A quality systems approach for identifying and controlling sources of error with point of care testing devices

Historically, due to the size and nature of the instrumentation, highly skilled laboratory professionals performed clinical testing in centralized laboratories. Today’s clinicians demand realtime test data at the point of care. This has led to a new generation of compact, portable instruments permitting ”laboratory” testing to be performed at or near the patient’s bedside by nonlaboratory workers who are unfamiliar with testing practices. Poorly controlled testing processes leading to poor quality test results are an insidious problem facing point of care testing today. Manufacturers are addressing this issue through instrument design. Providers of clinical test results, regardless of location, working with manufacturers and regulators must create and manage complete test systems that eliminate or minimize sources of error. The National Committee for Clinical Laboratory Standards (NCCLS) in its EP18 guideline, ”Quality management for unit-use testing,” has developed a quality management system approach specifically for test devices used for point of care testing (POCT). Simply stated, EP18 utilizes a ”sources of error” matrix to identify and address potential errors that can impact the test result. The key is the quality systems approach where all stakeholders – professionals, manufacturers and regulators – collaboratively seek ways to manage errors and ensure quality. We illustrate the use of one quality systems approach, EP18, as a means to advance the quality of test results at point of care. Received: 26 June, 2002 Accepted: 17 July 2002 Presented at the European Conference on Quality in the Spotlight in Medical Laboratories, 7–9 October 2001, Antwerp, Belgium Abbreviations NCCLS National Committee for Clinical Laboratory Standards (formerly) · POCT point of care testing · QC quality control · HACCP hazard analysis critical control points · CLIA clinical laboratory improvement amendments (of 1988) Correspondence to S. S. Ehrmeyer     

ECONOMICALLY OPTIMAL MARINE RESERVES WITHOUT SPATIAL HETEROGENEITY IN A SIMPLE TWO‐PATCH MODEL

Bioeconomic analyses of spatial fishery models have established that marine reserves can be economically optimal (i.e., maximize sustainable profit) when there is some type of spatial heterogeneity in the system. Analyses of spatially continuous models and models with more than two discrete patches have also demonstrated that marine reserves can be economically optimal even when the system is spatially homogeneous. In this note we analyze a spatially homogeneous two‐patch model and show that marine reserves can be economically optimal in this case as well. The model we study includes the possibility that fishing can damage habitat. In this model, marine reserves are necessary to maximize sustainable profit when dispersal between the patches is sufficiently high and habitat is especially vulnerable to damage.     

The catwalk task: Reflections and synthesis: Part 2

In this article we recount our experiences with a series of encounters with the catwalk task and reflect on the professional growth that these opportunities afforded. First, we individually reflect on our own mathematical work on the catwalk task. Second, we reflect on our experiences working with a group of community college students on the catwalk task and our interpretations of their mathematical thinking. In so doing we also detail a number of innovative and novel student-generated representations of the catwalk photos. Finally, we each individually reflect on the entire experience with the catwalk problem, as mathematics learners, as teachers, and as professionals.     

Reviving Pólya's “Look Back” in a Singapore school

This study is based on the stance that Pólya's “Look Back,” though understudied, remains relevant to Mathematics curricula that place emphasis on problem solving. Although the Singapore Mathematics curriculum adopts the goal of teaching Look Back, research about how it is carried out in actual classroom practice is rare. In our project, we focus on a redesign of a teacher development programme that is targeted to help teachers realize Pólya's original vision of Look Back in the classroom. We report the cases of two teachers who have participated in the teacher development programme: their thinking about Look Back (through interview records) and their interpretation of Look Back in their classroom practice (through video records). By bringing these two spheres of data together, we discuss their degree of ‘buy-in’ to Look Back in the overall problem solving enterprise.     

Evaluation of linear and nonlinear convection schemes on multidimensional non‐orthogonal grids with applications to KVLCC2 tanker

Almost all evaluations of convection schemes reported in the literature are conducted using simple problems on uniform orthogonal grids; thus, having limited contribution when solving industrial computational fluid dynamics (CFD), where the grids are usually non‐orthogonal with distortions. Herein, several convection schemes are assessed in uniform and distorted non‐orthogonal grids with emphasis on industrial applications. Linear and nonlinear (TVD) convection schemes are assessed on analytical benchmarks in both uniform and distorted grids. To evaluate the performance of the schemes, four error metrics are used: dissipation, phase and L₁ errors, and the schemes' effective order of accuracy. Qualitative and quantitative deterioration of these error metrics as a function of the grid distortion metrics are investigated, and rigorous verifications are performed. Recommendations for effective use of the convection schemes based on the range of grid aspect ratio (AR), expansion ratio (ER) and skewness (Q) are included. A ship hydrodynamics case is studied, involving a Reynolds averaged Navier–Stokes simulation of a bare‐hull KVLCC2 tanker using linear and nonlinear convection schemes coupled with isotropic and anisotropic Reynolds‐stress (ARS) turbulence models using CFDShip‐Iowa v4. Predictions of local velocities and turbulent quantities from the midships to the nominal wake plane are compared with experimental fluid dynamics (EFD), and rigorous verification and validation analyses for integral forces and moments are performed for 0° and 12° drift angles. Best predictions are observed when coupling a second‐order TVD scheme with the anisotropic turbulence model. Further improvements are observed in terms of prediction of the vortical structures for 30° drift when using TVD2S‐ARS coupled with DES. Copyright © 2009 John Wiley & Sons, Ltd.     

SOIL AGGREGATE AND ITS RESPONSE TO LAND MANAGEMENT PRACTICES

This paper provides a broad review of the existing study on soil aggregate and its responses to land management practices. Soil aggregate is used for structural unit, which is a group of primary soil particles that cohere to each other more strongly than other surrounding particles. The mechanism of soil particle aggregation may be expressed by a hierarchical model, which is based upon the hypothesis that macroaggregates （〉250μm） are collections of smaller microaggregates （〈250μm） held together with organic binding agents. Primary particles form microaggregates and then macroaggregates. Carbon （C）-rich young plant residues form and stabilize macroaggregates, whereas old organic C is occluded in the microaggregates. The interaction of aggregate dynamics with soil organic carbon （SOC） is complex and embraces a range of spatial and temporal processes within macroaggregates and microaggregates. The nature and properties of aggregates are determined by the quantity and quality of coarse residues and humic compounds and by the degree of their interaction with soil particles. The mechanisms resulting in the binding of primary soil particles into stable aggregates vary with soil parent material, climate, vegetation, and land management practices. Land management practices, including tillage methods, residue management, amendments, and soil fertility management, enhance soil aggregation. However, there is still much uncertainty in the dynamics of organic matter in macroaggregation and microaggregation, and research is still needed to understand further the mechanisms of aggregate formation and its responses to human activities.     

Developing collective capacity to improve mathematics instruction: Coaching as a lever for school-wide improvement

Mathematics coaching, as typically practiced in US schools tends to be responsive and individually focused work in which coaches respond to invitations from individual teachers to help them improve their teaching. But what does the work of coaching look like if it is organized instead to engage teachers collectively in service of school-wide improvement? This is the question we take up in this paper through examining the case of one school-based elementary mathematics coach whose work more closely aligned with emerging findings in the field of instructional improvement about the power of coaching for school-wide reform. The coach helped to dramatically transform a recent history of poor performance and deficit-oriented narratives pertaining to the school and its children. Through a fine-grain analysis, we illustrate the coach’s work implicated in supporting groups of teachers to come to mutual understanding around and further development of shared high-quality instructional practices. The components of coaching that help support collective capacity are discussed.     

Finding Alignment: The Perceptions and Integration of the Next Generation Science Standards Practices by Elementary Teachers

Preparing elementary‐level teachers to teach in alignment with the eight Next Generation Science Standards (NGSS) practices could prove to be a daunting endeavor. However, the process may be catalyzed by leveraging elements of teacher science instruction that inherently attend to the practice standards. In this study, we investigated the science instruction of three grade 3–5 elementary‐level teachers. We used observation, interviews, and surveys to determine the level to which the teachers perceived they taught and engaged in teaching science aligned with the eight NGSS practices. We found that the teachers were partially, and intrinsically implementing several of these practices in their instruction, and at the same time could not articulate the eight NGSS practices. Our results suggest there may be ample opportunity to build on the current science instruction of elementary‐level teachers to bring their instruction into alignment with the NGSS. We found that teachers’ perceive professional development, school culture, and access to additional instructional resources to be essential to their adoption of the NGSS practices.     

What Is a Fraction? Developing Fraction Understanding in Prospective Elementary Teachers

Classroom teachers need a well‐developed deep understanding of fractions and pedagogic practices so they can provide meaningful experiences for students to explore and construct ideas about fractions. This study sought to examine prospective elementary teachers' understandings of fraction by focusing specifically on their use of fractions meanings and interpretations. Results indicated that prospective elementary teachers bring with them to their final methods course a limited understanding of fractions and that experiences in methods courses resulted only in minor improvement of those limited understandings. The limited part‐whole understanding of fractions that prospective elementary teachers entered the course with was resilient. The implications of this study suggest a need for prospective elementary teachers to continue to develop their conceptual understanding of fractions and for changes to the content and instructional strategies of mathematics content courses designed for prospective elementary teachers.     

Beliefs,Practical Knowledge,and Context: A Longitudinal Study of a Beginning Biology Teacher's 5E Unit

The purpose of this three‐year case study was to understand how a beginning biology teacher (Alice) designed and taught a 5E unit on natural selection, how the unit changed when she took a position in a different school district, and why the changes occurred. We examined Alice's developing beliefs about science teaching and learning, practical knowledge, and perceptions of school context in relation to the 5E unit. Data sources consisted of interviews, classroom observations, and lesson materials. We found that Alice placed more emphasis on the explore phase, less emphasis on the engage and explain phases, and removed the elaborate phase over time. Alice's beliefs about science teaching and learning acted as a filter for making sense of practical knowledge and perceptions of context. Although her beliefs were student centered, they aligned with discovery learning in which little intervention from the teacher is required. We discuss how her beliefs, practical knowledge, and perceptions of context explained the changes in her practice. This study sheds insight into the nature of beliefs and how they relate to the 5E lesson phases, as well as the different lenses for viewing the 5E instructional model. Implications for science teacher preparation and induction programs are discussed.