Do optometrists see 20/20? A survey of vision care utilized by optometrists: Implications for the profession

Purpose: The American Optometric Association\u27s Optometric Clinical Practice Guidelines identify appropriate utilization strategies for eye and vision examinations. Optometrists, like all health care providers, should follow the recommended standard of care as a doctor and as a patient. The purpose of this survey was to evaluate if optometrists seek and recommend the standard of vision care. Method: A survey was mailed to 650 randomly selected optometrists in the states of Oregon and Washington. The survey provided data describing the optometrists\u27 personal demographics, medical conditions, visual conditions, and utilization of vision care. Additional data included a survey of the optometrists\u27 recommendation of preventive eye care for their patients. Results: A 41% response rate was achieved from the mailing. In evaluating the data from optometrists who reported no ocular or medical conditions, the data show that 70% of the doctors surveyed, between the age of twenty and forty, have met the AOA guidelines recommendation of having a refraction, anterior segment exam, posterior segment exam, and intraocular pressure measurement within the recommended three year interval. Sixty-four percent of the doctors surveyed, between the age of forty-one and sixty, have met the AOA guidelines recommendation of having all of the procedures listed performed within the past two years. Of the doctors surveyed over the age of sixty, 36% have met the AOA guidelines of having all the procedures listed performed within the past year. With respect to preventive vision care for their patients, 90% of doctors, of all ages, reported that they recommend the AOA guidelines recommendation for their patients between the age of twenty and forty. Eighty-one percent of doctors, of all ages, reported recommending the AOA guidelines to their patients between the age of forty-one and sixty. Of those doctors surveyed, 30% of the respondents recommend the AOA guidelines to their patients over the age of sixty. Conclusion: Most optometrists\u27 personal eye care is consistent with the AOA Optometric Clinical Practice Guidelines. Most optometrists are recommending to their patients care intervals that are consistent with these guidelines. However, optometrists over the age of sixty are not seeking the standard of vision care recommended by the AOA guidelines and optometrists off all ages are not recommending the AOA guidelines to their patients over the age of sixty. It is recommended that all optometrists be educated as to the reason for the frequency of optometric examinations for themselves as well as for their patients over the age of sixty

BARRIERS IN THE PROVISION OF FAMILY PLANNING INFORMATION FROM SOCIAL WORKERS TO THEIR CLIENTS

The United States has the highest unintended pregnancy rate relative to other Western countries (Division of Reproductive Health, 2002). Mothers and children of unintended births face increased risk of substantial physical and social problems (Brown & Eisenberg, 1995; Gold, 2001). The high unintended pregnancy rate in the U.S. is primarily due to the lack of consistent contraceptive use by many individuals who are at risk for unintended pregnancy (Piccinino & Mosher, 1998). Due in part to the NASW position on family planning, social workers are in a key position for providing family planning information to clients. This study investigates the barriers that social workers face in providing family planning information to their clients through the use of a survey questionnaire. The questionnaire includes a modified version of the Bardis Religion Scale (1961), and items related to Bandura's social cognitive theory (1986) with a focus on family planning knowledge, comfort, self-efficacy, perceived social worker roles, and moral attitudes toward providing information on family planning to clients. A section for respondent characteristics was also included. A sample of 800 respondents, with a final sample of 203 respondents, was randomly selected and surveyed from the 2007 roster of Pennsylvania licensed social workers. Findings revealed that greater religiosity, conservative political beliefs, a tendency to vote for Republicans, and a "pro-life" abortion stance were associated with reported increased barriers in providing family planning information. Participation in family planning coursework or training, and practicing in an urban area were found to be related to lower reported barriers, regardless of religiosity. Years of experience and work function had no significant effect on providing family planning information. Moral objection ranked low as compared to other barriers. Lack of workplace incentive and issues related to lack of family planning training and knowledge were of greater importance in understanding barriers. Furthermore, many social workers lack accurate family planning information, especially related to emergency contraception. These results suggest need for family planning training within social work professional education and continuing education, as well as an urgent need to address policies that undermine social work clients' access to family planning information and services

Nonhuman Primate Models Used to Study Pelvic Inflammatory Disease Caused by Chlamydia trachomatis

Pelvic inflammatory disease (PID) is a global health concern that is associated with significant morbidity and is a major cause of infertility. Throughout history animals have been used for anatomical studies and later as models of human disease. In particular, nonhuman primates (NHPs) have permitted investigations of human disease in a biologically, physiologically, and anatomically similar system. The use of NHPs as human PID models has led to a greater understanding of the primary microorganisms that cause disease (e.g., Chlamydia trachomatis and Neisseria gonorroheae), the pathogenesis of infection and its complications, and the treatment of people with PID. This paper explores historical and contemporary aspects of NHP modeling of chlamydial PID, with an emphasis on advantages and limitations of this approach and future directions for this research

Rubin Observatory LSST Transients and Variable Stars Roadmap

The Vera C. Rubin Legacy Survey of Space and Time holds the potential to revolutionize time domain astrophysics, reaching completely unexplored areas of the Universe and mapping variability time scales from minutes to a decade. To prepare to maximize the potential of the Rubin LSST data for the exploration of the transient and variable Universe, one of the four pillars of Rubin LSST science, the Transient and Variable Stars Science Collaboration, one of the eight Rubin LSST Science Collaborations, has identified research areas of interest and requirements, and paths to enable them. While our roadmap is ever-evolving, this document represents a snapshot of our plans and preparatory work in the final years and months leading up to the survey\u27s first light

Three cachexia phenotypes and the impact of fat-only loss on survival in FOLFIRINOX therapy for pancreatic cancer

BACKGROUND: By the traditional definition of unintended weight loss, cachexia develops in ~80% of patients with pancreatic ductal adenocarcinoma (PDAC). Here, we measure the longitudinal body composition changes in patients with advanced PDAC undergoing 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin therapy. METHODS: We performed a retrospective review of 53 patients with advanced PDAC on 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin as first line therapy at Indiana University Hospital from July 2010 to August 2015. Demographic, clinical, and survival data were collected. Body composition measurement by computed tomography (CT), trend, univariate, and multivariate analysis were performed. RESULTS: Among all patients, three cachexia phenotypes were identified. The majority of patients, 64%, had Muscle and Fat Wasting (MFW), while 17% had Fat-Only Wasting (FW) and 19% had No Wasting (NW). NW had significantly improved overall median survival (OMS) of 22.6 months vs. 13.0 months for FW and 12.2 months for MFW (P = 0.02). FW (HR = 5.2; 95% confidence interval = 1.5-17.3) and MFW (HR = 1.8; 95% confidence interval = 1.1-2.9) were associated with an increased risk of mortality compared with NW. OMS and risk of mortality did not differ between FW and MFW. Progression of disease, sarcopenic obesity at diagnosis, and primary tail tumours were also associated with decreased OMS. On multivariate analysis, cachexia phenotype and chemotherapy response were independently associated with survival. Notably, CT-based body composition analysis detected tissue loss of >5% in 81% of patients, while the traditional definition of >5% body weight loss identified 56.6%. CONCLUSIONS: Distinct cachexia phenotypes were observed in this homogeneous population of patients with equivalent stage, diagnosis, and first-line treatment. This suggests cellular, molecular, or genetic heterogeneity of host or tumour. Survival among patients with FW was as poor as for MFW, indicating adipose tissue plays a crucial role in cachexia and PDAC mortality. Adipose tissue should be studied for its mechanistic contributions to cachexia

Acute Ischemic Stroke After Moderate to Severe Traumatic Brain Injury: Incidence and Impact on Outcome

Background and Purpose—Traumatic brain injury (TBI) leads to nearly 300 000 annual US hospitalizations and increased lifetime risk of acute ischemic stroke (AIS). Occurrence of AIS immediately after TBI has not been well characterized. We evaluated AIS acutely after TBI and its impact on outcome. Methods—A prospective database of moderate to severe TBI survivors, admitted to inpatient rehabilitation at 22 Traumatic Brain Injury Model Systems centers and their referring acute-care hospitals, was analyzed. Outcome measures were AIS incidence, duration of posttraumatic amnesia, Functional Independence Measure, and Disability Rating Scale, at rehabilitation discharge. Results—Between October 1, 2007, and March 31, 2015, 6488 patients with TBI were enrolled in the Traumatic Brain Injury Model Systems National Database. One hundred and fifty-nine (2.5%) patients had a concurrent AIS, and among these, median age was 40 years. AIS was associated with intracranial mass effect and carotid or vertebral artery dissection. High-velocity events more commonly caused TBI with dissection. AIS predicted poorer outcome by all measures, accounting for a 13.3-point reduction in Functional Independence Measure total score (95% confidence interval, −16.8 to −9.7; P<0.001), a 1.9-point increase in Disability Rating Scale (95% confidence interval, 1.3–2.5; P<0.001), and an 18.3-day increase in posttraumatic amnesia duration (95% confidence interval, 13.1–23.4; P<0.001). Conclusions—Ischemic stroke is observed acutely in 2.5% of moderate to severe TBI survivors and predicts worse functional and cognitive outcome. Half of TBI patients with AIS were aged ≤40 years, and AIS patients more often had cervical dissection. Vigilance for AIS is warranted acutely after TBI, particularly after high-velocity events

Molecular Analysis of Mutations Induced at the hisD3052 Allele of Salmonella by Single Chemicals and Complex Mixtures

More single chemicals and complex environmental mixtures have been evaluated for mutagenicity at the hisD3052 allele of Salmonella, primarily in strain TA98, than in any other mutation assay. The development of colony probe hybridization procedures and the application of the polymerase chain reaction and direct DNA sequencing has permitted rapid molecular access to this allele. We discuss these techniques and the resulting mutation spectra that have been induced by a variety of environmental mutagens and complex mixtures. A common GC or CG deletion within a hot-spot region of the sequence dominates most of the spectra. In addition to this two-base deletion, we have recovered about 200 other types of mutations within the 72-base target for reversion of the hisD3052 allele. These include a variety of deletions (as large as 35 bases), duplications (as large as 46 bases), and complex mutations involving base substitutions. The quasipalindromic nature of the target sequence and its potential to form DNA secondary structures and slippage mismatches appear to be an important basis for the mutability of this allele

Defining success in graduate school

[Response to Weiner OD (2014) How should we be selecting our graduate students. Mol Biol Cell 25:429–430. doi: 10.1091/mbc.E13-11-0646.