Dissertations / Theses on the topic 'Medical technologists Medical technologists Medical laboratory technology'

Thesis (D.Tech) - Central University of Technology, Free State, 2006
Since 2002 all medical technologists and technicians have been obliged to participate in the compulsory continuing professional development (CPD) programme implemented by the Health Professions Council of South Africa (HPCSA). It was foreseen that CPD would not be equally accessible to medical technologists and technicians in urban and rural areas. The reason for this survey was to identify obstacles that might prevent medical technologists and technicians, especially those in rural areas from participating in CPD activities and to identify ways to overcome these obstacles. The survey was conducted in three phases. During the first phase quantitative information, concerning the profession of medical technology in South Africa, and CPD in general was obtained from registered medical technologists and technicians by means of a questionnaire. Information obtained from the questionnaire as well as that obtained from the literature led to the second phase in which an interview questionnaire was compiled. Structured interviews were conducted with medical technologists and technicians employed throughout South Africa, gathering mainly qualitative information regarding medical technology and CPD. Lack of time and financial constraints and to a lesser extent travelling were identified as the major obstacles to participating in CPD activities. The obstacles were an even bigger problem to those employed in rural areas. It was also confirmed that everybody involved in medical technology should be positively motivated to create and participate in CPD activities. A method suggested was to practise CPD activities during working hours which is cost effective but restricted, because of the workload. In addition medical technologists and technicians should participate in activities offered by the Society of Medical Laboratory Technologists of South Africa (SMLTSA) and attempt formal further qualifications. Being involved in research projects and identifying case studies could result in publishing in accredited journals. During the third phase of the survey a concept CPD framework was compiled. According to the framework all role players involved in the profession of medical technology must collaborate and contribute to making CPD activities accessible to all registered medical technologists and technicians and create a positive attitude to CPD. The role players include the HPCSA, employers and top management, the SMLTSA, medical companies, other health professionals, higher education institutions and the individual. It must be emphasised that the task of collecting CPD credits remains the responsibility of the medical technologist or medical technician. The framework offered suggestions for CPD activities whereby medical technologists and technicians could accumulate CPD credits. One major concern indicated in the framework, was that CPD should not only be measured by CPD credits but the outcomes of CPD should be reflected in the profession and the workplace and a system must be implemented to measure CPD outcomes. The CPD framework was evaluated by a panel of experts familiar with the profession of medical technology and the CPD programme, using the Delphi technique. This final CPD framework will be referred to the HPCSA for implementation in all South African pathology laboratories and the blood transfusion services. The aim of the framework is to assist the CPD guidelines currently under revision in establishing a usable CPD programme.

It is important to have well-trained and qualified laboratory professionals. Seventy percent of patient care is based on decisions made from laboratory results, yet there is a growing shortage of medical technologists. Although some baby boomers are delaying retirement, worsening of the shortage crisis is inevitable. Retention of medical technologists has become more important than recruitment. The purpose of this study was to identify and evaluate innovative retention strategies used by clinical laboratory managers throughout the United States. A significant finding of this study was the lack of qualified medical technologists entering the ranks of laboratory managers. This study identified a need for a more defined career path and more recognition of the importance of laboratory scientists. It is recommended that studies be undertaken to examine the opinions of hospital and medical group practice administrators as well as the view of medical technologists regarding retention strategies that are proven to be effective.

The research problem addressed in this study, was to identify strategies that could be employed to reduce stress related problems in the workplace. As the business environment is increasingly subjected to fast changing forces which include increased competition, the pressure for quality and advanced technology, innovation, and an increase in the pace of doing business, the demands on employees have grown equally dramatically. It is therefore essential to develop strategies for managing stress to give employees the required additional energy to handle particularly difficult and stressful work situations. It is important that organisations provide the assistance and support on the issue of stress as part of their proactive approach to managing employee health and safety, by drawing up contingency plans, and to have the necessary infrastructure to deal with such problems. This study investigates the strategies that can be implemented in organisations to reduce stressful situations affecting employees. The information gleaned from the literature and empirical studies enabled the development of a model for stress management in the workplace.

Electrodes are used in medicine for detection of biological signals and for stimulating tissue, e.g. in deep brain stimulation (DBS). For both applications, an understanding of the functioning of the electrode, and its interface and interaction with the target tissue involved is necessary. To date, there is no standardized method for medical electrode evaluation that allows transferability of acquired data. In this thesis, a physical axon (Paxon) potential generator was developed as a device to facilitate standardized comparisons of different electrodes. The Paxon generates repeatable, tuneable and physiological-like action potentials from a peripheral nerve. It consists of a testbed comprising 40 software controlled 20 μm gold wires embedded in resin, each wire mimicking a node of Ranvier. ECG surface Ag-AgCl electrodes were systematically tested with the Paxon. The results showed small variations in orientation (rotation) and position (relative to axon position) which directly impact the acquired signal. Other electrode types including DBS electrodes can also be evaluated with the Paxon. A theoretical comparison of a single cable neuronal model with an alternative established double cable neuron model was completed. The output with regards to DBS was implemented to comparing the models. These models were configured to investigate electrode stimulation activity, and in turn to assess the activation distance by DBS for changes in axon diameter (1.5-10 μm), pulse shape (rectangular biphasic and rectangular, triangular and sinus monophasic) and drive strength (1-5 V or mA). As both models present similar activation distances, sensitivity to input shape and computational time, the neuron model selection for DBS could be based on model complexity and axon diameter flexibility. An application of the in-house neuron model for multiple DBS lead designs, in a patient-specific simulation study, was completed. Assessments based on the electric field along multiple sample planes of axons support previous findings that a fixed electric field isolevel is sufficient for assessments of tissue activation distances for a predefined axon diameter and pulse width in DBS.
Elektroder används inom sjukvården, både för att mäta biologiska signaler, t.ex. hjärtats aktivitet med EKG, eller för att stimulera vävnad, t.ex. vid djup hjärnstimulering (DBS). För båda användningsområdena är det viktigt med en grundläggande förståelse av elektrodens interaktion med vävnaden. Det finns ingen standardiserad metod för att utvärdera medicinsk elektroders dataöverföringsfunktion. I den här avhandlingen presenteras en metod för att underlätta elektrodtestning. En hårdvarumodell av ett axon (Paxon) har utvecklats. Paxon kan programmeras för att efterlikna repeterbara aktionspotentialer från en perifer nerv. Längs axonet finns 40 noder, vilka var och en består av en tunn (20 μm) guldtråd inbäddad i harts och därefter kopplad till elektronik. Denna testbädd har använts för att undersöka EKG elektroders egenskaper. EKG elektroderna visade på variationer i orientering och position i relation till Paxon. Detta har en direkt inverkan på den registrerade signalen. Även andra elektrotyper kan testas i Paxon, t.ex. DBS elektroder. En teoretisk jämförelse mellan två neuronmodeller med olika komplexitet, anpassade för användning vid DBS studier, har utförts. Modellerna konfigurerades för att studera inverkan på aktiveringsavstånd från olika axondiametrar, stimulationspuls och stimulationsstyrka. Då båda modellerna visade likvärdiga aktiveringsavstånd och beräkningstid så förordas den enklare neuronmodellen för DBS simuleringar. En enklare modell kan lättare introduceras i klinisk verksamhet. Simuleringarna stöder tidigare resultat som visat att det elektriska fältet är en bra parameter för presentation av resultat vid simulering av DBS. Metoden exemplifieras vid simulering av aktiveringsavstånd och elektriska fältets utbredning för olika typer av DBS elektroder i en patient-specifik studie.

Abstract This research explores the development of Finnish Medical Laboratory Technologists based on education given in Turku covering the years 1955–1990. The data is limited into three time periods: education lasting for one year 1955–1963, education lasting for two years 1964–1983 and education 1984–1990 based on the secondary school reform. The development of the Finnish medical laboratory technologist education was connected with development of medical and natural sciences and technology. The representatives of the medicine were of vital importance in influencing the beginning of this education. The swift from industrial to service society speeded the development. The duration of education was extended gradually from one year to four and half year education. Even in the beginning of this education the students selected into training should have at least the basic general secondary school education which was not the case with other health care staff . Especially in the beginning the students should have good health in working with health hazard environment and substances. A distinctive change took place in the relationship of cognitive and practical teaching. In the beginning the greatest part of the educational training was practical given in health laboratories and hospital wards. Gradually the cognitive teaching was transferred into the school classrooms. Also the practical training in the hospital decreased. In the beginning of the educational training took place in the different faculties and institutes of Turku University given by medical staff. Later the teaching was moved to the nursing and health care colleges and the authority to teach was given to the permanent health care staff. The decrease of the infectious diseases and the development of internal medicine and surgery reflected in the changes of the selection of laboratory investigations from the bacteriological research to the chemical research. The manual research methods developed to automatic research methods was seen with a delay in the medical technologist education. Also the quality control appeared surprisingly late in the educational training. The education and training of the laboratory technologists were attached to the education of nursing instead of technical sector of health education. The intensive increase of the social and behaviorial sciences was part of wider international development. This research adds knowledge to the planning of laboratory technologist education. The analysis of the earlier actions helps to reveal the far reaching influences of the different choices made before and to explain why the situation is what it is
Tiivistelmä Tutkimuksessa selvitettiin Suomessa toteutuneen laboratoriohoitajakoulutuksen kehittymistä Turussa tapahtuneen koulutuksen avulla. Tutkimus rajautui vuosille 1955–1990 ja jakautui ajallisesti kolmeen jaksoon: yksivuotiseen koulutukseen vuosina 1955–1963, kaksivuotiseen koulutukseen vuosina 1964–1983 ja keskiasteen koulunuudistukseen vuosina 1984–1990. Tutkimuksen tarkastelun kohteena oli: Mitkä tekijät johtivat laboratoriohoitaja-koulutuksen käynnistymiseen ja kehittymiseen? Miten opiskelijat valittiin? Miten tietopuolinen ja käytännöllinen opetus jakaantui? Minkälainen oli opettajien pätevyys? Minkälainen oli oppisisältö? Minkälaista tutkintonimikettä käytettiin? Laboratoriohoitajakoulutuksen kehittyminen oli yhteydessä lääketieteen, luonnontieteen ja teknologian kehittymiseen. Lääketieteen edustajat olivat keskeisiä vaikuttajia laboratoriohoitajakoulutuksen alkamiselle ja kehittymiselle. Teolliseen ja palveluyhteiskuntaan siirtyminen vauhdittivat kehitystä. Koulutus piteni asteittain yksivuotisesta neljä ja puolivuotiseksi. Koulutukseen valituilta opiskelijoilta vaadittiin jo alkuaikoina muista hoitohenkilöistä poik-keavasti vähintään keskikoulun oppimäärä. Suuri osa oli kuitenkin ylioppilaita. Koulutuksen alkuaikoina vaadittiin opiskelijoilta hyvää terveyttä tartuntavaarallisen ympäristön ja terveydelle haitallisten aineiden kanssa työskenneltäessä. Koulutuksen alkuaikoina suurin osa oli käytännöllistä opetusta terveydenhuoltoalan laboratorioissa ja vuodeosastoilla. Ajan kuluessa suhde muuttui selvästi koululla annattavan tietopuolisen opetuksen eduksi. Myös vuodeosastoharjoittelu väheni. Koulutuksen alkuaikoina tietopuolinen opetus tapahtui Turun yliopiston eri laitoksilla pääasiassa lääketieteilijöiden voimin. Myöhemmin koulutus siirtyi sairaanhoito- ja terveydenhuolto-oppilaitoksiin ja samalla vetovastuu siirtyi vakinaisille sairaanhoidon opettajille. Tartuntatautien väheneminen ja sisätautien ja kirurgian kehittyminen heijastuivat laboratorio-tutkimusvalikoiman muuttumiseen bakteriologian tutkimuksista kemiallisiin tutkimuksiin. Ihmisen elimistön tutkiminen kudos- ja elintasolta syveni solutasolle. Manuaalisten tutkimusmenetelmien kehittyminen automaatio-menetelmiksi näkyi viiveellä laboratoriohoitajien koulutuksessa. Samoin laboratorioissa voimakkaasti kehittyvä laaduntarkkailu tuli koulutukseen yllättävän myöhään. Laboratoriohoitajakoulutus määriteltiin hoitoalan koulutuksiin terveydenhuollon teknisen alan sijaan. Tämä määritteli hoidollisuutta korostavat raamit laboratoriohoitajakoulutukselle. Yhteiskunta- ja käyttäytymistieteiden voimakas lisääntyminen oli osa laajempaa kansainvälistä kehitystä. Opiskelijoita tuli kasvattaa myös ammatillisissa koulutuksissa yhteiskuntatietoisiksi, osallistuviksi ja sivistyneiksi kansalaisiksi ja perheenjäseniksi. Muiden maiden laboratoriohoitajakoulutukseen ne eivät kuitenkaan sisältyneet. Tämä tutkimus antaa lisää tietoa laboratoriohoitajakoulutuksen suunnitteluun. Aikaisemman toiminnan analysoiminen auttaa näkemään, minkälaiset, kauaskantoisetkin, vaikutukset erilaisilla valinnoilla on ollut, miksi ollaan siinä tilanteessa missä ollaan

When performing sepsis diagnosis, the most important preanalytical variable is blood volume. Too little blood increases the risk for false negatives whereas overfilling causes increased risk for false positives. Even though this fact is known, there are case studies showing that in a majority of tests, the taken blood sample volume is not the recommended amount. As previously tried methods have been limited in their ability to tackle the problem this study aimed at creating a technical device to aid healthcare providers with blood volume sample collection. As a base, the double diamond approach by the Design Council was used. This design approach splits up the design process in four distinctly different phases (discover, define, develop, and deliver) all using their own methods to aid the creative process. After completing the discover and define phase it was determined that a non-contact capacitance liquid level sensor could operate as an ideal blood volume sample device. During the development and delivery phase prototypes were created and evaluated. The final results of this work could not give conclusive evidence concerning if a non-contact liquid level sensor could operate as an ideal blood volume collection device. The methodological approach used in this thesis can be used as inspiration for a designer to create a device for a similar or different purpose. Moreover, information from this thesis can also work as reference material to develop a device to perform ideal blood volume sample collection. Such a device would have the potential to be an essential part of the everyday workflow in sample collection from patients with sepsis worldwide and would aid in ensures effective and fast diagnostics.

The liver is one of the largest organs within the human body and it handles many vital tasks such as nutrient processing, toxin removal, and synthesis of important proteins. The number of people suffering from chronic liver disease is on the rise, likely due to the present ‘western’ lifestyle. As disease develops in the liver there are pathophysiological manifestations within the liver parenchyma that are both common and important to monitor. These manifestations include inflammation, fatty infiltration (steatosis), excessive scar tissue formation (fibrosis and cirrhosis), and iron loading. Importantly, as the disease progresses there is concurrent loss of liver function. Furthermore, postoperative liver function insufficiency is an important concern when planning surgical treatment of the liver, because it is associated with both morbidity and mortality. Liver function can also be hampered due to drug-induced injuries, an important aspect to consider in drug-development. Currently, an invasive liver needle biopsy is required to determine the aetiology and to stage or grade the pathophysiological manifestations. There are important limitations with the biopsy, which include, risk of serious complications, mortality, morbidity, inter- and intra-observer variability, sampling error, and sampling variability. Cleary, it would be beneficial to be able investigate the pathophysiological manifestations accurately, non-invasively, and on regional level. Current available laboratory liver function blood panels are typically insufficient and often only indicate damage at a late stage. Thus, it would be beneficial to have access to biomarkers that are both sensitive and responds to early changes in liver function in both clinical settings and for the pharmaceutical industry and regulatory agencies. The main aim of this thesis was to develop and evaluate methods that can be used for a ‘non-invasive liver biopsy’ using magnetic resonance (MR). We also aimed to develop sensitive methods for measure liver function based on gadoxetate-enhanced MR imaging (MRI). The presented work is primarily based on a prospective study on c. 100 patients suffering from chronic liver disease of varying aetiologies recruited due to elevated liver enzyme levels, without clear signs of decompensated cirrhosis. Our results show that the commonly used liver fat cut-off for diagnosing steatosis should be lowered from 5% to 3% when using MR proton-density fat fraction (PDFF). We also show that MR elastography (MRE) is superior in staging fibrosis. Finally we presented a framework for quantifying liver function based on gadoxetate-enhanced MRI. The method is based on clinical images and a clinical approved contrast agent (gadoxetate). The framework consists of; state-of the-art image reconstruction and correction methods, a mathematical model, and a precise model parametrization method. The model was developed and validated on healthy subjects. Thereafter the model was found applicable on the chronic liver disease cohort as well as validated using gadoxetate levels in biopsy samples and blood samples. The liver function parameters correlated with clinical markers for liver function and liver fibrosis (used as a surrogate marker for liver function). In summary, it should be possible to perform a non-invasive liver biopsy using: MRI-PDFF for liver fat and iron loading, MRE for liver fibrosis and possibly also inflammation, and measure liver function using the presented framework for analysing gadoxetate-enhanced MRI. With the exception of an MREtransducer no additional hardware is required on the MR scanner. The liver function method is likely to be useful both in a clinical setting and in pharmaceutical trials.

Significant technological advances of the last years have been possible by developments in Optofluidics, which is a field that deals with the integration of optics and microfluidics into single devices. The work described in this thesis is based on five scientific publications related to the use of fiber optic technology to build integrated optofluidic devices. The first three publications are within the field of life-science and point towards in-vivo and point-of-care applications, whereas the last two publications cover the study and the use of plasmonic nanoparticles for electrical modulation of light. Aiming at developing useful tools for in-vivo biological applications, the first publication consists of designing and testing a functional optical fiber for real-time monitoring and selective collection of fluorescent microparticles. This probe relies on a microstructured optical fiber with a hole along its cladding, which is used to selectively aspirate individual particles of interest once their fluorescence signal is detected. On the same line of research, the second publication contemplates the fabrication of a fiber probe that traps single microparticles and allows for remote detection of their optical properties. This probe is also based on a microstructured fiber that enables particle trapping by fluidic forces. The third publication addresses the development of an all-fiber miniaturized flow cytometer for point-of-care applications. This system can analyze, with excellent accuracy and sensitivity, up to 2500 cells per second by measuring their fluorescence and scattering signal. A novel microfluidic technique, called Elasto-inertial microfluidics, is employed for aligning the cells into a single-stream to optimize detection and throughput. The fourth publication involves the experimental and theoretical study of the electrical-induced alignment of plasmonic gold nanorods in suspension and its applicability to control light transmission. This study is done by using an all-fiber optofluidic device, based on a liquid-core fiber, which facilitates the interaction of light, electric fields, and liquid suspensions. Results show that nanorods can be aligned in microseconds, providing a much better performance than liquid-crystal devices. Finally, the fifth publication consists of an upgrade of the previous device by integrating four electrodes in the cladding of the liquid-core fiber. This improvement enables nanosecond response time and the possibility of digitally switching nanorods between two orthogonal aligned states, overcoming the limitation of slow thermal relaxation. The work presented here shows that optofluidics based on optical fibers is a robust and convenient platform, as well as a promising direction for the developing of novel instruments in fields such as life-science, non-linear optics, plasmonic, and sensing.

QC 20171018

Heart failure is a common disorder and a major cause of illness and death in the population, creating an enormous health-care burden. It is a complex condition, representing the end-point of many cardiovascular diseases. In general heart failure progresses slowly over time and once it is diagnosed it has a poor prognosis which is comparable with that of many types of cancer. The heart has an ability to adapt in response to long lasting increases in hemodynamic demand; the heart conforms its shape and size in order to maintain adequate cardiac output. This process is called remodeling and can be triggered by pathologies such as hypertension or valvular disease. When the myocardial remodeling is maintained chronically it becomes maladaptive and is associated with an increased risk of heart failure. In many cases, heart failure is associated with left bundle branch block (LBBB). This electrical disturbance leads to dyssynchronous left ventricular (LV) contraction and relaxation which may contribute to cardiac dysfunction and ultimately heart failure. Mechanical dyssynchrony can be treated with cardiac resynchronization therapy (CRT). However, many heart failure patients do not demonstrate clinical improvement despite CRT. Blood flow plays an important role in the normal development of the fetal heart. However, flow-induced forces may also induce changes in the heart cells that could lead to pathological remodeling in the adult heart. Until recently, measurement tools have been inadequate in describing the complex three-dimensional and time-varying characteristics of blood flow within the beating heart. 4D (3D + time) flow cardiovascular magnetic resonance (CMR) enables acquisition of three-dimensional, three-directional, time-resolved velocity data from which visualization and quantification of the blood flow patterns over a complete cardiac cycle can be performed. In this thesis, novel 4D Flow CMR based methods are used to study the intraventricular blood flow in healthy subjects and heart failure patients with and without ventricular dyssynchrony in order to gain new knowledge of the ventricular function. Different flow components were assessed in normal heart ventricles. It was found that inflowing blood that passes directly to outflow during the same heartbeat (the Direct Flow component) was larger and possessed more kinetic energy (KE) than other flow components. Diastolic flow through the normal heart appears to create favorable conditions for effective systolic ejection. This organized blood flow pattern within the normal LV is altered in heart failure patients and is associated with decreased preservation of KE which might be unfavorable for efficient LV ejection. Inefficient flow of blood through the heart may influence diastolic wall stress, and thus contribute to pathological myocardial remodeling. In dyssynchronous LVs of heart failure patients with LBBB, Direct Flow showed even more reduced preservation of KE compared to similarly remodeled LVs without LBBB. Furthermore, in LBBB patients, LV filling hemodynamic forces, acting on the myocardium, were more orthogonal to the main flow direction compared to patients without LBBB. Deviation of LV flow forces and reduction of KE preservation and may reflect impairment of LV diastolic function and less efficient ensuing ejection related to dyssynchrony in these failing ventricles. Blood flow patterns were also studied with respect to fluctuations of the velocity of the flow (turbulent flow) in normal and failing LVs. In failing hearts, turbulent kinetic energy (TKE) was higher during diastole than in healthy subjects. TKE is a cause of energy loss and can thus be seen as a measure of flow inefficiency. Elucidating the transit of multidimensional blood flow through the heart chambers is fundamental in understanding the physiology of the heart and to detect abnormalities in cardiac function. The 4D Flow CMR parameters presented in this thesis can be utilized to detect altered intracardiac blood flow and may be used as markers of deteriorating cardiac function, pathological remodeling and mechanical dyssynchrony in heart failure.

Lactate is an important biomarker in sports and the lactate threshold concept is one of the best indicators of endurance performance in an athlete. However, to quantify the lactate threshold, an invasive method to take a blood sample must be used. Limitations for this method include stopping the active exercise for blood sampling and no real-time feedback. Instead, a novel non-invasive wearable biosensor can be used to measure the lactate concentration in sweat. The sensor generates an electrical current depending on the lactate concentration in the sweat, and therefore must an electronic device called a potentiostat be used to condition the current. However, available potentiostats are not suitable for use in sports where form factor, battery life and wireless connectivity is important. This thesis aims to solve this by developing a wearable device and software which can be used to measure the lactate concentration in sweat in real-time during exercise. The development process consisted of the determination of specifications, prototype development and thorough laboratory and on-body testing. Finally, a novel wearable device and software capable of real-time lactate measurements in sweat during exercise were presented. The device, called LactateStat, was 58mm ∗ 55mm ∗ 13mm, the current consumption was only 7.8mA, the current measurement resolution was 0.5 nA, the limit of detection was 0.45 nA and the current measurement range was around 750 μA. LactateStat is one of the first of its kind and provides a base for future development as the hardware, firmware and software resources are provided as open-source.
Laktat är en viktig biomarkör inom idrott och konceptet laktattröskel är en av de bästa indikatorerna för uthållighet hos en idrottsutövare. Men för att mäta laktattröskeln krävs en invasiv metod som går ut på att man tar ett blodprov. Begränsningarna med denna metod är bland annat att idrottsutövningen måste stoppas för att ta ett blodprov och att man inte får realtidsåterkoppling. I stället kan en liten och icke-invasiv bärbar biosensor användas för att mäta laktatkoncentrationen i svett. Sensorn genererar en elektrisk ström beroende på laktatkoncentrationen i svetten och en enhet som kallas potentiostat måste därför användas för att mäta denna ström. Tillgängliga potentiostater är dock inte lämpliga för användning inom sport där formfaktor, batteritid och trådlös kommunikation är viktigt. Denna avhandling har som syfte att lösa detta genom att utveckla en bärbar enhet och mjukvara som kan användas för att mäta laktatkoncentrationen i svett i realtid under träning. Utvecklingsprocessen bestod av bestämning av specifikationer, framtagning av en prototyp och noggrann laboratorie- och kroppstestning. Som resultat presenterades en banbrytande bärbar enhet och mjukvara som kan mäta laktat i realtid i svett under träning. Enheten, som kallades LactateStat, var 58mm * 55mm * 13mm, den aktiva strömförbrukningen var 7.8mA, den bästa mätupplösningen för ström var 0.5 nA, detektionsgränsen var 0.45 nA och det maximala mätområdet för ström var ca. 750 μA. LactateStat är en av de första i sitt slag och ger en bas för framtida utvecklingsarbete eftersom hårdvaru-, programvaru- och mjukvaruresurserna tillhandahålls som öppen källkod.

Having a device with the capability of measure motions from gait produced by a human being, could be of most importance in medicine and sports. Physicians or researchers could measure and analyse key features of a person's gait for the purpose of rehabilitation or science, regarding neurological disabilities. Also in sports, professionals and hobbyists could use such a device for improving their technique or prevent injuries when performing. In this master thesis, I present the research of what technology is capable of today, regarding gait analysis devices. The research that was done has then help the development of a suggested standalone hardware sensor node for a Body Area Network, that can support research in gait analysis. Furthermore, several algorithms like for instance UWB Real-Time Location and Dead Reckoning IMU/AHRS algorithms, have been implemented and tested for the purpose of measuring motions and be able to run on the sensor node device. The work in this thesis shows that a IMU sensor have great potentials for generating high rate motion data while performing on a small mobile device. The UWB technology on the other hand, indicates a disappointment in performance regarding the intended application but can still be useful for wireless communication between sensor nodes. The report also points out the importance of using a high performance micro controller for achieving high accuracy in measurements.

To increase the survival rate from infectious- and noncommunicable diseases, reliable diagnostic during the preliminary stages of a disease onset is of vital importance. This is not trivial to achieve, a highly sensitive and selective detection system is needed for measuring the low concentrations of biomarkers available. One possible route to achieve this is through biosensing based on plasmonic nanostructures, which during the last decade have demonstrated impressive diagnostic capabilities. These nanoplasmonic surfaces have the ability to significantly enhance fluorescence- and Raman signals through localized hotspots, where a stronger then normal electric field is present. By further utilizing a periodic sub-wavelength nanohole array the extraordinary optical transmission phenomena is supported, which open up new ways for miniaturization. In this study a nanoplasmonic chip (NPC) composed of a nanohole array —with lateral size on the order of hundreds of nanometer— covered in a thin layer of gold is created. The nanohole array is fabricated using soft nanoimprint lithography on two resists, hydroxypropyl cellulose (HPC) and polymethyl methacrylate (PMMA). An in depth analysis of the effect of thickness is done, where the transmittance and Raman scattering (using rhodamine 6G) are measured for varying gold layers from 5 to 21 nm. The thickness was proved to be of great importance for optimizing the Raman enhancement, where a maximum was found at 13 nm. The nanohole array were also in general found beneficial for additionally enhancing the Raman signal. A transmittance minima and maxima were found in the region 200-1000 nm for the NPCs, where the minima redshifted as the thickness increased. The extraordinary transmission phenomena was however not observed at these thin gold layers. Oxygen plasma treatment further proved an effective treatment method to reduce the hydrophobic properties of the NPCs. Care needs be taken when using thin layers of gold with a PMMA base, as the PMMA structure could get severely damaged by the plasma. HPC also proved inadequate for this projects purpose, as water-based fluids easily damaged the surface despite a deposited gold layer on top.

This thesis looks at two sides of the same coin: how to support the production and future development at a specialist medical technology department at Danderyd Hospital. The two sides are; a pilot study of a product management system (PDM) and an interview based study on the characteristics of the silent knowledge of the technicians. The department (National respiratory centre, NRC) is facing retirement of several key employees.

The technical study shows that the success of an implementation is largely dependent on the users’ prior knowledge and use of a 3D Computer aided design system (CAD).The system itself is shown to fulfill the Lifecycle requirement of tracking the products (mostly tracheostomy tubes) but without a CAD centered workflow, some substantial education and preferably some new recruits, an implementation of the PDM system will fail. The author recommends development of the current “low-tech” system of MS Excel and Access rather than redistribute the dependency from technician towards a complex, commercial software and its vendor.

The analysis of the technicians’ silent knowledge with the newly developed method, epithet for silent knowledge (ETK), shows that the longer employment time:

• the more differentiated technicians become in describing their work,
• practical knowledge are regarded higher and
• the social and collective problem solving factors of the work becomes more important.

Typically, it is shown that a new employee should preferably enjoy problem solving, being pragmatic and social as well as having some prior education or work experience in a CAD and/or a PDM system.

Dissertation submitted in compliance with the Master's Diploma in Technology: Medical Technology, Technikon Natal, 1994.
The arena with the for medical technologists result that educational is continually changing directive must change accordingly. A number of big issues have changed the role of the medical technologist. Cognisance of the identified issues is essential if the profession is to survive the year 2000. The future directions of medical technology ar~ analysed in this disseration in order to identify the knowledge and skills that the professional medical technologist will require for the 21st century. The factors which have up to now introduced dramatic changes in clinical pathology laboratories will also present certain opoortunities for laboratory professionals but taking cognisance of the necessity for change and professional ability. This study was thus conducted to explore the educational requirements necessary for the professional future of medical Africa. laboratory technologists in the Republic of South !'.C.,' . A t~eoretical sub-structure lays the foundation for the study. The literature review in Chapter 2 outlines medical technology eduction both in the Republic of South Africa and in certain other countries. The necessity for change in the education of medical laboratory technologists is addressed here. Chapter 3 examines the factors (gleaned from the literature) which are producing a need for such dramatic change for the century ahead. It also examines the role of the technikons and the roles of the technikons with regard to the training of medical technologists and the influence of academic drift. The methodology in Chapter 4 explains the structuring and administration of a questionnaire used to capture data from registered medical laboratory technologists in the Republic of South Africa. The processed data results are discussed in Chapter 5. Tables are presented at the conclusion of certain groups of major issues. Chapter 6 concludes with the findings
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Submitted in fulfilment of the requirements of the Master of Health Sciences: Medical Laboratory Science Degree, Durban University of Technology, Durban, South Africa, 2017.
Background Medical laboratories play a crucial role in patient care and require a competent skilled workforce to deliver this essential service. The current process of Medical Technologist training is a summative assessment consisting of two written 3 hour papers that correlates theoretical knowledge acquired at a tertiary level with the practical internship. Currently there is no assessment of technical competence of Intern Medical Technologists (candidates) by the HPCSA. Aim: This study aims to determine how technical competence was assessed for Intern Medical Technologists who are eligible to write the National Board Examination in the Clinical Pathology discipline. Methods: A quantitative design was used for assessing the technical competence of the candidates that were eligible to write the National Board Examination by using an adapted SANAS witnessing tool across ten Clinical Pathology test procedures by direct observation as well as to determine how technical competence is assessed in HPCSA registered training laboratories using a survey administered to Laboratory managers and trainers. The data was collected and analysed using the statistical software SPSS version 24.0. Results Some candidates that were directly observed in each of the Clinical Pathology test procedures were deemed not yet competent in compliance and adherence to SOP’s, acceptability of results, internal quality control procedures and the acceptability of the outcome and availability of signed training and competency records on the direct observation checklist. These results of the assessment of technical competence were compared to the results of the National Board examination that candidates wrote and there was no correlation between the two except for the Microbiology sub-discipline and the general section. Results of operations of competency assessment in 9 HPCSA registered Training Laboratories revealed that 100% of respondents have a technical competence laboratory policy, 90% identified the Laboratory Manager as having responsibility for ensuring assessment of staff competency, 100% stated that frequency of competency testing was upon initial employment and once in two years thereafter, 90% had clear criteria to define competency assessment and 100% indicated that the remedial process used in their laboratories was documented corrective action which included re-training and re-assessment. Conclusion: From this study it can be concluded that assessment of technical competency for Intern Medical Technologists in the Clinical Pathology could augment current assessment systems of Intern Medical Technologists for conferment of professional designation and a policy review is recommended.
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碩士
臺北醫學大學
醫務管理學研究所
97
ISO15189 accreditation has been recognized as a quality standard for medical laboratory. The purpose of this study is to assess consciousness of laboratory workers on ISO-15189 based accreditation, and moreover, the way to prepare for approve. A questionnaire based survey were carried out from April to June 2009. A total of 550 questionnaires were sent to technologists who work in ISO 15189-compliant laboratories in Taiwan. The respond rate is 60.7% and 50.7% of which were valid. T-test, one way ANOVA and multiple regression analysis were employed to analyze contribution of demographic characteristics on workers’ awareness to implement ISO 15189. Results show that demographic characteristics, i.e., age, education, years of employment and job positions influence the success of laboratory accreditation based on ISO 15189

Thesis (Ph. D.)--University of Texas Health Science Center at Houston, School of Public Health, 2007.
Source: Dissertation Abstracts International, Volume: 68-10, Section: B, page: 6565. Adviser: Virginia Kennedy. Includes bibliographical references.