bluuebunny/crossref_metadata_2025 huggingface dataset:
Audiological Findings in Osteogenesis Imperfecta
Authors: Pillion Joseph P. , Shapiro Jay
Published: March 2009

Background: Osteogenesis imperfecta (OI) is an inherited bone and connective tissue disorder associated with the lifelong occurrence of frequent fractures following even mild trauma. Hearing loss is frequently reported in patients with OI. Purpose: This investigation is
a retrospective study of measurements of tympanometry, acoustic reflexes, and transient evoked otoacoustic emissions in a sample of patients with OI grouped according to age. The purpose of the study was to examine the relationship between the type of OI, age, and audiological findings in
a sample of individuals with OI. Research Design: The study examined the correlation between audiometric measures, hearing loss of all types, and type of OI. Study Sample: Forty-one patients with OI were included in the study. The patients were divided into two groups for analysis:
one group less than 20 years of age (n  =  21) and the other group aged 20 and over (n  =  20). Results: Hearing loss of all etiologies was observed in 62% of ears. Sensorineural or mixed hearing loss was observed in 41% and conductive hearing loss in 21% of ears.
Results indicate that the younger patients with OI were subject to a greater risk of middle ear dysfunction associated with otitis media than is typical for children of comparable age. Tympanometric abnormalities associated with ossicular dysfunction were more often found in the older age
group of patients. Hearing loss of all types was more prevalent in the older group of patients (88%) than in the younger patient group (38%). Conclusions: Hearing loss was not uncommon regardless of age. Therefore, close audiological monitoring of patients with OI is recommended across
the age spectrum.
Parents' Compliance With and Impressions of a Maturing Community-Based Early Hearing Detection and Intervention Program: An Update
Authors: Danhauer Jeffrey L. , Pecile Angela F. , Johnson Carole E. , Mixon Melissa , Sharp Susan
Published: March 2009

Background: For quality assurance reasons, it is important to monitor the services provided over time for infants and their families through both hospital and community-based early hearing detection and intervention programs (EHDIPs) and to compare results for local programs
to national benchmarks. This two-part study is an update to earlier reports published for a particular EHDIP. Purpose: To evaluate a maturing, diverse community-based EHDIP partially managed through a private practice in Santa Barbara, California, and to compare results to earlier reports
for this program and to national data. Research Design: A parent questionnaire and a retrospective case-report chart review process was used. Study Sample: Charts were reviewed for 150 babies that were referred to the practice from two hospitals and were seen for screenings and
follow-up. Also, parents of 34 infants seen beyond their initial or secondary screenings were surveyed about their experiences with and impressions of the program. Data Collection And Analysis: Babies seen by the practice between May 2003 and November 2006 were tracked across five levels
(from hospital screening through intervention) to determine if parents complied with professionals' recommendations, time taken to comply, and highest level reached and whether it was an appropriate termination point. Also, parents' responses to an 11-item questionnaire assessing their impressions
about their participation in the program were analyzed and compared to the compliance data. Results: Of the 150 babies, 116 passed initial or secondary screenings; compliance details at the subsequent levels of follow-up are provided for the remaining 34 infants. Seven of the 34 families
completed the questionnaire. Compliance at early levels was excellent, meeting EHDIP benchmarks and previous results for this program; that for subsequent levels was poorer, possibly due to the diverse population. Parents' impressions of this program ranged from neutral to generally positive.
Conclusions: This maturing EHDIP generally met national benchmarks and continued to serve the infants and families well. However, parents' compliance with physician visits and audiologic follow-up for habilitation including hearing aids in a timely manner could still be improved.
Prevalence of Hearing Impairment by Gender and Audiometric Configuration: Results From The National Health and Nutrition Examination Survey (1999‐2004) and The Keokuk County Rural Health Study (1994‐1998)
Authors: Ciletti Lindsay , Flamme Gregory A.
Published: March 2009

Purpose: This study describes the most common audiometric configurations and the prevalence of these configurations among adults (ages 20 to 69) in the noninstitutionalized population of the United States and in a sample of residents of a rural county in Iowa. Research Design:
This was a cross-sectional population-based study. Study Sample: Estimates generalizing to the noninstitutionalized population of the United States were based on National Health and Nutrition Examination Survey (NHANES) data collected from 2819 women and 2525 men between 1999 and 2004.
Estimates from the rural county were based on Keokuk County Rural Health Study (KCRHS) data collected from 892 women and 750 men between 1994 and 1998. Data Collection and Analysis: Cluster analyses (k-means) were used to divide participants into groups including maximally similar
bilateral air conduction audiograms. Separate cluster analyses were conducted for each gender. For NHANES data, prevalence and error estimates were obtained using sample weights intended to provide data generalizing to the noninstitutionalized population of the United States within this age
range. Results: The hierarchical structure of audiometric configurations revealed that approximately 25% of women and 50% of men aged 20 to 69 in the noninstitutionalized population of the United States were best described by a configuration consistent with a marked hearing impairment
in at least one frequency. Hearing impairments were more common among participants in the KCRHS. Gently sloping configurations of hearing impairment were dominant among women, while configurations featuring a greater slope were dominant among men. There was a greater variety of audiometric
configurations in men than women. Conclusions: In addition to their descriptive value, these data can be used to inform future studies of risk factors and progression of hearing loss, and to improve the generalizability of studies involving rehabilitative options for people with hearing
impairment.
Air-Conduction Auditory Steady-State Response: Comparison of Interchannel Recording Using Two Modulation Frequencies
Authors: Kaf Wafaa A. , Danesh Ali A.
Published: March 2009

Background: Two-channel auditory steady-state response (ASSR) recording at high and low MF (modulation frequency) most likely provides an insight about the response amplitude and latency from different directions at the brainstem level and at the thalamus or cortical level. Little
is known about the combined relationship between MF (39 and 79 Hz) and electrode montages (ipsilateral and contralateral) to single AM (amplitude modulation) tones on the ASSR amplitude and latency. Purpose: To determine if ipsilateral versus contralateral response asymmetries
are present at the brainstem level (79 Hz ASSR) and at the thalamus or cortical levels (39 Hz ASSR). Research Design: Descriptive and inferential statistics for interchannel ipsilateral and contralateral ASSR amplitude and latency to 79 and 39 Hz. Study Sample:
Twenty-five normal-hearing, right-handed young female adults participated in the study. All participants were right-handed, and their age ranged between 18 to 28 years (mean 24.5 ± 1.6 years). Data Collection and Analysis: Ipsilateral and contralateral ASSR to 39 and 79 Hz
MF and 100% AM stimuli were recorded at 500, 2000, and 4000 Hz carrier frequencies at 65 dB SPL. The ASSR amplitudes and phases were determined for each MF across Fc (carrier frequency) for the two channels to the test (right) ear. ASSR amplitude and latency between recording
montages for each MF and across carrier frequency were compared by computing two-way repeated measures ANOVA. Results: The mean ipsilateral ASSR amplitudes to 39 Hz across frequency were slightly larger (228.6 ± 61.6 µV) than the contralateral response amplitude
(223.2 ± 78 µV) while the mean ipsilateral 79 Hz amplitudes were smaller (127.3 ± 114.8) compared to contralateral 79 Hz amplitude (154.6 ± 112.7 µV). For latency response, the mean ipsilateral/contralateral latency difference, on
average, was 1 msec or less for both MFs. Results, in normal female adults, indicated no significant interchannel ASSR asymmetries for amplitude and latency (p > 0.05) at the brainstem (79 Hz ASSR) and at the thalamus or cortical levels (39 Hz ASSR). Conclusions:
Interchannel ipsilateral and contralateral ASSR amplitude and latency to 79 and 39 Hz are not significantly different in normal, young female adults. Two-channel recording of ASSR to different MFs may be of clinical value in otoneurologic assessment.
Universal Screening for Autism Spectrum Disorders: A Snapshot Within the Big Picture
Authors: Duby John C. , Johnson Chris Plauché
Published: March 2009

CME Educational Objectives

1.

Objectively define developmental screening and developmental surveillance and how these are deployed in the office setting.

2.

Describe an inclusive strategy to monitor for signs of autism spectrum disorders (ASD) within the context of general developmental surveillance.

3.

Discuss the logistics of universal screening for ASD in the office setting with special attention to feasibility and benefits when balanced against other time/cost pressures in the office setting.
Family Members’ Responsibilities to Nursing Home Residents: “She Is the only Mother I Got”
Authors: Bern-Klug Mercedes , Forbes-Thompson Sarah
Published: March 2009

Findings from this qualitative study indicate that family members of nursing home residents hold themselves responsible for overseeing the care of their loved one, representing the resident’s perspective and history, and keeping the family connections. These role expectations can be assets to nursing homes. Nursing and social work staff are called on to be leaders among all staff to maximize constructive family involvement and minimize the stress families may experience if they are not able to fulfill their role expectations.
Nurses’ Evaluation of the Confusion Assessment Method: A Pilot Study
Authors: Waszynski Christine M. , Petrovic Kimberly
Published: March 2009

Delirium is frequently overlooked in hospitalized adult patients of all ages. Because nurses spend significant amounts of time with patients, the nursing assessment is vital to the identification of delirium. This pilot study investigated nurses’ evaluation of the Confusion Assessment Method related to ease of use and helpfulness in identifying delirium in adult patients on two hospital units. Delirium rates are reported for patients across all shifts for 1 month. The majority of nurses found the Confusion Assessment Method to be an effective, user-friendly instrument for the assessment of patients’ cognitive status over time.
Over-The-Counter Medication Use in Older Adults
Authors: Rolita Lydia , Freedman Michael
Published: March 2009

Use of over-the-counter (OTC) medications is becoming more of a problem in the older adult population as the push to deregulate prescription medications grows. This article summarizes the side effects, adverse reactions, and medication interactions older adults face when using some common OTC medications.
Validating MDS Data about Risk Factors for Perineal Dermatitis by Comparing with Nursing Home Records
Authors: Toth Anna M. , Bliss Donna Z. , Savik Kay , Wyman Jean F.
Published: March 2009

Perineal dermatitis is one of the main complications of incontinence and increases the cost of health care. The Minimum Data Set (MDS) contains data about factors associated with perineal dermatitis identified in a published conceptual model of perineal dermatitis. The purpose of this study was to determine the validity of MDS data related to perineal dermatitis risk factors by comparing them with data in nursing home chart records. Findings indicate that MDS items defining factors associated with perineal dermatitis were valid and supported use of the MDS in further investigation of a significant, costly, and understudied health problem of nursing home residents.
Participation in Physical Activity: Influences Reported by Seniors in the Community and in Long-Term Care Facilities
Authors: Weeks Lori E. , Profit Sheila , Campbell Barbara , Graham Hope , Chircop Andrea , Sheppard-LeMoine Debra
Published: March 2009

This qualitative study identified influences on participation in physical activity among seniors living in the community and in long-term care facilities. A total of 24 seniors participated in individual face-to-face interviews. Through thematic analysis, the overarching theme identified that past experiences, life transitions, and future concerns influence seniors’ participation in physical activity. This overarching theme helps explain the complexity of physical activity participation in later life. The subthemes included intergenerational influences, establishment of early physical activity patterns, family transitions over the life course, changing health status over the life course, and future health concerns. A greater understanding of an individual’s life history is paramount for nurses to help increase participation in physical activity among seniors.
Depression Training Program for Caregivers of Elderly Care Recipients: Implementation and Qualitative Evaluation
Authors: Mellor David , Russo Sarah , McCabe Marita P. , Davison Tanya E. , George Kuruvilla
Published: March 2009

The prevalence of untreated depression is high among older adults who receive care in residential facilities or in their own homes and is associated with reduced quality of life and other medical conditions. Research has suggested a number of reasons for the low detection and treatment rates for this problem, including lack of knowledge and efficacy among those who provide direct care and poor communication between these caregivers and senior staff, and between senior staff and general practitioners. In this study, we report on the implementation of a training program for care staff that aims to address these issues. Focus groups with participants who completed the training indicated a high level of satisfaction with the program and reported improvements in knowledge, self-efficacy, and communication within services. It is recommended that the program be more systematically evaluated in relation to its longer term effects on care provider practices and the well-being of depressed elderly care recipients.
Are Nurses Recognizing Delirium? A Systematic Review
Authors: Steis Melinda R. , Fick Donna M.
Published: March 2009

Delirium is a prevalent, costly, and global problem in older adults. This article is a systematic review of the literature on nurse recognition of delirium. Ten articles, reporting rates of nurse recognition ranging from 26% to 83%, were included in the review. The most compelling finding is that although related, the notions of nurse knowledge of delirium, nurse recognition of delirium, and nurses’ assessment and documentation of delirium in older adults are different. Recommendations for practice are suggested at several levels, including education, guidelines, communication, health care system, and use of informatics.
Assuming The Mantle of Leadership: Issues and Challenges for Directors of Nursing
Authors: Fleming Mary Louise , Kayser-Jones Jeanie
Published: March 2009

This ethnographic study investigated leadership from the perspective of directors of nursing (DONs) in proprietary nursing homes. Data from interviews and extensive participant observation with 10 DONs were analyzed using open coding and content analysis. The study drew on a priori concepts from transformational leadership theory to describe the role, DON approaches to leadership, and factors that facilitate or impede leadership in nursing homes. This article reports findings from a larger study related to conditions existing when participants entered the DON position. Antecedent conditions influenced organizational expectations of incoming DONs and shaped participants’ leadership experiences. DONs filling long-standing vacancies had to reestablish the influence and authority of the role. Those replacing unsuccessful DONs confronted serious regulatory, care, and morale issues. In contrast, DONs with successful predecessors experienced organizational support and had confidence in their abilities to lead.
Prevalence and Treatment of Neuropsychiatric Symptoms in Advanced Dementia
Authors: Kverno Karan S. , Rabins Peter V. , Blass David M. , Hicks Kathryn L. , Black Betty S.
Published: March 2009

Neuropsychiatric symptoms (NPS) are common in dementia, although little is known about their prevalence and treatment near the end of life. This study used a retrospective review of the medical records of 123 hospice-eligible nursing home residents with advanced dementia to investigate the prevalence of NPS and NPS-targeted pharmacological and non-pharmacological treatments. The most prevalent NPS were agitation or aggression (50.4%), depression (45.5%), and withdrawal/lethargy (43.1%). Of the 105 (85.4%) residents who exhibited one or more NPS, 90.5% were receiving at least one NPS-targeted treatment, yet 41.9% received no documented nonpharmacological NPS-targeted care. The majority of documented nonpharmacological care focused on safety and explanations or instructions given to residents. Given the high prevalence of comorbidities, associated risks for medication interactions or serious side effects, and potential low-risk benefits of psychobehavioral care, these findings raise concerns about how to best increase the provision and documentation of nonpharmacological care in advanced dementia.
Promoting Positive Student Clinical Experiences with Older Adults Through Use of Group Reminiscence Therapy
Authors: Perese Eris Field , Simon Maria Rohlo , Ryan Emily
Published: March 2009

Interest in psychiatric nursing as a practice area is associated with positive undergraduate clinical experiences that include staff acceptance, diverse learning opportunities, direct involvement with patients, and community placements. Essential student preparedness includes attitudes affirmative of patient recovery; assessment, communication, teaching, and medication administration and monitoring skills; and a toolkit of nursing interventions such as group facilitation and reminiscence therapy. In an innovative intervention, students in a geriatric psychiatric community setting developed and facilitated a support group with reminiscence-based activities to reduce social isolation. Patients increased social interactions, and students gained awareness of older adults’ interests and self-identities, as well as confidence in providing care.
Evaluation of Comfort in Bedridden Older Adults Using an Air-Cell Mattress with an Automated Turning Function: Measurement of Parasympathetic Activity During Night Sleep
Authors: Futamura Megumi , Sugama Junko , Okuwa Mayumi , Sanada Hiromi , Tabata Keiko
Published: March 2009

This study objectively evaluated the degree of comfort in bedridden older adults using an air-cell mattress with an automated turning mechanism. The sample included 10 bedridden women with verbal communication difficulties. The high frequency (HF) components of heart rate variability, which reflect parasympathetic nervous activity, were compared for the manual and automated turning periods. No significant differences in the HF component were observed in 5 of the participants. Significant increases in the HF component associated with automated turning were observed in 3 participants; however, the two participants with the lowest body mass index values exhibited a significant reduction in the HF component during the automated turning period. The results revealed that comfort might not be disturbed during the automated turning period.
Does Falls-Efficacy Predict Balance Performance in Older Adults with Hip Osteoarthritis?
Authors: Arnold Catherine M. , Faulkner Robert A.
Published: March 2009

This cross-sectional study evaluated the relationship of falls-efficacy to physical performance of functional balance tasks in older adults with hip osteoarthritis (OA). Older adults with hip OA experience several factors associated with fall risk: loss of movement, loss of strength, and increased fear of falls. Seventy-nine men and women age 65 or older were measured for balance, dual task function, and falls-efficacy. Using hierarchical regression, falls-efficacy was a significant predictor of balance when number of medications, age, use of a walking aid, health status, and physical activity level were controlled for. Understanding the role of falls-efficacy in predicting fall risk helps clinicians develop falls screening and prevention programs.
A Dedicated Approach to Restorative Nursing
Authors: Bonanni Denise R. , Devers Geraldine , Dezzi Kathleen , Duerr Christine , Durkin Madeline , Hernan Judith , Joyce Carol
Published: March 2009

This study was conducted to determine whether a dedicated restorative nursing program fostered improvement in residents' functional status and quality of life. Restorative nursing assistants were selected, provided with special training, and under RN supervision, were solely responsible for the delivery of restorative care. The dedicated program was provided to 50 residents in a long-term care facility. Data were gathered using the Minimum Data Set, which measures activities of daily living, continence, and mood status in long-term care facilities. The data parameters included functional status and depression. The results indicated that a dedicated restorative program did foster improvement in some areas of functional ability. Dedicated restorative nursing staff were able to complete assignments in an efficient, timely manner and document results. The program led to more consistent care delivery and a higher quality of care.
Correlating Anatomy and Congruence of the Patellofemoral Joint With Cartilage Lesions
Authors: Yang Bin , Tan Hongbo , Yang Liu , Dai Gang , Guo Botao
Published: March 2009

Cartilage lesion of the patellofemoral joint is a common and challenging disease of the knee and an important cause of anterior knee pain. There are many naturally occurring variations in the anatomy and congruence of the patella and femoral trochlea. The purpose of this study was to identify the variations in patellofemoral anatomy and congruency that predispose to cartilage lesions. Among patients who underwent knee arthroscopy in our center from January 2005 to December 2006, 111 patients with chronic patellofemoral cartilage lesions and anterior knee pain were selected as the lesion group, while 124 patients with isolated meniscus rupture without anterior knee pain were selected as the control group. Twenty-one parameters measured on magnetic resonance images were used to assess the patellofemoral anatomy and congruence. A binary logistic regression model was used to look for possible associations between each of these parameters and the occurrence of patellofemoral cartilage lesions. The Bonferroni correction with a type I error rate of 0.0024 (0.05/21) was adopted to indicate statistical significance. Based on examination of the patellofemoral anatomy, 4 parameters were significantly associated with patellofemoral cartilage lesions. These were the patella lateral facet width, patella lateral facet ratio, sulcus depth and sulcus relative depth (
P
for linear trend <.0024). For patellofemoral congruence, 3 parameters were significantly associated with patellofemoral cartilage lesions. These were the lateral patella displacement, patella epicondylar axis angle and congruence angle (
P
for linear trend <.0024). Among the many kinds of patellofemoral variations, several were found to correlate with the development of patellofemoral cartilage lesions. These problems could be important risk factors for patellofemoral cartilage lesions.
Magnetic Resonance Arthrographic Findings of Presumed Stage-2 Adhesive Capsulitis: Focus on Combined Rotator Cuff Pathology
Authors: Yoo Jae Chul , Ahn Jin Hwan , Lee Yong Seuk , Koh Kyoung Hwan
Published: March 2009

The purpose of this study was to report the magnetic resonance arthrography (MRA) findings of patients considered to have stage-2 idiopathic adhesive capsulitis and to identify differences in rotator cuff pathologies between 2 age groups (ie, and 60 years). Eighty-one patients, considered to have stage-2 idiopathic adhesive capsulitis based on medical history and a physical examination underwent MRA. Magnetic resonance evaluations focused on combined pathologies other than adhesive capsulitis, especially on the supraspinatus tendon. The pathologies of supraspinatus tendon were divided into 4 categories: normal, tendinosis, partial-tears, and full-thickness tears. Mean patient age was 66 years and mean symptom duration was 8.9 months. There were 38 men and 43 women. Overall, 50 patients (61.7%) showed some form of supraspinatus tendon pathology [small full-thickness tears 6 (7.4%), partial-thickness tears 25 (30.9%), and supraspinatus tendon tendinosis 19 (23.5%)]. The most common MRA finding, other than rotator cuff pathology, was the impression of adhesive capsulitis in 58 patients (71.6%). Group 2 (>60 years) showed a higher prevalence of full and partial-thickness tears (
P
<.05), however the overall prevalence of supraspinatus tendon pathologies were similar in those younger than and older than 60 years (
P
=.1795). Approximately 1/3 of stage-2 adhesive capsulitis patients showed some form of supraspinatus tendon tear by MRA, and <10% of patients who were considered to have idiopathic adhesive capsulitis had a full-thickness tear. Adhesive capsulitis patients older than 60 years appeared to be more likely to have a supraspinatus tendon tear.
What’s Your Diagnosis?
Authors: Ledoux Danielle M. , Walton David S.
Published: March 2009

When the patient was 5 months old, his mother noticed a color change in his right eye. She described that the iris had become “less blue” than his left eye. This observation was followed in 2 weeks by poor pupillary dilation in the right eye in relative darkness. Consultation with his pediatrician was followed by referral to ophthalmologists. An examination under anesthesia was done, which confirmed the absence of posterior segment abnormalities. On examination, he appeared healthy without discomfort and possessed no scalp or systemic abnormalities. Excellent fixation and following were present in both eyes, and the eye movements and eye position were normal. The conjunctiva and sclera were without injection and the corneas were clear and equal in size. The pupils reacted to light. The right pupil was slightly larger than the left, exhibiting less movement with dilation and constriction. Heterochromia was present. Superotemporally and inferonasally, the iris stroma in the right eye was covered by a thin-layered brown-yellow deposit and thin abnormal stromal vessels were visible adjacent to the pupillary margin. In the inferior angle, an irregular accumulation of similar colored material was present. The intraocular pressures were 14 mm Hg in both eyes. His parents were advised of his diagnosis and medical treatment was recommended.
Asymmetry in Optic Disc Morphometry as Measured by Confocal Scanning Laser Ophthalmoscopy in Subjects With Hyperopic Anisometropia
Authors: Bozkurt Banu , Irkec Murat , Arslan Umut
Published: March 2009

Purpose:
To determine whether there is an asymmetry in optic nerve head morphometry in subjects with hyperopic anisometropia.

Methods:
Seventeen men and 20 women with a mean age of 31.43 ± 2.73 (standard error of mean) years underwent a complete eye examination and optic nerve head topography with the Heidelberg Retina Tomograph II (Heidelberg Engineering, GmBH, Heidelberg, Germany). Differences in optic nerve head parameters between anisometropic eyes and fellow eyes were evaluated using the paired-sample t test or Wilcoxon signed rank test and the correlations between refraction, visual acuity, and disc parameters were evaluated with Spearman’s correlation coefficient.

Results:
The median refractive errors of hyperopic anisometropic and fellow eyes were +4 D (range: +2.0 to +7.50 D) and 0 D (range: 0 to +4 D), respectively. The mean best-corrected visual acuity of the amblyopic eyes was 0.43 ± 0.25. The mean disc area of the anisometropic eyes (1.69 ± 0.35 mm2) was significantly smaller than the fellow eyes (2.01 ± 0.42 mm2) (P < .001). The differences between eyes in mean cup area, rim area, rim volume, and cup shape were statistically significant (P < .05). In aniosmetropic eyes, refractive error (r = −0.406; P = .013) and visual acuity (r = 0.347; P = .035) showed significant correlations with rim area.

Conclusion:
Hyperopic anisometropia is associated with a remarkable interocular difference in optic disc size and other topographic parameters.
What’s Your Diagnosis?
Authors: Walton David S. , Thacker Neepa
Published: March 2009

A 6-year-old boy was referred for an “abnormal right pupil” recognized by his pediatrician at an annual examination, which was associated with reduced vision in the right eye. The child was in good health with no history of gastrointestinal symptoms. On examination, the uncorrected visual acuity was 20/100 in the right eye, which improved to 20/25 with −3.00 diopters, and 20/20 in the left eye. Eyelids and extraocular movements were normal with no evidence of ptosis. Slit-lamp examination revealed clear corneas in both eyes and slight enlargement of the right cornea. No Haab’s striae were present. Inspection of the irides showed enlargement of pupillary frill with its extension superiorly onto the anterior iris surface in the right eye (<a href="EditorPage.aspx?da=core&id=%7b6D46A8A5-7376-4C8B-AE2E-566F064F88AE%7d&ed=FIELD2771452684&vs&la=en&fld=%7b3F6A9F60-49AD-4656-AEC8-BF7FC2999528%7d&so=%2fsitecore%2fsystem%2fsettings%2fhtml+editor+profiles%2frich+text+healio&di=0&hdl=H2771452798&us=sitecore%5cEAnderer&mo&pe=0#x01913913-20080501-08-fig1">Figure). The iris stroma in the right eye was smooth without normal crypts and circumferential folds and the iris in the left eye was normal. Intraocular pressures were 40 mm Hg in the right eye and 12 mm Hg in the left eye. Corneal thickness measured 528 μm in the right eye and 550 μm in the left eye. Gonioscopy demonstrated circumferential anterior iris insertion with minimally exposed trabecular meshwork in the right eye and normal trabecular mesh-work, scleral spur, and ciliary body band in the left eye. Axial length measured 20.5 mm in the right eye and 19.8 mm in the left eye. The right optic disc had a large cup with a cup-to-disc ratio of 0.9 and minimal neuroretinal rim, whereas the left optic disc was normal. The patient was given topical glaucoma medications with satisfactory initial intraocular pressure control.
Managing Epibulbar Choristoma With Microphthalmos
Authors: Huang Tien-Yi , Tsai Yueh-Ju , Tan Hsin-Yuan , Ma Lih
Published: March 2009

A 3-year-old boy had a large epibulbar choristoma with microphthalmos of his left eye. He received simple partial tumor excision due to significant local mechanical erosion and disfiguring appearance. The cosmetic outcome was satisfactory.
Optic Nerve Hypoplasia Potentiates Retinopathy of Prematurity
Authors: Arnold Robert W.
Published: March 2009

The risk of progression to threshold retinopathy of prematurity correlates with the area of avascular retinas and inversely with the degree of vascular maturity. Asymmetric retinal ablation was performed in two patients and asymmetric retinopathy of prematurity progression was observed in two infants with optic nerve hypoplasia.
Age and Racial Variation in Central Corneal Thickness of Preschool and School-Aged Children
Authors: Haider Kathryn M. , Mickler Casey , Oliver Dana , Moya Frank J. , Cruz Oscar A. , Davitt Bradley V.
Published: March 2009

Purpose:
The purpose of this study was to determine variations in central corneal thickness (CCT) of preschool and school-aged African American and white children. Secondary aims were to assess possible correlations between CCT measurements and gender, axial length, intraocular pressure (IOP), family history of glaucoma, or history of prematurity.

Methods:
Contact ultrasound was used to measure CCT and axial length in 76 white and 60 African American children between the ages of 7 months and 18 years. A questionnaire was completed by the parents or guardians, including medical and family history. Statistically significant associations and differences were assessed using the independent t test, analysis of variance, and linear regression. All associations were defined as significant when the alpha value was less than 0.05 (two-tailed).

Results:
Mean CCT was thinner in African American children (535 ± 35 μm) compared to white children (559 ± 38 μm) (P < .001). The corneal thickness in children ages 10 to 18 years was significantly higher than in all other age groups in both African American (P = .03) and white (P < .005) children. No association was found between CCT and gender, axial length, IOP, or family history of glaucoma. Premature children had thinner CCT (536 ± 40 μm) than full-term children (552 ± 38 μm) (P = .009).

Conclusions:
African American children have a thinner CCT compared to white children at all ages. Children of both racial groups have an increasing value of CCT with increasing age after approximately age 10 years. Children born prematurely have a thinner CCT than full-term children.
Aniridia With Congenital Glaucoma
Authors: Walton David S. , Yi Kayoung , Kelly Christopher J. , Mitchell Paul R. , Chen Teresa C.
Published: March 2009

The Images in Pediatric Ophthalmology column is a 1-page photo essay showing encounters in the field of pediatric ophthalmology.
A Review of Pediatric Uveitis: Part II. Autoimmune Diseases and Treatment Modalities
Authors: Madigan William P. , Raymond William R. , Wroblewski Keith J. , Thebpatiphat Nuthida , Birdsong Richard H. , Jaafar Mohamad S.
Published: March 2009

Uveitis is a manifestation of complex processes that can represent an infectious process or a dysfunction of the immune system that may have grave effects on the eye. Although infectious causes, once properly identified, may be successfully treated by addressing the inciting organism with recognized interventions, the immune-modulated chronic forms of uveitis often provide more complex challenges in management. Recent strides in understanding the inflammatory pathway and better bioengineering capabilities have resulted in some new modalities of treatment.
Congenital Bilateral Eversion of the Eyelids
Authors: Isawumi Michaeline A. , Adeoti Caroline O. , Umar Ismaila O. , Oluwatimilehin Ilesanmi O. , Raji Ralph A.
Published: March 2009

The authors report a case of congenital bilateral eversion of the eyelids with secondary conjunctival prolapse in a 4-hour-old neonate. Conservative treatment with hypertonic normal saline, lubricants, antibiotics, and padding was instituted. No surgery was performed. Complete eye opening was achieved by the 10th day after birth. Medical management is advantageous in that it is inexpensive, noninvasive, and can be performed even in a center with poor surgical facilities, as is commonly encountered in developing countries. The sociopsychological aspect of the disease, possible pathophysiology, and treatment are discussed.
Corneal Superinfection in Acute Viral Conjunctivitis in Young Children
Authors: Kuo Shu-Chen , Shen Su-Chin , Chang Shu-Wen , Huang Samuel C. M. , Hsiao Ching-Hsi
Published: March 2009

Two children suffered from corneal superinfection following acute viral keratoconjunctivitis. Group A β-hemolytic streptococci were isolated in one child and cultures were negative in the other child. The corneal ulcers resolved with prompt antibiotic therapy, but both patients developed amblyopia. Visual outcome following corneal superinfection in acute viral conjunctivitis may be poor when it occurs in young children.
Unusual Presentation of Orbital Cysticercosis in Subperiosteal Space
Authors: Singh Usha , Gupta Pankaj , Bansal Reema
Published: March 2009

The authors describe a previously unreported case of subperiosteal orbital cysticercosis in a child. Surgical incision on the periosteum led to the extrusion of a cyst, which was confirmed histopathologically. Cysticercosis should also be considered in the differential diagnosis of subperiosteal abscess.
Pars Plana Capsulectomy and Vitrectomy for Posterior Capsular Opacification in Pseudophakic Children
Authors: Xie Lixin , Huang Yusen
Published: March 2009

Purpose:
To evaluate the safety and efficacy of pars plana capsulectomy and vitrectomy for posterior capsular opacification (PCO) in pseudophakic children.

Methods:
Pars plana capsulectomy and vitrectomy was performed for PCO in 63 pseudophakic eyes of 57 children with an infusion through sutureless clear cornea. The patients’ ages ranged from 3 to 12 years (mean: 5.8 ± 1.9 years). Surgical technique, intraoperative and postoperative complications, visual acuity, intraocular pressure (IOP), and corneal endothelial cell density were recorded.

Results:
The surgical procedure was performed uneventfully in all patients. The mean follow-up was 2.4 ± 1.4 years (range: 6 months to 5.2 years). During the follow-up period, no incision leakage or other complications were noted and no eye developed recurrent PCO. All eyes had an improvement of visual acuity. Mean postoperative IOP was 13.8 ± 2.6 mm Hg (range: 8 to 19 mm Hg). Mean overall endothelial cell loss was 3.4%.

Conclusions:
Pars plana capsulectomy and vitrectomy with an infusion through sutureless clear cornea appears to be a safe and effective approach for thick PCO in pseudophakic children.
A Survey of Ophthalmology Residents' Attitudes Toward Pediatric Ophthalmology
Authors: Hasan S. Jafar , Castanes Maria S. , Coats David K.
Published: March 2009

Purpose:

To assess the level of ophthalmology resident interest in pediatric ophthalmology.

Methods:

An 18-item 5-point Likert scale was used to determine interest in pediatric ophthalmology among ophthalmology residents in the United States.

Results:

The response rate was 23% (316 of 1,341). Of the respondents, 74% agreed they had a clinical role model in pediatric ophthalmology, 66% perceived a good job market for this field, and 67% cited liking strabismus surgery. The majority of residents (56%) found pediatric patients difficult to examine and 50% stated income levels for pediatric ophthalmologists are low.

Conclusions:

Although most residents have an overall positive view about pediatric ophthalmology, few indicate interest in pursuing a fellowship. Specifically, most residents reported having a clinical role model in pediatric ophthalmology, perceiving a good job market, and liking strabismus surgery, whereas few residents had interest in further pediatric training and many found pediatric patients difficult to examine and income levels low.

[J Pediatr Ophthalmol Strabismus 2009;46:25–29.]
The Use of the Assessment of Motor and Process Skills (AMPS) in Predicting Need of Assistance for Adults with Mental Retardation
Authors: Kottorp Anders
Published: March 2009

Because the ability to perform activities of daily living (ADL) is associated with global aspects of community functioning, it is critical to evaluate whether the information gained from specific ADL assessments contributes to a reliable prediction of the overall amount of assistance needed for a person to function in the community. The purpose of this study was to evaluate the predictive use of an ADL assessment, the Assessment of Motor and Process Skills (AMPS), to determine which people with mental retardation need support or assistance to function in the community. A sample of 380 data records from the AMPS international database of people with various levels of mental retardation was included in the study. Many-faceted Rasch analyses and logistic regression models were used for data analysis. The results indicated that only the AMPS ADL process ability measures contributed significantly and substantially to the prediction of the level of assistance required to function in the community for individuals with mild to moderate mental retardation when used in conjunction with age, gender, and level of mental retardation. The results have clinical implications for occupational therapists working with these people because ADL process ability can be improved by occupational therapy interventions.
Occupational Performance, Self-Esteem, and Quality of Life in Substance Addictions Recovery
Authors: Martin Linda M. , Bliven Michelle , Boisvert Rosemary
Published: March 2009

A non-randomized pretest—posttest design was used to evaluate changes in occupational performance, self-esteem, and quality of life among clients completing a substance abuse recovery program that included occupational therapy services addressing life skills. Seventy-five clients participated in intake and discharge assessment (4- to 6-month interval) that used the Occupational Performance History Interview (Version 2.0), the Rosenberg Self-Esteem Scale, and the Quality of Life Rating scale. A limited number of follow-up interviews at 3 and 6 months were also conducted. Marked improvement with significant differences and large effect sizes were found between intake and discharge scores for all measures. Most clients scored in the range of moderate occupational dysfunction at discharge, when their highest performance level was seen. Follow-up data revealed that occupational performance declined at 3 months and improved again at 6 months. Change in occupational performance is clearly reflected in the recovery process, but recovery is challenged when clients leave the supportive halfway house environment.
Reporting of Randomized Controlled Trials in Occupational Therapy and Speech Therapy: Evaluation Using an Expansion of the Consort Statement
Authors: Norton-Mabus Julie C. , Nelson David L.
Published: March 2009

Research in occupational therapy is necessary for the validation of therapeutic interventions. Randomized controlled trials (RCTs) control against potentially confounding variables and provide validating evidence, if properly reported. The purpose of this study was to evaluate the quality of reporting RCTs in occupational therapy and speech therapy by use of an expansion of the Consolidated Standards of Reporting Trials (CONSORT) statement. The Nelson—Moberg—Norton Expanded CONSORT Instrument (NMNECI) was used to evaluate 15 occupational therapy RCTs and 15 speech therapy RCTs. After the principal investigator evaluated all 30 articles, a masked research assistant evaluated 16 randomly selected RCTs to test for inter-rater reliability. An intraclass correlation coefficient of .93 confirmed overall inter-rater agreement. On average, the 30 articles were consistent with 119.5 NMNECI sub-items ( SD = 25.48) of the 212 possible sub-items. Occupational therapy RCTs (mean = 130.07, SD = 20.21) were more consistent with the CONSORT statement than speech therapy RCTs (mean = 108.93, SD = 26.40), t(28) = 2.46, p = .02. RCTs in occupational therapy and other allied health professions could benefit from using the CONSORT statement as a tool for reporting future research studies.
Differences in Schoolwork Performance between Typically Developing Students and Students with Mild Disabilities
Authors: Munkholm Michaela , Fisher Anne G.
Published: March 2009

The purpose of this study was to examine whether students with mild disabilities differed from typically developing students in their ability to perform schoolwork tasks. The participants, selected from the School Assessment of Motor and Process Skills (School AMPS) database, comprised 175 students in each group. Their data were subjected to many-faceted Rasch analyses and then analyzed for statistically significant differences in mean school motor and school process abilities between groups. The relative and actual item difficulty calibration values were then compared to identify meaningful differences between groups. The results revealed a statistically significant mean difference in school motor and school process ability between groups (large effect sizes), essentially stable relative skill item hierarchies between groups, and actual hierarchies that differed such that some school motor and almost all school process skill items (occupational performance skills) were more difficult to perform for the mild disabilities group. The results of this study also provided evidence of validity for the use of the School AMPS measures to assist in identifying lower than expected schoolwork performance of students with mild disabilities.
Development and Validation of an Activities of Daily Living Inventory for the Rehabilitation of Patients with Chronic Obstructive Pulmonary Disease
Authors: So Chi Tao , Man David W. K.
Published: March 2009

There are few validated clinical tools assessing patients with chronic obstructive pulmonary disease (COPD) that identify relevant activities of daily living (ADL) domains for occupational therapy rehabilitation. This study aims to develop a comprehensive Activities of Daily Living Inventory (ADLI) for people with COPD in two phases. In phase I, the content validity of the ADLI was established by an expert panel of 12 patients with different stages of COPD. In phase II, 120 patients with COPD rated their perceived difficulty for each of the given items of activity. The underlying constructs were explored by a factor analysis of six components, accounting for a total of 78% of the variance. A high Cronbach's alpha value (α = 0.71 to 0.95) of the components and a moderate overall inter-item correlation coefficient (r = 0.54) were reported. These findings suggest that this 26-item ADLI is a valid, comprehensive ADL tool for assessing patients with COPD. By understanding the underlying constructs influencing a specific category of ADL items, occupational therapists can design appropriate strategies to deal with specific problems encountered by their patients.
The Effect of Nd:YAG Laser Membranotomy and Intravitreal Tissue Plasminogen Activator with Gas on Massive Diabetic Premacular Hemorrhage
Authors: Chung Jin , Park Young-Hoon , Lee Young-Chun
Published: March 2009

Background and Objective:
To investigate the combined therapeutic effects of Nd:YAG laser membranotomy and intravitreal tissue plasminogen activator (tPA) (Actilyse; Boehringer Ingelheim, Ingelheim, Germany) injection with perfluoropropane (C3F8, 100%) injection on massive diabetic premacular hemorrhage.

Patients and Methods:
Nd:YAG laser membranotomy was performed on the hemorrhagic membrane of premacular hemorrhage, and tPA (25 μg/0.1 mL) was injected into the vitreous cavity of seven eyes with massive diabetic premacular hemorrhage. For each procedure 0.2 mL of C3F8 was also injected.

Results:
After the combined therapy, the patients recovered vision within 4 weeks and the hemorrhages were completely absorbed within 8 weeks. Visual acuity at the last follow-up visit improved to a mean of 10 logarithm of the minimum angle of resolution lines in all cases. There were no associated ophthalmic complications.

Conclusion:
The combined therapy resulted in resolution of premacular hemorrhages with proliferative diabetic retinopathy and may allow for faster resolution of premacular hemorrhages and lessen the need for vitrectomy.