Biomedical subjects

C Clifford

Publications and source records attributed to C Clifford.

At least 37 records · Page 2Linked to original sources

PubMed1997

Confirmatory factor analysis of the Wechsler Memory Scale-Revised in a sample of clients with alcohol dependency.

Previous analyses of the Wechsler Memory Scale-Revised (WMS-R; Wechsler, 1987) have reported one-, two-, and three-factor solutions and raised questions about the validity of the visual memory subtests. These various findings may stem in part from different methods of analysis, and from the study of different participant samples. To address these issues, we analysed data from the WMS-R and a spatial maze test administered to 154 participants with a history of alcohol dependence. Results from confirmatory factor analysis supported the interpretation of three factors underlying the WMS-R subtests and the spatial maze score in this sample, namely, attention-concentration, immediate memory, and delayed recall. This result held despite the inclusion of the maze score which is a well-validated measure of visuo-spatial memory.

Adult↗

PubMed1996

Role: a concept explored in nursing education.

A number of research studies in nursing education have drawn on the concept of 'role' when defining differing aspects of both student nurse and nurse teacher experiences. Despite the fairly wide use of the word, little attention has been given to the origins and development of the study of role. Consequently, the purpose of this paper is to explore 'role' and to consider the implications of this concept when undertaking research into the work nurses do. The subject will be explored from the perspective of nursing education and the role of the nurse teacher will be used as the working example in this paper.

Education, Nursing↗

PubMed1996

Nurse teacher's clinical work: a survey report.

This paper reports on the results of a survey of nurse teachers in four colleges of nursing in England (n = 126). Data were collected using a questionnaire survey. In this survey a five-point Likert scale was developed from an earlier study, to explore nurse teachers' perception of this clinical role. The findings indicate that a number of factors may be influential in the way in which nurse teachers approach their clinical activity. This includes personal factors such as age, educational grade and the length of time spent working in nurse education. Organizational factors also appear to make a difference in the teacher who worked in an organizational model which ensured a smaller number link ward areas were more likely to exhibit a positive and orientation towards clinical work. Factor analysis of the clinical scale resulted in loading of items relating to confidence in clinical role, preparation for the role, influence in clinical area and supervision of students in clinical areas. The implications of these findings are discussed.

Adult↗

PubMed1996

The polyp prevention trial II: dietary intervention program and participant baseline dietary characteristics.

The Polyp Prevention Trial (PPT) is a multicenter randomized controlled trial to evaluate whether a low-fat, high-dietary fiber, high-fruit and -vegetable eating pattern will reduce the recurrence of adenomatous polyps of the large bowel. Men and women who had one or more adenomas removed recently were randomized into either the intervention (n = 1037) or control (n = 1042) arms. Food frequency questionnaire data indicate that PPT participants at the beginning of the trial consumed 36.8% of total energy from fat, 9.7 g of dietary fiber/1000 kcal, and 3.8 daily servings of fruits and vegetables. Baseline dietary characteristics, including intake of fat, fiber, and fruits and vegetables, as well as other macro- and micronutrients, were similar in the two study groups. The intervention participants receive extensive dietary and behavioral counseling to achieve the PPT dietary goals of 20% of total energy from fat, 18 g/1000 kcal of dietary fiber, and 5-8 daily servings (depending on total caloric intake) of fruits and vegetables. Control participants do not receive such counseling and are expected to continue their usual intake. Dietary intake in both groups is mentioned annually using a 4-day food record (also completed at 6 months by intervention participants only) and a food frequency questionnaire, with a 10% random sample of participants completing an annual unscheduled 24-h telephone recall. Blood specimens are drawn and analyzed annually for lipids and carotenoids. This article provides details on the rationale and design of the PPT dietary intervention program and describes the participant baseline dietary intake data characteristics.

Adenomatous Polyps↗

PubMed1995

New directions in dietary studies in cancer: the National Cancer Institute.

Through an orderly sequence incorporating epidemiologic and laboratory research, human clinical/metabolic studies, and clinical intervention trials, the NCI develops and maintains cancer prevention and control programs that are directed toward the overall goal to reduce cancer incidence, morbidity, and mortality. Epidemiologic studies have shown correlations between consumption of numerous dietary constituents and cancer risk. Results of in vitro and animal studies have reinforced many of these epidemiologic associations and data from clinical/metabolic studies are being used to evaluate the relevance of these associations in humans. Although much remains to be learned about the influence of specific dietary constituents and dietary patterns on cancer risk, it is clear that diet can have a significant impact in cancer prevention and control. Investigations on the cellular and molecular effects of dietary constituents, as well as their metabolic and physiologic effects should provide better insight on the mechanisms of action of these dietary constituents. There also is a need to develop biomarkers of dietary intake that could be used to monitor compliance in intervention studies, as well as biomarkers as clinical trial endpoints that can be used to predict the emergence and progression of cancer. Working with other agencies and the private sector, the NCI will continue to design and implement information programs that translate the knowledge gained from these diet and cancer prevention studies to help Americans adopt dietary patterns that may reduce cancer risk. Continued emphasis will be placed on intervention programs targeted toward high-risk and underserved segments of the U.S. population in an effort to reduce the high incidence of cancers in these groups.

Animals↗

PubMed1995

The role of the nurse teachers: concerns, conflicts and challenges.

As part of an ongoing study into the role of the nurse teacher a series of questionnaires was designed and administered to explore nurse teachers perception of different facets of their role. Reasons for entering nurse education as a career, preparation for that career, positive and negative aspects of working in nurse education and specific aspects of the role in classroom teaching, clinical practice, research and management were all explored. An exploratory study was undertaken in one college of nursing. Following this the questionnaire was refined and administered to four colleges of nursing in England to determine if the findings identified in the exploratory study were typical of the nurse teacher group as a whole. This paper reports some of the concerns and conflicts identified by nurse teachers in this study. As a result of this work some of the challenges facing nurse teachers, particularly in relation to a clinical role, are discussed.

Attitude of Health Personnel↗

PubMed1995

Caring: fitting the concept to nursing practice.

This paper explores the concept of caring when used to define the nature of nursing. It is suggested that explorations of caring in nursing fail to acknowledge the real world of work in nursing, which is influenced by personal career choice and the organization of the health-care systems in which nurses work. In some situations nurses delegate the caring role to others thus giving 'care by proxy', a factor that is not clearly acknowledged in the literature on caring. It is suggested that if caring in nursing practice was defined as 'formalized caring' it would offer a framework for the analysis of caring more conductive to the reality of nursing practice today.

Education, Nursing↗

PubMed1994

Assessment of clinical practice and the role of the nurse teacher.

The assessment of the practice of student nurses in the UK is a complex process that has evolved from school based practical assessment, carried out by nurse teachers to clinically based continuous practical assessment where students are assessed by clinical staff (i.e. registered nurses) on the ward. The role played by nurse teachers in the latter model is an advisory one in which they offer guidance to the clinical staff completing the assessment. Nurse teachers also monitor the process of assessment by monitoring and responding to learner evaluations of their clinical experience and by undertaking educational audit. This system is not without problems and raises questions about the ideal 'location' for assessment of clinical skills and the respective roles of registered nurse and the nurse teacher in the assessment process. It will be argued that the present system of distancing the nurse teacher from the assessment of practice creates a conflict in which perhaps the least experienced practitioners contribute the most to the assessment of clinical skills. A change in this system demands a review of the nurse teacher's role with particular focus, first of all on time spent in clinical practice. This paper presents a preliminary analysis of this problematic issue. There are implications in this analysis for teachers and other groups of health care professionals.

Clinical Competence↗

PubMed1993

The role of nurse teachers in the empowerment of nurses through research.

This paper explores some of the difficulties faced by nurse teachers supporting students in research studies. The issues raised in this paper were identified through a small scale exploratory study of the teachers role. Areas discussed include teachers' preparation for the research component of their role and their interpretation of research-based activity. Practical issues such as the time required to undertake research studies and methods of teaching research are also explored. It is argued that nurse teachers are a key group in increasing research knowledge within the nursing profession, yet attention to this important part of the role is lacking. If nurses are to be empowered through research it is suggested that nurse teachers are a key group in bridging a gap between the rhetoric and reality of research-based practices in nursing.

Conflict, Psychological↗

PubMed1993

Diet as risk and therapy for cancer.

This article provides a brief overview of the scientific rationale for dietary guidelines that may reduce the risk of some types of cancers--breast, colon, and prostate in particular. Dietary modification clinical trials currently sponsored by the National Cancer Institute are described. Other topics include the role of total parenteral nutrition in cancer therapy and low-fat dietary interventions as an adjunct to breast cancer treatment.

Diet↗

PubMed1993

The clinical role of the nurse teacher in the United Kingdom.

The focus of this paper is the clinical role of the nurse teacher. Using selected findings from a small exploratory study in which a questionnaire was used to gather quantitative and qualitative data from teachers about their role, three areas are discussed. Examination of the number of clinical areas teachers link with identified three different models of clinical contact. The frequency and timing of teachers' visits to clinical areas are not evenly distributed and some of the reasons for this are discussed. The nature of the clinical role is explored with emphasis on liaison and teachers' perceptions of support of students and clinical staff. Finally, teachers' perceptions of their clinical skill and the implications of this is discussed. It is concluded that all three areas require further analysis if the role of the nurse teacher is to be clarified and made more effective in the future.

Clinical Competence↗

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↗