Biomedical subjects

A E Mackenzie

Publications and source records attributed to A E Mackenzie.

11 recordsLinked to original sources

PubMed1998

Community nurses' assessment of the needs of Hong Kong family carers who are looking after stroke patients.

This research aimed to identify the current practice of community nurses in Hong Kong in assessing stroke patients and their carers, and to pilot a scale for inclusion in the routine assessment of Chinese carers and their families. Qualitative and quantitative methods were used. In Phase 1, information was gained about the current practice of Community Nurses in assessing the needs of carers, and appropriate areas for inclusion in a scale for assessing those needs were identified. In Phase 2, the Carer Assessment Scale was completed by 14 Community Nurses and subsequently administered by a research assistant independently to the carers themselves. The perceptions of the two groups of respondents were compared, agreements and differences noted, and conclusions drawn, as to the real needs of carers.

Caregivers↗

PubMed1998

Caring for relatives with serious mental illness at home: the experiences of family carers in Hong Kong.

This article describes a study recently carried out in Hong Kong. The aim of the study was to gain an understanding of the experiences of Chinese family carers in giving care to a relative with serious mental illness at home. Eight primary carers were selected, and data were collected through audiotaped, semistructured interviews in Cantonese. Five main categories emerged from the data: emotional impact, coping and adaptation, psychosocial effect, social support needs, and perceptions of mental illness and mental health services. Conclusions highlight the need for family-oriented mental health services to be developed and for further research to identify the specific nursing interventions that are effective in helping to sustain family caregiving in Chinese families.

Caregivers↗

PubMed1998

Case management: a review of the definitions and practices.

Case management has been suggested as an innovative strategy which facilitates the linking of quality and cost-effective care. However, there is little consensus about what is actually being introduced under the name of case management. It is suggested that this absence of a clear understanding of case management has been an obstacle in moving forward case management practice and research. This paper presents a critical review of the confusion surrounding case management with an attempt to unravel issues relevant to the implementation of case management into community nursing practice in Hong Kong. It is concluded that there is a need for different definitions of case management as a result of the differences in the cultural and health care context in which it is being practised. Also, if case management programmes are to be advanced, there needs to be more co-ordinated effort in researching not only the expected outcomes but also the structures and processes of these programmes so that findings of similar case management programmes can be compared for ways of future improvement.

Case Management↗

PubMed1998

State self-esteem following stroke.

BACKGROUND AND PURPOSE: Physical rehabilitation after stroke is often highlighted in the absence of consideration of psychosocial factors. This study sought to determine the relationship between state self-esteem and functional independence in patients recovering from stroke. METHODS: In a longitudinal study, data were collected from 152 stroke patients within 48 hours of admission to a rehabilitation hospital and at 2 weeks and 3 months after admission. The Modified Barthel Index was used to assess functional ability. Patients' current feelings of self-worth were assessed with use of the State Self-Esteem Scale. Additional variables included perceived social support, trait self-esteem, age, previous stroke, side of stroke, comorbidity, marital status, and gender. RESULTS: State self-esteem was significantly correlated to functional independence. The results of linear stepwise regression analysis indicated that functional ability and state self-esteem at 2 weeks, as well as the presence of heart disease, were significant predictors (55%) of functional ability at 3 months. For those with a functional ability score of >/=81 on admission to the rehabilitation unit, state self-esteem and functional ability at 2 weeks as well as previous stroke explained 53% of the variance in functional ability at 3 months. When functional ability was </=80, baseline and 2-week functional ability, state self-esteem at 2 weeks, and age predicted 53% of the variance in functional ability at 3 months. CONCLUSIONS: Functional ability at 2 weeks was a stronger predictor than baseline functional ability in this study. The level of state self-esteem was also a consistent factor in the prediction of functional outcome of patients after stroke.

Activities of Daily Living↗

PubMed1998

Expression of inhibitor of apoptosis proteins (IAPs) in rat granulosa cells during ovarian follicular development and atresia.

The inhibitor of apoptosis proteins (IAPs) constitute a family of highly conserved apoptosis suppressor proteins that was originally identified in baculoviruses. Although IAP homologs have been recently identified and demonstrated to suppress apoptosis in mammalian cells, their expression and role during follicular development and atresia are unknown. The present study was conducted to address these questions. Using established in vivo models for the induction of follicular development and atresia in immature rats, it was possible to compare the immunolocalization of X-link inhibitor of apoptosis protein (Xiap) and human inhibitor of apoptosis protein-2 (Hiap-2), two members of the IAP family, at defined stages of follicular maturation and to relate the differences observed with those of follicular cell proliferation and apoptosis [as determined by proliferating cell nuclear antigen (PCNA) immunohistochemistry and in situ terminal deoxynucleotidyl transferase-mediated dUTP-biotin end labeling (TUNEL), respectively]. In addition, granulosa cell DNA and proteins were assessed for apoptotic fragmentation by 3'-end labeling/agarose gel electrophoresis (DNA ladder) and Hiap-2 and Xiap protein content by Western blot analysis, respectively. Hiap-2 and Xiap expression in both granulosa and theca cells increased with follicular maturation, reaching maximal levels at the antral stage of development. The immunoreactivity for PCNA, Xiap, and Hiap-2 decreased markedly in atretic (TUNEL-positive) follicles at the small to medium sized antral stage of development, suggesting follicular atresia may be associated with decreased granulosa cell IAP protein content and decreased proliferation. Atresia was also associated with a change in the intracellular distribution of IAPs in granulosa cells. Biochemical analysis of DNA fragmentation (DNA ladder) in granulosa cells from preantral and early antral follicles indicates extensive apoptosis that was associated with minimal IAP protein content. Gonadotropin treatment increased Hiap-2 and Xiap protein content and suppressed apoptosis in granulosa cells, resulting in the development of follicles to the antral and preovulatory stages. In addition, gonadotropin withdrawal induced apoptotic DNA fragmentation in granulosa cells in early antral and antral follicles, which is accompanied by a marked decrease in Hiap-2 and Xiap expression. These data suggest that IAPs may be involved in the suppression of granulosa cell apoptosis by gonadotropin in small to medium-sized antral follicles and play an important role in determining the fate of the cells, and thus also the eventual follicular destiny (atresia vs. ovulation).

Animals↗

PubMed1996

An exploration of the carers' perceptions of caregiving and caring responsibilities in Chinese families.

This qualitative study carried out with 10 Chinese families in Hong Kong describes caregiving and caring from the perceptions of the primary carers. Semi-structured interviews were carried out to gain personal accounts of experiences of primary carers caring for dependent family members. The analysis resulted in categories identifying and explaining the needs of primary carers. Suggestions for practice are made.

Activities of Daily Living↗

PubMed1995

A review of the historical and social processes contributing to care and caregiving in Chinese families.

The purpose of this paper is to review the literature on caring and caregiving in Chinese families in relation to the contribution made by historical and social processes. The beliefs and traditions of care appearing in the professional and popular literature are explored to enable comparison with recent research from Hong Kong, China and the United Kingdom. Caring emerges as profoundly complicated and ambivalent, drawing on notions of morality, obligation, love, kinship and gender responsibility. Furthermore, caring in contemporary Chinese families in Hong Kong appears to have more similarities than differences with western families, possibly due to changing kinship networks. Such conclusions have particular relevance for nursing in the light of recent policy directives in Hong Kong promoting the role of the families in caring for their dependent members based on the assumption that families can and will care.

Aged↗

PubMed1995

Evaluating individual performance in higher education: a new challenge for nurse educators.

In response to the demands for more accountability and efficiency in higher education, of which nurse education is now a part, this paper explores the evaluation of individual performance. It considers the purposes of staff appraisal and draws upon a study of criteria for self-appraisal of teachers and upon experience gained in introducing teacher appraisal into schools. Different teaching environments are discussed and the additional demands upon academic staff in universities in terms of research are considered in the light of the recent Research Assessment Exercises. Particular consideration is given to the performance of nursing departments in the 1992 exercise and to the implications for staff appraisal. Successful procedures for evaluating individual performance in schools that might transfer to higher education are identified and strategies that might be adopted by nursing departments are suggested. This paper argues that evaluation of individual performance is a worthwhile departmental function which, when successful, may help to create an atmosphere more conductive to the eventual successful introduction of total quality management to the institution as a whole. It concludes that the extra substantial demands upon staff time and energy, at a time when nursing departments are trying to establish themselves in the higher education sector, might be alleviated if the groundwork already undertaken in schools is put to good use.

Education, Nursing, Baccalaureate↗

PubMed1994

Evaluating ethnography: considerations for analysis.

The informed evaluation of ethnographic reports is essential to the practitioner who is working towards research-based practice. It is also part of the process of developing and refining nursing knowledge. While there are features common to the critical examination of all research, an understanding of ethnographic design and, in particular, of issues of validity and reliability, is a prerequisite for evaluation of ethnographic research reports.

Anthropology, Cultural↗

PubMed1992

Learning from experience in the community: an ethnographic study of district nurse students.

This study seeks to gain an understanding of the learning experiences of district nurse students in the learning environment of the community, and to examine learning in the practice setting from the perspective of the student. Since the research depends upon the changing and differing interpretations of the individuals involved in the natural setting of the community, an ethnographic approach has been adopted. The experiences of students are monitored throughout the taught practice element of the district nurse course in both inner city and rural/urban locations. Data, collected through interview and observations, are analysed in the context of theory relating to adult learning and learning from experience. Three major categories are identified. Examples from these categories are identified and discussed. The categories are sequential and represent the learning process experienced by the students in the practice setting as they learn to fit into a new environment, test out their own ideas and compare the unreality of college with the reality of practice. Attention is drawn to the difficulties for students of fitting into new settings and trying out change, to the detrimental effect on learning of rigid practice routines and to the powerlessness of community practice teachers to exert a major influence on the learning environment. These issues are discussed in the context of changes in nurse education and evaluation of the community learning environment.

Community Health Services↗

PubMedDate not supplied

Simpson-Golabi-Behmel syndrome associated with renal dysplasia and embryonal tumor: localization of the gene to Xqcen-q21.

We report 6 affected males in a 5-generation family with x-linked Simpson-Golabi-Behmel (SGB) syndrome. All had pre- and postnatal overgrowth with 2 adult males attaining heights over 195 cm. Other features included "coarse" face with hypertelorism, broad nasal root, cleft palate, full lips with a midline groove of the lower lip, grooved tongue with tongue tie, prominent mandible, congenital heart defects, arrhythmias, supernumerary nipples, splenomegaly, large dysplastic kidneys, cryptorchidism, hypospadias, skeletal abnormalities and postaxial hexadactyly. All affected individuals were of normal intelligence. One boy died at age 19 months of a neuroblastoma. The putative origin of the gene in this family was the maternal great grandmother of the propositus. Eight carrier females, who showed varying manifestations of the gene, have been identified. Anthropometric analysis has identified preliminary characteristic craniofacial dimensions in this syndrome. Molecular studies have shown a maximal lod score of 2.81 with no recombinants observed for the SGB-DXYS68 pairing, mapping the disorder to Xqcen-Xq21.3.

Adolescent↗