bluuebunny/crossref_metadata_2025 huggingface dataset:
Complications of CT-Guided Biopsy of the Spine and Sacrum
Authors: Olscamp Adam , Rollins James , Tao Sidney S , Ebraheim Nabil A
Published: April 2021

ABSTRACT

This study reviews the results of 94 computed tomography (CT)-guided Craig needle biopsies of the spine and sacrum performed at one center. An indication for biopsy in this study was prompted by abnormal findings identified by one or more of the following diagnostic modalities: radiography, CT, magnetic resonance imaging (MRI), or bone scanning. These patients then underwent CT-guided Craig needle biopsy of the spine and sacrum for further evaluation. There were 1 biopsy of the cervical spine, 19 of the thoracic spine, 66 of the lumbar spine, and 8 of the sacrum. Biopsy sensitivity was 94.5% and specificity was 96.8%. This accuracy compared with other diagnostic modalities showed biopsy to be the gold standard for diagnosis of spine or sacral lesions.

Of the 94 cases reviewed, 6 complications were noted. All complications were acute in nature and included 1 aortic puncture, 2 psoas punctures with associated psoas hematomas, 1 biopsy of an incorrect level, and 2 aborted procedures secondary to patient discomfort. No infections or neurological sequelae were seen. Although the benefits of CT-guided biopsy over open biopsy have been shown previously, this review demonstrates it is not without significant risk.
Use of Hydroxyapatite: A Noncemented Fiction?
Authors: Cabanela Miguel E
Published: April 2021

Primary Femoral Fixation Options
A Global Approach to Management of Deep Vein Thrombosis in Total Hip and Knee Arthroplasty
Authors: Sculco Thomas P , Kahn Barbara A
Published: April 2021

Hip Arthroplasty: Postoperative Management Problems
The Evolving Cost Spectrum of Revision Hip Arthroplasty
Authors: Barrack Robert L
Published: April 2021

Revision Total Hip Arthroplasty: Fixation Options and Outcomes
Knee Challenges: What Would You Do?
Authors: Scott Richard D
Published: April 2021

Case Challenges in Hip & Knee Surgery
Resorbable Posterolateral Graft Containment in a Rabbit Spinal Fusion Model
Authors: Poynton Ashley R , Tomin Emre , Cornwall G Bryan , Zheng Fengyu , Lane Joseph M
Published: April 2021

Abstract

The effect of a resorbable graft containment device was evaluated in a rabbit posterolateral lumbar spinal fusion model. Twenty rabbits were divided into four groups: autogenous bone graft (ABG), ABG with the MacroPore containment device (MacroPore Biosurgery Inc, San Diego, Calif) (ABG+MP), demineralized bone matrix (DBM), and DBM with the containment device (DBM+MP). Fusion mass was assessed at 6 weeks with high resolution radiographs and volumetric computed tomography (CT). The graft containment device was associated with alteration of the fusion mass structure and significant enhancement of fusion mass volume (ABG versus ABG+MP, P=.027; DBM versus DBM+MP, P=.043). A bioabsorbable, protective graft containment device successfully enhanced posterolateral spinal fusion mass volume.
Applications of a Resorbable Interbody Spacer via a Posterior Lumbar Interbody Fusion Technique
Authors: Alexander Joseph T , Branch Charles L , Subach Brian R , Haid Regis W
Published: April 2021

Abstract

Polyhydroxyacids are a promising class of bioresorbable materials with potential applications in spinal surgery. One such polymer, MacroPore (MacroPore Biosurgery Inc, San Diego, Calif), offers a balance of strength, predictable degradation, lack of stimulus of foreign body reaction, and biocompatibility with neural tissue. MacroPore can be formed into an array of shapes and can be manufactured, sterilized, and stored with conventional techniques. Limited clinical experience has been gained with bioresorbable implants that are used as load-sharing devices in a posterior lumbar interbody fusion construct.
New Directions in Bioabsorbable Technology
Authors: Warren Stephen M , Sylvester Karl , Chen Constance M , Hedrick Marc H , Longaker Michael T
Published: April 2021

Abstract

Generating replacement tissues requires an interdisciplinary approach that combines developmental, cell, and molecular biology with biochemistry, immunology, engineering, medicine, and the material sciences. Since the basic cues for tissue engineering may be derived from endogenous models, investigators are learning how to imitate nature. Endogenous models may provide the biologic blueprints for tissue restoration, but there is still much to learn. Interdisciplinary barriers must be overcome to create composite, vascularized, patientspecific tissue constructs for replacement and repair. although multistep, multicomponent tissue fabrication requires an amalgamation of ideas, the following review is limited to the new directions in bioabsorbable technology. the review highlights novel bioabsorbable design and therapeutic (gene, protein, and cell-based) strategies that are currently being developed to solve common spinal problems.
Intramedullary Nailing of Distal Tibial Fractures: A Technique to Prevent Malalignment
Authors: Russell George V , Pearsall Albert W
Published: April 2021

This article presents a technique for treating distal tibial fractures using an interlocking syndesmosis screw in the distal portion of the intramedullary nail to prevent malalignment
Managing Thromboembolic Risk in Hip and Knee Arthroplasty: State of the Art
Authors: Colwell Clifford W
Published: April 2021

Abstract

Deep vein thrombosis and pulmonary embolism are major causes of morbidity and mortality after knee and hip arthroplasty in the United States. Although patients frequently receive prophylaxis for thromboembolism postarthroplasty, surgeons vary in their choice of modality and often use suboptimal strategies due to the possibility of provoking postoperative bleeding. This article discusses the rationale for the prevention of venous thromboembolism and offers an overview of clinical recommendations for prophylaxis in knee and hip replacement surgery. Supporting medical evidence for these recommendations is described. A summary of current prophylactic regimens and discussion of duration of therapy are also presented.
The Effectiveness of Autologous Chondrocyte Implantation for Treatment of Full-Thickness Articular Cartilage Lesions in Workers' Compensation Patients
Authors: Yates James W
Published: April 2021

Abstract

This prospective longitudinal analysis evaluated the effectiveness of autologous chondrocyte implantation in 24 workers' compensation patients with articular cartilage injuries >2 cm
p 2
. Mean lesion size was 4.7 cm
p 2
, (range: 2-10 cm
p 2
). Nineteen lesions were on the distal femur and 5 were on the patella. Clinical assessment scores improved from a mean of 3.2 at baseline to 6.8 one year postoperatively, with 78% rated good or excellent. Among patients with ≥1-year follow-up, 63% returned to unrestricted work status at a mean of 7 months; an additional 22% returned to modified work.
Lumbar Pedicle Morphology in Adolescent Idiopathic Scoliosis
Authors: King Andrew G , Mills Tara E , Chutkan Norman B , Strohmeyer Scott E
Published: April 2021

Abstract

Using computed tomography of lumbar spine pedicles, pedicle morphology was documented in 30 patients with adolescent idiopathic scoliosis. Lumbar pedicles are relatively symmetrical in patients with adolescent idiopathic scoliosis; however, a statistically significant difference was found between males and females at L2-L4. A trend for increased transverse pedicle width was observed on the concavity versus the convexity. At levels L3-L5, 90% of the pedicles were >5.5 mm but pedicles L1 and 12 were smaller, only >5.5 mm in 34% and 42%, respectively. Safe insertion of 5.5-mm screws is possible at L3-L5, but more cephalic pedicles necessitate caution.
Interobserver Variability of the Insall-Salvati Ratio
Authors: Kadakia Nimish R , Ilahi Omer A
Published: April 2021

Abstract

Thirty-six patients presenting with knee pain were enrolled in a prospective study to assess the variability of the radiographic measurement of patellar height by the traditional and modified Insall-Salvati ratios.

The traditional and modified Insall-Salvati ratios were measured from a lateral knee radiograph using a standard hand-heid ruler by four physicians in varying order.

The observers were in agreement in classifying the radiographs in two thirds of the cases when the traditional method was used but in less than one-half of the cases when the modified ratio was used. The source of the difference in the two ratios is a greater variability in measuring the distance from the inferior margin of the articular surface to the tibial tubercle.
Cementless Total Hip Arthroplasty for the Treatment of Advanced Tuberculosis of the Hip
Authors: Wang Qiaojie , Shen Hao , Jiang Yao , Wang Qi , Chen Yunsu , Shao Junjie , Zhang Xianlong
Published: April 2021

The question of whether a total hip arthroplasty (THA) should be attempted in a patient with a current or previous tuberculosis infection continues to cause controversy. The goal of this study was to evaluate the clinical result of cementless THA for the treatment of advanced tuberculosis of the hip.

Eight patients with advanced tuberculosis of the hip treated by cementless THA were retrospectively analyzed. None of the patients had draining sinus preoperatively. For patients with a confirmed preoperative diagnosis of tuberculosis and elevated C-reactive protein and erythrocyte sedimentation rate, antituberculous medication was prescribed for at least 2 weeks preoperatively. Inflamed soft tissues and destroyed bones were completely curetted out intraoperatively. All 8 patients received 1-stage cementless THA after thorough debridement. Antituberculous medications were prescribed for all patients for the first 6 months postoperatively. No patient experienced wound-healing complications. Mean Harris Hip Score was 35 (range, 30–43) preoperatively and 91 (range, 87–95) at last follow-up. At an average 46-month follow-up (range, 34–59 months), no reactivation of tuberculosis was detected. All 8 patients revealed stability by bone ingrowth on both the socket and femoral stem.

Cementless THA is a safe and effective procedure for advanced tuberculosis of the hip. With thorough debridement followed by a complete course of antituberculous chemotherapy, active tuberculous infection should not be considered a contraindication for THA.
Comparison of Dorsal and Volar Approaches to the Proximal Radius
Authors: Cross Jessica D. , White Jeffery A. , Johnson Anthony E. , Blair James A. , Hsu Joseph R.
Published: April 2021

Proximal radius exposure may be acquired by either the dorsal or volar approach depending on surgical requirements. The dorsal approach is traditionally recommended for fracture fixation of the proximal radius because of theoretically improved exposure and because the dorsal aspect of the bone is the tensile surface. The posterior interosseous nerve can be visualized and protected using this approach. The volar approach is preferred for biceps repair and boasts a distal extensile approach with adequate soft tissue coverage. Impingement on the bicipital tuberosity and biceps tendon, in addition to positioning on the compression side of the bone, makes the anterior or anterolateral position for plate placement less desirable.

The goal of this study was to quantify and compare in a cadaver model the area of bone exposed using both approaches. We hypothesized that equivalent exposures can be obtained and the posterior interosseous nerve can be identified with either the Thompson or Henry approach. Standard dorsal and volar approaches were performed on 10 fresh-frozen adult cadaveric upper-limb specimens. Cross-sectional area of exposure was quantified from digital photographs using software. The 2 approaches did not result in a significant difference in area exposed. Depending on case requirements, either the dorsal or volar approach will provide adequate exposure to the proximal radius.
The Role of Computed Tomography in the Diagnosis and Management of Femoral Neck Fractures in the Geriatric Patient
Authors: Melvin J. Stuart , Mataszewski Paul , Scolaro John , Baldwin Keith , Mehta Samir
Published: April 2021

Femoral neck fractures are common in the elderly; however, agreement on classification and treatment varies. It was hypothesized that computed tomography (CT) would increase agreement for Garden Classification and treatment plan over plain radiographs alone. This article presents results of an online survey completed by 32 respondents at a single institution. The survey was comprised of 5 elderly patients with femoral neck fractures using plain radiographs and CT images. Cases were randomly presented in 3 formats: (1) plain radiograph, (2) CT, and (3) plain radiograph and CT together. Patients were described as low-energy trauma, 65 years or older, and cleared for surgery. Garden Classification and treatment plans were queried. A single case was repeated for intraobserver reliability. Kappa was calculated for inter- and intraobserver reliability. The addition of CT and modification of the Garden Classification (nondisplaced vs displaced) improved interobserver agreement in all cases. Participants were 1.7× more likely (
P
=.042) to change their Modified Garden Classification when CT was added to plain radiograph compared to plain radiograph added to CT. Treatment agreement was slight to fair. Intraobserver agreement varied from slight to moderate. The rate of arthoplasty recommendations was similar across attending subspecialties; however, arthroplasty-trained surgeons were 20 to 60 times more likely to recommend total hip arthroplasty (
P
=.009) over hemiarthroplasty compared to nonarthroplasty-trained surgeons. The addition of CT to plain radiograph after femoral neck fracture improves Garden Classification agreement. However, treatment agreement was not impacted by CT. Factors other than improved classification agreement appeared to direct surgeons’ treatment recommendations.
Faculty and Administrator Perceptions of Decision Making
Authors: O'Kane Patricia K
Published: April 2021

ABSTRACT

This research study was conducted in associate and baccalaureate schools of nursing. This research focused on (1) the extent of faculty participation in decision making; (2) a description and analysis of the characteristics of nurse faculty, nurse administrators, and the organizations of associate and baccalaureate schools of nursing; (3) the interrelationships between opportunities for participation in decision making and the level and type of decision making; (4) the relationships between various personal and situational variables that affect decision making, (5) the relationship between the type of involvement in decision making to the variables of job satisfaction, professional commitment, and job tension; and (6) the relationships among the variables of job satisfaction, professional commitment and job tension.

Ninety-three faculty and 10 administrators participated in the research study. Research data were collected by three instruments: the School Information Profile, the Administrative Questionnaire, and the Faculty Questionnaire. The data were subjected to frequency distribution statistics, the RELIABILITY program of SPSS, Pearson correlation coefficients, Canonical correlations, and Multiple Regression analysis. The primary study results were: (1) Faculty reported that their participation in decision making is primarily in the area of making recommendations, not final determinations. (2) Faculty stated that decision making is usually a group process. (3) Administrator perceptions were that faculty possess more decision-making power than faculty believed. (4) Faculty reaffirmed that job satisfaction and professional commitment are positively correlated, and that job tension was found to be negatively correlated to job satisfaction and professional commitment. (5) Faculty stated that they were usually involved in classroom oriented decision-making areas but desire increased faculty involvement in administration and facilities utilization.
The Technical Competence of Registered Nurses in the Administration of Oral Medications
Authors: Ignatavicius Donna D , Naumann Phyllis A Luers
Published: April 2021

ABSTRACT

An individual who desires to become a registered nurse (RN) may choose from three types of education: associate degree, diploma, and baccalaureate degree programs. The dilemma of this decision is heightened by the strong disagreement within the nursing profession regarding which of the three modes best prepares a nurse to become a competent practitioner.

The purpose of this study was to examine variables which might explain variance in the technical competence of RNs as evidenced by skill in administering oral medications. Six variables were investigated as possible predictors of the variance in oral medication administration procedure, i.e., basic nursing education, drug knowledge, age, previous RN experience, previous nursing experience, and highest nursing education completed.

Sixty volunteer RNs in a Baltimore community hospital (252 beds) were observed twice each as they administered two oral medications to a patient. A Technical Competence Tool (TCT) was used to record performance of the 16 critical behaviors deemed essential for safe and accurate drug administration. The total scores from observation one and two were summed to obtain a total competence score. Each nurse also completed a 14-item Drug Knowledge Profile (DKP) and Demographic Data Sheet (DDS).

Although there was a wide range of total competence scores, only three percent of the variance was explained by the six predictor variables. It was concluded that the selected variables were not significant predictors of the technical competence of RNs in the administration of oral medications.

One of the major areas of concern in the nursing profession today is the difference in the clinical performance of nurses prepared at the associate degree, diploma, and baccalaureate degree levels. Skills of leadership, communication, and decision making have been the main foci for comparison by researchers, but concentration on technical skill differences has been limited. With the increasing public pressure for quality patient care and the push for accountability in the health professions, there is a need for substantive studies to examine the technical competence of registered nurses (RNs).
Rival Conceptions in Doctoral Education in Nursing and Their Outcomes: An Update
Authors: Lash Ayhan A
Published: April 2021

ABSTRACT

The need for two distinct types of doctoral programs in nursing was historically well conceived and well articulated. The growing literature on the doctoral education in nursing, however, shows that the implementation of the concept has not produced the intended results, that is the coexistence of academic and professional doctoral programs in nursing has not resulted in the differentiated career paths for the graduates. Instead, the competing aims of doctoral education in nursing, paved the way to varying doctoral titles, and weakened the claims of professional doctoral programs as preparing for advanced clinical practice. More significantly, however, this development is threatening the future existence of professional doctoral programs in nursing.
Analysis of Stressful Clinical and Didactic Incidents Reported by Returning Registered Nurses
Authors: Lee E Juanita
Published: April 2021

ABSTRACT

Although stress is an important issue for the returning or entry registered nurse, seldom is stress management discussed with students. This paper describes a study designed to identify and rank stressful clinical and didactic experiences of returning female registered nurses enrolled in baccalaureate degree nursing programs. A content analysis of critical incidents reported by these re-entry women is the focus of this paper.
Criteria Used for Patient Selection for Nursing Students' Hospital Clinical Experience
Authors: Goldenberg Dolly , Iwasiw Carroll L
Published: April 2021

ABSTRACT

This study investigated the criteria used by nurse educators when selecting patients for students' hospital clinical experience. Criteria were defined as individual elements or characteristics considered when selecting patients. Factors were defined as broad categories of related criteria. The sample consisted of 54 nurse educators from college and university nursing programs. A researcherdeveloped questionnaire was used. The three most important criteria for patient selection were: students' individual learning needs, patients' nursing care needs, and matching patients' needs with students' learning needs. One-way ANOVA was performed on the factors by subjects' demographic variables. Teacher-student clinical ratio, program in which teaching, and age most influenced the factors considered (p<.05).
Career Stage: The Heterogeneity of Nursing Faculty
Authors: Grunbaum Jo Anne
Published: April 2021

ABSTRACT

The purpose of this study was to examine attitudes of nursing faculty and determine if attitudinal differences did exist toward various facets of the work setting based on academic rank. This study also determined the effect of age on the aforementioned relationship.

Nursing faculty currently teaching at public colleges and universities were randomly selected from school catalogues and asked to participate in the study. A total of 496 affirmative responses were received from the initial and follow-up mailing. However, 27 were either ineligible to participate or returned an incomplete Job Attitude Scale. The remaining 469 responses were utilized for the descriptive statistics.

The results of a MANOVA (n=421) indicate that there are statistically significant differences in attitudes toward various factors within the work setting based on academic rank. That significance remains even when age is controlled. Full professors were more concerned with being creative, having a good relationship with subordinates, personnel policies and status. Nursing faculty who were instructors and assistant professors were interested in receiving praise, having a competent supervisor, having a good relationship with peers and a secure job.
Analysis of Coping Methods Reported by Returning RNs
Authors: Lee E Juanita
Published: April 2021

ABSTRACT

To teach registered nurses in a baccalaureate degree program effectively, educators need to be knowledgeable of the various coping methods used by these re-entry students in response to academic and clinical stress. This article describes a study designed to identify coping methods of registered nurses enrolled in programs designed for beginning students in nursing and programs designed to build on prior nursing education.
A Comparison of Clinical Evaluation Tools in Hospitals and Baccalaureate Nursing Programs
Authors: Grabbe Linda Louise
Published: April 2021

ABSTRACT

This study compared nurse educators' and hospital administrators' expectations of graduating baccalaureate students by analyzing the content of clinical evaluation tools in two settings: the last medical-surgical rotation and the beginning staff-level position. Ten baccalaureate nursing programs and 10 large university hospitals were studied as pairs. Evaluation tool criteria were divided into six role categories: care giver, client teacher, manager- team member, communicator, investigator, and professional. The study yielded data regarding similarities and differences regarding behaviors expected by schools and hospitals. The highest rates of similarity were found in the care giver and professional roles. The greatest difference was found in the manager-team member role with hospitals including many more of the behaviors. Few behaviors in the investigator role were included by school-hospital pairs, but schools included more of the behaviors than hospitals.
Stresses and Threats Reported by Baccalaureate Students in Relation to an Initial Clinical Experience
Authors: Pagana Kathleen Deska
Published: April 2021

ABSTRACT

Based upon the theory of cognitive appraisal of stress, an instrument was designed to describe the aspects of a clinical experience that were challenging or threatening. The qualitative data largely reflected the threatening, rather than the challenging, aspects of the experience. Thus, this research report provides a typological analysis of qualitative data describing the threatening nature of an initial medical-surgical experience for 262 baccalaureate students.

Content analysis was used to determine the six predominant themes of threat which included personal inadequacy, fear of making errors, uncertainty, the clinical instructor, being scared or frightened, and fear of failure. The threats elaborated upon in this research should provide the instructor with some insight into understanding the stressors inherent in the clinical experience. The students' comments offer direction for nurse educators to pursue in facilitating therapeutic discussions with nursing students.
The Effects of Interactive Video on Cognitive Achievement and Attitude Toward Learning
Authors: Schare Barbara L , Dunn Sally C , Clark Helen M , Soled Suzanne W , Gilman Barbara R
Published: April 2021

ABSTRACT

The purpose of this experimentally designed study was to determine the effects of an interactive videodisc program, entitled "Diabetic Health Assessment," versus traditional lecture on cognitive learning and affective behaviors of baccalaureate nursing students. It was hypothesized that: 1) there would be no significant difference in the cognitive achievement scores between those students taught by an interactive videodisc program (experimental group) compared to those students taught by a traditional lecture method (control group), and 2) there would be a statistically significant difference in student attitude toward learning between those students taught by an interactive videodisc program compared to students taught by a traditional lecture method.

Eighty-three third-year baccalaureate nursing students at a major urban university served as subjects and were randomly assigned to either a control (n = 41) or an experimental group (n = 42). The multivariate analysis of covariance with two criteria and the pretest as the covariate was significant (p = .000, df = 4, 140) indicating that the adjusted posttest scores on the two measures were significantly different for the experimental group compared to the control group. The univariate F for the cognitive measure was nonsignificant (p - .283, df = 2, 72) indicating that students' achievement under interactive video is not significantly different than under traditional lecture. The univariate F for the affective measure was significant (p = .000, df = 2, 72) indicating that the students learning by interactive video possessed a more positive attitude toward learning than those learning by traditional lecture method of instruction.
America's First School of Nursing: The New England Hospital for Women and Children
Authors: Davis Althea T
Published: April 2021

ABSTRACT

This is a historical research about America's first school of nursing. The purpose of this research is to explore and analyze the philosophy, training methods, and the setting in which nursing education began in America. The methodology included the use of primary sources and a site visit to the New England Hospital for Women and Children, now known as the Dimock Health Center. The findings reveal that through feminist endeavors, and women physicians as nurse educators, the New England Hospital for Women and Children emerged as a leader in training nurses. In addition, this institution is credited with graduating two prominent historical pioneers who were admitted to Nursing's Hall of Fame.
Direct Articulation of AD Nursing Students Into an RN-to-BSN Completion Program: A Research Study
Authors: McHugh Marylou K
Published: April 2021

ABSTRACT

A study was undertaken to investigate the educational validity of direct articulation for AD students into an upper division RN-completion program through transfer of nursing credit. The results suggested that there is a common core of content in both associate- and baccalaureate-level nursing curricula, and that transferring associate degree nursing (ADN) credit into an RN-to-BSN upper division program is defensible. Statistical analysis revealed no significant difference between ADN seniors graduating from National League for Nursing (NLN)-accredited programs and candidates for university admission in composite scores on the ACT-PEP validation battery if the student achieved a final GPA of 2.75 or above. Based on these results, the faculty has recommended the adoption of a general policy of direct articulation for students from state-approved, NLN-accredited ADN programs into the RN-to-BSN program at La Salle University.
Responses of Schools of Nursing to Physically, Mentally, and Substance-Impaired Students
Authors: Swenson Ingrid , Havens Beverly , Champagne Mary
Published: April 2021

ABSTRACT

Responses of schools of nursing to physically, mentally, and substance-impaired applicants and matriculating students were assessed in a 12% simple random sample (n = 132) of the 383 baccalaureate and 715 associate degree nursing schools and programs accredited by the National League for Nursing. A self-administered questionnaire concerning experiences, policies, procedures, and factors influencing decision-making was sent to the 132 deans and directors of the nursing schools and programs. Criteria for denning impairments, resources for developing criteria, methods of identifying impairments, actions taken, and individuals involved in the decision were also assessed.

While the schools used external resources to guide decision-making, the majority of the responsibility was with the school of nursing faculty and administration. Schools offered a range of options for impaired individuals continuing in the program while under treatment; nevertheless, seeking treatment was a frequent requirement for continuation in the program.
Integrating HIV/AIDS Policies and Curricular Content Into Baccalaureate Nursing Programs
Authors: Ryan Marilyn E , Jones Lorraine , Irvine Phyllis , Hodson Kay E
Published: April 2021

ABSTRACT

A model used by one school of nursing to implement HIV/AIDS policies, sequenced instructional opportunities, and a research-based evaluation process is described. In the evaluation phase, a study was undertaken to measure students' retention of HIV/AIDS knowledge and their application of universal precautions (U.P.). Findings revealed that 59% of junior baccalaureate nursing students and 75% of seniors retained knowledge about HIV/AIDS and U.P. Seniors indicated that in their role as nursing student or technician/extern, supplies and equipment were readily available and that they had sufficient time to implement U.P. However, only 64% admitted to following correct procedures, even though 96% acknowledged feeling confident in their ability to do so. Knowledge about HIV/AIDS and consistent application of U.P. protects nursing students, prevents legal problems, and promotes the quality of patient care.
Environmental Health Competencies: A Survey of U.S. Nurse Practitioner Programs
Authors: Bellack Janis P , Musham Catherine , Hainer Anne , Graber David R , Holmes Dylan
Published: April 2021

ABSTRACT

Because of widespread public and governmental concern about the health effects of environmental hazards and exposure in recent years, and the increasing incidence of environmentally-induced diseases, it is important that primary care nurse practitioners possess the knowledge and skills to effectively address environmental health as a component of their practice. A mailed questionnaire survey of 187 U.S. nurse practitioner (NP) programs was conducted, with a response rate of 64%, to determine: 1) current and ideal emphasis on environmental health, 2) faculty preparation for teaching environmental health, 3) environmental health competencies expected of graduates, 4) didactic and clinical contact hours devoted to environmental health, and 5) barriers and incentives to greater emphasis on environmental health. Findings reveal that more than two-thirds of NP program directors believe there should be greater emphasis on environmental health in their programs, but expressed concerns about overcrowded curricula and lack of faculty preparation as barriers to change. Competencies with the highest mean ratings included understanding the relationship between environmental hazards and human health, accessing information resources related to environmental hazards and health, and counseling clients about how they can reduce risks associated with environmental hazards. The two factors identified as most likely to increase the emphasis on environmental health in NP programs were having nurse faculty with expertise and being able to access information resources related to environmental health. Currently, insufficient attention is given to environmental health in nurse practitioner education programs.
Student/Faculty Practice and Research in Occupational Health: Health Promotion and Outcome Evaluation
Authors: Wold Judith L , Williams Armenia M
Published: April 2021

ABSTRACT

Faculty strive to connect theory and practice with real life situations for students. This study evolved from student intervention with small industries aa part of their undergraduate community health nursing clinical experience. A pre-experimental static group design was used to explore the impact of health service availability on selected cardiovascular risk factors. Levels of health service: a) no service; b) student service; and c) formal health care service were compared. Chi-square, t-tests and MANOVA analyses supported three hypotheses that student intervention was equally as successful as formal health care service in reducing the selected cardiovascular risk factors of high weight to height ratios, blood pressure readings above 140/90 on three separate measurements, total cholesterol readings above accepted norms and a health risk profile which identifies risk for cardiovascular disease.
Learning About Another Culture: Project and Curricular Reflections
Authors: Spitzer Ada , Kesselring Annemarie , Ravid Carol , Tamir Batya , Granot Michal , Noam Rivka
Published: April 2021

ABSTRACT

Over the past two years, an innovative collaborative project in the care of Ethiopian Jews who immigrated to Israel has been carried out. In this project, both students and faculty joined in activities of research and practice through a clinic at a trailer court that houses 96 Ethiopian immigrant families. This project brought about several favorable changes: a) Health of the underprivileged and underserved was enhanced through bi-weekly services provided to the poor and sick trailer court inhabitants; b) An educational program for learning in a crosscultural community setting was developed. This curricula advanced recognition of the growing cultural and racial diversity of both individual and family lifestyles, as well as allowed for learning events that are based on substantive contact with, or participation by, persons at health risk; c) An educational milieu that fosters the use of research-based interventions was developed. This article describes the cross-cultural educational project which was designed as a pilot for a new baccalaureate program in nursing, and critiques it based on the criteria of the five major concepts- primacy of the teacher-student relationship, social responsibility, centrality of caring, interpretive stance and theoretical pluralism, proposed by the promoters of the "curriculum revolution."
Grading Journals in Clinical Practice: A Delicate Issue
Authors: Holmes Vicki
Published: April 2021

ABSTRACT

Offering students opportunities to gain a strong sense of self, a positive professional image, and a chance to articulate their clinical practice is a challenge for nurse educators. Writing journals in clinical placements is one way in which students can create a dialogue with their teacher and reflect upon and explore their clinical experiences in the context in which these experiences occur. However, grading journals according to numerous predetermined criteria can sabotage the benefits and opportunities of writing journals. Judgment and control are two aspects of evaluation and subsequent grading that can sabotage the benefits. Limiting predetermined criteria and not assigning grades to students' journals are two answers to this delicate issue.
Contrast Sensitivity Functions in Normal Children With the Vistech Method
Authors: Rogers Gary L , Bremer Don L , Leguire L E
Published: April 2021

ABSTRACT

The Vistech Contrast Sensitivity Function tester (VCTS 6500-1) for distance was evaluated to determine the minimum age of children who could complete the test and to determine changes in the CSF as a function of age. A total of 72 normal children between the ages of 24 and 84 months were tested twice with each eye. The results revealed that no child below 36 months of age could complete the test and by 48 months of age 50% could complete the test. By 60 months all children could complete the test. It was also found that as age increased the CSF increased equally at all spatial frequencies. A comparison between the eyes of the CSFs revealed a highly statistically significant correlation of 0.78, which showed that the eyes were very similar. Testretest correlations (0.78) also were highly statistically significant, which demonstrated that the test was very reliable. The results are discussed within the context of screening young children for visual disorders and the evaluation of patching therapy for amblyopia.
Visual Pathway Abnormalities in Albinism and Infantile Nystagmus: VECPs and Stereoacuity Measurements
Authors: Guo Suqin , Reinecke Robert D , Fendick Michael , Calhoun Joseph H
Published: April 2021

ABSTRACT

The visual pathway of albinos is characterized by abnormal optic nerve fiber decussation with increased contralateral projection. This results in hemispheric asymmetry of monocular visually evoked cortical potentials (VECPs) and may be related to lack of stereopsis. Flash VECP, Random Dot E (RDE), and Titmus stereotest data were collected from 40 nystagmus patients, 19 albino and 21 with normal pigmentation. Data were compared with results obtained from 19 race- and age-matched normal subjects. All albino patients demonstrated hemispheric VECP asymmetries exceeding ± 2.0 standard deviations from the normal mean, showing either delayed ipsilateral P latency (88%), reduced ipsilateral P amplitude (59%), or both (47%). None of the normally pigmented Infantile nystagmus patients exceeded this criteria on either VECP measure. While only one albinotic patient showed positive RDE and stereofly results, 86% of normally pigmented nystagmus patients passed the stereofly test, 60% demonstrated 400 sec (Titmus) stereopsis, and 66% showed positive RDE results. These findings reveal that normally pigmented infantile nystagmus patients have variable degrees of stereopsis and no excessive abnormalities of optic nerve fiber decussation as evidenced by flash VECP. Additionally, this study verifies visual pathway abnormalities and the lack of stereopsis in albino nystagmus patients.
Study of Chart Designs and Optotypes for Preschool Vision Screening - I. Comparability of Chart Designs
Authors: Sprague James B , Stock Laetitia A , Connett John , Bromberg Jill
Published: April 2021

ABSTRACT

Design variations in children's distance vision screening charts contribute to inconsistencies noted in preschool vision screening programs. This study compares children's distance visual acuity on two chart designs: logarithm of the minimal angle of resolution (LOGMAR) vs a chart of 'standard' design. In theory, the LOGMAR chart offers the advantages of improved precision in measuring inter-patient differences and greater consistency of follow-up measurements. Our findings indicate the following: 1) the ability to complete a test depends upon the child's age. not on chart design ; 2) isolation of sym bols is required more frequently for the LOGMAR charts than for the standard charts; and 3) on average, children have slightly poorer visual acuity scores on LOGMAR charts than on standard charts.
Anterior Tendon Displacement of the Inferior Oblique for DVD
Authors: Kratz Richard E , Rogers Gary L , Bremer Don L , Leguire Lawrence E
Published: April 2021

ABSTRACT

The effect of grading the anteriorization of the posterior portion of the inferior oblique muscle tendon fibers, relative to the insertion of the inferior rectus, was assessed for patients with dissociated vertical deviation (DVD). The placement of these fibers was varied dependent on the degree of preoperative DVD. The results from the graded group were compared to a group of patients with DVD that always received the same amount of anteriorization regardless of the degree of preoperative DVD. The results showed that, in general, anteriorization of the inferior oblique muscle tendon fibers to the level of insertion of the inferior rectus was an effective treatment for DVD. In addition, grading the anteriorization of the posterior portion of the inferior oblique muscle tendon fibers significantly decreased residual postoperative deviation.
Recovery of Extraocular Muscle Function After Adjustable Suture Strabismus Surgery Under Local Anesthesia
Authors: Brown D Randolph , Pacheco Elba M , Repka Michael X
Published: April 2021

ABSTRACT

Limited data exist on the recovery of ocular motitity after adjustable suture strabismus surgery performed under local anesthesia. The timing of adjustment has been chosen empirically and has varied widely.

We sought to more precisely quantify the recovery of motility by measuring auctions before and after surgery with a modified arc perimeter. Twenty-one eyes of 20 patients were studied. All patients underwent adjustable suture strabismus surgery under retrobulbar or peri buibar anesthesia using 2% lidocaine with hyaluronidase. Mean auctions orthogonal to the field of action of the operated muscle(s) returned to 90% of preoperative levels between 5 and 6 hours after injection.

We recommend adjustment 6 or more hours after injection, or at least 5 to 6 hours postoperatively, when 2% lidocaine with hyaluronidase is used for local anesthesia.
Infantile Glaucoma Associated With the Diamond-Blackfan Syndrome
Authors: Young Terri L , Schaffer David B , Cohen Alan R
Published: April 2021

ABSTRACT

Diamond-Blackfan syndrome is a rare congenital hématologie disorder characterized by isolated erythroid hypoplasfa. Physical abnormalities such as short stature, thumb deformities, and ophthalmic findings including strabismus, hypertelorism, and microphthalmos have been reported to occur with this disease entity. We describe two patients with this blood dyscrasia and infantile glaucoma with trabeculodysgenesls. Both patients underwent multiple surgical procedures to control their glaucoma. The patients were on chronic systemic adrenal corticosteroid therapy for their anemia, which caused some confusion regarding the etiology of their glaucoma. To our knowledge, this is the first report of an association of Infantile glaucoma with DiamondBlackfan syndrome. We hope this report will encourage early recognition and treatment of glaucoma in patients with this disorder.
Oculocutaneous Albinism: Variable Expressivity of Nystagmus in a Sibship
Authors: Cheong Pauline Y Y , King Richard A , Bateman J Bronwyn
Published: April 2021

ABSTRACT

Traditionally, the diagnosis of ocular or oculocutaneous albinism (OCA) is based on a constellation of features including the presence of nystagmus associated with iris transillumination defects, hypopigmentation of the fundus, and hypoplasia of the fovea and optic nerve head. Nystagmus is the most frequent ocular sign for the ascertainment of albinism particularly in individuals who have lightly-pigmented parents. We report two siblings, a male and female, with minimal, if any, pigmentation of skin and hair, iris transillumination defects, blond fundi, and hypoplasia of the foveae and optic nerve heads who were discordant for nystagmus; the diagnosis of OCA was based on the clinical findings. These siblings presumably have the same genetic hypopigmentation defect and demonstrate that nystagmus is not a consistent finding in OCA and may not be an absolute criterion for diagnosis.
Anterior Polar Congenital Cataract and Corneal Astigmatism
Authors: Bouzas Andreas G
Published: April 2021

ABSTRACT

Seven eyes of six patients with anterior polar congenital cataract were examined. All patients presented with corneal astigmatism greater than 1.50 diopters. The combination of these two anomalies has often been responsible for amblyopia and occasionally for squint. The association of corneal astigmatism with this type of congenital cataract is possibly due to a delayed separation of the lens from the surface ectoderm during fetal development and thus may be considered a new syndrome.
Recognized Scleral Perforation During Eye Muscle Surgery: Incidence and Sequelae
Authors: Simon John W , Lininger Lloyd L , Scheraga Janet L
Published: April 2021

ABSTRACT

Inadvertent perforation of the sclera is a widely recognized complication of eye muscle surgery. In the 1960s and 1970s, it was estimated to occur in 9% to 12% of patients operated. Fortunately, dreaded visionthreatening sequelae have been much less common.

To better define the occurrence and sequelae of this complication, we sent a questionnaire to all 342 members of the American Association for Pediatrie Ophthalmology and Strabismus. Scierai perforations, defined to Include known retinal damage, occurred in 728 of nearly 554 000 eye muscle procedures performed by 223 surgeons. Perforations were two times more common with residents or fellows operating. They occurred not only during muscle reattachment (633 cases), but also during muscle disinsertion (24 cases), muscle dissection (6 cases), passage of traction sutures beneath the lateral rectus (5 cases), and preplacement of muscle sutures (5 cases). Many other perforations may have been unrecognized and uncounted.

Visual loss was uncommon, occurring in only nine patients. Fourteen retinal detachments included four cases with partial and two with total loss of vision. Only three cases of endophthalmitis occurred, one resulting in partial visual loss and two in total visual loss. Techniques suggested by respondent surgeons to avoid perforations are discussed.
Refractive Error Changes Following Strabismus Surgery
Authors: Preslan Mark W , Cioffi George , Min Yuan-I
Published: April 2021

ABSTRACT

Several uncontrolled, retrospective studies have suggested that permanent changes in refractive error can be seen following strabismus surgery. We prospectively enrolled 68 patients undergoing strabismus surgery for evaluation of pre- and postoperative cycloptegic refraction. In addition, the adult patients had computerized corneal topography recorded using the Corneal Modeling System, (Computed Anatomy, Inc, New York, NY). Pre- and postoperative refractions were compared using spherical equivalent and meridional equivalent (90- and 180-degree meridian). We found no significant change in the spherical equivalent between the pre- and postoperative measurements. However, a significant increase in the astigmatic power at 180° (meridional equivalent at 180°) was detected in both pediatrie and adult patients. We did not observe any qualitative change in the corneal topography pre- and postoperatively. The change in astigmatic power at 180° is equivalent to additional plus-cylinder correction at 90° and was persistent throughout the 4-month postoperative period.
Oculomotor Nerve Palsies in Children
Authors: Ing Edsel B , Sullivan Timothy J , Clarke Michael P , Buncic J Raymond
Published: April 2021

ABSTRACT

Fifty-four patients with oculomotor nerve palsy who presented over a 21-year period at our institution were reviewed retrospectively. There were 38 isolated third nerve lesions, and 16 with additional cranial nerve involvement. Eleven cases were congenital in origin, and 43 were acquired. Of the acquired group, 31 were traumatic, 7 infection-related, 3 attributed to migraine or other vascular causes, and 2 neoplastic. Average follow up was 36 months. The congenital lesions were predominantly right-sided; amblyopia, although common, responded well to treatment. Trauma and bacterial meningitis accounted for more cases of isolated oculomotor nerve palsy than seen in the previous literature. In distinct contrast to the adult population, no cases of diabetes, posterior communicating artery aneurysms, metastatic tumors, or pituitary lesions were found.