bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone Penetration of Antibiotics
Authors: Smith Bruce R , Rolston Kenneth V , LeFrock Jack L , Bayliff Charles
Published: April 2021

ABSTRACT: Osteomyelitis is caused by bacterial pathogens and, less frequently, by other infectious agents. Treatment of osteomyelitis should include a course of antimicrobial therapy with a batericidal agent. This therapy should be directed at the causative bacteria isolated by bone biopsy and culture, not by wound swab cultures above the infected bone. The bactericidal agent should be demonstrated effective against the organism isolated from bone and should penetrate the bone in sufficient concentrations. Many studies have assessed bone penetration of antimicrobials, but methodological problems must be addressed. Penicillins, cephalosporins, aminoglycosides, erythromycin, lincomycin and clindamycin, and metronidazole have all been evaluated.
Hyperextension Mallet Finger
Authors: Lange R H , Engber W D
Published: April 2021

ABSTRACT: Mallet finger injury of the distal extensor mechanism of a digit represents a spectrum of pathology. The hyperextension variant, characterized by a major intraarticular fracture fragment and volar subluxation of the distal phalanx, requires specific recognition. Its distinctive mechanism of injury requires modification of routine mallet finger management, whether open or closed. Persistent volar subluxation, in our experience, has been associated with consistently unsatisfactory results.
Open Elbow Dislocation With Brachial Artery Disruption: Case Report and Review of the Literature
Authors: Rubens Mark K , Aulicino Pat L
Published: April 2021

ABSTRACT: Open dislocations of the elbow are rare, while associated vascular injuries are common. The recommended method of treatment in a pulseless dislocated extremity is reduction, stabilization and vascular repair by interpositional vein grafting.
Bucket Handle Tear of a Discoid Medial Meniscus Arthroscopic Diagnosis-Partial Excision: A Case Report
Authors: Patel Dinesh , Dimakopoulos Panagiotis , Denoncourt Paul
Published: April 2021

ABSTRACT: A case of a rare, large discoid medial meniscus with a bucket-handle tear is described. The radiogram was normal and the clinical impression was torn medial meniscus. A diagnostic arthroscopy revealed an unusually large medial discoid meniscus with a bucket-handle tear. Open partial excision was performed following the arthroscopy.
PRIMARY BATEMAN-LEINBACH BIPOLAR PROSTHETIC REPLACEMENT OF THE HIP IN THE TREATMENT OF UNSTABLE INTERTROCHANTERIC FRACTURES IN THE ELDERLY
Authors: Harwin Steven F , Stern Richard E , Kulick Roy G
Published: April 2021

ABSTRACT

The results of primary Bateman-Leinbach bipolar prosthetic replacement for comminuted intertrochanteric fractures of the hip in the elderly are examined. In an effort to avoid the postoperative complications seen in open reduction and internal fixation of severely comminuted fractures with osteoporotic bone, and to avoid postoperative restrictions when fixation is suboptimal, a group of 58 patients were treated with a bipolar Bateman-Leinbach prosthesis. They were followed for an average of 28 months. Surgery was performed using an anterolateral approach, which is recommended. A detailed description of the surgical approach and operative technique are provided.

Eighty-eight percent of patients were able to ambulate within the first week, weight bearing as tolerated with no postoperative restrictions, except for a simple abduction pillow for 2 weeks while in bed. Ninety-one percent of patients ambulated prior to discharge. Morbidity and mortality was no greater in this group than in groups treated by open reduction and internal fixation for these types of fractures. Complications were few. Primary Bateman-Leinbach bipolar prosthetic replacement is recommended as the preferred treatment of selected unstable comminuted intertrochanteric fractures in the elderly.
REDUCTION OF POSTOPERATIVE CT ARTIFACTS OF PELVIC FRACTURES BY USE OF TITANIUM IMPLANTS
Authors: Ebraheim Nabil A , Coombs Robert , Rusin Joseph J , Jackson W T
Published: April 2021

ABSTRACT

The value of CT scanning for both preoperative and postoperative assessment of pelvic and acetabular fractures has been demonstrated. Previous attempts at our institution to obtain useful pelvic CT scans following internal fixation with stainless steel implants have been impaired by metal artifacts that degraded the transaxial CT images. Our use of titanium, instead of stainless steel implants, produced identical fixation and ultimate fracture healing, but yielded minimal artifacts. We recommend the use of titanium implants as substitutes for stainless steel implants in pelvic fixation to maximize the information obtained on subsequent CT exams.
INTRAVENOUS REGIONAL ANESTHESIA FOR OUTPATIENT FOOT AND ANKLE SURGERY: A PROSPECTIVE STUDY
Authors: Kim Donald D , Shuman Charles , Sadr Bahman
Published: April 2021

ABSTRACT

A prospective study was undertaken in 39 patients undergoing 48 foot and ankle procedures using intravenous regional anesthesia (IVRA). FVRA was administered using 35 cc of 033% or 0.5% Iidocaine. Single tourniquets inflated to 250 mm Hg were used at the ankle level. No supplemental analgesia or sedation was used. Those requiring supplemental local anesthetic infiltration were defined as IVRA failures. Thirty-one of the 39 patients (79.5%) tolerated the procedures with little or no discomfort, and 8 (20.5%) required additional local infiltration with 1 % Iidocaine. All 39 patients completed the procedures at the outpatient surgical unit without requiring conversion to other forms of anesthesia. Patchy non-anesthetic areas were noted in 14 patients (36.8%). In 7 patients, because the non-anesthetic areas were excluded from the operative fields, the procedures were completed without discomfort However, in 8 patients where the nonanesthetic areas were directly involved in the operative fields, supplemental local anesthesia was required. Only 1 of the 39 patients complained of tourniquet pain. IVTRA compared favorably with other methods of regional anesthesia in the lower extremity with respect to ease of technique, speed of onset, safety, and patient acceptance. However, it appears that it is less reliable than IVRA in the upper extremity. The reasons for this difference will require further investigation.
Prosthetic Management of the Dysplastic Hip
Authors: Gross Allan E
Published: April 2021

Primary Hip Arthroplasty: Operative Management Problems
The Pants Too Short, the Leg Too Long!
Authors: Ranawat Chitranjan S
Published: April 2021

Hip Arthroplasty: Postoperative Management Problems
Traumatic Anterior Knee Dislocation
Authors: Durbhakula Sridhar M , Das Shankar P , Uhl Richard L
Published: April 2021

Approximately 50% of patients with knee dislocations present with the affected knee in a reduced position, causing the diagnosis to be missed without a high degree of clinical suspicion.
Analysis of Retrieved Uncemented Porous-Coated Acetabular Components in Patients With and Without Pelvic Osteolysis
Authors: Barrack Robert L , Castro Frank P , Szuszczewicz Edward S , Schmalzried Thomas P
Published: April 2021

Abstract

Retrieved polyethylene liners and femoral heads from a consecutive series of revision components of one design were examined. All patients had Long-Term Stable Fixation (OsteoTechnology International, Timonium, Md) total hip arthroplasties (THAs) implanted between 1987 and 1992. The retrieved femoral heads and liners from patients with osteolysis were compared to those without osteolysis. Patients with osteolysis had significantly thinner polyethylene (5.1 mm versus 7.4 mm, P<.01) and a higher linear wear rate (0.5 mm/y versus 0.3 mm/y, P=.05). The average femoral head surface roughness also was significantly greater in patients with osteolysis (67 nm versus 35 nm, P<.05). Patients with osteolysis had more total volumetric wear, total linear wear, and volumetric wear rate compared to patients without osteolysis. Age, obesity index, time in situ, and cup inclination were not different between the two groups. Excessive polyethylene wear, probably accelerated by surface roughness of the femoral heads, was associated with pelvic osteolysis in these patients.
Outcomes of Hip Fracture Surgery in Patients Aged ≥90 Years
Authors: Tanaka Junichi , Tokimura Fumiaki , Seki Naoki
Published: April 2021

Abstract

The outcomes of 60 patients aged ≥90 years with hip fractures who underwent surgery between 1995 and 1998 were reviewed. Average follow-up was 21 months (range: 4-47 months). All patients experienced pain relief within 2 months postoperatively. Thirty-four of 60 patients failed to attain their prein/ury ambulatory status. The ability to walk 2 months postoperatively was observed more frequently in patients without severe dementia. Patients who were unable to walk postoperatively had a greater chance of dying than those who regained the ability to walk. No surgery related deaths occurred. Six months postoperatively, 2 (3%) patients had died; 1 year postoperatively, 9 (15%) had died. Therefore, patients aged ≥90 years benefit from surgical treatment of hip fractures.
Center Edge Angle Measurement for Hip Preservation Surgery: Technique and Caveats
Authors: Anderson Lucas A. , Gililland Jeremy , Pelt Christopher , Linford Samuel , Stoddard Gregory J. , Peters Christopher L.
Published: April 2021

Anterior and lateral center edge angles have traditionally been used to determine acetabular coverage, and thereby strongly influence the decision to perform acetabular reorientation versus osteochondroplasty in patients with dysplasia and/or femoroacetabular impingement. We propose templating the center of the contained articular femoral head in aspherical hips to provide reliable assessment of acetabular coverage. Digital radiographs of 30 patients with various combinations of femoral and acetabular morphologies were evaluated using 2 methods to identify the anterior center edge angle and lateral center edge angle. The control method used an estimated femoral head center for angle apex. The study technique determined the center of the femoral head by templating the congruent aspect of the femoral head contained by the acetabulum while ignoring the increasing lateral and anterior radius associated with cam deformities. Four readers measured lateral center edge angles on anteroposterior radiographs and anterior center edge angles on false-profile radiographs. Two reads were performed by each reader using both the estimated and the templated methods for a total of 4 reads. Interobserver reliability using the proposed method compared to the standard was much improved for anterior center edge angles (intraclass correlation coefficient of 0.76 vs 0.55) as well as with lateral center edge angles (ICC of 0.80 vs 0.42). Decreased correlation was most commonly associated with abnormal sourcil morphology, posterior wall deficiency combined with calcified labra, and os acetabuli. Including the anterolateral cam deformity in identifying the center of the femoral head for measuring center edge angles leads to an underestimation of acetabular coverage, which may negatively affect hip preservation surgical decision making.
Upper-Extremity Deep Venous Thrombosis Following Humeral Shaft Fracture
Authors: Sawyer Gregory A. , Hayda Roman
Published: April 2021

Upper-extremity deep venous thrombosis (DVT), although not as common as its lower-extremity counterpart, is a clinical entity with potentially devastating complications. Approximately 1% to 4% of all DVT cases involve the upper extremity, with 9% to 14% of these cases complicated by pulmonary embolism. Prompt diagnosis with duplex ultrasonography and subsequent anticoagulation are the gold standards for identification and treatment. The majority of these cases are secondary to medical comorbidities such as malignancy, hypercoagulable states, and indwelling catheters. Although rare, several case reports of orthopedic-related upper-extremity DVT are present in the literature. This article reports a case of upper-extremity DVT in a humeral shaft fracture treated nonoperatively.

A 58-year-old man presented with right elbow pain after a fall from scaffolding. Radiographs demonstrated a distal humeral shaft fracture at the tip of a previously placed intramedullary nail. Initial treatment consisted of closed reduction in a coaptation splint. The patient re-presented 4 days later with increasing forearm pain and swelling. An ultrasound revealed an extensive thrombus of the right brachial vein. A coaptation splint was replaced and the patient was admitted to the hospital for therapeutic anticoagulation. After hematology consultation and a short hospitalization, the patient was discharged home on a 3-month course of Warfarin. The goal of treatment of upper-extremity venous thrombosis is to improve the patient’s acute symptoms and prevent both pulmonary embolism and post-thrombotic syndrome. Post-thrombotic syndrome is a chronic, potentially debilitating condition that occurs in approximately 15% of upper-extremity DVT cases with symptoms consisting of pain, swelling, paresthesias, and functional limitation.
Neglected Patellar Tendon Rupture: Preserve the Fat Pad
Authors: Mittal Ravi , Singh Davinder Pal , Kapoor Amit
Published: April 2021

Management of neglected patellar tendon ruptures remains a difficult therapeutic endeavor, as complications such as adhesions, proximal patellar migration, and quadriceps contracture occur. Treatment goals include restoration of extensor mechanism, both structurally and functionally, which allows active knee extension. Few cases of neglected patellar tendon rupture have been reported in the literature, however, all have used preoperative or additional intraoperative procedures to relocate the patella or to provide additional support to the reconstructed tendon.

This article presents a case of a 25-year-old man whose diagnosis of patellar tendon rupture was delayed by 1 year. The patella was mobile and could be brought down to its original position manually. The patellar tendon was successfully reconstructed with autogenous semitendinosus and gracilis tendon graft. No preoperative or intraoperative traction was used on the patella. Quadriceps lengthening was not performed and no hardware was used between the patella and the tibia to augment the reconstruction. Scar tissue was not excised and was used to cover the hamstring tendons. The patient achieved a good functional result after 5 months of rehabilitation. At 14-month follow-up, the patient had returned to his pre-injury level of work with no deterioration of knee function.
Anomalies of the Discoid Medial Meniscus
Authors: Ahn Jin Hwan , Yoo Jae Chul , Wang Joon Ho , Lee Yong Seuk , Yim Hyun Seok , Chang Moon Jong
Published: April 2021

Anomalies associated with a discoid medial meniscus have been described. However, the clinical relevance of these anomalies has not been previously reported. Therefore, we report the clinical relevance of some of these anomalies based on our experience with a 21-year-old soldier with a 3-month history of medial right knee pain. Magnetic resonance imaging (MRI) revealed bilateral discoid medial menisci, cupping of the medial tibial plateau, and an abnormal anteroinferior transposition of the anterior horn of the meniscus. Partial meniscectomy was performed in the usual manner and the meniscus reshaped, including its anteromedial corner.

Six weeks postoperatively, the patient reported knee pain. Follow-up MRI showed that the anteromedial edge of the cup shaped tibial plateau directly contacted the femoral condyle and subchondral signal changes at the contact point. Several reports have addressed subluxation or dislocation of the anterior horn of the medial meniscus. However, the clinical significance of these lesions has not been clearly defined. In our case, however, subluxation of the anterior horn was combined with a discoid medial meniscus and cupping of the tibial plateau, which may have increased contact stress between the tibia and femur.

Our experience suggests that in cases with combined anomalies, anteroinferior transposition of the anterior horn of the discoid medial meniscus, and cupping of the tibial plateau, trimming of the anteromedial corner should be performed conservatively, because even minimal trimming or reshaping of anteromedial corner of the meniscus can cause direct bone-to-bone contact due to insufficient anterior coverage.
Relationship Between College Success and Employer Competency Ratings for Graduates of a Baccalaureate Nursing Program
Authors: Bolin Sharon E , Hogle Edith L
Published: April 2021

ABSTRACT

This expost facto correlational study sought to determine which measures of academic success in one class of BSN graduates predicted their competence as employees one year after graduation, as judged by their employers. The relationship between pre-entrance test scores, clinical experience grades, GPA, State Board Test Pool examination scores, and employer competency ratings were also determined. In keeping with the literature in fields other than nursing, the findings suggest that there may be little relationship between academic performance in a nursing program and subsequent job performance as a nurse, even though verbal ability may be predictive of success in school. While significant positive correlations were found between pre-entrance test data and final grade point averages, as well as pre-entrance test scores and State Board Test Pool examination scores, there was little evidence that preentrance test scores were predictive of nursing abilities. Isolated correlations were found between the clinical components of some nursing courses and specific nursing abilities. Using multiple regression analysis, no clinical course grade was found to be a significant predictor of the mean employer competency rating. Significant predictors were found for only four of the individual nursing abilities, with the clinical component of Leadership in Nursing being the most frequent and best predictor.
Nurse Educators' Involvement in Research
Authors: Nieswiadomy Rose M
Published: April 2021

ABSTRACT

The purposes of the study were: (1) to determine the relationship between selected demographic characteristics of nurse educators and research productivity; (2) to identify barriers to faculty research; (3) to examine the support being provided by educational institutions for faculty research; and (4) to determine the use of research productivity in the evaluation of faculty members for tenure, promotion and salary increase. Research productivity was defined as: (1) the number of past research studies conducted in relation to degree requirements, (2) the number of past research studies conducted which were not in connection with degree requirements, (3) the number of research studies that have been published, and (4) the number of ongoing research studies.

The study population was composed of nurse educators teaching in institutions granting a diploma, associate degree, baccalaureate degree or higher degree in nursing. A systematic random sample of 500 names was chosen from nurse educators who were members of the American Nurses' Association.

The major findings of the study were: (1) only 25% of the sample indicated current involvement in research; (2) nurse educators holding doctorates are the most productive researchers; (3) nurse educators who have taught more than 20 years reported the smallest percentage of ongoing research studies; (4) the majority of the current research is being conducted by faculty teaching in schools which grant graduate degrees; and (5) educational institutions are providing minimal support for faculty research and 50% of these institutions do not consider research productivity in the evaluation of faculty members for tenure, promotion, or salary increase.
An Analysis of the Relationship of Seven Selected Variables to State Board Test Pool Examination Performance of the University of Tennessee, Knoxville, College of Nursing
Authors: Sharp Theresa G
Published: April 2021

ABSTRACT

The study was designed to determine whether any one of seven selected variables or a combination of the variables is predictive of performance on the State Board Test Pool Examination. The selected variables studied were: high school grade point average (HSGPA), The University of Tennessee, Knoxville, College of Nursing grade point average (GPA), and American College Test Assessment (ACT) standard scores (English, ENG; mathematics, MA; social studies, SS; natural sciences, NSC; composite, COMP).

Data utilized were from graduates of the baccalaureate program of The University of Tennessee, Knoxville, College of Nursing from 1974 through 1979. The sample of 322 was selected from a total population of 572.

The Statistical Analysis System (SAS) was designed to accomplish analysis of the predictive relationship of each of the seven selected variables to State Board Test Pool Examination performance (result of pass or fail), a stepwise discriminant analysis was designed for determining the predictive relationship of the strongest combination of the independent variables to overall State Board Test Pool Examination performance (result of pass or fail), and stepwise multiple regression analysis was designed to determine the strongest predictive combination of selected variables for each of the five subexams of the State Board Test Pool Examination.

The selected variables were each found to be predictive of SBTPE performance (result of pass or fail).

The strongest combination for predicting SBTPE performance (result of pass or fail) was found to be GPA, MA, and NSC.
Nursing Educators: Perceptions of the Curricular Role of Human Genetics/Bioethics
Authors: Mertens Thomas R , Hendrix Jon R , Morris Martha M
Published: April 2021

ABSTRACT

In recent years medical geneticists have made tremendous advances in understanding hereditary diseases. Applying this new knowledge raises serious ethical questions which have relevance to nursing practice. Nursing educators must ask themselves: (1) what effects do these advances have on nursing practice; (2) have the subjects of human genetics and bioethics been sufficiently integrated into nursing educational programs; and (3) are professional nurses prepared to help patients become scientifically literate relative to principles of human genetics?

A 35-item questionnaire was prepared, and 616 copies were mailed to the chief administrators of 31 Indiana stateapproved nursing programs listed by the Indiana State Board of Nurses' Registration and Nursing Education. Data obtained from the 250 questionnaire respondents led to the conclusion that Indiana nursing educators are aware of the relevance of human genetics to their work, but they need direct access to helpful information to incorporate genetics instruction as a part of nursing education programs in Indiana. To accomplish this task, the respondents favor continuing education programs in human genetics. Although the data are based on responses of Indiana nursing educators, we believe that our findings can be generalized, at least, to nursing programs throughout the midwest. On the basis of our study, we recommend that continuing education programs in human genetics be implemented with the goal of providing all practicing nurses with a better understanding of the genetic basis of disease, thereby enabling them to counsel wisely those patients entrusted to their care.
Tenure and Promotion: An Update on University Nursing Faculty
Authors: Kruger Susan , Washburn Jane
Published: April 2021

ABSTRACT

The status of tenure and promotion practices in nursing schools in university settings was studied. Forty nursing administrators from nursing programs around the country responded to a questionnaire regarding requirements to achieve tenure and/or promotion in the areas of teaching, research and scholarly activities, clinical competence, and community service. Findings revealed that while a growing number of nursing programs were more integrated into the academic community, many programs continued to struggle with the need for more faculty prepared at the doctoral level and for increased research activities.
Health Policy in Nursing Curriculum
Authors: Andreoli Kathleen C , Musser Leigh Anne , Otto Dorothy A
Published: April 2021

ABSTRACT

This article presents the findings of a study on how health policy is integrated into the nursing curriculum at both the graduate and undergraduate levels, with particular emphasis on type of coursework, faculty preparation, and teaching strategies. The sample for the study included 210 randomly selected schools of nursing: 150 with undergraduate programs only and 60 with both graduate and undergraduate programs. The findings indicate that health policy has not yet received optimal placement in the curriculum at either the undergraduate or graduate level of nursing preparation. Recommendations are made based upon the findings of the study, a review of the literature, and the collective experience of the authors.
Clinical Teaching is More Than Evaluation Alone!
Authors: Flagler Susan , Loper-Powers Sue , Spitzer Ada
Published: April 2021

ABSTRACT

Gaining self-confidence as a nurse is an essential aspect of the nursing student's professional development. The purpose of this study was to determine clinical instruction behaviors that students perceived as important in promoting their self-confidence. One hundred thirty-nine baccalaureate students rated 16 clinical teaching behaviors as to the degree each helped or hindered their self-confidence as nurses. Factor analysis of these behaviors revealed five dimensions of clinical teaching that characterized the instructor as: resource, evaluator, encourager, promoter of patient care, and benevolent presence. Behaviors contributing to the dimensions of clinical instruction other than evaluation were rated by students as helpful in the development of their self confidence as nurses. Students' responses to open-ended questions provided further evidence of the importance of the nonevaluation dimensions. Focusing on evaluation to the exclusion of other aspects of clinical teaching may impede nursing students' professional development.
Nursing, Nursing Education, and Anxiety
Authors: Biggers Thompson , Zimmerman Rick S , Alpert Geoffrey
Published: April 2021

ABSTRACT

One hundred seventy-one graduating students in associate degree, diploma, and baccalaureate nursing programs completed a questionnaire concerning various state and trait measures of emotions (including general anxiety, apprehension about communication, and anxiety about one's future nursing career).

Differences among the three groups of nursing students on the various dimensions of emotions, anxiety, and communication apprehension were assessed from the perspective of Mehrabian's theory of emotion. Predictors of anxiety about one's nursing career were investigated for the overall sample and for the three groups separately.

Findings indicate that baccalaureate students are least apprehensive about communicating and feel most dominant in their setting. In addition, associate degree students were most anxious about nursing if they did not feel dominant, diploma students were most anxious if they did not feel dominant or were apprehensive about communication, and baccalaureate students were most anxious if they were generally unhappy. The results are discussed in terms of Mehrabian's emotion theory, the current crisis in and future direction of nursing education, and the use of theory in designing a strategy for nursing as a profession.
Attracting Men to Nursing: What Will They Find Important in Their Career?
Authors: Galbraith Michael
Published: April 2021

ABSTRACT

This study was designed to increase understanding of the career choices of men in non traditional careers such as nursing by exploring what they find important in their career, their sex role identity, and their personality components. The instruments used in the study were the Important Components of a Career Scale, Bern Sex Role Inventory, and the Cattell 16 Personality Factor measure. Questionnaire packets were mailed to a total of 1,000 potential respondents in the following five groups: male and female nurses and early educators, and male engineers. The response rate was 46%. The men in nursing (n = 57) and early education (n = 76) valued relationshiporiented components of their careers more than the men in engineerings = 103) (F [2,233] = 35.39, p < .01).
The Effect of Preceptorship Upon Diploma Program Nursing Students' Transition to the Professional Nursing Role
Authors: Jairath Nalini , Costello Judy , Wallace Paulette , Rudy Laura
Published: April 2021

ABSTRACT

This quasi-experimental study determined the effect of a 17-week pregraduate preceptorship program upon diploma nursing students' (N = 22) performance of the professional nursing role. Nine students participated in the preceptorship program; 13 received the standard pregraduate clinical experience. Nursing performance was measured using Schwirian's Six Dimension Scale of Nursing Performance prior to, during, and upon completion of the pregraduate clinical experience. Based on the faculty adviser's appraisals, the preceptorship program was associated with significantly greater improvements in nursing performance within the teaching/collaboration and planning/evaluation dimensions.
Multidimensional Stress Management in Nursing Education
Authors: Russler Michael F
Published: April 2021

ABSTRACT

This study investigated the effectiveness of multidimensional stress management training for beginning baccalaureate nursing students (N = 57). An experimental pretest-posttest placebo group, control group design was used. Two pretest and three posttest measurements of the dependent variables of state anxiety (SA), reported emotions, and coping methods were completed. The program incorporated cognitive, physiological, and behavioral approaches.

Second, this study examined the relationship of selfesteem, recent life experiences, and trait anxiety (TA) to encountered Stressors. A repeated measures analysis of variance demonstrated no significant differences between treatment groups across time. However, written workshop evaluations demonstrated a strongly positive response by the experimental group. Significant within-subjects change was demonstrated for all 57 subjects over the semester on the dependent variables of SA, Threat emotions, and Challenge emotions reinforcing Lazarus' transactional model. A correlation matrix revealed that individuals with low self-esteem appraised the environment in a negative manner as did those subjects with high state and TA. Recommendations include further revision of the multidimensional stress management approach and continued use of the transactional theoretical framework.
The Effect of an Innovative Clinical Teaching Method on Nursing Students' Knowledge and Critical Thinking Skills
Authors: Perciful Eileen Grow , Nester Patricia Anne
Published: April 2021

ABSTRACT

The purpose of this quasi-experimental study was to determine the effect of an experimental clinical teaching method on nursing students' knowledge and critical thinking skills during clinical rotations in psychiatric nursing. Ausubel's Assimilation Theory of Learning provided the theoretical framework for this research. The subjects (JV=83) were from the baccalaureate nursing graduating classes of 1992 and 1993 of a medium-sized state university in the mid-atlantic region of the United States. The experimental clinical teaching method used computer-assisted instruction (CAI) throughout and a collaboration model (student-faculty-service) during initial clinical experiences. Knowledge was measured by the score for the psychiatric nursing component of the Mosby Assess Test and two parts of the National League for Nursing's (NLN) Psychiatric Exam (theory and total scores). Critical thinking was measured by two parts of the NLN1S Psychiatric Nursing Exam (the score for assess, analyze, and evaluate as one measure and planning and implementation for the other measure). The comparison group scored significantly higher than the control group on assessing, analyzing, and evaluating (r=2. 15; ? <. 03), as well as planning and implementation (t=2.33; p<.02), measures for critical thinking skills. However, there was no significant difference between the study groups with respect to knowledge. The findings support the appropriateness of Ausubel's Assimilation Theory with this clinical teaching method. Discussion relevant to the application of the study findings to nursing education and future research is presented.
The Experience of Being a Male Student Nurse
Authors: Kelly Norma R , Shoemaker Mary , Steele Tim
Published: April 2021

ABSTRACT

Although schools of nursing market their programs to all segments of society, men are underrepresented in schools of nursing. The purpose of this study was to identify male students' perceptions of the motivational factors, barriers and frustrations encountered in becoming a nurse. Eighteen students attended one of four focus groups representing one associate program, two baccalaureate programs and one diploma program. The students' belief that society perceived nursing as a feminine profession was an underlying thread that related to many of their perceptions and feelings. The roost influential support people noted were immediate family, especially wives. The participants also believed that high school counselors were of no assistance in choosing nursing as a career. Even though the schools of nursing were perceived as supportive, the participants had feelings of isolation and self-doubt.
Heterosexism in Nursing Education
Authors: Gray D Patricia , Kramer Maeona , Minick Ptlene , McGehee Linda , Thomas Debera , Greiner Doris
Published: April 2021

ABSTRACT

If we are to take seriously the challenge of teaching nursing students skills in critical thinking, as nurse educators we must examine the most difficult issues facing society and nurses. Heterosexism and the resulting homophobia are such issues. This article provides an introduction to the concepts of heterosexism and homophobia and describes how they intersect and are revealed in nursing education. The consequences of heterosexism and homophobia are illustrated using examples from our experiences as lesbian and heterosexual nurse educators. We conclude with an action plan for undermining heterosexism and homophobia.
Clinical Knowledge and Skill Priorities in Substance Abuse Education: A Nursing Faculty Longitudinal Survey
Authors: Murphy Shirley A , Scott Craig S , Mandel Lynn P
Published: April 2021

ABSTRACT

The aims of this study were to: 1) determine which of 16 substance abuse content areas nursing faculty fellows considered important for their professional growth; 2) determine content areas in which faculty fellows planned to obtain knowledge and skill development during the coming year; and 3) to identify content areas faculty fellows thought undergraduate and/or graduate students should be taught. Questionnaires were mailed to the 43 nursing faculty fellows who were recipients of substance abuse federal training during the 1989-1994 academic years. The response rate was 81%. One and a half years later, 66% responded to the same items on a follow-up survey. The results showed that faculty ratings of knowledge and skill development needs for themselves and their students in nursing were stable over time. Findings can be used to guide faculty and curriculum development in alcohol and other substance abuse.
Evaluating Critical Thinking Skills of Baccalaureate Nursing Students
Authors: Vaughan-Wrobel Beth C , O'Sullivan Patricia , Smith Lynette
Published: April 2021

ABSTRACT

This study evaluates the critical thinking skills of students enrolled in a baccalaureate nursing program, using the WGCTA, for the classes of 1993 through 1996. Scores were obtained at entry and at end of junior and senior years. The mean entry WGCTA score was 56 for all four classes; however, the 1995 and 1996 classes had significantly higher scores than the class of 1994. Critical thinking scores were higher at entry for older students and students who had completed another education degree; however, critical thinking scores were lower for students who had previous nursing experience. After adapting for age, previous degree, and nursing experience, no significant differences in the WGCTA scores from entry to end of junior and senior years emerged for the classes of 1993, 1994, 1995.
Characteristics of the Iris in 100 Neonates
Authors: Spierer Abraham , Isenberg Sherwin J , Inkelis Stanley H
Published: April 2021

ABSTRACT

To better characterize the appearance of the iris at birth, we studied certain iris features of 100 normal newborns with slit lamp biomicroscopy. We noted the iris color, crypt-structure, and vascularity of the collarette and periphery of the iris. These features were considered in light of the child's birthweight, postnatal days of age, sex, and race. Iris vascularity correlated significantly with postnatal age at examination, and stage of crypt development was more advanced in males, and more evident in the blue and gray hides. Males also had a more advanced stage of iris development. In addition to our previous finding that iris vessels of cocaine intoxicated neonates were more tortuous and dilated than a control group, this study suggests that such vessels may also be more commonly found in sickly Infants.
Hang-Back Lateral Rectus Recessions for Exotropia
Authors: Capó Hilda , Repka Michael X , Guyton David L
Published: April 2021

ABSTRACT

The hang-back recession isa simple, safe alternative to conventional recession. We evaluated the surgical results in 23 consecutive patients undergoing bilateral hangback lateral rectus recessions and 24 consecutive patients undergoing bilateral conventional lateral rectus recessions. The 6-week postoperative success rate was 78% in the hang-back group and 75% in the conventional group. At the time of the most recent follow-up, the success rate was 64% In the hang-back group and 85% in the conventional group. Dose-response curves were similar for both methods. There were more late overcorrections with the hang-back technique. We suggest modified surgical guidelines for the hang-back recession technique.
Residual Incomitant DVD Following Large Bilateral Superior Rectus Recession
Authors: Freeman Richard S , Rosenbaum Arthur L
Published: April 2021

ABSTRACT

A recent survey of 25 experienced strabismus surgeons Indicated that a very large superior rectus recession is the procedure of choice for DVD. We report a series of seven patients who exhibited a persistent DVD following large superior rectus recession. Furthermore, the DVD was markedly incomitant, much greater in adduction than in abduction. This residual DVD would mimic inferior oblique overactlon on version testing, although proving to be purely DVD on critical observation. This "overactlon" is apparently due to the marked weakening of the superior rectus and was not always predictive of the location and amount of persistent DVD. This previously unreported complication of large superior rectus recession is important to recognize so that alternative surgical approaches may be contemplated. It Is hoped that more accurate observations and measurements both preoperatively and postoperatively will lead to a more orderly approach to DVD surgery.
Topical Anesthesia for Strabismus Surgery
Authors: Diamond Gary R
Published: April 2021

ABSTRACT

Twenty-two adults underwent strabismus surgery under topical anesthesia over the past 4 years. Benefits of this technique include avoidance of certain hazards of general and retrobulbar anesthesia, the ability to adjust eye position to the patient's satisfaction on the operative table, and expanded options for patients unwilling to undergo general anesthesia. The major disadvantages are the possibility of increased patient discomfort. Patient selection is important.
Expanded Binocular Peripheral Visual Fields Following Surgery for Esotropia
Authors: Wortham Edwin V , Greenwald Mark J
Published: April 2021

ABSTRACT

We measured the horizontal extent of the binocular peripheral field of vision in ten adult esotropes using Goldmann perimetry before and after strabismus surgery. In every case there was expansion of the field by an amount approximately commensurate with the change in angle of strabismic deviation. This occurred regardless of the presence of amblyopia or recovery of binocular fusion. Subjective improvement in peripheral vision was appreciated by a number of patients. Visual field expansion should be recognized as a significant indication for correction of esotropia.
Botulinum Toxin Injection Into the Superior Rectus Muscle of the Non-Dominant Eye for Dissociated Vertical Deviation
Authors: McNeer Keith W
Published: April 2021

ABSTRACT

A variety of surgical procedures on the superior rectus muscles have been proposed asa remedy for Dissociated Vertical Deviation (DVD); Botulinumtoxin (Oculinum) has been one such suggestion as a surgical alternative. We selected five older patients with DVD whose age placed them beyond a risk of amblyopia to evaluate Oculinum injection into the superior rectus muscle as therapy for DVD. The patients achieved a reduction from the mean value of 20 prism diopters to the mean value of less than 5 pd hypertropia at 172 weeks following injection. Our study suggests that Oculinum is effective in treating DVD, but caution should be exercised because transient ptosis invariably accompanies injection.
Möbius and Möbius-Like Syndromes (TTV-OFM, OMLH)
Authors: Miller Marilyn T , Ray Valencia , Owens Paul , Chen Felix
Published: April 2021

ABSTRACT

There exists a spectrum of syndromes characterized by cranial nerve palsies, limb anomalies, and craniofacial malformations. Criteria based on type and severity of limb anomaly or presence or absence of cranial nerve palsy may alter the syndrome nomenclature due to a selection bias but do not appear to benefit syndrome delineation to any extent. Patients with seventh nerve palsy and abduction weakness are usually diagnosed as having Möbius syndrome by ophthalmologists.

The observed ocular motility findings range from primarily abduction deficiencies to patients who have a Duane or gaze palsy pattern of horizontal movements. Some cases previously described as "sixth nerve and partial third" may better fall into one of the latter groups, since an isolated adduction deficit as a manifestation of third nerve involvement is rare,

The presence of clinical appearance of Duane syndrome in these Möbius-type patients raises the possibility of abnormal innervation of the lateral rectus as an explanation of some patterns of motility observed.
Neuroretinitis in Childhood
Authors: Weiss Avery H , Beck Roy W
Published: April 2021

ABSTRACT

We report the clinical features and results of laboratory testing of seven children with neuroretinitis, diagnosed on the basis of reduced visual acuity, relative afferent pupillary defect, and distinctive appearance of the fundi. Disc swelling was segmental in five patients with unilateral disease and diffuse in two patients with bilateral disease. Retinal infiltrates were transiently present in two patients. Swelling of the optic disc and peripapillary retina, along with the inflammatory vitritis resolved by 2 to 6 weeks but macular exudates persisted for 3 to 12 months. Two patients developed optic atrophy with permanent visual loss and two patients had visual acuity reduction detected only under low contrast conditions. Cat-scratch disease was implicated as the cause of the neuroretinitis in two patients; the etiology of the remaining cases was not established.
Prematures With and Without Regressed Retinopathy of Prematurity: Comparison of Long-Term (6-10 Years) Ophthalmological Morbidity
Authors: Cats Bernard P , Tan Karel E W P
Published: April 2021

ABSTRACT

Forty-two ex-prematures having had regressed forms ol retinopathy of prematurity (ROP) during the neonatal period were compared with 42 matched non-ROP expremature controls at ages 6 to 10 years. The overall incidence of ophthalmologic problems was 55% in the ROP and 36% in the non-ROP group. Strabismus, amblyopia, and refraction anomalies occurred more frequently in the ROP group. In this group, a significantly greater number of children had decreased vision in one or both eyes compared to the non-ROP group. Although the incidence of ophthalmologic problems in the ROP group was considerably higher, the incidence in the non-ROP group still turned out unexpectedly high. This implicates that non-ROP very low birth weight neonates should also be considered to be at a greatly increased risk for later visual problems. Regular ocular examinations, mandatory for the ROP group, thus should be included in follow-up programs of non-ROP very low birthweight neonates as well.
Prism Adaptation for Esotropia With a Distance-Near Disparity
Authors: Kutschke Pamela J , Scott William E , Stewart Susan A
Published: April 2021

ABSTRACT

A series of 64 patients who had surgery for esotropia with a distance-near disparity of at least 10 prism diopters was reviewed. Thirty-three patients were prism adapted for their distance deviation (PA distance). Thirtyone patients were prism adapted for near deviation (PA near). Both groups were divided Into responders and nonresponders.

In the PA distance group, 22 (67%) patients were responders. All responders had surgery for their prismadapted angle. Postoperatively, 19 (86%) responders had fusion. Thirteen (68%) required bifocals to maintain fusion.

In the PA near group, 21 (68%) patients were responders. All responders had surgery for their prism-adapted angle. Ninety-four percent of responders had fusion postoperatively. None needed bifocals for fusion postoperatively and none were overcorrected.

The results show that those patients who were prism adapted for their near angle, responded with fusion, and had surgery for their full amount of esotropia at prism response obtained better postoperative fusion, without the need for a bifocal at near and without overcorrectlon at distance.
Neuroradiological Features of Patients With Optic Nerve Hypoplasia
Authors: Zeki Sabah M , Hollman Anne S , Dutton Gordon N
Published: April 2021

ABSTRACT

Optic nerve hypoplasia (ONH) is associated with a wide range of neurological and endocrine disorders. A series of 21 patients is reported. This comprised 17 with ONH in association with manifest neurological and endocrine disturbance, 3 who were blind but who were otherwise normal, and 1 with bilateral impaired visual acuity only. AH patients underwent neuroradiological and detailed ophthalmic assessment. A wide range of abnormalities was observed. The most common findings were absent septum pel lucid urn, hydrocephaly, and porencephaly. Evidence of hypothalamic/pituitary hormone deficiency was present in nine patients, six of whom had demonstrable intracranial radiological abnormalities. All patients except one had bilateral optic nerve hypoplasia. Most patients had poor visual acuities and nystagmus. Astigmatism was also common. Two conditions which have not previously been reported in association with optic nerve hypoplasia were found: an intracranial arachnoid cyst and an intracranial epidermoid cyst.