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J McDermott

Publications and source records attributed to J McDermott.

80 records · Page 5Linked to original sources

Two models of in-service training to improve midwifery skills: how well do they work?

This program evaluation compared the knowledge, confidence, and skills of Indonesian village midwives who attended an intensive in-service training with midwives who received an internship program and midwives who attended no program. The five key skills compared were prevention of infection, use of the partograph, manual removal of placenta, bimanual uterine compression, and neonatal resuscitation. Midwives from the intensive in-service that combined competency-based skill training with peer review and continuing education scored higher on the knowledge test and demonstration of the five key skills and reported managing complications better than midwives who attended no training program. Midwives from the internship program scored intermediate between the intensively trained and the untrained midwives. Overall, skill scores were 71% for midwives in the intensive program, 62% for the interns, and 51% for midwives with no in-service training. Village midwives from the intensive program scored significantly higher in the practical demonstration of manual removal of placenta, bimanual compression, and neonatal resuscitation than the interns, but the scores on infection prevention and use of the partograph were not different between the two groups. Differences in the volume of training opportunities between the two programs could be responsible for the different outcomes.

Clinical Competence↗

Single payer health care--the 100 percent solution.

Unlike President Clinton's plan, we don't have to guess whether single payer health care will work--we know it does. It's also less disruptive, less costly, and is easy to understand and administer.

Cost-Benefit Analysis↗

Integrating herbs and botanicals into patient care.

Consumer use of herb and botanical preparations is burgeoning. Many common herbal remedies have proven efficacy, reported mainly in the European scientific literature. Although not mandated by law, responsible manufacturers of herbal products are working to establish efficacy, safety, and good manufacturing standards. Pharmacists should be alert for possible drug interactions between phytomedicines and pharmaceuticals, as well as potential adverse effects. Well-informed pharmacists can provide useful counseling and education about herbs and botanicals.

Patient Education as Topic↗

"Single step" PCR with a sensitivity similar to nested PCR for the detection of hepatitis C virus RNA.

OBJECTIVE: Evaluation of the performance of different HCV PCR detection systems for HCV RNA: A nested PCR, considered the reference assay, was compared with two single-step methods (ss-PCR): the first is based on the detection of PCR products by liquid hybridization with a 32P end-labelled probe (isotopic ss-PCR), while the second assay is a colorimetric method (colorimetric ss-PCR) using microwell plate hybridization with a specific nucleic acid probe (Amplicor HCV PCR, Roche Diagnostics Systems). METHODS: Sera from 56 patients with suspected hepatitis C infection based on reactive serology or altered liver parameters, and sera from 15 blood donors were tested for HCV RNA: After RNA extraction, the synthesized HCV cDNA was amplified in parallel using isotopic ss-PCR, colorimetric ss-PCR and nested PCR. The products were detected by autoradiography, color development and ethidium bromide fluorescence, respectively. RESULTS: In order to assess the analytical sensitivity of ss-PCR versus that of nested of PCR, experiments included serial dilutions of positive control samples. Results showed that both methods had an extinction signal at the 1:512 dilution. A comparative analysis of 71 clinical sera samples was obtained using the three protocols and the results clearly documented 100% concordance. CONCLUSIONS: Single step PCR methods for HCV RNA have a sensitivity equal to that of nested PCR and appear more suitable for diagnostic applications. Ss-PCR is safer than nested PCR in terms of both specificity and contamination problems. In particular, the Roche Amplicor HCV PCR assay minimizes sample exposure and management problems.

Hepacivirus↗