PubMed Health⌕ Search

Biomedical subjects

C Gifford

Publications and source records attributed to C Gifford.

8 recordsLinked to original sources
PubMed2001

Enhancing patient safety through teamwork training.

The effective reduction of medical errors depends on an environment of safety for patients in both clinically-based and systems-oriented arenas. Formal teamwork training is proposed as a systems approach that will achieve these ends. In a study conducted by Dynamics Research Corporation, weaknesses and error patterns in Emergency Department teamwork were assessed, and a prospective evaluation of a formal teamwork training intervention was conducted. Improvements were obtained in five key teamwork measures, and most importantly, clinical errors were significantly reduced.

Aviation↗
PubMed2001

Evidence towards the role of arylamine N-acetyltransferase in Mycobacterium smegmatis and development of a specific antiserum against the homologous enzyme of Mycobacterium tuberculosis.

Arylamine N-acetyltransferase (NAT) in humans inactivates the anti-tubercular drug isoniazid (INH). Homologues of human NAT are present in Mycobacterium tuberculosis and Mycobacterium smegmatis, where they can acetylate, and hence inactivate, INH. The in vivo role of mycobacterial NAT is not known but heterologous expression of the M. tuberculosis gene increases the INH resistance. The 0.85 kb nat gene is part of a gene cluster in M. smegmatis. The gene is transcribed as a large, 7.5 kb mRNA as demonstrated by Northern analysis. A nat knockout strain of M. smegmatis was generated by targeted disruption. The new strain was confirmed to be devoid of NAT activity. The growth of the knockout strain is considerably delayed compared with the wild-type, due to an extended lag phase. The knockout mutant has an increased sensitivity to INH as would be predicted. The NATs from M. smegmatis and M. tuberculosis have a high degree of homology, except in the region of the C terminus. A specific polyclonal antiserum raised against recombinant NAT protein from M. tuberculosis is described that recognizes a stretch of about twenty residues within the C terminus of M. tuberculosis NAT. This highly specific antiserum will enable comparison of nat expression between isolates of M. tuberculosis.

Acebutolol↗
PubMed1997

Evaluation of proficiency testing as a method of assessing competence to screen cervical smears.

Regular proficiency testing of pathologists and cytotechnologists who undertake the analysis of cervical smears has been carried out in cytology laboratories in the North Thames (West) region since 1989. The protocol followed is one that has been adopted nationally. Since the scheme started, laboratory personnel from 17 cytology laboratories in the Region have participated and seven rounds of testing have been completed. Nine hundred and seventy-one tests were carried out and a pass rate of 96.4% was recorded. Two hundred and forty-seven cytologists took the test on at least one occasion and 63 cytologists took part in all seven rounds. Our results indicate that proficiency testing is capable of detecting cytologists who consistently perform below an acceptable standard and require retraining. They also show that even the most competent screeners can miss an abnormal smear. Seven cytologists who had proved their competence to screen on six occasions, missed an abnormal smear on the seventh, despite the fact that they were screening under test conditions when their vigilance should have been at its peak. Our findings indicate that false-negative reporting will inevitable occur during manual screening, and emphasize the need for further research into the causes and prevention of screening error.

Clinical Competence↗
PubMed1996

Electrocardiograph QT lengthening associated with epileptiform EEG discharges--a role in sudden unexplained death in epilepsy?

EEG with co-registered electrocardiography was recorded during at least two interictal epileptiform EEG discharges in each of 11 patients who later suffered from sudden unexpected death in epilepsy (SUDEP), and from another 11 age and sex matched patients, also with uncontrolled tonic-clonic seizures, drawn from the same centre who were still alive at the time of investigation (non-SUDEPs). A corrected QT interval for rate (QTc) was obtained and a mean value calculated for the period immediately prior to discharge, during discharge and immediately post discharge. Mean QTc was also obtained interictally without discharge. There was a significant (P = 0.01) increase in the mean QTc during discharge compared to that measured interictally without discharge for the whole population of SUDEPs and non-SUDEPs, and this was maintained for the SUDEPs alone (P = 0.02) but did not hold for the non-SUDEP group alone. Although reaching statistical significance, increases in mean QTc in SUDEP patients only exceeded currently accepted upper limits in one case, and then only marginally. The clinical significance of these findings merits further investigation.

Adult↗
PubMed1994

Quality assurance in cervical cancer screening: results of a proficiency testing scheme for cytology laboratories in the north west Thames region.

OBJECTIVES: To examine the effectiveness of introducing External Quality Assessment (EQA) into all laboratories which undertake gynaecological cytopathology. To assess pathologists and cytotechnologists regularly for their competence to screen cervical smears, regardless of their standing in the laboratory hierarchy or their experience of gynaecological cytopathology. METHODS: Each participant was asked to screen and report on 10 slides during a 2 h period. The assessment was carried out by a facilitator under the direction of a specially appointed EQA Committee. A maximum score of 20 points was awarded for a completely correct set of answers. A minus score was awarded for a missed abnormal smear. Seventeen pathology laboratories in North West Thames Regional Health Authority participated; 146 cytologists were assessed. RESULTS: A pilot and four rounds of EQA have been completed and a total 5350 smears examined. Out of 2568 dyskaryotic (abnormal) smears screened, 0.7% were not identified correctly. Of the 146 cytologists taking part in the assessment, 95% achieved a score of 17 or more. Three participants were identified who did not reach an acceptable level of competence and appropriate remedial action was taken. CONCLUSION: The EQA scheme detected unacceptable levels of performance which can be quickly rectified. Participation of 100% has been maintained on a voluntary basis, and 4 years experience of the scheme confirms that a very high standard of screening prevails in the Region. The study illustrates that voluntary self-regulation is acceptable in the NHS, and the introduction of similar EQA schemes on a national scale will go a long way to establishing confidence in the cervical cancer screening programme.

Female↗
PubMed1991

The effects of local versus average baseline determination on spinal density.

We compared two approaches for determining soft tissue baseline with dual energy X-ray absorptiometry (DEXA) of the spine. An average baseline for the entire L2-L4 region resulted in overestimation of the L2 density by 2% and underestimation of L4 density by 2% in 122 subjects. The results for the L2-L4 region, and for L3, were comparable with both approaches and the precision error in vivo also was comparable (0.8%).

Absorptiometry, Photon↗
PubMedDate not supplied

Evaluating the impact of a continuing education program on change in gerontologic nursing practice.

In this article, the authors describe behavior changes reported by nurses after attending a continuing education program that addressed nursing care of the gerontologic client in the acute hospital setting. Although participants reflected positively upon knowledge gained at the conference and described themselves as amenable to change, they associated environmental and administrative factors negatively with implementation of practice changes. Conclusions from descriptive analysis of responses yielded suggestions for strategies to enhance the impact of continuing education programs on nursing care of the aged client.

Adult↗