bluuebunny/crossref_metadata_2025 huggingface dataset:
Transports et environnement (Transportation and environment)
Authors: Dezert Bernard
Published: June 2014

ABSTRACT. - The transport density development disturbes the natural equilibriums, namely ecology, but also the human life and activities. The environmental concept is here understood as a bio-social ecosystem, a space resultant to equilibrium. It's more difficult to measure the destruction of that natural equilibrium by the transportation pollutions. The next communications object consist to show the interaction between the transportation and the environment of life. The researches share in global environmental geography.
Autoroutes et agriculture dans la région Nord-Pas-de-Calais (Motorways and farming in the Nord-Pas-de-Calais region)
Authors: Barré Alain , Vaudois Jean
Published: June 2014

Abstract. - The motorways network is particularly dense in the Northern region of France. Built for most of it to the prejudice of farming lands, it tends to disorganize the regional farming space, especially in the areas of intensive farming, where it is particularly developed. Because of the purchase of lands and because of the various consequences of their buildings, motorways deeply disturb the farm plots and the economy of the regions they go through. The study of the measures adopted to bring solutions to the various problems (regrouping of lands, compensation allowances) leads us to stress wide disparities in the region's agriculture - differences which the building of motorways make even wider because it accelerates processes already on the move.
Les comportements socio-économiques induits par l'aménagement autoroutier (Social and economical comportments)
Authors: Wackermann Gabriel
Published: June 2014

Résumé. - L'aménagement d'une autoroute modifie sensiblement les comportements en matière commerciale, culturelle et récréative. Il bouscule également les pratiques migratoires, professionnelles et les habitudes prises sur le plan de la formation. La géographie des localisations d'activités s'en trouve modifiée. L'analyse de la HAFRABA méridionale, du tronçon adjacent Mulhouse-Belfort et de celui reliant Fréjus-Saint-Laurent-du-Var montre combien les solidarités locales sont transformées et orientées vers des habitudes nouvelles et tenaces.
Transport, climat et pollution (Transportation, climate, pollution)
Authors: Escourrou Gisèle
Published: June 2014

Résumé. - La circulation automobile engendre une pollution qui tient une place relativement importante dans l'ensemble de la pollution atmosphérique. L'intensité du trafic et les conditions climatiques déterminent la concentration des polluants. Celle-ci peut devenir dangereuse dans certains cas.
Un vieux problème géomorphologique : les niveaux bordiers au sud du Golfe de Corinthe (An old geomorphological problem : the levels developed on the southern border of the gulf of Corinth)
Authors: Dufaure Jean-Jacques , Zamanis Athéna
Published: June 2014

Abstract. - On the southern coast of the Gulf of Corinth, a quaternary rift margin (+ 1 000/1 800 m) is interfering with marine transgressions which developed nine levels, below a piedmont level formed after the end of the Pliocene and attacked by two levels, at least, deeply weathered. The variations of the heights and of the number of levels emphasize the complicated geometry of the deformations around the great faults. The pre-tyrrhenian marine levels do not enter easily into the traditionnal quaternary chronology.
Systèmes et approche systémique en géographie (Systems and system approach in geography)
Authors: Brunet R.
Published: June 2014

Résumé. - Les géographes ont affaire à des systèmes, mais pratiquent peu l'approche systémique. Pourtant, celle-ci est d'une rare fécondité, dans l'étude des ensembles régionaux en particulier. Ici, le concept d'environnement du système est capital, et complexe. Les implications de l'approche systématique sont de nature à entraîner une révision complète de l'étude régionale. Le cas de l'Ardenne française sert à appuyer la démonstration.
Morphogenèse et occupation humaine dans l'Antiquité (Morphogenesis and human settlement during classical antiquity)
Authors: Neboit-Guilhot René
Published: June 2014

Abstract. - The historical age for the fill dated by archaeological levels from the greek to the roman period, in the lucanian valleys, emphasizes the problem of the origin of the lowest terrace. Then we review the general problem of the recent fills in the mediterranean regions : climatic or anthropic ?
Lignes de rivage, climat et tectonique (Shorelines, climate and tectonics)
Authors: Pirazzoli Paolo Antonio , Sanlaville Paul
Published: June 2014

Abstract. - Thanks to satellites we know that an isostatic upheaval of the oceanic waters cannot be uniform, because of the variations of the Earth's gravity. Therefore the question of the shorelines variations appears rather more complicated to day than in past years.
Distribution spatiale des revenus dans l'agglomération parisienne (Spatial distribution of greater Paris incomes)
Authors: Globet F.
Published: June 2014

Abstract. - Data on average income before tax by « communes » of the Paris agglomeration in 1976 is used for a detailed mapping of the spatial distribution of incomes. A comparison 1949-1976 within the administrative limits of the previous Seine department shows a slightly increased range of income levels in 1976, tending to reinforce a sectorial distribution.
Scolarisation et espace social. L'exemple de l'agglomération parisienne (School attendance and greater Paris social space)
Authors: Sztokman Nicole
Published: June 2014

Résumé. - Malgré la « démocratisation » de l'enseignement, la scolarisation de la population de plus de 16 ans demeure très contrastée. Au sommet de la classification se distinguent les « beaux quartiers et belles banlieues » de l'ouest où résident 44 % des étudiants parisiens. A l'opposé la proche banlieue nord, encore largement ouvrière, se caractérise par une scolarisation plus restreinte et de durée plus brève. La scolarisation est bien encore un élément de la différenciation de l'espace social.
L'organisation d'un espace sous-régional de contact : l'exemple des Collines guinoises (Organic structure of a contact sub-regional space, for instance the «collines guinoises»)
Authors: Renard Jean-Pierre
Published: June 2014

Résumé. - Les Collines guinoises - dénomination régionale commode plutôt que réelle, bien qu'utilisée par les services de la DDA du Pas-de-Calais montrent une vocation de contact géographique bien affirmée. Bien que reposant sur une unité homogène naturelle entre la Plaine maritime et le Boulonnais, cet espace est éclaté dans le cadre des structures administratives, gestionnaires et d'aménagement existantes. Cette petite région géographique se situe par ailleurs aux marges des espaces fonctionnels et polarisés de Calais, Boulogne, Saint-Omer et même de Dunkerque.
Real-time Feedback on Nonverbal Clinical Communication
Authors: Patel R. A. , Czerwinski M. , Pratt W. , Roseway A. , Chandrasekaran N. , Back A. , Hartzler A. L.
Published: June 2014

Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on “Pervasive Intelligent Technologies for Health”.

Background: Effective nonverbal communication between patients and clinicians fosters both the delivery of empathic patient-centered care and positive patient outcomes. Although nonverbal skill training is a recognized need, few efforts to enhance patient-clinician communication provide visual feedback on nonverbal aspects of the clinical encounter.

Objectives: We describe a novel approach that uses social signal processing technology (SSP) to capture nonverbal cues in real time and to display ambient visual feedback on control and affiliation – two primary, yet distinct dimensions of interpersonal nonverbal communication. To examine the design and clinician acceptance of ambient visual feedback on nonverbal communication, we 1) formulated a model of relational communication to ground SSP and 2) conducted a formative user study using mixed methods to explore the design of visual feedback.

Methods: Based on a model of relational communication, we reviewed interpersonal communication research to map nonverbal cues to signals of affiliation and control evidenced in patient-clinician interaction. Corresponding with our formulation of this theoretical framework, we designed ambient real-time visualizations that reflect variations of affiliation and control. To explore clinicians’ acceptance of this visual feedback, we conducted a lab study using the Wizard-of-Oz technique to simulate system use with 16 healthcare professionals. We followed up with seven of those participants through interviews to iterate on the design with a revised visualization that addressed emergent design considerations.

Results: Ambient visual feedback on non-verbal communication provides a theoretically grounded and acceptable way to provide clinicians with awareness of their nonverbal communication style. We provide implications for the design of such visual feedback that encourages empathic patient-centered communication and include considerations of metaphor, color, size, position, and timing of feedback.

Conclusions: Ambient visual feedback from SSP holds promise as an acceptable means for facilitating empathic patient-centered nonverbal communication.
Point-process Nonlinear Autonomic Assessment of Depressive States in Bipolar Patients
Authors: Citi L. , Gentili C. , Lanatá A. , Scilingo E. P. , Barbieri R. , Valenza G.
Published: June 2014

Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on “Biosignal Interpretation: Advanced Methods for Studying Cardiovascular and Respiratory Systems”.

Objectives: The goal of this work is to apply a computational methodology able to characterize mood states in bipolar patients through instantaneous analysis of heartbeat dynamics.

Methods: A Point-Process-based Nonlinear Autoregressive Integrative (NARI) model is applied to analyze data collected from five bipolar patients (two males and three females, age 42.4 ± 10.5 range 32−56) undergoing a dedicated affective elicitation protocol using images from the International Affective Picture System (IAPS) and Thematic Apperception Test (TAT). The study was designed within the European project PSYCHE (Personalised monitoring SYstems for Care in mental HEalth).

Results: Results demonstrate that the inclusion of instantaneous higher order spectral (HOS) features estimated from the NARI nonlinear assessment significantly improves the accuracy in successfully recognizing specific mood states such as euthymia and depression with respect to results using only linear indices. In particular, a specificity of 74.44% using the instantaneous linear features set, and 99.56% using also the nonlinear feature set were achieved. Moreover, IAPS emotional elicitation resulted in a more discriminant procedure with respect to the TAT elicitation protocol.

Conclusions: A significant pattern of instantaneous heartbeat features was found in depressive and euthymic states despite the inter-subject variability. The presented point-process Heart Rate Variability (HRV) nonlinear methodology provides a promising application in the field of mood assessment in bipolar patients.
Optimizing the synthesis of CdS/ZnS core/shell semiconductor nanocrystals for bioimaging applications
Authors: Liu Li-wei , Hu Si-yi , Pan Ying , Zhang Jia-qi , Feng Yue-shu , Zhang Xi-he
Published: June 2014

In this study, we report on CdS/ZnS nanocrystals as a luminescence probe for bioimaging applications. CdS nanocrystals capped with a ZnS shell had enhanced luminescence intensity, stronger stability and exhibited a longer lifetime compared to uncapped CdS. The CdS/ZnS nanocrystals were stabilized in Pluronic F127 block copolymer micelles, offering an optically and colloidally stable contrast agents for in vitro and in vivo imaging. Photostability test exhibited that the ZnS protective shell not only enhances the brightness of the QDs but also improves their stability in a biological environment. An in-vivo imaging study showed that F127-CdS/ZnS micelles had strong luminescence. These results suggest that these nanoparticles have significant advantages for bioimaging applications and may offer a new direction for the early detection of cancer in humans.
A tandem Mannich addition–palladium catalyzed ring-closing route toward 4-substituted-3(2H)-furanones
Authors: John Jubi , Târcoveanu Eliza , Jones Peter G , Hopf Henning
Published: June 2014

A facile route towards highly functionalized 3(2H)-furanones via a sequential Mannich addition–palladium catalyzed ring closing has been elaborated. The reaction of 4-chloroacetoacetate esters with imines derived from aliphatic and aromatic aldehydes under palladium catalysis afforded 4-substituted furanones in good to excellent yields. 4-Hydrazino-3(2H)-furanones could also be synthesized from diazo esters in excellent yields by utilising the developed strategy. We could also efficiently transform the substituted furanones to aza-prostaglandin analogues.
NEW THINKING OF MULTI-OBJECTIVE PROGRAMMING WITH CHANGEABLE SPACE – IN SEARCH OF EXCELLENCE
Authors: Huang Jih-Jeng , Tzeng Gwo-Hshiung
Published: June 2014

Multi-objective programming (MOP) is a branch of mathematical programming that has been widely used to deal with various practical problems. With the introduction of new technologies and business models, a paradigm shift in optimization problems is gradually taking place from fixed to flexible optimization. For example, many organizations use outsourcing or business process reengineering (BPR) to improve or upgrade their objective and technological coefficients to achieve better performance. Hence, traditional MOP models should be extended from the concept of fixed to changeable parameters, called changeable space, which includes decision space and objective space. In this paper, we propose three kinds of MOP model with changeable parameters to help decision-makers achieve the desired point (aspiration level), which is better than the ideal point.
INTUITIONISTIC FUZZY EINSTEIN CHOQUET INTEGRAL OPERATORS FOR MULTIPLE ATTRIBUTE DECISION MAKING
Authors: Xu Yejun , Wang Huimin , Merigó José M.
Published: June 2014

In this paper, we propose some new aggregation operators which are based on the Choquet integral and Einstein operations. The operators not only consider the importance of the elements or their ordered positions, but also consider the interactions phenomena among the decision making criteria or their ordered positions. It is shown that the proposed operators generalize several intuitionistic fuzzy Einstein aggregation operators. Moreover, some of their properties are investigated. We also study the relationship between the proposed operators and the existing intuitionistic fuzzy Choquet aggregation operators. Furthermore, an approach based on intuitionistic fuzzy Einstein Choquet integral operators is presented for multiple attribute decision-making problem. Finally, a practical decision making problem involving the water resource management is given to illustrate the multiple attribute decision making process.
APPLYING FUZZY MCDM FOR FINANCIAL PERFORMANCE EVALUATION OF IRANIAN COMPANIES
Authors: Ghadikolaei Abdolhamid Safaei , Esbouei Saber Khalili , Antucheviciene Jurgita
Published: June 2014

Financial performance evaluation is very important in a highly competitive business environment. Accordingly, an accurate and appropriate performance evaluation is critical. Financial performance indicators reflect the competitiveness of a company and they must be carefully identified in the evaluation process. Generally, accounting measures are used for performance evaluation. However, these measures are not sufficient for performance evaluation in the today’s competitive economy. Therefore, value based measures have recently been introduced to express the company value. In this study, a hybrid approach is proposed for financial performance evaluation of automotive companies of Tehran stock exchange (TSE). For this purpose, a hierarchical financial performance evaluation model is structured based on the accounting measures and economic value measures. In this approach Fuzzy Analytic Hierarchy Process (FAHP) is applied to determine weights of criteria. Then the companies are ranked by using Fuzzy VIKOR (VlseKriterijumska Optimizacija I Kompromisno Resenje (in Serbian), Fuzzy Additive Ratio Assessment (ARAS-F) and Fuzzy Complex Proportional Assessment (Fuzzy COPRAS), simultaneously. Also results of three outranking methods are combined by using the mean ranks. The results represented the highest importance of economic value measures than accounting measures in financial performance evaluation of companies. Six companies were ranked applying the proposed approach.
STRUCTURAL CHANGES OF ECONOMIES: LITHUANIA IN THE GLOBAL CONTEXT
Authors: Dudzevičiūtė Gitana , Mačiulis Alminas , Tvaronavičienė Manuela
Published: June 2014

Structural economic change theory focuses on the process through which economic structures have been transformed from traditional agriculture economy to more modern and industrially diverse manufacturing and service ones. The purpose of this paper is to detect the pattern of structural changes of the Lithuanian economy and to evaluate it in the global context. Structural economic statistics of the countries provide a view of a particular year delivered by indicator of the level of output in a considered sector of selected country’s economy. Research methodology is based on the classic three-sector model, which involves structural changes’ assessment methods and comparative analysis of statistical data on economic structures. The main findings reveal peculiarities of the structural change tendencies of the Lithuanian economy in the global context. First of all, the economies of selected countries are being analyzed from the point of view of three-sectoral divisions, such as agriculture, industry and services; the authors highlight the main tendencies of global economy taken by regions. After further in-depth analysis of the Lithuanian economic structural changes’ assessment in the context of the other countries (regions) has been carried out and new evidence on patterns of structural change has been provided, concluding remarks have been formulated. Authors provide insights about peculiarities of Lithuanian economy’s structural changes, which could potentially lead to respective policy implications, ultimately aiming acceleration of economic development.
70TH ANNIVERSARY OF THE BIRTH OF ACADEMICIAN EDMUNDAS KAZIMIERAS ZAVADSKAS
Authors: Šaparauskas Jonas , Turskis Zenonas , Merkuryeva Galina V. , Liias Roode
Published: June 2014

"70th anniversary of the birth of Academician Edmundas Kazimieras Zavadskas review."Technological and Economic Development of Economy, 20(2), pp. 182-192
Le statut subjectif de la douleur : fatalité ou symptôme
Authors: Martin-Mattera Patrick
Published: June 2014

La douleur est un phénomène dans lequel la subjectivité occupe une place majeure. Elle peut être vécue soit comme le contraire du plaisir, autrement dit un déplaisir de provenance extérieure dont il faut se débarrasser, ou bien comme une expérience intérieure qui perdure et se chronicise au détriment du sujet mais à travers laquelle, parallèlement, celui-ci se définit. Elle est plus proche en ce cas d’une jouissance « négative » qui s’impose au sujet dans l’espace et le temps. Phénomène éminemment psychosomatique, l’inscription de la douleur dans l’économie psychique et aussi dans l’expérience existentielle est fonction de la position subjective. Nous puiserons notre clinique dans la pathologie des lombalgies chroniques et axerons le développement sur l’idée que le statut de la douleur dépend en grande partie de ce que le sujet en fait : soit une fatalité biologique, psychique, sociale, soit un symptôme de sa difficulté d’être.
Collaborative Academic–Practice Transition Program for New Graduate RNs in Community Settings: Lessons Learned
Authors: Jones-Bell Jessie , Karshmer Judith , Berman Audrey , Prion Susan , Van Paulina , Wallace Jonalyn , West Nikki
Published: June 2014

In 2010–2011, leaders from California academic and practice settings and additional community partners collaboratively developed four 12- to 16-week transition programs for 345 new registered nurse (RN) graduates who had not yet found employment as nurses. Program goals were to increase participants’ confidence, competence, and employability and expand the employment landscape to nontraditional new graduate settings. One program focused exclusively on community-based settings and was completed by 40 participants at clinics and school sites; all participants secured RN jobs. Key lessons learned go beyond the impact for participants and relate to changing the nursing culture about career path models for new graduates, troubleshooting regulatory issues, the potential for new graduates to help transform nursing, and advancing academic–practice partnerships and supporting practice sites. The community-based transition program continues to provide opportunities for new RN graduates and model an approach for transforming nursing practice.

J Contin Educ Nurs.
2014;45(6):259–264.
The Planning Team—Who Belongs?
Authors: Lubejko Barbara G.
Published: June 2014

The composition of the planning team has a significant impact on the quality and outcome of continuing nursing education programs. It is imperative to identify the knowledge and skills needed to plan a specific program before choosing planning team members who have the required competencies.

J Contin Educ Nurs.
2014;45(6):244–245.
Developing Leaders as Systems Thinkers—Part III
Authors: Bleich Michael R.
Published: June 2014

This article concludes a three-part series on developing leaders to function as systems thinkers. Part I differentiated between systematic and systems thinking and action, and part II elucidated competencies needed to develop and influence systems. The emphasis now shifts. Professional development educators are often expected to instruct individuals in multiple types of data collection, ranging from quality improvement to program evaluation metrics. The focus of this column is on collecting and using systems data.

J Contin Educ Nurs
. 2014;45(6):246–248.
Acute and Critical Care Nurses’ Perceptions of Palliative Care Competencies: A Pilot Study
Authors: White Kenneth R. , Roczen Marisa L. , Coyne Patrick J. , Wiencek Clareen
Published: June 2014

Competency development among acute and critical care nurses has focused primarily on the provision of life-sustaining care and less on the care of patients who fail to respond to life-prolonging treatments. Examining nurses’ beliefs, perceptions, and experiences with patients’ palliative care needs may improve continuing education programs, practice resources, educational curricula, and professional nursing practice. Survey methodology was used to conduct this pilot study. Forty-nine nurses completed a 33-item survey instrument in 2012. Respondents consisted of nurses attending a critical care continuing education event and graduate nursing students in an acute care nurse practitioner program. Statistical tests were used to examine differences in perceived importance of core competencies in palliative care. Findings from this study demonstrate variation in palliative care knowledge and perceived relative importance of core competencies needed in palliative care practice. This study provides preliminary data about knowledge differences among different nursing groups and a foundation for further study.

J Contin Educ Nurs.
2014;45(6):265–277.
Providing 360-Degree Multisource Feedback to Nurse Educators in the Country of Georgia: A Formative Evaluation of Acceptability
Authors: DeStephano Christopher Carl , Crawford Kimberley Anne , Jashi Maia , Wold Judith Lupo
Published: June 2014

Background:

Due to insufficient nursing education standards in the country of Georgia, 15 health professionals participated in a USAID grant-funded nurse educator faculty development program. These educators then offered continuing education courses and taught more than 1,700 practicing Georgian nurses over 3 years.

Method:

Using a 360-degree multisource feedback model (MSF), self, video, learner, peer, and program coordinator evaluations of teaching effectiveness were completed. After nurse educators reviewed their results and identified areas for improvement, a questionnaire about the perceived acceptability of teacher evaluations was completed.

Results:

Of the 15 nurse educators, 93.3% indicated that nurse educators should receive feedback through self, learner, peer, and video evaluations, and 100% indicated that nurse educators should receive feedback from the program coordinator. The accuracy and usefulness of the program coordinator evaluation was rated the highest, whereas peer evaluation was rated the lowest.

Conclusion:

This study revealed that MSF was acceptable to Georgian nurse educators.

J Contin Educ Nurs.
2014;45(6):278–284.
Prevalence, Views, and Impact of Advance Directives Among Older Adults
Authors: Kossman Debra A.
Published: June 2014

This article reviews the literature on advance directives among U.S. older adults published from 2008 through 2013, with a focus on advance directive prevalence, implications of advance directives on patient care, and impact of interventions to increase advance directive completion. Advance directive completion varies by demographic characteristics and is affected by patient attitudes toward advance directives and end-of-life care. Patients with advance directives are less likely to receive feeding tubes, experience burdensome transitions between nursing homes and hospitals, and die in the hospital. Advance directive completion increases when health care providers ask culturally sensitive questions and educate patients about advance directives, but better documentation and communication of advance directives are needed to ensure adherence to these measures. Despite increasing advance directive completion as patients move from community to nursing homes to hospice, advance directives are often insufficiently detailed and current for health care professionals to be confident they are acting in accordance with what patients would choose for themselves. [Journal of Gerontological Nursing, 40(7), 44–50.]
A Mixed-Methods Approach to Investigating the Adoption of Evidence-Based Pain Practices in Nursing Homes
Authors: Ersek Mary , Jablonski Anita
Published: June 2014

This mixed methods study examined perceived facilitators and obstacles to adopting evidence-based pain management protocols vis-a-vis documented practice changes that were measured using a chart audit tool. This analysis used data from a subgroup of four nursing homes that participated in a clinical trial. Focus group interviews with staff yielded qualitative data about perceived factors that affected their willingness and ability to use the protocols. Chart audits determined whether pain assessment and management practices changed over time in light of these reported facilitators and barriers. Reported facilitators included administrative support, staff consistency, and policy and procedure changes. Barriers were staff attitudes, regulatory issues, and provider mistrust of nurses’ judgment. Overall, staff reported improvements in pain practices. These reports were corroborated by modest but significant increases in adherence to recommended practices. Change in clinical practice is complex and requires attention to both structural and process aspects of care. [
Journal of Gerontological Nursing, 40
(7), 52–60.]
Lessons Learned in Multisite, Nursing Education Research While Studying a Technology Learning Innovation
Authors: North Sarah , Giddens Jean
Published: June 2014

Multiple challenges must be addressed when educational research is being conducted that involves a teaching innovation at multiple sites over time, including the consistent adoption and use of the intervention, attrition, response rates, and other aspects related to managing a complex study. After an 18-month nursing education study was conducted at multiple institutions across the United States, the authors’ study team reflected on strategies that worked well, the challenges faced, and what could have been done differently. This article details the challenges and offers recommendations for other researchers conducting similar studies. Recommendations related to communication and engagement, innovation fidelity, survey fatigue, multiple institutional review board applications, and flexibility are provided. [
J Nurs Educ.
2013;52(10):567–573.]
Teaching About Vulnerable Populations: Nursing Students’ Experience in a Homeless Center
Authors: Stanley Mary Jo
Published: June 2014

Cultural competence is not limited to ethnicity, religion, or race but is inclusive of vulnerable groups, such as the homeless. The complex health and social issues related to homelessness requires educational instruction that supports students’ ability to address and care for the multidimensional elements that surround this group. Exposure to homeless populations provides nursing students with increased awareness of the issues related to health disparities, while promoting introspective reflection on one’s values and beliefs. To increase student exposure to working with homeless clients, a service-learning project using a critical social theory (CST) lens was offered at a homeless center. The students’ response that clients were “just like” them, coupled with ambiguity regarding the complex social-economic-political issues surrounding the homeless, may indicate a need for further education regarding cultural understanding, sensitivity, and vulnerability. This project demonstrates the need for learning experiences that support advocacy and social responsibility for vulnerable groups. [
J Nurs Educ
. 2013;52(10):585–588.]
Novice Nurse Educator Entry-Level Competency to Teach: A National Study
Authors: Poindexter Kathleen
Published: June 2014

Expert nurse clinicians who are transitioning into academic positions after successful clinical careers often find they are unprepared to assume their new educator roles. Although nursing clinical expertise may be a necessary expectation, this knowledge is not sufficient to assume a nurse educator position. The purpose of this study was to identify essential entry-level nurse educator competencies, as reported by nurse administrators of accredited prelicensure nursing programs in the United States. Responses were categorized according to the type of academic institution housing the prelicensure nursing program and type of entry-level nurse educator position. A total of 374 program administrators representing 48 states participated, for a 44% response rate. The results indicate that administrators expect entry-level nurse educators to acquire teaching competencies prior to obtaining an entry-level position. Expected proficiency levels of competencies differed based on the position type and the academic setting. [
J Nurs Educ.
2013;52(10):559–566.]
Quality and Safety Education for Nurses: A Nursing Leadership Skills Exercise
Authors: Harrison Elizabeth Marion
Published: June 2014

The Quality and Safety Education for Nurses (QSEN) initiative was established to answer the Institute of Medicine’s trio of reports that stress the need to enhance the quality and safety of health care in the United States. The initiative has resulted in six competencies, along with innovative curricular guides to better prepare nurses to improve the health care systems within which they work. Participating in a root cause analysis (RCA) is one of several teaching strategies common to the development of QSEN competencies. This article describes the development, evaluation, and revision of a nursing leadership skills exercise that enabled students to participate in an RCA. In addition to making learning relevant, this exercise focused student attention on the nation’s concern about the quality and safety of health care in the United States. [
J Nurs Educ
. 2014;53(6):356–361.]
Teaching Civility to Undergraduate Nursing Students Using a Virtue Ethics-Based Curriculum
Authors: Russell Martha Joan
Published: June 2014

As professionals, nurses are expected to engage in respectful relationships with clients, other health care professionals, and each other. Regulatory bodies set standards and codes of ethics for professional behavior in nursing that clearly communicate expectations for civility. However, the wealth of literature on incivility in the profession indicates that nurses often fall short of meeting these standards in their interactions with other nurses. Currently, few effective strategies exist for nurse educators to teach civility to nursing students and prepare them to engage in healthy relationships with their colleagues. This article argues for the use of virtue ethics as a philosophical framework for teaching civility to undergraduate nursing students. The pedagogical strategies proposed may help students contribute to the development of healthy workplaces. [
J Nurs Educ.
2014;53(6):313–319.]
Prophylactic Scleral Buckle Implantation in Knobloch Syndrome
Authors: Moysidis Stavros N. , Aziz Hassan A. , Rachitskaya Aleksandra V. , Berrocal Audina M.
Published: June 2014

Knobloch syndrome is a rare autosomal recessive disorder characterized by a triad of high myopia, vitreoretinal degeneration, and congenital occipital scalp defects. On literature review of all reported cases, 25 of 85 eyes (29%) of patients diagnosed as having Knobloch syndrome have suffered retinal detachment. Due to high myopia, surgical repair of the retinal detachment is challenging and patients frequently require several reoperations. Even after vitrectomy or scleral buckle for retinal detachment, the final visual acuity outcomes are poor, with 11 of 12 (92%) patients having 20/200 visual acuity or worse and 6 of 12 (50%) having counting fingers visual acuity or worse. The role of retinal detachment prophylaxis has been discussed for other vitreoretinal degeneration disorders, but not for this disease. The authors report the case of a child affected with Knobloch syndrome who presented with total retinal detachment in the left eye at 24 months of age. He underwent successful repair and was then treated with prophylactic scleral buckle implantation in the right eye 5 months later. The retina in both of his eyes remains attached 4 years later.
[J Pediatr Ophthalmol Strabismus 2014;51:e40–e43.]
Early Postoperative Alignment as a Predictor of 6-Month Alignment After Intermittent Exotropia Surgery
Authors: Rajavi Zhale , Hafezian Seyede Fatemeh , Yaseri Mehdi , Sheibani Kourosh
Published: June 2014

Purpose:

The angle of postoperative deviation changes over time in patients undergoing surgery for intermittent exotropia. The aim of the current study was to assess the relationship between the motor alignment at 1 week and 6 months after exotropia surgery.

Methods:

The records of 81 patients who underwent surgery for intermittent exotropia from 2002 to 2012 at Imam Hussein Medical Center and had at least 6 months of postoperative follow-up were retrospectively reviewed. Each patient underwent complete eye examination and had surgery for orthophoria. Patients were divided into three groups according to their 1-week postoperative alignment (undercorrection [exotropia > 10 prism diopters (PD)], orthophoria [exotropia = 10 PD and esotropia = 5 PD], and overcorrection [esotropia > 5 PD]).

Results:

The postoperative success rates for 1 week and 6 months were 75.3% and 76.5% respectively. Of 61 orthophoric, 13 undercorrected, and 7 overcorrected patients at 1 week postoperatively, 51 (83.6%), 7 (53.8%), and 2 (28.6%) patients, respectively, preserved their initial alignment at 6 months (
P
= .024 for orthophoria). The type of surgery had no effect on the results at 6 months. Reoperation was needed in 10 (12.3%) of our patients at the 6-month follow-up (7 undercorrected and 3 orthophoric patients).

Conclusions:

Early postoperative alignment of intermittent exotropia at 1 week can be considered a predictor of orthophoria at 6 months, whereas fewer cases in other groups made predicting their alignment at 6 months statistically difficult. Reoperation was needed in 12.3% of cases at the 6-month follow-up.

[J Pediatr Ophthalmol Strabismus 2014;51(5):274–282.]
Gender Dysphoria and Children
Authors: Nicholson Chance , McGuinness Teena M.
Published: June 2014

The age at which gender dysphoria can be diagnosed with enough certainty to justify medical intervention is controversial. The aim of this article is to explore current literature as it relates to the gender reassignment process and diagnostic indicators supporting an appropriate age for intervention. The timing of diagnosis and treatment of gender dysphoria remains the center of debate between the long-term effects of early intervention versus delay of treatment. Limited research is available on gender dysphoria treatment protocols for children. However, preliminary studies suggest that early intervention improves the quality of life in individuals who are transgender. Ongoing research suggests that it may be possible to confirm gender dysphoria at an earlier age. [
Journal of Psychosocial Nursing and Mental Health Services,
52
(8), 27–30.]
Changes of Corneal Topography Indices After CXL in Progressive Keratoconus Assessed by Scheimpflug Camera
Authors: Kránitz Kinga , Kovács Illés , Miháltz Kata , Sándor Gábor László , Juhász Éva , Gyenes Andrea , Nagy Zoltán Zsolt
Published: June 2014

PURPOSE:

To evaluate the accuracy of Scheimpflug camera topography indices in detecting the therapeutic effect of corneal collagen cross-linking (CXL) on progressive keratoconus in the long term.

METHODS:

Fifty eyes of 25 patients with keratoconus were enrolled. CXL was performed in 25 eyes with progressive keratoconus (CXL group) and 25 fellow eyes with nonprogressive keratoconus served as controls. Thinnest corneal thickness, anterior keratometry (flat, steep), and keratoconus indices were measured with Scheimpflug camera before and 12 to 25 months after CXL. Regression analysis was used to evaluate the influence of corneal thickness and follow-up time on flattening effect of CXL.

RESULTS:

At baseline, steep keratometric values were significantly higher and thinnest corneal thickness values were lower in the CXL group (
P
= .027, .034), parallel with increased values of keratoconus indices: index of surface variance (
P
= .013), index of vertical asymmetry (
P
= .038), keratoconus index (
P
= .019), center keratoconus index (
P
= .039), index of height asymmetry (
P
= .037), index of height decentration (
P
= .0016), and radius minimum (
P
= .008). After adjustment for thinnest corneal thickness and follow-up time, CXL showed significant flattening effect expressed by changes in radius minimum (
P
< .001), index of surface variance (
P
= .03), keratoconus index (
P
= .006), center keratoconus index (
P
= .03), and index of height asymmetry (
P
= .026). Thinnest corneal thickness had significant influence on changes of index of surface variance (
P
= .049), index of vertical asymmetry (
P
= .01), and center keratoconus index (
P
= .03). Follow-up time showed no significant influence in any models (
P
> .05).

CONCLUSIONS:

Topographic indices indicate corneal flattening after CXL in the long term. Monitoring keratoconus index and index of height asymmetry should be the preferred choice in daily clinical practice because changes in values of these indices are independent from initial corneal thickness.

[
J Refract Surg.
2014;30(6):374–378.]
Transepithelial Phototherapeutic Keratectomy Protocol for Treating Irregular Astigmatism Based on Population Epithelial Thickness Measurements by Artemis Very High-Frequency Digital Ultrasound
Authors: Reinstein Dan Z. , Archer Timothy J. , Dickeson Zachary I. , Gobbe Marine
Published: June 2014

PURPOSE:

To report the outcomes of transepithelial phototherapeutic keratectomy (TE-PTK) in the treatment of irregular astigmatism and define a standard treatment protocol based on population epithelial thickness measurements.

METHODS:

Retrospective analysis of 41 TE-PTK procedures in cases of irregular astigmatism after refractive surgery or with corneal irregularities. The TE-PTK ablations were performed according to preoperative epithelial thickness maps obtained using an Artemis very high-frequency digital ultrasound arc-scanner (ArcScan, Inc., Morrison, CO). Visual and refractive outcomes were analyzed 12 months after the procedure. The efficacy of the stromal surface regularization was evaluated as the change in epithelial thickness range (ie, the difference between minimum and maximum epithelial thickness). A further refractive ablation was performed immediately after TE-PTK in 12 eyes.

RESULTS:

Corrected distance visual acuity was improved by one or more lines in 58% of eyes, whereas 1 eye lost one line and no eyes lost two lines. Significant stromal surface regularization was achieved with epithelial thickness range reduced on average from 41 to 29
μ
m. There was an unpredictable refractive shift in the TE-PTK only group with a change of more than 0.50 diopter (D) in 59% of eyes. Refractive accuracy in the TE-PTK with refractive ablation group was reasonably good, although there were two outliers (18%) outside ±1.00 D. A therapeutic window was identified between the highest thinnest epithelium of 51
μ
m and lowest thickest epithelium of 60
μ
m.

CONCLUSIONS:

TE-PTK can be a safe and effective method of reducing stromal surface irregularities by taking advantage of the natural masking effect of the epithelium. There can be a significant refractive shift due to lenticular epithelial masking. A standard protocol of targeting an initial TE-PTK ablation for 55
μ
m will likely achieve breakthrough of the thinnest epithelium without total epithelial removal, allowing the treatment to be continued in a stepwise fashion.

[
J Refract Surg.
2014;30(6):380–387.]
Femtosecond Laser Cataract Surgery: Updates on Technologies and Outcomes
Authors: Alió Jorge L. , Abdou Ahmed A. , Puente Alfonso Arias , Zato Miguel Angel , Nagy Zoltan
Published: June 2014

PURPOSE:

To describe femtosecond laser cataract surgery and discuss the published peer-reviewed articles to have a fair evaluation of this new technology and its comparisons to conventional phacoemulsification surgery.

METHODS:

The technology information released in this article comes from the key individuals in each of the U.S. Food and Drug Administration-approved companies and from the available commercial information. Bibliographic research was performed in PubMed and MEDLINE for the published prospective or retrospective clinical studies.

RESULTS:

The femtosecond laser has been reported to be safe intraoperatively and postoperatively, with less cornea and macula effect than conventional phacoemulsification. The incision is integrated, stable, and aberration free. Many studies reported the high precision of the capsulotomy over manual continuous curvilinear capsulorhexis, which favors less intraocular lens tilt, higher optical quality, and more accurate premium intraocular lens centration. The lens fragmentation is effective with significant reduction of the phacoemulsification power and effective phacoemulsification time. The refractive difference between femtosecond laser and standard phacoemulsification is minimal, with no difference in corrected distance visual acuity, but the optical quality and the internal aberrations results are significantly better for femtosecond laser phacoemulsification.

CONCLUSIONS:

Femtosecond laser cataract surgery is a good addition to cataract surgery despite its few remarkable advantages among experienced phacoemulsification surgeons.

[
J Refract Surg.
2014;30(6):420–427.]
Outcomes After Accommodative Bioanalogic Intraocular Lens Implantation
Authors: Pallikaris Ioannis G. , Portaliou Dimitra M. , Kymionis George D. , Panagopoulou Sophia I. , Kounis George A.
Published: June 2014

PURPOSE:

To evaluate the outcomes after Wichterle Intraocular Lens-Continuous Focus (Medicem, Kamenné Zehrovice, Czech Republic) accommodative bioanalogic intraocular lens implantation.

METHODS:

In this prospective case series, 50 eyes of 25 patients (mean age: 65.3 ± 8.4 years; range: 53 to 83 years) were included. All patients underwent routine cataract surgery and Wichterle Intraocular Lens-Continuous Focus implantation.

RESULTS:

Mean follow-up was 11.44 ± 2.46 months (range: 9 to 17 months). Both monocular uncorrected and corrected distance visual acuity statistically and significantly (
P
< .05) improved from 0.31 ± 0.17 (20/63 Snellen) (range: counting fingers to 0.7) to 0.74 ± 0.19 (20/25 Snellen) (range: 0.2 to 1) and from 0.61 ± 0.19 (20/32 Snellen) (range: 0.2 to 1) to 0.82 ± 0.13 (20/25 Snellen) (range: 0.4 to 1), respectively. Target postoperative refraction was −0.5 diopters (D) and preoperative and 1-year postoperative spherical equivalent refraction were 0.72 ± 2.71 D (range: −7.25 to 2.37 D) and −0.24 ± 0.65 D (range: −1.0 to 1.0 D), respectively. No eyes lost lines of corrected distance visual acuity during the follow-up period, whereas 88% of patients gained one or more lines of corrected distance visual acuity. Uncorrected intermediate and near visual acuity were J2 (Snellen 20/25) or better in 72% of patients. No complications occurred intraoperatively or postoperatively. The evaluation of the mean values of root mean square of third and fourth order higher-order aberrations at 1 year postoperatively revealed a mean negative spherical aberration of −0.18 ± 0.13
μ
m.

CONCLUSIONS:

Wichterle Intraocular Lens-Continuous Focus accommodative bioanalogic IOL implantation provides satisfactory visual acuity for far, intermediate, and near distances and the promising results remain stable throughout the follow-up period.

[
J Refract Surg.
2014;30(6):402–406.]
Contact Lens-Assisted Collagen Cross-Linking (CACXL): A New Technique for Cross-Linking Thin Corneas
Authors: Jacob Soosan , Kumar Dhivya Ashok , Agarwal Amar , Basu Sushanth , Sinha Pratheek , Agarwal Ashvin
Published: June 2014

PURPOSE:

To report a novel method of contact lens-assisted corneal cross-linking (CACXL) in eyes with thin corneas.

METHODS:

Patients diagnosed as having progressive keratectasia with a minimum corneal thickness less than 400 and greater than 350
μ
m after epithelial abrasion were included. After epithelial abrasion, the iso-osmolar riboflavin 0.1% in dextran was applied every 3 minutes for 30 minutes. An ultraviolet barrier-free soft contact lens (0.09-mm thickness, 14-mm diameter) soaked in iso-osmolar riboflavin 0.1% for 30 minutes was placed on the cornea. Once the minimum corneal thickness value was confirmed to be greater than 400
μ
m, the ultraviolet-A irradiance was started along with instillation of iso-osmolar riboflavin 0.1% in the pre-corneal and pre-contact lens region. Intraoperative minimum corneal thickness changes were recorded with ultrasound pachymetry and optical coherence tomography. Postoperative visual acuity, corneal topography (Orbscan; Bausch & Lomb, Rochester, NY), endothelial cell loss (EM-3000; Tomey, Nagoya, Japan), and stromal demarcation line (Visante; Carl Zeiss Meditec, Jena, Germany) were measured.

RESULTS:

Fourteen eyes underwent the procedure. Mean preoperative minimum corneal thickness after epithelial abrasion was 377.2 ± 14.5
μ
m (range: 350 to 398
μ
m). There was a significant difference in minimum functional corneal thickness (Friedman test,
P
= .000) intraoperatively, before epithelial abrasion, after epithelial abrasion, and with contact lens and riboflavin film. Mean minimum functional corneal thickness after the contact lens was 485.1 ± 15.8
μ
m (range: 458 to 511
μ
m). Mean absolute increase in the minimum corneal thickness along with the contact lens and pre-corneal riboflavin film was 107.9 ± 9.4
μ
m (range: 90 to 124
μ
m). Mean depth of stromal demarcation line was 252.9 ± 40.8
μ
m (range: 208 to 360
μ
m). There was no significant endothelial loss (
P
= .063) and the corneal topography was stable at the last follow-up (
P
= .505).

CONCLUSIONS:

CACXL technique was effective and safe in performing cross-linking in corneas less than 400
μ
m after epithelial abrasion and appeared effective based on stromal demarcation line depth.

[
J Refract Surg.
2014;30(6):366–372.]