Quality Assurance Scheme Research Articles

Quality assurance programs to support tuberculosis diagnostic capacity amongst laboratories within Meru county, Kenya

Background: According to the Kenya Ministry of Health, Meru County had reported a tuberculosis (TB) notification rate of 158/100,000 population in 2015. Aforementioned reports indicates that the prevalence of TB that warrants early detection and diagnosis, hence the need to determine quality assurance programs to Support tuberculosis diagnostic capacity of Tuberculosis amongst laboratories within Meru County. Objective: To determine quality assurance programs to support tuberculosis diagnostic capacity amongst laboratories within Meru County, Kenya. Materials and Methods: This was a descriptive study survey which utilized quantitative techniques to establish the potential and capacity of laboratory personnel in TB diagnostic laboratories in selected medical centres. Data entry was done through use of Statistical Package for Social Sciences (SPSS). Frequency and percentages were calculated. Findings were presented in form of frequency distribution tables and bar graphs and analyzed using Chi square. Results: Majority of laboratory personnel had indicated that their laboratories were public laboratories (69.2%) followed by private owned laboratories (30.8%). There were significant differences in the diagnostic capacity of TB between public and private owned laboratories in relation to availability of the following resources: Safety cabinet [χ2 (1 df, N= 26) = 18.49, p=0.000<0.05], Centrifuge [χ2 (1 df, N= 26) = 10.64, p=0.000<0.05], Gene Xpert resources [χ2 (1 df, N= 26) = 18.49, p=0.000<0.05], Freezer/refrigerator [χ2 (1 df, N= 26) = 14.28, p=0.000<0.05], Incubator [χ2 (1 df, N= 26) = 18.49, p=0.000<0.05] and TB florescence microscopy [χ2 (1 df, N= 26) = 18.49, p=0.000<0.05]. Majority of the respondents had been using Centre of Disease Control and Prevention (CDC) as their quality assurance schemes (61.5%) followed by Central TB reference laboratories, Ministry of Health (26.9%) and (others please specify) who never participated in any quality assurance scheme (11.5%). majority of respondents had been sending their specimens for TB culture and sensitivity to research institution (KEMRI Centre for Respiratory Diseases) (69.2%), followed by those who indicated ‘Any other’ thus not sending any specimen for TB culture and sensitivity (26.9%) and to private or commercial laboratories (3.8%). None of the respondents had indicated sending their specimens for TB culture and sensitivity to either Central TB Reference laboratories Q/A (ministry of health) or a university (0.0%).

Practical application of European biological variation combined with Westgard Sigma Rules in internal quality control.

Westgard Sigma Rules is a statistical tool available for quality control. Biological variation (BV) can be used to set analytical performance specifications (APS). The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) regularly updates BV data. However, few studies have used robust BV data to determine quality goals and design a quality control strategy for tumor markers. The aim of this study was to derive APS for tumor markers from EFLM BV data and apply Westgard Sigma Rules to establish internal quality control (IQC) rules. Precision was calculated from IQC data, and bias was obtained from the relative deviation of the External quality assurance scheme (EQAS) group mean values and laboratory-measured values. Total allowable error (TEa) was derived using EFLM BV data. After calculating sigma metrics, the IQC strategy for each tumor marker was determined according to Westgard Sigma Rules. Sigma metrics achieved for each analyte varied with the level of TEa. Most of these tumor markers except neuron-specific enolase reached 3σ or better based on TEamin. With TEades and TEaopt set as the quality goals, almost all analytes had sigma values below 3. Set TEamin as quality goal, each analyte matched IQC muti rules and numbers of control measurements according to sigma values. Quality goals from the EFLM BV database and Westgard Sigma Rules can be used to develop IQC strategy for tumor markers.

Consumer preferences for chlorine-washed chicken, attitudes to Brexit and implications for future trade agreements

This research employs two discrete choice experiments to examine UK consumer preferences regarding chlorine-washed chicken. Our analysis differentiates value estimates by respondents’ beliefs about the impact of Brexit on food. The results reveal that those holding positive attitudes towards food post-Brexit tend not to value chlorine-washed chicken as negatively as those who have negative attitudes about food post-Brexit. Yet, of equal or greater significance, those respondents who hold positive beliefs about the impact of Brexit on food still value EU food safety standards, quality assurance schemes and country of origin information. This indicates that attitudes to food post -Brexit and preferences regarding food do not necessarily align in support of trade agreements that may require the UK to lower existing food safety and animal welfare standards. Potential policy solutions to ensure consumer preferences are satisfied are discussed, in particular food labels enabling informed food choice.

Estimating HbA1c External Quality Assurance Scheme (EQAS) Findings in Princess Iman Center; a Stepwise in Quality Improvement Plan

Laboratory is simultaneously the most, and the least used resource of the healthcare system, laboratory tests provide information which help doctors to provide better and more effective care for their patients.

Interlaboratory Comparison Investigations (ICIs) and External Quality Assurance Schemes (EQUASs) for human biomonitoring of perfluoroalkyl substances (PFASs) in serum as part of the quality assurance programme under HBM4EU

Perfluoroalkyl substances (PFASs) are of very high concern due to their persistence and accumulative behaviour as well as their manifold adverse health effects. Human biomonitoring (HBM) based on the determination of PFASs in serum samples is an adequate and established strategy for exposure and risk assessment of the population. The suspected health risks associated with exposure levels in the general population call for reliable HBM data verified by Quality Assurance and Quality Control (QA/QC) measures. PFASs were among the chemicals selected as priority substances in HBM4EU, a pan-European project to harmonize and advance HBM within 30 European countries. For this purpose, the analytical comparability and accuracy of PFASs-analysing laboratories was assessed in a QA/QC programme comprising Interlaboratory Comparison Investigations (ICIs) and External Quality Assurance Schemes (EQUASs). This paper presents the evaluation process and discusses the results of four ICI/EQUAS rounds for the determination of eight perfluoroalkyl carboxylic acids and four perfluoroalkyl sulfonic acids (PFBS, PFHxS, PFHpS, PFOS) in serum. All 21 participating laboratories achieved satisfactory results for at least six of these biomarkers, although low limits of quantification (of about 0.1 μg/L) were required to quantify serum PFAS levels at general population exposure levels. The mean relative standard deviation of the participants' results (study RSDR) significantly improved from 22 % to 13 % over all PFAS biomarkers in the course of the four rounds. This QA/QC programme succeeded in establishing a network of laboratories with high analytical comparability and accuracy for the analysis of PFASs across 12 European countries.

P-287 An assessment of agreement between automated embryo annotation, through artificial intelligence, and manual embryo annotation

Abstract Study question How strong is the agreement between embryo morphokinetic annotations performed by experienced embryologists compared to an automated embryo annotation system based on artificial intelligence (AI)? Summary answer Agreement between manual and automated annotation as determined by the interclass correlation coefficient (ICC) revealed strong or very strong agreement for all analysed morphokinetic variables. What is known already Transitioning from time-lapse imaging to embryo selection for transfer, freezing or discard involves annotation; the action of converting images to numerical data. Numerical data can be used as input to selection models quantifying embryo viability. Currently, embryos are manually annotated by the embryologist which can be subjective and time-consuming. As such, clinics prioritise a manageable number of variables to annotate, leading to a range of clinic practices. There is the additional challenge of operator variation, despite the development of standardised definitions and quality assurance schemes. AI may help resolve these challenges. Study design, size, duration Retrospective comparative analysis, including 2442 embryos from IVF and ICSI cycles, from four private fertility clinics belonging to the same group in the UK. All the embryos cultured in a time-lapse incubator (EmbryoScope,Vitrolife) between January 2016 and 2019 were included in the study. Manual annotations (MA) versus automated annotations (AA) were compared using a two-way, mixed interclass correlation coefficient (ICC), which produced five categories of agreement, very weak(0-0.20), weak(0.21-0.40), moderate(0.41-0.60), strong(0.61-0.80), very strong(0.81-1.00). Participants/materials, setting, methods Videos were manually annotated by experienced embryologists from pronuclei fading (tPNf) to time of expanded blastocyst (tEB) with all cell stages annotated in between (time to two-cell (t2), three-cell (t3), four-cell (t4), five-cell (t5), six-cell (t6), seven-cell (t7), eight-cell (t8), nine-cell (t9), morula (tM), start of blastulation (tSB) and full blastocyst (tB)). Blind to human annotations, and without any training, the same videos were annotated by CHLOE (Fairtility) to produce automated annotation data. Main results and the role of chance Of the expected annotations, AA did not provide a result for 15.4% of the MA(3235/21008). Very strong agreement(0.81-1.00) between MA and AA was found for tPNf, t2, t3, t5, t6, tM, tSB, tB, tEB. Strong agreement(0.61-0.80) was found for t4, t7, t8 and t9+. Outliers in the AA data, defined as one standard deviation from the MA, were interrogated further for five key morphokinetic parameters; t2, t5, t8, tSB and tB. A total of 269 outliers were identified. For t2 outliers(n = 14,6%), the average time difference was 5.97h(range;5.50-24.44h). All embryos with a t2 outlier were classed as either poor(PQ) or average quality(AQ). The t5 outliers(n = 45,19%) had an average time difference of 2.84h(range;9.33-36.69h). 96%(n = 43) of these embryos were classed as PQ(n = 25,56%) or AQ(n = 18,40%). Outliers for t8(138,58%) were, on average, 17.53h different between MA and AA(range;12.68-40.35h). 94%(n = 130)of these embryos were classed as PQ(n = 77,56%) or AQ(n = 53,38%). The tSB outliers(n = 28,12%) had an average time difference of 3.58h(range;0.71-14.39h). 89%(n = 25) of these embryos were classed as PQ(n = 16,57%) or AQ(n = 9,32%). Finally, outliers associated with tB(n = 44,18%) had an average time difference of 6.39h(range;0.02-33.67h). 95%(n = 42) of these embryos were classed as PQ(n = 38,86%) or AQ(n = 4,9%). Almost 15%(n = 40) of the embryos had outliers in more than one of the five morphokinetic parameters. Limitations, reasons for caution The findings for this study reflect the capabilities of a specific AI-based annotation algorithm against the practice in multiple clinics in the same group and country. The automated annotation algorithm was not trained on this dataset prior to validation, which is encouraging for generalisability. Wider implications of the findings AI is ideally suited to resolve annotation challenges. This study demonstrates that where embryo quality is poor, annotation could be skewed both when performed manually and automatically. Once robustness is demonstrated, AI tools such as CHLOE, may allow clinics to process clinical data efficiently, objectively and consistently. Trial registration number None

Evaluating an external quality assurance program for semen analysis in China during 2009-2020.

Semen analysis (SA) plays a key role in guiding treatments of male reproductive diseases and infertility due to male factors; however, it remains challenging to conduct an accurate SA due to lack of standardization, highly subjective assessments, and problems with automated procedures. Therefore, quality assurance (QA) and teaching courses are essential for making the laboratory results more consistent. The external quality assurance (EQA) scheme was organized by national human sperm bank technology training bases in Guangdong province in China between 2009 and 2020. Until 2020, 124 laboratories from China participated in the EQA program. The EQA scheme per year has been organized involving two semen aliquots for sperm concentration, two video recordings for motility, and two smears for sperm morphology. All samples used in the EQA scheme were obtained from different healthy donors or patients. We estimated that the median coefficient of variation (CV) of sperm concentration, ignoring the method used, was 26.6%. Using a 100µm deep counting chamber led to a decreasing CV of 13.6%. For sperm motility, the median CV of nonprogressive motility was high (50.8%), but the CV of progressive motility (13.2%), immotile sperm (14.3%), and total motility (11.8%) were acceptable. The morphology assessment revealed large variability (44.4%) irrespective of the classification criteria. The reduction of interlaboratory variability is still a challenge during SA in China. Therefore, it is critical to increase awareness of joining EQA schemes and establish standardized training centers to follow WHO-recommended procedures toward Chinese standards.

MEAT DECLARATION – CONSUMER OPINION AND CONFIDENCE

One of the main goals of food safety measures is to increase consumer confidence in food in general, and meat in particular, and therefore consumers are provided with information about the quality and safety of meat through declaration. Consumer confidence and food safety have become central issues in the food chain. Recent developments in labelling, traceability and quality assurance schemes offer a large amount of information available to the consumer. Declaring is today one of the most reliable ways of informing consumers about food quality. For the purposes of this study, data were collected by surveying 1,000 consumers from the Banja Luka and Gradiška areas. The results of this survey show that the majority of consumers (98.1%) believe that meat should have a declaration and that the statistically most important (p0.05) information on the declaration is the expiration date (75.8% of responses) compared to other information (nutritional value, method of production, country of origin). The way the meat is packaged is also important for consumers (45.3% of responses). Also, the statistical significantly different answers (p0.05) were given related to the trust in information about the safety/quality of meat obtained in different ways (butcher, seller, relative, friend, cook). The consumers showed that they mostly believe to information about the safety/quality of meat received from doctors/nutritionists (53.1%), and most often have a neutral attitude towards information received from consumer protection associations (41.9%). It is not sufficiently clarified what type of information consumers are most looking for on declarations, especially when it comes to meat and meat products. Because of that, continuous examination of consumers is needed, including sociological and economic factors, what motivates them to buy, what quality characteristics they require and what sources of information they believe the most.

Quality risk and responsive actions in sourcing/procurement: an empirical study of food fraud cases in the UK

It is never an easy task to govern contemporary food systems and prevent contaminated foods from reaching further down the chains. This study aims to investigate how UK managers in food supply chains have perceived food fraud risk in their supply chain and to identify what their actions could be in response to the threat of food fraud. The study adopts the psychometric paradigm approach to measure risk perception and uses the data collected from 113 UK food practitioners to identify the determinants of their responsive actions. The results highlight that most managers have perceived high uncertainty in the food supply chain and considered the disruption of information flow as a major concern in dealing with food fraud. Therefore, this study suggests that putting effort into practices to improve supply chain visibility and facilitate the flow of information are weighted as important in the food fraud mitigation journey. Policy makers should also make better use of the current quality assurance schemes for proactive food quality control and fraud prevention; government agencies should improve the risk communication systems for trustworthy information dissemination.

Blended Bilingual Education Model in Chinese-Foreign Cooperatively-Run Programs in Higher Vocational Colleges With Foreign Language Other Than English as the Target Language

Bilingual teaching modules are commonly seen in Chinese-foreign cooperatively-run classes with English as the foreign language. In Chinese-foreign cooperatively-run classes with foreign languages other than English, blended bilingual education model is suggested with different bilingual education models applied in different courses and terms. This model may also face the challenges like comparatively high learning objectives and inefficient learners as well as limited bilingual teaching resources. To ensure its quality, both external and internal quality assurance schemes are suggested.

Characterization and traceability of two generations of standard reference material for the measurement of vitamin K1 (phylloquinone) at endogenous concentrations in human plasma and serum.

Vitamin K is an essential micronutrient required for blood coagulation, regulation of vascular calcification and bone mineralization. Plasma and serum measurements of vitamin K1 (phylloquinone, K1 ) made using high-performance liquid chromatography with fluorescence detection, or tandem mass spectrometry are used clinically and in population studies to assess vitamin K status. Standard reference materials provide a validation tool for laboratories, helping assure clinical diagnosis and the comparability of data from different populations. We manufactured two K1 standard reference materials, in 2009 (KEQAS SRM-001) and in 2019 (KEQAS SRM-002). The target concentrations of K1 were assigned to each SRM using the All Laboratory Trimmed Mean of results reported by selected laboratories enrolled in the Vitamin K External Quality Assurance Scheme (KEQAS). The assigned concentrations of K1 for KEQAS SRM-001 and SRM-002 were 0.25 and 0.36 μg/L respectively. In 2019 KEQAS SRM-001 was re-analysed simultaneously with KEQAS SRM-002 to provide traceability between the two standards, therefore aiding comparability of analysis performed using these materials. Both standards were stored as aliquots at -80°C in the dark; annual re-analysis of the materials indicated that K1 is stable for at least 12 years in these conditions.

The GIN-McMaster guideline tool extension for the integration of quality improvement and quality assurance in guidelines: a description of the methods for its development

Background and ObjectivesOur objective was to develop an extension of the widely used GIN-McMaster Guideline Development Checklist and Tool for the integration of quality assurance and improvement (QAI) schemes with guideline development. MethodsWe used a mixed-methods approach incorporating evidence from a systematic review, an expert workshop and a survey of experts to iteratively create an extension of the checklist for QAI through three rounds of feedback. As a part of this process, we also refined criteria of a good guideline-based quality indicator. ResultsWe developed a 40-item checklist extension addressing steps for the integration of QAI into guideline development across the existing 18 topics and created one new topic specific to QAI. The steps span from ‘organization, budget, planning and training’, to updating of QAI and guideline implementation. ConclusionThe tool supports integration of QAI schemes with guideline development initiatives and it will be used in the forthcoming integrated European Commission Initiative on Colorectal Cancer. Future work should evaluate this extension and QAI items requiring additional support for guideline developers and links to QAI schemes.

Application of sigma metrics in haematology laboratory

Objectives: Sigma metrics analysis indicates; the level quality control has achieved and how far a given process deviates from perfection. Though the concept is not new to quality and utility, its implementation in the haematology laboratory is still in its nascent stages. The study aimed to compare the utility of sigma metrics as a comprehensive quality control tool in Haematology laboratory against the current quality tools of Internal Quality Control (IQC) and External quality assurance scheme for haematology analyser.Methods: In the present study, IQC data was analysed from June 2021 to September 2021. Control material included 3 batches of second party controls (SPC). Sigma were calculated for five key haematological parameters run in Sysmex XN 350. OPSpecs charts were prepared. Sigma metrics were calculated using the formula Sigma = (TEa – Bias) / CV, Bias was taken from IQC kit insert. Quality goal index was also calculated when needed.Results: Average sigma metrics achieved for selected parameters was, RBC: 8.1, HB: 7.6, HCT 5.6, PLT: 7.0, and WBC: 6.7. The laboratory has achieved excellent to world class performance in all analytes. Sigma QC rules were applied and modifications proposed to the existing internal QC protocols to reduce the number of rejections.Conclusion: Labs must preferentially use the sigma metrics and sigma QC rules to design its IQC protocols, for individual parameters, rather than follow the ‘one fit for all’ recommendation. This would help save precious time, effort, unnecessary control runs and improve efficiency with better focus on quality control, where required.

On the Frontiers of Software Science and Software Engineering

Advances in software engineering, software science, computational intelligence, and intelligent mathematics have led to the establishment of Frontiers in Computer Science—Software (FCSS). FCSS aims to promote transdisciplinary research on software science and engineering (SSE), autonomous systems, and computational intelligence. FCSS covers not only classical empirical software engineering and industrial processes, but also contemporary topics of software science, intelligent programming languages, autonomous code generation, mathematical foundations of software, and programming knowledge bases. FCSS reports empirical studies and emerging topics in software engineering including tools, development platforms, industrial processes, management infrastructures, quality assurance schemes, big data systems, and software migrations across languages and platforms.

Beyond Diagnostics: The role of a RT-PCR laboratory in a pandemic

PurposeThe gold standard for the detection of SARS-CoV-2 is Real Time Reverse Transcriptase PCR (rRT-PCR). A combination of nasopharyngeal and oropharyngeal swabs improves the sensitivity of detection of SARS-CoV-2 in samples. The first wave of COVID-19 impacted Chennai in May 2020 and lasted till October 2020. The second wave began in March 2021 and lasted till June 2021. The aim of this study is to compare and analyze the COVID-19 waves in 2020 and 2021 based on the data from a tertiary care centre in Chennai, India.Methods & MaterialsA total of 42,374 samples were tested by rRT-PCR (Rotor Gene-Q) between March 2020 and June 2021. RNA was extracted using Zybio nucleic acid extraction kit. The target regions of the RT-PCR kits (ViroQ SARS CoV2, Bag Diagnostics, Germany) were the E-gene and RdRp gene. Quality control is maintained by routine participation in the external quality assurance scheme (EQAS).ResultsIn 2020, 22,905 samples were tested and 3,415 samples tested positive for COVID 19. During the first wave of COVID-19 between May-October 2020, 2989 samples tested positive for COVID 19. Between January and June 2021, 19,469 samples were tested and 2,320 samples were COVID-19 positive. A total of 2,155 samples were positive for COVID-19 in the second wave between March-June 2020. The duration of the first wave was longer with a smaller peak in incidence of COVID 19. The second wave in 2021 had a shorter duration with a more pronounced spike in COVID-19 cases in April 2021.ConclusionThe number of COVID 19 positive cases are similar between the two waves of COVID 19. However, the first wave of COVID-19 took place over a period of nearly six months, while the second wave occurred over three to four months. There is a noticeable surge in COVID-19 incidence observed in April-May 2021. This could indicate the increased infectivity of the virus as observed with the cases doubling rapidly during this time. Documenting the characteristics of the wave in terms of its rapidity of onset of disease and peaks in incidence would offer insight into the progression of COVID-19.

European interlaboratory comparison investigations (ICI) and external quality assurance schemes (EQUAS) for the analysis of bisphenol A, S and F in human urine: Results from the HBM4EU project

The Human Biomonitoring for Europe initiative (HBM4EU) aims to study the exposure of citizens to chemicals and potentially associated health effects. One objective of this project has been to build a network of laboratories able to answer to the requirements of European human biomonitoring studies. Within the HBM4EU quality assurance and quality control scheme (QA/QC), a number of interlaboratory comparison investigations (ICIs) and external quality assurance schemes (EQUASs) were organized to ensure data consistency, comparability and reliability. Bisphenols are among the prioritized substance groups in HBM4EU, including bisphenol A (BPA), bisphenol S (BPS) and bisphenol F (BPF) in human urine. In four rounds of ICI/EQUAS, two target concentration levels were considered, related to around P25 and P95 of the typical exposure distribution observed in the European general population. Special attention was paid to the conjugated phase II metabolites known to be most dominant in samples of environmentally exposed individuals, through the analysis of both native samples and samples fortified with glucuronide forms. For the low level, the average percentage of satisfactory results across the four rounds was 83% for BPA, 71% for BPS and 62% for BPF. For the high level, the percentages of satisfactory results increased to 93% for BPA, 89% for BPS and 86% for BPF. 24 out of 32 participating laboratories (75%) were approved for the analyses of BPA in the HBM4EU project according to the defined criterion of Z-scores for both low and high concentration levels in at least two ICI/EQUAS rounds. For BPS and BPF, the number of qualified laboratories was 18 out of 27 (67%) and 13 out of 28 (46%), respectively. These results demonstrate a strong analytical capability for BPA and BPS in Europe, while improvements may be needed for BPF.

Rate of Peripheral Blood Smear Examination Service Provision and its Barriers among Public Hospitals in Southern Ethiopia: A Mixed-Methods Study

Introduction: Peripheral blood smear examination is a vital hematological test for diagnosis and monitoring of blood disorders. Despite its substantial role in the management of communicable and non-communicable diseases, its utilization is low. We aimed to assess the rate of peripheral blood smear examination service provision and its barriers among public hospitals in southern Ethiopia. Method: A cross-sectional study was conducted from January 01 to March 31, 2019, in five public hospitals of Southern Ethiopia. Socio-demographic data was collected from patients and healthcare providers. Peripheral blood smears were prepared using capillary blood collected from 423 patients with abnormal complete blood cell count. The smears were stained with Wright’s stain and examined under microscope by 1000X magnification to detect and identify morphological abnormality in the blood cells. A key informant interview was done with healthcare providers. Health facilities were assessed using a standard checklist. The quantitative data were analyzed by SPSS version 20 software. The qualitative data were transcribed, categorized, and thematically analyzed. The results of descriptive analyzes are presented in tables and figures. Result: The rate of provision of peripheral blood smear examination service was 11.6%. Nearly 90% of the eligible patients did not receive this service. Relatively better rate of service provision was observed among hospitals with essential resources for the service, and those participating in Hematology external quality assurance scheme. Lack of training, shortage of laboratory supplies, and inadequate supportive supervision were identified as barriers to regularly provide peripheral blood smear examination service. Conclusion: Rate of peripheral blood smear examination service provision is low in the area. A large proportion of eligible patients missed the deserved service. Adequate laboratory supplies, training, and continued supportive supervision should be considered to improve the provision of this vital service.

Sigma metrics in quality control- An innovative tool

The clinical laboratory in today’s world is a rapidly evolving field which faces a constant pressure to produce quick and reliable results. Sigma metric is a new tool which helps to reduce process variability, quantitate the approximate number of analytical errors, and evaluate and guide for better quality control (QC) practices.To analyze sigma metrics of 16 biochemistry analytes using ERBA XL 200 Biochemistry analyzer, interpret parameter performance, compare analyzer performance with other Middle East studies and modify existing QC practices.This study was undertaken at a clinical laboratory for a period of 12 months from January to December 2020 for the following analytes: albumin (ALB), alanine amino transferase (SGPT), aspartate amino transferase (SGOT), alkaline phosphatase (ALKP), bilirubin total (BIL T), bilirubin direct (BIL D), calcium (CAL), cholesterol (CHOL), creatinine (CREAT), gamma glutamyl transferase (GGT), glucose (GLUC), high density lipoprotein (HDL), triglyceride (TG), total protein (PROT), uric acid (UA) and urea. The Coefficient of variance (CV%) and Bias % were calculated from internal quality control (IQC) and external quality assurance scheme (EQAS) records respectively. Total allowable error (TEa) was obtained using guidelines Clinical Laboratories Improvement Act guidelines (CLIA). Sigma metrics was calculated using CV%, Bias% and TEa for the above parameters. It was found that 5 analytes in level 1 and 8 analytes in level 2 had greater than 6 sigma performance indicating world class quality. Cholesterol, glucose (level 1 and 2) and creatinine level 1 showed >4 sigma performance i.e acceptable performance. Urea (both levels) and GGT (level 1) showed <3 sigma and were therefore identified as the problem analytes. Sigma metrics helps to assess analytic methodologies and can serve as an important self assessment tool for quality assurance in the clinical laboratory. Sigma metric evaluation in this study helped to evaluate the quality of several analytes and also categorize them from high performing to problematic analytes, indicating the utility of this tool. In conclusion, parameters showing lesser than 3 sigma need strict monitoring and modification of quality control procedure with change in method if necessary.

Current Consumer Perceptions of Animal Welfare across Different Farming Sectors on the Island of Ireland.

Simple SummaryThe well-being and welfare of animals on farms is a topic of interest to many people. On the island of Ireland, this issue has received increased attention because of political and governance changes, including Brexit and COVID-19. Policy-makers and industry are considering labelling schemes to inform the food consumer about welfare standards on farms. Focus groups and an online survey were carried out with members of the public on the island of Ireland to explore their awareness, perceptions, and attitudes toward farm animal welfare standards on farms in Ireland and Northern Ireland. Most consumers believed farm animal welfare standards were high, although different farming sectors were rated differently: beef and dairy farms were viewed more positively, and pig and poultry farms were viewed less positively. The living conditions of the animal, size and intensity of the farm, national standards and schemes, and visibility all influenced perceptions of welfare standards. The public also expressed a lack of knowledge and information on the topic. In developing new policies and labelling schemes, it is important to be apprised of the current awareness, attitudes, and perceptions that the public has regarding farm animal welfare standards, as identified in the current paper. There has been increased public interest and concerns in issues such as farm animal welfare (FAW) on the island of Ireland, stoked in part by political and governance changes, such as Brexit and COVID-19. Front-of-pack food labelling represents a primary information channel for many people. In advance of considering formalised food labelling schemes, specifically relating to FAW, it is important to ensure an up-to-date understanding of current consumer perceptions of FAW. With this aim, the current study utilised a mixed methodology. Nine focus group discussions (n = 41) and an online survey (n = 972) with food consumers in Ireland and Northern Ireland explored perceptions of FAW. Results suggest that overall perceptions of FAW are high, and consumers perceive FAW to have improved in the last decade. Quantitative (ANOVA) and qualitative results show variations in perception of FAW between sectors. Results from the focus group discussions identified factors underlying consumers’ perception of FAW: the living conditions of the animal, size and intensity of the farm, national standards and schemes, and visibility. Information insufficiencies and knowledge gaps were identified. The findings are discussed in relation to policy implications for the role of public engagement, front-of-pack welfare labelling, and quality assurance schemes.

Current Status of Quality Assurance Scheme in Selected Undergraduate Medical Colleges of Bangladesh

This descriptive cross sectional study was carried out to determine the current status of Quality Assurance Scheme in undergraduate medical colleges of Bangladesh. This study was carried out in eight (four Government and four Non- Government) medical colleges in Bangladesh over a period from July 2015 to June 2016. The present study had an interview schedule with open question for college authority and another interview schedule with open question for head of department of medical college. Study revealed that 87.5% of college had Quality Assurance Scheme (QAS) in their college, 75% of college authority had regular meeting of academic coordination committee in their college, 50% of college had active Medical Education Unit in their college, 87.5% of college authority said positively on publication of journal in their college. In the present study researchers interviewed 53 heads of department with open question about distribution, collection of personal review form, submission with recommendation to the academic co-coordinator, and annual review meeting of faculty development. The researchers revealed from the interviews that there is total absence of this practice which is directed in national guidelines and tools for Quality Assurance Scheme (QAS) for medical colleges of Bangladesh. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 33-39