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Biomedical subjects

C Clifford

Publications and source records attributed to C Clifford.

At least 19 recordsLinked to original sources
PubMed1992

The role of the nurse teacher.

This paper reports on selected findings of a small exploratory study of the role of the nurse teacher. A questionnaire was circulated to teaching staff in one college of nursing. Quantitative data collected included a range of biographical detail, an outline of career patterns, professional qualifications and specific preparation undertaken for the teaching role. Qualitative data gathered in the study was transcribed and categorised into themes. The areas that are reported here include the identification of the factors that influenced decisions to work in nurse education, educator's views on preparation for the teaching role and areas of satisfaction and dissatisfaction in their work. Issues related to classroom teaching role, clinical teaching role, management and research are discussed.

Adult↗
PubMed1992

How we use questionnaires for learner evaluation of clinical experiences.

The use of questionnaires incorporating quantitative and qualitative analysis are an integral part of practice when monitoring the learning experience for student nurses on clinical placement. This paper outlines this system in the belief that the information could be helpful to other health professionals who are responsible for monitoring the clinical learning experiences of their students. Reference is made to other systems, such as educational audit, and some of the trends identified in analysing data collected is discussed. Finally, the potential for further developing this system is noted.

Education, Nursing↗
PubMed1992

More on AuD.

Explore the source record for details and available documents.

Audiology↗
PubMed1991

Socioeconomic status and cancer mortality and incidence in Melbourne.

Data were obtained for all deaths registered between 1979-1983, and for all new cancers recorded at the Victorian Cancer Registry between 1982-1983, in residents of Melbourne. A socioeconomic status (SES) measure had been produced for each local government area (LGA) by principal components analysis of sociodemographic variables recorded at the 1981 census. A SES score from 1 to 10 was assigned to each death and cancer. Population data from the census were similarly scored. Age standardised rates for all cause mortality, for mortality from all causes other than cancer and for both incidence and mortality of total cancers, cancer of the stomach, colon, rectum, lung, female breast, cervix, uterus, prostate and bladder, and for melanoma, lymphoma and leukaemia were analysed as a function of SES decile using weighted linear regression. Despite the limited number of years of data and the misclassification of the SES score, analyses showed there were inequitable distributions of mortality, and of some major cancers, across social strata in Melbourne during the early 1980s. The incidences of cancer of the breast, colon, prostate and melanoma were all positively associated with SES, while the incidences of cancer of the stomach, lung and cervix demonstrated negative SES gradients. For cancers where incidence showed a significant SES gradient there was a similar SES gradient with mortality. These patterns are consistent with the literature and implicate SES differences in education and access to services. Implications for health policy are discussed.

Adult↗
PubMed1990

Analysis of dietary fat, calories, body weight, and the development of mammary tumors in rats and mice: a review.

We have extracted from the literature data from 100 animal experiments, involving 7838 rats and mice, which compared the effects of different levels of dietary fat and/or calorie intake on the development of mammary tumors. Both higher calorie intake (P less than 0.0001) and higher fat intake (P less than 0.0001) independently increased mammary tumor incidence in Sprague-Dawley rats and in mice, as judged from analyses combining ad libitum feeding experiments and restricted feeding experiments. The effect of fat was two thirds the magnitude of the calorie effect in both Sprague-Dawley rats and mice. In ad libitum feeding experiments, a modest but significant (P less than 0.0001) average increase in body weight was found in animals fed high fat diets. However, these differences in body weight did not correspond to differences in mammary tumor incidence. The effect of log body weight on the log odds of tumor incidence was not significant (P = 0.16), while dietary fat intake significantly increased tumor incidence (P less than 0.0001). The collection of animal experimental data supports the hypothesis that, in mammary tumor development, there is a specific enhancing effect of dietary fat, as well as a general enhancing effect of calories.

Animals↗
PubMed1990

Identification of hematopoietic progenitors of macrophages and dendritic Langerhans cells (DL-CFU) in human bone marrow and peripheral blood.

Colonies of cells with distinctive dendritic appearance were observed in methylcellulose cultures of human bone marrow and peripheral blood mononuclear cells (PBMC). Such cells appeared alone in colonies of less than 50 cells, together with macrophages in mixed colonies and also within clusters of T lymphocytes at high culture cell numbers. The morphologic resemblance to lymphoid dendritic cells was confirmed by electron microscopy and the cells were distinguished from macrophages by immunoenzymatic and immunogold labeling with monoclonal antibodies (MoAbs). Like macrophages they were HLA-DR+ and CD4+. However, they lacked nonspecific esterase and the macrophage cytoplasmic marker Y1/82A. Most strikingly, cells were strongly HLA-DQ+ and expressed CD1a (T6), which is characteristic of skin Langerhans cells. Their functional similarity to lymphoid dendritic cells was demonstrated by their ability to stimulate allogeneic mixed leukocyte reactions. Dendritic cell colony numbers were estimated in both bone marrow and peripheral blood of controls and in leukemia and lymphoma patients before and after chemotherapy. Colony numbers were low in control blood and in patients before treatment (less than 1.0 to 3.7/10(5) cells). However, during hematopoietic recovery the mean value increased to 37.5/10(5) cells and this increase correlated closely with the observed increase in circulating colony forming unit-granulocyte macrophage (CFU-GM) in individual patients. Autoradiographic studies demonstrated mitotic activity within CD1a+ colonies and a linear relationship between cultured cells and both pure and mixed colonies was consistent with their derivation from a single precursor. These data indicate that a novel hematopoietic progenitor of dendritic/Langerhans cells (DL-CFU) may now be identified in a clonal assay system and suggest a probable common progenitor for these cells and macrophages.

Antibodies, Monoclonal↗
PubMed1990

Dietary fat reduction and plasma estradiol concentration in healthy postmenopausal women. The Women's Health Trial Study Group.

Concentrations of total and weakly bound plasma estradiol were significantly (P less than .01) reduced in 73 healthy post-menopausal women after 10-22 weeks of participation in a low-fat diet intervention program. Nonsignificant reductions in estrone sulfate and sex hormone-binding protein were also observed. The 17% reduction in average estradiol concentration was accompanied by an average reduction of 12 mg/dL in total plasma cholesterol (P less than .001), an average weight loss of 3.4 kg (P less than .001), and an average reduction in daily dietary fat from 68.5 to 29.5 g. Our review of case-control studies indicates that a 17% reduction in plasma estradiol may explain a noteworthy component of the international variation in breast cancer incidence. We find a need for further studies of (a) disease risk in relation to hormone concentrations and (b) changes in hormone concentrations as a function of the duration of low-fat diet intervention.

Aged↗
PubMed1990

Validation of a self-administered diet history questionnaire using multiple diet records.

The validity of a self-administered diet history questionnaire has been estimated using as the reference data the mean of three 4-day diet records collected over the year prior to the administration of the questionnaire, in 1985-1986. Subjects were women ages 45-70 years, participants in the Women's Health Trial Feasibility Study, a multi-center clinical trial in which some women were randomized to be taught to adopt and maintain a low-fat diet, while others maintained their usual diet. The questionnaire produced group mean nutrient estimates closely approximating the values obtained by three 4-day records, e.g. in the usual-diet group, 37.7% of calories from fat by both food records and by questionnaire, and in the low-fat group, 21.3% of calories from fat by food records and 23.7% of calories from fat by questionnaire. Correlations between questionnaire and diet records for per cent of calories from fat were 0.67 and 0.65 respectively in the two groups; most correlations were in the 0.5-0.6 range, and were similar to those achievable by a single 4-day food record.

Aged↗
PubMed1990

Twin children in volunteer registries: biases in parental participation and reporting.

The biases in voluntary participation by adult twins are well known but less attention has been paid to twin children where parents decide on participation and provide much of the information. Several aspects of reporting including the assessment of zygosity are compared in four large Australian data bases: 1) a nationwide compulsory (and hence representative) survey of literacy and numeracy; 2) a nationwide "Twins in School" survey of parents and teachers of twins run through Education Departments and AMBA, the parents organisation in conjunction with LaTrobe; 3) the LaTrobe Twin Study which is a longitudinal program involving frequent interactions between families and researchers, and 4) the Australian NHMRC Twin Registry which has surveyed a large sample of their families with twin children by mail. One potential bias comes when recruitment is on a continuing basis as in the LaTrobe Twin Study and the Australian Twin Registry when differences between "early" and "late" enrolling families arise. One difference between the four samples arose from parents being much more likely to contrast their twins and to report problems in one but not the other, whereas teachers' and psychologists' assessments of these same children generally reported much smaller intrapair differences. Future studies should have some common questions to provide comparative data on such biases. Key questions are proposed for this area, mainly on the perceived need for different forms of remediation, together with other recommendations about the minimal essential baseline data set for a registry.

Attitude↗
PubMed1990

The source and significance of raised serum enzymes in rheumatoid arthritis.

Hepatobiliary dysfunction in rheumatoid arthritis has been suggested on the basis of raised serum activity of alkaline phosphatase, 5-nucleotidase, lactic dehydrogenase and gamma-glutamyl transferase, but a specific pathological lesion has not been demonstrated and serum transaminases and bilirubin are almost invariably normal. This paper reports a series of studies designed to determine the tissues of origin of the enzymes and offers an alternative interpretation of the enzymological findings. The results suggest that only alkaline phosphatase originates from the liver, while lactic dehydrogenase and 5-nucleotidase originate from synovial fluid polymorphs and synovial lining cells, respectively. Serum alkaline phosphatase may be induced by inflammatory mediators such as interleukin-1 because it correlates with the acute phase response. Serum lactic dehydrogenase is an integrated measure of polymorph lysis in all joints and offers a marker of joint inflammation more specific than measures such as the ESR. Levels of serum 5-nucleotidase provide information about the activity of the synovium. Finally, because hepatic necrosis does not normally occur, the transaminases may be used to monitor drug toxicity.

5'-Nucleotidase↗
PubMed1990

Changes in food patterns during a low-fat dietary intervention in women.

The Women's Health Trial was initiated by the National Cancer Institute to study the effects of a low-fat diet on the incidence of breast cancer in women at elevated risk for the disease. The purpose of this article is to examine the specific dietary changes that 173 women made while participating in a feasibility intervention program to reduce their fat intake to approximately 20% of total calories over a 12-month period. The intervention program used group sessions to teach nutrition information and behavioral skills necessary to make a life-style dietary change. Four-day food records were collected from participants at the beginning of the study and again at 12 months. Women in the intervention group reduced their total fat intake from a mean of 76 gm (39% of total energy) to 31 gm (22% of total energy), mainly by decreasing their fat intake from milk products, red meats, and fats/oils. These women used cheddar cheese, American cheese, whole milk, butter, mayonnaise, salad dressing, bacon, and hamburgers less frequently, and used diet American cheese, low-fat cottage cheese, and skim milk more frequently. They consumed less fat in their vegetable dishes, and their total caloric intake from fruit increased slightly. In addition, the overall quality of the diets improved, since there was a 20% to 50% increase in the energy-adjusted intake of vitamins and minerals from food sources.

Aged↗
PubMed1990

A case report of demodicosis.

We report on a patient who had an excessive number of mites (Demodex folliculorum) on his eye lashes, i.e. 10 mites on eight lashes examined. A review of three previous reports suggested that one mite for every two lashes represents an over population of this nearly ubiquitous mite. Greasy scales on the lashes and foamy tears suggested that seborrhea was present as well as demodicosis. The primary symptoms of itching was relieved after one week of treatment with mercuric oxide ointment and lid scrubs, although the number of mites was not reduced. Treatment for an additional two weeks did reduce the mite number. We therefore recommend continuing treatment for demodicosis for at least three weeks even if symptoms abate sooner.

Aged↗
PubMed1990

Results of a randomized feasibility study of a low-fat diet.

A 2-year randomized clinical trial was conducted to test whether free-living women aged 45 to 69 years can reduce the fat content of their diet from the typical US level of approximately 39% to 20% of energy from fat, using readily available foods, when given nutritional and behavioral counseling and social support. Three clinical units randomized 303 selected volunteers into intervention (low-fat eating plan) or control (customary diet) groups. The two groups were comparable at baseline. The intervention group received nutrition instruction and behavioral counseling largely in permanent groups of 12 to 15 participants meeting weekly, then biweekly, and finally monthly. At 6 months, they had substantially reduced the mean proportion of total energy from fat from 39.1% to 20.9%, compared with the control group's nonsignificant reduction from 39.0% to 38.1%. At 12 and 24 months, they sustained the reduction of energy from fat. Weight loss and plasma cholesterol level changes in the intervention group supported the self-recorded dietary intake changes. Attendance at intervention sessions averaged 75% during the first 6 months and, subsequently, 60% to 70%. Four-day food records for the randomized women were obtained at 6 and 12 months from approximately 95% and at 24 months from 87%. A clinical trial of a low-fat diet is feasible in women.

Aged↗
PubMed1989

In vitro comparison of quantitative computed tomography and broadband ultrasonic attenuation of trabecular bone.

In vitro measurements of os calces and trabecular bone samples have been carried out using broadband ultrasonic attenuation (BUA) and quantitative computed tomography (QCT). The correlation between the measurements was 0.92 and 0.86 for the heelbones and the trabecular samples respectively, and the QCT and BUA correlated equally well with the physical density of the samples, indicating that the new ultrasonic technique is potentially useful for the evaluation of trabecular bone for the diagnosis of osteoporosis.

Adult↗
PubMed1978

A reappraisal of the mechanisms of hypocholesterolemic action of therapeutic agents.

The most commonly used methods to study the mechanisms of hypocholesterolemic action of therapeutic agents generally determine the turnover of total (exchangeable) cholesterol pools in the body. This approach is based on the view that whatever increases the total load of cholesterol in the body will increase the levels of plasma cholesterol, and vice versa. Despite the importance of this assumption it has never been tested, and there is no evidence to indicate that it is valid under all conditions. This "overload" hypothesis dates from the times before the importance of plasma lipoproteins was recognized and their role in the transport of lipids was well understood. However, it is becoming increasingly clear that the levels of plasma cholesterol are determined more directly by the "transport" of cholesterol into and out of plasma compartment by lipoproteins than by the synthesis, absorption and elimination of cholesterol from the total body pools. Any effects that the latter parameters of cholesterol metabolism have on the levels of plasma cholesterol must be mediated through changes in synthesis and the subsequent metabolism of plasma lipoproteins. In other words, in any equation relating changes in the levels of plasma cholesterol to the changes in synthesis, absorption and elimination of cholesterol from the body pools we must consider the "transport" of cholesterol by lipoproteins and their metabolism.

Animals↗