Reliability of Reflotron in Testing of Total Cholesterol

Reliability of Reflotron in Testing of Total Cholesterol Reliability of Reflotron in Testing of total Cholesterol and Urea in Non- centralized Medical Setting Introduction Point-of-care testing (PoCT) has been defined as â€Å"those analytical patient-testing activities provided within the institution, but performed outside the physical facilities of the clinical laboratories (1). There has been a growing interest in point-of-care testing (PoCT) because of its advantages over standard laboratory procedures, it provides timely information to medical teams, facilitating rational, time-critical decisions, and has been demonstrated to improve patient outcomes in critical care settings (2). At least a dozen portable cholesterol and urea testing instruments have been designed for use in community and office settings. These instruments have made mass screenings for these risk factors feasible and thus are now in widespread use for this purpose (3). Dyslipidemia; including both hypercholesterolemia and hypertriglyceridemia represent significant risk factors for the development of peripheral artery diseases and negative health outcomes (4, 5). High blood cholesterol increases the risk of heart disease, is a major modifiable risk factor, and contributes to the leading cause of death in the USA (6,7). Chronic kidney disease (CKD) is now recognized as a major world-wide health problem (8). A method for the estimation of the urea in blood coming from individual organs and for clinical purposes must be efficient when only small quantities of blood can be obtained (9). Aim of work: In Arar city many non- centralized Medical Setting used Reflotron for medical analysis and diagnosis disease. The purpose of this study was to assess the validity of Reflotron in the testing of total cholesterol and urea for screening and diagnosis in Arar city. Methods: Cross sectional study held in Arar city in the period from 1 November 2013 to 10 November 2013, 30 blood sample was taken and measured by Reflotron apparatus and the results was rechecked by Dimension RXI MAX apparatus to compare between the results between 2 methods. Approximately 20ml of blood was collected from each participant, after fasting for 12h, using standardized venipuncture techniques in the antecubital vein in the bend of the elbow. In order to overcome technician error, two drops of blood (30ÃŽ ¼l) were collected immediately from the previously drawn venous sample by drawing blood into the capillary tube from the opening in the top of the venous tube before centrifuging the venous sample, rather than ‘sticking’ the finger. Statistical analysis was done by SPSS 20 and suitable statistical methods were used, p Results: Table (1): Comparison between Reading of Reflotron and Dimension RXI MAX test: Table 1 shows that the mean of urea was 65.22 ±46.3 by Dimension RXI MAX apparatus while it was 63.73 ±41.1 by Reflotron, as regards Total cholesterol mean by Dimension RXI MAX and Reflotron was 150.04 ±38.9 and 167.7 ±40.3 respectively, the difference between the reading of the two apparatuses was not statistically significant in both Urea and cholesterol. Table (2): Mean Percent of change between Reflotron and Dimension RXI MAX test in urea and cholesterol Table 2 shows that the mean percent of change between Reflotron and Dimension RXI MAX test in urea and cholesterol was -0.4% and 12.5% respectively Discussion The Reflotron has been marketed aggressively for use in community screening programs. The marketing has focused heavily on the instrument’s relatively low cost, ease of operation, and accuracy. This strategy has resulted in the widespread use of this instrument in blood cholesterol screenings. The Reflotron has been studied previously using various settings, sample sizes, and methodologies (10). This study compared the same blood sample using dry chemistry by the portable analyzer Reflotron plus and wet chemistry by Dimension RXI MAX apparatus. The MultiCare systems are pocket-sized reflectance photometers, in which the intensity of the color developed from a chromogen reaction being proportional to the concentration of the cholesterol or urea in the blood. The results of the MultiCare method compared with the reference method demonstrated good agreement between the 2 methods, the difference between the reading of the two apparatuses was not statistically significant in both Urea and cholesterol with a mean difference of 12.5% and –0.4% for cholesterol and urea, respectively. The availability of POCT lipid monitors has increased in recent years, any POCT must be validated for bias and imprecision to ensure that appropriate medical decisions and population screenings are made (11-17). The National Cholesterol Education Program (NCEP) in the United States recommended bias goals of 3% and 5% for cholesterol and triglycerides, respectively. Conclusion: The portable analyzer Reflotron provided clinically relevant underestimations of total cholesterol values comparison with Dimension RXI MAX, whereas, urea values urea values satisfied. Consequently, lipid values obtained using the Reflotron may be useful for screening, but the Reflotron should not be used as a diagnostic tool. Urea values useful for screening and diagnosis kidney diseases . References U.S. Department of Health and Human Services, National institutes of Health. Point-of-Care Diagnostic Testing Fact Sheet. Jul 2007. Birkhahn RH, Haines E, Wen W, Reddy L, Briggs WM, Datillo PA (2011). Estimating the clinical impact of bringing a multimarker cardiac panel to the bedside in the ED. Am J Emerg Med, 29(3):304-8. Havas, Stephen; Bishop, Robert; et al Performance of the Reflotron in Massachusetts Model System for blood cholesterol screening program. American journal of public health; Mar 1992;82,3, ProQuist central. Davis, C.L., Harmon, W.E., Himmelfarb, J., Hostetter, T., Powe, N., Smedberg, P., Szczech, L.A. and Aronson, P.S. 2008: World Kidney Day 2008: think globally, speak locally. Journal of the American Society of Nephrology 19, 413–16. Sullivan DR. Screening for cardiovascular disease with cholesterol. Int J Clin Chem 2002;315:49–60. State-specific cholesterol screening trends-United States, 1991–1999. MMWR Morb Mortal Wkly Rep 2000;284: p. 1374–5. Cheng AY, Leiter LA. (2006). Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Curr Opin Cardiol 21(4):400–404. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001).Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285:2486–2497. Volles DF, McKenney JM, Miller WG, Ruffen D, Zhang D. Ana- lytic and clinical performance of two compact cholesterol-testing devices. Pharmacotherapy 1998;18:184–92. Havas S, Bishop R, Koumjian L, Reisman J, Wozenski S.Performance of the Reflotron in Massachusetts’ model system for blood cholesterol measurement. Am J Public Health 1992;82:458–61. Shephard MD, Mazzachi BC, Shephard AK. Comparative perfor- mance of two point-of-care analysers for lipid testing. Clin Lab 2007;53:561–6. Stein JH, Carlsson CM, Papcke-Benson K, Einerson JA, McBride PE, Wiebe DA. Inaccuracy of lipid measurements with the portable Cholestech L.D.X analyzer in patients with hypercho- lesterolemia. Clin Chem 2002;48:284–90. du Plessis M, Ubbink JB, Vermaak WJ. Analytical quality of near- patient blood cholesterol and glucose determinations. Clin Chem 2000;46:1085–90. Gottschling HD, Reuter W, Ronquist G, Steinmetz A, Hattemer A. Multicentre evaluation of a non-wipe system for the rapid determination of total cholesterol in capillary blood, Accutrend Cholesterol on Accutrend GC. Eur J Clin Chem Clin Biochem 1995;33:373–81. Laboratory Standardization Panel of the National Cholesterol Education Program. Current status of blood cholesterol measurement in clinical laboratories in the United States: a report from the Laboratory Standardization Panel of the National Cholesterol Education Program. Clin Chem 1988;34:193–201. Carey M, Markham C, Gaffney P, Boran C, Maher V. Validation of a point of care lipid analyser using a hospital based reference laboratory. Ir J Med Sci 2006;175:30–5. Luley C, Ronquist G, Reuter W, et al. Point-of-care testing of triglycerides: evaluation of the Accutrend triglycerides system. Clin Chem 2000;46:287–91.

Online Classes versus Traditional Classes Essay

Technology and education has given students many choices in how they obtain their education such as online classes. There have been numerous discussions recently about the success of online learning. The success of the online classes versus traditional classes is based upon the uniqueness of each individual way of learning. Online classes and traditional classes provide flexibility, direct communication and course materials. Studies have shown that online classes can be successful and that on average most students perform better than being in a traditional classroom. The argument of online classes and traditional classes; which is better than the other has many exceptional differences. One is the discussion of how does a person learn: is he a visual, auditory or kinesthetic learner? A visual leaner needs written materials, exercises and graphics. An auditory learner has to hear it, repeat it and needs to have a discussion. A kinesthetic learner needs real life simulations, hands on demonstration and needs to see how the principle works. Visual learners and kinesthetic learners most likely would be more successful in online courses because of the atmosphere it provides. Auditory learners would need to have traditional classes which would provide the best learning opportunity for their learning style. There are cases that individuals do not know how they learn best; an assessment should be given in the situation. The second discussion is flexibility. Online classes and traditional classes both can be just as flexible as the other. Online classes may seem more flexible but depending on the class the deadlines of each assignment may be very time consuming. Online classes sometimes provide more work than traditional classes. Traditional classes can be flexible due to the times that you select to take the classes. Schools are providing more night classes and early morning classes for the working and family-oriented students. Traditional classes provide more lecturing and sometimes more hands on in order to teach the concepts. The third discussion is communication. Online classes communicate by sending  and receiving emails. Some classes have chat rooms for discussions which provide the students opportunities to enrich their understanding of the course or subject being discussed. It also allows those individuals that normally would not speak in discussions to express their thoughts. The instant transfer of material is convenient for the students and professors to communicate. A traditional class allows students to verbally exchange ideas and ask questions directly to the professors. Sometimes this environment does not allow the students to fully express themselves due to time constraints. Some people feel that there are communication barriers in a face to face classroom setting due to time and class structure. (Anderson) One of the most important debates between the two classes is the course materials. The question has been asked if the online course is giving adequate material to teach an individual a lesson. Studies show that online professors give more than enough resources to express the subject and also gives practice graded material to ensure that the student understands. Traditional classes have been accused of doing the opposite and taking for granted that the students are in their presence and extra resources are sometimes a rarity. Online classes allow a person to minimize their distractions and it gives them the ability to fully concentrate on the material they are presented with. A person that enrolls in an online course should be self-motivated in order to be in an environment that requires the individual to monitor themselves and be responsible to handle the course as if it was a traditional course. (Kassop) Online courses provide the ability to be accessible at all times but the work that is required should be quality work. The students’ writing ability will enhance because this is their only form of communication. (Kassop) The professors do not expect students to procrastinate because of the accessibility but the possibility is there. The professors of these courses expect more from the online students since there are not time restraints. Online students have the ability to form small groups to relate to because the workload in online course is difficult. The workload is believed to be difficult be cause of the apparent reason of teaching themselves. Traditional classes allow students social interaction which is a vital piece for many students. There is a set amount of time in a classroom setting and there is limited one on one interaction with the professor. Professors have the ability to read their students body language to assure them if the material or concept is being understood by his or her students. Traditional classes also allow students to get behind if they miss a day or an assignment. The traditional classroom allows the students to strengthen various areas of their social skills such as verbally expressing themselves in classroom discussions. There are differences and similarities in online courses and traditional courses. Throughout are reading and research there can be two conclusions: 1. Online courses are better than traditional courses if the individual is discipline to take the course. 2. Online courses and traditional courses are just as good as the other because they both have the same goals and are achieving the goals to the students that are willing to receive. Works Cited Anderson, Terry, & Elloumi, Fathi Theory and Practice of Online Learning (eds.) (2003) http://cde.athabascau.ca/online_book Angiello, Roanne. â€Å"Study Looks at Online Learning vs. Traditional Instruction.† Education Digest 76.2 (2010): 56-59. Academic Search Premier. EBSCO. Web. 30 Nov. 2010. Diaz, D.P.,& Cartnal. R.B. Students’ learning styles in two classes: Online distance learning and equivalent on-campus. College Teaching 47(4), 130-135 Kassop, Mark. The Technology Source. May/June 2003. 6 August 2011

The Kiss Klimt

The Kiss Gustav Klimt The Kiss is a work that was painted by the Austrian artist, Gustav Klimt, between the years 1907 and 1908. Klimt utilizes his personal experiences and life changes as his inspiration for the creation of perhaps his most famous work yet. He links modernity and eroticism at the center of his work, the couple’s embrace. This embrace is a quintessential expression of one of the deepest passions known to mankind, sensual love. Klimt’s color choices, use of depth, line, and balance, are all techniques that contribute to the message he is trying to convey.This couple’s love radiates passion at its strongest, the love between man and woman, and the disconnect from reality they experience as they embrace. In order to understand the meaning behind The Kiss, one must know a little bit about the artist’s history. Klimt was born on July 14, 1862 in Baumgarten near Vienna. He studied architectural painting at the Vienna School of Arts and Crafts. B y 1880, Klimt and his brother collaborated and began working together. As a result, they garnered the attention of many new clients. Eventually, Klimt embarked on his own career path and started his professional painting career.He began by painting interior murals and ceilings in large public areas. In 1888, Klimt was even awarded for the murals he painted in Burg Theater. This particular mural portrayed the Golden Order of Orders from the empire of Franz Josef I of Austria. Klimt’s success and joy was quickly followed by tremendous grief when his brother and father tragically passed away, leaving him financially responsible for his family. As a result of this tragedy, Klimt’s art began to reflect the sadness and difficulty he was experiencing in his personal life.He continued on this path for a while, until he created The Kiss. Some say this painting was his magnum opus, his greatest work. Society immediately fell in love with his work, and he quickly regained his suc cess. In this work, Klimt illustrates two figures, one male and one female. They are entangled in what seems to be a passionate embrace at the center of the work. Their love immediately becomes the focal point. Their gilded clothing beams as it pulls the viewer deeper into the center of the painting, the very essence of work, the kiss itself.It quickly lets the viewer know that this is the main focus of the painting. The entanglement of shapes initially blends the lovers’ bodies into one, exposing only their hands, feet, and faces. However, when more closely examined, the viewer can see that there is a separation. Klimt uses rectangles and squares on the male figure, and more rounded and circular shapes on the female figure. So in spite of the fact that the figures are intertwined, and almost seem as one, the variations of the geometric rectangles and the organic flower pattern illustrates each figure as a separate entity.This juxtaposition between jagged and soft can also be viewed as a metaphorical representation of the contrast between the rough nature of man versus the sensitive nature of woman. Their tight embrace clearly expresses sensuality and intimacy, the powerful connection that only lovers can experience. This power is enhanced by Klimt’s use of color. Just as he juxtaposes contrasting jagged and soft shapes, he creates contrast through the juxtaposition of earth tones and vibrant colors against a golden background. Despite the array of colors and shapes that make up the majority of the painting, the focal point remains distinct.As mentioned previously, their emotion radiates. The couple’s faces are essentially all that is needed to portray Klimt’s message. Their positions create an extra element of interest within the painting. The man’s face is hidden, and only a quarter view is shown. This indicates a euphoric state as he is lost in the bewilderment of love. The women’s face, however, is in full view. He r expression reveals a sense of tranquility and satisfaction. Her eyes are closed as she allows herself to enter into this euphoric state as well.Her cheeks are flushed, hinting a climactic moment in her embrace with her lover. Color and technique is another major aspect of The Kiss. In creating this painting, Klimt gained inspiration from his travels to the Byzantine, the mosaics in Ravenna in particular. This inspiration is reflected in his use of gold and the arrangement of shapes. While the majority of the painting was done using golden hues (he uses actual gold leaf to achieve this affect), Klimt manages to apply all of the colors necessary to achieve intrigue and convey his message clearly.He uses vibrant colors such as; blue, purple, and green in the flowerbed. He strategically uses the gold by integrating it into the robes and vines that swathe over the figures and over the woman’s feet. He continues his theme of contrast and juxtaposition in his use of complimentary colors. The green in the flowerbed contrasts with the red in the woman’s dress, making her dominate and stand out. This contrast is even shown in the skin tones of the figures. The man has an olive complexion and the woman has a peach complexion, making her stand out even more.An additional component is Klimt’s use of depth. He uses a variety of sizes among his shapes to emphasize the curves of the figures’ bodies. The flowerbed beneath the figures indicates Klimt’s use of perspective. He allows the line of grass to blur, giving the illusion of space. The Kiss remains unique, unlike most of Klimt’s other work. Unlike the portrayal of women as femme fatales in his other paintings, Klimt portrays the woman in The Kiss as the protagonist. This is illustrated through the full view of her face, as well as the color of her complexion.Since the male is painted in deeper hues, it gives him a more dominant role. This is also illustrated by the way he stands over the kneeling woman and how he pulls her face over towards him. As one of Klimt’s most famous paintings, The Kiss is arguably a perfect composition of shape, color, line, and scale. Unfortunately, I have not had the privilege of seeing The Kiss in person, yet I still felt the intensity and passion that is illustrated in the painting. I was originally drawn to research this particular work because of its color and beauty.Only once I began to dissect the painting’s individual attributes did I discover that it is so much more than just a beautiful painting. It is a representation of love, the most passionate emotion of all. What originally began as awe and reverence for the artist, became envy towards the lovers. It makes me long to experience passion and love as the couple does in Klimt’ work. His genius is evident in his technique, but more so, in his ability to evoke an emotional response in the viewer.

Leadership, Communication, And Problem Solving Career Center

Eight Weeks that Changed My Life Deciding to go back to college was simple, just a few years of some college classes and I would have that ever elusive Bachelor’s degree – my first eight weeks of college, not as simple! Learning the materials taught in my courses has not only provided me with information about leadership, organizations and information technology, it has taught me so much about myself that I am changing my degree and career goals in order to find a career path that focuses on my strengths in leadership, communication and problem solving. Career Center Resources CSU Globals extensive Career Center offers many valuable resources to their students. Their Job Center, located within the Career Center provides students with†¦show more content†¦Taking and researching the Meyers-Briggs personality test has absolutely changed my life in many ways. Most drastically is the shift I have made from pursuing a Management Information Sciences and Business Analytics Degree, to a Business Management with HR specialization degree. I have always been highly driven by aspiration and very eager to realize it, however I never had the ability to identify the strategy for accomplishing my success (Krishna, 2014). Working inside the Career Center and exploring the tools provided to me provides, perhaps for the first time in my life, the tools necessary to become successful. Throughout my life, my careers have been based on what was offered to me, instead of what I was seeking. Understanding that as an ENTP I am able to adapt to most situations, quickly master new concepts and all while building meaningful relationships, helped me to see that just because I am really good at a particular task does not mean I should do it as a full time career. The boredom I will inevitably experience along with the day to day detailed tasked that will pile up may cause me to lose focus and eliminate me from being as successful as possible. As long as I stay honest with myself about my strengths and weaknesses, instead of trying t o handle everything, I will thrive in any career that is in need of a new way of thinking (16 Personalities, 2015). The Path to CSU Global In January of 2010 I moved from the state of