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Accommodation and vergence response gains to different near cues characterize specific esotropias
Aim. To describe preliminary findings of how the profile of the use of blur, disparity and proximal cues varies between non-strabismic groups and those with different types of esotropia.
Design. Case control study
Methodology. A remote haploscopic photorefractor measured simultaneous convergence and accommodation to a range of targets containing all combinations of binocular disparity, blur and proximal (looming) cues. 13 constant esotropes, 16 fully accommodative esotropes, and 8 convergence excess esotropes were compared with age and refractive error matched controls, and 27 young adult emmetropic controls. All wore full refractive correction if not emmetropic. Response AC/A and CA/C ratios were also assessed.
Results. Cue use differed between the groups. Even esotropes with constant suppression and no binocular vision (BV) responded to disparity in cues. The constant esotropes with weak BV showed trends for more stable responses and better vergence and accommodation than those without any BV. The accommodative esotropes made less use of disparity cues to drive accommodation (p=0.04) and more use of blur to drive vergence (p=0.008) than controls. All esotropic groups failed to show the strong bias for better responses to disparity cues found in the controls, with convergence excess esotropes favoring blur cues. AC/A and CA/C ratios existed in an inverse relationship in the different groups. Accommodative lag of >1.0D at 33cm was common (46%) in the pooled esotropia groups compared with 11% in typical children (p=0.05).
Conclusion. Esotropic children use near cues differently from matched non-esotropic children in ways characteristic to their deviations. Relatively higher weighting for blur cues was found in accommodative esotropia compared to matched controls
Empowerment, intimate partner violence and skilled birth attendance among women in rural Uganda
DUSTiNGS. III. DISTRIBUTION OF INTERMEDIATE-AGE AND OLD STELLAR POPULATIONS IN DISKS AND OUTER EXTREMITIES OF DWARF GALAXIES
The potential of transdisciplinary research for sustaining and extending linkages between the health and social sciences
The last decade of the twentieth century is witnessing a profusion of projects drawing together social and health scientists to study and recommend solutions for a wide range of health problems. The process--practices in both developed and developing countries--is usually called multidisciplinary or interdisciplinary research. Its historical precedents are briefly reviewed in this paper along with the types of problems addressed. From a review and discussion of a sample of projects selected from two major proponents of this approach to research, the Social and Economic Research Component of the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases and the Applied Diarrheal Disease Research Project, conclusions are drawn about the nature of contributions from such efforts--very useful for short-term problem solving, less so for longer-term programmatic changes, especially beyond the health sector, and even more limited in impact on theory building for coping with the changing human condition. The recognition of such limitations is now widespread in the social and natural sciences beyond the health sector, in population, ecology, and the humanities. Following these observations, I argue for a new approach to transcend the disciplinary bounds inherent in multi-and interdisciplinary research. A transdisciplinary approach can provide a systematic, comprehensive theoretical framework for the definition and analysis of the social, economic, political, environmental, and institutional factors influencing human health and well-being. The academic and career challenges for such researchers, while considerable, may be overcome since there is now flexibility in research-supporting organizations to encourage new ideas in international health, such as that of essential national health research.multidisciplinary interdisciplinary transdisciplinary health and social sciences public health