bluuebunny/crossref_metadata_2025 huggingface dataset:
PHYSICIAN PRACTICES IN THE PREVENTION OF DEEP VEIN THROMBOSIS: THE MASSPRO DVT STUDY
Authors: Anderson Frederick A , Audet Anne-Marie
Published: April 2021

ABSTRACT

Numerous well-designed clinical trials have demonstrated that prophylaxis reduces the incidence of acute deep vein thrombosis (DVT) in high-risk surgical patients by two-thirds, with a corresponding reduction in mortality from pulmonary embolism. However, studies of clinical practices suggest that DVT prophylaxis is underused - for example, only 39% of high-risk surgical patients in 16 central Massachusetts hospitals were administered DVT prophylaxis in 1986. Subsequently, an intensive educational initiative was launched to improve utilization of DVT prophylaxis. Although some improvement was reported, the level of use was not optimal. The Massachusetts Peer Review Organization (MassPRO) DVT study was designed to gather data on recent practice patterns among Massachusetts surgeons and determine the need for additional educational and quality assurance efforts. The results indicate that there is broad compliance among orthopedic surgeons with consensus recommendations for the use of DVT prophylaxis. Nearly all patients who undergo total hip replacement in Massachusetts are protected from DVT by one or more methods of prophylaxis. These data suggest that the ongoing efforts to improve the use of DVT prophylaxis in Massachusetts since 1986 have come to fruition, at least with respect to total hip replacement.
POST-DISCHARGE PREVENTION OF DEEP VEIN THROMBOSIS FOLLOWING TOTAL JOINT REPLACEMENT
Authors: Fitzgerald Robert H
Published: April 2021

ABSTRACT

Recent prospective studies demonstrate that the peak incidence of deep vein thrombosis (DVT) occurs on the fifth postoperative day. If the patient is to be discharged from an acute care facility on day 3 through 6, then the patient will be removed from direct supervision by professionals - frequently observing the patient in an acute care hospital during the high-risk period for the development of DVT or pulmonary embolism. In addition, the period of vulnerability for the development of thromboembolic disease in this group of patients appears to occur for an extended period of time, eg, 3 months.

This change in practice has altered the surgeon's approach to the selection of agents for the prevention of thromboembolic complications. Most surgeons wish to administer an agent in the acute care setting that can be continued after the patient is discharged to the rehabilitation facility, subacute care facility, or home. This information reflects the belief of most orthopedic surgeons that prophylactic therapy should be continued beyond the time frame in which the patient is confined to the acute care facility. Although progress has been made in identifying effective prophylactic agents, questions remain as to the appropriate duration of prophylaxis. Based upon available data, it would appear that prophylaxis against thromboembolic disorders should be continued until the patient is spending the majority of his or her day ambulating with or without external aides.
Osteonecrosis of the Femoral Head in Patients With Inflammatory Arthritis or Asthma Receiving Corticosteroid Therapy
Authors: Colwell Clifford W , Robinson Charles A , Stevenson Donald D , Vint Vinton C , Morris Beverly A
Published: April 2021

ABSTRACT

The utilization of corticosteroids in the management of acute and chronic inflammatory processes, such as asthma or inflammatory arthritis, has been implicated in the adverse effects of multiple organ systems. One potential area of these negative consequences in the use of corticosteroids is the development of osteonecrosis of the femoral head. A direct time/dosage relationship for treatment with corticosteroids of patients with an established diagnosis of asthma or inflammatory arthritis and femoral osteonecrosis is unknown. A prospective study was undertaken to evaluate the use of corticosteroids and the incidence of osteonecrosis of the femoral head and potentially establish a time/dosage relationship in this patient population. No direct relationship between corticosteroid dosage and the development of femoral head osteonecrosis in 1420 hip-years was demonstrated at 1 0-year follow up.
The Post-Discharge Prophylactic Management of the Orthopedic Patient With Low-Molecular-Weight Heparin: Enoxaparin
Authors: Nilsson Paul E , Bergqvist David , Benoni Göran , Björgell Ola , Fredin Hans , Hedlund Urban , Nicolas Sylvain , Nylander Göran
Published: April 2021

ABSTRACT

This prospective, double-blind trial was performed to determine whether 4 weeks' prophylaxis with enoxaparin after total hip replacement (THR) is more effective in protecting against deep vein thrombosis (DVT) than prophylaxis during hospitalization. Two hundred sixty-two patients undergoing THR were given enoxaparin 40 mg once daily during hospitalization (9 ± 2 days) before being randomized at discharge to continue enoxaparin (N=131) or receive placebo (N=131) for a total of 1 month (30 ± 4 days). According to intention-to-treat analysis, 43 DVT and 2 pulmonary emboli (PE) occurred in the placebo group (34.4%) versus 21 DVT and no PE in the enoxaparin group (P<0.001). The reduction in proximal DVT was also significant (21.4 vs 6.1%; P<0.001). No major bleeding complications developed. Prophylaxis with enoxaparin for one month significantly reduces venous thromboembolic disease in patients undergoing THR compared to conventional prophylaxis during hospitalization.
Newborn Clavicle Fractures
Authors: McBride Mark T , Hennrikus William L , Mologne Timothy S
Published: April 2021

ABSTRACT

A prospective screening program of 9106 newborns identified 43 infants with clavicle fractures for a prevalence of 1 fracture in every 213 live births (0.5%). The fractures were equally distributed by right and left side involvement and male and female sex. All fractures occurred during vaginal deliveries. None were breech presentation. Risk factors for fracture included large birthweight, shoulder dystocia, mechanically assisted delivery, and prolonged gestational age. One in 11 newborns with a clavicle fracture also had a brachial plexus palsy.
The Location of the Spinal Nerve Root on Plain Radiographs of the Cervical Spine
Authors: Ebraheim Nabil A , Reader Doug , Xu Rongming , Yeasting Richard A
Published: April 2021

ABSTRACT

Twelve cervical spines from C2 to T1 were harvested from embalmed cadavers to study the location of the nerve root on plain radiographs. After removal of the soft tissue, the spinal nerves just lateral to the transverse processes were exposed and injected with lead oxide. Plain radiographs including anteroposterior (AP) and left and right oblique views were taken. Angular and linear measurements were performed directly on the radiographs.

Results showed that the average frontal angle of the nerve root for all levels was 1 55° on the AP view, 108° on the foraminal side of the oblique view, and 153° on the opposite side of the oblique view. The nerve root height for all levels averaged 4.7±0.5 mm. The interpedicular space height increased consistently from 7.8±0.7 mm at C3-C4 to 9.0±1.3 mm at C6-C7 except at C2-C3. The nerve root height with respect to the interpedicular space height was 56.2% at C2-C3, 57.8% at C4-C5, and 53.7% at C6-C7. A knowledge of the location of the cervical nerve root related to plain radiographs may enhance the value of plain radiographs in the diagnosis and treatment of cervical spinal disorders.
Early Rehabilitation After a Modified Inferior Capsular Shift Procedure for Multidirectional Instability of the Shoulder
Authors: Nixon Robert T , Lindenfeld Thomas N
Published: April 2021

ABSTRACT

Sixteen patients with multidirectional instability of the shoulder underwent an inferior capsular shift procedure with suture anchor augmentation and participated in an early motion and strengthening program. Postoperative rehabilitation included use of a sling with 0° to 90° elevation allowed during the first 3 weeks. All patients began isometric shoulder exercise by 3 weeks and initiated progressive resistance exercises by 6 weeks postsurgery.

After an average 20 months of follow-up, 1 4 patients were evaluated for pain, function, range of motion, stability, and activity level. Pain and function improved significantly. No patient reported postoperative subluxation or dislocation, and ? of 14 patients had returned to their premorbid activity level.
Long-Term Results of the Operative Treatment of Clubfoot: A Representative Study
Authors: Kránicz János , Than Péter , Kustos Tamás
Published: April 2021

ABSTRACT

This study reports the long-term results of operative treatment of clubfoot. Of the patients who underwent posteromedial release for congenital clubfoot between 1972 and 1975 at the Medical University in Pecs, Hungary, 41 feet of 30 patients have been under control examination. Control consisted of the distribution of questionnaires, physical examination, and in some cases, radiologic analysis.

At an average of 20 years postsurgery, good clinical results were observed in 31 (75%) feet. In these patients. satisfying foot form and good function were achieved, yet the characteristic atrophy of the calf and shortening of the foot were visible. Abnormal conditions were found in 1 0 feet, consisting of overcorrection in 6 and undercorrection in 4 cases. Subjective judgment of the patients was considerably better; only 5 (1 2%) feet had no satisfying results. Data of feet in an incorrect position were analyzed and compared with other cases. In cases of feet operated on in patients aged s*1 year and in patients who underwent multiple operations, abnormalities were found in a significantly higher percentage.
A Simple Outpatient Test for Proprioception in the Anterior Cruciate Ligament-Deficient Knee
Authors: Al-Othman Abdullah , Moussa Mohammed , Eraky Mohammed Zakaria
Published: April 2021

ABSTRACT

Proprioception was quantified in 32 patients who had an arthroscopically documented complete anterior cruciate ligament tear using a simple single-limb standing test. An age-matched control group underwent identical testing. Control subjects demonstrated identical values between their two limbs, with the mean variation being 4.8%. The test group, however, showed significantly higher mean values for the injured compared with the noninjured limb, the mean variation being 43.8%. Patients who have a complete tear of the anterior cruciate ligament may experience a decline in proprioceptive function of their knees. This can be tested clinically using a simple single-limb standing test in an outpatient setting.
Outpatient ACL Reconstruction Using Intraoperative Local Analgesia and Oral Postoperative Pain Medication
Authors: Aronowitz Eric R , Kleinbart Frederic A
Published: April 2021

ABSTRACT

Thirty-five consecutive anterior cruciate ligament (ACL) reconstructions were performed in an ambulatory surgical unit using a bone-patellar tendon-bone autograft. Patients, were evaluated postoperativeiy to determine the amount of pain medication used, the readmission rate, postoperative complications, and cost. Outpatient ACL reconstruction led to a savings of $4700 compared with the cost of performing the same procedure in a hospital operating room with an overnight admission. This study demonstrates that outpatient ACL reconstruction, using local analgesia intraoperatively and oral narcotic pain medication postoperatively, is a safe and cost-effective procedure with minimal to no morbidity.
Flexor Tendon Suture Methods: A Quantitative Analysis of Suture Material Within the Repair Site
Authors: Norris Steven R , Ellis Frank D , Chen Michael I , Seiler John G
Published: April 2021

ABSTRACT

This study compared the cross-sectional area and volume occupied by suture material at the repair site in three common methods of flexor tendon repair. A total of 5) human cadaveric tendons were studied. Zone M flexor digitorum profundus tendon lacerations were created and then repaired using the techniques described by Kessler, Tajima, and Savage. Quantitative cross-sectional area and volumetric measurements of suture material within each repair site were determined using a digital image analysis system. The Tajima repair occupied 27% of the tendon area at the repair site, while the Savage and Kessler repairs occupied 18% and 2%, respectively.
Role of Pin Traction in Wound Closure
Authors: Sangwan S S , Sharma Vinod , Siwach R C
Published: April 2021

ABSTRACT

This study examined the role of pin traction in wound closure. Forty patients comprised the study population. Wounds treated were on legs, thighs, and forearms. Kirschner wires were passed around margins of the wound and interconnected with stainless steel wires, which were gradually tightened to approximate the wound edges to healing. Final results were excellent in 18 (45%), good in 13 (32.%), fair in 5 (12.%), and poor in 4 (1%) patients. The main complication was cutting through the wires. The results were unsatisfactory in old, scarred, and large wounds.
The Impact of Simulated Distal Interphalangeal Joint Fusion on Grip Strength
Authors: Morgan William J , Schulz Lisa A , Chang Joseph L
Published: April 2021

ABSTRACT

This study assessed the impact of distal interphalangeal (DIP) joint fusion on grip strength and how this may be related to a profundus quadriga. Nineteen adults (12 men and 7 women) with an average age of 32.6 years (range: 24-6-1 years) underwent a series of grip strength measurements with simulation of DIP arthrodesis to the index, long, and index and long (index-long) fingers. The nondominant hand served as a control for the testing. All participants were tested in the same manner: baseline dominant and nondominant hands without DIP block followed by blocking of DIP flexion on the dominant hand only for index, index-long, and long finger alone. Nondominant hands also were tested each time, but without blocking to serve as a control for normal changes in grip strength with repeated testing. Grip strength values were compared to baseline for each trial using the Student's t test. Significant decreases in grip strength were seen for all DIP blocking compared with baseline, but no significant differences were noted in the equivalent trial in the nondominant, nonblocked hand. These findings may have clinical relevance when performing DIP arthrodesis.
Transfusion in Unilateral Total Knee Arthroplasty
Authors: Gainor John W
Published: April 2021

ABSTRACT

Blood transfusion requirements were analyzed in 102 total knee arthroplasties in 92 patients. All components were cemented, and no postoperative drainage was used. Six patients received transfusions; two of these patients received transfusions for symptoms and four received transfusions prophylactically. These findings do not support the routine practice of preoperative autologous blood donation.
Histopathological Characterization of Melorheostosis
Authors: Hoshi Kazuto , Amizuka Norio , Kurokawa Takahide , Nakamura Kozo , Shiro Ryoji , Ozawa Hidehiro
Published: April 2021

ABSTRACT

Melorheostotic bone was examined histopathologicalIy. In the severely affected areas, an abundance of osteoid and increased angiogenesis was observed. Increased osteoid without mineralization indicated the overproduction of bone matrix. Bone resorption also appeared to increase because osteoclasts were numerous in melorheostotic bone, thus suggesting a high rate of bone turnover. In addition, transforming growth factor-ß was immunolocalized in the periosteal fibroblasts, mesenchymal cells surrounding vessels, endothelial cells, and osteoblasts, while basic fibroblast growth factor was found in endothelial cells and mast cells near vessels. These cytokines may have some association with the exuberant bone matrix production and angiogenesis in melorheostosis.
Triple Innominate Osteotomy in Young Adults for the Treatment of Acetabular Dysplasia: A 9-Year Follow-Up Study
Authors: Peters Christopher L , Fukushima Brian W , Park Tammy K , Coleman Sherman S , Dunn Harold K
Published: April 2021

ABSTRACT

Fifty patients who underwent 60 triple innominate osteotomies were reviewed radiographically and clinically using a modified Harris hip score (HHS). Average patient age was 26 years (range: 13-48 years). At average 9-year follow-up (range: 5-14 years), 12 (20%) hips had been converted to total hip arthroplasty (THA) and 4 (7%) hips had incapacitating pain. Sixteen (27%) hips were considered failures. Average modified HHS at final follow-up was 67 (range: 28-91). Forty-nine (98%) of 50 patients reported they would recommend the procedure to others in the same situation. Radiographically, there was significant improvement in the center-to-edge angle of Wiberg and the acetabular angle of Sharp. There also was a statistically significant relationship between failure of the osteotomy and severity of preexisting hip arthrosis as measured by the Tonnis criteria. The results demonstrate triple innominate osteotomy was effective in eliminating pain, but the fact that 27% of hips required or will require THA indicates results may deteriorate with time.
Incidence of Bilateral Proximal Femoral Fractures in a Tertiary Care Center
Authors: Kaper Bertrand P , Mayor Michael B
Published: April 2021

ABSTRACT

Over a 7-year period, a total of 545 osteoporotic fractures involving the proximal femur were treated at our institution. Twenty-nine patients sustained fractures of both hips, representing an overall incidence of bilateral hip fractures of approximately 5.5%. Of the 29 patients with bilateral hip fractures, adequate records and radiographs were avaialable for 28. There was a significant similarity between fracture patterns in the majority of bilateral hip fracture patients: 18 (64%) patients demonstrated similar fracture patterns on both sides. In these 18 patients, the average interval between fractures was approximately 1.7 years; in the remaining 10 patients, in whom the fractures were of dissimilar nature, the average interval between fractures was approximately 3.5 years.

These findings suggest that at least 1 in 20 patients who sustain a fracture about the hip can expect to suffer a fracture involving the contralateral side. Moreover, the difference in the average interval for fractures of similar nature compared to fractures of dissimilar nature suggests the effects of physiologic age and the accordant changes in bone architecture play a larger role in predicting subsequent fracture pattern.
Proximal Rectus Femoris Lengthening
Authors: Guerado Enrique , de la Varga Vicente
Published: April 2021

There are two main problems with muscle tendon lengthening: thinness created by the technical procedure weakens the tendon, and in short tendons, lengthening may not provide enough length for the amount of joint motion required. In proximal rectus femoris lengthening, the distal ends of the reflected and straight heads are sutured together. Using this technique, the tendon will not be thinned, and a later second lengthening is possible.
Effectiveness of Suction Drainage After Primary or Revision Total Hip and Total Knee Arthroplasty
Authors: Ashraf T , Darmanis S , Krikler S J
Published: April 2021

ABSTRACT

Postoperative suction drainage of a surgical wound is aimed at evacuation of wound hematoma. This study evaluated the effectiveness of suction drainage in joint replacement surgery. Surgical wounds in 206 patients with primary or revision hip and knee arthroplasty were assessed according to a set criteria. Forty-eight hours postoperatively, wound hematoma and exudate formation were not related to the use of suction drains. A greater tendency of wound oozing was seen in revision hip arthroplasty performed with postoperative suction drainage. Therefore, postoperative suction drainage did not affect hematoma formation or wound oozing and is thus considered an unnecessary practice.
An Evaluation of Paper-and-Pencil and Computer-Assisted Simulations
Authors: Schleutermann Joanna A , Holzemer William L , Farrand Linda L
Published: April 2021

ABSTRACT

Two formats of delivering clinical simulations for nurse practitioners were evaluated in this study. The two formats included paper-and-pencil, latent-image format, and computer-assisted instruction. Twelve students in a graduate family nurse practitioner curriculum were the subjects. They reported no preference for type of format nor were any differences observed in student performance when comparing the two formats. The cost for the latent-image format was estimated at approximately $8500 and the cost for computer simulation at approximately $10,500. The implications of these findings for nursing curriculums are discussed.
Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation
Authors: Bondy Kathleen Nowak
Published: April 2021

ABSTRACT

The evaluation of clinical competence of nursing students is often considered subjective and inconsistent. To avoid these pitfalls, the author developed criteria for a five-point rating scale for evaluation of student clinical performance. This rating system may be applied to any professional behavior and provides the student with diagnostic feedback as well as a fair assessment of performance.
Do Baccalaureate Students Possess Basic Mathematics Proficiency?
Authors: Bindler Ruth , Bayne Tina
Published: April 2021

ABSTRACT

Since 1979, over 700 junior level baccalaureate nursing students at the Intercollegiate Center for Nursing Education (ICNE) in Spokane, Washington, have had their basic mathematical skills tested, using a teacher constructed examination. The "Mathematics Proficiency Exam" utilized evaluates the nursing students ability to add, subtract, multiply, and divide whole numbers, fractions, decimals, and percentages. Ratios, proportions, and problems are also included in the exam.

The results of the testing have been surprising. From 9% to 38% of each student group tested have been unable to pass all parts of the examination at the 70% level. These findings have led the ICNE to require basic mathematical proficiency via the "Mathematics Proficiency Exam," developed by the authors, as a criterion for admission to the upper division nursing major. Subsequently, competence in medication calculation skills has been required within the first clinical course at the ICNE via a second teacher-constructed examination.
Infection Control Programmed Instruction: An Alternative to Classroom Instruction in Baccalaureate Nursing Education
Authors: Goldrick Barbara , Appling-Stevens Susan , Larson Elaine
Published: April 2021

ABSTRACT

The purpose of this study was to determine whether self-managed learning in the form of a programmed unit of instruction (PUI) in the basic principles of infection control is an acceptable alternative to a standard lecture format for teaching infection control to nursing students. A sample of 108 subjects was selected from third-year baccalaureate nursing students at two universities. The subjects were randomly assigned to two groups. The experimental group was given the pretest, the PUI (treatment), the post-test, and a Likert scale opinionnaire of the PUI. The control group was pretested and presented the same content in a lecture format, then post-tested. A pretest-post-test control group design was used for data analysis and a one-way analysis of covariance was performed on the post-test means of the groups. Analysis of covariance (ANCOVA) was applied to the post-test means of the groups, with pretest scores and educational setting as covariates. Results indicate that nursing students who complete an infection control PUI score higher on post-tests than those who attend a lecture (p < .001), regardless of pretest scores and educational setting. Subjects using the PUI also preferred this format and found the content manageable.
A Comparison of New Graduate and Evaluator Appraisals of Nursing Performance
Authors: Vanetzian Eleanor V , Higgins Millicent G
Published: April 2021

ABSTRACT

The purpose of this longitudinal, descriptive study was to compare new graduate self-appraisals of nursing performance with those of their evaluators and provide information about the length of time new graduates practiced before they and their evaluators agreed about their level of performance. The panel of new graduates and their evaluators were surveyed 6 months and 1 year after graduation using a repeated measures design. The Six-Dimension Scale of Nursing Performance (Schwirian, 1978) operationalized nursing performance and a demographic data form was used to collect background information about both groups. Performance on the six dimensions was rated as satisfactory or above at both data collection periods. Both new graduates and their evaluators rated performance of professional development highest, IPR/ communication next, and teaching/collaboration last. Six months after graduation, the new graduates rated themselves significantly higher than their evaluators on all dimensions except critical care. At 1 year, evaluators rated new graduate performance higher on all subscales than at 6 months. A comparison of new graduates' responses indicated that new graduates evaluated themselves significantly higher at 1 year than at 6 months on the planning/evaluation subscale alone.
The Liberating Effects of RN-to-BSN Education
Authors: Witt Barbara S
Published: April 2021

ABSTRACT

This study investigated whether postlicensure baccalaureate education was associated with decreased acceptance of oppressed status for nursing and the self, with behavioral changes in job performance, and in joining a professional organization. Selected writings of Freire (1970a, 1970b, 1973) concerning education of the oppressed were used to form the conceptual framework. Baccalaureate education was conceptualized as a means of overcoming oppression-related behaviors and attitudes in nurses. The criterion measures were self-reports of job performance, joining the American Nurses Association (ANA), self-concept measurements, and perception of nursing measured by a semantic differential. Except for self-concept, which remained unchanged, all the findings were in the predicted direction supporting the conceptual framework.
Effect of Pregraduate Preceptorship Experience on Development of Adaptive Competencies of Baccalaureate Nursing Students
Authors: Laschinger Heather K Spence , MacMaster Elsie
Published: April 2021

ABSTRACT

Kolb's (1984) theory of experiential learning was used as a framework to study 50 baccalaureate nursing students' perceptions of the contributions of a senior preceptorship experience to the development of adaptive competencies. Nursing learning environments were thought to contribute most to divergent and convergent competencies, reflecting the importance of both peopleoriented and scientific skills in nursing. The preceptorship had a significant impact on most learning competencies. Significant increases occurred in competencies considered not important for nursing by students prior to the experience, e.g., assimilative competencies such as testing theories and ideas, and accommodative competencies such as leading and influencing others. These results support the notion of further research of nursing learning environments from the experiential learning perspective.
Effects of an Educational Intervention on Students' Attitudes Toward the Disabled
Authors: Lindgren Carolyn L , Oermann Marilyn H
Published: April 2021

ABSTRACT

The purposes of this study were to determine if the attitudes of nursing students toward the disabled would improve following participation in a one-day educational conference on care of the physically disabled and to identify variables influencing these attitudes. Nursing students completed Yuker and Block's Attitudes Toward Disabled Persons scale (ATDP) (1986) prior to and one month following the conference. T test indicated that subjects had significantly higher ATDP scores following the rehabilitation conference (p = <.0001). Subjects with prior work experience with the disabled had significantly higher scores on the ATDP, indicating more positive attitudes toward the disabled.
Relationships Among Faculty Practice Involvement, Perception of Role Stress, and Psychological Hardiness of Nurse Educators
Authors: Lambert Clint , Lambert Vickie A
Published: April 2021

ABSTRACT

This study examined the relationships of role stress and psychological hardiness and identified predictors of role stress in nurse educators overall and in those either involved or not involved in faculty practice. In addition, the study examined differences in psychological hardiness and role stress between nurse educators either involved or not involved in faculty practice.

Data were obtained through three mailed self-report questionnaires from 871 nurse educators employed fulltime in a National League for Nursing (NLN)-accredited school of nursing with both undergraduate and graduate programs. The findings revealed significant negative correlations between role stress and psychological hardiness and between components of role stress and components of psychological hardiness. Predictors of role stress were identified. No significant difference was found in role stress or in psychological hardiness between nurse educators involved and those not involved in faculty practice.
Mental Practice: An Alternative Approach to Teaching Motor Skills
Authors: Doheny Margaret O'Bryan
Published: April 2021

ABSTRACT

Nursing educators expect that students will learn psychomotor skills and demonstrate competence in these skills. However, current emphasis on cognitive and psychosocial skills concerns nursing educators because psychomotor skills are necessary for safe practice. One possible strategy, based on a holistic framework, is mental practice. This is the same type of practice that athletes use when preparing to perform a sports activity. The purpose of this study was to determine whether mental imaging practice for nursing students affected the learning and performance of giving an intramuscular injection. Findings suggest that mental practice does affect learning and performance of motor skills.
A Survey of BSN Curricula: Research Content
Authors: Dvorak Eileen McQuaid , Brophy Elizabeth B , Binder Dorothy M , Carlson Elizabeth
Published: April 2021

ABSTRACT

The purpose in this study was to survey educators in National League for Nursing (NLN)-accredited programs regarding the goals in the research component. The 21-item survey instrument was sent to 200 randomly selected schools, of whom 165 (83%) responded. The responses fell into two classes: cognitive goals, i.e., critical thinking and theory/practice; and professional skills, i.e., research utilization and clinical judgment. While a number of variables were analyzed, no significant findings were observed.
Accord and Discord in Students' Images of Nursing
Authors: Kiger Alice K
Published: April 2021

ABSTRACT

This article discusses findings from a qualitative study of student nurses' images of nursing from entry to training through early clinical experiences. Three rounds of interviews were conducted with 24 Scottish students. Analysis revealed five major themes in students' initial images: pictures of nursing, the good nurse, what nursing entails, occupational labels for nursing, and being a student/ becoming a nurse. These were pursued in later interviews and characteristics of students' experience-mediated images were identified. The picture of adult medical-surgical nursing as typical of real nursing persisted throughout. "Working with people" and "helping" appeared as central characteristics of nursing. Notions of good and bad underlay many features of the image. The paradoxical nature of "involvement" was noticeable. Staff attitudes figured prominently in determining the quality of students' experience and in development of image. Commitment and belonging were integral to students' images and made nursing more than just a job. Processes through which students' images developed included affirmation, accommodation, and nonaccommodation. Associated processes included identification, disillusionment, and extenuation. There was clear evidence of the importance of support to enable students to adapt to image disparities.
Summers of No Return: Transforming Care Through a Nursing Field School
Authors: Kavanagh Kathryn Hopkins
Published: April 2021

ABSTRACT

Nursing education is developing a wide variety of ways to educate for cultural competence that expedites culturecongruent care and effective diversity management in practice. Using a praxis orientation, this article reports research done on an innovative nursing field school during the past four summers on the Pine Ridge Indian Reservation in South Dakota. Learning context emphasizing formation of a collaborative, caring community is created for 6-week immersion learning experiences during which student groups work with the High Plains OgIaIa Lakota in tribal programs. Triangulated data based on participant observation and student journals, stories, discussions, interviews, academic coursework, and evaluation surveys provide a comprehensive record of complex and multifaceted field school and immersion learning processes. Through collaboration with students, Diekelmann's "Concernful Practices" are tested and adapted for fit as a framework for organizing and examining the field school experience, as well as the practice of health care across cultures.
Improving Undergraduate Nursing Research Education: The Effectiveness of Collecting and Analyzing Oral Histories
Authors: Duggleby Wendy
Published: April 2021

ABSTRACT

Nine oral histories of retired RNs (age range from 60 to 77) were collected by trained senior nursing students in their nursing research class. Attitudes toward nursing research of the 18 undergraduate baccalaureate nursing students participating in the collection and analysis of oral histories were compared with 20 students who did not participate. Both groups of students completed a pretest and posttest Attitudes Toward Nursing Research Questionnaire. The participating students had significantly positive changes in their attitudes toward nursing research. The nonparticipating group did not.

While reminiscing about their careers, the retired RNs related historical events that influenced their nursing practice. Three themes emerged: World War II, technology, and intensive care units. Through an open-ended, written questionnaire following the interview, the nurses expressed positive benefits of participation. The collection and analysis of oral histories was an effective experiential learning strategy with positive outcomes for the students and the retired nurses who were interviewed.
Shift Report: A Time for Learning
Authors: Yurkovich Eleanor , Smyer Tish
Published: April 2021

ABSTRACT

Shift report provides an opportunity for professional communication that supporte role socialization and development of a cohesive group process in the health care ayatern. In this learning project, nursing students were able to practice professional behaviors, prioritize information, and reduce material to the boundaries of a work setting without relinquishing the holistic approach to the client. Critical thinking, direct application, self-analysis, peer critiques, and problem-solving processes were used by the student groups which will assist in their role transition to professional nursing practice.
External Examiners: Quality Assurance in Nursing Education
Authors: Karuhije Harriet F , Ruff Coralease
Published: April 2021

ABSTRACT

External examining is a system of quality assurance in nursing education that is quite foreign to most American nurses. The concept of an external examiner- a visiting assessor of high academic standing and possessed of integrity and objectivity-supports a notion of the universality of educational standards and justice for the individual student. Potential external examiners are appointed primarily through informal social and professional networks within educational institutions of the host country. Criteria for appointment, roles and functions of an examiner, and the four stages of the external examination process are discussed. Suggestions to facilitate each stage as well as implications for potential American external examiners are included. The manuscript concludes with insights from two American nurse educators about their experience as external examiners.
The U.S. Air Force Pilot Simulated Medical Unit: A Teaching Strategy With Multiple Applications
Authors: Eaves Richard H , Flagg Amanda J
Published: April 2021

ABSTRACT

Historically, Air Force military hospitals have provided excellent training platforms for students and nurses to remain proficient and ready to deliver competent care in a war-time environment. Because of a decrease in the number of admissions, the opportunity to maintain competence is diminishing. The concept of a Simulated Medical Unit (SMU) is being developed at Sheppard Air Force Base, Wichita Falls, Texas to assist in the training and evaluation of such skills. The SMU is a simulation of an actual enactment of an inpatient unit that begins with shift report to the oncoming nursing team. The instructor can then guide the student and team through a series of complex situations using specialized mannequins and live actors as "patients." The student is expected to carry out physicians' orders, perform nursing assessments, document nursing care, as well as administer medications and IV fluids. Scenarios can be made to be as simple or as complex as the situation demands and can be adapted to any specialty. The student can practice technical knowhow, sharpen critical thinking abilities, and exercise delegation skills. Should an error occur, the instructor can freeze the moment and assist the student in developing more appropriate choices in their delivery of care. The use of algorithms, performance checklists, and videotaping can be used to evaluate the student's performance. Other adaptations for the SMU can include orientation, cross training into different specialties, competency assessment, and upgrade training.
Working With American Indians Toward Educational Success
Authors: Yurkovich Eleanor E
Published: April 2021

ABSTRACT

Past research has focused on identifying barriers that American Indian college students experience in attempting to complete programs in higher educational systems. Recommendations to reduce these barriers have not significantly decreased attrition rates or increased the completion rates of this minority group. Nationally, nursing professionals recognize the shortage of minorities in the field of nursing. Likewise, the need for American Indian health care providers is growing in direct proportion to the number of health care issues facing this population. This grounded theory study focused on the enablers that supported educational success of American Indian baccalaureate nursing graduates between the years 1986 and 1995 in a western university. Through constant comparative analysis of 18 interviews, four core variables emerged. The interactive core variables are individual American Indian student, instructor, institutions (university and college of nursing), and external influences. This article focuses on the core variable individual American Indian student and the following seven properties that support success: focuses on goal, adjusts to dominant cultural, invests in self-assessment, develops assertive skills, establishes support community, socializes into roles of student and nurse, and masters content. This central core variable and properties create a gestalt that promotes educational success. The implications are that faculty, in their roles as advisor and instructor, can assist in the development and maintenance of these seven properties. This can be achieved through proactive culturally responsive advisement, creation of a culturally relevant environment, and use of humanistic andragogical approaches to teaching-learning processes.
Professional Socialization of Baccalaureate Nursing Students: Can Students in Distance Nursing Programs Become Socialized?
Authors: Nesler Mitchell S , Hanner Mary Beth , Melburg Valerie , McGowan Stephanie
Published: April 2021

ABSTRACT

Distance education programs may have difficulty socializing nursing students due to limited face-to-face student-faculty interaction. Socialized attitudes toward the nursing profession were assessed using two measures with three groups- senior BSN students enrolled at campus-based programs, senior BSN students enrolled in distance programs, and non-nursing students. The purpose of this analysis was to determine whether nursing students enrolled in distance programs had professional socialization outcomes comparable to nursing students enrolled in campus-based programs, and to examine the psychometric properties of two popular measures of professional socialization. Results indicated that students in the distance programs had higher scores than the campus-based nursing students, who, in turn, had higher scores than nonnursing students. A statistical interaction of RN status by program type indicated that health care experience was a critical factor in the socialization process. Of the two socialization measures examined, one had acceptable psychometric properties. These data suggest that health care and preceptorship experiences are important determinants of professional socialization and that students who opt for distance nursing programs graduate with socialization outcomes that are at least comparable to those of students who attend traditional programs.
Empowering Versus Enabling in Academia
Authors: Espeland Karen , Shanta Linda
Published: April 2021

ABSTRACT

The literature endorses empowered nurses as essential to changing not only the nursing profession but also the current health care system. Nurse educators have embraced the concept of empowering students. However, faculty frequently enable students rather than empower them in both clinical and classroom settings. This article describes the difference between enabling and empowering. Collegiality, communication, accountability, and autonomy are components of a model used to compare empowering versus enabling in the academic setting. Nurse educators will become aware of behaviors that sabotage the empowerment of students. Strategies designed to facilitate students' development of empowering behaviors will be provided throughout the article.
Nursing Students With Learning Disabilities
Authors: Selekman Janice
Published: April 2021

ABSTRACT

Children with learning disabilities grow up to be adults with learning disabilities, who may go to nursing school, Nurse educators currently are faced with the same challenges as primary and secondary school teachers in meeting the education needs of individuals with learning disabilities. It is essential for nurse educators to be knowledgeable about learning disabilities, to understand the issues involved, and to use appropriate interventions to help these students succeed.
Literary Pedagogy in Nursing: A Theory-Based Perspective
Authors: Sakalys Jurate A
Published: April 2021

ABSTRACT

Using fictional and autobiographical literature in nursing education is a primary way of understanding patients' lived experiences and fostering development of essential relational and reflective thinking skills. Application of literary theory to this pedagogic practice can expand conceptualization of teaching goals, inform specific teaching strategies, and potentially contribute to socially consequential educational outcomes. This article describes a theoretical schema that focuses on pedagogical goals in terms of the three related skills (i.e., reading, interpretation, criticism) of textual competence.
Development and Congenital Abnormalities of the Nasolacrimal Apparatus
Authors: Sevel David
Published: April 2021

Abstract

The development of the nasolacrimal appartus was reassessed based on the examination of serial sections done in 27 (54 orbits) embryos and fetuses ranging in size from 13.6 mm to term. In addition two adult specimens were examined. The entire nasolacrimal apparatus viz. canaliculi, lacrimal sac, and nasolacrimal duct develop contemporaneously. Canalization thereafter occurs throughout its length at the same time. The epithelium which lines the nasolacrimal apparatus abuts against the conjunctival epithelium superiorly in relationship to the puncta and the nasal mucosa at the opening of the nasolacrimal duct. These gossamer-like membranes perforate at term or soon thereafter.

With the development of the face, the maxillary process grows medially to abut against, and then to override, the paraxial mesoderm of the nasolacrimal process. The nasooptic fissure is thus formed between these two mesodermal complexes. The surface ectoderm within the fissure thickens in a cord-like fashion, and this is the analaga of the nasolacrimal apparatus.1-5

There is divergence of opinion as to the subsequent development of tear drainage system. A cord of epithelial cells forms from the nasal cavity and grows cephalad to become continuous with the main cord of buried surface ectoderm (Figure 1). It has been contended by Duke-Elder that the main epithelial cord then sends extensions laterally to form the superior and the inferior canaliculi. The inferior canaliculus extends more laterally than the superior canaliculus. At 3 months' development, canalization of the nasolacrimal apparatus is purported' to occur in a segmental manner. These cavities then coalesce in a haphazard manner, finally forming a continuous tube.3 It is also suggested' that the main core of buried epithelium canalizes from cephal/ caudalwards and that the epithelium arising from the nasal cavity canalizes in a reverse direction (Figure 2). The lacrimal sac then expands: the canaliculi canalize and the final section of the nasolacrimal duct to become patent is the opening into the nferior meatus of the nose below the inferior turbinate.
An Infant Scleral Depressor
Authors: Katz Norman N K , Przybyla Vincent A
Published: April 2021

Abstract

An infant scleral depressor is described that facilitates peripheral fundus examination in infants, including those with small palpebral fissures. This appears superior to presently available scleral depressors or other materials used for such examination.
Infantile Idiopathic Hypercalciuria, High Congenital Myopia, and Atypical Macular Coloboma: A New Oculo-Renal Syndrome?
Authors: Gil-Gibernau J , Galan A , Callis L , Rodrigo C
Published: April 2021

Abstract

Four cases of infantile idiopathic hypercalciuria with high congenital myopia and atypical macular coloboma are discussed; two of them are brother and sister.

The eye examination shows bilateral congenital myopia of more than 10 diopters in every case. In the fundus examination, there is a bilateral macular colobomatous lesion in two of them and monocular lesion in the remaining ones.

Hypercalciuria is considered to be due to renal tubulus malformation.

The macular atypical coloboma etiopathogenesis is discussed, commenting on the malformative, dystrophic and inflammatory hypothesis, having discarded the usual inflammatory etiologies.

We have only found two cases similar to these in the literature. Given the relative scarce occurrence of each of the three mentioned clinical features we suggest the possibility of a new oculo-renal syndrome rather than a coincidental association.
Succinylcholine as a Predictor in Strabismus Surgery
Authors: Lingua Robert W , Azen Stanley , Szirth Ben , Edelman Paula , Walonker Frances
Published: April 2021

ABSTRACT

Succinylcholine was injected intra operatively in 20 patients with congenital esotropia, before and after the surgical procedure. Regression analysis was performed to investigate the relationship between the awake preand postoperative alignment and the drug-induced ocular positions, under anesthesia. The postoperative succinylcholine-induced ocular position was found to be a highly significant predictor of the one week post-operative alignment (r=0.98, p < 0.0001). Further investigation may lead to an ability to predict the postoperative alignment intraoperatively.