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Biomedical subjects

P Clifford

Publications and source records attributed to P Clifford.

At least 19 recordsLinked to original sources
PubMed2005

Heterogeneity in codon usages of sobemovirus genes.

When conventional phylogenetic trees were built using 14 genome sequences of 9 sobemoviruses, two main lineages were apparent: monocot-infecting viruses and dicot-infecting viruses. To investigate whether members of the genus Sobemovirus originated from monocot hosts or from dicot hosts, we constructed relationship trees based on Relative Synonymous Codon Usage (RSCU) of the viruses. The RSCU relationship trees grouped the monocot-infecting and dicot-infecting viruses even better than the genome phylogenetic trees. The RSCU approach also enabled direct comparisons among viral and host species. When host species were added into the RSCU tree, the viral species clustered with the monocot hosts, indicating codon usage homologies to monocots. The stability of the RSCU tree was improved when RSCU values were calculated for individual viral open reading frames (ORFs). Most interestingly, the codon usages of the viral ORF-2 that encodes the replicase showed affinity to that of the plants whereas codon usages of the other viral ORFs were not relevant to the host species. All ORF-2s from 3 monocot viruses and 4 out of 6 dicot viruses had greater RSCU affinities to sequences of ORFs in monocot than to dicot hosts, possibly indicating that ORF-2, and therefore the replicase module of sobemovirus has a monocot origin.

Arabidopsis↗
PubMed2001

International mental health outcomes and benchmarking using the FACE (functional analysis of care environments) approach.

This article describes and compares the nature and severity of problems encountered by persons receiving mental health services in the United Kingdom and Australia, and the outcome of their treatment. The perspective of service providers and service users in the two countries was strikingly similar. Treatment was effective in alleviating problems with social circumstances, and in increasing adaptive and interpersonal functioning. Treatment was less effective in addressing psychological or physical problems. Service users in the United Kingdom were more involved in developing their treatment care plan than those in Australia. The study demonstrates how data required for benchmarking and outcome evaluation purposes can be generated as part of routine clinical processes.

Activities of Daily Living↗
PubMed2000

Comparing patients' experience of mental health services in England: a five-Trust survey.

The implementation of the Care Programme Approach (CPA) in English mental health services has been slow to proceed despite general support, both in England and in other countries, of its principles of good practice. This study set out to evaluate the implementation of the CPA directly from patients' experience using the "Your Treatment and Care" assessment tool. The results of a survey of 503 patients across five NHS Trusts in England showed that many patients did not have a copy of their care plan and had not been involved in the care planning procedure. Many reported shortcomings in their experience of their key worker and their psychiatrist. However, there was substantial variation in experience across services. "Your Treatment and Care" showed good internal reliability, was acceptable to users, and appeared to be able to access actual experiences better than a traditional "satisfaction" item. It appears to be very useful as a benchmarking tool and is now being used in services across the UK, the USA and Australia.

Adolescent↗
PubMed1998

Neurodevelopmental consequences associated with the premature neonate.

Changes in neonatal care have resulted in an increased survival rate among low birth weight infants. Because their neurologic system is immature, these infants are vulnerable to neurologic injury. Major and minor neurodevelopmental consequences can result. Most preterm infants survive without serious difficulties; however, the lower the birth weight, the higher the likelihood that problems will occur. Numerous factors can increase a preterm infant's risk for disease and impairment, and the neonatal nurse can perform a significant role in minimizing this risk.

Developmental Disabilities↗
PubMed1997

Coping with chronic pain: assessing narrative approaches.

Individuals suffering from chronic pain are of concern to social workers because such pain disrupts job, family, and overall social functioning and can lead to depression, excessive health concerns, and withdrawal from activities. This article discusses a project developed to gain understanding of the experiences of people suffering from fibromyalgia, a chronic pain condition with no visible symptoms, and to test the use of narrative approaches in group work with this population. The study used a qualitative ethnographic approach as the primary method and also used some quantitative measures to assess the usefulness of the approach. Both qualitative and quantitative findings suggest that narrative approaches helped participants find their own strengths and means of coping and helped them find identities other than as patients.

Adaptation, Psychological↗
PubMed1996

The results of open reduction and Internal fixation of distal femur fractures using a biologic (indirect) reduction technique.

The results of 57 A-O type A or C supracondylar femur fractures treated by open reduction and internal fixation using indirect reduction techniques are reported. No bone grafting or dual plating was used. All patients were placed in a continuous passive motion (CPM) machine postoperatively. Patients were followed at 4-week intervals until fracture healing had occurred. All patients were followed for at least 1 year after injury. All fractures were treated by a single surgeon. The average time for fracture healing was 10.7 weeks (range 8-16). Hardware failure did not occur in this series. Outcomes were assessed using a modified Schatzker scoring method. Using the scale, there were 84% good to excellent results, 11% fair results, and 5% poor outcomes. Fair and poor results tended to occur in more severe fractures and were primarily due to limited knee motion. Complications included two broken screws, one deep infection, and one malunion. No fractures failed to unite. In conclusion, holding the surgical skill factor constant, it appeared that biologic reduction techniques, although they provided excellent bone healing capability, did not guarantee universally satisfactory outcomes.

Adolescent↗
PubMed1994

Quality assurance in mental health: the QUARTZ system.

This paper is concerned with how quality might be assured in mental health services. It includes an account of why a concern with quality and quality assurance procedures are now high on the agenda of the Health Service. A quality assurance programme requires a decision about what elements of a service to monitor, what information is relevant, how it can be collected, and a system for acting on the results. This paper provides a brief review of the kind of information that has been considered relevant and the methods that have been used to collect it. In addition, the principles underlying good and comprehensive quality assurance programmes will be outlined and the development of a particular system, known as QUARTZ, which has attempted to incorporate these principles, described briefly.

Humans↗
PubMed1994

A national audit of new long-stay psychiatric patients. I: Method and description of the cohort.

BACKGROUND: This first report of a national audit of new long-stay (NLS) psychiatric patients conducted in 1992 describes the survey method and characteristics of the cohort. METHOD: Psychiatrists from 59 UK mental health services returned data on 905 patients, aged 18-64 on admission, who had been in hospital for between six months and three years. RESULTS: Two particular sub-groups were observed. Younger NLS patients (aged 18-34) were predominantly single men with schizophrenia; 43% of these had a history of serious violence, dangerous behaviour or admission to a Special Hospital and over one-third were formally detained. Older NLS patients (aged 55-67) were predominantly married or previously married women, more often with a diagnosis of affective disorder or dementia and with poor personal and social functioning; over half were at moderate or severe risk of non-deliberate self-harm. CONCLUSIONS: Despite the continued policy of bed closures and focus on care in the community, some patients admitted recently to psychiatric units in the UK still have protracted hospital stays.

Adolescent↗
PubMed1994

Harm reduction: an emerging new paradigm for drug education.

Harm reduction is a new paradigm now emerging in the field of drug education. This strategy recognizes that people always have and always will use drugs and, therefore, attempts to minimize the potential hazards associated with drug use rather than the use itself. The rationale for a harm reduction strategy is presented, followed by an example of the kind of needs assessment which may be needed for planning a harm reduction strategy.

Adolescent↗
PubMed1992

A needs survey among patients in Leros asylum.

The recent exposure of the plight of inmates living in poor conditions at the state asylum on the Greek island of Leros has caused public and professional outrage. If Greece is to avoid mistakes made by other countries, the plans for rehabilitating the patients and closing the hospital should from the outset include identification of the precise needs of patients for support and care. The survey of the patients' characteristics and needs for care found that most patients had no outside friends or relatives, and most were unable to perform basic daily skills. They shared many basic characteristics, however, with a large sample of the long-stay population in the UK, and 25% were thought to be able to live independently.

Adolescent↗
PubMed1991

Planning for community care: the Community Placement Questionnaire.

The article reviews methodological issues relating to planning surveys of long-stay populations and describes the development of an assessment instrument, the Community Placement Questionnaire, designed to aid planning for long-stay patients resident in hospitals scheduled for rundown or closure. Reliability and validity data are presented and the advantages and limitations of the instrument are discussed.

Adult↗
PubMed1991

Planning for community care. Long-stay populations of hospitals scheduled for rundown or closure.

Using the Community Placement Questionnaire, the long-stay populations of five hospitals were surveyed. The results suggest that there is little need for large hospitals if adequate community provision is made. However, a small number of patients continue to accumulate for whom community placement is hard to envisage. Investigating the characteristics of the 'new long-stay' patients suggests that the usual definition should be extended to include those over 65 years old with no diagnosis of dementia and those in hospital for 1-10 years. About 20% of 'new long-stay' patients have organic diagnoses and the needs of this group require assessment.

Adult↗
PubMed1990

The privatization of treatment services for alcohol abusers: effect on the black community.

This article discusses the "new wave" of privatization of treatment services for alcohol abusers. Despite the prevalence of alcohol abuse among ethnic minorities, the problem is still only marginally accepted as a focus for public health services. Instead of a consolidated effort or an integrated network, there are territorial fights among providers, a mistargeting of audiences, and a lack of any effort directed toward preventive health care. Recent research indicates that 68.5% of private sector employees are now covered by alcohol abuse treatment benefits as compared with only 36.2% in 1982. The growing number of employee assistance programs also has addressed the financial problems associated with long-term treatment in the work environment. Unfortunately these efforts are only directed at those in the society who are employed. As minority employment is much lower than that of the majority, minorities have not received the benefits of employer-financed treatment. This article assesses the growing privatization of treatment services and the failure of public alcohol prevention and rehabilitation programs to provide needed treatment for American minorities.

Black or African American↗
PubMed1989

Assessing the significance of the correlation between two spatial processes.

Modified tests of association based on the correlation coefficient or the covariance between two spatially autocorrelated processes are presented. These tests can be used both for lattice and nonlattice data. They are based on the evaluation of an effective sample size that takes into account the spatial structure. For positively autocorrelated processes, the effective sample size is reduced. A method for evaluating this reduction via an approximation of the variance of the correlation coefficient is developed. The performance of the tests is assessed by Monte Carlo simulations. The method is illustrated by examples from geographical epidemiology.

Adult↗
PubMed1985

Postcricoid carcinoma: a retrospective study of 13 patients.

Thirteen consecutive patients presenting with squamous cell carcinoma in the postcricoid region (PCC) are studied and details of their age, sex, TNM status, treatment and results are analysed. Follow-up ranges from 33 months to 11 years. Three patients presented with cervical node involvement and 2 of these remain disease free without surgical intervention, at 33 months and 9 years. The principal treatment policy has been the combination of multi-agent chemotherapy with radical radiotherapy, reserving wide excision surgery for patients with residual or recurrent carcinoma. Only 4 patients underwent pharyngolaryngectomy, one radical neck dissection was performed and 7 of the 13 patients have remained free of disease for more than 3 years.

Adult↗