bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship Between Acromial Morphology and Conservative Treatment of Patients With Impingement Syndrome
Authors: Wang Jeffrey C , Horner Gregory , Brown Eric D , Shapiro Matthew S
Published: April 2021

ABSTRACT

This study assessed the predictive value of acromial morphology in the treatment outcome of patients with impingement syndrome. Sixty-five patients with impingement syndrome were treated by a single orthopedic surgeon according to the same protocol and initially received the same conservative modalities. The incidence of acromial types in the nonoperative group was significantly different from those in the operative group (P=.008). A large proportion (88.9%) of the patients with type I acromions responded to conservative measures, while fewer (73.1%) patients with type II acromions responded to conservative measures. The majority (58.3%) of patients with type III acromions required surgical intervention. Acromial morphology appears to have a predictive value in determining the success of conservative measures and the need for surgery in patients with impingement syndrome.
Current Concepts in Sports Medicine: The Use of COX-2 Specific Inhibitors and the Emerging Trends in Arthroscopic Surgery
Authors: Andrews James R
Published: April 2021

ABSTRACT

Arthritis does not escape the athlete. From the recreational athlete to the professional athlete, arthritis can be a common and perplexing problem. In the typical orthopedic sports medicine practice, it is no longer uncommon to see relatively young patients suffering from arthritis. It can affect the major joints such as the knee, hip, ankle, shoulder, and elbow. One of the most common problems is shoulder arthritis secondary to injury in recreational athletes. Athletes at risk for shoulder arthritis typically include overhead athletes and weight lifters. The clinical presentation is usually specific for pain, decreased range of motion, and sometimes mechanical symptoms. Physical examination reveals a loss of motion, crepitus, catching, and locking; often, there is associated underlying instability. Radiographs can confirm the diagnosis of glenohumeral degenerative arthritis.

Pain control is a primary objective when treating these athletes with arthritis at any level. Cyclooxygenase-2 (COX-2) specific inhibitors are emerging as primary treatment because of their anti-inflammatory and analgesic effect. Although a nonsteroidal anti-inflammatory drugs, COX-2 inhibitors block the en2ymes that trigger pain and inflammation, while sparing a related enzyme that helps maintain the normal stomach lining (cyclooxygenase-1 ). In contrast, traditional nonsteroidal anti-inflammatory drugs block both enzymes and may cause damage to the stomach lining, potentially leading to ulcers.

Minimally invasive surgery can be performed as a palliative procedure for treating early arthritis in athletes. These procedures include removal of loose bodies, debridement, capsular release, and other associated procedures such as rotator cuff repair and decompression.

Rehabilitation plays an important role in nonoperative treatment and also an important roie in postoperative treatment particularly to restore motion. Modification of activities continues to be an important adjunct in managing these types of arthritic problems in relatively young athletes.
Adolescent Quadriceps Mechanism Disruption
Authors: Alexander Vladimir A , Keilin Steven , Cohn Bruce T
Published: April 2021

Quadriceps mechanism ruptures may be misdiagnosed in young patients due to their infrequent occurrence. However, the diagnosis should be considered in patients with a previous knee injury, incomplete rehabilitation, and presentation with the following symptoms: suprapatellar knee pain, inability to actively extend the knee, and the presence of a suprapatellar gap/defect.
A Modified Anterior Approach to the Middle Third of the Humeral Shaft
Authors: Mirdad Tarek M , Jenyo Matthew
Published: April 2021

A modified surgical approach to the anterior portion of the middle third of the humeral shan minimizes the risk of damage to the radial nerve and provides better exposure compared to the standard conventional anterolateral approach.
Three-Dimensional Computerized Selection of Hip Prostheses in Patients With Congenital Dislocated Hips
Authors: Gelalis Ioannis D , Xenakis Theodore A , Hantes Michael , Vartziotis Kostantine , Soucacos Panayiotis N
Published: April 2021

ABSTRACT

This study assessed the effectiveness of the combined use of computed tomography (CT) and computeraided design (CAD) in the preoperative evaluation and implant selection in 20 patients (20 hips) with congenital dislocation of the hip who were scheduled to undergo total hip arthroplasty. Computerized selection of the femoral implant with optimum fit and fill was made after a three-dimensional reconstruction of the femoral canal using CT data and CAD. Implantation of all sizes of 5 noncemented and 2 cemented femoral implants was simulated using CATIA software (IBM, Kingstone, NY). When patients underwent surgery, 1 8 of 20 preselected prostheses agreed by type and size with the prostheses implanted. The remaining 2 preselected implants agreed by type only. In patients with dislocated and dyspJastic hips, combined use of CT and CAD allows effective preoperative planning by providing the surgeon with vital information about the proximal femoral canal geometry and the possible femoral implant with optimum fit and fill to be used.
Selecting Technical Skills to Teach for Competency
Authors: Kieffer Judith S
Published: April 2021

ABSTRACT

This pilot project describes a method using data from the clinical setting to assist nurse educators in the selection of technical nursing skills to teach for competency within the basic nursing program. Based on Dr. Dorothy del Bueno's proposal that skills taught should be those which are most frequently performed and considered most important in the community where new graduates are employed, five registered nurses in 16 metropolitan hospitals were asked to rate 154 technical nursing skills for frequency and importance. Findings for medical-surgical, intensive care, obstetric and pediatric areas, as well as for all groups combined, are described as skills ranking from 1) most frequent to least frequent, 2) most important to least important, and 3) most important/most frequent to least important/least frequent. Examination of skills placement within the rankings assisted faculty within an associate degree program to decide which skills to select and which to eliminate from the program.
Computer-Managed Instruction: An Alternative Teaching Strategy
Authors: Day Rene , Payne Louise
Published: April 2021

ABSTRACT

Computer-managed instruction is an instructional strategy whereby the computer is used to provide learning objectives, learning resources, and assessment of learner performance. Computer-managed instruction (CMI) aids the instructor in instructional management without actually doing the teaching. Central CMI themes discussed in the literature are individualization, behavioral objectives, and educational technology. The main objective of this study was to compare the outcomes of two teaching strategies: CMI versus the traditional lecture method. The learning objectives were based on specified theoretical content from a Health Assessment course for baccalaureate nursing students. The design of the study was quasiexperimental incorporating two experimental treatments applied to two groups on two occasions. Data analysis addresses differences between groups using CMI and the traditional lecture method. The variables examined were the cognitive performance of learners, the learners attitude toward the instructional strategy, the learners retention of knowledge, the time involved in mastering the learning objectives, and the relationship between learner characteristics and the effectiveness of the instructional strategy. No significant mean difference (p<0.05) was found between groups on cognitive performance as measured by written and practical examination scores. For these first-year baccalaureate nursing students, CMI did not prove to be a positive instructional method as assessed by the Attitude Questionnaire. The majority of students preferred a combination of instructional methods. There was no significant difference between groups in the time spent meeting the learning objectives by either teaching strategy. The findings suggested that these students preferred learning strategies that are traditional in nature and teacher directed. The implications of the study are discussed in relation to the applicability of alternative instructional methods in nursing education.
Baccalaureate Student Nurse Success Prediction: A Replication
Authors: Wold Jean E , Worth Charles
Published: April 2021

ABSTRACT

The use of group testing that predicts success in understanding and using the nursing process suggests a tempting solution to a vexing problem: selecting those students from an applicant pool who have the potential to successfully complete a nursing program. Failure to replicate or extend previous studies has been recognized as a major limitation in nursing research (Brown, Tanner, & Padrick, 1984). The purpose of this research was to replicate a study using a set of four short test instruments identified as being successful predictors (Kissinger & Munjas, 1982). As part of a larger research project, four successive classes of students admitted to the school of nursing (N = 155) were tested and followed over a 4½-year period with 100% participation. The results were not supportive of the findings in the previous study. The importance of cross validation of prediction studies, as well as the need for periodic sampling of previously validated prediction batteries due to changing elements in selection programs, was demonstrated. The study's outcome and the nursing literature suggest that some configuration of prerequisite grade point average, with all of its limitations and student manipulations, and a required verbal SAT/ACT score may still be the most efficient predictors available to admission committees in schools of nursing.
A Study to Determine the Difference in Clinical Judgment Abilities Between BSN and Non-BSN Graduates
Authors: Sanford Martha , Genrich Sandra , Nowotny Mary
Published: April 2021

ABSTRACT

The purpose of this retrospective study is to determine the difference in clinical judgment abilities of recent baccalaureate nurses (BSN) seeking employment in a large metropolitan hospital and of nurses without a baccalaureate degree. Using an ex post facto design, the orientation records of 116 newly hired nurses were analyzed to determine the clinical judgment abilities using video vignettes produced by Medcom, Inc. Findings indicated that there was no difference in clinical judgment in newly hired BSN and non-BSN graduates. These findings indicate a need for more research studies to determine how clinical judgment is developed and to evaluate teaching strategies that facilitate clinical judgment.
Effects of Structured Controversy on Students' Perceptions of Their Skills in Discussing Controversial Issues
Authors: Pederson Carol
Published: April 2021

ABSTRACT

The teaching strategy that educators use when addressing controversial issues can help students develop the skills they need to deal effectively with controversial issues. Structured controversy is designed to allow students to practice these skills. This study measured the change in students' perceptions of their skills in perspectivetaking, logical arguing, and reaching consensus after using structured controversy on two controversial issues. Results of two-factor analyses of variance and comparison of means indicate significant positive changes in 51 senior nursing students' perceptions of their skills in perspectivetaking (<.001), logical arguing (<.01), and reaching consensus (<.01). These results are consistent with findings of previous research studies on the effectiveness of structured controversy.
Power and Change in Health Care: Challenge for Nursing
Authors: Cohen Leland B
Published: April 2021

ABSTRACT

This article proposes the need for consideration of status and power issues in nursing research, in theory, and at all levels of nursing education. Including the concept of power in nursing curricula will better prepare nurses to participate in social and political decisions affecting health care. By recognizing the role nurses have played, often in the face of opposition, nursing students will gain a sense of the potential power and strength of nurses. Curricular reform and revision of nursing theories to emphasize the sociopolitical context of nursing may change the socialization of student nurses by stressing autonomy, independence, and confidence. These changes may have a positive impact on recruitment, retention, and on efforts to change the public's perception of nursing.
Empowerment Through Teaching
Authors: Chally Pamela S
Published: April 2021

ABSTRACT

Empowerment through teaching is built on the feminist belief that successful and effective teaching is a cointentional process, emerging from meaningful connections between students and faculty. Empowerment results from teaching characterized by caring, commitment, creativity, interaction, and a recognition of the humanity of both teacher and students. Teaching is conceptualized as a directional process emerging from the energy of both student and teacher. There must be continued, intense, and frequent exchange of these energies. The tools that students and teacher must possess or acquire for empowerment include positive self-concept, creativity, resources, information, and support. This perspective permits a new understanding of teaching that results in empowerment of both parties involved in the process of learning.
Undergraduate Preparation for Primary Health Care Roles in an Academic Nursing Center
Authors: Tyree Elizabeth A , Henly Susan J , Schauer Janet B , Lindsey Deborah L
Published: April 2021

ABSTRACT

The goal of the Nursing Center at the University of North Dakota is to prepare professional nurses to meet priority health needs of the next century through service to people currently in need. Health needs in the state, educational needs related to preparation for primary health care roles, and an explicit nursing paradigm for primary health care framed the development of the Nursing Center. As an integral part of the College of Nursing, the Nursing Center serves as a primary site for undergraduate clinical experiences. Family-centered, community-based programs were designed to simultaneously meet health needs of underserved rural populations and educational needs of undergraduates for preparation in primary health care roles. Implementation proved feasible from both service and educational perspectives. Initial evaluation data demonstrated a high level of effective clinical activity and role development for students beyond that experienced in more traditional settings.
Using Feedback to Reduce Students' Judgment Bias on Test Questions
Authors: Flannelly Laura T
Published: April 2021

ABSTBACT

Judgment bias represents a common tendency of people to inaccurately gauge the extent of their own knowledge. While research has shown that people tend to overestimate their knowledge on hard questions and underestimate their knowledge on easy questions, overconfidence poses a more pernicious problem from an educational perspective since it can undermine students' ability to monitor their own learning effectively and interfere with their test performance. The findings of the present study show that students who perform poorly on a test are more overconfident about their answers to hard test questions, especially those they answer wrongly, than are students who perform better. The results also show that judgment bias can be reduced by providing feedback to students about their prior performance and confidence on specific test questions. This intervention was found to be effective in decreasing both underconfidence on easy questions and overconfidence on hard questions regardless of students' performance level.
Perspective Transformation in RN-to-BSN Distance Education
Authors: Cragg C E (Betty) , Plotnikoff Ronald C , Hugo Kylie , Casey Alberta
Published: April 2021

ABSTRACT

This study examines perspective transformation (or professional resociahzation) in RN-to-BSN students obtaining their degree by distance education. A socialization scale was used to compare newly admitted and graduating RN-to-BSN students who had taken their courses onsite, by distance education, or a mixture of the two methods. The scores of entering and graduating RN-toBSN students also were compared to those of graduates from the generic program to identify if program and experience are factors in scores achieved. Results indicate that all BSN graduates had significantly higher scores than the diploma-prepared nurses entering the RN-to-BSN program. RN-to-BSN graduates who had used distance education had the highest scores, followed by the onsite RN-to-BSN students. Students who had taken a mixture of distance and onsite courses had scores similar to those of generic program graduates. Experience and full-time employment status were significantly associated with higher scores among graduating RN-to-BSN students. Implications for nurse educators working with RN-to-BSN students who use distance education are discussed.
Sclerosing Endophthalmitis in Children: Computed Tomography with Histopathologic Correlation
Authors: Margo Curtis E , Katz Norman N K , Wertz Fleming D , Dorwart Robert H
Published: April 2021

ABSTRACT

Three children with histopathologically diagnosed aclerosing endophthalmitis presumably secondary to Toxocara cam's were studied by orbital computed tomography. The diffuse increased intraocular density present in the CT scans was indistinguishable from that observed in Coats's disease and non- calcify ing retinoblastoma.

Although retinoblastoma constitutes the major lifethreatening cause of leukocoria in children, a number of other simulating conditions (pseudoglioma) can cause diagnostic confusion. In some cases of leukocoria it is exceedingly difficult to exclude the possibility of retinoblastoma without having to resort to enucleation.1 The availability of new non-invasive tests may make the distinction between retinoblastoma and pseu dogli om as more easily attainable. Computed tomography (CT) has been shown to be of particular value in this regard by demonstrating intraocular calcification within retinoblastoma and rarely in lesions that stimulate it.2-4 CT may also be used to more appropriately plan therapy for children with retinoblaatoma by assessing the status of the optic nerve and orbit.' The exact role of CT in the evaluation of children with leukocoria, however, has not been completely established, since the computed tomographic features of several lesions that simulate retinoblastoma have not been described.

The three most common causes of pseudoglioma are persistent hyperplastic primary vitreous, Coats's disease and sclerosing endophthalmitis. The latter entity when associated with a characteristic granulomatous inflammation is considered to represent the sequela of Taxocara canis infection of the eye. This report describes the computed tomographic findings in three cases of histologically diagnosed sclerosing endophthalmitis, presumably due to Toxocara canis.
Medical Management of Accommodative Esotropia
Authors: Hiatt Roger L
Published: April 2021

ABSTRACT

Cycloplegic drugs are the principal medications used in the diagnosis of accommodative esotropia. The same cycloplegics can be used as a "medical patch" in the treatment of amblyopia. Miotics may be as good as glasses in controlling accommodative esotropia but are almost never better. The response to miotica does not rule out the presence of accommodative esotropia. Miotics also may be used as a supplementary agent to glasses, bifocals, or surgery in the treatment of esotropia. The most widely used miotics today include phosphoiine iodide and DFP with iris cysts being the major local side effect in the eye with the use of miotics in children. Miotics and other drugs are valuable tools in the treatment of accommodative esotropia; however, the use must be correlated with other tools, including surgery, patching, glasses, and orthoptic exercises.
Orbital and Childhood Sarcoidosis
Authors: Khan Jemshed A , Hoover Darren L , Giangiacomo Joseph , Singsen Bernhard H
Published: April 2021

ABSTRACT

Orbital infiltration, anterior uveitis, disc edema, choroiditis, erythema nodosum, and polyarticular arthritis due to sarcoidosis occurred in a five-year-old child who presented with unilateral proptosis. Diagnosis was enhanced by computerized tomography of the orbit, and confirmed by synovial biopsy findings. This patient's course illustrates the importance of thorough and frequent ocular examinations in childhood uveitis associated with systemic disease and demonstrates an unusual finding of orbital sarcoidosis. Childhood sarcoid arthritis may be misdiagnosed as juvenile rheumatoid arthritis. Familiarity with the ocular and systemic findings may lead to the correct diagnosis.
Horner's Syndrome in Children
Authors: Woodruff Geoffrey , Buncic J Raymond , Morin J Donald
Published: April 2021

ABSTRACT

Ten cases of Horner's syndrome with pharmacologic testing and computed tomography scans are described in patients up to age 8 years. The patients also were assessed for iris color and facial sweating. Classical preganglionic Horner's syndrome associated with brachial plexus birth injury was not identified in any case. Two patients who presented with ptosis had neuroblastoma. Two other children had undergone corrective cardiothoracic surgery. Two patients had major congenital abnormalities. In four patients, no cause of Horner's syndrome was determined.
The Eyelid Crease Approach to Superficial Lateral Dermoid Cysts
Authors: Kersten Robert C
Published: April 2021

ABSTRACT

Although the traditional approaches to lateral orbital dermoids with incision directly over the lesion or camouflaged beneath the inferior brow provide good direct exposure of the lesion, the result may be cosmetically less acceptable due to prolonged erythema and ultimate depression of the scar when placed in the thicker skin of this region. The results in 11 patients in whom an eyelid crease incision was used are reported. Camouflage of the incision by the overlying lid fold resulted in very satisfactory cosmesis in the immediate postoperative period. The extremely thin lid skin in the crease resulted in rapid healing with a virtually imperceptible mature scar. With sufficient extension of the incision and undermining, the lid tissues could be displaced to allow adequate exposure and removal of the dermoid in all cases.
Keratolenticular Dysgenesis (Peters' Anomaly) as a Result of Acute Embryonic Insult During Gastrulation
Authors: Cook Cynthia S , Sulik Kathleen K
Published: April 2021

ABSTRACT

Keratolenticular dysgenesis (Peters' anomaly) was Induced in mice by exposure to the human teratogens, ethanol or 13-cis retinole acid (isotretinoin, Accutane9). Acute teratogen exposure on the seventh day of gestation (corresponding to the third week of human gestation) resulted in an eye malformation incidence of 46% to 100% in day 14 fetuses. Of the abnormal eyes, 10% to 29% demonstrated failure of detachment of the lens from the surface ectoderm. Delayed lens detachment was seen ss anterior lenticonus in 33% to 35% of the abnormal eyes. Abnormal lens detachment appeared to result in mechanical interference with neural crest migration to form the corneal stroma and endothelium, and iris stroma. This secondary effect on neural crest derivatives is exhibited in the adult animals as corneal opacities associated with defects in Descemets membrane and endothelium, and anterior polar cataracts.
Reoperation Rate in Adjustable Strabismus Surgery
Authors: Wisnicki H Jay , Repka Michael X , Guyton David L
Published: April 2021

ABSTRACT

Adjustable suture strabismus surgery may reduce the frequency of reoperations by reducing immediate postoperative over- and undercorrections. We reviewed 290 strabismus procedures performed with an adjustable suture technique. Thirty-five patients required additional surgery, for a reoperation rate of 9.7%. Reoperation frequencies for patients undergoing non-adjustable procedures average approximately 20% in our experience and in reported series. Our low reoperation rate with adjustable strabismus surgery supports our clinical impression that more accurate results are possible with this technique in appropriate patients.
Acuity Card Testing of Spastic Children: Preliminary Results
Authors: Hertz B Gevene , Rosenberg Jacob
Published: April 2021

ABSTRACT

Acuity card testing of spastic children showed a high success rate. Agreement between repeated tests for children with mild motor handicaps was within the limits reported for non-handicapped children. Although more of the children with severe motor handicaps had greater test-retest variabilities, the majority of results from this group also showed an acceptable agreement. The high success rate and good test-retest agreement Indicate that acuity cards can be very useful for testing children with cerebral palsy, who often have reduced acuity.
The Disc-Macula Distance to Disc Diameter Ratio: A New Test for Confirming Optic Nerve Hypoplasia in Young Children
Authors: Alvarez Emilio , Wakakura Masato , Khan Zia , Dutton Gordon N
Published: April 2021

ABSTRACT

The disc-macula: disc diameter (DM:DD) ratio is the ratio of the horizontal distance between the center of the optic disc and the macula to the mean diameter of the optic disc, as evaluated from fundus photographs. The diagnosis of optic nerve hypoplasia may be difficult in cases in which the optic discs are slightly reduced In size, or when the double ring sign is absent and the condition is bilateral. The DM : DD ratio was calculated for six eyes of five children with ophthalmoscopically obvious optic nerve hypoplasia, 12 eyes of six children in whom the diagnosis of optic nerve hypoplasia was equivocal (but established by visual field examination and retinal red free photography), 13 eyes of eight children with optic atrophy, and 25 eyes of 17 children with normal optic discs. The DM:DD ratio was found to be significantly higher for both groups with optic nerve hypoplasia than for those with optic atrophy and the normal controls. For practical purposes, when the DM:DD ratio Is greater than 3.0, the diagnosis of optic nerve hypoplasia should be seriously considered.
Ocular Trauma Following Amniocentesis as the Cause of Leukocoria
Authors: Admoni M M , BenEzra D
Published: April 2021

ABSTRACT

Among the various causes of leukocoria in a newborn, intrauterine ocular trauma following amniocentesis Is not included. We describe a three-day-old girl whose leukocoria ol the left eye resulted from traction retinal detachment, caused by the perforation of the globe during diagnostic amniocentesis.
Familial Brown's Syndrome
Authors: Moore Anthony T , Walker Jane , Taylor David
Published: April 2021

ABSTRACT

We present findings in two siblings with bilateral Brown's syndrome and review other reported familial cases.
Acquired Brown's Syndrome Caused by Frontal Sinus Osteoma
Authors: Biedner B , Monos T , Frilling F , Mozes M , Yassur Y
Published: April 2021

ABSTRACT

A 32-year-old man had a history of acquired Brown's syndrome associated with diplopia, proptosis, downward displacement of the globe, and lid edema. A CT scan of the orbit revealed an osleoma arising from the left frontal sinus and extending into the left orbit. After surgical extirpation the proptosis and diplopìa disappeared and the globe returned to normal. To our knowledge, such a case has not been reported previously.
Ocular Vicarious Menstruation
Authors: Barat Michael , Kwedar Stephen A
Published: April 2021

ABSTRACT

Vicarious menstruation represents cyclical bleeding in extragenital organs during a normal menstrual cycle. We present an unusual case of ocular vicarious menstruation (bloody tears) in a 17-year-old girl. The indications and treatment of this rare disorder are discussed.
Interdisciplinary Teamwork in a Community SRO
Authors: Bohm Evelyn
Published: April 2021

ABSTRACT

During the past year, much attention has been given by the news media to the new State Department of Mental Hygiene's discharging thousands of chronically ill patients from the mental hospitals, to the "streets" of New York, mostly into the single-room-occupancy hotels. Out of the nearly 1,000 City SROs, only 15-20 are staffed with any kind of program to aid the residents of the hotel.
The Tyranny of Seclusion: A Brief Essay
Authors: Pilette Patricia Chehy
Published: April 2021

ABSTRACT

In the last decade there has been increased interest among mental health providers and the public in safeguarding the civil and legal rights of mentally impaired patients. Legislation currently pending in various states and already passed in others, i.e., California's LanternmanPetris-Short Act of 1974, is attempting to set strict guidelines by which the rights of patients are to be protected. In focusing on the protection of the civil rights of patients many of the traditional aspects of mental health care have come to be challenged on their therapeutic as well as legal validity.

This manuscript places the common practice of seclusion in the role of specimen to the professionals' microscope. As an issue, the seclusion of a "disturbing" patient in an empty room behind locked doors, goes beyond violation of that patient's civil liberties and addresses the human rights of that patient.

This essay critically analyzes the utilitarian rule which governs the use of seclusion as a treatment and attempts to illuminate its faulty rationale. It treats the notions of seclusion as an ethical and moral issue and poses questions designed to focus the practitioner's conscious awareness.

Seclusion, as a viable component of mental health care, has managed to avoid the questioning eye of the mental health practitioner. Consequently, it has received very little literary attention. This essay is an effort to "open up" a needed dialogue among today's professionals on this common, albeit tyrannical, treatment relic of the past. Its purpose is not to posit alternative treatment forms - but to promote examination of the present form.

No one shall be subject to torture or to cruel, inhuman or degrading treatment or punishment.

UNIVERSAL DECLARATION OF HUMAN RIGHTS
Psychiatric Patients' Perceptions of Their Milieu Therapy Program
Authors: Sweeney Linda J
Published: April 2021

ABSTRACT

This study was designed to provide information concerning psychiatric patients' perceptions of their individual treatment program in an inpatient treatment facility with an established therapeutic milieu. The responses of 24 patients aged 16 to 69 years to an 8-item questionnaire, developed and administered by the investigator, constituted the data collected.

The 24 patients identified 57 components as part of their treatment programs. Patients with more education mentioned more treatment components than those with less education. Talking with staff members was considered the most helpful treatment component by the most patients, and medication was the most frequently mentioned least helpful treatment component.

Six categories were used to organize the data: recreation-physical, recreation-mental, verbal interaction, creature comforts, staff supervision, and diagnostic and medical services. More of the identified treatment components were categorized under verbal interaction than any other category. The second most mentioned category was recreation-physical.

As patients listed the most helpful persons during their hospitalization, 36 students and staff members and four other patients were identified. Two psychiatric technicians, a registered nurse, and an occupational therapist were mentioned most often. Patients tended to see persons of their same sex and close to their age as particularly helpful.
Teaching Patients Self Care: A Critical Aspect of Psychiatric Discharge Planning
Authors: Buckwalter Kathleen Coen , Kerfoot Karlene M
Published: April 2021

ABSTRACT

This article addresses techniques that can be incorporated into both inpatient and outpatient programs in psychiatric-mental health nursing to decrease chances of rehospitalization. The authors write from their clinical experience in these settings and from research by the first author that has examined discharge planning techniques and outcome measures.
RAPID GROWTH
Authors: Anonymous
Published: April 2021

SELF HELP GROUPS
FILM PRIZE
Authors: Anonymous
Published: April 2021

LIVING WITH GRACE
COUPLES' CONFLICTS
Authors: Anonymous
Published: April 2021

FAMILY VIOLENCE
NSGAE Nursing Adaptation Evaluation
Authors: Morrison Eileen , Fisher Lucille Y , Wilson Holly Skodol , Underwood Patricia
Published: April 2021

A Proposed Axis VI of DSM-III
BREAKING THE RACE BARRIER: The White Therapist in Interracial Psychotherapy
Authors: Minrath Marilyn
Published: April 2021

White therapists must learn to respond to minority patients' requests for help in coping with unemployment, culture shock, discrimination, and poverty.
Restraining the Elderly
Authors: Strome Therese M
Published: April 2021

The use of physical restraints presents a problem for nursing staff, since there are few established guidelines and existing ones are nonspecific.
THAT WAS THEN: ELDERLY SURVIVORS OF INCEST
Authors: Walter Kathleen
Published: April 2021

Some elderly survivors of incest, possibly for various developmental reasons, experience a resurgence of thoughts, feelings, and fears about the incest.
Assessing Geropsychiatric Patients
Authors: Abraham Ivo L , Smullen Dianne E , Thompson-Heisterman Anita A
Published: April 2021

Although other disciplines involved in the care of geriatric patients with psychiatric or neurobehavioral problems have established assessment procedures, this is not the case for nursing. Some approaches to assessing geropsychiatric patients from a nursing perspective have been proposed (Baldwin, 1987; Burnside, 1981; Ninos, 1985), but they have been limited in scope (Abraham, 1990b). However, with nursing assuming an increasingly central role in the multidisciplinary care of geropsychiatric patients and their families, a comprehensive and accepted method of multidimensional geropsychiatric nursing assessment is necessary.

This method enables nurses to provide the best possible nursing care to patients and families while contributing effectively to multidisciplinary assessment and intervention. To this end, Abraham and associates (Abraham, 1990a; ThompsonHeisterman, 1992) developed the Psychogeriatric Nursing Assessment Protocol (PNAP). Previous articles have described the rationale and content of the PNAP (Abraham, 1990a; Thompson-Heisterman, 1992). This article will draw on the authors' clinical experience in using the PNAP and will offer practical clinical strategies for assessment within the PNAP framework.

The PNAP is presented in the Figure, and readers are referred to previous articles for detailed descriptions of the various aspects of the PNAP. A rating form has been developed for use with the PNAP that permits quantification of clinical observations and the determination of selected clinical scores.
A Portrait of Homelessness
Authors: Wallsten Sharon M
Published: April 2021

The homeless elderly are vulnerable, silent, and fearful. Their trajectory into homelessness more often than not precludes recovery and takes them on a course toward early death or nursing home placement. Psychiatric nurses who work in community or acute care settings are in key positions to recognize elderly victims of homelessness, assess their needs, match them to services, start them on the road to recovery, and become their advocates.

The definition of a homeless person as agreed on in the Report of the Federal Task Force on Homelessness and Severe Mental Illness (1992) is the one used in the Stewart B. McKinney Homeless Assistance Act (Public Law 100-77). A homeless person is someone "who lacks a fixed, regular, and adequate nighttime residence" and whose main nighttime residence is a "supervised public or private shelter designed to provide temporary living accommodations; an institution that provides a temporary residence for individuals intended to be institutionalized; or a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings." This definition, then, excludes those individuals living on the "fringes" in substandard or condemned housing, a condition that warrants attention in general and particularly among the elderly.
Assessing for Sexual Abuse
Authors: Garber Alissa , Grindel Cecelia Gatson , Mitchell David
Published: April 2021

Although many managers agree on the importance of assessment, most facilities do not assess for sexual abuse history on admission.
MANAGED CARE: The Effect of Case Management on State Psychiatric Clients
Authors: Parson Charlynne
Published: April 2021

Abstract

This study examined whether case management services, mandated under the managed care contract for adult clients in a medium-sized state psychiatric hospital in Tennessee between July 1996 and June 1997, were offered as specified, and the impact these services had on recidivism for individuals who were identified as having a severe or persistent mental illness.

Although all of the clients were offered case management, 47% refused the service. Of the 14 who had one or more readmissions, six (43%) had case management. These findings demonstrate that health care providers must offer sufficient information to their clients so that they can use the managed care system more effectively.
Aggressive Behavior of Nursing Home Residents
Authors: Swift Michael B , Williams Robert B , Potter Mertie L
Published: April 2021

Using Group Process to Educate Staff and Manage
Prognosis for Penetrating Keratoplasty in Iridocorneal Endothelial Syndrome
Authors: Chang Patricia C T , Soong H Kaz , Couto Marcia F , Meyer Roger F , Sugar Alan
Published: April 2021

ABSTRACT

BACKGROUND: Iridocorneal endothelial syndrome is characterized by the proliferation and spreading of an abnormal corneal endothelial membrane across the iridocorneal angle and iris surface, resulting in iridocorneal adhesions, glaucoma, pupillary distortion, varying degrees of iris atrophy, and occasionally corneal decomposition with edema. These changes may possibly affect the long-term prognosis of penetrating keratoplasty in an adverse fashion.

METHODS: We reviewed the clinical course of 12 consecutive eyes (12 patients) which underwent penetrating keratoplasty for corneal edema associated with the iridocorneal endothelial syndrome (mean postoperative follow up = 30 months).

RESULTS: The grafts remained clear in 10 patients (83%) and the visual acuity was 20/40 or better in nine patients (75%). The endothelial cell losses averaged 13% at 6 months and 17% at 1 year after surgery. Simultaneous extracapsular cataract extraction and posterior chamber lens implantation at the time of keratoplasty posed no measurable compromise to the overall postoperative prognosis. Causes of poor visual acuity after surgery included glaucoma and graft failure (immune and nonimmune).

CONCLUSIONS: The prognosis of penetrating keratoplasty in the iridocorneal endothelial syndrome appears to be very favorable in the majority of eyes. (Refract Corneal Surg. 1993;9:129-132.)
Influence of Patient Age on Photorefractive Keratectomy for Myopia
Authors: Loewenstein Anat , Lipshitz Isaac , Levanon Daniella , Ben-Sirah Ayala , Lazar Moshe
Published: April 2021

ABSTRACT

BACKGROUND: To determine whether the outcomes of photorefractive keratectomy (PRK) for myopia are age-dependent.

METHODS: The influence of age on PRK outcomes was analyzed for one eye of each of 72 patients divided into two groups: 39 patients (18 to 26 years) and 33 patients (35 to 54 years). The influence of the amount of preoperative myopia (low myopia less than -4.00 diopters (D); moderate to high myopia -4.00 or more D) was also evaluated. All patients were followed for at least 1 year, and all underwent cycloplegic refractions.

RESULTS: One year after PRK, the average refraction was -0.15 D in the younger group and +0.38 D in the older group. The achieved refraction was higher than the attempted by +1.00 D or more only in eyes with moderate to high myopia (-4.00 to -10.00 D); 11.54% (3 eyes) of the younger group and in 34.78% (8 eyes) of the older group.

CONCLUSION: After PRK for myopia, patients between the ages of 35 and 54, with moderate to high myopia, obtained more refractive change with the same intended dioptric correction compared to younger patients with moderate to high myopia. Attempted correction should be adjusted according to age and amount of myopia. [J Refract Surg 1997;13:23-26]
Screening for Psychiatric Distress and Low Self-esteem in Patients Presenting for Excimer Laser Surgery for Myopia
Authors: Kidd Brian , Stark Cameron , McGhee Charles N J
Published: April 2021

ABSTRACT

BACKGROUND: Patients presenting for photorefractive keratectomy (PRK) may have unusual psychological profiles. Certain psychological variables may impact treatment outcome, making early identification crucial. We report a controlled questionnaire study of psychiatric "anxiety/distress'' and self-esteem in myopic patients who presented for excimer laser treatment.

METHODS: Ninety consecutive myopic individuals (patients) who presented for excimer laser PRK and 50 consecutive myopic individuals who presented to an optometrist for contact lens fitting (controls) were assessed using two self-completion questionnaires-the GHQ30 and Hudson Index of Self-Esteem ISE. The questionnaires were distributed during assessment for treatment.

RESULTS: PRK patients had a 90% response rate for both questionnaires and control patients, 98% for GHQ30 and 100% for Hudson ISE. PRK patients were significantly older (p=0.000003), had a greater myopic spherical equivalent refraction (p=0.012) and had better spectacle-corrected visual acuity (p=0.0096). No significant differences were demonstrated with regard to anxiety/distress in terms of absolute scores (p=0.07), or the proportion of patients being positive or negative (p=0.10). Similarly, self-esteem was not significantly different between the two groups (absolute scores p=0.69; positive/negative p=0.29). The high response rate shows that the GHQ30 and Hudson ISE are easy to use and well tolerated by myopes in a busy clinic setting. The fact that the patients were older, with a greater refractive error, may partly reflect the onset of contact lens intolerance.

CONCLUSION: The psychological findings suggest that PRK patients cannot be considered more distressed or anxious than other myopic individuals. There is no evidence that their decision to undergo surgery is driven by abnormally low selfesteem. [J Refract Surg 1997;13:40-44]
Ultrastructural and Immunohistochemical Findings after Linear Excimer Laser Keratectomy
Authors: Winter Martin , Behrendt Stephan , Binder Perry S , Duncker Gernot I W
Published: April 2021

ABSTRACT

BACKGROUND: One human pathology specimen has been studied previously following the use of the excimer laser for the correction of astigmatism. We report histopathologic findings following linear corneal excisions with the excimer laser.

METHODS: A 193nm excimer laser was used to create symmetrical, transverse excisions in a human eye to correct astigmatism. Three months later, a full-thickness corneal transplant was performed due to unsatisfactory refractive results. The excised corneal button was examined with light microscopy, transmission electron microscopy and immunohistochemistry.

RESULTS: An area 10 to 20-µm wide was observed between the epithelial cells within the keratectomy and the sharply dissected stromal lamellae. This area stained positive for laminin and pro-collagen type III. Some epithelial cells showed processes reaching into this area. Descemet's membrane, immediately underneath the area of the keratectomy, contained atypically striated collagen fibers.

CONCLUSIONS: These findings demonstrate wound healing changes similar to those reported following diamond knife keratotomy and photorefractive keratectomy for myopia. The changes in the posterior cornea are similar to those previously reported when an excimer laser beam approached Descemet's membrane. [J Refract Surg 1997;13:60-68]
Clinical Effect of Blowing Nitrogen Gas across the Cornea during Photorefractive Keratectomy
Authors: Itoi Motozumi , Ryan Robert , Depaolis Michael , Aquavella James V
Published: April 2021

ABSTRACT

OBJECTIVE: We evaluated the clinical effects of blowing nitrogen gas over the cornea during photorefractive keratectomy.

METHODS: We retrospectively compared clinical outcomes of 32 patients (37 eyes), divided into two groups who had photorefractive keratectomy with nitrogen gas blowing across the cornea (n=19) and without nitrogen gas (n=18). All photorefractive keratectomies were performed between April 1991 and August 1992. Ablation zone diameters were 5.0 or 5.5 mm. The average attempted correction was -3.47 ± 1.76 diopters (D) in the nitrogen gas group, and -3.48 ± 1.25 D in the non-nitrogen gas group.

RESULTS: The nitrogen gas group achieved more accurate corrections than the non-nitrogen gas group, but had a significantly greater amount of corneal haze at all postoperative examinations. Corneal haze was most evident at 1 month and gradually diminished thereafter in both groups. At 6 months, videokeratography revealed a central island in 2 eyes (11.1%) of the non-nitrogen gas group. Because of undercorrection (2 eyes) or central island (1 eye), 3 out of 18 eyes in the non-nitrogen gas group were reablated 6 months later.

CONCLUSIONS: The non-nitrogen gas group had more undercorrections and a higher frequency rate of central steep islands, but nitrogen gas blowing caused a greater amount of corneal haze. [J Refract Surg 1997;13:69-731
Patient Satisfaction after 5.0-mm Photorefractive Keratectomy for Myopia
Authors: Ben-Sira Ayala , Loewenstein Anat , Lipshitz Isaac , Levanon Daniela , Lazar Moshe
Published: April 2021

ABSTRACT

PURPOSE: To examine patient satisfaction following photorefractive keratectomy (PRK) in a large number of subjects.

METHODS: We used a questionnaire to examine overall patient satisfaction in 173 patients (173 first-operated eyes) at least 1 year after they had undergone PRK. Mean preoperative spherical equivalent refraction was -7.05 ± 3.73 D (range, -1.50 to -15.00 D). Fifty-one patients had unilateral surgery and 122 had bilateral surgery, 60 of whom had follow-up of 1 year for both eyes. Visual and refractive results, the use of corrective lenses, and subjective side effects were also studied.

RESULTS: Eighty percent of 173 patients reported they were satisfied or very satisfied with the surgical outcome, while 19.7% reported they were dissatisfied. The average satisfaction score was 7.92 ± 2.22 out of a possible 10. After PRK, 77.5% reported improvement or great improvement in their general quality of life; 16.8% were very disturbed by subjective visual symptoms. Of the 51 bilateral patients, 85% required no corrective lenses after surgery. Patients who had bilateral operations were more satisfied than those who had unilateral ones. Statistically significant associations were found between patient satisfaction and initial refraction: as preoperative refraction increased, percentage of satisfied or very satisfied patients decreased.

CONCLUSION: Patient satisfaction after PRK was generally high, but subjective visual symptoms remain a problem. [J Refract Surg 1997; 13:129-134.]