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1.  KEEPING THE CULTURE ALIVE 
This paper reports results from a detailed study of the careers of laboratory technicians in British medical research. Technicians and their contributions are very frequently missing from accounts of modern medicine, and this project is an attempt to correct that absence. The present paper focuses almost entirely on the Medical Research Council’s National Institute for Medical Research in North London, from the first proposal of such a body in 1913 until the mid 1960s. The principal sources of information have been technical staff themselves, largely as recorded in an extensive series of oral history interviews. These have covered a wide range of issues and provide valuable perspectives about technicians’ backgrounds and working lives.
PMCID: PMC2628576  PMID: 18548906
medical laboratory technicians; medical laboratories; medical history
2.  Incidence of tuberculosis, hepatitis, brucellosis, and shigellosis in British medical laboratory workers. 
British Medical Journal  1976;1(6012):759-762.
A retrospective postal survey of 21 000 medical laboratory workers in England and Wales showed 18 new cases of pulmonary tuberculosis in 1971, a five-times increased risk of acquiring the disease compared with the general population. Technicians were at greatest risk, especially if they worked in morbid anatomy departments. Of the 35 cases of hepatitis, the technicians were again the occupational group most likely to acquire the disease. Microbiology staff were twice as likely to report shigellosis as those in other pathology divisions but only one case of brucellosis was reported in the whole laboratory population. A similar survey carried out in 1973 of 3000 Scottish medical laboratory workers corroborates the results from England and Wales. Medical laboratory workers continue to experience a considerable risk of developing an occupationally acquired infection. Improvements in staff safety and health care seem to be necessary.
PMCID: PMC1639170  PMID: 1260318
3.  Assessment of the technical quality of electrocardiograms. 
The technical quality of 600 electrocardiograms (ECG's) was assessed for missing leads and clipping, and graded from 1 to 5 for each of noise, lead drift and beat-to-beat drift. Three subgroups of 200 ECGs each were studied: group A, those obtained by emergency department staff (non-technicians); group B, records obtained by ECG technicians; and group C, telephone-transmitted records obtained by technicians performing all the laboratory work at a smaller, outlying hospital. Records with missing leads, clipping, grade 4 or 5 noise, grade 5 lead drift or grade 5 beat-to-beat drift were classified as unsatisfactory or rejected. With these stringent criteria the rejection rate was 71.0% for group A records, 58.5% for group B and 44.5% for group C. The proportions of records with peak quality (no missing leads or clipping, and grade 1 noise, lead drift or beat-to-beat drift) were 4.5% for group A, 5.5% for group B and 23.0% for group C. Suggested revisions in the grading of technical quality of ECGs are presented.
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PMCID: PMC1818330  PMID: 688125
4.  Infections in British clinical laboratories, 1988-1989. 
Journal of Clinical Pathology  1991;44(8):667-669.
During 1988-89 this continuing survey showed 18 infections in the staff of laboratories reporting from 166 centres, representing 21,756 person-years of exposure. Shigella and other bowel infections (one caused by S typhi) predominated, affecting 11 microbiology medical laboratory scientific officers. Three shigella infections originated from quality control samples. Pulmonary tuberculosis affected four workers, including two mortuary technicians, but without detected occupational exposure to Mycobacterium tuberculosis. Other infections included one caused by Brucella melitensis. Hepatitis was not reported. The sustained low level of hepatitis is encouraging and suggests a low risk to staff of bloodborne infections such as human immunodeficiency virus.
PMCID: PMC496761  PMID: 1890201
5.  Mortality study of pathologists and medical laboratory technicians. 
British Medical Journal  1975;4(5992):329-332.
Membership lists of professional bodies were used to establish study populations of British pathologists (1955-73) and medical laboratory technicians (1963-73). The standardised mortality ratio (SMR) for pathologists was 60 and for medical laboratory technicians 67. Twenty-seven of the 310 deaths were due to suicide. These numbers gave SMRs of 250 for pathologists and 243 for medical laboratory technicians. Suicide was the commonest cause of death in female technicians. Access to lethal chemicals at work is a possible factor explaining the high proportion of suicide by poisoning compared with the general population. Suicide rates for pathologists exceed those of all medical practitioners; similary medical laboratory have higher rates than all laboratory technicians. Excess deaths from lymphatic and haemopoietic neoplasms were noted in English male pathologists (observed 8, expected 3-3; P less than 0-01). This difference is not due to Hodgkin's disease or leukaemia and remains unexplained. No other neoplastic diseases were noted as causing excess mortality in either occupational group but a small, possibly spurious, excess number of deaths was noted for aortic aneurysm in male pathologists (observed 4, expected 1-8).
PMCID: PMC1675173  PMID: 1192055
6.  Development of a protocol testing the ability of Stomoxys calcitrans (Linnaeus, 1758) (Diptera: Muscidae) to transmit Besnoitia besnoiti (Henry, 1913) (Apicomplexa: Sarcocystidae) 
Parasitology Research  2012;112(2):479-486.
Cattle besnoitiosis due to the cyst-forming coccidian parasite Besnoitia besnoiti has recently been reported in expansion in Europe since the end of the twentieth century. The B. besnoiti life cycle and many epidemiological traits are still poorly known. Hematophagous flies, including the worldwide-distributed Stomoxys calcitrans, could be mechanical vectors in the contamination of mouthparts after the puncture of cutaneous cysts or ingestion of infected blood. In this study, a protocol is presented to assess more deeply the role of S. calcitrans, reared in laboratory conditions, in parasite transmission. A preliminary trial showed that stable flies could transmit tachyzoites from bovine artificially parasite-enriched blood to B. besnoiti-free blood using glass feeders. Evidence of transmission was provided by the detection of parasite DNA with Ct values ranging between 32 and 37 in the blood recipient. In a second time, a B. besnoiti-infected heifer harboring many cysts in its dermis was used as a donor of B. besnoiti. An interruption of the blood meal taken by 300 stable flies from this heifer was performed. Immediately after the blood meal was interrupted, they were transferred to a glass feeder containing B. besnoiti-free blood from a non-infected heifer. Quantitative PCR and modified direct fluorescence antibody test (dFAT) were used to detect B. besnoiti DNA and entire parasites, respectively, in the blood recipient, the mouthparts, and the gut contents of S. calcitrans at two time intervals: 1 and 24 h after the interrupted blood meal. Parasite DNA was detected at both time intervals (1 and 24 h) in all samples (blood recipient, mouthparts, and gut contents of stable flies) while entire parasites by dFAT were only found in the abdominal compartment 1 h after the interrupted blood meal. Then, S. calcitrans were able to carry B. besnoiti from chronically infected cattle to an artificial recipient in the conditions of the protocol.
doi:10.1007/s00436-012-3157-6
PMCID: PMC3556472  PMID: 23064799
7.  Infections in British clinical laboratories, 1986-87. 
Journal of Clinical Pathology  1989;42(7):677-681.
During 1986-87 this continuing survey showed 15 specific infections in the staff of 235 laboratories, representing 28,524 person years of exposure. The community was the probable source of four of the five cases of tuberculosis and one of the five cases of salmonellosis. Occupational exposure was the probable cause of four infections by Shigella flexneri, three by Salmonella typhimurium, and one by S typhi, all affecting medical laboratory scientific officers (MLSOs) in microbiology. Occupational exposure was also the probable cause of one case of tuberculosis in a mortuary technician and one of probable non-A, non-B hepatitis in a medical laboratory scientific officer haematology worker. The overall incidence of reported infections was 52.6/100,000 person years (35/100,000 for infections of probable occupational origin). The highest rates of laboratory acquired infections related to MLSO microbiology workers and mortuary technicians. No additional infections were seen as a result of extending the survey to forensic laboratories.
PMCID: PMC1142013  PMID: 2503546
8.  Infections in British clinical laboratories, 1984-5. 
Journal of Clinical Pathology  1987;40(8):826-829.
During 1984-5 this continuing survey showed that 41 infections occurred in the staff of 193 laboratories, representing 23,043.5 person years of exposure. The community was the probable source of two cases each of hepatitis A and B, one of tuberculosis, two of campylobacter enteritis, and 12 of Norwalk viral diarrhoea. Occupational exposure was the probable cause of six hepatitis B infections (affecting haematology, biochemistry, and microbiology staff), three of tuberculosis (affecting mortuary and morbid anatomy workers), seven shigella, three salmonella (including one typhoid) and one pseudocholera infection (all in microbiology medical laboratory scientific officers), and a streptococcal infection in a mortuary technician. An episode of hepatitis of uncertain cause affected a carrier of hepatitis B. The incidence of reported infections of all types was 178 per 100,000 person years (91 for infections of suspected occupational origin). The highest incidence was in morbid anatomy and mortuary workers, followed by microbiology medical laboratory scientific officers.
PMCID: PMC1141119  PMID: 3654983
9.  Computer printing and filing of microbiology reports. 1. Description of the system. 
Journal of Clinical Pathology  1976;29(6):543-552.
From March 1974 all reports from this microbiology department have been computer printed and filed. The system was designed to include every medically important microorganism and test. Technicians at the laboratory bench made their results computer-readable using Port-a-punch cards, and specimen details were recorded on paper-tape, allowing the full description of each specimen to appear on the report. A summary form of each microbiology phrase enabled copies of reports to be printed on wide paper with 12 to 18 reports per sheet; such copies, in alphabetical order for one day, and cumulatively for one week were used by staff answering enquiries to the office. This format could also be used for printing allthe reports for one patient. Retrieval of results from the files was easily performed and was useful to medical and laboratory staff and for control-of-infection purposes. The system was written in COBOL and was designed to be as cost-effective as possible without sacrificing accuracy; the cost of a report and its filing was 17-97 pence.
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PMCID: PMC476114  PMID: 939809
10.  The Research Council System and the Politics of Medical and Agricultural Research for the British Colonial Empire, 1940–52 
Medical History  2013;57(3):338-358.
Historical accounts of colonial science and medicine have failed to engage with the Colonial Office’s shift in focus towards the support of research after 1940. A large new fund was created in 1940 to expand activities in the colonies described as fundamental research. With this new funding came a qualitative shift in the type of personnel and activity sought for colonial development and, as a result, a diverse group of medical and technical officers existed in Britain’s colonies by the 1950s. The fact that such variety existed amongst British officers in terms of their qualifications, institutional locations and also their relationships with colonial and metropolitan governments makes the use of the term ‘expert’ in much existing historical scholarship on scientific and medical aspects of empire problematic. This article will consider how the Colonial Office achieved this expansion of research activities and personnel after 1940. Specifically, it will focus on the reasons officials sought to engage individuals drawn from the British research councils to administer this work and the consequences of their involvement for the new apparatus established for colonial research after 1940. An understanding of the implications of the application of the research council system to the Colonial Empire requires engagement with the ideology promoted by the Agricultural Research Council (ARC) and Medical Research Council (MRC) which placed emphasis on the distinct and higher status of fundamental research and which privileged freedom for researchers.
doi:10.1017/mdh.2013.17
PMCID: PMC3865944  PMID: 24069883
Medical Research Council; Agricultural Research Council; Colonial Office; 1940 CDW Act; Colonial Medical Research Council; East Africa
11.  Knowledge, Attitude, and Practices about Biomedical Waste Management among Healthcare Personnel: A Cross-sectional Study 
Background:
The waste produced in the course of healthcare activities carries a higher potential for infection and injury than any other type of waste. Inadequate and inappropriate knowledge of handling of healthcare waste may have serious health consequences and a significant impact on the environment as well.
Objective:
The objective was to assess knowledge, attitude, and practices of doctors, nurses, laboratory technicians, and sanitary staff regarding biomedical waste management.
Materials and Methods:
This was a cross-sectional study.
Setting:
The study was conducted among hospitals (bed capacity >100) of Allahabad city.
Participants:
Medical personnel included were doctors (75), nurses (60), laboratory technicians (78), and sanitary staff (70).
Results:
Doctors, nurses, and laboratory technicians have better knowledge than sanitary staff regarding biomedical waste management. Knowledge regarding the color coding and waste segregation at source was found to be better among nurses and laboratory staff as compared to doctors. Regarding practices related to biomedical waste management, sanitary staff were ignorant on all the counts. However, injury reporting was low across all the groups of health professionals.
Conclusion:
The importance of training regarding biomedical waste management needs emphasis; lack of proper and complete knowledge about biomedical waste management impacts practices of appropriate waste disposal.
doi:10.4103/0970-0218.84135
PMCID: PMC3180941  PMID: 21976801
Biomedical waste management; hospital; medical professionals
12.  Survey of the sputum cytology service in England and Wales. 
Thorax  1975;30(5):489-496.
Of the 231 laboratories carrying out sputum cytology in England and Wales, information on the staffing, laboratory procedures, workload, records, and results for the year 1971 was obtained from 228 (98.7%) by means of a questionnaire, which was completed in 1973 in 81% of the laboratories and at the end of 1972 in the remainder. At the time the questionnaire was completed, the number of laboratories per region offering a service ranged from 6 to 25. Most of the processing of specimens was done by technicians and non-medical screeners (technicians without recognized qualifications) and most of the microscopy by pathologists and technicians. Papanicolaou and/or haematoxylin and eosin stains were used in 97% of the laboratories. During 1971, the number of specimens tested per laboratory ranged from 9 to 6000. A median of 381 specimens and 165 patients were tested per laboratory. Almost all specimens were submitted by hospitals and chest clinics and only 1% by general practitioners. An estimated median of 6.5% of all cytological specimens were sputum, most of the remainder being cervical smears. Laboratories varied greatly in their positive (0%-24%) and doubtful positive (0%-27%) rates. An estimated 63 000 patients had their sputum tested in 1971, and about 6300 had positive reports, rather less than one-quarter of all patients diagnosed as having lung cancer in England and Wales in 1971. The cost of the service was estimated to be of the order of pound375 000 at 1974 prices; that is, pound2.50 per specimen or pound6.00 per patient tested. An improved service might best be provided by district general hospital laboratories testing at least 1000 specimens per year so that a high level of accuracy in reporting could be assurred. A large proportion of the microscopy might be done by non-medical graduates and technicians under the supervision of pathologists.
PMCID: PMC470315  PMID: 53890
13.  LABORATORY TECHNICIANS—The Clinical Laboratory Law and Its Meaning to Private Physicians 
California Medicine  1955;82(4):309-313.
The present laws and regulations relating to clinical laboratories in California are the outcome of over a quarter century of cooperative development.
The medical profession, public health department, laboratory workers, and the legislature have worked together in this development.
At first the system of certifying technicians and laboratories was on a voluntary basis. The clinical laboratory law in effect legalized and made generally applicable a system which had already been accepted voluntarily.
The application of the clinical laboratory law provides physicians a reasonable assurance that competence and reliability will prevail in clinical laboratory operation.
Of great importance is the conduct of proper training programs by approved laboratories.
Since modern medical practice is so dependent on accurate clinical laboratory work it is essential that special effort be directed by physicians toward influencing young people to enter the profession of medical technology.
PMCID: PMC1532423  PMID: 14364286
14.  Thomas Graham Brown (1882–1965): Behind the Scenes at the Cardiff Institute of Physiology 
Thomas Graham Brown undertook seminal experiments on the neural control of locomotion between 1910 and 1915. Although elected to the Royal Society in 1927, his locomotion research was largely ignored until the 1960s when it was championed and extended by the distinguished neuroscientist, Anders Lundberg. Puzzlingly, Graham Brown's published research stopped in the 1920s and he became renowned as a mountaineer. In this article, we review his life and multifaceted career, including his active neurological service in WWI. We outline events behind the scenes during his tenure at Cardiff's Institute of Physiology in Wales, UK, including an interview with his technician, Terrence J. Surman, who worked in this institute for over half a century.
doi:10.1080/0964704X.2010.510991
PMCID: PMC3259622
physiology; spinal cord; locomotion; motoneurones; interneurones; neural control; mountaineering; sailing; medical school politics
15.  Respiratory morbidity in a population of French dental technicians 
Aims: To compare wage earner dental technicians with non-exposed salaried subjects for the prevalence of respiratory symptoms and function, and chest x ray abnormalities.
Methods: A total of 134 dental technicians and 131 non-exposed subjects participated. A medical and an occupational questionnaire were filled in to evaluate the prevalence of respiratory symptoms and occupational exposures. Subjects underwent respiratory tests and chest x ray examination.
Results: Mean age of the dental technicians was 36.6 years with a mean duration of dental work of 16.5 years. There was a significant risk of cough (day and night) and usual phlegm in dental technicians. Respiratory function parameters were lower in dental technicians with a significant difference between exposed and non-exposed groups for % FVC (forced vital capacity), % FEF25 (forced mid expiratory flow), and % FEF50. The prevalence of small opacities increased with age. Small opacities were significantly related to an exposure to asbestos in the past.
Conclusions: Our young population of dental technicians is at risk of respiratory morbidity. They should benefit from adequate technical prevention measures.
doi:10.1136/oem.59.6.398
PMCID: PMC1740304  PMID: 12040116
16.  A Life Course Perspective on Child Health, Academic Experiences and Occupational Skill Qualifications in Adulthood: Evidence from a British Cohort* 
Existing research rarely examines the social consequences of poor childhood health from a longitudinal perspective. Using data from the British National Child Development Study, I follow a cohort from before birth through middle age to examine whether children's health limitations before and during the educational process predict occupational skill qualifications in mid-adulthood, and whether any negative consequences are strongest for children in persistently poor health. I also examine whether differences in achievement explain the observed associations, and at what point during the schooling process performance begins to play a large explanatory role. Poor health is strongly negatively related to qualifications in adulthood, particularly for children in persistently poor health. These associations are largely explained by differences in performance early in children's academic careers, before the first important transition point. The relationship between prenatal maternal smoking and mid-adulthood qualifications is more persistent. This paper demonstrates that a static conceptualization of childhood health is inadequate to fully understand the dynamic process through which social status and health over the course of childhood have long-run consequences for the adult life course.
doi:10.1353/sof.2010.0101
PMCID: PMC3893027  PMID: 24443594
17.  Cardiac rehabilitation in the United Kingdom: guidelines and audit standards. National Institute for Nursing, the British Cardiac Society and the Royal College of Physicians of London. 
Heart  1996;75(1):89-93.
This paper summarises a multidisciplinary workshop convened to prepare clinical guidelines and audit standards in cardiac rehabilitation in the United Kingdom. The workshop developed a three element model of the rehabilitation process and identified needs relating to medical and psychosocial care and the potential contributions of exercise, education, secondary prevention, and vocational advice. Draft clinical standards are proposed as a basis for locally developed guidelines and further research.
PMCID: PMC484231  PMID: 8624882
18.  APPLICATION OF INFORMATION AND COMMUNICATION TECHNOLOGIES IN MEDICAL EDUCATION 
The recognition that information and communication technologies should play an increasingly important role in medical education is a key to educating physicians in the 21st century. Computer use in medical education includes, Internet hypermedia/multimedia technologies, medical informatics, distance learning and telemedicine. Adaptation to the use of these technologies should ideally start from the elementary school level. Medical schools must introduce medical informatics courses very early in the medical curriculum. Teachers will need regular CME courses to prepare and update themselves with the changing circumstances. Our infrastructure must be prepared for the new developments with computer labs, basic skill labs, close circuit television facilities, virtual class rooms, smart class rooms, simulated teaching facilities, and distance teaching by tele-techniques. Our existing manpower including, doctors, nurses, technicians, librarians, and administration personal require hands-on training, while new recruitment will have to emphasize compulsory knowledge of and familiarity with information technology. This paper highlights these subjects in detail as a means to prepare us to meet the challenges of the 21st century.
PMCID: PMC3425760  PMID: 23011983
Medical education; communication; technologies; medical informatics; distance learning; telemedicine
19.  Splenomegaly in 2,505 patients at a large university medical center from 1913 to 1995. 1963 to 1995: 449 patients. 
Western Journal of Medicine  1998;169(2):88-97.
Splenomegaly was studied retrospectively at the University of California, San Francisco (UCSF), School of Medicine in 301 patients from 1963 to 1995 and compared with the UCSF service of the San Francisco General Hospital Medical Center (SFGH) in 148 patients from 1979 to 1994. The combined 449 patients were classified into several diagnostic groups and were studied by means of several clinical and laboratory associations. Hepatic disease in the percentage of patients at UCSF (with those at SFGH given in parentheses) was associated with splenomegaly in 29% (41%), hematologic disease, 32% (16%); infectious diseases, 16% (36%); congestive or inflammatory disease, 10% (4%); primary splenic disease, 6% (1%); other, 5% (1%); and cause unknown, 2% (1%). Massive splenomegaly occurred in 27% of the patients of the combined series, particularly in patients with hematologic diseases. The acquired immunodeficiency syndrome (AIDS) occurred in more than half of the patients with infectious diseases at SFGH and was four times frequent than in the patients at UCSF. The commonest diseases associated with splenomegaly were hematologic (lymphoma), hepatic (chronic liver disease), infectious diseases (AIDS and endocarditis), congestive (congestive heart failure), primary splenic (splenic vein thrombosis), and other (malignancy not metastatic to the spleen). In 11 patients with AIDS and massive splenomegaly, Mycobacterium avium complex occurred in 8 (73%). Splenectomy was performed in 117 patients (26%), primarily for hematologic amelioration. I conclude that for splenomegaly of unknown origin, the invasive procedure of choice for patients with hematologic associations may be a bone marrow biopsy; for hepatic association, a liver biopsy; and for infectious disease associations, a lymph node biopsy, before any consideration of a diagnostic splenectomy.
PMCID: PMC1305177  PMID: 9735689
20.  The science of medical librarianship: investing in the future. 
Information science is changing from an applied service-oriented activity to a basic research discipline. The library profession must earn a central place in this endeavor, and must address a number of important issues. These include ownership and intellectual property rights, a stronger research component for the profession, development of quality assurance systems for health information services, and a conceptual framework for training and career development of health sciences library technicians. The future of medical librarianship as a profession depends on a lasting commitment to research, a clear vision of the profession's fundamental mission and of the library's place in society.
PMCID: PMC227745  PMID: 3450341
21.  New York State Council of Health-system Pharmacists 
Pharmacy and Therapeutics  2013;38(7):425-426.
The Emily Jerry Foundation was instrumental in requiring training and certification for pharmacy technicians; and a representative from the institute for Safe Medication Practices discusses “off-the-beaten-track” areas of medication use.
PMCID: PMC3776484  PMID: 24049431
22.  A Patient Data Management Computer System with a Respiratory Care Subsystem 
Modern medical practice is becoming increasingly complicated and diverse as new equipment is introduced at hospitals. Community, government and research institutions stand at widely varied stages of technological development. Critical care settings demand an organized but flexible approach towards assimilating large amounts of data. Hewlett-Packard has designed a Patient Data Management System (PDMS) to organize information in intensive care units. The system is a multi-partition software package that can be divided into two parts: configuration and real-time, interactive operation. The PDMS is configured at all installations to adapt it to each individual institution's medical procedures and equipment. Once the system is configured, it is used by nurses, technicians, therapists and physicians. The computer collects, organizes, processes and displays data. Monitored values are acquired automatically, and laboratory test results are entered manually. Then certain calculations are performed upon request. Once data is processed, it is available for video displays or printed reports.
PMCID: PMC2231935
23.  Pharmacy-Based Medication Reconciliation Program Utilizing Pharmacists and Technicians: A Process Improvement Initiative 
Hospital Pharmacy  2013;48(2):112-119.
Background:
Pharmacists and pharmacy technicians have an opportunity to impact the quality of the medication histories and improve patient safety by ensuring accurate medication lists are obtained and complete reconciliation has occurred with the admission medication orders by owning the admission medication reconciliation process.
Objective:
To compare the quality of a pharmacy-based medication reconciliation program on admission utilizing pharmacists and technicians to the usual multidisciplinary process.
Methods:
This was a retrospective chart review process improvement study at a 186-bed tertiary care inpatient facility. Primary outcomes included both the accuracy of pre-admission medications listed and the reconciliation of those medications with admission inpatient orders. Technicians obtained patient medication histories. Pharmacists checked the technician-obtained medication histories and ensured reconciliation of those medications with admission orders.
Results:
Medication accuracy increased from 45.8% to 95% per patient (P < .001) and medication reconciliation increased from 44.2% to 92.8% (P < .001) and remained above benchmark.
Conclusion:
A pharmacy-based medication reconciliation program utilizing both pharmacists and technicians significantly increased the accuracy and reconciliation of medications on admission. These gains were maintained for the duration of the 6-month period studied and beyond per continued process improvement data collection.
doi:10.1310/hpj4802-112
PMCID: PMC3839485  PMID: 24421448
admission; medication reconciliation; process improvement
24.  Cerebellar Zones: A Personal History 
Cerebellum (London, England)  2010;10(3):334-350.
Cerebellar zones were there, of course, before anyone noticed them. Their history is that of young people, unhindered by preconceived ideas, who followed up their observations with available or new techniques. In the 1960s of the last century, the circumstances were fortunate because three groups, in Leiden, Lund, and Bristol, using different approaches, stumbled on the same zonal pattern in the cerebellum of the cat. In Leiden, the Häggqvist myelin stain divulged the compartments in the cerebellar white matter that channel the afferent and efferent connections of the zones. In Lund, the spino-olivocerebellar pathways activated from individual spinal funiculi revealed the zonal pattern. In Bristol, charting the axon reflex of olivocerebellar climbing fibers on the surface of the cerebellum resulted in a very similar zonal map. The history of the zones is one of accidents and purposeful pursuit. The technicians, librarians, animal caretakers, students, secretaries, and medical illustrators who made it possible remain unnamed, but their contributions certainly should be acknowledged.
doi:10.1007/s12311-010-0221-6
PMCID: PMC3169774  PMID: 20967577
Cerebellum; Zones; Climbing fibers; Mossy fibers; Pattern formation
25.  The Feasibility of Establishing Agreement Between Laboratories for Measures of Oropharyngeal Structural Movements 
Kinematic analysis, also commonly referred to as biomechanical analysis, of the swallow is used to measure movement of oropharyngeal structures over time. Two laboratory directors who have used kinematic analysis in their research collaborated to determine the feasibility of establishing agreement between two separate laboratories on measures of structural movements of the swallow. This report describes the process that was followed toward the goal of establishing measurement agreement. Under the direction of the laboratory directors, one research technician from each laboratory participated in a process that included initial meetings, training sessions, and pre- and post-training evaluation of reproducibility.
Because agreement on initial measures of structural movement demonstrated weak correlation on some measures, the research technicians trained together for approximately 6 hours. After training, statistical analyses indicated that (a) most Pearson correlations for measures of structural movements were greater than 0.80 and were highly statistically significant; (b) most percentages of absolute deviation were under 25%; and (c) most concordance coefficients were above .70. These statistics indicate that the two laboratories were able to increase their level of agreement in measuring selected structural movements of the swallow after a brief amount of training.
Factors affecting measurement agreement include image quality, establishment of rules for measuring, and the opportunity for regular discussions among research assistants and investigators from both laboratories.
PMCID: PMC3079209  PMID: 21512610

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