A Comparative Analysis of Teaching and Evaluation Methods in Nurse Practitioner Education Programs in Australia, Canada, Finland, Norway, the Netherlands and USA.

A scoping review of published literature and dialogue with international nurse practitioner educators and researchers revealed the education of nurse practitioner students varied within and between countries. This lack of cohesiveness hinders nurse practitioner role development and practice nationally and internationally. A rapid review of grey literature was conducted on nurse practitioner education standards in six countries (Australia, Canada, Finland, Norway, the Netherlands, and USA). Data were extracted from graduate level nurse practitioner education programs' websites from each country (n = 24). Extracted data were verified for accuracy and completeness with a nurse practitioner educator from each program. Data were analyzed using content analysis. Variations in nurse practitioner education within and between countries were explored by comparing admission criteria, curricular content, clinical requirements, teaching methods, and assignment and evaluative methods. The findings will help inform education programs and further research about nurse practitioner education internationally.

Effect of surface polishing and oxidization induced strain on electronic order at the Verwey transition in Fe3O4.

Following the controversy between two previous publications (Lorenzo et al 2008 Phys. Rev. Lett. 101 226401 and Garcia et al 2009 Phys. Rev. Lett. 102 176405), we report on the influence of mechanical polishing, and subsequent sample storage, on the electronic order at the Verwey transition of highly pure magnetite, Fe(3)O(4), by resonant x-ray scattering. Contrary to expectations, mechanically polishing the surface induces an inhomogeneous micron deep dead layer, probably of powdered Fe(3)O(4). In addition, we have found that polishing the sample immediately before the experiment influences and favors the appearance of long range order electronic correlations, whereas samples polished well in advance have their electronic order quenched. Conversely, lattice distortions associated with the Verwey transition appear less affected by the surface state. We conclude that mechanical polishing induces stresses at the surface that may propagate into the core of the single crystal sample. These strains relax with time, which affects the different order parameters, as measured by x-ray resonant diffraction.

Functional states of mandibular movements and synovial pumps of the temporomandibular joint. Is it possible to provide a biomechanically correct replacement for the TMJ?

Due to its complexity, there is currently an incomplete understanding of temporomandibular joint (TMJ) function, especially in relation to the morphological interplay of the condyle and the disc as well as the disc, the Os temporale and the lateral pterygoid muscle. This also holds true for synovial flow and synovial pumps, the existence of which we postulate and for which we present a theory of their mechanism. In view of the complexity of mandibular movements and the morphology and function of the TMJ, we need to know how precisely a reconstruction of the TMJ, if necessary, must be adapted to nature. An analysis of the morphology of the functional states of the mandible, as well as the synovial pump system, should at least provide a basis for moulding reconstructions.

Antiferromagnetic-paramagnetic insulating transition in Cr-doped V(2)O(3) investigated by EXAFS analysis.

We have performed extended x-ray absorption fine-structure (EXAFS) spectroscopy on a 2.8% Cr-doped V(2)O(3) sample, with the aim of studying its structural evolution in a wide temperature range across the paramagnetic-antiferromagnetic insulating phase transition at T(c). The data were registered with two different set-ups in fluorescence and transmission geometries, for polarized and unpolarized spectra, respectively. Our idea, based on previous experiments reported in the literature, is that extended structural modifications of the nominal trigonal symmetry are present in the paramagnetic insulating phase for several tens of degrees above T(c), involving further-nearest-neighbor vanadium ions. Our data confirm that the paramagnetic insulating phase is not structurally homogeneous in a temperature range of about 30 K around T(c), where local distortions of monoclinic symmetry involving further-nearest neighbors are present. Moreover, the analysis of the absorption profile at Cr K-edge suggests that Cr ions enter the lattice randomly. We finally analyze our findings in light of current theoretical models.

Zener double exchange from local valence fluctuations in magnetite.

Magnetite (Fe3O4) is a mixed valent system where electronic conductivity occurs on the B site (octahedral) iron sublattice of the spinel structure. Below T(V)=123 K, a metal-insulator transition occurs which is argued to arise from the charge ordering of 2+ and 3+ iron valences on the B sites (Verwey transition). Inelastic neutron scattering measurements show that optical spin waves propagating on the B site sublattice (approximately 80 meV) are shifted upwards in energy above T_{V} due to the occurrence of B-B ferromagnetic double exchange in the mixed valent phase. The double exchange interaction affects only spin waves of Delta(5) symmetry, not all modes, indicating that valence fluctuations are slow and the double exchange is constrained by short-range electron correlations above T(V).

The rectified second law of thermodynamics.

Equilibrium thermodynamics is combined with Jarzynski's irreversible work theorem to quantify the excess entropy produced by irreversible processes. The resulting rectified form of the second law parallels the first law, in the sense that it facilitates the experimental measurement of excess entropy changes resulting from irreversible work and heat exchanges, just as the first law quantifies energy changes produced by either reversible or irreversible work and heat exchanges. The general form of the rectified second law is further applied to a broad class of quasi-static irreverisble (QSI) processes, for which all of the thermodynamic functions of both the system and surroundings remain continuously well-defined, thus facilitating excess entropy measurements by integrating exact differential functions along QSI paths. The results are illustrated by calculating the mechanical and thermal excess entropy produced by the irreversible unfolding of an RNA molecule.

Average entropy dissipation in irreversible mesoscopic processes.

The Clausius inequality is rectified to obtain expressions for the entropy produced as the result of irreversible work and/or heat exchanges. These are combined with the Jarzynski equality and its generalizations to explicitly relate mean (as opposed to transient) entropy dissipation to experimental or simulation observables. The results are extended to nonisothermal processes which begin and end at nonequilibrium steady states, leading to a new exact expression and positive lower bound for the resulting average entropy dissipation. The Carnot engine emerges as a limiting case of a family of irreversible processes arising from an interface between materials at different temperatures, whose mapping onto reversible and irreversible molecular extension experiments is discussed.

[Soft tissue enhancement with injectable fillers for correction of age related folds and wrinkles]. / Allgemeine Ubersicht der gebräuchlichsten injizierbaren Weichgewebsfüller zur initialen Faltenbehandlung des Gesichts.

Injectable fillers for facial soft tissue enhancement have been developed and used for decades for the correction of age related folds and wrinkles. Many of the disadvantages of xenogenic and prior exogenous materials have been overcome with the advent of autologous and synthetic alternative materials. Autologous and synthetic injectable fillers herald a new era in the treatment of the aging face. Therefore this article will give an in-depth look at the implant choice, surgical approach, and possible complications and will provide a review of current injectable fillers for age related facial soft tissue augmentation.

Omega incision face-lift approach and SMAS rotation advancement flap in parotidectomy for prevention of contour deficiency and conspicuous scars affecting the neck.

To overcome the disadvantages after the surgical removal of tumours of the parotid gland, especially the depressed facial deformity and conspicuous cervical scar formation subsequent to parotid surgery, we have concentrated on omega face-lift incision in combination with an SMAS rotation advancement flap for the last several years using a lazy omega incision. Nine patients (3 male and 6 female) ranging in age from 43 to 68 years (mean age: 56.3 years) fulfilled the selection criterion of having a clinically benign discrete parotid lump with a benign preoperative fine needle cytology result. Parotidectomy was performed using the modified omega face-lift incision in conjunction with the rotation advancement SMAS flap. All patients underwent follow-up every 3 months in the first year. During the follow-up, the patients were specifically asked about their satisfaction with the post-operative appearance and whether they would consent to the operation again. The vascularized SMAS rotation advancement flap is clinically simple to perform and provides satisfactory cosmetic and functional results in patients undergoing conservative parotidectomy. There are no drawbacks in the use of modified face-lift incision to remove tumours of the parotid gland.

Universality and critical behavior at the Mott transition.

We report conductivity measurements of Cr-doped V2O3 using a variable pressure technique. The critical behavior of the conductivity near the Mott insulator to metal critical endpoint is investigated in detail as a function of pressure and temperature. The critical exponents are determined, as well as the scaling function associated with the equation of state. The universal properties of a liquid-gas transition are found. This is potentially a generic description of the Mott critical endpoint in correlated electron materials.

[Renaissance of the Franz König bilateral lip repair procedure - clinical experiences with an one hundred year old technique]. / Die Renaissance des doppelseitigen Lippenspaltverschluss nach Franz König - Klinische Erfahrungen mit einer über hundert Jahre alten Technik -

Surgical correction of bilateral cleft lips is known to have a lot of problems. The surgical principles of treatment of bilateral cleft lips are similar to those of unilateral clefts but differ in the area of the prolabium due to specific anatomical disorders of the orbicularis oris muscle. The postoperative results of simultaneous bilateral cleft lip repair according to König were analysed retrospectively in 15 young children (6.1 +/- 1.1 years) paying special emphasis to the aesthetic and functional postoperative outcome of the upper lip and nose. The mean values were compared with measurements from normal infants at ages 8.3 +/- 1.8 years. Lip height and lip length were in 87 % similar to those of the age-matched normal group. Only two cleft patients showed a slightly shorter lip. Distortions of the lip function were not obvious. Our data show that König's surgical procedure of bilateral cleft lip closure meets the requirements of modern surgical concepts of cleft lip repair and should belong to the armamentarium of modern face surgery.

Group B streptococcal disease prevention practices of obstetrician-gynecologists.

OBJECTIVE: To describe group B streptococcal (GBS) disease prevention practices of obstetrician-gynecologists. METHODS: We surveyed 1019 ACOG Fellows-the 419 members of the Collaborative Ambulatory Research Network (CARN) and 600 randomly selected non-CARN Fellows. RESULTS: There were 601 eligible respondents. More than 95% in both the CARN and the non-CARN groups reported adopting one of three GBS prevention strategies. The most commonly reported strategy was a combination approach not described in the consensus guidelines. The second most common strategy was the screening-based strategy; the risk-based strategy was third. Most respondents provided GBS information to all prenatal patients, but those using a risk-based strategy and those in solo practice were less likely to do so. Less than 60% in each group used penicillin as their first choice for GBS prophylaxis. More than 20% in each group who routinely screened for GBS did not collect both vaginal and rectal cultures. Respondents rated ACOG publications as the most important influence on their GBS prevention approach. CONCLUSION: Almost all ACOG Fellows have adopted a GBS prevention strategy. The importance of providing GBS prevention information to all patients, use of penicillin, and collection of both vaginal and rectal cultures should be reinforced.

Subgaleal versus subperiosteal dissection in fronto-orbital advancement procedures.

Extensive cranioorbital surgery for craniosynostosis in young children can produce excessive blood loss. Thus, to overcome the disadvantage of unappropriated blood loss and translocation of the osteosynthesis material, we performed a subgaleal dissection in infants and compared the subperiosteal with the subgaleal surgical approach in 29 children who underwent surgery for craniosynostosis. The treatment goal of correction of the deformity was accomplished in each case. Fronto-orbital deformities were significantly improved in all patients. Blood loss was less in the group with subgaleal elevation of the forehead (mean = 163 ml) compared with the subperiosteal group, which had a mean 266 ml blood loss. The subgaleal dissection caused less bleeding and tethering of the advanced bone.

Elimination of rabies from red foxes in eastern Ontario.

The province of Ontario (Canada) reported more laboratory confirmed rabid animals than any other state or province in Canada or the USA from 1958-91, with the exception of 1960-62. More than 95% of those cases occurred in the southern 10% of Ontario (approximately 100,000 km2), the region with the highest human population density and greatest agricultural activity. Rabies posed an expensive threat to human health and significant costs to the agricultural economy. The rabies variant originated in arctic foxes: the main vector in southern Ontario was the red fox (Vulpes vulpes), with lesser involvement of the striped skunk (Mephitis mephitis). The Ontario Ministry of Natural Resources began a 5 yr experiment in 1989 to eliminate terrestrial rabies from a approximately 30,000 km2 study area in the eastern end of southern Ontario. Baits containing oral rabies vaccine were dropped annually in the study area at a density of 20 baits/km2 from 1989-95. That continued 2 yr beyond the original 5 yr plan. The experiment was successful in eliminating the arctic fox variant of rabies from the whole area. In the 1980's, an average of 235 rabid foxes per year were reported in the study area. None have been reported since 1993. Cases of fox rabies in other species also disappeared. In 1995, the last bovine and companion animal cases were reported and in 1996 the last rabid skunk occurred. Only bat variants of rabies were present until 1999, when the raccoon variant entered from New York (USA). The success of this experiment led to an expansion of the program to all of southern Ontario in 1994. Persistence of terrestrial rabies, and ease of elimination, appeared to vary geographically, and probably over time. Ecological factors which enhance or reduce the long term survival of rabies in wild foxes are poorly understood.

[Intra-individual comparison of alpha- and beta-TCP ceramics in an animal experiment]. / Intraindividueller Vergleich von alpha- und beta-TCP-Keramik im Tierexperiment.

In the quest for bioinert adaptable alloplastic materials, TCP ceramics have gained a new application in craniofacial bone substitutes. Therefore, a histomorphological, intraindividual, comparative study was conducted on seven adult Goettingen miniature pigs (GMP) to analyze the difference of the degradation and remodelling processes of alpha-TCP and beta-TCP in critical size defects of the proximal tibiae. In addition, primary insertion of dental implants followed to study osseous integration. The critical size defects, which were created in the proximal tibiae in GMPs, were filled on the left side with beta-TCP and on the right side with alpha-TCP. Two GMPs were used as control group. After 4-68 weeks of investigation, the GMPs were sacrificed by narcosis. The histological investigation showed that these ceramics have an osteoconductive effect. It was noted that ossification proceeds centripetally. It could be demonstrated that the degradation of the materials follows a hydrolytical process and that the intratrabecular integrated ceramic remnants follow a dynamic remodelling process. Within 68 weeks after implantation, 90% of the TCP granulae were degraded. Macrophages were found in the marrow space, containing microparticles of TCP, especially after alpha-TCP implantation. In conclusion, defined degradation of these ceramics allows early functional bone regeneration with an additional undisturbed biofunctional unisotrop orientation of new trabeculae. Furthermore, dental implants should be inserted 5-6 months after TCP implantation.

[The modern surgery of face lift: indications and results]. / Die moderne Chirurgie des Face liftings. Indikationen und Ergebnisse.

In this retrospective study with a group of 55 patients aged 47.7 +/- 8.3 years, surveyed for a period of 16 months, the results of different face lift techniques--subcutaneous face lift combined with imbrication of the SMAS-Platysma complex versus sub-SMAS-dissection with transposition of the SMAS-Platysma complex--were compared in order to evaluate risks and complication rates of these two techniques. Various indications and different techniques including special features were discussed. A slightly higher complication rate is evident in the patient group treated with the sub-SMAS face lift technique, mainly referring to temporary asthenia of the nervus facialis, which regressed in all cases after 7 months. The post op bleeding rate was 2.3%, within the range given in the literature. Concludingly, the pure subcutaneous face lift with imbrication of the SMAS-Platysma complex still is an established method in modern rhytidectomy treatment.

Surgical removal of intra- and extraoral cavernous lymphangiomas using intraoperative-assisted intralesional fibrin glue injections.

Benign lymphangiomas are encountered frequently in the head and neck region. They may be well circumscribed or diffusely invasive, involving subcutaneous tissue and underlying muscle, and consist of dilated, thin-wall sinuses. Surgical therapy with excision as wide as possible, while taking care to avoid rupturing the lesion, is the treatment of choice. To simplify complete excision, the authors introduce an intraoperative technique--intralesional injection of fibrin glue. Using this technique over period of 10 years in 27 patients (age range, 7-24 years) they removed successfully intra- and extraoral lymphangiomas. There have been no recurrences. This technique helps avoid rupture of the epithelium and bleeding, and makes it easier to remove lymphangiomas surgically and as completely as possible. This technique reduces recurrence remarkably and ensures successful surgical excision.

Inheritance of Hippel-Lindau disease: a rare case of maxillary bone metastasis.

A rare case of familial Hippel-Lindau disease, which is an autosomal dominant disorder with inherited susceptibility to various forms of cancer, is reported in a 46-year-old father and his sons. The father complained of a malignant hypernephroma, which metastasized in the upper jaw 6 months later. As in this patient, renal cell carcinomas are fatal and are exhibited at an early age. Consequentially, patients with familial von Hippel-Lindau disease exhibiting cases of renal cell carcinoma should be examined very carefully in the head and neck region to detect and treat metastases as early as possible.