Promoting collaboration in nursing education: the development of a regional simulation laboratory.

This article describes a collaboratively developed plan for a regional patient simulation laboratory for nursing education. The Western North Carolina Regional Simulation Laboratory will be located at the Enka Campus of the Asheville-Buncombe Technical Community College at the Department of Nursing of Western Carolina University (Candler, NC). A proactive collaborative consortium has been established to help meet the demand for nursing education in the 13 most rural mountain counties of western North Carolina. Through a 2-year process with regional networking, the nursing administration of Western Carolina University, Mission Hospitals, Asheville-Buncombe Technical Community College, and affiliated community colleges, consortium hospitals, and emergency care services developed a vision and a proposal for an innovative program for the nursing education of the future. The consortium proposed the establishment of a 3-year integrated educational program utilizing state-of-the-art simulation manikin technology. Financial resources were obtained from a charitable grant from The Duke Endowment (Charlotte, NC). Sustainability of funding will be ensured through university, hospital, and community college collaboration.     

Florid reactive periostitis and bizarre parosteal osteochondromatous proliferation: pre-biopsy imaging evolution, treatment and outcome

Objective. To report on the imaging evolution of florid reactive periostitis (FRP) and bizarre parosteal osteochondromatous proliferation (BPOP) of the phalanges of the hands from prospective diagnosis to operation and on postsurgical outcome. Design and patients. Three patients (2 female, 1 male; age range 11–34 years) presented with a swollen digit of the hand. Following presumptive radiographic diagnosis of FRP, they were closely observed both clinically and radiographically until operation. All three patients had radiographs of the involved digit, and one patient had an MR imaging examination. The interval between presumptive diagnosis and operation ranged from 2 to 8 months. Following operation, the patients have been clinically followed for 9–13 months (mean 10 months). Results. In each of the patients, maturing of periosteal reaction without bone destruction was observed within 1–2 weeks of the presumptive diagnosis of FRP. Periosteal reaction was initially minimal in relation to the extent of soft tissue swelling and subsequently became more florid. In one patient, the lesion ossified, became adherent to the phalanx, and had an ”osteochondromatous” appearance. In another patient, periosteal reaction was seen on both sides of the phalanx with an intact phalanx. In the sole patient who had MR imaging, edema was seen in the phalanx distal to the symptomatic site and the metacarpal proximal to the symptomatic site. Conclusions. Close clinical and radiographic correlation permits an accurate pre-biopsy diagnosis of FRP. The first follow-up radiograph taken within 2 weeks usually provides reassurance of the accuracy of the diagnosis. FRP may progress to BPOP. Arbitrary antibiotic treatment can be avoided, and a planned surgical approach can be adopted. Received: 21 August 2000 Revision requested: 8 December 2000 Revision received: 26 December 2000 Accepted: 26 December 2000     

Measurement properties of the Medical Outcomes Study Sleep Scale in patients with fibromyalgia

ObjectiveSleep problems are a common symptom of fibromyalgia (FM). The objective of this study was to evaluate the Medical Outcomes Study (MOS) Sleep Scale as a measure of FM-related sleep problems.MethodsAnalyses were based on data from the 1056 and 1077 studies, two randomized, double-blind, placebo-controlled trials of pregabalin for adults with FM. MOS Sleep Scale scores of study patients were compared with United States normative scores using a one-sample Z test. Subscale structure of the MOS was evaluated by confirmatory factor analyses, internal consistency was evaluated using Cronbach’s alpha reliability coefficients. Estimated clinically important differences (CID) in MOS Sleep Disturbance subscale scores were evaluated using mixed-effects models of change in subscale scores as a function of the Patient Global Impression of Change (PGIC).Results1056 and 1077 included 748 and 745 patients, respectively. Most patients were female (1056: 94.4%, 1077: 94.5%) and white (1056: 90.2%, 1077: 91.0%). Mean ages were 48.8 years (1056) and 50.1 years (1077). Baseline MOS Sleep Scale scores were statistically (P < 0.001) and substantially poorer than general population values. The MOS subscale structure was confirmed in both studies at each assessment except at baseline in the 1056 study. Cronbach’s alpha coefficients were acceptable, at least 0.70, for all multi-item scales at baseline and end-of-study assessments in both studies, with the exception of the Sleep Adequacy subscale at baseline. The estimated CID for the MOS Sleep Disturbance subscale was 7.9.ConclusionsThe MOS Sleep Scale is an appropriate measure of FM-related sleep problems. These analyses provide the foundation for further use and evaluation of the MOS Sleep Scale in FM patients.     

Applying area-under-the-curve analysis to enhance interpretation of response profiles: an application to sleep quality scores in patients with fibromyalgia

Purpose  

To introduce an application of area-under-the-curve (AUC) that can enrich interpretation of response analysis and illustrate this method on sleep quality scores in patients with fibromyalgia.