Needs Experienced by Persons with Late Stage AIDS

The paper examines needs experienced during the late stage of AIDS with reference to a phenomenological explication of unstructured interviews with persons with acute symptoms of the disease. A distinct pattern of health care needs emerged, characterized by a relative emphasis on the psychosocial as distinct from biomedical or economical aspects of the disease and emotion focused coping strategies. Results are compared with those of other studies and implications for palliative care are discussed.Indo-Pacific Journal of Phenomenology, Volume 1, Edition 1 April 200

Measurement accuracy in accommodative response by the Nott method

The measurement of accommodative response is usually performed by means of the Nott method. The accommodative response values were obtained as described in the bibliography and considering that the neutralizing lens shapes the target image. The values in accommodative response differ according to the calculation method utilized. The accommodation and convergence values when the target is placed 40 cm away from the glasses are not the same in emmetropic and ametropic subjects. At the position of the effective binocular object, the initial values are indeed the same for both types of subjects. Comparing with experimental measurements using the Monocular Estimate Method (Mem), it was obtained the same values given the effect of the neutralizing lens. Optimizing the Nott method would require placing the target at a position where the effective binocular object is 40 cm. Furthermore, the effect of the neutralizing lens should be considered in the calculation method

Creative style: The measurement, changeability and relationships with leadership and performance

The majority of existing creativity research focuses on measuring the level to which people are creative, or the amount of creative output achieved; in contrast, research into creative style refers instead to the tendencies of an individual in terms of how they personally achieve and/or contribute to creativity. Creative style is currently an under-researched area which often lacks theoretical links to the wider field of creativity and innovation, resulting in a fragmented and isolated body of research. This thesis presents two research studies which aim to: align creative style to an established model of creativity and innovation (the Dynamic Componential Theory; Amabile & Pratt, 2016); and to better understand the nature of creative style and its relationships with other constructs through a new measurement tool. Study 1 involved 303 participants across two timepoints, six months apart. This study established the reliability and factor structure of the Creative ID measure of creative style, whilst demonstrating that creative style (at time 1) can account for additional variance in creative/innovative performance (at time 2) after controlling for Big Five Personality Domains. Additionally, creative styles were seen to be generally stable over time, yet can develop following the experience of specific work-life events such as being promoted to a leadership position. Study 2 involved multilevel data from 178 participants (125 followers nested within 48 leaders). This study found no significant relationships between the creative style and leadership style of an individual, implying that ways of being creative and ways of leading are not related. Some significant relationships were found between the creative style of a leader and their followers’ creative/innovative performance; as well as between leadership style and follower creative/innovative performance. Theoretical contributions and practical implications of this work are discussed, along with recognised limitations and suggestions for future research

Qualitative evaluation of Australian Caregiver's experiences of parent–child interaction therapy delivered in a community-based clinic setting

Background: Parent–child interaction therapy (PCIT) is a short-term, evidence-based parent training program for parents of children aged 2–7 years with disruptive behaviour disorders (DBDs). The evidence-base for the effectiveness of PCIT is extensive but to date most studies have been quantitative in nature and conducted in university research clinics within the United States. Thus, understanding of the effectiveness and acceptability of PCIT in community-based settings in other countries, including Australia, is limited. Objective: This study used a qualitative methodology to explore Australian caregiver's perceptions of a standard PCIT program delivered at a community-based PCIT clinic. Method: Participants were nine mothers and one father who completed the PCIT program at the clinic for treatment of child DBD. Results: Thematic analysis yielded four major themes, namely “Parenting challenges before PCIT”; “Positive treatment outcomes” (sub-themes: improved child behaviour, increased parental confidence, increased insight into the child needs, and improved relationships with partner); “Program strengths” (sub-themes: child-directed interaction, parent-directed interaction, home practice, therapeutic relationship); and “Challenges experienced.”. Conclusions: These findings highlight the benefits of the PCIT program for families who are struggling with DBD in early childhood, and point to the potential positive impacts of disseminating PCIT within clinical settings more widely across Australia

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

Background: The prevalence of visual impairment (VI) and dementia increases with age and these conditions may coexist, but few UK data exist on VI among people with dementia. Objectives: To measure the prevalence of eye conditions causing VI in people with dementia and to identify/describe reasons for underdetection or inappropriate management. Design: Stage 1 – cross-sectional prevalence study. Stage 2 – qualitative research exploring participant, carer and professional perspectives of eye care. Setting: Stage 1 – 20 NHS sites in six English regions. Stage 2 – six English regions. Participants: Stage 1 – 708 participants with dementia (aged 60–89 years): 389 lived in the community (group 1) and 319 lived in care homes (group 2). Stage 2 – 119 participants. Interventions: Stage 1 gathered eye examination data following domiciliary sight tests complying with General Ophthalmic Services requirements and professional guidelines. Cognitive impairment was assessed using the Standardised Mini-Mental State Examination (sMMSE) test, and functional ability and behavior were assessed using the Bristol Activities of Daily Living Scale and Cambridge Behavioural Inventory – Revised. Stage 2 involved individual interviews (36 people with dementia and 11 care workers); and separate focus groups (34 optometrists; 38 family and professional carers). Main outcome measures.: VI defined by visual acuity (VA) worse than 6/12 or worse than 6/18 measured before and after refraction. Results: Stage 1 – when participants wore their current spectacles, VI prevalence was 32.5% [95% confidence interval (CI) 28.7% to 36.5%] and 16.3% (95% CI 13.5% to 19.6%) for commonly used criteria for VI of VA worse than 6/12 and 6/18, respectively. Of those with VI, 44% (VA 80% of participants. There was no evidence that the management of VI in people with dementia differed from that in older people in general. Exploratory analysis suggested significant deficits in some vision-related aspects of function and behaviour in participants with VI. Stage 2 key messages – carers and care workers underestimated how much can be achieved in an eye examination. People with dementia and carers were unaware of domiciliary sight test availability. Improved communication is needed between optometrists and carers; optometrists should be informed of the person’s dementia. Tailoring eye examinations to individual needs includes allowing extra time. Optometrists wanted training and guidance about dementia. Correcting VI may improve the quality of life of people with dementia but should be weighed against the risks and burdens of undergoing examinations and cataract surgery on an individual basis. Limitations: Sampling bias is possible owing to quota-sampling and response bias. Conclusions: The prevalence of VI is disproportionately higher in people with dementia living in care homes. Almost 50% of presenting VI is correctable with spectacles, and more with cataract surgery. Areas for future research are the development of an eye-care pathway for people with dementia; assessment of the benefits of early cataract surgery; and research into the feasibility of specialist optometrists for older people

Optical ‘dampening’ of the refractive error to axial length ratio:implications for outcome measures in myopia control studies

Purpose: To gauge the extent to which differences in the refractive error axial length relationship predicted by geometrical optics are observed in actual refractive/biometric data.Methods: This study is a retrospective analysis of existing data. Right eye refractive error [RX] and axial length [AXL] data were collected on 343 6-to-7-year-old children [mean 7.18 years (SD 0.35)], 294 12-to-13-year-old children [mean 13.12 years (SD 0.32)] and 123 young adults aged 18-to-25-years [mean 20.56 years (SD 1.91)]. Distance RX was measured with the Shin-Nippon NVision-K 5001 infrared open-field autorefractor. Child participants were cyclopleged prior to data collection (1% Cyclopentolate Hydrochloride). Myopia was defined as a mean spherical equivalent [MSE] ≤-0.50D. Axial length was measured using the Zeiss IOLMaster 500. Optical modelling was based on ray tracing and manipulation of parameters of a Gullstrand reduced model eye.Results: There was a myopic shift in mean MSE with age (6-7 years +0.87 D, 12-13 years -0.06 D and 18-25 years -1.41 D), associated with an increase in mean AXL (6-7 years 22.70 mm, 12-13 years 23.49 mm and 18-25 years 23.98 mm). There was a significant negative correlation between MSE and AXL for all age groups (all p <0.005). RX: AXL ratios for participant data were compared with the ratio generated from Gullstrand model eyes. Both modelled and actual data showed non-linearity and non-constancy, and that as axial length is increased, the relationship between myopia and axial length differs, such that it becomes more negative.Conclusions: Optical theory predicts that there will be a reduction in the RX: AXL ratio with longer eyes. The participant data although adhering to this theory show a reduced effect, with eyes with longer axial lengths having a lower refractive error to axial length ratio than predicted by model eye calculations. We propose that in myopia control intervention studies when comparing efficacy, consideration should be given to the dampening effect seen with a longer eye

A review of depth of focus in measurement of the amplitude of accommodation

Abstract: The aim of this review is to investigate the role of depth of focus (DoF) as a potential confounding variable in the measurement of the amplitude of accommodation (AoA). The role of DoF in human vision is briefly summarised, and it is noted that the prevalent method of measuring AoA is the push-up method. Factors influencing the effect of DoF on the push-up and other methods of measuring AoA are reviewed in detail. DoF is shown to add substantial measurement error in the routine assessment of accommodation when the AoA is measured by methods involving subjective judgement of an object’s clarity. Reliable compensation for this source of error is not realistically possible because of the complexity of the aetiology of DoF, and its inter-individual and intra-individual variation. The method of measurement also influences the extent of the error. It is concluded that methods of measurement of AoA that exclude DoF should be preferred

Optical characteristics of Alvarez variable-power spectacles

Purpose: To establish the optical performance of currently-available Alvarez variable-power spectacles in relation to their possible utility for ametropes and presbyopes.Methods: Two commercial designs of variable-power (variable-focus) spectacles were studied: FocusSpecs and Adlens Adjustables. Using focimetry, power and prism at three different power settings were measured across the aperture of the lenses of each design and local optical quality was explored in more detail using interferometry.Results: In general, equivalent-sphere powers at all lens settings were adequately stable across the central aperture (about 20 mm diameter) of the lenses, with prism changes following the Prentice rule. Some astigmatism (generally ≤0.5 DC over the central area) and higher-order aberration (comparable to the normal wavefront aberration of the eye) were found, the latter increasing towards the edge of the useable lens area.Conclusions: Within their designed power ranges, optical performance of currently-available Alvarez variable-power spectacles appears to be adequate to correct the distance and near vision of spherical ametropes

Immediate cortical adaptation in visual and non-visual areas functions induced by monovision

Key points: Monovision is an optical correction for presbyopes that consists of correcting one eye for far distance and the other for near distance, creating a superimposition of an in-focus with a blurred image. Brain adaptation to monovision was studied in unexperienced observers by measuring visual evoked potentials from 64-channels. The first clear effect of monovision on visual evoked potentials was the C1 amplitude reduction, indicating that the unilateral blurring induced by monovision reduces feed-forward activity in primary visual area. Monovision led also to an increased amplitude of the P1 and pP1 components, with the latter originating in prefrontal regions. This effect probably works as an attentional compensatory activity used to compensate for the degraded V1 signal. A common and often successful option to correct presbyopia with contact lenses is monovision. This is an unbalanced correction across the two eyes where one eye is corrected for far vision and the other eye is corrected for near vision. Monovision is therefore a form of acquired anisometropia that causes a superimposition of an in-focus image with a blurred image. In spite of this visual anisometropia, monovision has been successfully used for many decadesl however the brain mechanism supporting monovision is not well understood. The present study aimed to measure the visual evoked potentials with a high-density electrode array (64-channel) in a group of presbyopes and to provide a detailed spatiotemporal analysis of the cortical activity after a short period of adaptation to monovision with contact lenses. When compared with a balanced eye near correction, monovision produced both a clear reduction of the earliest visual evoked potential components, the C1 and the N1, and an amplitude increase of the P1 and pP1. These results indicate that the unilateral blurring induced by wearing monovision contact lenses reduces feed-forward activity in the primary visual area and feedback activity in extrastriate areas (C1 and N1 reduction). Interestingly, other brain activities in both extrastriate visual areas (the P1 component) and in the anterior insula (the pP1 component) appear to compensate for this dysfunction, increasing their activity during monovision. These changes confirm the presence of fluid brain adaptation in visual and non-visual areas during monocular interferences