Efficacy of a web-based intervention to improve and sustain knowledge and screening for amblyopia in primary care settings.

Purpose: To evaluate the efficacy of a physician-targeted website to improve knowledge and self-reported behavior relevant to strabismus and amblyopia ("vision") in primary care settings.

Methods: Eligible providers (filing Medicaid claims for at least eight well-child checks at ages 3 or 4 years, 1 year before study enrollment), randomly assigned to control (chlamydia and blood pressure) or vision groups, accessed four web-based educational modules, programmed to present interactive case vignettes with embedded questions and feedback. Each correct response, assigned a value of +1 to a maximum of +7, was used to calculate a summary score per provider.

Retinal pigment epithelial expression of complement regulator CD46 is altered early in the course of geographic atrophy.

In geographic atrophy (GA), the non-neovascular end stage of age-related macular degeneration (AMD), the macular retinal pigment epithelium (RPE) progressively degenerates. Membrane cofactor protein (MCP, CD46) is the only membrane-bound regulator of complement expressed on the human RPE basolateral surface. Based on evidence of the role of complement in AMD, we hypothesized that altered CD46 expression on the RPE would be associated with GA development and/or progression.

Factors associated with incomplete childhood immunization among residents in St. Mary, Jamaica.

Aim: To investigate factors associated with caregiver failure to complete immunizations for their children in the parish of St. Mary, Jamaica.

Methods: A case-control study was conducted with 50 cases defined as caregivers who failed to immunize their children and 179 controls defined as caregivers of children who were properly immunized.

Genetic analyses of interferon pathway-related genes reveal multiple new loci associated with systemic lupus erythematosus.

Objective: The overexpression of interferon (IFN)-inducible genes is a prominent feature of systemic lupus erythematosus (SLE); it serves as a marker for active and more severe disease, and is also observed in other autoimmune and inflammatory conditions. This study was undertaken to investigate the genetic variations responsible for sustained activation of IFN-responsive genes in SLE.

Methods: We systematically evaluated association of SLE with a total of 1,754 IFN pathway-related genes, including IFN-inducible genes known to be differentially expressed in SLE patients and their direct regulators.

Human chorioretinal layer thicknesses measured in macula-wide, high-resolution histologic sections.

Purpose: To provide a comprehensive description of chorioretinal layer thicknesses in the normal human macula, including two-layer pairs that can produce a combined signal in some optical coherence tomography (OCT) devices (ganglion cell [GCL] and inner plexiform [IPL] layers and outer plexiform [OPL] and outer nuclear [ONL] layers).

Methods: In 0.8-μm-thick, macula-wide sections through the foveola of 18 donors (age range, 40-92 years), 21 layers were measured at 25 locations by a trained observer and validated by a second observer.

Masked trial of topical anesthesia for retinopathy of prematurity eye examinations.

Purpose: To observe the effect of a topical anesthetic on pain and corneal clarity in premature infants undergoing eye examinations for retinopathy of prematurity (ROP).

Methods: ROP examinations were performed on premature infants who were randomized to receive either proparacaine 0.5% or an artificial tear solution in the right eye.

Hemianopic and quadrantanopic field loss, eye and head movements, and driving.

Purpose: To compare eye and head movements, lane keeping, and vehicle control of drivers with hemianopic and quadrantanopic field defects with controls, and to identify differences in these parameters between hemianopic and quadrantanopic drivers rated safe to drive by a clinical driving rehabilitation specialist compared with those rated as unsafe.

Methods: Eye and head movements and lane keeping were rated in 22 persons with homonymous hemianopic defects and 8 with quadrantanopic defects (mean age, 53 years) who were ≥6 months post-injury and 30 persons with normal fields (mean age, 53 years). All were licensed to drive and were current drivers or aimed to resume driving.

Prospective identification of patients at risk for massive transfusion: an imprecise endeavor.

Most retrospective studies evaluating fresh-frozen plasma:packed red blood cell ratios in trauma patients requiring massive transfusion (MT) are limited by survival bias. As prospective resource-intensive studies are being designed to better evaluate resuscitation strategies, it is imperative that patients with a high likelihood of MT are identified early. The objective of this study was to develop a predictive model for MT in civilian trauma patients.

Identifying risk for massive transfusion in the relatively normotensive patient: utility of the prehospital shock index.

Background: In the prehospital environment, the failure of medical providers to recognize latent physiologic derangement in patients with compensated shock may risk undertriage. We hypothesized that the shock index (SI; heart rate divided by systolic blood pressure [SBP]), when used in the prehospital setting, could facilitate the identification of such patients. The objective of this study was to assess the association between the prehospital SI and the risk of massive transfusion (MT) in relatively normotensive blunt trauma patients.

Association between retinal thickness measured by spectral-domain optical coherence tomography (OCT) and rod-mediated dark adaptation in non-exudative age-related maculopathy.

Aim: To examine associations between retinal thickness and rod-mediated dark adaptation in older adults with non-exudative age-related maculopathy (ARM) or normal macular health.

Methods: A cross-sectional study was conducted with 74 adults ≥ 50 years old from the comprehensive ophthalmology and retina services of an academic eye centre. ARM presence and disease severity in the enrolment eye was defined by the masked grading of stereofundus photos using the Clinical Age-Related Maculopathy grading system.

Self-reported driving difficulty by persons with hemianopia and quadrantanopia.

Purpose: To compare self-reported driving difficulty by persons with hemianopic or quadrantanopic field loss with that reported by age-matched drivers with normal visual fields; and to examine how their self- reported driving difficulty compares to ratings of driving performance provided by a certified driving rehabilitation specialist (CDRS).

Method: Participants were 17 persons with hemianopic field loss, 7 with quadrantanopic loss, and 24 age-matched controls with normal visual fields, all of whom had current driver's licenses. Information was collected via questionnaire regarding driving difficulties experienced in 21 typical driving situations grouped into three categories (involvement of peripheral vision, low visibility conditions, and independent mobility).

Hospice use in Alabama, 2002-2005.

Context: The literature predominately describes hospice utilization among Medicare recipients, with a limited number of reports describing use among all age groups.

Objectives: This study aimed to describe and compare patterns of hospice use among decedents of all ages in Alabama using a population-based approach.

Methods: We obtained death certificates for Alabama residents who died from January 1, 2002 to December 31, 2005 (n=178,420).