There are a number of pre-analytical and analytical factors, which cause false results in the complete blood count. The present case identifies cold agglutinins as the cause for the mismatch between hematocrit and hemoglobin values.
Materials and methods:
70-year old female patient had a history of cerebrovascular diseases and rheumatoid arthritis. During routine laboratory examination, the patient had normal leukocyte and platelet counts; however, the hemoglobin (Hb: 105 g/L) and hematocrit (HCT: 0.214 L/L) results were discordant. Hemolysis, lipemia and cold agglutinin were evaluated as possible reasons for the mismatch between hematocrit and hemoglobin values.
Results:
First blood sample was slightly hemolysed. Redrawn sample without hemolysis or lipemia was analyzed but the mismatch became even more distinct (Hb: 104 g/L and HCT: 0.08 L/L). In this sample, the titration of the cold agglutinin was determined and found to be positive at 1:64 dilution ratios. After an incubation of the sample at 37°C for 2 hours, reversibility of agglutination was observed.
Conclusion:
We conclude that cold agglutinins may interfere with the analysis of erythrocyte and erythrocyte-related parameters (HCT, MCV, MCH and MCHC); however, Hb, leukocyte and platelet counts are not affected. 相似文献
This paper explores medical teachers' perceived barriers and opportunities for educational and professional development. Data has been gathered through 19 semi-structured interviews with participants on a staff development course 1 year after their participation. The analysis shows that most perceived barriers are found on an organisational level, whilst motivation for development is found on an individual level and often related to the notion of teaching as a ‘private business’. However, what some respondents perceive as barriers are by others seen as opportunities. Some of these differences in perception may be explained by self-efficacy beliefs. 相似文献
The increasing complexity of health care practice makes continuing professional development (CPD) essential for health care professionals. Simulation-based training is a CPD activity that is often applied to improve interprofessional collaboration and the quality of care. The aim of this study is to explore simulation as a pedagogical practice for the CPD of health care professionals. Specifically, the study focuses on how a professional development activity, the simulation, is enacted to support interprofessional collaboration and learning. A practice theory perspective is used as the theoretical framework. In this, the professional practice is conceptualised as being embodied, relational and situated in sociomaterial arrangements. Ten introduction and reflection sessions following interprofessional full-scale manikin-based simulations with professionals were video-recorded. The recordings were analysed following a stepwise qualitative collaborative approach developed for the purpose. The key findings suggest that the professional competence activity is enacted and interconnected with and governed by historical traditions of institutional teaching practices as well as simulation practices. Despite the intentions of team and interprofessional training, the institutional teaching and simulation practices constrain and hinder the intended outcomes of professional development in interprofessional collaboration. 相似文献
Background: Sustainable development, as an area of knowledge, appears in several different places in the curriculum and does not fit neatly within the scope of traditional subject areas. In many countries, including Sweden, it has long been upheld as an important tool for increasing understanding of, and dealing with, environmental problems. It is not clear, however, what role education can actually have in the making of a more sustainable future. Even though there are several potential ways for sustainable development to be involved in education, the concept raises many questions when transferred to the school context.Purpose: This paper investigates how teachers deal with the difficulty of defining and approaching sustainable development as an area of knowledge in Swedish schools.Sample: This article is based on semi-structured interviews with 40 teachers, 13 of whom were lower secondary school teachers (pupil age 12–15) and 27 were upper secondary school teachers (pupil age 15–18). The study involves teachers in all subjects where sustainable development is a goal in the syllabus. The study is also based on participant observation in one upper secondary class. A total of 17 different schools were involved, from a wide range of locations in Sweden.Design and methods: The paper builds on qualitative data and the analysis of transcribed interviews and group interviews with teachers in Swedish lower and upper secondary schools. Group interviews, involving three or more people, were conducted on eight occasions. The pupils at an upper secondary school were also observed while they were working on a course called ‘policy and sustainable development’. Data were transcribed and analysed thematically.Findings: The analysis suggests that, according to the teachers’ experiences, the demands of equivalence and measurability in school have increased and that this affects how sustainable development is approached in teaching and learning. Three main categories of knowledge were identified. The study also presents two representations that model how teachers may approach knowledge about sustainable development – metaphorically termed ‘the Accountant’ and ‘the Adventurer’ – and their different effects on knowledge.Conclusions: There is a tendency for complex knowledge areas such as sustainable development, which do not fit seamlessly into traditional curriculum subjects, to become oversimplified when translated into teaching situations. According to the representations that we described metaphorically, the teacher, as an accountant, is characterised by ‘knowledge instrumentalism’, which means that teachers administer knowledge and the pupils consume it. In this transactional model, the accountant is also very dependent on external governance and control. Alternatively, the teacher, as an adventurer, is characterised by authority, knowledge and self-control. In this model, knowledge sometimes grows in an unpredictable way in the meeting between people who share common experiences. For adventurers, sustainable development is a matter of commitment and awareness, and it involves an explicit stance. The metaphors can be placed on a continuum which describes how teachers manage the demands of the school system in relation to the knowledge area of sustainable development. 相似文献
Background: Research indicates that physical education teacher education (PETE) has only limited impact on how physical education (PE) is taught in schools. In this paper, our starting point is that the difficulties of challenging the dominating subject traditions in PE could be due to difficulties of challenging certain epistemological assumptions recurring in significant PETE subject matter and didactics courses.
Purpose: The purpose of this paper is to scrutinise how knowledge is expressed in learning outcomes formulated in curriculum documents at PETE institutions in Sweden and to discuss the potential educational consequences of the epistemological assumptions underlying the analysed expressions of knowledge.
Setting and participants: This paper offers possible explanations for the difficulties of influencing subject traditions in PE through analysing learning outcomes formulated in PETE curriculum documents. The analysis is based on 224 learning outcomes collected from a total of 18 course syllabi, spread at 6 PETE institutions in Sweden.
Research design, data collection and analysis: The documents have been collected through contact by e-mail with representatives for each institution. Through the analysis different themes in the material have been identified and clustered together. Inspired by Fenstermacher's ideas about teacher knowledge as propositional knowledge and performance knowledge, our ambition is to discuss the potential educational consequences of the epistemological assumptions underpinning the analysed learning outcomes.
Findings: In the collected learning outcomes, the following themes were identified: teaching PE, interpreting curriculum documents, physical movement skills, science, social health, pedagogy, critical inquiry, and research methods. In most of the identified themes, the learning outcomes represent both subject matter knowledge and general teacher knowledge and are also formulated with an integrated perspective on so-called performance knowledge and propositional knowledge. However, particularly in the themes science and physical movement skills, two very influential themes, the learning outcomes are limited to subject matter knowledge and the concept of knowledge in these themes is also limited and unilateral in relation to ideas of different forms of teacher knowledge.
Conclusions: We argue that a decontextualisation of knowledge, in this paper identified through dissolving science from its use in practice and through detaching physical movement skills from other conceptual foundations, contributes to the reproduction of subject traditions that render PE teachers incapable of critically reflecting over their practice, for instance how different groups of students benefit or suffer from the teaching of certain content. Drawing on the work of Tinning, we offer an explanation as to how teacher knowledge in the themes science and physical movement skills, emanating from behaviouristic and craft knowledge orientations, is formulated. 相似文献
AbstractStudies indicate that sport within youth institutional settings can be beneficial (e.g. learning social skills) or problematic (e.g. social exclusion) depending on how they are structured, delivered and, ultimately, experienced by students. In this article, we examine the experiences of students and staff in an educational sport program at a Swedish all-male youth detention home (ages 16–20) in order to increase understanding of the pedagogical approach of a sports-based program for detained youth. Drawing on interviews with both students and staff, we identify and elaborate four aspects of the program—building a pedagogical platform, ‘seeing’ and meeting students, creating a supportive environment, and thinking beyond the institution—that were collectively represented to initiate and guide a process of growth and change for students. We discuss how these aspects of the program’s pedagogical approach, in contrast to deficiency-based approaches, can provide a useful framework for delivering sport in ways that can benefit detained youth and other young people in socially vulnerable situations. 相似文献
