bluuebunny/crossref_metadata_2025 huggingface dataset:
The Evolution and Status of Genetics Education in Nursing in the United States 1983–1995
Authors: Anderson Gwen W.
Published: October 2007

Despite rapid advances in genetic diagnosis andgene therapy, only a few nurses are addressing the need for widespread dissemination of genetic information. A critical question is: How long will nurses be able to maintain high‐quality care and contend with the conundrums of genopathic medicine? The purpose of this state‐of‐the‐science paper is to trace progress in nursing education in genetics and to recommend curriculum change. A recurrent theme—the need for knowledge—is found in nursing studies and national forums in genetics. Genetic knowledge for nurses should be a priority.
Problem‐Focused Coping in HIV‐Infected Mothers in Relation to Self‐Efficacy, Uncertainty, Social Support, and Psychological Distress
Authors: Sharts‐Hopko Nancy C. , Regan‐Kubinski Mary Jo , Lincoln Patricia S. , Heverly Mary Ann
Published: October 2007

A preliminary investigation of relationships among perceived self‐efficacy, uncertainty, social support, psychological distress, and problem‐focused coping was conducted in a convenience sample of 41 HIV‐infected mothers. The mothers represented 93% of the clients in a large HIV clinic in 1992 who met the study criteria. Support was found for using Lazarus and Folkman's stress, appraisal, and coping framework to understand the health‐related needs of HIV‐infected mothers. Maternal coping was related to living with one's children and their HIV‐status. The feasibility of studying this population of women was demonstrated. Findings suggest the need for exploration of family‐focused interventions.
The Lived Experience of Women Military Nurses in Vietnam During the Vietnam War
Authors: Scannell‐Desch Elizabeth A.
Published: October 2007

The lived experience of 24 military nurses during the Vietnam war is described in addition to common elements of their lives after returning from Vietnam. In‐depth interviews generated data about personal and professional aspects of the lives of women nurses in the war zone. Data analysis incorporated the qualitative methods of Colaizzi, Lincoln and Guba, and Van Manen. Findings revealed that the nurses struggled with moral and ethical dilemmas of wartime nursing, felt out‐of‐place, and lacked privacy. The nurses described a deep and special bonding, and many found serving in Vietnam to be the most rewarding experience in their careers. The Vietnam War continues to have an effect on the lives of the nurses who served there. They balance their personal andprofessionalgrowth gleaned from this experience with the physical and emotional stresses experienced during the war and since the war. The findings of this study have implications for further research about nurses in Vietnam and nurses who have served in other wars.
Adolescents' Views of Sexual Decision‐Making
Authors: Keller Mary L. , Duerst Barbara L. , Zimmerman Janet
Published: October 2007

The purpose of this study was to ascertain the reasons adolescents give for abstinence, safer sex, and unprotected sexual intercourse. Participants were 7 7 5 high school students living in a midwestern state; average age was 17.5 years. Students completed a two‐part questionnaire about (a) their expectations for the outcome of a vignette in which two teenagers had the opportunity for intercourse and (b) their ideas about the reasons, thoughts, and feelings associated with three possible endings to the vignetteabstinence, intercourse with a condom, unprotected intercourse. Content analysis of responses indicated that four interconnected factors are significant contributors to sexual behavior: social norms, fear, gratification or pleasure, and availability of condoms.
Advice for Beginning Nurse Researchers
Authors: Byrne Michelle M. , Kangas Sandra Keenan , Warren Nancy
Published: October 2007

Heideggerian hermeneutics was used to illuminate the advice of six nurse researchers who were interviewed by the authors. The advice given to us as beginning researchers included identifying a planned program of research with a topic that we “love” and conducting research that is meaningful. Additional advice included keeping an idea log, networking, mentoring, and developing collegial relationships. The words of these researchers are intended for future investigators, yet much wisdom exists for all nurses.
The Seventh Star: Dorothy Ford Buschmann and the Founding of Sigma Theta Tau
Authors: Hamilton Diane Bronkema
Published: October 2007

Several women from the Indiana University Training School for Nurses founded Sigma Theta Tau in 1922. While the legend identifies six student founders, this historical study examined the contributions of Dorothy Charlotte Ford Buschmann (1895–1953), a key advisor whom some might consider the seventh founding star. Sources include primary data from Sigma Theta Tau archives. The findings suggest that Dorothy Buschmann believed that the foundations of professional nursing were love, honor, and courage and that the enduring value of nursing was its contribution to the social good. While Buschmann did not claim credit as a founder, she played a vital role in designing Sigma Theta Tau's philosophy and constitution, extended membership throughout the Midwest, and served as the first national president from 1927–1934.
Effects of Case Management on the Nursing Context‐Perceived Quality of Care, Work Satisfaction, and Control Over Practice
Authors: Lynn Mary R. , Kelley Betsy
Published: October 2007

Purpose: To examine in 1995 the effects of case management on the context of nursing practice‐perceived quality of care delivered, work satisfaction, and control over nursing practice‐rather than the commonly studied effect on fiscal outcomes.

Design: Prospective quasi‐experimental. Sampled were nurses on four units at one community hospital where patients with DRG 107 (Coronary Artery Bypass Graft, with no cardiac catheterization) were traditionally hospitalized.

Methods: Registered nurses on these units completed quality of care, satisfaction, and practice‐control scales before and 1 year after implementation.

Findings: Significant positive differences were found in several aspects of perceived quality of care for both staff nurses and case managers, with specific increases found in nurses' perceived ability to develop relationships with patients, ability to be therapeutic, and support for good care from the institutional structure and administration. A significant decrease in nurses' satisfaction with their pay and other rewards as well as respect from colleagues was found. Case managers were found to have significantly increased perceptions of control over their practice.

Conclusions: Case management was found to have a primarily positive effect on nurses‐staff and case managers alike. There were significant increases in several aspects of the nurses' perceptions of the quality of care delivered. Additionally, case managers were more satisfied with the administration, the respect they received, and their pay and rewards in the institution. Most strikingly, case managers perceived themselves to have more control over their practice. Some negative effects of the program were a decrease in satisfaction with the pay and rewards by the staff who were not case managers.
Therapeutic Use of Companion Animals in Health Care
Authors: Jorgenson Jennifer
Published: October 2007

Purpose: To explore research that lends credibility to the therapeutic use of animals in health care. By integrating research from other disciplines and applying it to nursing, the art of nursing is fostered through the creative application of knowledge to practice.

Significance: Positive physiological and psychological benefits have been linked to the presence of companion animals. For example, researchers suggest that decreases in blood pressure, heart rates, and stress levels, as well as increases in emotional well‐being and social interaction are benefits of the human‐animal bond.

Conclusions: Compiling what has been learned in earlier scientific studies provides direction for future research in nursing to enhance nursing knowledge and expand nursing theory to improve care. Further investigation is necessary to clarify the concepts of animal assisted therapy (AAT) to build a body of useful knowledge for practice.
Research and Practice in an Academic Community Nursing Center
Authors: Zachariah Rachel , Lundeen Sally P.
Published: October 2007

Purpose: To identify issues and describe strategies used in developing a successful program of clinical research focused on the vulnerale populations served by one urban academic nursing center. Academic community nursing centers provide ideal settings to implement programs of research. Understanding the challenges when integrating research into these practices and the strategies used is important.

Setting and Scope: The University of Wisconsin‐Milwaukee Silver Spring Community Nursing Center has provided primary health care services to a low‐income urban population since 1987. A team of advanced practice nurse clinicians, community health nurses, and other health care professionals and community residents implemented a broad range of innovative, community‐focused, clinical inteventions that are routinely studied throughan integrated program of nursing research. Their strategies for research implementation are analyzed.

Conclusions and Implications: Factors affecting the integration of research into the center include (a) community mistrust, (b) the need for participatory recruitment strategies, and (c) the need for multiple data collection methods. Meeting these challenges requires that research agendas and methods are consonant with community goals. The inclusion of clinicians, other providers, and community residents as active members of research teams is critical to success. Reframing research and practice roles in terms of team effort that incorporates the community can strengthen research and practice‐and benefit professionals and the populations they serve.
Knowledge Generation for the HIV‐Affected Family
Authors: Brown Marie‐Annette
Published: October 2007

Purpose: To examine the current literature about HIV‐affected families in regard to knowledge development and priorities for future research.

Significance: The current view of HIV focuses largely on HIV‐infected individuals. There is a paucity of relevant research and a need to make explicit the priorities for knowledge generation about HIV‐affected families.

Scope: HIV family literature, 1980‐1996, was reviewed and categorized and serves as the context for presenting future priorities for knowledge generation about HIV‐affected families. Priorities identified were designing and testing family‐level services; determining epidemiology of the phenomenon of HIV family caregiving; who gives care and why, what caregivers do, the outcomes of caregiving, quality of family care, and relationships

Conclusions: A critical need is to address in‐depth the problems that have limited knowledge development about HIV‐affected families. This explication of issues and questions to understand HIV‐affected families can stimulate future research.
Proposal to Bring Nursing Into the Information Age
Authors: Project Iowa Intervaention
Published: October 2007

Purpose: To address issues related to documentation of nursing care and propose a model that illustrates how nursing practice data, collected through the use of standardized languages, are useful to staff nurses, nurse administrators, researchers, and policy makers.

Significance: Obtaining information about nursing practice is critical in times of health care change and reform.

Conclusions: There are three main challenges: the level of detail to document, the inclusion of nursing language in critical paths, and the need for articulation among different nursing classifications.

Implications: With recent advances in nursing classifications, the documentation systems in nursing can now be improved and much of the previous waste and redundancy eliminated.
Nursing Science in the Global Community
Authors: Ketefian Shaké , Redman Richard W.
Published: October 2007

Knowledge development and research are generally embedded in cultural values and perspectives. This article examines the development of knowledge in nursing in a global context and addresses the degree to which Western values and the social environment in the United States shape nursing theory development. Three perspectives illustrate the influence of US values and contextual factors. Questions are raised about the relevance of knowledge to other cultural or national contexts. Recommendations are made for nursing inquiry that makes knowledge more applicable to the global community.
Pain in Frail, Elderly Women After Surgery
Authors: Zalon Margarete Lieb
Published: October 2007

Purpose:To describe the lived experience of postoperative pain in frail, elderly women.

Design:Colaizzi's (1978) phenomenological approach.

Sample, Method:16 hospitalized women from ages 75 to 93, who had abdominal surgery. Unstructured, open‐ended interviews were conducted in 1992.

Findings:Three major themes emerged: the immediate reality of pain, security, and dealing with pain. The immediate reality of pain consisted of the feeling, awareness, and past imposing on the present. Security consisted of comfort and trust. Dealing with pain consisted of endurance, control, and self‐discovery of strategies, the most predominant of which was being still to relieve pain.

Conclusions:The frail elderly women in this study tended to endure pain and to trust nurses to provide pain‐relief measures. Nurses should carefully assess pain and the desire of patients for control of pain‐relief measures.
Roadblocks Encountered in Recruiting Patients for a Study of Sleep Disruption in Alzheimer's Disease
Authors: Dowling Glenna A. , Wiener Carolyn L.
Published: October 2007

Recruitment strategies and the roadblocks encountered in a clinical trial are described. A four‐group, repeated measures design was used to test the effects of three sleep‐related behavioral interventions on sleep disruption and related variables in Alzheimer's disease patients and their primary caregivers. Despite extensive recruitment efforts, enrollment did not meet expectations. Data analysis revealed three types of roadblocks to recruitment: caregiver resistance, provider resistance, and a mismatch of the disease characteristics with protocol requirements. Recommendations are made to help others solve recruitment problems.
Nurse‐Expressed Empathy, Patient Outcomes, and Development of a Middle‐Range Theory
Authors: Olson Joanne , Hanchett Effie
Published: October 2007

Purpose: To demonstrate how a middle‐range theory was developed and tested through research that examined relationships between nurse‐expressed empathy and two patient outcomes: patient‐perceived empathy and patient distress.

Significance: Nurse‐patient relationships are the basis for all nursing care and empathy is an important aspect of these relationships. Research is needed, however, to determine the patient outcomes that are related to the empathy of nurses.

Organizing Framework: Orlando's (I 96 1, 1972) nursing model. Scope: 140 subjects, 70 staff RNs and 70 patients from hospital medical‐surgical acute care units. Each nurse‐subject completed two measures of nurse‐expressed empathy and each patient‐subject completed a measure of perceived empathy and two measures of distress.

Findings: Negative relationships were found between nurse‐expressed empathy and patient distress (r = ‐.71, p < .001), and between patient‐perceived empathy and patient distress (r = ‐.71, p < .007). A moderate positive relationship was found between nurse‐expressed empathy and patient‐perceived empathy (r = .35 to .47, p < .05).

Conclusions: A model can be tested when propositions theoretically linked to the model are empirically tested. This study's findings demonstrated support for relationships proposed in Orlando's model.
Nursing Education in Austria, Gemany, and Switzerland
Authors: Clift Judith M.
Published: October 2007

Development of nursing education in three European countries is presented in an historical context. The educational system as well as the political and economic influences in these countries are discussed. The current status of reform and academization of nursing education in Austria, Germany, and Switzerland is highlighted. In Austria, several nursing courses have been developed and implemented in the school of education at the University of Graz. In Germany, over 20 university and “Fachhochschule” prorams have been established since 1990 for nurse‐educators and ‐managers, although attempts to reform basic nursing education are being thwarted by some government officials. Swiss nurses are negotiating for a nursing science program at the University of Basel and have established new guidelines to revise the 3‐year basic nursing schools.
Balancing Engagement and Detachment in Caregiving
Authors: Carmack Betty J.
Published: October 2007

Purpose: To investigate how caregivers balance engagement with detachment to cope with cumulative demands and losses.

Design: Qualitative, descriptive. Population, formal and informal caregivers in the United States. A sample of 14 was studied between 1992 and 1994.

Methods: Data were collected in open‐ended interviews, then were coded and analyzed using grounded‐theory methods. Credibility and fittingness were established.

Results: Caregivers who balance engagement and detachment can affect outcomes without needing to control outcomes. Such caregivers are pragmatic and make conscious choices based on their emotional needs. They set and maintain limits and boundaries and are able to monitor the balancing process while recognizing the importance of practicing self‐care.

Conclusions: The longer and more intense a caregiver's involvement, the more important it is to learn to balance engagement and detachment. Caregivers may need to learn effective balancing skills.
Change and Continuity in Family Caregiving Practices with Young Mothers and Their Children
Authors: SmithBattle Lee
Published: October 2007

Purpose: To examine how young mothers who gave birth during adolescence extended and developed caregiving practices within the context of family relationships, caregiving traditions, and life events.

Design: Longitudinal, interpretive‐phenomenological. A community‐based sample in 1993 consisted of 13 of the 16 young mothers and 11 of the 18 grandparents who had participated in a 1988 study. Three male partners of the young mothers also participated in this 1993 study. Families resided in a Western metropolitan area in the United States.

Methods: Life history accounts of the intervening years, stories of family routines, and recent coping episodes of parenting were elicited through in‐depth interviews with the young mothers and their male partners; one interview was conducted with grandparents. Data were analyzed using the interpretive approach.

Findings: Adversarial caregiving practices develop or change in the context of transformed family relationships.

Conclusions: Life‐course and parenting experiences of young mothers are not private and located in the self, but are developed in interaction with others. Family‐centered interventions are needed that support the efforts of young mothers and grandparents to become responsive caregivers.
Peer Review, Authorship, Ethics, and Conflict of Interest
Authors: King Cynthia R. , McGuire Deborah B. , Longman Alice J. , Carrol‐Johnson Rose Mary
Published: October 2007

Purpose: To explore problems in peer review, authorship, ethics, and conflict of interest related to writing and publishing. Publishing and adhering to principles is nurse researchers, educators, administrators, and practitioners, participate in the development and dissemination of knowledge.

Conclusions: The quality and integrity of nursing publications are affected by peer review, author collaboration, and ethical conduct. Understanding the conflicts of interest inherent in each action and being committed to impartial review and meeting the requirements of authorship can ensure fewer difficulties for authors, publishers, and consumers.
(Ir) Reconcilable Differences? The Debate Concerning Nursing and Technology
Authors: Sandelowski Margarete
Published: October 2007

Purpose: To review and critique the debate concerning nursing and technology. Technology has been considered both at one at odds with nursing.

Organizing Construct: Mitcham's (1994) concepts of technological optimism and romanticism.

Source: Nursing literature since 1960.

Methods: Historical analysis.

Findings: Technological optimists in nursing have viewed technology as an extension of and as readily assimilable into humanistic nursing practice, and nursing as socially advantaged by technology. Technological romantics have viewed technology as irreconcilable with nursing culture, as an expression of masculine culture, and as recirculating existing gender and social inequalities.

Conclusions: Both optimists and romantics essentialize technology and nursing, treating the two as singular and fixed entities. The (ir)reconcilability of nursing and technology may be a function of how devices are used by people in different contexts, or of the (ir)reconcilability of views of technology in nursing.
Fathers' Experience of Their Partners' Antepartum Bed Rest
Authors: Maloni Judith A. , Ponder M. Barbara
Published: October 2007

Purpose: To survey paternal worries, concerns, streses, or problems and the type of support received by men whose partners were prescribed antepartum bed rest at home, or in the hospital, or both.

Design: Descriptive retrospective. A national subsmaple of 59 men whose mates were on pregnancy bed rest were randomly selected in 1995 from a nonrandom select sample of individuals who had contacted a bed‐rest support group for information.

Methods: The Paternal Bed Rest Questionnaire of open‐ended questions designed to detail paternal concerns, stresses, and supports was mailed to fathers.

Results: Major problems for fathers were assuming multiple roles, managing emotional responses, and caring for their partner. The major paternal worry was for the health of mate and fetus. Coping strategies included using tangible assistance; altering cognitive, behavioral, and emotional responses; and verbalizing worries. Fahers reported receiving little assistance from health care providers.

Conclusions: Fathers experience extreme stress when pregnancy bed rest is prescribed for a mate. Family‐centered care should include care of the partner whose mate is at high‐risk. Interventions that ruduce paternal worry and provide emotional and tangible support are needed.
Hampton, Nutting, and Rival Gospels at The Johns Hopkins Hospital and Training School for Nurses, 1889–1906
Authors: Connolly Cynthia A.
Published: October 2007

Purpose: To examine the attempts by Isabel Hampton Robb and Mary Adelaide Nutting to reshape nurse training into an academic system of nursing education. As health care delivery undergoes transformation in the 1990s, it is useful to consider the strategies used as well as the successes and failures, of past nurse leaders.

Design: Historical research.

Methods: Archival data were analyzed in 1996 pertaining to the creation in 1889 and administration of the nursing school and hospital founded by Johns Hopkins in Baltimore, Maryland, USA. Events were studied using published and unpublished writings by Hampton and Nutting, as well as relevant secondary sources.

Findings: Separated by class from those with power, and limited by 19th century notions of women's place, Isabel Hampton Robb and Adelaide Nutting helped inaugurate nursing's quest for professionalization. Undaunted by adversity, they achieved novel accomplishments for women and nurses. Hampton and Nutting possessed vision, intelligence, the capacity to motivate, political skills, good judgement, and managerial competence.

Conclusions: Hampton's and Nutting's inability to strengthen the link between the school of nursing and the Johns Hopkins University and the lack of unity within nursing limited their success. This research illuminates some of the controversies pertaining to nursing during an earlier period of sweeping health care change.
Around‐the‐Clock Nursing Care for the Elderly in Japan
Authors: Murashima Sachiyo , Zerwekh Joyce V. , Yamada Masako , Tagami Yutaka
Published: October 2007

Purpose: To describe the first phase of creating a Japanese model of community‐based long‐term care, called around‐the‐clock care (ACQ, by operationally defining the components of ACC, identifying those eligible for the program, clarifying methods of planning and organization, and exploring outcomes.

Design: Exploratory evaluation for the population of frail elderly Japanese citizens living at home. A convenience sample of 44 patients receiving care from four visiting‐nurse‐service stations during 3 months in 1994 was used.

Methods: Needs assessments; record reviews of patient encounters; evaluations by patients, families, and visiting nurses; and reviews of administrative data.

Findings: Nurses perceived that ACC stabilized medical status, reduced the emotional and physical burden of treatment, and improved hygiene. It also reduced family caregiving burdens and the stress of family caregivers' employment responsibilities. The highest rating of ACC by patient and families was for those with the most complex physical needs. Skilled nursing at home permitted early identification and treatment of problems before they became crises or required hospitalization.

Conclusions: Early findings suggest 24‐hour nurse‐home helper teamwork may bean effective system of community‐based long‐term care and should be considered a key element of future Japanese health policy.
New Definition of Mental Retardation for the American Association of Mental Retardation
Authors: Fredericks Debra W. , Williams W. Larry
Published: October 2007

Purpose: To describe the new definition of mental retardation developed by the American Association of Mental Retardation (AAMR) published in 1992. The previous definition was based on a deficiency model that identified “subaverage intelligence” using an intelligence quotient (IQ) score equal to or less than 70. The new definition places greater emphasis on adaptive skills and environmental support needs.

Scope: Defining mental retardation according to AAMR criteria reflects a significant paradigm shift from an absolute trait to a functional conception. The new definition is dynamic, attends to context, is inherently holistic—and, therefore—closely aligned with nursing theory. Diagnosis is a three‐step process by which functional strengths and weaknesses are identified along 4 dimensions and 10 adaptive‐skill areas. Identification of needed supports is incorporated within the three‐step process.

Conclusions: Nurses can enhance holistic care by working to have AAMR's new definition adopted by government legislators and administrators of state and county agencies that provide mental‐retardation services. Nurses should become active participants as interdisciplinary diagnostic team members as well as case managers. Nurse researchers and educators can contribute toward further developing AAMR's definition by standardizing assessment instruments, working to make diagnostic procedures more user‐friendly, and researching the construct validity of adaptive‐skill areas. Finally, nurses should help legislators and policy makers understand the sociocultural ramifications of AAMR's new definition.
Professional, Ethical, and Legal Implications for Spiritual Care in Nursing
Authors: Wright Kathy B.
Published: October 2007

Purpose: To highlight nurses' professional and ethical responsibility to consistently provide spiritual care. The legal issue of nurse‐client privilege in relation to spiritual care is also discussed. Spiritual care is consistent with the model of holistic care. Yet spiritual care often remains a neglected focus of current nursing practice.

Conclusions: Spirituality, as an important aspect of wellness, is indispensable in nursing care. Nurses are obligated to take an active role in meeting the spiritual needs of patients.
Quotation and Reference Accuracy of Three Nursing Journals
Authors: Schulmeister Lisa
Published: October 2007

Purpose: To determine the accuracy of bibliographic citations in three widely circulated nursing journals, RN, Nursing Management, and Image: Journal of Nursing Scholarship. Accurate citations facilitate retrieval of the cited documents and establish the judgment and credibility of authors.

Design: Descriptive, comparative.

Methods: A random sample of 60 references per journal published July 1995 to June 1996 was reviewed for citation and quotation accuracy. Errors were classified as major or minor. Data were analyzed using the SAS statistical package.

Findings: Of the 180 references, 58 (32%) had citation errors, with 43 of 58 errors classified as major errors, which made retrieval of the cited work difficult; 72 of the 780 articles contained a major quotation error, including four instances where the content of the original article contradicted or was unrelated to the author's contention.

Conclusions: The rate of citation and quotation errors in the three sampled nursing journals is comparable to rates previously reported for medical and nursing journals. Errors of citation and quotation diminish the value of published papers.
Understanding Seasonal Affective Disorder and Experiences in Northern Norway
Authors: Stuhlmiller Cynthia M.
Published: October 2007

Purpose: To better understand a diagnosis corresponding to mental distress and sleep disturbance associated with seasonal change known as seasonal affective disorder (SAD).

Design: This ethnographically guided investigation, conducted from 1993 through 1995 in Tromsø, Norway at a latitude of 69 degrees north describes how the residents experience extreme seasonal change.

Method: Qualitative interview data from 28 participants plus observation, folk wisdom, and literature were used to describe local understanding of seasonality and illustrate how cultural values, meanings, and practices can contribute to alternative experiences that differ from scientists' expectations.

Findings: While there is evidence that human physiologic alterations occur in response to the changing seasonal patterns of light and dark and to a greater extent, at latitudes further from the equator, the findings related to psychological changes and their causes remain inconsistent and controversial.

Conclusion: Investigators concerned with the effects of seasonal change should be aware of and develop an appreciation of cultural perception and adaptation.
Translation and Validation of Nursing Interventions Classification (NIC) in English and Korean
Authors: Yom Young‐Hee
Published: October 2007

Purpose: To describe the translation and validation of the Nursing Interventions Classification (NIC) Use Questionnaire.

Methods: The NIC Use Questionnaire was translatpd to Kurmri using back‐translation and three criteria to test the semantic, content, and technical equivalence of the original and translated versions.

Findings: Three factors made translation difficult including structural differences in the two languages, long modifier phrases in English, and nonequivalent words in Korean.

Conclusions: This translation facilitates communication among nurses. The findings suggest a method for similar validation in other languages.
Nursing Research in Finland from 1958 to 1995
Authors: Leino‐Kilpi Helena , Suominen Tarja
Published: October 2007

Purpose: To review the methods and content of nursing research carried out in Finland between 1958 and 7996. University‐level nursing education and research started in Finland in 1979. In 1997, there were seven universities with nursing programs and, in all of them, active internationaI collaboration.

Scope: First emperical and nonemperical studies were identified, then the research topics and research methods were analyzed. Some historically interesting evaluations were also documented.

Sources: Articles published in the Yearbook of Nursing (1958–1988, n=228), in the Finnish Journal of Nursing Science (1989–1995, n=116), and all Finnish licentiate and doctoral theses (n=104).

Method: Content analysis.

Findings: The number of research articles and theses is increasing. Nursing practice has been the most common research topic, and especially primary health care and surgical and medical care. Questionnaires and interviews are the methods used most often, observational methods are rare. Most research is discriptive.

Conclusions: In the future, research is recommended in nursing care of children and adolescents as well as evaluative research.
Mapping Nursing Diagnosis Nomenclatures for Coordinated Care
Authors: Zielstorff Rita D. , Tronni Catherine , Basque Julie , Griffin Lynne Reeves , Welebob Emily M.
Published: October 2007

Purpose: To map the problem or diagnosis terms from three nomenclatures, term to term, to determine commonalities and differences; and to determine whether it is possible to develop a singie vocabulary that contains the best features of all. When different nomenclatures are used in different settings, continuity of care is hampered by the need to re‐state problems and interventions.

Design: The sample for this descriptive analysis was 396 terms from three nursing diagnosis and problem nomenclatures recognized by the American Nurses Association: the North American Nursing Diagnosis Association (NANDA) Approved List, the Home Health Care Classification(HHCC), and the Omaha System.

Method: Terms from each of the three nomenclatures were mapped to terms in each of the others. Consensus methods were used to resolve differences in mapping decisions. Terms were characterized as “Same,”“Similar,”“Broader,”“Narrower,” and “No Match.” Validation of consistency and accuracy was done by reverse mapping, use of syllogisms, use of taxonomic groupings, and expert review.

Results: Of 396 terms, 21 concepts accounting for 63 terms were found to be the same or similar in all three nomenclatures; 91 terms were unique to the nomenclature in which they were found (“No Match”). The remaining 242 terms had a narrower or broader relationship to at least one term in another nomenclature. In all three nomenclatures, inconsistencies existed in level of abstractness of the diagnosis or problem terms, and in definition and placement of terms within their own taxonomic structure.

Conclusion: Because of differences in structure and incompatible taxonomic arrangements, a master list of “preferred terms” taken from the three nomenclatures is not feasible. However, the mappings are useful for determining commonalities and the unique contributions of each nomenclature, which can facilitate the development of a uniform language for nursing diagnoses. The mapping can also form the basis for automatic translation of computer‐stored nursing diagnoses from one setting to another when different nomenclatures are used.
Pathogen or commensal: a PCR based study of ocular surface bacteria in normal and dry eyes
Authors: GRAHAM JE , MOORE JE , XU J , MOORE JE , GOODALL E , DOOLEY J , DARTT DA , DOWNES SC , MOORE T
Published: October 2007

Purpose: To determine the ocular surface bacteria in normal and dry eye subjects and investigate whether there was any association between the bacterial population and goblet cell density (GCD).

Methods: Fifty‐seven normal and 34 dry eye subjects were recruited. Conventional culture, 16S rDNA PCR and DNA sequencing were used to identify bacteria. The association between reduced GCD and bacterial numbers in a sub‐group of 27 subjects was assessed. Conjunctival impression cytology samples were stained with PAS and GCD graded as follows: Grade (1), >30 goblet cells/4 high power fields; (2), 15‐30 GC/4HPF; (3), 5‐15 GC/4HPF; (4), <5 GC/4HPF. Grades 3 and 4 indicated reduced GCD.

Results: The majority of cultured bacteria were coagulase‐negative Staphylococci, while molecular methods demonstrated additional atypical bacterial species. Bacterial levels were higher overall in subjects displaying reduced GCD compared to normals. A statistically significant difference (P = 0.005) was noted between mean bacterial counts in IC Grade 4 samples of dry eye subjects (35 cfu/swab) and normals (5 cfu/swab).

Conclusions: Molecular analysis revealed a diverse ocular surface bacterial population with identification of potentially pathogenic bacteria presenting a diagnostic dilemma. A trend of increasing bacterial numbers with reduced GCD was observed and studies are ongoing to investigate whether bacterial colonisation of the ocular surface may alter the number and function of goblet cells. The clinical relevance of such results and whether they should prompt intervention with therapy is not yet fully determined. A fuller definition of the normal ocular flora is needed to determine bacteria implicated in ocular surface disease.
The epidemiology of dry eye disease
Authors: SMITH JA
Published: October 2007

Purpose: The goals of the Epidemiology Subcommittee of the 2007 Dry Eye WorkShop were to evaluate and present knowledge on the epidemiology of dry eye disease, to summarize dry eye risk factors and and to review and assess dry eye questionnaires.

Methods: Review of the published English language literature of dry eye epidemiologic and clinical studies which included dry eye questionnaires and which used rigorous methods was performed. Dry eye questionnaires were required to have been used in clinical trials or epidemiologic studies, undergone psychometric evaluation and be publically available.

Results: Based on large epidemiologic studies, the age‐specific prevalence of dry eye ranges from 5 to 35%. Different operational definitions of dry eye are likely to be responsible for some of the disparity between studies. There are very little data on the natural history and incidence of dry eye. The public health importance of dry eye is heightened by the high proportion of older people affected and the aging of the world population. Dry eye can have a deleterious impact on ocular and general heath and quality of life and visual function. Both direct and indirect costs exist for dry eye. Major risk factors for dry eye include age, female sex, certain medications and diseases, incisional refractive surgery, nutritional intake of essential fatty acids and disturbance in sex hormones due to a variety of causes.

Conclusions: There is a need to expand epidemiological studies to more geographic regions, to include multiple races /ethnicities and to establish a consensus on diagnostic criteria for epidemiological studies. Dry eye questionnaires should be responsive, reproducible, with a specified recall period, validated and appropriate for the use. Vision targeted quality of life and prevention strategies warrant further study.
Stromal response to orthokeratology: an X‐ray diffraction study
Authors: OWENS H , HAYES S , MEEK KM
Published: October 2007

Purpose: To examine the impact of overnight orthokeratology lens wear on stromal collagen fibril diameter and spacing using synchrotron X‐ray diffraction.

Methods: Seven New Zealand White rabbits (10 eyes) wore orthokeratology lenses (Capricornia, Brisbane, Australia) overnight during a 2‐week period to determine the effect of corneal refractive therapy on stromal collagen fibrils. To verify the effectivity of treatment, corneal topography (Medmont, Brisbane, Australia), corneal thickness (Allergan Humphrey pachymetry) and refractive error (retinoscopy) were measured prior to and every 3‐4 days during the treatment period. Following completion of treatment, rabbits were euthanased and corneas immediately dissected and snap frozen for subsequent X‐ray diffraction analysis every 1mm over the central c.10mm horizontal corneal band.

Results: Orthokeratology treatment induced an average change in refraction of 2.0 +/‐ 1.3DS, and a topography‐measured treatment zone diameter of 4.2 +/‐ 0.7mm. The results from X‐ray diffraction revealed no significant difference in collagen fibril diameter between treated and untreated eyes (p>0.05). Interfibrillar spacing (IFS) was positively correlated with tissue hydration but no significant association between the change in IFS and refraction was apparent.

Conclusions: The magnitude and time course of refractive change induced by orthokeratology in the rabbit eye is similar to that reported in humans, producing significant rapid and characteristic changes in corneal topography. Such specific changes in topography seem limited to the epithelial layers, with no parallel topographic modification evident in the underlying stromal architecture.
Two‐year follow‐up of patients with Diabetic Macular Edema (DME) treated with pegaptanib (Macugen)
Authors:   MACUGEN DIABETIC RETINOPATHY STUDY GROUP, MEHRA S
Published: October 2007

Purpose: The results of a 36‐week, phase 2 trial of pegaptanib (Macugen) for DME suggest pegaptanib improves visual acuity (VA), reduces retinal thickness, and causes regression of neovascularization (NV). The results of an extended follow‐up after pegaptanib discontinuation are reported.

Methods: This multicenter, double‐masked, controlled study included subjects with best‐corrected VA between 20/50 and 20/320 in the study eye and DME involving the center of the macula. Subjects were randomized (1:1:1:1) to intravitreous pegaptanib (0.3, 1, 3 mg) or sham injections at study entry and weeks 6 and 12. Additional pegaptanib injections and/or focal/grid laser photocoagulation were administered as needed for another 18 weeks; thereafter, only photocoagulation was given at the investigators’ discretion. Study endpoints were evaluated at weeks 36, 52, and 82.

Results: At baseline, treatment groups (total N=172) were well balanced for VA and retinal thickness. At weeks 36, 52, and 82, mean VA change from baseline was better for subjects receiving 0.3 mg (n=44) versus sham (n=42) (+4.7 vs ‐0.4 letters, P<0.04; +3.6 vs ‐0.3 letters, P<0.15; +1.3 vs ‐2.4 letters, P<0.23). At each time point, more subjects receiving 0.3 mg gained ≥10 and ≥15 letters and had a greater reduction in mean central retinal thickness (‐68 vs +3.7 μm; ‐82 vs ‐37 μm; ‐122 vs ‐49 μm). Retinal NV at baseline showed regression at week 36 in 8/13 (62%) eyes. Treatment with pegaptanib was well tolerated.

Conclusions: The relative treatment benefit and safety of pegaptanib in DME achieved at week 36 appears to remain evident through 2 years even after injections are discontinued. Further trials of pegaptanib for DME appear to be warranted.
Efficacy and safety of pegaptanib sodium for macular edema secondary to Central Retinal Vein Occlusion (CRVO)
Authors:   MACUGEN RETINAL VEIN OCCLUSION STUDY GROUP, WIROSTKO B
Published: October 2007

Purpose: To assess the efficacy and safety of pegaptanib in the treatment of macular edema secondary to CRVO.

Methods: This phase 2, multicenter, double‐masked, sham‐controlled study included subjects with nonischemic CRVO of <6 months duration, baseline center point retinal thickness ≥250 μm, and best‐correct visual acuity (VA) of 65 to 20 ETDRS letters inclusive. Subjects were randomized (1:1:1) to intravitreous pegaptanib (0.3, 1 mg) or sham injections every 6 weeks for 24 weeks with follow‐up through 52 weeks. Additional therapy was allowed after week 30 for losses ≥15 letters. Endpoints included mean changes from baseline in VA and retinal thickness.

Results: Baseline characteristics were well balanced across study arms (0.3, 1 mg, n=33; sham, n=32). Mean change in VA from baseline at week 30 was +7.1, +9.9, and ‐3.2 letters in the pegaptanib 0.3 mg, 1 mg, and sham groups, respectively (P<.05 for 1 mg vs sham). At week 52, mean VA change was +7.5, +6.3, and ‐2.4 letters, respectively (P=ns). From baseline to week 52, fewer treated with 0.3 mg pegaptanib than sham lost ≥15 letters (9% vs 31%; P<.05) and more gained ≥0 (P=.01), 5 (P=.02) and 10 or 15 letters (P=ns). From baseline to week 52, mean change in center point thickness in the 0.3 mg, 1 mg, and sham groups was ‐295 μm, ‐216 μm, and ‐183 μm, respectively.

Conclusions: This is the first randomized trial to show any treatment benefit for macular edema due to CRVO compared with sham. The anatomical and functional benefits provided by pegaptanib are consistent with the clinical benefit already presented with diabetic macular edema, and the ocular neovascularization of diabetic retinopathy and age‐related macular degeneration.
Safety of Macugen (pegaptanib sodium) for neovascular age‐related macular degeneration (NV‐AMD). After 3 years of experience
Authors: LEYS A ,   VEGF INHIBITION STUDY IN OCULAR NEOVASCULARIZATION (V.I.S.I.O.N.)
Published: October 2007

Purpose: To evaluate the safety of Macugen in the treatment of NV‐AMD after 3 years experience in the V.I.S.I.O.N. trial.

Methods: Two concurrent, multicenter, double‐masked studies included subjects with all angiographic subtypes. Macugen (0.3, 1, or 3 mg) or sham injections were given every 6 wks for 54 wks. Those initially assigned to Macugen were re‐randomized (1:1) to continue/discontinue therapy for 48 wks; sham‐treated subjects continued, discontinued, or received Macugen. At 102 wks, subjects receiving Macugen 0.3 or 1 mg continued; those receiving other treatments or who received no treatment in yr 2 were re‐randomized to 0.3 or 1 mg (1:1). Safety endpoints included AEs, deaths, and lab values. Retrospective analysis compared fundus photos for RPE and optic disc damage of subjects receiving pegaptanib and sham.

Results: Macugen was well tolerated in yr 3. In the primary safety population (n=161) who received study medication in yr 3 and active treatment during yrs 1 and 2, AEs were mainly ocular (114 [71%] subjects) and mild, with no evidence of increased systemic safety signals. Among 422 subjects treated with Macugen in yr 3, regardless of previous treatment, 2 cases of endophthalmitis (0.06%/injection), 1 case of rhegmatogenous retinal detachment (0.03%/injection), and 0 cases of traumatic cataract were reported, and no evidence of new systemic safety signals was noted. No additional damage was found to the RPE or to retinal neurons in subjects receiving 0.3 mg pegaptanib vs. sham.

Conclusions: Continuous treatment with Macugen over three years in patients with NV‐AMD does not confer an increased risk for ocular or systemic AEs.
Vital pulpotomy in primary molars
Authors: HANSEN HARRY P. , RAVN JENS JØRGEN , ULRICH DORTE
Published: October 2007

abstract – Vital pulpotomy was carried out on 28 primary molars of IT) children between the ages of 3 and 6 years. As dressing material zink oxide‐eugenol cement was used in 14 teeth and Ledermix® cement in 14 teeth. Contralateral teeth were treated in 13 of the children. The observation period varied from 1 to 42 months. None of the treated teeth were painful during the period of observation. Internal resorption, evaluated radiographic‐ally, occurred in six teeth treated with zinc oxide‐eugenol cement, and in three teeth treated with Ledermix cement. No other complications were observed. Evaluated clinically and radiographically, the treatment was thus successful in 57% of the cases with zinc oxide‐eugenol cement and in 79% of the cases with Ledermix cement. Histologically, the occurrence of internal resorption was of almost the same frequency in the two groups, but the degree of resorption was considerably less in the group treated with Ledermix cement. The inflammation of the pulp tissue in the area of the amputation was clearly more severe in the group treated with zinc oxide‐eugenol cement than in the group treated with Ledermix cement. Accepting the importance of correct diagnosis, this histologic study indicates that Ledermix cement, as dressing material in vital pulpotomy of primary molars, is superior to zinc oxide‐eugenol cement.