Issue 502 February 2005 - Association for Clinical Biochemistry

Transcription

ACB News
The Association of Clinical Biochemists • Issue 502 • 20th February 2005
Paediatric
Metabolic
Training
Update
AFC
Assimilation
and More
Situations
Vacant
Feedback
About ACB News
The monthly magazine
for Clinical Science
The Editor is responsible for the final
content. Views expressed are not
necessarily those of the ACB.
Editor
Dr Jonathan Berg
Department of Clinical Biochemistry
City Hospital
Dudley Road
Birmingham B18 7QH
Tel: 07973-379050/0121-507-5353
Fax: 0121-765-4224
Email: [email protected]
Associate Editors
Miss Sophie Barnes
Department of Chemical Pathology
St Thomas’ Hospital
London SE1 7EH
Mrs Louise Tilbrook
Broomfield Hospital
Chelmsford
Essex CM1 5ET
Mr Ian Hanning
Hull Royal Infirmary
Anlaby Road
Hull HU3 2JZ
ACB News
Number 502 • February 2005
General News
4
ACB Training Course
8
Disposable Laboratory Tips
9
MRCPath Short Questions
10
Current Topics
12
Meeting Reports
21
ACB News Crossword
27
Corporate News
28
Situations Vacant
31
Situations Vacant Advertising
Please contact the ACB Office:
Tel: 0207-403-8001
Fax: 0207-403-8006
Display Advertising & Inserts
PRC Associates
The Annexe, Fitznells Manor
Chessington Road
Ewell Village
Surrey KT17 1TF
Tel: 0208-786-7376 Fax: 0208-786-7262
Front cover:
Gifford Batstone, Rick Jones, Bob DeJong and Jonathan Kay outside the Thackeray Museum
in Leeds during the CPD4IT Autumn meeting
ACB Administrative Office
Association of Clinical Biochemists
130-132 Tooley Street
London SE1 2TU
Tel: 0207-403-8001 Fax: 0207-403-8006
ACB Chairman
Miss Janet Smith
University Hospital Birmingham NHS Trust
Birmingham B29 6JD
Tel: 0121-627-8449 Fax: 0121-414-0078
ACB Home Page
http://www.acb.org.uk
Printed by Piggott Black Bear, Cambridge
ISSN 1461 0337
© Association of Clinical Biochemists 2005
February 2005 • ACB News Issue 502 • 3
General News General News General News General News General News
Dundee and Edinburgh
35 Years On!
ACB Wales Regional Meeting
“Point of Care Testing: The Welsh Perspective”
In 1974, Mike Stewart was a Lecturer at Ninewells and
Peter Ojwang was a Registrar in Edinburgh Royal. In
1975 they swapped over, with Peter going to Dundee as
Senior Registrar and Mike to RIE as Senior Lecturer. They
didn’t meet again until Mike moved to South Africa in
1995, but for the last two years they have been together
in the University of the Witwatersrand in Johannesburg.
Sadly, with the retiral age being 60, Peter has now left
to take up a new post in Nairobi at the Aga Khan
Medical School. Mike is Honorary Professor in Chemical
Pathology (pace Gemmell for those who understand!)
and is co-ordinating the new Problem Based learning
course, which he describes as “The best job I’ve had
since Ninewells”. Both Peter and Mike are grateful for
mentors in Scotland in the 1970s who prepared them
for the joys and sorrows of working in Africa today. ■
Mike Stewart and Peter Ojwang at Peter’s farewell party in December
Postgraduate Centre
Royal Gwent Hospital, Newport
Thursday 7th April
Full programme to be published shortly.
For further information contact: Catherine Davies,
Department of Clinical Biochemistry, Royal Gwent
Hospital, Newport. Tel: 01633-234500 or email
[email protected] ■
ACP Management Course
2005
Run by Pathologists for Pathologists
Hardwick Hall Hotel
Sedgefield, County Durham
Wednesday 7th - Friday 9th September 2005
This is a wide ranging, residential, three-day course
introducing management issues relevant to the running
of a modern pathology service.
It is intended for Specialist Registrars in pathology,
Clinical Scientists and those who have held their first
consultant post for less than one year.
Course fee: Resident £485; Non-resident fee on
application. Fee includes course information handbook,
en-suite accommodation, all meals, refreshments and
course dinner.
Hotel details at: www.hardwickhallhotel.co.uk
As the 2004 course was heavily over subscribed, early
application is encouraged.
Full details from: Miss Jacqui Rush, Association of
Clinical Pathologists, 189 Dyke Road, Hove, East Sussex
BN3 1TL. Tel: 01273-775700. Fax: 01273-773303.
E-mail: [email protected] ■
CPD - 4 - IT
Where does Pathology fit in NPfIT?
Monday 11th April 2005
Thackray Medical Museum, Leeds
Wireless Computing
HL7 v3
National Programme for IT: Update on Progress
Pathology IT Across the Borders
Coding: The Latest on SNOMED
Pathology Messaging Update
Implementation of the New Analyser Management
System (AMS) from Abbott Diagnostics
Andrew Frith, Director, Health-IX
Tim Benson, Abies Ltd
Martyn Forrest, Regional Implementation Director, NPfIT –
North East Cluster
Ken Miller & Tom Cowan, Princess of Wales Hospital, Bridgend, Wales
& Glasgow Royal Infirmary
David Robinson, Accenture
Sally Stanley, Project Manager, Pathology Messaging – NpfIT
Howard Smith, Biochemistry Department, Pinderfields General Hospital
For further information and registration email: Diane Young at [email protected] or visit www.cpd4it.org.uk
4 • ACB News Issue 502 • February 2005
ACB Promotes Scientist Careers
Every year the ACB promotes careers in Clinical
Biochemistry by participating in three
Biosciences Federation Careers Conferences.
These conferences take place in November and
this year were held in London, Leeds and
Glasgow for life science undergraduate and
postgraduate students. Each conference
includes a range of talks on career choices and
further training and an exhibition. In Glasgow,
Dr Ian Godber presented an overview of
careers in Clinical and Biomedical Sciences at
the event. The ACB stand received a lot of
attention, and Dr Mike Wallace (ACB Scottish
Regional Tutor), Sarah Jarvis (Grade A trainee)
and Karen Smith (Grade B Biochemist - not
shown in photograph) were on hand to
provide plenty of information to would-be
clinical scientists. For those members wishing
to promote clinical biochemistry locally, the
ACB office at Tooley Street can provide a large Mike Wallace, Sarah Jarvis and Ian Godber running the Careers Fair stand
range of information, ranging from leaflets to
PowerPoint templates. ■
Royal Society of Chemistry Atomic Spectroscopy Group
Clinical and Biomedical Applications of ICPMS
Imperial College and Charing Cross Hospital
7th April 2005
Session 1: Use of ICPMS in Clinical Laboratories
Determination of Mercury in Whole Blood and Urine by Inductively Coupled Plasma Mass Spectrometry
(ICP-MS): Developing Robust Methods for Challenging Matrices
Christopher D Palmer and Patrick J Parsons
Boron Neutron Capture Therapy and Measurement of Boron by ICP-MS
Robin Braithwaite, Rebecca Wright and Ted Sheehan
ICPMS and EQA Performance
Andrew Taylor
Use of ICPMS in Clinical Laboratories
Lunch
Session 2: ICPMS in Biomedical Research
Uranium in the Environment: Exposure Factors, Measurement and Implications
Simon Chennery and Barry Smith
Use of Mathematical Modelling of Stable Isotope Data to Investigate Mineral Metabolism,
Jack Dainty
ICP-MS in Biomedical Research
Cameron McLeod
Conclusion: Barry Sampson
Registration Fee: Royal Society of Chemistry members - £30; Others - £35.
Contact: Barry Sampson, Department of Clinical Chemistry, Charing Cross Hospital London W6 8RF.
Tel: 020-8383-3644. Email: [email protected]
On the IT Curve
Association of Clinical
Pathologists’
National Scientific Meeting
Royal College of Physicians
London
16th & 17th June 2005
Gifford Batstone, Rick Jones, Bob DeJong and Jonathan Kay
The Autumn meeting of the CPD4IT group looked at a
number of developing areas in the hospital IT arena.
Gifford Batstone looked at Accenture and Jonathan Kay
was on form, but only just on time, to present a
thought-provoking talk on the “request-report cycle”.
It was great to see Rick along for the afternoon session,
and as always, Bob DeJong was working hard behind
the scenes to make sure the meeting went well. ■
• Histopathology/Immunology joint session:
Case Presentations and Disease Mechanisms
• Histopathology slide seminar
• Forensic Pathology session:
Deaths in a Healthcare Setting
• Chemical Pathology sessions:
Chemical Pathology outside Healthcare Provision;
You’re the Local Expert?
• Chemical Pathology/Haematology sessions:
Quality; The Role of Accreditation
• Microbiology sessions: Hospital Acquired
Infections; Microbiology Updates
• Haematology sessions: Blood Transfusion Updates;
Laboratory Issues
Full programme available February 2005 on
ACP website (www.pathologists.org.uk) or from
ACP Central Office, 189 Dyke Road, Hove BN3 1TL.
Tel: 01273-775700.
Email: [email protected] ■
EuroMedLab Reduced Rate
Registration Deadline
15th March 2005
Please remember that the deadline for reduced rate registration is 15th March
so do not simply put your form into the hospital training department and forget about it as the
increase in registration fees is substantial - as much as £121 for the full conference registration.
If you are looking for accommodation for EuroMedLab then the site www.expedia.co.uk can
offer some excellent prices on hotels in Glasgow. For example staying in the four star
Glasgow Moat House, adjacent to the conference venue, could be booked with a single room
rate of just £87 per night in January and with other city centre hotels available from £36 per night..
ACB News readers should note that the interest in EuroMedLab is very high
and early booking of rooms is strongly advised.
ACB Training Course 4
Monday 4th April - Friday 8th April 2005
Devonshire Hall, University of Leeds
This course is intended primarily for trainees preparing to sit the
MRCPath part 1 examination. It is one of a series of six,
which complement each other to deliver a complete syllabus.
Delegates will be expected to prepare for the course in advance as
advised in the registration pack.
Principal Topics:
•
•
•
•
•
•
•
Immunoassay
Haematological Disorders
Clinical Genetics
Biochemical Genetics
Organising Laboratory Services
Staff Development Interviews
Report Writing
In addition there will be an emphasis on biochemical calculations and case
reports. Each day there will be small group activity in breakout sessions.
Social Programme
• Welcome Evening Quiz in the College bar
• An evening at Xscape with facilities for snow sports and bowling
• Course Dinner at The Royal Armouries Museum
Full details and application forms:
ACB Office, Tel: 020-7403-8001. Email: [email protected]
For further enquiries contact:
Dr Mick Henderson, Department of Clinical Biochemistry,
St James’s University Hospital, Beckett Street, Leeds LS9 7TF
Tel: 0113-2066861. Email: [email protected]
Tips Disposable Laboratory Tips Disposable Laboratory Tips
MRCPath Short Questions MRCPath Short Questions MRCPath Short
Deacon’s Challenge
No. Answer 47
A specimen of spinal fluid from a patient who had suffered head trauma was noted to
be bloodstained. The CSF protein was found to be 1183 mg/L on clear colourless
supernatant after centrifuging (no scan done). The CSF contained red cells 10,200 cells
per cubic millimeter.
As the diagnosis was not clear, the doctors looking after the patient wondered how
much of the CSF protein may have come from the traumatic tap. On the same day, the
patient’s serum total protein was 73 g/L, and the RBC from the full blood count was
4.5 x 1012 cells/L.
Estimate the percentage of the measured CSF protein that may have come from the
serum.
MRCPath, November 2004
When blood leaks into CSF, the proportion of red cells and protein added to the CSF
remains constant. This is regardless of whether the blood in the CSF arises by trauma
during collection or from a subaracchnoid haemorrhage. i.e.
Red cell count in CSF
Red cell count in blood
=
Protein concentration in CSF arising from blood
Protein concentration in blood
It is important that the units used should be the same for blood and CSF. Converting the
units in CSF to those used for blood:
1L = 1000 cm3 = (10 cm)3 = (100 mm)3 = 1,000,000 mm3 = 1.0 x 106 mm3
Therefore CSF red cell count
= 10,200 cells/mm3 = 1.02 x 104 cells/mm3
= 1.02 x 104 x 1.0 x 106 = 1.02 x 1010 cells/L
(Note that when multiplying numbers that are in exponential form, the exponents
are added, not multiplied)
Questions MRCPath Short Questions MRCPath Short Questions
For CSF protein concentration:
1g = 1000 mg, therefore 1 mg = 0.001 g
so that 1183 mg/L
= 1183 g/L = 1.183 g/L
1000
Substituting these values into the equation relating CSF and blood ratios:
1.02 x 1010
4.05 x 1012
=
CSF protein derived from blood
CSF protein derived from blood
73
=
73 x 1.02 x 1010
4.05 x 1012
=
73 x 1.02
4.05 x 102
=
74.46
405
=
0.184 g/L
% CSF protein derived from blood = CSF protein derived from blood (g/L) x 100
Measured CSF protein (g/L)
= 0.184 x 100
1.183
= 15.55 % (16% to 2 sig figs)
Question 48
Calculate the least significant difference for a change in cholesterol if the
intra-individual coefficient of variation for cholesterol is 4.7% and the analytical
coefficient of variation, 2.4%. A patient was changed from Atorvastatin 80 mg to
Rosuvastatin 40 mg and the total cholesterol fell from 6.9 to 5.9 mmol/L.
Calculate the percentage change in cholesterol and state whether this is significant.
MRCPath, November 2004
Current Topics Current Topics Current Topics Current Topics Current
Paediatric Metabolic
Training Update
By Mick Henderson, National Lead Trainer
s many of you will know we advertised eight Higher
Specialist Trainee (HST) posts, to be based in centres across
England, in the June ACB News. These posts are funded by
the Department of Health with money that resulted from the
Genetics White Paper. The training proposals were put together by
Anne Green as part of the MetBioNet (Metabolic Biochemistry
Network) initiative. We are delighted to announce that all eight
vacancies have been filled. With three HSTs already in post in
Birmingham, Manchester and Leeds this makes a national cohort
of eleven.
Funding was also obtained to support the appointment of
trainers. It was accepted by the Department of Health that in order
for the training programme to be successful there had to be time
made available for experienced staff to take responsibility for
training.
Following an advert in the April ACB News for a National Lead
Trainer, I was the successful candidate and was appointed to
oversee the whole process. In addition local trainers have been
appointed to each of the three ‘clusters’ of laboratories in the
north, south and midlands. Between us we will oversee the HST
training programme and also work with ACB Regional Tutors in
ensuring that all A grades receive adequate paediatric training.
In the coming months we are planning to implement a
programme of work to achieve the following:
A
• Provide the HSTs with a training syllabus and logbooks.
• Define minimum training goals for A grades.
• Provide additional training resources on the website,
www.metbio.net
These resources will have open access.
The following is a list of the MetBioNet trainers, where they are
based and the HSTs that they will be responsible for. Also shown
are the supervisors (some as job shares) in the host Trusts.
South
Trainer: Colin Samuel, London
Trainee
Elizabeth Davidson
Guy’s London
Hoi Yee Wu (Teresa)
GOS London
Supervisor
Fiona Carragher
Ying Foo
News from
the National
Metabolic
Biochemistry
Network –
see the website
www.metbio.net
for lots more
Midlands
Trainers: Kate Hall and George Gray, Birmingham
Trainee
Supervisor
Rachel Carling
Cambridge
Jaqui Calvin
Daniel Herrera
Birmingham
Mary Anne Preece/Paul Griffiths
Annette Powell
Birmingham
Mary Anne Preece/Paul Griffiths
Maryan Khan
Bristol
Helena Kemp/David Stansbie
North
Trainers: Jim Bonham and Rodney Pollitt, Sheffield
Trainee
Supervisor
Beverly Harland
Manchester
Lesley Tetlow/Guy Besley
Carys Jones
Leeds
Mick Henderson
Camilla Reed
Manchester
Lesley Tetlow/Guy Besley
Roy Talbot
Sheffield
Jim Bonham
Katherine Wright
Liverpool
Paul Newland/David Isherwood
We have all been delighted by the progress made so far. I would like to
thank all those who have given considerable time to this project, in
particular Anne Green. It is hoped that through this training programme
we will ensure that sufficient Clinical Scientists are trained to maintain the
future of the sub-modality of metabolic paediatric biochemistry, including
the needs for neonatal screening. ■
Topics Current Topics Current Topics Current Topics Current Topics
Agenda for Change
Assimilation to Pay
Bands: What Next?
By Geoff Lester, Secretary, Federation of Clinical Scientists
n the January ACB News we announced the AfC agreement and indicated
what is going to occupy the minds of managers and staff representatives
during 2005 – assimilation to the new system through matching to job
profiles or full job evaluation. The performance of trusts in delivery
of this change, which is of unique magnitude in employee relations, will
form an important element of the trust’s “star” performance ratings.
A letter issued to Chief Executives on 10th January sets out a
month-on-month schedule of assimilation targets which is, to say the least,
ambitious, some may say unrealistic. The letter and schedule can be
downloaded from the Chief Executive Bulletin web site:
http://www.publications.doh.gov.uk/cebulletin/index.htm, bulletin
number 251. The key target is for the assimilation of 100% of the affected
workforce by the end of September 2005.
There has been lots of training and preparation for job matching with
managers and staff representatives trained in the skills involved so that, by
the end of the exercise there will be a wealth of local experience in
operating the new grading system. Much less publicised, though FCS would
contend in the longer term of much greater significance, is the Knowledge
and Skills Framework (KSF). The same letter to CEOs sets even more
demanding targets, because of the lack of prior exposure, for the
implementation of the KSF. The objective is for 100% of staff to have a KSF
“outline” by the end of December 2005.
I
The KSF
What is the KSF about and why is it so significant?
Just as the 16 “Factors” of the NHS Job Evaluation Scheme give a generic,
rational, NHS-wide basis for grading posts the KSF is designed to give a
generic, rational, NHS-wide basis for the assessment of individual
performance. This takes on quintessential importance for all of us as we
meet the pay progression “Gateways”.
Setting aside the transitional period, in the future when we advertise a
vacant post we will need:
• A job description.
• A person specification.
• A pay band, rationalised against a job profile or the Job Evaluation Scheme.
• A KSF outline, which describes the standards of performance, under a
series of standard and specific headings, which the satisfactory
jobholder is required to attain after experience in the job.
During transition we, that is jobholders, managers and staff representatives,
working in partnership of course, will have to graft KSF outlines onto
current notions of performance requirements for our jobs.
The second edition of the KSF Handbook (October 2004) represents a
substantial revision of the first KSF used by the Early Implementer sites. Thus
it is difficult to take lessons from the Early Implementation exercise. Each
and every post will have assigned levels (ranging from 1 to 4) against 6
“core” KSF dimensions and a number drawn from 24 specific dimensions
agreed as being most apposite to the role in question.
Each Pay Band has two gateways:
• The Foundation Gateway, within one year of appointment.
• The Second Gateway, nearer the top of the band.
All staff will have an annual development review against the requirements of
their KSF outline, effectively imposing more structure and formality to the
familiar staff appraisal process. The purpose is to assess how the individual is
developing (the underlying notion being that all staff should be facilitated to
develop) with reference to:
• How the duties and responsibilities of the job are being undertaken
• The application of knowledge and skills in the workplace
• The consequent development needs.
Thus it informs the training and development that management needs to
plan and resource.
Progression
The Foundation Gateway represents the end of what could be described
as a probationary period. Within the first year a new appointee is tested
against a sub-set of the full KSF for the post and if delivering satisfactorily
will pass through but there is the potential to be held even at this early
pay point.
At the Second Gateway the test is against the full KSF on the basis that the
employer has given the necessary training opportunities and facilities for the
post-holder to develop and the post-holder themselves has taken advantage
of them. The importance of the KSF is that the post-holder who has not
grown into their KSF can have pay progression held at this Gateway.
This will clearly impose a completely different dynamic on the performance
review process which will be familiar to many outside the NHS but is new
to us. The sword is two-edged. The employer who does not provide
facilities and opportunities to its employees to undertake the required
development will not be able to hold them back from pay progression.
The key message is that all those involved in staff appraisal will need
to be trained in the KSF and the new development review process
and in future these must be conducted to a strict timetable to meet
incremental dates.
What of those butting up to a Gateway at assimilation? It is taken as
already proven that anyone who has been in post for at least one year is
capable of delivering the basic requirements of the role and hence there is
no need for testing at the Foundation Gateway. Testing at Second Gateways
however may be a reality for some of us at our first increment.
Change is the Agenda
The provisions we have described so far, plus the new national Terms &
Conditions, are all essentially designed to meet the “equal pay for work of
equal value” objective. This is only one part of the thinking behind AfC.
The second is enabling new, innovative roles to be invented, graded, pay
banded and performance reviewed. It is a personal view that assimilation
will be followed in the years to come by a series of skill mix review
exercises across all healthcare areas as the true costs of extended pay scales
take effect and the drive to “breakdown professional barriers” becomes a
priority. The immediate effect will be that specifications for new roles can
be written without the old constraints of Whitley profession definitions.
Being optimistic this should open up opportunities for clinical scientists
who wish to pursue tangential job interests, such as quality management or
IT. Most of us in senior roles in our departments will have jobs in our
laboratories that simply do not fit the old structure. At least we no longer
have to trouble about that.
In whatever ways this less stated agenda is worked through we can be
sure that change will happen. It is incumbent on us to be there leading it
whilst preserving clinical standards, rather than reacting to it or worse, the
unsustainable position of standing in its way. ■
Situations Vacant
Feedback
By Louise Tilbrook, Associate Editor, ACB News
uch has been said about the problems with recruiting to
advertised Clinical Biochemist posts. ACB News has been
conducting an audit of the Situations Vacant adverts and trying
to gain information on the number of successfully filled posts. This
started at the beginning of 2004 and data is now available on the first
six months of the study. The study format is relatively simple, with a
brief one-page questionnaire being sent to the contact name in each
advert two months after it was placed. For ease of communication the
questionnaire was emailed wherever possible. One month was allowed
for the completed questionnaire to be returned and after this time a
gentle reminder was sent. A further month was allowed before the audit
for that month was closed.
M
Excellent Response . . .
Over a six-month period 47 adverts were placed for a total of 53
positions. Non-NHS posts accounted for 9% of the total adverts and
these were excluded from the audit results since they invariably failed to
respond to the questionnaires. Workforce development adverts for
regional trainees were also discounted since the large number of
applicants would otherwise have skewed the data.
From all NHS clinical scientist adverts, the response rate to the
questionnaire was an encouraging 68% (accounting for 29 adverts and
32 positions), reflecting the interest shared by many in the thorny
issues of recruitment.
The Questionnaire Used
Institution name
Post title
Spine point/Salary range
Number short listed for interview
Was an appointment made?
Y/N
Name of appointed candidate**
** This information is sometimes sensitive but the question was asked in order to determine
how many respondents would be happy to provide this information. If readers are interested,
this information could be provided in a regular ‘new appointments’ feature within ACB News.
Feedback is welcome on this issue to the Editor.
Louise presents
an initial study
of feedback
from users of
the Situations
Vacant column
Number of Adverts January-June 2004
There were an average of 2.7 applicants per post with 65% of positions being filled.
Adverts with no applicants accounted for 9% of the total, and a further 26% failed to
shortlist a suitable candidate.
The posts advertised were reasonably well distributed across the grades of the profession,
with a relatively high number of advertised banding criteria spanning more than one
grade. For example, several posts were advertised at Grade B 14-24, perhaps reflecting the
difficulties in recruiting at this level and the need to appeal to as many potential candidates
as possible.
When examining the success of recruitment by grade, it appears that there is less success
at recruiting in the B grades 12-16 compared to the others and this probably bears out the
experience nationally.
Distribution of Posts Advertised
January - June 2004
Recruitment by Grade of Post
Advertised
Recruited
Grade B 8-11
3
3
Grade B 12-16
6
2
Grade B 17-24
6
3
Grade C
5
4
12
8
Span >1 band
Moderately Encouraged
A successful recruitment rate of 68% among the posts surveyed appears at first
glance to be moderately encouraging. However, this is not equal among all grades of
staff and may highlight a particular problem in recruiting in the mid-grade B range.
To those of you who have recently tried to recruit with no success this may seem like
an exercise in ‘stating the obvious’ but it is interesting to see this borne out by
others across the country.
A number of posts were re-advertised later in the year and although the audit
wasn’t specifically designed to address this issue, examination of the next six-months
worth of data may reveal some interesting trends. In addition, once more data is
available it may be of value to examine the trends in recruitment geographically.
Problems With WWW Applicants
Several respondents expressed concern about the quality of applications, particularly
those Trusts who also used the NHS media or New Scientist for advertising. One
respondent in particular received a large number of unsuitable overseas applicants
for one particular post and was unable to shortlist anyone. It was felt that these
adverts yielded far fewer suitable applicants for short listing than using the ACB
News. Although this audit wasn’t designed to address this specific issue, the
questionnaire has subsequently been modified to ask what number of applicants
and short listed candidates made their application through ACB News.
Updated audit information will be published in ACB News, once information has
been gathered from November and December 2004. In the meantime, we would be
interested to hear comments and feedback from ACB members on this initiative and
the issues raised. ■
Meeting Reports Meeting Reports Meeting Reports Meeting Reports
Challenges,
Controversies and
Crystal Gazing . . .
Reported by Sue Bird, Dorset County Hospital, Dorchester
he Royal Bournemouth Hospital gave us an excellent meeting in
the splendid new facilities of their education centre. Over 50
delegates were treated to a feast of lectures and discussion,
interrupted by a very good lunch.
T
Regional Bayer Award
The morning session, chaired by Dr Joe Begley from Poole, started with
the Bayer Award, nice timing so that the junior members giving talks
were not nervously kept hanging round all day before they were in the
firing line! The regional Bayer Award is open to all members in
training.
There were three presentations. Anna Barton from Bristol Royal
Infirmary had looked at the stability of homocysteine in dried blood
spots. Stability is a problem in liquid samples so it was very interesting
to find out that on neonatal blood spot cards homocysteine is stable for
24 hours and that there is only a 9% fall over 28 days.
Aimee Smith from Queen Alexandra Hospital, Portsmouth had
looked at the clinical usefulness of BNP and NT proBNP in heart failure
patients in two studies, the first on different drug regimes, the second
looking at the relationship with pulsatility, a marker of aortic stiffness,
in patients undergoing cardiac catheterisation.
Dr Julie Wassell from North Bristol NHS Trust gave the last
presentation. Her topic was faecal calprotectin compared to other
inflammatory markers in Crohn’s disease. Faecal calprotectin is
measured using an ELISA method and Julie persuaded us that
measuring faecal samples was not so bad. The study confirmed that a
single random calprotectin is better than either ESR or CRP in
identifying patients with Crohn’s disease. In patients referred for
barium follow-through (an expensive procedure), a negative
calprotectin can rule out organic disease so negating the need for this
test in these patients.
The winner of the Bayer Award was announced in the afternoon
session. A panel of three judges said that the result was very close
as all the presentations were very good and Dr Julie Wassell was
declared the winner. Dr Allen Thompson from Bayer Healthcare
Diagnostics presented Julie with her prize of a cheque for £100. The
two runners up were presented from ACB funds with what looked
suspiciously like bottles.
The Autumn
Meeting of the
South West and
Wessex Region
was held at the
Education
Centre, Royal
Bournemouth
Hospital, on 4th
November 2004
Cardiac Biomarkers/Acute Coronary
Syndromes
We were treated to lectures from two of the ACB’s leading lights in the field of cardiac
markers.
Dr Paul Collinson spoke about the cardiac biomarkers in current use, and gave an
excellent overview of what he called the plaque trilogy (formation, destabilisation
and occlusion). He predicted that apolipoprotein b and homocysteine would be very
important markers used in the future. He talked about the plethora of tests that are
being used in assessing plaque destabilisation, of which high sensitivity-CRP is
proving exciting. CRP reduction following statin therapy has now been demonstrated
by a number of studies. In clinical laboratories we are mainly currently involved in
the third stage, assessing occlusion and he mentioned a new early marker in this
process, ischaemia modified albumin.
Dr Julian Barth reminded us that it is 16 years since the introduction of troponin
and pointed out that most of us have only been measuring it for the last three years.
He then discussed the problem of imprecision of the assay at the low end where
distinction of acute coronary syndrome from normal is critical. He challenged us to
think about how good patients are at telling us when chest pain commenced and
what effect this has on the usefulness of troponin.
There was then a lively discussion about clinical requirements. After lunch the
afternoon session was chaired by Dr Keith Wakelin from Dorchester.
A Cardiologist’s Perspective
Dr Bud Chandrasekaren, specialist registrar in cardiology at Bournemouth, gave a very
elegant presentation. He had been roped in to give the talk at the last minute due to
the consultant being unavailable and showed some stunning clips of the images of
heart function now available in cardiology departments. He emphasised how useful
troponin is in the armoury of tests available to the cardiologist and how treatment
intervention is now at an earlier stage than previously possible.
BNP in the Real World
All the lectures so far had mentioned BNP but there was a lot of interest in the talk by
Mr Stephen Wilkins, a BMS1 from Northampton General Hospital, whose MSc project
had involved setting up the BNP assay. Northampton had been running a routine
service for approximately a year. Stephen talked about the importance of setting up a
multi-professional team to obtain funding for new initiatives. Their successful team
consisted of two lead GPs from the two PCTs involved, the director of finance of one
of the PCTs, two consultant cardiologists, the consultant clinical biochemist and the
directorate managers of pathology and medicine.
Inflammatory Markers in Coronary Artery
Disease
The last speaker was a leading expert in the field, Professor Juan Carlos Kaski from St
George’s Hospital Medical School. He gave a balanced summary of the current state
of the use of inflammatory markers in investigating the pathology of coronary artery
disease. This included high sensitivity-CRP but his view was that a single marker would
not be useful on its own in identifying vulnerable individuals with high risk plaques.
Dr Roy Fisher, the meeting’s secretary, was thanked for organising a very successful
meeting and thanks were also given to the sponsors Bayer, Randox and Pfizer. ■
Support all the way!
Visit www.dpcweb.com or call 01286 871872 for more details.
Diagnostic Products Corporation - UK, Glyn Rhonwy, Llanberis, Gwynedd, LL55 4EL
Not Just Hot Air in
Nottingham . . .
Reported by Dr John Monaghan, Derby
he theme for the ACB TNY Region Scientific Meeting held on the
30th November 2004 was ‘The Lungs’. This concentrated on
pathological diseases that are linked to the lungs such as cystic
fibrosis and alpha-1 antitrypsin deficiency.
The day started with an excellent presentation by Dr Ina Aldag from
Sheffield Children’s Hospital on the basic physiology of the lungs. She
explained the anatomy, development, function, control and the effects
of its failure. I found it a refreshing review of the fundamental science
behind all the topics which were discussed later in the day.
Alpha-1 antitrypsin deficiency is a relatively common disorder that
can affect the lungs and the liver. Professor Noor Kalsheker gave an
enlightening lecture on the prevalence, biochemistry, analytical
methods and the clinical presentation of this disorder. I was interested
to find out that carriers sometimes do not present with symptoms, but
smokers often do. Another good reason to give up cigarettes?
Professor Rodney Pollitt explained the evolution of cystic fibrosis
screening using immuno-reactive trypsin (IRT) from a few laboratories
with an interest, through to the proposed national programme we see
today. He also showed the problems associated with providing a
national service which has financial and resource demands from other
professions, not just pathology. He explained ways of improving the
current service with the help from the National Screening Committee
and how this may change in the future. Angela Matthews then gave an
informative presentation on the problems with standardisation of IRT
T
The Lungs and
the Geoffrey
Walker Award
were features of
the Autumn
Trent, Northern
and Yorkshire
Regional
Meeting
Geoffrey Walker with presenters for his Award!
assays, especially with changes of reagent batch number, and how
this important aspect is being monitored.
Sweat testing is an important biochemical test which can help in
the diagnosis of cystic fibrosis. Paul Griffiths reported on the
development of the UK guidelines for the performance of the
sweat test, followed by the outcomes of regional audits performed
before and after the introduction of the guidelines. This showed
improved standardisation of protocols throughout the region and
that most laboratories are now following the guidelines.
With the help of clinical cases, Dr Jayesh Bhatt summarised the
prevention protocols currently used to avoid infection and improve
the quality of life for patients with cystic fibrosis. This ranges from
antibiotic therapy and recombinant DNA therapy to mechanical
ways of reducing lung damage using physiotherapy. Dr Bhatt also
listed the secondary problems associated with CF such as malabsorption, diabetes and liver disease and how to treat these patients.
Geoffrey presents the award to Rafaq Azad
Geoffrey Walker Award
The Geoffrey Walker Award is an annual competition held at the
autumn scientific meeting. Seven trainees from the region gave
presentations on their work.
Alkaline Phosphatase in Diabetes Mellitus
Heidi Cox, Hull
Analysis of Bence Jones Protein by Capillary Zone Electrophoresis
Lorraine Brunt, Nottingham
Two Cases of Copper Deficiency in the Enterally Fed
Alex Oliver, Leeds
Measurement of Immunosuppressants by Tandem Mass Spectrometry
Sarah Knowles, Nottingham
Plasma Aluminium: A Redundant Test?
Paula Gault, Leeds
Oral Fluid Analysis for Drugs of Abuse Using Tandem Mass Spectrometry
Rafaq Azad, Bradford
Insulin Autoimmune Syndrome (Hirata’s Disease)
Nuthar Jassam, Leeds
The presentations were excellent and the Regional Chairman,
Dr Ian Holbrook, commented on how difficult it was to choose a
winner. Congratulations go to Rafaq Azad who was this years
winner. Dr Walker presented Rafaq with an engraved paperweight,
a complete bursary for attendance to a national/international
meeting (up to the value of £1000) and a £100 book token. The
other participants did not go away empty handed. They were each
given a £50 book token for all their hard work.
So concluded an interesting and informative day at King’s Mill
Hospital. ■
ACB News Crossword ACB News Crossword ACB News Crossword
ACB News Crossword
Keep sane at coffee time with the ACB News Crossword. Always relating to the
science and practice of Clinical Chemistry, you will never cease to be astounded
by the convoluted mind of the ACB News crossword compiler.
Prizes for your department: The first five correct solutions to appear on the ACB
News fax machine (Fax: 0121-765-4224) will receive a copy of the new edition
of Clinical Chemistry by William Marshall and Stephen Bangert. Please state
clearly the name and address of the Department that is entering the competition.
Remember that ACB News appears first as a PDF on www.acb.org.uk around the
7th of each month.
Crossword set by Rugosa
Across
9
10
11
12
13
15
16
19
Answers to November’s Crossword
Across: 1 Chip, 3 Statistics, 10 Indiana, 11 Extreme, 12 Queries,
13 Taints, 15 Allyl, 16 Orangeade, 18 Easter egg, 21 Abhor,
23 Temper, 25 Budgets, 27 Sutured, 28 a priori, 29 Inaccuracy,
30 Anon
Down: 1 Chi-squared, 2 Indwell, 4 Transpose, 5 t-test, 6 Setting,
7 Inertia, 8 Skew, 9 Radial, 14 Regression, 17 Algebraic, 19 Spectra,
20 Empiric, 21 Adders, 22 Hoedown, 24 Radar, 26 Asti
Lucky Winners for the December issue . . .
Gethin Roberts, Aberystwyth
Judith Barnes, Glasgow
Graham Johnson, Hull
Tom Layton, Salford
David Worthington, Solihull
Paul Walker, Wakefield
Rod Larter, Leicester
Peter Beresford, Bristol
Steph Bailey, Haywards Heath
Congratulations all you lucky winners and especially for coping with the madatorary incorrect
clue. A prize in the form of a commemorative piece of china is now on the way.
Athlete needed to get puzzle early (7)
Goodbye and farewell to stasis in bad case-histories (7)
Country with six 14 (7)
Traveller to ancient city is ahead of time (7)
Enamel anomalies include a malignant tumour (8)
Region where loiterers get no sort of rest (5)
Metabolising with no limit disturbed source
of nutrition (7)
Oxbridge teacher about European silver has
many angles (7)
Descriptively, reference has replaced normal grassland (5)
Distortion of said fact staining character (4-4)
Disharmonious morass left upset illusionist (7)
See 6 Down
A vitamin is put back in cannelloni terrines (7)
Reconstructed semis or related structures (7)
20
21
25
26
28
29
Down
1
Laments heard west of 11, one of 14 (5)
2
Second class scoundrel with marked accent
heard in 26 (6)
3
Sailor with degree forms a singing group (4)
4
Fit young man with debt loses turn for a
teaching place (6)
5
See off disturbed adolescents in one of 14 (8)
6/26 Final reproducible mixture for title of
one of 14 (8, 2, 7)
7
About rating in one of the Association’s objects (8)
8
Obsolete French coin the navy followed in one of 14 (8)
14 Boring case involved our constituents capital start! (3, 7)
16 First of two and second of five words in titles of 14 (8)
17 Summer clothing boy said will do (8)
18 Pleased I finished with Olive early - flowers! (8)
22 In clean air it is an unusual inflammation (6)
23 Ask her about a member of a religous group (6)
24 In other words, edits alteration (2,3)
27 Lone sort of compound (4)
Corporate News Corporate News Corporate News Corporate News
Simultaneous Ventilation and Oxygen
Status Measurement
A new monitor that can simultaneously measure both patient
ventilation and oxygenation status has been launched by Radiometer.
The new TCM40 provides continuous and non-invasive monitoring of
oxygen and carbon dioxide together with oxygen saturation levels –
the latter by using world-renowned Nellcor sensors. This advanced
capability makes the new monitor ideal for neonatal and sleep units,
as well as adult critical care.
Measurements are made through two separate sensors. One measures
SpO2 only, (offering different fixation options), while the other
determines tcpCO2 – alone or together with tcpO2. The use of two separate sensors means that the
SpO2 is measured continuously, even when the transcutaneous electrode is being calibrated.
Fast and reliable results are ensured by a pair of advanced special features, SmartHeat and
SmartTrend, that are unique to Radiometer. SmartHeat quickly stabilizes transcutaneous values by
increasing electrode temperature by one degree during the initial five minutes of measurements, while
SmartTrend™ uses a unique algorithm to improve the stability of measurements, thereby ensuring
they reflect true physiological changes in patient status. The TCM40 can be interfaced to major patient
monitoring systems. For more information on Radiometer and transcutaneous monitoring,
visit www.radiometer.com/tc ■
Automated Immunofixation Using
Capillary Electrophoresis
Sebia Capillarys, available from Analytical Technologies, can now be used for the detection
and identification of paraproteins. Capillarys performs all sequences automatically by a new
immunotyping technique to characterise the detected bands by qualitative analysis.
Capillarys is already established for automated protein electrophoresis and the new
immunotyping technique simplifies the process and improves results. The serum is
automatically diluted and mixed with the five antisera (IgG, IgA, IgM, Kappa and Lambda)
and a sixth well used to obtain the reference pattern.
The increased sensitivity of capillary electrophoresis, compared to previous methods,
together with the user-friendly software and zooming capabilities available on Capillarys,
makes for easy interpretation and identification.
The Capillarys immunotyping technique gives a very fast reaction between the antisera
and antigen without the necessity for incubation and sedimentation. With rapid separation
in the capillaries and direct detection of proteins at a specific wavelength, a high degree of
precision and accuracy is obtained. Designed to optimise and completely automate routine
electrophoresis techniques, Capillarys is a continuous feed capillary system allowing
complete walk away automation, from bar coded primary tube to result. For further
information please contact: Jan Wimms, Analytical Technologies on Tel: 01252-51471 or
New Warehouse for Axis-Shield
In January, Axis-Shield UK opened
a new warehouse facility at its
HQ in Kimbolton, Cambridgeshire.
All orders placed with Axis-Shield
UK will now be processed and
distributed from the 1,250 sq ft
warehouse. Relocation of the
warehouse provides the final step
in consolidating the company’s
operations on one site.
The relocated warehouse is
being managed by new logistics
co-ordinator, Sean Ward. ■
Logistics co-ordinator, Sean Ward, in the new
Axis-Shield UK warehouse
Direct HDL Cholesterol for
ADVIA 1650
Bayer Diagnostics has launched a new Direct HDL cholesterol method and a new liquid
stable CO2 for use on their ADVIA Clinical Chemistry Systems. The ADVIA Direct HDL
method provides improved assay performance for HDL cholesterol with low interference
from endogenous triglyceride and reduced reactivity to LDL. Benefiting from a
calibration stability of 30 days the new method also demonstrates a linear range of
5-115 mg/dL.
For more information about the ADVIA® Clinical Chemistry Systems
please contact: Claire Walker-Lloyd, Product Manager, Clinical Chemistry
and Automation, Bayer Diagnostics on Tel: 01635-566203.
Hello-Goodbye to David of Genzyme!
David Bush will be retiring from Genzyme at the end of March this year and David Torrens, Director of
Marketing will be taking over as the ACB liaison person in the company David’s e-mail address is:
[email protected] ■
New Olympus Booklet Summarises
EU Directive
The EU Directive 2002/98/EC of
the European parliament and of
the council, January 2003 sets
standards of quality and safety
regarding the collection, testing,
processing, storage and
distribution of human blood and
blood components. From
February 8th 2005, all UK
hospitals and blood banks will
need to have in place a fully
auditable system for traceability of
blood from donor to recipient. A
new booklet “Executive Briefings:
The EU Blood Safety Directive”
recently published by Olympus
osYris helps managers and
healthcare professionals
understand the major
implications of the directive.
Olympus osYris has been working
with several hospitals to prepare
for the directive using its bar
coding and point of care patient
identification systems, and has
seen a steady increase in interest
as the deadline approaches.
“However we believe there is still
a great deal of confusion about
how best to comply with the
directive,” says Tony Sackville,
Marketing Director, “so we have
prepared this executive briefing to
explain the main points of the
directive and how it will affect
Trusts and management,
including the need for vein to
vein traceability”.
Olympus osYris provide
barcode solutions using their
BloodTrack Courier and SafeTx
systems. BloodTrack Courier
electronically controls and tracks
the movement of blood products
into and out of hospital fridges
and can be used in conjuction
with BloodTrack SafeTx to
provide a full management
reporting suite showing the
movement of every unit of blood
and blood components. This
helps blood establishments to
comply with both the EU
Directive and with SHOT
(Serious Hazards of Transfusion).
To receive a copy of
‘Executive Briefings:
The EU Blood Safety Directive’,
contact Olympus osYris on
Tel: 020-7250-4800 or
Email [email protected] ■
Trent, Northern and Yorkshire Region Regional Scientific Meeting/AGM
ERMEC, Hull Royal Infirmary
Thursday 17th March 2005
The Fats of Life: Obesity and Lipids
Speakers include:
• Dr Bill Richmond, St Mary’s, London
• Dr Eric Kilpatrick, Hull
• Dr Dermot Neely, Newcastle
• Dr Stuart Smellie, Bishop Auckland
In addition, Gilbert Wieringa, Manchester, will talk about ‘Clinical and Diagnostic
Testing Services at the Point-of-Care in Pharmacies across Greater Manchester’
Regional members will receive the mailing as usual.
Full details will be posted on the Mailbase
Contact [email protected] for further details
Vacant Situations Vacant Situations Vacant
Situations Vacant
Situations Vacant Situations Vacant Situations Vacant Situations
Vacant Situations Vacant Situations Vacant
Situations Vacant
Situations Vacant Situations Vacant Situations Vacant Situations
University of London
MSc Clinical Biochemistry
Applications are invited for this two year, part-time intercollegiate course beginning in September 2005.
Candidates should have a first or second class honours degree in Chemistry, Biochemistry or a related subject,
or hold a medical qualification registrable in the United Kingdom. Candidates without these qualifications may be considered
providing they have relevant work experience. Students will usually be expected to have at least one year’s experience in
Clinical Chemistry, but well qualified candidates working in a clinical chemistry laboratory for less than one year will be
considered. Candidates must hold posts in suitable laboratories for the duration of the course and must be in a position to
attend lectures and seminars at a London medical school on Wednesday afternoons (2pm-7pm) during the university terms.
Students will be registered as internal students of the University of London. The degree is awarded on the basis of
examinations held at the end of the course, a project and assessment of the practical work set throughout the course.
The course provides an excellent grounding for those individuals wishing to progress to the MRCPath in Chemical Pathology.
For further details and application forms write to: Dr Gill Rumsby, Clinical Biochemistry, UCL Hospitals, 60 Whitfield Street,
London W1T 4EU. Tel: 020-7636-8333 ext. 2955. Fax: 020-7380-9584. Email: [email protected]
Closing date for receipt of applications: 1st June 2005.
To advertise your vacancy contact:
ACB Administrative Office, 130-132 Tooley Street, London SE1 2TU
Tel: 0207-403-8001 Fax: 0207-403-8006 Email: [email protected]
Deadline: 26th of the month prior to the month of publication
Training Posts: When applying for such posts you should ensure that appropriate supervision and training support will be
available to enable you to proceed towards state registration and the MRCPath examinations.
For advice, contact your Regional Tutor.
The editor reserves the right to amend or reject advertisements deemed unacceptable to the Association.
Advertising rates are available on request
How can I provide a
better service to our
doctors and patients?
the answer is
Ortho-Clinical Diagnostics,
Johnson & Johnson,
Tel: + 44 (0)1494 658600
50-100 Holmers Farm Way,
Fax: + 44 (0)1494 658604
High Wycombe,
Bucks HP12 4DP
www.jnjgateway.com/ocduk

Issue 502 February 2005 - Association for Clinical Biochemistry

Transcription

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