bluuebunny/crossref_metadata_2025 huggingface dataset:
Osteoclast Dysfunction in the Osteosclerotic Variant of Renal Osteodystrophy
Authors: Noy Ron , Lipton Jeffrey F , Vigorita Vincent J , Bryk Eli
Published: April 2021

Abstract

Six iliac crest bone biopsies were obtained from five patients with renal osteodystrophy and osteosclerotic lesions to investigate the mechanism of osteosclerosis in renal osteodystrophy. Each specimen was prepared in an undecalcified fashion and measured under light microscopy for routine analysis and histomorphometry. Osteoclast resorptive lacunae were estimated by measuring the lacunar length and depth. Histomorphometric studies revealed an increase in all parameters with a mean trabecular bone volume of 66% (normal: 1 9%-26%), mean trabecular osteoid surface of 71% (normal: 16%-22%), and a mean trabecular osteoid volume of 15% (normal: 1 %-2%). In one patient, there was a ten-fold increase over the norm of osteoclasts/mm2 (0.3; normal: 0.02-0.04), whereas the mean width of trabecular bone was twice the norm. In all biopsies, the calculated lacunar area was markedly diminished compared to published controls. These results support the hypothesis that osteoclast function is impaired in patients with renal osteodystrophy.
Dorsal Carpal Metacarpal Fracture Dislocation Associated With Nondissociative Volar Intercalated Segmental Instability
Authors: Freeland Alan E , McAuliffe John A
Published: April 2021

Traumatic dorsal carpal metacarpal dislocation is caused by a high-energy impact and may be accompanied by articular surface damage or fracture. Reduction provides the optimal result, however, it may be difficult to perform. Several combined treatment modalities may help achieve stability.
Changes in Patellar Tracking After Total Knee Arthroplasty: 10-Year Follow-Up of Miller-Galante I Knees
Authors: Miyagi Tomoyuki , Matsuda Shuichi , Miura Hiromasa , Nagamine Ryuji , Urabe Ken , Inoue Sanshiro , Iwamoto Yukihide
Published: April 2021

Abstract

Changes in patellar tilt angle and patellar displacement were evaluated in 18 knees with the Miller-Galante I knee arthroplasty system (Zimmer, Warsaw, lnd). Mean follow-up was 10 years. Patellar tilt angle at final follow-up (5.7e) was significantly larger than at 1 year postoperatively (2.8°). Patellar displacement at final follow-up (5.1 mm) was significantly larger than at 1 year postoperatively (3.4 mm). Preoperative^, patellar tilt angle showed a statistically significant correlation with the change in tilting angle during follow-up. These results suggest patellar tracking can worsen during the long-term postoperative period.
Lateral Ulnar Collateral Ligament Reconstruction Using the Lateral Triceps Fascia
Authors: DeLaMora Sergai N , Hausman Michael
Published: April 2021

Lateral collateral ligament reconstruction of the elbow can be simplified by mobilizing the distal lateral third of the triceps fascia and securing it to the distal lateral humerus.
Metal-On-Metal: All Things Bright and Beautiful!-In Opposition
Authors: Holzmann Patrick , Eggli Stephan , Ganz Reinhold
Published: April 2021

Alternative Bearing Surfaces
Ceramic-Ceramic Bearings in THA: The New Gold Standard-In the Affirmative
Authors: Murphy Stephen B
Published: April 2021

Alternative Bearing Surfaces
Enhanced Cross-Linked Polymers: The Promise-In the Affirmative
Authors: Maloney William J
Published: April 2021

Alternative Bearing Surfaces
Minimally Invasive Surgical Techniques for the Reconstruction of Calcaneal Fractures
Authors: Stein Haim , Rosen Nimrod , Lerner Alexander , Kaufman Hanna
Published: April 2021

Two minimally invasive techniques are presented for the reconstruction of calcaneal fractures. The soft tissues play a crucial part in the stabilization of the multiple joint surfaces of the calcaneus; therefore, maintaining the soft-tissue envelope is vital to fracture treatment outcome.
Humeral Shaft Fractures Secondary to Throwing
Authors: Pehlivan Ozcan , Kiral Ahmet , Akmaz Ibrahim , Solakoglu Can , Arpacioglu Omer , Kaplan Haluk
Published: April 2021

Abstract

Twenty-seven mate military recruits with humeral shaft fractures that occurred during throwing of a hand grenade were analyzed to determine the causes and contributing factors of this fracture in recreational pitchers. Average patient age was 22 years (range: 19-27 years). Objective criteria included type and fracture site on radiographs. Subjective data such as throwing style, previous pitching experience, and prodromal arm pain were obtained. The recruits' throwing style was deemed faulty. Analysis of the fracture configurations indicated an external rotation mechanism.
Allograft Reconstruction for Extensor Mechanism Rupture After Total Knee Arthroplasty: 4.8-Year Follow-Up
Authors: Prada Stefan A , Griffin Frankie M , Nelson Carl L , Garvin Kevin L
Published: April 2021

Abstract

Three patients who experienced extensor mechanism rupture after total knee arthroplasty underwent reconstruction using an allograft consisting of quadriceps tendon, patella, patellar tendon, and tibial tubercle. All patients who failed initial attempts to repair the extensor mechanism disruption achieved pain relief at average 4.8year follow-up. Patients were able to extend their knee actively against resistance. Ambulation with full weight bearing was possible in all patients; however, one patient required a cane.

Few reports have been published on allograft reconstruction of the extensor mechanism. The current study supports its use for patients who have failed to achieve knee extension with reconstruction by other means.
Proximal Tibia Nonunion in a Patient With a Previous Knee Fusion
Authors: Uhl Richard L , Lozman Jeffrey
Published: April 2021

Intramedullary nailing can be used to treat fracture nonunion in knees that have undergone previous knee arthrodesis. This technique avoids direct exposure of the previous fusion and nonunion site.
Baccalaureate Nursing Student Preceptorship Programs and the Development of Clinical Competence
Authors: Scheetz Linda J
Published: April 2021

ABSTRACT

Clinical competence is germane to professional nursing practice. One goal of nursing student preceptorship programs is to develop the student's level of clinical competence beyond that of traditional baccalaureate education. This study investigated the effect of nursing student preceptorship programs on the development of clinical competence among 72 senior BSN students. Results indicated that students who participated in summer preceptorship programs gained greater levels of clinical competence, than did students who worked as nursing assistants in noninstructional clinical settings. Both groups perceived their summer work experiences as valuable in helping them to develop skills in problem solving, application of theory to practice, and psychomotor skill performance. They also reported an increased level of self-confidence in a nursing role. Study findings provide baseline data for decision making for nursing faculty and administrators.
A Comparison of the Clinical Judgment Process in Experienced Registered Nurses and Student Nurses
Authors: Itano Joanne K
Published: April 2021

ABSTRACT

The purpose of this study was to analyze the clinical judgment process used by registered nurses identified as highly-skilled judgment-makers (HSJMs) and student nurses. Two areas of the clinical judgment process were explored: the type and number of cues elicited, and the judgment process. Thirteen students within a month of graduation, and 13 HSJMs participated in this study.

For each participant, the judgment task was the initial assessment of a hospitalized patient. Each nurse reviewed the patient's Kardex, listened to the end-of-shift report and then assessed the patient as if this was the beginning of a workshift. This nurse-patient interview was tape recorded. Each nurse was then asked to review her thoughts as short segments of the nurse-patient interview were replayed. This was also tape recorded. These tapes were transcribed, and three nurse educators rated each transcript using a judgment process rating scale.

Results of this study indicated the following: the registered nurses collected significantly more cues than the students, use of each cue type was not the same, students and HSJMs collected cues in the same proportion, and total scores on the rating scale could discriminate between the student and HSJM groups.
A National Survey of AIDS Education in Schools of Nursing
Authors: Chilly Kay K
Published: April 2021

ABSTRACT

This survey was undertaken to determine how nursing school curricula have been impacted by the dramatic increase in Acquired Immune Deficiency Syndrome (AIDS). The purpose of the study was to determine the status of current AIDS-related curricular offerings in associate degree, diploma, and baccalaureate National League for Nursing (NLN) accredited schools of nursing.

A random sample of 547 of the nations 1,073 NLNaccredited nursing programs was selected and surveyed by mail. Usable questionnaires were returned by 366 schools, representing a 67% response rate. Forty-nine states and the District of Columbia were represented in the sample. Responses were received from 47 states and the District of Columbia. The survey instrument was researcherdeveloped with expert review. Ninety-eight percent of respondent schools were including some AIDS content in their curricula. Didactic teaching methods were used more often than affective and behavioral ones. Seventy- 1 wo percent of respondents reported spending five or fewer classroom hours on AIDS-related content. No statistically significant differences were found in the amount of time devoted to AIDS in associate degree, diploma and baccalaureate curricula.
The Urgency of Substance Abuse Education in Schools of Nursing
Authors: Murphy Shirley A
Published: April 2021

ABSTRACT

The abuse of alcohol and drugs has become a major health and social problem in the United States, Nurses comprise the largest segment of health-care professionals, yet report their educational experiences offer little to prepare them to develop substance abuse prevention and intervention programs. This article identifies factors that contribute to this educational gap, discusses challenges in planning and implementing substance abuse curricula, and offers specific guidelines for improving educational experiences.
Nursing Education Component in Master's Programs
Authors: Oermann Marilyn H , Jamison Marie T
Published: April 2021

ABSTRACT

The purposes of this study were to: a) describe the outcomes, content, and structure of master's programs in nursing in the functional area of teaching; b) describe related learning experiences of students; and c) identify trends in graduate nursing education in preparing students for the role of teacher. A self-administered questionnaire developed by the investigators was mailed to all NLN accredited masters programs (N = 139). The instrument collected data on the nursing education component of the master's program. Ninety-two questionnaires were completed and returned, resulting in a response rate of 66.2%. Only 10 (10.9%) master's programs offered a major in nursing education. More common were minors, elective courses, and tracks in nursing education, as well as other similar curriculum patterns (N = 66). Fifteen (16.3%) master's programs offered no courses in nursing education. There was a statistically significant difference between the mean number of credits of nursing education courses required in programs offering a major (M = 11.4) compared with a minor (M = 8.8). More than half of the master's programs required nursing education courses in learning theory, curriculum development, instructional design, teaching methods, clinical teaching, various aspects of evaluation, and grading.

Learning experiences in which students participated to prepare themselves for teaching roles included in the majority of programs: classroom teaching, clinical teaching (generally involving a practicum), clinical evaluation of students, development of a course/curriculum, and test construction. The research documents the continued emphasis on advanced nursing practice as the primary area of graduate study with preparation for teaching occurring through minors in the program. The issue of preparation for advanced clinical practice and a functional role continues to be one facing graduate nursing education.
Wrestling with the Larger Picture: Placing Ethical Behavior in Clinical Situations in Context
Authors: Ryden Muriel B , Waithe Mary Ellen , Crisham Patricia , Caplan Arthur , Duckett Laura
Published: April 2021

ABSTRACT

This article provides an account of the use of a modelbuilding process as an educational strategy for the teaching of ethics. Designed to integrate students' growing knowledge and skill in nursing with their intellectual and professional development, this model-building process has its theoretical foundations in cognitive moral development theory, and in an integrative approach to nursing education called Multi-Course Sequential Learning (MCSL).
The Development of a Master's Degree Program Based on Perceived Future Practice Needs
Authors: Hill Barbara A
Published: April 2021

ABSTRACT

The need for an accessible master's degree program was determined through informal communication between practicing nurses and nursing educators. The purpose of the descriptive study was to project a master's degree program based on perceived future nursing practice needs. Forty-seven nurse administrators and staff nurses responded to a mailed survey (61.8%). The respondents were asked to make predictions regarding the probability of occurrence of 18 previously Delphi-generated events by the year 2000. Respondents also provided judgments regarding the degree of agreement/disagreement that various content items would be critical to survival in practice and best learned in a master's degree program. Most respondents agreed that general education content items were both critical to survival and best learned by master's education. Less strong agreement that nursing content items were critical to survival and best learned in a master's degree program was an unexpected finding. A multidisciplinary master's program for all health-care professionals was proposed.
Mathematics Anxiety and its Effect on Drug Dose Calculation
Authors: Fulton William H , O'Neill G Patrick
Published: April 2021

ABSTRACT

Eighty learners were randomly selected from 160 first-year nursing students enrolled in an urban community college nursing program in Ontario. They were subsequently divided into control and treatment groups to investigate the effects of different teaching methods on mathematics anxiety and the students' ability to accurately calculate fractional drug doses. The results obtained in this study indicated that there were no statistically significant differences between the control and treatment groups in either mathematics anxiety levels or in arithmetic test performance. These findings counter many of those found in previous investigations. Reasons for these discrepancies are provided along with recommendations for present practice and future research.
Baccalaureate Entry Into Practice: An Example of Political Innovation and Diffusion
Authors: George Susy , Young Wendy B
Published: April 2021

ABSTRACT

Activity within several states over the past two decades to require a baccalaureate nursing degree as the minimum educational preparation for licensure as a registered professional nurse is reviewed as an example of policy innovation and diffusion. Sufficient ratio of baccalaureate degree to associate degree programs and political party turnover in the governor's office have frequently accompanied private and public policy action on BS entry.
The Effect of Guided Imagery Upon First Semester Nursing Students Performing Their First Injections
Authors: Speck Barbara J
Published: April 2021

ABSTRACT

This study examined the effect of guided imagery upon the anxiety of baccalaureate nursing students learning to perform their first injections. The quasi-experimental post test design used a treatment (imagery) group and a control group of subjects who were first semester undergraduate students. Anxiety was measured by State-Trait Anxiety Inventory (STAI), Biodot stress dots, performance time, and performance score.

Analyses of covariance were performed on the post treatment STAI scores, performance times, and performance scores. A Kruskal-Wallis was performed on post treatment Biodot stress dot reading. Results indicated statistically significant lower anxiety levels by self-report (STAI), p = .008, in the experimental group. No statistically significant differences were found in the Biodot stress dot readings, p = .6777, performance times, p = .130, or performance scores, p = .11 A.

The significance of the findings is that if guided imagery reduces self-reported anxiety levels in nursing students, introduction of this teaching strategy early in the curriculum may be beneficial to students.
The Effect of Knowledge on Nursing Students' Attitudes Toward Individuals With ATOS
Authors: Brown Yvonne , Calder Barbara , Rae Donna
Published: April 2021

ABSTRACT

The purpose of this study was to determine if increased knowledge changes nursing students' attitudes toward individuals with AIDS. A pretest/post-test design was used to administer a questionnaire, developed and validated in the United States, and adapted for use in this study. Subjects were total population of first to fourth year baccalaureate undergraduate nursing students attending a 1-day AIDS workshop. Questions dealt with knowledge and fears concerning AIDS and caring for AIDS patients, and attitudes toward homosexuality and toward the terminally ill. With the level of significance set at (p<.05), post-test results indicated that all groups of students displayed a knowledge gain (p =.000) and a more positive attitude toward caring for AIDS patients (p = .000), particularly by first and third year students (p =.001). Although positive, younger students and students who had cared for AIDS patients were less positive. In this study, AIDS education had a positive influence on attitudes of nursing students. This finding supports the use of education to foster positive attitudes toward AIDS and individuals with AIDS.
Family Nursing Curricula in U.S. Schools of Nursing
Authors: Hanson Shirley M H , Heims Marsha L
Published: April 2021

ABSTRACT

Care of individual clients has been the traditional focus of health care and therefore nursing education. Recently, the family as a unit of care has received more attention. This study provides a current and accurate description of family nursing content, summarizing the major concepts, definitions, course titles, textbooks, and assessment instruments used in teaching family nursing in baccalaureate and graduate programs. The findings identify trends in family nursing education that will provide direction to educators and clinicians planning to strengthen family nursing in their curricula.
Caring Between Nursing Students and Physically/Mentally Handicapped Children: A Phenomenological Study
Authors: Beck Cheryl Tatano
Published: April 2021

ABSTRACT

Advanced technology has increased the life expectancy to age 20 for most chronically ill children. Consequently, nurses will be encountering an increasing number of physically and mentally handicapped children. Nursing students' discovery of the meaning of caring with exceptional children will help prepare them for interactions with these special children during their nursing careers. A phenomenological study was undertaken to explore 36 nursing students' caring experiences with physically and mentally handicapped children. Van Kaam's phenomenological methodology was used to analyze the data. Sharing the findings of this phenomenological study with nursing students is one approach faculty can use to help reduce their anxiety regarding upcoming clinical rotations with exceptional children.
Nursing Education in the United States, 1898-1910: A Time of Auspicious Beginnings
Authors: Rush Susan L
Published: April 2021

ABSTRACT

Nursing education in the United States has been and continues to be a slowly evolving process. For those involved in nursing education at the end of the 20th century, a brief trip back to the end of the 19th century-to chronicle some of the events of that time that have had an impact on nursing education today, and to review some of the accomplishments of our early nursing educators-makes for an interesting journey.
Curriculum Issues Related to Nurse Turnover
Authors: Gorrell Betty J , Langenbach Michael
Published: April 2021

ABSTRACT

The problem of turnover rates among registered nurses has implications for nursing curriculum and for continuing education programs. After a brief presentation of turnover issues, curriculum implications will be discussed under three broad areas: (a) content about turnover included in nursing management textbooks; (b) nursing curriculum issues that influence the survivability of graduates of schools of nursing and thereby affect turnover rates; and (c) continuing education needs of registered nurses. This paper is not a summary of solutions for turnover. The problem of turnover is complex and poorly understood. The curricular issues provide challenges to traditional nursing education that would increase the likelihood of the development of "hardy" nurse graduates who have survival skills for the practice environment.
Concepts Included in and Critical to Nursing Curricula: An Analysis
Authors: Valiga Theresa K , Bruderle Elizabeth
Published: April 2021

ABSTRACT

This study was designed as a first step toward concept clarification in nursing education, to stimulate educators' thinking about the clarity of the concepts critical to nursing curricula.

The sample included 70 baccalaureate and 67 associate degree programs randomly selected from each of the six regional accrediting areas. Respondents to a mailed questionnaire identified concepts included in their curricula and those they viewed as critical to a nursing curriculum.

Results suggest that (a) BSN program faculty agree on concepts included in and critical to nursing curricula, (b) ADN program faculty agree on critical concepts but agree less about concepts included in their curricula, and (c) both groups noted that process-oriented concepts were included in their curricula more frequently than were contentoriented concepts.

The variability of responses raises questions about the clarity of concepts used in nursing curricula and the meaning behind those concepts. We recommend further research related to the meaning, nature, and use of concepts in nursing curricula.
A Model for Critical Thinking Within the Context of Curriculum as Praxis
Authors: Ford Joan S , Profetto-McGrath Joanne
Published: April 2021

ABSTRACT

The curriculum may be informed by a technical, practical, or emancipatory interest. Curricula informed by these three interests are referred to as curriculum as product, curriculum as practice, and curriculum as praxis (Grundy, 1989) respectively. When curricula are viewed from different perspectives, it is plausible to suggest that each perspective requires a different conceptualization of critical thinking. The literature search revealed that critical thinking has been equated with problem solving, which is congruent with a curriculum-as-product orientation.

The purpose of this paper is to provide an overview of a conceptual model for critical thinking that is congruent with an orientation to the curriculum as praxis. The model is derived from the work of Freiré (1972), Habermas (1972), and Grundy (1989). The key concepts of the model are knowledge, critical reflection, and action. There is a reciprocal relationship between knowledge and action, which is mediated by critical reflection.
A Replication Study of Experienced Graduate Nurse Faculty Orientation Offerings and Needs
Authors: Morin Karen H , Ashton Kathleen C
Published: April 2021

ABSTRACT

A recent study indicated information about expectations regarding research, peer review and evaluation, promotion, course content, and student evaluation in orientation programs for a predominantly undergraduate faculty sample was absent. This direct replication and extension study determined whether similar results exist for seasoned graduate nurse faculty. Of 240 questionnaires returned, 66 met sample criteria. Data were collected using a two-part questionnaire. Results indicate 79% received an orientation, lasting an average of 3 days. The mode, however, was 2 days. Fourteen topics were addressed. Data provide additional information regarding the scope of orientation for nursing faculty. Orientation programs that better meet the needs of all nurse faculty need to be developed.
Work-Related Stress of Clinical Nursing Faculty
Authors: Oermann Marilyn H
Published: April 2021

ABSTRACT

The purpose of this research was to examine work-related stress experienced by clinical faculty (N = 226) in ADN and BSN programs. Faculty rated the extent to which they experienced 23 potential stressors associated with clinical teaching. The predominant stressors were: coping with job expectations associated with their clinical teaching roles; feeling physically and emotionally drained at the end of a clinical teaching day; job demands that interfere with activities of personal importance; heavy workload; pressure to maintain clinical competence or a clinical practice without time to do so; feeling unable to satisfy the demands of work-related constituencies (e.g., students, clinical agency personnel, patients); and teaching inadequately prepared students.
Toward a Narrative-Centered Curriculum for Nurse Practitioners
Authors: Swenson Melinda M , Sims Sharon L
Published: April 2021

ABSTRACT

This paper discusses various alternative and nontraditional teaching strategies currently used in nurse practitioner curricula. These instructional strategies include case-study analysis (Ryan-Wenger & Lee, 1997) and problem-based learning/practice-based learning (Barrows, 1994). We suggest a further evolution, using principles and practices of a narrative pedagogy (Diekelmann, 1995) to allow convergence of these several narratively-focused inductive and interpretive approaches. This combination of ways of learning has led us toward a narrative-centered curriculum for family nurse practitioners (FNPs). Specific ways to use narrative in the FNP curriculum are presented to demonstrate how to take the curriculum beyond traditional ways of teaching and learning.

"Education is the reconstruction of experience" (Dewey, 1929, 1971).
An Integrative Review Illuminates Curricular Applications of Primary Health Care
Authors: MacIntosh Judith , McCormack Dianne
Published: April 2021

ABSTRACT

The International Council of Nurses supported primary health care and advocated its acceptance by other intersectorial stakeholders. Nurse educators involved in curriculum development have respected this direction. To pursue the primary health care vision and influence the adoption of primary health care delivery systems, all principles of primary health care must be implemented simultaneously. An integrative review was conducted to ascertain the interpretation of primary health care held by nurse authors. A content analysis of the nursing literature revealed that 184 of the 254 articles retrieved (72%), applied primary health care in a manner that is consistent with the World Health Organization (WHO) definition. Through curricular applications of different interpretations of the primary health care principles, differences in the created learning environment are discussed.

The Declaration of Alma Ata, evolving from beliefs and values shared by 134 member nations present at the Assembly, delineated that primary health care was the accepted infrastructure to guide policies that direct health care delivery systems regardless of the context in the country (WHO, 1978). Even with this overwhelming endorsement, very few countries have made changes in policies and infrastructure for implementing the underlying values and beliefs ascribed in primary health care. Changes that have occurred have not been organized around the vision or the principles of primary health care. This delay has had, and will continue to have, a huge impact on nursing education, practice, and research. Nurses are interested in helping people attain, maintain, or regain health; primary health care has the potential to achieve health for all citizens of the world.
Comparison of Student Outcomes and Preferences in a Traditional vs. World Wide Web-Based Baccalaureate Nursing Research Course
Authors: Leasure A Renee , Davis Lisa , Thievon Susan L
Published: April 2021

ABSTRACT

The purpose of this project was to compare student outcomes in an undergraduate research course taught using both World Wide Web-based distance learning technology and traditional pedagogy. Reasons given for enrolling in the traditional classroom section included the perception of increased opportunity for interaction, decreased opportunity to procrastinate, immediate feedback, and more meaningful learning activities. Reasons for selecting the Web group section included cost, convenience, and flexibility. Overall, there was no significant difference in examination scores between the two groups on the three multiple-choice examinations or for the course grades (t = -.96, P = .343). Students who reported that they were self-directed and had the ability to maintain their own pace and avoid procrastination were most suited to Web-based courses. The Web-based classes can help provide opportunities for methods of communication that are not traditionally nurtured in traditional classroom settings. Secondary benefits of the World Wide Webbased course were to increase student confidence with the computer, and introduce them to skills and opportunities they would not have had in the classroom. Additionally, over time and with practice, student's writing skills improved.
Language as Constitutive: Critical Thinking for Multicultural Education and Practice in the 21st Century
Authors: Phillips Debby A
Published: April 2021

ABSTRACT

Postmodern understandings of language can function as revolutionary critical thinking tools and enable multicultural education in a way yet to be resolutely embraced by the discipline. This thesis is illustrated with critical thinking examples relevant to topics in nursing education, such as maternal infant attachment, HIV prevention education, standardized instruments measuring quality of life and self-esteem, domain of person, and adolescent male identity formation. Working through postmodern positions on language produces important questions. It offers nursing provocative ways of thinking about education and provides radically different approaches to critical thinking and cultural competence. Capitalizing on postmodern sensibilities about language to create multicultural education and practice will take persistent selfreflective educational practices that question the ground that nursing stands on, as well as good intentions regarding a deep and broad embrace of complexly understood cultural competence.
Primary Health Care Theory to Practice: Experience of First-Year Nursing Students in Hong Kong
Authors: Simpson Peggy , Chan Mun Che , Cheung Lai Yin , Hui Tze Shau , Li Ka Ying , Tang Hiu Tung , Tong Hoi Ning , Wong Sik Kwan , Wong Po Ming
Published: April 2021

ABSTRACT

In the past, nursing education in Hong Kong has focused on acute illness care, and institutions providing nursing education have been slow to modify the illnessfocused curriculum to a health-based curriculum. The nursing curriculum at the University of Hong Kong is unique in that it focuses on primary health care, and these concepts are introduced in both theory and practice in the first year of the baccalaureate program. In the second semester of the first year, students are required to develop and implement a primary health care project in a community setting. This article outlines the process and outcomes of the experience of 8 first-year nursing students who developed and implemented a primary health care project with older adults in a Hong Kong community. The Generalized Model for Program Development (McKenzie & Smeltzer) was used to guide the students in their practicum activities. The students demonstrated a high degree of competency in relation to health assessment skills; analysis of individual and community needs; development of appropriate health promotion sessions in relation to coronary artery disease, diabetes mellitus, and arthritis; and evaluation strategies to demonstrate effectiveness of the intervention. This experience early in the program provided a strong foundation for the students in primary heath care and grounded their nursing practice in scientific-based evidence.
Read All About It: Writing Health Articles for the Student Newspaper
Authors: Tierney Roberta
Published: April 2021

ABSTRACT

The thrust of health care is prevention. Individuals are encouraged to become better informed about health issues and to assume more responsibility for their own health. Health has become a popular topic in the press, on radio and television, and on the Internet.

Like other health care professionals, nurses are placing increased emphasis on health promotion and consumer education. Expanding the nurse educator role means oral and written communication skills are assuming greater importance, and nursing students need the opportunity to continuously develop these skills as part of their educational experience. Writing for the student newspaper gives students the opportunity to broaden and improve their writing skills and to share their expertise while promoting health.
Use of Videotaping to Assess Competencies and Course Outcomes
Authors: Winters Janice , Hauck Barbara , Riggs C Jo , Clawson Julie , Collins John
Published: April 2021

ABSTRACT

A constant challenge in nursing education is effectively teaching competencies and allowing students to safely practice essential nursing skills. Faculty members must develop sound methods of instruction to achieve program outcomes, which determine program effectiveness, assure professional readiness, and meet accreditation standards. Ib this end, the use of videotaping is suggested. Videotaping oners a safe way for students to practice skills and develop confidence prior to actual performance. This article reviews the literature on videotaping and discusses videotaping as used at Central Missouri State University baccalaureate school of nursing. Videotaping is a teaching-learning strategy used to help students develop effective communication, physical assessment, and selected psychomotor skills. Videotaping also provides students with a mechanism for detailed instructor feedback to improve performance.
Establishing Consensus About the Baccalaureate Entry-to-Practice Policy
Authors: Rhéaume Ann
Published: April 2021

ABSTRACT

This article is based on the results of a qualitative study examining educational reforms in New Brunswick, Canada, during the 1980s. Using the province of New Brunswick as a case study, three issues related to the baccalaureate entry-to-practice policy are examined. First, the process of upgrading nursing education to a baccalaureate degree and the conflict this change created between the Nurses Association of New Brunswick and the New Brunswick Nursing Union are described. Second, the reasons leaders of the professional nursing organization desired to upgrade nursing education are examined, and third, the issues underlying the conflict over nursing education are discussed
Torsion and Elevation Under General Anesthesia and During Voluntary Eyelid Closure (Bell Phenomenon)
Authors: Paez Juan H , Isenberg Sherwin , Apt Leonard
Published: April 2021

ABSTRACT

The amount and interrelationship of ocular torsion and elevation was measured in 30 patients under general anesthesia; half received muscle relaxants (pancuronium bromide) during induction and half did not. Similar measurements were made in 20 patients during voluntary eyelid closure (Bell phenomenon).

The mean amount of excycloduction was between 2.0° and 2.5° when the patients were under general anesthesia, whether or not muscle relaxants were used, and during voluntary eyelid closure. No statistically significant difference in the amount of torsion was found among the three groups. Elevation was significantly greater during voluntary eyelid closure (mean 5.3 mm) than during general anesthesia (p < 0.01). No statistically significant difference in ocular elevation was found in patients under general anesthesia whether they were given a muscle relaxant (mean 1.5 mm) or not (mean 1.2 mm).
Surgical Treatment of Compensatory Head Position in Congenital Nystagmus
Authors: Scott William E , Kraft Stephen P
Published: April 2021

SUMMARY

Records of 32 patients with congenital nystagmus who underwent surgery for a significant head turn were reviewed to assess the effectiveness of current surgical approaches.

Eighteen patients (Group I) had single binocular vision and had bilateral recess/resect procedures either according to Parks' 5-6-7-8 scheme (nine patients) or "augmented" from 10% to 40% for large head turns (nine patients). Fourteen (78%) had a reduction of the turn to 15 degrees or less, six (33%) being 5 degrees or less. One was overcorrected.

Fourteen patients had a heterotropia in addition to head turn. Seven (Group II) had bilateral surgery to attempt to correct the head turn and reduce the tropia to less than 10 prism diopters. In three cases (43%) there was both successful treatment of the tropia and reduction of the turn to 15 degrees or less. The tropia was successfully treated in six patients (86%).

In seven patients (Group III) monocular recess/resect surgery was done to attempt to correct both abnormalities. In four (57%) the turn was reduced to 15 degrees or less with successful treatment of the tropia at the same time. Five (71%) had a tropia of less than or equal to 10 diopters postoperatively.

Overall, the head turns were reduced to 15 degrees or less in 23 (72%) of the 32 patients including 11 (35%) with 5 degrees or less residual turn. Three (9%) were overcorrected at least 10 degrees.

The frequency of undercorrections indicates that larger amounts of surgery have to be done, especially for large turns, although ductions will be limited in some gaze positions, at times significantly, to achieve this goal.
Coats' Disease: A Study of 62 Histologically Confirmed Cases
Authors: Chang Meimei , McLean Ian W , Merritt John C
Published: April 2021

SUMMARY

We studied 62 eyes submitted to the Armed Forces Institute of Pathology (AFIP) from 1958 through 1980 that satisfied our criteria for the histologie diagnosis of Coats' disease. Our histopathologic definition of Coats'disease was the presence of a primary vascular lesion consisting of retinal telangiectasia with leakage of plasma toform intraretinal and subretinal exuda t es. In the cases we reviewed, Coats' disease occurred more frequently in boys, it usually affectedonly one eye, and wasgenerally detected in the first decade of life. In 52 cases (79%) theclinical manifestations, strabismus and leukokoria, were thought to be caused by retinoblastoma. Angle closure glaucoma was present in 36 cases (58%). In all but one of the cases studied, the lesion waslocated peripheral to theequator. We further identified diffuse involvement of capillaries in the peripheral retina using trypsin-digest preparations. Associated histologie findings included: rubeosis iridis, cataract, vitreous neovascular ization, and nodules resulting from fibrous metaplasia of the retinal pigment epithelium. These fibrous nodules typically occurred in the macular area and occasionally contained calcium or bone.
Ocular Torsional Movements in Humans With Normal and Abnormal Ocular Motility - Part I: Objective Measurements
Authors: Kushner Burton J , Kraft Stephen E , Vrabec Michael
Published: April 2021

SUMMARY

Using a corneal marker and cinematography, we analyzed ocular torsionalmovementsduringforced head tilt in three patients with superior oblique palsy before and after i pallate r al inferior oblique recession and compared them to those of normal subjects. As the head is tilted in normal subjects, the eye lags behind the head in a slow rolling movement. Periodic rapid wheel-like movements occur in the direction of head tilt which do not completely allow the eye to catch up with the head. This results in a partial compensatory intorsion on ipsilateral head tilt and extorsion on contraiateral head tilt. In patients with superior oblique palsy, the rapid extorsional movement on ipsilateral head tilt is greater and faster than in the normal, but becomes slowerafter inferior oblique recession, indicating it comes from the o ver act ing inferió r oblique. The rapid into raion al move ment seen during contralateral head tilt is absent in patients with superior oblique palsy, but appears in a diminished form after inferior oblique recession.
Anterior Segment Ischemia Following Strabismus Surgery
Authors: Simon John W , Price Elaine C , Krohel Gregory B , Poulin Robert W , Reinecke Robert D
Published: April 2021

SUMMARY

Anterior segment ischemia (ASI) is a potentially blinding complication of extensive eye muscle surgery. Eyes have been described with this complication following surgery on as few as two rectus muscles, especially in patients with thyroid dysfunction or other medical illnesses. In an attempt to assess the risk of ASI, we have reviewed the records of 34 eyes in 26 patients who underwent surgery on three or four rectus muscles. Seven eyes of six patients with thyroid ophthalmopathy which underwent two- or threemuscle surgery were also studied. Evidence of clinically significant ASI was apparent in only one patient during a follow-up period of seven months to eleven years. This case was mild and no visual toss resulted. Our findings suggest that surgery on three or four rectus muscles in healthy patients is probably safe when performed in a staged fashion.
Diagnosis and Treatment of Inferior Oblique Palsy
Authors: Pollard Zane E
Published: April 2021

ABSTRACT

We present the work-up and treatment for 25 patients with inferior oblique palsy, including 2 with bilateral inferior oblique palsy and 23 with unilateral inferior oblique palsy.

Nineteen patients were adults over the age of 21 years, and six were children under the age of 10 years. Sixteen adults and two children underwent CT scanning of the head. All scans were normal. Eight adults also underwent MRI evaluation of the head. These also were all normal. All adults had a negative Tensilon test for myasthenia gravis.

The majority presented with a head tilt to the side of the paretic muscle. None of these patients complained of tilting images, but incyclotorsion was measurable in all cases that were tested.

The most important conclusion from this study is that inferior oblique palsy is a benign entity, with none of these patients having a brain tumor or myasthenia gravis.
Medial Rectus Electromyographic Abnormalities in Duane Syndrome
Authors: Saad Nick , Lee John
Published: April 2021

ABSTRACT

We report on four patients from the botulinum toxin clinic at Moorfields Eye Hospital with Duane syndrome, who exhibited paradoxical medial rectus activity. EMGs were performed with a standard toxin needle and were qualitative in nature.

Current physiodynamic theories as to the etiology of Duane syndrome are based on an aberrant innervation of the lateral rectus.

Paradoxical electromyographic activity of the medial rectus may occur in Duane type I syndrome. A possible explanation for this finding is that the medial rectus may receive aberrant innervation but this may not be physiodynamically significant.

We postulate that peripheral innervational anomalies may be secondary to, or coexist with, a brain stem anomaly. If an extraocular muscle possesses a dual innervation, then electromyographic abnormalities, without physiodynamic significance, may occur if the recording electrode comes into contact with muscle fibers innervated by a nerve that supplies a small segment of muscle.
Cyclic Strabismus Without Binocular Function
Authors: Riordan-Eva Paul , Vickers Sarah F , McCarry Bernadette , Lee John P
Published: April 2021

ABSTRACT

Various forms of cyclic strabismus have been described. A cyclic variation in binocular function modifying a tendency to strabismus is said to be the underlying mechanism.

Cyclic esotropia developed in two adult patients, one having no demonstrable binocular function and the other having suffered complete unilateral visual loss in the affected eye. In each case, on the "good days" there was still a manifest esotropia, in contrast to those patients with cyclic esotropia and good binocular function in which the eyes are straight on the "good days."

The presence of binocular function is not required for the development of cyclic strabismus, although the level of binocular function is correlated with the ocular alignment on the "good days."
Posterior Lenticonus: Clinical Patterns and Genetics
Authors: Gibbs Martin L , Jacobs Mark , Wilkie Andrew O M , Taylor David
Published: April 2021

ABSTRACT

Posterior lenticonus is an uncommon abnormality in the shape of the crystalline lens, characterized by a spheroidal or conical protuberance affecting the posterior lens surface. It may be unilateral or bilateral.

A male infant with bilateral posterior lenticonus is described, whose mother was found to have bilateral sutural cataracts. The association of cataracts with posterior lenticonus and the genetics of the condition are discussed.
Ocular and Systemic Characteristics of Duane Syndrome
Authors: Shauly Yaacov , Weissman Abraham , Meyer E
Published: April 2021

ABSTRACT

The clinical features of 63 patients with Duane syndrome are described in this report. All data in the study were gathered retrospectively except for measurements of vertical palpebral fissure and axial eye length, which were investigated prospectively. The following new aspects of the syndrome are emphasized: 1) In most cases with heterotropia, the angle of deviation was not large (≤25 prism diopters). 2) Visual acuity of 0.66 (20/30) or better was recorded in 94% of the affected eyes. 3) Smaller palpebral fissure by 1 mm or more) of the affected eye was measured in primary position among 9 of 40 (22%) unilateral cases. 4) The axial length of the affected eye (mean, 22.8 ± 0.6 mm) was not significantly different from the uninvolved eye. 5) Two cases of heterochromia iridis (3.2%) were found among the Duane syndrome patients. 6) A 4.8% prevalence of high-tone hearing loss was detected, in addition to 4.8% of sensorineural deafness.
Primary Iris Stromal Cysts
Authors: Brooks Steven E , Baerveldt George , Rao Narsing A , Smith Ronald E
Published: April 2021

ABSTRACT

The clinical and histopathologic features of four cases of primary iris stromal cysts are reported. Though the histologic characteristics of iris stromal cysts have been well described by previous authors, their exact embryologic origin is not clear. Also, because of the relatively uncommon nature of these lesions, the most appropriate management is not well defined. In our series, routine histopathologic studies were supplemented with immunohistochemical stains for cytokeratins and S100 proteins, results of which suggested an origin from surface ectoderm. All of our patients required surgical management, although spontaneous involution of a temporary nature was observed in one case, and recurrences following incomplete removal were common.