The results of a close follow-up of trainees to gain a good blood collection practice

BackgroundPhlebotomy is one of the most important steps in the preanalytical phase of a clinical laboratory process. In order to decrease phlebotomy errors, this specific procedure should be taught in detail by laboratory organizations. Our study aims to practice the training program on venous blood sampling and observe the close follow-up results.MethodsIn this observational study, 127 students who started their summer internship in Antalya Education and Research Hospital were given a one-day theoretical phlebotomy training in accordance with the Venous Blood Sampling Guidelines. After the theoretical training, phlebotomy applications of 10 students who were working in the field of out-patient blood sampling were observed both with and without their knowledge. A comprehensive checklist related to phlebotomy was created by the trainers in Antalya Education and Research Hospital and the observers answered each question as yes or no. For the statistical analysis, IBM SPSS Statistics 21.0 was used.ResultsAfter the theoretical education, the trainees were observed but no significant difference was found between the first and the second informed observations (p = 0.125). The students were observed three times more in the following week without their knowledge. There was a statistically significant difference between the first and the third unannounced observations (p=0.001).ConclusionsIn order to perform phlebotomy correctly, apart from theoretical education, a close follow-up is necessary too.     

Reimagining policy: Power,problems, and public stories

The authors of various practitioner and scholarly documents suggest markedly contrasting understandings about the nature of “policy.” These divergent conceptions raise the question: What is at stake by understanding the nature of policy in one way as opposed to another? The purpose of this philosophical inquiry is to interrogate the nature of “policy” as it relates to music education and to question the values that do and might underlie and propagate through contrasting understandings of “policy.” Subsequently, I examine two aspects of policy, problem identification and meaning-making, that have gone largely unexplored in the arts education literature.

Using Foucault's writings, I argue that power-laden policy texts often have the greatest impact, not when they are mandated, but when they go misrecognized as common sense. I also advocate for the consistent use of the terms “policy texts” and “policy actions,” including as an alternative to the imbalanced designations of “soft policies” and “hard policies.” Drawing on Dewey arts educators might form “publics” around problems having consequences that they deem far-reaching, recurrent, and irreparable. Individual and collective political narratives, including what Ganz explains as “stories of self,” “stories of us,” and “stories of now,” can foster the meaningful connections necessary for forming “publics” who address pressing problems in arts education.     

多措并举 激发兴趣 提高教学效果

针对高职招生文理兼收和学生学习基础实际,在细胞生物学与医学遗传学课程教学中,通过案例引导丰富感性认识,创设问题情境培养主动学习能力,运用网络优势培养获取信息和解读问题能力,设计趣味性开放实验提高实践能力,促进知识理解和技能提高,提高教学实效.     

戈壁野营驻训我部开展卫生防病的实践体会

新形势下,做好部队野营训练的卫勤保障工作,深入研究训练伤及其相关疾病的防治,是新时期军事斗争准备卫勤保障的重要内容,也是时代赋予医务人员的崇高责任。随着信息化进程的不断加快,部队完成军事斗争准备各项任务日趋繁重。对广大官兵的身心健康提出了更高标准,发挥健康教育优势,促进官兵健康,必须与时俱进,不断创新。我部采取多种方式、提高官兵自我防护及保健能力,从而促进部队整体全面建设稳步发展。     

How do we restore New Zealand's biological heritage by 2050?

If we are to make meaningful and measurable progress in restoring New Zealand's biological heritage by 2050, a range of fundamental issues need to be addressed. These relate not just to restoration science but also to building ecosystem resilience in the wider socio‐economic and cultural context within which restoration occurs.     

Wolf population genetics in Europe: a systematic review,meta‐analysis and suggestions for conservation and management

The grey wolf (Canis lupus) is an iconic large carnivore that has increasingly been recognized as an apex predator with intrinsic value and a keystone species. However, wolves have also long represented a primary source of human–carnivore conflict, which has led to long‐term persecution of wolves, resulting in a significant decrease in their numbers, genetic diversity and gene flow between populations. For more effective protection and management of wolf populations in Europe, robust scientific evidence is crucial. This review serves as an analytical summary of the main findings from wolf population genetic studies in Europe, covering major studies from the ‘pre‐genomic era’ and the first insights of the ‘genomics era’. We analyse, summarize and discuss findings derived from analyses of three compartments of the mammalian genome with different inheritance modes: maternal (mitochondrial DNA), paternal (Y chromosome) and biparental [autosomal microsatellites and single nucleotide polymorphisms (SNPs)]. To describe large‐scale trends and patterns of genetic variation in European wolf populations, we conducted a meta‐analysis based on the results of previous microsatellite studies and also included new data, covering all 19 European countries for which wolf genetic information is available: Norway, Sweden, Finland, Estonia, Latvia, Lithuania, Poland, Czech Republic, Slovakia, Germany, Belarus, Russia, Italy, Croatia, Bulgaria, Bosnia and Herzegovina, Greece, Spain and Portugal. We compared different indices of genetic diversity in wolf populations and found a significant spatial trend in heterozygosity across Europe from south‐west (lowest genetic diversity) to north‐east (highest). The range of spatial autocorrelation calculated on the basis of three characteristics of genetic diversity was 650?850 km, suggesting that the genetic diversity of a given wolf population can be influenced by populations up to 850 km away. As an important outcome of this synthesis, we discuss the most pressing issues threatening wolf populations in Europe, highlight important gaps in current knowledge, suggest solutions to overcome these limitations, and provide recommendations for science‐based wolf conservation and management at regional and Europe‐wide scales.     

Global solid biomass trade for energy by 2020: an assessment of potential import streams and supply costs to North-West Europe under different sustainability constraints

The expected use of solid biomass for large-scale heat and power production across North–West Europe (NW EU) has led to discussions about its sustainability, especially due to the increasing import dependence of the sector. While individual Member States and companies have put forward sustainability criteria, it remains unclear how different requirements will influence the availability and cost of solid biomass and thus how specific regions will satisfy their demand in a competitive global market. We combined a geospatially explicit least-cost biomass supply model with a linear optimization solver to assess global solid biomass trade streams by 2020 with a particular focus on NW EU. We apply different demand and supply scenarios representing varying policy developments and sustainability requirements. We find that the projected EU solid biomass demand by 2020 can be met across all scenarios, almost exclusively via domestic biomass. The exploitation of domestic agricultural residue and energy crop potentials, however, will need to increase sharply. Given sustainability requirements for solid biomass as for liquid biofuels, extra-EU imports may reach 236 PJ by 2020, i.e., 400% of their 2010 levels. Intra-EU trade is expected to grow with stricter sustainability requirements up to 548 PJ, i.e., 280% of its 2010 levels by 2020. Increasing sustainability requirements can have different effects on trade portfolios across NW EU. Excluding pulpwood pellets may drive the supply costs of import dependent countries, foremost the Netherlands and the UK, whereas excluding additional forest biomass may entail higher costs for Germany and Denmark which rely on regional biomass. Excluding solid biomass fractions may create short-term price hikes. Our modeling results are strongly influenced by parameterization choices, foremost assumed EU biomass supply volumes and costs and assumed relations between criteria and supply. The model framework is suited for the inclusion of dynamic supply–demand interactions and other world regions.     

The development of patient information leaflets. Care of the mouth after radiotherapy

Objectives: Describe the methodology used to produce a patient leaflet on care of the mouth after radiotherapy. Design: Prospective study to design a patient information leaflet. Setting and Subjects : Patients undergoing radiotherapy for oral cancer. Intervention: After a review of the relevant literature, a patient questionnaire was produced. This was then completed by patients undergoing radiotherapy treatment and gave an indication of the problems being encountered. Healthcare professionals were surveyed for their views. A leaflet was then produced according to published guidelines. It was taken back to another group of patients and a further version produced after input from a health promotion group. Results: A leaflet was produced after wide consultation and survey. Conclusion: Considerable effort must to be put into the production of patient information leaflet. It must be discussed with patients in the target group if it is to be sensitive, understood and find acceptance among its users     

Thermodynamic rarity of electrical and electronic waste: Assessment and policy implications for critical materials

The strategic relevance of extracting raw materials from waste from electrical and electronic equipment (WEEE) in the EU is increasing due to value chain risks caused by geopolitical instability, accessibility of specific minerals, and decreasing reserves due to growing extraction rates. This article examines the quantities of so-called critical raw materials (CRMs) originating within WEEE streams from a depletion perspective. Presently, current recycling targets are based solely on mass collection and recycling rates. We examine the potential limitations of this approach using an exergy-based indicator named thermodynamic rarity. This indicator represents the exergy costs needed for producing materials from the bare rock to market. The case of Italy is used to explore the application of the indicator at the macro (national) and micro (company) level for the product categories “small electronics” and “screens and monitors.” Our estimations show significant differences between the mass and rarity of materials within Italian WEEE streams. While iron accounts for more than 70% of the weight of the product categories analyzed, it accounts for less than 15% of the rarity. Similarly, several CRMs with a small mass have a higher rarity value, for example, tungsten with less than 0.1% of the mass and over 6% of the rarity. The policy context is reflected upon, where it is argued that thermodynamic rarity can provide novel insights to support end-of-life WEEE decision-making processes, for example, target development and recycling standards setting to help prioritize material monitoring and recovery options.     

Are life cycle assessments a threat to sound public policy making?

This paper deals with the question of whether Life Cycle Assessments (LCAs), with their focus on objective and quantitative results, are the best way to support public policy processes. The public policy making process is characterized as a continuous discoursive struggle. Criteria are defined to distinguish between good and bad public policy discourses to judge the effects of LCA on the public policy process. Many policy scientists argue that methodologies that emphasize quantification and the use of formal methods are not beneficial for sound public policy making. An empirical report of the role LCAs played in public policy making processes on PVC and chlorine in the Netherlands is made to evaluate the contribution of LCAs to public policy making processes and to identify the main limitations of the current LCA methodologies and practices. It appears that political actors tend to use LCAs in a polarizing way. LCAs are easily misused due to their apparent objectivity, and the quantitative and black box nature of their results. LCAs contain an implicit, normative frame that does not match the environmentalists’ perception on the kind of evidence needed on toxic effects of organochlorines, which reduced the open nature of the Dutch PVC debate. It is recommended to develop a methodology for product evaluation that approaches the issue in a more open and emergent way to prevent “premature closure” of the analysis. It is expected that a focus on the development of balanced, rich arguments on facts and values in the study process will be more fruitful than the calculation of integral, quantitative indicators.