Technical Note: A comparison of central and peripheral intraocular pressure using rebound tonometry

Purpose: To compare central and peripheral intraocular pressure (IOP) readings obtained with rebound tonometry.Methods: Intraocular pressure was measured on the right eye of 153 patients (65 males, 88 females), aged from 21 to 85 years (mean +/- S.D., 55.5 +/- 15.2 years) with the ICare rebound tonometer at centre, and 2 mm from the limbus (in the nasal and temporal regions along the 0-180O corneal meridian).Results: Intraocular pressure values obtained with the ICare were 14.9 +/- 2.8; 14.1 +/- 2.5 and 14.5 +/- 2.7 mmHg at centre, nasal and temporal corneal locations, respectively. On average, nasal and temporal IOP readings were 0.75 and 0.37 mmHg lower than the central reading (p 0.05, respectively). A highly significant correlation was found between central and peripheral measurements in nasal (r(2) = 0.905; p < 0.001) and temporal (r(2) = 0.879; p < 0.001) regions along the horizontal meridian. Almost 80% of patients presented nasal IOP values within +/- 1 mmHg of the central value.Conclusions: Intraocular pressure values measured with the ICare (R) rebound tonometer on the nasal corneal region is slightly lower on average and highly correlated with IOP values recorded at corneal centre. Both nasal and temporal readings are in good agreement with central IOP, and could be used to obtain a reliable estimate of rebound IOP in corneas where central readings cannot be taken.- (undefined

Climate change adaptation in the rental sector

© 2015 by John Wiley & Sons, Ltd. All rights reserved. This chapter examines both assets and barriers for climate adaptation in the rental housing sector through a case study of renters and housing managers in regional Australia. The study included in-depth semi-structured interviews with 22 tenants and 17 housing managers in the public and private housing sectors. A wide range of secondary sources including media articles, sustainable renting guides and legislative and policy documents. Private sector tenants believed that negative social and political attitudes to renters in Australia were an obstacle to changing tenancy conditions and improving housing. There was a wide range of views among property managers about the importance or reality of climate change, from belief to some scepticism. Amending tenancy conditions to enhance the active contribution of tenants to climate change adaptation may require innovative legislative frameworks that reflect climate change and equity imperatives as well as protection for landlords and tenants

Developing risk prediction models for type 2 diabetes: a systematic review of methodology and reporting

<p>Abstract</p> <p>Background</p> <p>The World Health Organisation estimates that by 2030 there will be approximately 350 million people with type 2 diabetes. Associated with renal complications, heart disease, stroke and peripheral vascular disease, early identification of patients with undiagnosed type 2 diabetes or those at an increased risk of developing type 2 diabetes is an important challenge. We sought to systematically review and critically assess the conduct and reporting of methods used to develop risk prediction models for predicting the risk of having undiagnosed (prevalent) or future risk of developing (incident) type 2 diabetes in adults.</p> <p>Methods</p> <p>We conducted a systematic search of PubMed and EMBASE databases to identify studies published before May 2011 that describe the development of models combining two or more variables to predict the risk of prevalent or incident type 2 diabetes. We extracted key information that describes aspects of developing a prediction model including study design, sample size and number of events, outcome definition, risk predictor selection and coding, missing data, model-building strategies and aspects of performance.</p> <p>Results</p> <p>Thirty-nine studies comprising 43 risk prediction models were included. Seventeen studies (44%) reported the development of models to predict incident type 2 diabetes, whilst 15 studies (38%) described the derivation of models to predict prevalent type 2 diabetes. In nine studies (23%), the number of events per variable was less than ten, whilst in fourteen studies there was insufficient information reported for this measure to be calculated. The number of candidate risk predictors ranged from four to sixty-four, and in seven studies it was unclear how many risk predictors were considered. A method, not recommended to select risk predictors for inclusion in the multivariate model, using statistical significance from univariate screening was carried out in eight studies (21%), whilst the selection procedure was unclear in ten studies (26%). Twenty-one risk prediction models (49%) were developed by categorising all continuous risk predictors. The treatment and handling of missing data were not reported in 16 studies (41%).</p> <p>Conclusions</p> <p>We found widespread use of poor methods that could jeopardise model development, including univariate pre-screening of variables, categorisation of continuous risk predictors and poor handling of missing data. The use of poor methods affects the reliability of the prediction model and ultimately compromises the accuracy of the probability estimates of having undiagnosed type 2 diabetes or the predicted risk of developing type 2 diabetes. In addition, many studies were characterised by a generally poor level of reporting, with many key details to objectively judge the usefulness of the models often omitted.</p