Biomedical subjects
E Cameron
Publications and source records attributed to E Cameron.
District nursing, the disabled and the elderly: who are the black patients?
Community care research in central Birmingham has shown that disabled and old black people are under-represented on the caseloads of district nurses compared to their white counterparts. Whilst factors suggested as contributing to this (service ethnocentrism and general practitioners as 'gate-keepers') are discussed elsewhere, this paper focuses on those few old and disabled black people who are district nurse patients. Following comparisons between these black and white patient groups, the differing perspectives of black patient and district nurse are explored. Stereotypes and myths, knowledge about each other and language/communication are discussed as important areas which may disadvantage black patients in their interaction with district nurses. Attention is drawn to the urgent need for district nursing to address the issue of black disabled and old people in the community and the accompanying central role of research.
The nursing auxiliary service and the care of elderly patients.
Although nurse auxiliaries comprise a large and rapidly expanding part of the district nursing service, nursing research has largely neglected this group of nurses and the people they see. Using a patient-centred approach, which is a key element of the research, we studied the characteristics of patients who were either physically handicapped, frail elderly or elderly mentally infirm, who make up a large majority of the patients. We found that auxiliaries' patients fell into a typical 'at risk' group; they were older and more likely to be living alone than qualified nurses' patients, and yet they received less frequent visits. Motives for providing and continuing the service to patients were not always related to nursing need, and while recipients were grateful for the service, both they and auxiliaries themselves identified areas of potential improvement. The need to continue to monitor and improve the overall quality, effectiveness and efficiency of the service to patients and potential patients, demands that practitioners, managers and researchers systematically review referral to the service and the work of the nurse auxiliary using a patient-focused approach.
District nurses' patients--issues of caseload management.
Current pressures on all community services mean that practitioners must give more detailed attention to evaluation of patient outcomes and caseload review. District nursing caseloads in one health authority have been examined using a patient-focused approach. Random samples of patients who were either physically disabled, frail elderly, or elderly mentally infirm (n = 202) were examined for the distinctive and differing characteristics, if any, of recently referred and long-stay patients. Recently referred patients in our sample were either terminally ill, or had more chronic physical disorders. Patients who stayed on the books received either injections, general care from qualified staff or baths from nurse auxiliaries. Although covering similar areas of the health authority, nursing teams varied in the proportions of recently referred and long-stay patients, suggesting that individual nurses' caseload management is a crucial determinant of length of time on the books. In particular, nursing and medical review of all patients receiving vitamin B12 injections is urgently called for. In order for caseload monitoring to be facilitated, practitioners need relevant local and patient based data in order to make inter-team comparisons. The findings also have training and management support implications.
Put race on the agenda.
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Behavioral and sociocognitive correlates of ratings of prosocial behavior and sociometric status.
Although peers' and teachers' evaluations of children's prosocial behavior and peers' sociometric ratings frequently have been used in studies of social development, the validity of young children's ratings of others has been questioned, as has that for teachers' ratings of prosocial behavior. In this study, preschoolers' ratings of peers' sociometric status and prosocial behavior, as well as teachers' ratings of children's prosocial dispositions, were obtained. These were correlated with children's naturally occurring prosocial or social behavior; ratings of prosocial behavior also were correlated with children's prosocial moral reasoning and prosocial self-attributions. Peers' sociometric ratings were positively related to children's sociability whereas prosocial ratings were related to helping (but not sharing) behavior. Teachers' ratings of prosocial behavior were not related to frequency of prosocial behaviors, but were positively related to developmentally mature moral judgments and self-reported motives.
[Conconi's test, the 5 x 200 m test, and the anaerobic threshold in swimming].
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Living-related kidney donors: a multicenter study of donor education, socioeconomic adjustment, and rehabilitation.
To determine the consequences of living-related kidney donation, a study was conducted of 536 donors whose nephrectomies had been performed at nine geographically dispersed centers during the past 12 years. The data demonstrated that greater than 84.0% of the donors thought they had been adequately informed regarding all aspects of donation, and less than 15.0% reported being pressured in their decision. Only two serious medical complications were directly attributable to the surgery, greater than 92.0% of the donors believed their health had not been adversely affected by donation, and 96.8% reaffirmed their decision regardless of the graft's success or the financial distress they experienced (P greater than .05). However, greater than 14.0% experienced direct pressure, particularly not to donate. Donation also appeared to stress previously troubled marriages, especially among donors without a religious affiliation, who were pressured to donate by their families, or who borrowed from family members (P less than .05). Substantial unreimbursed expenses (greater than or equal to $1,000) were incurred by 43 donors, and 23.2% of all donors reported that donation caused a financial hardship.
Paediatric acquired immune deficiency syndrome report of the first case from Trinidad.
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Permutation methods for the structured exploratory data analysis (SEDA) of total cholesterol measured in five Israeli populations.
Three structured exploratory data analysis-functionals are applied to plasma total cholesterol concentrations measured for 2,480 young men and women aged 17-18 years and living in Jerusalem, and for their parents. These triad families are divided into five groups according to whether both parents were born in Asia, North Africa, Europe-America, or Israel or whether they were of mixed "origins." The significances of the functionals were determined by a spectrum of permutation techniques that selectively shuffled the trait values across families in order to systematically alter certain family structure relationships while keeping other familial relationships intact. These analyses suggest that generational differences and various distributional effects influence patterns of spouse and parent-offspring interactions within these families and that the nature and forms of these effects and interactions may differ according to the origin of the parents. Results are discussed in relationship to historical and cultural differences among groups.
Leukaemia mortality in Trinidad and Tobago 1957-1976.
Leukaemia mortality in Trinidad and Tobago over the period 1957-1976 was reviewed. The mortality rate was stable except for an unexplained drop in the adult leukaemia mortality in 1966/67. Throughout the period, annual deaths due to leukaemia were less than one percent of the total annual deaths from all causes. The age and sex patterns of leukaemia mortality were similar to that of the United States of America but the overall mortality rate of 24 per million was low when compared with that of the USA where the rate in 1971 was 70 per million.
[Chronic hepatic encephalopathies. Acquired cerebral degeneration not due to Wilson's disease].
We report on 4 cases of perennial hepatic encephalopathy and review similar published cases. The neurological picture consists of a cerebellar syndrome, both static and kinetic, dysarthria, choreo-athetoid abnormal movements and mental deterioration. Symptoms are permanent and usually worsen progressively. Some patients may present with a myelopathy, either isolated or combined with an encephalopathy. Relevant anatomical alterations, either encephalic or spinal, may be observed similarly in several varieties of liver disease, but in every case the role of portocaval shunts, whether spontaneous or surgically performed, appears essential. Altered results of laboratory studies, such as EEG or ammonemia, are described. Histological changes include a peculiar sort of hyperplasia of the protoplasmic astrocytes, along with a certain amount of neuronal loss. Surmised pathological mechanisms and applied therapy are briefly reviewed. For an appraisal of therapeutic results, perennial hepatic encephalopathies should be set apart from both the acute varieties and the usual chronic variety with its succession of recurrent exacerbations and remissions.
Properties of the major gene index for three-allele and two-locus models.
The expected value of the MGI(2) statistic was evaluated for several three-allele and two-locus models for which we have specified dominance relationships among phenotype classes based on heterozygote and homozygote genotype groupings. In a parallel simulation study we investigated the nature of MGI(alpha) for alpha = 1/2, 1, 2 under more elaborate continuous trait expressions incurred from superposition of a background distribution upon each of the phenotypic mean effects.