bluuebunny/crossref_metadata_2025_split huggingface dataset:
ROLE CONFLICTS & COPING STRATEGIES IN Caregiving: A Symbolic Interactionist View
Authors: Clarke Egerton 
Published: April 2021

ABSTRACT
Institutional health care delivery is characterized by interdependency among caregivers and between caregivers and care receivers, which leads to role conflicts. This article examines role conflicts and coping strategies of health care aides who are faced with differing expectations of RNs and residents. Guided by a symbolic interactionist perspective, ethnographic data from 12 RNs, 15 health care aides, and 32 nursing home residents of Italian-Catholic and AngloSaxon descent in Toronto, Ontario, Canada, was gathered. Results showed that health care aides differed in how they handled role conflict and their elderly clients' concerns. Health care aides were more likely to reject conflicting role expectations from residents than from RNs.
Before the Experts Arrive
Authors: Chandley Mark 
Published: April 2021

Best Practice Considerations for Early-Stage Hostage Negotiation
ABSTRACT
This article addresses the rare event of the hostage situation in a forensic psychiatric nursing setting. It has a specific focus on the initial response and the accompanying issues for nurses at the clinical interface as the situation emerges. The intention of this article is to both offer guidance and raise the profile of this unique management issue because little attention is drawn to early-stage hostage situations at an organizational level.
When a hostage situation occurs, inadequate preparation can mean the difference between life and death for the hostage, negotiator, or hostage taker. This article provides an overview of the relevant literature and offers guidance about the actions required when a nurse suddenly becomes responsible for managing the early stages of such a traumatic event. Responses, safety, and communication factors concerning the hostage taker are covered.
Social Isolation & Sexual Abuse Among Women Who Smoke Crack
Authors: Young Amy M , Boyd Carol , Hubbell Amy 
Published: April 2021

ABSTRACT
The purpose of this study was to explore the prevalence of social isolation and its relationship to sexual trauma in a sample of Black women who smoke crack cocaine. Using a convenience sample of 115 Black women with a history of smoking crack cocaine, participants were interviewed for 2 to 4 hours and asked a variety of questions about their health, relationships, sexuality, and drug use. Bivariate and multivariate logistical regressions were used to predict whether the women reported being socially isolated.
While social isolation was not necessarily a common experience among the sample, it was found that women who had been sexually abused were three times more likely to report being socially isolated than women who had not been sexually abused. In addition, social isolation was more common among women who had been abused by a family member, who had been abused when they were young, and who had been abused for a long period of time. However, multivariate analyses revealed that the age at which the sexual trauma occurred was the most salient predictor of social isolation in adulthood. Implications for drug treatment are discussed.
Revisiting the Identity Issue in Anorexia
Authors: Finelli Lois A 
Published: April 2021

ABSTRACT
Anorexia nervosa is considered an enigmatic disease with a multitude of predisposing factors and no empirically confirmed effective treatment. However, all people with the disease relentlessly pursue a common idealized goal - the state of severe emaciation. In this article, the perspective that this condition epitomizes a lifetime struggle for self-acceptance and self-definition is reexamined. People afflicted with anorexia come to define themselves through their emaciated form, and maintenance of this form becomes their major focus and primary means of fulfillment. Therapy must address the identity issue, which is fundamental to the onset and perpetuation of the disease. Use of interpersonal techniques is advocated as most appropriate in serving this purpose.
Accuracy in Communication: A Contextual Approach to Child Behavior Assessment
Authors: Olson James N , Mohr Wanda K 
Published: April 2021

ABSTRACTThis article analyzes the problem of accuracy of communication in clinical settings and argues that clinical language is replete with theoretical constructs that may not have shared meaning among speakers and listeners in mental health settings. It is suggested that mental health providers be trained in a contextually based data language. The value of such a data language employed in behavioral assessment is emphasized. The authors contend that events and behavior are products of the contextual environment; contextual variables are more accurately identified and agreed on; and the use of contextual variables in treatment intervention increases consequential validity. A developmental ecological approach, coupled with applied behavior analysis, are discussed and offered as a foundation on which clinical interventions should be planned and assessed. Using objective methods that yield demonstrable and meaningful outcomes can help improve children's mental health service delivery and the lives of children.
Clinical Experience of Two-Step Photorefractive Keratectomy in 19 Eyes With High Myopia
Authors: Kim Jae Ho , Hahn Tae Won , Lee Young Chun , Sah Woo Jin 
Published: April 2021

ABSTRACT
The maximum myopic correction with one-step ablation in excimer laser photorefractive keratectomy (PRK) using the ExciMed UV200 LA 193nanometer excimer laser (Summit Technology, Ine, Waltham, Mass,) Is only up to 6.00 D because of a fixed computer program.
We performed a simultaneous two-step PRK procedure for nearly full correction on 19 eyes of 19 patients with myopia ranging from -8.00 to - 1 3.50 D. We clinically evaluated the results of this modified technique at 6 months, or more, after surgery.
In the two-step PRK procedure, we attempted in the first-step of a maximum correction of -6.00 D (including up to - 7.50 D) with 4.5-millimeter ablation zone. The second step was performed immediately thereafter to correct the remaining myopia with a 5.0 -millimeter diameter ablation.
Mean preoperative manifest refraction was -9.77, D and mean postoperative manifest refraction was - 1 .09 D at 6 months after two-step PRK. Uncorrected visual acuity of 20/40 or better was achieved in 74% of 19 eyes (two were amblyopic eyes).
Corneal subepithelial haze was trace or + 1 in all cases at 3 months, but faded out after 3 months. Transient intraocular pressure elevation occurred in one case. No other significant complications developed. Long-term follow up will be required to evaluate the results of two-step PRK. (Refract Corneal Surg (suppl.) 1993;9:S44-S47.)
Treatment of Halos after Photorefractive Keratectomy
Authors: Lafond Gilles 
Published: April 2021

ABSTRACT
BACKGROUND: Some patients, despite a good visual outcome after photorefractive keratectomy (PRK), have severe problems with halos.
METHODS: Ten eyes with a near-piano refraction after PRK were treated again with PRK to reduce halos. The goal of the second surgery was to enlarge the diameter of the treatment zones without changing the refraction obtained by the first surgery. The treatment zone was enlarged from 5 or 6 mm to 7 mm. In eyes in which a multizone technique was used in the first PRK, the amount of correction was increased in the transition zone. However, the refractive power in the central 4 or 5-mm zone was not altered. This result was obtained by calculating the amount of desired increased correction on a large zone (6 or 7 mm) and then for the same amount on a smaller zone (4 or 5 mm). The latter, which would produce changes of curvature in the central zone, is subtracted from the overall treatment. Only the part of the treatment where the laser beam increased from 4 or 5 mm to 6 or 7 mm was delivered to the eye. In this process, only the peripheral zones were modified. The central 4 or 5 mm zone was deepened but its curvature and the refraction remained the same.
RESULTS: A decrease of symptoms was noticed by seven of the ten patients. In all eyes, the refraction obtained by the initial surgery was not significantly changed by the second surgery. The best results were obtained in milder myopic patients who had their first surgery with a small diameter ablation zone.
CONCLUSION: Halos can be reduced by repeating the PRK and by increasing the treatment zone without changing the refraction obtained by the first PRK. [J Refract Surg 1997;13:83-88]
Corneal Ablation Profilometry and Steep Central Islands
Authors: Shimmick John K , Telfair William B , Munnerlyn Charles R , Bartlett Jimmy D , Trokel Stephen L 
Published: April 2021

ABSTRACT
BACKGROUND: Photorefractive keratectomy with large diameter ablations using a uniform laser beam has produced central undercorrections, or "steep central islands" in patients, as seen with videokeratography.
METHODS: Using a custom optical profilometer to measure corneal ablation profiles and a VISX excimer laser system, we measured the effect of ablation algorithms, diameter, depth, and dioptric correction on enucleated porcine eyes and living rabbit eyes. Our profilometer was verified using a 43.00 diopter (D) spherical surface and a 35.00 and 43.00 D bicurve test surface as a model for the ablated cornea.
RESULTS: The profilometer measured the test surfaces to within 3 µm of predicted values. Photorefractive keratectomies showed over-ablation peripherally and under-ablation centrally which increased with ablation diameter and dioptric correction. Fixed diameter ablations 2 to 6 mm in diameter and 10 to 80 µm deep showed stromal ablation rates vary spatially but not with ablation depth. These spatially variant ablation profiles were used to re-engineer the ablation algorithm and to produce photorefractive keratectomies with improved sphericity.
CONCLUSIONS: Steep central islands are caused by the spatial variance of tissue ablated with a uniform laser beam irradiance. This aberration can be corrected by modifying the laser ablation algorithm to correct for the spatial variance of stromal ablation. [J Refract Surg 1997;13:235-245]
Laser in situ Keratomileusis for Low Myopia and Astigmatism with a Scanning Spot Excimer Laser
Authors: Zaldivar Roberto , Davidorf Jonathan M , Shultz Mitchell C , Oscherow Susana 
Published: April 2021

ABSTRACT
PURPOSE: To determine the efficacy, predictability, safety, and short term stability of laser in situ keratomileusis (LASIK) in treating patients with low myopia and astigmatism using the Chiron Technolas Keracor 117 PlanoScan excimer laser.
METHODS: We retrospectively studied the results of our initial 83 eyes with myopia ranging from -1.13 to -7.25 diopters (D) and astigmatism of no more than 4.00 D that underwent LASIK with the Chiron Technolas Keracor 117 PlanoScan. Follow-up was at 1 day, 1 month, and 3 to 6 months.
RESULTS: Mean baseline spherical equivalent refraction was -3.54 ± 1.41 D and cylinder -1.64 ± 1.14 D. Mean postoperative spherical equivalent refraction was -0.52 ± 0.50 D at 1 month and -0.65 ± 0.62 D at 3 to 6 months; mean postoperative refractive cylinder was -0.45 ± 0.54 D at 1 month and -0.50 ± 0.63 D at 3 to 6 months. Fifty-three percent (44 eyes) achieved a spherical equivalent refraction within ± 0.50 D and 81% (67 eyes) within ± 1.00 D of emmetropia at the last examination. Fifty-seven percent (47 eyes) achieved a refractive cylinder of =s0.50 D, and 27% (22 eyes) had an undercorrection of their refractive cylinder at the last examination. An uncorrected visual acuity of 20/40 or better was achieved in 86% (71 eyes) of patients on postoperative day one, in 81% (67 eyes) at 1 month, and in 76% (63 eyes) at 3 to 6 months. Twenty-eight percent (23 eyes) saw 20/20 or better uncorrected at the last visit (41% [34 eyes] had a baseline spectaclecorrected visual acuity of 20/20). There was no statistically significant difference in the refractions or uncorrected visual acuities between the different postoperative examinations. No eye experienced a loss of spectacle-corrected visual acuity of more than one line at the last examination.
CONCLUSION: LASIK with the Chiron PlanoScan excimer laser appears to be an effective, safe, and reasonably predictable means to reduce low myopia and astigmatism. Adjustment of computer algorithms is needed to decrease the number of undercorrections. [J Refract Surg 1997;13:614-619]
Photodisruption in the Human Cornea as a Function of Laser Pulse Width
Authors: Kurtz Ron M , Liu Xinbing , Elner Victor M , Squier Jeffrey A , Du Detao , Mourou Gerard A 
Published: April 2021

ABSTRACT
BACKGROUND: We investigated the role of laser pulse width in determining fluence thresholds and efficiency for corneal photodisruption.
METHODS: A laser system that delivers a wide range of pulse energies and pulse widths was used to produce ablations at pulse widths from 100 femtoseconds (fs) to 7 nanoseconds (ns). The laserinduced breakdown fluence threshold at each pulse width was determined by monitoring individual plasma emissions. Using multiple shots, the photodisruption threshold and cutting depth at each pulse width were determined histologically.
RESULTS: Corneal breakdown thresholds decreased at a faster rate from 7 ns to approximately 10 picoseconds (ps), compared to further reductions in pulse width below 10 ps, where little variation was seen. Breakdown for pulse widths below 10 ps showed little intershot variability, resulting in highly reproducible fluence thresholds. Corneal tissue examined histologically showed similar fluence dependency.
CONCLUSIONS: Corneal tissue photodisruption thresholds demonstrate pulse width dependence. At pulse widths less than 10 ps and with fluences near the breakdown threshold, ablations are maximally precise and efficient. These findings suggest optimal laser parameters for corneal surgery. [J Refract Surg 1997;13:653-6581
Conoidal Fitting of Corneal Topography Height Data After Excimer Laser Penetrating Keratoplasty
Authors: Langenbucher Achim , Viestenz Anja , Seitz Berthold 
Published: April 2021

ABSTRACT
PURPOSE: To demonstrate a mathematical method for approximation of discrete corneal topography height data with a biconic model surface for better appreciation of the optical performance of the graft after penetrating keratoplasty.
METHODS: In this retrospective study we included 50 eyes of 50 patients (30 keratoconus; 20 Fuchs' dystrophy) undergoing nonmechanical excimer laser penetrating keratoplasty. Conventional keratometry, corneal topography (TMS-I), subjective refraction, and best spectacle-corrected visual acuity (BSCVA) were assessed preoperativeIy, 3 and 6 months postoperatively, and before/after suture removal. A biconic model surface was fitted to the topographic raw data (8.0-mm region of interest) minimizing the root mean square error and a set of parameters (meridional power, axis, conic constant, and approximation error) was determined. The refractive cylinder was correlated with keratometric power readings, the Simulated Keratometry (SimK) of the topography system, and the respective parameters of the model surface.
RESULTS: Keratometric/SimK astigmatism increased from preoperatively (3.40/4.30 D) to 3 months (4.30/4.80 D) and decreased to 3.40/3.90 D after suture removal. Refractive cylinder/cylinder of the biconic increased slightly from 2.10/2.60 D preoperatively to 3.20/3.30 D after suture removal. The topographic cylinder SimK yielded the highest and the refractive cylinder the lowest values at each follow-up examination. Central keratometric power readings were stable before suture removal and decreased (about 1 D) due to suture removal. The conic constants in both meridional cross-sections changed from a prolate to a spherical shape in the early time course after penetrating keratoplasty and reconverted to a prolate shape after suture removal. Regarding cylinder axis, there was a significant correlation of the model surface with the refractive cylinder at all examinations (P<05) but only a mild correlation of the keratometric and SimK cylinder axis to the refractive cylinder axis at some examination stages.
CONCLUSION: Approximation of corneal topography height data with a biconic model surface renders reconstruction of clinically relevant corneal topography parameters including corneal asphericity with marked data compression. The correlation of amount/axis of refractive cylinder was best represented with the model surface parameters. [J Refract Surg 2002;18:63-71]
Immediate Transepithelial Photorefractive Keratectomy for Treatment of Laser in situ Keratomileusis Flap Complications
Authors: Jain Vivek K , Abell Thomas G , Bond William I , Stevens Garth 
Published: April 2021

ABSTRACT
PURPOSE: To study the role of photorefractive keratectomy (PRK) in the management of laser in situ keratomileusis (LASIK) flap complications.
METHODS: A retrospective analysis was performed of seven patients (14 eyes) who had bilateral, simultaneous LASIK (single surgeon [TGA], Summit Apex Plus laser, Hansatome microkeratome in six patients [12 eyes], Automated Corneal Shaper keratome in one patient [two eyes]). One eye of each patient received PRK for a flap complication. The seven patients (four women, three men) had a mean age of 39.2 years (range, 22 to 64 yr). The uncomplicated LASEK eyes had moderate to high myopia (-2.25 to -8.75 D) and the eyes with LASIK flap complications had mild to moderate myopia (-1.50 to -5.75 D). Immediate transepithelial PRK was performed in all eyes after repositioning the defective flap.
RESULTS: All seven patients had excellent visual outcome at ? months follow-up; one patient required an enhancement (astigmatic keratotomy). Six of the seven LASEK eyes had best spectaclecorrected visual acuity of 20/20 or better and one LASEK eye had 20/25. In the transepithelial PRK eyes, six of the seven eyes had best spectaclecorrected visual acuity of 20/20 or better and one eye had 20/30.
CONCLUSIONS: Immediate transepithelial PRK treatment of irregular and incomplete LASDK flaps at the time of surgery is an excellent therapeutic option to delayed surgical treatment. [J Refract Surg 2002;18:109-112]
Concomitant Effect of Topical Ubiquinone Q10 and Vitamin E to Prevent Keratocyte Apoptosis After Excimer Laser Photoablation in Rabbits
Authors: Brancato Rosario , Fiore Tito , Papucci Laura , Schiavone Nicola , Formigli Lucia , Orlandini Sandra Zecchi , Gobbi Pier Giorgio , Carones Francesco , Donnini Martino , Lapucci Andrea , Capaccioli Sergio 
Published: April 2021

ABSTRACT
PURPOSE: To investigate in vivo whether ubiquinone QlO together with vitamin E protects rabbit corneas from keratocyte apoptosis after excimer laser irradiation.
METHODS: Photorefractive keratectomy (PRK) was performed in both eyes of three New Zealand white rabbits. During 3 days before surgery, each right eye received four-times-daily instillation of an eye-drop solution containing ubiquinone QlO 0.20% and vitamin E 0.04%; each left eye was treated with a solution that did not contain ubiquinone or vitamin E. The central cornea was analyzed after surgery using the in situ end labelling (ISEL) technique of nicked DNA to detect DNA fragmentation. To determine the number of ISEL positive nuclei, an average of 70 random microscopic fields (five for each de-epithelialized tissue section) of 138,000 ?2 were examined in the right and left cornea samples at 250X by two different observers.
RESULTS: Light microscopic examination of the sections from corneas treated before PRK showed that cells committed to apoptosis by PRK were about 50% compared to those of untreated controls.
CONCLUSION: Treatment of rabbit eyes before PRK with ubiquinone QlO lowered the number of apoptotic events. [J Refract Surg 2002;18:135-139]
Pain Reduction After Laser in situ Keratomileusis With Ketorolac Tromethamine Ophthalmic Solution 0.5%: A Randomized, Double-masked, Placebo-controlled Trial
Authors: Price Francis W , Price Marianne O , Zeh William , Dobbins Kendall 
Published: April 2021

ABSTRACT
PURPOSE: To evaluate the analgesic efficacy of ketorolac tromethamine ophthalmic solution 0.5% after laser in situ keratomileusis (LASIK).
METHODS: In this two-center, randomized, double-masked, placebo-controlled, parallel group study, 39 patients underwent bilateral simultaneous LASIK. Patients received study drops (Acular PF or Lens Plus) in both eyes 15 to 30 minutes before surgery, again immediately before passing of the microkeratome, and again after flap repositioning. Proparacaine was used during surgery, but no additional therapeutics were used for the next 24 hours, except acetaminophen or propoxyphene napsylate acetaminophen allowed as escape medication. Patients rated their eye pain hourly through 6 hours after surgery.
RESULTS: Ketorolac significantly reduced eye pain at every time point compared to placebo (P-cOl). Escape medication use declined significantly; 16% (3/19) of those who received ketorolac required escape medication compared to 50% (8/16) of placebo-treated patients (P=.03). Ketorolactreated eyes were pain-free significantly sooner (P-cOl), with 47% (18/38) having pain cessation by hour 4, compared to 15% (5/33) of placebotreated eyes. No treatment-related adverse events occurred.
CONCLUSION: This study supports the use of topical ketorolac for control of early postoperative pain following LASIK, significantly increasing patient comfort and reducing usage of other pain medications. [J Refract Surg 2002;18:140-144]
Aberration-sensing and Wavefront-guided Laser in situ Keratomileusis: Management of Decentered Ablation
Authors: Mrochen Michael , Krueger Ronald R , Bueeler Michael , Seiler Theo 
Published: April 2021

ABSTRACT
PURPOSE: To clarify the feasibility of aberration-sensing and wavefront-guided laser in situ keratomileusis (LASIK) to manage grossly decentered ablation and to discuss the limitations of the technology.
METHODS: Three patients with previous decentrations of the ablation zone between 1.5 to 2.0 mm were scheduled for wavefront-guided LASIK. AU patients reported monocular diplopia and halos. Wavefront aberrations were measured with a Tscherning-type aberrometer. Laser ablation was done with a WaveLight Allegretto in a one-step procedure with ablation profiles calculated only from the individual wavefront map. Decentrations were determined from corneal topography.
RESULTS: Three months after surgery, patient WM and patient SU had gained uncorrected and best spectacle-corrected visual acuity. The root mean square-wavefront error decreased up to 61% and 33%, respectively, for total and higher order aberrations (Zernike modes of 3rd order and higher). There was significant enlargement of the optical zone determined by corneal topography, and both patients no longer reported diplopia and halos at 3 months postoperatively. The optical aberration of the third patient (RE), after a 5.00-D overcorrection with a 2-mm decentratici!, was too high for aberration-sensing; retinal images obtained from the wavefront device were too smeared and not of sufficient contrast. In addition, this patient had a residual corneal thickness of 416 µm and thus wavefront-guided LASEK was not done.
CONCLUSIONS: Wavefront-guided LASIK offers a new way of managing grossly decentered laser ablations. Unfortunately, there are still patients who have aberrations too large for wavefront sensing or with other clinical limitations such as a residual corneal thickness too thin for further treatment. [J Refract Surg 2002;18:418-429]