Infectious disease is the most common cause of illness and death in Africa, yet health practitioners routinely fail to identify causative microorganisms in most patients. As a result, patients often ...do not receive the right medicine in time to cure them promptly even when such medicine is available, outbreaks are larger and more devastating than they should be, and the impact of control interventions is difficult to measure. Wrong prescriptions and prolonged infections amount to needless costs for patients and for health systems. In Divining without Seeds, Iruka N. Okeke forcefully argues that laboratory diagnostics are essential to the effective practice of medicine in Africa.The diversity of endemic life-threatening infections and limited public health resources in tropical Africa make the need for basic laboratory diagnostic support even more acute than in other parts of the world. This book gathers compelling case studies of inadequate diagnoses of diseases ranging from fevers—including malaria—to respiratory infections and sexually transmitted diseases. The inherited and widely prevalent health clinic model, which excludes or diminishes the hospital laboratory, is flawed, to often devastating effect. Fortunately, there are new technologies that make it possible to inexpensively implement testing at the primary care level. Divining without Seeds makes clear that routine use of appropriate diagnostic support should be part of every drug delivery plan in Africa and that diagnostic development should be given high priority.
Abstract
Introduction
This study sought to evaluate the nature and frequency of laboratory recommendations made by medical societies other than ASCP.
Methods
Review of all 2012 to 2018 ABIM Choosing ...Wisely (CW) non-ASCP laboratory recommendations and categorization of recommendations per topic area.
Results
There are 107 total recommendations made by other medical specialties that involve laboratory medicine. The most common recommendations are (1) Transfusion Medicine: to minimize transfusion of PRCs (19 recommendations, 18%); (2) Women’s Health: Pap smear testing, other women’s health testing (18 recommendations, 17%); and (3) General Laboratory: reducing repetitive routine laboratory tests (10 recommendations, 9%). Most (64, 60%) recommendations addressed screening while 29 (27%) focused on treatment and 14 (13%) were related to monitoring disease.
Conclusion
Almost one-half (44%) of all recommendations fell into three common areas and there were more recommendations related to screening for disease than for treatment or monitoring. For Choosing Wisely to achieve increasing success, increasing efforts are needed to disseminate this information, promote multidisciplinary effective test utilization, and encourage continued laboratory medicine recommendations from all medical stakeholders.
BackgroundDutch estimates suggest that general practitioners (GPs) perform two-third of all STI consultations, and centres for sexual health (CSH) account for most of the remaining consultations. ...Yet, a comparison of consultation rates by both providers is hampered due to separate surveillance systems. We assessed the distribution of STI consultations (defined as urogenital Chlamydia trachomatis (CT) test-rates) in five regions.MethodsData (2011 to 2016) on laboratory testing and diagnosis of urogenital CT were retrieved from CSH at public health services and laboratories in five Dutch geographical regions, aggregated by sex and age category (15–24 and 25–64 years). Regions included Amsterdam, Rotterdam, Northeast –Netherlands (N-NL), Twente and Maastricht. Using negative binomial regression, we tested for time-trends in CT test-rate per 10,000 population at GPs and CSH within five regions and differences between the providers by region.ResultsThe five regions included in this study varied from mostly rural (N-NL) to highly urban (Amsterdam and Rotterdam). The relative contribution of GPs in consultation rate decreased over time in Amsterdam (60.0–47.8%), Twente (78.6–61.4%), Maastricht (59.2–47.2%), N-NL (82.4–76.9%), but not in Rotterdam (65.4–67.0%). This decrease resulted from an increase in all CSH consultation rates and a slight decrease in GP consultation rate (except for Rotterdam). Women and persons aged 25–64 years were more likely to be tested by GPs compared to CSH (relative risks of 5 regions ranging from 1.47–4.76; 1.58–7.43 respectively). All regions combined, the average yearly positivity rate was 9.2% at the GP and 10.7% at the CSH.ConclusionGPs are still a major contributor in STI consultations, yet the CSH- contribution has increased between 2011 and 2016. In urban regions, the CSH has a considerable role, whereas in rural areas the GP provides most consultations. An explanation for differences may be CSH accessibility.DisclosureNo significant relationships.
Hao Win, Hui Ma and Sajjad Hussain were incorrectly affiliated to 'Department of Radiation Oncology, The Houston Methodist Research Institute, Houston, TX 77030 USA'. These authors should only have ...been affiliated to 'Hefei National Laboratory for Physical Sciences at Microscale, The First Affiliated Hospital of USTC, USTC-SJH Joint Center for Human Reproduction and Genetics, The CAS Key Laboratory of Innate Immunity and Chronic Diseases, School of Life Sciences, CAS Center for Excellence in Molecular Cell Science, Collaborative Innovation Center of Genetics and Development, University of Science and Technology of China, Hefei 230027, China'. They were also not noted as contributing equally to the paper. Both these errors have now been corrected in the PDF and HTML versions of the paper.
O estudo tem como objetivo fomentar a utilização de um Laboratório de Práticas no Curso de Administração. Trata-se de um estudo de caso com abordagem qualitativa. Foram inicialmente selecionados ...cursos de Administração, conceito máximo no Exame Nacional de Desempenho dos Estudantes (ENADE), foram selecionados aqueles que possuíam Laboratório de Práticas (LP), onde foram levantadas atividades realizadas nesses espaços. Em seguida, foram aplicados questionários com professores que atuam em um Curso de Administração em uma universidade pública, no intuito de conhecer percepções e perspectivas com Laboratório de Práticas. Os cursos selecionados apresentaram poucas informações sobre seus laboratórios, a maioria apresenta laboratórios de informática com usos diversificados. Os professores participantes da pesquisa se mostraram conscientes da importância dos laboratórios, a maioria revelou experiências com atividades práticas vivenciadas em outras instituições, eles veem o laboratório como espaço potencial para utilizar metodologias ativas, ferramentas geradoras de ideias e de diagnóstico organizacional.
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