James F. Jekel

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The study reported in this Monograph of the effects of early supplementary feeding on cognition included two data collection periods: a longitudinal investigation spanning the years 1969-1977 and a cross-sectional follow-up carried out in 1988-1989. The study was conducted in four rural villages in Guatemala and compared the differential effects of exposure(More)
BACKGROUND In adults with suspected meningitis clinicians routinely order computed tomography (CT) of the head before performing a lumbar puncture. METHODS We prospectively studied 301 adults with suspected meningitis to determine whether clinical characteristics that were present before CT of the head was performed could be used to identify patients who(More)
OBJECTIVE To describe the assessments for exposure to violent events and posttraumatic stress disorder (PTSD) symptoms in a population of urban adolescent girls. METHOD Seventy-nine urban adolescent girls attending an adolescent medicine clinic were assessed via clinician-assisted self-report measures called the Adolescent Self-Report Trauma(More)
needs of the dying patient (or colleague) and their families. Beyond "greater awareness," however, the solution to this problem is not found in this book. It simply reminds us to consult with social work or psychiatry in order to mask our own deficiencies. Such consultation will not substantially improve the effectiveness of the physician in handling these(More)
To determine the diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity for meningitis, 297 adults with suspected meningitis were prospectively evaluated for the presence of these meningeal signs before lumbar puncture was done. Kernig's sign (sensitivity, 5%; likelihood ratio for a positive test result [LR(+)], 0.97), Brudzinski's(More)
The causes of peritonitis in patients with end-stage renal disease maintained on long-term peritoneal dialysis (PD) are unclear. One possible explanation for peritonitis, particularly in patients with multiple episodes of infection, is the release of planktonic bacteria from biofilm on the walls of catheters. Bacteria form biofilm on the walls of catheters(More)
Virtually every course of medical action is associated with some adverse risk to the patient. Discussing these risks with patients is a fundamental duty of physicians both to fulfill a role as trusted adviser and to promote the ethical principle of autonomy (particularly as embodied in the doctrine of informed consent). Discussing medical risk is a(More)
Since 1982, there have been summer camps for children and adolescent burn survivors. Although the primary focus of camp is to have "fun," the principal goal is psychosocial readjustment through peer interactions and the resulting enhancement of self-esteem (SE). This study was initiated to test the hypothesis that the burn camp experience enhances the SE of(More)
OBJECTIVE To describe the role of spiritual beliefs in HIV-positive patients' end-of-life decisions. DESIGN Inperson, cross-sectional survey. SETTING An HIV/AIDS floor of an urban, university teaching hospital. PATIENTS Ninety hospitalized HIV-positive patients. MAIN OUTCOME MEASURES Prior discussions about advance directives, possession of a living(More)
The long-term effects of school-age pregnancy were investigated in a 20-year follow-up of a cohort of women who were pregnant adolescents in the late 1960s. Of the 149 living young black primiparas in the original cohort, 121 (81%) were located and interviewed. At follow-up the study population ranged in age from 32 to 38 years, 68% were unmarried, 71% had(More)