ABSTRACT
BACKGROUND: Assuring/demonstrating metrologic traceability of in vitro diagnostics necessitates the availability of measurand-specific reference measurement systems (RMSs) and the possibility for industry to work with competent reference measurement laboratories (RMLs). Here we report the results of a European project to investigate the feasibility of developing a RMS for serum total thyroxine. METHODS: Four candidate RMLs (cRMLs) developed/implemented variants of a candidate reference measurement procedure (cRMP) based on isotope dilution-liquid chromatography-mass spectrometry. The sole constraint implemented was calibration with a common thyroxine primary calibrator. The RMPs were externally validated and assessed for comparability in round-robin trials using common samples, i.e., 5 lyophilized and 33 frozen native sera. At the same time, the performance of the cRMLs organized in a network was assessed. For uniform external quality assessment, common performance specifications were agreed on. RESULTS: All cRMLs performed the cRMPs with fulfillment of the predefined specifications: total and between-laboratory CVs < or =2.0% and 2.5%, respectively, and a systematic deviation < or =0.9%, estimated with a target assigned from the mean of means obtained by the cRMLs. The mean expanded uncertainty for value assignment to the native sera was 2.1%. CONCLUSIONS: A network of cRMLs, with externally conformed competence to properly perform RMPs, has been established. Performance specifications were defined and will form the basis for admittance of new network members. A serum panel, successfully targeted during the validation process, is available for split-sample measurements with commercial routine measurement procedures. The model can now be used for other measurands for which traceability to the Systeme International d'Unites is needed.
Subject(s)
Clinical Laboratory Techniques/standards , Laboratories/organization & administration , Thyroxine/blood , Chromatography, Liquid , Feasibility Studies , Humans , Indicator Dilution Techniques , Mass Spectrometry , Reference Standards , Reproducibility of Results , Serum , Thyroxine/standardsSubject(s)
Humans , Adolescent , Adult , Middle Aged , Male , Cannabis , Marijuana Abuse , Alcoholism , Alcohol Drinking , Mental Health , Jamaica , Mental Disorders , Mental Health Services , Hospitals, Psychiatric , Brain Damage, Chronic , Chronic Disease , Marijuana Smoking , Religion , Religion and Psychology , Drinking Behavior , Social BehaviorABSTRACT
This review of the Jamaican Child Guidance Clinic referrals shows the following trends:- 1. Children referred to the clinic show relatively higher percentage of parent/child separation than is the average in Jamaica. 2. Predominantly neurotic disorders were associated with (a) children living with both parents (b) middle-class families and higher intelligence. 3. Anti-social behaviour was associated with parent/child separation particularly in the early formative years (under 5 years) and frequently with a low I.Q. in the range or 70-90, but there was no association between clearcut mental sub-normality and parental background. The tendency was in fact for mentally subnormal children to come as often from the middle-class as lower-class families. Anti-social behaviour was also associated with lower-class background, but even within the middle-class group anti-social behaviour occurred significantly more often among the separated than among the non-separated. 4. We have endeavoured to relate certain clinical data to some social and cultural features peculiar to Jamaica and the West Indies. (Summary)
Subject(s)
Humans , Child , Adolescent , Personality Assessment , Personality Development , Parent-Child Relations , Child Guidance Clinics/statistics & numerical data , Child Guidance Clinics/trends , JamaicaABSTRACT
A Psychiatric Questionnaire, similar to the Cornell-Aro one was administered to sixty consecutive medical admissions to the University Hospital of the West Indies. Results showed that one-sixth of patients could be regarded as having significant psychiatric symptomatology, and a further 40 percent had a degree of psychiatric symptomatology, which appeared to be probably significant. These fairly high figures are in keeping with fairly high rates of symptomatology recorded in other studies of non-psychiatric hospital patients, and, indeed, in keeping with certain community studies. Certain specifically Jamaican factors are discussed, such as-beliefs in Faith Healing and Obeah. Comment is made of the teaching of psychiatry to students in a medical setting (AU)