The perception of strabismus by children and adults

Background: Visible strabismus has been shown to have adverse psychosocial consequences. It remains controversial if esotropia or exotropia is perceived more negatively. The aim of this study was to determine if esotropia or exotropia and the eye (side) in which strabismus is present are perceived differently. We also asked our adult participants: (1) if they thought visible strabismus should be corrected by surgery, (2) if they thought that strabismus surgery should only be to improve the cosmesis, and (3) if they thought that the surgery should be paid for by health insurance. Methods: One hundred adults and 61 children rated four photographs of a digitally altered picture of a boy and four of a girl, showing a large-angle esotropia or exotropia either in the left or on the right eye. The adults were additionally asked if a squint should be operated, if they considered strabismus surgery to be a cosmetic procedure, if in their opinion strabismus surgery should be covered by compulsory health insurance, and if children with strabismus are disadvantaged. Comparisons were performed using ANOVA and regression analysis. Results: Adults perceived a squinting right eye as more disturbing than a squinting left eye p  0.1 for each). Children also found that a squinting right eye is more disturbing (p < 0.001) than a left one. Additionally, children ranked esotropia worse than exotropia (p < 0.001). Neither age nor gender had an impact on the perception of strabismus by children. Of the adults, 94% would recommend surgery for all forms of strabismus, 18% thought that surgery is only cosmetic, and 94% found that health insurance should cover strabismus surgery for everybody. Problems of squinting children named by the adults included: being made fun of by other children (53%), problems with eyesight (39%), people looking strangely at them (21%), less acceptance by peers (17%), less self confidence (6%), problems judging distances (4%), and that they are perceived as less intelligent (3%). Conclusions: Adults and children rated a squinting right eye as worse compared to a left one. Children perceived esotropia as more disturbing than exotropia. Neither age, nor gender, nor the fact that the respondents have friends or family members with a squint, had an impact on this ranking. Almost all adults would correct all forms of strabismus, and think that surgery should be covered by compulsory health insuranc

Factors associated with quality of life and mood in adults with strabismus

Background/Aims To explore the factors associated with the mood and quality of life (QoL) of patients with strabismus due to undergo realignment surgery. Methods A cross-sectional study was undertaken with adult patients. Along with demographic, clinical and psychosocial process variables, the Hospital Anxiety and Depression Scale and AS-20 QoL measures were administered. Regression models were used to identify the factors associated with QoL and mood. Results Of the 220 participants, 11% were experiencing clinical levels of depression, and 24% clinical anxiety. This is in line with other forms of facial disfigurement but higher than other chronic diseases. Although mood and QoL were associated with age and diplopia, it was beliefs and cognitions which were more consistently associated with well-being. This included feelings of social anxiety and avoidance, a belief that strabismus has negative consequences, poor understanding of strabismus, social support, fear of negative evaluation and the perceived visibility of their condition. Conclusions Psychosocial rather than clinical characteristics were identified as determinants of wellbeing in this population. It is important for clinicians planning surgery to be aware of these factors which could influence outcomes. Longitudinal studies need to be conducted to explore the direction of causality before interventions to improve well-being are developed and evaluated

Comparison of hypertension healthcare outcomes among older people in the USA and England

Funding: Economic and Social Research Council. G1001375/1. Medical Research Council. G1001375/1. US Department of Health and Human Services. National Institutes of Health. National Institute on Aging. 2R01 AG030153.Background The US and England have very different health systems. Comparing hypertension care outcomes in each country enables an evaluation of the effectiveness of each system. Method The English Longitudinal Study of Ageing and the Health and Retirement Survey are used to compare the prevalence of controlled, uncontrolled and undiagnosed hypertension in the population aged over 50 in the US and in England. Results Controlled hypertension is more prevalent in the US (age 50 to 64: 0.53 (0.50-0.57) and age 65+: 0.51 (0.49-0.53)) than in England (age 50 to 64: 0.45 (0.42-0.48) and age 65+: 0.42 (0.40-0.45)). This difference is driven by lower undiagnosed hypertension in the US (age 50 to 64: 0.18 (0.15-0.21) and age 65+: 0.13 (0.12-0.14)) relative to England (age 50 to 64: 0.26 (0.24-0.29) and age 65+: 0.22 (0.20-0.24)). The prevalence of uncontrolled hypertension is very similar in the US (age 50 to 64: 0.29 (0.26-0.32) and age 65+: 0.36 (0.34-0.38)) and England (age 50 to 64: 0.29 (0.26-0.32) and age 65+: 0.36 (0.34-0.39)). Hypertension care outcomes are comparable across US insurance categories. In both countries undiagnosed hypertension is positively correlated with wealth (ages 50-64). Uncontrolled hypertension declines with rising wealth in the US. Conclusions Different diagnostic practices are likely to drive the cross-country differences in undiagnosed hypertension. US government health systems perform at least as well as private health care and are more equitable in the distribution of care outcomes. Higher undiagnosed hypertension among the affluent may reflect less frequent medical contact.Publisher PDFPeer reviewe

Déjà vu: a database of highly similar citations in the scientific literature

In the scientific research community, plagiarism and covert multiple publications of the same data are considered unacceptable because they undermine the public confidence in the scientific integrity. Yet, little has been done to help authors and editors to identify highly similar citations, which sometimes may represent cases of unethical duplication. For this reason, we have made available Déjà vu, a publicly available database of highly similar Medline citations identified by the text similarity search engine eTBLAST. Following manual verification, highly similar citation pairs are classified into various categories ranging from duplicates with different authors to sanctioned duplicates. Déjà vu records also contain user-provided commentary and supporting information to substantiate each document's categorization. Déjà vu and eTBLAST are available to authors, editors, reviewers, ethicists and sociologists to study, intercept, annotate and deter questionable publication practices. These tools are part of a sustained effort to enhance the quality of Medline as ‘the’ biomedical corpus. The Déjà vu database is freely accessible at http://spore.swmed.edu/dejavu. The tool eTBLAST is also freely available at http://etblast.org

How to write an ICS/IUGA conference abstract

Contains fulltext : 88292.pdf (publisher's version ) (Closed access)INTRODUCTION: This article aims to condense the lectures and discussions from workshops on good reporting at IUGA Como 2009 and ICS San Francisco 2009, providing practical advice for the novice researcher summarising their data for the first time. CONCLUSIONS: Drafting an abstract can be a time consuming process. Formal guidance, such as CONSORT and STROBE, exists for the kinds of information that should be included regarding almost all designs of clinical trials. Follow the abstract submission rules closely to avoid outright rejection. Plan to highlight the novelty, scientific merit and clinical impact of the work. Try not to overstate the importance of the findings. Do not forget to publish the work in a peer reviewed journal.1 mei 201

An Empirical Analysis of Overlap Publication in Chinese Language and English Research Manuscripts

BACKGROUND: There are a number of sound justifications for publishing nearly identical information in Chinese and English medical journals, assuming several conditions are met. Although overlap publication is perceived as undesirable and ethically questionable in Europe and North America, it may serve an important function in some regions where English is not the native tongue. There is no empirical data on the nature and degree of overlap publication in English and Chinese language journals. METHODS/PRINCIPAL FINDINGS: A random sample of 100 English manuscripts from Chinese institutions was selected from PubMed. Key words and institutions were searched in the China National Knowledge Infrastructure, a comprehensive Chinese language research database. Unacknowledged overlap was a priori defined according to International Committee of Medical Journal Editor (ICMJE) guidelines following examination by two individuals. 19% (95% CI 11-27) of English manuscripts from Chinese institutions were found to have substantial overlap with Chinese published work based on full text examination. None of the manuscripts met all of the criteria established by the ICMJE for an acknowledged overlap publication. Individual-level, journal-level, and institutional factors seem to influence overlap publication. Manuscripts associated with an institution outside of China and with more than one institution were significantly less likely to have substantial overlap (p<0.05). CONCLUSIONS/SIGNIFICANCE: Overlap publication was common in this context, but instances of standard ICMJE notations to acknowledge this practice were rare. This research did not cite the identified overlap manuscripts with the hope that these empirical data will inform journal policy changes and structural initiatives to promote clearer policies and manuscripts

Effects and feasibility of a standardised orientation and mobility training in using an identification cane for older adults with low vision: design of a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Orientation and mobility training (O&M-training) in using an identification cane, also called symbol cane, is provided to people with low vision to facilitate independent participation in the community. In The Netherlands this training is mainly practice-based because a standardised and validly evaluated O&M-training in using the identification cane is lacking. Recently a standardised O&M-training in using the identification cane was developed. This training consists of two face-to-face sessions and one telephone session during which, in addition to usual care, the client's needs regarding mobility are prioritised, and cognitive restructuring techniques, action planning and contracting are applied to facilitate the use of the cane. This paper presents the design of a randomised controlled trial aimed to evaluate this standardised O&M-training in using the identification cane in older adults with low vision.</p> <p>Methods/design</p> <p>A parallel group randomised controlled trial was designed to compare the standardised O&M-training with usual care, i.e. the O&M-training commonly provided by the mobility trainer. Community-dwelling older people who ask for support at a rehabilitation centre for people with visual impairment and who are likely to receive an O&M-training in using the identification cane are included in the trial (N = 190). The primary outcomes of the effect evaluation are ADL self care and visual functioning with respect to distance activities and mobility. Secondary outcomes include quality of life, feelings of anxiety, symptoms of depression, fear of falling, and falls history. Data for the effect evaluation are collected by means of telephone interviews at baseline, and at 5 and 17 weeks after the start of the O&M-training. In addition to an effect evaluation, a process evaluation to study the feasibility of the O&M-training is carried out.</p> <p>Discussion</p> <p>The screening procedure for eligible participants started in November 2007 and will continue until October 2009. Preliminary findings regarding the evaluation are expected in the course of 2010. If the standardised O&M-training is more effective than the current O&M-training or, in case of equal effectiveness, is considered more feasible, the training will be embedded in the Dutch national instruction for mobility trainers.</p> <p>Trial registration</p> <p>ClinicalTrials.gov NCT00946062</p