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Biomedical subjects

D Humphris

Publications and source records attributed to D Humphris.

13 recordsLinked to original sources
PubMed1996

Clinical guidelines: an introduction to their development and implementation.

There is a great deal of interest in the United Kingdom in clinical guidelines as a means of assisting practitioner and patient decision making about care options and in improving the quality of the care provided. Confusion remains, however, over what is meant by a clinical guideline and how it differs from and relates to protocols and standards. This paper was written under the auspices of the Royal College of Nursing Steering Group for the college's work on clinical guidelines, with the aim of clarifying some of the terminology used in the field and introducing ways in which clinical guidelines might be used by practitioners and patients to readers. At the moment just how effective the use of clinical guidelines can be on care is poorly established. What is known, however, is that crucial to their success are the strategies and methods used for their implementation. Such strategies and methods raise questions about how a sense of ownership can be engendered in those using the clinical guidelines and how they may be best operationalized. These questions are considered in this paper.

Clinical Protocols↗
PubMed1994

Medial-Golgi retention of N-acetylglucosaminyltransferase I. Contribution from all domains of the enzyme.

We have previously shown that the transmembrane domain and flanking residues of beta-1,2-N-acetylglucosaminyltransferase I (GnTI) can localize a hybrid molecule to medial-Golgi cisternae (Burke, J., Pettitt, J. M., Schachter, H., Sarkar, M., and Gleeson, P.A. (1992) J. Biol. Chem. 267, 24433-24440). Here, we have further examined the contribution of the cytoplasmic tail, transmembrane domain, and the catalytically active, luminal domain of GnTI in medial-Golgi localization, by analyzing the localization of hybrid molecules stably expressed in murine cells. In contrast to wild-type GnTI, which was efficiently localized to the medial-Golgi and not detected at the cell surface, hybrid molecules containing any two of the three domains of GnTI were localized to the medial-Golgi and were also present at low levels at the cell surface. Hybrid molecules containing only the transmembrane domain or the luminal domain of GnTI showed partial Golgi retention together with an increased level of cell surface expression compared with molecules containing two GnTI domains. The cytoplasmic tail independently was unable to retain reporter sequences to the Golgi but increased the ability of constructs containing either the luminal or transmembrane domain of GnTI to localize to the Golgi apparatus. Therefore, all three domains of GnTI contribute significantly to medial-Golgi localization. Furthermore, GnTI hybrid molecules showing increased cell surface expression were more readily extracted in a low salt buffer, suggesting that Golgi localized GnTI differs in physicochemical properties from cell surface GnTI. Based on an aggregation model of localization, we propose that Golgi retention of these hybrid molecules is mediated by the interaction of their GnTI domains with the corresponding domains of endogenous glycosyltransferase aggregates within the Golgi membranes of the transfected cell.

Amino Acid Sequence↗
PubMedDate not supplied

Clinical guidelines: an industry for growth.

This paper looks at the development of clinical guidelines in the health service. The main thrust towards the development of guidelines has come from the seeming desperation over the profileration of locally produced quality standards emanating from virtually every clinical area over the past few years. While the involvement of staff at grass-roots level is to be welcomed in setting goals, how much of the work that they produce in standard-setting amounts to paper exercises, and how far can their standards be said to reflect the state of knowledge at the cutting edge? How far are they simply statements describing existing, perhaps even poor, practice? The movement towards clinical guidelines is an attempt to codify best practice and ensure that it relates to the latest valid research. This article looks at an initiative that will go some way towards retaining clinical involvement in standard-setting while ensuring that these will meet the requirement that they reflect, as far as possible, the latest research.

Humans↗
PubMedDate not supplied

Quality assurance.

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Education, Nursing, Continuing↗