Life Lab

Although direct reporting of laboratory test results to patients improves engagement and utilization of healthcare services, this assumes that results are presented in a manner that can be comprehended and acted upon by patients. To evaluate the practice of patient reporting across Canadian laboratories, a voluntary survey was distributed. 22 responses were received from laboratories and laboratory networks nationwide, representative of the range of Canadian laboratory and patient demographics. Despite the Connected Care for Canadians Act being passed in June 2024, one-third of respondents do not provide results to patients. Of those that do, results largely replicate physician reports and are heterogeneous between labs, with different strategies used to present data and flag abnormalities. A minority of labs suppress some testing from patient receipt, modify reports to improve patient comprehension, or provide graphs to support interpretation and trending. Laboratory professionals largely agreed that there are benefits in modifying reports to aid in patient comprehension but expressed concern that patient health literacy is currently in adequate. This may lead to increased anxiety, misinterpretation of results, follow-up questions, self-diagnosis, and undue stress until a healthcare provider could be consulted. Collaboration with patients and healthcare providers is necessary to develop guidelines on meaningful direct-to-patient reporting.

Point-of-care testing (POCT) is the analysis of patient specimens outside the clinical laboratory, near or at the site of patient care, usually performed by clinical staff without laboratory training, although it also encompasses patient self-monitoring. It is able to provide a rapid result near the patient and which can be acted upon immediately. The key driver is the concept that clinical decision making may be delayed when samples are sent to the clinical laboratory. Balanced against this are considerations of increased costs for purchase and maintenance of equipment, staff training, connectivity to the laboratory information system (LIS), quality control (QC) and external quality assurance (EQA) procedures, all required for accreditation under ISO 22870. The justification for POCT depends upon being able to demonstrate that a more timely result (shorter turnaround times (TATs)) is able to leverage a clinically important advantage in decision making compared with the central laboratory (CL). In the four decades since POCT was adapted for the self-monitoring of blood glucose levels by subjects with diabetes, numerous new POCT methodologies have become available, enabling the clinician to receive results and initiate treatment more rapidly. However, these instruments are often operated by staff not trained in laboratory medicine and hence are prone to errors in the analytical phase (as opposed to laboratory testing where the analytical phase has the least errors). In some environments, particularly remote rural settings, the CL may be at a considerable distance and timely availability of cardiac troponins and other analytes can triage referrals to the main centers, thus avoiding expensive unnecessary patient transportation costs. However, in the Emergency Department, availability of more rapid results with POCT does not always translate into shorter stays due to other barriers to implementation of care. In this review, we apply the principles of evidence-based laboratory medicine (EBLM) looking for high quality systematic reviews and meta-analyses, ideally underpinned by randomized controlled trials (RCTs), looking for evidence of whether POCT confers any advantage in clinical decision making in different scenarios.

Graphene oxide (GO) is rapidly emerging worldwide as a breakthrough precursor material for next-generation devices. However, this requires the transition of its two-dimensional layered structure into more accessible three-dimensional (3D) arrays. Peroxiredoxins (Prx) are a family of multitasking redox enzymes, self-assembling into ring-like architectures. Taking advantage of both their symmetric structure and function, 3D reduced GO-based composites are hereby built up. Results reveal that the "double-faced" Prx rings can adhere flat on single GO layers and partially reduce them by their sulfur-containing amino acids, driving their stacking into 3D multi-layer reduced GO-Prx composites. This process occurs in aqueous solution at a very low GO concentration, i.e. 0.2 mg ml(-1). Further, protein engineering allows the Prx ring to be enriched with metal binding sites inside its lumen. This feature is exploited to both capture presynthesized gold nanoparticles and grow in situ palladium nanoparticles paving the way to straightforward and "green" routes to 3D reduced GO-metal composite materials.

This article critiques two studies conducted by Jacobson and colleagues whose findings indicated that hypnosis hinders encoding and might not be useful in education. While their findings provide important information about hypnosis and its possible uses in teaching and learning, there are several important methodological and interpretive shortcomings that limit the applicability of the study. It is argued that the authors conflated some components of hypnotic phenomenology, as measured by the Phenomenology of Consciousness Inventory, and consequently failed to assess the hypnotic experience properly. This article argues that the encoding deficits produced by hypnosis may have resulted from the way hypnosis was used and other contextual factors, and highlights some additional concerns with the statistical analyses. This article suggests some more effective uses of hypnosis and suggestion in improving the learning process in light of prior research, and offers some ideas for future research.

The problems of nursing are symptoms of the oppression of women, asserts the president of a leading feminist* organization, who is herself a nurse. She believes, however, that with heightened consciousness to the feminist analysis, nursing can be in the vanguard in creating a fully human and humanae health care system.