The Impact of Preoperative Education on Patients Undergoing Elective Total Hip and Knee Arthroplasty: The Relationship Between Patient Education and Psychosocial Factors.

Background: Preoperative education has been found to be responsible for patients having a realistic expectation of surgery as well as high level of satisfaction with their recovery. The Joint Academy offers preoperative educational classes for all patients undergoing elective knee and hip replacements.

Purpose: The purpose of this descriptive study was to determine whether the education provided by The Joint Academy has an impact on anxiety, expectation, and preparedness in patients who undergo elective total knee or hip arthroplasty.

Percutaneous Nephrostomy Infusion: Nursing Considerations for Treatment of Upper Urinary Tract Urothelial Carcinoma.

An intrarenal approach using a percutaneous nephrostomy tube is a novel method to deliver chemotherapy and biotherapy to patients with upper urinary tract urothelial carcinoma. A paucity of evidence exists regarding basic nursing implications for this unique treatment option. This column will provide suggested guidelines to administer intrarenal treatment via a percutanous nephrostomy tube.

Conceptual models to guide best practices in organization and development of State Action Coalitions.

The RWJF/AARP National Campaign for Action established a goal of establishing Action Coalitions in every state by 2012. Last year, a small Steering Committee formed in Nebraska and used two conceptual models to guide the organization and development of its Action Coalition. The purpose of this article is to present the Internal Coalition Outcome Hierarchy (ICOH) model that guided development of partnership and coalition building.

Health care in rural hospitals: a role for nurse practitioners.

Disparities in rural health care are associated with poor patient outcomes. There is a need to further evaluate opportunities to bridge the gaps and improve rural health care. This descriptive, exploratory study examined the current and potential expanded use of nurse practitioners (NPs) in rural hospitals of one Midwestern state.

Management of exercise-induced bronchospasm in adolescents with asthma.

Physical activity in persons with asthma is important at any age but even more so in adolescents. Collaboration between the nurse practitioner and adolescent is essential to develop an asthma management plan that will provide for optimal physical activity and prevent asthma exacerbations while exercising.

Postnatal follow-up of prenatally diagnosed trisomy 16 mosaicism.

Objective: To determine the long-term outcome of pregnancies prenatally diagnosed with trisomy 16 and identify variables associated with the outcome.

Methods: We reviewed all published and our unpublished data from trisomy 16 pregnancies for which outcomes were available for children of greater than 1 year of age.

Results: Nineteen cases were diagnosed with trisomy 16 on chorionic villus sampling (CVS) and 17 cases at amniocentesis.

A pilot study of bone density loss in menopausal women treated with chemotherapy for cancer.

Goals Of Work: To estimate the incidence and severity of bone loss in menopausal women diagnosed with cancer who receive treatment with chemotherapy. Also, to evaluate the use of bone loss prevention agents in this population.

Patients And Methods: A total of 25 postmenopausal women with newly diagnosed cancers who received chemotherapy for a minimum of six cycles were enrolled in this pilot study.

Strategies for acquiring affordable medications for seniors.

While Congress continues to debate issues related to Medicaredrug benefits, senior citizens grow increasingly frustrated withtheir monthly medication bills. Many seniors are unable to affordall of their medications, and therefore find that they must choosebetween those that are the most helpful and those that have thegreatest potential for severe medical consequences if missed. Op-tions are available for helping senior citizens with this financialburden, but many seniors are either unaware or unable to availthemselves of the existing programs.

Prenatal screening for birth defects: an update.

This article summarizes current second trimester prenatal screening methods, and describes recently developed first trimester screening tools. The advantages and potential pitfalls of first trimester screening are outlined.

Hospice utilization by male and female cancer patients in an end-of-life transition program.

Objective: to determine if there were sex differences in patients' use of hospice services in a regional cancer center in Texas from 1998 to 2000.

Methods: A quality-of-life program for patients with cancer that included an end-of-life component was initiated in 1998 at a regional cancer center. The records of 1057 female and 986 male cancer patients who died from 1998 to 2000 were reviewed.