Transportation is a key element of access to healthcare. The COVID-19 pandemic posed unique and unforeseen challenges to patients receiving hemodialysis who rely on three times weekly transportation to receive their life-saving treatments, but there is little data on the problems they faced. This study explores the attitudes, fears, and concerns of hemodialysis patients during the pandemic with a focus on their travel to/from dialysis treatments. A mixed methods travel survey was distributed to hemodialysis patients from three urban centers in Montréal, Canada, during the pandemic (n= 43). The survey included closed questions that were analysed through descriptive statistics as well as open-ended questions that were assessed through thematic analysis. Descriptive statistics show that hemodialysis patients are more fearful of contracting COVID-19 in transit than they are at the treatment center. Patients taking paratransit, public transportation, and taxis are more fearful of COVID-19 while traveling than those who drive, who are driven, or who walk to the clinic. In the open-ended questions, patients reported struggling with confusing COVID-19 protocols in public transport, including conflicting information on whether paratransit taxis allowed one or multiple passengers. Paratransit was the most used travel mode to access treatment (n = 30), with problems identified in the open-ended questions, such as long and unreliable pickup windows, and extended travel times. To limit COVID-19 exposure and stress for paratransit users, agencies should consider sitting one patient per paratransit taxi, clearly communicating COVID-19 protocols online and in the vehicles, and tracking vehicles for more efficient pickups.
The hemocytometer is the most widely used device for determining cell concentrations, requiring consistent criteria and tenacity to obtain measurements correctly and reproducibly. As an alternative, the Countess(tm) Automated Cell Counter employs digital imaging and an image analysis algorithm to identify and enumerate cells in a sample. To compare the performance of these two methods, the accuracy, precision, and effective ranges were determined for total cell count and percent viability. First, using a standardized bead solution, the accuracy and precision of glass and disposable hemocytometers were measured and found to be 30% and 5% different from the anticipated value, respectively. Subsequently, disposable hemocytometers and the automated counter were used to determine total cell numbers and percent viability for multiple cell types over a range of cell concentrations. Using a Student's t‐test, the results showed the Countess(tm) instrument measured cell concentrations and viability as accurately and precisely as the disposable hemocytometer. Additionally, the effective concentration range for the Countess(tm) instrument was two times greater than the hemocytometer, and the viability range matched the hemocytometer. The Countess(tm) Automated Cell Counter overall produces results much more rapidly without the problem of operator tedium and fatigue or compromised accuracy and precision.
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