Delay in diabetic retinopathy screening increases the rate of detection of referable diabetic retinopathy

Aims - To assess whether there is a relationship between delay in retinopathy screening after diagnosis of Type 2 diabetes and level of retinopathy detected. Methods - Patients were referred from 88 primary care practices to an English National Health Service diabetic eye screening programme. Data for screened patients were extracted from the primary care databases using semi-automated data collection algorithms supplemented by validation processes. The programme uses two-field mydriatic digital photographs graded by a quality assured team. Results - Data were available for 8183 screened patients with diabetes newly diagnosed in 2005, 2006 or 2007. Only 163 with Type 1 diabetes were identified and were insufficient for analysis. Data were available for 8020 with newly diagnosed Type 2 diabetes. Of these, 3569 were screened within 6 months, 2361 between 6 and 11 months, 1058 between 12 and 17 months, 366 between 18 and 23 months, 428 between 24 and 35 months, and 238 at 3 years or more after diagnosis. There were 5416 (67.5%) graded with no retinopathy, 1629 (20.3%) with background retinopathy in one eye, 753 (9.4%) with background retinopathy in both eyes and 222 (2.8%) had referable diabetic retinopathy. There was a significant trend (P = 0.0004) relating time from diagnosis to screening detecting worsening retinopathy. Of those screened within 6 months of diagnosis, 2.3% had referable retinopathy and, 3 years or more after diagnosis, 4.2% had referable retinopathy. Conclusions - The rate of detection of referable diabetic retinopathy is elevated in those who were not screened promptly after diagnosis of Type 2 diabetes

RESTRAINT OF TRADE DURING AND ON THE TERMINATION OF A CONTRACT OF EMPLOYMENT

RESTRAINT OF TRADE DURING AND ON THE TERMINATION OF A CONTRACT OF EMPLOYMEN

Bessel beam propagation: Energy localization and velocity

The propagation of a Bessel beam (or Bessel-X wave) is analyzed on the basis of a vectorial treatment. The electric and magnetic fields are obtained by considering a realistic situation able to generate that kind of scalar field. Specifically, we analyze the field due to a ring-shaped aperture over a metallic screen on which a linearly polarized plane wave impinges. On this basis, and in the far field approximation, we can obtain information about the propagation of energy flux and the velocity of the energy.Comment: 6 pages, 4 figure

Why and when the Minkowski's stress tensor can be used in the problem of Casimir force acting on bodies embedded in media

It is shown that the criticism by Raabe and Welsch of the Dzyaloshinskii-Lifshitz-Pitaevskii theory of the van der Waals-Casimir forces inside a medium is based on misunderstandings. It is explained why and at which conditions one can use the ''Minkowski-like '' stress tensor for calculations of the forces. The reason, why approach of Raabe and Welsch is incorrect, is discussed.Comment: Comment, 2 pages. 2 misprints were correcte

Photonic band mixing in linear chains of optically coupled micro-spheres

The paper deals with optical excitations arising in a one-dimensional chain of identical spheres due optical coupling of whispering gallery modes (WGM). The band structure of these excitations depends significantly on the inter-mixing between WGMs characterized by different values of angular quantum number, $l$. We develop a general theory of the photonic band structure of these excitations taking these effects into account and applied it to several cases of recent experimental interest. In the case of bands originating from WQMs with the angular quantum number of the same parity, the calculated dispersion laws are in good qualitative agreement with recent experiment results. Bands resulting from hybridization of excitations resulting from whispering gallery modes with different parity of $l$ exhibits anomalous dispersion properties characterized by a gap in the allowed values of \emph{wave numbers} and divergence of group velocity.Comment: RevTex, 28 pages, 7 Figure

Koinonia

Back to the Future in Christian Counseling: Thoughts from a Student Learning Perspective President\u27s Corner Editor\u27s Disk CoCCA: A Bridge Toward Cultural Competency in Christian Colleges & Hot Ideas Book Review: Postmodern Timeshttps://pillars.taylor.edu/acsd_koinonia/1028/thumbnail.jp

System-level and patient-level explanations for non-attendance at diabetic retinopathy screening in Sutton and Merton (London, UK): a qualitative analysis of a service evaluation

Objectives: Non-attendance at diabetic retinopathy screening has financial implications for screening programmes and potential clinical costs to patients. We sought to identify explanations for why patients had never attended a screening appointment (never attendance) in one programme. Design: Qualitative analysis of a service evaluation. Setting: One South London (UK) diabetic eye screening programme. Participants and procedure: Patients who had been registered with one screening programme for at least 18 months and who had never attended screening within the programme were contacted by telephone to ascertain why this was the case. Patients’ general practices were also contacted for information about why each patient may not have attended. Framework analysis was used to interpret responses. Results: Of the 296 patients, 38 were not eligible for screening and of the 258 eligible patients, 159 were not contactable (31 of these had phone numbers that were not in use). We obtained reasons from patients/general practices/clinical notes for non-attendance for 146 (57%) patients. A number of patient-level and system-level factors were given to explain non-attendance. Patient-level factors included having other commitments, being anxious about screening, not engaging with any diabetes care and being misinformed about screening. System-level factors included miscommunication about where the patient lives, their clinical situation and practical problems that could have been overcome had their existence been shared between programmes. Conclusions: This service evaluation provides unique insight into the patient-level and system-level reasons for never attendance at diabetic retinopathy screening. Improved sharing of relevant information between providers has the potential to facilitate increased uptake of screening. Greater awareness of patient-level barriers may help providers offer a more accessible service

On the Possibility of Measuring the Abraham Force using Whispering Gallery Modes

Critical experimental tests of the time-dependent Abraham force in phenomenological electrodynamics are scarce. In this paper we analyze the possibility of making use of intensity-modulated whispering gallery modes in a microresonator for this purpose. Systems of this kind appear attractive, as the strong concentration of electromagnetic fields near the rim of the resonator serves to enhance the Abraham torque exerted by the field. We analyze mainly spherical resonators, although as an introductory step we consider also the cylinder geometry. The order of magnitude of the Abraham torques are estimated by inserting reasonable values for the various input parameters. As expected, the predicted torques turn out to be very small, although probably not beyond any reach experimentally. Our main idea is essentially a generalization of the method used by G. B. Walker et al. [Can. J. Phys. 53, 2577] for low-frequency fields, to the optical case.Comment: 6 pages, no figures. Minor typos corrected, acknowledgment added. To appear in Phys. Rev.

Raman Spectroscopic and Quantum Chemical Investigation of the Pyridine-Borane Complex and the Effects of Dative Bonding on the Normal Modes of Pyridine

The pyridine-borane (PyBH3) complex was analyzed by Raman vibrational spectroscopy and density functional theory to elucidate its structural and vibrational properties and to compare these with those for neat pyridine (Py). The borane-nitrogen (BN) bond length, the BN dative bond stretching frequency, and the effects of dative-bonded complex formation on Py are presented. Rather than having a single isolated stretching motion, the complex exhibits multiple BN dative bond stretches that are coupled to Py\u27s vibrations. These modes exhibit large shifts that are higher in energy relative to neat Py, similar to previous observations of Py/water mixtures. However, significantly higher charge transfer was observed in the dative-bonded complex when compared to the hydrogen-bonded complex with water. A linear relationship between charge transfer and shifts to higher frequencies of pyridine\u27s vibrational modes agrees well with earlier observations. The present work is of interest to those seeking a stronger relationship between charge-transfer events and concomitant changes in molecular properties