EN ISO 15189 (2003) Medical laboratories-particular requirements for quality and competence. British Standards Institute, Bristol, UK). In the United States clinical laboratories performing human diagnostic tests are regulated by the Centers for Medicare and Medicaid Services (CMS) following the requirements within the Clinical Laboratory Improvement Amendments document 1988 (CLIA-88). This chapter focuses on the key quality assurance and quality control requirements within the

  9. Laboratory equipment maintenance contracts.

    PubMed

    Boudreau, D A; Scheer, W D; Catrou, P G

    1985-12-01

    The increasing level of technical sophistication and complexity found in clinical laboratory instrumentation today more than ever demands careful attention to maintenance service needs. The time-worn caution for careful definition of requirements for acquisition of a system should also carry over to acquisition of maintenance service. Guidelines are presented for specifications of terms and conditions for maintenance service from the perspective of the laboratorian in the automated clinical laboratory.

  10. Challenges Faced by Pre-Service Chemistry Teachers Teaching in a Laboratory and Their Solution Proposals

    ERIC Educational Resources Information Center

    Yalcin-Celik, Ayse; Kadayifci, Hakki; Uner, Sinem; Turan-Oluk, Nurcan

    2017-01-01

    This study examines the challenges faced by pre-service chemistry teachers teaching in a laboratory and their proposed solutions to these challenges. The study was conducted in a 13-week-long methodology course. Written statements from participants and observations from researchers were used as data sources. From these data, it was found that the…

  11. Differences in Routine Laboratory Ordering Between a Teaching Service and a Hospitalist Service at a Single Academic Medical Center.

    PubMed

    Ellenbogen, Michael I; Ma, Madeleine; Christensen, Nicholas P; Lee, Jungwha; O'Leary, Kevin J

    2017-01-01

    Studies have shown that the overutilization of laboratory tests ("labs") for hospitalized patients is common and can cause adverse health outcomes. Our objective was to compare the ordering tendencies for routine complete blood counts (CBC) and chemistry panels by internal medicine residents and hospitalists. This observational study included a survey of medicine residents and hospitalists and a retrospective analysis of labs ordering data. The retrospective data analysis comprised patients admitted to either the teaching service or nonteaching hospitalist service at a single hospital during 2014. The survey asked residents and hospitalists about their practices and preferences on labs ordering. The frequency and timing of one-time and daily CBC and basic chemistry panel ordering for teaching service and hospitalist patients were obtained from our data warehouse. The average number of CBCs per patient per day and chemistry panels per patient per day was calculated for both services and multivariate regression was performed to control for patient characteristics. Forty-four of 120 (37%) residents and 41 of 53 (77%) hospitalists responded to the survey. Forty-four (100%) residents reported ordering a daily CBC and chemistry panel rather than one-time labs at patient admission compared with 22 (54%) hospitalists ( P < 0.001). For CBCs, teaching service patients averaged 1.72/day and hospitalist service patients averaged 1.43/day ( P < 0.001). For basic chemistry panels, teaching service patients averaged 1.96/day and hospitalist service patients averaged 1.78/day ( P < 0.001). Results were similar in multivariate regression models adjusting for patient characteristics. Residents' self-reported and actual use of CBCs and chemistry panels is significantly higher than that of hospitalists in the same hospital. Our results reveal an opportunity for greater supervision and improved instruction of cost-conscious ordering practices.

  12. The State Public Health Laboratory System.

    PubMed

    Inhorn, Stanley L; Astles, J Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M; Wilcke, Burton W; White, Vanessa A

    2010-01-01

    This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the goal of which is to promote public-private collaboration to assure quality laboratory services and public health surveillance. To enhance the realization of the NLS, the Association of Public Health Laboratories (APHL) launched in 2004 a State Public Health Laboratory System Improvement Program. In the same year, APHL developed a Comprehensive Laboratory Services Survey, a tool to measure improvement through the decade to assure that essential PHL services are provided.

  13. Correlating field and laboratory rates of particle abrasion, Rio Medio, Sangre de Cristo Mountains, New Mexico

    NASA Astrophysics Data System (ADS)

    Polito, P. J.; Sklar, L. S.

    2006-12-01

    River bed sediments commonly fine downstream due to a combination of particle abrasion, selective transport of finer grains, and fining of the local sediment supply from hillslopes and tributaries. Particle abrasion rates can be directly measured in the laboratory using tumbling barrels and annular flumes, however, scaling experimental particle abrasion rates to the field has proven difficult due to the confounding effects of selective transport and local supply variations. Here we attempt to correlate laboratory and field rates of particle abrasion in a field setting where these confounding effects can be controlled. The Rio Medio, which flows westward from the crest of the Sangre de Cristo Mountains in north central New Mexico, is one of several streams studied by John P. Miller in the early 1960's. Several kilometers downstream of its headwaters, the river crosses the Picuris-Pecos fault. Upstream of the fault the river receives quartzite, sandstone and shale clasts from the Ortega Formation, while downstream sediments are supplied by the Embudo Granite. Because the upstream lithologies are not resupplied downstream of the fault, any observed fining of these clasts should be due only to abrasion and selective transport. We hypothesize that we can account for the effects of selective transport by comparing relative fining rates for the different upstream lithologies from both the field and a laboratory tumbler. By correlating laboratory abrasion rates with rock strength, we can predict the relative fining rates due solely to abrasion expected in the field; differences between the predicted and observed fining rates could then be attributed to selective transport. We used point counts to measure bed surface sediment grain size distributions at 15 locations along a 25 kilometer reach of the Rio Medio, beginning just downstream of the fault and ending upstream of a developed area with disturbed channel conditions. We recorded intermediate particle diameter as well

  14. 78 FR 12967 - Establishment of Class A TV Service and Cable Television Rate Regulation; Cost of Service Rules...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-26

    ... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Parts 73 and 76 [MM Docket No. 00-10; FCC 01-123 and MM Docket No. 93-215; FCC 95-502] Establishment of Class A TV Service and Cable Television Rate Regulation; Cost of Service Rules--Clarification Regarding Information Collection Requirements AGENCY: Federal...

  15. Estimating implementation and operational costs of an integrated tiered CD4 service including laboratory and point of care testing in a remote health district in South Africa.

    PubMed

    Cassim, Naseem; Coetzee, Lindi M; Schnippel, Kathryn; Glencross, Deborah K

    2014-01-01

    An integrated tiered service delivery model (ITSDM) has been proposed to provide 'full-coverage' of CD4 services throughout South Africa. Five tiers are described, defined by testing volumes and number of referring health-facilities. These include: (1) Tier-1/decentralized point-of-care service (POC) in a single site; Tier-2/POC-hub servicing processing < 30-40 samples from 8-10 health-clinics; Tier-3/Community laboratories servicing ∼ 50 health-clinics, processing < 150 samples/day; high-volume centralized laboratories (Tier-4 and Tier-5) processing < 300 or > 600 samples/day and serving > 100 or > 200 health-clinics, respectively. The objective of this study was to establish costs of existing and ITSDM-tiers 1, 2 and 3 in a remote, under-serviced district in South Africa. Historical health-facility workload volumes from the Pixley-ka-Seme district, and the total volumes of CD4 tests performed by the adjacent district referral CD4 laboratories, linked to locations of all referring clinics and related laboratory-to-result turn-around time (LTR-TAT) data, were extracted from the NHLS Corporate-Data-Warehouse for the period April-2012 to March-2013. Tiers were costed separately (as a cost-per-result) including equipment, staffing, reagents and test consumable costs. A one-way sensitivity analyses provided for changes in reagent price, test volumes and personnel time. The lowest cost-per-result was noted for the existing laboratory-based Tiers- 4 and 5 ($6.24 and $5.37 respectively), but with related increased LTR-TAT of > 24-48 hours. Full service coverage with TAT < 6-hours could be achieved with placement of twenty-seven Tier-1/POC or eight Tier-2/POC-hubs, at a cost-per-result of $32.32 and $15.88 respectively. A single district Tier-3 laboratory also ensured 'full service coverage' and < 24 hour LTR-TAT for the district at $7.42 per-test. Implementing a single Tier-3/community laboratory to extend and improve delivery of services in Pixley-ka-Seme, with an

  16. 7 CFR 91.36 - Appeal laboratory certificate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Appeal laboratory certificate. 91.36 Section 91.36..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.36 Appeal laboratory certificate. (a...

  17. 7 CFR 91.36 - Appeal laboratory certificate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Appeal laboratory certificate. 91.36 Section 91.36..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.36 Appeal laboratory certificate. (a...

  18. Heart rate variability indicates emotional value during pro-social economic laboratory decisions with large external validity.

    PubMed

    Fooken, Jonas

    2017-03-10

    The present study investigates the external validity of emotional value measured in economic laboratory experiments by using a physiological indicator of stress, heart rate variability (HRV). While there is ample evidence supporting the external validity of economic experiments, there is little evidence comparing the magnitude of internal levels of emotional stress during decision making with external stress. The current study addresses this gap by comparing the magnitudes of decision stress experienced in the laboratory with the stress from outside the laboratory. To quantify a large change in HRV, measures observed in the laboratory during decision-making are compared to the difference between HRV during a university exam and other mental activity for the same individuals in and outside of the laboratory. The results outside the laboratory inform about the relevance of laboratory findings in terms of their relative magnitude. Results show that psychologically induced HRV changes observed in the laboratory, particularly in connection with social preferences, correspond to large effects outside. This underscores the external validity of laboratory findings and shows the magnitude of emotional value connected to pro-social economic decisions in the laboratory.

  19. Building and Rebuilding: The National Public Health Laboratory Systems and Services Before and After the Earthquake and Cholera Epidemic, Haiti, 2009–2015

    PubMed Central

    Jean Louis, Frantz; Buteau, Josiane; Boncy, Jacques; Anselme, Renette; Stanislas, Magalie; Nagel, Mary C.; Juin, Stanley; Charles, Macarthur; Burris, Robert; Antoine, Eva; Yang, Chunfu; Kalou, Mireille; Vertefeuille, John; Marston, Barbara J.; Lowrance, David W.; Deyde, Varough

    2017-01-01

    Abstract. Before the 2010 devastating earthquake and cholera outbreak, Haiti’s public health laboratory systems were weak and services were limited. There was no national laboratory strategic plan and only minimal coordination across the laboratory network. Laboratory capacity was further weakened by the destruction of over 25 laboratories and testing sites at the departmental and peripheral levels and the loss of life among the laboratory health-care workers. However, since 2010, tremendous progress has been made in building stronger laboratory infrastructure and training a qualified public health laboratory workforce across the country, allowing for decentralization of access to quality-assured services. Major achievements include development and implementation of a national laboratory strategic plan with a formalized and strengthened laboratory network; introduction of automation of testing to ensure better quality of results and diversify the menu of tests to effectively respond to outbreaks; expansion of molecular testing for tuberculosis, human immunodeficiency virus, malaria, diarrheal and respiratory diseases; establishment of laboratory-based surveillance of epidemic-prone diseases; and improvement of the overall quality of testing. Nonetheless, the progress and gains made remain fragile and require the full ownership and continuous investment from the Haitian government to sustain these successes and achievements. PMID:29064354

  20. Recorded gonorrhoea rates in Denmark, 1900-2010: the impact of clinical testing activity and laboratory diagnostic procedures.

    PubMed

    Lind, Inga; Hoffmann, Steen

    2015-11-30

    Assessment of the relations between recorded gonorrhoea rates and clinical testing activity and disposable diagnostic tests. In Denmark, two sources of information on the epidemiology of gonorrhoea are available: (1) a mandatory clinical notification system (since 1867) comprising summary information about geographic distribution, season, age group and gender; in 1994, more detailed anonymous individualised epidemiological information was included; (2) a voluntary countrywide laboratory surveillance system for culture-confirmed cases (since 1957) comprising information about patient's age and gender, infected anatomical sites and medical setting attended. Both surveillance systems showed marked simultaneous changes in gonorrhoea rates, although periodically considerable under-reporting or under-diagnosing was demonstrated. The annual incidence of notified cases peaked in 1919 (474/100,000), in 1944 (583/100,000) and in 1972 (344/100,000). Since 1995, the incidence has been at a low endemic level (1.5-10/100,000) and the total male/female incidence ratios were from 3 to 7 times higher than previously recorded. Among approximately 2 million persons tested during 1974-1988 78,213 men and 63,143 women with culture-confirmed gonorrhoea were identified. During this period, pharyngeal sampling was performed in 36% of men and 25% of women with gonorrhoea; pharyngeal gonorrhoea was found in 10% and 16%, respectively; 40% and 30% of these patients had no concomitant urogenital gonorrhoea. Among men with gonorrhoea, 34% were sampled from the rectum; 9% had rectal gonorrhoea, among whom the rectum was the only infected site in 67%. Crucial factors for case finding are clinical sampling tradition and appropriate laboratory diagnostic facilities. When case finding is insufficient, a reservoir of asymptomatic rectal or pharyngeal gonorrhoea remains unrecognised. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

  1. Modelling the expected rate of laboratory biosafety breakdowns involving rinderpest virus in the post-eradication era.

    PubMed

    Beauvais, W; Fournié, G; Jones, B A; Cameron, A; Njeumi, F; Lubroth, J; Pfeiffer, D U

    2013-11-01

    Now that we are in the rinderpest post-eradication era, attention is focused on the risk of re-introduction. A semi-quantitative risk assessment identified accidental use of rinderpest virus in laboratories as the most likely cause of re-introduction. However there is little data available on the rates of laboratory biosafety breakdowns in general. In addition, any predictions based on past events are subject to various uncertainties. The aims of this study were therefore to investigate the potential usefulness of historical data for predicting the future risk of rinderpest release via laboratory biosafety breakdowns, and to investigate the impacts of the various uncertainties on these predictions. Data were collected using a worldwide online survey of laboratories, a structured search of ProMED reports and discussion with experts. A stochastic model was constructed to predict the number of laboratory biosafety breakdowns involving rinderpest that will occur over the next 10 years, based on: (1) the historical rate of biosafety breakdowns; and (2) the change in the number of laboratories that will have rinderpest virus in the next 10 years compared to historically. The search identified five breakdowns, all of which occurred during 1970-2000 and all of which were identified via discussions with experts. Assuming that our search for historical events had a sensitivity of over 60% and there has been at least a 40% reduction in the underlying risk (attributable to decreased laboratory activity post eradication) the most likely number of biosafety events worldwide was estimated to be zero over a 10 year period. However, the risk of at least one biosafety breakdown remains greater than 1 in 10,000 unless the sensitivity was at least 99% or the number of laboratories has decreased by at least 99% (based on 2000-2010 during which there were no biosafety breakdowns). Copyright © 2013 Elsevier B.V. All rights reserved.

  2. 7 CFR 94.5 - Charges for laboratory service.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... costs for analysis of mandatory egg product samples at Science and Technology Division laboratories... program. The costs for any other mandatory laboratory analyses and testing of an egg product's identity...

  3. 7 CFR 94.5 - Charges for laboratory service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... costs for analysis of mandatory egg product samples at Science and Technology Division laboratories... program. The costs for any other mandatory laboratory analyses and testing of an egg product's identity...

  4. 7 CFR 94.5 - Charges for laboratory service.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... costs for analysis of mandatory egg product samples at Science and Technology Division laboratories... program. The costs for any other mandatory laboratory analyses and testing of an egg product's identity...

  5. 7 CFR 94.5 - Charges for laboratory service.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... costs for analysis of mandatory egg product samples at Science and Technology Division laboratories... program. The costs for any other mandatory laboratory analyses and testing of an egg product's identity...

  6. Self-reported eating rate aligns with laboratory measured eating rate but not with free-living meals.

    PubMed

    Petty, Amanda J; Melanson, Kathleen J; Greene, Geoffrey W

    2013-04-01

    Methodological differences may be responsible for variable results from eating rate (ER) studies. It is unknown whether self-reported, lab-measured, and free-living ER's align. This study was the first to explore relationships among self-reported, laboratory-measured and free-living ER's. We investigated this relationship in 60 randomly selected male and female college students who were stratified by self-reported eating rate (SRER) (Slow, Medium, and Fast) from 1110 on-line survey respondents. Test day; subjects ate a prescribed breakfast (∼400kcal) at home, recording meal duration (MD); 4h later they individually ate an ad libitum laboratory pasta lunch at their own (natural) pace; remainder of the day they recorded free-living intake and MD. As expected the three self-reported ER categories aligned with lab ER (Fast=83.9±5.5, Medium=63.1±5.2, Slow=53.0±5.4kcals/min). In all ER categories at all meals, men ate faster than women (Men=80.6±30.7kcals/min: Women=52.0±21.6kcals/min). A difference in lab measured ER by SRER F=(2, 58)=7.677, post hoc Tukey analysis found fast differed from medium and slow. The three free-living meal ER's did not align with self-report categories. Findings suggest various methods of measuring ER may yield differing results, at least in this population, but results support the use of SRER as a valid measure. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Laboratory medicine: challenges and opportunities.

    PubMed

    Bossuyt, Xavier; Verweire, Kurt; Blanckaert, Norbert

    2007-10-01

    Technologic innovations have substantially improved the productivity of clinical laboratories, but the services provided by clinical laboratories are increasingly becoming commoditized. We reflect on how current developments may affect the future of laboratory medicine and how to deal with these changes. We argue that to be prepared for the future, clinical laboratories should enhance efficiency and reduce costs by forming alliances and networks; consolidating, integrating, or outsourcing; and more importantly, create additional value by providing knowledge services related to in vitro diagnostics.

  8. The changing landscape of genetic testing and its impact on clinical and laboratory services and research in Europe.

    PubMed

    Hastings, Ros; de Wert, Guido; Fowler, Brian; Krawczak, Michael; Vermeulen, Eric; Bakker, Egbert; Borry, Pascal; Dondorp, Wybo; Nijsingh, Niels; Barton, David; Schmidtke, Jörg; van El, Carla G; Vermeesch, Joris; Stol, Yrrah; Carmen Howard, Heidi; Cornel, Martina C

    2012-09-01

    The arrival of new genetic technologies that allow efficient examination of the whole human genome (microarray, next-generation sequencing) will impact upon both laboratories (cytogenetic and molecular genetics in the first instance) and clinical/medical genetic services. The interpretation of analytical results in terms of their clinical relevance and the predicted health status poses a challenge to both laboratory and clinical geneticists, due to the wealth and complexity of the information obtained. There is a need to discuss how to best restructure the genetic services logistically and to determine the clinical utility of genetic testing so that patients can receive appropriate advice and genetic testing. To weigh up the questions and challenges of the new genetic technologies, the European Society of Human Genetics (ESHG) held a series of workshops on 10 June 2010 in Gothenburg. This was part of an ESHG satellite symposium on the 'Changing landscape of genetic testing', co-organized by the ESHG Genetic Services Quality and Public and Professional Policy Committees. The audience consisted of a mix of geneticists, ethicists, social scientists and lawyers. In this paper, we summarize the discussions during the workshops and present some of the identified ways forward to improve and adapt the genetic services so that patients receive accurate and relevant information. This paper covers ethics, clinical utility, primary care, genetic services and the blurring boundaries between healthcare and research.

  9. The changing landscape of genetic testing and its impact on clinical and laboratory services and research in Europe

    PubMed Central

    Hastings, Ros; de Wert, Guido; Fowler, Brian; Krawczak, Michael; Vermeulen, Eric; Bakker, Egbert; Borry, Pascal; Dondorp, Wybo; Nijsingh, Niels; Barton, David; Schmidtke, Jörg; van El, Carla G; Vermeesch, Joris; Stol, Yrrah; Carmen Howard, Heidi; Cornel, Martina C

    2012-01-01

    The arrival of new genetic technologies that allow efficient examination of the whole human genome (microarray, next-generation sequencing) will impact upon both laboratories (cytogenetic and molecular genetics in the first instance) and clinical/medical genetic services. The interpretation of analytical results in terms of their clinical relevance and the predicted health status poses a challenge to both laboratory and clinical geneticists, due to the wealth and complexity of the information obtained. There is a need to discuss how to best restructure the genetic services logistically and to determine the clinical utility of genetic testing so that patients can receive appropriate advice and genetic testing. To weigh up the questions and challenges of the new genetic technologies, the European Society of Human Genetics (ESHG) held a series of workshops on 10 June 2010 in Gothenburg. This was part of an ESHG satellite symposium on the ‘Changing landscape of genetic testing', co-organized by the ESHG Genetic Services Quality and Public and Professional Policy Committees. The audience consisted of a mix of geneticists, ethicists, social scientists and lawyers. In this paper, we summarize the discussions during the workshops and present some of the identified ways forward to improve and adapt the genetic services so that patients receive accurate and relevant information. This paper covers ethics, clinical utility, primary care, genetic services and the blurring boundaries between healthcare and research. PMID:22453292

  10. Quantifying sources of bias in National Healthcare Safety Network laboratory-identified Clostridium difficile infection rates.

    PubMed

    Haley, Valerie B; DiRienzo, A Gregory; Lutterloh, Emily C; Stricof, Rachel L

    2014-01-01

    To assess the effect of multiple sources of bias on state- and hospital-specific National Healthcare Safety Network (NHSN) laboratory-identified Clostridium difficile infection (CDI) rates. Sensitivity analysis. A total of 124 New York hospitals in 2010. New York NHSN CDI events from audited hospitals were matched to New York hospital discharge billing records to obtain additional information on patient age, length of stay, and previous hospital discharges. "Corrected" hospital-onset (HO) CDI rates were calculated after (1) correcting inaccurate case reporting found during audits, (2) incorporating knowledge of laboratory results from outside hospitals, (3) excluding days when patients were not at risk from the denominator of the rates, and (4) adjusting for patient age. Data sets were simulated with each of these sources of bias reintroduced individually and combined. The simulated rates were compared with the corrected rates. Performance (ie, better, worse, or average compared with the state average) was categorized, and misclassification compared with the corrected data set was measured. Counting days patients were not at risk in the denominator reduced the state HO rate by 45% and resulted in 8% misclassification. Age adjustment and reporting errors also shifted rates (7% and 6% misclassification, respectively). Changing the NHSN protocol to require reporting of age-stratified patient-days and adjusting for patient-days at risk would improve comparability of rates across hospitals. Further research is needed to validate the risk-adjustment model before these data should be used as hospital performance measures.

  11. Financial incentives and the supply of laboratory tests.

    PubMed

    Carlsen, Fredrik; Grytten, Jostein; Skau, Irene

    2003-11-01

    This study examined how the number of laboratory tests taken by a sample of Norwegian contract physicians is influenced by their private economy outside of the practice and by changes in remuneration. The data are drawn from 40,000 consultations carried out by 44 contract physicians in 1991-1994. Two factors which led to changes in the level of physicians' income are considered: changes in remuneration for consultations and laboratory tests and changes in interest rates on loans and bank deposits. The effect which changes in interest rates have on physicians' disposable income was calculated using information about their financial assets and debts obtained from tax assessments. The main finding was that changes in private economy and changes in remuneration have no or only a small effect on the number of laboratory tests taken. Our results suggest that fee regulation can be an effective means of controlling physicians' income and therefore government expenditure on primary physician services.

  12. 47 CFR 76.923 - Rates for equipment and installation used to receive the basic service tier.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rates for equipment and installation used to receive the basic service tier. 76.923 Section 76.923 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation...

  13. Selective testing of women based on age for genital Chlamydia trachomatis and Neisseria gonorrhoeae infection in a centralized regional microbiology laboratory.

    PubMed

    Church, Deirdre L; Amante, L; Semeniuk, H; Gregson, D B

    2007-04-01

    Calgary Laboratory Services, Alberta, Canada, provides microbiology services via a centralized laboratory to the Calgary Health Region. A selective genital Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (GC) testing policy for women >35 years was implemented. The changes in physician ordering practice, the rate of detection of infections, and the test turnaround times were monitored. The volume of tests, the cost/test, and the total service costs accrued in the year before and after this policy change were compared. An immediate impact was a 30% decrease in tests performed due to the laboratory rejecting samples from older women. Subsequently, physicians' practice changed so that tests were ordered when test criteria were met. Detection rates did not change in any age group. A 27.9% decrease in the total service costs resulted in a labor reduction of 0.2 FTE. Selective testing of women >35 years with a low prevalence of CT/GC infection is clinically relevant and cost-effective.

  14. Strain rate effects in stress corrosion cracking

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Parkins, R.N.

    Slow strain rate testing (SSRT) was initially developed as a rapid, ad hoc laboratory method for assessing the propensity for metals an environments to promote stress corrosion cracking. It is now clear, however, that there are good theoretical reasons why strain rate, as opposed to stress per se, will often be the controlling parameter in determining whether or not cracks are nucleated and, if so, are propagated. The synergistic effects of the time dependence of corrosion-related reactions and microplastic strain provide the basis for mechanistic understanding of stress corrosion cracking in high-pressure pipelines and other structures. However, while this maymore » be readily comprehended in the context of laboratory slow strain tests, its extension to service situations may be less apparent. Laboratory work involving realistic stressing conditions, including low-frequency cyclic loading, shows that strain or creep rates give good correlation with thresholds for cracking and with crack growth kinetics.« less

  15. [ISO 15189 medical laboratory accreditation].

    PubMed

    Aoyagi, Tsutomu

    2004-10-01

    This International Standard, based upon ISO/IEC 17025 and ISO 9001, provides requirements for competence and quality that are particular to medical laboratories. While this International Standard is intended for use throughout the currently recognized disciplines of medical laboratory services, those working in other services and disciplines will also find it useful and appropriate. In addition, bodies engaged in the recognition of the competence of medical laboratories will be able to use this International Standard as the basis for their activities. The Japan Accreditation Board for Conformity Assessment (AB) and the Japanese Committee for Clinical Laboratory Standards (CCLS) are jointly developing the program of accreditation of medical laboratories. ISO 15189 requirements consist of two parts, one is management requirements and the other is technical requirements. The former includes the requirements of all parts of ISO 9001, moreover it includes the requirement of conformity assessment body, for example, impartiality and independence from any other party. The latter includes the requirements of laboratory competence (e.g. personnel, facility, instrument, and examination methods), moreover it requires that laboratories shall participate proficiency testing(s) and laboratories' examination results shall have traceability of measurements and implement uncertainty of measurement. Implementation of ISO 15189 will result in a significant improvement in medical laboratories management system and their technical competence. The accreditation of medical laboratory will improve medical laboratory service and be useful for patients.

  16. Estimating Implementation and Operational Costs of an Integrated Tiered CD4 Service including Laboratory and Point of Care Testing in a Remote Health District in South Africa

    PubMed Central

    Cassim, Naseem; Coetzee, Lindi M.; Schnippel, Kathryn; Glencross, Deborah K.

    2014-01-01

    Background An integrated tiered service delivery model (ITSDM) has been proposed to provide ‘full-coverage’ of CD4 services throughout South Africa. Five tiers are described, defined by testing volumes and number of referring health-facilities. These include: (1) Tier-1/decentralized point-of-care service (POC) in a single site; Tier-2/POC-hub servicing processing <30–40 samples from 8–10 health-clinics; Tier-3/Community laboratories servicing ∼50 health-clinics, processing <150 samples/day; high-volume centralized laboratories (Tier-4 and Tier-5) processing <300 or >600 samples/day and serving >100 or >200 health-clinics, respectively. The objective of this study was to establish costs of existing and ITSDM-tiers 1, 2 and 3 in a remote, under-serviced district in South Africa. Methods Historical health-facility workload volumes from the Pixley-ka-Seme district, and the total volumes of CD4 tests performed by the adjacent district referral CD4 laboratories, linked to locations of all referring clinics and related laboratory-to-result turn-around time (LTR-TAT) data, were extracted from the NHLS Corporate-Data-Warehouse for the period April-2012 to March-2013. Tiers were costed separately (as a cost-per-result) including equipment, staffing, reagents and test consumable costs. A one-way sensitivity analyses provided for changes in reagent price, test volumes and personnel time. Results The lowest cost-per-result was noted for the existing laboratory-based Tiers- 4 and 5 ($6.24 and $5.37 respectively), but with related increased LTR-TAT of >24–48 hours. Full service coverage with TAT <6-hours could be achieved with placement of twenty-seven Tier-1/POC or eight Tier-2/POC-hubs, at a cost-per-result of $32.32 and $15.88 respectively. A single district Tier-3 laboratory also ensured ‘full service coverage’ and <24 hour LTR-TAT for the district at $7.42 per-test. Conclusion Implementing a single Tier-3/community laboratory to extend and improve delivery

  17. Comparison of nonmesonic hypernuclear decay rates computed in laboratory and center-of-mass coordinates

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    De Conti, C.; Barbero, C.; Galeão, A. P.

    In this work we compute the one-nucleon-induced nonmesonic hypernuclear decay rates of {sub Λ}{sup 5}He, {sub Λ}{sup 12}C and {sub Λ}{sup 13}C using a formalism based on the independent particle shell model in terms of laboratory coordinates. To ascertain the correctness and precision of the method, these results are compared with those obtained using a formalism in terms of center-of-mass coordinates, which has been previously reported in the literature. The formalism in terms of laboratory coordinates will be useful in the shell-model approach to two-nucleon-induced transitions.

  18. The WHO/PEPFAR collaboration to prepare an operations manual for HIV prevention, care, and treatment at primary health centers in high-prevalence, resource-constrained settings: defining laboratory services.

    PubMed

    Spira, Thomas; Lindegren, Mary Lou; Ferris, Robert; Habiyambere, Vincent; Ellerbrock, Tedd

    2009-06-01

    The expansion of HIV/AIDS care and treatment in resource-constrained countries, especially in sub-Saharan Africa, has generally developed in a top-down manner. Further expansion will involve primary health centers where human and other resources are limited. This article describes the World Health Organization/President's Emergency Plan for AIDS Relief collaboration formed to help scale up HIV services in primary health centers in high-prevalence, resource-constrained settings. It reviews the contents of the Operations Manual developed, with emphasis on the Laboratory Services chapter, which discusses essential laboratory services, both at the center and the district hospital level, laboratory safety, laboratory testing, specimen transport, how to set up a laboratory, human resources, equipment maintenance, training materials, and references. The chapter provides specific information on essential tests and generic job aids for them. It also includes annexes containing a list of laboratory supplies for the health center and sample forms.

  19. Quality assessment of malaria laboratory diagnosis in South Africa.

    PubMed

    Dini, Leigh; Frean, John

    2003-01-01

    To assess the quality of malaria diagnosis in 115 South African laboratories participating in the National Health Laboratory Service Parasitology External Quality Assessment Programme we reviewed the results from 7 surveys from January 2000 to August 2002. The mean percentage incorrect result rate was 13.8% (95% CI 11.3-16.9%), which is alarmingly high, with about 1 in 7 blood films being incorrectly interpreted. Most participants with incorrect blood film interpretations had acceptable Giemsa staining quality, indicating that there is less of a problem with staining technique than with blood film interpretation. Laboratories in provinces in which malaria is endemic did not necessarily perform better than those in non-endemic areas. The results clearly suggest that malaria laboratory diagnosis throughout South Africa needs strengthening by improving laboratory standardization and auditing, training, quality assurance and referral resources.

  20. Current and proposed molecular diagnostics in a genitourinary service line laboratory at a tertiary clinical institution.

    PubMed

    Udager, Aaron M; Alva, Ajjai; Mehra, Rohit

    2014-01-01

    The idea that detailed knowledge of molecular oncogenesis will drive diagnostic, prognostic, and therapeutic clinical decision making in an increasingly multidisciplinary practice of oncologic care has been anticipated for many years. With the recent rapid advancement in our understanding of the molecular underpinnings of genitourinary malignancies, this concept is now starting to take shape in the fields of prostate, kidney, bladder, testicular, and penile cancer. Such breakthroughs necessitate the development of robust clinical-grade assays that can be quickly made available for patients to facilitate diagnosis in challenging cases, risk-stratify patients for subsequent clinical management, select the appropriate targeted therapy from among increasingly diverse and numerous options, and enroll patients in advanced clinical trials. This rapid translation of basic and clinical cancer research requires a streamlined, multidisciplinary approach to clinical assay development, termed here the molecular diagnostics service line laboratory. In this review, we summarize the current state and explore the future of molecular diagnostics in genitourinary oncology to conceptualize a genitourinary service line laboratory at a tertiary clinical institution.

  1. Strengthening laboratory systems in resource-limited settings.

    PubMed

    Olmsted, Stuart S; Moore, Melinda; Meili, Robin C; Duber, Herbert C; Wasserman, Jeffrey; Sama, Preethi; Mundell, Ben; Hilborne, Lee H

    2010-09-01

    Considerable resources have been invested in recent years to improve laboratory systems in resource-limited settings. We reviewed published reports, interviewed major donor organizations, and conducted case studies of laboratory systems in 3 countries to assess how countries and donors have worked together to improve laboratory services. While infrastructure and the provision of services have seen improvement, important opportunities remain for further advancement. Implementation of national laboratory plans is inconsistent, human resources are limited, and quality laboratory services rarely extend to lower tier laboratories (eg, health clinics, district hospitals). Coordination within, between, and among governments and donor organizations is also frequently problematic. Laboratory standardization and quality control are improving but remain challenging, making accreditation a difficult goal. Host country governments and their external funding partners should coordinate their efforts effectively around a host country's own national laboratory plan to advance sustainable capacity development throughout a country's laboratory system.

  2. Using a reactive transport model to elucidate differences between laboratory and field dissolution rates in regolith

    NASA Astrophysics Data System (ADS)

    Moore, Joel; Lichtner, Peter C.; White, Art F.; Brantley, Susan L.

    2012-09-01

    The reactive transport model FLOTRAN was used to forward-model weathering profiles developed on granitic outwash alluvium over 40-3000 ka from the Merced, California (USA) chronosequence as well as deep granitic regolith developed over 800 ka near Davis Run, Virginia (USA). Baseline model predictions that used laboratory rate constants (km), measured fluid flow velocities (v), and BET volumetric surface areas for the parent material (AB,mo) were not consistent with measured profiles of plagioclase, potassium feldspar, and quartz. Reaction fronts predicted by the baseline model are deeper and thinner than the observed, consistent with faster rates of reaction in the model. Reaction front depth in the model depended mostly upon saturated versus unsaturated hydrologic flow conditions, rate constants controlling precipitation of secondary minerals, and the average fluid flow velocity (va). Unsaturated hydrologic flow conditions (relatively open with respect to CO2(g)) resulted in the prediction of deeper reaction fronts and significant differences in the separation between plagioclase and potassium feldspar reaction fronts compared to saturated hydrologic flow (relatively closed with respect to CO2(g)). Under saturated or unsaturated flow conditions, the rate constant that controls precipitation rates of secondary minerals must be reduced relative to laboratory rate constants to match observed reaction front depths and measured pore water chemistry. Additionally, to match the observed reaction front depths, va was set lower than the measured value, v, for three of the four profiles. The reaction front gradients in mineralogy and pore fluid chemistry could only be modeled accurately by adjusting values of the product kmAB,mo. By assuming km values were constrained by laboratory data, field observations were modeled successfully with TST-like rate equations by dividing measured values of AB,mo by factors from 50 to 1700. Alternately, with sigmoidal or Al-inhibition rate

  3. Evaluation of quality indicators in a laboratory supporting tertiary cancer care facilities in India.

    PubMed

    Kumar, Savitha Anil; Jayanna, Prashanth; Prabhudesai, Shilpa; Kumar, Ajai

    2014-01-01

    To collect and tabulate errors and nonconformities in the preanalytical, analytical, and postanalytical process phases in a diagnostic clinical laboratory that supports a super-specialty cancer center in India, and identify areas of potential improvement in patient services. We collected data from our laboratory during a period of 24 months. Departments in the study included clinical biochemistry, hematology, clinical pathology, microbiology and serology, surgical pathology, and molecular pathology. We had initiated quality assessment based on international standards in our laboratory in 2010, with the aim of obtaining accreditation by national and international governing bodies. We followed the guidelines specified by International Organization for Standardization (ISO) 15189:2007 to identify noncompliant elements of our processes. Among a total of 144,030 specimens that our referral laboratory received during the 2-year period of our study, we uncovered an overall error rate for all 3 process phases of 1.23%; all of our error rates closely approximated the results from our peer institutions. Errors were most common in the preanalytical phase in both years of study; preanalytical- and postanalytical-phase errors constituted more than 90% of all errors. Further improvements are warranted in laboratory services and are contingent on adequate training and interdepartmental communication and cooperation. Copyright© by the American Society for Clinical Pathology (ASCP).

  4. 76 FR 20363 - Accreditation and Approval of Atlantic Product Services, Inc., as a Commercial Gauger and Laboratory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    .... Customs and Border Protection by calling (202) 344-1060. The inquiry may also be sent to [email protected] 1060. Dated: April 1, 2011. Ira S. Reese, Executive Director, Laboratories and Scientific Services. [FR Doc. 2011-8688 Filed 4-11-11; 8:45 am] BILLING CODE 9111-14-P ...

  5. Reducing Non-Attendance Rates for Assessment at an Eating Disorders Service: A Quality Improvement Initiative.

    PubMed

    Jenkins, Paul E

    2017-10-01

    Rates of non-attendance at initial appointments within community eating disorder (ED) services are frequently high, although this has received relatively little research attention and no reports of interventions designed to address this. The current report describes outcomes following a change of procedure introducing a 'partial booking' system. Attendance rates at first appointments (N = 1260) were audited following introduction of a system designed to reduce non-attendance in January 2013 within a UK ED service. Rates were compared following implementation of the new system, using a historical control group for comparison, and showed a decline from 20.4 to 15.1%, a medium-sized effect. Use of a system asking patients to book an appointment reduced non-attendance at initial appointments and may be of use to similar services experiencing high non-attendance rates. Opt-in initiatives can reduce burden resulting from long waiting times and can be easily adapted to individual services.

  6. Specimen rejection in laboratory medicine: Necessary for patient safety?

    PubMed

    Dikmen, Zeliha Gunnur; Pinar, Asli; Akbiyik, Filiz

    2015-01-01

    The emergency laboratory in Hacettepe University Hospitals receives specimens from emergency departments (EDs), inpatient services and intensive care units (ICUs). The samples are accepted according to the rejection criteria of the laboratory. In this study, we aimed to evaluate the sample rejection ratios according to the types of pre-preanalytical errors and collection areas. The samples sent to the emergency laboratory were recorded during 12 months between January to December, 2013 in which 453,171 samples were received and 27,067 specimens were rejected. Rejection ratios was 2.5% for biochemistry tests, 3.2% for complete blood count (CBC), 9.8% for blood gases, 9.2% for urine analysis, 13.3% for coagulation tests, 12.8% for therapeutic drug monitoring, 3.5% for cardiac markers and 12% for hormone tests. The most frequent rejection reasons were fibrin clots (28%) and inadequate volume (9%) for biochemical tests. Clotted samples (35%) and inadequate volume (13%) were the major causes for coagulation tests, blood gas analyses and CBC. The ratio of rejected specimens was higher in the EDs (40%) compared to ICUs (30%) and inpatient services (28%). The highest rejection ratio was observed in neurology ICU (14%) among the ICUs and internal medicine inpatient service (10%) within inpatient clinics. We detected an overall specimen rejection rate of 6% in emergency laboratory. By documentation of rejected samples and periodic training of healthcare personnel, we expect to decrease sample rejection ratios below 2%, improve total quality management of the emergency laboratory and promote patient safety.

  7. Specimen rejection in laboratory medicine: Necessary for patient safety?

    PubMed Central

    Dikmen, Zeliha Gunnur; Pinar, Asli; Akbiyik, Filiz

    2015-01-01

    Introduction The emergency laboratory in Hacettepe University Hospitals receives specimens from emergency departments (EDs), inpatient services and intensive care units (ICUs). The samples are accepted according to the rejection criteria of the laboratory. In this study, we aimed to evaluate the sample rejection ratios according to the types of pre-preanalytical errors and collection areas. Materials and methods The samples sent to the emergency laboratory were recorded during 12 months between January to December, 2013 in which 453,171 samples were received and 27,067 specimens were rejected. Results Rejection ratios was 2.5% for biochemistry tests, 3.2% for complete blood count (CBC), 9.8% for blood gases, 9.2% for urine analysis, 13.3% for coagulation tests, 12.8% for therapeutic drug monitoring, 3.5% for cardiac markers and 12% for hormone tests. The most frequent rejection reasons were fibrin clots (28%) and inadequate volume (9%) for biochemical tests. Clotted samples (35%) and inadequate volume (13%) were the major causes for coagulation tests, blood gas analyses and CBC. The ratio of rejected specimens was higher in the EDs (40%) compared to ICUs (30%) and inpatient services (28%). The highest rejection ratio was observed in neurology ICU (14%) among the ICUs and internal medicine inpatient service (10%) within inpatient clinics. Conclusions We detected an overall specimen rejection rate of 6% in emergency laboratory. By documentation of rejected samples and periodic training of healthcare personnel, we expect to decrease sample rejection ratios below 2%, improve total quality management of the emergency laboratory and promote patient safety. PMID:26527231

  8. Secondary standards laboratories for ionizing radiation calibrations: The national laboratory interests

    NASA Astrophysics Data System (ADS)

    Roberson, P. I.; Campbell, G. W.

    1984-11-01

    The national laboratories are probable candidates to serve as secondary standards laboratories for the federal sector. Representatives of the major Department of Energy laboratories were polled concerning attitudes toward a secondary laboratory structure. Generally, the need for secondary laboratories was recognized and the development of such a program was encouraged. The secondary laboratories should be reviewed and inspected by the National Bureau of Standards. They should offer all of the essential, and preferably additional, calibration services in the field of radiological health protection. The selection of secondary laboratories should be based on economic and geographic criteria and/or be voluntary.

  9. Computing and information services at the Jet Propulsion Laboratory - A management approach to a diversity of needs

    NASA Technical Reports Server (NTRS)

    Felberg, F. H.

    1984-01-01

    The Jet Propulsion Laboratory, a research and development organization with about 5,000 employees, presents a complicated set of requirements for an institutional system of computing and informational services. The approach taken by JPL in meeting this challenge is one of controlled flexibility. A central communications network is provided, together with selected computing facilities for common use. At the same time, staff members are given considerable discretion in choosing the mini- and microcomputers that they believe will best serve their needs. Consultation services, computer education, and other support functions are also provided.

  10. Frederick National Laboratory Collaboration Success Stories | Frederick National Laboratory for Cancer Research

    Cancer.gov

    Nanotechnology Characterization Laboratory Unveils New Technical Services for Drug Developers Drug developers now have access to a shared analytical technology, developed and provided by the Frederick National Laboratory, that helps fine-tune nano

  11. Using a Time-Driven Activity-Based Costing Model To Determine the Actual Cost of Services Provided by a Transgenic Core.

    PubMed

    Gerwin, Philip M; Norinsky, Rada M; Tolwani, Ravi J

    2018-03-01

    Laboratory animal programs and core laboratories often set service rates based on cost estimates. However, actual costs may be unknown, and service rates may not reflect the actual cost of services. Accurately evaluating the actual costs of services can be challenging and time-consuming. We used a time-driven activity-based costing (ABC) model to determine the cost of services provided by a resource laboratory at our institution. The time-driven approach is a more efficient approach to calculating costs than using a traditional ABC model. We calculated only 2 parameters: the time required to perform an activity and the unit cost of the activity based on employee cost. This method allowed us to rapidly and accurately calculate the actual cost of services provided, including microinjection of a DNA construct, microinjection of embryonic stem cells, embryo transfer, and in vitro fertilization. We successfully implemented a time-driven ABC model to evaluate the cost of these services and the capacity of labor used to deliver them. We determined how actual costs compared with current service rates. In addition, we determined that the labor supplied to conduct all services (10,645 min/wk) exceeded the practical labor capacity (8400 min/wk), indicating that the laboratory team was highly efficient and that additional labor capacity was needed to prevent overloading of the current team. Importantly, this time-driven ABC approach allowed us to establish a baseline model that can easily be updated to reflect operational changes or changes in labor costs. We demonstrated that a time-driven ABC model is a powerful management tool that can be applied to other core facilities as well as to entire animal programs, providing valuable information that can be used to set rates based on the actual cost of services and to improve operating efficiency.

  12. Quality assurance of laboratory work and clinical use of laboratory tests in general practice in norway: a survey.

    PubMed

    Thue, Geir; Jevnaker, Marianne; Gulstad, Guri Andersen; Sandberg, Sverre

    2011-09-01

    Virtually all the general practices in Norway participate in the Norwegian Quality Improvement of Laboratory Services in Primary Care, NOKLUS. In order to assess and develop NOKLUS's services, it was decided to carry out an investigation in the largest participating group, general practices. In autumn 2008 a questionnaire was sent to all Norwegian general practices asking for feedback on different aspects of NOKLUS's main services: contact with medical laboratory technologists, sending of control materials, use and maintenance of practice-specific laboratory binders, courses, and testing of laboratory equipment. In addition, attitudes were elicited towards possible new services directed at assessing other technical equipment and clinical use of tests. Responses were received from 1290 of 1552 practices (83%). The great majority thought that the frequency of sending out control material should continue as at present, and they were pleased with the feedback reports and follow-up by the laboratory technologists in the counties. Even after many years of practical experience, there is still a need to update laboratory knowledge through visits to practices, courses, and written information. Practices also wanted quality assurance of blood pressure meters and spirometers, and many doctors wanted feedback on their use of laboratory tests. Services regarding quality assurance of point-of-care tests, guidance, and courses should be continued. Quality assurance of other technical equipment and of the doctor's clinical use of laboratory tests should be established as part of comprehensive quality assurance.

  13. Laboratory studies of low temperature rate coefficients: The atmospheric chemistry of the outer planets

    NASA Technical Reports Server (NTRS)

    Leone, Stephen R.

    1993-01-01

    The objectives are to measure laboratory rate coefficients for key reactions of hydrocarbon molecules and radicals at low temperatures, which are relevant to the atmospheric photochemistry of Saturn, Jupiter, and Titan. Upcoming NASA planetary missions, such as Cassini, will probe the atmosphere of Titan in more detail, offering an excellent opportunity to test kinetic models and to establish fiducial standards for using kinetic models to interpret various parameters of the outer planets. Accurate low temperature kinetic data, which are presently lacking, may require crucial revisions to the rates of formation and destruction and are of utmost importance to the success of these efforts. In this program, several key reactions of ethynyl radicals (C2H) with acetylene (C2H2), methane (CH4), and oxygen (O2), down to temperatures of 170 K were successfully investigated. The experimental apparatus developed in our laboratory for measuring reaction kinetics at low temperatures consists of a laser photolysis/infrared probe laser setup. The rate measurements are carried out as a function of (low) temperature with a transverse flow cell designed specifically for these studies. A 193 nm argon fluoride pulsed excimer laser is used to photolyze a suitable precursor molecule, such as acetylene to produce C2H, and a high resolution, tunable infrared F-center laser (2.3-3.35 mu m) probes the transient concentrations of the radical species directly in absorption to extract the kinetic rate coefficients.

  14. Measuring methylphenidate response in attention-deficit/hyperactvity disorder: how are laboratory classroom-based measures related to parent ratings?

    PubMed

    Sonuga-Barke, Edmund J S; Coghill, David; DeBacker, Marc; Swanson, James

    2009-12-01

    Methylphenidate (MPH) is an efficacious and normally well-tolerated treatment for attention-deficit/hyperactivity disorder (ADHD). Although treatment effects are usually assessed using parent-rating scales, these can be supplemented by more objective methods. Here we examine the associations between ratings and one such method, assessments made across the day in the laboratory classroom. Comparison of Methylphenidates in the Analog Classroom Setting (COMACS) was made in a large (n = 184) placebo-controlled trial comparing Equasym XL/Metadate CD, Concerta, and placebo (PLA) using a Laboratory School protocol. Therapeutic effects were measured using direct observation, scores on a simple math productivity task and parent ratings. Treatment effects were observed on all measures. Laboratory measures were correlated with each other, most strongly between Swanson, Kotkin, Agler, M-Flynn and Pelham Scale (SKAMP) inattention and Permanent Product Measure of Performance (PERMP). Parental ratings were correlated with classroom measures during the main morning period (1.5-4.5 hours after dosing) and to a lesser extent in the afternoon (6.0-7.5 hours after dosing), but not, by and large, immediately after dosing or in the evening. The morning correlations seemed stronger for female than for male participants. The results suggest that parental ratings and direct observations tap different aspects of MPH response and that both may be required for comprehensive assessment.

  15. 78 FR 31842 - Determination of Rates and Terms for Preexisting Subscription Services and Satellite Digital...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-28

    ... II] Determination of Rates and Terms for Preexisting Subscription Services and Satellite Digital Audio Radio Services AGENCY: Copyright Royalty Board, Library of Congress. ACTION: Final determination... ephemeral recordings by preexisting subscription services and preexisting satellite digital audio radio...

  16. The demand for pregnancy testing: The Aschheim–Zondek reaction, diagnostic versatility, and laboratory services in 1930s Britain

    PubMed Central

    Olszynko-Gryn, Jesse

    2014-01-01

    The Aschheim–Zondek reaction is generally regarded as the first reliable hormone test for pregnancy and as a major product of the ‘heroic age’ of reproductive endocrinology. Invented in Berlin in the late 1920s, by the mid 1930s a diagnostic laboratory in Edinburgh was performing thousands of tests every year for doctors around Britain. In her classic history of antenatal care, sociologist Ann Oakley claimed that the Aschheim–Zondek test launched a ‘modern era’ of obstetric knowledge, which asserted its superiority over that of pregnant women. This article reconsiders Oakley’s claim by examining how pregnancy testing worked in practice. It explains the British adoption of the test in terms less of the medicalisation of pregnancy than of clinicians’ increasing general reliance on laboratory services for differential diagnosis. Crucially, the Aschheim–Zondek reaction was a test not directly for the fetus, but for placental tissue. It was used, less as a yes-or-no test for ordinary pregnancy, than as a versatile diagnostic tool for the early detection of malignant tumours and hormonal deficiencies believed to cause miscarriage. This test was as much a product of oncology and the little-explored world of laboratory services as of reproductive medicine. PMID:24388014

  17. 9 CFR 391.5 - Laboratory accreditation fees.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Laboratory accreditation fees. 391.5 Section 391.5 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.5...

  18. 9 CFR 391.5 - Laboratory accreditation fees.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Laboratory accreditation fees. 391.5 Section 391.5 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.5...

  19. 9 CFR 391.5 - Laboratory accreditation fees.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Laboratory accreditation fees. 391.5 Section 391.5 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.5...

  20. 9 CFR 391.5 - Laboratory accreditation fees.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Laboratory accreditation fees. 391.5 Section 391.5 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES AND LABORATORY ACCREDITATION § 391.5...

  1. Impact of Appointment Waiting Time on Attendance Rates at a Clinical Cancer Genetics Service.

    PubMed

    Shaw, Tarryn; Metras, Julie; Ting, Zoe Ang Li; Courtney, Eliza; Li, Shao-Tzu; Ngeow, Joanne

    2018-05-24

    The increase in demand for clinical cancer genetics services has impacted the ability to provide services timeously. Given limited resources, this often results in extended appointment waiting times. Over the last 3 years, the Cancer Genetics Service at the National Cancer Centre Singapore has continued to experience a steady increase in demand for its service. Nevertheless, significant no-show rates have been reported. This study sought to determine whether an association exists between appointment waiting times and attendance rates. Data was gathered for all participants meeting inclusion criteria. Attendance rates and appointment waiting times were calculated. The relationship between mean waiting times for those who did and did not attend their scheduled appointments was evaluated using Welch's t test and linear regression model. The results showed a significant difference in mean appointment waiting times between patients who did and did not attend (32.66 versus 43.50 days respectively; p < 0.0001). Furthermore, patients who waited for longer than 37 days were significantly less likely to attend. No-show rates increased as the waiting time increased, at a rate of 19.60% per 20 days and 21.40% per 30 days. In conclusion, appointment waiting time is a significant predictor for patient attendance. Strategies to ensure patients receive an appointment within the necessary timeframe at the desired setting are important to ensure that individuals at increased cancer risk attend their appointments in order to manage their cancer risks effectively.

  2. 75 FR 82381 - Oracle Energy Services, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-30

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER11-2436-000] Oracle Energy Services, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for Blanket... proceeding of Oracle Energy Services, LLC's application for market-based rate authority, with an accompanying...

  3. 75 FR 71425 - Border Energy Electric Services, Inc.; Supplemental Notice That Initial Market-Based Rate Filing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-23

    ... proceeding, of Border Energy Electric Services, Inc.'s application for market-based rate authority, with an... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER11-2088-000] Border Energy Electric Services, Inc.; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for...

  4. 75 FR 35016 - EDF Industrial Power Services (NY), LLC; Supplemental Notice That Initial Market-Based Rate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ... Industrial Power Services (NY), LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes...-referenced proceeding of EDF Industrial Power Services (NY), LLC's application for market-based rate... authorization, under 18 CFR part 34, of future issuances of securities and assumptions of liability. Any person...

  5. 75 FR 35018 - Eagle Industrial Power Services (IL), LLC; Supplemental Notice That Initial Market-Based Rate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ... Industrial Power Services (IL), LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes...-referenced proceeding of Eagle Industrial Power Services (IL), LLC's application for market- based rate... authorization, under 18 CFR part 34, of future issuances of securities and assumptions of liability. Any person...

  6. 37 CFR 385.23 - Royalty rates and subscriber-based royalty floors for specific types of services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS RATES AND TERMS FOR STATUTORY LICENSES RATES AND... DIGITAL PHONORECORDS Limited Offerings, Mixed Service Bundles, Music Bundles, Paid Locker Services and... expensed for the rights to make the relevant permanent digital downloads and ringtones. (b) Computation of...

  7. Estimated Glomerular Filtration Rate; Laboratory Implementation and Current Global Status.

    PubMed

    Miller, W Greg; Jones, Graham R D

    2018-01-01

    In 2002, the Kidney Disease Outcomes Quality Initiative guidelines for identifying and treating CKD recommended that clinical laboratories report estimated glomerular filtration rate (eGFR) with every creatinine result to assist clinical practitioners to identify people with early-stage CKD. At that time, the original Modification of Diet in Renal Disease (MDRD) Study equation based on serum creatinine measurements was recommended for calculating eGFR. Because the MDRD Study equation was developed using a nonstandardized creatinine method, a Laboratory Working Group of the National Kidney Disease Education program was formed and implemented standardized calibration traceability for all creatinine methods from global manufacturers by approximately 2010. A modified MDRD Study equation for use with standardized creatinine was developed. The Chronic Kidney Disease Epidemiology Collaboration developed a new equation in 2009 that was more accurate than the MDRD Study equation at values above 60 mL/min/1.73 m 2 . As of 2017, reporting eGFR with creatinine is almost universal in many countries. A reference system for cystatin C became available in 2010, and manufacturers are in the process to standardize cystatin C assays. Equations for eGFR based on standardized cystatin C alone and with creatinine are now available from the Chronic Kidney Disease Epidemiology Collaboration and other groups. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  8. Analysis of Student Loan Special Rate Allowances and Servicing Costs.

    ERIC Educational Resources Information Center

    Technology Management, Inc., Cambridge, MA.

    This document addresses two separate, though related aspects of the operation of the Guaranteed Student Loan Program (GSLP): (1) the mechanism for setting the special rate allowance (SRA); and (2) the effect of the operating requirements of the program on lender servicing costs. The study develops recommendations for improving both aspects of the…

  9. Merging physical parameters and laboratory subjective ratings for the soundscape assessment of urban squares.

    PubMed

    Brambilla, Giovanni; Maffei, Luigi; Di Gabriele, Maria; Gallo, Veronica

    2013-07-01

    An experimental study was carried out in 20 squares in the center of Rome, covering a wide range of different uses, sonic environments, geometry, and architectural styles. Soundwalks along the perimeter of each square were performed during daylight and weekdays taking binaural and video recordings, as well as spot measurements of illuminance. The cluster analysis performed on the physical parameters, not only acoustic, provided two clusters that are in satisfactory agreement with the "a priori" classification. Applying the principal component analysis (PCA) to five physical parameters, two main components were obtained which might be associated to two environmental features, namely, "chaotic/calm" and "open/enclosed." On the basis of these two features, six squares were selected for the laboratory audio-video tests where 32 subjects took part filling in a questionnaire. The PCA performed on the subjective ratings on the sonic environment showed two main components which might be associated to two emotional meanings, namely, "calmness" and "vibrancy." The linear regression modeling between five objective parameters and the mean value of subjective ratings on chaotic/calm and enclosed/open attributes showed a good correlation. Notwithstanding these interesting results being limited to the specific data set, it is worth pointing out that the complexity of the soundscape quality assessment can be more comprehensively examined merging the field measurements of physical parameters with the subjective ratings provided by field and/or laboratory tests.

  10. 77 FR 33210 - EDF Industrial Power Services (CA), LLC; Supplemental Notice That Initial Market-Based Rate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ... Industrial Power Services (CA), LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes... proceeding of EDF Industrial Power Services (CA), LLC's application for market-based rate [[Page 33211... authorization, under 18 CFR part 34, of future issuances of securities and assumptions of liability. Any person...

  11. 78 FR 36769 - EDF Industrial Power Services (OH), LLC; Supplemental Notice That Initial Market-Based Rate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ... Industrial Power Services (OH), LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes... proceeding, of EDF Industrial Power Services (OH), LLC's application for market- based rate authority, with... authorization, under 18 CFR Part 34, of future issuances of securities and assumptions of liability. Any person...

  12. Customer satisfaction in anatomic pathology. A College of American Pathologists Q-Probes study of 3065 physician surveys from 94 laboratories.

    PubMed

    Zarbo, Richard J; Nakhleh, Raouf E; Walsh, Molly

    2003-01-01

    Measurement of physicians' and patients' satisfaction with laboratory services has recently become a requirement of health care accreditation agencies in the United States. To our knowledge, this is the first customer satisfaction survey of anatomic pathology services to provide a standardized tool and benchmarks for subsequent measures of satisfaction. This Q-Probes study assessed physician satisfaction with anatomic pathology laboratory services and sought to determine characteristics that correlate with a high level of physician satisfaction. In January 2001, each laboratory used standardized survey forms to assess physician customer satisfaction with 10 specific elements of service in anatomic pathology and an overall satisfaction rating based on a scale of rankings from a 5 for excellent to a 1 for poor. Data from up to 50 surveys returned per laboratory were compiled and analyzed by the College of American Pathologists. A general questionnaire collected information about types of services offered and each laboratory's quality assurance initiatives to determine characteristics that correlate with a high level of physician satisfaction. Hospital-based laboratories in the United States (95.8%), as well as others from Canada and Australia. Ninety-four voluntary subscriber laboratories in the College of American Pathologists Q-Probes quality improvement program participated in this survey. Roughly 70% of respondents were from hospitals with occupied bedsizes of 300 or less, 65% were private nonprofit institutions, just over half were located in cities, one third were teaching hospitals, and 19% had pathology residency training programs. Overall physician satisfaction with anatomic pathology and 10 selected aspects of the laboratory service (professional interaction, diagnostic accuracy, pathologist responsiveness to problems, pathologist accessibility for frozen section, tumor board presentations, courtesy of secretarial and technical staff, communication of

  13. The rate of mental health service use in New Zealand as analysed by ethnicity.

    PubMed

    Tapsell, Rees; Hallett, Charlene; Mellsop, Graham

    2018-06-01

    To compare by ethnicity the rates of apparent new referrals and admissions to mental health services for selected major diagnostic groupings. Using a Ministry of Health database covering all referrals and admissions to New Zealand's Mental Health services in 2014 and who had not been patients in the preceding six years, population adjusted rates of presentation were calculated and compared across the two major New Zealand ethnic groupings. Population corrected rates of apparently new cases of schizophrenia are more than twice as common in Māori as in non-Māori. Major depression is also significantly more common in Māori. That same trend was not evident for bipolar patients. These ethnically associated apparent differences in the rates of schizophrenia and depression need both confirmation and explanation.

  14. 42 CFR 493.1407 - Standard; Laboratory director responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... developed and used for each of the tests performed in the laboratory provide quality laboratory services for... results are found to be unacceptable or unsatisfactory; (5) Ensure that the quality control and quality assessment programs are established and maintained to assure the quality of laboratory services provided and...

  15. Estimation of waste component-specific landfill decay rates using laboratory-scale decomposition data.

    PubMed

    De la Cruz, Florentino B; Barlaz, Morton A

    2010-06-15

    The current methane generation model used by the U.S. EPA (Landfill Gas Emissions Model) treats municipal solid waste (MSW) as a homogeneous waste with one decay rate. However, component-specific decay rates are required to evaluate the effects of changes in waste composition on methane generation. Laboratory-scale rate constants, k(lab), for the major biodegradable MSW components were used to derive field-scale decay rates (k(field)) for each waste component using the assumption that the average of the field-scale decay rates for each waste component, weighted by its composition, is equal to the bulk MSW decay rate. For an assumed bulk MSW decay rate of 0.04 yr(-1), k(field) was estimated to be 0.298, 0.171, 0.015, 0.144, 0.033, 0.02, 0.122, and 0.029 yr(-1), for grass, leaves, branches, food waste, newsprint, corrugated containers, coated paper, and office paper, respectively. The effect of landfill waste diversion programs on methane production was explored to illustrate the use of component-specific decay rates. One hundred percent diversion of yard waste and food waste reduced the year 20 methane production rate by 45%. When a landfill gas collection schedule was introduced, collectable methane was most influenced by food waste diversion at years 10 and 20 and paper diversion at year 40.

  16. 42 CFR 493.645 - Additional fee(s) applicable to approved State laboratory programs and laboratories issued a...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS General Administration § 493.645 Additional fee(s) applicable to approved State laboratory programs and... laboratory programs and laboratories issued a certificate of accreditation, certificate of waiver, or...

  17. COMPARISON OF MICROBIAL TRANSFORMATION RATE COEFFICIENTS OF XENOBIOTIC CHEMICALS BETWEEN FIELD-COLLECTED AND LABORATORY MICROCOSM MICROBIOTA

    EPA Science Inventory

    Two second-order transformation rate coefficients--kb, based on total plate counts, and kA, based on periphyton-colonized surface areas--were used to compare xenobiotic chemical transformation by laboratory-developed (microcosm) and by field-collected microbiota. Similarity of tr...

  18. 76 FR 8730 - Desert Southwest Customer Service Region-Rate Order No. WAPA-151

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ..., DSW- GI1, PD-NTS3, and INT-NTS3 would go into effect on October 1, 2011, and would remain in effect... Schedule DSW-GI1, would go into effect and coincide with the other ancillary service rates in this rate...-based rates would, if adopted, go into effect October 1, 2011, and remain in effect through September 30...

  19. The Nature of Pre-service Science Teachers' Argumentation in Inquiry-oriented Laboratory Context

    NASA Astrophysics Data System (ADS)

    Ozdem, Yasemin; Ertepinar, Hamide; Cakiroglu, Jale; Erduran, Sibel

    2013-10-01

    The aim of this study was to investigate the kinds of argumentation schemes generated by pre-service elementary science teachers (PSTs) as they perform inquiry-oriented laboratory tasks, and to explore how argumentation schemes vary by task as well as by experimentation and discussion sessions. The model of argumentative and scientific inquiry was used as a design framework in the present study. According to the model, the inquiry of scientific topics was employed by groups of participants through experimentation and critical discussion sessions. The participants of the study were 35 PSTs, who teach middle school science to sixth through eighth grade students after graduation. The data were collected through video- and audio-recordings of the discussions made by PSTs in six inquiry-oriented laboratory sessions. For the analysis of data, pre-determined argumentation schemes by Walton were employed. The results illustrated that PSTs applied varied premises rather than only observations or reliable sources to ground their claims or to argue for a case or an action. It is also worthy of notice that the construction and evaluation of scientific knowledge claims resulted in different numbers and kinds of arguments. Results of this study suggest that designing inquiry-oriented laboratory environments, which are enriched with critical discussion, provides discourse opportunities that can support argumentation. Moreover, PSTs can be encouraged to support and promote argumentation in their future science classrooms if they engage in argumentation integrated instructional strategies.

  20. 7 CFR 91.39 - Premium hourly fee rates for overtime and legal holiday service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Premium hourly fee rates for overtime and legal holiday service. 91.39 Section 91.39 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE...

  1. Medical Service Clinical Laboratory Procedures--Bacteriology.

    ERIC Educational Resources Information Center

    Department of the Army, Washington, DC.

    This manual presents laboratory procedures for the differentiation and identification of disease agents from clinical materials. Included are procedures for the collection of specimens, preparation of culture media, pure culture methods, cultivation of the microorganisms in natural and simulated natural environments, and procedures in…

  2. ATM traffic experiments: A laboratory study of service interaction, loss fairness and loss characteristics

    NASA Astrophysics Data System (ADS)

    Helvik, B. E.; Stol, N.

    1995-04-01

    A reference measurement scenario is defined, where an ATM switch (OCTOPUS) is offered traffic from three source types representing the traffic resulting from typical services to be carried by an ATM network. These are high quality video (HQTV), high speed data (HSD) and constant bitrate transfer (CBR). In addition to be typical, these have widely different characteristics. Detailed definitions for these, and other actual source types, are made and entered into the Synthetic Traffic Generator (STG) database. Recommended traffic mixes of these sources are also made. Based on the above, laboratory measurements are carried out to study how the various kinds of traffic influence each other, how fairly the loss is distributed over services and connections, and what are the loss characteristics experienced. (Due to a software error detected in the measurement equipment after the work was concluded, the measurements are carried out with a HSD source with a load less 'aggressive' than intended.) The main findings are: Cell loss is very unfairly distributed among the various connections. During a loss burst, which occurs less frequently than the duration of a typical connection, affects mainly one or a few connections; Cell loss is unfairly distributed among the services. The ratios in the range from HSD: HQTV: CBR = 5 : 1 : 0.85 are observed, and unfairness increases with decreasing load burstiness; The loss characteristics vary during a loss burst, from one burst to the next and between services. Hence, it does not seem feasible to use 'typical-loss-statistics' to study the impairments on various services. In addition some supplementing work is reported.

  3. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

  4. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-26

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2013 Through June 30, 2014...

  5. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-20

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

  6. Optimized resolved rate control of seven-degree-of-freedom Laboratory Telerobotic Manipulator (LTM) with application to three-dimensional graphics simulation

    NASA Technical Reports Server (NTRS)

    Barker, L. Keith; Mckinney, William S., Jr.

    1989-01-01

    The Laboratory Telerobotic Manipulator (LTM) is a seven-degree-of-freedom robot arm. Two of the arms were delivered to Langley Research Center for ground-based research to assess the use of redundant degree-of-freedom robot arms in space operations. Resolved-rate control equations for the LTM are derived. The equations are based on a scheme developed at the Oak Ridge National Laboratory for computing optimized joint angle rates in real time. The optimized joint angle rates actually represent a trade-off, as the hand moves, between small rates (least-squares solution) and those rates which work toward satisfying a specified performance criterion of joint angles. In singularities where the optimization scheme cannot be applied, alternate control equations are devised. The equations developed were evaluated using a real-time computer simulation to control a 3-D graphics model of the LTM.

  7. [ISO 15189 accreditation in clinical microbiology laboratory: general concepts and the status in our laboratory].

    PubMed

    Akyar, Işin

    2009-10-01

    One important trend in the laboratory profession and quality management is the global convergence of laboratory operations. The goal of an accredited medical laboratory is to continue "offering useful laboratory service for diagnosis and treatment of the patients and also aid to the health of the nation". An accredited clinical laboratory is managed by a quality control system, it is competent technically and the laboratory service meets the needs of all its patients and physicians by taking the responsibility of all the medical tests and therapies. For this purpose, ISO 15189 international standard has been prepared by 2003. ISO 15189 standard is originated from the arrangement of ISO 17025 and ISO 9001:2000 standards. Many countries such as England, Germany, France, Canada and Australia have preferred ISO 15189 as their own laboratory accreditation programme, meeting all the requirements of their medical laboratories. The accreditation performance of a clinical microbiology laboratory is mainly based on five essential points; preanalytical, analytical, postanalytical, quality control programmes (internal, external, interlaboratory) and audits (internal, external). In this review article, general concepts on ISO 15189 accreditation standards for the clinical microbiology laboratories have been summarized and the status of a private laboratory (Acibadem LabMed, Istanbul) in Turkey has been discussed.

  8. Scaling of metabolic rate on body mass in small laboratory mammals

    NASA Technical Reports Server (NTRS)

    Pace, N.; Rahlmann, D. F.; Smith, A. H.

    1980-01-01

    The scaling of metabolic heat production rate on body mass is investigated for five species of small laboratory mammal in order to define selection of animals of metabolic rates and size range appropriate for the measurement of changes in the scaling relationship upon exposure to weightlessness in Shuttle/Spacelab experiment. Metabolic rates were measured according to oxygen consumption and carbon dioxide production for individual male and female Swiss-Webster mice, Syrian hamsters, Simonsen albino rats, Hartley guinea pigs and New Zealand white rabbits, which range in mass from 0.05 to 5 kg mature body size, at ages of 1, 2, 3, 5, 8, 12, 18 and 24 months. The metabolic intensity, defined as the heat produced per hour per kg body mass, is found to decrease dramatically with age until the animals are 6 to 8 months old, with little or no sex difference. When plotted on a logarithmic graph, the relation of metabolic rate to total body mass is found to obey a power law of index 0.676, which differs significantly from the classical value of 0.75. When the values for the mice are removed, however, an index of 0.749 is obtained. It is thus proposed that six male animals, 8 months of age, of each of the four remaining species be used to study the effects of gravitational loading on the metabolic energy requirements of terrestrial animals.

  9. Are inspectors' assessments reliable? Ratings of NHS acute hospital trust services in England.

    PubMed

    Boyd, Alan; Addicott, Rachael; Robertson, Ruth; Ross, Shilpa; Walshe, Kieran

    2017-01-01

    The credibility of a regulator could be threatened if stakeholders perceive that assessments of performance made by its inspectors are unreliable. Yet there is little published research on the reliability of inspectors' assessments of health care organizations' services. Objectives We investigated the inter-rater reliability of assessments made by inspectors inspecting acute hospitals in England during the piloting of a new regulatory model implemented by the Care Quality Commission (CQC) during 2013 and 2014. Multi-professional teams of inspectors rated service provision on a four-point scale for each of five domains: safety; effectiveness; caring; responsiveness; and leadership. Methods In an online survey, we asked individual inspectors to assign a domain and a rating to each of 10 vignettes of service information extracted from CQC inspection reports. We used these data to simulate the ratings that might be produced by teams of inspectors. We also observed inspection teams in action, and interviewed inspectors and staff from hospitals that had been inspected. Results Levels of agreement varied substantially from vignette to vignette. Characteristics such as professional background explained only a very small part of the variation. Overall, agreement was higher on ratings than on domains, and for groups of inspectors compared with individual inspectors. A number of potential causes of disagreement were identified, such as differences regarding the weight that should be given to contextual factors and general uncertainty about interpreting the rating and domain categories. Conclusion Groups of inspectors produced more reliable assessments than individual inspectors, and there is evidence to support the utility of appropriate discussions between inspectors in improving reliability. The reliability of domain allocations was lower than for ratings. It is important to define categories and rating levels clearly, and to train inspectors in their use. Further research

  10. Will available bit rate (ABR) services give us the capability to offer virtual LANs over wide-area ATM networks?

    NASA Astrophysics Data System (ADS)

    Ferrandiz, Ana; Scallan, Gavin

    1995-10-01

    The available bit rate (ABR) service allows connections to exceed their negotiated data rates during the life of the connections when excess capacity is available in the network. These connections are subject to flow control from the network in the event of network congestion. The ability to dynamically adjust the data rate of the connection can provide improved utilization of the network and be a valuable service to end users. ABR type service is therefore appropriate for the transmission of bursty LAN traffic over a wide area network in a manner that is more efficient and cost effective than allocating bandwdith at the peak cell rate. This paper describes the ABR service and discusses if it is realistic to operate a LAN like service over a wide area using ABR.

  11. The role of total laboratory automation in a consolidated laboratory network.

    PubMed

    Seaberg, R S; Stallone, R O; Statland, B E

    2000-05-01

    In an effort to reduce overall laboratory costs and improve overall laboratory efficiencies at all of its network hospitals, the North Shore-Long Island Health System recently established a Consolidated Laboratory Network with a Core Laboratory at its center. We established and implemented a centralized Core Laboratory designed around the Roche/Hitachi CLAS Total Laboratory Automation system to perform the general and esoteric laboratory testing throughout the system in a timely and cost-effective fashion. All remaining STAT testing will be performed within the Rapid Response Laboratories (RRLs) at each of the system's hospitals. Results for this laboratory consolidation and implementation effort demonstrated a decrease in labor costs and improved turnaround time (TAT) at the core laboratory. Anticipated system savings are approximately $2.7 million. TATs averaged 1.3 h within the Core Laboratory and less than 30 min in the RRLs. When properly implemented, automation systems can reduce overall laboratory expenses, enhance patient services, and address the overall concerns facing the laboratory today: job satisfaction, decreased length of stay, and safety. The financial savings realized are primarily a result of labor reductions.

  12. The Level of Awareness of Safety Measures Practiced in School Laboratories among Pre-Service Science Teachers at Najran University

    ERIC Educational Resources Information Center

    Fagihi, Yahea Ali

    2018-01-01

    This study is an attempt to identify the level of awareness of safety measures practiced in school laboratories among pre-service Science teachers at Najran University. It also aims to identify the sources of safety measures awareness and the statistically significant differences among the sample responses due to specialization and grade…

  13. Laboratory Experiments Investigating Glacier Submarine Melt Rates and Circulation in an East Greenland Fjord

    NASA Astrophysics Data System (ADS)

    Cenedese, C.

    2014-12-01

    Idealized laboratory experiments investigate the glacier-ocean boundary dynamics near a vertical 'glacier' (i.e. no floating ice tongue) in a two-layer stratified fluid, similar to Sermilik Fjord where Helheim Glacier terminates. In summer, the discharge of surface runoff at the base of the glacier (subglacial discharge) intensifies the circulation near the glacier and increases the melt rate with respect to that in winter. In the laboratory, the effect of subglacial discharge is simulated by introducing fresh water at melting temperatures from either point or line sources at the base of an ice block representing the glacier. The circulation pattern observed both with and without subglacial discharge resembles those observed in previous studies. The buoyant plume of cold meltwater and subglacial discharge water entrains ambient water and rises vertically until it finds either the interface between the two layers or the free surface. The results suggest that the meltwater deposits within the interior of the water column and not entirely at the free surface, as confirmed by field observations. The submarine melt rate increases with the subglacial discharge rate. Furthermore, the same subglacial discharge causes greater submarine melting if it exits from a point source rather than from a line source. When the subglacial discharge exits from two point sources, two buoyant plumes are formed which rise vertically and interact. The results suggest that the distance between the two subglacial discharges influences the entrainment in the plumes and consequently the amount of submarine melting and the final location of the meltwater within the water column. Hence, the distribution and number of sources of subglacial discharge may play an important role in glacial melt rates and fjord stratification and circulation. Support was given by NSF project OCE-113008.

  14. GROSS N TRANSFORMATION RATES AND MICROBIAL POPULATION DYNAMICS UNDER FIELD AND LABORATORY CONDITIONS FROM TWO DIFFERENT ECOSYSTEMS

    EPA Science Inventory

    Change of soil and environmental conditions can influence microbial activities and subsequent soil nitrogen (N) transformation processes. The objective of this study was to compare gross N transformation rates between field and laboratory incubation conditions using an old-field...

  15. Consolidated clinical microbiology laboratories.

    PubMed

    Sautter, Robert L; Thomson, Richard B

    2015-05-01

    The manner in which medical care is reimbursed in the United States has resulted in significant consolidation in the U.S. health care system. One of the consequences of this has been the development of centralized clinical microbiology laboratories that provide services to patients receiving care in multiple off-site, often remote, locations. Microbiology specimens are unique among clinical specimens in that optimal analysis may require the maintenance of viable organisms. Centralized laboratories may be located hours from patient care settings, and transport conditions need to be such that organism viability can be maintained under a variety of transport conditions. Further, since the provision of rapid results has been shown to enhance patient care, effective and timely means for generating and then reporting the results of clinical microbiology analyses must be in place. In addition, today, increasing numbers of patients are found to have infection caused by pathogens that were either very uncommon in the past or even completely unrecognized. As a result, infectious disease specialists, in particular, are more dependent than ever on access to high-quality diagnostic information from clinical microbiology laboratories. In this point-counterpoint discussion, Robert Sautter, who directs a Charlotte, NC, clinical microbiology laboratory that provides services for a 40-hospital system spread over 3 states in the southeastern United States explains how an integrated clinical microbiology laboratory service has been established in a multihospital system. Richard (Tom) Thomson of the NorthShore University HealthSystem in Evanston, IL, discusses some of the problems and pitfalls associated with large-scale laboratory consolidation. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  16. Testing an Adapted Modified Delphi Method: Synthesizing Multiple Stakeholder Ratings of Health Care Service Effectiveness.

    PubMed

    Escaron, Anne L; Chang Weir, Rosy; Stanton, Petra; Vangala, Sitaram; Grogan, Tristan R; Clarke, Robin M

    2016-03-01

    The Affordable Care Act incentivizes health systems for better meeting patient needs, but often guidance about patient preferences for particular health services is limited. All too often vulnerable patient populations are excluded from these decision-making settings. A community-based participatory approach harnesses the in-depth knowledge of those experiencing barriers to health care. We made three modifications to the RAND-UCLA appropriateness method, a modified Delphi approach, involving patients, adding an advisory council group to characterize existing knowledge in this little studied area, and using effectiveness rather than "appropriateness" as the basis for rating. As a proof of concept, we tested this method by examining the broadly delivered but understudied nonmedical services that community health centers provide. This method created discrete, new knowledge about these services by defining 6 categories and 112 unique services and by prioritizing among these services based on effectiveness using a 9-point scale. Consistent with the appropriateness method, we found statistical convergence of ratings among the panelists. Challenges include time commitment and adherence to a clear definition of effectiveness of services. This diverse stakeholder engagement method efficiently addresses gaps in knowledge about the effectiveness of health care services to inform population health management. © 2015 Society for Public Health Education.

  17. Cost containment: strategies and responsibilities of the laboratory manager.

    PubMed

    Martin, B G

    1985-12-01

    In these difficult times we must not lose the sense of purpose and the personal drive that makes it possible to achieve excellence. We can be exasperated with reduced funding, burdened with excuses, debilitated with confusion about budgetary cuts, and even be stubborn about alternatives, but we must be serious about excellence and quality. It is natural that during these times we will face those with conflicting views, negative ideas, and erratic long-term goals, but that in itself should rouse us, as professionals, toward the pursuit of quality health care services. With better scheduling of tests and procedure, improved discharge planning, more careful review of the need for patient hospitalization, and a more careful examination of the number, mix, and quality of services furnished during a patient's hospital stay, we, as a health care team, can and will reduce unnecessary utilization of all services. Well-managed laboratories must operate around a return on investment threshold, from which all products, services, and expenditures are ranked. On this basis, management decisions will be made to add to service, reduce service, improve or sustain quality, change technology, or discontinue the business altogether. Given the mandate embodied in the DRG regulations, laboratories have become cost centers. New ideas, new technology, and creative efforts must now be used to improve laboratory productivity while sustaining quality health care services. It is argued philosophically that the DRGs or other major measures to reduce funding adversely affect quality of service. This may be true under the traditional definition of services, but there must be "a new order of things." Today's complex problems indicate that orthodox solutions no longer apply, and in our quest to answer who should pay versus who should receive, and how much is enough, we must ensure quality of all services offered. This new order of doing things could result in far greater savings than has

  18. Rural-Urban Differences in Suicide Rates for Current Patients of a Public Mental Health Service in Australia

    ERIC Educational Resources Information Center

    Sankaranarayanan, Anoop; Carter, Gregory; Lewin, Terry

    2010-01-01

    Rural versus urban rates of suicide in current patients of a large area mental health service in Australia were compared. Suicide deaths were identified from compulsory root cause analyses of deaths, 2003-2007. Age-standardized rates of suicide were calculated for rural versus urban mental health service and compared using variance of…

  19. National survey on turnaround time of clinical biochemistry tests in 738 laboratories in China.

    PubMed

    Zhang, Xiaoyan; Fei, Yang; Wang, Wei; Zhao, Haijian; Wang, Minqi; Chen, Bingquan; Zhou, Jie; Wang, Zhiguo

    2018-02-01

    This survey was initiated to estimate the current status of turnaround time (TAT) monitoring of clinical biochemistry in China, provide baseline data for establishment of quality specifications and analyze the impact factors of TAT. 738 laboratories were included. Questionnaires involved general information and data of related indicators of TAT during 1 week were provided to participating laboratories. Nine quality indicators were covered, which were medians, 90th and outlier rates of pre-examination, examination, and post-examination TAT. The 25th percentile, median, and 75th percentile of TATs were calculated as optimum, desirable, and minimum quality specifications. Percentages and sigma values were used to describe the outlier rates. Mann-Whitney and Kruskal-Wallis tests were used to identify the potential impacts of TAT. Response rate of this survey was 46.44%. More than 50% of the laboratories indicated they had set up target TATs in three time intervals and monitored TATs generally. The post-examination TAT of most laboratories was 0min, while the pre-examination and examination TAT varied. Sigma values of outlier rates for 45%~60% of laboratories were above 4, while 15%~20% of labs whose sigma values were below 3. Group comparisons suggested nurse or mechanical pipeline transportation, link laboratory information system with hospital information system, and using computer reporting instead of printing report were related to shorter TATs. Despite of the remarkable progresses of TATs in China, there was also room to improve. Laboratories should strengthen the construction of information systems, identify reasons for TAT delay to improve the service quality continuously. © 2017 Wiley Periodicals, Inc.

  20. Laboratory Animal Technician | Center for Cancer Research

    Cancer.gov

    PROGRAM DESCRIPTION The Laboratory Animal Sciences Program (LASP) provides exceptional quality animal care and technical support services for animal research performed at the National Cancer Institute at the Frederick National Laboratory for Cancer Research. LASP executes this mission by providing a broad spectrum of state-of-the-art technologies and services that are focused

  1. 78 FR 44954 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Clinical... and Human Services; the Assistant Secretary for Health; the Director, Centers for Disease Control and... laboratory quality and laboratory [[Page 44955

  2. 76 FR 59682 - Desert Southwest Customer Service Region-Western Area Lower Colorado Balancing Authority-Rate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... percentage of metered generation, since there is no load. 2. Intermittent resources are exempt from the outer...--Western Area Lower Colorado Balancing Authority--Rate Order No. WAPA-151 AGENCY: Western Area Power... Services Formula Rates. SUMMARY: The Deputy Secretary of Energy has confirmed and approved Rate Order No...

  3. Initiatives toward effective decision making and laboratory use.

    PubMed

    Benson, E S

    1980-09-01

    Escalating health care costs constitute a public issue of paramount importance today, Among the leading growth factors in this rise is the cost of hospital services, notably laboratory services. With respect to the clinical laboratory, rising costs appear to be almost entirely attributable to expanding utilization and introduction of new services. The clinical laboratory has gone through a technological revolution in two decades that has changed it from a largely manual to a highly automated system of great speed and capacity. This change had produced a change in the style of providing services, a change that includes the provision of quantities of unsolicited data. A parallel change in the style of use of the laboratory has taken place on the part of patient care physicians from a relatively sparing, problem oriented use pattern to a relatively lavish, data oriented one. These reciprocal changes have transformed medicine, in the United States, at least, into a relatively high laboratory use culture. Abandonment of the new technology and return to a simpler, more primitive laboratory world would be a drastic and most inappropriate response to the new situation. Furthermore, arbitrary measures such as rationing, quotas, and tariffs are, if enacted, almost certain to fail. The most effective long term strategies, though more demanding of time and effort, lie through modification of physician behavior through the pathways of education and research. Education and research initiatives now in progress can in time influence laboratory use patterns of physicians at all career levels, improving the logic of test use and providing more strategic, prudent, and cost effective overall laboratory utilization practices. These approaches will require much improved communication between laboratory and bedside and a new intense involvement of laboratory physicians and scientists in the tasks of helping to improve the use of laboratory tests and laboratory data.

  4. Managing demand for laboratory tests: a laboratory toolkit.

    PubMed

    Fryer, Anthony A; Smellie, W Stuart A

    2013-01-01

    Healthcare budgets worldwide are facing increasing pressure to reduce costs and improve efficiency, while maintaining quality. Laboratory testing has not escaped this pressure, particularly since pathology investigations cost the National Health Service £2.5 billion per year. Indeed, the Carter Review, a UK Department of Health-commissioned review of pathology services in England, estimated that 20% of this could be saved by improving pathology services, despite an average annual increase of 8%-10% in workload. One area of increasing importance is managing the demands for pathology tests and reducing inappropriate requesting. The Carter Review estimated that 25% of pathology tests were unnecessary, representing a huge potential waste. Certainly, the large variability in levels of requesting between general practitioners suggests that inappropriate requesting is widespread. Unlocking the key to this variation and implementing measures to reduce inappropriate requesting would have major implications for patients and healthcare resources alike. This article reviews the approaches to demand management. Specifically, it aims to (a) define demand management and inappropriate requesting, (b) assess the drivers for demand management, (c) examine the various approaches used, illustrating the potential of electronic requesting and (d) provide a wider context. It will cover issues, such as educational approaches, information technology opportunities and challenges, vetting, duplicate request identification and management, the role of key performance indicators, profile composition and assessment of downstream impact of inappropriate requesting. Currently, many laboratories are exploring demand management using a plethora of disparate approaches. Hence, this review seeks to provide a 'toolkit' with the view to allowing laboratories to develop a standardised demand management strategy.

  5. 42 CFR 493.1445 - Standard; Laboratory director responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... quality laboratory services for all aspects of test performance, which includes the preanalytic, analytic... result is found to be unacceptable or unsatisfactory; (5) Ensure that the quality control and quality assessment programs are established and maintained to assure the quality of laboratory services provided and...

  6. 75 FR 5513 - Determination of Rates and Terms for Preexisting Subscription Services and Satellite Digital...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-03

    ... LIBRARY OF CONGRESS Copyright Royalty Board 37 CFR Part 382 [Docket No. 2006-1 CRB DSTRA] Determination of Rates and Terms for Preexisting Subscription Services and Satellite Digital Audio Radio Services AGENCY: Copyright Royalty Board, Library of Congress. ACTION: Final rule. SUMMARY: The Copyright...

  7. 42 CFR 493.1230 - Condition: General laboratory systems.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: General laboratory systems. 493.1230... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing General Laboratory Systems § 493.1230 Condition: General laboratory systems. Each laboratory that...

  8. 47 CFR 76.944 - Commission review of franchising authority decisions on rates for the basic service tier and...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Commission review of franchising authority... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.944 Commission review of franchising authority... forum for appeals of decisions by franchising authorities on rates for the basic service tier or...

  9. Miniaturization and globalization of clinical laboratory activities.

    PubMed

    Melo, Murilo R; Clark, Samantha; Barrio, Daniel

    2011-04-01

    Clinical laboratories provide an invaluable service to millions of people around the world in the form of quality diagnostic care. Within the clinical laboratory industry the impetus for change has come from technological development (miniaturization, nanotechnology, and their collective effect on point-of-care testing; POCT) and the increasingly global nature of laboratory services. Potential technological gains in POCT include: the development of bio-sensors, microarrays, genetics and proteomics testing, and enhanced web connectivity. In globalization, prospective opportunities lie in: medical tourism, the migration of healthcare workers, cross-border delivery of testing, and the establishment of accredited laboratories in previously unexplored markets. Accompanying these impressive opportunities are equally imposing challenges. Difficulty transitioning from research to clinical use, poor infrastructure in developing countries, cultural differences and national barriers to global trade are only a few examples. Dealing with the issues presented by globalization and the impact of developing technology on POCT, and on the clinical laboratory services industry in general, will be a daunting task. Despite such concerns, with appropriate countermeasures it will be possible to address the challenges posed. Future laboratory success will be largely dependent on one's ability to adapt in this perpetually shifting landscape.

  10. [Effects of breast-feeding education and support services on breast-feeding rates and infant's growth].

    PubMed

    Jang, Gun-Ja; Kim, Sun-Hee

    2010-04-01

    This study was done to investigate the effects of breast-feeding education and support services on rate of breast-feeding three and six months after birth, and the effect on infant's growth (weight, height, body mass index [BMI]). The experimental group which had both education and support services was compared with the control group which had only breast-feeding education. This study was a quasi-experimental study with a time-series design. The participants were 39 mothers who were hospitalized for childbirth. Twenty mother were assigned to the experimental group and 19 mothers, to the control group. The breast feeding education was done during hospitalization, and support services were provided once a week after discharge for a month (a total 4 times) by a maternity ward nurse. Data regarding breastfeeding rate at one month after childbirth was collected by phone call; the breast-feeding rates at three and six months after childbirth were collected in a visit to the families. The child's weight and height were also measured during the visit. The experimental group had a statistically significant higher rate for frequency of breast-feeding at one, three and six months after childbirth than the control group. However, there was no meaningful difference between the two groups for infant growth. The results of this study suggest that breast-feeding education is helpful for a start, but support services are also necessary to sustain breast-feeding.

  11. Clinical laboratory: bigger is not always better.

    PubMed

    Plebani, Mario

    2018-06-27

    Laboratory services around the world are undergoing substantial consolidation and changes through mechanisms ranging from mergers, acquisitions and outsourcing, primarily based on expectations to improve efficiency, increasing volumes and reducing the cost per test. However, the relationship between volume and costs is not linear and numerous variables influence the end cost per test. In particular, the relationship between volumes and costs does not span the entire platter of clinical laboratories: high costs are associated with low volumes up to a threshold of 1 million test per year. Over this threshold, there is no linear association between volumes and costs, as laboratory organization rather than test volume more significantly affects the final costs. Currently, data on laboratory errors and associated diagnostic errors and risk for patient harm emphasize the need for a paradigmatic shift: from a focus on volumes and efficiency to a patient-centered vision restoring the nature of laboratory services as an integral part of the diagnostic and therapy process. Process and outcome quality indicators are effective tools to measure and improve laboratory services, by stimulating a competition based on intra- and extra-analytical performance specifications, intermediate outcomes and customer satisfaction. Rather than competing with economic value, clinical laboratories should adopt a strategy based on a set of harmonized quality indicators and performance specifications, active laboratory stewardship, and improved patient safety.

  12. Laboratory Integration and Consolidation in a Regional Health System.

    PubMed

    Cook, Jim

    2017-08-01

    Health systems face intense pressure to decrease costs and improve services as the health care delivery system in the United States undergoes tremendous change due to health care reform. As health systems grow, like any business, they are forced to explore standardization to realize and maintain efficient practices. Clinical services, such as laboratory medicine, are more difficult to integrate due to wider variation in acceptable practice and culture, compared with other services. However, changes to laboratory service are imperative if health care professionals expect to survive and thrive in the new business environment. In this article, I describe the advocation efforts of the System Laboratory Council group toward implementation of a standardization process that we call integration, to improve the efficiency of the Laboratory Services department of our health system, the University of Maryland Medical System (UMMS). © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Numerical Investigation of Earthquake Nucleation on a Laboratory-Scale Heterogeneous Fault with Rate-and-State Friction

    NASA Astrophysics Data System (ADS)

    Higgins, N.; Lapusta, N.

    2014-12-01

    Many large earthquakes on natural faults are preceded by smaller events, often termed foreshocks, that occur close in time and space to the larger event that follows. Understanding the origin of such events is important for understanding earthquake physics. Unique laboratory experiments of earthquake nucleation in a meter-scale slab of granite (McLaskey and Kilgore, 2013; McLaskey et al., 2014) demonstrate that sample-scale nucleation processes are also accompanied by much smaller seismic events. One potential explanation for these foreshocks is that they occur on small asperities - or bumps - on the fault interface, which may also be the locations of smaller critical nucleation size. We explore this possibility through 3D numerical simulations of a heterogeneous 2D fault embedded in a homogeneous elastic half-space, in an attempt to qualitatively reproduce the laboratory observations of foreshocks. In our model, the simulated fault interface is governed by rate-and-state friction with laboratory-relevant frictional properties, fault loading, and fault size. To create favorable locations for foreshocks, the fault surface heterogeneity is represented as patches of increased normal stress, decreased characteristic slip distance L, or both. Our simulation results indicate that one can create a rate-and-state model of the experimental observations. Models with a combination of higher normal stress and lower L at the patches are closest to matching the laboratory observations of foreshocks in moment magnitude, source size, and stress drop. In particular, we find that, when the local compression is increased, foreshocks can occur on patches that are smaller than theoretical critical nucleation size estimates. The additional inclusion of lower L for these patches helps to keep stress drops within the range observed in experiments, and is compatible with the asperity model of foreshock sources, since one would expect more compressed spots to be smoother (and hence have

  14. AMT's Position on Physician's Office Laboratories.

    ERIC Educational Resources Information Center

    AMT Events, 1986

    1986-01-01

    The following standards are affirmed by the American Medical Technologists organization: (1) regardless of the size of the laboratory setting, the patient deserves the highest quality of laboratory service available; (2) certified personnel should be employed by physicians in office laboratories; (3) quality control should be mandatory and…

  15. Towards the VWO Annotation Service: a Success Story of the IMAGE RPI Expert Rating System

    NASA Astrophysics Data System (ADS)

    Reinisch, B. W.; Galkin, I. A.; Fung, S. F.; Benson, R. F.; Kozlov, A. V.; Khmyrov, G. M.; Garcia, L. N.

    2010-12-01

    Interpretation of Heliophysics wave data requires specialized knowledge of wave phenomena. Users of the virtual wave observatory (VWO) will greatly benefit from a data annotation service that will allow querying of data by phenomenon type, thus helping accomplish the VWO goal to make Heliophysics wave data searchable, understandable, and usable by the scientific community. Individual annotations can be sorted by phenomenon type and reduced into event lists (catalogs). However, in contrast to the event lists, annotation records allow a greater flexibility of collaborative management by more easily admitting operations of addition, revision, or deletion. They can therefore become the building blocks for an interactive Annotation Service with a suitable graphic user interface to the VWO middleware. The VWO Annotation Service vision is an interactive, collaborative sharing of domain expert knowledge with fellow scientists and students alike. An effective prototype of the VWO Annotation Service has been in operation at the University of Massachusetts Lowell since 2001. An expert rating system (ERS) was developed for annotating the IMAGE radio plasma imager (RPI) active sounding data containing 1.2 million plasmagrams. The RPI data analysts can use ERS to submit expert ratings of plasmagram features, such as presence of echo traces resulted from reflected RPI signals from distant plasma structures. Since its inception in 2001, the RPI ERS has accumulated 7351 expert plasmagram ratings in 16 phenomenon categories, together with free-text descriptions and other metadata. In addition to human expert ratings, the system holds 225,125 ratings submitted by the CORPRAL data prospecting software that employs a model of the human pre-attentive vision to select images potentially containing interesting features. The annotation records proved to be instrumental in a number of investigations where manual data exploration would have been prohibitively tedious and expensive

  16. 21 CFR 225.158 - Laboratory assays.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Laboratory assays. 225.158 Section 225.158 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... Laboratory assays. Where the results of laboratory assays of drug components, including assays by State feed...

  17. 21 CFR 225.158 - Laboratory assays.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Laboratory assays. 225.158 Section 225.158 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... Laboratory assays. Where the results of laboratory assays of drug components, including assays by State feed...

  18. Pre-Service and Beginning Teachers Rate the Utility of Virtual Museum Exhibits

    ERIC Educational Resources Information Center

    Iding, Marie; Nordbotten, Joan

    2011-01-01

    This study investigated criteria that 91 pre-service teachers used to evaluate award-winning virtual museum exhibits for future use in teaching. Individual differences affected ratings, including teaching experience, age and gender. A categorization of participants' reasons for selection included audience level, site design and information…

  19. Current and Projected Modes of Delivery of Veterinary Medical Services to Animal Agriculture: Diagnostic Laboratory Services.

    ERIC Educational Resources Information Center

    Seaton, Vaughn A.

    1980-01-01

    The veterinary diagnostic laboratory's prime role has been diagnosis and/or laboratory findings to assist a diagnosis. Interpretation and evaluation and more involvement with decision-making in monitoring groups of animals and their health status are seen as future roles for diagnostic laboratories. (MLW)

  20. Accidental fires in clinical laboratories.

    PubMed

    Hoeltge, G A; Miller, A; Klein, B R; Hamlin, W B

    1993-12-01

    The National Fire Protection Association, Quincy, Mass, estimates that 169 fires have occurred annually in health care, medical, and chemical laboratories. On the average, there are 13 civilian injuries and $1.5 million per year in direct property damage. Most fires in which the cause or ignition source can be identified originate in malfunctioning electrical equipment (41.6%) or in the facility's electrical distribution system (14.7%). The prevalence of fire safety deficiencies was measured in the College of American Pathologists Laboratory Accreditation Program. Of the 1732 inspected laboratories, 5.5% lacked records of electrical receptacle polarity and ground checks in the preceding year. Of these inspected laboratories, 4.7% had no or incomplete documentation of electrical safety checks on laboratory instruments. There was no evidence of quarterly fire exit drills in 9% of the laboratories. Deficiencies were also found in precautionary labeling (6.8%), in periodic review of safe work practices (4.2%), in the use of safety cans (3.7%), and in venting of flammable liquid storage areas (2.8%). Fire preparedness would be improved if all clinical laboratories had smoke detectors and automatic fire-extinguishing systems. In-service training courses in fire safety should be targeted to the needs of specific service areas.

  1. 42 CFR 493.25 - Laboratories performing tests of high complexity.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Laboratories performing tests of high complexity. 493.25 Section 493.25 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS General Provisions § 493.25 Laboratories performing tests of high...

  2. 42 CFR 493.20 - Laboratories performing tests of moderate complexity.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Laboratories performing tests of moderate complexity. 493.20 Section 493.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS General Provisions § 493.20 Laboratories performing tests of...

  3. Commercialization of a DOE Laboratory

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Stephenson, Barry A.

    2008-01-15

    On April 1, 1998, Materials and Chemistry Laboratory, Inc. (MCLinc) began business as an employee-owned, commercial, applied research laboratory offering services to both government and commercial clients. The laboratory had previously been a support laboratory to DoE's gaseous diffusion plant in Oak Ridge (K-25). When uranium enrichment was halted at the site, the laboratory was expanded to as an environmental demonstration center and served from 1992 until 1997 as a DOE Environmental User Facility. In 1997, after the laboratory was declared surplus, it was made available to the employee group who operated the laboratory for DOE as a government-owned, contractor-operatedmore » facility. This paper describes briefly the process of establishing the business. Attributes that contributed to the success of MCLinc are described. Some attention is given to lessons learned and to changes that could facilitate future attempts to make similar transitions. Lessons learnt: as with any business venture, operation over time has revealed that some actions taken by the laboratory founders have contributed to its successful operation while others were not so successful. Observations are offered in hopes that lessons learned may suggest actions that will facilitate future attempts to make similar transitions. First, the decision to vest significant ownership of the business in the core group of professionals operating the business is key to its success. Employee-owners of the laboratory have consistently provided a high level of service to its customers while conducting business in a cost-efficient manner. Secondly, an early decision to provide business support services in-house rather than purchasing them from support contractors on site have proven cost-effective. Laboratory employees do multiple tasks and perform overhead tasks in addition to their chargeable technical responsibilities. Thirdly, assessment of technical capabilities in view of market needs and a decision to

  4. Veterinary Laboratory Services Study - 1976.

    DTIC Science & Technology

    1976-09-01

    rabies , equine infectious anemia and other zoonotic and animal dis— eases has actually increased or increase in this area is p lanned. Some special...functions were transferred to the Department of Chemistry in October 1975. A sheep flock is main- tained and sheep blood is supplied to clinical...since several dv~guostic procedures involving zoonotic diseases are done there. Their ciagnostic service could be considered a prototype for other Medical

  5. 78 FR 23053 - Determination of Rates and Terms for Preexisting Subscription Services and Satellite Digital...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ...The Copyright Royalty Judges are announcing their final determination of the rates and terms for the digital transmission of sound recordings and the reproduction of ephemeral recordings by preexisting subscription services and preexisting satellite digital audio radio services for the period beginning January 1, 2013, and ending on December 31, 2017.

  6. 18 CFR 35.17 - Withdrawals and amendments of rate schedule, tariff or service agreement filings.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... service agreement filings prior to Commission action. (1) A public utility may withdraw in its entirety a... Commission or delegated order has been issued by filing a withdrawal motion with the Commission. Upon the filing of such motion, the proposed rate schedule, tariff or service agreement sections will not become...

  7. Assessment of post-laparotomy pain in laboratory mice by telemetric recording of heart rate and heart rate variability

    PubMed Central

    Arras, Margarete; Rettich, Andreas; Cinelli, Paolo; Kasermann, Hans P; Burki, Kurt

    2007-01-01

    Background Pain of mild to moderate grade is difficult to detect in laboratory mice because mice are prey animals that attempt to elude predators or man by hiding signs of weakness, injury or pain. In this study, we investigated the use of telemetry to identify indicators of mild-to-moderate post-laparotomy pain. Results Adult mice were subjected to laparotomy, either combined with pain treatment (carprofen or flunixin, 5 mg/kg s/c bid, for 1 day) or without pain relief. Controls received anesthesia and analgesics or vehicle only. Telemetrically measured locomotor activity was undisturbed in all animals, thus confirming that any pain experienced was of the intended mild level. No symptoms of pain were registered in any of the groups by scoring the animals' outer appearance or spontaneous and provoked behavior. In contrast, the group receiving no analgesic treatment after laparotomy demonstrated significant changes in telemetry electrocardiogram recordings: increased heart rate and decreased heart rate variability parameters pointed to sympathetic activation and pain lasting for 24 hours. In addition, core body temperature was elevated. Body weight and food intake were reduced for 3 and 2 days, respectively. Moreover, unstructured cage territory and destroyed nests appeared for 1–2 days in an increased number of animals in this group only. In controls these parameters were not affected. Conclusion In conclusion, real-time telemetric recordings of heart rate and heart rate variability were indicative of mild-to-moderate post-laparotomy pain and could define its duration in our mouse model. This level of pain cannot easily be detected by direct observation. PMID:17683523

  8. Phenomenological Modeling and Laboratory Simulation of Long-Term Aging of Asphalt Mixtures

    NASA Astrophysics Data System (ADS)

    Elwardany, Michael Dawoud

    The accurate characterization of asphalt mixture properties as a function of pavement service life is becoming more important as more powerful pavement design and performance prediction methods are implemented. Oxidative aging is a major distress mechanism of asphalt pavements. Aging increases the stiffness and brittleness of the material, which leads to a high cracking potential. Thus, an improved understanding of the aging phenomenon and its effect on asphalt binder chemical and rheological properties will allow for the prediction of mixture properties as a function of pavement service life. Many researchers have conducted laboratory binder thin-film aging studies; however, this approach does not allow for studying the physicochemical effects of mineral fillers on age hardening rates in asphalt mixtures. Moreover, aging phenomenon in the field is governed by kinetics of binder oxidation, oxygen diffusion through mastic phase, and oxygen percolation throughout the air voids structure. In this study, laboratory aging trials were conducted on mixtures prepared using component materials of several field projects throughout the USA and Canada. Laboratory aged materials were compared against field cores sampled at different ages. Results suggested that oven aging of loose mixture at 95°C is the most promising laboratory long-term aging method. Additionally, an empirical model was developed in order to account for the effect of mineral fillers on age hardening rates in asphalt mixtures. Kinetics modeling was used to predict field aging levels throughout pavement thickness and to determine the required laboratory aging duration to match field aging. Kinetics model outputs are calibrated using measured data from the field to account for the effects of oxygen diffusion and percolation. Finally, the calibrated model was validated using independent set of field sections. This work is expected to provide basis for improved asphalt mixture and pavement design procedures in

  9. [Accreditation of medical laboratories].

    PubMed

    Horváth, Andrea Rita; Ring, Rózsa; Fehér, Miklós; Mikó, Tivadar

    2003-07-27

    In Hungary, the National Accreditation Body was established by government in 1995 as an independent, non-profit organization, and has exclusive rights to accredit, amongst others, medical laboratories. The National Accreditation Body has two Specialist Advisory Committees in the health care sector. One is the Health Care Specialist Advisory Committee that accredits certifying bodies, which deal with certification of hospitals. The other Specialist Advisory Committee for Medical Laboratories is directly involved in accrediting medical laboratory services of health care institutions. The Specialist Advisory Committee for Medical Laboratories is a multidisciplinary peer review group of experts from all disciplines of in vitro diagnostics, i.e. laboratory medicine, microbiology, histopathology and blood banking. At present, the only published International Standard applicable to laboratories is ISO/IEC 17025:1999. Work has been in progress on the official approval of the new ISO 15189 standard, specific to medical laboratories. Until the official approval of the International Standard ISO 15189, as accreditation standard, the Hungarian National Accreditation Body has decided to progress with accreditation by formulating explanatory notes to the ISO/IEC 17025:1999 document, using ISO/FDIS 15189:2000, the European EC4 criteria and CPA (UK) Ltd accreditation standards as guidelines. This harmonized guideline provides 'explanations' that facilitate the application of ISO/IEC 17025:1999 to medical laboratories, and can be used as a checklist for the verification of compliance during the onsite assessment of the laboratory. The harmonized guideline adapted the process model of ISO 9001:2000 to rearrange the main clauses of ISO/IEC 17025:1999. This rearrangement does not only make the guideline compliant with ISO 9001:2000 but also improves understanding for those working in medical laboratories, and facilitates the training and education of laboratory staff. With the

  10. Development opportunities for hospital clinical laboratory joint ventures.

    PubMed

    Van Riper, J A

    1995-01-01

    Regional health-care providers are being given the opportunity to collaborate in specialty health-care services. Collaboration to achieve superior economies of scale is very effective in the clinical laboratory industry. National laboratory chains are consolidating and enhancing their control of the industry to ensure their historic profitability. National companies have closed many laboratory facilities and have laid off substantial numbers of laboratory personnel. Health-care providers can regain control of their locally generated laboratory health-care dollars by joining forces with clinical laboratory joint ventures. Laboratorians can assist the healthcare providers in bringing laboratory services and employment back to the local community. New capital for operational development and laboratory information systems will help bring the laboratory to the point of care. The independent regional laboratory is focused on supporting the medical needs of the community. The profit generated from a laboratory joint venture is shared among local health-care providers, supporting their economic viability. The laboratories' ability to contribute to the development of profit-making ventures will provide capital for new laboratory development. All of the above will ensure the clinical laboratories' role in providing quality health care to our communities and employment opportunities for laboratory personnel.

  11. Reinventing Information Services.

    ERIC Educational Resources Information Center

    Farkas-Conn, Irene; And Others

    1996-01-01

    This special section includes seven articles that discuss reinventing information services. Highlights include linking information services to business strategies; meeting client initiatives; information services at the Ottawa laboratory of Bell-Northern Research (BNR); product service strategies; information management and transition economies;…

  12. Effectiveness of distinct mulch application rates and schemes under laboratory conditions

    NASA Astrophysics Data System (ADS)

    Prats, Sergio; Abrantes, Joao; Crema, Isabela; Keizer, Jacob; de Lima, Joao

    2017-04-01

    Post-fire forest residue mulching using eucalypt bark strands have been proven effective for reducing hillslope runoff and erosion in field plots of different sizes. Application rates of around 8-10 Mg ha-1 achieved about 80% of protective soil surface. Lower application rates, however, would reduce costs and, possibly, also allow faster application, which could be especially critical in late summer high-severity fires. Such lower rates could be achieved by applying less mulch per unit area, by applying mulch in specific zones (strips) and by removing the finest fractions, especially since these can be expected to contribute little to reduce erosion risk. The objective of this laboratory study was to identify the threshold, or the minimum application rate, at which a new mulch blend (without the fraction ≤4 cm) would effectively control runoff and erosion. Two levels of ground cover by forest residue mulch (50 and 70%) and three mulch strips (of 1/3, 2/3 and 3/3) at the bottom of the flume were tested against the untreated bare soil, by applying simulated rainfall and simulated inflow. The seven treatments were replicated three times using a 2.7 m x 0.3 m soil flume with a 40% slope, filled with a dry loamy sand soil. Each experiment included: (i) a "Dry" soil run comprising 20 min of simulated rainfall at a rate of 56 mm h-1; (ii) a "Wet" soil run with the same rainfall characteristics; (iii) a "Flow" run combining 20 min of rainfall with three inflows at increasing rates (52, 110, 232 mm h-1) on nearly saturated soil. The results showed that runoff, interrill and rill erosion were strongly reduced by covering 3/3 and 2/3 of the flume with mulch at 70% ground cover (overall mulch application rates of 2.6 and 1.3 Mg ha-1). The 1/3 mulch strip at 70% mulch cover (application rate of 1 Mg ha-1) also reduced significantly erosion but not runoff. The mulch strips at 50% were less effective, and only the application over the whole plot was able to reduce interrill and

  13. Terminology modeling for an enterprise laboratory orders catalog.

    PubMed

    Zhou, Li; Goldberg, Howard; Pabbathi, Deepika; Wright, Adam; Goldman, Debora S; Van Putten, Cheryl; Barley, Amanda; Rocha, Roberto A

    2009-11-14

    Laboratory test orders are used in a variety of clinical information systems at Partners HealthCare. At present, each site at Partners manages its own set of laboratory orders with locally defined codes. Our current plan is to implement an enterprise catalog, where laboratory test orders are mapped to reference terminologies and codes from different sites are mapped to each other. This paper describes the terminology modeling effort that preceded the implementation of the enterprise laboratory orders catalog. In particular, we present our experience in adapting HL7's "Common Terminology Services 2 - Upper Level Class Model" as a terminology metamodel for guiding the development of fully specified laboratory orders and related services.

  14. Terminology Modeling for an Enterprise Laboratory Orders Catalog

    PubMed Central

    Zhou, Li; Goldberg, Howard; Pabbathi, Deepika; Wright, Adam; Goldman, Debora S.; Van Putten, Cheryl; Barley, Amanda; Rocha, Roberto A.

    2009-01-01

    Laboratory test orders are used in a variety of clinical information systems at Partners HealthCare. At present, each site at Partners manages its own set of laboratory orders with locally defined codes. Our current plan is to implement an enterprise catalog, where laboratory test orders are mapped to reference terminologies and codes from different sites are mapped to each other. This paper describes the terminology modeling effort that preceded the implementation of the enterprise laboratory orders catalog. In particular, we present our experience in adapting HL7’s “Common Terminology Services 2 – Upper Level Class Model” as a terminology metamodel for guiding the development of fully specified laboratory orders and related services. PMID:20351950

  15. Laboratory services series: a programmed maintenance system

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tuxbury, D.C.; Srite, B.E.

    1980-01-01

    The diverse facilities, operations and equipment at a major national research and development laboratory require a systematic, analytical approach to operating equipment maintenance. A computer-scheduled preventive maintenance program is described including program development, equipment identification, maintenance and inspection instructions, scheduling, personnel, and equipment history.

  16. Frequency Regulation Services from Connected Residential Devices: Short Paper

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Baker, Kyri; Jin, Xin; Vaidhynathan, Deepthi

    In this paper, we demonstrate the potential benefits that residential buildings can provide for frequency regulation services in the electric power grid. In a hardware-in-the- loop (HIL) implementation, simulated homes along with a physical laboratory home are coordinated via a grid aggregator, and it is shown that their aggregate response has the potential to follow the regulation signal on a timescale of seconds. Connected (communication-enabled), devices in the National Renewable Energy Laboratory's (NREL's) Energy Systems Integration Facility (ESIF) received demand response (DR) requests from a grid aggregator, and the devices responded accordingly to meet the signal while satisfying user comfortmore » bounds and physical hardware limitations. Future research will address the issues of cybersecurity threats, participation rates, and reducing equipment wear-and-tear while providing grid services.« less

  17. Materials Science Laboratory

    NASA Technical Reports Server (NTRS)

    Jackson, Dionne

    2005-01-01

    The NASA Materials Science Laboratory (MSL) provides science and engineering services to NASA and Contractor customers at KSC, including those working for the Space Shuttle. International Space Station. and Launch Services Programs. These services include: (1) Independent/unbiased failure analysis (2) Support to Accident/Mishap Investigation Boards (3) Materials testing and evaluation (4) Materials and Processes (M&P) engineering consultation (5) Metrology (6) Chemical analysis (including ID of unknown materials) (7) Mechanical design and fabrication We provide unique solutions to unusual and urgent problems associated with aerospace flight hardware, ground support equipment and related facilities.

  18. Laboratory automation: trajectory, technology, and tactics.

    PubMed

    Markin, R S; Whalen, S A

    2000-05-01

    Laboratory automation is in its infancy, following a path parallel to the development of laboratory information systems in the late 1970s and early 1980s. Changes on the horizon in healthcare and clinical laboratory service that affect the delivery of laboratory results include the increasing age of the population in North America, the implementation of the Balanced Budget Act (1997), and the creation of disease management companies. Major technology drivers include outcomes optimization and phenotypically targeted drugs. Constant cost pressures in the clinical laboratory have forced diagnostic manufacturers into less than optimal profitability states. Laboratory automation can be a tool for the improvement of laboratory services and may decrease costs. The key to improvement of laboratory services is implementation of the correct automation technology. The design of this technology should be driven by required functionality. Automation design issues should be centered on the understanding of the laboratory and its relationship to healthcare delivery and the business and operational processes in the clinical laboratory. Automation design philosophy has evolved from a hardware-based approach to a software-based approach. Process control software to support repeat testing, reflex testing, and transportation management, and overall computer-integrated manufacturing approaches to laboratory automation implementation are rapidly expanding areas. It is clear that hardware and software are functionally interdependent and that the interface between the laboratory automation system and the laboratory information system is a key component. The cost-effectiveness of automation solutions suggested by vendors, however, has been difficult to evaluate because the number of automation installations are few and the precision with which operational data have been collected to determine payback is suboptimal. The trend in automation has moved from total laboratory automation to a

  19. Pharmacology Portal: An Open Database for Clinical Pharmacologic Laboratory Services.

    PubMed

    Karlsen Bjånes, Tormod; Mjåset Hjertø, Espen; Lønne, Lars; Aronsen, Lena; Andsnes Berg, Jon; Bergan, Stein; Otto Berg-Hansen, Grim; Bernard, Jean-Paul; Larsen Burns, Margrete; Toralf Fosen, Jan; Frost, Joachim; Hilberg, Thor; Krabseth, Hege-Merete; Kvan, Elena; Narum, Sigrid; Austgulen Westin, Andreas

    2016-01-01

    More than 50 Norwegian public and private laboratories provide one or more analyses for therapeutic drug monitoring or testing for drugs of abuse. Practices differ among laboratories, and analytical repertoires can change rapidly as new substances become available for analysis. The Pharmacology Portal was developed to provide an overview of these activities and to standardize the practices and terminology among laboratories. The Pharmacology Portal is a modern dynamic web database comprising all available analyses within therapeutic drug monitoring and testing for drugs of abuse in Norway. Content can be retrieved by using the search engine or by scrolling through substance lists. The core content is a substance registry updated by a national editorial board of experts within the field of clinical pharmacology. This ensures quality and consistency regarding substance terminologies and classification. All laboratories publish their own repertoires in a user-friendly workflow, adding laboratory-specific details to the core information in the substance registry. The user management system ensures that laboratories are restricted from editing content in the database core or in repertoires within other laboratory subpages. The portal is for nonprofit use, and has been fully funded by the Norwegian Medical Association, the Norwegian Society of Clinical Pharmacology, and the 8 largest pharmacologic institutions in Norway. The database server runs an open-source content management system that ensures flexibility with respect to further development projects, including the potential expansion of the Pharmacology Portal to other countries. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  20. [CAP quality management system in clinical laboratory and its issue].

    PubMed

    Tazawa, Hiromitsu

    2004-03-01

    The CAP (College of American Pathologists) was established in 1962 and, at present, CAP-accredited laboratories include about 6000 institutions all over the world, mainly in the U.S. The essential purpose of CAP accreditation is high quality reservation and improvement of clinical laboratory services for patient care, and is based on seven points, listed below. (1) Establishment of a laboratory management program and laboratory techniques to assure accuracy and improve overall quality of laboratory services. (2) Maintenance and improvement of accuracy objectively by centering on a CAP survey. (3) Thoroughness in safety and health administration. (4) Reservation of the performance of laboratory services by personnel and proficiency management. (5) Provision of appropriate information to physicians, and contribution to improved quality of patient care by close communication with physicians (improvement in patient care). (6) Reduction of running costs and personnel costs based on evidence by employing the above-mentioned criteria. (7) Reduction of laboratory error. In the future, accreditation and/or certification by organizations such as CAP, ISO, etc., may become a requirement for providing any clinical laboratory services in Japan. Taking the essence of the CAP and the characteristics of the new international standard, ISO151589, into consideration, it is important to choose the best suited accreditation and/or certification depending of the purpose of clinical laboratory.

  1. Senior Laboratory Animal Technician | Center for Cancer Research

    Cancer.gov

    PROGRAM DESCRIPTION The Laboratory Animal Sciences Program (LASP) provides exceptional quality animal care and technical support services for animal research performed at the National Cancer Institute at the Frederick National Laboratory for Cancer Research. LASP executes this mission by providing a broad spectrum of state-of-the-art technologies and services that are focused

  2. The effect of carbon dioxide flow rate on the euthanasia of laboratory mice.

    PubMed

    Moody, C M; Chua, B; Weary, D M

    2014-10-01

    Laboratory rodents are commonly euthanized by exposure to gradually increasing concentrations of carbon dioxide (CO2). Current recommended flow rates range between 10 and 30% chamber vol/min and result in insensibility before exposure to painful concentrations (<40%). However, this method causes dyspnea, indicated by deep, rapid breathing. In humans dyspnea is associated with a negative affective experience. Sensations of dyspnea may explain why rodents find CO2 concentrations >3% aversive. This study aimed to assess the effect of CO2 flow rates on time between the onset of dyspnea and various measures of insensibility (recumbency, loss of the righting reflex and loss of the pedal withdrawal reflex) to identify flow rates that minimize the potential experience of dyspnea. The results of this study indicate that a flow rate of 50% chamber vol/min, while holding the CO2 cage concentration just below 40%, minimizes the interval between the onset of labored breathing and recumbency. Using a 50% flow rate this interval averaged (± SE) 30.3 ± 2.9 s versus 49.7 ± 2.9 s at 20% chamber vol/min (F3,22 = 7.83, P = 0.0013). Similarly, the interval between the onset of labored breathing and loss of the righting reflex averaged 38.2 ± 2.4 s at a flow rate of 50% versus 59.2 ± 2.4 s at 20% chamber vol/min of CO2 (F3,22 = 13.62, P < 0.0001). We conclude that higher flow rates reduce the duration of dyspnea, but even at the highest flow rate mice experience more than 30 s between the onset of dyspnea and the most conservative estimate of insensibility. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  3. Algorithm for Automatic Behavior Quantification of Laboratory Mice Using High-Frame-Rate Videos

    NASA Astrophysics Data System (ADS)

    Nie, Yuman; Takaki, Takeshi; Ishii, Idaku; Matsuda, Hiroshi

    In this paper, we propose an algorithm for automatic behavior quantification in laboratory mice to quantify several model behaviors. The algorithm can detect repetitive motions of the fore- or hind-limbs at several or dozens of hertz, which are too rapid for the naked eye, from high-frame-rate video images. Multiple repetitive motions can always be identified from periodic frame-differential image features in four segmented regions — the head, left side, right side, and tail. Even when a mouse changes its posture and orientation relative to the camera, these features can still be extracted from the shift- and orientation-invariant shape of the mouse silhouette by using the polar coordinate system and adjusting the angle coordinate according to the head and tail positions. The effectiveness of the algorithm is evaluated by analyzing long-term 240-fps videos of four laboratory mice for six typical model behaviors: moving, rearing, immobility, head grooming, left-side scratching, and right-side scratching. The time durations for the model behaviors determined by the algorithm have detection/correction ratios greater than 80% for all the model behaviors. This shows good quantification results for actual animal testing.

  4. 47 CFR 76.923 - Rates for equipment and installation used to receive the basic service tier.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation...) The equipment regulated under this section consists of all equipment in a subscriber's home, provided... categorization may be made, provided that each category includes only equipment of the same type, regardless of...

  5. 47 CFR 76.923 - Rates for equipment and installation used to receive the basic service tier.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation...) The equipment regulated under this section consists of all equipment in a subscriber's home, provided... categorization may be made, provided that each category includes only equipment of the same type, regardless of...

  6. 47 CFR 76.923 - Rates for equipment and installation used to receive the basic service tier.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation...) The equipment regulated under this section consists of all equipment in a subscriber's home, provided... categorization may be made, provided that each category includes only equipment of the same type, regardless of...

  7. 47 CFR 76.923 - Rates for equipment and installation used to receive the basic service tier.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation...) The equipment regulated under this section consists of all equipment in a subscriber's home, provided... categorization may be made, provided that each category includes only equipment of the same type, regardless of...

  8. Effective utilization of clinical laboratories.

    PubMed

    Murphy, J; Henry, J B

    1978-11-01

    Effective utilization of clinical laboratories requires that underutilization, overutilization, and malutilization be appreciated and eliminated or reduced. Optimal patient care service, although subjective to a major extent, is reflected in terms of outcome and cost. Increased per diem charges, reduced hospital stay, and increased laboratory workload over the past decade all require each laboratory to examine its internal operations to achieve economy and efficiency as well as maximal effectiveness. Increased research and development, an active managerial role on the part of pathologists, internal self-assessment, and an aggressive response to sophisticated scientific and clinical laboratory data base requirements are not only desirable but essential. The importance of undergraduate and graduate medical education in laboratory medicine to insure understanding as well as effective utilization is stressed. The costs and limitations as well as the accuracy, precision, sensitivity, specificity, and pitfalls of measurements and examinations must also be fully appreciated. Medical malpractice and defensive medicine and the use of critical values, emergency and routine services, and an active clinical role by the pathologist are of the utmost value in assuring effective utilization of the laboratory. A model for the optimal use of the laboratory including economy and efficiency has been achieved in the blood bank in regard to optimal hemotherapy for elective surgery, assuring superior patient care in a cost effective and safe manner.

  9. Scarcity of ecosystem services: an experimental manipulation of declining pollination rates and its economic consequences for agriculture.

    PubMed

    Sandhu, Harpinder; Waterhouse, Benjamin; Boyer, Stephane; Wratten, Steve

    2016-01-01

    Ecosystem services (ES) such as pollination are vital for the continuous supply of food to a growing human population, but the decline in populations of insect pollinators worldwide poses a threat to food and nutritional security. Using a pollinator (honeybee) exclusion approach, we evaluated the impact of pollinator scarcity on production in four brassica fields, two producing hybrid seeds and two producing open-pollinated ones. There was a clear reduction in seed yield as pollination rates declined. Open-pollinated crops produced significantly higher yields than did the hybrid ones at all pollination rates. The hybrid crops required at least 0.50 of background pollination rates to achieve maximum yield, whereas in open-pollinated crops, 0.25 pollination rates were necessary for maximum yield. The total estimated economic value of pollination services provided by honeybees to the agricultural industry in New Zealand is NZD $1.96 billion annually. This study indicates that loss of pollination services can result in significant declines in production and have serious implications for the market economy in New Zealand. Depending on the extent of honeybee population decline, and assuming that results in declining pollination services, the estimated economic loss to New Zealand agriculture could be in the range of NZD $295-728 million annually.

  10. Scarcity of ecosystem services: an experimental manipulation of declining pollination rates and its economic consequences for agriculture

    PubMed Central

    Waterhouse, Benjamin; Wratten, Steve

    2016-01-01

    Ecosystem services (ES) such as pollination are vital for the continuous supply of food to a growing human population, but the decline in populations of insect pollinators worldwide poses a threat to food and nutritional security. Using a pollinator (honeybee) exclusion approach, we evaluated the impact of pollinator scarcity on production in four brassica fields, two producing hybrid seeds and two producing open-pollinated ones. There was a clear reduction in seed yield as pollination rates declined. Open-pollinated crops produced significantly higher yields than did the hybrid ones at all pollination rates. The hybrid crops required at least 0.50 of background pollination rates to achieve maximum yield, whereas in open-pollinated crops, 0.25 pollination rates were necessary for maximum yield. The total estimated economic value of pollination services provided by honeybees to the agricultural industry in New Zealand is NZD $1.96 billion annually. This study indicates that loss of pollination services can result in significant declines in production and have serious implications for the market economy in New Zealand. Depending on the extent of honeybee population decline, and assuming that results in declining pollination services, the estimated economic loss to New Zealand agriculture could be in the range of NZD $295–728 million annually. PMID:27441108

  11. Forest service access to and use of the Germplasm Information Network (GRIN-Global) database and security backup at the National Laboratory for Genetic Resource Preservation

    Treesearch

    B. Loth; R.P. Karrfalt

    2017-01-01

    The U.S. Department of Agriculture Forest Service (USDA FS) National Seed Laboratory (NSL) began long term seed storage for genetic conservation, in 2005, for USDA FS units and cooperators. This program requires secure storage of both seeds and the data documenting the identification of the seeds. The Agricultural Research Service (ARS) has provided both of these...

  12. Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services.

    PubMed

    Salata, Brian M; Sterling, Madeline R; Beecy, Ashley N; Ullal, Ajayram V; Jones, Erica C; Horn, Evelyn M; Goyal, Parag

    2018-05-01

    Given high rates of heart failure (HF) hospitalizations and widespread adoption of the hospitalist model, patients with HF are often cared for on General Medicine (GM) services. Differences in discharge processes and 30-day readmission rates between patients on GM and those on Cardiology during the contemporary hospitalist era are unknown. The present study compared discharge processes and 30-day readmission rates of patients with HF admitted on GM services and those on Cardiology services. We retrospectively studied 926 patients discharged home after HF hospitalization. The primary outcome was 30-day all-cause readmission after discharge from index hospitalization. Although 60% of patients with HF were admitted to Cardiology services, 40% were admitted to GM services. Prevalence of cardiovascular and noncardiovascular co-morbidities were similar between patients admitted to GM services and Cardiology services. Discharge summaries for patients on GM services were less likely to have reassessments of ejection fraction, new study results, weights, discharge vital signs, discharge physical examinations, and scheduled follow-up cardiologist appointments. In a multivariable regression analysis, patients on GM services were more likely to experience 30-day readmissions compared with those on Cardiology services (odds ratio 1.43 95% confidence interval [1.05 to 1.96], p = 0.02). In conclusion, outcomes are better among those admitted to Cardiology services, signaling the need for studies and interventions focusing on noncardiology hospital providers that care for patients with HF. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Unit-level voluntary turnover rates and customer service quality: implications of group cohesiveness, newcomer concentration, and size.

    PubMed

    Hausknecht, John P; Trevor, Charlie O; Howard, Michael J

    2009-07-01

    Despite substantial growth in the service industry and emerging work on turnover consequences, little research examines how unit-level turnover rates affect essential customer-related outcomes. The authors propose an operational disruption framework to explain why voluntary turnover impairs customers' service quality perceptions. On the basis of a sample of 75 work units and data from 5,631 employee surveys, 59,602 customer surveys, and organizational records, results indicate that unit-level voluntary turnover rates are negatively related to service quality perceptions. The authors also examine potential boundary conditions related to the disruption framework. Of 3 moderators studied (group cohesiveness, group size, and newcomer concentration), results show that turnover's negative effects on service quality are more pronounced in larger units and in those with a greater concentration of newcomers.

  14. The Tanzania experience: clinical laboratory testing harmonization and equipment standardization at different levels of a tiered health laboratory system.

    PubMed

    Massambu, Charles; Mwangi, Christina

    2009-06-01

    The rapid scale-up of the care and treatment programs in Tanzania during the preceding 4 years has greatly increased the demand for quality laboratory services for diagnosis of HIV and monitoring patients during antiretroviral therapy. Laboratory services were not in a position to cope with this demand owing to poor infrastructure, lack of human resources, erratic and/or lack of reagent supply and commodities, and slow manual technologies. With the limited human resources in the laboratory and the need for scaling up the care and treatment program, it became necessary to install automated equipment and train personnel for the increased volume of testing and new tests across all laboratory levels. With the numerous partners procuring equipment, the possibility of a multitude of equipment platforms with attendant challenges for procurement of reagents, maintenance of equipment, and quality assurance arose. Tanzania, therefore, had to harmonize laboratory tests and standardize laboratory equipment at different levels of the laboratory network. The process of harmonization of tests and standardization of equipment included assessment of laboratories, review of guidelines, development of a national laboratory operational plan, and stakeholder advocacy. This document outlines this process.

  15. Impact of social service and public health spending on teenage birth rates across the USA: an ecological study

    PubMed Central

    Sipsma, Heather L; Canavan, Maureen; Gilliam, Melissa; Bradley, Elizabeth

    2017-01-01

    Objective To examine whether greater state-level spending on social and public health services such as income, education and public safety is associated with lower rates of teenage births in USA. Design Ecological study. Setting USA. Participants 50 states. Primary outcome measure Our primary outcome measure was teenage birth rates. For analyses, we constructed marginal models using repeated measures to test the effect of social spending on teenage birth rates, accounting for several potential confounders. Results The unadjusted and adjusted models across all years demonstrated significant effects of spending and suggested that higher spending rates were associated with lower rates of teenage birth, with effects slightly diminishing with each increase in spending (linear effect: B=−0.20; 95% CI −0.31 to 0.08; p<0.001 and quadratic effect: B=0.003; 95% CI 0.002 to 0.005; p<0.001). Conclusion Higher state spending on social and public health services is associated with lower rates of teenage births. As states seek ways to limit healthcare costs associated with teenage birth rates, our findings suggest that protecting existing social service investments will be critical. PMID:28611088

  16. ISO 15189 accreditation: Requirements for quality and competence of medical laboratories, experience of a laboratory I.

    PubMed

    Guzel, Omer; Guner, Ebru Ilhan

    2009-03-01

    Medical laboratories are the key partners in patient safety. Laboratory results influence 70% of medical diagnoses. Quality of laboratory service is the major factor which directly affects the quality of health care. The clinical laboratory as a whole has to provide the best patient care promoting excellence. International Standard ISO 15189, based upon ISO 17025 and ISO 9001 standards, provides requirements for competence and quality of medical laboratories. Accredited medical laboratories enhance credibility and competency of their testing services. Our group of laboratories, one of the leading institutions in the area, had previous experience with ISO 9001 and ISO 17025 Accreditation at non-medical sections. We started to prepared for ISO 15189 Accreditation at the beginning of 2006 and were certified in March, 2007. We spent more than a year to prepare for accreditation. Accreditation scopes of our laboratory were as follows: clinical chemistry, hematology, immunology, allergology, microbiology, parasitology, molecular biology of infection serology and transfusion medicine. The total number of accredited tests is 531. We participate in five different PT programs. Inter Laboratory Comparison (ILC) protocols are performed with reputable laboratories. 82 different PT Program modules, 277 cycles per year for 451 tests and 72 ILC program organizations for remaining tests have been performed. Our laboratory also organizes a PT program for flow cytometry. 22 laboratories participate in this program, 2 cycles per year. Our laboratory has had its own custom made WEB based LIS system since 2001. We serve more than 500 customers on a real time basis. Our quality management system is also documented and processed electronically, Document Management System (DMS), via our intranet. Preparatory phase for accreditation, data management, external quality control programs, personnel related issues before, during and after accreditation process are presented. Every laboratory has

  17. 76 FR 82299 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Clinical... under which clinical laboratories are regulated; the impact on medical and laboratory practice of... the Clinical Laboratory Workforce; laboratory communication and electronic health records, integration...

  18. 18 CFR 35.1 - Application; obligation to file rate schedules, tariffs and certain service agreements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... specifically setting forth all rates and charges for any transmission or sale of electric energy subject to the... same rate schedule or tariff, each public utility transmitting or selling electric energy subject to... schedule, tariff, or service agreement applicable to a transmission or sale of electric energy, other than...

  19. Apel - Applied Process Engineering Laboratory

    Science.gov Websites

    startup and testing Equipment can be quickly connected to building services and effluent systems. A professional, regulated environment for bringing forth new product processes and services. Testing shortens the support Pacific Northwest National Laboratory (PNNL) scientists, engineers, and other professional staff

  20. Testing Services

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Trace Laboratories is an independent testing laboratory specializing in testing printed circuit boards, automotive products and military hardware. Technical information from NASA Tech Briefs and two subsequent JPL Technical Support packages have assisted Trace in testing surface insulation resistance on printed circuit board materials. Testing time was reduced and customer service was improved because of Jet Propulsion Laboratory technical support packages.

  1. Laboratory medicine in Ontario: its downsizing and the consequences on quality.

    PubMed

    Richardson, H

    1999-12-01

    Health care in Ontario consumes 35% of provincial government annual revenues. Fiscal constraint mandates restructuring of health services to maintain a fully, publicly-funded universally-accessible health system that is patient-focussed and health-outcome driven. Acute-care hospital restructuring under the authority of the Health Services Restructuring Commission and primary health-care reform characterise present government initiatives. Laboratory medicine services at about Can $1 billion annually account for about 5% of health expenditure. A Laboratory Services Restructuring Secretariat created by the Ministry of Health in 1995 has planned regionally-based integrated laboratory services systems bringing together public and private providers, designed a province-wide laboratory information system, developed a quality management program, reviewed the human resource needs for laboratory physicians, scientists and technologists, and recommended that the legislation be rewritten so as to be enabling - not controlling. Meanwhile both hospital and private laboratories have closed, leaving 296 in 1998 compared to 394 in 1991. Laboratory physician numbers at 39 per million population falls far short of the recommended target of 52 and many are within 10 years of retirement. Renewal of laboratory physicians and scientists to meet the shortfall is not occurring. The numbers of registered laboratory technologists has fallen by 6. 8% over 2 years. Consolidation and downsizing of laboratories with the formation of core laboratories has resulted in multi-discipline and cross discipline tasking of specialist technologists. Senior and middle level management technologists have been declared redundant. As a consequence, quality control practices have been hard hit. Plans to address these deficiencies through regional integration and sharing of resources remain to be implemented.

  2. The relationship between general population suicide rates and mental health funding, service provision and national policy: a cross-national study.

    PubMed

    Shah, Ajit; Bhandarkar, Ritesh; Bhatia, Gurleen

    2010-07-01

    The main aims were to examine the relationship between general population suicide rates and the presence of national policies on mental health, funding for mental health, and measures of mental health service provision. Data on general population suicide rates for both genders were obtained from the World Health Organization (WHO) databank available on the WHO website. Data on the presence of national policies on mental health, funding for mental health and measures of mental health service provision were obtained from the Mental Health Atlas 2005, also available on the WHO website. The main findings were: (i) there was no relationship between suicide rates in both genders and different measures of mental health policy, except they were increased in countries with mental health legislation; (ii) there was a significant positive correlation between suicide rates in both genders and the percentage of the total health budget spent on mental health; and (iii) suicide rates in both genders were higher in countries with greater provision of mental health services, including the number of psychiatric beds, psychiatrists and psychiatric nurses, and the availability of training in mental health for primary care professionals. Cross-national ecological studies using national-level aggregate data are not helpful in establishing a causal relationship (and the direction of this relationship) between suicide rates and mental health funding, service provision and national policies. The impact of introducing national policies on mental health, increasing funding for mental health services and increasing mental health service provision on suicide rates requires further examination in longitudinal within-country studies.

  3. Effects of an injectable trace mineral supplement on first-service conception rate of dairy cows.

    PubMed

    Vanegas, J A; Reynolds, J; Atwill, E R

    2004-11-01

    A total of 825 dairy cows from a commercial dairy farm in central California were used to evaluate effects of one or 2 doses of an injectable trace mineral supplement containing 20 mg/mL of zinc, 20 mg/mL of manganese, 5 mg/mL of selenium, and 10 mg/mL of copper on first-service conception rate. Cows were randomly allocated into treatment or control group to either a single dose (experiment 1) or a double dose (experiment 2) of injected supplement. Allocation was based on days in lactation for experiment 1 and the length of gestation periods for experiment 2. In experiment 1, cows 38 to 45 d in lactation (n = 190) received a single dose of 5 mL of injected supplement. Similar cows were used as controls (n = 227). In experiment 2, cows and pregnant heifers received an initial injection of 5 mL of the mineral supplement from 2 to 3 wk precalving (n = 186). An equal dose was repeated 38 to 45 d in lactation. A similar group of cows and pregnant heifers served as controls for experiment 2 (n = 222). Health and reproductive events postcalving were recorded. In experiment 1, the odds of first-service conception were not significantly different for cows receiving a one-dose regimen of minerals compared with untreated control cows; conception rates were 26.8 and 27.5% for experiment 1 treatment and control groups, respectively. In experiment 1, the odds of first-service conception were significantly lower (odds ratio = 0.66) for cows and heifers given the 2-dose regimen of minerals compared with untreated controls; overall conception rates were 21.5 and 31.5% for experiment 2 treatment and control groups, respectively. In this intensively managed dairy herd, a single dose of injected trace minerals before breeding had no beneficial effects on first-service conception rate. However, dairy cows receiving a dose of trace minerals before calving and another dose before breeding had lower conception at first service.

  4. Using Interorganizational Partnerships to Strengthen Public Health Laboratory Systems

    PubMed Central

    Kimsey, Paul; Buehring, Gertrude

    2013-01-01

    Due to the current economic environment, many local and state health departments are faced with budget reductions. Health department administrators and public health laboratory (PHL) directors need to assess strategies to ensure that their PHLs can provide the same level of service with decreased funds. Exploratory case studies of interorganizational partnerships among local PHLs in California were conducted to determine the impact on local PHL testing services and capacity. Our findings suggest that interorganizational forms of cooperation among local PHLs can help bolster laboratory capacity by capturing economies of scale, leveraging scarce resources, and ensuring access to affordable, timely, and quality laboratory testing services. Interorganizational partnerships will help local and state public health departments continue to maintain a strong and robust laboratory system that supports their role in communicable disease surveillance. PMID:23997305

  5. 42 CFR 493.1357 - Standard; laboratory director qualifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; laboratory director qualifications. 493... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Personnel for Nonwaived Testing Laboratories Performing Provider-Performed Microscopy (ppm) Procedures § 493.1357 Standard...

  6. 42 CFR 493.1357 - Standard; laboratory director qualifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; laboratory director qualifications. 493... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Personnel for Nonwaived Testing Laboratories Performing Provider-Performed Microscopy (ppm) Procedures § 493.1357 Standard...

  7. 20 CFR 404.1519k - Purchase of medical examinations, laboratory tests, and other services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Standards for the Type of Referral and for Report Content § 404.1519k Purchase of medical examinations... determinations of disability may not exceed the highest rate paid by Federal or public agencies in the State for the same or similar types of service. See §§ 404.1624 and 404.1626 of this part. (b) If a physician's...

  8. 20 CFR 416.919k - Purchase of medical examinations, laboratory tests, and other services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... for the Type of Referral and for Report Content § 416.919k Purchase of medical examinations... determinations of disability may not exceed the highest rate paid by Federal or public agencies in the State for the same or similar types of service. See §§ 416.1024 and 416.1026 of this part. (b) If a physician's...

  9. Laboratory services series: a master-slave manipulator maintenance program

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jenness, R. G.; Hicks, R. E.; Wicker, C. D.

    1976-12-01

    The volume of master slave manipulator maintenance at Oak Ridge National Laboratory has necessitated the establishment of a repair facility and organization of a specially trained group of craftsmen. Emphasis on cell containment requires the use of manipulator boots and development of precise procedures for accomplishing the maintenance of 287 installed units. A very satisfactory computer programmed maintenance system has been established at the Laboratory to provide an economical approach to preventive maintenance.

  10. 46 CFR 164.012-12 - Recognized laboratory.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Recognized laboratory. 164.012-12 Section 164.012-12...: SPECIFICATIONS AND APPROVAL MATERIALS Interior Finishes for Merchant Vessels § 164.012-12 Recognized laboratory. A recognized laboratory is one which is operated as a nonprofit public service and is regularly...

  11. 46 CFR 164.012-12 - Recognized laboratory.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Recognized laboratory. 164.012-12 Section 164.012-12...: SPECIFICATIONS AND APPROVAL MATERIALS Interior Finishes for Merchant Vessels § 164.012-12 Recognized laboratory. A recognized laboratory is one which is operated as a nonprofit public service and is regularly...

  12. COMPARISON OF FIELD AEROBIC BIODEGRADATION RATES TO LABORATORY

    EPA Science Inventory

    It is common to use bioventing as a polishing step for soil vapor extraction. It was originally planned to use soil vapor extraction and bioventing at a former landfill site in Delaware but laboratory scale biodegradation studies indicated that most of the volatile organic compou...

  13. Short Paper: Frequency Regulation Services from Connected Residential Devices: Preprint

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Baker, Kyri; Jin, Xin; Vaidhynathan, Deepthi

    In this paper, we demonstrate the potential benefits that residential buildings can provide for frequency regulation services in the electric power grid. In a hardware-in-the- loop (HIL) implementation, simulated homes along with a physical laboratory home are coordinated via a grid aggregator, and it is shown that their aggregate response has the potential to follow the regulation signal on a timescale of seconds. Connected (communication-enabled), devices in the National Renewable Energy Laboratory's (NREL's) Energy Systems Integration Facility (ESIF) received demand response (DR) requests from a grid aggregator, and the devices responded accordingly to meet the signal while satisfying user comfortmore » bounds and physical hardware limitations. Future research will address the issues of cybersecurity threats, participation rates, and reducing equipment wear-and-tear while providing grid services.« less

  14. Tritium laboratory with multiple purposes at NIPNE Magurele Romania

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Matei, L.; Postolache, C.

    2008-07-15

    The Tritium Laboratory from NIPNE (Romania)) is part of Radioisotope Research and Production Center. The Tritium Laboratory has been in operation since 1960, and carries out R and D activities involving tritium sources in gaseous, liquids and solid state, provides specialized service to CANDU NPP Cernavoda (Romania)), and provides tritium assay services to internal and external customers. The paper presents the activities and perspectives of Tritium Laboratory and its performances in accordance with Quality System Management. (authors)

  15. 75 FR 1052 - Castle Energy Services, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-08

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [ Docket No. ER10-385-000] Castle Energy Services, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for Blanket Section 204 Authorization December 30, 2009. This is a supplemental notice in the above-referenced proceeding of Castle Energy Services LLC's...

  16. 42 CFR 493.20 - Laboratories performing tests of moderate complexity.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Laboratories performing tests of moderate complexity. 493.20 Section 493.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS General...

  17. 42 CFR 493.20 - Laboratories performing tests of moderate complexity.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Laboratories performing tests of moderate complexity. 493.20 Section 493.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS General...

  18. Concept for a commercial space station laboratory

    NASA Technical Reports Server (NTRS)

    Wood, P. W.; Stark, P. M.

    1984-01-01

    The concept of a privately owned and operated fee-for-service laboratory as an element of a civil manned space station, envisioned as the venture of a group of private investors and an experienced laboratory operator to be undertaken with the cooperation of NASA is discussed. This group would acquire, outfit, activate, and operate the labortory on a fee-for-service basis, providing laboratory services to commercial firms, universities, and government agencies, including NASA. This concept was developed to identify, stimulate, and assist potential commercial users of a manned space station. A number of the issues which would be related to the concept, including the terms under which NASA might consider permitting private ownership and operation of a major space station component, the policies with respect to international participation in the construction and use of the space station, the basis for charging users for services received from the space station, and the types of support that NASA might be willing to provide to assist private industry in carrying out such a venture are discussed.

  19. 7 CFR 75.43 - Laboratory testing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Laboratory testing. 75.43 Section 75.43 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... AND CERTIFICATION OF QUALITY OF AGRICULTURAL AND VEGETABLE SEEDS Fees and Charges § 75.43 Laboratory...

  20. 7 CFR 75.43 - Laboratory testing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Laboratory testing. 75.43 Section 75.43 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... AND CERTIFICATION OF QUALITY OF AGRICULTURAL AND VEGETABLE SEEDS Fees and Charges § 75.43 Laboratory...

  1. Laboratory Guide to Instruments, Equipment, and Chemicals, 1971-72.

    ERIC Educational Resources Information Center

    American Chemical Society, Washington, DC.

    This edition of the American Chemical Society laboratory guide is designed to assist the buyers of laboratory supplies and services. The guide contains 40,000 entries and 1,850 product headings presented within these listings: products and services advertised; main dealer location and their branch offices in the southern, northeastern, midwestern,…

  2. 42 CFR 493.1443 - Standard; Laboratory director qualifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Laboratory director qualifications. 493.1443 Section 493.1443 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Testing Laboratories Performing High Complexity Testing § 493.1443 Standard; Laboratory director...

  3. 42 CFR 493.1443 - Standard; Laboratory director qualifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; Laboratory director qualifications. 493.1443 Section 493.1443 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Testing Laboratories Performing High Complexity Testing § 493.1443 Standard; Laboratory director...

  4. 42 CFR 493.1445 - Standard; Laboratory director responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; Laboratory director responsibilities. 493.1445 Section 493.1445 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Testing Laboratories Performing High Complexity Testing § 493.1445 Standard; Laboratory director...

  5. 42 CFR 493.1407 - Standard; Laboratory director responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; Laboratory director responsibilities. 493.1407 Section 493.1407 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Testing Laboratories Performing Moderate Complexity Testing § 493.1407 Standard; Laboratory director...

  6. 42 CFR 493.551 - General requirements for laboratories.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false General requirements for laboratories. 493.551... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Accreditation by a Private, Nonprofit Accreditation Organization or Exemption Under an Approved State Laboratory Program § 493.551...

  7. 42 CFR 493.551 - General requirements for laboratories.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false General requirements for laboratories. 493.551... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Accreditation by a Private, Nonprofit Accreditation Organization or Exemption Under an Approved State Laboratory Program § 493.551...

  8. Comparison of Rate of Utilization of Medicare Services in Private Versus Academic Cardiology Practice.

    PubMed

    Hovanesyan, Arsen; Rubio, Eduardo; Novak, Eric; Budoff, Matthew; Rich, Michael W

    2017-11-15

    Cardiovascular services are the third largest source of Medicare spending. We examined the rate of cardiovascular service utilization in the community of Glendale, CA, compared with the nearest academic medical center, the University of Southern California. Publicly available utilization data released by Medicare for the years 2012 and 2013 were used to identify all inpatient and outpatient cardiology services provided in each practice setting. The analysis included 19 private and 17 academic cardiologists. In unadjusted analysis, academic physicians performed half as many services per Medicare beneficiary per year as those in private practice: 2.3 versus 4.8, p <0.001. Other factors associated with higher utilization included male physician, international (vs US) medical school graduate, interventional (vs general) cardiologist, and more years in practice. Factors independently associated with higher utilization rates by multivariable analysis included private practice setting (odds ratio [OR] 1.84, 95% confidence interval [CI] 1.30 to 2.61, p <0.001), male physician (OR 1.64, 95% CI 1.00 to 2.67, p = 0.049), and international medical school graduate (OR 1.37, 95% CI 1.07 to 1.78, p = 0.014). In conclusion, in this analysis of 2 cardiology practice settings in southern California, medical service utilization per Medicare beneficiary was nearly 2-fold higher in private practice than in the academic setting, suggesting that there may be opportunity for substantially reducing costs of cardiology care in the community setting. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Impact of social service and public health spending on teenage birth rates across the USA: an ecological study.

    PubMed

    Sipsma, Heather L; Canavan, Maureen; Gilliam, Melissa; Bradley, Elizabeth

    2017-06-13

    To examine whether greater state-level spending on social and public health services such as income, education and public safety is associated with lower rates of teenage births in USA. Ecological study. USA. 50 states. Our primary outcome measure was teenage birth rates. For analyses, we constructed marginal models using repeated measures to test the effect of social spending on teenage birth rates, accounting for several potential confounders. The unadjusted and adjusted models across all years demonstrated significant effects of spending and suggested that higher spending rates were associated with lower rates of teenage birth, with effects slightly diminishing with each increase in spending (linear effect: B=-0.20; 95% CI -0.31 to 0.08; p<0.001 and quadratic effect: B=0.003; 95% CI 0.002 to 0.005; p<0.001). Higher state spending on social and public health services is associated with lower rates of teenage births. As states seek ways to limit healthcare costs associated with teenage birth rates, our findings suggest that protecting existing social service investments will be critical. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Implantation of radiotelemetry transmitters yielding data on ECG, heart rate, core body temperature and activity in free-moving laboratory mice.

    PubMed

    Cesarovic, Nikola; Jirkof, Paulin; Rettich, Andreas; Arras, Margarete

    2011-11-21

    The laboratory mouse is the animal species of choice for most biomedical research, in both the academic sphere and the pharmaceutical industry. Mice are a manageable size and relatively easy to house. These factors, together with the availability of a wealth of spontaneous and experimentally induced mutants, make laboratory mice ideally suited to a wide variety of research areas. In cardiovascular, pharmacological and toxicological research, accurate measurement of parameters relating to the circulatory system of laboratory animals is often required. Determination of heart rate, heart rate variability, and duration of PQ and QT intervals are based on electrocardiogram (ECG) recordings. However, obtaining reliable ECG curves as well as physiological data such as core body temperature in mice can be difficult using conventional measurement techniques, which require connecting sensors and lead wires to a restrained, tethered, or even anaesthetized animal. Data obtained in this fashion must be interpreted with caution, as it is well known that restraining and anesthesia can have a major artifactual influence on physiological parameters. Radiotelemetry enables data to be collected from conscious and untethered animals. Measurements can be conducted even in freely moving animals, and without requiring the investigator to be in the proximity of the animal. Thus, known sources of artifacts are avoided, and accurate and reliable measurements are assured. This methodology also reduces interanimal variability, thus reducing the number of animals used, rendering this technology the most humane method of monitoring physiological parameters in laboratory animals. Constant advancements in data acquisition technology and implant miniaturization mean that it is now possible to record physiological parameters and locomotor activity continuously and in realtime over longer periods such as hours, days or even weeks. Here, we describe a surgical technique for implantation of a

  11. Contracting with the Frederick National Laboratory | Frederick National Laboratory for Cancer Research

    Cancer.gov

    Our Acquisitions Directorate supports the national laboratory with high quality products and services to achieve its national mission. In addition to engaging large subcontractors, we are also committed to working with small businesses, minority- and

  12. The effects of laboratory housing and spatial enrichment on brain size and metabolic rate in the eastern mosquitofish, Gambusia holbrooki

    PubMed Central

    Turschwell, Mischa P.; White, Craig R.

    2016-01-01

    ABSTRACT It has long been hypothesised that there is a functional correlation between brain size and metabolic rate in vertebrates. The present study tested this hypothesis in wild-caught adult mosquitofish Gambusia holbrooki by testing for an intra-specific association between resting metabolic rate (RMR) and brain size while controlling for variation in body size, and through the examination of the effects of spatial enrichment and laboratory housing on body mass-independent measures of brain size and RMR. Controlling for body mass, there was no relationship between brain size and RMR in wild-caught fish. Contrary to predictions, spatial enrichment caused a decrease in mass-independent brain size, highlighting phenotypic plasticity in the adult brain. As expected, after controlling for differences in body size, wild-caught fish had relatively larger brains than fish that had been maintained in the laboratory for a minimum of six weeks, but wild-caught fish also had significantly lower mass-independent RMR. This study demonstrates that an organisms' housing environment can cause significant plastic changes to fitness related traits including brain size and RMR. We therefore conclude that current standard laboratory housing conditions may cause captive animals to be non-representative of their wild counterparts, potentially undermining the transferability of previous laboratory-based studies of aquatic ectothermic vertebrates to wild populations. PMID:26794608

  13. 9 CFR 391.5 - Laboratory accreditation fees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Laboratory accreditation fees. 391.5 Section 391.5 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE ADMINISTRATIVE PROVISIONS FEES AND CHARGES FOR INSPECTION SERVICES...

  14. 42 CFR 493.1806 - Available sanctions: All laboratories.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Available sanctions: All laboratories. 493.1806... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Enforcement Procedures § 493.1806 Available sanctions: All laboratories. (a) Applicability. CMS may impose one or more of the sanctions...

  15. 42 CFR 493.1806 - Available sanctions: All laboratories.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Available sanctions: All laboratories. 493.1806... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Enforcement Procedures § 493.1806 Available sanctions: All laboratories. (a) Applicability. CMS may impose one or more of the sanctions...

  16. Laboratory Automation and Middleware.

    PubMed

    Riben, Michael

    2015-06-01

    The practice of surgical pathology is under constant pressure to deliver the highest quality of service, reduce errors, increase throughput, and decrease turnaround time while at the same time dealing with an aging workforce, increasing financial constraints, and economic uncertainty. Although not able to implement total laboratory automation, great progress continues to be made in workstation automation in all areas of the pathology laboratory. This report highlights the benefits and challenges of pathology automation, reviews middleware and its use to facilitate automation, and reviews the progress so far in the anatomic pathology laboratory. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Quality of the clinical laboratory department in a specialized hospital in Alexandria, Egypt.

    PubMed

    Elhoseeny, T A; Mohammad, E K

    2013-01-01

    Assessment and improvement of turnaround times (TAT) as well as customer satisfaction is essential for laboratory quality management. This study in a specialized hospital in Alexandria, Egypt measured the current TAT for outpatient department bilirubin samples and evaluated the satisfaction of physicians with aspects of clinical laboratory services. While the mean TAT for 110 bilirubin tests [58.1 (SD 31.8) min] was within the College of American Pathologists' benchmark, the 90th percentile was long (96.7 min); 62.7% of tests were reported within 60 min. The mean overall satisfaction score of physicians (range 1-5) was 3.46 (SD 0.49). The highest satisfaction rating was for staff courtesy while the lowest ratings were for laboratory management responsiveness, outpatient stat TAT and critical value notification. Quality or reliability of results was judged by physicians as the most important factor (32.3%), followed by routine test TAT (18.5%). Further analysis of the different steps of the TAT would be helpful and follow-up through examining outliers is recommended

  18. Laboratory medicine in France. A jeopardized situation.

    PubMed

    Valdiguié, P M; de Graeve, J S; Guerre, J P

    1997-11-06

    The expenses for health care in France have risen considerably during the present decade, ranking third after USA and Canada in the Western world. In spite of the very low cost of laboratory medicine (2.4% of the total expenditure in 1995), clinical laboratories have undergone a severe squeeze, due to two limiting factors; a decrease in the ordering of laboratory tests from private physicians and a reduction in the total expenses for laboratory services from the Social Security. Consequently, there has been unemployment of technical and secretarial staff and severe restriction in investment for buying new equipment. However, hospital laboratories will manage to assume their challenge in developing robotics, automation, molecular pathology techniques and expert systems. Private laboratories, in spite of their efforts to follow the technological advances in automation, will survive thanks to consolidation of regional networks that operate in a cooperative rather than competitive mode. Therefore, the challenge will be not in the adaptation of clinical laboratories, but in the limitation of overspending at the national level and in modification of the behaviour of irresponsible citizens accustomed to spending freely on health care services.

  19. Implications of the introduction of laboratory demand management at primary care clinics in South Africa on laboratory expenditure

    PubMed Central

    Lekalakala, Ruth; Asmall, Shaidah; Cassim, Naseem

    2016-01-01

    Background Diagnostic health laboratory services are regarded as an integral part of the national health infrastructure across all countries. Clinical laboratory tests contribute substantially to health system goals of increasing quality of care and improving patient outcomes. Objectives This study aimed to analyse current laboratory expenditures at the primary healthcare (PHC) level in South Africa as processed by the National Health Laboratory Service and to determine the potential cost savings of introducing laboratory demand management. Methods A retrospective cross-sectional analysis of laboratory expenditures for the 2013/2014 financial year across 11 pilot National Health Insurance health districts was conducted. Laboratory expenditure tariff codes were cross-tabulated to the PHC essential laboratory tests list (ELL) to determine inappropriate testing. Data were analysed using a Microsoft Access database and Excel software. Results Approximately R35 million South African Rand (10%) of the estimated R339 million in expenditures was for tests that were not listed within the ELL. Approximately 47% of expenditure was for laboratory tests that were indicated in the algorithmic management of patients on antiretroviral treatment. The other main cost drivers for non-ELL testing included full blood count and urea, as well as electrolyte profiles usually requested to support management of patients on antiretroviral treatment. Conclusions Considerable annual savings of up to 10% in laboratory expenditure are possible at the PHC level by implementing laboratory demand management. In addition, to achieve these savings, a standardised PHC laboratory request form and some form of electronic gatekeeping system that must be supported by an educational component should be implemented. PMID:28879107

  20. 21 CFR 211.173 - Laboratory animals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Laboratory animals. 211.173 Section 211.173 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... Laboratory animals. Animals used in testing components, in-process materials, or drug products for compliance...

  1. 21 CFR 211.173 - Laboratory animals.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Laboratory animals. 211.173 Section 211.173 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... Laboratory animals. Animals used in testing components, in-process materials, or drug products for compliance...

  2. 21 CFR 211.173 - Laboratory animals.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Laboratory animals. 211.173 Section 211.173 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... Laboratory animals. Animals used in testing components, in-process materials, or drug products for compliance...

  3. 21 CFR 211.173 - Laboratory animals.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Laboratory animals. 211.173 Section 211.173 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... Laboratory animals. Animals used in testing components, in-process materials, or drug products for compliance...

  4. 21 CFR 211.173 - Laboratory animals.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Laboratory animals. 211.173 Section 211.173 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... Laboratory animals. Animals used in testing components, in-process materials, or drug products for compliance...

  5. [Laboratory accreditation and proficiency testing].

    PubMed

    Kuwa, Katsuhiko

    2003-05-01

    ISO/TC 212 covering clinical laboratory testing and in vitro diagnostic test systems will issue the international standard for medical laboratory quality and competence requirements, ISO 15189. This standard is based on the ISO/IEC 17025, general requirements for competence of testing and calibration laboratories and ISO 9001, quality management systems-requirements. Clinical laboratory services are essential to patient care and therefore should be available to meet the needs of all patients and clinical personnel responsible for human health care. If a laboratory seeks accreditation, it should select an accreditation body that operates according to this international standard and in a manner which takes into account the particular requirements of clinical laboratories. Proficiency testing should be available to evaluate the calibration laboratories and reference measurement laboratories in clinical medicine. Reference measurement procedures should be of precise and the analytical principle of measurement applied should ensure reliability. We should be prepared to establish a quality management system and proficiency testing in clinical laboratories.

  6. American Indians, hunting and fishing rates, risk, and the Idaho National Engineering and Environmental Laboratory

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Burger, J.

    1999-05-01

    Hunting, fishing, and recreational rates of 276 American Indians attending a festival at Fort Hall, near the Idaho National Engineering and Environmental Laboratory (INEEL), were examined. Nearly half of the sample lived on the Fort Hall Reservation, and half were American Indians from elsewhere in the western United States. An additional 44 White people attending the festival were also interviewed. The hypothesis that there are differences in hunting, fishing, and recreational rates as a function of tribal affiliation, educational level, gender, and age was examined. Information on hunting and fishing rates are central for understanding potential exposure scenarios for Americanmore » Indians if the Department of Energy`s INEEL lands are ever opened to public access, and the data are important because of the existence of tribal treaties that govern the legal and cultural rights of the Shoshone-Bannock regarding INEEL lands. Variations in hunting, fishing, and photography rates were explained by tribal affiliation (except fishing), gender, age, and schooling. Hunting rates were significantly higher for Indians (both those living on Fort Hall and others) than Whites. Men engaged in significantly higher rates of outdoor activities than women (except for photography). Potential and current hunting and fishing on and adjacent to INEEL was more similar among the local Whites and Fort Hall Indians than between these two groups and other American Indians.« less

  7. Validating dose rate calibration of radiotherapy photon beams through IAEA/WHO postal audit dosimetry service.

    PubMed

    Jangda, Abdul Qadir; Hussein, Sherali

    2012-05-01

    In external beam radiation therapy (EBRT), the quality assurance (QA) of the radiation beam is crucial to the accurate delivery of the prescribed dose to the patient. One of the dosimetric parameters that require monitoring is the beam output, specified as the dose rate on the central axis under reference conditions. The aim of this project was to validate dose rate calibration of megavoltage photon beams using the International Atomic Energy Agency (IAEA)/World Health Organisation (WHO) postal audit dosimetry service. Three photon beams were audited: a 6 MV beam from the low-energy linac and 6 and 18 MV beams from a dual high-energy linac. The agreement between our stated doses and the IAEA results was within 1% for the two 6 MV beams and within 2% for the 18 MV beam. The IAEA/WHO postal audit dosimetry service provides an independent verification of dose rate calibration protocol by an international facility.

  8. 42 CFR 493.1481 - Condition: Laboratories performing high complexity testing; cytotechnologist.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing high complexity testing; cytotechnologist. 493.1481 Section 493.1481 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY...

  9. 42 CFR 493.1481 - Condition: Laboratories performing high complexity testing; cytotechnologist.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Laboratories performing high complexity testing; cytotechnologist. 493.1481 Section 493.1481 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY...

  10. Local Access to Family Planning Services and Female High School Dropout Rates.

    PubMed

    Hicks-Courant, Katherine; Schwartz, Aaron L

    2016-04-01

    To assess whether geographic access to family planning services is associated with a reduced female high school dropout rate. We conducted a retrospective cross-sectional study. We merged the location of Planned Parenthood and Title X clinics with microdata from the 2012-2013 American Community Surveys. The association between female high school dropout rates and local clinic access was assessed using nearest-neighbor matching estimation. Models included various covariates to account for sociodemographic differences across communities and male high school dropout rates to account for unmeasured community characteristics affecting educational outcomes. Our sample included 284,910 16- to 22-year-old females. The presence of a Planned Parenthood clinic was associated with a decrease (4.08% compared with 4.83%; relative risk ratio 0.84, P<.001) in female high school dropout rates. This association was consistent across several model specifications. The presence of a Title X clinic was associated with a decrease (4.79% compared with 5.07%; relative risk ratio 0.94, P=.03) in female high school dropout rates, an association that did not remain significant across model specifications. Local access to Planned Parenthood is associated with lower high school dropout rates in young women.

  11. 9 CFR 147.51 - Authorized laboratory minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Authorized laboratory minimum requirements. 147.51 Section 147.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE.... The testing procedures at the laboratory must be run or overseen by a laboratory technician who has...

  12. 9 CFR 147.51 - Authorized laboratory minimum requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Authorized laboratory minimum requirements. 147.51 Section 147.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE.... The testing procedures at the laboratory must be run or overseen by a laboratory technician who has...

  13. 9 CFR 147.51 - Authorized laboratory minimum requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Authorized laboratory minimum requirements. 147.51 Section 147.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE.... The testing procedures at the laboratory must be run or overseen by a laboratory technician who has...

  14. 9 CFR 147.51 - Authorized laboratory minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Authorized laboratory minimum requirements. 147.51 Section 147.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE.... The testing procedures at the laboratory must be run or overseen by a laboratory technician who has...

  15. 9 CFR 147.51 - Authorized laboratory minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Authorized laboratory minimum requirements. 147.51 Section 147.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE.... The testing procedures at the laboratory must be run or overseen by a laboratory technician who has...

  16. LABORATORY MISCONDUCT - WHAT CAN HAPPEN TO YOU?

    EPA Science Inventory

    Contracted laboratories perform a vast number of routine and special analytical services that are the foundation of decisions upon which rests the fate of the environment. Guiding these laboratories in the generation of environmental data has been the analytical protocols and ...

  17. 21 CFR 225.58 - Laboratory controls.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Laboratory controls. 225.58 Section 225.58 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... Laboratory controls. (a) The periodic assay of medicated feeds for drug components provides a measure of...

  18. Communication and the laboratory physician

    PubMed Central

    Penistan, J. L.

    1973-01-01

    A clinical laboratory documentation system is described, suitable for community hospitals without computer services. The system is cumulative and is designed to provide the laboratory physician with the clinical information necessary for intelligent review and comment on the laboratory's findings. The mode of presentation of requests to the laboratory and lay-out of the reports to the clinicians are designed to make the two-way communication as close and personal as possible; to encourage the selection of those investigations likely to prove rewarding, and to discourage unnecessary investigation. The possibility of important data escaping notice is minimized. The system is economical in capital equipment, labour and supplies. PMID:4758594

  19. Improved estimates of environmental copper release rates from antifouling products.

    PubMed

    Finnie, Alistair A

    2006-01-01

    The US Navy Dome method for measuring copper release rates from antifouling paint in-service on ships' hulls can be considered to be the most reliable indicator of environmental release rates. In this paper, the relationship between the apparent copper release rate and the environmental release rate is established for a number of antifouling coating types using data from a variety of available laboratory, field and calculation methods. Apart from a modified Dome method using panels, all laboratory, field and calculation methods significantly overestimate the environmental release rate of copper from antifouling coatings. The difference is greatest for self-polishing copolymer antifoulings (SPCs) and smallest for certain erodible/ablative antifoulings, where the ASTM/ISO standard and the CEPE calculation method are seen to typically overestimate environmental release rates by factors of about 10 and 4, respectively. Where ASTM/ISO or CEPE copper release rate data are used for environmental risk assessment or regulatory purposes, it is proposed that the release rate values should be divided by a correction factor to enable more reliable generic environmental risk assessments to be made. Using a conservative approach based on a realistic worst case and accounting for experimental uncertainty in the data that are currently available, proposed default correction factors for use with all paint types are 5.4 for the ASTM/ISO method and 2.9 for the CEPE calculation method. Further work is required to expand this data-set and refine the correction factors through correlation of laboratory measured and calculated copper release rates with the direct in situ environmental release rate for different antifouling paints under a range of environmental conditions.

  20. Ranges of diurnal variation and the pattern of body temperature, blood pressure and heart rate in laboratory beagle dogs.

    PubMed

    Miyazaki, Hiroyasu; Yoshida, Mutsumi; Samura, Keiji; Matsumoto, Hiroyoshi; Ikemoto, Fumihiko; Tagawa, Masahiro

    2002-01-01

    Ranges in diurnal variation and the patterns of body temperature (T), blood pressure (BP), heart rate (HR) and locomotor activity (LA) in 61 laboratory beagle dogs were analyzed using a telemetry system. Body temperature, BP, HR and LA increased remarkably at feeding time. Locomotor activity increased sporadically during the other periods. Body temperature was maintained at the higher value after feeding but had decreased by 0.2 C by early the next morning. Blood pressure fell to a lower value after feeding but had increased by 2.8% by early the next morning. Heart rate decreased progressively after feeding and was 14.5% lower the next morning. This study determined that in laboratory beagles the ranges of diurnal variation and patterns of T, BP and HR are significantly different from those reported in humans and rodents, and that over 24 hr these physiological changes were associated with their sporadic wake-sleep cycles of the dogs.

  1. 42 CFR 493.807 - Condition: Reinstatement of laboratories performing nonwaived testing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Reinstatement of laboratories performing nonwaived testing. 493.807 Section 493.807 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS...

  2. 42 CFR 493.807 - Condition: Reinstatement of laboratories performing nonwaived testing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Reinstatement of laboratories performing nonwaived testing. 493.807 Section 493.807 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS...

  3. 42 CFR 493.1361 - Condition: Laboratories performing PPM procedures; testing personnel.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing PPM procedures; testing personnel. 493.1361 Section 493.1361 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS...

  4. 42 CFR 493.1361 - Condition: Laboratories performing PPM procedures; testing personnel.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Laboratories performing PPM procedures; testing personnel. 493.1361 Section 493.1361 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS...

  5. 42 CFR 493.1359 - Standard; PPM laboratory director responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; PPM laboratory director responsibilities... AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Personnel for Nonwaived Testing Laboratories Performing Provider-Performed Microscopy (ppm) Procedures § 493.1359 Standard...

  6. Laboratory studies of low temperature rate coefficients: The atmospheric chemistry of the outer planets

    NASA Technical Reports Server (NTRS)

    Leone, Stephen R.

    1992-01-01

    The purpose of the project is to perform laboratory measurements of reaction rate coefficients at low temperature. The reactions and temperatures of interest are those that are important in the chemistry of the hydrocarbon rich atmospheres of the outer planets and their satellites. In this stage of the study we are investigating reactions of ethynyl radicals, C2H, with acetylene (C2H2), methane (CH4), and hydrogen (H2). In the previous status report from 24 Jan. 1992, we reported on the development of the experimental apparatus and the first, preliminary data for the C2H + C2H2 reaction.

  7. Factors affecting the first service conception rate of cows in smallholder dairy farms in Bangladesh.

    PubMed

    Siddiqui, M A R; Das, Z C; Bhattacharjee, J; Rahman, M M; Islam, M M; Haque, M A; Parrish, J J; Shamsuddin, M

    2013-06-01

    The successful outcome of an insemination is a combination of both male and female fertility-linked factors. We investigated the first service conception rate of cows at artificial insemination (AI) in the smallholder dairy farms in Bangladesh. Frozen straws were prepared from ejaculates of Bos indicus (n = 7) and Bos indicus × Bos taurus (n = 7) AI bulls. Fertility was determined from 6101 first services in cows that were performed by 18 technicians in four regions between April 2004 and March 2005. Pregnancy was diagnosed by rectal palpation between 60 and 90 days post-insemination. The Asian version of Artificial Insemination Database Application (AIDA ASIA) was used for bulls-, cows- and AI-related data recording, and later retrieved for analysis. The mean ± SD number of inseminations performed from individual bulls and their conception rates were 436.0 ± 21.6 and 50.7 ± 1.9%, respectively. Logistic regression demonstrated body condition scores (BCS), heat detection signs, months of AI and their interactions had greatest effects (odds ratios: 1.24-16.65, p < 0.04-0.001) on first service conception rate in cows. Fertility differed (p < 0.02-0.001) between the regions, previous calving months, months of AI, BCS, parity and heat detection signs of cows. Inseminations based on mounting activity (n = 2352), genital discharge (n = 3263) and restlessness and/or other signs (n = 486) yielded a conception rate of 53.6%, 48.8% and 50.1%, respectively (p < 0.05). Conception rate between technicians ranged between 43.4% and 58.6% (p < 0.05). The days interval from calving to first service (overall mean ± SD = 153.4 ± 80.6) had relationship (p < 0.001) with BCS, months of previous calving and parity of the cows. Fertility at AI in smallholder farms can be improved by training farmers on nutrition and reproductive management of the cows. © 2012 Blackwell Verlag GmbH.

  8. Autoclaving practice in microbiology laboratories: report of a survey. The Public Health Laboratory Service Subcommittee on laboratory autoclaves.

    PubMed Central

    1978-01-01

    The performance of autoclaves in 27 laboratories, operated in accordance with the normal routine of local practice, has been monitored using thermometric equipment. Sterilising performance was unsatisfactory on 10 of 62 occasions, and cooling was inadequate on 52 of 60 occasions. PMID:649767

  9. Noise Emission from Laboratory Air Blowers

    ERIC Educational Resources Information Center

    Rossing, Thomas D.; Windham, Betty

    1978-01-01

    Product noise ratings for a number of laboratory air blowers are reported and several recommendations for reducing laboratory noise from air blowers are given. Relevant noise ratings and methods for measuring noise emission of appliances are discussed. (BB)

  10. Neighborhood Alcohol Outlet Density and Rates of Child Abuse and Neglect: Moderating Effects of Access to Substance Abuse Services

    PubMed Central

    Morton, Cory M.; Simmel, Cassandra; Peterson, N. Andrew

    2014-01-01

    This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. PMID:24529493

  11. Investigating the Effect of Argument-Driven Inquiry in Laboratory Instruction

    ERIC Educational Resources Information Center

    Demircioglu, Tuba; Ucar, Sedat

    2015-01-01

    The aim of this study is to investigate the effect of argument-driven inquiry (ADI) based laboratory instruction on the academic achievement, argumentativeness, science process skills, and argumentation levels of pre-service science teachers in the General Physics Laboratory III class. The study was conducted with 79 pre-service science teachers.…

  12. 7 CFR 91.4 - Kinds of services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... in performing commodity testing services. (c) Quality assurance reviews. The Science and Technology..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS.... Analytical laboratory testing services under the regulations in this subchapter consist of microbiological...

  13. 7 CFR 91.4 - Kinds of services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... in performing commodity testing services. (c) Quality assurance reviews. The Science and Technology..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS.... Analytical laboratory testing services under the regulations in this subchapter consist of microbiological...

  14. 7 CFR 91.4 - Kinds of services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... in performing commodity testing services. (c) Quality assurance reviews. The Science and Technology..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS.... Analytical laboratory testing services under the regulations in this subchapter consist of microbiological...

  15. 7 CFR 91.4 - Kinds of services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... in performing commodity testing services. (c) Quality assurance reviews. The Science and Technology..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS.... Analytical laboratory testing services under the regulations in this subchapter consist of microbiological...

  16. 7 CFR 868.90 - Fees for certain Federal inspection services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Laboratory Test Services 1 Laboratory tests Fees (1) Aflatoxin (Quantitative—HPLC) $182.00 (2) Aflatoxin (Quantitative—Test Kit) 87.00 (3) Aflatoxin (Qualitative—Test Kit) 47.00 (4) Appearance and odor 7.00 (5) Ash 17...) Vomitoxin (Quantitative—Test Kit) 81.00 (32) Other laboratory analytical services (per hour per service...

  17. 7 CFR 868.90 - Fees for certain Federal inspection services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Laboratory Test Services 1 Laboratory tests Fees (1) Aflatoxin (Quantitative—HPLC) $182.00 (2) Aflatoxin (Quantitative—Test Kit) 87.00 (3) Aflatoxin (Qualitative—Test Kit) 47.00 (4) Appearance and odor 7.00 (5) Ash 17...) Vomitoxin (Quantitative—Test Kit) 81.00 (32) Other laboratory analytical services (per hour per service...

  18. 7 CFR 868.90 - Fees for certain Federal inspection services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Laboratory Test Services 1 Laboratory tests Fees (1) Aflatoxin (Quantitative—HPLC) $182.00 (2) Aflatoxin (Quantitative—Test Kit) 87.00 (3) Aflatoxin (Qualitative—Test Kit) 47.00 (4) Appearance and odor 7.00 (5) Ash 17...) Vomitoxin (Quantitative—Test Kit) 81.00 (32) Other laboratory analytical services (per hour per service...

  19. 7 CFR 868.90 - Fees for certain Federal inspection services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Laboratory Test Services 1 Laboratory tests Fees (1) Aflatoxin (Quantitative—HPLC) $182.00 (2) Aflatoxin (Quantitative—Test Kit) 87.00 (3) Aflatoxin (Qualitative—Test Kit) 47.00 (4) Appearance and odor 7.00 (5) Ash 17...) Vomitoxin (Quantitative—Test Kit) 81.00 (32) Other laboratory analytical services (per hour per service...

  20. 75 FR 1063 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory Committee (CLIAC) In accordance with section 10(a)(2) of the Federal Advisory... under which clinical laboratories are regulated; the impact on medical and laboratory practice of...

  1. 42 CFR 493.555 - Federal review of laboratory requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Federal review of laboratory requirements. 493.555... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Accreditation by a Private, Nonprofit Accreditation Organization or Exemption Under an Approved State Laboratory Program § 493.555...

  2. 42 CFR 493.555 - Federal review of laboratory requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Federal review of laboratory requirements. 493.555... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Accreditation by a Private, Nonprofit Accreditation Organization or Exemption Under an Approved State Laboratory Program § 493.555...

  3. Helicopter emergency medical services accident rates in different international air rescue systems

    PubMed Central

    Hinkelbein, J; Schwalbe, M; Genzwuerker, HV

    2010-01-01

    Aim Each year approximately two to four helicopter emergency medical services (HEMS) crashes occur in Germany. The aim of the present study was to compare crash rates and fatal crash rates in Germany to rates in other countries. Materials and methods A MEDLINE search from 1970 to 2009 was performed using combinations of the keywords “HEMS”, “rescue helicopter”, “accident”, “accident rate”, “crash”, and “crash rate”. The search was supplemented by additional published data. Data were compared on the basis of 10,000 missions and 100,000 helicopter flying hours. These data were allocated to specific time frames for analyis. Results Eleven relevant studies were identified. Five studies (three from Germany, one from the US, one from Australia) analyzing HEMS accidents on the basis of 10,000 missions were identified. Crash rates per 10,000 missions ranged between 0.4 and 3.05 and fatal crash rates between 0.04 and 2.12. In addition, nine studies (six from the US, two from Germany, one from Australia) used 100,000 flying hours as a denominator. Here, crash rates ranged between 1.7 and 13.4 and fatal crash rates between 0.91 and 4.7. Conclusions Data and accident rates were inhomogeneous and differed significantly. Data analysis was impeded by publication of mean data, use of different time frames, and differences in HEMS systems. PMID:27147837

  4. Hospital laboratory outreach: benefits and planning.

    PubMed

    Anderson, Victoria

    2007-12-01

    A laboratory outreach program can benefit the hospital in several ways, such as increasing revenues, filling unused capacity, and solidifying relationships with the physician and patient communities. Building rapport with physicians and the community ultimately brings economic value to the hospital. To service this new market it is necessary to modify current systems and processes and develop new services. The areas most likely to be developed are logistics, service centers, client services, physician connectivity, billing, marketing, sales, and finance reporting. Developing efficient customer-related services is a key to reaping the benefits.

  5. Adding value to laboratory medicine: a professional responsibility.

    PubMed

    Beastall, Graham H

    2013-01-01

    Laboratory medicine is a medical specialty at the centre of healthcare. When used optimally laboratory medicine generates knowledge that can facilitate patient safety, improve patient outcomes, shorten patient journeys and lead to more cost-effective healthcare. Optimal use of laboratory medicine relies on dynamic and authoritative leadership outside as well as inside the laboratory. The first responsibility of the head of a clinical laboratory is to ensure the provision of a high quality service across a wide range of parameters culminating in laboratory accreditation against an international standard, such as ISO 15189. From that essential baseline the leadership of laboratory medicine at local, national and international level needs to 'add value' to ensure the optimal delivery, use, development and evaluation of the services provided for individuals and for groups of patients. A convenient tool to illustrate added value is use of the mnemonic 'SCIENCE'. This tool allows added value to be considered in seven domains: standardisation and harmonisation; clinical effectiveness; innovation; evidence-based practice; novel applications; cost-effectiveness; and education of others. The assessment of added value in laboratory medicine may be considered against a framework that comprises three dimensions: operational efficiency; patient management; and patient behaviours. The profession and the patient will benefit from sharing examples of adding value to laboratory medicine.

  6. Revealing all: misleading self-disclosure rates in laboratory-based online research.

    PubMed

    Callaghan, Diana E; Graff, Martin G; Davies, Joanne

    2013-09-01

    Laboratory-based experiments in online self-disclosure research may be inadvertently compromising the accuracy of research findings by influencing some of the factors known to affect self-disclosure behavior. Disclosure-orientated interviews conducted with 42 participants in the laboratory and in nonlaboratory settings revealed significantly greater breadth of self-disclosure in laboratory interviews, with message length and intimacy of content also strongly related. These findings suggest that a contrived online setting with a researcher presence may stimulate motivation for greater self-disclosure than would occur naturally in an online environment of an individual's choice. The implications of these findings are that researchers should consider the importance of experimental context and motivation in self-disclosure research.

  7. 76 FR 53160 - Postal Service Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-25

    ... Functionally Equivalent Agreement, August 12, 2011 (Notice). See also Docket Nos. MC2010-35, R2010-5 and R2010... Operators 1 product and two functionally equivalent agreements, Strategic Bilateral Agreement Between United...[egrave]s Service Agreement is functionally equivalent to the delivery confirmation service provided with...

  8. Heparin-induced thrombocytopenia: reducing misdiagnosis via collaboration between an inpatient anticoagulation pharmacy service and hospital reference laboratory.

    PubMed

    Burnett, Allison E; Bowles, Harmony; Borrego, Matthew E; Montoya, Tiffany N; Garcia, David A; Mahan, Charles

    2016-11-01

    Misdiagnosis of heparin-induced thrombocytopenia (HIT) is common and exposes patients to high-risk therapies and potentially serious adverse events. The primary objective of this study was to evaluate the impact of collaboration between an inpatient pharmacy-driven anticoagulation management service (AMS) and hospital reference laboratory to reduce inappropriate HIT antibody testing via pharmacist intervention and use of the 4T pre-test probability score. Secondary objectives included clinical outcomes and cost-savings realized through reduced laboratory testing and decreased unnecessary treatment of HIT. This was a single center, pre-post, observational study. The hospital reference laboratory contacted the AMS when they received a blood sample for an enzyme-linked immunosorbent HIT antibody (HIT Ab). Trained pharmacists prospectively scored each HIT Ab ordered by using the 4T score with subsequent communication to physicians recommending for or against processing and reporting of lab results. Utilizing retrospective chart review and a database for all patients with a HIT Ab ordered during the study period, we compared the incidence of HIT Ab testing before and after implementation of the pharmacy-driven 4T score intervention. Our intervention significantly reduced the number of inappropriate HIT Ab tests processed (176 vs. 63, p < 0.0001), with no increase in thrombotic or hemorrhagic events. Overall incidence of suspected and confirmed HIT was <3 and <0.005 %, respectively. Overall cost savings were $75,754 (US) or 62 % per patient exposed to heparin between the pre and post intervention groups. Collaboration between inpatient pharmacy AMS and hospital reference laboratories can result in reduction of misdiagnosis of HIT and significant cost savings with similar safety.

  9. Peoria Disposal Co.`s PDC Laboratories: Analyzing and cleaning up -- Literally

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    McAdams, C.L.

    1995-10-01

    In the early 1980s, says Royal Coulter, president and CEO of Peoria Disposal Co. (PDC, Peoria, IL), many PDC customers were unfamiliar with the methods required for the proper characterization of then newly regulated hazardous wastes. So in early 1981, to expedite permitting and, ultimately, acceptance of waste by PDC, a lab was set up so the company could step in and provide the needed services. By focusing on the delivery of quality services in the analysis of groundwater, wastewater, and solid waste for PDC, Coulter says, the laboratory soon developed into a successful and independent commercial operation. In Julymore » of 1981, PDC Laboratories was incorporated as an independent environmental analytical laboratory. PDC Labs is a subsidiary of PDC Technical Services, Inc., which provides environmental consulting and site remediation services, and is itself a wholly-owned subsidiary of Coulter Companies, Inc. Peoria Disposal offers solid waste disposal, industrial waste water treatment, waste stabilization, transportation services, and brokerage services.« less

  10. A Laboratory to Demonstrate the Effect of Thermal History on Semicrystalline Polymers Using Rapid Scanning Rate Differential Scanning Calorimetry

    ERIC Educational Resources Information Center

    Badrinarayanan, Prashanth; Kessler, Michael R.

    2010-01-01

    A detailed understanding of the effect of thermal history on the thermal properties of semicrystalline polymers is essential for materials scientists and engineers. In this article, we describe a materials science laboratory to demonstrate the effect of parameters such as heating rate and isothermal annealing conditions on the thermal behavior of…

  11. Utilization of professional mental health services according to recognition rate of mental health centers.

    PubMed

    Lee, Hyo Jung; Ju, Young Jun; Park, Eun-Cheol

    2017-04-01

    Despite the positive effect of community-based mental health centers, the utilization of professional mental health services appears to be low. Therefore, we analyzed the relationship between regional recognition of mental health centers and utilization of professional mental health services. We used data from the Community Health Survey (2014) and e-provincial indicators. Only those living in Seoul, who responded that they were either feeling a lot of stress or depression, were included in the study. Multiple logistic regression analysis using generalized estimating equations was performed to examine both individual- and regional-level variables associated with utilization of professional mental health services. Among the 7338 participants who reported depression or stress, 646 (8.8%) had consulted a mental health professional for their symptoms. A higher recognition rate of mental health centers was associated with more utilization of professional mental health services (odds ratio [OR]=1.05, 95% confidence interval [CI]=1.03-1.07). Accessibility to professional mental health services could be improved depending on the general population's recognition and attitudes toward mental health centers. Therefore, health policy-makers need to plan appropriate strategies for changing the perception of mental health services and informing the public about both the benefits and functions of mental health centers. Copyright © 2017. Published by Elsevier B.V.

  12. Challenges to laboratory hematology practice: Egypt perspective.

    PubMed

    Rizk, S H

    2018-05-01

    Laboratory hematology is an integral part of all clinical laboratories along the extensive healthcare facilities in Egypt. The aim of this review is to portrait the laboratory hematology practice in Egypt including its unique socioeconomic background, blood disease pattern, education and training, regulatory oversight, and the related challenges. Current practice varies widely between different parts of the healthcare system in terms of the range of tests, applied techniques, workforce experience, and quality of service. The national transfusion service (NBTS) in Egypt has been recently upgraded and standardized according to the World Health Organization (WHO) guidelines. Formal postgraduate education roughly follows the British system. Laboratory hematology specialization is achieved through 2-3 years masters' degree followed by 2-4 years doctorate degree in clinical pathology with training and research in hematology. Improvement of laboratory hematology education is recently undergoing a reform as a part of the modernization of higher education policy and following the standards developed by the National Quality Assurance and Accreditation Agency (NQAAA). Accreditation of medical laboratories is recently progressing with the development of the "Egyptian Accreditation Council" (EGAC) as the sole accreditation body system and training of assessors. Current laboratory system has many challenges, some are related to the inadequate system performance, and others are unique to laboratory hematology issues. The rapid technological advances and therapeutic innovations in hematology practice call for an adapting laboratory system with continuous upgrading. © 2018 John Wiley & Sons Ltd.

  13. The laboratory diagnosis of syphilis.

    PubMed

    Ratnam, Sam

    2005-01-01

    Syphilis has several clinical manifestations, making laboratory testing a very important aspect of diagnosis. In North America, many unsuspected cases are discovered by laboratory testing. The etiological agent, Treponema pallidum, cannot be cultured, and there is no single optimal alternative test. Serological testing is the most frequently used approach in the laboratory diagnosis of syphilis. The present paper discusses the various serological and alternative tests currently available along with their limitations, and relates their results to the likely corresponding clinical stage of the disease. The need to use multiple tests is discussed, and the importance of quality control is noted. The complexity of syphilis serology means that the services of reference laboratories and clinical experts are often needed.

  14. 10 CFR 430.25 - Laboratory Accreditation Program.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Procedures § 430.25 Laboratory Accreditation Program. The testing for general service fluorescent lamps... Appendix R to this subpart. The testing for medium base compact fluorescent lamps shall be performed in accordance with Appendix W of this subpart. This testing shall be conducted by test laboratories accredited...

  15. 10 CFR 430.25 - Laboratory Accreditation Program.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Procedures § 430.25 Laboratory Accreditation Program. The testing for general service fluorescent lamps... Appendix R to this subpart. The testing for medium base compact fluorescent lamps shall be performed in accordance with Appendix W of this subpart. This testing shall be conducted by test laboratories accredited...

  16. Clinical Laboratory Automation: A Case Study

    PubMed Central

    Archetti, Claudia; Montanelli, Alessandro; Finazzi, Dario; Caimi, Luigi; Garrafa, Emirena

    2017-01-01

    Background This paper presents a case study of an automated clinical laboratory in a large urban academic teaching hospital in the North of Italy, the Spedali Civili in Brescia, where four laboratories were merged in a unique laboratory through the introduction of laboratory automation. Materials and Methods The analysis compares the preautomation situation and the new setting from a cost perspective, by considering direct and indirect costs. It also presents an analysis of the turnaround time (TAT). The study considers equipment, staff and indirect costs. Results The introduction of automation led to a slight increase in equipment costs which is highly compensated by a remarkable decrease in staff costs. Consequently, total costs decreased by 12.55%. The analysis of the TAT shows an improvement of nonemergency exams while emergency exams are still validated within the maximum time imposed by the hospital. Conclusions The strategy adopted by the management, which was based on re-using the available equipment and staff when merging the pre-existing laboratories, has reached its goal: introducing automation while minimizing the costs. Significance for public health Automation is an emerging trend in modern clinical laboratories with a positive impact on service level to patients and on staff safety as shown by different studies. In fact, it allows process standardization which, in turn, decreases the frequency of outliers and errors. In addition, it induces faster processing times, thus improving the service level. On the other side, automation decreases the staff exposition to accidents strongly improving staff safety. In this study, we analyse a further potential benefit of automation, that is economic convenience. We study the case of the automated laboratory of one of the biggest hospital in Italy and compare the cost related to the pre and post automation situation. Introducing automation lead to a cost decrease without affecting the service level to patients

  17. Clinical Laboratories – Production Factories or Specialized Diagnostic Centers

    PubMed Central

    Tóth, Judit

    2016-01-01

    Since a large proportion of medical decisions are based on laboratory results, clinical laboratories should meet the increasing demand of clinicians and their patients. Huge central laboratories may process over 10 million tests annually; they act as production factories, measuring emergency and routine tests with sufficient speed and accuracy. At the same time, they also serve as specialized diagnostic centers where well-trained experts analyze and interpret special test results. It is essential to improve and constantly monitor this complex laboratory service, by several methods. Sample transport by pneumatic tube system, use of an advanced laboratory information system and point-of-care testing may result in decreased total turnaround time. The optimization of test ordering may result in a faster and more cost-effective laboratory service. Autovalidation can save time for laboratory specialists, when the analysis of more complex results requires their attention. Small teams of experts responsible for special diagnostic work, and their interpretative reporting according to predetermined principles, may help to minimize subjectivity of these special reports. Although laboratory investigations have become so diversely developed in the past decades, it is essential that the laboratory can provide accurate results relatively quickly, and that laboratory specialists can support the diagnosis and monitoring of patients by adequate interpretation of esoteric laboratory methods. PMID:27683528

  18. Centralization of a regional clinical microbiology service: The Calgary experience

    PubMed Central

    Church, Deirdre L; Hall, Paula

    1999-01-01

    Diagnostic laboratory services in Alberta have been dramatically restructured over the past five years. In 1994, Alberta Health embarked on an aggressive laboratory restructuring that cut back approximately 30% of the overall monies previously paid to the laboratory service sector in Calgary. A unique service delivery model consolidated all institutional and community-based diagnostic testing in a company called Calgary Laboratory Services (CLS) in late 1996. CLS was formed by a public/private partnership between the Calgary Regional Health Care Authority (CRHA) and MDS-Kasper Laboratories. By virtue of its customer service base and scope of testing, CLS provides comprehensive regional laboratory services to the entire populace. Regional microbiology services within CLS have been successfully consolidated over the past three years into a centralized high volume laboratory (HVL). Because the HVL is not located in a hospital, rapid response laboratories (RRLs) are operated at each acute care site. Although the initial principle behind the proposed test menus for the RRLs was that only procedures requiring a clinical turnaround time of more than 2 h stay on-site, many other principles had to be used to develop and implement an efficient and clinically relevant RRL model for microbiology. From these guiding principles, a detailed assessment of the needs of each institution and extensive networking with user groups, the functions of the microbiology RRLs were established and a detailed implementation plan drawn up. The experience at CLS with regards to restructuring a regional microbiology service is described herein. A post-hoc analysis provides the pros and cons of directing and operating a regionalized microbiology service. PMID:22346397

  19. Neighborhood alcohol outlet density and rates of child abuse and neglect: moderating effects of access to substance abuse services.

    PubMed

    Morton, Cory M; Simmel, Cassandra; Peterson, N Andrew

    2014-05-01

    This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Competency Guidelines for Public Health Laboratory Professionals: CDC and the Association of Public Health Laboratories.

    PubMed

    Ned-Sykes, Renée; Johnson, Catherine; Ridderhof, John C; Perlman, Eva; Pollock, Anne; DeBoy, John M

    2015-05-15

    These competency guidelines outline the knowledge, skills, and abilities necessary for public health laboratory (PHL) professionals to deliver the core services of PHLs efficiently and effectively. As part of a 2-year workforce project sponsored in 2012 by CDC and the Association of Public Health Laboratories (APHL), competencies for 15 domain areas were developed by experts representing state and local PHLs, clinical laboratories, academic institutions, laboratory professional organizations, CDC, and APHL. The competencies were developed and reviewed by approximately 170 subject matter experts with diverse backgrounds and experiences in laboratory science and public health. The guidelines comprise general, cross-cutting, and specialized domain areas and are divided into four levels of proficiency: beginner, competent, proficient, and expert. The 15 domain areas are 1) Quality Management System, 2) Ethics, 3) Management and Leadership, 4) Communication, 5) Security, 6) Emergency Management and Response, 7) Workforce Training, 8) General Laboratory Practice, 9) Safety, 10) Surveillance, 11) Informatics, 12) Microbiology, 13) Chemistry, 14) Bioinformatics, and 15) Research. These competency guidelines are targeted to scientists working in PHLs, defined as governmental public health, environmental, and agricultural laboratories that provide analytic biological and/or chemical testing and testing-related services that protect human populations against infectious diseases, foodborne and waterborne diseases, environmental hazards, treatable hereditary disorders, and natural and human-made public health emergencies. The competencies support certain PHL workforce needs such as identifying job responsibilities, assessing individual performance, and providing a guiding framework for producing education and training programs. Although these competencies were developed specifically for the PHL community, this does not preclude their broader application to other professionals

Some links on this page may take you to non-federal websites. Their policies may differ from this site.