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Patients’ attitudes and beliefs to presbyopia and its correction
Objective
Presbyopia is the gradual inability to focus near objects with age. This study explores patients’ attitudes and beliefs towards presbyopia including preferred modes of near refractive correction.
Methods
In the United Kingdom, twenty-four volunteers completed an online questionnaire and attended a structured, recorded focus group. Participants’ age ranged between 36 and 48 years, representing a pre-presbyopic and a presbyopic population. Attitudes and beliefs about presbyopia, its significance, and opinions about current refractive correction including multifocal contact lenses were transcribed and coded using content analysis for overarching themes and patterns.
Results
Six participants (25%) were already wearing a near visual correction while 18 (75%) were not. Five key primary themes with clear inter-participant similarities were identified as ‘age-related’ (75%), ‘acceptance’ (50%), clear lack of ‘familiarity with the word presbyopia’ (65%), a mixed/ reluctant attitude ‘towards (multifocal) contact lenses’ (62.5%), and ‘comfort and convenience’ of a presbyopic correction (79%) whereby cost is of less importance.
Conclusion
The need for a reading correction was perceived as a sign of age. Spectacles were the most preferred mode of near vision correction, while comfort and convenience were seen as more important than cost. Patient education about presbyopia is lacking. Multifocal contact lenses are not necessarily the preferred visual correction even if the patient already wears contact lenses for distance
Humanistic, and Particularly Classical, Studies as a Preparation for the Law
Aside from the elementary branches, no particular subject is absolutely essential as a basis for the study and practice of the law. In this respect the law occupies a place somewhat different from that of the other learned professions. The student and practitioner of medicine must of necessity get a substantial scientific foundation for his professional work. This for him is an absolutely essential prerequisite. For the professional courses in engineering a special and definite scientific preparation must be made; without it nothing but the most ordinary work in engineering can be accomplished. And it is probable that for theology, work along certain well-defined lines is desirable, if not essential. But it by no means follows that, because success in the study of the law or in the practice of it does not depend upon the mastery of particular subjects, a thorough preparation therefor is not necessary. The contrary is most emphatically true, particularly at the present time. The law is a practical subject, most intimately connected with the private interests of the citizen, and with questions affecting his public rights and obligations; but it is at the same time a science, the mastery of which requires a mental equipment above the ordinary. No one can hope for much success as a student of it without adequate preliminary training, or in its application as an art, without being prepared for the keenest kind of intellectual competition
Examination of the Medical Expert
The expert witness differs essentially from the ordinary witness in at least two particulars; first, in that the field of his testimony is outside the range of ordinary knowledge and experience; and, secondly, in that his testimony in the great majority of cases is in the form of opinions or conclusions that are deemed necessary for the proper guidance of the jury. It goes without saying that the \u27lawyer who undertakes the examination of the expert should have such familiarity with the subject of inquiry as will enable him to develop it through the expert logically and clearly, but unfortunately it does not go without saying that this is generally the case
Disbarment or Suspension of Attorney
The decision of the Supreme Court of Oregon in the case of State ex rel Grievance Committee of State Bar Association v. Tanner, rendered Jan. 12, 19O7, 88 Pac. Rep. 301, is of sufficient importance to merit brief notice. The proceeding was instituted by the grievance committee of the State Bar Association for the removal from practice of the defendant, an attorney at law, under a statute of the State that provides for the removal or suspension of an attorney from practice by the Supreme Court upon his being convicted of a felony or of a misdemeanor involving moral turpitude
Should Men Bearing the Same Title in Any Institution Receive the Same Pay?
I suppose that there is at the present time in most universities discrimination to a limited extent between men holding the same title. In some cases it is based upon length of service; in others, it is made in favor of men who perform extra duties. Sometimes, moreover, special endowments lead to discriminations. And occasionally the salary of a man is fixed above that of his associates in order to retain his services when he has been called at an increased salary by another university. Sometimes, also, special and exceptional circumstances put a man in a different class from that of his associates, although he may have the same title, and his exceptional position is recognized by a difference in salary. This happens not infrequently in professional schools, where a man in accepting a professorship, makes a pecuniary sacrifice, or where his standing is such as to make the securing of his services particularly desirable. Or it may happen that there is a discrimination because some of the men are engaged in outside professional work. In each of the cases mentioned, there is a definite reason for the discrimination which serves as a basis for the fixing of compensation. Although causing undoubtedly some friction and criticism, discriminations like those indicated are not subject to the objections that may be urged against a general policy of discrimination, and their wisdom and propriety are, I think, generally recognized. If we eliminate the cases to which reference has been made, it may be said, I think, to be the general custom in American universities to pay the same salary to men bearing the same title. Should the custom be continued, with the exceptions mentioned, or should there be a general policy of discrimination based upon merit? Or, to put the question differently, should the money value of the services of the university professor be fixed by the arbitrary standard of rank, or should it rather be determined by the same standards by which the value of services of like grade in other fields is determined
Humanistic, and Paticularly Classical, Studies, as a Preparation for the Law
Aside from the elementary branches, no particular subject is absolutely essential as a basis for the study and practice of the law. In this respect the law occupies a place somewhat different from that of the other learned professions. The student and practitioner of medicine must of necessity get a substantial scientific foundation for his professional work. This for him is an absolutely essential prerequisite. For the professional courses in engineering, a special and definite scientific preparation must be made. Without it nothing but the most ordinary work in engineering can be accomplished. And it is probable that for theology, work along certain well defined lines is desirable, if not essential. But it by no means follows that because success in the study of the law or in the practice of it does not depend upon the mastery of particular subjects, a thorough preparation therefor is not necessary. The contrary is most emphatically true, particularly at the present time. The law is a practical subject, most intimately connected with the private interests of the citizen and with questions affecting his public rights and obligations, but it is at the same time a science, the mastery of which requires a mental equipment above the ordinary. No one can hope for much success as a student of it without adequate preliminary training, or in its application as an art without being prepared for the keenest kind of intellectual competition. Upon the very threshold of his work the law student discovers that his success is to depend very largely upon his equipment, not upon his having mastered any particular subject but upon his having made himself master of his own mental processes to such an extent that he can do independent and original thinking. The fundamental principles of the different departments of the law must be mastered, and that their full significance may be appreciated, their historical development, through the successive decisions of the courts, must be traced. But he soon discovers that his task embraces more than the memorizing of principles and the study of their origin and growth. His eyes are soon opened to the fact that the serious business of the law student consists in the application of general principles to the solution of problems involving new conditions and varying statements of fact. And then, too, he discovers directly that, although the body of the settled law is large, there are continually arising questions upon which the law is unsettled and whose solution requires the harmonizing, if possible, of conflicting decisions, or where this is not possible, the determination as to the weight of reason and authority. He soon discovers that for every step taken and for every conclusion reached a logical and forceful reason must be assigned. It is needless for me to suggest that work of this nature, if successfully accomplished, calls for analytical power ind constructive ability; it demands the informed and trained judgment of an educated man. While occasionally one having a natural aptitude for the law may be able, even with limited preparation, to master its principles and the art of its application and to push to the front with, apparent ease, the fact remains that, as a rule, the appreciative and successful study of jurisprudence demands preliminary training of a high order and of the thorough, and rigorous kind
The Compensation of Medical Witnesses
The power to compel testimony is inherent in every court, for without it justice could constantly be thwarted. Generally all persons may be compelled to give evidence that is relevant to the matter in controversy. If, therefore, a person who has been duly summoned as a witness at a particular trial absents himself therefrom, without just cause, or attending, refuses to give evidence or to answer questions when directed so to do by the court, he is liable to punishment for contempt.1 But there are limitations upon the general rule, some based upon principles of legal policy and some upon statutory enactment. In regard to some of these the law is well settled, but in regard to others there is still considerable conflict in judicial opinion. The question, for example, of whether or not the physician is bound, in obedience to process and for the compensation provided by law for ordinary witnesses, to attend at a trial and give evidence, is one upon which, in some of its phases, the courts that have reviewed the matter are not in entire harmony. All agree that the physician, like the ordinary witness, is bound to obey the command of a subpoena to the extent of reporting in court, and further that he must give evidence as to competent facts connected with the controversy that are within his own knowledge. As to such facts he testifies as an ordinary witness. But when he is summoned for the purpose of securing his opinion as an expert upon a given state of facts, as an aid to the court and jury, may he properly refuse to furnish that opinion in the absence of a provision for adequate professional compensation? Different answers to this question have been made by different courts. In some cases the question has assumed this form: Can the medical expert be compelled, for the ordinary witness fees, to attend a trial, listen to the evidence adduced therein, and give his opinion in answer to hypothetical questions? And in others this: Can testimony as to scientific results, obtained by special preparation and experiment, be compelled? As will be seen, there is comparative unanimity in judicial opinion as to the proper course where the question arises under either of the last two forms
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