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4 results

  • Development of a Mobile Laboratory for Sudden Onset Disasters

  • Ian Marr, Joshua R. Francis, Dianne P. Stephens, Kristy Marshall, David J. Read, Rob W. Baird, Nicholas Coatsworth
  • Journal:
    Disaster Medicine and Public Health Preparedness / Volume 15 / Issue 2 / April 2021
    Published online by Cambridge University Press:
    21 April 2020, pp. 170-180
  • Objectives:

    Clinical diagnostics in sudden onset disasters have historically been limited. We set out to design, implement, and evaluate a mobile diagnostic laboratory accompanying a type 2 emergency medical team (EMT) field hospital.

    Methods:

    Available diagnostic platforms were reviewed and selected against in field need. Platforms included HemoCue301/WBC DIFF, i-STAT, BIOFIRE FILMARRAY multiplex rt-PCR, Olympus BX53 microscopy, ABO/Rh grouping, and specific rapid diagnostic tests. This equipment was trialed in Katherine, Australia, and Dili, Timor-Leste.

    Results:

    During the initial deployment, an evaluation of FilmArray tests was successful using blood culture identification, gastrointestinal, and respiratory panels. HemoCue301 (n = 20) hemoglobin values were compared on Sysmex XN 550 (r = 0.94). HemoCue WBC DIFF had some variation, dependent on the cell, when compared with Sysmex XN 550 (r = 0.88-0.16). i-STAT showed nonsignificant differences against Vitros 250. Further evaluation of FilmArray in Dili, Timor-Leste, diagnosed 117 pathogens on 168 FilmArray pouches, including 25 separate organisms on blood culture and 4 separate cerebrospinal fluid pathogens.

    Conclusion:

    This mobile laboratory represents a major advance in sudden onset disaster. Setup of the service was quick (< 24 hr) and transport to site rapid. Future deployment in fragmented health systems after sudden onset disasters with EMT2 will now allow broader diagnostic capability.

  • 32 - Peregrinations through the Heathlands and Moorlands of Britain: an Applied Plant Ecologist’s Tale

  • from Part II - Essays: Inspiring Fieldwork
  • Edited by Tim Burt, Durham University, Des Thompson
  • Book:
    Curious about Nature
    Published online:
    11 February 2020
    Print publication:
    20 February 2020, pp 264-270

  • Summary

    My earliest interests in fieldwork were spawned from a schoolboy passion for hill walking on trips organised by my two biology teachers, Ella Bryce and Sandy Robertson. While biology was not part of the deal, there was obviously a subliminal message sinking in. I then had the privilege of doing biology at the University of Stirling in Scotland, where again my enthusiasm was stoked by official field courses to Millport (where I met my wife) and Loch Rannoch, and in between times, unofficial ones run by the Students’ Biological Society to Durness in Sutherland. Students don’t seem to organise their own field courses now, unfortunately. This overall experience must have worked because I gradually transferred from a biochemist to a card-carrying plant ecologist; eventually doing a PhD in physiological ecology. The PhD was meant to be centred on a garden experiment, but I soon expanded this to do fieldwork. What I really liked was that you could study in great places and get paid to do it. This really did open up a career option.

  • 12 - Paths to Practice

  • Edited by Catrina Denvir, Monash University, Victoria
  • Book:
    Modernising Legal Education
    Published online:
    30 December 2019
    Print publication:
    09 January 2020, pp 221-238

  • Summary

    Most agree that lawyers of the future will need a greater understanding of how technology can be used to design and deliver legal services. The issue for those involved in setting content for any route to qualification is defining the extent to which this must be regulated, as much as identifying the right level of technological capability. The issue is not merely one of content, but the acquisition of competences. Any accreditation must look beyond simply ensuring capability in relation to discrete tools, looking instead to ensure that future solicitors have the ability to adapt to new technologies. Separately, consideration has to be given to the emerging profession of legal technologists. Whilst some technologists may be legally qualified, those that are not must understand the ethical boundaries and regulatory requirements that lawyers work within. The organisation of the legal profession and the regulatory boundaries shared between various stakeholders require us to consider whether accreditation is the right way forward, where responsibility for accreditation should lie and who should take initiative in this space. This chapter explores these issues by contrasting the approach adopted by the Solicitors Regulation Authority in England and Wales with that of the Law Society of Scotland.

  • Development of a Mobile Laboratory for Sudden Onset Disasters

  • Ian Marr, Dianne Stephens, Rob Baird, Josh Francis, David Read, Nicholas Coatsworth
  • Journal:
    Prehospital and Disaster Medicine / Volume 34 / Issue s1 / May 2019
    Published online by Cambridge University Press:
    06 May 2019, p. s24
    Print publication:
    May 2019
    • Article
      • You have access
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  • Introduction:

    Clinical diagnostics in sudden-onset disasters (SOD) has historically been limited. With poor supply routes, lack of a cold chain, and challenging environmental conditions, many diagnostic platforms are unsuitable.

    Aim:

    We set out to design, implement, and evaluate a mobile diagnostic laboratory accompanying a type II emergency medical team (EMT) field hospital.

    Methods:

    Available diagnostic platforms were reviewed and selected against infield need. Platforms included HemoCue301/WBC DIFF, i-STAT, BioFire multiplex RT-PCR, Olympus BX53 microscopy, ABO/Rh Grouping, and specific rapid diagnostic tests (RDT). This equipment was trialed in Katherine, Australia and Dili, Timor-Leste.

    Results:

    During the initial deployment, validation of FilmArray rt-PCR multiplex tests was successful on blood culture, gastrointestinal, and respiratory panels. HemoCue301 (n = 20) haemoglobin values were compared on Sysmex XN 550 (r = 0.94). Analysis of HemoCue WBC DIFF samples had some variation when compared to Sysmex XN 550, (neutrophils r = 0.88, lymphocytes r = 0.49, monocytes r = 0.16, eosinophils r = 0.70, basophils r = 0.16). i-STAT showed non-significant differences for CHEM4 (n=10), CG8 (n = 10), and TnI (n = 5) against Vitros 250. A further trial of BioFire rt-PCR testing in Dili, Timor-Leste diagnosed 117 causative pathogens on 168 FilmArray test cartridges.

    Discussion:

    This mobile laboratory represents a major advance in SOD. Setup of the service was quick (<24hr) and transport to site rapidly. Training was simple and performance consistent. Future deployment in fragmented health systems after sudden onset disasters with EMT2 will now allow broader diagnostics.