Monitoring Of Quality Indicators Research Articles

Structures for quality assurance and measurements for kidney replacement therapies: A multinational study from the ISN-GKHA.

Optimal care for patients with kidney failure reduces the risks of adverse health outcomes, including cardiovascular events and death. We evaluated data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to assess the capacity for quality service delivery for kidney failure care across countries and regions. We explored the quality of kidney failure care delivery and the monitoring of quality indicators from data provided by an international survey of stakeholders from countries affiliated with the ISN from July to September 2022. One hundred and sixty seven countries participated in the survey, representing about 97.4% of the world's population. In countries where haemodialysis (HD) was available, 81% (n = 134) provided standard HD sessions (three times weekly for 3-4 h per session) to patients. Among countries with peritoneal dialysis (PD) services, 61% (n = 101) were able to provide standard PD care (3-4 exchanges per day). In high-income countries, 98% (n = 62) reported that >75% of centers regularly monitored dialysis water quality for bacteria compared to 28% (n = 5) of low-income countries (LICs). Capacity to monitor the administration of immunosuppression drugs was generally available in 21% (n = 4) of LICs, compared to 90% (n = 57) of high-income countries. There was significant variability between and within regions and country income groups in reporting the quality of services utilized for kidney replacement therapies. Quality assurance standards on diagnostic and treatment tools were variable and particularly infrequent in LICs. Standardization of delivered care is essential for improving outcomes for people with kidney failure.

Fine-scale monitoring of catkins reveals an association between catkin concentration and plant community characteristics and microclimate

Catkins, as a significant source of plant-caused pollution, disrupts daily human activities and industrial processes. Despite their impact, catkins have not been included in official environmental quality monitoring indicators, leading to a deficiency in scientifically rigorous collection and monitoring methodologies, as well as a lack of ecological prevention and management strategies. In this study, we introduced a fine-scale monitoring approach for catkins. Qualitative and quantitative relationships between catkin concentrations, plant community characteristics and microclimate factors were elucidated by analyzing on-site catkin concentration data from 33 representative plant communities in Beijing. Furthermore, we summarized the ecological strategies for the prevention and management of these catkins. The results indicated that (1) TS (three-dimensional green volume of trees in the catkin source layer), SB (three-dimensional green volume of shrubs in the catkin barrier layer), GB (three-dimensional green volume of ground cover plants in the catkin barrier layer), T (three-dimensional green volume of trees in the whole plant community), W (three-dimensional green volume of the whole plant community), species diversity, and relative air humidity were key plant community characteristics and microclimate factors influencing catkin concentration. Among these factors, TS, T, W, and relative air humidity showed a significant positive correlation with catkin concentration, while SB, GB, and species diversity exhibited a significant negative correlation with catkin concentration. (2) All seven key factors exhibited nonlinear relationships with catkin concentration. (3) TS served as the primary deciding factor for catkin concentration within the plant community. When TS > 744.0755 m3, the secondary decision factor for catkin concentration was GB. Otherwise, the determinants were SB and species diversity. The results showed that enhancing tree species diversity, enhancing the three-dimensional green volume of shrubs and ground cover plants, and increasing air humidity were practical means to facilitate the sedimentation of catkins. The measures used to obstruct catkins vary depending on the TS. When catkin source plants are abundant within a plant community, it is advisable to prioritize increasing ground cover plants. Conversely, when fewer sources of such plants exist, emphasis can be placed on augmenting mid-layer shrubs and diversifying plant species. These findings provide a scientific foundation for the planting design and stock optimization of communities containing catkin source plants.

Big data technology for teaching quality monitoring and improvement in higher education - joint K-means clustering algorithm and Apriori algorithm

With the development of big data technology, the field of monitoring and improving teaching quality in universities has ushered in new opportunities and challenges. Big data technology enables the capture and analysis of massive amounts of data generated during the teaching process, providing the possibility for a deeper understanding of teaching activities. However, how to extract useful information from these vast amounts of data and transform it into strategies for teaching improvement is a challenge. The research aims to propose a teaching quality monitoring and improvement method based on big data technology, which combines K-means clustering algorithm and association rule mining algorithm to improve the accuracy of teaching monitoring and the effectiveness of teaching improvement. In order to cope with these challenges, the study proposes a research method of big data technology based on joint K-mean clustering algorithm and association rule mining algorithm. The study first analyzes the teaching quality monitoring and evaluation indexes using the K-mean algorithm. Then the association rule mining algorithm is utilized to mine the data in the teaching quality monitoring indicators with association rules on the basis of the obtained cluster analysis. Finally, on the basis of association rule mining, the study constructs the assessment model of teaching quality monitoring indicators by utilizing the fused method. The outcomes revealed that the average of data analysis accuracy and the average of recall rate of the modeling method were 93.79 % and 91.95 %, respectively. Meanwhile, the evaluation time of the modeling method in the process of teaching quality monitoring data processing was 17.3 s, and the evaluation precision was 93.15 % respectively. Additionally, the process's overall confidence and enhancement are 95.01 % and 86.73 %, respectively, and the modeling method's performance is compared to other approaches. This shown that the approach may significantly boost the precision and effectiveness of monitoring the quality of instruction, as well as offer strong backing for the enhancement of instruction in higher education institutions.

Quality indicators in respiratory therapy

Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance, effectiveness, and safety of healthcare services. These indicators provide a systematic way to evaluate the quality of care offered, and thereby to identify areas for improvement and to ensure that patient care meets established standards and best practices. Respiratory therapists play a vital role in areas of clinical administration such as infection control practices and quality improvement initiatives. Quality indicators serve as essential metrics for respiratory therapy departments to assess and enhance the overall quality of care. By systematically tracking and analyzing indicators related to infection control, treatment effectiveness, and adherence to protocols, respiratory care practitioners can identify areas to improve and implement evidence-based changes. This article reviewed how to identify, implement, and monitor quality indicators specific to the respiratory therapy departments to set benchmarks and enhance patient outcomes.

Conducting a National RT-QI Project – Challenges and Opportunities

Over the past decade, there has been an increased interest in defining and monitoring quality indicators (QI) in the field of oncology including the field of radiation oncology. The comprehensive gathering and analysis of QIs on a multicentric scale offer valuable insights into identifying gaps in clinical practice and fostering continuous improvement. This article delineates the evolution and results of the Belgian national project dedicated to radiotherapy-specific QIs while also exploring the challenges and opportunities inherent in implementing such a multi-centric initiative.

Research on water environmental indicators prediction method based on EEMD decomposition with CNN-BiLSTM.

Water resources protection is related to the development of the social economy, and the monitoring and prediction of water environmental indicators have important practical significance. In view of the seasonality, periodicity, uncertainty, and nonlinear characteristics of water quality indicators data, traditional prediction models have poor performance. To address this issue, this paper introduces a hybrid water quality index prediction model based on Ensemble Empirical Mode Decomposition (EEMD), combined with Convolutional Neural Network (CNN) and Bidirectional Long Short-Term Memory Network (BiLSTM). We have conducted out experiments to predict dissolved oxygen based on the water quality monitoring indicators of the Liaohe National Control Sanhongcun Village station in Yichun City. The results show that the model proposed in this paper improves the [Formula: see text] index by 5%, 7% and 5% compared to the suboptimal model in the 4-h, 1-day and 2-day index predictions, respectively.

How patients define success for integrated care: How the University Health Network identifies iterative improvement priorities

Background: While many standardized surveys exist to measure patient experience, they are not designed to assess unique features of integrated care (IC) programs including transitions from hospital to community, satisfaction with homecare, or resources and supports provided post-discharge. The aim was to have patients lead efforts to develop a set of quality indicators for routine monitoring of patient experience in the University Health Network (UHN) integrated models of care in Toronto, Ontario, Canada. The output would be used to evaluate efforts and prioritize ongoing improvement to continue to meet patient needs.
 Population: We invited 29 stakeholders to participate in this study between April-July 2022. Twenty-three (79%) were female, 14% identified as a person with a disability, and 28% identified as a person of colour. Nearly half of all participants were patients or caregivers (42%), followed by administration/clinicians (58%).
 Engagement: This work was carried out in partnership with patients and caregivers. We worked collaboratively with the UHN Patient Experience Team to ensure materials and processes were effectively designed for engagement. 
 Methods: We used the RAND-modified Delphi method, an approach combining scientific literature and expertise of stakeholders, to reach consensus on an agreed-upon set of indicators to measure patient experience. The study consisted of two surveys and a virtual meeting. In survey #1, participants answered demographic questions and rated 45 patient-reported experience measures (PREMs) on whether they felt the indicator was reliable, necessary, and actionable, and also provided written feedback on each. We averaged responses and feedback to rank indicators; those with above-average ratings were included in survey #2 where respondents identified if each indicator should be included as a key performance metric. All results were shared and discussed at the virtual meeting.
 Results: Among the 29 stakeholders surveyed, 27(93%), 25(86%) participated in survey #1 and #2, respectively. The average rating for indicators in survey #1 was 79%, resulting in 23 indicators proceeding to survey #2. In 71.1% of indicators from survey #1 there was full agreement, meaning that both patients/caregivers and administration/clinicians rated above or below 79% (i.e., there was agreement to keep or remove the indicator). The remaining 29% of indicators had half agreement between patients/caregivers and administration/clinicians. Divergence of opinion mostly occurred for indicators that assessed the patient’s emotional well-being (e.g., addressing anxieties, fears, worries). The final set of indicators covers pre-hospital admission through the post-discharge period and assesses domains such as informational continuity, person-centered care, timeliness of care, effectiveness of resources and supports, and efficacy of knowledge translation.
 Conclusions: After 2 survey rounds and a virtual meeting participants reached consensus on 13 indicators to measure patient experience. This is the first set of PREMs co-designed by patients and caregivers with a focus on IC applications in Canada. 
 Lessons Learned: Patients and caregivers rated indicators that measure domains of emotional support and reassurance higher than administration/clinicians, highlighting the importance of sub-group analysis in designing patient experience measures. 
 Next Steps: Following a successful pilot in the Division of Orthopedics, these indicators will be implemented in all UHN IC programs.

Records of quality indicators for management of long‐term health conditions of patients with intellectual disabilities in Dutch residential care

AbstractBackgroundType 2 diabetes mellitus, cardiovascular disease and chronic obstructive pulmonary disease contribute significantly to societal and individual impact globally. High‐quality management of these long‐term health conditions is important to prevent deterioration of health, although potentially more complex for patients with intellectual disabilities in residential care. Disease management in this context particularly benefits from complete and accurate recording of disease management. Without complete records, long‐term health conditions are more difficult to track due to the level of uncertainty regarding which clinical examinations have and have not been performed. This study therefore aims to examine the recording routines of quality indicators for disease monitoring for chronically ill patients with intellectual disabilities in Dutch residential care.MethodsThis retrospective study utilised medical record data from a large Dutch long‐term care provider. We assessed the occurrence of cardiovascular disease (ICPC‐2 codes K74, K75, K76, K89 and K90), type 2 diabetes mellitus (T90, T90.02) and/or COPD (R91, R95). For adults with intellectual disabilities and long‐term condition, we analysed data entries in an 18‐month period (between July 2020 and December 2021). Observed consultation rates were calculated and presented in median with interquartile range and contrasted against the baseline number of consultations in primary care. Information on recorded quality indicators was presented in frequencies and percentages.FindingsOf the three long‐term conditions investigated, the most common was type 2 diabetes mellitus (8.6%; n = 287), followed by cardiovascular disease (5.8%; n = 195) and COPD (3.0%; n = 101). Of those who received management for their long‐term condition from their contracted GP, patients with type 2 diabetes mellitus, cardiovascular disease, or COPD had fewer consultations in 2021 than the Dutch baseline. Discussion of lifestyle was often not recorded. Disease monitoring quality indicators were recorded more often but at a lower frequency than expected.ConclusionsBecause of the infrequent recording of quality indicators, recording of management of long‐term conditions for patients with intellectual disabilities in long‐term care appears suboptimal. Although this may not directly harm individual patients, it may jeopardise the quality of management of long‐term conditions, as suboptimal recording limits opportunities for evaluation and improvement. Within a broader trend towards data‐driven work methods in healthcare, recording of quality indicators requires attention from practice, research and policy.

The Danish Atrial Fibrillation Registry: A Multidisciplinary National Pragmatic Initiative for Monitoring and Supporting Quality of Care Based on Data Retrieved from Administrative Registries.

The Danish Atrial Fibrillation (AF) Registry monitors and supports improvement of quality of care for all AF patients in Denmark. This report describes the registry's administrative and organizational structure, data sources, data flow, data analyses, annual reporting, and feedback between the registry, clinicians, and the administrative system. We also report the selection process of the quality indicators and the temporal trends in results from 2017-2021. The Danish AF Registry aims for complete registration and monitoring of care for all patients diagnosed with AF in Denmark. Administrative registries provide data on contacts to general practice, contacts to private cardiology practice, hospital contacts, medication prescriptions, updated vital status information, and biochemical test results. The Danish Stroke Registry provides information on stroke events. From 2017 to 2021, the proportion with a reported echocardiography among incident AF patients increased from 39.9% (95% CI: 39.3-40.6) to 82.6% (95% CI: 82.1-83.1). The initiation of oral anticoagulant therapy among patients with incident AF and a CHA2DS2-VASc score of ≥1 in men and ≥2 in women increased from 85.3% (95% CI: 84.6-85.9) to 90.4% (95% CI: 89.9-91.0). The 1-year and 2-year persistence increased from 85.2% (95% CI: 84.5-85.9) to 88.7% (95% CI: 88.0-89.3), and from 85.4% (95% CI: 84.7-86.2) to 88.2% (95% CI: 87.5-88.8), respectively. The 1-year risk of ischemic stroke among prevalent patients with AF decreased from 0.88% (95% CI: 0.83-0.93) to 0.71% (95% CI: 0.66-0.75). Variation in clinical performance between the five administrative Danish regions was reduced. Continuous nationwide monitoring of quality indicators for AF originating from administrative registries is feasible and supportive of improvements of quality of care.

Sustainability assessment of water coast systems through bird monitoring and water quality indicators. Case study: Juan Angola Channel - Cartagena, Colombia

Sustainability assessment of water coast systems through bird monitoring and water quality indicators. Case study: Juan Angola Channel - Cartagena, Colombia

Health policy approach to the treatment and prevention of pressure ulcers

A pressure sore (decubitus) is a wound that develops on the skin and subcutaneous tissue in places exposed to pressure. Primarily occurs in elderly, non-mobile individuals, the prevention and control of which requires not only medical and nursing participation, but it also financial expenditure. In our study, after a systematic document analysis, we present the relevant results of the decubitus survey conducted among state hospitals during Q2 of 2022, focusing on the organizational and management factors of decubitus prevention and care. The national survey was comprehensive in terms of the range of institutions relevant to decubitus care. After defining the selection criteria, we got a picture of 86 institutional practices for the base year of 2019. During the review and systematization of domestic and European Union professional policy documents, regulators and strategy documents, it can be established that pressure ulcer prevention and care can be adapted to several development policy objectives, and its incidence appears as a quality indicator of the health sector. Based on the results of our national decubitus survey, it can be said that domestic good practices operate in isolation, our reporting system is inhomogeneous, and the documentation is not uniform in our institutional system. 17 of the 86 institutions have new (2021-2022) documents regulating decubitus care at the institutional level, which in 17% of the institutions are dated 2010 or earlier. The scope of revision of the regulatory documents is set at 10% of the institutions. 61 of the examined institutions (71%) operate decubitus teams, 55 institutions (64%) use prophylactic bandages. There is a lack of professional monitoring measures and quality indicators, institutional-level expenditure analyses, controlling-type feedback, which would form the basis of costing and cost-effectiveness analyses. In addition to our proposals for several organizational and managerial measures, we advocate the renewal of the relevant professional directive and the introduction of a uniform institutional reporting system as well. Orv Hetil. 2023; 164(21): 821-830.

Intelligent Colorimetric Indicators for Quality Monitoring and Multilevel Anticounterfeiting with Kinetics-Tunable Fluorescence

The spoilage and forgery of perishable products such as food, drugs, and vaccines cause serious health hazards and economic loss every year. Developing highly efficient and convenient time-temperature indicators (TTIs) to realize quality monitoring and anticounterfeiting simultaneously is urgent but remains a challenge. To this end, a kind of colorimetric fluorescent TTI, based on CsPbBr3@SiO2 nanoparticles with tunable quenching kinetics, is developed. The kinetics rate of the CsPbBr3-based TTIs is easily regulated by adjusting temperature, concentration of the nanoparticles, and addition of salts, stemming from the cation exchange effect, common-ion effect, and structural damage by water. Typically, when combined with europium complexes, the developed TTIs show an irreversible dynamic change in fluorescent colors from green to red upon increasing temperature and time. Furthermore, a locking encryption system with multiple logics is also realized by combining TTIs with different kinetics. The correct information only appears at specific ranges of time and temperature under UV light and is irreversibly self-erased afterward. The simple and low-cost composition and the ingenious design of kinetics-tunable fluorescence in this work stimulate more insights and inspiration toward intelligent TTIs, especially for high-security anticounterfeiting and quality monitoring, which is really conducive to ensuring food and medicine safety.

Polyethylene glycol functionalized Fe3O4@MIL-101(Cr) for the efficient removal of heavy metals from Ligusticum chuanxiong Hort

In recent years, the quality and safety issues of Chinese medicinal herbs have received great attention worldwide. Thereinto, heavy metal contamination has been one of the most serious concerns. Compared to the wide research in the analysis of heavy metals in medicinal herbs, the studies on the removal of heavy metals are relatively limited. In this study, polyethylene glycol functionalized Fe3O4@MIL-101(Cr) (Fe3O4@MIL-101(Cr)@PEG) was designed and synthesized to remove heavy metals from the decoction of Ligusticum chuanxiong Hort. The in-house fabricated Fe3O4@MIL-101(Cr)@PEG was characterized by a porous structure and a large specific surface area. Then, the efficiency of the material for the removal of five heavy metals was tested under optimal adsorption conditions. Meanwhile, the content of Senkyunolide A, Senkyunolide I, and Ferulic acid, the solid content, and the HPLC fingerprints similarity were used as the quality monitoring indicators of Ligusticum chuanxiong Hort decoction before and after the heavy metal removal. Results showed that the magnetic nanomaterial had excellent removal efficiency for As5+ (81.4 %), Cd2+ (88.19 %), and Pb2+ (83.79 %) and certain removal efficiency for Ni2+ (51.59 %) and Zn2+ (55.4 %) under the spiked concentration of 50 μg/mL. The content of Senkyunolide A, Senkyunolide I, and Ferulic acid were decreased by less than 8.00 % after the removal of heavy metals. Besides, the loss rate of solid content was only 0.18 %, and the fingerprints similarity was over 99.9 %. The results indicated that Fe3O4@MIL-101(Cr)@PEG could efficiently and selectively remove heavy metals from Ligusticum chuanxiong Hort without affecting its effective components. Due to the advantages of low-cost, simple manipulation, and good efficiency, the material can be recommended for heavy metals removal from the aqueous solutions of medicinal herbs, providing a new and promising application for the removal of exogenous contaminants in medicinal herbs.

Ameliorating the prediction ability of laccase time temperature indicator for dynamic monitoring quality of fresh‐cut papaya

SummaryLaccase was immobilised on electrospun chitosan fibres to prepare a laccase time–temperature indicator (LTTI) to predict the quality deterioration of fresh‐cut papaya. Using sodium azide (NaN3) as an enzyme inhibitor could retard the laccase‐catalysed coloration and to expand activation energy (Ea) range, in which the LTTI was calibrated to correlate with fresh‐cut papaya deterioration. The fresh‐cut papaya reaching total plate count (TPC) of 105 CFU g−1 demonstrated unacceptable quality and the time it took was close to the coloration endpoint of formulated LTTI at different storage temperatures. The Ea of the LTTI, formulated with 20 μg cm−2 of laccase and 0.1 mm NaN3, was 55.69 kJ mol−1, which only differed by approximately 15 kJ mol−1 from the Ea of the TPC of fresh‐cut papaya. In the 5, 15, 25, and 35 °C isothermal response tests, the prediction errors were 1.15%, 2.78%, 2.78%, and 0.83%, respectively. In temperature fluctuation response experiments, the coloration endpoint of the LTTI was correlated with the quality deterioration of fresh‐cut papaya. These results revealed that the formulated LTTI had high reliability in evaluating the shelf life of fresh‐cut papaya.

Spanish National Registry of Major Osteoporotic Fractures (REFRA) seen at Fracture Liaison Services (FLS): objectives and quality standards

SummaryREFRA-FLS is a new registry in Spain aimed at identifying individuals over 50 years of age with a fragility fracture. Using this registry, we found hip fracture is the most prevalent fracture. Treatment for osteoporosis was 87.7%, with 65.3% adherence. REFRA-FLS provides fundamental data in the study of fragility fractures.PurposeFragility fractures are a growing public health concern in modern-aged societies. Fracture Liaison Services (FLS) have been shown to successfully lower rates of secondary fractures. A new registry (REFRA-FLS) has been created to monitor quality indicators of FLS units in Spain and to explore the occurrence and characteristic of fragility fractures identified by these centers.MethodsWe conducted a prospective cohort study based on fragility fractures recorded in the REFRA-FLS registry. Participants were individuals 50 years or above who suffered a low energy fragility fracture identified by the 10 participating FLS units during the study period. The type of FLS unit, the characteristics of the individuals at baseline, along with patient outcomes as quality indicators among those who completed 1 year of follow-up were analyzed.ResultsA total of 2965 patients and 3067 fragility fractures were identified, and the most frequent locations were hip (n = 1709, 55.7%) and spine (n = 492, 16.0%). A total of 43 refractures (4.5%) and 46 deaths (4.9%) were observed among 948 individuals in the follow-up analyses. Time from fracture to evaluation was less than 3 months in 76.7% of individuals. Osteoporosis treatment was prescribed in 87.7%, and adherence was 65.3% in Morisky–Green test.ConclusionOur results provide a comprehensive picture of fragility fractures identified in FLS units from Spain. Overall, quality indicators are satisfactory although a much higher use of DXA would be desirable. As the registry grows with the incorporation of new FLS units and longer follow-up, incoming analyses will provide valuable insight.

P11.16: Quality Monitoring Indicators in the Process of Organ And Tissue Donation for Transplantation: A Scoping Review Preliminary Results

P11.16: Quality Monitoring Indicators in the Process of Organ And Tissue Donation for Transplantation: A Scoping Review Preliminary Results

A supervised multisegment probability density analysis method for incipient fault detection of quality indicator

The quality indicator monitoring has received widely attention and research in recent years, however, the detection of indicator-related incipient fault is still a challenging topic. In this paper, a supervised probability density analysis algorithm is proposed to detect the incipient fault in quality indicator. Firstly, the core process variable filter is introduced, and the regression model is constructed to extract the indicator-related information from process variable. Secondly, the data distribution extension and subsegment division strategy are presented, and a probability density estimation method is put forward for the indicator-related latent variable. Through the proposed symmetric divergence index, the distribution discrepancy between the online sample and the reference sample set is evaluated, which can be used for the incipient fault detection. Finally, a numerical example and the Tennessee Eastman process are used to demonstrate the effectiveness of the proposed method.

MONITORING QUALITY INDICATORS IN A MEDIUM-SIZED LABORATORY OF SOUTH BENGAL: MOVING TOWARDS ACCREDITATION

Introduction: Documenting and monitoring quality indicators are important to improve the quality of a laboratory. The objective of this study was to record the quality indicators of a clinical laboratory and prepare it for accreditation by National Accreditation Board of Laboratories (NABL) as per ISO 15189. Materials And Methods: A total of 9 quality indicators in different phases of sample analyses viz. pre-analytical, analytical and post-analytical were monitored for 21459 samples over a period of one year. Results: Incomplete requisition forms were the most common outlier (2.5%) in the pre-analytical phase followed by samples not maintaining cold chain during transport (2.1%). Internal non-conformance with quality control was seen in 0.6% of samples in analytical phase. In post analytical phase, turnaround time (TAT) could not be maintained for 8% of the samples. Conclusion: Monitoring and recording quality indicators give us an idea about the performance of a medical laboratory. Therefore, working with a goal to reduce quality indicator outliers will improve the quality of a laboratory and ultimately enhance patient care. Moreover, it can help comparing different laboratories in a particular area based on performance.

Improved water quality monitoring indicators may increase carbon storage in the oceans

Indicators related to organic matter are important when assessing aquatic environment quality. The chemical oxygen demand (COD) is widely used as a water quality reference. However, oxidizing agents used to determine the COD can oxidize refractory organic matter that is not pollutant and can persist in the ocean for thousands of years. This means the COD can misrepresent the water quality. The actual water quality can be indicated better by the biochemical oxygen demand (BOD) than the COD, but determining the BOD is time-consuming and gives variable results. In this study, the optical properties of dissolved organic matter in water samples from the Chinese coast that had been incubated for a long time or directly oxidized using COD oxidant were analyzed. The results indicated that the oxidizing agent rapidly oxidized 22.93% ± 4.96% of refractory dissolved organic matter (RDOM) that was resistant to microbial degradation, implying that RDOM made a marked contribution to the COD. Meanwhile, size-fractional fluorescence spectroscopy and COD measurements indicated that the COD of the >0.7 μm fraction and the fluorescence intensity of the protein-like component significantly positively correlated with the BOD of the bulk sample. This indicated that, for monitoring organic pollutants in coastal waters, the COD of the >0.7 μm fraction could be used as a proxy for the standard COD and that the fluorescence intensity of the protein-like component could be used as a convenient proxy for the BOD. The method can help retain recalcitrant organic matter in seawater to act as a carbon sink.

Policies and practices in the field of laboratory hematology in Croatia- a current overview and call for improvement.

In 2019 The Croatian Working Group for Laboratory Hematology, on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine, wanted to explore the background in field of laboratory hematology routine practice among Croatian laboratories in order to develop future strategies for producing national recommendations, if needed. During April and May 2019, a comprehensive survey covering all main parts of the total testing process within the field of laboratory hematology among Croatian medical laboratories was conducted. The survey comprised 49 inquiries. Data was collected using Survey Monkey (Palo Alto, CA, USA). All collected data was anonymized. The response rate was 72%. There is still a substantial number of laboratories that have only three-part differential hematology analyzers (9%). Furthermore, a very high number of laboratories did not perform analyzer verification prior to implementation into routine work (31%). Out of those who have verified their analyzers, a diversity of guidelines and recommendations were used. Nearly 10% of the laboratories do not have a defined policy regarding specimen rejection. The majority of the participants perform internal quality control daily (83%), however, only 51% of respondents evaluate the agreement between different hematology analyzers on daily basis. Although more than 90% of Croatian laboratories have a defined policy regarding specimen rejection, only 61% of respondents continuously monitor quality indicators in routine practice. The survey revealed substantial differences in all aspects of laboratory hematology practices among Croatian medical laboratories, indicating the need for universal recommendations at the national level.