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Biomedical subjects

T Walden

Publications and source records attributed to T Walden.

11 recordsLinked to original sources
PubMed2005

Compulsive behavior in Prader-Willi syndrome: examining severity in early childhood.

Prader-Willi syndrome (PWS) is a genetic disorder characterized by hyperphagia and food preoccupations. Researchers indicate that individuals with PWS, including young children, exhibit food and non-food-related compulsions. Normative rituals are also often present among typically developing preschoolers. However, it is unclear how these behaviors affect the child. Although preschoolers with PWS exhibit more types of rituals than other populations, it is uncertain if the severity of these behaviors differs from the rituals experienced during normative development. Thus, the purpose of this research was to determine whether the ritualistic behaviors exhibited by preschoolers with PWS differ in severity from those exhibited during normative development. We also sought to identify whether non-food ritualistic behavior was related to the hyperphagia in PWS. Parents of 68 children with PWS, 86 typically developing children, and 57 children with developmental delays completed questionnaires on rituals and eating behavior. Children with PWS exhibited more severe ritualistic behavior than typically developing children but not other children with developmental delays. However, the severity of non-food-related rituals was related to the severity of eating behavior in PWS. We hypothesize that this link between hyperphagia and non-food-related compulsivity may share a common underlying neurobiological mechanism.

Child↗
PubMed1992

Multiple large calculi in a continent urinary reservoir: a case report.

Continent urinary reservoirs have increasingly become popular during the last decade but they are associated with long-term complications. We report a case of huge multiple stones in an ileocecal reservoir, which formed as a result of noncompliance with intermittent self-catheterization. An open method was required for removal of the stones to prevent recurrent urosepsis.

Adult↗
PubMed1990

Case management: planning and coordinating strategies.

In summary, planning a case management system involves moving through sequenced stages; namely, (1) a developmental stage; (2) a phase-in stage; and (3) an operational stage. During the developmental stage, before processes have been formalized, attention is given to the political realities, the formation of a representative planning group, formulating goals and objectives, obtaining administrative support, information gathering, assessment of needs, resource procurement, program structure and design, selection of a case management model, participatory decision making, determining organizational fit, and beginning networking. During the phase-in or early implementation state, the formal stage of system introduction, attention is given to the establishment of interorganizational relationships, contracting for services, job descriptions, work assignments, training, problem solving, and conflict resolution. During the operational or full implementation stage, a period when the system should become more stabilized, attention needs to be given to managing movement of the client through the system, the flow of information, program updating, quality assurance, recordkeeping, resource management, evaluating, and system refurbishing. In practice, these stages will interact and overlap. Closure, if the system is to remain viable and open to change, should never occur.

Aged↗
PubMed1988

Distinguishing teaching interactions of physically abusive from nonabusive parent-child dyads.

Researchers using a variety of behavioral coding instruments have demonstrated differences between the interactions of physically abusive parent-child dyads and those of nonabusive pairs. Despite fair consistency among these findings, there remains controversy regarding the value of observation of parent-child interaction to the clinical evaluation of child abuse. This study was an investigation of the ability of child protective service workers to distinguish videotaped interactions of physically abusive parent-child dyads from interactions of nonabusive dyads. The interactions occurred as part of a teaching task and were nondisciplinary. The child protection workers achieved a 76% rate of accuracy in identifying the abuse status of the dyads based on observation of only three minutes of semi-structured videotaped interaction. Of the workers, 40% were accurate in classifying 100% of the dyads observed. Increased protective service experience was not associated with increased accuracy, but subjects with no experience in protective service performed at chance level only. The results of this study show that experienced professionals can detect interactional differences in nondisciplinary parent-child interchanges of abusive as compared to nonabusive dyads. This suggests that clinical observation of parent-child interaction may be one important diagnostic tool within a comprehensive evaluation of families suspected of physical child abuse.

Adult↗
PubMed1985

Clinical computing in a teaching hospital.

This report describes a hospital-wide clinical computing system that permits physicians, nurses, medical students, and other health workers to retrieve data from the clinical laboratories; to look up reports from the departments of radiology and pathology; to look up demographic data and outpatient visits; to look up prescriptions filled in the outpatient pharmacy; to perform bibliographic retrieval of the MEDLINE data base; to read, write, retract, edit, and forward electronic mail; and to request delivery of a patient's chart. During a one-week study period, from 300 video display terminals located throughout the hospital, 818 patient care providers used a common registry of 539,000 patients to look up clinical and laboratory data 16,768 times; 477 other hospital workers used the patient registry 46,579 times. In a separate study of 586 health care providers, 470 (80 per cent) indicated that they used computer terminals "most of the time" to look up laboratory results; in contrast, 48 (8 per cent) preferred printed reports. Of 545 hospital workers, 440 (81 per cent) indicated that the computer terminals definitely or probably made their work more accurate, and 452 (83 per cent) indicated that terminals enabled them to work faster. The large amount of use by clinicians and their judgment that the computer has been so helpful to them suggests that a reliable, comprehensive, and easy-to-use computer system can contribute substantially to the quality of patient care.

Boston↗