bluuebunny/crossref_metadata_2025 huggingface dataset:
Veterans' Health Care Considerations for Today's Nursing Curricula
Authors: Allen Patricia E. , Armstrong Myrna L. , Conard Patricia L. , Saladiner Jason E. , Hamilton Mary Jane
Published: February 2014

Although there have been several wars and conflicts since World War I, the escalating numbers of veterans since that time is now evident. Extraordinary survival results have evolved from effective triage, trauma treatment, and recovery maneuvers during Operation Iraqi Freedom and Operation New Dawn (OIF) in Iraq and Operation Enduring Freedom (OEF) in Afghanistan. Yet even with those results, the number of physical and mentally wounded individuals exceeded 32,000 from OIF and 16,000 from OEF. How will we help these service men and women meet the special challenges they may face after discharge from the military? This article presents a rationale for content integration, health concerns, and realistic educational suggestions for faculty as they prepare professional nurses to care for these veterans and their families. Future nurses need to be prepared to care for this patient population in community health care systems. [
J Nurs Educ
. 2013;52(11):634–640.]
Development and Validation of a Tool to Measure Self-Confidence and Anxiety in Nursing Students During Clinical Decision Making
Authors: White Krista A.
Published: February 2014

Clinical decision making (CDM) is a cornerstone skill for nurses. Self-confidence and anxiety affect the learning and adeptness of CDM. This study aimed to develop and test a quantitative tool to assess undergraduate nursing students’ self-confidence and anxiety during CDM. The 27-item Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM) scale is a 6-point, Likert-type tool with two subscales. Two samples of prelicensure associate and baccalaureate nursing students participated in the pilot (n= 303) and main testing (n= 242) phases of the study. Construct validity assessment, using exploratory factor analysis, produced a stable three-dimensional scale. Convergent validity assessment produced positive, moderate, and statistically significant correlations of the tool sub-scales with two existing instruments. Internal consistency reliability was assessed for each subscale (self-confidence, α = .97; anxiety, α = .96). The NASC-CDM scale may be a useful assessment tool for nurse educators to help novice clinicians improve CDM skills. [J Nurs Educ. 2014;53(1):14–22.]
Team-Based Learning and Ethics Education in Nursing
Authors: Hickman Susan E. , Wocial Lucia D.
Published: February 2014

This report describes the use of team-based learning concepts in an undergraduate nursing applied ethics course using established reporting guidelines. Team-based learning relies on actively engaging students in the learning process through small-group activities that facilitate the development of skills, including concept analysis, critical thinking, and problem solving. Students are divided into teams of five to seven members who collaborate throughout the semester to work through activities that build on ethics concepts introduced through reading and lectures. Nurse educators are challenged to develop educational approaches that will engage students and help them to apply what they learn from the study of ethics to the lived experience of clinical practice. The ultimate goal is to help students to develop into morally sensitive and competent professionals. Team-based learning represents a novel way to teach these skills to undergraduate nursing students. [
J Nurs Educ
. 2013;52(12):696–700.]
Partnering to Provide a Summer Institute of Nursing
Authors: Myers Lynnea Heather
Published: February 2014

With national projections indicating the need for more RNs to meet the health care workforce demands, innovative strategies to recruit high school students into the profession of nursing must be utilized. This article describes an innovative strategy aimed at high school students through a Summer Institute of Nursing—a 5-day, 4-night, college-based experience—designed to allow them the opportunity to explore the profession of nursing. Through skills laboratories, service projects, and health care site visits, students were able to experience the profession of nursing hands on. Based on the research conducted through pre- and post-surveys, the high school students experienced a significant change in their likelihood of pursuing a career in nursing after completing the Institute (
p
< 0.001). The format of the Summer Institute of Nursing represents an innovative strategy to recruit high school students into the profession of nursing. [
J Nurs Educ.
2013;52(12):701–704.]
Effect of Simulation on Knowledge of Advanced Cardiac Life Support, Knowledge Retention, and Confidence of Nursing Students in Jordan
Authors: Tawalbeh Loai I. , Tubaishat Ahmad
Published: February 2014

This study examined the effect of simulation on nursing students’ knowledge of advanced cardiac life support (ACLS), knowledge retention, and confidence in applying ACLS skills. An experimental, randomized controlled (pretest–posttest) design was used. The experimental group (
n
= 40) attended an ACLS simulation scenario, a 4-hour PowerPoint presentation, and demonstration on a static manikin, whereas the control group (
n
= 42) attended the PowerPoint presentation and a demonstration only. A paired
t
test indicated that posttest mean knowledge of ACLS and confidence was higher in both groups. The experimental group showed higher knowledge of ACLS and higher confidence in applying ACLS, compared with the control group. Traditional training involving PowerPoint presentation and demonstration on a static manikin is an effective teaching strategy; however, simulation is significantly more effective than traditional training in helping to improve nursing students’ knowledge acquisition, knowledge retention, and confidence about ACLS. [
J Nurs Educ.
2014;53(1):38–44.]
Addressing the Challenges of Nursing Student Attrition
Authors: Harris Robin C. , Rosenberg Lisa , Grace O’Rourke Marilyn E.
Published: February 2014

With the passage of the Affordable Care Act and as the number of aging and diverse individuals in society increases, access to health care will expand and the need for more competent and diverse nursing graduates will increase. An adequate number of nurse graduates is imperative to meet societal demands; however, this is complicated by high nursing student attrition rates. This article examines the need for more nurses (including those from diverse backgrounds), current attrition rates among schools of nursing, at-risk student characteristics, and previous attempts to increase student success. Applying the evidence to practice, findings from a multipronged approach to increase student success within an associate degree nursing program located within a historically Black college and university in the midwestern United States are discussed. The program’s successes and opportunities for improvement are examined, as well as the recommendations for other nursing programs facing issues with student attrition. [
J Nurs Educ.
2014;53(1):31–37.]
Emancipatory Knowing: Empowering Nursing Students Toward Reflection and Action
Authors: Snyder Marianne
Published: February 2014

Nursing students in the 21st century are entering highly complex health care systems that require advocates for social justice and human rights on behalf of patients. Nurses are well positioned as patient advocates. This article presents a brief overview of the historical and theoretical perspectives underpinning emancipatory knowing and proposes several methods nursing faculty can use to empower nursing students to provide care informed by this way of knowing. Nursing faculty are urged to adopt a curriculum that supports an emancipatory and caring praxis and to mentor students to provide care supportive of social justice, particularly for the vulnerable and marginalized members of society. Nursing students who learn to embrace and value emancipatory knowing during their educational program may likely continue this praxis after they graduate. [
J Nurs Educ.
2014;53(2):65–69.]
Preventing Information Overload: Cognitive Load Theory as an Instructional Framework for Teaching Pharmacology
Authors: Kaylor Sara K.
Published: February 2014

Nursing students are challenged by content-laden curricula and learning environments that emphasize testing outcomes. Likewise, educators are challenged to support student-centered learning in a manner that encourages students to connect and act upon their personal motivations. This article describes the use of cognitive load theory (CLT) as an instructional design framework for an undergraduate pharmacology for nursing course. Guided by the principles of CLT, four instructional strategies were used in this course: (a) opening review activities, (b) providing students with lecture notes, (c) a “Top Five” prototype approach, and (d) deciphering “Need to Knows” from “Nice to Knows.” Instructional style and strategies received positive student feedback and were found to promote a student-centered environment and active learning. On the basis of this feedback, cognitive load theory may be a successful and effective framework for undergraduate pharmacology and other nursing courses, thus assisting students and educators alike in overcoming obstacles imposed on learning environments. [
J Nurs Educ
. 2014;53(2):108–111.]
Advancing the Science of Research in Nursing Education: Contributions of the Critical Decision Method
Authors: McNelis Angela M. , Ironside Pamela M. , Zvonar Sarah E. , Ebright Patricia R.
Published: February 2014

Advancing the science of nursing education will require the discipline to conduct research that investigates complex phenomena, such as students’ clinical thinking and decision-making skills, using multiple methods. The research methods developed in other disciplines can provide nursing education researchers with new ways to investigate clinical teaching and learning in nursing. The critical decision method (CDM), derived from psychology and human factors engineering, is a technique by which researchers elicit experts’ thinking and the cognitive work informing decision making in the context of practice. This article describes how the CDM was adapted to study nursing students’ situation awareness, cues for action, and pattern recognition during clinical experiences. The CDM is a promising method for investigators to use to conduct research in nursing education and to inform the design of clinical experiences to promote these critical abilities. [
J Nurs Educ.
2014;53(2);61–64.]
What Matters Most? Students’ Rankings of Simulation Components That Contribute to Clinical Judgment
Authors: Kelly Michelle A. , Hager Paul , Gallagher Robyn
Published: February 2014

As the pedagogy of health care simulation matures, the level of guidance provided and types of simulation components included increasingly vary. To prepare students for professional practice, one university embedded Tanner’s model of clinical judgment within the nursing curricula and integrated simulations. There was interest in seeking students’ opinions of “what matters most” in the design and delivery of simulations, which may vary from the academic’s viewpoint. Senior undergraduate nursing students (
N
= 150) from three types of study programs rated 11 simulation components in relation to clinical judgment. The three student groups rated all components above 2.9 on a 5-point Likert scale, with some variation across groups for component rankings. The highest ranking components for applying clinical judgment were facilitated debriefing, postsimulation reflection, and guidance by the academic. The lowest ranked components were patient case notes and briefing and orientation to the simulation area. Age and previous nursing experience did not influence the study variables. [
J Nurs Educ
. 2014;53(2):97–101.]
Academic Dishonesty in Schools of Nursing: A Literature Review
Authors: Klocko Marilyn N.
Published: February 2014

Academic dishonesty in schools of nursing is surprisingly common. The following literature review defines academic dishonesty, describes the scope of the problem, and sheds light on factors that affect student behaviors that lead to academic dishonesty in schools of nursing. Finally, barriers to and best practices for solutions to the problem will be reviewed as they appear within the literature. [
J Nurs Educ.
2014;53(3):121–125.]
Nursing Faculty Preparedness for Clinical Teaching
Authors: Suplee Patricia Dunphy , Gardner Marcia , Jerome-D’Emilia Bonnie
Published: February 2014

Nursing faculty who teach in clinical settings face complex situations requiring evidence-based educational and evaluative strategies, yet many have had limited preparation for these tasks. A convenience sample of 74 nursing faculty participated in a survey about clinical teaching in prelicensure nursing programs. Most faculty developed teaching skills through conferences (57%), orientation at their educational institution (53%), or exposure in graduate school (38%). Thirty-one percent reported having no preparation for clinical teaching. Faculty felt least prepared to manage students with learning, physical, or emotional disabilities and incivility. Twenty-six percent had no preparation for evaluating students in the clinical setting, and only 17% had worked with a faculty mentor. Few evidence-based teaching strategies were used by the faculty. These findings indicate gaps exist in the preparation of clinical faculty. Graduate education, comprehensive orientation programs, and continuing professional development may help to ensure faculty are effective in managing and evaluating student learning. [
J Nurs Educ
. 2014;53(3, Suppl.):S38–S41.]
Nursing Faculty Use of High-Fidelity Human Patient Simulation in Undergraduate Nursing Education: A Mixed-Methods Study
Authors: Davis Alison H. , Kimble Laura P. , Gunby Susan Sweat
Published: February 2014

High-fidelity human patient simulation (HFHPS) is an innovative teaching tool. However, limited data exist regarding factors affecting faculty use of HFHPS in undergraduate nursing education. Using a convergent, parallel, mixed-methods design, predictors of undergraduate faculty (
N
= 139) use of HFHPS were explored. Data were collected using a Web-based survey. Results indicated a high percentage of HFHPS use in nursing programs but a low percentage of HFHPSs substituting for traditional clinical hours. Faculty who substituted clinical hours with HFHPS had lower self-efficacy beliefs around HFHPS than other faculty surveyed. Qualitative data supported the quantitative findings, including themes that HFHPS provided a safe environment for learning, but it was a mixed result. Results support that nursing faculty’s beliefs about HFHPS were strongly associated with HFHPS use. Specifically, self-efficacy beliefs and further exploration of the meaning of a safe environment for student learning should be addressed in future studies. [
J Nurs Educ.
2014;53(3):142–150.]
Risk Factors Predicting the Need for Additional Surgery in Consecutive Esotropia
Authors: Choi Yong-Min , Lee Joo-Yeon , Jung Jae-Hoon , Kim Seung-Hyun , Cho Yoonae A.
Published: February 2014

Purpose:

To evaluate the risk factors predicting surgical treatment in consecutive esotropia occurring after surgery for intermittent exotropia.

Methods:

The clinical records of 52 patients with consecutive esotropia who underwent exotropia surgery were retrospectively reviewed. All patients demonstrated consecutive esotropia with diplopia or suppression for more than 1 month after surgery for exotropia. Patients were divided into two groups (the surgical group and nonsurgical group) depending on whether surgery was required for consecutive esotropia. Surgery for esotropia was performed only in patients with more than 10 prism diopters (PD) esodeviation that persisted for a minimum of 6 months, those who had suppression in 1 eye or diplopia, and those who could not achieve fine stereopsis. The nonsurgical treatment up to 6 months postoperatively was part-time patching and prism therapy in both groups. Patient characteristics were evaluated in the two groups.

Results:

The surgical group was composed of 17 patients and the nonsurgical group was composed of 35 patients. Age, gender, refractive error, best-corrected visual acuity, and postoperative overcorrection at 1 day were not significantly different in the two groups (
P
> .05). However, the distance strabismic angle at 1 month postoperatively was 2.5 ± 3.8 PD esodeviation (range: 14 PD esotropia to 4 PD exotropia) in the nonsurgical group and 5.4 ± 5.1 PD esodeviation (range: 20 PD esotropia to orthotropia) in the surgical group; these values were statistically significant (
P
< .05).

Conclusions:

The clinically significant risk factor affecting the surgical decision for consecutive esotropia was a large esotropic angle at 1 month postoperatively in this study.

[J Pediatr Ophthalmol Strabismus 2013;50(6):335–339.]
Surgical Procedure Joining the Lateral Rectus and Superior Rectus Muscles With or Without Medial Rectus Recession for the Treatment of Strabismus Associated With High Myopia
Authors: Akar Serpil , Gokyigit Birsen , Aribal Erkin , Demir Abdulvahit , Göker Yasin Sakir , Demirok Ahmet
Published: February 2014

Purpose:

To evaluate the outcomes of a surgical procedure involving the muscle union of the superior rectus (SR) and lateral rectus (LR) muscles with or without medial rectus (MR) recession for the treatment of strabismus associated with high myopia and the anatomic changes from before and after surgery.

Methods:

Thirty-five eyes of 20 patients who had undergone a muscle union of the SR and LR muscles with or without MR recession for treatment of acquired strabismus associated with an inferior displacement of the LR and nasal displacement of the SR in magnetic resonance imaging of the orbit due to axial high myopia were observed prospectively. Main outcome measures were the angles of the dislocation of the globe, angles of horizontal or vertical deviations, abductions, and supraductions. The angles of the dislocation of the globe were analyzed using magnetic resonance imaging (1.5 Tesla Magnet; Siemens Symphonia, Munich, Germany).

Results:

The axial lengths ranged from 26 to 36 mm (mean: 30.6 ± 2.8 mm). The angle of dislocation of the globe changed from 178º ± 10º to 101º ± 6º, the angle of esotropia changed from 58.6 ± 2.5 to 6.8 ± 1.4 prism diopters (PD); and the angle of hypotropia changed from 12.5 ± 1.3 to 3.3 ± 1.1 PD postoperatively. Abduction and supraduction improved significantly after surgery. At the 4-year follow-up, the postoperative outcomes were stable.

Conclusions:

In the treatment of strabismus caused by high myopia, the surgical procedure involving the muscle union of the SR and LR muscles with or without MR recession was effective on both the restoration of the dislocated globe into the muscle cone and the improvement of ocular motility.

[J Pediatr Ophthalmol Strabismus 2014;51(1):53–58.]
Combination Treatment of Pediatric Coats’ Disease: A Bicenter Study in Taiwan
Authors: Lin Chun-Ju , Chen San-Ni , Hwang Jiunn-Feng , Yang Chung-May
Published: February 2014

Purpose:

To present the clinical outcome of different combination treatment modalities in pediatric Coats’ disease in two Taiwan medical centers.

Methods:

A retrospective review of clinical records was done of pediatric patients with Coats’ disease treated at National Taiwan University Hospital and Changhua Christian Hospital. Data regarding the age at the time of diagnosis, initial presentation, methods of treatment, visual and anatomic results, and complications were recorded. Changes in vision and retinal status with the different methods of treatment were specifically evaluated.

Results:

From 2005 through 2011, 10 eyes of 9 patients were treated under the diagnosis of Coats’ disease. The clinical manifestations varied from localized vascular abnormalities with subretinal fluid and hard exudates to extensive detachment with massive exudates and retinal hemorrhage. The main treatment modalities include argon laser photocoagulation, micropulse laser, and cryotherapy. The adjunctive therapies included intravitreal triamcinolone, bevacizumab, and ranibizumab. The mean follow-up was 40.50 ± 20.52 months (range: 14 to 72 months). Best corrected visual acuity at last follow-up was light perception to 1.0 (20/20 Snellen). Anatomic improvement was achieved in 9 eyes (90%). Visual improvement was noted in 7 eyes (70%), visual stabilization in 2 eyes (20%), and visual deterioration in 1 eye (10%). Vitreous fibrosis evolving into tractional retinal detachment occurred in 1 patient receiving cryotherapy combined with intravitreal bevacizumab injections. No enucleation was ultimately necessary.

Conclusions:

Pediatric Coats’ disease varies greatly in severity. Carefully selected treatment modalities can improve most eyes with different conditions. Intravitreal anti-vascular endothelial growth factor agents may act as useful adjuncts to improve anatomic and functional outcome. Cryotherapy combined with the intravitreal bevacizumab injection in severe cases of exudative retinal detachment may carry the risk of vitreoretinal traction and tractional retinal detachment.

[J Pediatr Ophthalmol Strabismus 2013;50(6):356–362.]
Successful Treatment of Macular Retinoblastoma With Superselective Ophthalmic Artery Infusion of Melphalan
Authors: Hadjistilianou Theodora , Coriolani Gianni , Bracco Sandra , Gennari Paola , Caini Mauro , Cerase Alfonso , Galimberti Daniela , De Francesco Sonia , De Luca Mariacarla , Mastrangelo Domenico
Published: February 2014

Purpose:

To report our experience with superselective ophthalmic artery infusion of melphalan (SOAIM) for macular retinoblastoma to obtain tumor control while preserving as much useful vision as possible.

Methods:

Five patients with newly diagnosed unilateral retinoblastoma involving the macula were selected within a group of patients eligible for SOAIM as the primary treatment.

Results:

The mean tumor basal dimension and thickness in this group of five patients with macular retinoblastoma were 11.6 and 12.3 mm, respectively. The stage at diagnosis ranged from II to VB (Reese-Ellsworth) or B to D (International Classification System). Tumor regression with SOAIM was achieved in all cases with regression patterns type I in four cases and III in one case.

Conclusions:

SOAIM can be of value in the treatment of macular retinoblastoma. It may allow the salvage of the residual eyesight with a low rate of complications due to the local and systemic toxicity related to chemotherapy.

[J Pediatr Ophthalmol Strabismus 2014;51(1):32–38.]
The Role of Patient Experience and its Influence on Adherence to Antidepressant Treatment
Authors: Johnston Brenda J.
Published: February 2014

Major depression can be a very challenging illness and although antidepressant agents are shown to provide benefit, many patients do not adhere to antidepressant treatment guidelines. Multiple factors contribute to adherence, including the influence of patient experience. The purpose of this article is to conduct a systematic review on the influence of patient experience with depression and antidepressant agents on treatment adherence. Thirteen research articles were selected for the review and revealed that patient past experience with depression and antidepressant agents, vicarious experiences, beliefs and attitudes, and the treatment experience itself can impact adherence. It is important for providers to be vigilant with assessment and include patient experience when developing a plan of care. This approach encourages shared decision making and a patient-centered focus for improved management of depression. [
Journal of Psychosocial Nursing and Mental Health Services, 51
(12), 29–37.]
Factors That Affect Decisions to Receive (or Not Receive) Life-Sustaining Treatment in Advance Care Planning
Authors: Schubart Jane R. , Levi Benjamin H. , Dellasega Cheryl , Whitehead Megan , Green Michael J.
Published: February 2014

This study identifies factors that affect decisions people make regarding whether they want to receive life-sustaining treatment. It is an interpretive-descriptive study based on qualitative data from three focus groups (
N
= 23), representing a diverse population in central Pennsylvania. Study sites included a suburban senior center serving a primarily White, middle-class population; an urban senior center serving a frail, underserved, African American population; and a breast cancer support group. The most important factors affecting whether participants wished to receive life-sustaining medical treatment were prognosis, expected quality of life, burden to others, burden to oneself in terms of the medical condition and treatment, and effect on mental functioning and independence. Our findings contribute to the knowledge of the complex factors that influence how people make decisions about advance care planning and life-sustaining treatments. This understanding is critical if nurses are to translate the patient’s goals, values, and preferences into an actionable medical plan. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(2), 38–44.]
Seclusion and Restraint use in Children and Adults: Differences Between Age Groups
Authors: Allen Diane E. , de Nesnera Alexander , Moreau Michele A. , Barrnett R. Joffree
Published: February 2014

This 1-year study of seclusion and restraint in an acute inpatient psychiatric hospital revealed a marked difference in reasons and duration for adults, children, and adolescents. Children and adolescents are most often secluded and restrained in response to identifiable patterns of dangerous behavior, and episodes of seclusion and restraint involving children and adolescents are considerably shorter than episodes involving adults. This information is being used to find ways to improve the care and treatment of all patients, especially for children. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(3), 20–25.]
The Choking Game: A Risky Behavior for Youth
Authors: Mechling Brandy , Ahern Nancy R. , McGuinness Teena M.
Published: February 2014

Nurses working with children and adolescents should be cognizant of choking games, risky acts in which pressure is applied to the neck and the airway is obstructed to achieve a high. Evidence supports that many children and adolescents do not understand the grave consequences of choking games nor do they view participation as dangerous. Parents, teachers, pediatricians, nurses, and psychiatric-mental health professionals are not always aware that children and adolescents are engaging in choking games. The purpose of this article is to describe the signs, changes over the years, consequences, and educational resources available for addressing this behavior in children and adolescents. Understanding the nomenclature of choking games, how to assess, and how to intervene when participation in this behavior is suspected are also addressed. [
Journal of Psychosocial Nursing and Mental Health Services, 51
(12), 15–20.]
Evaluating the Selection, Training, and Support of Peer Support Workers in the United Kingdom.
Authors: Simpson Alan , Quigley Jody , Henry Susan J. , Hall Cerdic
Published: February 2014

This article describes the preparation, selection, training, and support of a group of people with lived experience of mental distress/illness and mental health service use to work as peer support workers (PSWs). The PSWs were recruited to provide support alongside conventional aftercare to service users discharged from acute psychiatric units in London, England. Training was delivered over 12 weekly, 1-day sessions from April to July 2010. Supervision and support were provided by a peer support coordinator and a training facilitator. The overall view of the training by those who went on to work as PSWs was that it was a valuable, challenging, yet positive experience that provided them with a good preparation for the role. A key area for improvement concerned the strength of emotional involvement and feelings PSWs had for their peers, especially in regard to ending the support relationship. Skilled, sensitive supervision and support is essential for the success of such roles. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(1), 31–40.]
Adding SUGAR: Service User and Carer Collaboration in Mental Health Nursing Research
Authors: Simpson Alan , Jones Julia , Barlow Sally , Cox Leonie ,   Service User and Carer Group Advising on Research (SUGAR)
Published: February 2014

SUGAR (Service User and Carer Group Advising on Research) is an initiative established to develop collaborative working in mental health nursing research between mental health service users, carers, researchers, and practitioners at City University London, United Kingdom. This article will describe the background of SUGAR; how the group operates; some of the achievements to date, including researcher reflections; and case studies of how this collaboration influences our research. Written reflective narratives of service user and carer experiences of SUGAR were analyzed using constant comparative methods by the members. Common themes are presented with illustrative quotes. The article highlights the benefits and possible limitations identified to date by members of SUGAR, outlines future plans, and considers the findings in relation to literature on involvement and empowerment. This article, written by staff and members of SUGAR, is the first venture into collaborative writing of the group and reflects the shared ethos of collaborative working. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(1), 22–30.]
Mobile Apps for Psychiatric Nurses
Authors: Elias Beth L. , Fogger Susanne A. , McGuinness Teena M. , D’Alessandro Katherine R.
Published: February 2014

Many health care professionals, including psychiatric nurses, are faced with increasing questions from patients about mobile applications (apps). The purpose of this article is to give psychiatric-mental health nurses (PMHNs) an overview of the world of mobile health and medical apps to answer their own questions as well as those of their patients. Mobile apps will continue to evolve; thus, this article will serve as a base for PMHNs to build knowledge and understanding to help their patients. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(4), 42–47.]
Disruptive Mood Dysregulation Disorder: A New Diagnosis in the
DSM-5
Authors: Johnson Karmie , McGuinness Teena M.
Published: February 2014

This article explores a new diagnosis in the
Diagnostic and Statistical Manual of Mental Disorders
(5th ed.)—disruptive mood dysregulation disorder (DMDD). Frequent comorbidities of DMDD include oppositional defiant disorder and attention-deficit/hyperactivity disorder. The evolution of DMDD and how this diagnostic category may remedy an overdiagnosis of pediatric bipolar disorder are discussed. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(2), 17–20.]
A Research Tool for Mental Health Services
Authors: Hennessy Julia L. , Hughes Frances
Published: February 2014

Appreciative inquiry (AI) provides an alternative approach to the inquisitional style of uncovering “what went wrong and who is at fault” to instead “what can be done to make things better,” thus creating an environment that enables one to discover (investigate), dream (what could have been done instead), design (what needs to be done to bring about change), and deliver/ destiny (working with a whole of health and community approach to obtain the positive outcomes for mental health consumers). AI is transformational in nature and provides a way of viewing organizations from an enabling perspective. This article discusses the concept of AI, highlights opportunities and challenges that may be encountered, and explores the possibility of applying the AI concept to mental health research/inquiry. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(6), 34–40.]
Variability of Subjective Classifications of Corneal Topography Maps From LASIK Candidates
Authors: Ramos Isaac C. , Correa Rosane , Guerra Frederico P. , Trattler William , Belin Michael W. , Klyce Stephen D. , Fontes Bruno M. , Schor Paulo , Smolek Michael K. , Dawson Daniel G. , Chalita Maria Regina , Cazal Jorge O. , Ruiz Milton , Randleman J. Bradley , Ambrósio Renato
Published: February 2014

PURPOSE:

To evaluate the variability of subjective corneal topography map classification between different experienced examiners and the impact of changing from an absolute to a normative scale on the classifications.

METHODS:

Preoperative axial curvature maps using Scheimpflug imaging obtained with the Pentacam HR (Oculus Optikgeräte, Wetzlar, Germany) and clinical parameters were sent to 11 corneal topography specialists for subjective classification according to the Ectasia Risk Scoring System. The study population included two groups: 11 eyes that developed ectasia after LASIK and 14 eyes that had successful and stable LASIK outcomes. Each case was first reviewed using the absolute scale masked to the patient group. After 3 months, the same cases were represented using a normative scale and reviewed again by the same examiners for new classifications masked to the patient group.

RESULTS:

Using the absolute scale, 17 of 25 (68%) cases had variations on the classifications from 0 to 4 for the same eye across examiners, and the overall agreement with the mode was 60%. Using the normative scale, the classifications from 11 of 25 (44%) cases varied from 0 to 4 for the same eye across examiners, and the overall agreement with the mode was 61%. Eight examiners (73%) reported statistically higher scores (
P
< .05) when using the normative scale. Considering all 550 topographic analyses (25 cases, 11 examiners, and two scales), the same classification from the two scales was reported for 121 case pairs (44%).

CONCLUSION:

There was significant inter-observer variability in the subjective classifications using the same scale, and significant intra-observer variability between scales. Changing from an absolute to a normative scale increased the scores on the classifications by the same examiner, but significant inter-observer variability in the subjective interpretation of the maps still persisted.

[
J Refract Surg.
2013;29(11):770–775.]
Changes in Prostaglandin Levels in Patients Undergoing Femtosecond Laser-Assisted Cataract Surgery
Authors: Schultz Tim , Joachim Stephanie C. , Kuehn Mathias , Dick H. Burkhard
Published: February 2014

PURPOSE:

To investigate the intraocular prostaglandin concentrations after femtosecond laser treatment and the potential relationship to miosis.

METHODS:

Aqueous humor was collected from patients after femtosecond laser pretreatment and at the beginning of routine cataract surgery. The total prostaglandin and the prostaglandin E
2
concentrations were measured in two independent studies using an enzyme-linked immunoassay.

RESULTS:

A significantly higher level of prostaglandins was noted in the aqueous humor of patients immediately after femtosecond laser treatment. This could be confirmed in two studies consisting of independent patient populations (study I: control = 17.3 ± 4.0 pg/mL [n = 22], femtosecond laser [femto] = 182.1 ± 38.1 pg/mL [n = 22],
P
= .0001, and study II: control = 17.5 ± 1.4 pg/mL [n = 37], femto: 377.1 ± 83.6 pg/ mL [n = 35],
P
= .00004). A significant increase of prostaglandin E
2
was noted in two measurements (study III: control = 4.5 ± 1.9 pg/mL [n = 13], femto: 19.2 ± 2.5 pg/mL [n = 20],
P
= .0002, and study IV: control = 11.3 ± 1.6 pg/mL [n = 35], femto: 60.3 ± 16.1 pg/mL [n = 36],
P
= .004). No correlation was noted between age or cataract density and prostaglandin/prostaglandin E
2
level or between corneal incision, suction time, or laser time in the femto groups and prostaglandin/prostaglandin E
2
level.

CONCLUSIONS:

Prostaglandins rise immediately after femtosecond laser treatment. Future patients should perhaps be treated with non-steroidal anti-inflammatory drugs to maintain mydriasis before undergoing femto-second laser treatment for cataract surgery.

[
J Refract Surg.
2013;29(11):742–747.]
Subjective Outcomes After Bilateral Implantation of an Apodized Diffractive +3.0 D Multifocal Toric IOL in a Prospective Clinical Study
Authors: Knorz Michael C. , Rincón José L. , Suarez Enrique , Alfonso José F. , Fernández-Vega Luis , Titke Christine , Kohnen Thomas , Tucker Sally
Published: February 2014

PURPOSE:

To assess subjective outcomes after bilateral implantation of an aspheric apodized diffractive +3.0 diopter (D) multifocal toric intraocular lens (IOL).

METHODS:

This was a prospective, single-arm, 6-month study conducted at five study sites in Europe and South America. Forty-nine patients requiring bilateral cataract extraction or refractive lens exchange and IOL implantation in both eyes with preoperative regular corneal astigmatism of 0.75 D or greater and 2.5 D or less received bilateral AcrySof ReSTOR +3.0 D toric IOLs (Models SND1T3, SND1T4, or SND1T5; Alcon Laboratories, Inc., Fort Worth, TX). Subjective questionnaires were administered preoperatively and 6 months postoperatively.

RESULTS:

Patient subjective experience with visual tasks at all distances improved from the preoperative visit to the 6-month visit. At the 6-month visit, 90% (36 of 40) of respondents reported complete freedom from corrective wear compared with 14% (6 of 43) pre-operatively. On a scale of 0 (worst) to 10 (best), the mean score that patients rated their uncorrected vision was 7.9 ± 1.9 at 6 months (n = 37) compared with 3.6 ± 2.0 at the preoperative visit (n = 38).

CONCLUSIONS:

Six months following bilateral implantation of the AcrySof ReSTOR +3.0 D toric IOL revealed improved subjective experience, increased spectacle freedom, and higher satisfaction when compared with the preoperative baseline.

[
J Refract Surg.
2013;29(11):762–767.]
Femtosecond Laser-Assisted Keyhole Endokeratophakia: Correction of Hyperopia by Implantation of an Allogeneic Lenticule Obtained by SMILE From a Myopic Donor
Authors: Pradhan Kishore R. , Reinstein Dan Z. , Carp Glenn I. , Archer Timothy J. , Gobbe Marine , Gurung Reeta
Published: February 2014

PURPOSE:

To describe endokeratophakia in which a small incision lenticule extraction (SMILE) lenticule from a myopic patient is implanted into a recipient eye through a small incision to correct hyperopia.

METHODS:

A 23-year-old aphakic woman presented following cataract surgery to remove a childhood congenital cataract with hyperopia of +12.00 −1.50 × 155, corrected distance visual acuity of counting fingers, and exotropia. A SMILE procedure using the VisuMax femto-second laser (Carl Zeiss Meditec, Jena, Germany) was performed on a donor patient with high myopia and the extracted lenticule was stored (power −10.50 diopter sphere, optical zone 5.75 mm, central lenticule thickness 127
μ
m). In the recipient eye, a pocket lamellar incision was created using the VisuMax SMILE software. The upper interface was separated and the donor lenticule was inserted through the small incision.

RESULTS:

One year postoperatively, retinoscopy refraction was +7.50 −3.00 × 150, a spherical equivalent refraction reduction of 5.25 diopters. Mean keratometric power increased by 2.91 diopters. The posterior surface elevation changed significantly with a central bulge into the anterior chamber. Central corneal thickness by Pentacam (Oculus Optikgeräte, Wetzlar, Germany) increased by 121
μ
m. Central lenticule thickness was 130
μ
m and central epithelial thickness was 43
μ
m measured by RTVue OCT (Optovue Inc., Fremont, CA). The cornea remained clear over the 1-year postoperative period.

CONCLUSIONS:

Endokeratophakia appears to be a viable procedure for correcting hyperopia on the cornea by implantation of an extracted myopic SMILE lenticule from a donor patient. However, posterior surface changes and epithelial remodeling resulted in only 50% of the intended correction. No adverse side effects were observed following implantation of donor tissue for 1 year.

[
J Refract Surg.
2013;29(11):777–782.]
Safety Profile of High-Fluence Corneal Collagen Cross-Linking for Progressive Keratoconus: Preliminary Results From a Prospective Cohort Study
Authors: Gatzioufas Zisis , Richoz Olivier , Brugnoli Eliane , Hafezi Farhad
Published: February 2014

PURPOSE:

To investigate the effect of high-fluence corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A in the management of progressive keratoconus.

METHODS:

Preliminary results from a prospective cohort study. Seven eyes from 7 patients with progressive keratoconus subjected to CXL were included. CXL was performed as a standard epithelium-off procedure, irradiating with high-fluence settings (18 mW/cm
2
for 5 minutes). Endothelial cell density (ECD), speed of postoperative epithelial healing, maximal and average keratometric readings (Kmax and Kmean, respectively) of the anterior corneal surface, and corrected distance visual acuity (CDVA) were evaluated preoperatively and at 1 and 6 months after CXL. One-way analysis of variance was applied for statistical analysis.
P
values less than .05 were considered significant.

RESULTS:

ECD did not change significantly postoperatively and complete epithelial healing occurred in all eyes within 96 hours postoperatively. No morphological alterations in the corneal limbus were observed. Kmax, Kmean, and CDVA showed no significant changes at 1 and 6 months postoperatively. No complications were observed postoperatively.

CONCLUSIONS:

Although the preliminary results are not sufficient for a valid evaluation of the biomechanical effect and the overall safety profile of high-fluence CXL in vivo, they demonstrate that CXL at 18 mW/cm
2
for 5 minutes affects neither endothelial cell density nor the speed of epithelial healing, an indirect indicator of limbal stem cell function.

[
J Refract Surg.
2013;29(12):846–848.]
Intrastromal Corneal Ring Segments Implantation in Patients With Keratoconus: 10-Year Follow-Up
Authors: Torquetti Leonardo , Ferrara Guilherme , Almeida Franklin , Cunha Leandro , Araujo Luana P. N. , Machado Aydano P. , Lyra João Marcelo , Merayo-Lloves Jesús , Ferrara Paulo
Published: February 2014

PURPOSE:

To evaluate the long-term safety and efficacy of Ferrara intrastromal corneal ring segments (ICRS) (Ferrara Ring; AJL, Boecillo, Spain) in patients with keratoconus.

METHODS:

The chart records of 36 eyes of 30 patients with keratoconus implanted with ICRS, operated on between July 1996 and January 2002, were retrospectively reviewed. The following parameters were studied: uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry (K), and central corneal thickness. The outcomes were evaluated at 5 and 10 years after ICRS implantation.

RESULTS:

The mean UDVA (logMAR) improved from 1.01 ± 0.28 (20/200 Snellen) to 0.71 ± 0.38 (20/100 Snellen) at 5 years (
P
< .05) and 0.67 ± 0.25 (20/90 Snellen) at 10 years (
P
= .735). The mean CDVA (logMAR) improved from 0.45 ± 0.45 (20/55 Snellen) to 0.24 ± 0.19 (20/35 Snellen) at 5 years (
P
< .05) and 0.29 ± 0.09 (20/38 Snellen) at 10 years (
P
= .292). The mean maximum K value decreased from 54.99 ± 6.33 to 50.58 ± 5.11 D at 5 years (
P
< .05) and 50.65 ± 5.17 D at 10 years (
P
= .854). The mean minimum K value decreased from 48.85 ± 5.70 to 46.90 ± 5.08 D at 5 years (
P
< .05) and 47.12 ± 4.22 D at 10 years (
P
= .945). The central corneal thickness decreased from 457.42 ± 58.21 to 421.34 ± 74.12
μ
m at 5 years (
P
= .039) and 434.32 ± 77.65
μ
m at 10 years (
P
= .427).

CONCLUSIONS:

Intrastromal corneal ring segments can effectively improve UDVA and CDVA 10 years after implantation in patients with keratoconus.

[
J Refract Surg.
2014;30(1):22–26.]
Silicone-Diffractive Versus Acrylic-Refractive Supplementary IOLs: Visual Performance and Manual Handling
Authors: Schrecker Jens , Blass Sandra , Langenbucher Achim
Published: February 2014

PURPOSE:

To compare visual outcome and manual handling of additional multifocal sulcus-fixated intraocular lenses (IOLs) of different materials and lens concepts.

METHODS:

Visual outcomes after implantation of a monofocal IOL in the capsular bag followed by implantation of a sulcus-fixated multifocal IOL (MIOL) in patients with cataract were assessed. Patients were randomly assigned to receive either the refractive Sulcoflex 653F (Rayner Surgical GmbH, Bamberg, Germany) (35 eyes) or the diffractive MS 714 PB Diff (Dr. Schmidt Intraocularlinsen GmbH, St. Augustin, Germany) (33 eyes) additional MIOL. Three months postoperatively, visual acuity at far, intermediate, and near distance and contrast sensitivity under different conditions were evaluated. Patients with binocular implantation were asked to rate their subjective quality of vision.

RESULTS:

No complications occurred during or after surgery. No significant differences in uncorrected and corrected distance visual acuity at all distances were found between groups. All eyes achieved uncorrected visual acuity of 0.3 logMAR (20/40 Snellen) or better at all distances. Contrast sensitivity was significantly better in the diffractive MS 714 PB Diff group than in the refractive Sulcoflex 653F group under all conditions. The refractive Sulcoflex 653F group experienced more photic phenomena (81%) than the diffractive MS 714 PB Diff group (25%), but the disturbances were scored as mild to moderate in most cases (93%/100%). The unfolding procedure of the acrylic Sulcoflex 653F IOL was smoother and more controllable than that of the silicone MS 714 PB Diff IOL.

CONCLUSIONS:

Both additional MIOLs performed well in terms of far, intermediate, and near vision and enabled patients to handle almost all areas of activity without glasses.

[
J Refract Surg.
2014;30(1):41–48.]
Comparison of Corneal Sensation Between Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser-Assisted LASIK for Myopia
Authors: Li Meiyan , Zhou Zimei , Shen Yang , Knorz Michael C. , Gong Lan , Zhou Xingtao
Published: February 2014

PURPOSE:

To compare the impact on corneal sensation after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (femto-LASIK) in patients with myopia.

METHODS:

In this prospective, nonrandomized comparative study, 71 subjects were enrolled. Thirty-eight eyes of 38 patients underwent SMILE and 33 eyes of 33 patients underwent femto-LASIK. Corneal sensation was tested with Cochet-Bonnet esthesiometry in five corneal areas preoperatively and at 1 week and 1, 3, and 6 months postoperatively. Comparison of corneal sensation was performed for the SMILE and femto-LASIK groups. Additionally, the correlations were evaluated between the postoperative corneal sensation, preoperative spherical equivalent, and ablation depth.

RESULTS:

All tested areas within the cap or flap demonstrated corneal hypoesthesia immediately after both surgeries. SMILE-treated eyes showed less compromised corneal sensation than femto-LASIK–treated eyes at all postoperative visits in the central, inferior, nasal, and temporal areas at the 1-week and 1-month visits. In the SMILE group, the inferior, nasal, and temporal quadrants recovered faster than other areas. In the femto-LASIK group, the sensation over the flap did not recover to preoperative levels by postoperative 6 months. There was no correlation between postoperative corneal sensation, preoperative spherical equivalent, and ablation depth in both groups.

CONCLUSIONS:

The impairment of corneal sensation was less significant in the SMILE group than in the femto-LASIK group and was independent of preoperative spherical equivalent or ablation depth.

[
J Refract Surg.
2014;30(2):94–100.]