Comparison of RGP fitting capabilities: MasterVue vs. EyeSys

The advent of computer aided videokeratology has many practitioners hopeful that the fitting of rigid gas permeable contact lenses will become more efficient and successful than diagnostic and empirical methods; therefore making an RGP lens more often the lens of choice. This is especially important in a day when the growth of managed health care necessitates less doctor time per patient. The EyeSys Corneal Analysis System and the MasterVue System both claim to provide these benefits using somewhat different fitting strategies. This study assesses the success of each method of lens fitting according to patient satisfaction and on-eye lens performance. Twenty-nine subjects were initially fitted with one lens generated by the MasterVue System and one lens generated by the EyeSys Corneal Topography System. The authors graded the lens position, edge pattern, apical pattern, visual acuity, over-refraction and overall outcome. Subjects were asked to grade vision, lens comfort and preferred eye. The only areas where one system\u27s lens statistically performed better was subjective comfort and preferred eye. In both cases the MasterVue did better than the EyeSys. The authors feel the difference in comfort was due to the fact that the MasterVue usually designed a larger lens than the EyeSys. However, neither system performed well overall. Only 12.5% of the patients who were followed at the dispense were allowed to keep and wear their lenses. While there are some cases where a detailed topographical map of the cornea is very helpful in fitting certain patients, particularly those with irregular corneas, the study indicates both systems in their current form are not accurate enough to be used in the fitting of the average low myope to make their use cost effective

Exploring efficacy in personal constraint negotiation: an ethnography of mountaineering tourists

Limited work has explored the relationship between efficacy and personal constraint negotiation for adventure tourists, yet efficacy is pivotal to successful activity participation as it influences people’s perceived ability to cope with constraints, and their decision to use negotiation strategies. This paper explores these themes with participants of a commercially organised mountaineering expedition. Phenomenology-based ethnography was adopted to appreciate the social and cultural mountaineering setting from an emic perspective. Ethnography is already being used to understand adventure participation, yet there is considerable scope to employ it further through researchers immersing themselves into the experience. The findings capture the interaction between the ethnographer and the group members, and provide an embodied account using their lived experiences. Findings reveal that personal mountaineering skills, personal fitness, altitude sickness and fatigue were the four key types of personal constraint. Self-efficacy, negotiation-efficacy and other factors, such as hardiness and motivation, influenced the effectiveness of negotiation strategies. Training, rest days, personal health, and positive self-talk were negotiation strategies. A conceptual model illustrates these results and demonstrates the interplay between efficacy and the personal constraint negotiation journey for led mountaineers

The Engaged Department Initiative: GVSU, GRCC, and Aquinas Join Forces for Place-Based Impact

The Engaged Department Initiative (EDI) is a place-based cross-institutional collaboration located in the Grand Rapids region. Participating organizations include Michigan Campus Compact (MiCC), Grand Valley State University (GVSU), Grand Rapids Community College (GRCC), and Aquinas College (AQ). This innovative ethnographic case study is focused on evaluating how well the initiative completes their goals of increasing faculty knowledge and skills, expanding students’ community engagement, fostering intra- and inter- collaborations between the three institutions of higher education, and enhancing community partnerships. The hopes of this initiative is to make a real difference in the community and to create engaged citizens. By disseminating this research, we aspire to offer recommendations for people interested in spanning boundaries and working on place-based change in their own region

A hypothesis-generating study to evaluate platelet activity in diabetics with chronic kidney disease

BACKGROUND: It is well described that diabetes mellitus is a hypercoagulable state. It is also known that patients with renal dysfunction have impaired platelet aggregation and function. It is not well described how renal dysfunction affects the hypercoagulability associated with diabetes. This post-hoc sub-group analysis compares platelet function, clot structure and thrombin generation time at baseline, and following enoxaparin exposure in three groups of subjects. METHODS: 30 total subjects were evaluated in the three groups: Group I: normal controls (n = 10), Group II: subjects with renal dysfunction but without diabetes (n = 13), and Group III: subjects with concomitant diabetes and renal dysfunction (n = 7). For each subject, platelet contractile force (PCF), clot elastic modulus (CEM) and thrombin generation time (TGT) were simultaneously measured in whole blood at baseline, and following increasing enoxaparin antifactor Xa activity exposure. The group means for each parameter were determined and compared using one-way analysis of variance, with post-hoc Tukey-Kramer test. RESULTS: At baseline, subjects in Group III (diabetics with concomitant renal dysfunction) display significantly enhanced platelet activity, as measured by PCF (p = 0.003) and CEM (p = 0.03), relative to the non-diabetic Groups I and II. Subjects in Group II (renal dysfunction without diabetes) had significantly prolonged TGT values relative to controls when the antifactor Xa activity concentration reached 0.5 (p = 0.007), 1.0 (p = 0.005) and 3.0 IU/mL (p < 0.0001), respectively. There were no differences between Group II and Group III with respect to TGT at these antifactor Xa activity concentrations. When the antifactor Xa activity concentration reached 3.0 IU/mL, Groups II and III formed significantly less rigid blood clots (CEM p = 0.003) and also trended toward reduced PCF (p = 0.06) relative to Group I. CONCLUSION: This hypothesis-generating sub-group analysis suggests that at baseline, patients with concomitant diabetes and renal dysfunction have significantly enhanced platelet activity (PCF), and form more rigid blood clots (CEM) compared to controls and subjects with renal dysfunction but no diabetes. This may suggest that the presence of renal dysfunction does not ameliorate the hypercoagulable state associated with diabetes. Secondly, it appears that subjects with renal dysfunction but without diabetes have an enhanced response to enoxaparin relative to controls

A hypothesis-generating study to evaluate platelet activity in diabetics with chronic kidney disease

Background It is well described that diabetes mellitus is a hypercoagulable state. It is also known that patients with renal dysfunction have impaired platelet aggregation and function. It is not well described how renal dysfunction affects the hypercoagulability associated with diabetes. This post-hoc sub-group analysis compares platelet function, clot structure and thrombin generation time at baseline, and following enoxaparin exposure in three groups of subjects. Methods 30 total subjects were evaluated in the three groups: Group I: normal controls (n = 10), Group II: subjects with renal dysfunction but without diabetes (n = 13), and Group III: subjects with concomitant diabetes and renal dysfunction (n = 7). For each subject, platelet contractile force (PCF), clot elastic modulus (CEM) and thrombin generation time (TGT) were simultaneously measured in whole blood at baseline, and following increasing enoxaparin antifactor Xa activity exposure. The group means for each parameter were determined and compared using one-way analysis of variance, with post-hoc Tukey-Kramer test. Results At baseline, subjects in Group III (diabetics with concomitant renal dysfunction) display significantly enhanced platelet activity, as measured by PCF (p = 0.003) and CEM (p = 0.03), relative to the non-diabetic Groups I and II. Subjects in Group II (renal dysfunction without diabetes) had significantly prolonged TGT values relative to controls when the antifactor Xa activity concentration reached 0.5 (p = 0.007), 1.0 (p = 0.005) and 3.0 IU/mL (p \u3c 0.0001), respectively. There were no differences between Group II and Group III with respect to TGT at these antifactor Xa activity concentrations. When the antifactor Xa activity concentration reached 3.0 IU/mL, Groups II and III formed significantly less rigid blood clots (CEM p = 0.003) and also trended toward reduced PCF (p = 0.06) relative to Group I. Conclusion This hypothesis-generating sub-group analysis suggests that at baseline, patients with concomitant diabetes and renal dysfunction have significantly enhanced platelet activity (PCF), and form more rigid blood clots (CEM) compared to controls and subjects with renal dysfunction but no diabetes. This may suggest that the presence of renal dysfunction does not ameliorate the hypercoagulable state associated with diabetes. Secondly, it appears that subjects with renal dysfunction but without diabetes have an enhanced response to enoxaparin relative to controls

Current velocity and catch efficiency in sampling settlement-stage larvae of coral-reef fishes

Light traps and channel nets are fixed-position devices that involve active and passive sampling, respectively, in the collection of settlement-stage larvae of coral-reef fishes. We compared the abundance, taxonomic composition, and size of such larvae caught by each device deployed simultaneously near two sites that differed substantially in current velocity. Light traps were more selective taxonomically, and the two sampling devices differed significantly in the abundance but not size of taxa caught. Most importantly, light traps and channel nets differed greatly in their catch efficiency between sites: light traps were ineffective in collecting larvae at the relatively high-current site, and channel nets were less efficient in collecting larvae at the low-current site. Use of only one of these sampling methods would clearly result in biased and inaccurate estimates of the spatial variation in larval abundance among locations that differ in current velocity. When selecting a larval sampling device, one must consider not only how well a particular taxon may be represented, but also the environmental conditions under which the device will be deployed