bluuebunny/crossref_metadata_2025_split huggingface dataset:
Institute for Nursing Excellence: A Retention Model
Authors: Shay Saundra , Stallings Karen 
Published: April 2021

ABSTRACT
In 1989, the General Assembly funded initiatives for the recruitment and retention of nurses, including two pilot "Institutes for Nursing Excellence" designed to develop, recognize, and reward excellent staff nurses. The Wake Area Health Education Center (AHEC) implemented the pilot projects.
In 1991, additional funding was obtained to replicate the pilot projects. The grant was awarded to the Wake AHEC from the General Assembly, through the newly established Center for Nursing. This cooperative effort between the legislature and nursing is considered a model of its kind in this state and possibly the nation.
The purpose of the Institute was to develop mentoring, role-modeling, change, and lifelong learning skills in an atmosphere of renewal, rejuvenation, and trust.
The Multicultural Workplace: Preparing Preceptors
Authors: Williams Jane , Rogers Susan 
Published: April 2021

ABSTRACT
As we approach the 21st century, the workforce in the United States is becoming more culturally diverse. This is evident in many of our hospitals across the nation. Preceptors, who are trained as role models, communicators, and teachers, are poorly prepared to deal with the cultural diversity of nurses and their clients. The Texas Medical Center Collaborative Preceptor Program uses several methods to explore cultural differences and increase preceptors' sensitivity to people from other cultures. The course assists preceptors in identifying potential conflicts of value systems and cultural differences and enables them to identify methods of facilitating cultural adjustment. Preceptors are given the opportunity to identify their own cultural values and communication techniques and to experience cultural differences firsthand. The class includes lecture/ discussion, gaming, role-play, and video. Experiential learning is used to identify cultural differences without being culturally offensive or stereotypical.
A Qualitative Analysis of Factors in the Work Environment That Influence Nurses' Use of Knowledge Gained from CE Programs
Authors: Scheller Mary Kay Suitor 
Published: April 2021

ABSTRACT
Continuing education (CE) programs for nurses often result in improved quality of patient care and personal and professional growth of participants. These outcomes are not achieved when nurses perceive barriers to putting knowledge from CE programs into practice.
This qualitative study examined nurses' perceptions of factors in the work environment that influence the use of knowledge gained from CE programs. Fourteen themes were identified from analysis of in-depth interviews of eight RNs and observations of their work environment, a 40-bed general medical unit. Factors identified by the nurses were rated on a Likert-type scale and these factors were represented in diagrammatic form, consistent with Lewin's (1951) Field Theory analysis. An in-depth analysis of two qualitative themes is presented here. This analysis suggests three important implications for educators and reemphasizes the need for participant involvement in the planning phase of continuing education programs.
Teaching Infant CPR to Mothers of Cocaine-Positive Infants
Authors: Messmer Patricia , Meehan Renée , Gilliam Nancy , White Susan , Donaldson Pamela 
Published: April 2021

ABSTRACT
Cocaine abuse, a major problem in our society, has increased in women of childbearing age. Because cocaine-positive infants are at greater risk for apnea/sudden infant death syndrome (SIDS), their mothers need to be instructed in infant CPR. This study compared the use of a computerized interactive video learning system to the traditional infant CPR teaching method (lecture, video, and return demonstration) to determine the most effective method. This study indicated that mothers of cocaine-exposed infants can learn infant CPR in the immediate postpartum period and that the traditional method was found to be more effective. One unexpected positive outcome was the increase in these mothers' self-esteem.
A Systematic Evaluation of a Poster Presentation
Authors: Horn Phyllis B , Kopser Kathleen G , Carpenter Alicia D 
Published: April 2021

ABSTRACT
The purpose of this study was to describe an alternative approach to educating nurses and comparing attendance rates between traditional and alternative programs. In these times of scarce nursing resources, traditional methods of staff development have been found to be ineffective. Frequently, nurses are unwilling to leave their patient care responsibilities to attend even short presentations at a given place and time. A poster presentation designed for oncology nurses attracted 65% of all possible participants.
Continuing Education for Advanced Nurse Practitioners: Preparing Nurse-Midwives as Clinical Preceptors
Authors: Meng Anne , Morris Donna 
Published: April 2021

ABSTRACT
Nurses in advanced practice roles are increasingly being sought as clinical preceptors for master's students. These nurses have variable experience as clinical teachers. A program was designed to prepare Certified Nurse-Midwives as clinical preceptors for students enrolled in a masters-level nurse-midwifery program. The program focused on techniques to foster clinical decision making, feedback, evaluation, and learning styles. Evaluations were positive and reflected that preceptors benefited from filmed modeling simulations and case study analyses.
SUPRAPATELLAR PLICA: A STUDY OF THEIR OCCURRENCE AND ROLE IN INTERNAL DERANGEMENT OF THE KNEE IN ACTIVE DUTY PERSONNEL
Authors: Blatz Douglas J , Fleming Richard , McCarroll John 
Published: April 2021

ABSTRACT: Over the past two years, 380 knee procedures have been reviewed to determine the number of suprapatellar plicas that were observed as contributing factors in the patello-femoral derangement problems of active duty personnel seen at the Naval Regional Medical Center in Charleston. Fiftyeight cases with a follow-up of greater than six months were found in which a suprapatellar plica was considered to be pathological, and was removed. The surgical cases involving a plicectomy, a plicectomy and partial chondrectomy of the patella, a plicectomy and menisectomy, or a plicectomy and extensor reconstruction of the patella were followed to determine whether the patients with these conditions returned to full active duty. It was felt that because of the rigors required for shipboard activities, a return to full active duty was considered a good result. One hundred percent of the cases treated by plicectomy and menisectomy were able to return to full active duty after six months. Eighty percent of the cases treated by plicectomy, extensor reconstruction, and partial chondrectomy of the patella were able to return to full shipboard activities.
A more detailed look at the knees that had a plicectomy alone, with a pathologic plica as its only internal derangement, showed that 40% had an excellent result with a return to full active duty and unlimited sports activities. Another 44% had a good result with a return to their full shipboard responsibilities.
Treatment of Fractures of the Femur with the Grosse-Kempf Rod
Authors: Acker James H , Murphy Charles , D'Ambrosia Robert 
Published: April 2021

ABSTRACT: Intramedullary rod placement provides excellent fixation for many fractures of the femur. It also carries a high union rate, a low infection rate, and a shortened hospital stay for the patient. Certain fractures of the femur are not suitable for fixation with a standard intramedullary rod alone. Use of the Grosse-Kempf rod, with interlocking screws, allows for stable fixation for long oblique fractures, spiral fractures, comminuted fractures, segmental fractures, fractures with a butterfly fragment, and fractures located in the proximal or distal shaft of the femur.
The Louisiana State University (LSU) Orthopedic experience in the use of the Grosse-Kempf rod is presented in this article. We have treated a total of 60 fractures of the femur in 58 patients with this fixation system. This series consists of 58 acute fractures, one established nonunion, and one established infected nonunion. All patients in the group of acute fractures and who have had adequate follow up and time have healed. This group consists of 29 healed fractures and four fractures which are healing, but have recently had the static screw removed. Eight patients were lost to follow up, two died of causes unrelated to the treatment, and 17 have been placed recently and have not had time to healThere was one instance of wound infection in the acute fracture group, associated with the distal screws, but this has not required rod removal.
The Grosse-Kempf rod provides the treating physician with another option in the treatment of fractures of the femur not suitable for use by the standard intramedullary rod. The procedure is difficult, but we have found it to be reliable in treatment of difficult fractures.
Synovial Chondromatosis
Authors: Wilson William J , Parr Thomas J 
Published: April 2021

ABSTRACT: Two patients were evaluated for a complaint of long-standing hip pain. No etiology of their progressively disabling symptoms was found by routine diagnostic studies. Hip arthrography and arthrotomography in each case, however, demonstrated multiple intraarticular filling defects consistent with nonradiopaque loose bodies. These were subsequently confirmed at arthrotomy.
Synovial chondromatosis is a rare disease in which intrasynovial cartilage metaplasia results in multiple intracapsular loose bodies. Its presence in plain radiographs is uncommon, but has been previously documented. This can account for frequent long delays in accurate diagnosis. Arthrography and/or arthrotomography, however, can be key diagnostic tools. They are recommended in the evaluation of patients whose relatively normal initial clinical examination, laboratory, and roentgenographic studies fail to adequately explain the presence of genuinely disabling symptoms.
The Charnley Total Hip Arthroplasty in Juvenile Rheumatoid Arthritis Patients
Authors: Gudmundsson G H , Harving S , Pilgaard S 
Published: April 2021

ABSTRACT: A follow up of 27 consecutive total hip arthroplasties in 16 patients with juvenile rheumatoid arthritis was performed. The mean age at surgery was 18 years, and the average follow-up period was 64 months. No serious early complications were recorded, but three deep infections developed from 6 to 18 months after the arthroplasty, all requiring revision. The clinical results were good at follow up, as 20 hips were free of pain and 7 had only slight pain. Most of the patients had improved their walking ability and the range of motion in the hip as well. A poor correlation was, however, shown between the clinical and the roentgenographical results, as there was one femoral implant that was definitely loose and four more hips that had components which were probably loose.
The frequency of infections might have been reduced by using antibiotic prophylaxis during surgery in all the cases; the frequency of aseptic loosening might also have been reduced by improved cementing techniques. Because of high loosening rate without clinical symptoms, it is recommended to follow the patients roentgenographicaily to make revision surgery possible while the bone stock still is sufficient.
INTRAMEDULLARY REAMING AND SOFT TISSUE PROCEDURES IN TREATMENT OF CHRONIC OSTEOMYELITIS OF LONG BONES
Authors: Ochsner P E , Brunazzi M G 
Published: April 2021

ABSTRACT
Forty patients suffering from chronic osteomyelitis were treated by intramedullary reaming at the authors' clinic from 1985 to 1991. The patients were divided into two groups according to follow-up time. The observation period averaged 4.4 years in the intermediate-term group and 1.7 years in the short-term group. Four patients suffered a recurrence. Special attention was given to plastic surgical procedures involving intramedullary reaming. Techniques and results of 7 fasciocutaneous flaps, 1 pedicled gastrocnemius muscle flap, and 1 free microvascular rectus abdominis muscle flap are reported. Intramedullary reaming is recommended as a valuable method in the treatment of long-term chronic osteomyelitis. Primary soft tissue grafting with the objective of providing total wound coverage with all available means seems to be the most advantageous method of achieving primary wound healing and avoiding reinfection.
PREDOMINANCE OF LEFT-SIDED FRACTURES OF THE PROXIMAL FEMUR IN A GERIATRIC POPULATION
Authors: Rudolph Valerie 
Published: April 2021

ABSTRACT
Two hundred consecutive admissions to a community medical center with a diagnosis of proximal femoral fracture were analyzed to determine the left:right ratio. It was found that there were 134 left-sided and 66 rightsided fractures. Although no apparent reason was noted, this appears to be a significant finding that warrants further investigation.
THE MANAGEMENT OF DOG BITES AND DOG BITE INFECTIONS TO THE HAND
Authors: Wiggins Michael E , Akelman Edward , Weiss Arnold-Peter C 
Published: April 2021

ABSTRACT
Dog bites account for approximately one of 200 emergency room visits. The majority of bites are from dogs known to the victim. Due to the numerous small compartments and the thin covering of soft tissue over the bones and joints, bite wounds to the hand are more likely to become infected than are bites to the arm, leg, or face. Improper management can result in significant morbidity and prolonged treatment. This article discusses the microbiology of dog bite wounds, antibiotic selection, and proper wound management.
A GREATER TROCHANTERIC INSERTION SITE FOR FEMORAL INTRAMEDULLARY NAILING IN LIPOMATOUS PATIENTS
Authors: Ostrum Robert F 
Published: April 2021

ABSTRACT
This is a review of the treatment of 12 femoral shaft fractures and three nonunions in lipomatous patients who had a greater trochanteric insertion point for intra medullary nailing. Indications included overweight patients and trochanteric lipodystrophy. Combined with a small proximal extension of the incision, maximal limb adduction, and a slotted intramedullary nail, the greater trochanteric insertion point was effective, and no complications directly related to this procedure were encountered.
TREATMENT OF POSTERIOR TIBIAL TENDON DYSFUNCTION WITH FLEXOR DIGITORUM LONGUS TENDON TRANSFER AND CALCANEAL OSTEOTOMY
Authors: Myerson Mark S , Corrigan John 
Published: April 2021

ABSTRACT
We treated 32 patients with stage-II posterior tibial tendon dysfunction with calcaneal osteotomy and flexor digitorum longus tendon transfer. These 32 patients (29 women, 3 men) had an average age of 58 years (range, 46 to 73 years) and had been symptomatic for an average of 2.5 years (range, 1 to 8 years) before surgical correction. The indication for surgery was the presence of medial foot pain refractory to nonoperative treatments, including shoewear modifications, orthoses, and bracing. All patients were examined at a mean of 20 months (range, 14 to 48 months) after surgery. Functional and radiographic examinations were performed for each patient and the American Orthopaedic Foot and Ankle Society (AOFAS) foot rating scale was used. Of the 32 patients, 30 were satisfied with the outcome of surgery, had improved function, and exhibited radiographic correction of the foot deformity. The AOFAS score improved from a preoperative mean of 48 points (range, 23 to 76) to a postoperative mean of 84 points (range, 68 to 92). In one patient, treatment failed, necessitating a triple arthrodesis for worsening deformity. The short-term results of this procedure are encouraging. Most patients (94%) experienced pain relief, had improvement in the arch of the foot, and were able to wear regular shoes without orthotic support. In order to correct deformity and provide substantial relief of foot pain and dysfunction, a medial translational calcaneal osteotomy was performed in addition to a flexor digitorum longus tendon transfer for management of stage-II posterior tibial tendon dysfunction.
VALGUS TILTING OF THE ANKLE JOINT AFTER SUBTALAR (HINDFOOT) FUSION: COMPLICATION OR NATURAL PROGRESSION OF VALGUS HINDFOOT DEFORMITY?
Authors: Fitzgibbons Timothy C 
Published: April 2021

ABSTRACT
Six patients treated over a 2-year period were noted to have valgus tilting of the talus at the ankle joint on standing anteroposterior ankle films taken after subtalar (hindfoot) fusions. All patients had significant preoperative hindfoot valgus, but no changes on ankle films. All patients underwent "moldable insitu fusions." Severity and duration of preoperative deformity, as well as obesity, appear to be predisposing factors. Most patients were satisfied with their pain relief despite their persistent valgus deformity. Treatment alternatives may include medial displacement calcaneal osteotomy, lateral column lengthening, combination bone and soft tissue procedures, or even tibial talar calcaneal fusion.
LONG-TERM FOLLOW UP OF TALUS FRACTURES
Authors: Inokuchi Suguru , Ogawa Kiyohisa , Usami Norio , Hashimoto Takeshi 
Published: April 2021

ABSTRACT
Eighty-six patients who had experienced a fracture of the talus more than 10 years previously were assessed. The fracture had occurred in the neck of the talus in 52 feet and in the body of the talus in 27 feet. The fracture was complicated by dislocation in 47 feet, and aseptic necrosis had developed in 33 feet. The outcome was rated as excellent in 20 feet, good in 43, fair in 18, and poor in 7. The cause of poor outcome in the late stage was posttraumatic osteoarthritis secondary to avascular necrosis and incongruity of the joint surface. Early active exercise without weight bearing is recommended to prevent contracture and bone atrophy due to disuse, which may promote osteoarthrosis. Arthrodesis is recommended in patients with pain because the outcome is greatly improved by arthrodesis, even when performed more than 10 years after the injury.
FRACTURES IN CHILDREN TREATED WITH RADIOTHERAPY FOR SOFT TISSUE SARCOMA
Authors: Wall Judith E , Kaste Sue C , Greenwald Carol A , Jenkins Jesse J , Douglass Edwin C , Pratt Charles B 
Published: April 2021

ABSTRACT
There is a clear association between multimodal therapy for bone tumors and the development of skeletal complications; however, this has not been addressed in children with soft tissue sarcomas. We reviewed records of the 70 children treated for soft tissue sarcoma of the lower extremity at St Jude Children's Research Hospital between 1962 and 1991. Of the 12 patients who received radiation after surgical excision of their tumors, three subsequently developed fractures. Two of the three had also received chemotherapy. Our findings indicate that, although the risk of fracture after therapy for soft tissue sarcoma may be multifactorial, radiation may play a significant role. Minimizing the size of surgical incisions, improving radiotherapy techniques, maximizing chemotherapy, and emphasizing physical therapy and appropriate follow up can all serve to decrease long-term toxicities. Such optimal use of therapy could subsequently reduce side effects, such as osteoporosis and muscle and bone atrophy, that predispose patients to fractures.
Revision Total Hip Arthroplasty in Patients With Avascular Necrosis
Authors: Wei Steven Y , Klimkiewicz John J , Lai Max , Garino Jonathan P , Steinberg Marvin E 
Published: April 2021

ABSTRACT
This retrospective study compared the results of revision total hip arthroplasty (THA) In patients with avascular necrosis to patients with osteoarthritis. Twenty-two revision THAs (34 components) in 19 patients with avascular necrosis were compared with 35 revision THAs (55 components) in 31 patients with osteoarthritis. All of the procedures were performed by a single surgeon between 1981 and 1994, and all patients had a minimum of 2 years of follow-up. At the time of revision surgery, the average age was 54 years for the avascular necrosis patients and 67 years for the osteoarthritis patients (P=.002). Clinical and radiographic follow-up was performed for an average of 7 years (range: 2-12 years).
Six (18%) components in the avascular necrosis group and nine (16%) components in the osteoarthritis group required re-revision for aseptic loosening an average of 7 years after the original revision (range: 2-11 years). Statistical analysis demonstrated no significant difference between the two groups in regard to the incidence of failure, time to failure, Harris Hip Score, and radiographic appearance. Contrary to expectations derived from the literature on primary THA, no difference was found between the outcome and survivorship of revision THA in patients with avascular necrosis and patients with osteoarthritis, despite a significant difference in age.
Medium- and Long-Term Results of Open Reduction and Internal Fixation for Unstable Pelvic Ring Fractures
Authors: Korovessis Panagiotis , Baikousis Andreas , Stamatakis Marios , Katonis Pavios 
Published: April 2021

ABSTRACT
Over a 1 0-year period, 74 patients with unstable pelvic injuries were treated with open reduction and internal fixation. Radiographic and clinical follow-up averaged 71 months (range: 38-141 months). Satisfactory (ie, good and very good) radiographic results were obtained in 90% of patients. Clinical results were superior in patients without associated injuries (f^=.Q5-.001). Most of the complications in this series were due to associated injuries. Sepsis was mostly due to open pelvic injuries and malunion to either lack of patient cooperation or inadequate open reduction and internal fixation. Careful preoperative analysis of the nature of the pelvic injury and selection of the appropriate operative technique for open reduction and internal fixation result in a satisfactory outcome for the majority of operative patients.
Human Immunodeficiency Virus Testing for Elective Orthopedic Procedures: Results in a Community-Based Hospital
Authors: LaPorte Dawn M , Mont Michael A , Jones Lynne C , Padden David A , Hungerford David S 
Published: April 2021

ABSTRACT
Between January 1, 1989 and July 31 , 1995, voluntary preoperative screening tests for human immunodeficiency virus (HIV) infection, using an enzyme-linked immunosorbant assay, were completed on 2727 patients who underwent elective orthopedic surgical procedures. There were 2719 (99.7%) negative, 4 (0.15%) positive, and 3 (0.11%) false-positive results; 1 test was indeterminate (0.04%). All 4 positive patients were men with a mean age of 32 years (range: 26-43 years). Although the prevalence of positive tests is low in this setting, voluntary testing alerts the surgeon to higher risk patients, does not sacrifice patient care, and enables the incorporation of more extensive precautionary measures in the operating room to minimize occupational risks to the surgical team.
Use of a Calcium Sulfate-Based Bone Graft Substitute for Benign Bone Lesions
Authors: Gitelis Steven , Piasecki Patricia , Turner Thomas , Haggard Warren , Charters John , Urban Robert 
Published: April 2021

ABSTRACT
Twenty-three patients with a benign bone lesion grafted with calcium sulfate, with and without demineralized bone matrix, were reviewed. At a minimum of 1 year postoperatively, 21 patients had achieved between 76% and 100% bone repair based on anteroposterior and lateral radiographs. Overall, the mean Enneklng Functional Evaluation System score was 98%. Calcium sulfate is a well-tolerated, biodegradable, osteoconductive bone graft substitute. It is a reasonable alternative to autogenous bone graft for benign bone lesions.