Association of hearing impairment and subsequent driving mobility in older adults

- Purpose of the study Hearing impairment (HI) is associated with driving safety (e.g., increased crashes and poor on-road driving performance). However, little is known about HI and driving mobility. This study examined the longitudinal association of audiometric hearing with older adults’ driving mobility over three years. - Design and Methods Secondary data analyses were conducted of 500 individuals (63-90 years) from the Staying Keen in Later Life (SKILL) study. Hearing (pure tone average of 0.5, 1, and 2 kHz) was assessed in the better hearing ear and categorized into normal hearing <25 dB HL; mild HI 26-40 dB HL; or moderate and greater HI>41 dB HL. The Useful Field of View Test (UFOV) was used to estimate the risk for adverse driving events. MANCOVA compared driving mobility between HI levels across time, adjusting for age, sex, race, hypertension, and stroke. Adjusting for these same covariates, Cox regression analyses examined incidence of driving cessation by HI across three years. - Results Individuals with moderate or greater HI performed poorly on the UFOV, indicating increased risk for adverse driving events (p<.001). No significant differences were found among older adults with varying levels of HI for driving mobility (ps>.05), including driving cessation rates (p=.38), across time. - Implications Although prior research indicates older adults with HI may be at higher risk for crashes, they may not modify driving over time. Further exploration of this issue is required to optimize efforts to improve driving safety and mobility among older adults.

Do small-aperture presbyopic corrections influence the visual field?

Purpose To explore the effect of small-aperture optics, designed to aid presbyopes by increasing ocular depth-of-focus, on measurements of the visual field. Methods Simple theoretical and ray-tracing models were used to predict the impact of different designs of small-aperture contact lenses or corneal inlays on the proportion of light passing through natural pupils of various diameters as a function of the direction in the visual field. The left eyes of five healthy volunteers were tested using three afocal, hand-painted opaque soft contact lenses (www.davidthomas.com). Two were opaque over a 10 mm diameter but had central clear circular apertures of 1.5 and 3.0 mm in diameter. The third had an annular opaque zone with inner and outer diameters of 1.5 and 4.0 mm, approximately simulating the geometry of the KAMRA inlay (www.acufocus.com). A fourth, clear lens was used for comparison purposes. Visual fields along the horizontal meridian were evaluated up to 50° eccentricity with static automated perimetry (Medmont M700, stimulus Goldmann-size III; www.medmont.com). Results According to ray-tracing, the two lenses with the circular apertures were expected to reduce the relative transmittance of the pupil to zero at specific field angles (around 60° for the conditions of the experimental measurements). In contrast, the annular stop had no effect on the absolute field but relative transmittance was reduced over the central area of the field, the exact effects depending upon the natural pupil diameter. Experimental results broadly agreed with these theoretical expectations. With the 1.5 and 3.0 mm pupils, only minor losses in sensitivity (around 2 dB) in comparison with the clear-lens case occurred across the central 10° radius of field. Beyond this angle, sensitivity losses increased, to reach about 7 dB at the edge of the measured field (50°). The field results with the annular stop showed at most only a slight loss in sensitivity (≤3 dB) across the measured field. Conclusion The present theoretical and experimental results support earlier clinical findings that KAMRA-type annular stops, unlike circular artificial pupils, have only minor effects on measurements of the visual field.

Nitrification (DMPP) and urease (NBPT) inhibitors had no effect on pasture yield, nitrous oxide emissions nor nitrate leaching under irrigation in a hot-dry climate

Modern dairy farming in Australia relies on substantial inputs of fertiliser nitrogen (N) to underpin economic production. However, N lost from dairy systems represents an opportunity cost and can pose a number of environmental risks. Nitrogen cycle inhibitors can be co-applied with N fertilisers to slow the conversion of urea to NH4+ to reduce losses via volatilisation, and slow the conversion of NH4+ to NO3- to minimize leaching of NO3- and gaseous losses via nitrification and denitrification. In a field campaign in a high input ryegrass-kikuyu pasture system we compared the soil N pools, losses and pasture production between a) urea coated with the nitrification inhibitor (3,4-dimethyl pyrazole phosphate - DMPP) b) urea coated with the urease inhibitor (N-(n-butyl) thiophosphoric triamide - NBPT) and c) standard urea. There was no treatment effect (P>0.05) on soil mineral N, pasture yield, N2O flux nor leaching of NO3- cf. standard urea. We hypothesise that at our site, because gaseous losses were highly episodic (rainfall was erratic and displayed no seasonal rainfall nor soil wetting pattern) that there was a lack of coincidence of N application and conditions conducive to gaseous losses, thus the effectiveness of the inhibitor products was minimal and did not result in an increase in pasture yield. There remains a paucity of knowledge on N cycle inhibitors in relation to their effective use in field system to increase N use efficiency. Further research is required to define under what field conditions inhibitor products are effective in order to be able to provide accurate advice to managers of nitrogen in production systems.

Honesty in the provision of expert services: The effect of naturalistic framings and participants' professions

This thesis studies the incentives and behaviour of providers of expert services, like doctors, financial advisors and mechanics. The focus is in particular on provision of health care using a series of credence goods experiments conducted to investigate undertreatment, overtreatment and overcharging in a medical context. The findings of study one suggest that a medical framing compared to a neutral framing significantly increases pro-social behaviour for standard participants in economic experiments. Study two compares the behaviour of medical practitioners - mainly doctors - to students. It is observed that medical doctors’ undertreat and overcharge significantly less, but at the same time overtreat significantly more than students. The final study compares behaviours for other experts - accountants, engineers and lawyers - using experimental framings drawn from the respective contexts and students from the respective faculties as participants in credence goods experiments.