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Distriktssköterskans erfarenhet av Senior Alert : -En kvalitativ studieInger, Malmstedt, Louise, Rudenstam January 2017 (has links)
Bakgrund: Den äldre befolkningen ökar och allt fler kommer behöva sjukvårdande insatser i hemmet. Distriktssköterskan är en av flera vårdprofessioner som arbetar i hemsjukvården och ska arbeta hälsofrämjande och förebyggande. Det finns flera kvalitetsregister som är utvecklade för att användas i det hälsoförebyggande arbetet inom hälso- och sjukvården. Senior Alert är ett av kvalitetsregistren som är användbart hjälpmedel i hälsoförebyggande arbetet. Syfte: Att undersöka distriktssköterskans erfarenhet av Senior Alert och dess nytta inom förebyggande hälsoarbete i kommunala hemsjukvården. Metod: I studien användes kvalitativ innehållsanalys utifrån beskrivning av Elo & Kyngäs. Datainsamlingen utfördes genom semistrukturerade frågor och intervjuer gjordes på tretton distriktssköterskor inom den kommunala hemsjukvården i åtta kommuner i Sverige. Vid analysen av materialet användes induktiv innehållsanalys. Resultat: Tre huvudkategorier framkom, och stor betydelse och sex underkategorier. Konklusion: Deltagarna hade varierande erfarenhet av kvalitetsregistret Senior Alert. Det var svårt att få till implementering av kvalitetsregistret.
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Doing diabetes (Type 1) : symbiotic ethics and practices of care embodied in human-canine collaborations and olfactory sensitivityEason, Fenella January 2017 (has links)
The chronically ill participants in this study are vulnerable experts in life’s uncertainties, and have become aware over time of multiple medical and social needs and practices. But, unlike the hypo-aware respondents documented in some studies of diabetes mellitus Type 1, these research participants are also conscious of their inability to recognise when their own fluctuating blood glucose levels are rising or falling to extremes, a loss of hyper- or hypo-awareness that puts their lives constantly at risk. Particular sources of better life management, increased self-esteem and means of social (re-)integration are trained medical alert assistance dogs who share the human home, and through keen olfactory sensitivity, are able to give advance warning when their partners’ blood sugar levels enter ‘danger’ zones. Research studies in anthrozoology and anthropology provide extensive literature on historic and contemporary human bonds with domestic and/or wild nonhuman animals. Equally, the sociology of health and illness continues to extend research into care practices performed to assist people with chronic illness. This study draws from these disciplines in order to add to multispecies ethnographic literature by exploring human-canine engagement, contribution and narrative, detailing the impact each member of the dyad has on the other, and by observing the 'doing' of the partnerships' daily routines to ward off hypo-glycaemia and hospitalisation. In addition, the project investigates the place, role and 'otherness' of a medical alert dog in a chronically ill person's understanding of 'the-body-they-do'. The perspective of symbolic interactionism assists in disentangling individual and shared meanings inherent in the interspecies collaboration by examining the mutualistic practices of care performed. The often-flexible moral boundaries that humans construct to differentiate between acceptable use and unacceptable exploitation of nonhuman animals are questioned within ethics-of-care theory, based on the concept of dogs as animate instruments and biomedical resources.
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Biologia em temperaturas alternantes e exigências térmicas de Diaphorina citri Kuwayama, 1908 (Hemiptera: Liviidae) e Tamarixia radiata (Waterston, 1922) (Hymenoptera: Eulophidae) visando ao seu zoneamento em regiões citrícolas do estado / Biology in alternating temperatures and thermal requirements of Diaphorina citri Kuwayama, 1908 (Hemiptera: Liviidae) and Tamarixia radiata (Waterston, 1922) (Hymenoptera: Eulophidae), aimed its zoning in citrus-growing areas of São PauloVieira, Jací Mendes 18 May 2016 (has links)
A pesquisa teve por objetivo determinar o desenvolvimento, o número de gerações e a constante térmica de Diaphorina citri Kuwayama, 1908 (Hemiptera: Liviidae) e Tamarixia radiata (Waterston, 1922) (Hymenoptera: Eulophidae), sob 20 combinações de temperaturas alternantes que simulam as condições de Limeira, Tatuí, Araraquara, Santa Cruz do Rio Pardo e Votuporanga, áreas citrícolas do estado de São Paulo, nas quatro estações do ano. Paralelamente, discutem-se as estimativas dos períodos de liberação do parasitoide associados ao alerta fitossanitário desenvolvido pelo FUNDECITRUS. Foi estudado o desenvolvimento de D. citri e T. radiata, sendo registrado o tempo necessário para completarem o ciclo biológico. A partir destes dados, foi calculada a constante térmica e o número de gerações da praga e do parasitoide para cada uma das condições propostas. Com base na duração do desenvolvimento de D. citri, foi definido o momento ideal para liberação de T. radiata em campo. Os resultados da determinação do número de gerações de D. citri e de T. radiata, baseando-se em temperaturas alternantes, foram comparáveis ao modelo desenvolvido em temperaturas constantes, sendo que as variações existentes entre os dois modelos se deveram à inclusão do período de pré-oviposição que foi variável em função da temperatura. A previsão do número de gerações se ajustou mais a T. radiata do que a D. citri, sendo propostos fatores de correção para casos em que a constante térmica observada superou 10- 15% do valor determinado em laboratório. Observou-se que uma geração de D. citri variou de 22,9 a 74,2 dias, no verão e inverno para as simulações de Votuporanga e Tatuí, respectivamente; por outro lado, nas mesmas condições, uma geração de T. radiata pode variar de 9,8 a 21,6 dias. A relação entre o número de gerações de D. citri: T. radiata no decorrer do ano é superior a 1:2, sendo de 1: 2,58; 1: 2,47; 1: 2,28; 1: 2,28; 1: 2,34, respectivamente, para as simulações de Limeira, Tatuí, Araraquara, Santa Cruz do Rio Pardo e Votuporanga. A regressão linear mostrou que o número de gerações de D. citri é melhor explicado pela média das temperaturas diurna e noturna, enquanto que para T. radiata, apenas pela temperatura diurna. Os valores extremos de dias para liberação de T. radiata após o alerta fitossanitário, correspondem às regiões de Avaré e Bebedouro. Os resultados indicam que há uma variação no desenvolvimento da praga e do seu parasitoide entre as regiões e que há necessidade de validação em campo; no entanto, se confirmados, permitirão o uso mais eficiente do parasitoide T. radiata, se tornando um componente auxiliar ao sistema de alerta e ao Manejo Integrado dessa importante doença, o HLB. / This study determined the development, number of generations and thermal constant of the HLB vector Diaphorina citri Kuwayama, 1908 (Hemiptera: Liviidae) and the parasitoid Tamarixia radiata (Waterston, 1922) (Hymenoptera: Eulophidae) under 20 combinations of alternating temperatures that simulated the conditions of five citrus-growing areas of São Paulo state (Limeira, Tatuí, Araraquara, Santa Cruz do Rio Pardo and Votuporanga) in the four seasons. The estimated optimum release time of the parasitoid is discussed in relation to a phytosanitation alert developed by FUNDECITRUS. The development time and time needed to complete the life cycles of D. citri and T. radiata were assessed. The thermal constant and number of generations of the pest and parasitoid for each temperature condition were calculated based on these data. Based on the development time of D. citri, the optimum time to release T. radiata in the field was established. The estimated number of generations of D. citri and T. radiata in alternating temperatures was comparable to the model developed at constant temperatures; the differences between the two models were due to the inclusion of the pre-oviposition period, which varied as a function of temperature. The estimated number of generations was larger for T. radiata than D. citri, and correction factors were proposed for those cases in which the observed thermal constant exceeded 10-15% of the value determined in the laboratory. Generation times of D. citri ranged from 22.9 days in summer to 74.2 days in winter for the simulations for Votuporanga and Tatuí. Under the same conditions, one generation of T. radiata may range from 9.8 to 21.6 days. The ratio between the annual number of generations of D. citri: T. radiata was higher than 1: 2, ranging from 1: 2.58; 1: 2.47; 1: 2.28; 1: 2.28; 1: 2.34 for the simulations for Limeira, Tatuí, Araraquara, Santa Cruz do Rio Pardo and Votuporanga, respectively. Linear regression analysis showed that the number of generations of D. citri is best explained by the mean diurnal and nocturnal temperatures, whereas for T. radiata, only by the mean diurnal temperature. The extreme values for optimum release day of T. radiata after a phytosanitation alert were found for Avare and Bebedouro. The results indicate that the development of the pest and its parasitoid differ among areas, and there is need for validation in the field. However, if confirmed, these data will allow more efficient use of the parasitoid T. radiata as a complementary component of the alert system and of Integrated Management of HLB.
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Estudo das notificações relacionadas aos medicamentos de alto risco em um hospital terciário / Study of the notices related to high alert medications in a tertiary hospitalReis, Débora Alves 16 November 2016 (has links)
INTRODUÇÃO: O tema segurança do paciente ganhou importância a partir da publicação dos Estudos Harvard I e II, e dimensão pública a partir do livro To Error is Human pelo Institute of Medicine em 1999, onde são apresentados números alarmantes sobre erros durante o processo do cuidado em saúde. Esses estudos demonstram que os erros com medicamentos são a causa mais frequente de incidentes em pacientes internados. O Institute for Safe Medication Practices (ISMP), uma organização que se dedica à prevenção de erros de medicação e ao uso seguro dos medicamentos publicou em 1989 a primeira lista de medicamentos reconhecidos como perigosos. Em 1995, o ISMP avaliou os erros notificados com medicamentos quanto à gravidade e os danos causados no Medication Error Reporting and Prevention (MERP). Após este estudo, o termo \"High Alert Medication\" foi adotado para designar um grupo de medicamentos mais relacionados a danos graves ou fatais quando ocorre alguma falha no seu processo de utilização. No Brasil estes medicamentos são conhecidos como Medicamentos de Alto Risco, Medicamentos de Alta Vigilância (MAV) ou Medicamentos Potencialmente Perigosos (MPP). OBJETIVOS: Avaliar a ocorrência de incidentes com medicamentos de acordo com a classificação MPP e suas variáveis no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP - USP), nos anos de 2013 e 2015. MÉTODOS: Estudo transversal descritivo retrospectivo com abordagem quantitativa dos incidentes notificados ao Núcleo de Segurança do Paciente relacionados aos MPP. RESULTADOS: Durante o ano de 2013, foram notificados 28% de incidentes envolvendo MPP na unidade Campus e 37,5% na Unidade de Emergência (UE). Os medicamentos quimioterápicos foram os mais notificados e com as maiores Taxas de Incidência (TI) na unidade Campus; o cloreto de potássio foi o mais notificado e com a maior TI na UE. A etapa de prescrição foi a mais notificada nas duas unidades. Utilizando a classificação ATC, os subgrupos terapêuticos que mais atingiram o paciente foram Análogos da Purina, Análogos do Ácido Fólico e Nutrição Parenteral (Campus); Insulina e Análogos Injetáveis, Outras Preparações Cardíacas foram os mais notificados na UE. Em 2015, os percentuais de notificações com MPP foram 8,8% (Campus) e 31,7% (UE). Nesse ano, os medicamentos mais notificados foram o cloridrato de tramadol e a enoxaparina nas duas unidades. Na unidade Campus a etapa de dispensação foi a mais notificada, e etapa de administração na UE. Os subgrupos com maiores TI foram Agentes Alquilantes, Anti Histamínico para Uso Sistêmico e Agente com Ação no Músculo Liso Arteriolar (Campus); na UE, Antiarrítmico, Classe III e Analgésico Opióide. CONCLUSÃO: A classificação MPP pode padronizar a atuação do farmacêutico clínico, além de prover indicadores clínico-gerenciais que auxiliem no desenho de processos proativos de prevenção de erros de medicação. / INTRODUCTION: The patient safety issue gained importance from the publication of Harvard Studies I and II, and public dimension from the book To Error is Human by the Institute of Medicine in 1999, which presents the alarming dates about errors during the process of healthcare. These studies demonstrate that the errors with medications are the most common cause of incidents in hospitalized patients. The Institute for Safe Medication Practices (ISMP), an organization dedicated to the prevention of medication errors and the safe use of medication published in 1989 the first list of recognized dangerous drugs. In 1995, the ISMP evaluated the reports of drugs errors according the severity and damage to the Medication Error Reporting and Prevention (MERP). After this study, the term \"High Alert Medication\" was adopted to designate a group of drugs more related to serious injury or death occurs when a fault in its usage. In Brazil, these drugs are known as high-risk drugs, high alert medications or potentially dangerous drugs. OBJECTIVES: Analyze the occurrence of reported incidents involving the high alert medication and its variables at the Hospital of Ribeirão Preto Medical School, University of São Paulo (HCFMRP - USP) in the years 2013 and 2015. METHODS: Retrospective descriptive cross-sectional study with a quantitative approach of the reported incidents to the Patient Safety Center related to high alert medication. RESULTS: During the year 2013 it was reported 28% of incidents involving high alert medication in the Campus Unit (CU) and 37.5% at the Emergency Unit (EU). Chemotherapeutic drugs were the most reported and with the highest Incidence Rates (IR) (CU) and 19.1% potassium chloride was the most commonly reported and the largest IR in the EU. Prescription stage was the most reported in both units. Using the ATC classification, therapeutic subgroups most reached the patient were Purine Analogues, Folic Acid Analogues and Parenteral Nutrition (CU), Insulin and Analogs for Injections and Other Cardiac Preparations (EU). In 2015, the percentage of notifications with high alert medication was 8.8% (CU) and 31.7% (EU). The most reported drugs were tramadol hydrochloride and enoxaparin in both units. On CU dispensing stage was the most notified and administration stage in the EU. Subgroups with higher IR were Alkylating Agents, Antihistamine for Systemic Use and Arteriolar Smooth Muscle, Agent Action On (CU) and Antiarrhythmic, Class III and Analgesic Opioid (EU). CONCLUSION: The MPP classification can standardize the performance of the clinical pharmacist, and provide clinical and management indicators to assist in the proactive process design to prevent medication errors.
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Signální psi a jejich využití u osob s diabetes mellitus / Signal alert dogs and their use in people with diabetes mellitusZemanova, Monika January 2019 (has links)
The theses is focused on diabetic alert dogs, which create impact on compensation of diabetes mellitus. Differences in topic's between Czech republic and USA is compared based on questionnaire. Part of diploma thesis is also short questionnaire dedicated for members of Czech republic parliament. The aim of thesis is to extend public knowledge about diabetic alert dogs in Czech republic. To compare knowledges about this topic between Czech republic and USA and to compare number of owners of diabetic alert dogs in Czech republic and USA. Analysis was done by using selected method of questionnaire targeting this topic. Questions were related to people suffering from diabetes mellitus in Czech republic and USA. Second anonymous questionnaire was prepare for members of Czech parliament and their knowledges about this topic. Structualized interwievs with people suffering from diabetes were conducted only for additional information. Key words signal alert dogs, diabetes mellitus, assistance dogs, assistive device
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如何運用DEFCON建立銀行放款品質之預警系統 / The application of DEFCON as an alert system to non-performing-loan management in the banking industry李貞慧, Lee, Demi Unknown Date (has links)
The study attempts to apply the DEFCON Concept as an early alert system to Non-Performing-Loan (NPL) Management in Taiwan’s Banking Industry.
The recent financial crises in South East Asia have stimulated a significant body of empirical research on the subject of potential leading indicators for banking crises. Specifically, a number of statistical models have been developed to provide early warning signals of impending risks and also the relationship between the NPL and those leading indicators.
The purpose of this study is to 1) Explain the definition of DEFCON and the application of DEFCON in the banking industry, 2) The literature review is on the correlation between Non-Performing Loans and Macroeconomic variables, giving particular importance to regression models. 3) The methodology of DEFCON Planning includes the data used, variables selection via the coefficient analysis, a simple regression model and usage of the selected variables to set the DEFCON triggers 4) Ultimately, to help aid in what Bank’s can undertake under different levels of DEFCON to prevent potential loss.
Our empirical results show that 1) Economic Growth Rate 2) the Leading Index 3) Bounced Check Rate, 4) Shinyi Housing Index 5) Unemployment Rate 6) Consumer Price Index 7) Consumer Debt 8) M1B currency supply and 9) Unemployment Rate, are the leading indicators that predict Taiwan’s NPL ratio; however, it is prudent to note that the NPL ratio may be manipulated by banks, and may result to inaccurateness in some indictor’s prediction of the model. It is imperative that constant monitoring be the practice to ensure the effectiveness of the model.
The Banks in Taiwan should monitor the overall DEFCON status periodically and use it as early alert system and take proactive actions based on the level of economic deterioration (DEFCON level) to well manage their asset and reduce NPL.
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Analysis of RED ONE Digital Cinema Camera and RED WorkflowForoughi Mobarakeh, Taraneh January 2009 (has links)
<p>RED Digital Cinema is a rather new company that has developed a camera that has shaken the world of the film industry, the RED One camera. RED One is a digital cinema camera with the characteristics of a 35mm film camera. With a custom made 12 megapixel CMOS sensor it offers images with a filmic look that cannot be achieved with many other digital cinema cameras.</p><p>With a new camera comes a new set of media files to work with, which brings new software applications supporting them. RED Digital Cinema has developed several applications of their own, but there are also a few other software supporting RED. However, as of today the way of working with the RED media files together with these software applications are yet in progress.</p><p>During the short amount of time that RED One has existed, many questions has risen about what workflow is the best to use. This thesis presents a theoretical background of the RED camera and some software applications supporting RED media files. The main objective is to analyze RED material as well as existing workflows and find the optimal option.</p>
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STCA : an aircraft conflict alert system / STCA : ett varningsystem för konflikter mellan flygplanNorén, Bång Ola January 2004 (has links)
<p>The purpose of this Master’s Thesis is to produce a specification for the aircraft conflict alert system STCA, and implement a prototype as a module in the air traffic surveillance system NOVA9000. </p><p>The specification is constructed based on functional requirements from EUROCONTROL and describes a system using a nominal trajectory method, where the future paths of aircraft are estimated. The trajectory is created using a probabilistic approach, where future positions are described with probability fields. </p><p>The prototype is implemented using the specification with some simplifications. The prototype is evaluated using recorded traffic from a heavy air traffic region surrounding an airport with parallel runways. 15 alerts were induced in 1,5 hour of morning traffic; this is far too much to be acceptable. Improvements are proposed and explanations to the high rate of alerts are made.</p>
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POLITICHE DELLA SICUREZZA E ALLERTE ALIMENTARI NELL'UNIONE EUROPEALOZZI, NICOLE 22 April 2010 (has links)
La tesi ha come finalità lo studio della sicurezza alimentare e del suo sistema di controllo nel contesto europeo. Per sicurezza alimentare qui s’intende da un lato, quell’insieme di disposizioni e di procedure previste dal legislatore, atte a garantire che gli alimenti a rischio non siano immessi sul mercato; dall’altro quel meccanismo predisposto per individuare i problemi di sicurezza degli alimenti e agire di conseguenza. Sicurezza alimentare, intesa dal punto di vista normativo, è sia l’ampia gamma di disposizioni che hanno un’incidenza diretta o indiretta sulla sicurezza degli alimenti e dei mangimi (come ad esempio i provvedimenti sui materiali e gli oggetti a contatto con gli alimenti, sui mangimi e su altri mezzi di produzione agricola a livello primario), sia un vero e proprio sistema inteso come meccanismo o insieme di procedure pensate per garantire la sicurezza degli alimenti. Tale apparato di tutela opera, tenendo in considerazione tutti gli aspetti della catena di produzione alimentare, come un unico processo, partendo dalla produzione, passando attraverso la trasformazione fino ad arrivare alla distribuzione e vendita dei prodotti.
Oggetto principale di questa tesi è l’analisi del sistema di controllo alimentare, poiché non solo elemento integrante, ma soprattutto presupposto della sicurezza stessa. Precisamente, in Europa il sistema di sorveglianza si presenta come un meccanismo di allarme rapido per la notificazione di un rischio diretto o indiretto per la salute umana dovuto ad alimenti o mangimi, una sorta di rete di collegamento cui partecipano gli Stati membri, la Commissione Europea e l’Autorità per la sicurezza alimentare / The idea of research comparing the legal and policy choices which form the basis for the current agrofood safety systems derive from the observation of several cases of “food emergency”(such as BSE, dioxin contamination , bird flu, GMOs) and food alert, which occurred in the recent European history and have caused reactions and worries in public opinion. The study of the above mentioned events and the reflection upon the attitudes and the decisions about food safety made by the European Union institutions raised many different questions. First of all I wondered if this is only a European phenomenon or if it may also apply to overseas countries like the USA. I also wanted to investigate about science regulation policies ruling the safety system born to face feared or evident risks for public health (as a consequence of BSE), i.e. to understand how scientific knowledge is used in legal and policy choices and which are the political and social consequences. In effect, the emergencies, risks and uncertainties caused by the social implementation of science have increased the gap between society and institutions both at national and community level, generating mistrust not so much of scientific and technological progress but of the institutions themselves. The public isn’t only worried about “safety” meant as the likelihood of a damage occurring, but also about the unexpected social effects neglected by the institutions. Europe expressed its concerns about these situations by trying to fill the gap from different perspectives : • new governance of science; • subsequent new regulatory and policy model of science; • expertise and its credibility; • more collective decision making processes Such steps are fundamental to generate and new idea of science governance which connects the need of a more democratic science with that of a more involving society . The Democratization of science implies the acquisition by institutions of several scientific opinions involving all of the aspects of knowledge in order to obtain decisions making processes meeting social needs and, consequently, closer to citizens.
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Re-Evaluierung, methodische Optimierung und weitergehende Charakterisierung der Empfindlichkeitstestung von Mycobacterium tuberculosis mit dem BacT/Alert 3D (bioMérieux)Knigge, Anna Sophie 07 April 2014 (has links) (PDF)
Es erfolgte die Re-Evaluierung der Empfindlichkeitstestung von Tuberkuloseerregern mit dem BacT/Alert-3D-System (bioMérieux) unter besonderer Berücksichtigung des Materialwechsels der Kulturflasche von Glas auf Plastik. Dazu wurden insgesamt 61 vergleichende MHK-Bestimmungen mit diesen beiden Flaschentypen durchgeführt, wobei sechs Antituberkulotika (INH, RMP, EMB, SM, PTH und MOX) sowie zwölf Mykobakterienstämme (davon neun Mtb.) untersucht wurden. Dabei findet sich kein Unterschied in den MHK-Werten zwischen Glas- und Plastikflaschen. Die Plastikflaschen sind folglich ebenso wie die Glasflaschen zur Empfindlichkeitstestung von Tuberkuloseerregern mit dem BacT/Alert-3D-System geeignet. Bei der bisherigen Methode wurde bei der PZA-Testung auf die Verwendung der Kontrollflasche zur Festlegung der Untersuchungszeit verzichtet, weil der erniedrigte pH-Wert ein unverhältnismäßig langsames oder gar fehlendes Wachstum in dieser Flasche bewirkt. Durch Optimierung von pH-Wert (pH 5,9) und PZA-Testkonzentration (200 mg/l) wurde erreicht, dass die PZA-Testung nach der gleichen Methode wie auch bei den anderen Antituberkulotika praktiziert, durchgeführt werden kann. Im weiteren wurde untersucht, wie hoch der Anteil resistenter Mutanten in Mischkulturen sein muss, um erkannt zu werden. Dazu wurden dem sensiblen Stamm H37Rv jeweils isogene Mutanten mit Monoresistenzen gegen INH, RMP oder SM bzw. EMB- und PZA-resistente Stämme in verschiedenen Anteilen zugesetzt. Es zeigte sich, dass ein Anteil von 1% resistenter Stämme noch nicht sicher detektiert wird. / The purpose of this paper is to optimize and reevaluate the methods of susceptibility testing of M.tuberculosis with the BacT/Alert 3D System (bioMérieux). The key aspect was the comparison between culture bottles from glass between those made out of plastic material. Therefore 61 comparative MIC-tests were carried out, with six antituberculous drugs (INH, RMP; EMB, SM, PTH and MOX) and twelve mycobacterial strains (nine Mtb.) in order to compare the MIC in the two different bottle types. The MIC of 40 comparative tests between plastic culture bottles were identical to those in glass material. Only 18 test results deviated between the two bottle types. In each of those tests the discrepancy was only one degree of dilution, which is considered as not relevant. Resistant strains were found in three tests, with no difference between glass and plastic bottles. The deviant twelve results of Mtb. strains show a six times higher MIC-value in plastic bottles and a six times lower MIC in plastic bottles. In the case of the substance INH all four discrepant results had a higher MIC in the plastic bottle. Since these results were known by the Institut für Medizinische Mikrobiologie und Infektionsepidemiologie of the University Leipzig, it was consequently used with good results in the laboratory routine, as well as in external quality control (INSTAND-Ringversuche 2009 to 2011).
The second topic of this study was to optimize the current method of susceptibility testing of Mtb. concerning pyrazinamide (PZA). In the current method the low pH of the dilution (5.5) with the resulting weak growth of the strains forced the laboratory assistant to abandon the 1% control bottle as endpoint of measurement. The new and optimized pH of 5.9 and a concentration of PZA of 200 mg/l allows the susceptibility testing of PZA with the same method as practiced for the other antituberculous drugs.
Yet another focus of this study was the sensitivity of the BacT/Alert 3D System to detect heteroresistant clones in the mycobacterial broth. Resistant clones and fully susceptible Mtb. strain (H37Rv) were mixed in different percentages and susceptibility testing was performed. It could be shown, that a secure detection of resistant clones is not possible at a percentage 1% of resistant clones in the culture.
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