Does Knowledge of the Causes of Glaucoma Impact Adherence?

poster abstractPurpose: Glaucoma is informally known as loss of sight due to the deterioration or damage to the optic nerve; some scientists claim to have identified the genes related to these causes. The most prevalent risk factor includes those of African descendant. We tested the hypothesis that the adherence level is higher in patients with more knowledge of their condition than those with none. Methods: A dataset of the first visit from a clinical diagnosis of open-angle glaucoma was retrieved, in which all the patients administered once-daily prostaglandin analog eye drops themselves. Participants were on average 60.38±9.93yrs of age and identified as African descendants; of the 29 patients, 16 self-identified as male and the rest female. Participants were specifically asked to “Please list in rank-order the three most important factors that you believe caused your illness”. We grouped the results into three different conditions: (1) those with at least on “true” (current factors that are widely accepted scientifically) risk factors vs those with none, (2) those who included race as a risk factor vs those who did not, and (3) those who listed any risk factors vs those with none. We compared the adherence within each condition using two-tailed t-test to calculate the “level of significance”. Results: Our results did not agree with our hypothesis. The values returned were: (1) 0.1244, (2) 0.3744, and (3) 0.2516. Because all three results were ≥ 0.05, our data displayed that there were no relationship between the groups. It meant that our outcomes were most likely a consequence of chance with no significance. Conclusions: Though our results were not consistent with our hypothesis, we were still able to come to a different deduction: whether or not individuals are educated on the causes of their conditions, their adherence will only improve if they decide it so

A Comparison of Objectively- and Subjectively-Measured Adherence in Glaucoma Patients of African Descent

poster abstractPurpose. Adherence to medical treatment of glaucoma is challenging. People of African descent (AD) have higher prevalence of open-angle glaucoma (OAG) and have been shown to have worse adherence. The goal of this prospective, observational study was to compare objectively- and subjectively-measured adherence in patients of African descent and to determine their relationship with self-efficacy. Methods. Twenty-one patients of AD diagnosed with OAG in the past five years were included in this study. Patients used a once-daily topical prostaglandin analog eye drop and self-administered their medication. Subjective adherence was assessed through self-report. Adherence was objectively measured using MEMS bottles. The cap of these bottles records the number of times the bottle is opened. Self-efficacy was assessed using the 10-item Glaucoma Medication Self-Efficacy scale and the 6-item Eye Drop Technique Self-Efficacy scale. MEMS adherence percentages were compared to self-reported adherence using a paired sample two-tailed t-test. To assess the relationship between objectively measured adherence and self-efficacy, patients were divided into 3 groups (n=7 each): high, medium and low adherence groups. The Chi-square test was used to determine whether differences in self-efficacy between the groups were present for each question on the two self-efficacy scales. Results. Subjectiveadherence (mean ± standard deviation) (97.34% ± 5.61) was significantly higher than objective adherence (66.34% ± 26.68) (p= 0.01). Of the 21 patients, 17 self-reported higher adherence levels than MEMS adherence levels. 4 patients with the highest levels of objectively measured adherence were the only patients to correctly estimate their adherence by self-report. Only one question was significantly associated with objective adherence: patients with high adherence were significantly more confident about taking their glaucoma medications when they do not experience symptoms (p = 0.04). Conclusions. Results showed that patients with higher adherence are more confident about using their eye drops in the absence of symptoms

Severity of Schistosoma haematobium co-infection with malaria in school-children is potentially modulated by host CD14 gene variants

Abstract Objective Schistosomiasis remains a chronic disease of global importance, especially in many rural areas of the world where co-infection with Plasmodium falciparum is common. It is critical to decipher the role of single or co-infected disease scenarios on immune system regulation in such individuals and how such co-infections can either ameliorate or complicate immune response and the consequent disease outcome. First, 10 ml of urine samples, collected between 10:00 am and 2:00 pm, was filtered for diagnosis of schistosomiasis, while egg count, indicative of disease severity, was determined by microscopy. Furthermore, genomic DNA samples extracted from dried blood spots collected on filter paper from one hundred and forty-four Schistosoma haematobium-infected school-children was tested for P. falciparum parasite positivity by an allele-specific nested-PCR analysis of merozoite surface protein (msp)-1 and -2 genes and a real-time PCR assay. In addition, among P. falciparum parasite-positive individuals, we carried out a Taqman SNP genotyping assay to extrapolate the effect of host CD14 (-159 C/T; rs2569190) genetic variants on schistosome egg count. Results Of the 144 individuals recruited, P. falciparum parasite positivity with msp-1 gene were 34%, 43% and 55% for MAD20, RO33 and K1 alleles respectively. Of the co-infected individuals, CD14 genetic variants ranged from 18.8% vs 21.5%, 33.3% vs 44.4%, 9.7% vs 11.8% for single versus schistosome co-infection for the wild type (CC), heterozygous (CT) and mutant (TT) variants respectively. Though the mean egg count for co-infected individuals with CD14 wild type (33.7 eggs per 10 ml of urine) and heterozygote variants (37.5 eggs per 10 ml of urine) were lower than that of schistosome infection alone (52.48 and 48.08 eggs/10 ml of urine respectively), it lacked statistical significance (p-value 0.12 and 0.29), possibly reflecting the benefit of the CD14 activation in schistosome plus malaria co-infection and not schistosome infection alone. In addition, the lower mean egg count in co-infected individuals reveal the benefit of downstream Th1 immune response mitigated by CD14 innate activation that is absent in schistosome infection alone

Projections of Mountain Snowpack Loss for Wolverine Denning Elevations in the Rocky Mountains

Abstract Future reduction in mountain snowpack due to anthropogenic climate change poses a threat to many snow‐adapted species worldwide. Mountain topography exerts a strong control on snowpack not only due to elevation but also through the effect of slope and aspect on the surface energy balance. We develop high‐resolution projections of snowpack in order to provide improved, physically based estimates of the spatial distribution of future snowpack to inform species conservation efforts for the wolverine (Gulo gulo) in two study areas in the Rocky Mountains: one in Montana with known den sites and one in Colorado with recent wolverine activity and potential for reintroduction. Here we assess springtime snowpack loss in actual and potential denning areas under five future climate scenarios for the mid‐21st century. Snowpack in April and May is likely to persist into the mid‐21st century in the upper half of current denning elevations in all but the warmest future climate scenario, while large declines are projected for the lower half of the denning elevations. We gain new insight into the influence of topographical aspect on future snowpack and quantify the potential for enhanced snow persistence on north and east facing slopes under future scenarios that is only revealed in simulations where terrain slopes are resolved

Health-Related Quality of Life, Psychological Distress, and Sexual Changes Following Prostate Cancer:A Comparison of Gay and Bisexual Men With Heterosexual Men

AbstractIntroductionDecrements in health-related quality of life (HRQOL) and sexual difficulties are a recognized consequence of prostate cancer (PCa) treatment. However little is known about the experience of gay and bisexual (GB) men.AimHRQOL and psychosexual predictors of HRQOL were examined in GB and heterosexual men with PCa to inform targeted health information and support.MethodOne hundred twenty-four GB and 225 heterosexual men with PCa completed a range of validated psychosexual instruments.Main outcome measureFunctional Assessment of Cancer Therapy – Prostate (FACT-P) was used to measure HRQOL, with validated psychosexual measures, and demographic and treatment variables used as predictors.ResultsGB men were significantly younger (64.25 years) than heterosexual men (71.54 years), less likely to be in an ongoing relationship, and more likely to have casual sexual partners. Compared with age-matched population norms, participants in both groups reported significantly lower sexual functioning and HRQOL, increased psychological distress, disruptions to dyadic sexual communication, and lower masculine self-esteem, sexual confidence, and sexual intimacy. In comparison with heterosexual men, GB men reported significantly lower HRQOL (P = .046), masculine self-esteem (P < .001), and satisfaction with treatment (P = .013); higher psychological distress (P = .005), cancer related distress (P < .001) and ejaculatory concern (P < .001); and higher sexual functioning (P < .001) and sexual confidence (P = .001). In regression analysis, psychological distress, cancer-related distress, masculine self-esteem, and satisfaction with treatment were predictors of HRQOL for GB men (R2Adj = .804); psychological distress and sexual confidence were predictors for heterosexual men (R2Adj = .690).ConclusionThese findings confirm differences between GB and heterosexual men in the impact of PCa on HRQOL across a range of domains, suggesting there is a need for GB targeted PCa information and support, to address the concerns of this “hidden population” in PCa care