The detection of automated perimetric stimuli in ocular disease

Automated perimetry has made viable a rapid threshold examination of the visual field and has reinforced the role of perimetry in the diagnostic procedure. The aim of this study was twofold: to isolate the influence of certain extraneous factors on the sensitivity gradient, since these might limit the early detection and accurate monitoring of visual field loss and to investigate the efficacy of certain novel combinations of stimulus parameters in the detection of early visual field loss. The work was carried out with particular reference to glaucoma and to ocular hypertension. The effects of media opacities on the visual field were assessed by forward intraocular light scatter (n= 15) and were found to mask diffuse glaucomatous visual field loss and underestimate focal loss. Correction of the visual field indices for the effects of forward intraocular light scatter (n= 26) showed the focal losses to be, in reality, unaffected. Measurements of back scatter underestimated forward intraocular light scatter (n= 60) and the resultant depression of the visual field. Perimetric sensitivity improved with patient learning (n= 25) and exhibited eccentricity- and depth-dependency effects whereby improvements in sensitivity were greatest for peripheral areas of the field and for those areas which initially demonstrated the lowest sensitivity. The effects of practice were retained over several months (n= 16). Perimetric sensitivity decreased during prolonged examination due to fatigue effects (n&61 19); these demonstrated a similar eccentricity-dependency, being greatest for eccentricities beyond 30o. Mean sensitivities over the range of adaptation levels employed obeyed the Weber-Fechner law (n= 10) and, as would be expected, were independent of pupil size. No relationship was found between short-term fluctuation and adaptation level. Detection of diffuse glaucomatous visual field loss was facilitated using a size III stimulus of duration 200msec at an adaptation level of 31.5asb, compared with a size III stimulus of duration 100msec at an adaptation level of 4asb (n= 20). In a pilot study (n= 10), temporal summation was found to be higher in glaucomatous patients compared with age-matched controls, although the difference was not statistically significant

A narrative exploration of the relationship between reading literature and poetry and ethical practice : narratives of student nurses and nurse educators

The emerging dialogue between the arts and humanities and professional health care education is explored by considering ethical practice in nursing via several narratives of student nurses and nurse educators in one Scottish university. Adopting a narrative methodology based upon the literary hermeneutic of Paul Ricoeur, this thesis is presented as a ‘narrative research text’ in which my own role as a narrative researcher is critically developed. Utilising two different narrative frameworks, narratives are ‘constructed’ from data drawn from the research methods of focus groups, one-to-one interviews, reflective practice journals and documentary sources. Contemporary approaches in professional health care ethics education tend to share features of deduction, universality and generalisability. Their merits notwithstanding, perspectives drawn from the arts and humanities can offer valid critiques and alternative perspectives. Reading literature and poetry is offered as an engaged and interpretive contribution to a teleological ethic characterised by attention to ends (e.g. human flourishing), cultivation of virtue, telling of narrative, recognising relationality and in acknowledging the significance of contextual factors. These perspectives can all contribute to an ‘eclectic’ approach to ethics education in nursing. These narratives of student nurses support the careful inclusion of the arts and humanities within nurse education curricula for their potential to encourage self-awareness, critical thinking and concern for others. Narratives of nurse educators support these insights in addition to demonstrating ways in which the arts and humanities themselves can offer critical perspectives on current curriculum philosophies. These narratives suggest that the reading of literature and poetry can contribute to an eclectic approach to ‘ethical competency’ in nurse education. This is a broad-based educational approach which draws upon shared interpretive dimensions of the arts and humanities via engagement, action and response. This thesis contributes to current literature in the field of professional health care education by demonstrating the significance of findings derived from inclusion of a teleological ethic within ethics education.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Gefaehrdungspotential von undichten Kanaelen bei industriellen und gewerblichen Grundstuecksentwaesserungsleitungen und die Ableitung von Empfehlungen zur Revitalisierung defekter Entwaesserungsleitungen Abschlussbericht

SIGLEAvailable from TIB Hannover: RN 8908(2000,210) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Umwelt, Naturschutz und Reaktorsicherheit, Bonn (Germany)DEGerman