Blur point versus indistinguishable point in assessment of accommodation: objective and subjective findings in early presbyopes

Aim: To measure the distance from the eye and the refraction of the eye at the point at which print blurs and the point at which it becomes unreadable. Methods: Subjective accommodation in 7 early presbyopic subjects (mean age 45 years), with no additional near correction, was tested using 6/12 reduced Snellen and 6/12 Lea symbols. The point at which blur was first noticed and the point at which the print became indistinguishable were noted in centimetres. Objective measures of refraction were taken at each of these points. Results: Subjective and objective results for reduced Snellen and Lea symbols were similar ( p = 0.91; p = 0.81) as were the points where the print was no longer distinguishable ( p = 0.23; p = 0.72). The difference between the blur point and the indistinguishable point measured in centimetres for both the reduced Snellen text and Lea symbols were statistically significant ( p = 0.005; p = 0.0001). The objective measures for these points, however, were not statistically different ( p = 0.32 and p = 0.63, respectively). Conclusion: A clinically significant difference exists in the distance from the eyes between the point at which text blurs and the point at which it becomes indistinguishable. No significant change occurs in accommodation when measured objectively after the blur point. It is recommended that the end point of this test is the point at which print starts to blur

Regulating Casino Gaming: A Checklist for States Considering It

In his essay - Regulating Casino Gaming: A Checklist for States Considering It – by Leonard E. Goodall, Professor of Management and Public Administration, College of Business and Econornics, University of Nevada, Las Vegas, Professor Goodall initially states: “Since various states are likely to continue to debate the issue of the establishment of legal casinos, and since states considering legal casinos must also decide how best to regulate them, the author discusses the similarities and contrasts in the regulatory systems already in operation.” Certainly not all states have solicited casino gaming, or what people generally refer to as gambling, but many have and the list is growing. If casinos are to be, and indications are that many more states will endorse gaming as a source of revenue, then regulating them must follow as a matter of due course says the author. Keep in mind this essay was written in 1988, and the actuality of casino gaming has indeed come to fruition in many states. “Nevada, having legalized casino gaming in 1931, has over a half-century of experience with the regulatory process,” Professor Goodall informs. “When New Jersey approved the establishment of casinos in Atlantic City in 1976, state officials studied the Nevada system carefully and adopted many of Nevada\u27s procedures.” Professor Goodall bullet-points at least 7 key elements that states wanting to pursue gaming should, or in the cases of Nevada and New Jersey, have already addressed in regard to regulation of the industry. Goodall parses, in more detail, those essentials. The ultimate form of regulation is ownership Goodall says. Either state run, or private are the logical options. “The arguments for private ownership have been both pragmatic and political,” Goodall says. “Legislators, like the general public, are skeptical of the ability of state bureaucracies to run big businesses in an efficient manner. Many of them also believe regulation can be more effective if there is at least an arm\u27s-length distance between regulation and ownership,” the professor opines. Additionally important to consider is the purpose of legalization, says Goodall. Are the proceeds earmarked for general funds, or to be used specifically? Geographic considerations are key, Goodall points out. “This decision will depend partly on a state\u27s reasons for having casinos in the first place,” he expands. “New Jersey\u27s policy, for example, is obviously consistent with its goal of using casinos to reinvigorate Atlantic City.” “In both states, one of the most important functions of the regulatory agencies is that of licensing, the process of investigating individuals or organizations and then authorizing them to participate in the gaming business,” Goodall provides. In closing, Goodall says there is no need for ensuing states to reinvent the wheel when it comes to casino gaming regulation. Nevada and New Jersey already provide two good designs from which to emulate and/or build upon

Hospital performance and clinical leadership: New evidence from Iran

Purpose: There is growing interest in the potential need for clinical involvement in leadership and managementof hospitals. Most studies of clinical leadership use US and European data. This paper contributes the first evidence for the country of Iran. It examines three different forms of hospital system: public, private and social security organisation, and these include teaching and non-teaching hospitals. This study adds to a small but growing literature that examines the possible value of ‘expert’ clinical leaders. Method: This study uses data from 72 general hospitals in the city of Tehran. The data were collected for years 2015 and 2016. Data Envelopment Analysis (DEA) is used in this study to assess hospital performance. Hospitals’ chief operating officers are divided into two groups: clinicians (the majority of whom are physicians) and non-medically trained managers. Findings: The average performance scores for hospitals with clinical managers and non-clinically trained managers areequal to 96.68±5.50 and 89.78±7.20 respectively (P <0.001). Performance is thus higher under clinical managers. Outcome differences are observed in each of the three types of ownership, and in teaching and non-teaching hospitals. The advantage in performance-score varies, when comparing the clinically led institutions and managerially led institutions, by between 5 and 10 points on a 0-100 scale. These differences remain after regression-equation adjustment for other influences. Practical implications: Succession planning and targeted leadership development is made more efficient with greater awareness about the kinds of leaders and managers that enhance organizational performance

MODIFYING SMOKING BEHAVIOR THROUGH PUBLIC SERVICE ANNOUNCEMENTS AND CIGARETTE PACKAGE WARNING LABELS: A COMPARISON OF CANADA AND THE UNITED STATES.

This project investigates the use of cigarette package warning labels and public service announcements in Canada and the United States to prevent and reduce cigarette use. The purpose of doing so is to evaluate which country’s approach is more successful and to discover how to improve upon the current strategies. When cigarette warning labels and public service announcements share common themes and images, they have the potential to be more powerful in reducing and preventing cigarette use. Canada has successfully used an integrated approach in these areas of health communication. Further, in 2000, Canada took major steps in tobacco control by introducing 16 full-color graphic warning labels. These unique warnings consist of graphic images and use fear appeals. Research in Canada has suggested that the warnings are successfully encouraging smoking cessation among adults. However, there has been limited research addressing the effects these fear appeals may be having on adolescents. Interestingly, research on message framing and prospect theory has suggested that when dealing with the issues of smoking cessation and prevention, anti-smoking messages should actually be more successful if they are framed in terms of gains rather than losses. In order to test this theory on adolescents, the opinions of 210 American high school students were measured regarding the message framing of warning labels. Although theory and previous research suggested that gain-framed messages would more effectively influence adolescents’ smoking related attitudes and behaviors toward that of prevention and cessation, one of the loss-framed messages currently being used in Canada was perceived as more effective, resulted in more favorable opinions of the warnings and led to stronger intentions to not smoke than the gain-framed warnings. By using two actual Canadian warning labels, this study gained some important insight on the effectiveness of the fear appeals among young people. This research is also valuable because no researcher has compared the use of gain-framed or loss-framed warning labels on adolescents. Additionally, this project addresses an important political issue. Since 1985, the U.S. has been using the same four text-based warning labels. These labels are worn out and have likely lost their intended effect. The U.S. has clearly fallen behind in this area of tobacco control

Art+Politics

For the exhibition Art + Politics, students worked closely with the holdings of Gettysburg College\u27s Special Collections and College Archives to curate an exhibition in Schmucker Art Gallery that engages with issues of public policy, activism, war, propaganda, and other critical socio-political themes. Each of the students worked diligently to contextualize the objects historically, politically, and art-historically. The art and artifacts presented in this exhibition reveal how various political events and social issues have been interpreted through various visual and printed materials, including posters, pins, illustrations, song sheets, as well as a Chinese shoe for bound feet. The students\u27 essays that follow demonstrate careful research and thoughtful reflection on the American Civil War, nineteenth-century politics, the First and Second World Wars, World\u27s Fairs, Dwight D. Eisenhower\u27s campaign, Vietnam-War era protests, and the Cultural Revolution in China. [excerpt]https://cupola.gettysburg.edu/artcatalogs/1009/thumbnail.jp