We Solve It! Immersing the Quality Enhancement Plan in a Traditional and Online Baccalaureate Nursing Program.

Problem-solving and critical thinking are essential in nursing; therefore, nurse educators must equip students with these skills. Through a campus-wide initiative to foster problem-solving skills (Quality Enhancement Plan), five school of nursing faculty implemented new pedagogical approaches in face-to-face and online courses. This article discusses the problem-based approaches in nursing education implemented at a state university and their effects on student learning.

Lipophilic statins inhibit growth and reduce invasiveness of human endometrial stromal cells.

Purpose: To compare effects of lipid-soluble statins (simvastatin, lovastatin, atorvastatin) and water-soluble statin (pravastatin) on growth and invasiveness of human endometrial stromal (HES) cells.

Methods: Endometrial biopsies were collected during the proliferative phase from five volunteers. HES cells were isolated and cultured in the absence or in the presence of simvastatin, lovastatin, atorvastatin, and pravastatin.

Intramedullary fixation of lateral malleolus using Fibula Rod System in ankle fractures in the elderly.

Background: Operative management of ever increasing ankle fractures in the elderly need a reliable system of internal fixation. We present results of one such fixation, Fibula Rod System.

Methods: Patients who underwent Fibula Rod System were included.

Bilateral Osteonecrosis of the Femoral and Humeral Heads after Short Term Corticosteroid Therapy. A Case Study.

Steroid induced osteonecrosis is a devastating injury that usually requires rebuild of the joint, with the femoral and the humeral head being most commonly affected. Steroid therapy is the most common reported cause of atraumatic osteonecrosis. The Collaborative Osteonecrosis Group Study confirmed that steroids are the primary cause of multi-focal osteonecrosis in 91% of the cases.

Atypical Osteomyelitis Caused by Mycobacterium chelonae in a Nonimmunocompromised Patient: A Case Report.

Case: A previously healthy fifty-seven-year-old woman presented with an acute atypical mycobacterial infection of the first metatarsal bone of the left foot. Despite antimicrobial treatment, the infection was not controlled. First-ray amputation was performed, and antimicrobial treatment was continued for a total of six months.

Cardiac biomarkers at high altitude.

Background: Classically, biomarkers such as the natriuretic peptides (NPs) BNP/NT-proBNP are associated with the diagnosis of heart failure and hs-cTnT with acute coronary syndromes. NPs are also elevated in pulmonary hypertension. High pulmonary artery systolic pressure (PASP) is a key feature of high altitude pulmonary edema (HAPE), which may be difficult to diagnose in the field.

The effects of exercise at high altitude on high-sensitivity cardiac troponin release and associated biventricular cardiac function.

Background: It has been consistently shown that heavy exercise leads to cardiac troponin (cTn) release and variable changes in post exercise cardiac function. This relationship has not been explored at increasing or significant high altitude (HA). This study assessed the effects of exercise at progressively increasing HA on high-sensitivity (hs)-cTnT levels and their relationship to biventricular cardiac function and severity of acute mountain sickness (AMS).

The use of standardized exit examinations in baccalaureate nursing education.

To improve pass rates on the NCLEX-RN, many nursing programs have implemented progression policies that require a minimal passing score on a commercial standardized exit examination. In this article, the authors provide an overview of the controversy surrounding the use of these examinations in nursing education, including ethical, legal, cultural, socioeconomic, and technological considerations, as well as discuss their program's exit examination policy, pass rates, and recommendations for the use of exit examinations.

Renal impairment after high-dose flucloxacillin and single-dose gentamicin prophylaxis in patients undergoing elective hip and knee replacement.

Background: Following advice from the Scottish Antimicrobial Prescribing Group, we switched our antibiotic prophylaxis for elective hip and knee replacement surgery from cefuroxime to flucloxacillin with single-dose gentamicin in order to reduce the incidence of Clostridium difficile associated diarrhoea (CDAD). A clinical impression that more patients subsequently developed acute kidney injury (AKI) led us to examine this possibility in more detail.

Methods: We examined the incidence of AKI in 198 consecutive patients undergoing elective hip or knee surgery.

Fixation of 3- and 4-part proximal humerus fractures using the PHILOS plate: mid-term results.

Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remains challenging, and optimal treatment continues to be controversial. Fifty-six patients with displaced 3- and 4-part fractures of the proximal humerus had open reduction and internal fixation using the proximal humeral internal locking system (PHILOS) plate (Synthes, Stratec Medical Ltd, Mezzovico, Switzerland). Data were collected retrospectively, and clinical and radiological outcomes were assessed.

Rapid recovery from spontaneous and simultaneous bilateral quadriceps tendon rupture in an active, healthy individual.

Bilateral spontaneous quadriceps rupture is an uncommon injury that is usually seen in association with multiple medical conditions and is frequently misdiagnosed. It is rarely seen in healthy, active individuals. This article presents a case of bilateral simultaneous and spontaneous rupture of the quadriceps tendon in a healthy, athletic, active and highly motivated patient with rapid recovery from injury and return to full sport activity within a relatively short period of time.

Parents' evaluation of adoption success: a follow-up study of intercountry and domestic adoptions.

Parents of 165 children adopted from Romania and 52 children adopted from within the United Kingdom rated the success of the adoptions when the children were 11 years old. As was the case at two earlier study waves, satisfaction was found to be extremely high. Both positive and negative assessments were generally stable between ages 6 and 11, although for the children who had more problems there was an increase in negative evaluation, albeit within an overall positive picture.

Is sub-nutrition necessary for a poor outcome following early institutional deprivation?

Institutional deprivation is multifaceted and includes adverse psychosocial and nutrition-related components. In this study we partitioned these risks in relation to cognitive impairment and mental ill health, and explored the mediating role of reduced head/brain size. There were 138 participants (61 males, 77 females) in the study.

Knowledge-based inferences across the hemispheres: domain makes a difference.

Language comprehension occurs when the left-hemisphere (LH) and the right-hemisphere (RH) share information derived from discourse [Beeman, M. J., Bowden, E.

Do theory of mind and executive function deficits underlie the adverse outcomes associated with profound early deprivation?: findings from the English and Romanian adoptees study.

Theory of Mind (ToM) and Executive Function (EF) have been associated with autism and with attention-deficit hyperactivity disorder (ADHD), and hence might play a role in similar syndromes found following profound early institutional deprivation. In order to examine this possibility the current study included a group of 165 Romanian adoptees, of whom 144 were adopted into the UK from deprived institutional settings before 43months of age, and a group of 52 within-UK adoptees, all adopted before 6months of age. Both groups were assessed at 6 and 11years.

Emotional difficulties in early adolescence following severe early deprivation: findings from the English and Romanian adoptees study.

The study assessed conduct and emotional difficulties in a group of Romanian adoptees at age 11, and serves as a follow-up to assessments made when the children were 6 years old. It was found that there was a significant increase in emotional difficulties, but not conduct problems, for the Romanian sample since age 6. It was also found that emotional difficulty was significantly more prevalent at age 11 in the Romanian group than in a within-UK adoptee group.

Inattention/overactivity following early severe institutional deprivation: presentation and associations in early adolescence.

The current study examined the persistence and phenotypic presentation of inattention/overactivity (I/O) into early adolescence, in a sample of institution reared (IR) children adopted from Romania before the age of 43 months. Total sample comprised 144 IR and 21 non-IR Romanian adoptees, and a comparison group of 52 within-UK adoptees, assessed at ages 6 and 11 years. I/O was rated using Rutter Scales completed by parents and teachers.

Scholastic attainment following severe early institutional deprivation: a study of children adopted from Romania.

The relationship between severe early institutional deprivation and scholastic attainment at age 11 in 127 children (68 girls and 59 boys) adopted from institutions in Romania was compared to the attainment of 49 children (17 girls and 32 boys) adopted within the UK from a non-institutional background. Overall, children adopted from Romania had significantly lower attainment scores than those adopted within the UK; the children within the Romanian sample who had spent 6 months or more in an institution had significantly lower attainment scores than those who had spent less than 6 months in an institution, but there was no additional risk of low attainment associated with longer institutional care after 6 months. The lower scholastic attainment in the children adopted from Romanian institutions, as compared with domestic adoptees, was mediated by IQ, and to a lesser degree, inattention/overactivity.

Normality and impairment following profound early institutional deprivation: a longitudinal follow-up into early adolescence.

Longitudinal analyses on normal versus impaired functioning across 7 domains were conducted in children who had experienced profound institutional deprivation up to the age of 42 months and were adopted from Romania into U.K. families.

Early adolescent outcomes of institutionally-deprived and non-deprived adoptees. II: language as a protective factor and a vulnerable outcome.

Background: There is uncertainty about the extent to which language skills are part of general intelligence and even more uncertainty on whether deprivation has differential effects on language and non-language skills.

Methods: Language and cognitive outcomes at 6 and 11 years of age were compared between a sample of 132 institution-reared Romanian children adopted into UK families under the age of 42 months, and a sample of 49 children adopted within the UK under the age of 6 months who had not experienced either institutional rearing or profound deprivation.

Results: The effects of institutional deprivation were basically similar for language and cognitive outcomes at age 6; in both there were few negative effects of deprivation if it ended before the age of 6 months and there was no linear association with duration of deprivation within the 6 to 42 month range.

Early adolescent outcomes for institutionally-deprived and non-deprived adoptees. I: disinhibited attachment.

Background: Disinhibited attachment is an important sequel of an institutional rearing, but questions remain regarding its measurement, its persistence, the specificity of the association with institutional rearing and on whether or not it constitutes a meaningful disorder.

Method: Children initially reared in profoundly depriving institutions in Romania and subsequently adopted into UK families were compared with respect to findings at 11 years with children who had not experienced institutional deprivation and who had been adopted within the UK before the age of 6 months. Measures included parental reports, a Strange Situation procedure modified for use in the home and systematic standardised investigator ratings of the children's behaviour.

In vitro carbohydrate digestibility of whole-chickpea and chickpea bread products.

Pulses such as the chickpea are generally considered to be valuable dietary sources of slowly digestible starch, a form of starch that is considered beneficial to health since it results in relatively low post-meal blood glucose levels compared with more rapidly digested starch. The development of novel chickpea-based foods is necessary to help expand the worldwide consumption of the chickpea. However, the effect of different processing methods on the starch digestibility of chickpea-based foods has not been widely investigated.

A simple modification of the Pavlik harness for unstable hips.

The Pavlik harness has been used in the treatment of developmental dysplasia of the hip for almost 60 years. During this time there has been little in the way of modification of the original design. In clinical practice it has an established role, but it is recognized to be less effective in more unstable hips, which are often associated with marked acetabular dysplasia.