Initial experience in self-monitoring of intraocular pressure.

Background/aims: Diurnal variation in intraocular pressure (IOP) is a routine assessment in glaucoma management. Providing patients the opportunity to perform self-tonometry might empower them and free hospital resource. We previously demonstrated that 74% of patients can use the Icare® HOME tonometer. This study further explores Icare® HOME patient self-monitoring. Methods: Patients were trained by standard protocol to use the Icare® HOME rebound tonometer. Patient self-tonometry was compared to Goldmann applanation tonometry (GAT) over one clinical day. Following this, each patient was instructed to undertake further data collection that evening and over the subsequent two days. Results: Eighteen patients (35 eyes) participated. Good agreement was demonstrated between GAT and Icare® HOME for IOPs up to 15 mm Hg. Above this IOP the Icare® tended to over-read, largely explained by 2 patients with corneal thickness >600 um. The mean peak IOP during ‘clinic hours’ phasing was 16.7 mm Hg and 18.5 mm Hg (p = 0.24) over three days. An average range of 5.0, 7.0 and 9.8 mm Hg was shown during single day clinic, single day home and three day home phasing respectively (p =<0.001). The range of IOP was lower in eyes with prior trabeculectomy (6.1 mm Hg vs 12.2 mm Hg). All patients undertook one reading in the early morning at home with an average of 4.8 readings during, and 3.1 readings after office hours. Conclusions: This small study shows that self-tonometry is feasible. The findings from home phasing demonstrated higher peak and trough IOPs, providing additional clinical information. Home phasing is a viable alternative. The cost-effectiveness of this approach has yet to be addressed

Avoidance as a strategy of (not) coping: qualitative interviews with carers of Huntington's Disease patients

Peer reviewedPublisher PD

Conversational Synchronization in Naturally Occurring Settings:A Recurrence-Based Analysis of Gaze Directions and Speech Rhythms of Staff and Clients with Intellectual Disability

<p>Past research has shown that rapport and cooperation between individuals is related to the level of nonverbal synchrony they achieve in their interactions. This study investigates the extent to which staff and clients with mild to borderline intellectual disability achieve interactional synchrony in daily social interactions. Whilst there has been work examining how staff can adapt their verbal communication to help achieve better mutual understanding, there has been an absence of work concerning the responsiveness of staff and clients regarding their nonverbal behavior. Nineteen staff members video-recorded a social interaction with one of their clients in which the client had a need for support. The recordings were analyzed using cross recurrence quantification analysis. In addition, fifteen staff members as well as clients with an intellectual disability completed a questionnaire on the quality of the nineteen video-recorded interactions. Analysis of the nonverbal patterns of interaction showed that the staff-client dyads achieved interactional synchrony, but that this synchrony is not pervasive to all nonverbal behaviors. The client observers appeared to be more sensitive to this synchrony or to value it more highly than the staff raters. Staff observers were sensitive to quantitative measures of talking. The more staff in the interactions talked, the lower the quality rating of the interaction. The more the clients talked, the more positively the staff observers rated the interactions. These findings have implications for how collaborative relationships between clients and support workers should be understood. © 2013 Springer Science+Business Media New York.</p>

Conversation Among Primate Species

International audienceThe literature in psychology and sociolinguistic suggests that human interlocutors, when conversing, virtually sign a sort of contract that defines the exchange rules in both structural and social domains. These rules make the messages more understandable and the interaction more predictable, but they may also act as a social bond regulator. These rules can be very basic such as speech overlap avoidance, respect of response delays, turn-taking and vocal accommodation to the context and interlocutor’s social status. Interestingly, these rules are universally spread among human cultures questioning their biological basis and motivating the search for possible parallels with our primate cousins. Here, we will review the available literature on monkeys and apes. We will describe the different forms of vocal interactions, the temporal rules underlying these coordinated interactions, the non-random social selection of interlocutors and the context-dependent acoustic plasticity associated to these exchanges. The fact that primate species are socially varied, in terms of both social structure and social organisation, is another interesting aspect, since different social needs may predict different vocal interaction patterns and conversational rules. For example, duets, choruses and dyadic exchanges are not randomly distributed in the primate phylogeny and may even show different functions. Also, age proximity, kin membership, social affinity and hierarchy seem to play species-specific roles. Regarding plasticity, cases of vocal sharing and acoustic matching have been described in some species, notably in contact calls which are the calls the most frequently involved in dyadic exchanges. At last, a few studies also show that these ‘primitive’ conversational rules are often broken by juveniles and that the appropriate way to vocally interact with others may be socially learned, thus another aspect that do not seem strictly human