bluuebunny/crossref_metadata_2025 huggingface dataset:
Senior Nursing Students' and Professional Nurses' Perceptions of Effective Caring Behaviors: A Comparative Study
Authors: Mangold Antonia M
Published: April 2021

ABSTRACT

Care forms the basic core of nursing actions. Traditionally nurses have described the acts of administering to patients as care behaviors. Many nurses find it difficult to define these caring behaviors. It is important that nurses have insight into the specific behaviors that patients perceive to be most important. Several studies have examined and compared nurses' and patients' perceptions of effective care behaviors. The literature supports an incongruence of what nurses perceive and what patients perceive as effective. This study identifies and compares student nurses' and professional nurses' perceptions of effective caring behaviors.

The Caring Assessment Report Evaluation Q-sort (CAREQ) was used to obtain the data. The participants included senior baccalaureate nursing students (n = 30) at Thomas Jefferson University, College of Allied Health Sciences, and professional nurses (n = 30) with 1 or more years experience. The significance of the difference between the groups was tested using the Mann Whitney U test. Results indicate agreement between the students and the nurses in all categories except trusting relationship (p = .06). The ages within the groups varied from 21 to 47 years. The difference in ages between the nurses and the students is significant (p = .0002). Findings provide a better understanding of student nurse perceptions of caring behaviors and provide implications for further research for nurse educators.
Critical Thinking and Nursing Education: Perplexities and Insights
Authors: Kintgen-Andrews Jean
Published: April 2021

ABSTRACT

The impetus for this literature review was an exploratory study conducted by the writer which indicated that a sample of nursing students seemed to make no significant gains in the development of critical thinking over an academic year. Surprised, the writer undertook an analysis of relevant studies in the nursing literature focusing upon the following questions: Does nursing education impact upon critical thinking? Does nursing education impact upon clinical judgment? How do critical thinking and clinical judgment relate? How do critical thinking and achievement in nursing education relate?

This endeavor yielded mixed findings while reference to literature in the field of education produced several insights that help to explain some of the perplexities. Suggestions are offered regarding research and teaching related to critical thinking.
Student Nurse Recruitment: Determinants for Choosing a Nursing Program
Authors: MA Tim , Riordan Jan , Delamaide Gina , Kilian Gloria
Published: April 2021

ABSTRACT

Competitive recruitment of nursing school applicants requires a thorough understanding of why they pick a particular school. By applying marketing techniques, nursing schools can identify their institutions' perceived strengths and tailor their recruitment efforts to applicants' needs. Students and alumni (n = 228) responding to a mail survey indicated that their awareness of the nursing program was primarily through personal contacts and direct mail. Other marketing media were perceived as ineffective. Several market segments were identified through canonical correlation analysis: traditional and nontraditional students. Traditional students (under age 25, unmarried, local, in the baccalaureate program) chose the program due to quality of clinical instruction and financial aid. Nontraditional students (age 25 or older, married, returning LPN or RN, transfer, in generic BSN or associate programs) decided to attend based on convenience. The research resulted in the development of recruiting materials emphasizing the unique strengths of the nursing program.
Preventing Abuse During Pregnancy: A National Educational Model for Health Providers
Authors: Young Anne , McFarlane Judith
Published: April 2021

ABSTRACT

The National Preceptorship Program was funded by the March of Dimes and established at Texas Woman's University in Houston to prepare health care providers to assess pregnant women for abuse and to initiate primary intervention strategies. Essential content was identified and a diversity of learner-focused teaching methods and learning strategies were required for the 21-hour program, Combining didactic and experiential strategies proved to be effective.

Thirty-nine health care providers from across the country participated in the program. Process evaluation of the classroom and field learning experiences were particularly positive. A 1-year follow-up product evaluation revealed that participants had presented 120 seminars on preventing battering, had instituted assessment for battering in their agencies, and were planning future seminars.
An Empirically Based Substance Abuse Course for Graduate Students in Nursing
Authors: Murphy Shirley A
Published: April 2021

ABSTRACT

Currently, no texts or compilations of readings offer a comprehensive graduate-level nursing foundation in addictive behaviors. This article describes the development of a theory- and research-based collection of readings and a course designed to meet this need.
Public Values and Beliefs Toward Nursing as a Career
Authors: May Frederick E , Champion Victoria , Austin Joan K
Published: April 2021

ABSTRACT

The purpose of this study was to compare the perceptions of "ideal career" and "nursing as a career." The goal was to provide information for development of innovative recruitment strategies. The sample of 1,116 included college freshmen, students in grades 6 through 12, parents, school nurses, teachers, and counselors.

Data were analyzed by t test and analysis of variance to determine differences in attitudes between "ideal career" and "nursing as a career." Similar perceptions for both were opportunities for employment, application of intellectual abilities, caring for people, and an opportunity for academic and scholastic achievement. An "ideal career" was seen as more financially rewarding, more respected, and more powerful than nursing, and as providing more opportunities for leadership, for making decisions, for obtaining and applying knowledge, and for working in a safe environment. Recommendations include strategies to improve recruitment and retention of nurses.
The Effects of Institutional and Community Experiences on Nursing Students' Intentions Toward Work With the Elderly
Authors: Dellasega Cheryl , Curriero Frank C
Published: April 2021

ABSTRACT

The intentions of nursing students toward working with older adults are similar to those of nurses in general. Several authors have suggested that educational interventions are the key to reversing the reluctance of nursing students to work with elderly persons.

In this longitudinal study, the intentions of 39 junior baccalaureate nursing students were examined at three points: prior to any treatment, after clinical work with aged persons in an institutional setting, and after clinical work with aged persons in a community setting. The analysis of variance model run on this data revealed no significant differences in students' intentions as a consequence of their clinical experiences.
Mathematical Calculation Ability and Mathematical Anxiety of Baccalaureate Nursing Students
Authors: Pozehl Bunny J
Published: April 2021

ABSTRACT

Accurate mathematical calculations are a critical skill that nurses must demonstrate in order to safely administer medications. This study was designed to investigate differences in mathematical calculation ability and mathematical anxiety for a group of baccalaureate nursing students (ra=56) and a group of undergraduate students majoring in fields other than nursing (n=56). Results showed the nursing students had significantly lower mathematical skills test performance than the non-nursing students. No group differences were found for mathematical anxiety. These results are consistent with previous findings that indicate that nursing students are seriously deficient in mathematical skills. The greater deficiency in mathematical skills performance noted in the nursing group indicates that nureing education must consider more selective admission requirements related to mathematics. Mathematical calculation skills must be evaluated early in the program of study and educational opportunities to increase mathematical proficiency must be planned throughout the nursing program.
An Investigation off Learning Styles of Practical and Baccalaureate Nursing Students
Authors: Duncan Gena
Published: April 2021

ABSTRACT

The purpose of this non-experimental, descriptive study was to identify the predominant perception and ordering learning styles of practical and baccalaureate nursing students and to ascertain if there was a difference in the learning styles of the two levels of nursing students. The Gregore Style Delineator was used to assess the learning styles. The sample consisted of 55 practical nursing students at a vocational college and 48 junior and senior baccalaureate nursing students at a small university. Both colleges were located in the midwestern United States. The findings indicated there was a statistically significant relationship between the learning style of practical and baccalaureate nursing students. The small sample size (N= 103) and the use of a non-random, convenience sample limits the generalization of the findings.
Symposium on Nursing Centers: Past, Present and Future
Authors: Frenn Marilyn , Lundeen Sally Peck , Martin Karen S , Riesch Susan K , Wilson Sarah A
Published: April 2021

ABSTRACT

A call for articles related to nursing centers was generated (Tanner, 1994), based on the fact that many existing nursing centers operate out of schools of nursing. Proceedings of a symposium on nursing centers presented at the Midwest Nursing Research Society (MNRS) meeting in April 1994 are shared as a way of advancing the development, implementation, and evaluation of nursing centers. The four contributions represent a review of the historical, empirical, and anecdotal literature, key elements in creating and maintaining a research laboratory, data sets useful for practice and research, and policy issues germane to nursing centers, which are a cornerstone of health care reform.
Nurse Practice Centers in Academia: An Emerging Subsystem
Authors: Boettcher Janet Hardy
Published: April 2021

ABSTRACT

Nurse practice centers have been instituted by numerous schools of nursing throughout the United States. This study was done in part to better identify their components as well as the forces constraining and stimulating their development. General systems theory was used as the theoretical base. Academically-based nursing centers were identified as a subsystem of both the health care system and the higher education system in America. As a subsystem of both of these systems, the nurse practice center operated by a school of professional nursing represents an entity that has the capacity to foster all components of professional nursing including scholarly practice, education and research. Forty such centers were found to be sites for a wide variety of care, research and learning involving faculty and students. Forces stimulating the development of such centers were faculty clinical practice, clinical learning experiences and service opportunities. Constraining forces were time management and role ambiguity. Faculty members' job satisfaction correlated significantly with the budget at the .007 level.
A Process Model to Guide Selection of Essential Curriculum Content
Authors: Morse Winifred A , Corcoran-Perry Sheila
Published: April 2021

ABSTRACT

The purpose of this qualitative study was to develop and test the usefulness of a process model to identify guidelines for selecting essential content in undergraduate nursing curricula from nursing and related disciplines. The study was designed to test the usefulness of the model. Usefulness was determined by evaluating the operationalization of the model and the product resulting from operationalization of the model. The criteria of practicality, purpoeiveness, realism, and judiciousness were used. The model consists of four steps. In Step 1, the content area is delineated. Step 2 consists of a review of the Literature of both disciplines. Analysis and synthesis of this information results in guidelines, stated in conceptual terms and accompanied by brief rationale, for essential content. In Step 3, educators and clinicians are interviewed to determine reliability and validity of the guidelines. In Step 4, guidelines are revised based on comments obtained in Step 3. Operationalization of the model using nutrition content resulted in five content and three process guidelines. Both the process described by the model and the guidelines which resulted from that process were evaluated as useful. Suggestions for future research using the model are made.
Critical Thinking in Nursing: Classroom Tactics That Work
Authors: Abegglen JoAnn , Conger Cynthia O'Neill
Published: April 2021

ABSTRACT

Critical thinking ability is one of the required outcomes of nursing education and content coverage is a focus of the past (National League for Nursing, 1996). As educators, we must attend to how we define critical thinking, what educational methods support its development, and how we can assure that students have achieved some acceptable level of critical thinking skill (Tanner, 1993).

This article describes the emergent development of one critical thinking format in a Community Health Nursing course. Rather than approaching critical thinking from a theoretical perspective or focusing on one type of assignment or experience as a tool to foster critical thinking development in nursing courses, this article shares with the reader a complete package. Problems, pitfalls, new insights, and changes are shared as they developed through the teaching of a semester-long Community Health Nursing course. The authors hope their experiences give faculty ideas about how to infuse critical thinking into nursing curricula.
Solitary Neurofibroma of the Iris
Authors: Wolter J Reimer
Published: April 2021

Report of A Case
Cyclic Esotropia With Central Nervous System Disease: Report of Two Cases
Authors: Pillai Premi , Dhand Upinder K
Published: April 2021

ABSTRACT

Two cases of cyclic esotropia with associated central nervous system lesions are presented. One had a 48-hour cycle and the other a 24-hour cycle. In the first child, the condition developed after a third ventricular astrocytoma removal and in the second with the advent of an epileptiform disorder. Both were non-accommodative, non-paralytic in nature, and not associated with fusion disrupting factors. These patterns persisted uninterruptedly in one child for 22 months and in the other for more than 8 months until lost for follow-up.
Ophthalmologic Findings Associated With Arthrogryposis Multiplex Congenita: Case Report and Review of the Literature
Authors: Zeiter John H , Boniuk Milton
Published: April 2021

ABSTRACT

Arthrogryposis multiplex congenita is a birth defect characterized by multiple joint deformities and sometimes associated with various other congenital anomalies. There have been several reported cases of miscellaneous ocular abnormalities in conjunction with this syndrome. We report the first case of congenital ophthalmoplegia as well as juvenile onset glaucoma associated with arthrogryposis multiplex congenita. This case represented a unique therapeutic dilemma in that it was extremely difficult to surgically treat the patient's glaucoma because of her severe restrictions of ocular motility.
Blue Cone Monochromatism
Authors: Weiss Avery H , Biersdorf William R
Published: April 2021

ABSTRACT

Blue cone monochromatism (BCM) is a subtype of achromatopsia in which the blue cone mechanism predominates. Each of the four patients in this study had BCM proven by their having peak spectral sensitivities in the blue region of the visible spectrum (near 440 nm). Clinically, the diagnosis was suspected because of xlinked inheritance, the presence of acuities better than 20/200 in two patients and myopia ranging from -1.75 to 15.00 diopters in three patients. Congenital nystagmus was the presenting sign in three of the four patients. Examination of the fundi was uniformly normal. The distinctive spectral properties of BCM were demonstrated by the American Optical H-R-R and the Panel D-15 tests. All affected patients correctly identified three of the four blue-yellow plates and a variable number of the red-green plates in the American Optical H-R-R test. The study patients consistently made errors oriented along the protan and deutan axes but they made none along the tritan axis. The authors conclude that the results of these two color discrimination tests are useful in diagnosing BCM.
Necrotizing Scleritis Following Strabismus Surgery for Thyroid Ophthalmopathy
Authors: Kaufman Lawrence K , Folk Eugene R , Miller Marilyn T , Tessler Howard H
Published: April 2021

ABSTRACT

Necrotizing scleritis with inflammation of the right eye developed after bilateral eye muscle surgery for thyroid ophthalmopathy. Debilitating pain, delay in onset, and Involvement of the sclera distinguish this condition from anterior segment ischemia. The surgery may have acted as a nonspecific trigger in an eye at risk for scleritis. Necrotizing scleritis has occurred infrequently after types of eye surgery but, to our knowledge, has not been previously reported as a complication of eye surgery.
Epibulbar Complex Choristoma Involving the Bulbar Conjunctiva and Cornea
Authors: Hayasaka Seiji , Sekimoto Mihoko , Setogawa Tomoichi
Published: April 2021

ABSTRACT

A male infant was born with a fleshy mass between the temporal bulbar conjunctiva and cornea in the right eye. Four weeks after birth the patient underwent excision of the epibulbar tumor and a lamellar keratoplasty. Histopathologic examination of the excised tumor revealed cartilage, lobules of lacrimal gland, and adipose tissue, indicating an epibulbar complex choristoma. Although the graft remained almost completely transparent, right amblyopia ensued. Epibulbar complex choristoma involving the conjunctiva and cornea is a rare condition.
Polaroid Photorefractive Screening of Infants
Authors: Hsu-Winges Charlene , Hamer Russell D , Norcia Anthony M , Wesemann Henrike , Chan Christine
Published: April 2021

ABSTRACT

We modified a Polaroid SE camera for use as a photoretinoscope. A total of 187 infants between 2 and 18 months of age were photographed using this device. About half of these infants (97) participated in a double blind study in which the results of photorefraction were compared with those of standard cycloplegic retinoscopy. Eighty-three infants were photographed without cycloplegia. Thirty-four infants were photographed while cyclopleged. Photographs were evaluated for significant refractive errors and other ocular abnormalities.

The effectiveness of the camera system to screen for significant refractive errors without the use of cycloplegia was assessed. Infants were identified to be at risk by photorefraction if, in any photograph, a hyperopic bright crescent calculated to be ≥ +1.25 D was present in the pupil. Clinically significant refractive errors were defined by the results of cycloplegic retinoscopy: "at-risk" infants had either 3.5 D or more hyperopia in either eye, or astigmatism In either eye ≥ 2.5 D, or anisometropia ≥ 1.5 D. With these clinical criteria and the above photographic screening criterion, the camera's sensitivity and specificity were 83% and 69%, respectively.

The present system compares favorably with earlier, more sophisticated units in alerting practitioners to potentially significant refractive errors in infants. Additionally, as a screening tool, this device offers the benefits of being inexpensive and easy to use, and of providing immediate feedback.
Changes in the Aphakic Refraction of Children With Unilateral Congenital Cataracts
Authors: Moore Bruce D
Published: April 2021

ABSTRACT

Forty-two infants who presented to the Children's Hospital in Boston with unilateral congenital cataracts and had cataract surgery by 6 months of age received serial refractions (N = 369) of their aphakic eyes during the first 4 years of life. The 14 patients followed most intensively (185 refractions) showed a rapid decrease in mean spherical equivalent during the first year of life from +30.75 D to +26.36 D, with a less rapid decrease thereafter (24 months, +23.02 D; 36 months, +21.19 D; 48 months, +20.86 D). The rate of change per month decreased from .43 D between 1 and 6 months, .37 D between 6 and 12 months, -30 D between 12 and 18 months, .24 D between 18 and 24 months, and less than .19 D per month thereafter. This study shows that the refractive error of the aphakic eye of patients treated for unilateral congenital cataracts decreases most rapidly during infancy and less rapidly during the next few years of childhood. This information will be helpful in facilitating the treatment of these infants by allowing an approximation of their future contact lens refractive power changes.
Fusion and Suppression: Development and Loss
Authors: Pratt-Johnson J A
Published: April 2021

ABSTRACT

A retrospective study (coauthored with Geraldine Tillson) of 118 patients with the congenital esotropia syndrome Is described. All patients were aligned with surgery and, in some cases, glasses as well, within 10 prism diopters of orthotropia before the age of 2 years and had remained so aligned for at least a year.

A standardized final examination was performed on patients over the age of 6 years, after at least 5 years' follow up, to study the effect of significant refractive error, amblyopia, nystagmus, dissociated vertical divergence, and inferior oblique overaction on the sensory outcome. None of the patients obtained central fusion. Fifty-three of 118 obtained peripheral fusion with at least 5? of fusiona! amplitude. Twenty-eight of the 53 fusers had stereopsis. The findings did not show any factors to explain why 65 did not obtain fusion. A congenital lack of the potential to develop fusion is postulated.

The development of fusion and suppression is discussed with relevant references. Evidence is presented that the anatomical location of the lesion in central fusion disruption is in the midbrain. Fusion may be lost, in visual adults, without developing suppression from prolonged sensory deprivation. Examples include unilateral cataract, unconnected unilateral aphakia, and unilateral severe herpetic keratitis.
Motility Disturbances After Molteno Implants
Authors: Christmann Linda M , Wilson M Edward
Published: April 2021

ABSTRACT

Molteno implants are gaining wide acceptance for refractory glaucoma In both children and adults. Such surgery led to vertical strabismus In three patients. Two children developed an inability to elevate the globe after Molteno implants were placed superiorly. One adult, whose Molteno Implant was placed interiorly, could not fully depress the globe postoperatlvely, and experienced vertical diplopia. This complication of Molteno implants was explored using forced auction testing and surgery. We feel a likely explanation for this Is a Faden or posterior fixation suture effect induced by scarring under the rectus muscle. Patients undergoing this surgery should be counseled about possible postoperative diplopia, an especially devastating complication when the implant is placed inferiorly.
Iatrogenic Inferior Rectus Palsy
Authors: Brodsky Michael C , Fritz Katherine J , Carney Susan H
Published: April 2021

ABSTRACT

We examined two patients who developed unilateral inferior rectus muscle palsy following inferior oblique myectomy. Surgical exploration showed a normal inferior rectus muscle and tendon in both patients. Surgical correction consisted of inferior rectus resection in one patient and inferior rectus resection combined with an ipsilateral superior rectus recession in the other. We propose inadvertent excision of the lateral portion of the inferior rectus muscle during inferior oblique myectomy as the probable mechanism of inferior rectus injury.
Ocular Torsion-Direct Measurement With Indirect Ophthalmoscope and Protractor
Authors: Madigan William P , Katz Norman N K
Published: April 2021

ABSTRACT

Objective measurement of the optic nerve head (ONH)foveal angle, representing the torsional status of 40 eyes in 20 normal patients, was performed by fundus photography and compared to a method utilizing an indirect ophthalmoscope and protractor described herein. Photography established a mean ONH-foveal angle of 7.03° (SD 2.94°). Comparison with the indirect/protractor method revealed a mean difference of 1.10° (SD 0.99) with a range of 0° to 4° between methods. The indirect/ protractor method seems to provide a rapid, inexpensive, and accurate method of determining the degree of ocular torsion when compared to the fundus photograph method which requires greater patient cooperation and investment in time and equipment.

The ONH-foveal angle varies widely among normal individuals (0° to 16°). Variation between left and right eyes of the same individual was not significant (1 .15°, SD 1.39°), and if greater than 4°, probably represents cyclovertical muscle dysfunction or restrictive orbitopathy. The converse, however, may not always be true as individuals with less than 4° difference between eyes may have cyclovertical muscle imbalance.
Eye Muscle Prosthesis
Authors: Scott Alan B , Miller Joel M , Collins Carter C
Published: April 2021

ABSTRACT

We inserted a silicone rubber elastic band along the course of a paralyzed lateral rectus and of a paralyzed superior oblique to restore alignment and to provide a spring against which the antagonist could pull. The lateral rectus band has been in place for 7 years. It provides alignment and a field of single binocular vision of 20°. The superior oblique band has been in place for 1 7 months. It provides alignment and single vision over 30° from the primary position except for a restriction in upgaze-adduction to 25° (Brown syndrome) and in downgaze-adduction to 20°. Such engineered elastic bands are a useful addition to current surgical techniques for management of cases of paralysis and restriction.
The Ocular Manifestations of the Sturge-Weber Syndrome
Authors: Sullivan Timothy J , Clarke Michael P , Morin J Donald
Published: April 2021

ABSTRACT

Sturge-Weber syndrome (SWS) is a rare neurooculocutaneous disorder. The ocular component manifests as glaucoma and vascular malformations of the conjunctiva, episclera, choroid, and retina. The authors reviewed the records of and recalled for examination 51 consecutive patients with a diagnosis of SWS seen at The Hospital for Sick Children, Toronto, Ontario, Canada, from 1980 to 1991. Of the 51 patients, 36 (71%) had glaucoma, 26 experienced onset before 24 months of age and the remainder after 66 months of age, 35 (69%) had conjunctival or episcleral hemangiomas, and 28 (55%) had choroidal hemangiomas, which were bilateral in 12 patients. Other ocular manifestations (retinal vascular tortuosity, iris heterochromia, retinal detachment, and strabismus) also occurred. Thirty-four of 51 (67%) glaucomatous eyes had a final visual acuity of 20/40 or better, or central, steady, and maintained fixation in each eye.
Artifacts in Fusion and Stereopsis Testing Based on Red/Green Dichoptic Image Separation
Authors: Simons Kurt , Elhatton Kelly
Published: April 2021

ABSTRACT

A red/green anaglyph stereotest (TNO) was administered to a group of patients who had anisometropic amblyopia, and the Worth 4-Dot test for fusion to two groups of strabismus patients. Both tests were administered twice, with the red/green lens position of the glasses reversed between eyes for the second administration. Twelve of 15 patients with anisometropic amblyopia exhibited a stereo acuity difference of 2:1 or more, and 18 of 89 strabismic patients changed Worth 4-Dot fusion or suppression status, between the two positions of the glasses. A group of seven strabismic patients who showed the reversal effect on the Worth 4-Dot test had the results of one glass4 position discrepant with those of a geometrically identical achromatic test. It appears that the red/green format can introduce artifacts in binocular vision testing. Testing twice, with the red/green glasses reversed between trials, will prevent misinterpretation of binocular status and may provide diagnosticai Iy useful information.
Orbital Kaposiform Hemangioendothelioma
Authors: Gelston Christopher D. , Said Sherif , Durairaj Vikram D.
Published: April 2021

Kaposiform hemangioendothelioma is a rare, locally aggressive vascular tumor found in infants and children. It is often found on the trunk, extremities, and retroperitoneal regions but has not been previously described to primarily involve the orbital region. This report describes a 6-day-old female infant with an orbital kaposiform hemangioendothelioma and the treatment.
CLINICAL SUPERVISION for Psychiatric Nurses
Authors: Platt-Koch Lois M
Published: April 2021

Are misconceptions keeping you from a great learning opportunity?
ELOPE Why Psychiatric Patients Go A.W.O.L.
Authors: McIndoe Katherine I
Published: April 2021

Have A.W.O.L. patients ever made you feel as if you should have been issued a pair of track shoes when you were hired? Examining the event from the patient5 s perspective may provide some understanding of the elopement - and perhaps even help avoid some future races.
LITHIUM and the THYROID
Authors: Vogel Phyllis
Published: April 2021

Not every patient taking lithium develops thyroid malfunction, but the difficulties in diagnosing thyroid disease in patients who present with what seems to be a psychiatric syndrome justify attention to this problem.
Building Better Treatment Plans
Authors: Parsons Patricia J
Published: April 2021

Good clinical treatment depends on good treatment planning; following the seven basic steps outlined here can help you develop treatment plans that work.
Psychiatric Insurance Inadequate for Most Americans
Authors: Anonymous
Published: April 2021

Report States Physical Illnesses May be Covered While Psychiatric Coverage is Restricted
Sexual Needs of Psychiatric Clients
Authors: Young Elaine Wilson
Published: April 2021

Over 100 medical or surgical disorders and numerous prescribed drugs have been identified as having the potential to interfere with sexual functioning. Clients at risk have a need to be alerted to the effects of illness and drugs on their sexuality.
BULIMIA
Authors: Dippel Nelda M , Becknal Billie K
Published: April 2021

Nursing care of known bulimics involves the need for a non-judgmental caring attitude to bolster their lowered self-esteem
Selecting and Applying to a Graduate Program
Authors: Maurin Judith T
Published: April 2021

Graduate Psychiatric Nursing Education
To Treat or Not to Treat?
Authors: Deegan Robert , Bailey Katharine P
Published: April 2021

Managing Acute Symptoms in an Elderly Patient With Alzheimer's Disease
Establishing a Mutual Reality
Authors: O'Connell Michael
Published: April 2021

ABSTRACT

Nursing stories are a vehicle for sharing the uniqueness of the nurse-patient relationship. In this article, a nurse-patient engagement within an acute mental health inpatient unit is described and viewed through various lenses. Consideration is given to literature on reflective thinking. Each lens lends itself to exploring the reflective thinking that occurred for the author. The author's personal perspective on an ethic of care is presented.
Corneal Preservation: Past, Present, and Future
Authors: Bourne William M
Published: April 2021

ABSTRACT: In the past 15 years, techniques of corneal preservation have progressed from the storage of whole eyes in moist chambers for 24 hours at 4°C to the preservation of isolated corneas for 1 week at 4°C and for 1 month at 34°C. Both of the latter techniques display a time-dependent deterioration of corneal tissue during storage. This deterioration has forced a reappraisal of corneal cryopreservation as a method for permanent corneal storage. Future advances will involve: decreasing this timedependent deterioration by improving current techniques of 4°C storage, and eliminating the deterioration by cryopreservation with a process called vitrification. [Refractive and Corneal Surgery 1991;7:60-61]
Management of Corneal Astigmatism After Cataract Surgery
Authors: Gelender Henry
Published: April 2021

ABSTRACT: High degrees of surgically induced astigmatism following cataract surgery may limit the desired visual rehabilitation. The induced astigmatism is a reflection of the cataract incision, its closure, and subsequent wound healing. Excessively tight sutures induce central corneal steepening. Wound dehiscence and wound gap cause a flattening of the central cornea along this axis. Wound compression steepens the central curvature. The management of induced astigmatism is directed to the underlying problem. Suture cutting and removal will reduce suture compression of the wound. Repair of wound dehiscence and wound gap will reestablish wound integrity. Incisional keratotomy will compensate the corneal steepening induced by limbal wound compression. The reduction of astigmatism aids visual function by realizing the visual potential of the operated eye. [Refractive and Corneal Surgery 1991;7:99-102.]
Analysis of the Effects of Astigmatism and Misalignment on Corneal Surface Reconstruction From Photokeratoscopic Data
Authors: Wang Jianyi , Rice David A , Klyce Stephen D
Published: April 2021

ABSTRACT: This article presents a general method of error analysis for reconstruction algorithms employed by corneal topography systems and applies this method to assess the accuracy of the Wang reconstruction algorithms. Using mathematical surface reconstructions, the method detects artifacts introduced in topographic analysis by astigmatism and misalignment. For the Wang algorithms, error introduced by astigmatism was less than 1% of the true value for surfaces with more than 10.00 diopters of astigmatism. A 1-mm translational misalignment of the analyzed surface introduced error of no more than 1.3%. Errors caused by rotational misalignment were less than 3% for misalignments of 5° or less. It is concluded from the error analysis method that the Wang algorithms are sufficiently accurate for use in the analysis of corneal topography. Similar analyses need to be accomplished for the validation of commercially available corneal topography systems. (Refract Corneal Surg 1991;7:129-140.)
Ab Interno Radial Keratotomy
Authors: Mansour Ahmad M , Rowsey James J , Munn Albert R
Published: April 2021

ABSTRACT: We describe a modified approach to perform radial keratotomy which was tested in human donor eyes. Using a Beaver blade #5910, the sclera was entered tangentially 1 mm from the limbus up to the edge of the optical zone while staying in the deep stroma. The shaft was rotated 90°, allowing the cutting edge to dissect from the deep stroma to the epithelium in a radial fashion. The procedure was repeated resulting in eight radial incisions. An average of 8.20 diopters (standard deviation SD = 2.40 D) of flattening was obtained in 20 human donor eyes. Histopathologic study of the radial incisions in another group of 1 0 donor eyes revealed a mean depth of 58.9% of corneal thickness. (SD = 12.4%). The present technique allows radial keratotomy to be performed without the sophisticated instrumentation necessary for the "external" approach. Refract Corneal Surg 1991;7:181-1 85.)
Sodium Bicarbonate Reduces Pain Associated With Ophthalmic Nerve Blocks
Authors: Manka Richard L , Gast Thomas J
Published: April 2021

ABSTRACT: Administration of local nerve blocks for ophthalmic surgical procedures causes pain resulting in an unpleasant and stressful experience for the patient. A prospective, randomized, double-masked study compared injection pain of anesthetic solutions used for facial and retrobulbar nerve blocks. Anesthetic solutions to which sodium bicarbonate had been added were compared with anesthetic solutions without added sodium bicarbonate.

Pain on injection of both facial and retrobulbar nerve blocks was significantly less (P = .0009 and P < .0001 respectively), without diminution of effectiveness of either type of nerve block, in the group using anesthetic solutions to which sodium bicarbonate had been added. Refract Corneal Surg 1991;7:186-187.)
Current Status of Synthetic Epikeratoplasty
Authors: Thompson Keith P , Hanna Khalil , Waring George O , Gipson Ilene , Liu Yung , Gailitis Raymond P , Johnson-Wint Barbara , Green Keith
Published: April 2021

ABSTRACT: Many of the deficiencies with human tissue epikeratoplasty might be improved by the use of a suitable synthetic lenticule. Potential biomaterials for epikeratoplasty include collagen (types I1 III, or IV), collagen-hydrogel copolymers, bioactive synthetics, and coated hydrogels. The biomaterial must be engineered to achieve strict specifications of optical clarity, support of epithelial migration and adhesion, permeability to solutes, and stability to corneal proteases. Attaching synthetic lenticules to the cornea without cutting Bowman's layer by adhesives, laser welding, or direct adhesion may also improve the efficacy of synthetic epikeratoplasty. Refract Corneal Surg 1991;7:240-248.)
Corneal Lathing Using the Excimer Laser and a Computer-controlled Positioning System
Authors: Biowski Robert , Homolka Peter , Barisani-Asenbauer Talin , Baumgartner Isabella , Husinsky Wolfgang , Kaminski Stephan , Lametschwandtner Anton , Muss Wolfgang , Grabner Günther
Published: April 2021

ABSTRACT

PURPOSE: To present the excimer laser corneal shaping system (ELCS-S), an add-on device to the Keratom, a commercially available 193-nm excimer laser built by Schwind.

METHODS: The system is designed for the preparation of donor corneas under sterile conditions using the ultraviolet laser to offer greatest possible flexibility. Lenticules for planolamellar grafting and refractive epikeratoplasty, as well as donor buttons for penetrating keratoplasty can be computer-designed by the surgeon or technician and lathed with the system.

RESULTS: Using the excimer laser corneal shaping system (ELCS-S) on human donor corneas, the central surface of the epikeratoplasty lenticule exhibited only narrow, flat concentric notches corresponding to the single lathing steps. Transmission electron microscopy revealed a damage zone of less than 0.3 µta in close approximation to the treated surface. The final thickness revealed a difference of less than ±53 µm from the intended, initially programmed value. Ultrastructural studies showed the perpendicular stromal surface of the penetrating keratoplasty buttons to be smooth with minimal protrusion of Descemet's membrane. Endothelial injury was observed in a zone averaging between 40 and 100 µta adjacent to the cutting edge only.

CONCLUSION: The excimer laser corneal shaping system (ELCS-S) allows a computer-controlled, surgeon-designed, sterile preparation of lamellar and penetrating corneal grafts with the use of the excimer laser. This could offer significant advantages in comparison to presently available systems for lamellar dissection and trephination. [J Refract Surg 2000;16:23-31]
Arcuate Transverse Keratotomy Remains a Useful Adjunct to Correct Astigmatism in Conjunction With Photorefractive Keratectomy
Authors: Kapadia Manasvee S , Krishna Rohit , Shah Sujal , Wilson Steven E
Published: April 2021

ABSTRACT

PURPOSE: To retrospectively evaluate the effectiveness of paired, arcuate transverse keratotomy (Arc-T) performed prior to or after photorefractive keratectomy (PRK) to correct low to moderate amounts of natural or laser-induced astigmatism.

METHODS: Spherical PRK was performed in 730 eyes for myopia of -1.00 to -7.00 D. PRK with arcuate transverse keratotomy was performed in 150 of these eyes; we studied 123 eyes that did not have PRK enhancement. Arc-T was performed prior to PRK in all 37 study eyes with astigmatism of 1.50 D or more at the preoperative examination. Arc-T keratotomy was performed after PRK in 86 study eyes for residual astigmatism of +0.75 D or more and uncorrected visual acuity of 20/30 or worse.

RESULTS: Arc-T before PRK group: PRK was performed at a mean 1.0 ± 1.5 months after Arc-T. Mean astigmatism decreased from +2.40 ± 0.6 D (range, 1.00 to 4.00 D) before Arc-T to 0.60 ± 0.60 D (range, 0 to 2.25 D) after Arc-T (P < .0001). Net change in astigmatism was 1.80 ± 0.60 D (range, 0.80 to 2.80 D) and mean reduction was 75%. Spherical equivalent refraction changed from -4.10 ± 1.90 D (range, -0.25 to -8.10 D) to -4.40 ± 1.80 D after Arc-T (P = .002). Mean change in spherical equivalent refraction after Arc-T was -0.30 ± 0.50 D (range, -1.10 to +0.40 D).

Arc-T after PRK group: Arc-T was performed at a mean 3.5 ±1.9 months after PRK. Six months after Arc-T, astigmatism was decreased from +1.50 * 0.60 D to 0.40 ± 0.40 D (P = .04). Net change in astigmatism at 6 months was 1.10 ± 0.60 D and mean reduction was 74%. Vector change in astigmatism magnitude was 1.30 ± 0.60 D (range, 0 to 4.00 D) at 6 months and vector change in astigmatism axis was 65° ± 68°. Spherical equivalent refraction did not change when Arc-T was performed after PRK for eyes with low astigmatism (P = .4). Arc-T retreatment was performed in 6 of 37 (16%) eyes that had Arc-T before PRK and 18 of 86 (21%) eyes that had Arc-T after PRK (P = .12).

CONCLUSION: Arcuate transverse keratotomy performed prior to PRK for high astigmatism or after PRK for lower levels of residual astigmatism effectively improved visual outcome. Coupling was less predictable for high levels of astigmatism correction with Arc-T. [J Refract Surg 2000;16:60-68]
Lower Intraoperative Flap Complication Rate With the Hansatome Microkeratome Compared to the Automated Corneal Shaper
Authors: Walker Mark B , Wilson Steven E
Published: April 2021

ABSTRACT

PURPOSE: The purpose of this study was to retrospectively compare the incidence of intraoperative flap complications, such as partial flaps, donutshaped flaps, central corneal cuts, and complete caps with the Hansatome and Automated Corneal Shaper (ACS) microkeratomes.

METHODS: All laser in situ keratomileusis (LASHi) procedures performed by a single surgeon with the Hansatome or Automated Corneal Shaper in which intraocular pressure was verified with a pneumotonometer were reviewed.

RESULTS: A total of 90 eyes had LASHi with the ACS microkeratome. Six of the ACS eyes (6.7%) had intraoperative flap complications (4 partial flaps, 1 donut-shaped flap, 0 central corneal cuts, 1 complete cap). Partial flaps and donut-shaped flaps were replaced without laser application and the procedure repeated 2 to 3 months later. Two of these eyes lost 2 lines and one lost 1 line of spectacle-corrected visual acuity at 6 months after repeat LASHL The eye with the donut-shaped flap was treated with transepithelial photorefractive keratectomy (PRK) and had no change in spectaclecorrected visual acuity at 6 months after PRK. The eye with the complete cap had no change in spectacle-corrected visual acuity after laser ablation. Five hundred ninety-eight (598) eyes had LASHi with the Hansatome microkeratome. Two of the Hansatome eyes (0.3%) had a flap complication (1 partial flap and 1 donut-shaped flap). The first eye retained spectacle-corrected visual acuity at 6 months after repeat LASEK. The second eye had transepithelial PRK to eliminate the donut shaped flap with no loss of spectacle-corrected visual acuity at 6 months after surgery. The difference in flap complications between the two procedures was statistically significant (P < .01). There were no flap displacements following surgery in either group.

CONCLUSION: Intraoperative flap complications are less likely to occur with the Hansatome microkeratome than with the ACS microkeratome. [J Refract Surg 2000;16:79-82]
Photospallation: A New Theory and Mechanism for Mid-infrared Corneal Ablations
Authors: Hoffman Hanna J , Telfair William B
Published: April 2021

ABSTRACT

PURPOSE: A new mechanism for ablating corneal tissue is proposed, based on photospallation with short pulse mid-infrared (IR) laser radiation.

METHODS: By using a judicious combination of high absorption, short pulses, and low fluences, ablation with this process can potentially remove tissue in a highly localized manner with submicron collateral thermal damage characteristics similar to those achieved by excimer lasers. We provide a brief qualitative overview of aspects of the spallation process that distinguish it from the more familiar photoablation and photothermal mechanisms.

RESULTS: Results of preliminary parametric analysis based on one-dimensional models of thermoelastic expansion are summarized.

CONCLUSION: These preliminary calculations lend support to the conjecture that corneal tissue can be removed effectively with strongly absorbed nanosecond pulses from a mid-IR laser, using operational fluence levels of less than 200 mJ/cm
p 2
. [J Refract Surg 2000;16:90-94]
Wavefront-guided Laser in situ Keratomileusis: Early Results in Three Eyes
Authors: Mrochen Michael , Kaemmerer Maik , Seiler Theo
Published: April 2021

ABSTRACT

PXJRPOSE: Wavefront optical aberrations induced by refractive corneal surgery correction of myopia are probably the reason for deterioration of visual performance in some eyes after surgery. Customized photoablation of the cornea to correct both the sphero-cylindrical refractive error as well as individual optical aberrations may improve postoperative visual acuity and visual performance.

METHODS: In 3 eyes of 3 patients the wavefront deviations were measured by means of an aberrometer of the Tscherning-type. Based on these measurements an ablation pattern was determined and applied during a LASIK procedure using a Wavelight Allegretto scanning spot excimer laser with a spot size of 1 mm and a laser repetition rate of 200 Hz. The 3 eyes are part of a prospective study on wavefront-guided LASK started in July 1999.

RESULTS: At 1 month after LASBK, all 3 eyes had gained up to 2 lines of best spectacle-corrected visual acuity. Best spectacle-corrected visual acuity improved to 20/10 in all 3 eyes, uncorrected visual acuity was 20/10 in two eyes, and 20/12.5 in 1 eye 1 month postoperatively. The wavefront deviations were reduced by 27% on average. At 3 months, best spectacle-corrected visual acuity was 20/10 in 2 eyes and 20/12.5 in 1 eye.

CONCLUSION: Wavefront-guided LASBK is a feasible approach in refractive corneal surgery. Optimized ablation patterns may further improve the visual results. [J Refract Surg 2000;16:116-121]
Prevention and Management of Microkeratome-related Laser in situ Keratomileusis Complications
Authors: Gimbel Howard V , Iskander Nader G , Peters N Timothy , Penno Ellen Anderson
Published: April 2021

ABSTRACT

PURPOSE: To review the most commonly encountered laser in situ keratomileusis (LASIK) microkeratome-related complications, and the most up-to-date methods in their prevention and treatment.

METHODS: A review of microkeratome-related complications including epithelial complications, bleeding, thin flap, button hole, free cap, incomplete pass, and corneal perforation was conducted. The most recent techniques for prevention and treatment of each complication were included.

RESULTS AND CONCLUSION: Microkeratome complications are difficult to predict. With proper attention to anatomical and mechanical considerations, many can be reduced or prevented. [J Refract Surg 2000;16(suppl):S226-S229]