Subject(s)
Terminal Care/methods , Aged , Communication , Counseling , Ethics, Medical , Family , Humans , Terminal Care/standardsABSTRACT
While scientific developments have done much to improve the lot of mankind, especially in the developed world, this progress has been purchased by the division of our understanding of the person into parts. The effect has been that spiritual concerns of the person have not been considered the proper role of the medical community. The number of aged persons who are less reticent to demand discussion of their overall needs as well as the hospice movement itself has had the effect of bringing the spiritual back into consideration by health-care professionals.
Subject(s)
Attitude to Death , Christianity , Holistic Health , Hospices/history , Demography , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , United Kingdom , United StatesSubject(s)
Heroin/therapeutic use , Legislation, Drug , Pain, Intractable/drug therapy , Canada , Foundations , Humans , Palliative CareABSTRACT
A compulsory programme of proficiency testing in immunohaematology has been conducted for the last 4 years. The collection, processing and analysis of testing data reported by participating laboratories depends on a computer-based system, which allows the generation of reports for participants and working documents essential to the functioning of a committee which supervises the operation of the programme. The options open to the committee in coping with laboratories with poor performance are summarized.
Subject(s)
Blood Group Antigens , Laboratories/standards , Reference Standards , ABO Blood-Group System , Antibodies , Computers , Coombs Test , Data Collection , Diagnostic Errors , Humans , Rh-Hr Blood-Group SystemABSTRACT
An analysis of the results of a compulsory proficiency testing programme in immunohaematology is presented. Error rates have been calculated for the determination of ABO and Rh(D) groups, the direct antiglobulin test and antibody detection according to defined criteria. The introduction of proficiency testing has been associated with alterations in error rates for some determinations. An educational programme introduced for laboratories with poor performance has proved effective in improving their results in the proficiency testing programme.
Subject(s)
Blood Group Antigens , Laboratories/standards , Reference Standards , ABO Blood-Group System , Antibodies , Blood Grouping and Crossmatching , Data Collection , Humans , Rh-Hr Blood-Group SystemABSTRACT
Since April 1975 the proficiency of laboratories in Ontario that perform immunohematology tests has been assessed. While the majority of test samples have required only ABO and Rh(D) typing, others have posed problems. The error rate in uncomplicated ABO typing was 1.3/1,000 in 17,479 tests and that in straightforward Rh(D) grouping, 6.6/1,000 in 17,757 tests. False-negative (36/1,000) and false-positive (1.4/1,000) direct antiglobulin tests occurred. Errors in detection of strong alloantibodies (e.g., anti-D) were 19.7, 10.2 and 5.1/1,000 in three test samples. A2B or A2 cells with anti-A1 in serum were sent out in two surveys; error rates in ABO interpretation were 189 and 52/1,000, respectively. Laboratories also experienced difficulty in interpreting the Rh(D) type of cells with positive antiglobulin tests. These surveys have had several effects: (1) laboratories with poor performance have been identified, (2) patterns of practice have been influenced, (3) areas of ignorance have been identified, and (4) a stimulus has been provided for continuing education in immunohematology.
