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This article deals with the piling behavior of individuals. It is assumed that paper enables a certain kind of thinking. Piles might look like a mess, but in truth they are not. A group of researchers at Apple Computer studied piling behavior several years ago and they discovered that even the most disorganized piles usually makes perfect sense to the piler, and that office workers can determine the precise history and meaning of their piles. Piles are considered as living, breathing archives of the piler.

This article deals with the continued consumption of paper. It was assumed that computer technology has the potential of reducing the use of paper. However, every country in the Western world uses more paper as of December 2005, on a per-capita basis, that it did ten years ago. Cognitive psychologists and ergonomics experts argued that paper persisted for very good reasons: when it comes to performing certain kinds of cognitive tasks, paper has many advantages over computers. The fundamental confusion about the role of paper makes people feel dismayed at the sight of a disorganized desk.

Objectives: To compare laboratory and programmatic issues in neonatal hemoglobin screening in two systems using either liquid cord blood or heel puncture blood dried on filter paper (DB) to determine the accuracy of hemoglobin phenotype; the collection rate of cord blood versus DB; and the types of and reasons for errors., Methods: Cord blood samples for 6904 newborns were analyzed by electrophoresis in a large hospital laboratory. DB samples on the same cohort were analyzed by isoelectric focusing in a state public health laboratory., Results: Interlaboratory concordance was 99.4% for 6904 matched specimen pairs, which included 27 disease and 596 carrier phenotypes. In 42 pairs, discordances for potential disease phenotypes occurred with cord blood samples. Errors involving carrier phenotypes occurred in 15 cord blood samples and 14 DB samples. Inconclusive results requiring repeat testing occurred more often in the cord blood testing system (92) than in the DB system (23). Clerical transcriptions and limitations of the techniques accounted for most laboratory errors. Noncompliance in sample collection occurred more frequently with cord blood (181) than DB (86)., Conclusions: Both systems are subject to errors, but are equally reliable for neonatal hemoglobinopathy screening.