bluuebunny/crossref_metadata_2025 huggingface dataset:
Plaster and Synthetic Cast Temperatures in a Clinical Setting: An in Vivo Study
Authors: Ahmed Sonya S. , Carmichael Kelly D.
Published: April 2021

Previous studies have reported thermal injuries with thick cast materials and warm dip water temperatures, often much higher than is clinically applicable. The goal of this study was to assess the temperature produced in vivo by current casting techniques and materials. The study was done using clinically applicable materials and water temperatures.

A single volunteer was used to test skin temperatures produced with various casting techniques. We tested several types of fiberglass and plaster of 5 or 10 layers, used soft roll of 1 or 3 layers, and used dip water temperatures of 30°C and 40°C. We tested 2 plaster types: Johnson & Johnson Specialist Fast Set and Specialist Extra Fast Set (New Brunswick, New Jersey). Fiberglass tested included 3M Scotchcast Poly Casting Tape and Scotchcast Plus (St Paul, Minnesota), Royce Medical Techform (Camarrillo, California), and DeBusk Classic Synthetic Tape (Powell, Tennessee). The highest temperature reached using 30°C water temperature was 39°C with 10 layers of 3M Scotchcast fiberglass and 1 layer of soft roll. The highest temperature reached with 40°C water was 39.5°C, which was reached twice: once with Johnson & Johnson Fast Set Plaster with 5 layers of plaster and 3 layers of soft roll, and once with DeBusk Classic Synthetic Casting Tape of 10 layers with 1 layer of soft roll.

Under the clinically applicable conditions described in this study, using the materials we tested and with a normal vascular supply, it is unlikely that temperatures high enough to cause a burn will be produced. We caution that good clinical judgment is advised if a patient reports a cast is too hot.
Teaching Methodologies: Knowledge Acquisition and Retention
Authors: Roberts Karen K , Thurston Hester I
Published: April 2021

ABSTRACT

In studying the curriculum of a nursing program, knowledge acquisition and retention by nursing students is a primary concern of nursing instructors. The purpose of this study was to determine if a lecture which stimulated several senses would significantly increase knowledge acquisition and retention compared to lectures that stimulate only the auditory sense. Forty-three, junior year, diploma nursing students who had essentially the same clinical experience were the subjects randomly assigned to either Group A or B for this study. Group A (control group) attended a formal lecture on "Spinal Cord Injuries" which stimulated only the auditory sense. Group B (experimental group) attended a lecture on the same subject which stimulated the auditory, visual, and tactile senses. A pretest was given to evaluate the knowledge base prior to the lecture, a posttest was given immediately after the lecture to evaluate initial knowledge acquisition, and a retention test was given three weeks later to evaluate amount of knowledge retained.

Students attending the multimodal lecture demonstrated a significantly higher retention test score at the .05 level although they did not demonstrate a significantly higher gain score from pretest to posttest.
The Effects of an Undergraduate Clinical Internship on the Self-Concept and Professional Role Mastery of Baccalaureate Nursing Students
Authors: Olson Roberta K , Gresley Ruth Seris , Heater Barbara Stewart
Published: April 2021

ABSTRACT

Purpose: The purpose of this investigation was to determine whether an eight-week undergraduate clinical course would enhance students' self-concepts and increase their perception of competence in critical care, teaching/collaboration, planning/evaluation, professional development, leadership and interpersonal skills, and communication.

Research Questions: Is there a need for an undergraduate clinical internship? Will there be a difference in self-concept and perception of role mastery between the group of students who participated in the internship and those who did not participate?

Methodology: Nursing students at the University who were between their junior and senior years were offered the opportunity to enroll in the course (didactic and clinical). Eight interns enrolled in the course; five non-interns enrolled in the didactic portion only; and the remaining 36 classmates were designated as the control group.

Design: A pretest-post test designed was utilized. Two instruments were used: 1) The Tennessee Self-Concept Scale and 2) The Six-Dimensional Scale of Nursing Performance.

Results: One way ANOVA with .05 level of significance was used as the statistical test. There were no significant differences noted.

Conclusions: The number of interns and non-interns was too small and the consequence is low statistical power. The generic program in nursing at this university provides a strong conceptual and practice base to students and an internship is unnecessary. The pretest-post test of the 6-D Scale of Nursing Performance may not be sensitive in picking up behavior changes when there are changes.
Concerns of Final Year Baccalaureate Students About Nursing Dying Patients
Authors: Milton Isabel C
Published: April 2021

ABSTRACT

The study was designed to investigate whether final year baccalaureate nursing students in one Faculty of Nursing had concerns about nursing dying patients. This was done to determine when concerns were expressed how these related to students' personal (family) experiences with death and/or to critical experiences in learning to nurse dying patients.
Critical Thinking and Nursing Education
Authors: Gross Yukie T , Takazawa Evelyn S , Rose Charles L
Published: April 2021

ABSTRACT

This study evaluated the impact of nursing education on students' critical thinking abilities, as measured by the Watson-Glaser Critical Thinking Appraisal (WG). In addition, the WG and the NLN Pre-Admission Test were related to GPA and NCLEX. A sample of 108 AS and BS students at the University of Hawaii School of Nursing were tested at entry and exit. AS and BS students showed comparable improvement in critical thinking ability. NCLEX was best predicted by the GPA, which in turn summed up effects of WG and NLN. The results confirm the efficacy of nursing education in improving critical thinking skills and suggest that the GPA is more important than the WG in predicting the NCLEX. The latter effect was more prominent in the BS group. Further investigation of the role of critical thinking in nursing and academic performance is suggested.
The Effects of a Support Group on Student Attrition Due to Academic Failure
Authors: Brown Mary Louise
Published: April 2021

ABSTRACT

This article describes a research project which tested the effect of a support group on student attrition due to academic failure. The investigator hypothesized that if specific supportive behaviors were rendered in a group setting, the group members would (a) achieve an increased perception of self-competence, and (b) experience academic success. The sample for this study was selected from two consecutive classes in an upper division BSN program and was comprised of students who had achieved only minimal passing grades in the first semester nursing course. Following utilization of the support group, a significant difference in academic failure, and therefore attrition, existed between the experimental and control groups, thus supporting part of the original hypothesis. The recommendation is made that when the study is replicated, an attempt be made to determine specific factors responsible for the effects noted in this study.
A Contextual Analysis of Faculty Productivity
Authors: Holzemer William L , Chambers Donald B
Published: April 2021

ABSTRACT

This study examined the contextual effects of the educational environment on faculty productivity (N = 241) from 25 nursing doctoral programs. There was a modest contextual effect upon faculty productivity after removing the contributions of individual characteristics. Highly productive programs were characterized by faculty of senior rank who had extensive teaching experience and who worked in highly productive environments. In addition, faculty who perceived their environment positively were more productive. There was also a significant individual effect upon faculty productivity after removing the contributions of the environment. Highly productive faculty were characterized by having higher academic rank, being older, and reporting a higher percentage of time spent on research activity. The significance of the contextual effects of working in a productive environment, perceiving the environment positively, and time spent on research activity are discussed.
Reducing Nursing Students' Anxiety Level and Increasing Retention of Materials
Authors: Phillips Ann P
Published: April 2021

ABSTRACT

The purpose of this descriptive study is to examine the effects active learning, collaboration and modified group testing have on reducing students' anxiety and increasing learning and retention of material. Subjects consist of 34 associate degree nursing students enrolled in the Advanced Adult Health nursing class at North Georgia College. Most of the students are married, have children and work part time.

A self-reporting questionnaire suggests a reduction of the students' anxiety during the quarter. The attitudinal questionnaire reveals an atmosphere of collaboration among peers. Data evaluating learning and retention of material were analyzed using the parametric (T-test) and nonparametric (Wiley Rank Sum test) methods. Examination of the Null Hypotheses I and II suggests there were increased learning and retention of material as evidenced by higher grades on the comprehensive final examination than on the quizzes given after presentation of content. Principles of andragogy as defined by Knowles (1980) and cooperation with peers as described by Johnson, Johnson, Holabec, and Roy (1984), Johnson, Johnson, and Maruyama (1983), and Johnson and Johnson (1975) form the theoretical foundation.
Competencies of Liberal Education and Registered Nurses' Behavior
Authors: Bottoms Marjorie Sullivan
Published: April 2021

ABSTRACT

The purpose of this study was to determine the relationship between liberal education competencies as demonstrated in the behavior of nursing graduates and the type of nursing education program completed by the graduates. A secondary purpose was to examine graduate behavior as these competencies are demonstrated in both personal and professional life.

A self-report instrument was developed and mailed to a random sample of registered nurses in Iowa. An analysis of a subsample (N = 565) of subjects who obtained no education beyond licensure is reported.

Major findings were:

1. Nurses with basic baccalaureates apply more compentencies in their personal lives than associate degree graduates and more competencies in their professional lives than hospital diploma graduates.

2. There is a disordinal interaction of scores with diploma graduates reporting more personal behaviors and associate degree graduates reporting more professional behaviors.

3. Nursing graduates reported more liberal education behaviors applied in their personal lives than in their professional lives.
The Senior Preceptorship as a Method for Anticipatory Socialization of Baccalaureate Nursing Students
Authors: Dobbs Kathleen K
Published: April 2021

ABSTRACT

This study supported the effectiveness of a senior preceptorship experience as a method for promoting anticipatory socialization to the working role of professional nurses. Anticipatory socialization was evidenced by changes in role expectations and self-image. Corwin's Nursing Role Conception Scale was administered to 103 generic baccalaureate nursing students immediately prior to and after their final clinical course, a preceptorship experience. A significant decrease in perceived role deprivation (p < .01) and a significant increase in the work -centered role models (p < .01) indicated changes in students' self-image and role expectations.

For many nurses, the most stressful time of their career was the period immediately after graduation. A difficult period of transition from student to practitioner is not unique to nursing. But, it seems to be more of a problem for baccalaureate nurse graduates than for other nurse graduates (Schmalenberg & Kramer, 1979).

Pregraduation preceptorship is an increasingly popular approach for dealing with this problem. While nursing education, service, and students applaud the preceptorship experience as easing role transition, there is little research data to document this belief.
Perceptions of Caring by Nurse Educators
Authors: Komorita Nori I , Doehring Kathleen M , Hirchert Phyllis W
Published: April 2021

ABSTRACT

The purpose of this paper is to report on nurse educators' perceptions of caring behaviors. A review of the literature indicated a lack of consensus between nurses and patients of exactly what constitutes caring behaviors. Since subjects in previous studies were based on nurses educated at various levels, it was hypothesized that a more homogeneous sample of nurses with advanced education might provide different findings. Using the Larson CAREQ, 110 nurse faculty, managers, and clinical specialists/ practitioners were asked to indicate what they believed were the most and least important caring behaviors. Because the 72 educators' findings were similar to those of 38 other nurses with advanced education, their responses were combined. A clear difference between the perceptions of nurses and patients was obtained, and the data support the results of previous studies - nurses have a tendency to consider comfort and trusting relationship items as most important while patients perceive behaviors associated with physical care as most important. No significant differences were found between educators according to type of programs or functional groups, and few differences were found according to age, years of experience, or clinical areas.
The Composing Processes of Nursing Students in Writing Nurses' Notes
Authors: Sorrell Jeanne Merkle
Published: April 2021

ABSTRACT

In this exploratory research, a microethnographic approach was used to investigate how nursing students learn to write nurses' notes. The research focused on the perceptions and behaviors of first-year nursing students as they learned to write nurses' notes in the classroom, campus lab, and hospital. Aspects of the environment were identified that facilitated or hindered the process of learning to write nurses' notes. Adoption of a mental organizing framework by the students appeared to facilitate the composing process. The use of a standard flow sheet appeared to hinder the writing-to-learn and writingto-remember aspects of the composition of nurses' notes. Students were aware of a hostile authence for their nurses' notes - a court of law. The study provides important information on the assessment and decision-making processes that students use in learning to write nurses' notes, as well as the various environmental influences that must be considered in on-the-job writing. Findings suggest that nurses and educators should consider how to restructure the learning environment to facilitate composition of effective nurses' notes.
Learning a Complex Nursing Skill: Student Anxiety and the Effect of Preclinical Skill Evaluation
Authors: Bell Margaret L
Published: April 2021

ABSTRACT

The purpose of this study was to identify the anxiety profile of undergraduate nursing students when learning a complex psychomotor skill, and to determine the effect of preclinical skill evaluation on student anxiety and performance when applying the skill in a patient situation. Findings support preclinical skill evaluation as an effective strategy for reducing anxiety related to initial transfer of skill learning from a laboratory to a clinical setting and enhancing self-confidence.
Undergraduate Nursing Students' Lived Experience of Health: A Phenomenological Study
Authors: Beck Cheryl Tatano
Published: April 2021

ABSTRACT

In order to function as promoters of health, nursing students first need to examine their own meaning of health. A phenomenological study was conducted to explore 56 undergraduate nursing students' lived experience of health. Using Van Kaam's (1966) phenomenological methodology, three necessary constituents of health emerged: optimal unfolding, peaceful contentedness, and perpetual vigilance. These necessary constituents were synthesized into a valid description of the total experience of health as perceived by undergraduate nursing students, i.e., the experience of health is basking in peaceful contentedness permeated by optimal unfolding and perpetual vigilance. Implications for both nursing students and faculty are discussed.
Retention of English-as-a-Second-Language (ESL) Students: Approaches Used by California's 21 Generic Baccalaureate Nursing Programs
Authors: Memmer Mary Kelly , Worth Charles C
Published: April 2021

ABSTRACT

A rapidly growing number of California's ethnic minority nursing students are individuals whose primary language in not English; these English-as-a-second-language (ESL) students often have high attrition rates. This research surveys the approaches used in all of California's 21 generic baccalaureate nursing programs to retain their ESL students until graduation. Comparisons between the five programs with the highest ESL student retention rates and the group as a whole show significant differences.
Characteristics of Israeli Women Studying Nursing Compared to Women Studying Education and Engineering
Authors: Horn Hadassa , Holzemer William L
Published: April 2021

ABSTRACT

This study examined the demographic characteristics, vocational personality, and sex-role orientation of Israeli women studying nursing compared to women studying education and engineering. The convenience sample was 176 university students. The instrument included a demographic inventory, Holland's Self-Directed Search (SDS) questionnaire, and the Sex-Role Orientation Attitude questionnaire.

Nursing and education students had Holland's "social" personality types and engineering students were more "realistic" or "investigative." Nursing and engineering students were significantly more feminist in their orientation than education majors. Nursing students were nontraditional women who had traditional family backgrounds, yet were nontraditional in their feminist orientation. With nursing's move into colleges and universities, the need for academically qualified applicants has intensified. Developing a better understanding of the unique nature of nursing and nursing students is a challenge.
Reflective Learning: A Teaching Strategy for Critical Thinking
Authors: Baker Charles R
Published: April 2021

ABSTRACT

Most nurse educators claim that ability to critique one's clinical practice is a skill which must be acquired if nursing students are to continue to learn and develop as practitioners after they have graduated. This skill is of particular relevance for nurses who will be working independently in the community. The author reviews recent literature on critical thinking and reflective learning and identifies the results of one baccalaureate nursing school's use of reflective journals.
Nursing Students' Perspectives: Experiences of Caring and Not-So-Caring Interactions with Faculty
Authors: Hanson Lynn E , Smith Marjorie J
Published: April 2021

ABSTRACT

The purpose of this study was to describe the meaning of baccalaureate nursing students' lived experience of caring and not-so-caring interactions with faculty, The research questions explored the phenomenon of being cared-for or not-cared-for by asking, "What does being cared-for by faculty mean to baccalaureate nursing students?" Students were also asked to describe not-so-caring interactions with faculty. Seventeen baccalaureate nursing students at a private Uberai arts college and 15 baccalaureate nursing students at a public university were interviewed. Transcripts of the tape-recorded interviews were analyzed using Giorgi's technique. After reflection upon the content of the interviews, significant statements were identified, meaning units were developed, and themes were extracted which were then abstracted into categories of Recognition, Connection, and Confirmation/Affirmation. Finally, general structural descriptions of the phenomena of a caring and of a not-socaring interaction were constructed. Implications for teaching, research, and practice are described.
Stress and Coping: First-Year Nepalese Nursing Students in Clinical Settings
Authors: Mahat Ganga
Published: April 2021

ABSTRACT

The purpose of this descriptive study was to identify stressful events of first-year Nepalese nursing students in the clinical setting and to determine how the; cope with the stressful events. The sample consisted of 104 nursing students who had been in the clinical setting for 6 to 8 weeks. Four stressful events identified were: interpersonal relationships, initial experiences, feeling helpless, and demeaning experiences. The most frequently reported stressful event was interpersonal relationship (50%). Eight categories of coping from students' description were problem-solving, accepting responsibility, seeking social support, self-control, tension reduction, avoidance, wishful thinking and negative feelings. The majority of students utilized the "seeking social support" category of coping.
Undergraduates' Perceptions of Their Psychiatric Practicum: Positive and Negative Factors in Inpatient and Community Experience
Authors: Perese Eris F
Published: April 2021

ABSTRACT

To identify factors contributing to positive or negative undergraduate experiences, often cited as influencing student selection of practice area, 38 baccalaureate students were queried about their inpatient/community psychiatric practicum. Positive, negative and potentially helpful factors were derived from the themes of their responses, Positive factors included staffs professionalism, enthusiasm and acceptance of students; diversity of learning opportunities; and involvement with patients. Negative factors related to nursing staff performance. Potentially helpful factors were those promoting goodness of fit between program expectations for students, characteristics of the clinical setting and modeling of psychiatric nursing career options.
Conservative Management of Congenital Nasolacrimal Duct Obstruction
Authors: Nucci Paolo , Capoferri Carlo , Alfarano Rosetta , Brancato Rosario
Published: April 2021

ABSTRACT

Fifty-nine children 1 to 24 months of age with congenital nasolacrimal duct obstruction (CNDO) were treated with local hydrostatic massage and antibiotic eye drops. Children 1 to 12 months of age showed a cure rate of 93.3%; only two of them underwent nasolacrimal probing. Children 13 to 24 months of age had a cure rate of 79.3%, and six underwent probing. The initial probings were successful in both age groups. Fifty-one children (86.4%) were thus spared nasolacrimal probing.
Primary and Secondary Orbital Teratomas
Authors: Weiss Avery H , Greenwald Mark J , Margo Curtis E , Myers William
Published: April 2021

ABSTRACT

Two patients with primary teratomas of the orbit and a third patient with a teratoma Invading the orbit from the maxillary sinus are presented. The clinical presentation of each patient was spectacular. In the primary teratomas, the globe was displaced out of the orbit by the attached tumor, causing extreme proptosis. Computed tomography was virtually diagnostic, showing a variegated orbital mass with solid and cystic components. Histologic examination showed multiple tissues derived from two or three germinal layers. The surgical removal of the tumors and reasons for the poor visual outcome are discussed. The appearance of teratomas in the orbit and other cephalic structures appears to arise from the survival and proliferation of germ cells deposited there during embryogenesis.
Observations on the Use of Three Different Contrast Sensitivity Tests in Children and Young Adults
Authors: Mäntyjärvi Maija I , Autere Marja H , Silvennoinen Anne M , Myöhänen Terttu
Published: April 2021

ABSTRACT

Forty-one children and young adults aged 4 to 25 years (mean 14.5 ±6.9, SD) with normal eyes were examined with three different contrast sensitivity tests: the Vistech distance and near test, the Cambridge Low Contrast Gratings test, and the LH-5 Contrast test. In different age groups, the youngest children aged 4 to 9 years had the lowest result values. The results of the older children aged 10 to 15 years and young adults aged 16 to 25 years were close to each other. The range of the results in all tests was large in every age group. The values of contrast sensitivity could not be compared from one test to another; in the Vistech tests the values varied from 10 to 200, in the Cambridge test from 170 to 560, and in the LH-5 test from 5 to 50. Most of the children liked the LH-5 test best, while most of the young adults preferred the Vistech distance test. It is useful to examine children and adults with different contrast sensitivity tests; however, the same test should be used in follow-up examinations.
Genetic Counseling in X-Linked Retinitis Pigmentosa
Authors: Anandakrishnan Indira , Musarella Maria A
Published: April 2021

ABSTRACT

The current status regarding genetic counseling In Xlinked retinitis pigmentosa (XLRP) is reviewed. XLRP is the most severe form of retinitis pigmentosa (RP) and leads to blindness in the third or fourth decade of life. The biochemical basis of the disease is not known. Until now genetic counseling in this disease has been dependent on simple Mendelian laws of inheritance and the detection of carriers by clinical and electrodiagnostic means. The limitations with regard to carrier detection are discussed. With the recent advances made in recombinant DNA technology, genetic counseling has come to play an important part in the management of XLRP. The methods of DNA technology and their application to localizing the XLRP gene on the X chromosome are reviewed. The discovery of DNA linkage markers known as restriction fragment length polymorphisms (RFLPs) allow a marker closely linked to a disease gene to be followed through succeeding generations in an affected family. Since linkage studies suggest two XLRP loci, carrier detection and prenatal diagnosis of the disease still remain problematic.
Medial Rectus Re-Recession in Undercorrected Esotropia
Authors: Biedner B , Yassur Y , David R
Published: April 2021

ABSTRACT

Conventional surgical management of surgically undercorrected esotropia includes bilateral lateral rectus resection, marginal myotomy, and Faden operation. During a 3-year period, 10 patients with surgically undercorrected esotropia had medial rectus re-recession 13.5 mm from the limbus.

Successful binocular realignment (to 10 prism diopters or less residual binocular misalignment) was achieved in 9 of the 10 cases for both near and distance measurements.
Adult Amblyopia Reversed by Contralateral Cataract Formation
Authors: Wilson M Edward
Published: April 2021

ABSTRACT

Two adutt patients are presented whose childhood amblyopia improved markedly when the sound eye became cataractous. In each case, the amblyopic eye became the preferred eye for fixation, allowing each patient to temporarily delay cataract surgery. Most remarkably, the acuity improvement has been sustained for greater than 2 years in each patient after full visual rehabilitation of the sound eye by cataract extraction.
Ocular Findings of Incontinentia Pigmenti in a Male Infant With Klinefelter Syndrome
Authors: Fowell Susan M , Greenwald Mark J , Prendiville Julie S , Jampol Lee M
Published: April 2021

ABSTRACT

A male infant with Klinefelter karyotype (47, XXY) manifested both the typical dermatologie findings of the X-linked dominant disorder incontinentia pigmenti (BlochSulzberger syndrome) and ocular findings including retinal pigmentary changes, peripheral retinal avascularity, and preretinal fibrovascular proliferation. To our knowledge, this is the first reported case of incontinentia pigmenti with this specific abnormal genotype manifesting ocular findings.
ALZHEIMER'S DISEASE SYNDROME
Authors: Thornton Joe E , Davies Helen D , Tinklenberg Jared R , Terry Robert
Published: April 2021

Research, clinical service, and social support are inextricably linked in the battle against Alzheimer's disease. Each of these areas must be addressed in order to effectively treat the syndrome.
VIETNAM NURSES
Authors: Rogers Barbara , Nickolaus Janet
Published: April 2021

While some, perhaps many, look back on Vietnam as a maturing experience, few were prepared for the exposure to personal danger, suffering, and death.
TRANSITIONAL HOUSING
Authors: Huffman Roberta W
Published: April 2021

for Veterans With a Psychiatric Diagnosis
Use of Music Therapy and Other ITNIs in Acute Care
Authors: Gagner-Tjellesen Desiree , Yurkovich Eleanor E , Gragert Marcia
Published: April 2021

ABSTRACT

The purpose of this descriptive study was to examine the clinical use of music therapy as an independent therapeutic nursing intervention (ITNI) in acute inpatient settings. This study identified the frequency, rationale, and perceived effectiveness of its use as an ITNI. In addition, barriers and facilitators to nurses' use of music therapy were identified. Frequency of use of other ITNIs also were investigated. An author-designed questionnaire, based on the literature and reviewed by a panel of experts, was used to survey a convenience sample (N = 321) of RNs at an acute inpatient facility with more than 50 beds, located in the midwestern United States. One hundred thirty-five RNs (42%) participated in the study.

Findings indicated that 85.2% (n = 1 1 5) of respondents knew of music therapy, with 69.6% (n = 94) of them reporting using it in practice. Of the other listed ITNIs, deep breathing was used most frequently, followed by therapeutic touch and massage. Music therapy was used most commonly to reduce anxiety and was ranked as the ITNI used most often to enhance sleep and decrease distraction, agitation, aggression, and depression. Psychiatry/ chemical dependency and intensive care units had the highest incidence of use of music therapy.

The ranking of barriers and facilitators identified the strongest barrier as not having time to help patients with music therapy, whereas the strongest facilitator was nurses' comfort with the idea of using music therapy. This research begins to fill an information gap about the frequency, purpose, and perceived effectiveness of use of ITNIs. The use of ITNIs can increase patient comfort and facilitate conservation of energy, which aids healing processes, as described in Levine's Conservation Model. Use of ITNIs also can empower nurses and facilitate their control over nursing practice. This study indicates that nurses need further education on the use of music therapy and other ITNIs.
Effects of Intrastromal Corneal Ring Size and Thickness on Corneal Flattening in Human Eyes
Authors: Burris Terry E , Ayer Carol T , Evensen David A , Davenport James M
Published: April 2021

ABSTRACT: Intrastromal corneal rings can flatten the human cornea, providing a potential new method of keratorefractive surgery. We investigated the effect of implanting various ring sizes of a given thickness in 8.50-mm intrastromal channels dissected in human eye bank corneas. A new intraoperative corneal topography device was used to obtain serial data. Smaller rings with no expansion pressure on the channels were found to induce corneal flattening presumably due to the ring thickness alone. Rings of increasing diameters produced high degrees of corneal flattening at progressively declining rates; this suggests that shear stresses may have expanded the channel due to mechanical stresses placed by our particular experimental technique. Implantation techniques that minimize stress on the outer channel lamellae appear advisable. New ring designs should take ring thickness into consideration along with outer edge configurations that minimize shear stresses on the lamellar channels. [Refractive and Corneal Surgery 1991;7:46-50.]
Histological Comparison of Corneal Ablation With Er:YAG Laser, Nd:YAG Optical Parametric Oscillator, and Excimer Laser
Authors: Telfair William B , Bekker Carsten , Hoffman Hanna J , Yoder Paul R , Nordquist Robert E , Eiferman Richard A , Zenzie Henry H
Published: April 2021

ABSTRACT

PURPOSE: To use histological techniques to assess and compare the ablation depth, local damage, and surface quality of corneal ablations by a Q-switched Er:YAG laser, an optical parametric oscillator laser at 2.94 µm, a long pulse Er:YAG laser, and a 193-nm excimer laser.

METHODS: Human cadaver eyes and in vivo cat eyes were treated with a 6.0-mm diameter, 30-jrai-deep phototherapeutic keratectomy ablation and a 6.0-mm diameter, -5.0O-D photorefractive keratectomy ablation. Human cadaver eyes were also treated with a 5.0-mm diameter, -5.00-D laser in situ keratomileusis (LASHi) ablation. Fluences and pulse widths used were 200 mJ/cm
p 2
and 70 ns for the Q-switched Er:YAG, 150 mJ/cm
p 2
and 7 ns for the optical parametric oscillator laser (OPO), 500 mJ/cm
p 2
and 50 microseconds for the long pulse Er:YAG, and 160 mj/cm
p 2
and 20 ns for the excimer laser. In the ablation rate study, 12 porcine eyes were ablated by the OPO laser with a range of layers and at different fluences ranging from 60 to 150 mJ/cm
p 2
, all using a 1.5-mm spot on the eye. The ablation depth of these acute ablations was evaluated by light microscopy examination.

RESULTS: In the acute damage study, light microscopy showed a thin surface layer in all samples with minimal thermal damage except on the long pulse Er:YAG corneas. Transmission electron microscopy revealed less than 0.3-µm surface damage for all specimens of both the optical parametric oscillator and the excimer laser samples with no evidence of collagen shrinkage. Transmission electron microscopy showed damage layers of 0.5 to 3 µm for Q-switched Er:YAG and 3 to 10 µm for long pulse Er:YAG. Scanning electron microscopy showed smooth surfaces in all eyes, although the excimer was the roughest. In the porcine eye study, ablations were produced in both PTK and PRK modes with the ablation rate per layer increasing with the fluence. At 120 mJ/cm
p 2
, the average ablation rate was 1.9 µm per layer.

CONCLUSIONS: The histology from the short pulse mid-infrared optical parametric oscillator laser at 2.94 µm was comparable to the 193-nm excimer with a smooth, damage-free, ablation zone when performing PRK and LASLK. [J Refract Surg 2000;16:40-501
Laser in situ Keratomileusis for Ametropia After Penetrating Keratoplasty
Authors: Koay Peter Y P , McGhee Charles N J , Weed Kathryn H , Craig Jennifer P
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the efficacy of excimer laser in situ keratomileusis (LASIK) in the treatment of refractive errors after penetrating keratoplasty.

METHODS: Eight eyes underwent LASIK after a mean 71 months (SD 60) following the initial penetrating keratoplasty. A full ophthalmic assessment was performed before LASLK and at 1 week, 1, 3, 6, and 12 months after surgery. Mean follow-up was 8.6 months (SD 3.2).

RESULTS: No eyes lost any Snellen lines of best spectacle-corrected visual acuity at the latest follow-up. Mean reduction in spherical equivalent refraction was 91% from -6.79 D (SD 4.17) to -0.64 D (SD 1.92) and mean reduction of cylinder was 72% from -6.79 D (SD 3.28) to -1.93 D (SD 1.17) at 6 months. Mean surgically induced astigmatism was 5.50 D (SD 2.42) and the index of surgically induced astigmatism divided by the initial cylinder expressed as a percentage was 81%. Mean outcome indices were: correction index 0.87, index of success 0.31, and angle of error 0.95°. Three eyes (43%) achieved a spherical equivalent refraction of ±0.50 D and 4 eyes (57%) achieved a spherical equivalent refraction of ±1.00 D of emmetropia.

CONCLUSIONS: The efficacy of LASIK after penetrating keratoplasty was good compared to incisional or surface based excimer laser methods and has the advantage of reducing the myopic spherical equivalent refraction in addition to astigmatism, thus improving the uncorrected visual acuities. [J Refract Surg 2000;16:140-147]
Laser in situ Keratomileusis Corneal Flap Creation With the Nidek MK-2000 and the Carriazo Barraquer Microkeratomes
Authors: Vongthongsri Anun , Srivannaboon Sabong , Horatanaruang Orasa , Nariptaphan Pichit
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the performance of the Nidek MK-2000 and the LSK Carriazo Barraquer microkeratomes in the creation of corneal flaps for laser in situ keratomileusis (LASLK).

METHODS: A prospective randomized study of 55 eyes of 30 patients who underwent LASLK was performed. Twelve corneal flaps were created hy the Nidek MK-2000 microkeratome (160-/«n head), 30 corneal flaps by the Carriazo Barraquer 160-¿m head microkeratome, and 13 corneal flaps by the Carriazo Barraquer 180-/tm head microkeratome. Flap thickness (evaluated by ultrasonic pachymetry), flap diameter, hinge size, and hinge-to-centerof-pupil distance were measured.

RESULTS: For the Nidek MK-2000 microkeratome, mean flap thickness was 149.58 ± 25.61 µ?? (range, 94 to 186 /im), flap diameter was 8.81 ± 0.34 mm (range, 8.4 to 9.1 mm), hinge size was 4.31 ± 0.45 mm (range, 3.9 to 4.8 mm), and hinge-to-centerof-pupil distance was 3.79 ± 0.70 mm (range, 3.9 to 4.7 mm). For the Carriazo Barraquer 160-/im head microkeratome, mean flap thickness was 123.9 ± 22.28 jttm (range, 104 to 155 /an), flap diameter was 9.08 ± 0.44 mm (range, 8.7 to 11 mm), hinge size was 4.04 ± 0.61 mm (range, 4 to 6 mm), and hinge-tocenter-of-pupil distance was 4.37 ± 0.24 mm (range, 4 to 4.5 mm). For the Carriazo Barraquer I80-/«n head microkeratome, mean flap thickness was 167.23 ± 24.92 ^m (range, 145 to 198 /nn), flap diameter was 9.12 ± 0.18 mm (range, 9 to 9.4 mm), hinge size was 4.21 ± 0.39 mm (range, 4 to 5 mm), and hinge-to-center-of-pupil distance was 4.47 ± 0.24 mm (range, 4.2 to 4.7 mm). There was no correlation between corneal curvature and flap diameter. No case was aborted due to improper corneal flap creation. An epithelial defect was found in 5 eyes after reverse movement of the Nidek MK2000 microkeratome.

CONCLUSION: The Nidek MK-2000 and the Carriazo Barraquer microkeratomes were effective, safe, and reliable in the creation of corneal flaps for LASLK. [J Refract Surg 2000;16(suppl): S272-S275]
Relationship Between Anterior Chamber Depth, Refractive State, Corneal Diameter, and Axial Length
Authors: Hosny Mohamed , Alió Jorge L , Claramonte Pascual , Attia Walid H , Pérez-Santonja Juan J
Published: April 2021

ABSTRACT

PURPOSE: Phakic intraocular lenses are being used increasingly to correct refractive errors. We studied the relationship between anterior chamber depth, refractive state of the eye, spherical equivalent refraction, axial length of the globe, corneal diameter, and keratometry.

METHODS: Two hundred eleven eyes of 211 patients were enrolled. All eyes underwent the same protocol with a complete ocular examination that included slit-lamp microscopy, intraocular pressure, objective and subjective refraction, calculation of the spherical equivalent refraction, corneal pachymetry, anterior chamber depth, axial length of the globe, and keratometry. All results were analyzed statistically using SPSS statistics software. Correlations between different parameters were studied using the Pearson correlation test.

RESULTS: The anterior chamber depth was found to correlate significantly with both the average corneal diameter and the axial length of the globe (0.744, 0.531, P < .01) and was also found to correlate through an inverse relation with both age and spherical equivalent refraction (-0.391, -0.623, P < .01). Corneal thickness and keratometric power did not correlate with the anterior chamber depth.

CONCLUSION: Most parameters (axial length, corneal diameter, spherical equivalent refraction, patient age) affected anterior chamber depth and should be considered carefully when planning refractive procedures that employ phakic intraocular lenses. [J Refract Surg 2000;16:336-340]
Laser in situ Keratomileusis and Photorefractive Keratectomy for Residual Refractive Error After Phakic Intraocular Lens Implantation
Authors: Sánchez-Galeana César A , Smith Ronald J , Rodriguez Xavier , Montes Miguel , Chayet Arturo S
Published: April 2021

ABSTRACT

PURPOSE: To determine the visual and refractive outcome of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) in eyes with prior posterior chamber phakic intraocular lens implantation for high myopia.

METHODS: We studied a series of 37 consecutive eyes of 31 patients who underwent LASIK or PRK for residual refractive error following collamer posterior chamber intraocular lens (IOL) (Staar Surgical Implantable Contact Lens) implantation into a phakic eye. Twenty-eight eyes had LASIK and nine eyes had PRK. Mean follow-up was 8.1 ± 4.7 months after laser ablation (range, 3 to 18 mo).

RESULTS: The preoperative mean spherical equivalent refraction prior to phakic posterior chamber IOL implantation was -17.74 ± 4.89 D (range, -9.75 to -28.00 D). Following phakic IOL implantation and prior to LASIK or PRK, mean spherical equivalent refraction was -2.56 ± 2.34 D (range, -0.25 to -8.75 D). One month following LASIK or PRK, mean spherical equivalent refraction was -0.24 ± 0.52 D (range, -1.50 to +1.50 D), 3 months following LASIK or PRK, mean spherical equivalent refraction was -0.19 ± 0.50 D (range, -1.50 to +1.00 D). The refraction was within ±1.00 D of emmetropia in 36 eyes (97.2%) and within ±0.50 D in 31 eyes (83.7%). Three eyes developed anterior subcapsular opacities several weeks after laser ablation, one eye developed macular hemorrhage 4 weeks after laser ablation, and one eye had corticosteroid induced ocular hypertension.

CONCLUSIONS: LASIK or PRK can be used to treat the residual refractive error following posterior chamber phakic IOL implantation. [J Refract Surg 2001;17:299-304]
The Effect of Corneal Stretch on the Endothelium
Authors: Miller David , Weiss Jeffrey N
Published: April 2021

SUMMARY

A model has been developed to describe the phenomenon of corneal stretch. In the model situation, suction is applied to the corneal surface of the bovine eye. The newly induced corneal shape forces the endothelial layer to stretch and sometimes to tear apart in places. This same type of stretch can be induced when a soft lens is placed on the bovine cornea.

We postulate that drying of the soft lens produces a local flow of water from the cornea at the lens periphery with a secondary bowing of the central cornea. These results are confirmed by a decrease in the peripheral keratometry readings with an increase in the central keratometry measurements. The resultant deformation increases the posterior surface area of the cornea thus stretching the endothelium. These reversible/irreversible changes are time/drying dependent.

The endothelial effects of corneal bending, as in cataract extraction, radial keratotomy and tight suture placement were investigated. As expected, when these techniques stretch the cornea, the result is endothelial changes.
Bacterial Contamination of Donor Corneas Stored in McCarey-Kaufman Medium
Authors: Christenson Jeannine , Kastl Peter R , Caldwell Delmar R
Published: April 2021

SUMMARY

A new method is presented for culturing eye bank corneas stored in McCarey-Kaufman (M-K) medium. Of 30 donor corneoscleral rims, each was cultured in three ways: a swab of the M-K medium, a swab of the cut edge, and by culture of a 0.2 micron filter through which an aliquot of solution had been passed and washed of any antibiotic. We found a much higher rate of positive cultures using the latter method than has previously been reported in the literature.
Scleral Grafting in the Management of Ligneous Conjunctivitis
Authors: Berlin A Jan , Carim M , Langston Roger H S , Price Ronald L
Published: April 2021

SUMMARY

Ligneous conjunctivitis is a rare, usually bilateral, chronic membranous conjunctivitis, which begins acutely in childhood and persists for many years. In view of the poor results obtained with other forms of therapy in the past, the resection of the involved conjunctiva and tarsus with the grafting of donor sclera is offered as another alternative in the management of this distressing condition.
Granulomatous Reaction to Choyce Style Intraocular Lens
Authors: Kincaid Marilyn C , Green W Richard , Iliff W Jackson
Published: April 2021

SUMMARY

Despite the large number of intraocular lens implants performed since Ridley first devised the procedure, there have been few reports of postmortem examination in clinically successful cases.

We report a patient who tolerated his Choyce Mark VIII style implant well, despite a three-month episode of mild nongranulomatous uveitis occurring two months postoperatively, until his death 17 months later. This is the sixth postmortem study of an anterior chamber IOL and the only one in which there was a conspicuous granulomatous reaction on the anterior iris surface, with large foreign body giant cells.

Despite the presence of a foreign body, the previous eyes that have clinically tolerated implants well and have come to postmortem examination have shown remarkably little inflammation; none have shown this degree of granulomatous reaction previously.
Office Slit Lamp Discissions in Artiphakic Eyes
Authors: Murphy Gates E
Published: April 2021

SUMMARY

What is believed to be the first reported series of discissions in artiphakic eyes done in the office with a standard examination slit lamp is reported. Adequate optical openings were obtained in 22 of 24 eyes. No major complications such as vitreous wick, endophthalmitis, epithelial implantation, or lens dislocation occurred in this small series. It is felt to be a safe, inexpensive alternative to operating room discissions.
Surgical Considerations for Dacryocystorhinostomy with Special Emphasis on Hemostatic Techniques
Authors: Sweet Robert M , Hofmann Robert F
Published: April 2021

SUMMARY

Thirty patients were treated. All surgical procedures were carried out without technical difficulty. Estimated blood loss varied between 5 ml and 25 ml. In no case did bleeding obscure the operative field. Two patients did experience transient hypertension after injection of lidocaine with epinephrine. This was easily controlled by the anesthesiologist. After follow-up periods ranging from one year to five years, all patients have achieved a satisfactory result. No recurrent epiphora or infection has been noted.

The technique described in this communication involves drugs, instruments, and equipment which have made our dacryocystorhinostomy rapid (35 to 45 minutes), controlled, and predictable. Surgical morbidity is negligible. Hemorrhage is no longer a fearsome problem. Exposure is always adequate. And, above all, uniform success has been very gratifying to surgical patients and surgeons.
Intraocular Response to Cotton, Collagen and Cellulose in the Rabbit
Authors: Peiffer Robert L , Safrit H D , White Elizabeth , Eifrig David E
Published: April 2021

SUMMARY

Cotton, cellulose and collagen were each implanted into the anterior chamber and anterior vitreous of rabbit eyes. The ocular inflammatory response was studied clinically over a 28-day period and histologically at seven and 28 days. In general, cotton was the least reactive, with collagen and cellulose moderately reactive. Cellulose was associated with progressive inflammation and marked granulomatous response. Vitreous implants showed minimal inflammation, with virtually no response to cotton. These findings support current literature suggesting that the use of cellulose in ophthalmic surgery may increase the risk of postoperative granulomatous inflammation.