Ophthalmic disorders among the homeless and nonhomeless in Los Angeles

BACKGROUND: Few studies have addressed ocular disorders among the homeless and nonhomeless poor. METHODS: To better understand the health problems of the homeless, ophthalmic disorders were analyzed among 512 homeless and 413 nonhomeless poor individuals receiving vision-screening examinations in Los Angeles. RESULTS: Significantly, more 4- to 17-year-old nonhomeless poor were diagnosed with uncorrected visual acuity worse than or equal to 20/50 without correction (p = 0.001), total refractive errors (p < 0.0005), astigmatism (p = 0.001), and myopia (p < 0.0005) than were a control group of 4- to 17-year-old homeless individuals. More homeless individuals had extraocular muscle imbalance (p < 0.040), but fewer had external eye diseases (p2 = 0.016) than the nonhomeless poor, when age adjusted. In addition, higher rates of glaucoma and cataracts were observed in both homeless and poor nonhomeless populations than in the general population. CONCLUSIONS: Health care professionals should provide vision screenings intended to detect these ocular disorders. Screening and correction of myopia and glaucoma, in particular, can greatly improve the quality of life for those treated.     

The relationship between moderate hyperopia and academic achievement: how much plus is enough?

BACKGROUND: There is evidence linking uncorrected hyperopia in children with academic learning problems. METHODS: This study was designed to test that hypothesis and--given supportive data--to then address a second topic: the minimal amount of uncorrected hyperopia that appears to impede elementary school performance. RESULTS: The refractive status and achievement test scores of 782 first-through-fifth grade children were compared. CONCLUSIONS: Statistical analysis indicated significantly lower achievement test scores among hyperopic children whose refractive errors exceeded 1.25 D (ANOVA F = 12.51; df = 4; p = 0.014).     

Metabolism of an anionic fluorescent dye, 1-anilino-8-naphthalene sulfonate (ANS) by rat liver microsomes

OBJECTIVE: To examine the association between chronic illness and functional status change during a 3-year period in older people enrolled in an in-home comprehensive geriatric assessment (CGA) and preventive care program. DESIGN: Secondary analysis of data from a longitudinal cohort study. SETTING: Santa Monica, California. PARTICIPANTS: Two hundred two community-dwelling older persons (mean age at baseline was 81 years, 70% were women, and 72% reported good health) randomized to the intervention group in a trial of in-home comprehensive geriatric assessment and preventive care. MEASUREMENTS: We studied 13 common chronic illnesses/conditions determined clinically from an annual comprehensive evaluation by gerontologic nurse practitioners (GNPs) in consultation with study geriatricians. These target conditions included hypertension, osteoarthritis, coronary artery disease, obesity, undernutrition, urinary incontinence, sleep disorders, falls, gait/balance disorders, hearing and vision deficits, depression, and unsafe home environment. The dependent variable was functional change as measured by instrumental activities of daily living (IADL) and basic activities of daily living (BADL) assessed at baseline and annually for 3 years by independent research personnel. Potential confounding variables, including comorbid conditions and other subject characteristics, were controlled for in the analyses. RESULTS: Although functional status was similar at baseline, the presence of certain target conditions in this sample was associated significantly with functional decline in IADL and BADL during the 3-year period. Four conditions (gait/balance disorders, depression, unsafe home environment, and coronary artery disease) were associated with significant declines in IADL, and four conditions (gait/balance disorders, depression, hypertension, and urinary incontinence) were associated with significant declines in BADL. Conversely, subjects with obesity had no significant change in IADL or BADL throughout the study period and had less decline in IADL compared with nonobese subjects. CONCLUSIONS: Certain chronic conditions, particularly gait/balance disorders and depression, are associated with significant decline in functional status in older persons who receive CGA. These findings may help identify older persons at risk for greatest functional decline despite participation in CGA and may also suggest the need for more effective intervention strategies in these individuals.     

Prevalence of vision and ocular disease conditions in a clinical pediatric population

BACKGROUND: The purpose of this study was to fill a significant void in the ophthalmic literature by performing a large scale, comprehensive, prospective study of the prevalence of vision disorders and ocular pathology in a clinical pediatric population using well-defined diagnostic criteria. METHODS: A prospective study was performed on 2,023 consecutive patients between the ages of 6 months and 18 years presenting for an initial comprehensive examination at the Eye Institute of The Pennsylvania College of Optometry. There were 373 subjects between 6 months and 5 years, 11 months of age, and 1,650 subjects between 6 years and 18 years of age. RESULTS: The most important finding from this study is that other than refractive anomalies, the most common conditions optometrists are likely to encounter in a pediatric population are binocular vision and accommodative disorders. The prevalence of accommodative and binocular (strabismic and non-strabismic) vision disorders is 9.7 times greater than the prevalence of ocular disease in children 6 months to 5 years of age, and 8.5 times greater than the prevalence of ocular disease in children 6 to 18 years of age. CONCLUSIONS: The data from this study has great significance for clinicians, optometric educational institutions, health care planners, and administrators. This data suggests that other than refractive anomalies, the most prevalent conditions in the clinical pediatric population are binocular and accommodative disorders. Clinicians should use a minimum data base that includes assessments of accommodation and binocular vision that will allow them to detect conditions with the highest prevalence.     

Adaptive Neurofuzzy Computing Technique for Evapotranspiration Estimation

The accuracy of an adaptive neurofuzzy computing technique in estimation of reference evapotranspiration (ET0) is investigated in this paper. The daily climatic data, solar radiation, air temperature, relative humidity, and wind speed from two stations, Pomona and Santa Monica, in Los Angeles, Calif., are used as inputs to the neurofuzzy model to estimate ET0 obtained using the FAO-56 Penman–Monteith equation. In the first part of the study, a comparison is made between the estimates provided by the neurofuzzy model and those of the following empirical models: The California Irrigation Management System, Penman, Hargreaves, and Ritchie. In this part of the study, the empirical models are calibrated using the standard FAO-56 PM ET0 values. The estimates of the neurofuzzy technique are also compared with those of the calibrated empirical models and artificial neural network (ANN) technique. Mean-squared errors, mean-absolute errors, and determination coefficient statistics are used as comparing criteria for the evaluation of the models’ performances. The comparison results reveal that the neurofuzzy models could be employed successfully in modeling the ET0 process. In the second part of the study, the potential of the neurofuzzy technique, ANN and the empirical methods in estimation ET0 using nearby station data are investigated.     

Use of urine biomarkers to evaluate menstrual function in healthy premenopausal women

A total of 403 healthy, premenopausal women, residing near Santa Clara, California, were recruited from a large health care plan in California for a study of menstrual function. After a telephone interview, participants collected daily urine samples and recorded bleeding and other information in diaries. Data were collected during 1990-1991. Urine samples were analyzed for creatinine and for estradiol and progesterone metabolites by enzyme-linked immunoassay. Computer algorithms were developed to derive menstrual segment length, ovulatory status, day of ovulation, and other parameters from the urine and diary data. (We use "segment" rather than "cycle" to avoid implying that normal cycling occurred.) The average length of participation was 141 (standard deviation, 45) days. The mean segment length was 28.8 (standard deviation, 4.4) days; follicular phase length, 16.0 (standard deviation, 4.4) days; and luteal phase length, 12.9 (standard deviation, 1.7) days; 19 (4.7%) women experienced anovulatory episodes. In exploratory multivariate analyses, important associations included the following: age of > or = 35 years with decreased segment and follicular phase lengths; heavier weight (upper quartile) with anovulation and increased follicular phase and decreased luteal phase lengths; Hispanic ethnicity with anovulation and increased segment length; and past difficulty in achieving pregnancy with anovulation and increased length and variability of segments and follicular phases. Urine biomarkers can be used successfully to evaluate menstrual function in epidemiologic studies.     

Preferential presentation of herpes simplex virus T-cell antigen by HLA DQA1*0501/DQB1*0201 in comparison to HLA DQA1*0201/DQB1*0201

The relation of childhood personality types, or configurations of personality traits, to adolescent development was examined. Three personality types were identified in an inverse factor analysis of California Child Q-Sort data on 128 Icelandic 7-year-olds: resilient, overcontrolled, and undercontrolled. Growth curve analyses demonstrated that in comparison to children of the other 2 types, children of the resilient personality type had higher levels of academic achievement and lower levels of concentration problems throughout adolescence; resilient children also developed sophisticated friendship reasoning and an internal locus of control more quickly. Children of the overcontrolled type were found to be more prone to social withdrawal and low levels of self-esteem during adolescence than children of the other 2 types. In contrast to the other 2 types, children classified as undercontrolled showed an increase in aggressive behavior in adolescence. Implications of the findings for research on personality development are discussed.     

Average optical performance of the human eye as a function of age in a normal population

PURPOSE: To determine the average optical performance of the human eye, in terms of the modulation transfer function (MTF), as a function of age. METHODS: An apparatus was constructed to measure the ocular MTF, based on the recording of images of a green, 543-nm laser-point source after reflection in the retina and double pass through the ocular media. MTFs were computed from the average of three 4-second-exposure double-pass images recorded by a slow-scan, cooled charge-coupled device camera. The ocular MTF was measured for three artificial pupil diameters (3 mm, 4 mm, and 6 mm) with paralyzed accommodation under the best refractive correction in 20 subjects for each of three age categories: young subjects aged 20 to 30 years, middle-aged subjects aged 40 to 50 years, and older subjects aged 60 to 70 years. The selected subjects passed an ophthalmologic examination, excluding subjects with any form of ocular or retinal disease, spherical or cylindrical refractive errors exceeding 2 D, and corrected visual acuity lower than 1 (0.8 in the older age group). RESULTS: The average MTF was determined for each age group and pupil diameter. A two-parameter analytical expression was proposed to represent the average MTF in each age group for every pupil diameter. The ocular MTFs declined as age increased from young to older groups. The SD of the MTF results within age groups was lower than the differences between the mean for each group. CONCLUSIONS: The average optical performance of the human eye progressively declines with age. These MTF results can serve as a reference for determining mean ocular optics according to age.     

The relation of childhood personality types to adolescent behavior and development: A longitudinal study of Icelandic children.

The relation of childhood personality types, or configurations of personality traits, to adolescent development was examined. Three personality types were identified in an inverse factor analysis of California Child Q-Sort data on 128 Icelandic 7-year-olds: resilient, overcontrolled, and undercontrolled. Growth curve analyses demonstrated that in comparison to children of the other 2 types, children of the resilient personality type had higher levels of academic achievement and lower levels of concentration problems throughout adolescence; resilient children also developed sophisticated friendship reasoning and an internal locus of control more quickly. Children of the overcontrolled type were found to be more prone to social withdrawal and low levels of self-esteem during adolescence than children of the other 2 types. In contrast to the other 2 types, children classified as undercontrolled showed an increase in aggressive behavior in adolescence. Implications of the findings for research on personality development are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical features of 201 cases with Duane''s retraction syndrome

OBJECTIVE: To summarize the clinical features of 201 cases with Duane's retraction syndrome (DRS) and discuss its differential diagnosis. METHODS: We retrospectively summarized the 201 cases from 1979 to 1996. The clinical features including chief complaints, sexual distribution, age at first visit, laterality, type of presentation, ocular deviation in the primary position, refractive errors, amblyopia, globe retraction, change of the palpebral fissure, upshoot and downshoot in adduction, binocular single vision, and its associated ocular and non-ocular anomalies were analysed. RESULTS: There were 99 males and 102 females with a female-to-male ratio 1:1. The 65.88% of DRS cases had left eye involvement with two-to-one predilection for the left eye. The most common form of the syndrome was type I (184 patients, 91.54%). Exotropia was the most common deviation in the primary gaze (72 patients, 35.8%). Among 118 patients, most had abduction deficits, globe retraction in adduction, and faceturn as to maintaining single binocular vision. Crocodial tears (26 patients, 11.93%) was the most frequently encounted ocular abnormalities. CONCLUSIONS: Diagnosis of DRS in a typical case is not difficult, however, children with bilateral abduction deficits which may mimic DRS must be differentiated from the following four motility disorders, namely, abducens nerve palsy, Moebius syndrome, congenital oculomotor apraxia, and congenital or infantile esotropia.     

Michael D. Newcomb (1952–2010).

Michael D. Newcomb was a gifted psychologist who had an indelible impact on the study of drug etiology and consequences. He was a prodigious scholar, capable of weaving together the most challenging methodological, developmental, and psychological concerns, all framed by a deep clinical acumen. He resolved some of the most difficult challenges facing longitudinal researchers examining the range of psychosocial forces affecting drug use and deviant behaviors. Michael Newcomb was born on December 20, 1952, in Laguna Beach, California, and died in Santa Monica, California, on February 13, 2010, after a long battle with a degenerative neurological disease. He received his bachelor’s degree in social ecology from the University of California, Irvine (1974), where he pursued joint studies in developmental psychology and mathematics. Much later, he would forge these two academic disciplines together in a rare and powerful blend examining substance use etiology and consequences. Newcomb made latent constructs come alive, something that many of us overlook or fail to fully appreciate. He was a staid nonconformist, which was reflected in his ardor for research on deviant lifestyles. His “liberal” tendencies were captured well by his long, flowing mane of reddish-blond hair tied back in a pony tail. He was a modern Wittgenstein, a connoisseur of wine, food, travel, and friendship, and probably the most widely read person one could meet. Newcomb was the quintessential mentor, and his life force will remain indelibly etched in many minds. Collectively, his students’ sojourn and their own grappling with lofty ideals are a mere reflection of his caring professional tutelage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vertical fixation disparity in learning disabled

In this correlation study of visual parameters as related to learning disabilities, we considered several deficits: uncorrected refractive error, accommodative infacility, inaccurate pursuits, and vertical fixation disparity. Because vision is the primary sensory input involved in reading, it is nothing new to find a correlation between visual deficits and learning problems; however, vertical fixation disparity, unique in its relation to other sensory systems, deserves a great deal of attention. The high incidence of vertical fixation disparity measured in 5th and 6th graders with learning disabilities suggests that there is a plausible causal relation. Vertical oculomotor imbalance, vestibular problems, and learning disability are discussed.     

Evapotranspiration Modeling Using Linear Genetic Programming Technique

The study investigates the accuracy of linear genetic programming (LGP), which is an extension to genetic programming (GP) technique, in daily reference evapotranspiration (ET0) modeling. The daily climatic data, solar radiation, air temperature, relative humidity, and wind speed from three stations, Windsor, Oakville, and Santa Rosa, in central California, are used as inputs to the LGP to estimate ET0 obtained using the FAO-56 Penman-Monteith equation. The accuracy of the LGP is compared with those of the support vector regression (SVR), artificial neural network (ANN), and those of the following empirical models: the California irrigation management system Penman, Hargreaves, Ritchie, and Turc methods. The root-mean-square errors, mean-absolute errors, and determination coefficient (R2) statistics are used for evaluating the accuracy of the models. Based on the comparison results, the LGP is found to be superior alternative to the SVR and ANN techniques.     

Changes in the visual system in low birth weight children

PURPOSE: Evaluation of the visual system, especially refraction, in children with low birth weight under observation between 1990-1992. MATERIAL AND METHODS: 248 children with birth weight 600-2500 g and gestational age 26-37 weeks underwent ophthalmological examination including USG, ERG and VER. The children were first examined between 3-4 weeks of life, then at 8 and 12 weeks and 6, 12, 18 and 24 months. RESULTS: Refractive errors were found in 216 of patients, in 85.2% hypermetropia. ROP occurred in 7 children with birth weight below 1500 g and gestational age 27-32 weeks. Other ocular changes were observed in 19 (7.6%) of the examined children.     

Fuzzy Genetic Approach for Modeling Reference Evapotranspiration

This study investigates the ability of fuzzy genetic (FG) approach in modeling of reference evapotranspiration (ET0). The daily climatic data, solar radiation, air temperature, relative humidity, and wind speed from three stations, Windsor, Oakville and Santa Rosa, in central California, are used as inputs to the FG models to estimate ET0 obtained using the FAO-56 Penman-Monteith equation. A comparison is made between the estimates provided by the FG and those of the following empirical models: the California Irrigation Management System Penman, Hargreaves, Ritchie, and Turc methods. The FG results are also compared with the artificial neural networks. Root-mean-square errors (RMSE), mean-absolute errors (MAE), and correlation coefficient statistics are used as comparing criteria for the evaluation of the models’ performances. The comparison results reveal that the FG models are superior to the ANN and empirical models in modeling ET0 process. For the Windsor, Oakville, and Santa Rosa stations, it was found that the FG models with RMSEW = 0.138, MAEW = 0.098, and RW = 0.999; RMSEO = 0.144, MAEO = 0.102, and RO = 0.999; and RMSES = 0.167, MAES = 0.115, and RS = 0.998 in test period is superior in modeling daily ET0 than the other models, respectively.     

Preschoolers monitor the relative accuracy of informants.

In 2 studies, the sensitivity of 3- and 4-year-olds to the previous accuracy of informants was assessed. Children viewed films in which 2 informants labeled familiar objects with differential accuracy (across the 2 experiments, children were exposed to the following rates of accuracy by the more and less accurate informants, respectively: 100% vs. 0%, 100% vs. 25%, 75% vs. 0%, and 75% vs. 25%). Next, children watched films in which the same 2 informants provided conflicting novel labels for unfamiliar objects. Children were asked to indicate which of the 2 labels was associated with each object. Three-year-olds trusted the more accurate informant only in conditions in which 1 of the 2 informants had been 100% accurate, whereas 4-year-olds trusted the more accurate informant in all conditions tested. These results suggest that 3-year-olds mistrust informants who make a single error, whereas 4-year-olds track the relative frequency of errors when deciding whom to trust. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of emergency department visits for disorders of the eye and ocular adnexa

OBJECTIVE: To characterize the magnitude and patterns of visits to the emergency department (ED) for problems related to the eye and ocular adnexa. METHODS: The National Hospital Ambulatory Medical Care Survey was used to obtain information on ED visits in the United States for conditions of the eye and ocular adnexa in 1993. Patients were identified by International Classification of Diseases, Ninth Revision, Clinical Modification, codes. National projections were based on a staged probability design. RESULTS: There were 2.32 million projected ED visits for problems of the eye and ocular adnexa in 1993. Forty-nine percent of visits were for injuries, two thirds of which occurred in males. Thirty-five percent of injuries occurred in the home and 18% occurred in the workplace. Only 3% of patients required hospitalization. Most patients had private insurance, but substantial variations in coverage existed for patients who used the ED for injury- vs non-injury-related care. CONCLUSIONS: Emergency departments in the United States provide a large amount of eye care, much of which is for conditions other than trauma. Differences in insurance coverage for injury- and non-injury-related eye care indicate that factors other than medical urgency are involved in the decision to use ED services. Further studies are needed to determine the cost-effectiveness and quality of ocular-related ED visits.     

Psychiatric hospitalization of persons with dual diagnoses: estimates from two national surveys

Individuals with both mental illness and alcohol or drug use disorders present distinctive treatment and human service problems, including increased risk for psychiatric hospitalization in community hospitals. Using national hospital discharge abstract data for 1990 and 1994, this study compared differences in psychiatric hospitalization in community hospitals of patients with mental illness only and those with mental disorders and substance use disorders. Individuals with dual diagnoses were younger, and a greater proportion were men. Medicaid was the primary payer for a larger percentage of those with dual diagnoses. Nationally, the number of community hospitalizations for dually diagnosed patients increased 15 percent from 1990 to 1994, and total hospital charges increased from $1.9 to $2.2 billion.     

Measures of individual and group changes in ordered categorical data: application to the ADL staircase

BACKGROUND: Diabetes mellitus is a serious public health concern. Approximately 7.8 million Americans have been diagnosed with the disease. Researchers estimate an additional 6 to 7 million individuals currently have the disease, but remain undiagnosed. Diabetes is the leading cause of new blindness in Americans 20 to 74 years of age. Disproportionately high rates of diabetes exist within Native American, Hispanic, and black populations. METHODS: This process review documents the experiences of a collaborative primary care team approach to the prevention and treatment of ocular complications of diabetes in patients receiving care at the White Earth Indian Health Center, Bemidji Area Indian Health Service. The White Earth Indian Health Center was one of four primary care clinics that pilot-tested the Minnesota Department of Health Diabetes Control Program. RESULTS: The rate of diabetic eye examination increased to 86% of all individuals diagnosed with diabetes. CONCLUSIONS: This article describes the experiences of the White Earth Indian Health Center in establishing priorities, selecting guidelines, and implementing and monitoring a pilot-project for the prevention of ocular complications of diabetes. Application or modifications of this model may be of benefit to other programs that use the primary care team approach in the care and management of diabetes and other chronic disease entities.