Managing risk in the face of adversity: design and outcomes of rapid glaucoma assessment clinics during a pandemic recovery

Background: The provision of timely care to the high volume of glaucoma patients stratified as “low risk” following pandemic-related appointment deferrals continues to prove challenging for glaucoma specialists. It is unknown whether stratification as “low risk” remains valid over time, raising the potential risk of harm during this period if left unmonitored. This study aimed to evaluate whether Rapid Glaucoma Assessment Clinics (RGACs) are an effective method of assessing “low-risk” patients in order to identify those who may need an escalation of care, therefore reducing the risk of the future incidents of preventable vision loss. / Methods: RGACs were developed which comprised a brief advance telephone history by a clinician and then ophthalmic technician-measured visual acuity and intraocular pressure in clinic. We report outcomes from the first month of operation describing attendance patterns, the proportion of patients from this “low risk” cohort requiring escalation and underlying reasons for treatment escalations. / Results: 639 patients were invited to attend RGACs. 75% attended their booked appointment. Pre-attendance telephone consultations were associated with lower non-attendance rates (13.9% vs 29.3%, p < 0.00001). 15% of patients were no longer deemed to remain at “low risk” with further expedited clinical review scheduled. 10.4% of patients required an escalation in treatment following review. / Conclusions: RGACs are an effective approach to deliver high throughput clinical assessments for large numbers of “low-risk” glaucoma patients with deferred appointments. They enable the rapid identification and treatment of patients who would otherwise face significantly delayed review reducing the risk of future preventable vision loss

Beyond the merchant and the clergyman: assessing moral claims about development cooperation

This article proposes to move beyond the categories of altruism and self-interest in the analyses of the motives for development cooperation. This opposition ignores the inherently moral nature of development policy. The article illustrates the shortcomings of such a perspective by tracing the metaphor of the merchant and the clergyman as archetypical figures shaping Dutch development policy. Through these images the suggestion of an opposition between moral and amoral motives in the history of development has gained a strong foothold within the interplay of scholars, policy makers and public opinion. We go on to assess claims about economy, security, solidarity, prestige and guilt, and ecology, which have been brought forward to legitimise Dutch foreign aid. This analysis calls for research on the dynamics of the transnational exchanges of ideas, interests and expectations, especially during episodes when the moral validity of policy has been explicitly contested

Comment on: ‘Could the AREDS formula benefit patients with glaucoma?’

We read the article recently published in Eye titled “Could the AREDS formula benefit patients with glaucoma?” by Sethi A. and Vajaranant, T.S with great interest [1]. The authors have considered multiple studies examining how components of the AREDS and AREDS2 formulas affect patients with primary open angle glaucoma...</p

Optimisme en/of pessimisme: factorstructuur van de Nederlandse Life Orientation Test-Revised

This study examined the construct validity of the Dutch Life Orientation\ud Test-Revised (LOT-R) in two samples; one sample of patients with psychiatric\ud disorders (n=157) and one sample of patients with rheumatoid arthritis\ud (RA, n=83). Confirmatory factor analyses showed that the LOT-R was not\ud sufficiently unidimensional and could be better explained by two underlying\ud factors consisting of positively and negatively worded items, respectively.\ud This two-factor solution fitted the data significantly better than the onefactor\ud solution in both groups, but satisfied all criteria for good model fit in\ud the psychiatric patient sample only. One-factor models allowing correlated\ud error terms between the positively or negatively worded items performed\ud equally better than the original one-factor solution in both groups, indicating\ud that the two factors may be the result of the specific wording of the\ud items. However, the two factors were differentially associated with other\ud relevant psychological constructs and correlation patterns differed substantially\ud between both populations, indicating possible conceptual differences\ud between optimism and pessimism. Overall, the findings suggest that the\ud positively and negatively worded items of the Dutch LOT-R do not reflect a\ud true unidimensional construct, but two underlying factors which may reflect\ud a complex combination of methodological artefact and substantive differences.\ud Therefore, researchers using the Dutch LOT-R are encouraged to not\ud only rely on total scale scores, but to use additional sub-scores for optimism\ud and pessimism to better examine possible relationships and effects\ud in optimism research

On the dimensionality of the Dispositional Hope Scale

The Dispositional Hope Scale (DHS; C. R. Snyder et al., 1991) consists of two subsets of items measuring Agency and Pathways. ne authors used bifactor analysis to evaluate the dimensionality structure of the scale. Data from 676 persons (295 psychiatric patients, 112 delinquents, and 269 students) were analyzed. The authors conclude that although the Pathway items seem to explain some additional variance when the Hope scale variance is partionalized out, the DHS allows unidimensional measurement