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Biomedical subjects

J W Duncan

Publications and source records attributed to J W Duncan.

At least 19 recordsLinked to original sources
PubMed2001

MSHAKE. A tool for measuring staff knowledge related to geriatric mental health.

This article describes the development of a knowledge-screening instrument used with staff caring for elderly patients with neuropsychiatric disability. A 25-item tool, referred to as the Mary Starke Harper Aging Knowledge Exam (MSHAKE), was developed to verify knowledge competencies of 171 employees at a geropsychiatric center in the Southeastern United States. The MSHAKE assesses basic geriatric mental health knowledge in an educationally diverse health care work force. A variety of descriptive and inferential statistics provide preliminary evidence supporting the use of the MSHAKE as an effective measure of staff members' essential knowledge of aging and neuropsychiatric disorders. This tool has practical application in the clinical setting as part of a competency verification system or in-service evaluation.

Administrative Personnel↗
PubMed1983

Modified Hoke-Miller flatfoot procedure.

Within a relatively limited follow-up study of ten patients, the modified Hoke-Miller flatfoot operation proved effective both in removing symptoms and changing the architecture of the foot.

Adolescent↗
PubMed1981

Mixed Streptococcus pneumoniae and gram-negative bacillary pneumonia in the elderly.

Of 24 elderly patients with Streptococcus pneumoniae pneumonia confirmed by transtracheal aspiration, six had concomitant infection with gram-negative aerobic bacilli. All six patients were elderly men with underlying cardiopulmonary disease. Three had had recent prior episodes of gram-negative pneumonia and four had previously received antibiotics. The clinical, laboratory, and epidemiologic characteristics of these six patients with mixed bacterial pneumonia are reported.

Aged↗
PubMed1981

The role of the nurse in the care of sexual assault victims.

In this article, a unique and comprehensive role has been described for the nurse who functions within the context of a rape counseling team. Nurses can assume a variety of nontraditional roles in facilitating the recovery of sexual assault victims. They can function as crisis intervention counselors, victim advocates with regard to law enforcement and medical personnel, as well as educators in relation to both the victim's significant other and to legal, medical, mental health personnel with whom the victim may interact. The nurse who responds to the victim in a holistic manner, fulfilling a number of nontraditional roles, can promote the victim's smooth navigation of systems involved with her care. In so doing, the nurse provides continuity of care and facilitates the victim's recovery from the trauma of sexual assault by simplifying the process of treatment.

Counseling↗
PubMed1979

Idiopathic chondrolysis of the hip.

Eight patients were seen with idiopathic chondrolysis in nine hips, with from one to eight years' follow-up. The adolescent patients showed characteristic diagnostic patterns--patients in the hip and a limp. The disease occurs most frequently in black girls and in them it tends to be more severe. Threre is progressive loss of articular cartilage, frequently progressing to flexion-adduction contracture and fibrous ankylosis. The pathological process in our patients mainly consisted of chronic synovitis and loss of articular cartilate in the weight-bearing surface of the femoral head. The patients with mild cases were satisfactorily treated with physical therapy, non-weight-bearing, and analgesics. The other hips, however, did best when allowed to undergo fibrous ankylosis with the hip in a functional position.

Adolescent↗
PubMed1978

Medical, psychologic, and legal aspects of child custody disputes.

An increasing number of children seen in pediatric practice are children of divorce. The child is often involved in the conflict between his parents in regard to custody and visitation. The physician will want to be familiar with the historical background of child custody decisions and the present guidelines the courts are using in determining custody and visitation, together with the newer and controversial proposals concerning the elusive concept of "best interests of the child." It is important that the pediatrician recognize the usual phenomenology of the young child's response to family disruption, lest he ascribe it to some fault on the part of the current caretaker. Some children respond to disruption in the family with symptoms that warrant intervention directed toward helping the child. All cases warrant intervention designed to enhance the parenting ability of the custodial parent and to enlist the cooperation of the noncustodial parent to minimize adverse influences on the child's developmental agenda. The physician should be well prepared if he participates in court procedures regarding custody and visitation controversy.

Adolescent↗
PubMed1978

Hoke triple arthrodesis.

One hundred and nine cases of the Hoke triple arthrodesis which were done between 1945 and 1974 are reviewed. The results of the procedure are similar to other series insofar as correction of the deformity and the non-union rate are concerned. There was, however, an over-all incidence of aseptic necrosis of the talus of 6.5 per cent. A change in technique, in which the origin of the artery to the tarsal canal was left intact, has eliminated this complication. Excessive stress on the ankle joint as a result of the triple arthrodesis, although theoretically a problem, was not significant during follow-up of these patients. In the fourteen patients with myelomeningocele, there was acceleration of degeneration of the ankle joint, but Charcot joints did not develop.

Ankle↗
PubMed1977

The immediate management of suicide attempts in children and adolescents: psychologic aspects.

Adolescent suicide is steadily on the increase. Many attempters have previously consulted a physician, but have concealed their suicidal intent. When the attempt is made the family doctor is often the first physician contacted. In children under 12 years of age, the population at risk for suicide includes those who feel abandoned because of neglect, child abuse, or bereavement. The early adolescent may suicide by mis-adventure. Adolescents at risk include those who experience rage associated with feelings of utter helplessness and hopelessness and those who use self-destructive behavior to manipulate other people in the expectation that these other people will gratify their wishes. To ensure adequate medical and psychologic care, the physician should hospitalize the suicide attempter. Future suicide attempts are less likely if the physician can elicit the adolescent's awareness of his anger, diminish the child's self-contempt, help him to explore nondestructive solutions to his problems, and increase his awareness that his death by suicide would cause irreparable emotional damage to his family. The initial management provides the data required for formulation of an aftercare plan that the physician may coordinate and monitor.

Adolescent↗
PubMed1976

The treatment of anorexia nervosa.

The authors report on their treatment of 32 young patients with severe anorexia nervosa who had lost an average of 37% of their original body weight. The therapeutic approach, conceived to meet both the physiological and the psychological needs of the patients, was carried out in a psychiatric unit for adolescents in a general hospital and involved separation of the patient from his or her family, treatment of the malnutrition, individually planned psychotherapy, and concurrent work with the family. The importance of accepting the patient's uniqueness, maintaining long-term contact, and encouraging the patient's striving toward constructive growth and autonomy is emphasized.

Adolescent↗
PubMed1975

The bizarre stiff hip. Possible idiopathic chondrolysis.

Idiopathic chondrolysis of the hip is characterized by pain and limp in adolescence, with progressive loss of articular cartilage space and stiffness of the hip. In our five cases, the best results were obtained in those patients immobilized in a position of function. Those cases in which range-of-motion exercises were carried out resulted in ankylosis in a position of excessive flexion.

Acute Disease↗