12,612 research outputs found

    ‘It’s too late’. Is it really? Considerations for amblyopia treatment in older children

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    In recent years, media coverage has demonstrated instances in which families of children aged 7 and older, newly diagnosed with strabismic and/or anisometropic amblyopia through community eyecare services, were told it was ‘too late’ for their child to effectively respond to conventional amblyopia treatment (occlusion or atropine penalisation). Formal guidance pertaining to binocular vision anomalies from eyecare professional bodies does not specifically make reference to a child’s age, beyond stating the importance of early diagnosis and treatment of strabismus/amblyopia. However, there have been many changes in the way we view the recovery period for amblyopia, and it is well demonstrated both within literature and clinical practice that conventional treatment can improve amblyopic eye visual acuity in children beyond the age of 7 years. The occurrence of these media described cases within the community eyecare sphere would suggest it is worthwhile revisiting the literature on the subject of amblyopia treatment in older children (aged 7+ years), to address misconceptions and place in the spotlight current considerations facing clinicians when treating newly diagnosed amblyopia within this age group. This perspective review provides an evidence-based update covering the various considerations associated with treatment of amblyopia in older children, along with recent amblyopia treatment advances that could have an impact on treatment prospects for this patient group. Considerations include the risks, benefits and efficacy of treating newly diagnosed amblyopia in older children, monitoring density of suppression to mitigate intractable diplopia risk, and recent findings regarding binocular treatments for amblyopia

    Holographic Metamagnetism, Quantum Criticality, and Crossover Behavior

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    Using high-precision numerical analysis, we show that 3+1 dimensional gauge theories holographically dual to 4+1 dimensional Einstein-Maxwell-Chern-Simons theory undergo a quantum phase transition in the presence of a finite charge density and magnetic field. The quantum critical theory has dynamical scaling exponent z=3, and is reached by tuning a relevant operator of scaling dimension 2. For magnetic field B above the critical value B_c, the system behaves as a Fermi liquid. As the magnetic field approaches B_c from the high field side, the specific heat coefficient diverges as 1/(B-B_c), and non-Fermi liquid behavior sets in. For B<B_c the entropy density s becomes non-vanishing at zero temperature, and scales according to s \sim \sqrt{B_c - B}. At B=B_c, and for small non-zero temperature T, a new scaling law sets in for which s\sim T^{1/3}. Throughout a small region surrounding the quantum critical point, the ratio s/T^{1/3} is given by a universal scaling function which depends only on the ratio (B-B_c)/T^{2/3}. The quantum phase transition involves non-analytic behavior of the specific heat and magnetization but no change of symmetry. Above the critical field, our numerical results are consistent with those predicted by the Hertz/Millis theory applied to metamagnetic quantum phase transitions, which also describe non-analytic changes in magnetization without change of symmetry. Such transitions have been the subject of much experimental investigation recently, especially in the compound Sr_3 Ru_2 O_7, and we comment on the connections.Comment: 23 pages, 8 figures v2: added ref

    Differences in field effectiveness and adoption between a novel automated chlorination system and household manual chlorination of drinking water in Dhaka, Bangladesh: a randomized controlled trial.

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    The number of people served by networked systems that supply intermittent and contaminated drinking water is increasing. In these settings, centralized water treatment is ineffective, while household-level water treatment technologies have not been brought to scale. This study compares a novel low-cost technology designed to passively (automatically) dispense chlorine at shared handpumps with a household-level intervention providing water disinfection tablets (Aquatab), safe water storage containers, and behavior promotion. Twenty compounds were enrolled in Dhaka, Bangladesh, and randomly assigned to one of three groups: passive chlorinator, Aquatabs, or control. Over a 10-month intervention period, the mean percentage of households whose stored drinking water had detectable total chlorine was 75% in compounds with access to the passive chlorinator, 72% in compounds receiving Aquatabs, and 6% in control compounds. Both interventions also significantly improved microbial water quality. Aquatabs usage fell by 50% after behavioral promotion visits concluded, suggesting intensive promotion is necessary for sustained uptake. The study findings suggest high potential for an automated decentralized water treatment system to increase consistent access to clean water in low-income urban communities

    Seasonal phosphorus and carbon dynamics in a temperate shelf sea (Celtic Sea): uptake, partitioning, release, turnover and stoichiometry.

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    The seasonal cycle of resource availability in shelf seas has a strong selective pressure on phytoplankton diversity and the biogeochemical cycling of key elements, such as carbon (C) and phosphorus (P). Shifts in carbon consumption relative to P availability, via changes in cellular stoichiometry for example, can lead to an apparent ‘excess’ of carbon production. We made measurements of inorganic P (Pi) uptake, in parallel to C-fixation, by plankton communities in the Celtic Sea (NW European Shelf) in spring (April 2015), summer (July 2015) and autumn (November 2014). Short-term (< 8 h) Pi-uptake coupled with dissolved organic phosphorus (DOP) release, in parallel to net (24 h) primary production (NPP), were all measured across an irradiance gradient designed to typify vertically and seasonally varying light conditions. Rates of Pi-uptake were highest during spring and lowest in the low light conditions of autumn, although biomass-normalised Pi-uptake was highest in the summer. The release of DOP was highest in November and declined to low levels in July, indicative of efficient utilization and recycling of the low levels of Pi available. Examination of daily turnover times of the different particulate pools, including estimates of phytoplankton and bacterial carbon, indicated a differing seasonal influence of autotrophs and heterotrophs in P-dynamics, with summer conditions associated with a strong bacterial influence and the early spring period with fast growing phytoplankton. These seasonal changes in autotrophic and heterotrophic influence, coupled with changes in resource availability (Pi, light) resulted in seasonal changes in the stoichiometry of NPP to daily Pi-uptake (C:P ratio); from relatively C-rich uptake in November and late April, to P-rich uptake in early April and July. Overall, these results highlight the seasonally varying influence of both autotrophic and heterotrophic components of shelf sea ecosystems on the relative uptake of C and P

    Signal processing with Levy information

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    Levy processes, which have stationary independent increments, are ideal for modelling the various types of noise that can arise in communication channels. If a Levy process admits exponential moments, then there exists a parametric family of measure changes called Esscher transformations. If the parameter is replaced with an independent random variable, the true value of which represents a "message", then under the transformed measure the original Levy process takes on the character of an "information process". In this paper we develop a theory of such Levy information processes. The underlying Levy process, which we call the fiducial process, represents the "noise type". Each such noise type is capable of carrying a message of a certain specification. A number of examples are worked out in detail, including information processes of the Brownian, Poisson, gamma, variance gamma, negative binomial, inverse Gaussian, and normal inverse Gaussian type. Although in general there is no additive decomposition of information into signal and noise, one is led nevertheless for each noise type to a well-defined scheme for signal detection and enhancement relevant to a variety of practical situations.Comment: 27 pages. Version to appear in: Proc. R. Soc. London

    The Relationship Between Diabetes-Related Attitudes and Patients' Self- Reported Adherence

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    This study involved 1202 patients who were placed into low adherence or high adherence groups based on their answers to questionnaires. The attitudes of each group were compared for a variety of adherence behaviors. Patients who reported high levels of adherence tended to have attitudes more in accord with diabetes experts. Members of the high adherence group strongly supported the need for special training for health care professionals who treat diabetes, favored team care, accepted the importance of patient compliance, acknowledged the seriousness of non-insulin-dependent diabetes mellitus (NIDDM), and recognized the relationship between glucose control and complications. Differences in attitudes between high- and low adherence groups were more prevalent for difficult adherence areas, eg, diet and exercise, than for easy adherence areas, eg, carrying sweets or diabetic identification. An understanding of patients' attitudes can help diabetes educators and patients develop realistic and relevant self-care plans.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68603/2/10.1177_014572179301900407.pd

    Third Party Reports influence parents’ perceptions of coaching ability: Implications for youth sport coaches.

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    According to Olson, Roese, and Zanna’s (1996) Model of Expectancy Processes, information conveyed by others can determine our expectancies of people. Furthermore, Third Party Reports (TPRs) such as reputation may influence athletes’ initial expectancies of coaches (e.g., Manley et al., 2008; 2010; Thelwell et al., 2013). Parents are believed to play a fundamental role in the development of coach-athlete relationships (e.g., Jowett & Katchis, 2005) and, in turn, athletic achievement in youth sport (Gould et al., 2008). However, person perception research has not yet examined the impact of cues such as TPRs on the initial impressions and expectancies that parents form of youth sport coaches. The current study addresses this gap in the literature. Athletes’ parents viewed a hypothetical online report describing the appointment of a new coach at a local sports club. The report included a “comments” section, which consisted of “tweets” posted by the newly-appointed coach’s former athletes. Four experimental conditions were created by manipulating the coach’s level of warmth and competence (i.e., high vs. low) as reported through the “comments/tweets” (i.e., TPRs). After reading the online report, participants provided ratings of the coach’s ability using the Coaching Competency Questionnaire (Myers et al., 2006). Participants are currently being recruited via gatekeepers at sports clubs/organisations, as well as through social media. However, based on an initial sample (n = 83), Kruskal-Wallis tests typically revealed that high-warmth/high-competence TPRs resulted in highest evaluations of overall coaching ability, while TPRs low in both warmth and competence received poorest ratings. Interestingly, perceptions of Character-building Competence were highest for high-warmth/low-competence TPRs. These preliminary findings reveal that TPRs can influence parents’ perceptions of coaching proficiency, but that parents may value warmth over competence when assessing a coach’s ability to develop more holistic qualities in youth sport athletes
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