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Biomedical subjects

E Clifford

Publications and source records attributed to E Clifford.

At least 19 recordsLinked to original sources
PubMed1997

Psychosocial adjustment to unsuccessful IVF and GIFT treatment.

Twenty-one couples for whom in vitro fertilisation (IVF) or GIFT treatment failed were followed-up 15-30 months after treatment and compared with 20 couples for whom IVF had been successful. Current mental health status, quality of life and marital adjustment were assessed via standardised questionnaires. In addition, couples' experiences of IVF/GIFT treatment were explored via a semi-structured interview. Questionnaire results showed that unsuccessful IVF/GIFT recipients cannot be distinguished from general population norms. However, these couples reported more emotional distress relative to those whom treatment had worked and females in particular indicated a lower quality of life. Couples who had at least one child prior to IVF/GIFT treatment tended to show greater emotional distress at follow-up. Both groups gave similar accounts of the positive and negative aspects of IVF/GIFT treatment, but the unsuccessful group felt less supported by the IVF Unit staff and were less satisfied with the counseling they received. The data indicate that post-treatment counseling may be particularly important for facilitating positive reconstructions of the IVF experience when treatment is unsuccessful.

Adaptation, Psychological↗
PubMed1993

Human ciliary neurotrophic factor: localization to the proximal region of the long arm of chromosome 11 and association with CA/GT dinucleotide repeat.

Ciliary neurotrophic factor (CNTF) promotes survival and differentiation of several types of sensory, motor, sympathetic, and parasympathetic neurons. We have used the polymerase chain reaction to amplify, clone, and partially sequence CNTF cDNA from human muscle. Using a rodent-human mapping panel and fluorescence in situ hybridization, we have localized a single copy of the gene for human CNTF to the proximal long arm of chromosome 11. We have also identified a polymorphic tandem CA/GT dinucleotide repeat associated with the human CNTF gene.

Base Sequence↗
PubMed1993

A follow-up study of 'successful' IVF/GIFT couples: social-emotional well-being and adjustment to parenthood.

Twenty couples who conceived their babies by in vitro fertilization/gamete intrafallopian transfer (IVF/GIFT) were seen between 15 and 27 months postdelivery in order to evaluate social-emotional well-being and parental functioning. Emotional health and marital adjustment were assessed by standard questionnaires and compared with general population norms. Questionnaires measuring quality of life, parents' feelings about their babies and child-rearing attitudes were also administered. Scores from these were compared with those obtained from a group of parents who had conceived without medical assistance. Results indicated that IVF/GIFT parents were undifferentiated from the general population with respect to emotional health and marital adjustment. Also, relative to non-IVF parents, they gave higher positive ratings for their feelings about their babies and for one aspect of quality of life (feelings of freedom). Parenting attitudes for the two groups differed in only one respect, IVF/GIFT parents reported being more overprotective.

Adaptation, Psychological↗
PubMed1990

Day-case surgery: enhanced recovery with flumazenil.

In an open, randomized, parallel group study of 84 adult patients undergoing elective day-case urological surgery the specific benzodiazepine antagonist flumazenil was shown to reverse effectively subjective postoperative sedation due to midazolam and enabled 83% of patients to recover and be ready for potential discharge within 15 min of surgery (control group 24% p less than 0.001). The significantly shorter recovery time has benefits in terms of increased patient cooperation and reduced demands on postoperative nursing care. The implications of these findings for day-case surgery are discussed.

Adult↗
PubMed1988

The state of what art?

Psychological studies need to meet contemporary standards of research design and theoretical relevance within the mainstream of its behavioral science. The use of a clinical-scientist model for psychologists with greater emphasis on clinician than on scientist results in an impoverishment of psychological research and a paucity of stimulating theoretical speculation. Sporadic and pedestrian studies cannot explain why a necessary and sufficient relationship should exist between the presence of a cleft and the dependent measures used. As a result, psychological studies about cleft palate have managed to achieve a state of invisibility as far as most psychologists are concerned. As long as the present status remains at the current level, real progress is impossible, and we will be content with mediocrity.

Behavioral Sciences↗
PubMed1986

Social and psychological problems associated with clefts: motivations for cleft palate treatment.

Adolescents probably constitute a significant proportion of patient case loads for well-established cleft palate teams. Most teenagers return for periodic recall and continue to do so until they are discharged by the team. The proposition that social and psychological dissatisfactions might coalesce during adolescence and influence young people to stop treatment was examined. The modest drop-out rate argues against this contention. An alternative explanation for the low drop-out rate stresses that these patients are poorly equipped psychologically to deal with their clefts during any period of development. Maladaptation is brought into adolescence, influencing some patients to discontinue team treatment. Since most adolescents remain in treatment, it is suggested they do so because it is in their best interests or because there are no other reasonable alternatives. Adolescents who are knowledgeable about their clefts and the purpose of cleft palate teams may view treatment as a necessary and logical sequence of events designed ultimately to enhance appearance and function. For these adolescents, the goals of treatment are in keeping with existing well differentiated self-concepts and body images. It can be argued that prior good psychological adaptation to having a cleft, provides adolescents with a solid base upon which to cope effectively with the subsequent challenges of adolescence.

Adolescent↗
PubMed1984

The meaning of concepts related to breast reconstruction.

Information is presented from a psychometric study using a semantic differential to measure the meaning of concepts related to breast reconstruction. One hundred five women participated. All were experiencing breast reconstruction subsequent to mastectomy. The average woman was married, middle-aged, and had 11/2 years of education beyond high school. Results from the semantic differential demonstrated that the women viewed themselves, their bodies, and their femininity positively. They valued themselves, and their self-concepts were closer in meaning to health than to mastectomy, death, or cancer.

Adult↗
PubMed1982

Psychologist in a plastic surgery service.

Some of the roles of a psychologist on a plastic surgery service, particularly with patients undergoing cleft palate, craniofacial, and breast reconstruction, are explored. Psychological counseling with parents of infants with birth defects is described. For patients with craniofacial anomalies team management, extensive presurgical evaluations, and a psychological support system during hospitalization are required. Patients undergoing breast reconstruction need to work through preexisting feelings and attitudes about mastectomy as well as their anticipation of results of corrective surgery. For all patients, printed materials are used to augment the counseling. Research is emphasized, in keeping with the role of such a plastic surgery service in a university setting.

Attitude to Health↗
PubMed1980

Breast reconstruction following mastectomy: I. Social characteristics of patients seeking the procedure.

Information is presented from a clinical study of 65 women and a psychometric study of 85 women having breast reconstruction following mastectomy for breast cancer. The average woman was in her midforties. Less than a third of the women described themselves as fulltime housewives; most were employed outside the home. Almost all had completed high school and most had received additional education. Most of the women were married when they sought breast reconstruction. The time at which women had had their mastectomies was related to their source of information about breast reconstruction. When more than five years had elapsed between mastectomy and reconstruction, a woman most often had obtained her information from the media. Women with more recent mastectomies, though utilizing the media, obtained their information more frequently from medical sources.

Adult↗
PubMed1980

Breast reconstruction following mastectomy: II. Marital characteristics of patients seeking the procedure.

Information is presented from a clinical study of 65 women and a psychometric study of 85 women. All had had mastectomies because of breast cancer and were reconstruction patients at Duke Hospital. Women seeking breast reconstruction did not exhibit characterological problems. Relatively few were in psychiatric treatment, and previous research had established the presence of positive rather than negative self-images. The marriages of women seeking this surgical procedure were positively and the women viewed their marriages as a chief source of support. Considerable satisfaction was expressed about husbands being supportive, although husbands were also viewed as poor listeners and, at times, as unable to communicate effectively. Most women were satisfied with various aspects of their sexual lives. A small percentage of the women reported problematic marriages. Various factors, related to the presence of conflict in the marriage and the ability of the husband to understand his wife, may account for the distress evidenced in these marriages. Such factors, of course, are present in any problematic marriage; it remains to be demonstrated whether these problems were caused or exacerbated by the woman's mastectomy and decision to seek breast reconstruction.

Adaptation, Psychological↗
PubMed1980

When my child was born: maternal reactions to the birth of a child.

A 32-item multiple choice test, "When My Child Was Born," was designed to measure maternal perceptions of their reactions at the time of their child's birth. A total of 200 mothers were administered the test. The population included 97 mothers of children with cleft lip/palate and 103 mothers of physically normal children. Factor analyses identified three factors: Maternal Positive Affect, Paternal Affect, and Parental Anxiety. On all factors, normal subject had the highest scores, and mothers of children with defects had the lowest scores. The findings suggest that the test measures both current and projected feelings of the mothers about the birth of their child.

Adolescent↗
PubMed1979

Psychosocial aspects of craniofacial disfigurement. A "State of the Art" assessment conducted by the Craniofacial Anomalies Program Branch, The National Institute of Dental Research.

The psychosocial sequelae of craniofacial disfigurement may have as great an impact on the patient as the strictly physical aspects of the problem. Very little systematic work has been focused directly on these effects. The following broad recommendations would constitute initial research steps in this field: Development of satisfactory measures of physical attractiveness and their use in studies to explore the role of craniofacial features in over-all physical attractiveness. The establishment of valid metrics for assessing the severity of craniofacial anomalies through the use of both physiologic and behavioral measures, thus constructing a broader definition of what constitutes a craniofacial handicap. Studies of the relationships among physiologic and behavioral variables using recently developed statistical techniques and computer methods to determine the psychosocial consequences of craniofacial disfigurement. Studies of the process through which persons with various types of malocclusion decide to seek and complete treatment. The studies would include the patients' demographic characteristics, self-perceptions, perceptions of them by others, and the complex patient-clinician interactions during the treatment programs.

Body Image↗
PubMed1979

Relationship of static respiratory muscle pressure and maximum voluntary ventilation in normal subjects.

40 normal subjects performed spirometry, maximum voluntary ventilation (MVV), and tests of static inspiratory (Pi max) and expiratory (Pe max) respiratory muscle pressure. Forced expiratory volumes in 0.5 (FEV0.5), in 0.75 (FEV0.75), and 1 sec (FEV1) correlated significantly with MVV (r = 0.805, 0.804, 0.779, respectively). When Pi max was considered as a second independent variable, the probability of predicting MVV from timed forced expiratory volumes was enhanced (r = 0.914, 0.900 and 0.872 for FEV0.5, FEV0.75, and FEV1, respectively). Statistical analysis indicated that multiple regression with Pi max was superior to regression with timed forced expiratory volume alone in the prediction of MVV. For any given FEV1, however, Pi max was widely dispersed (range: -60 to -200 cm H2O). MVV values, expressed as percentage difference between largest and smallest value, varied less than did Pi max. Pe max, vital capacity, height and age did not enhance the ability of timed forced expiratory volumes to predict MVV. These data indicate that while respiratory muscle strength is important for sustaining maximal ventilation, the MVV is not a sensitive indicator of respiratory muscle strength.

Adult↗
PubMed1979

Cognitive, self-concept, and body image measures of normal, cleft palate, and obese adolescents.

Using discriminant function analyses, this study attempted to establish linear combinations of variables that would identify group membership correctly. Groups of normal (N = 100), cleft palate (N = 51), and obese (N = 22) adolescents responded to measures of cognitive sytle and structure, body image, and self-concept. Linear combinations of congitive measures were not effective in differentiating group membership. Body image measures, in combination, clearly distinguished obese adolescents from the other two groups. A linear combination of self-concept measures differentiated adolescents with clefts from normals, with the former group having a pattern of higher self-esteem and lower perceived acceptability by their parents.

Adolescent↗