bluuebunny/crossref_metadata_2025 huggingface dataset:
CROSSED PINS VS PARALLEL PINS IN THE TREATMENT OF FEMORAL NECK FRACTURES
Authors: Gebuhr Peter , Hovgaard Claus , Petersen Jes Reinholdt
Published: April 2021

ABSTRACT

Twenty femoral neck fractures treated with three crossed modified Knowles pins (Gouffon pins) were compared to 20 fractures treated with three parallel pins. All patients had survived for more than 2 years after operation. The groups were comparable concerning Garden stage, reduction, and age, No significant difference concerning the failure rate was found.
SHOULDER ARTHROPLASTY IN COMPLEX ACUTE AND CHRONIC PROXIMAL HUMERAL FRACTURES
Authors: Frich Lars Henrik , Søjbjerg Jens Ole , Sneppen Otto
Published: April 2021

ABSTRACT

From 1983 to 1988, 42 shoulder arthroplasties were performed on comminuted acute or chronic proximal humeral fractures. Patients were categorized according to the postfracture operative delay; there were 15 fourpart fractures, with median post-fracture delay of 13 days (range: 7 to 21), and 27 chronic fractures, including 11 four-part fractures, 9 three-part fractures, and 7 two-part fractures, with median post-fracture delay of 14 months (range: 4 to 72). Follow up was approximately 2 years in both groups (range: 1 to 5). AH patients were evaluated according to a modified Neer score-system and classified into four groups. Pain relief was satisfactory in the acute group, but was unpredictable in the chronic group. The results in the acute group were significantly superior (P<.05). In the acute group, 3 (20%) patients had an excellent result and 6 patients (40%) had a good result, compared to a good result obtained by 6 patients (22%) in the chronic group. Two patients (13%) in the acute group and 11 patients (40%) in the chronic group had a poor result. There were no statistical differences between two-part, three-part, or four-part fractures in the chronic group. Five cases of persistent instability were seen in shoulders formerly treated with osteosynthesis (one acute and four chronic cases). Two of these cases developed an infection. Good results can be expected after prosthetic replacement in acute proximal humeral fractures. Failed primary treatment reduces the possibility of a good result with revision arthroplasty.
TREATMENT OF COMPLEX LIMB DEFORMITIES IN CHILDREN WITH THE ILIZAROV TECHNIQUE
Authors: Atar Dan , Lehman Wallace B , Grant Alfred D , Strongwater Allan , Frankel Victor , Golyakhovsky Vladimir
Published: April 2021

ABSTRACT

Twenty-nine children underwent 36 Ilizarov procedures for a variety of limb deformities. We present the results in 11 patients, six with leg length discrepancies and five with achondroplasia, who underwent lengthening procedures using the Ilizarov method. Lengthening was accomplished in 15 of the 16 procedures (93%). Average increase in femur length was 10 cm (32%), in tibial length 7.5 cm (30%), in humerus length Il cm (40%), Eleven complications occurred. The most common were pin tract infections (4), joint contractures (2), transient nerve injury (4), premature consolidation (5), and three fractures of the regenerated bone. The complication rate was as high as in other methods, but with the Ilizarov apparatus longer segments of bone were lengthened and more complex deformities were treated. The number of complications were lessened as experience was gained.
QUADRICEPS DISLOCATION MEDIAL APPROACH FOR INTRAARTICULAR AND MEDIAL STRUCTURES OF THE KNEE
Authors: Kim Jung-Man
Published: April 2021

ABSTRACT

To minimize possible complications such as patellar subluxation, quadriceps atrophy and skin tightness and slough which interfere with successful rehabilitation following knee surgery, the author employed a quadriceps dislocation medial approach for total knee arthroplasty and ligament (medial and both cruciates) surgery. The results of this approach (99 knees) were compared with a medial capsular incision approach (Ul knees), a lateral capsular incision approach (114 knees), and Hughston's medial hockey stick incision approach (122 knees). The skin slough, patellar subluxation, and sense of tightness during rehabilitation occurred least with the quadriceps dislocation medial approach (P<.05). The quadriceps dislocation medial approach was also the most convenient approach of the four.
THE CULTURAL CONTEXT OF POLIO BIOGRAPHIES
Authors: Scheer Jessica , Luborsky Mark L
Published: April 2021

ABSTRACT

Cultural contexts influence the ways individuals interpret and experience functional losses associated with post-polio sequelae. Using in-depth multiple interview case studies from two National Institute on Aging projects, the concept of "biographies" is presented to place the individuals' polio-related experiences within the context of their lives. Two major cultural contexts shape the construction of polio biographies: normative life course expectations and developmental tasks; and traditions associated with polio recovery and rehabilitation. The authors identify key dimensions of personal concern among polio survivors that can be used as entrance points for effective clinical intervention and to promote treatment compliance.
ARTHROSCOPIC TREATMENT OF DEGENERATIVE JOINT DISEASE OF THE KNEE
Authors: Gross David E , Brenner Stephen L , Esformes Ira , Gross Michael L
Published: April 2021

ABSTRACT

The role of arthroscopy in the management of degenerative conditions of the knee continues to evolve. This study was undertaken to: (1) assess the efficacy of arthroscopic treatment, (2) identify significant prognostic factors, and (3) further define the indications for treatment. A retrospective review of charts and operative videotapes along with followup evaluation was obtained for 43 knees in 40 patients. Average age was 54 years. Average follow up was 24 months; 72.1% of patients had good results at follow up, 16.3% had fair results, and 11.6% were treatment failures. Preoperative clinical status, severity of degenerative changes, and number of pathologic entities encountered at the time of surgery correlated with the results of treatment. We believe that arthroscopic debridement is an effective means of treatment for mild to moderate degenerative joint disease after failure of conservative measures. By using this treatment option, more extensive surgical procedures may be delayed or avoided.
LYME DISEASE: AN ORTHOPEDIC PERSPECTIVE
Authors: Lawrence Steven J
Published: April 2021

ABSTRACT

The incidence of Lyme disease is increasing. This spirochetal infection may frequently manifest itself with joint involvement without characteristic dermatologie signs or history of tick bite. Serologic testing remains unreliable. Oral or parenteral antibiotics remain the mainstay of treatment. Chronic arthritis develops in approximately 10% of patients with Stage ?? disease. Lyme arthritis must be considered in the differential diagnosis of patients with mono- or oligoarticular joint involvement, especially in children and young adults with possible tick exposure. Further advances in antimicrobial therapy and serologic testing are anticipated.
PHOTOELASTIC ANALYSIS OF STRESS DISTRIBUTION ON THE TIBIOFEMORAL JOINT AFTER MENISCECTOMY
Authors: Ihn Joo-Chul , Ahn Myun-Whan , Kim Dae-Mang
Published: April 2021

ABSTRACT

Three-dimensional photoelasticity models of the knee joints were made of epoxy to observe the change in the status of stresses according to the size of defect in the meniscus. Three kinds of meniscus models were made of rubber. Through axial application of a vertical compressive load of 8 kg, equivalent to the joint reaction of 3000 N in the human knee joint, the patterns of the isochromatic fringes were observed and stresses around the knee joint were analyzed according to the size of the defect in the medial meniscus. Stress was increased in magnitude according to the size of the defect of the meniscus, and was focalized after meniscectomy. In the partial meniscectomy model, the maximum stress concentration point of the removed side migrated to the margin of the same side of the joint. But, in the total meniscectomy model, stresses were markedly increased in magnitude on both sides of joints, and maximum stress concentration points were more centralized. This centralization effect would contribute to the degenerative process of the knee joint after meniscectomy.
TREATMENT OF ISOLATED ULNAR SHAFT FRACTURES WITH FUNCTIONAL BRACING
Authors: Oberlander Michael A , Seidman Glen D , Whitelaw George P
Published: April 2021

ABSTRACT

A prospective study was initiated using functional bracing to treat isolated ulnar shaft fractures. Forty-seven consecutive patients with 48 fractures were treated from July 1987 to January 1989. Twenty-eight patients with 29 fractures were available for follow up. Three of these fractures were subsequently excluded, as they had open reduction and internal fixation, leaving a group of 26 fractures. The mean time to union was 45 days (6.4 weeks). Fractures of the middle third of the ulnar diaphysis had the highest mean time to union, as did those with an oblique fracture pattern of 26% to 50% initial displacement. For union time, there was no significant difference for fracture location (P>.05 via t-test) or for fracture pattern (P>.05 via analysis of variance).
A CLINICAL AND COMPARATIVE BIOMECHANICAL EVALUATION OF PROXIMAL FEMORAL OSTEOTOMY FIXATION IN CHILDREN
Authors: Greis Patrick E , Ward W Timothy , Rodosky Mark , Rudert M J , Stanitski Carl
Published: April 2021

ABSTRACT

This study compared the biomechanical characteristics of a 90° infant blade plate construct and anteriorly applied 120° angled plate construct in response to an axial compression load. The blade plate construct stiffness was three times greater than the angled plate construct (238.9 vs 85.7 N/deg). Four degrees failure load was also significantly higher for the blade plate. Despite inferior biomechanical characteristics, the 120° angled plate functioned very satisfactorily in a retrospective clinical review of 21 proximal femoral varus osteotomies. The authors conclude that the 120° angled plate has practical benefits in terms of ease of insertion and intraoperative adjustability which may outweigh its biomechanical inferiority.
TWO-YEAR FOLLOW UP OF BIPOLAR HEMIARTHROPLASTY
Authors: Rogalski R , Huebner J , Goulet J , Kaufer H
Published: April 2021

ABSTRACT

Forty-seven bipolar hemiarthroplasties were performed from January 1985 to December 1986. Twenty-three patients (24 hips) returned for a history, physical, and repeat radiographs. Ten primary press-fit and two cemented primary bipolar hemiarthroplasties were performed. Four patients underwent cemented and eight received press-fit revision bipolar hemiarthroplasties. Fourteen patients had simultaneous cancellous, reamed femoral head autograft, or allograft acetabular bone augmentation. Omitting one patient who had replacement for Leri's pleonosteosis, the average acetabular migration among the remaining 23 patients was 4 mm of superior and 1.5 mm of medial progression. The mean modified d'Aubigne hip score was 33 for primary press-fit arthroplasty, 30 for primary cemented arthroplasty, 22 for pressfit revisions, and 32 for cemented bipolar revision arthroplasty. Morcellized bone graft tended to variably resorb with time. Among the press-fit stems, all but two patients complained of at least occasional thigh pain. All but one patient with primary press-fit hemiarthroplasty walked with a limp. We conclude that, although good early results can be obtained, significant number of patients will have groin and thigh pain. We have found no evidence either radiologically or clinically that nonstructural bone grafting with reamed femoral head will reliably incorporate or prevent further acetabular migration.
ARTHROSCOPICALLY ASSISTED REPAIR OF ACUTE BANKART LESION
Authors: Uribe John W , Hechtman Keith S
Published: April 2021

ABSTRACT

Acute traumatic anterior shoulder dislocations are associated with high recurrence rates in young athletic individuals. Arthroscopically assisted stabilization of acute initial traumatic anterior dislocation was carried out in 11 young athletes. The average age was 20 years, with nine males and two females. The anterior acute Bankart lesion was surgically repaired using the technique described by Caspari/Morgan. There were no surgical complications. All patients were able to return to their sport without restriction. One patient had a transient episode of instability 8 months postoperatively associated with trauma, but no further sequelae. Using the Rowe scale there were nine excellent and two good results. Using repair of a Bankart lesion provides a stable shoulder with minimal loss of function and low recurrence rate. Early intervention should be considered in young, highly competitive athletes.
RADIOLOGIC CASE STUDY
Authors: Hildebrandt John W , Olson Paul , Paratainen Helena , Griffiths Harry J
Published: April 2021

MACRODYSTROPHIA LIPOMATOSA
CONTROVERSIES IN THE PREVENTION OF DEEP VEIN THROMBOSIS WITH TOTAL HIP ARTHROPLASTY
Authors: Fitzgerald Robert H
Published: April 2021

ABSTRACT

Thromboembolic disease is a serious problem that is growing because both total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients are now being discharged from the hospital as early as the fourth postoperative day. The current estimate is that 50000 deaths a year in the United States can be attributed to this disease process, and it is an equally large problem in other countries such as Great Britain (Table 1).1 Thromboembolic disease is asymptomatic in the vast majority of patients undergoing joint replacement. Approximately one in six patients develops the condition following THA or TKA.
LIGAMENT RELEASE AND BONE GRAFTING IN TOTAL ARTHROPLASTY OF THE VARUS KNEE
Authors: Whiteside Leo A
Published: April 2021

Abstract

A simplified technique is described for restoring joint line position, correcting bony defects, and achieving ligament balance in the varus knee. The thickness of the Implant is resected based on the intact surface at a predetermined 5° or 7° valgus angle. Resulting medial femoral and tibial defects are grafted with morselized cancellous autograft, and the medial ligaments are released from the tibial surface to achieve appropriate matching of varus/valgus stability. Four hundred twenty-three knees with varus deformity of 5° to 55° were followed for 2 to 7 years after surgery. Of the 98 knees with moderate varus deformity, two had grafting of minor tibial defects and none had femoral grafting. Of the 36 with severe varus deformity, three had grafting of the femoral condyle distal surface and 26 had medial tibial plateau grafting. Mean valgus angle 1 year after surgery was 5.3°, and yearly follow up revealed no tendency for deterioration of alignment Bone graft collapse was not found in any knee. Radiographic analysis of the tibial grafts routinely demonstrated trabeculation of the graft 2 years postoperatively. Mean postoperative range of motion was 111° 1 year after surgery and 115° 2 years after surgery. No major complications were found as a result of

either bone grafting or ligament release. This simplified technique of resection of the bone surfaces to match the thickness of the implant is safe and effective in the severely deformed varus knee.
THE DEVELOPMENT OF RICKETS AS A COMPLICATION OF CHEMOTHERAPY FOR THE TREATMENT OF WILMS' TUMOR
Authors: Segal Lee S , Palumbo Robert C , Robertson William W
Published: April 2021

ABSTRACT

Musculoskeletal complaints were the presenting symptoms in four of 44 children (9%) treated for relapsed Wilms' tumors with ifosfamide, a derivative of cyclophosphamide. Subsequent radiologic examination revealed rachitic bone and joint changes. A fifth child manifested clinical and radiographic signs of rickets after presenting with hypophosphatemia, hypouricemia, and glycosuria. Recognition of a potential drug-induced Fanconi syndrome is important when managing pediatric oncology patients previously treated with ifosfamide. Early replacement therapy is recommended when proximal renal tubular abnormalities are detected to help prevent and control the severe metabolic bone disease associated with the Fanconi syndrome.
ADOLESCENT FEMORAL SHAFT FRACTURES: RIGID VERSUS FLEXIBLE NAILS
Authors: Gregory Paul , Sullivan J Andy , Herndon William A
Published: April 2021

ABSTRACT

Twenty-one skeletally immature patients between 11 and 16 years of age were treated operatively for a unilateral femoral shaft fracture. Eleven patients underwent fixation with flexible nails and 10 with rigid nails. The patients were studied retrospectively to determine the similarity of the groups. Each method of fixation was then compared to determine the technical ease and final outcome. Both methods gave excellent final radiographic alignment with minimal complications. Flexible nailing required much less operative time and less fluoroscopy time. Estimated cost of using Ender nails is much less than using Russell-Taylor interlocking nails.
COMPRESSION PLATING OF ACUTE FEMORAL SHAFT FRACTURES
Authors: Geissler William B , Powell Thomas E , Blickenstaff Kyle R , Savoie Felix H
Published: April 2021

ABSTRACT

Although intramedullary fixation has standardized the management of femoral shaft fractures, compression plating may offer a viable alternative. A retrospective review of acute femoral shaft fractures managed by open reduction and compression plating between 1980 and 1987 revealed 71 fractures in 69 patients. There were 58 closed fractures, and six grade I and seven grade II open fractures. All patients received prophylactic antibiotics. Sixty-nine percent of patients were bone grafted. Sixty-six of 71 fractures (93%) healed uneventfully. The average time until union was 16 weeks (range: 23 to 72). Complications included two nonunions, two refractures, and one broken implant (7%). Careful adherence to the principles of prophylactic antibiotics, medial cancellous bone grafting, and meticulous soft tissue technique can significantly reduce the complication rate of compression plating.
PERCUTANEOUS OSTEOSYNTHESIS WITH TWO SCREWS IN TREATING FEMORAL NECK FRACTURES
Authors: Poulsen Torben Dam , Ovesen Ole , Andersen Inger
Published: April 2021

ABSTRACT

In a consecutive, retrospective study, 182 patients were followed 1 year after surgical treatment of a fractured femoral neck. The patients were admitted on alternate days to the neighboring departments of orthopedic surgery O and Ø, respectively. In Department O, the patients were submitted to sliding screw-plate (SSP) osteosynthesis, while patients in Department Ø were treated with two percutaneously introduced screws. Our results showed that double-screw osteosynthesis can be performed significantly quicker and with less blood loss than application of SSP. Healing of the fractures in the two groups did not differ significantly, nor did the cumulative rate of failure or the frequency of secondary surgical procedures. We find that, judged from these parameters, percutaneously introduced double-screw osteosynthesis is at least as effective as SSP osteosynthesis.
A COMPARISON STUDY OF TREATMENT OF THORACOLUMBAR FRACTURES USING THE ACE POSTERIOR SEGMENTAL FIXATOR AND COTREL-DUBOUSSET INSTRUMENTATION
Authors: Markel David C , Graziano Gregory P
Published: April 2021

ABSTRACT

The results of 26 consecutive thoracolumbar fractures treated with Cotrel-Dubousset instrumentation (CDI) (n = 12) or the ACE Posterior Segmental Fixator (n = 14) with a mean follow up of 20.2 months were analyzed. Preoperatively, no statistically significant difference was noted between the two treatment groups. Postoperatively, no statistically significant difference was noted for improvement of kyphosis (mean: - 6.00° ACE, 1.92° CDI), vertebral body height (mean: 17.86% ACE, 18.83% CDI), vertebral body angle (mean: -6.21° ACE, -5.42° CDI), or estimated blood loss (mean: 1544 cc ACE, 1620 ce CDI). All patients with incomplete paraplegia improved by at least one Frankel grade. Statistically significant differences were noted in operative time (mean: 269 minutes ACE, 357 minutes CDI, P<.0005), and in the number of instrumented levels (mean: 3 ACE, 5.8 CDI). All patients exhibited solid fusion radiographically. Thoracolumbar fractures can be effectively treated by either CDI or the ACE Fixator. The ACE Fixator has the advantage of sparing motion segments and decreased operative time.
Unusual Manifestations of Proximal Tibiofibular Joint Synovial Cysts
Authors: Damron Timoy A , Rock Michael G
Published: April 2021

ABSTRACT

Synovial cysts emanating from the proximal tibiofibular articulation are commonly symptomatic and may progress to compromise peroneal nerve function. They may cause diagnostic confusion when they present as intraosseous masses or as soft tissue masses causing extrinsic bony erosion. Twelve cases treated surgically are reviewed. Electromyography and nerve conduction studies were valuable in localizing the lesions to the knee when no mass was palpable. Of the six cases involving the peroneal nerve, three required loupe or microscopic dissection of the cyst from within the epineurium. Two other cases had bony changes. Magnetic resonance imaging, though not diagnostic, is valuable in planning the dissection.
Excision and Radiotherapy for Heterotopic Ossification of the Elbow
Authors: Poggi Matthew M , Thomas Bruce E , Johnstone Peter A S
Published: April 2021

ABSTRACT

Radiotherapy has a well-defined role in prophylaxis of recurrent heterotopic ossification of the hip, but has been described infrequently in other situations. This article reports the use of excision and low-dose external beam radiotherapy in three patients with heterotopic ossification of the elbow treated between February 1995 and September 1996. Radiotherapy was delivered in a single fraction of 7-8 Gy within 48 hours postoperatively using opposed anteroposterior portals. After a median follow-up of 10.5 months, all three patients demonstrated a significant increase in range of motion without any evidence of recurrence. These results indicate adjuvant postexcision radiotherapy may be used for prophylaxis of recurrent heterotopic ossification of the elbow.
The Influence of Sterilization Method on Wear Performance of the Low Contact Stress Total Knee System
Authors: McNulty Donald E , Liao Yen-Shuo , Haas Brian D
Published: April 2021

Abstract

Sterilization method changes to the Low Contact Stress (LCS) Total Knee System (DePuy Orthopaedics Ine, Warsaw, lnd) have resulted in progressive improvements in wear resistance. Initially, the system used the traditional gamma in air irradiation sterilization method, but was transitioned to Gas plasma sterilization. The Gas plasma technique did not introduce free radicals that subsequently oxidize with extended shelf aging found with gamma in air irradiation. This oxidation has demonstrated a significant reduction in mechanical properties leading to increased wear. The introduction of Gas plasma was also accompanied by a transition to polyethylene resins that no longer contained calcium stéarate, surmised to influence the rate of oxidation. More recently, gamma irradiation and storage of the poiyethyiene components in an essentially oxygenfree environment imparted by gamma irradiation in a vacuum foil pouch (GVF), has been shown to protect the implant from oxidation. Additionally, the GVF process imparts the beneficial effects of moderate crosslinking that has been demonstrated to improve wear resistance.
Broken Guide Pin: A Method of Retrieval From Within the Hip Joint
Authors: Salamon Peter B
Published: April 2021

Broken guide pin removal from within the hip joint can be accomplished using a combined method of drilling and suction. This technique also may be of value when a small loose body or foreign object needs to be retrieved from the hip joint.
A New Resorbable Bone Void Filler in Trauma: Early Clinical Experience and Histologic Evaluation
Authors: Hinz Peter , Wolf Eduard , Schwesinger Günther , Hartelt Elisabeth , Ekkernkamp Axel
Published: April 2021

Abstract

Six patients with traumatic bone injuries were treated by packing ultraporous ß-tricalcium phosphate (ß-TCP), a synthetic bone void filler, into defect sites using firm finger pressure. Radiographs showed new bone consolidating in treated sites after as little as 2 months. A biopsy obtained from a fractured calcaneus 9 months after surgery showed new bone growing within the ultraporous scaffold. Regions of newly mineralized bone and woven bone in the scaffold suggested that the defect site was undergoing repair. Some new bone had developed lamellar architecture. Higher radiodensity and slower resorption of ultraporous bone void filler in this human case, relative to that seen in a canine study, is attributed to slower metabolism in humans relative to dogs and to greater packing pressures used in the clinic. The histology specimen did not indicate untoward inflammatory response or significant foreign body reaction. Thus, this first human histology report supports the use of biocompatible ultraporous ß-TCP to enhance new bone formation in bone defects.
Biomechanical Testing of Bioabsorbable Cannulated Screws for Slipped Capital Femoral Epiphysis Fixation
Authors: Kroeber Markus W , Rovinsky David , Haskell Andrew , Heilmann Moira , Lotz Jeff , Otsuka Norman
Published: April 2021

Abstract

This study compared cannulated 4.5-mm bioabsorbable screws made of self-reinforced poly-levolactic acid to cannulated 4.5-mm steel and titanium screws for resistance to shear stress and ability to generate compression in a polyurethane foam model of slipped capital femoral epiphysis fixation. The maximum shear stress resisted by the three screw types was similar (self-reinforced poly-levolactic acid 371 ±146 MPa, steel 442±43 MPa, and titanium 470±91 MPa). The maximum compression generated by both the self-reinforced poly-levolactic acid screw (68.5±3.3 N) and the steel screw (63.3±5.9 N) was greater than that for the titanium screw (3±1.4 N, P<.05). These data suggest cannulated self-reinforced poly-levolactic acid screws can be used in the treatment of slipped capital femoral epiphysis because of their sufficient biomechanical strength.
Metal-on-Metal: All Things Bright and Beautiful!-In the Affirmative
Authors: Dorr Lawrence D
Published: April 2021

Alternative Bearing Surfaces
Treatment of Osteoarthritic Cartilage Lesions With Osteochondral Autograft Transplantation
Authors: Andres Brett M , Mears Simon C , Somel Deniz S , Klug Ray , Wenz James F
Published: April 2021

Abstract

Twenty-two osteochondral autograft transplantations were performed on two types of knees: those with isolated (group 1) and multiple (group 2) degenerative cartilage lesions. At minimum 24-month follow-up, group 1 had significantly better pain relief and function than group 2 based on the Western Ontario and McMaster Universities Osteoarthritis Index and pain scores (10-point visual analog scale). Osteochondral autograft transplantation may be effective in treating knees with isolated degenerative cartilage lesions but appears contraindicated in those with multiple lesions.
Chart Reading and Anxiety Levels of Nursing Students Prior to First Interactions with Psychiatric Clients
Authors: Nieswiadomy Rose , Arnold Wilda K , Johnson Margie
Published: April 2021

ABSTRACT

Nursing students' anxiety levels on the first day of their psychiatric clinical experience were compared between those students who were assigned to read (N =58) or not read (N =60) the client's chart prior to the first nurse-client interaction. Students' trait and state anxiety levels were measured at the beginning of the day. State anxiety levels were measured again after students were given instructions to read or not read the client's chart. Using trait and the first measure of state anxiety as covariates, there was no significant difference in the state anxiety scores between readers and non-readers. Based on anxiety theory, it was concluded that being told to read/not read the psychiatric client's record prior to the first interaction with the client, does not significantly influence the student's state anxiety level. Thus, when nurse educators are planning the psychiatric experience, they may wish to allow the student to make the decision whether to read or not read the client's chart, after being told the advantages and disadvantages of this action.
Multi-Course Sequential Learning as a Model for Content Integration: Ethics as a Prototype
Authors: Ryder Muriel B , Duckett Laura , Crisham Patricia , Caplan Arthur , Schmitz Kathy
Published: April 2021

ABSTRACT

Multi-course sequential learning (MCSL), a model for integrating content throughout the curriculum, is described using ethics education as a prototype. In this model, content is presented via a vertical course, with units embedded in existing courses across various levels of the nursing program, which is designed to provide coherent organization of content, visibility, and accountability, and to prevent gaps and unnecessary duplication. This article describes the process of developing an Ethics MCSL, which is being implemented and evaluated with support from a three-year grant from the Fund for the Improvement of Postsecondary Education (FIPSE).
Developing Case Situations for Ethics Education in Nursing
Authors: Waithe Mary , Duckett Laura , Schmitz Kathy , Crisham Patricia , Ryden Muriel
Published: April 2021

ABSTRACT

Developing cases for the clinical teaching of ethics can be extremely time-consuming. Often, the cases that are developed either represent unrealistic situations or mere technical puzzles rather than genuine ethical problems. This article describes how faculty at the University of Minnesota modified a simple, quick and inexpensive think tank technique, the Crawford Slip Method, for use with nursing educators to generate an extensive list of ethical issues within each clinical specialty. Selecting from these lists, faculty in each specialty developed one realistic nursing case situation to illustrate selected ethical issues. Faculty were asked to use the Alverno College criteria for designing a moral dilemma when writing their cases. Suggestions for adapting the cases for multiple uses are presented.
The Relative Influence of Identified Components of Text Anxiety in Baccalaureate Nursing Students
Authors: Howell Carol C , Swanson Sue C
Published: April 2021

ABSTRACT

The relative influence on test anxiety of cognitive interference, self-concept, study and test-taking skills, and cumulative grade point average was investigated. Fifty-six female baccalaureate nursing students completed the following measures: Sarason's Test Anxiety Scale, Brown's Effective Study Test, Sarason's Cognitive Interference Questionnaire, and Brookover's Self-Concept of Ability Scale. Subjects also reported their cumulative grade point average (GPA). Data were analyzed through the use of correlation and stepwise multiple regression. Data analyses revealed significant negative relationships between test anxiety and the variables of academic self-concept and GPA (p < .05). Academic self-concept was the most powerful predictor of test anxiety, while GPA and cognitive interference contributed significantly but minimally to the multiple regression equation. Results support Meichenbaum and Butler's (1980) contention regarding the multidimensional nature of the test anxiety construct.
Specialization in Adult Health/Medical Surgical Nursing: What Does it Mean?
Authors: Kitchens Edeth K , Piazza Dianne E , Ellison Kathy J
Published: April 2021

ABSTRACT

In this descriptive study, all NLN-accredited master's programs in the United States were surveyed to describe the content and form of the Adult Health/Medical Surgical (AH/MS) Nursing component of the curricula. An 82% response rate was achieved.

The study confirmed a high degree of diversity in the AH/ MS Nursing component of master's degree programs. It revealed a lack of consensus on the amount and kind of content necessary for specialization in AH/MS Nursing. Few curricula were based on an identified nursing model/ theoretical framework, although students in most programs were required to utilize a nursing model as a framework for advanced or specialty practice. The structure of class and clinical learning activities varied markedly. Ideas about graduate faculty's role in clinical instruction were dissimilar. Findings from the study could guide decision making for the AH/MS Nursing component of master's-level curricula.

Curriculum revision seems to be inherent in the nursefaculty role, yet curriculum decision making can be an onerous task. This is especially true in today's master's nursing programs where clinical specialty areas are not well defined and diversity and ambiguity abound.

As faculty members in a master's nursing program where numerous specialty areas had been developed, we became increasingly frustrated in our attempts to identify specific knowledge and skills that should be acquired by students specializing in adult health nursing. Traditionally, this rather broad specialty area has been a "catch-all" for the study of a wide variety of age groups and health alterations. In recent years, however, as nursing has attempted to keep pace with scientific and technological advances in health care, many of the areas that were once subsumed under the Adult Health/Medical Surgical (AH/MS) Nursing component of graduate nursing curricula have evolved into recognized specialties in their own right, e.g., cardiovascular, gerontology, oncology, rehabilitation, critical care, and long-term care nursing.

Given this splintering into increasingly narrow clinical specialties, what constitutes specialization in AH/MS Nursing? What content have nurse educators identified as appropriate for this broad specialty area? How is the content organized and delivered? What clinical learning experiences and skills are most germane to this specialty? The purpose of this study was to describe the form (structure) and content of the AH/MS Nursing component of master's nursing curricula.
A Comparative Study of Learning Characteristics of RN and Generic Students
Authors: Linares Aletta Z
Published: April 2021

ABSTRACT

The constructs of locus of control, self-directed learning readiness, and learning style preference are related components of an individual's learning characteristics. If group differences between registered nurse and generic students on these constructs could be documented, then the educational process could be directed toward facilitating educational goal attainment for these two distinct groups of students. Three instruments were used for this study: the Adult Nowicki-Strickland Internal-External Scale (ANS-IE), Guglielmino's Self-Directed Learning Readiness Scale (SDLRS), and Rezler's Learning Preference Inventory (LPI). The sample consisted of 175 generic and 170 RN students enrolled in two BSN programs. No significant group differences were found for the three constructs except for the interpersonal mode of learning, a subscale of the LPI. Although no group differences were found, the data showed an ethnic and age effect involving all subjects. Although there are no wide differences in learning characteristics between generic and RN students, the individual variations support the use of teaching strategies that incorporate independent study and self-paced methodologies.
Accelerated LPN-RN Nursing Education: Is Role Socialization Lost Along the Way?
Authors: Boyar Dawn C , Senturia Brenda B , Palisin Helen
Published: April 2021

ABSTRACT

In response to a critical shortage of registered nurses, an accelerated transition program for licensed practical nurses (LPNs) was developed and implemented. A study of the program was undertaken to evaluate students' academic achievement and socialization into the RN role. NCLEX-RN scores and the Professional Nursing Questionnaire (PNQ) of Minnick, Yocum and Scherubel were used for evaluation. Experimental program students were compared with students in the second year of conventional twoyear nursing programs. Results of role socialization revealed no significant differences between the groups at either the beginning or end of the program. NCLEX-RN scores were not significantly different. The lack of significant results may be attributable to the inability of the PNQ to detect changes over a short time, or to LPNs' knowledge of the RN role prior to program entry. NCLEX score results indicated that comparable academic achievement was possible in the accelerated program.
Risk-Taking Propensity of Nurses: ADN and BSN
Authors: Masters Marcia L , Masters Robert J
Published: April 2021

ABSTRACT

Nursing literature indicates that skills in decision making are inherently important to the modern nurse. The literature also reports a controversy between the associate degree nurse (ADN) and the bachelor degree nurse (BSN). This conflict relates to educational level and experience in terms of leadership and decision-making skills. All decisions involve risk. Therefore decisions in nursing should be influenced by the risk-taking propensity of the individual nurse. The literature shows a linkage between risk-taking propensity and both training and experience.

The major purpose of the study was to attempt to correlate risk-taking propensity of nurses by level of education and experience. The study investigated whether differences exist between risk-taking propensity of recently graduated ADNs and BSNs without experience. In addition, the study attempted to determine any differences in risk-taking propensity of ADNs and BSNs with practical experience. The results were analyzed in terms of decisionmaking competency.
Smoking Practices Among Nursing Students: A Comparison of Two Studies
Authors: Casey Frances S , Haughey Brenda P , Dittmar Sharon S , O'Shea Robert M , Brasure John
Published: April 2021

ABSTRACT

Findings of numerous studies that have explored the smoking practices of nurses reveal a high incidence of smoking that is incongruent with the health beliefs of the profession. Nurses who smoke are less likely to teach or positively influence patients who smoke. They may even undermine health teaching efforts of other health professionals. Studies of smoking practices of nursing students also reveal high incidences of smoking. Included among the determinants of this practice are lack of knowledge of the health effects of smoking, the academic setting, and the role that nursing education may play. In this comparison of two independent studies similar in design, smoking rates were similar to that of the female population and to registered nurses. Students who smoke either started smoking or increased their smoking in nursing school. They knew the health hazards of smoking and most had tried to quit in the past. Challenging opportunities exist for nurse educators to study and implement strategies to prevent smoking initiation and encourage cessation among future nurses.
Integrating Experienced and Novice Nurses into Graduate Home Health Education
Authors: Alley Janet M , Donckers Susan W , King Judith C
Published: April 2021

ABSTRACT

Preparing master's-level professionals in home health nursing presents challenges because nurses come to graduate programs with varying degrees of home health experience. The purpose of this study was to examine how nurses with varying experience in home health nursing are integrated into graduate clinical practicum courses. Representations of 10 home health graduate programs were surveyed regarding how they adapt their clinical practicums to meet the special needs of their novice and experienced nurses. Respondents revealed that individualization was used to meet the individual needs of students. Individualization allows for creativity in developing learning experiences that are both challenging and satisfying for the student. However, lack of consistency in the advanced practice skills of graduates, and lack of time efficiency for faculty and agency personnel can also occur. Faculty members need to share creative ways of teaching students, to identify unique opportunities for clinical experiences, and to collaborate on research.
Degree of Comfort in Providing Care to PWAs: Effect of a Workshop for Baccalaureate Nursing Students
Authors: Williams Roma D , Benedict Susan , Pearson Bonnie C
Published: April 2021

ABSTRACT

A low-incidence area of HIV/AIDS was the site for this study, which examined baccalaureate nursing students' degree of comfort in providing basic nursing care to people with AIDS (PWAs), and determined the effect of a National Institutes of Health (NIH)-sponsored one-day workshop on HIV/AIDS on this degree of comfort. The pretest-posttest study revealed no statistically significant decrease after the workshop in the amount of discomfort associated with providing basic nursing care to PWAs. However, there were changes in the ranking of nursing procedures following the workshop. Included is a discussion of the workshop's effect on students' comfort level and implications for nurse educators. Ideas for related studies in the area of HIV health care are explored.
The Teamwork Project: A Collaborative Approach to Learning to Nurse Families
Authors: Warner Marguerite , Ford-Gilboe Marilyn , Laforet-Fliesaer Yvette , Olson Joanne , Ward-Griffin Catherine
Published: April 2021

ABSTRACT

The purpose of this exploratory study was to gain insight into students' perceptions of learning to nurse families using a team approach. A sample of 112 thirdyear baccalaureate nursing students provided data from clinical journals and responses to a teacher-developed questionnaire regarding number of home visits made with a partner, the extent to which partners shared responsibility for the nursing care of two families, perceived benefits and disadvantages of teamwork, roles assumed by team members, perceived outcomes of the team approach, and suggestions for revision of the approach. The degree to which students shared responsibility was moderate and positive perceptions of teamwork were significantly correlated with the degree of sharing of nursing activities. Using Spradle/s qualitative method of domain analysis, interpretation of data from students' clinical journals revealed subjective aspects of the experience that appeared to influence teamwork practices and attitudes. Results suggest that the shared assignment approach offers students a unique opportunity to learn about the realities of collaborative nursing practice.
Experienced Faculty Orientation Offerings: Do They Meet Faculty Needs?
Authors: Morin Karen H , Romeo Kathleen C
Published: April 2021

ABSTRACT

The purposes of this descriptive study were to identify existing orientation protocols for seasoned nurse faculty who change academic positions and which orientation protocols these faculty perceived helpful. Subjects were drawn from 460 NLN-accredited generic baccalaureate programs. All subjects (N =372) had a minimum of three years' prior teaching experience and were employed at the institution within 1990-91 and 1991-92. A two-part questionnaire, adapted from Mills (1983), was used. Some form of orientation was offered to 81% of the sample, with 27% reporting an orientation of less than one day. Topics addressed by orientation programs for the majority of the sample included conceptual framework and curriculum; teaching and library resources; and organizational structure. Areas not addressed included introduction to local nursing organizations and the community in general. Results suggest that experienced faculty receive some form of orientation. The scope is limited, with such topics as clinical placement and student evaluation omitted.
The Need for Significant Reform: A Practice Driven Approach to Curriculum
Authors: MacLeOd Martha L P , Farrell Pat
Published: April 2021

ABSTRACT

The central theme of the curriculum revolution is the preparation of graduates with new and different perspectives and abilities who can function well in a rapidly changing health care environment. Discussions of approaches needed to prepare such graduates center on making substantive changes within the education system. Experience from a collaborative undergraduate nursing program reveal that revised structural and power relationships between nursing education and nursing practice are needed to support such fundamental changes in nursing curricula. This article explores structural and power relationship issues arising from implementing a practice-driven, phenomenological approach to a 4-year undergraduate nursing curriculum. The meaning of a practice-driven approach, the inherent benefits and risks, the outcomes and evaluation issues are included in the discussion. It is suggested that if learning to nurse is grounded in nursing practice as well as in nursing academia, then systems of nursing practice and of educating nurses must change.
Clinical Teaching Effectiveness Described in Relation to Learning Outcomes of Baccalaureate Nursing Students
Authors: Krichbaum Kathleen
Published: April 2021

ABSTRACT

Grounded in cumulative findings on teaching effectiveness from K-12 education, higher education, and professional education, this process-product study empirically explored the relationship between 24 specific teacher behaviors generally thought to be effective for student learning and learning outcomes of baccalaureate nursing students. Two measures of learning in a critical care practicum taught by staff nurse preceptors were used: performance in the practicum as assessed on a clinical evaluation instrument developed by faculty, and performance on a standardized test of knowledge in critical care. Important aspects of clinical teaching effectiveness included the ability to set clear objectives to help students organize their learning, to ask appropriate questions, to provide specific and timely feedback to students, and to convey a positive, concerned attitude. Certain teaching behaviors showed significant relationships with cognitive learning outcomes, while others were tied to performance outcomes.
Study Groups: Are They Effective in Preparing Students for NCLEX-RN?
Authors: Ashley Jane , O'Neil Jean
Published: April 2021

ABSTRACT

The effectiveness of faculty-directed study groups as an intervention to prepare nurse candidates for NCLEX-RN was evaluated. The NCLEX-RN performance of a baccalaureate class who had participated in study groups was compared to the performance of a prior class who had not participated in study groups. Academic subgroups within the classes were compared to determine if study groups were equally effective across levels of academic achievement.

The possible reasons for the significant difference in the NCLEX-RN passing rate between "at-risk" students who participated in study groups and at-risk students who did not participate in study groups are discussed. Discussion also considers possible factors influencing the generally better performance of study group participants at all academic levels. Suggestions for future intervention research direct attention to time intensity of interventions and research control through random assignments to treatment groups.
Statewide Nursing Articulation Model Design: Politics or Academics?
Authors: Rapson Mary F
Published: April 2021

ABSTRACT

Designing statewide nursing articulation models is more about politics than it is about academics. Resolution of the articulation question lies in collaboration, establishment of trust, dialogue, and compromise that identifies a common ground tolerable for all stakeholders in the region or state. Achieving satisfactory articulation outcomes frequently involves negotiation of conflicts, assumptions, beliefs, goals, and sometimes program survival. This article reviews factors that influence the process of articulation model design, describes steps in the process, discusses issues essential for successful implementation, and briefly describes research evaluating the effectiveness of statewide or regional articulation models. The nursing profession continues to face many workforce issues and must engage in effective strategic planning to achieve an adequate workforce. One important strategy is to build a strong, flexible educational infrastructure that includes a quality, efficient statewide articulation that enhances educational mobility for nurses with diverse backgrounds and levels of preparation.