Adaptarnos para sobrevivir. Requerimientos de un nuevo paradigma / Adapting to survive. Requirements for a new paradigm

A lo largo de la historia, el rol del bioquímico en el laboratorio clínico ha ido mutando, adaptándose a nuevos paradigmas, consecuencia del avance de la tecnología1 y la informática, de la presión externa ejercida por las empresas proveedoras de reactivos que reducen el tiempo útil de los equipos, aumentando su tasa de recambio, de una medicina más compleja que impone nuevos desafíos diagnósticos y de los cambios sociales que se ven reflejados en una alteración en el orden de los valores adoptado por las nuevas generaciones de profesionales que conviven con otras, provocando "turbulencia generacional" en los lugares de trabajo. Los laboratorios necesitan hoy someterse a una reingeniería de sus procesos, descartar aquellos que no agreguen valor, que causan fugas innecesarias de insumos, personas y tiempo e intervenir la cultura organizacional de manera integral, para adaptarse a las exigencias que la actualidad requiere, donde la calidad, la seguridad y la sostenibilidad son los principales protagonistas )AU)

Over time, the role of the biochemist in the clinical laboratory has been changing, adapting to new paradigms, as a consequence of the advance of technology and informatics, of the external pressure exerted by the companies supplying reagents that reduce the useful time of the equipment, increasing its replacement rate, of a more complex medicine that imposes new diagnostic challenges, and of social changes that are reflected in an alteration in the values adopted by the new generations of professionals who coexist with others, causing "generational turbulence" in the workplace. Laboratories today need to reengineer their processes, eliminate those that do not add value, that cause unnecessary waste of supplies, people and time, and intervene in the organizational culture in a comprehensive manner, in order to adapt to the demands of today's world, where quality, safety, and sustainability are the main drivers (AU)

Desempeño de los Tecnólogos Médicos como Oficiales de Protección Radiológica - 2021 / Performance of Medical Technologist as Radiation Protection Officers Lima - 2021

Las radiaciones ionizantes tienen el potencial de generar efectos adversos a la salud de las personas. Para hacer un uso más seguro y eficiente de estas radiaciones, la Comisión Internacional de Protección Radiológica fundamentalmente ha implementado un sistema de protección radiológica (SPR) que se basa en tres principios: justificación, optimización y límites. A su vez, estos principios se sustentan en cuatro valores éticos (beneficencia, prudencia, justicia y dignidad). Se sabe que en Chile el profesional que esta mandatado para realizar la toma de los exámenes que utilizan radiaciones ionizantes es el/la Tecnólogo Médico en Imagenología. Por lo tanto, resulta interesante valorar el grado de conocimiento adquirido y posteriormente aplicado en torno a los valores éticos del SPR por parte de dichos profesionales. De esta manera el objetivo del este artículo de tipo Punto de Vista fue realizar una serie de reflexiones en torno a esta temática. Cuando se realiza un procedimientos médico u odontológico con radiaciones ionizantes, el/la Tecnólogo Médico en Imagenología participa esencialmente en la realización del mismo, por lo que no debería ser su responsabilidad el cautelar que se cumplan los 4 valores éticos descritos dentro del SPR. A juicio nuestro, el principio de optimización, sería el único principio o pilar del SPR donde tiene real obligación de participar, utilizando las restricciones a las exposiciones individuales y los niveles de referencia para diagnóstico para reducir las desigualdades en la distribución de las exposiciones entre los grupos expuestos. Finalmente, resulta vital investigar si en su formación de especialidad se tocan estas temáticas.

Ionizing radiation has the potential to generate adverse effects on people's health. To make safer and more efficient use of these radiations, the International Commission on Radiological Protection has fundamentally implemented a radiological protection system (RPS) based on three principles: justification, optimization and limits. In turn, these principles are based on four ethical values (beneficence, prudence, justice and dignity). It is known that in Chile the professional who is mandated to perform the exams that use ionizing radiation is the Medical Imaging Technologist. Therefore, it is interesting to assess the degree of knowledge acquired and subsequently applied around the ethical values of the RPS by these professionals. In this way, the objective of this Point of View article was to make a series of reflections on this subject. When a medical or dental procedure is performed with ionizing radiation, the Medical Imaging Technologist essentially participates in its performance, so it should not be their responsibility to ensure that the 4 ethical values described in the RPS are met. In our opinion, the principle of optimization would be the only principle or pillar of the RPS where it has a real obligation to participate, using the restrictions on individual exposures and the diagnostic reference levels to reduce inequalities in the distribution of exposures between exposed groups. Finally, it is vital to investigate whether these topics are addressed in his specialty training.

Cultivating Research Skills During Clinical Training to Promote Pediatric-Scientist Development.

Physician-scientists represent a critical component of the biomedical and health research workforce. However, the proportion of physicians who spend a significant amount of effort on scientific research has declined over the past 40 years. This trend has been particularly noticeable in pediatrics despite recent scientific work revealing that early life influences, exposures, and health status play a significant role in lifelong health and disease. To address this problem, the Duke University Department of Pediatrics developed the Duke Pediatric Research Scholars Program for Physician-Scientist Development (DPRS). The DPRS is focused on research training during pediatric residency and fellowship. We aim to provide sufficient research exposure and support to help scholars develop a research niche and scholarly products as well as identify the career pathways that will enable them to achieve their research goals. Herein, we describe the DPRS's organizational structure, core components, recruitment strategies, and initial results, and we discuss implementation challenges and solutions. Additionally, we detail the program's integration with the department's residency and fellowship training programs (with particular reference to the challenges of integrating research into small- to medium-sized residency programs) and describe the development and integration of related initiatives across Duke University School of Medicine. The program served as the basis for 2 successful National Institutes of Health Stimulating Access to Research in Residency (R38) applications, and we hope it will serve as a model to integrate formalized research training for residents and fellows who wish to pursue research careers in academic medicine.

Facilitators and barriers to implementing task shifting: Expanding the scope of practice of clinical technologists in the Netherlands.

Despite recent studies confirming task shifting is both safe and effective, its implementation has proven difficult in practice. So too in the Netherlands, where legal barriers enforcing strict professional boundaries have historically limited task shifting. In recent years, Dutch policymakers have experimented with temporary expanded scopes of practice (ESP) for several professional groups, with the aim to facilitate task shifting in order to increase the overall effectiveness and efficiency of health care. The Clinical Technologist (CT), is an emerging new professional group that has received such a temporary ESP pending an evaluation. This paper reports the qualitative findings of the implementation process of providing CTs with an temporary ESP. Data collection consisted of 69 semi-structured interviews, 3 focus group interviews and 9 participant observations, conducted between September 2015 and October 2017. Analysis was conducted through an 'editing analysis style' whereby data were categorized using the conceptual framework of Grol & Wensing's implementation model. The study suggests that social features are of great importance when implementing task shifting. In situations with few social barriers, organizational and administrative barriers seem to be less dominant, thereby expediting the overall implementation process. Consequently, we recommend that policymakers should prioritize social features over organizational features when implementing task shifting.

[The future of laboratory medicine, the future laboratory physician]. / Framtidens laboratorieläkare bör bidra mer med råd och tolkningar - Klokt utnyttjande av ett växande utbud av analyser krävs för att fortsatt kunna ge värdeskapande svar till allt fler.

Internal and external factors influence the future of laboratory medicine. In the coming years point of care testing and faster and cheaper methods of genome sequencing are predicted to become more important. Changes in laboratory organization and demography with an aging population will likewise impact the coming years. An increased information flow between laboratories and clinicians, where symptoms, findings and vital signs are combined with laboratory results and their change over time, has the potential of generating refined reports. Sharing of equipment between laboratory specialities as well as working in conjunction with clinicians in influencing patterns of testing through guidelines and algorithms may also aid in saving precious resources.

Autism Scientists' Reflections on the Opportunities and Challenges of Public Engagement: A Qualitative Analysis.

This article draws upon qualitative interviews in order to examine how UK based research psychologists understand public engagement activities and interactions with autistic advocates. Researchers describe public engagement as difficult and understand these difficulties as stemming from autistic impairments. In particular, it is reported that a heterogeneity of autism impairments means there is little agreement on the form research should take, while socio-communicative impairments make interactions difficult. Conversely, researchers describe autistic individuals as having the capacity to positively influence research. In this paper we discuss the nature of these claims and stress the need for autism-specific modes of engagement to be developed.

[Clinical Personnel Training in Laboratory Medicine in Chiba University Hospital during the Past 15 Years].

During the past 15 years, various approaches have been adopted for medical personnel training in the Division of Laboratory Medicine, Chiba University Hospital. Medical personnel have been encouraged to enter the Graduate School of Medicine, Chiba University. At present, 14 of them have successfully completed the Ph.D. program and 16 have been awarded a master's degree. In our unit, clinical proteomics is a principal research subject, and we have identified a number of biomarker candidates in collaboration with clinical units. In Chiba University Hospital, all clinical laboratory physicians are certified as medical geneticists and are in charge of the Division of Clinical Genetics as well. We have treated a total of 1,009 patients, including those with hereditary neuromuscular diseases, familial cancers, and prenatal diagnoses. We have also encouraged medical technologists to become certified as genetic counselors, which may be a promising subspecialty for medical technologists. Mass spectrometry (MS) is a powerful analytical tool used in an increasing number of clinical laboratories around the world. Liquid chromatography (LC) coupled with tandem mass spectrometry (MS/MS) has been used for newborn screening, toxicology, therapeutic drug monitoring endocrinology, and, more recently, for the measurement of targeted proteins and peptides. Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) has proven to be a rapid and reliable tool for identifying microorganisms. The Japanese Society for Medical Mass Spectrometry has started to certify medical mass spectrometrists, which could be another promising subspecialty for medical technologists.