Two-year results after combined phacoemulsification and iris-fixated phakic intraocular lens removal

Graefe's Archive for Clinical and Experimental Ophthalmology - To describe and present results after a technique for cataract surgery combined with explantation of an iris-fixated phakic...     

Neighborhood: A Conceptual Analysis

Researchers interested in measuring neighborhood‐level effects should understand how “neighborhood” is defined within nursing sciences and other sciences, and the inherent strengths and weaknesses of current research methodologies. This concept analysis provides clarity around the concept of neighborhood within the context of health, analyzes the current state of development of the neighborhood concept, and proposes areas for future nursing research. Using the Rodger's Method of analysis, the concept of neighborhood within nursing and public health research is described based on existing literature. The concept's attributes, related concepts, antecedents, and consequences are given from the literature. Comparisons of the use of neighborhood are made between nursing, public health, sociology, and other sciences. The evolution of the concept of neighborhood throughout history is described, and important implications for future research are discussed.     

Therapy by written communication

A case of marital and sexual therapy using behavioural techniques was concluded using written communication. It was a successful and cost-effective intervention.     

Managing depression in patients with vision impairment: A descriptive study of practitioners' beliefs and confidence

Aim: Depression is common in older adults with vision impairment yet it often remains unidentified and untreated. Eye health professionals (EHPs) and rehabilitation workers (RWs) may be able to assist in detecting depression. This study identified EHPs' and RWs' beliefs about depression and confidence in working with patients with vision impairment and depression. Methods: A self‐administered cross‐sectional survey of 94 EHPs and RWs assessed beliefs about the symptoms and treatment for depression, and confidence in working with depressed people with vision impairment. Results: Participants showed awareness of both the symptoms and treatment options for depression. However, some important misconceptions were identified and many symptoms of depression were commonly attributed to vision loss. Participants lacked confidence in communicating about depression with patients and their families. Conclusions: Training programs are needed to enable EHPs and RWs to confidently identify depression and discuss appropriate treatment and referral options with their patients.     

Comparison of biodegradable and newer generation durable polymer drug-eluting stents with short-term dual antiplatelet therapy: a systematic review and Bayesian network meta-analysis of randomized trials comprising of 43,875 patients

Journal of Thrombosis and Thrombolysis - Newer generation durable polymer drug-eluting stents (DP-DES) and biodegradable polymer DES (BP-DES) have similar efficacy with dual-antiplatelet therapy...     

Attitudes towards the care of elderly people: are they getting better?

This paper reports findings of research assessing the attitudes of both learner and trained nurses towards the elderly. At the time of the study, all subjects were employed on wards within the care of the elderly unit of a large district general hospital. Assessment of stress perceived on these wards was also made to determine its effect on learner nurses' attitudes towards the elderly. Attitudes of the learner nurses towards the elderly became slightly more negative over their training module. Stress perceptions only correlated with this change to a small extent. Trained staff were also found to be quite neutral in their beliefs about the elderly. The study pointed to the great need for further research into this area so as to prepare the health care services to meet the increasing needs of elderly people. Several implications of the research and more practical considerations are discussed.     

Evaluation and development of integrated teams: the use of Significant Event Analysis

Significant Event Analysis (SEA) is a practical, problem-solving technique that can help teams learn from their experiences and generate practical solutions to complex issues. It has mainly been conducted in Primary Health Care Teams (PHCTs) with the use of an external facilitator. Although SEA is envisioned to address issues of integration and complement routine audit, there is limited evidence that this has been achieved. This paper reports on a 1 day workshop during which team members were trained to use SEA to address issues of service integration. This paper presents an evaluation of the workshop in order to determine if SEA is a feasible tool to support and encourage team self-evaluation without external facilitation. The main barriers to SEA are discussed as well as the need for longitudinal research to assess the impact of SEA on integration of the team and wider service.     

O2 sensing in the human ductus arteriosus: regulation of voltage-gated K+ channels in smooth muscle cells by a mitochondrial redox sensor

Functional closure of the human ductus arteriosus (DA) is initiated within minutes of birth by O2 constriction. It occurs by an incompletely understood mechanism that is intrinsic to the DA smooth muscle cell (DASMC). We hypothesized that O2 alters the function of an O2 sensor (the mitochondrial electron transport chain, ETC) thereby increasing production of a diffusible redox-mediator (H2O2), thus triggering an effector mechanism (inhibition of DASMC voltage-gated K+ channels, Kv). O2 constriction was evaluated in 26 human DAs (12 female, aged 9+/-2 days) studied in their normal hypoxic state or after normoxic tissue culture. In fresh, hypoxic DAs, 4-aminopyridine (4-AP), a Kv inhibitor, and O2 cause similar constriction and K+ current inhibition (I(K)). Tissue culture for 72 hours, particularly in normoxia, causes ionic remodeling, characterized by decreased O2 and 4-AP constriction in DA rings and reduced O2- and 4-AP-sensitive I(K) in DASMCs. Remodeled DAMSCs are depolarized and express less O2-sensitive channels (including Kv2.1, Kv1.5, Kv9.3, Kv4.3, and BK(Ca)). Kv2.1 adenoviral gene-transfer significantly reverses ionic remodeling, partially restoring both the electrophysiological and tone responses to 4-AP and O2. In fresh DASMCs, ETC inhibitors (rotenone and antimycin) mimic hypoxia, increasing I(K) and reversing constriction to O2, but not phenylephrine. O2 increases, whereas hypoxia and ETC inhibitors decrease H2O2 production by altering mitochondrial membrane potential (DeltaPsim). H2O2, like O2, inhibits I(K) and depolarizes DASMCs. We conclude that O2 controls human DA tone by modulating the function of the mitochondrial ETC thereby varying DeltaPsim and the production of H2O2, which regulates DASMC Kv channel activity and DA tone.