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Trevor Hughes,1 Matthew Traynor2 1Brigham Young University, Rexburg, ID, USA; 2Premier Eye Care of Eastern Idaho, Idaho Falls, ID, USACorrespondence: Matthew TraynorPremier Eye Care of Eastern Idaho, Idaho Falls, ID, USATel +1 208 529-6600Email doctortraynor@gmail.comPurpose: To report treatment outcomes of ab interno canaloplasty using the Visco360 and Omni system devices as a standalone procedure or combined with cataract surgery in patients with open-angle glaucoma (OAG).Design: Retrospective, single-center, consecutive case series.Study Patients: Eighty-nine eyes of 64 patients aged 43 to 91 with open-angle glaucoma treated with ab interno canaloplasty between January 2018 and September 2019. Eyes with previous incisional glaucoma surgery and eyes with less than 90 degrees of viscodilation were excluded.Intervention: Patients underwent ab interno canaloplasty as a stand-alone procedure or in conjunction with cataract surgery. Ab interno canaloplasty was performed with either the Visco360 or Omni System devices (Sight Sciences, Menlo Park, CA). Treatment consisted of viscodilation without trabeculotomy.Main Outcome Measures: Primary outcome measures were mean IOP and mean number of glaucoma medications. Additional analysis included the impact of degrees of treatment on treatment outcomes.Results: Preoperative mean IOP was 24.5 ± 8.3; the number of preoperative glaucoma medications was 2.5 ± 1.3. At 18 months postoperative, the mean IOP was reduced 36% to 15.8 ± 2.5 (P< 0.001) and glaucoma medications were reduced 32% to 1.7 ± 1.5 (P< 0.05). Higher preoperative IOP was significantly correlated with increased IOP lowering. Reduction of mean IOP and medications were not significantly different between standalone ab interno canaloplasty vs cataract surgery/ab interno canaloplasty. Reduction of mean IOP and medications were not significantly different between patients with 180 degrees of treatment vs 360 degrees of treatment.Conclusion: Ab interno canaloplasty reduces IOP and glaucoma medication use in patients with OAG whether as a standalone surgery or in combination with cataract surgery.Keywords: ab interno, canaloplasty, MIGS, open angle glaucoma, Visco360, Omni, glaucoma surgery, viscodilation

Context: Throughout the UK a large amount of unwanted, expired or patient returned controlled drugs are disposed of every day, in community and hospital pharmacies, veterinary surgeries, hospices, private hospitals and industrial settings. This is mostly achieved through the use of commercially available controlled drug destruction/denaturing kits, but what do these kits actually do to the drug within them? Objective: The primary aim of this study was to investigate the effect of six commercially available kits on morphine, a chosen model controlled drug. The secondary aim was to establish if the kits could be adapted to chemically destroy any drug disposed within it. Materials and methods: Morphine was dispensed in to six commercially available controlled drug destruction kits at a known concentration. The instructions on the kits were followed and after 48 h the amount of drug remaining was determined by HPLC. In addition a new kit containing sodium perborate was tested in the same way. Results: Between 78 and 111% of the parent drug was found to still be present in the commercial kits tested after 48 h. In the sodium perborate 5% kit this level fell to 22%. Discussion and conclusions: In conclusion all the commercially available CD denaturing kits tested do not destroy the controlled drug (morphine) tested but simply encapsulated it in gel. This means the parent form of the drug is still present and could potentially be recovered and abused. The new kit containing sodium perborate was much more effective in chemically destroying the parent drug but care must be taken in its use. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to outline how the immediate life support (ILS) course was incorporated into an undergraduate nursing curriculum in a university in Northern Ireland. It also reports on how the students perceived the impact of this course on their clinical practice. Rationale and Background: The rationale of the course was to develop the student's ability to recognize the acutely ill patient and to determine the relevance of this to clinical practice. Prior to this, the ILS course was only available to qualified nurses, and this paper reports on the first time undergraduate nursing students were provided with an ILS course. Methods: The ILS course was delivered to 89 third-year nursing students from the adult branch pathway of the BSc (Hons) programme in Nursing Sciences. Each course was taught to 10-12 students and was completed over eight 7·5 h sessions within a 2-week period. Recognized advanced life support (ALS) instructors, in keeping with the UK Resuscitation Council guidelines, taught the students. Results and Conclusion: Student feedback reported that the ILS course helped them understand what constituted the acutely ill patient and the role of the nurse in managing a deteriorating situation. Students also reported that they valued the experience as highlighting gaps in their knowledge. [ABSTRACT FROM AUTHOR]

Title. Humanism and its critiques in nursing research literature. Aim. This paper raises for debate the issue of how humanist ideas have been taken up by nurse scholars, particularly in research literature. Background. Many nurses from the mid-1970s onwards have described and promoted humanism as an appropriate philosophical basis for nursing practice and research. This has been partly in an attempt to sharply differentiate the profession from medicine, and later, managerialism, which have been represented as reductionist and failing to adequately respond to the whole patient. Methods. A summary of definitions of humanism and critiques of humanism in broad philosophical literature is followed by an examination and critique of literature appearing in PubMed published within nursing scholarship from 1976 to 2007 which discusses or promotes humanism in nursing practice or research. Findings. Writers have attempted to enhance the importance of nursing by associating it with the humanistic project of accepting responsibility for realizing our human potential. They have promoted a version of research which is qualitative and centres on understanding individual lifeworlds of research participants because of a strong valuing of the experiences and perspectives of the individual. Much of the literature on this topic describes this humanism in dualistic contrast to medico-scientific reductionism and objectivity. Conclusion. Some of the presentations of humanistic nursing lack rigour and can be seen as doing little more than reproducing professional ideology. Scholars and others in the field of nursing could take the trouble to submit these ideologies to proper scrutiny. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of an integrative literature review to investigate: (a) the extent of entrepreneurial activity by nurses, midwives and health visitors in the United Kingdom and (b) the factors that influenced these activities. Background. Internationally, social and commercial entrepreneurial activity is regarded as important for economic growth and social cohesion. Methods. Seventeen bibliographic databases were searched using single and combined search terms: 'entrepreneur$', 'business', 'private practice', 'self-employ$', 'intrapreneur$' 'social enterprise$' 'mutuals', 'collectives', 'co-op' and 'social capital' which were related to a second layer of terms 'Nurs$', 'Midwi$', 'Visit$'. 'Entrepreneur$' Private Midwi$, Independent Midwi$, and 'nursing workforce'. In addition, hand searches of non-indexed journals and grey literature searches were completed. The following inclusion criteria were: (a) describing nurses, midwife and/or health visitor entrepreneurship (b) undertaken in the UK, and (c) reported between January 1996 and December 2005. Results. Of 154 items included only three were empirical studies; the remainder were narrative accounts. While quality of these accounts cannot be verified, they provide as complete an account as possible in this under-researched area. The numbers of nurses, midwives and health visitors acting entrepreneurially were very small and mirror international evidence. A categorization of entrepreneurial activity was inductively constructed by employment status and product offered. 'Push' and 'pull' influencing factors varied between types of entrepreneurial activity. Conclusion. Empirical investigation into the extent to which nurses and midwives respond to calls for greater entrepreneurialism should take account of the complex interplay of contextual factors (e.g. healthcare legislation), professional and managerial experience and demographic factors. [ABSTRACT FROM AUTHOR]

Aim. The aim of the paper is (1) to offer an overview of different theoretical approaches to discourse analysis and (2) to review papers published in the Journal of Advanced Nursing from 1996-2004 in which discourse analysis is identified as a method of data analysis. Background. Discourse analysis offers rigorous approaches to analysing naturally occurring talk and texts. Forms of discourse analysis have developed across broad theoretical bases. Such development has created challenges for researchers wishing to adopt this methodology and readers wishing to evaluate the quality of discourse analytic work. Methods. First, key documents which describe the theoretical range of discourse analysis are used to provide (i) a comprehensive overview of the approach, (ii) the identification of categories of discourse analysis and (iii) minimum criteria for determining if an individual paper can realistically claim to be adopting discourse analysis. Secondly, an electronic search followed by hand search of the Journal of Advanced Nursing full- contents between 1996 and 2004 was undertaken. The papers were grouped into the types of approach identified in i, and evaluated to see whether they met the 'minimum criteria' also identified in i. Findings. The search of Journal of Advanced Nursing revealed 24 papers where the authors stated that discourse analysis was among the methods or was the sole method of data analysis. The majority of the papers cluster around critical approaches to discourse analysis. Only a few approach discourse analysis primarily as analysis of conversation. Some papers are excellent, while others offer analysis that bears little resemblance to any form of discourse analysis. Conclusions. A strategy for improvement could include more rigorous attention on the part of those practising discourse analysis to methodology and the key features that differentiate the different approaches to discourse analysis from other qualitative methods. Authors should include sufficient detail of their approach. [ABSTRACT FROM AUTHOR]

AIM: This paper attempts to illuminate some of the factors necessary to influence policy, using recent changes in the UK research policy as a case study. BACKGROUND: Changes in the UK research policy have shown how the profession can successfully influence a government agenda. METHODS: The paper critically reviews recent UK research policy with relevance for nursing. RESULTS: Successful policy change in nursing requires a contingent alignment of professional and governmental agendas. CONCLUSIONS: Although nursing research has made significant gains over the last 10 years, there is need for the continued development of politically minded research leadership, lest these gains be lost. [ABSTRACT FROM AUTHOR]

Aims of the study. This paper uses the findings of a recent bibliometric analysis of published UK nursing research to ask whether the field is characterized by a fundamental split between two underlying areas of research interest. These can be termed 'endogenous' and 'exogenous'. The former term describes research which tends to be concerned with problems and issues to do with nursing as a profession; the latter is concerned with problems and issues centring around the nursing of patients.Design/methods. Papers in the Wellcome Trust's Research Outputs Database (ROD), a database of UK biomedical research, were analysed. Nursing papers published between 1988 and 1995 numbered 1845, just less than 1% of the total papers in the ROD.Results/findings. Analysis of the subfield identified that nursing research was atypical of biomedical research as a whole in a number of ways. One difference was that usually in biomedical research there is a general correlation between numbers of funders acknowledged on a paper, numbers of authors, and esteem of the journal in which a paper appears. In nursing there was, if anything, a tendency for highly esteemed papers to have fewer authors and be less likely to have acknowledged funding. However, the apparently endogenous and exogenous papers have quite different characteristics. This paper explores this apparent difference and possible reasons for this difference and will briefly compare nursing research with some other newly emerging social and academic groups.Conclusions. Thinking of nursing research outputs in this way can provide insight into the existence of different reward systems influencing nurse researchers. However, it is impossible to draw too confident a differentiation without reading each individual paper and making judgements about whether they are 'endogenous' or 'exogenous', a practice generally beyond the scope of bibliometric practice. [ABSTRACT FROM AUTHOR]

This paper recontextualises research evidence as an example of textually-based social control. It does this by drawing on two areas of theoretical literature; feminist literary theory and the sociology of scientific knowledge. Accounts of literary works as ideological instruments of social control suggest that (at least some kinds of) research literature may fulfil a similar role among a clinical readership. There have also been compelling accounts of scientific writing as expressions of desire on the part of one group to 'act at a distance' upon others. In the light of this literature, it becomes less tenable to see research dissemination as the simple transfer of information, supplemented by organisational work. Research is implicated in the attempt by one group to enrol others in its own project and in the (self-) construction of the identities of the healthcare worker. The accounts that literary theory can provide do not remain focused upon the text, but draw links between the reading process and the experience and place in society, for example the gender, of the writer and reader. As such their explanations create a space for the resisting reader. [ABSTRACT FROM AUTHOR]

The issue of knowledge has generated much literature, recently from writers influenced by post-modernism. These writers argue that an epistemological space has existed since the time of the Enlightenment with which anyone concerned with value or truth has to grapple. The analysis of nursing texts detailed in this paper gives an account of such grappling. The link between discourse, knowledge and power is also explored. Using a discourse analysis approach, this paper offers an examination of nursing texts on research, education, professionalization or conceptualizations known as nursing models. It argues that groups in nursing have responded to the dominant biomedical discourse by seeking to re-establish their activities within a different discourse, one involving caring, holism and, within research, a qualitative approach. Others have aligned their search for appropriate truth claims with feminist projects. After examining some of these responses, this paper attempts to point to some of the problems of aligning a professional strategy with one of political emancipation and philosophical shift. The paper argues that the issue of a philosophical and moral base for nursing is particularly crucial at a time when so-called market rationalism dominates not only in health care but in an increasing range of human activities. [ABSTRACT FROM AUTHOR]

This paper presents preliminary findings from research being carried out into how community nurses in three first-wave community trusts are responding to changes stemming from recent legislation. A Measure of Job Satisfaction was devised for the study for administration to the entire nursing workforce in the participating trusts and semi-structured interviews were carried out with managers at all levels in each of the trusts. This paper concentrates on the textual data arising from the study dealing with how nurses understood the values of managers and how managers viewed nurses' values. Nurses tended to express their beliefs about managers as a series of us-them oppositions while the comments of managers can be seen within a rational/irrational dualism. Some possible theoretical frameworks in which these texts ca be further explored are briefly discussed, including Foucault's power/knowledge concept and the literature of 'colonization.' [ABSTRACT FROM AUTHOR]

The development of the Measure of Job Satisfaction (MJS) for use in a longitudinal study of the morale of community nurses in four trusts is described. The review of previous studies focuses on the use of principal component analysis or factor analysis in the development of measures. The MJS was developed from a bank of items culled from the literature and from discussions with key informants. It was mailed to a one in three sample of 723 members of the community nursing forums of the Royal College of Nursing. A 72% response rate was obtained from those eligible for inclusion. Principal component analysis with varimax rotation led to the identification of five dimensions of job satisfaction; Personal Satisfaction, Satisfaction with Workload, Satisfaction with Professional Support, Satisfaction with Pay and Prospects and Satisfaction with Training. These factors form the basis of five subscales of satisfaction which summate to give an Overall Job Satisfaction score. Internal consistency, test-retest reliability, concurrent and discriminatory validity were assessed and were found to be satisfactory. The factor structure was replicated using data obtained from the first three of the community trusts involved in the main study. The limitations of the study and issues which require further exploration are identified and discussed. [ABSTRACT FROM AUTHOR]