RESUMEN
DNA assays for viral load (VL) monitoring are key tools in the management of immunocompromised patients with cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection. In this study, the analytical and clinical performances of the NeuMoDx™ CMV and EBV Quant Assays were compared with artus CMV and EBV QS-RGQ Kits in a primary hospital testing laboratory. Patient plasma samples previously tested using artus kits were randomly selected for testing by NeuMoDx assays. The NeuMoDx CMV Quant Assay and artus CMV QS-RGQ Kit limits of detection (LoDs) are 20.0 IU/mL and 69.7 IU/mL, respectively; 33/75 (44.0%) samples had CMV DNA levels above the LoD of both assays. The Pearson correlation coefficient was 0.9503; 20 samples (60.6%) had lower NeuMoDx CMV quantification values versus the artus kit. The LoD of the NeuMoDx EBV Quant Assay and artus EBV QS-RGQ Kit are 200 IU/mL and 22.29 IU/mL, respectively; 16/75 (21.3%) samples had EBV DNA levels above the LoD of both assays. The Pearson correlation coefficient was 0.8990. EBV quantification values with the NeuMoDx assay were higher versus the artus kit in 15 samples (93.8%). In conclusion, NeuMoDx CMV and EBV Quant Assays are sensitive and accurate tools for CMV and EBV DNA VL quantification.
Asunto(s)
Citomegalovirus , Herpesvirus Humano 4 , Carga Viral , Virología , Herpesvirus Humano 4/fisiología , Citomegalovirus/fisiología , Carga Viral/instrumentación , Carga Viral/métodos , Virología/instrumentación , Virología/métodos , Límite de Detección , Infecciones por Citomegalovirus/sangre , Infecciones por Citomegalovirus/virología , Infecciones por Virus de Epstein-Barr/sangre , Infecciones por Virus de Epstein-Barr/virología , Técnicas de Laboratorio Clínico/instrumentación , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/normas , HumanosRESUMEN
It is now recognised that therapists require career-long training in order to maintain and improve their expertise. However, training will fail to improve services to clients unless the work environment supports staff in its use. Although this "training transfer" problem is widely acknowledged, to the authors' knowledge the way that the work environment influences clients' access to effective therapies has not been subjected to a detailed and systematic formulation. Therefore, this small study illustrates a suitable formulation, based on the training received by a group of National Health Service (NHS) staff in "psychosocial interventions", and proposes its use as a "feedback fascia" to managers and others. To do this, structured interviews were held with a self-selected sample of n = 20 therapists (mostly nurses) and all of their managers (n = 11) in one NHS Trust. The results indicated an impressive degree of training transfer. It is concluded that staff training can improve clients' access to effective treatments, but that significant organisational support for innovation is required. A feedback fascia can guide such support.