Biomedical subjects
J M Scanlan
Publications and source records attributed to J M Scanlan.
Nursing through the eyes of a child.
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Identifying the sexually abused deaf child: the otolaryngologist's role.
As a primary physician for most deaf children, the otolaryngologist must be able to identify signs and symptoms of sexual abuse. Child sexual abuse is a topic of national concern as epidemiologic data indicate more than 100,000 American children become victims annually. This paper provides an overview of the incidence, demographic characteristics, risk factors, and dynamics of child sexual abuse within both the general handicapped and, specifically, the hearing imparied populations. Strategies for identifying the sexually abused hearing impaired child are delineated including the physical appearance and behavioral manifestations of child victims, as well as the characteristics of abusive caretakers and perpetrators. Case summaries are presented which illustrate these characteristics. A national center specializing in the evaluation and treatment of abused handicapped children is described.
Elective mutism in a 26 year old deaf female.
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Lithium carbonate in the treatment of tardive dyskinesia.
Six patients with tardive dyskinesia were treated with lithium carbonate in an open clinical trial. Evaluations using a new tardive dyskinesia rating scale showed statistically significant improvement in dyskinetic movements while the patients received lithium. This improvement was consistently observed in all patients but was relatively small when compared to the amount of pathology present.
Letter: Treatment of tardive dyskinesia with lithium carbonate.
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Psychiatric consultation in a general hospital.
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The funding crisis: an opportunity for growth.
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Physician to student: the crisis of psychiatric residency training.
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Insulin and glucose: relationships with hassles, anger, and hostility in nondiabetic older adults.
Relationships of psychosocial factors (anger, hostility, hassles, and caregiving) with fasting insulin and glucose levels were examined. Samples included two groups of nondiabetic adults (mean age = 69.4 years): spouse caregivers (CG) of individuals with diagnoses of Alzheimer's disease (AD) (N = 78) and spouses of nondemented controls (CO) (N = 72) matched for age and gender. The groups were assessed twice with a 15-to 18-month hiatus. To obtain more stable assessments, all biopsychosocial measures were averaged over time. Psychosocial factors were associated with insulin and glucose, even after controlling for significant health variables: obesity, lipids, and cardiovascular disease. As hypothesized, CG with high anger-out/hostility (AOHO) had significantly higher glucose levels than all other group combinations. The glucose levels for subjects with high hassles or high AOHO were significantly higher than those for subjects who were low on both of these factors. For insulin, a three-way interaction occurred among AOHO, hassles, and gender-hormone replacement therapy (HRT); in women taking HRT, no relationships occurred between insulin with AOHO and hassles. In women not taking HRT, those with high AOHO and high hassles had significantly higher insulin levels than the other three combinations, whereas in men, those with either high AOHO or high hassles had significantly higher insulin levels than men who were low on both of these factors. Given these results, future research should examine the degree to which interactions between metabolic processes with psychosocial variables, gender, and HRT have long term health consequences in nondiabetics.
CD4 and CD8 counts are associated with interactions of gender and psychosocial stress.
OBJECTIVE: This study examined relationships of gender, psychosocial stress/distress (caregiving, hassles, depressed mood), and the relative percentage and absolute cell counts of CD4 and CD8 cells in two samples of older adults (mean age = 69.4)--spouse caregivers of persons with Alzheimer's disease (N = 78) and age- and gender-matched spouses of nondemented controls (N = 72). METHODS: Counts and percentages of CD4 and CD8 cells and psychosocial variables were assessed twice (Time 1, Time 2) over a 15- to 18-month period. Several covariates were examined in the analyses, including body mass index (BMI), medication use, alcohol use, exercise, and illness history. RESULTS: Caregiver men had fewer CD4 cell counts at Times 1 and 2 than did control men (p < .05). At Times 1 and 2, both CD8 cell counts and percentages were positively associated with hassles in men (p < .05), but not in women. Although interactions of hassles and gender were present for CD8 percentages at both times, interactions and main effects were not present for CD4 percentages at either time. When the ratio of CD4 to CD8 levels was analyzed, hassles by gender interactions were present at both Times 1 and 2-hassles were negatively associated with the CD4/CD8 ratio in men (p < .05), but unrelated in women. From Time 1 to Time 2, change analyses showed that increases in hassles scores were associated with decreases in CD4 counts (p < .05), whereas increases in Hamilton Depression Scores were related to increases in both CD8 counts and percentages (p < .05). CONCLUSION: Caregiver status, hassles, and depressed mood had cross-sectional and/or longitudinal associations with CD4 and CD8 counts, but such relationships occurred primarily in men. Moreover, absolute cell counts were more related to psychosocial factors than were percentages.
Assessment of continuing nursing education needs: a literature review.
Continuing education literature is replete with disagreement and confusion regarding the value and methods of conducting needs assessments for nurses. Literature that describes the usefulness of needs assessment ranges from fuzzy rhetoric to sound empirical studies of learners' needs. Sorting through the numerous articles is a difficult and tedious task for the continuing education planner. In addition, the lack of consistency in the writings makes comparison of needs assessment findings onerous. This article presents a synthesis and critical analysis of the needs assessment literature in nursing. One hundred and thirty-two articles and books were reviewed, and four major themes emerged from the analysis.
Empowering nurses for politically astute change in the workplace.
While studies of the shortage of nurses have documented the need for nurses to play a greater role in decision-making processes in their workplaces, it cannot be assumed that nurses have the confidence or skills for making changes in the workplace in politically astute ways that will be effective. This article describes a continuing education program that was designed to prepare nurses to realize their potential power and to develop skills for effectively bringing about changes in their workplaces. Based on a feminist model of empowerment, the program content and methods reflected three dimensions of empowerment: consciousness-raising, building self-esteem, and skill development. Both short- and long-term evaluations (immediate and at 7 months) demonstrated that education can be a vehicle for empowering nurses to effectively bring about changes in their workplaces. The program was sponsored by the Manitoba Nurses Union, The University of Manitoba Continuing Education Division, and The University of Manitoba School of Nursing.
Meeting the challenge of developing courses for distance delivery: two different models for course development.
Nursing education is increasingly challenged to convert traditional course offerings to distance delivery modalities to accommodate practicing RNs who wish to pursue continuing education. There is a lack of understanding regarding the experiences of faculty and staff from other departments within the university in the development of distance education courses. The purpose of this descriptive study was to uncover the experiences of nursing faculty and members of a university support unit involved in interdisciplinary development of distance delivery courses. Interviews were conducted with 11 participants. Two organizational models were identified. Other issues that emerged in the development of distance delivery courses were: faculty ownership of distance courses; workload implications for faculty; clinical practice by distance; and faculty expertise in new technologies. Implications for incorporating the challenges facing nursing faculty in the 21st century in the development of distance delivery courses are discussed.