A rapid method is described for the analysis of Cannabis products by supercritical fluid chromatography (SFC) coupled to atmospheric pressure chemical ionization-mass spectroscopic (APCI-MS) detection. The method had a shorter analysis time than GC-MS methods, without the need for derivatization prior to analysis. It was also faster than HPLC methods, with better resolution and definitive identification. Linearity of detector response to cannabidiol, delta 8-tetrahydrocannabinol, delta 9-tetrahydrocannabinol and cannabinol was established, the detection limits for mass on column being 0.55 ng, 1.20 ng, 0.69 ng and 2.10 ng respectively. The technique offers a means by which Cannabis products can be definitively identified in a single chromatographic run. Application to casework samples is described.

Cannabinoids↗

PubMedDate not supplied

Partial calcaneal ostectomy for retrocalcaneal bursitis.

Heel pain in runners is very common. Retrocalcaneal bursitis may be disabling to the competitive runner. When conservative treatment fails, surgery (partial calcaneal ostectomy) may be indicated. Ten patients underwent partial calcaneal ostectomies at our clinic and returned to their desired level of activity within 6 months. When the surgeon adheres to the surgical principles outlined in this article, the results are uniformly good.

Adult↗

PubMedDate not supplied

Long-term evaluation of knee stability and function following surgical reconstruction for anterior cruciate ligament insufficiency.

Currently used measures of knee stability and function for ACL reconstructed knees have not gained universal acceptance. Clinical test results often are given more value than the patient's subjective evaluation of the surgical outcome. This study was designed to identify specific knee stability and function variables that were most predictive of the patient's rating of knee function following one of two types of combined (intraarticular and extraarticular) ACL reconstruction procedures. Individual measures of knee stability and function were also evaluated for differences between contralateral operated and nonoperated limbs. Postoperative and healthy contralateral knees of 51 male and female patients aged 18 to 49 years (mean, 23.7 years) were evaluated on a battery of tests at an average of 48.0 months after surgery (range, 24 to 101 months). All subjects possessed a normal contralateral knee for comparative purposes. The results of this retrospective study indicated that the variables selected were not highly correlated with, nor could they effectively predict, the patients' perceptions of postoperative knee status as measured by the Knee Function Rating Form (KFR). Statistically significant differences (P less than 0.001) between operated and nonoperated knees were found for 9 of 11 variables analyzed. The data suggest that patients' perceptions of postoperative knee status were independent of the results of static and dynamic clinical tests commonly used to assess knee stability and function. Postoperative deficits of up to 30% between the surgically reconstructed and normal contralateral knees on specific measures of knee stability and function did not greatly influence the patients' perceptions of knee function. Development of new, more specific dynamic tests may be necessary before stronger relationships between clinical test results and patients' perceptions of knee status in the ACL reconstructed knee can be realized.

Adolescent↗

PubMedDate not supplied

Retrospective direct comparison of three intraarticular anterior cruciate ligament reconstructions.

A long-term retrospective study (minimum 5 years) was done looking at three groups of anterior cruciate deficient knee patients using both subjective and objective anterior cruciate tests. Twenty-seven chronic anterior cruciate ligament deficient knees reconstructed with the middle third of the patellar tendon and 28 chronic anterior cruciate ligament deficient knees reconstructed with the semitendinosus tendon were included in this consecutive group of patients and were felt to be directly comparable. It was found that the chronic anterior cruciate ligament deficient group reconstructed with the semitendinosus tendon had 4 excellent, 10 good, 7 poor, and 7 failures with an objective score averaging 4.5 of a possible 12, while the comparable group reconstructed with the middle third of the patellar tendon had 16 excellent, 7 good, 3 poor, and only 1 failure with a score of 10 of a possible 12 (P less than 0.0032). For completeness sake, 20 anterior cruciate deficient knees from this group of consecutive patients that were reconstructed acutely with the semitendinosus tendon were also examined. This group had 8 excellent results, 9 good, 3 poor, and no failures with a score of 9.8 (P less than 0.03 compared to the other group using the semitendinosus tendon). This comparison between the two groups where the semitendinosus tendon was used in the anterior cruciate ligament reconstruction was made only to show the difference between studies dealing with knee reconstructions. There may be a significant difference between a study dealing with acutely reconstructed knees versus one focusing on chronically reconstructed knees, most likely because of both patient selection and time between injury and reconstruction.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMedDate not supplied

Effect of parental participation on hospitalized child behavior.

A short-term longitudinal descriptive evaluation of current levels of parents' participation in the care of a child hospitalized with leukemia was conducted to identify varying levels of parent participation and their relationship to the child's behavior during hospitalization. A positive relationship between the number of activities a parent participates in and the child's behavior during hospitalization was revealed.

Adult↗

PubMedDate not supplied

A case study approach: developing critical thinking skills in novice pediatric nurses.

BACKGROUND: The development of critical thinking skills in pediatric nurses is imperative to ensure quality nursing care is delivered. Many new graduates have had limited exposure to pediatric nursing. METHOD: The case study method is an approach to develop competencies with real or hypothetical situations. RESULTS: Case studies provide an interactive teaching-learning strategy that can be applied to novice pediatric nurses in a variety of settings. CONCLUSION: By using case studies, nurse educators responsible for the professional development of new graduates, help expand learners' critical thinking as they assume increased responsibility for pediatric nursing care.

Asthma↗

PubMedDate not supplied

BSN education and PHN practice: good fit or mismatch?

Explore the source record for details and available documents.

Clinical Competence↗

PubMedDate not supplied

Delegation in nursing staff development.

Delegating work, responsibility, and authority in a staff development department is difficult because it means letting others make decisions. Delegation, however, is necessary because it allows competent educators to perform and to get work done proficiently. Delegation is perhaps the hardest job directors have to learn. It requires planning, skill, and the use of available resources. When carried out effectively, delegation is the key to a successful department.

Clinical Competence↗