PURPOSE: To assess the effect of four contemporary cataract surgery incisions on the number of postoperative visits required. SETTING: Cataract service of a large free-standing eye hospital in a capital city. METHODS: This study comprised a prospective evaluation of three incisions for phacoemulsification and a retrospective assessment of age- and sex-matched patients having conventional corneal section extracapsular cataract extraction. All patients had age-related cataract. Main outcome measures were complications, best corrected and uncorrected visual acuities 6 weeks after surgery, and number of visits before discharge. Follow-up was at least 6 months. RESULTS: Patients who had small and scleral incisions had better uncorrected visual acuities 6 weeks postoperatively because they had less astigmatism. Patients who had small and scleral incisions required significantly fewer postoperative visits before discharge. CONCLUSION: A prospective assessment of the feasibility and acceptability of reduced postoperative follow-up after phacoemulsification using a scleral tunnel is required.

Astigmatism↗

PubMedDate not supplied

Plasma membrane NADH oxidase is gravi-responsive.

NADH oxidase activities measured with intact tissue sections and with isolated plasma membrane vesicles from etiolated hypocotyls of soybean (Glycine max) respond to gravity and imposed centrifugal forces. The response is one of inhibition of activity with tissue sections lying flat for 20 min or less at 1 x g and one of stimulation with times of lying flat of 30 min or longer at 1 x g. Turning the tissue sections upside down resulted in stimulation of the activity with a lag of about 30 min. Returning the sections to the normal upright position resulted in a return to initial rates with a lag of less than 20 min. Both the stimulated and non-stimulated activities oscillate with a period of 24 min, precluding a more precise analyses of lag times. The activity was stimulated reversibly to a maximum of about 2-fold both in tissue sections and in isolated plasma membrane vesicles when subjected to centrifugal forces of 10 to 400 x g for 0.5 to 4 min duration. The findings are the first description of a gravi-responsive enzymatic activity related to the growth response in plants.

Cell Membrane↗

PubMedDate not supplied

A cross-cultural tool to identify continuing education needs.

Cost-controlled health reforms have created the need for training nurses to provide evidence-based care in new contexts. Planing for nurses' continuing education must thus target the appropriate personnel and simultaneously consider local healthcare needs and training requirements. To plan such educational programmes, a training needs analysis instrument was developed in the UK and used to compare the training needs of nurses in Australia, the USA and the UK. Below, the findings of this survey.

Australia↗

PubMedDate not supplied

Predicting violence: nursing diagnosis versus psychiatric diagnosis.

Predicting violent behavior is a major concern for nurses as well as other mental health professionals. Two diagnostic assessment systems (Nursing Diagnosis-NANDA and Psychiatric Diagnosis-DSM III-R) were compared in their ability to predict assaultive behavior. The nursing diagnosis potential for violence suggested a difference (p = .07) between the assaultive and control subjects. No differences were found between assaultive and control subjects on psychiatric diagnoses. Nursing diagnosis is based upon measurable behaviors and is time specific. Clinical implications and further research endeavors in this area are suggested.

Case-Control Studies↗

PubMedDate not supplied

Homocysteine thiolactone disposal by human arterial endothelial cells and serum in vitro.

Previous work with cultured mammalian cells and perfused laboratory animals suggested to us that hydrolysis of homocysteine thiolactone was catalyzed in these systems. We confirmed this finding by measuring the sulfhydryl-releasing activity of cultured endothelial cells from human umbilical arteries in homocysteine thiolactone solution, pH 7.4, 37 degrees C. The reaction was vigorous and stereospecific and showed saturation kinetics (Km values for L- and D,L-homocysteine thiolactone were 3.9 and 8.2 mmol/l, respectively, and Vmax values were 10.75 and 10.1 mumol/min/10(9) cells, respectively). L-Homocysteine thiolactone was quantitatively converted to homocysteine, as measured by amino acid analysis. Human serum also accelerated the elimination of homocysteine thiolactone, although in this process, the majority of the newly formed sulfhydryl-containing product was precipitable by sulfosalicylic acid, indicating likely homocysteinylation of serum proteins. However, approximately 38% of the sulfhydryl-containing product was not precipitated, and because thiolactone elimination stereospecifically favored the L-enantiomer, a possible subsidiary role for serum-catalyzed hydrolysis of the thiolactone was suggested. No homocysteine thiolactone could be found in serum samples from six patients with acute myocardial infarction, three patients with cystathionine beta-synthase deficiency, and six normal subjects. Thus, humans have active vascular systems for elimination of homocysteine thiolactone, a process that could be responsible for an absence of the compound in serum.

Benzenesulfonates↗

PubMedDate not supplied

The dilemma of incorporating research into clinical practice.

Despite pressure to move towards evidence-based practice within the health service, a considerable proportion of nursing intervention continues to be founded on time-honoured tradition and historical precedent. Most explanations for this research/practice hiatus have focused on organizational problems such as the lack of appropriate skills training, inadequate time and limited resources. This article suggests that the problem may also relate to psychological resistance from nurses, especially at the level of professional stereotyping, a lack of confidence and entrenched gender stereotypes, all of which predispose nurses to maintaining the traditional basis of clinical practice. If nursing is to become a more scientific, clinical service then an open-minded and flexible approach which takes account of the relevant psychological factors is required.

Attitude of Health Personnel↗

PubMedDate not supplied

Nursing staff characteristics related to patient assault.

There is an underlying belief that there is something special about the victims of patient assault, that they possess certain characteristics or behave in a different way from those staff who are not assaulted. Is this a case of blaming the victims, or are there some actual differences between those staff members who are assaulted and those who are not? This study undertook this question. Its specific purpose was to (1) characterize staff victims and compare them to nonassaulted staff and (2) document outcomes on staff who were assaulted. The design included a prospective and retrospective phase. Nursing staff on two acute and four long-term psychiatric units were asked sociodemographic and job-related information at the beginning of the study. The frequency with which each staff member was assaulted was recorded. At the end of 1 year, staff who had been assaulted were compared with staff who had not been assaulted. Any staff members who were assaulated were interviewed to assess the physical and emotional effect of the assault on the victim. Findings indicated no difference between assaulted versus nonassaulted staff on sociodemographic factors, with the exception of marital status. Assessment of job-related factors suggested differences on position in the administrative hierarchy, type of activities involved in direct patient care such as medication administration, and education about handling the aggressive patient. Victim outcomes supported the existing literature. The most frequent site of injury was the head. Staff either did not take leave time or returned to work before they recovered, and many reported emotional stress.

Hospitals, Psychiatric↗