bluuebunny/crossref_metadata_2025 huggingface dataset:
FEMORAL LENGTHENING IN PATIENTS HAVING ABNORMAL IPSILATERAL HIP OR KNEE
Authors: Gabriel Keith R , Russell John M , Crawford Alvin H , Roy Dennis R
Published: April 2021

ABSTRACT

Femoral lengthening using the Wagner technique was performed for 13 patients with abnormal adjacent joints. An average of 6.3 cm (19.5%) of lengthening was achieved. Three patients had no difficulties during lengthening. Transient non-surgical problems identified were blood pressure elevation, nerve palsy, and psychiatrie reactions. Significant obstructions or complications occurred 13 times in nine cases. These included contractures of ipsilateral joints, angulations of the lengthened femur, Wagner device slippage, nonunion, and late hip subluxation. Other authors have reported similar difficulties in patients with normal ipsilateral joints. In this series, the advantage of achieving greater length appeared to outweigh the complications.
TREATMENT OF ULNAR SHAFT FRACTURES: A PROSPECTIVE, RANDOMIZED STUDY
Authors: Atkin David M , Bohay Donald R , Slabaugh Peter , Smith Briant W
Published: April 2021

ABSTRACT

The treatment of isolated ulnar shaft fractures is controversial. Previous studies comparing treatment options have been largely retrospective and nonrandomized. In this study, consecutive patients were randomized into treatment groups of long arm plaster immobilization, short arm plaster immobilization, or Ace Wrap bandage, based on the order of hospital admission. Thirty-one patients were followed until radiographic or clinical union, with no significant difference in time to union between groups. Age, sex, fracture pattern, and displacement did not significantly influence time to union or final angulation. Two patients in both the long arm cast group and the short arm cast group lost significant motion at final follow up. Seventy percent of patients in the Ace Wrap group failed treatment secondary to pain and were converted to plaster immobilization. Furthermore, patients in this group demonstrated significantly greater angulation than those treated in a long arm cast. Our results demonstrate that above-elbow plaster immobilization offers no advantage over below-elbow immobilization. We recommend short arm casting for a period of 8 weeks.
CLOSED REDUCTION AND PERCUTANEOUS STABILIZATION OF TIBIAL PLATEAU FRACTURES
Authors: Harper Marion C , Henstorf Jan E , Vessely Michael B , Maurizi Michael G , Allen William C
Published: April 2021

ABSTRACT

Twenty-eight patients with tibial plateau fractures treated by closed reduction using forceful traction and percutaneous stabilization with pins or screws were reviewed. For six bicondylar fractures, transfixion pins with an external fixation device were used. In six cases, an arthroscopic exam was also done. For 21 patients, external support was used postoperatively. Twenty-one patients were followed an average of 26 months. All fractures healed. Functional ratings were: 14 excellent, 6 good, and 1 poor. Radiographic ratings were: 11 excellent, 9 good, and 1 fair. For fractures with large fragments without excessive comminution or severe central depression, this technique yields good results with minimal surgical morbidity.
EXPANDING THE USE OF THE ANKLE DISTRACTOR IN THE TREATMENT OF COMPLEX ANKLE FRACTURES
Authors: Rupp Robert E , Ebraheim Nabil A , Moronell Mark
Published: April 2021

ABSTRACT

Use of the ankle distractor with ankle arthroscopy is well known to allow improved evaluation of the intraarticular surfaces. A less common application of the ankle distractor is for the treatment of complex ankle fractures. We evaluated the use of the ankle distractor in the treatment of six patients with ankle trauma. Five of these cases involved comminuted intraarticular fractures of the distal tibia, and one case involved a malunion of an ankle fracture with widening of the mortise. In each case, the ankle distractor increased the exposure of the ankle joint and allowed better access for fracture fragment reduction. There were no complications associated with the use of the distractor. The technique of using the ankle distractor in these situations is described.
A COMPUTER TOMOGRAPHIC CLASSIFICATION SYSTEM FOR THE DISPLACED INTRAARTICULAR FRACTURE OF THE OS CALCIS
Authors: Corbett Michael , Levy Andrew , Abramowitz Andrew J , Whitelaw George P
Published: April 2021

ABSTRACT

The treatment of the displaced intraarticular fracture of the os calcis continues to be controversial. One of the reasons for this is the lack of a workable classification system which would allow comparison among different treatment modalities. Plain radiographs are unable to depict the complex three-dimensional pathology of this fracture. Computed tomography (CT) scanning, however, has the potential to quite accurately depict all components of this injury. At our hospital, a five-part, CT-based classification system has been utilized. This system suggests which fractures will do well with conservative care, and which fractures are amenable to operative stabilization.
RADIOLOGIC CASE STUDY
Authors: Salomon Caryl G , Bednar Michael S , Light Terry R
Published: April 2021

GLOMUS TUMOR
The Ability of Various Acetabular Components to Resist Protrusio Migration
Authors: Benjamin James , Thomas Maxwell , Szivek John
Published: April 2021

ABSTRACT

A foam model of a protrusio acetabulum with cylindrical voids of varying diameters was used to test acetabular components for their ability to resist migration within the defect. A bipolar component, a hemispherical cup, and a hemispherical cup with peripheral rim augmentation were tested in defects with diameters ranging from 1 to 3 mm less than the major diameter of the component. The cup with peripheral rim augmentation demonstrated 20% to 40% greater resistance to migration than the hemispherical cup, depending on the extent of under-reaming, with the bipolar component consistently demonstrating the lowest load to failure. The results of this study confirm the less-than-satisfactory clinical results seen with bipolar reconstruction of protrusio acetabuli, and support the use of "fixed" cups in these settings.
The Use of Three-Dimensional Computed Tomography in Evaluating Snapping Scapula Syndrome
Authors: Mozes Gavriel , Bickels Jacob , Ovadia Dror , Dekel Samuel
Published: April 2021

ABSTRACT

This article evaluates imaging of the scapula and scapulothoracic joint in patients with snapping scapula, syndrome. Between 1990 and 1996, a total of 20 patients (1 0 men and 1 0 women) with snapping scapula syndrome were evaluated. Diagnosis was based on patient complaints and physical examination findings. There were 26 affected scapulae (6 patients had bilateral presentation). Imaging of the scapula included plain radiography, computed tomography (CT), and 3-dimensional computed tomography (3-D CT) reconstruction.

Plain radiography revealed bony incongruity between the anterior aspect of the scapula and the chest wall in 7 scapulae, CT revealed such incongruity in 19 scapulae, and 3-D CT revealed incongruity in all 26 scapulae. Treatment was conservative, consisting of nonsteroidal anti-tnflammatory drugs, a physiotherapy program, and subscapular injection of a local anesthetic and steroids. In 5 patients who responded poorly to conservative treatment, the region responsible for the snapping was resected. Pain relief and resolution of the snapping were complete following surgery in 4 patients, while pain and crepitation persisted in the fifth. Three-dimensional CT is recommended as the main imaging modality in the evaluation of any patient with snapping scapula syndrome who is a candidate for surgical intervention.
Clinical, Radiographic, and Scintigraphic Comparison of the Mechanical Stability of Mueller and Zweymueller Total Hip Prostheses
Authors: Stamatakis Marios , Korovessis Panagiotis , Mastorakou Anna , Profanti Maria , Soukakos Panagiotis N
Published: April 2021

ABSTRACT

Twenty-two cemented Mueller and 25 uncemented Zweymueller total hip arthroplasties (THAs) were performed in the same period in 47 consecutive randomly selected patients with unilateral primary osteoarthritis. Patients were evaluated using the same clinical and radiographic protocol preoperatively; 3, 6, and 1 2 months postoperatively; and annually thereafter as well as with Tc 99m MDP three-phase bone scintigraphy 3, 6, 12, and 24 months postoperatively. At "? periprostatic regions of interest (ROIs) around the stem and socket of each prosthesis, several radiographic parameters and bone scintigram uptake grade were recorded and correlated to determine the significance of early scintigraphic uptake for prediction of the stability of cemented and uncemented THA components over time.

Around stable Zweymueller and Mueiler sockets, the radionuclide uptake was s'imHar during aì periods of observation. Radionuclide uptake around stable Zweymueller stems was significantly more than around stable Mueller stems at the medial femoral cortex 3 and 6 months postoperatively, at the lateral femoral cortex 3-24 months postoperatively, and near the tip of the stem 3 months postoperatively. Radionuclide uptake around stable Mueller stems was significantly more than around Zweymueller stems at the greater trochanter 6 and 1 2 months postoperatively and at the lesser trochanter 1 2 months postoperatively. Any significant deviation of radionuclide uptake at any ROI, time, and THA component during the first 2 years postoperatively in combination with radiographic findings of loosening should be considered a serious predictive sign for loosening of a Mueller or Zweymueller THA component.
In Vivo Kinematics of the Low Contact Stress Rotating Platform Total Knee
Authors: Haas Brian D , Komistek Richard D , Dennis Douglas A
Published: April 2021

Abstract

The Rocky Mountain Musculoskeletal Research Laboratory uses in vivo video fluoroscopy to evaluate kinematics of total knee arthroplasty. This method allows us to evaluate In vivo weight bearing activity for a variety of knee designs, as well as kinematics of the normal knee. Our proprietary method of automated model fitting allows for three-dimensional analysis obtained from twodimensional fluoroscopic images with minimal error. This article outlines the details of our kinematic analysis of the Low Contact Stress (LCS) Total Knee System (DePuy Orthopaedics Ine, Warsaw, lnd) rotating platform total knee and compares this design with fixedbearing posterior cruciate-retaining and posterior cruciate-substituting total knee and normal knee kinematics.
The Clinical History of Mobile-Bearing Patella Components in Total Knee Arthroplasty
Authors: Jordan Louis R , Dowd James E , Olivo Jane L , Voorhorst Paul E
Published: April 2021

Abstract

Two hundred fifty-six primary cementless meniscalbearing total knee arthroplasties were performed between May 1985 and January 1989. All knees were replaced with a low contact stress metal-backed anatomic mobile patella. The average patient followup was 1 1 .5 years. No patellae were revised for failure of fixation and no dislocations or subluxations were reported. One patella was revised for polyethylene wear, and one well-functioning component was removed at the time of revision to facilitate range of motion and wound closure. The survival estimate at 12 years was 99.5%. Compared to the high incidence of failure of metal-backed fixed-bearing patellae components, the anatomic rotating patella provides durable long-term results with a low incidence of complications.
Latissimus Dorsi Pedicled Flap for Upper Extremity Soft-Tissue Reconstruction
Authors: Rogachefsky Richard A , Aly Ali , Brearley Wayne
Published: April 2021

Abstract

The latissimus dorsi often is used as a functional muscle transfer to restore elbow and shoulder motion. Although less common, its use as a pedicled muscle flap with a split-thickness skin graft provides excellent soft-tissue coverage of large upper extremity wounds. Seven male patients ranging in age from 6-71 years were treated with a pedicled latissimus dorsi muscle flap and splitthickness skin graft for coverage of open wounds of the shoulder, arm, or elbow with exposed vital structures (mean wound size: 15x10 cm). The flap also was used as a functional muscle transfer in one patient to replace destroyed anterior and middle portions of the deltoid. Wounds resulted from trauma in three patients, infection following trauma in two, and sarcoma excision in two. All flaps healed well, and donor site morbidity was minimal. At mean 16-month follow-up (range: 3-41 months), all muscle flaps had contoured well, producing satisfactory cosmesis. Functional results were good, and all patients were satisfied with their outcome. The tendinous insertion is left intact to guard against excessive traction on the pedicle when the flap is used for soft-tissue coverage only.
Utilitarian Shoulder Approach for Malignant Tumor Resection
Authors: Wittig James C , Bickels Jacob , Wodajo Felasfa , Kellar-Graney Kristen L , Meller Isaac , Malawer Martin M
Published: April 2021

Malignant tumors involving the shoulder girdle can arise from four distinct locations: the proximal humerus, scapula, periscapular muscles, and axillary structures. This article describes a utilitarian shoulder approach that can be used to resect these tumors.
Giant-Cell Tumors of the Patella
Authors: Agarwal Sanjeev , Jain U K , Chandra T , Bansal G Jyoti , Mishra U S
Published: April 2021

Abstract

This study describes the clinical, radiographic, and histopathologic features, and discusses the management options of 11 cases of benign giant-cell tumors of the patella seen over 20 years. Fine needle aspiration cytology was a useful preoperative diagnostic tool. Patellectomy and reconstruction of the extensor apparatus is the favored treatment option with curettage and bone grafting restricted to selected localized lesions.
Ceramic-Ceramic Bearings in THA: The New Gold Standard-In Opposition
Authors: Rorabeck Cecil H
Published: April 2021

Alternative Bearing Surfaces
Intramedullary Fixation of Humeral Shaft Fractures Using an Inflatable Nail
Authors: Lorich Dean G , Geller David S , Yacoubian Shahan V , Leo Andrew J , Helfet David L
Published: April 2021

Intramedullary fixation has become increasingly popular for humeral shaft fracture treatment New inflatable intramedullary devices offer indirect reduction and improved load-sharing biomechanics without the need for interlocking screws.
Computer-Assisted Total Knee Arthroplasty: Navigation in TKA
Authors: Krackow Kenneth A , Phillips Matthew J , Bayers-Thering Mary , Serpe Louis , Mihalko Wm M
Published: April 2021

Total knee arthroplasty (TKA) requires precise bone preparation and prosthesis placement in addition to careful adjustment of soft-tissue connections. The importance of overall accuracy suggests computer assistance can provide useful enhancement to current mechanical instrumentation.
Localized Pigmented Villonodular Synovitis of the Knee
Authors: Akgün Isik , Ögüt Tahir , Kesmezacar Hayrettin , Dervisoglu Sergülen
Published: April 2021

Abstract

Eight patients with localized pigmented villonodular synovitis (LPVNS) of the knee were treated with arthroscopic and open techniques, with diagnosis confirmed by histological examination. Average patient age was 29 years (range: 13-50 years). At arthroscopy, all lesions except one were in the anterior compartment of the involved knee. Treatment consisted of complete local excision with partial synovectomy. This procedure was completed arthroscopically in seven patients. No recurrence was reported at average 24-month follow-up (range: 12-33 months). Arthroscopy is a valuable tool in the diagnosis and treatment of LPVNS.
The Educational Impact of a Course About Addiction
Authors: Jack Lynette W
Published: April 2021

ABSTRACT

The purpose of this study was to evaluate the impact of a nursing course about addiction on baccalaureate nursing students' attitudes toward addictive substances and on their personal lifestyle behaviors. The course was a threecredit, 15-week offering, focusing on: 1) learning to care for addictive clients, and 2) learning to value responsible attitudes and healthy lifestyle behaviors, as a strategy for primary prevention of addiction in the nursing profession.

A non-random treatment group of 46 students enrolled in the course was compared with a control group of 36 students. Data were collected at the beginning and end of the term using Goodstadt's Drug Attitudes Scale and the Healthstyle Self-Test, and analyzed using a two-way analysis of variance with repeated measures over time. The treatment group made significantly greater changes than did the control group when measured by the tobacco subscale and the opiates subscale. Both groups showed a significantly decreased ability to manage stress at the end of the term. In addition, a subgroup of students who indicated a family background of drug or alcohol abuse reported significantly different lifestyle behaviors when compared with a subgroup of students whose families did not use drugs or alcohol.
Success in NCLEX-RN: Identifying Predictors and Optimal Timing for Intervention
Authors: Jenks Joan , Selekman Janice , Bross Theodore , Paquet Michael
Published: April 2021

ABSTRACT

This ex post facto study was designed to identify predictors of success in the NCLEX-RN and determine the optimal point in time for identifying students at risk. The convenience sample consisted of 407 graduates of an integrated, upper division, baccalaureate nursing program, 1984-1987. Prematriculation (total lower division GPA, science GPA, type of lower division College, age, and sex), junior year (three Nursing theory course grades) and pre graduation variables (three senior year nursing theory course grades and Mosby ASSESSTEST) were analyzed for predictive value. Nursing theory courses at the junior and senior year and the Mosby ASSESSTEST strongly correlated (p<.0001) with NCLEX performance. Discriminant analysis enabled successful classification of 62% of the sample at prematriculation, 81% at the end of the junior year, and 86% at the end of the senior year. The study indicates that students at high risk can be identified at the end of the junior year so that enrichment and support programs can be introduced at that time.
Providing Health Services to Elderly in Public Housing: A Case for Clinical Experience
Authors: Reinardy James R , Quam Jean
Published: April 2021

ABSTRACT

A research project, carried out by social workers in consultation with nurses, evaluated the services provided by a student nursing clinical program to elderly high-rise residents. The analysis included number and type of services provided, data on what types of services were utilized by different clients, and client opinions on the value of the services offered.
The Master's Prepared Mental Health Nurse: An Assessment of Employer Expectations
Authors: Brophy Elizabeth B , Rankin Donna , Butler Shirley , Egenes Karen
Published: April 2021

ABSTRACT

A needs assessment survey seemed essential to a group of faculty members engaged in updating the curriculum in a Master's program in Mental Health Nursing in a University School of Nursing in the Midwest. An attempt was made to identify those nurse administrators who interviewed and hired clinical nursing personnel in hospitals in which psychiatric services were provided. Data were obtained from 23 respondents. The findings indicated that 1) Master's-prepared mental health-psychiatric nurses are being hired in the area; 2) at least 50% of the time, MSN graduates are expected to function in middle-management or administrative roles; and 3) Comprehensive Mental Health Nursing theory and skill development, rather than subspecialties, is viewed as the most important curricular focus. The need to continue recruiting students and develop and articulate the knowledge base in Mental Health Nursing through research and theory development is critical.
Faculty Practice: Nurse Educators' Views and Proposed Models
Authors: Just Gloria , Adams Eda , DeYoung Sandra
Published: April 2021

ABSTRACT

Faculty practice is an issue that has been extensively debated, yet no consensus about its definition, purposes, or implementation has yet been achieved among nurse educators. This nationwide survey of a random sample of 909 AD and BSN educators was designed to elicit concepts of faculty practice and to find how and why faculty are implementing practice.

Sixty percent of the sample are practicing nursing; the reason most frequently given was to maintain clinical skills. The 40% not practicing stated lack of time as the primary reason. Responses demonstrated no differences between AD and BSN educators regarding definition, implementation, and motivation for faculty practice.

As a result of the survey, a definition of faculty practice has been formulated and conceptual models of faculty practice delineated. The models that have been developed are the Nurse-Researcher Model, Nurse-Clinician Model, and Nurse-Consultant Model.
The Effects of Overhead Transparency Design on Retention, Recall, and Application of Data Analysis Content
Authors: Van Hoozer Helen , Brink Pamela J , Oppliger Robert
Published: April 2021

ABSTRACT

This experimental study tested the effects of overhead transparency design in conjunction with live lecture on retention, recall, and application of data analysis content over three occasions using a Solomon Four-Group, pretestposttest design. Pretested subjects showed significant (p < .001 ) gains in test scores from pre to posttest. No significant differences were found in pretest scores between control and experimental treatment groups or among the posttest scores of either the experimental or control groups.
Motivational Orientations of Registered Nurse Baccalaureate Students in Rural New England
Authors: Lethbridge Dona J
Published: April 2021

ABSTRACT

Using Houle's learning typology, this study examined the dimensions underlying reasons RNs in rural New England return to school to obtain a baccalaureate nursing degree. Factor analysis of the Educational Participation Scale revealed eight motivational orientations. These factors differ somewhat from the study of motivations of other continuing learners, in non-credit courses and in nursing baccalaureate study in an urban area. It is suggested that more study is needed with more diverse populations to validate nurses' motivational orientations, and that consideration must be paid to whether instruments aimed at the general population of continuing learners or the specific nursing population of study are appropriate.
Investing in Nursing Education: Some Evidence of Immediate Private Monetary Benefits
Authors: Siedenberg Jeffrey M
Published: April 2021

ABSTRACT

Sir Alexander Fleming's discovery of penicillin and Wilhelm Roentgen's detection of X rays are two of the more famous illustrations of research findings coming about accidentally. Fleming and Roentgen each was working in the general field of his major breakthrough when a significant disclosure occurred quite fortuitously. Results presented in this article also came about somewhat unintentionally. While studying the benefits of investment in cooperative education, positive outcomes in completing a baccalaureate degree with a specialization in nursing, turned up. A study of Lehman College alumni (1980-1985) revealed that nursing students fared better in the labor market upon graduation than did their nonnursing counterparts. This article examines several of the employment variables, such as wage rate and search costs, in light of factors including background differences of graduates, and market conditions such as the nursing shortage. Evidence suggests that the relative advantage enjoyed by the nursing group is associated with the additional human capital obtained through pursuing an academic concentration in nursing.
Effect of a Career Decision-Making Course on the Career Planning of Nursing Students
Authors: Hay Cindy Lund , Mitchell Lynda K , Allen Carol Easley
Published: April 2021

ABSTRACT

This study assessed whether participation in a structured career decision-making course would enhance the career planning of 42 final semester associate degree nursing students. Levels of career planning were measured by the Career Planning Scale (CPS) (Super, Thompson, Lindman, Jordaan, & Myers, 1982), and the Nursing Career Development Inventory (NCDI) (Savickas, 1984). Subjects were randomly assigned to either an experimental or control group. The experimental group received a fourweek career decision-making course, which included selfassessment of values, interests, and skills, and information on occupational opportunities in nursing. An ANOVA on the change scores from pretest to post-test revealed significance between the groups on the CPS (p = .002), and on the NCDI (p < .00001). The experimental group progressed much more in career planning. All subjects were found to have lower levels of career planning than the average college student at pretest. Intercorrelational data and multiple regression analyses indicated that individuals who had worked in a nursing-related field had higher levels of career planning. Overall, the course emerged as being effective in enhancing the career planning of nursing students.
Measuring Perceptions of the Exemplary Nurse
Authors: Llewellyn-Thomas H A , Sims-Jones N , Sutherland H J
Published: April 2021

ABSTRACT

Qualitative and quantitative data identifying and weighting the perceived importance of different attributes of the "exemplary" nurse were collected from nursing respondents at different points in their professional development. Statistically significant differences in the attribute weights reported by fourth-year students and graduate nurses were observed. Because their pool was qualitatively different, quantitative comparisons with first-year students were not possible. The results indicate that these methods may be useful in examining the processes whereby the members of different groups (eg, nursing students and faculty) formulate and modify their assumptions about their own and others' professional values.
Dimensions of Leadership of Assistant/Associate Deans in Collegiate Schools of Nursing
Authors: Rogers Mary Ann S
Published: April 2021

ABSTRACT

The purpose of this study was to discover whether there were differences in the perceptions of deans, assistant/associate deans, and faculty of leadership styles, initiating structure and consideration, and position power of assistant/associate deans in selected collegiate schools of nursing. In addition, the effect of leadership styles on performance as perceived by the three groups related to the position power of assistant/associate deans was also examined. Collegiate schools of nursing, identified as having a hierarchical organization structure with persons identified by the title "assistant/associate dean," were invited to participate. Data were collected from a sample of 36 collegiate nursing schools. The tools used were the Ohio State Leadership Behavior Description Questionnaire, and the Fiedler Position Power Scale. Three questions were posed. A multi-variate analysis of testing the three hypotheses showed a significant difference between the three groups' perceptions of initiating structure, consideration, and position power. A main effect for initiating structure was found in the deans' perceptions of position power. A main effect for consideration was found in the perception of the faculty sampled.
Factors that Interfere with Clinical Judgments of Students' Performance
Authors: Orchard Carole
Published: April 2021

ABSTRACT

A review of literature pertaining to clinical evaluation revealed six factors having the potential to interfere unconsciously with the clinical evaluative decisionmaking process of students' performance. This article provides a synopsis of the writers' views about these factors and provides potential actions to minimize their impact on the decision-making process. Actions are discussed in relation to educational preparation of nurse educators, orientation of new faculty to a program, and faculty practices.
The Use of Cognitive Style Mapping as a Predictor for Academic Success of First-Semester Diploma Nursing Students
Authors: Nortridge Judith A , Mayeux Virginia , Anderson Sandy J , Bell Michael L
Published: April 2021

ABSTRACT

This study determined the relationship between the components of the cognitive map and the diploma nursing student's successful academic completion of the first semester. This ex post facto study applied the Modified Hill Cognitive Style Model (MHCSM) instrument; the final grade, the dependent variable, was intercorrelated with the instrument's 28 mapping elements. Data analysis indicated three positively correlated predictors: a preference for finding meaning from written words, for independent problem-solving, and for a logical deductive approach in decision-making. Four negatively correlated predictors included a preference for finding meaning from the spoken word, for finding meaning from sight, for problem-solving with peers, and for categorical reasoning. Implications applicable to nursing education are included.
Preceptor Development Programs: An Interpretive Approach
Authors: Rittman Maude R
Published: April 2021

ABSTRACT

The behavioral model commonly used in preceptor educational programs is inadequate for conveying the complexity of precepting. An interpretive approach is offered as an alternative for preceptor education. Using an interpretive approach is one way to extend our understanding of precepting as an educational process. A preceptor education program is described along with examples of narratives from preceptors. Interpretations of each narrative provide nurse educators with a model for utilizing narratives with preceptors. Themes of teaching, nursing as precepting, and timing are explored. Restoring the narrative to the nursing practice of precepting promises to recapture the richness and complexity of precepting.
The Relevance of Modelings' Ethics of Care to the Moral Education of Nurses
Authors: Crowley Margaret A
Published: April 2021

ABSTRACT

Noddings' ethics of care is proposed as a model for moral education in nursing. A discussion of Noddings1 moral theory is followed by a review of significant criticisms of her theory and her response to these criticisms. Finally, the usefulness of her moral theory as a guide to moral education in nursing is explored.
National Response to the Nursing Shortage: Implications for Nursing Education
Authors: Webber Pamela Bayliss
Published: April 2021

ABSTRACT

The nursing shortage has been addressed at multiple levels in both the private and public sectors. This article offers an overview of the federal and organizational responses and an analysis of the implications for nursing education. Several initiatives being used by various schools of nursing to enhance their regional response are presented. In addition, the author also offers several recommendations designed to ensure that nursing education remains in a leadership position in the designing and implementation of initiatives that influence our outcomes.
University-College Collaboration: Rethinking Curriculum Development in Nursing Education
Authors: Hills Marcia D , Lindsey A Elizabeth , Chisamore Molly , Bassett-Smith Joan , Abbott Karen , Fournier-Chalmers Jacqueline
Published: April 2021

ABSTRACT

The behavioral approach to curriculum development is inadequate to educate nurses to practice in the future health care system. As a result of a government initiative, a Canadian university and four community colleges had an opportunity to collaborate on development of a nursing program and thereby consider alternative approaches to curriculum development. This paper describes the process used to develop this curriculum and provides an overview of the curriculum development model that emerged. A community development process characterized by a commitment to be futuristic and visionary about nursing while making curriculum decisions was established. The curriculum model that emerged used a phenomenological exploration of our common vision for nursing in the future. The resulting curriculum is based on a human science paradigm that encourages nurses to work from a health promotion perspective with an ethic of caring.
Nursing Students' Knowledge and Anxiety About AIDS: An Experiential Workshop
Authors: Bower Dolores A , Webb Adele A , Stevens Dennis
Published: April 2021

ABSTRACT

The purpose of this quasiexperimental study was to examine the effectiveness of an experiential workshop on nursing students' anxiety and knowledge about AIDS. This study was based on Peplau's interpersonal theory in nursing practice.

The sample included 67 senior nursing students and was designed as a three-group pre/post quasiexperiment. All groups received a pretest, posttest, and 6-week follow-up posttest. The experimental intervention was a 6-hour workshop that included anxiety awareness exercises in an experiential format and information about AIDS.

Knowledge and anxiety scores were significantly higher for the group that attended the didactic portion of the workshop before the experiential portion. The control group showed no change in knowledge or anxiety. Results indicated that recognition of anxiety through experiential exercises contributed to learning about AIDS.
Does Constructivist Epistemology Have a Place in Nurse Education?
Authors: Peters Matt
Published: April 2021

ABSTRACT

Nursing students who undertake the bachelor of nursing degree program are adults, many of whom are considered mature students. As such, they have significant life experiences and a vast amount of knowledge that has been acquired both formally and informally. Much of formal education historically, and even today, is content and curriculum driven, and teacher focused. Constructivist epistemology offers an alternative to traditional pedagogy in that it is student focused and considers previous learning done by the students as a foundation upon which to modify, build, and expand new knowledge. Constructivism also appears to be congruent with adult education theory and therefore offers great potential for the enhancement of self-directed learning. It enhances empowered learning because of the consideration of prior knowledge and the ownership of learning by the students. Implicit in this is the development of metacognitive skills that are an important facet of active and self-directed learning.

As a result of undergraduate learning within a constructivist framework, there are likely to be benefits for nurses in the practice setting for making the transition from inexperienced to experienced practitioners. Constructivist learning frameworks provide learning skills that enhance knowledge acquisition with understanding.
Verbal and Cognitive Activities Between and Among Students and Faculty in Clinical Conferences
Authors: Rossignol Marycarol
Published: April 2021

ABSTRACT

This study analyzes verbal and cognitive activities between and among students and faculty during 30 postconference sessions. Data indicate that faculty used a student-centered model to structure conferences and encourage students' verbal participation (student dialogue 58% of total conference Unes). Students assumed the teaching role surpassing teachers in use of all pedagogical activities: lecturing (62%), soliciting (52%), responding (74%), and reacting (62%). Verbal interactions in conferences were described as lively with cooperative student-faculty relationships. One-fourth of conference discourse was spent in high cognitive levels with faculty employing high cognitive levels more often (27%) than their students (24%). Emphasis is placed on the role of faculty to coach for cognition by carefully monitoring cognitive levels in discourse to encourage higher levels in thinking and extension of student thought.
Performance Expectations of the Associate Degree Nurse Graduate within the First Six Months
Authors: Diede Nancy , McNish Gayle , Coose Carol
Published: April 2021

ABSTRACT

The Oklahoma Associate Degree Nursing Directors Council was determined to be proactive in defining the role of the associate degree registered nurse (ADN) within the evolving health care delivery system. A task force was formed by the Council to design and implement strategies for defining the emerging roles. Strategies included surveying health care employers on the performance expectations of the ADN graduates within the first six months of employment. The employers were asked to determine the importance of various functions and abilities that the ADN graduates may or may not possess. Surveys returned were representative of a variety of rural and urban agencies throughout the state and bordering areas. Responses were grouped into 21 categories. Ranked highest was the ability to demonstrate verbal and written communication effectively with accountability to the employer and personal attributes such as open-mindedness, flexibility, and receptiveness to criticism ranked second and third. The lowest rankings received were for competency with fiscal management. The results of the survey highlight the continued need to stress strong communication skills, as well as professional accountability throughout the educational process.
Health Behaviors of Nursing Students: A Longitudinal Study
Authors: Clément Madeleine , Jankowski Louis W , Bouchard Louise , Perreault Michel , Lepage Yves
Published: April 2021

ABSTRACT

To ascertain the degree to which a health science curriculum may influence health-related behaviors among students, nine selected health behaviors of 52 undergraduate nursing students were studied for 3 consecutive years and compared to those of a similar group of education students. In addition, the health behaviors of both student groups were compared to those of the general population. During the study, the nursing students had no significant alterations in the observed health behaviors, and no significant differences were observed between the health behaviors of the two groups of students. Both groups manifested certain health behaviors that were significantly different from the general population. However, nursing students were observed more frequently to be significantly different from the general population. A 3-year nursing curriculum may have facilitated the adoption of some personal health behaviors, but the time demands of academic life may have induced students to reduce time-consuming health behaviors, such as getting enough sleep, eating breakfast, and exercising.
Megalocornea: A Clinical and Echographic Study of an Autosomal Dominant Pedigree
Authors: Kraft Stephen P , Judisch G Frank , Grayson Donald M
Published: April 2021

SUMMARY

A family with au t oso mal dominant megalocornea was studied clinically and echographically. The anterior chamber angles, intraocular pressures and axial lengths were all normal. These findings strongly support the dualist proposition which contends that e ti o logic ally, megalocornea and congenital glaucoma are distinct.
Binocular Diplopia Associated With Retinal Wrinkling
Authors: Bixenman Wayne W , Joffe Leonard
Published: April 2021

ABSTRACT

Four patients with retinal wrinkling and epiretinal membrane formation presented with a unique clinical syndrome consisting of comitant, small angle hyperdeviations with intractable vertical diplopia, and unstable single vision with a failure to respond to conventional prism therapy.

The pathophysiology underlying this presentation appears to be the establishment of a rivalry between central and peripheral fusional mechanisms due to mechanical macular distortion.
Complications Following Surgery for Thyroid Ophthalmopathy
Authors: Metz Henry S
Published: April 2021

ABSTRACT

A marked reaction postoperatively was noted following strabismus surgery for thyroid ophthalmopathy. Preoperatively, the right eye was noted to have a small amount of lower nasal conjunctival injection and Chemosis while the left eye was quiet. Only the right eye had the severe inflammatory reaction postoperatively, while the left eye responded normally.

The findings included marked proptosis, Chemosis, subconjunctival hemorrhage, corneal exposure and drying with a sterile ring infiltrate, corneal thinning and vascularization, and ocular immobility. The treatment and course of these complications is described. It is suggested that muscle surgery be deferred in patients with thyroid ophthalmopathy when there are signs of continued inflammation.
Good Visual Result Following Early Penetrating Keratoplasty for Peters' Anomaly
Authors: Cameron James A
Published: April 2021

ABSTRACT

Visual results following penetrating keratoplasty for congenital corneal opacities have been generally disappointing, prompting many ophthalmologists to recommend no surgery for congenital, monocular corneal opacities.

A 14-day-old boy had a penetrating keratoplasty performed for unilateral Peters' anomaly and microcornea.

Visual acuity 49 months after surgery was 20/40 and peripheral fusion was present.

Early surgery with early suture removal, amblyopia therapy, frequent clinical examinations, and motivated, well-informed parents were important factors in obtaining a good visual result.
Myoblast Transfer Therapy in the Treatment of Ptosis: A Preliminary Study
Authors: Baker Robert S , Bonner Philip H , Porter John D , Madhat Maher N , Gross John
Published: April 2021

ABSTRACT

Congenital ptosis with poor levator function is now managed by frontalis suspension techniques. While this procedure is better than those used in the past, serious shortcomings exist. A technique producing more normal lid function would be a beneficial addition to surgical management. Since congenital ptosis is thought to be a focal myopathy, we investigated the potential of myoblast transfer therapy in myopathic levator palpebrae superioris.

Satellite cells harvested from temporalis muscle were grown as clones, labeled with Dil, and transplanted into experimentally myopathic levator muscle of the same animal. Within 2 weeks, the injected cells were found to be incorporated into muscle fibers within the levator basal lamina. The control side appeared myopathic with very little muscle regeneration. The presence of Dil labeled muscle fibers in the experimental muscles strongly suggests their origin from the injected cells. Electron microscopy of nearby sections showed these fibers to be maturing striated muscle.

We feel that the development of this technique may make autogenous myoblast transfer therapy a useful treatment for congenital ptosis and other focal myopathies.
Ocular Implications of Long-Term Prednisone Therapy in Children
Authors: Kaye Laurence D , Kalenak Jeffrey W , Price Ronald L , Cunningham Robert
Published: April 2021

ABSTRACT

We compared 23 patients (ages 4 to 18 years) who were receiving long-term oral prednisone therapy with 31 normal controls (ages 7 to 16 years). Indications for corticosteroid treatment included renal transplant in 11 patients, nephrotic syndrome in 7, glomerulonephritis in 4, and vasculitis without renal disease in 1. The mean duration of prednisone therapy was 5.0 ± 3.5 years, and the mean dose at the time of examination was 0.29 ± 0.18 mg/kg/day. Mean intraocular pressure was 16.0 ± 3.0 mm Hg (range, 12 to 25 mm Hg) in the prednisone group and 15.4 ± 2.1 mm Hg (range, 12 to 20 mm Hg) in the control group. The difference between the means was 0.6 mm Hg (P = 0.35). Posterior subcapsular cataracts were present in seven (30%) of the prednisone patients, but in none of the controls (P = .001). None of the cataracts were visually significant. We found no evidence that pediatric patients on long-term, low-dose prednisone have higher intraocular pressures (IOPs) than normal children, although they are more likely to develop posterior subcapsular cataracts.
The Effect of Torsional Muscle Dysfunction and Surgery on Eye Position Under General Anesthesia
Authors: McCall Laurie C , Isenberg Sherwin J , Apt Leonard
Published: April 2021

ABSTRACT

Under general anesthesia, normal eyes exhibit 2.0° to 2.5° of extorsion. To investigate the effect of torsional muscle dysfunction and surgery on eye position under general anesthesia, we measured the torsional change before and after torsional muscle surgery in 26 eyes of 18 patients with clinical torsional muscle dysfunction.

Under general anesthesia, compared with normals, eyes with preoperative intorter overaction or extorter underaction demonstrated a significant intorsional change (P < .01). However, eyes with intorter underaction or extorter overaction did not demonstrate a significant extorsional change.

Postoperatively, while patients remained under general anesthesia, intorter weakening procedures produced measurable extorsion while intorter strengthening procedures and extorter weakening procedures produced measurable intorsion. Superior oblique tenotomy produced a greater net torsional change than inferior oblique weakening surgery (P < .01).

Under general anesthesia, eyes with preoperative torsional muscle dysfunction exhibit torsion in the direction consistent with the dysfunction. After surgery on the torsional muscles, a measurable torsional effect can be demonstrated while the patient is still under general anesthesia.
Secondary Exotropia: A Retrospective Analysis of Matched Cases
Authors: Bradbury J A , Doran R M L
Published: April 2021

ABSTRACT

Secondary exotropia, that is exotropia following surgery for esotropia, remains frustratingly common, even among experienced strabismologists. In this study, we have compared a group of secondary exotropia cases with a matched group of cases of residual esotropia. Of the factors analyzed, only the presence of an A- or V-pattern preoperatively (P = .0077), the presence of limited postoperative adduction (P < .001), and postoperative binocular function (P = .0073) identified the secondary exotropes. The presence of reduced adduction postoperatively in subjects with secondary exotropia was a poor prognostic sign with 11 of the 13 cases requiring further surgery for poor cosmesis. The authors suggest two subclassifications of secondary exotropia.
Ankyloblepharon Filiforme Adnatum in Trisomy 18
Authors: Bacal Darron A , Nelson Leonard B , Zackai Elaine H , Lavrich Judith B , Kousseff Boris G , McDonald-McGinn Donna
Published: April 2021

ABSTRACT

Ankyloblepharon filiforme adnatum (AFA) is a mild form of ankyloblepharon, in which there is partial thickness fusion of the central portion of the Hd margins, sparing the canthi. Although it can be seen as an isolated sporadic congenital defect, it is important for pediatric ophthalmologists to be cognizant of its possible association with a number of anomalies. One infrequent, but nevertheless important association, is with trisomy 18. We present three cases of AFA in association with trisomy 18, and emphasize the need for clinicians to search for other abnormalities in a newborn presenting with AFA.
Incomplete Presentations in a Series of 37 Children With Kawasaki Disease: The Role of the Pediatric Ophthalmologist
Authors: Blatt Andrew N , Vogler Lawrence , Tychsen Lawrence
Published: April 2021

ABSTRACT

Background: Kawasaki disease (KD) is an acute and sometimes fatal febrile vasculitis of childhood, the presenting signs of which include conjunctival vessel dilatation and iridocyclitis. Consultation with a pediatric ophthalmologist is helpful for early recognition of the disease, especially In identifying "incomplete" cases, ie, those which lack all of the classical, systemic signs.

Methods: After encountering a case of incomplete KD in which diagnosis was delayed, we reviewed the hospital records of 37 children with KD to establish how often the disease manifested "incompletely," and how often pediatricians consulted pediatric ophthalmologists to help in its early diagnosis.

Results: Forty-five percent of the children eventually diagnosed with KD lacked the complete diagnostic criteria of KD when admitted to the hospital, and diagnosis and treatment therefore were delayed. Coronary artery aneurysms, a complication that might have less serious consequences if treated earlier, developed in 24% of these patients. Although 67% presented to their pediatrician with bilateral conjunctival injection and/or iridocyclitis, pediatricians requested ophthalmologic consultation for only 5% of them.

Conclusions: Our review of these cases indicates that the eye findings in KD could play a role in earlier diagnosis and treatment. Pediatric ophthalmologists and pediatricians should be more aware of their combined responsibilities for expethent recognition of KD.