bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive Developmental Approach to Dementia
Authors: Matteson Mary Ann , Linton Adrianne D. , Barnes Susan J.
Published: October 2007

Systematic observations of people suffering from dementia of the Alzheimer's type (DAT) reveal they regress in behavior and become childlike. These observations have been used to structure clinical research and therapeutic interventions for dementia patients. However, no concise framework explains successful caregiving. Models for care exist but they lack an adequate framework for the long‐term care of a person with DAT. This state of the science review describes what is known about cognitive functioning in people with DAT. It examines studies based on cognitive functioning. It also then relates this information to an emerging theory tentatively identified as a “cognitive developmental approach” which may be useful for understanding people with dementia and for predicting caregiver requirements.
Indian Summer
Authors: Pope Diana Spies
Published: October 2007

This story is about my experience with the Oglala Lakota (Sioux) on the Pine Ridge Indian Reservation in South Dakota. For 6 weeks, as part of my last elective in the Community Health Intercultural Nursing Program at the University of Maryland, I made home visits with a Community Health Representative (CHR). Dianne Iron Bird, the CHR with whom I traveled, and a woman who was close to my age and stage of life, was largely responsible for my view of the reservation and for the level of acceptance I had in people's homes. My experience was rich and rewarding. It afforded me the opportunity to participate in a different kind of health care. I used this exercise in story‐telling to test my knowledge and understanding of the Lakota's world view. By definition, it is my view of both my world and theirs. Using literal rather than abstract language helped me to see both worlds from a new perspective.
Toward A Model For Nursing Informatics
Authors: Turley James P.
Published: October 2007

Purpose: To propose a new model for the development of nursing informatics based on historical precedent.

Significance: Nursing informatics is expanding rapidly. The proposed model aids in understanding the areas of research, relating them to each other, and it shows areas where work is missing or should be extended.

Organizing Framework: Nursing informatics as the interaction of cognitive science, computer science, and information science resting on a base of nursing science.

Implications: As this model is tested, it can act as an organizing framework to understand and relate studies of nursing informatics and give organization for future research, education, and development.
Collaborative Research by Graduate Students
Authors: Yonge Olive , Skillen D. Lynn , Henderson Dianne
Published: October 2007

Purpose: Educators are challenged to prepare graduate students for future cooperative efforts by fostering collaboration.

Organizing Framework: Assumptions and beliefs about collaborative research are examined and a definition and ethical considerations are suggested. A sample letter of agreement is also provided.

Conclusions: Effective collaborative research is accomplished through planning and organization, and cannot be left to chance.
An Exploration of Factors Influencing Adjustment Among Relocating Rural Elders
Authors: Armer Jane M.
Published: October 2007

The aim of this preliminary qualitative study was to examine factors influencing the adjustment of 34 elderly people relocating to an age‐segregated planned housing unit in a rural community. Factors identified as affecting urban relocation were explored as a basis for developing a greater understanding of rural elders. Data from open‐ended interviews were analyzed through sorting into categories by themes. Inclusion of factors reported to influence relocation among urban‐dwelling elders in rural relocation research was validated through the template analytic technique. Content analysis resulted in support for the variables of predictability, controllability, social support and interaction, recency of loss, and prior life satisfaction as potential influences on post‐relocation adjustment. Health professionals can ease adjustment through increased understanding of the factors that affect adjustment to relocation. Based on these preliminary findings, a more comprehensive study of relocation among the rural aged is warranted.
Comparison of Nurses and Alternative Healers
Authors: Engebretson Joan
Published: October 2007

Nurses and alternative healers often share a common holistic philosophy of health and healing as well as the use of therapeutic touch. This ethnography compared the concepts of health and healing used by nurses and alternative healers. Seven categories of activities in healing or health domains common to both groups were physical, mental, attitudinal, relational, spiritual, self‐caring, and help‐seeking. Similarities were in the holistic approach. Differences were found in locus of responsibility and spirituality. These differences may be largely explained by various social factors in practice settings.
Reformulation of Deviance and Labeling Theory for Nursing
Authors: Trexler Judith Carveth
Published: October 2007

Caring for a “difficult patient” is a concern frequently communicated among nurses and reported in the clinical and research literature. A theoretical perspective explaining the phenomenon of difficult patients is proposed and is based on a reformulation of propositions from labeling theory and the concept of social deviance. Applications to nursing practice focus on patient characteristics judged as deviant by nurses, communication of the deviant label, and exclusionary and inclusionary reactions to perceived patient deviance.
Defining Nursing Interventions
Authors: Snyder Mariah , Egan Ellen C. , Nojima Yoshiko
Published: October 2007

Nurses are giving increasing attention to independent nursing interventions. However, numerous conceptualizations of interventions have evolved and are being used. The purpose of this essay is to examine some of the existing definitions and classification systems for interventions and to provide a rationale for a common universal language for nursing interventions. Definitions and approaches used in five intervention classification systems are examined in relation to inclusion of assessment and evaluation activities, autonomy, level of conceptualization, and inclusiveness of intervention labels. Lack of a common intervention language can deter international collaboration, development of a scientific basis for practice, and reimbursement for nursing services.
Transcultural Nursing Research to Transform Nursing Education and practice: 40 Years
Authors: Leininger Madeleine
Published: October 2007

In this article, an overview of some major trends, philosophical perspectives, and theoretical perspectives are presented, along with selected transcultural nursing research findings, primarily from the theory of culture care using the ethnonursing research method. A substantial body of transcultural nursing knowledge with health or well being outcomes has been forthcoming since transcultural nursing was launched in the 1950s. The author contends that transcultural nursing knowledge of Western and non‐Western cultures is urgently needed to meet health needs in a multicultural world. Some misconceptions and reflections are offered to advance transcultural nursing research, education, and practice. For “newcomers” to transcultural nursing, some basic readings are recommended.
Building the Information Infrastructure Required for Managed Care
Authors: Jones Lynette D.
Published: October 2007

Purpose: To describe the information used by health care purchasers, policymakers, and administrators when making the decisions required in a managed‐care environment and what the profession must do to develop an information infrastructure to demonstrate its contribution to patient outcomes.

Scope: Managed care has created a competitive environment for all health care organizations in which they must offer the best value for their dollar. The purchasing processes germane to managed care rely heavily on information for the selection of cost‐effective providers and the provision of efficient care. lnformation used in these processes is derived from transaction systems that largely describe physician and other health care worker's services, but not nursing care. Data analysis by computers requires that data be obtained using a standardized language. Currently, nursing lacks a unified approach to the use of a standardized nursing language.

Conclusions: Individual nurses, nurse managers, executives, and educators should strive to develop an information infrastructure that will overcome barriers. Nurses should both adopt a unified approach to a standardized language, and develop a nationwide information infrastructure that will demonstrate nursing's contribution to patient outcomes.
Validation of a Vignette Simulation of Assault on Nurses by Patients
Authors: Lanza Marilyn Lewis , Carifio James , Pattison Ivor , Hicks Carol
Published: October 2007

Purpose: To determine the degree to which causal attribution (“blame”) scores obtained from written vignettes of assault incidents, simulations of reality, reflect results that would be obtained from victims of actual assaults.

Design: Correlational study. Data were collected, 1990–1993, from a convenience sample of 59 RNs who had been assaulted verbally or physically at one neuropsychiatric hospital in the United States.

Methods: Victims used the Causal Attribution Scale to assign blame for their assault. Three judges then used the same scale to attribute cause for the assault based on a written description of the assault by the victim.

Findings: No significant differences in mean causal attribution levels were found between victims and the average ratings for the three judges for mild or severe assaults, nor between victims, judges, and the response levels obtained in two previous vignette studies.

Conclusions: Mean causal attribution (“blame”) scores observed in simulations that are carefully constructed assault vignettes are nearly the same as those observed in actual assaults. Vignettes appear promising as a simulation to study actual or hypothetical responses to assault.
Perspectives Unifying Symptom Interpretation
Authors: Teel Cynthia S. , Meek Paula , McNamara Anne M. , Watson Lorraine
Published: October 2007

Purpose: To introduce the symptom interpretation model (SIM) and facilitate understanding symptoms from an intrapersonal perspective. Determining an individual's interpretation of symptoms is critical to understanding the resulting decisions.

Organizing Construct: SIM is based on an illness representation model, knowledge structures theroy, and propositions about reasoning. Individuals name and assign meaning to environmental stimuli. Based on this interpretation, behaviors are selected for symptom management.

Methods: Theory derivation was used to develop SIM for understanding comparisons of known and new symptoms in a behavioral outcomes context.

Conclusions: Symptom familiarity reinforces patterns about symptom management. SIM enriches understanding of symptom experiences. Comprehensive assessment, including the intraindividual perspective, is essential to successful symptom management.
Using Literature to Create Cultural Competence
Authors: Bartol Genevieve M. , Richardson Lenora
Published: October 2007

Purpose: To describe how literature can be used to promote cultural competence. Cultural competence is essential for nurses who practice in diverse societies like the United States.

Organizing Framework: Cultural competence is viewed as a dynamic process of framing assumptions, knowledge, and meanings from a culture other than one's own. Selected excerpts from “The Color Purple” by Alice Walker are used to illustrate the method. Isler' s readers' response theory serves as a guide for imaginative engagement and reflective discussion of the concept of health.

Conclusions: Literature helps to dispel the false notion of a monolithic culture. Reflecting on reputable literature helps us hear the stories of those we hope to help and heal.
Diabetes Research in an American Indian Community
Authors: Jacobson Sharol F. , Booton‐Hiser Deborah , Moore John H. , Edwards Karethy A. , Pryor Sue , Campbell Janis M.
Published: October 2007

Purpose: To describe field experiences of a nurse‐led team conducting collaborative research on diabetes with an American Indian community. Diabetes is of epidemic proportions among Indians. Methodological reports can assist nurse researchers to make important contributions to Indian health and diabetes care.

Organizing Framework: Wax's, stages of fieldwork: Initiation, fieldwork, post‐field work.

Scope and Method: Report of key research experiences from all phases of a study with an Indian community (1988–1996). Based on review of classic literature, field notes, and team meetings.

Findings: Methodological literature on research with Indians and cultural tutelage by Indians were helpful but neither sufficient nor infallible. A long period of investigator presence in the community before beginning the research was extremely useful. The need for researchers to explain their presence and the contribution of research to the community was ongoing.

Conclusions: Wax's conception of field work as a dialectic process was supported. A collaborative, community focus and willingness to spend much time acquiring cultural knowledge can facilitate successful research on Indian health.
Cost‐Effectiveness Analysis in the Nursing Literature, 1992–1996
Authors: Allred Charlene A. , Arford Patricia H. , Mauldin Patrick D. , Goodwin Linda K.
Published: October 2007

Purpose: To review the recommendations by the U.S. Panel on Cost‐Effectiveness in Health and Medicine (panel) for use in future nursing research. The review (a) provides a critique of the nursing cost‐effectiveness and cost utility literature from the perspective of the recommendations set forth by the panel and other recognized authorities in cost‐effectiveness analysis (CEA), (b) constructs an interdisciplinary framework to show the steps in the conduct of CEA, (c) makes the fechniques and major findings of nursing CEA studies available and understandable, and (d) offers guidelines for the incorporation of CEA into the evaluation of future nursing intervention and research.

Data Sources: Seven nursing studies published between 1992 and 1996 that compared two or more interventions for costs and outcomes.

Organizing Framework: For each study, the (a) perspective, fb) net costs, (c) net effect, (d) analysis of costs and effects, and (e) decision outcomes were analyzed.

Findings: If the panel's recommendations reflect the problems in the health care CEA literature in general, then on balance, the nursing CEA 1992–1996 studies are no more or less flawed than CEA studies in the health or medical care fields.

Conclusions: Methodologic guidelines and interdisciplinary strategies are needed to advance the progress of nursing cost‐effectiveness research.
Spirituality and Chronic Illness
Authors: O'Neill Debra P. , Kenny Elaine K.
Published: October 2007

Purpose: To present a comprehensive overview of spirituality and identify strategies to support the spiritual dimensions of nursing care for people with chronic illness, focusing specifically on HIV‐related illness and AIDS.

Significance and Scope: The AIDS crisis has brought new emphasis to the need to develop therapeutic interventions to support the coping resources of people living and dying with chronic illness. Conceptual, theoretical, and empirical knowledge related to spirituality was reviewed, integrated, and interpreted within the context of nursing care for this population, emphasizing the spiritual needs of people with HIV‐related illness and AIDS.

Conclusions and Implications: Spirituality has evolved beyond religious considerations to encompass multidimensional and existential perspectives that are integral to maintaining well‐being for the chronically ill. A deeper understanding of spirituality enhances the potential for nurses to identify spiritual needs and incorporate spiritual caring into practice.
Nurse Staffing Levels and Adverse Events Following Surgery in U.S. Hospitals
Authors: Kovner Christine , Gergen Peter J.
Published: October 2007

Purpose: To examine the relationship between nurse staffing and selected adverse events hypothesized to be sensitive to nursing care, while controlling for related hospital characteristics. Efforts in the United States to reduce hospital costs, resulting in strategies to use fewer nurses, have stimulated extensive debate but little evaluation.

Design: Survey using data from a 20% stratified probability sample to approximate U.S. community hospitals. The sample included 589 acute‐care hospitals in 10 states.

Methods: Discharge data from 1993 for patients aged 18 years and over were used to create hospital‐level adverse event indicators. These hospital‐level data were matched to American Hospital Association data on community hospital characteristics, including nurse staffing, to examine the relationship between nurse staffing and adverse events.

Results: A large and significant inverse relationship was found between full‐time‐equivalent RNs per adjusted inpatient day (RNAPD) and urinary tract infections after major surgery (p<.0001) as well as pneumonia after major surgery (p<.001). A significant but less robust inverse relationship was found between RNAPD and thrombosis after major surgery (p<.01), as well as pulmonary compromise after major surgery (p<.05).

Conclusions: Inverse relationships between nurse staffing and these adverse events provide information for managers to use when redesigning and restructuring the clinical workforce employed in providing inpatient care.
Estimating the Market for Nursing Personnel in North Carolina
Authors: Cleary Brenda L. , Lacey Linda M. , Beck‐Warden Michelle
Published: October 2007

Purpose: To facilitate nurse workforce planning in the United States at the state level, the North Carolina Center for Nursing conducted a statewide survey of nurse employers to describe the current market for nurses; identify the types of nursing personnel in short supply; estimate the effect of organizational changes on nursing demand; examine preferences for RNs with varying levels of education; and identify the specific skills or competencies desired by employers.

Design: Descriptive.

Methods: A geographically stratified random sample of 909 nurse‐employing organizations in North Carolina was surveyed in 1996 by telephone. A total of 667 interviews were completed for a response rate of 78%. Descriptive statistics and correlation analyses are reported.

Results: A nursing labor market was found characterized by uncertainty in hospitals, particularly those undergoing reorganization, but of definite growth outside of hospitals. Demand is increasing for unlicensed assistive personnel, RNs with baccalaureate degrees, some advanced practice RNs, and in hospitals, for RNs with master's degrees in management. Recruitment continues to be a major challenge to hospitals in specialty areas, particularly critical care and surgery. In the community sector, demand is strong for all types of nursing personnel. Tests for substitution of specific types of nursing personnel revealed no systematic substitution by employers. Critical thinking and management skills were Competencies most valued by hospital employers while specific clinical competencies, including assessment skills and technical skills, received priority emphasis by community‐based employers.

Conclusions: Although change is occurring in the health system of North Carolina, there remains a strong demand for nursing personnel. The findings pose a challenge to produce a nursing workforce sufficient in numbers and education.
When is the Dyspnea Worth It? Understanding Functional Performance in People with Alpha‐1 Antitrypsin Deficiency
Authors: Knebel Ann , Leidy Nancy Kline , Sherman Sandra
Published: October 2007

Objective and Significance: To examine functional performance in people with emphysema because of alpha‐1 antitrypsin (AAT) deficiency. A severe deficiency of AAT affects 1:3,500 to 1:1,670 Americans who can develop debilitating emphysema in the third to fifth decades of life.

Design: Exploratory.

Population: People with a severe deficiency of AAT.

Sample and Demographics: Thirty‐three patients (27 men) with a mean age of 47 (SD=7) years.

Years: Data were collected 7993–7996.

Methods: Activities patients identified as important on the dyspnea subscale of the Chronic Respiratory Disease Questionnaire were categorized and interpreted within the context of an integrity framework (i.e., effectiveness—or connectedness‐related).

Findings: Patients identified over 25 activities. Effectiveness activities, such as bathing, were mentioned most frequently (78%). Connectedness activities, such as praying with children, were mentioned less often (22%) but were ranked more important. Two patients reviewed and supported the content validity of the framework.

Conclusions: Results offer insight into the activities patients with genetic emphysema choose to perform and the factors that influence the decision that “the dyspnea is worth it.”

Implications: Identifying the activities people with AAT deficiency choose to perform and understanding why these activities are meaningful can guide interventions to help patients maintain a sense of integrity.
The Ameba Balamuthia mandrillaris Feeds by Entering into Mammalian Cells in Culture
Authors: DUNNEBACKE THELMA H.
Published: September 2007

ABSTRACT. Microscopic observations of live cultures of the pathogenic ameba Balamuthia mandrillaris and mammalian cells showed that amebic feeding involved the invasion of the pseudopodia, and/or the whole ameba into the cells. The ameba, recognized by their size and flow of organelles in the cytosol, was seen to extend the tip of a pseudopodium into the cytoplasm of a cell where it moved about leaving visible damage when retracted. In rounded cells, whole amebas were seen to enter into and move around before exiting a cell and then remain quiescent for hours. The invaded mammalian cells retained their turgidity and excluded vital dyes until only their denuded nuclei remained. The cytoplasm of the cells was consumed first, then the nuclei, but not their mitotic chromosomes. The feeding pattern of four isolates of B. mandrillaris, two from humans and two from soil samples, was by amebic invasion into the mammalian cells. The resulting ameba population included cysts, amebas on the surface, and free‐floating amebas as individuals or in dense‐packed clusters. There was no morphologic indication of a cytopathic change in the mammalian cells before their invasion by the amebas. Feeding by cell invasion is a distinctive feature of B. mandrillaris.
Synthesis of Zinc Oxide Nanostructures with Controlled Morphologies Using a Simple Sonochemical Method
Authors: Pu Xi‐peng , Zhang Da‐feng , Jia Li‐ping , Su Chang‐hua
Published: September 2007

Zinc oxide (ZnO) nanostructures were synthesized by a simple sonochemical method without the assistance of an additional surfactant. The morphologies can simply be controlled only by changing the addition sequence of NH3·H2O. When NH3·H2O was added before or at the beginning of the ultrasonic treatment, a flower‐like nanostructure and ellipsoidal particles self‐assembled by nanorods were obtained, respectively. The strong visible emission implied high atomic defects. The emission intensity was dependent on the addition sequence of NH3·H2O greatly.
New perspectives in retinal imaging: fundus autofluorescence and age‐related macular degeneration
Authors: HOLZ F
Published: October 2007

Fundus Autofluorescence (FAF) imaging using confocal scanning laser ophthalmoscopy is a non‐invasive method to to accurately record the topographic distribution of RPE lipofuscin in the human eye in vivo. Excessive lipofuscin accumkulation in the RPE is a common downstream pathogenetic pathway in various complex and monogenetic retinal diseases. Toxic compounds and molecular mechanisms of interference with normal cellular functions have been identified including the dominant fluorophore A2‐E. Alterations in fundus autofluorescence (FAF) appearance in eyes with early and late age‐related macular degeneration (AMD) can be striking. FAF patterns and distribution do not necessarily correlate with the features of interest in color or angiographic images of eyes with early or late AMD. In the prospective, multicenter FAM study distinct patterns of abnormal FAF were identified and classified in the junctional zone of geographic atrophy (GA). Areas of increased FAF outside GA were associated with variable degrees of loss of retinal sensitivity when tested with microperimetry which suggests a functional correlate of lipofuscin accumulation. Increased FAF preceded the development and enlargement of outer retinal atrophy associated with spread of absolute scotoma in eyes with AMD. Longitudinal examinations showed that the abnormal phenotypic FAF patterns serve as novel prognostic determinants which allows to distinguish fast vs. slow progressors. These findings are relevant and now used to design and carry out interventional trials with agents aimed at slowing down spread of atrophy, e.g. using visual cycle modulators to influence lipofuscinogenesis. Hereby FAF imaging also serves as a mean to accurately delineate and measure areas of GA over time in an automated fashion. A phenotype‐genotype correlation was identified for a distinct FAF phenotype subset which was found to represent late‐onset Stargardt macular dystrophy mimicking late‐stage atrophic AMD. New imaging technologies were recently applied including simultaneous recordings of FAF images and high‐resolution, spectral‐domain optical coherence tomography (OCT) which allows to identify morphological correlates of abnormal FAF signals in optical biopsies.
Optic radiation damage can be assessed directly by tractography
Authors: YAMAMOTO T , YAMADA K , PLANT GT
Published: October 2007

Purpose: To verify the clinicoradiological correlation of tractographs of optic radiations (OR) involved by brain tumors and infarcts.

Methods: We performed diffusion‐tensor magnetic resonance imaging (DT‐MRI) on 7 patients with brain lesions adjacent to or involving the visual pathway, 5 of whom underwent DT‐MRI before and after surgical excision of the brain lesions. Tractographic findings of OR on coronal reconstruction images, including those in the contralesional hemisphere, were analyzed with respect to their location and size and correlated with existing visual field defects. When the ipsilesional OR appeared to be reduced in craniocaudal height by 70% or more in coronal section than the contralesional OR, we considered the finding abnormal.

Results: The contralesional ORs were successfully depicted in all cases. In 8 examinations the ipsilesional ORs were successfully depicted, in 4 they were not. The 8 depicted ORs in the ipsilesional hemisphere were abnormal either in size (n=8) and/or location (n=4). OR defects were noted in either the superior or inferior portions in 8 tractographs. OR deviation due to mass effect from the brain lesions was noted in 4 tractographs. In 5 tractographs with OR defects there was a good correlation with the location of the visual field defect.

Conclusions: The tractography demonstrates the ORs all the time on the contralesional side, correlates some of our cases with the visual field defect on the ipsilesional side.
Modulation transfer function in refractive‐diffractive multifocal intraocular lenses in vitro
Authors: PERIS‐MARTINEZ C , ARTIGAS JM , MENEZO ROZALEN JL , FELIPE A , DIEZ AJENJO A
Published: October 2007

Purpose: The optical quality of two types of multifocal, hybrid refractive‐diffractive, intraocular lenses (IOL) is analyzed in vitro. Following the EN‐ISO international standard, the IOLs’ modulation transfer functions (MTF) are determined for both distance and near vision. The behaviour of these curves when the pupil size varies is studied.

Methods: The IOLs analyzed were: AcrySoft ResTor SN60D3 (Alcon) and Tecnis ZM900 (AMO). The MTF was calculated from the cross line‐spread function recorded with the OPAL Vector System (Image Science Ltd. Oxford) by using fast Fourier transform techniques. The artificial eye model used simulates in vivo conditions of the anterior chamber including an artificial cornea and a physiological solution where the IOL were positioned. Following pupil sizes were analyzed: 2.0, 2.5, 3.0, 3.5, 4.0, 4.5 and 5.0 mm.

Results: The MTFs of the two multifocal IOLs analyzed show a good image quality for both in all conditions analyzed. However, a monofocal IOL with the same power (22.5 dioptres) provides a better image quality for distance vision. The Strehl ratio of the two multifocal IOLs decreases when pupil size increases, for both distance and near vision. To the contrary, the average modulation (from 0 to 100 c/mm) of the two multifocal IOLs remains approximately constant for all the pupil sizes.

Conclusions: The image quality provided by the two multifocal refractive‐diffractive IOLs is very similar, although the quality with ResTor IOL is always slightly better than with Tecnis IOL in distance vision. In near vision, to the contrary. The conclusion is that when the distance vision improves the near vision worsens and vice‐versa.
Dynamic contour tonometry in corneal oedema
Authors: RENNINGS CA , PLANGE N , KAUP M , REMKY A
Published: October 2007

Purpose: Tonometry in corneal oedema is a current problem. In clinical routine intraocular pressure (IOP) may be measured erroneously too low in edematous thickened cornea using Goldmann applanation tonometry.

To compare Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT, Pascal, Technomed, Germany) in postsurgical corneal oedema.

Methods: Fifty patients with cataract were included in a prospective study. IOP was measured by means of GAT and DCT before and one day after cataract surgery. Corneal thickness was determined using a Scheimpflug camera system (Pentacam, Oculus, Germany).

Results: After surgery corneal thickness increased significantly (pre‐surgery: 548 μm, post‐surgery: 677 μm, p<0.0001). No significant difference of IOP values measured with DCT compared to GAT was detected before and after cataract surgery (pre‐surgery: GAT: 17 ±5 mmHg, DCT: 17 ±6 mmHg; post‐surgery: GAT 15 ± 7 mmHg, DCT: 15 ±7 mmHg). IOP measured with DCT and GAT were significantly correlated (pre‐surgery: r=0.808, p<0.0001; post‐surgery: r=0.767, p<0.0001). The difference between GAT and DCT pre‐surgery compared to post‐surgery was not significantly different. The IOP difference using GAT or DCT pre‐surgery compared to post‐surgery was not correlated to the change in corneal thickness.

Conclusions: DCT does not give any additional information compared to GAT in patients with corneal oedema. However, a marked difference in IOP values using GAT or DCT is apparent in some subjects.
Resolution visual fields in children surgically treated for congenital cataract
Authors: MARTIN L , MAGNUSSSON G , POPOVIC Z , SJÖSTRAND J
Published: October 2007

Purpose: To evaluate best‐corrected visual acuity (BCVA) and high‐pass resolution perimetry (HRP) visual fields in children surgically treated for congenital cataract.

Methods: BCVA and HRP was recorded from 10 aphakic children, aged 10‐15 years and surgically treated for bilateral dense cataract before the age of nine months, and from six aphakic children, aged 10‐15 years and surgically treated for bilateral partial cataract at ages between 6 months and 9 years. Twenty‐three healthy children, 11 years of age, served as controls.

Results: The aphakic children had significantly (p < 0.0001) lower BCVA in their best eye (range 0.1‐1.3) compared to controls (range 1.0‐1.6). Two aphakic children were visually disabled according to WHO. The children with previous dense bilateral cataract showed significantly (p < 0.05) lower sensitivity in their resolution visual fields (from their best eyes) compared to both controls and children with previous partial cataract. The dense cataract group also showed significantly (p<0.05) smaller difference between the innermost (5 deg) and the outermost (20‐30 deg) eccentricity locations in their visual fields than the other two groups.

Conclusions: Dense cataract, even when surgically treated before the age of nine months, causes persistent impairment of spatial vision both in the fovea and the visual field. Partial cataract appears only to reduce visual acuity.
Visual acuity and use of eye care services in elderly population
Authors: LAITINEN A , KOSKINEN S , RUDANKO SL , MARTELIN T , LAATIKAINEN L , AROMAA A
Published: October 2007

Purpose: To assess the use of eye care services and associated socio‐economic factors in different visual acuity categories.

Methods: Cross‐sectional population‐based survey on a sample representing Finnish population aged 55 years and older. Of the 3392 eligible people, 2781 (82.0%) were both interviewed and had distance visual acuity (VA) assessed with the current spectacles. Home interview included an assessment of socio‐economic variables, use of eye care services and possession of vision aids.

Results: Prevalence of vision examination and spectacles decreased with decreasing VA (p<0.001). Of elderly persons with good VA (VA≥0.8), three‐quarters (73%) had had a vision examination during the past five years and almost all (97%) had spectacles. On the contrary, only one half (58%) of visually impaired person (VA≤0.25) had had a vision examination and two‐thirds (62%) had spectacles. Of visually impaired, 34% had magnifying glasses or other low vision aids and 28% had received formal low vision rehabilitation. Living in an institution, lower annual income level and decreased cognitive capacity seemed to decrease the use of vision examination and possession of spectacles in all VA categories. Also, men had spectacles less frequently than women and persons with lower educational level had less likely had vision examination. In visually impaired persons, decreased cognitive capacity and living in an institution were associated with limited use of low vision rehabilitation services.

Conclusions: Low prevalence of regular vision examinations and vision rehabilitation services in visually impaired persons highlights the need for screening the visual function in elderly persons and for actively delivering information on rehabilitation services.
The effect of Blue‐Light exposure in an ocular melanoma animal model
Authors: FERNANDES BF , DI CESARE S , MALONEY S , MARSHALL JC , DAWSON WW , BURNIER MN
Published: October 2007

Purpose: Uveal melanoma (UM) cells lines, when exposed to blue light in vitro, show a significant increase in proliferation. In order to see if the same effect would be seen in vivo, we investigated the influence of blue‐light exposure in an animal model of UM.

Methods: Twenty albino rabbits were injected with 1 million human UM cells (92.1) into the suprachoroidal space of the eye. Animals were immunosuppressed using cyclosporin A throughout the 8 week long experiment. The animals were divided into two groups of 10 animals each. The experimental group was exposed to blue‐light, while the control group was protected from blue‐light using a yellow‐filter. Intraocular tumor growth was evaluated weekly by fundoscopic examination. One animal was sacrificed per week, after the 2nd week, in order to evaluate progression of the disease. The eyes were removed after sacrifice and the proliferation rates of the re‐cultured cells obtained from the intraocular tumors were performed using the Sulfordhamine‐B assay. The Student's t–test was used to compare results for statistical significance.

Results: Re‐cultures of UM cells were establish from 4 and 5 rabbits of the experimental and control group respectively. Cells were re‐cultured for a very short period of time (1 passage only) in order to maintain any in vivo cellular changes. The exposure of rabbits to blue light led to an increase in proliferation of the cell lines derived from intraocular tumors compared to the control (p=0.001).

Conclusions: There is increasing amount of data suggesting that Blue‐light, one of the components of visible light, may influence the progression of UM. Our results warrant further studies to relate the importance of Blue‐Light filtering lenses for UM patients.
Effect of intravitreal injection of indocyanine green, triamcinolone acetonide and trypan blue on the electroretinographic response in the rat
Authors: GARCHER CREUZOT C , ACAR N , GUILLAUBEY A , BIDOT S , PASQUIS B , JOFFRE C , BRON AM , BRETILLON L
Published: October 2007

Purpose: The purpose of this study was to evaluate the effects of intravitreal injection of ICG (indocyanine green), TB (trypan blue) and TA (triamcinolone acetonide) on the visual function assessed by electroretinogram (ERG) in the rat.

Methods: Three groups of 12‐week‐old Sprague Dawley rats (n=6) received intravitreal injection in one eye of 0.1mL of either ICG 0.5mg/mL, TB 3mg/mL or TA 40mg/mL followed by a rinse with 1mL of saline solution. The controlateral eye was used as a control and was injected similarly with saline only. The scotopic ERG was recorded at different intensities (10mcds/m², 2500mcds/m² and 25000mcds/m²) before injection and 28 days after treatment.

Results: No effect of the treatment was observed on the ERG amplitudes and wave latencies in control eyes and in eyes treated with TB and TA. The ERG b‐wave amplitudes and latencies were significantly reduced in eyes treated with ICG at 10mcds/m² and 2500mcds/m² but not at 25000mcds/m² (amplitude means: t0=174.8μV versus t28=55.0μV at 10mcds/m² p<0.05; t0=176.5μV versus t28=70.0μV at 2500mcds/m² p<0.05; t0=140.3μV versus t28=40.0μV at 25000mcds/m² p=0.057). The ERG a‐wave amplitudes and latencies were also significantly lowered at 2500mcds/m² in eyes treated with ICG (amplitude means: t0=45.0μV versus t28=23μV p<0.05; latency means: t0=7.6msec versus t28=9.5msec p<0.01).

Conclusions: This study shows a side effect of ICG on retinal function four weeks after a transient retinal exposure. TA and TB could be considered as interesting alternatives to ICG for macular surgery.
Foveal damage volume and visual acuity in solar retinopathy
Authors: LARA MEDINA J , ISPA CALLEN C , GONZALEZ DEL VALLE F
Published: October 2007

Purpose: To correlate the size of foveal lesion measured by OCT and the visual acuity in patients complain of acute solar retinopathy.

Methods: We studied patients diagnosed of acute solar retinopathy after a solar eclipse by OCT. In the acute phase, all the patients showed a hyperreflective lesion in the fovea using OCT. We measured the volumen in pixels of this foveal lesion by software image analysis (MatLab 7) and correlated this value with the best corrected visual acuity (Snellen). To evaluate the correlation we used the Spearman test and a level of P<0.05 was accepted as statistically significant.

Results: Eighteen eyes were enrolled in the study. Mean age was 32,15±12 years and 33,3% were woman and 66,7% were man. Mean best corrected visual acuity was 0,65±0,29. In 100% of the eyes was observed a hyperreflective foveal lesion using OCT. Mean pixel volume lesion was 6997,62±4662,229.

The correlation (r) of foveal lesion volume and best corrected visual acuity was ‐0,793 (p< 0,05)

Conclusions: Solar retinopathy shows a typical image in OCT, a hyperreflective lesion located in the fovea. We report a negative relation between the size of the above mentioned injury and the visual acuity. Thus, the OCT can be of great help for the diagnosis of this disease and the evaluation of the foveal damage.
Trace elements in the retina of eyes enucleated due to complications of a severe trauma
Authors: IOMDINA EN , FILATOVA IA , KHOROSHEVA EV
Published: October 2007

Purpose: to find out whether trace element concentration in the retina is related to chronic eye pathologies caused by traumatic eye injuries.

Methods: The content of 12 trace elements in the retina (Zn, Cu, Fe, Al, B, Si, Ca, Ba, Ti, Mg, Mn, Pb) was analyzed using an atomic absorption spectrophotometer AS‐3 and a Perkin‐Elmer chromato‐mass spectrometer. 25 samples of 25 enucleated eyes of patients aged 17 to 68 (average age 31.6±2.6 years) were studied. Enucleations were required due to complications of a severe trauma: secondary glaucoma, buphthalmum, subatrophy, uveitis, retinal detachment, amaurosis, corneal leucoma, or combinations thereof.

Results: Retinal samples revealed a significant scatter of trace element concentration: the level of Ca varied from 10 to 1000 mg/kg; Fe, 10 to 350 mg/kg; Mg, 30 to 150 mg/kg; Al, 3 to 70 mg/kg; Si, 0.1 to 50 mg/kg; Mn, 0.3 to 50 mg/kg; Zn, 3.0 to 30 mg/kg; B, 0.03 to 30 mg/kg; Cu, 0.5 to 17 mg/kg; Ba, 0.05 to 6 mg/kg; Ti, 0.05 to 2 mg/kg; Pb, trace quantities to 28 mg/kg. Typical changes of trace element concentration in the retina for different eye pathologies could be revealed. Secondary glaucoma and buphthalmum showed reduced content of Ba, Ti, Al, B, Mn, Zn and Mg and a 2‐fold increase of Cu and Si. The opposite changes were found in chronic uveitis: levels of Fe, B, Al and Cu showed a 2 to 4‐fold increase while Si showed a 2‐fold decrease.

Conclusions: The revealed changes may be linked to intravital violation of trace element metabolism: in glaucoma, a shortage of elements participating in the metabolism of photoreceptors and neural structures of the retina was found, whilst uveitis demonstrated an increase of elements linked to the activation of peroxidation.
Modeling fluid mixing within the crystalline lens during accommodation
Authors: CHE S , HUNTER P , PHILLIPS JR , JACOBS M
Published: October 2007

Purpose: Historically, cataract and presbyopia are treated as separate entities. However, it has recently been hypothesized that as the ageing lens looses its ability to change shape, this reduces the mixing and transport of nutrients and antioxidants within the lens that normally occurs as the young, flexible lens alters its shape during accommodation. Such a loss of antioxidant mixing may render the lens more susceptible to cataract formation.

Methods: We have developed a 3D cubic Hermite finite element model of the human lens to investigate the effect of increasing lens stiffness on fluid movement. Data obtained from previous studies are used to construct an anatomically accurate model. A spherical polar coordinate system is used to provide an accurate physical representation and as a framework to examine mechanics. Polynomial functions are used to define the lens surfaces. Lens capsule thickness and material properties of lens tissue are taken from the literature. Tension is applied via zonules to simulate accommodation.

Results: Preliminary results verify that the change in shape of the lens surfaces (and the change in optical power) associated with displacement of the lens equator are similar to results from other published models and fall within the physiological range (i.e. using parameters for 30 y.o. lens, approx 25 dioptres per mm change in equatorial radius). We are currently investigating the fluid movements associated with these changes.

Conclusions: Our lens model provides a basis for investigating fluid mixing in the young lens during simulated accommodation and also the reduction of fluid movement in stiffer, older lenses.
Rarebit Fovea Test and OCT findings in diabetes
Authors: NILSSON M , VON WENDT G , WANGER P , MARTIN L
Published: October 2007

Purpose: To evaluate foveal structure and function using optical coherence tomography (OCT)

and the Rarebit Fovea Test (RFT) in diabetic patients without known maculopathy or

retinopathy.

Methods: Forty‐two patients with diabetes mellitus (DM) were selected from the screening

records at St Erik Eye Hospital. Inclusion criteria were no previously known macular or other

retinal changes and best corrected visual acuity ≥ 1.0. These patients and 42 healthy controls

were examined with the recently developed RFT and retinal thickness was measured

using OCT. Lens thickness and light scatter was evaluated by Scheimpflug photography.

Results: Significantly more DM subjects (12/42) had a subnormal RFT result compared to the

controls (2/42) (p = 0.007). The retina in the inner OCT zone was significantly (p<0.05)

thinner in DM patients with subnormal RFT compared with the controls. No difference between groups were observed in lens thickness or light scatter.

Conclusions: Macular changes, not detected by comventional screening methods, could be demonstrated using both structural and functional tests in a subgroup of patients with DM. Prospective studies are underway to evaluate the prognostic implications.
Use of sodium hyaluronate "doughnut" in corneal glueing
Authors: SKINNER KC , MERRICK CD , GREGORY PTS , CHRONI FC
Published: October 2007

Purpose: To highlight a surgical technique using sodium hyaluronate and tissue glue in the repair of corneal holes.

Methods: Case Report

Results: An 86 year old man was referred to clinic with a cataract. The other eye was normal after cataract surgery. When he was seen in clinic it was noted that actually he had a small hole in the cornea at the 5 o'clock position off axis. Visual acuity was 6/60. The iris was incarcerated and there was marked inflammation with posterior synechiae and cataract. The hole was felt too be small enough to attempt closure with tissue glue. To perform this a small "doughnut" of sodium hyaluronate was placed around the hole. A very important step was to ask the gentleman to look up so that the "doughnut"would not slide off. The glue was then carefully placed within the "doughnut". When felt to be dry a bandage lens was placed over the eye. The cataract was also removed at the same time. The cornea healed very quickly and within 10 days post op was half of normal thickness. The gentleman now has 6/18 vision and a quiet eye with normal AC and IOP.

Conclusions: The use of tissue glue is widespread, it was first documented in use by midwives and then by medics in Vietnam. Their use in corneal perforations is also well documented. The problem however with their use is that the glue can tend to "stick" to everything and cause complications. This is a marked problem with use on cornea due to the wet nature of the eye. Here we highlight a method whereby sodium hyaluronate is used to create a "doughnut" to limit the spread of the glue and localise it to the area of need. What is also important to note is asking the patient to position their eye accordingly before placing the glue to achieve maximum effect as highlighted in other cases.
Elevated levels of 3‐Nitrotyrosine (3‐NT) in human eyes with primary open‐angle glaucoma (POAG)
Authors: FERNANDEZ‐DURANGO R , FERNANDEZ‐MARTINEZ A , GARCIA FEIJOO J , MARTINEZ DE LA CASA JM , FERNANDEZ‐CRUZ A
Published: October 2007

Purpose: We have previously demonstrated the expression of inducible nitric oxide synthase in the trabecular meshwork from patients with POAG (EVER 2006, Abstract 2256). Therefore, we evaluated the involvement of peroxynitrite in the development of POAG by measuring the expression of 3‐NT, a biomarker of oxidative damage

Methods: Aged‐matched donor human eyes (3 controls and 4 with POAG) were fixed, embedded in paraffin and sectioned. Cellular location was determined by immunohistochesmistry using a mouse anti‐3‐NT monoclonal antibody

Results: 3‐NT immunoreactivity was observed in the anterior segment of POAG eyes: non‐pigmented epithelial and stroma cells of the ciliary processes, cells of the ciliary muscles, trabecular meshwork and Schlemm’s canal. In the retina, staining was observed in the ganglion, inner and outer nuclear cell layers. None of the donor control eyes showed any immunoreactivity for 3‐NT

Conclusions: The presence of 3‐NT immunoreactivity in human eyes with POAG suggests that peroxynitrite‐mediated oxidative stress may have an important role in the pathophysiology of POAG