News
Medical lab technologists across Canada feeling the pressure of high job vacancies
The national organization representing medical laboratory technologists says the stress of job vacancies and limited back fill coverage being felt by Prince Edward Island MLTs is not uncommon in other provinces.
Christine Nielsen, CEO of the Canadian Society for Medical Laboratory Science, said that 35 per cent of the society's members report feeling stressed or burned out on a weekly basis while on the job. "One of the things that we've been hearing from our members across Canada over the last few years is the toll that the workload as well as the absence of other staff are placing on them," Nielsen said.
According to Nielsen, one of the biggest challenges within medical lab sciences in Canada is the aging national population. As the population gets older, she said, there are more people retiring from the profession met with an increasing demand for lab testing across the country.
A national CSMLS survey reported that 52 per cent of MLT respondents said there were regularly not enough people or staff to get the work done. Nielsen said while doctors and nurses often have locum staff to back fill for temporary leaves, MLTs across the country often don't have the staff for this kind of short-term coverage.
"Only about 75 per cent of the people who come to the exam pass," Nielsen said. This sometimes makes it difficult for labs to recruit students, Nielsen said, because not every student is guaranteed to get their certification.
"There's not enough students in school right now in Canada to replace those retiring," she said.
One of the unique challenges for MLTs on P.E.I., according to Nielsen, is that there aren't any training programs available on the Island. "They don't have a natural pipeline to recruit new blood, or new workers. They have to get students from one of the other 25 programs in Canada."
She said wages for MLTs on P.E.I. are not the highest in the country, which puts it at a disadvantage when competing for new graduates with provinces like Alberta, Ontario and British Columbia.
A spokesperson from Health PEI said there are currently five full-time temporary vacancies due to maternity leaves or temporary assignment between the QEH and Prince County Hospital laboratories. One person will be returning full-time in March and another in July. The remaining staff are scheduled to return by early fall.
In the interim, these positions are being temporarily covered by a combination of locum medical laboratory technologists, medical laboratory assistants and the redistribution of some workload between laboratory sites.
Health PEI said these vacancies have had no impact on patient care. It said it's confident the MLT staffing complement will be stable over the coming years with five Island students in the program in Nova Scotia and three in New Brunswick that the Island will be able to recruit.
Related: LETTER: Critical shortage for lab technologists
Related: P.E.I.'s medical lab technologists concerned about workload
Olympics Could Require Athletes' Genetic Code to Test For Doping
For years, the World Anti-Doping Agency (WADA) has considered requiring all Olympic athletes to submit copies of their genetic code. It would work as a check on so-called "gene doping," the idea of changing the body’s biological machinery to make it stronger, run faster, or recover more quickly. A clean slate would reveal any nefarious performance-boosting tweaks—like, theoretically, altering the expression of fast-twitch muscle genes to engineer a perfect sprinter.
Establishing a genetic baseline for every professional athlete has long been cost-prohibitive—especially if it calls for a full genome sequence. But on Monday, February 5, the proposal is being seriously discussed for the first time at WADA's headquarters in Montreal. As the cost of sequencing a person’s entire genome drops to only a few hundred dollars, the agency could implement the plan within the next few years. “It will be easy in the future to have full genome sequencing for a reasonable amount of money,” said Olivier Rabin, WADA’s science director. “It will be reasonable to have full genome sequencing with some very strong ethical guidelines.”
Yukon union, hospital corporation dispute implications of new lab contract
The Yukon Employees’ Union (YEU) is concerned about what it says is a plan to close the microbiology lab at Whitehorse General Hospital in favour of sending samples to a Vancouver hospital.
The Yukon Hospital Corporation, however, says the lab is not closing.
On Feb. 1, the YEU and the Public Service Alliance of Canada North issued a joint press release saying a contract would be in place between WGH and St. Paul’s Hospital in Vancouver by April 1.
James Low, manager of communications for the YHC, said that’s not the case. He said there was a request for proposals out for lab services to renew an existing contract that was set to expire. Five proposals came back. Low said St. Paul’s is currently the preferred proponent. The B.C. hospital currently holds the contract being renewed. That contract includes lab medical directorship, lab consulting services, and a specialized lab test. He said the only new item included in the current RFP is potentially sending routine microbiology tests to B.C.
“To that point, I would stress that it’s only a proposal and we have a lot of work to do to see if this is even the best option for patient care,” said Low, noting a business case study is needed to determine whether choosing St. Paul’s would save money. He said the hospital corporation also needs to understand what the impact would be for human resources in order to determine if it will provide the best services for patients.
He said that because nothing is finalized, he can’t speculate how the jobs might change for the four microbiology technicians at WGH.
Steve Geick, president of YEU, said his main concern, though, is the time it’s going to take for results to come back if tests have to go to Vancouver.
Geick said results generally take 24 to 48 hours when tests are done in Whitehorse. He’s concerned that shipping them to Vancouver will double that time, or extend it even further for patients in communities such as Old Crow.
Transfusion Medicine
New statistical model to forecast future demand of blood platelets has potential to save $80 annually
Donated blood platelets continue to be wasted in today's modern health care delivery system since they have a short shelf life and must be used within five days of collection, according to the American Red Cross.
Recognizing the challenge this presents in providing optimal patient care, researchers at Stanford University and Stanford Blood Center have developed a new statistical model that forecasts future platelet demand, thereby reducing waste—a development that could save millions of dollars annually. The research, titled "Big Data Modeling to Predict Platelet Usage and Minimize Wastage in a Tertiary Care System," appears in a recent issue of Proceedings of the National Academy of Sciences (PNAS).
Typically, blood centers employ historical averages as they manufacture, test and then distribute product to hospital customers. In a large tertiary care setting, where close to 15,000 units of platelets are potentially transfused annually, the wastage may translate close to $1 million.
Tho Pham, clinical assistant professor in the department of pathology at Stanford University and medical director at Stanford Blood Center, collaborated in the development of a first-of-its-kind statistical model that uses hospital patient data to determine platelet transfusion needs days in advance. Researchers investigated platelet usage patterns at the Stanford University Hospital, Stanford Transfusion Service and Stanford Blood Center and specifically interrogated the relationship between platelet usage and aggregated hospital-wide patient data over 29 consecutive months. They discovered platelet usage is highly dependent on weekday/weekend patterns, the number of patients with various abnormal complete blood count measurements and location-specific hospital census data. The research team is in the process of implementing the model institutionally at Stanford and has fielded inquiries from blood centers throughout the United States and Canada. And while the statistical model thus far only applies to platelets transfusion and wastage, researchers believe it can be extended to other medical products that must always be on hand, have high costs and are perishable. "If generally applied," they concur "this method represents a logical and automated approach to changing the way health care is delivered without ever compromising patient care."
Microbiology
Blood test cuts time to diagnosis for common, deadly yeast infection, national trial shows
A new blood test seems to perform as well as, if not better than, traditional blood cultures at detecting a type of fungal yeast infection that commonly strikes hospital patients, according to an analysis led by University of Pittsburgh Medical Center.
The T2Candida Panel is the first diagnostic test for candidemia that has been cleared by the U.S. Food and Drug Administration and doesn't require culturing a blood sample from the patient to see what grows. The results of the trial, named DIRECT2, are reported today in the journal Clinical Infectious Diseases. The trial was funded by T2 Biosystems, the company that makes the panel, which is used by UPMC.
"There are many advantages to quickly diagnosing the specific type of infection a patient has," said lead author Cornelius J. Clancy, M.D., associate professor of medicine in the University of Pittsburgh's Division of Infectious Diseases, and director of the mycology program. "With an accurate diagnosis, we can start the patient on the correct medication for the type of infection he or she has, which will hopefully allow us to stop the infection before it spreads, but also keep us from giving the patient a drug that won't work and potentially contributing to drug resistance. For candidemia, we know that the shorter the time to administering an active antifungal medication to a patient, the higher the survival rate. "
The T2Candida Panel involves putting a small vial of blood from the patient into a desktop machine that uses magnetic resonance to scan the blood for the five most common Candida species. Positive or negative results are available within five hours.
In the trial, the T2Candida test was positive in 89 percent of patients at the time of a positive blood culture for Candida. The T2Candida Panel was significantly more likely to be positive than blood cultures in patients with recent candidemia, in particular those patients who were being treated with antifungal drugs.
Are hand dryers full of bacteria? A viral photo doesn’t tell the whole story
The assignment from Nichole Ward’s microbiology professor was simple: Choose a location, open a petri dish for three minutes and observe what grew over the next two days.
No one’s sample came back clean — a foregone conclusion given that a petri dish opened in any nonsterile room will collect microbes from the air. But when Ward returned to class with a dish that she had put in an enclosed Dyson hand dryer in a women’s restroom, the colonies of fungi and bacteria that had grown in it outstripped anything her classmates had found in their chosen locations.
"Mine just had so much more mass in the fungal growth," she said in a phone interview Thursday. "Their little colonies were just a speck here and a speck there. It just stood out by far."
Without further testing, which the class did not do, it is impossible to say whether the organisms in Ward’s petri dish were harmful to humans. But when she posted a photo on Facebook at the urging of her classmates, more than 500,000 people shared it in a matter of days.
Many horrified commenters vowed never to use a hand dryer again. Others ridiculed what they called unscientific fearmongering. Ward, who is taking the microbiology class as a prerequisite for a nursing program, said she had even received death threats.
Dyson, the manufacturer of the hand dryer she used, said in a statement to ABC that it was "very surprised to see these results, and unclear on the methodology employed." "All Dyson Airblade hand dryers have HEPA filters that capture particles as small as bacteria from the washroom air before it leaves the machine," the company said. "Dyson Airblade hand dryers are proven hygienic by university research and are trusted by hospitals, food manufacturers and businesses worldwide."
Whether hand dryers do, in fact, spread pathogens is a matter of dispute among scientists.
"The hot air will kill the bacteria on the hands, but some studies have found they will also deposit bacteria in the restroom on your hands — i.e., from the air," said Charles P. Gerba, a microbiologist at the University of Arizona.
A study published in 2016 in The Journal of Applied Microbiology found that jet air dryers — high-powered machines like the one Ward used — contaminated the surrounding area with 1,300 times as many viral particles as a paper towel would. Standard hand dryers — those that simply blow warm air — spread far fewer particles, but still 60 times as many as a paper towel. (Dyson said when that study was released that it had been conducted under unrealistic conditions: Participants’ hands were thoroughly coated with a virus, which would not be the case for a typical pair of just-washed hands.)
A similar study in 2014, using a bacterium instead of a virus, found that jet air dryers spread 4.5 times as much bacteria as warm air dryers, and 27 times as much as paper towels — but the study was funded by a trade association for paper manufacturers. Another study published in 2010 found that jet air dryers resulted in fewer bacteria on the hands than warm air dryers — but it was funded by Dyson.
One of the few independently funded studies on the subject, published by the Mayo Clinic in 2000, found no statistically significant hygienic difference between dryers and paper towels.
Related: California woman's viral Facebook post sparks fear of bathroom hand dryers
Molecular Genetics
A new DNA test will look for 190 diseases in your newborn’s genetic code - MIT Technology Review
Using a swab of saliva from a newborn’s cheek, a new DNA test will probe the baby’s genes to search for 193 genetic diseases, like anemia, epilepsy, and metabolic disorders.
The $649 test is meant for healthy babies, as a supplement to existing screening tests.
Eric Schadt, CEO of Sema4, the company behind the test, says some parents may want more information about their child’s genes than standard newborn screening delivers. Some people suffer for years before getting a proper diagnosis for some of the diseases that his company’s test covers, he says.
"If you can, at birth, canvass some of the most common disorders, you get a better understanding of the health of your child," Schadt says. "We think parents want the best for their children and are going to do whatever they can so that their child can have the healthiest life possible."
The trouble is, even if a baby has a mutation in a gene, it could take years for symptoms to appear. And sometimes a child can carry a mutation but never develop the corresponding disease. That’s one reason DNA sequencing isn’t yet routine for children and adults who are currently healthy.
That raises a big question: is a test like Sema4’s always a good thing?
"For many families, this is the kind of thing that can open up a can of worms where it doesn’t end up necessarily benefiting the parent or child," says Laura Hercher, a geneticist at Sarah Lawrence College.
In some cases, the results of the test could cause anxiety and confusion for parents and lead to unnecessary tests and procedures for children, she says: "You put parents in a terrible position, because they don’t know if they should wait until the child is sick to do in some cases draconian treatments."
Research
New paper-based test to detect HIV early
Scientists have developed a paper- based diagnostic tool for HIV that is affordable and highly sensitive, making the early detection of the virus possible. The test developed by researchers at Imperial College London in the UK could also be adapted to be used in other infectious diseases such as Ebola and Zika.
Currently, cheap point-of-care methods employed to detect infectious diseases have their limitations, particularly when it comes to detecting very low levels of markers in the blood.
Now, Imperial researchers, alongside their collaborators at University College London, have developed a new diagnostic tool for HIV that is affordable, capable of withstanding harsh conditions and highly sensitive, making the early detection of the disease possible.
The research, published in the journal ACS Nano, refined a current diagnostic method known in the field as a lateral flow immunoassay, a similar method employed by pregnancy tests.
In the case of HIV, if a patient is positive, virus components present in the blood will bind to coloured particles on the paper test, indicating HIV infection.
"To the best of our knowledge, our newly developed test is the simplest and most sensitive colourimetric paper-based lateral flow diagnostic test for HIV to date," said Mike Thomas from Imperial.
This newly developed technology employs a similar technique to the lateral flow immunoassay, but is far more sensitive, meaning it can detect HIV even when the level of the virus in the blood is very low, allowing for earlier diagnosis.
The test senses a protein called p24, found on the outside of the HIV virus, which acts as a biomarker of the disease.
By incorporating an 'amplification stage' to the standard immunoassay, which acts to increase the signal produced by p24 up to 100-fold, the team was able to detect the presence of the virus with sensitivity surpassing that of the current industry standard tests.
First human eggs grown in laboratory
Human eggs have been grown in the laboratory for the first time, say researchers at the University of Edinburgh. The team say the technique could lead to new ways of preserving the fertility of children having cancer treatment. It is also an opportunity to explore how human eggs develop, much of which remains a mystery to science.
It has taken decades of work, but scientists can now grow eggs to maturity outside of the ovary. It requires carefully controlling laboratory conditions including oxygen levels, hormones, proteins that simulate growth and the medium in which the eggs are cultured.
But while the scientists have shown it is possible, the approach published in the journal Molecular Human Reproduction still needs refinement. It is very inefficient with only 10% of eggs completing their journey to maturity. And the eggs have not been fertilised, so it is uncertain how viable they are.
Prof Evelyn Telfer, one of the researchers, told the BBC: "It's very exciting to obtain proof of principle that it's possible to reach this stage in human tissue.
"But that has to be tempered by the whole lot of work needed to improve the culture conditions and test the quality of the oocytes [eggs].
"But apart from any clinical applications, this is a big breakthrough in improving understanding of human egg development."
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