Health risk appraisal in older people 6: factors associated with self-reported poor vision and uptake of eye tests in older people

BACKGROUND Although free eye testing is available in the UK from a nation-wide network of optometrists, there is evidence of unrecognised, tractable vision loss amongst older people. A recent review identified this unmet need as a priority for further investigation, highlighting the need to understand public perceptions of eye services and barriers to service access and utilisation. This paper aims to identify risk factors for (1) having poor vision and (2) not having had an eyesight check among community-dwelling older people without an established ophthalmological diagnosis. METHODS Secondary analysis of self-reported data from the ProAge trial. 1792 people without a known ophthalmological diagnosis were recruited from three group practices in London. RESULTS Almost two in ten people in this population of older individuals without known ophthalmological diagnoses had self-reported vision loss, and more than a third of them had not had an eye test in the previous twelve months. In this sample, those with limited education, depressed mood, need for help with instrumental and basic activities of daily living (IADLs and BADLs), and subjective memory complaints were at increased risk of fair or poor self-reported vision. Individuals with basic education only were at increased risk for not having had an eye test in the previous 12 months (OR 1.52, 95% CI 1.17-1.98 p=0.002), as were those with no, or only one chronic condition (OR 1.850, 95% CI 1.382-2.477, p<0.001). CONCLUSIONS Self-reported poor vision in older people without ophthalmological diagnoses is associated with other functional losses, with no or only one chronic condition, and with depression. This pattern of disorders may be the basis for case finding in general practice. Low educational attainment is an independent determinant of not having had eye tests, as well as a factor associated with undiagnosed vision loss. There are other factors, not identified in this study, which determine uptake of eye testing in those with self-reported vision loss. Further exploration is needed to identify these factors and lead towards effective case finding.

Self-Reported Psychotic-Like Experiences Are a Poor Estimate of Clinician-Rated Attenuated and Frank Delusions and Hallucinations

Background: One reason for the decision to delay the introduction of an Attenuated Psychosis Syndrome in the main text of the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders was the concern that attenuated psychotic symptoms (APS) might in fact be common features in adolescents and young adults from the general population of no psychopathological significance in themselves. This concern was based on reports of high prevalence rates of psychotic-like experiences (PLEs) in the general population and the assumption that PLEs are a good estimate of APS. Although the criterion validity of self-reported PLEs had already been studied with respect to clinician-rated psychotic symptoms and found insufficient, it had been argued that PLEs might in fact be more comparable with mild, subclinical expressions of psychotic symptoms and, therefore, with APS. The present paper is the first to specifically study this assumption. Sampling and Methods: The sample consisted of 123 persons seeking help at a service for the early detection of psychosis, of whom 54 had an at-risk mental state or psychosis, 55 had a nonpsychotic mental disorder and 14 had no full-blown mental disorder. PLEs were assessed with the Peters Delusion Inventory and the revised Launay-Slade Hallucination Scale, and psychotic symptoms and APS were assessed with the Structured Interview for Prodromal Syndromes. Results: At a level of agreement between the presence of any PLE (in 98.4% of patients) and any APS (in 40.7%) just exceeding chance (κ = 0.022), the criterion validity of PLEs for APS was insufficient. Even if additional qualifiers (high agreement or distress, preoccupation and conviction) were considered, PLEs (in 52.8%) still tended to significantly overestimate APS, and agreement was only fair (κ = 0.340). Furthermore, the group effect on PLE prevalence was, at most, moderate (Cramer's V ≤ 0.382). Conclusions: The prevalence of APS cannot be deduced from studies of PLEs. Thus, the high population prevalence rate of PLEs does not allow the conclusion that APS are common features of no pathological significance and would lack clinical validity as an Attenuated Psychosis Syndrome in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Rather, the population prevalence rate of APS has to be assumed to be largely unknown at present but is likely lower than indicated by epidemiological studies of PLEs. Therefore, dedicated studies are warranted, in which APS are assessed in a way that equates to their clinical evaluation.

Service Brand Relationship Quality: Hot or Cold?

Customers’ long-term brand relations are crucial drivers of a service brand’s sustainable competitive advantage. This research empirically examines the quality of customer-service brand relationships in the context of an airline’s frequent flyer program. The authors show that service brand relationship quality (BRQ) involves both a hot (based on emotions) and a cold (based on objectrelevant beliefs) component. They find that these two components have different implications for a service brand’s performance and are at least partially driven by different antecedents whose relative importance changes over time. Specifically, cold BRQ is important for word-of-mouth behavior and is strongly driven by partner quality (i.e., the generalized assessment of the brand in its role as a relationship counterpart). Hot BRQ, on the other hand, has a stronger impact on willingness to pay a price premium and consideration set size. In early stages of a customer-brand relationship hot BRQ is more strongly driven by self-congruence (i.e., consumer’s perception of the fit between his/her self and the brand’s personality), in later stages partner quality becomes more relevant. The authors discuss the implications of their findings for the development of BRQ and the implementation of alternative growth strategies in a services context.

Software Development in the Cloud: Exploring the Affordances of Platform-as-a-Service

Software development teams increasingly adopt platform-as-a-service (PaaS), i.e., cloud services that make software development infrastructure available over the internet. Yet, empirical evidence of whether and how software development work changes with the use of PaaS is difficult to find. We performed a grounded-theory study to explore the affordances of PaaS for software development teams. We find that PaaS enables software development teams to enforce uniformity, to exploit knowledge embedded in technology, to enhance agility, and to enrich jobs. These affordances do not arise in a vacuum. Their emergence is closely interwoven with changes in methodologies, roles, and norms that give rise to self-organizing, loosely coupled teams. Our study provides rich descriptions of PaaS-based software development and an emerging theory of affordances of PaaS for software development teams.

Mobility and Bandwidth Prediction as a Service in Virtualized LTE Systems

Recently telecommunication industry benefits from infrastructure sharing, one of the most fundamental enablers of cloud computing, leading to emergence of the Mobile Virtual Network Operator (MVNO) concept. The most momentous intents by this approach are the support of on-demand provisioning and elasticity of virtualized mobile network components, based on data traffic load. To realize it, during operation and management procedures, the virtualized services need be triggered in order to scale-up/down or scale-out/in an instance. In this paper we propose an architecture called MOBaaS (Mobility and Bandwidth Availability Prediction as a Service), comprising two algorithms in order to predict user(s) mobility and network link bandwidth availability, that can be implemented in cloud based mobile network structure and can be used as a support service by any other virtualized mobile network services. MOBaaS can provide prediction information in order to generate required triggers for on-demand deploying, provisioning, disposing of virtualized network components. This information can be used for self-adaptation procedures and optimal network function configuration during run-time operation, as well. Through the preliminary experiments with the prototype implementation on the OpenStack platform, we evaluated and confirmed the feasibility and the effectiveness of the prediction algorithms and the proposed architecture.

A Demonstration of Mobility Prediction as a Service in Cloudified LTE Networks

Location prediction has attracted a significant amount of research effort. Being able to predict users’ movement benefits a wide range of communication systems, including location-based service/applications, mobile access control, mobile QoS provision, and resource management for mobile computation and storage management. In this demo, we present MOBaaS, which is a cloudified Mobility and Bandwidth prediction services that can be instantiated, deployed, and disposed on-demand. Mobility prediction of MOBaaS provides location predictions of a single/group user equipments (UEs) in a future moment. This information can be used for self-adaptation procedures and optimal network function configuration during run-time operations. We demonstrate an example of real-time mobility prediction service deployment running on OpenStack platform, and the potential benefits it bring to other invoking services.

Using service-learning to encourage community health advocacy among high school students

The project outlined throughout this program management plan aims to develop a health-focused student advocacy group in the San Antonio Independent School District (SAISD). At its core, this project will be an opportunity for SAISD students to engage in service-learning, through which they will learn and develop by designing, organizing and participating in meaningful public health service experiences. ^ This program management plan addresses the genuine need for public health community education by using the service-learning model as a framework to engage students to effect change. The plan delineates the process by which the student advocacy group is to be assembled, selection of service-learning project, project objectives, technical objectives, and communication requirements. Ideally, the plan should help to facilitate project coordination, communication, and planning, and to support the direction of resources. The appendices that follow also provide useful tools with which to follow through with project implementation. ^ The plan is about more than providing a tool to educate students about the health issues in their community. It is about providing a way to teach health advocacy and self-interest and encourage civic engagement via public health. Students have the potential to positively effect lasting change among their peers, in their schools and in the community.^

Understanding treatment-related symptoms, symptom management techniques, and symptom management self-efficacy in a sample of non-muscle invasive bladder cancer patients

The current literature available on bladder cancer symptom management from the perspective of the patients themselves is limited. There is also limited psychosocial research specific to bladder cancer patients and no previous studies have developed and validated measures for bladder cancer patients’ symptom management self-efficacy. The purpose of this study was to investigate non-muscle invasive bladder cancer patients’ health related quality of life through two main study objectives: (1) to describe the treatment related symptoms, reported effectiveness of symptom-management techniques, and the advice a sample of non-muscle invasive bladder cancer patients would convey to physicians and future patients; and (2) to evaluate Lepore’s symptom management self-efficacy measure on a sample of non-muscle invasive bladder cancer patients. Methods. A total of twelve (n=12) non-muscle invasive bladder cancer patients participated in an in-depth interview and a sample of 46 (n=4) non-muscle invasive bladder cancer patients participated in the symptom-management self-efficacy survey. Results. A total of five symptom categories emerged for the participants’ 59 reported symptoms. Four symptom management categories emerged out of the 71 reported techniques. A total of 62% of the participants’ treatment related symptom-management techniques were reported as effective in managing their treatment-related symptoms. Five advice categories emerged out of the in-depth interviews: service delivery; medical advice; physician-patient communication; encouragement; and no advice. An exploratory factor analysis indicated a single-factor structure for the total population and a multiple factor structure for three subgroups: all males, married males, and all married participants. Conclusion. These findings can inform physicians and patients of effective symptom-management techniques thus improving patients’ health-related quality of life. The advice these patients’ impart can improve service-delivery and patient education.^

A study of the determinants of the utilization of preventive health care service among Chicanos

This study examines the individual and health care system determinants of two types of preventive health care practice behaviors, having a routine physical exam or a preventive dental exam, in the past year among Chicanos in the Southwestern United States. The study utilizes the Health System Model, developed by Aday and Andersen in 1974, to analyze the relative effect of education, income and occupation on the use of discretionary health care, controlling for other individual and health care system determinants.^ The study is based on a sample of 4,111 Mexican origin adults, drawn from the Hispanic Health and Nutrition Examination Survey (HHANES). This sample is representative of Mexican American residing in the Southwestern United States.^ The study tests the hypothesis that education is the most important social class predictor of preventive health care practice behavior. The fully elaborated model tests the hypothesis that individual determinants alone are insufficient to explain the use of preventive health care services among Chicanos.^ The study found that education and income are statistically significant social class indicators only as it relates to having a preventive dental exam. Education is not the most important social class predictor of either preventive health care practice behavior. Health care system determinants are key predictors of both behaviors. Need, as measured by self-perceived health status of teeth and gender, is as important a determinant as having dental insurance coverage as it relates to having a preventive dental exam. Implications for health programs to effectively reach Chicano target groups and remove access barriers to their use of discretionary health care services are discussed. ^

Volunteering: Demographic characteristics, motives and potential benefits from service

Volunteering is intricately woven into the fabric of our society. In 2009 alone, approximately 63.4 million Americans participated in volunteer activities, collectively donating over 8.1 billion service-hours (Corporation for National and Community Service [CNCS], 2010). Each service-hour is determined by the U.S. Bureau of Labor Statistics (2010) to be valued at $20.85/hr which translates to a national savings of $169 billion. Thus, we can clearly observe the significance of volunteer contribution to the overall benefit of society. In addition, there is now evidence that voluntary service may also benefit the actual volunteer, especially individuals who are 65+ years. As we reach 2020 this elderly class, composed of nearly 13 million (CNCS, 2010) Americans, will be of much consequence. Their potential to contribute in community-related efforts may save the U.S. billions in labor costs, and may also help reduce healthcare-related expenditures if volunteering proves to be a protective factor. In this literature review, we set out to explore the potential relationship between volunteer participation and increased mental and physical wellness. We also examined volunteer demographic characteristics and common motives for engaging in service-related activities. Analysis showed that volunteer work often combined low-impact physical activity and mental satisfaction from serving others, resulting in overall health benefit. Demographic characteristics displayed were consistent with previous studies and found that a majority of volunteers were female, White, married status, having received college degree or higher, employed, middle-high SES. In addition, age was seen to be a key characteristic in forecasting volunteer motivation and self-reported perceived health benefits.^

Responses to Domestic Violence Public Service Ads: Memory, Attitudes, Affect, and Individual Differences

Public service ads (PSAs) are an increasingly visible part of efforts to decrease the occurrence and consequences of domestic violence. Like other advertising, domestic violence PSAs are designed to grab attention, influence attitudes, and enhance memory for ad content. Over the years, images in domestic violence PSAs have changed substantially; agencies have started using pictures that generate emotions - either vivid negative images (bruised faces or body parts), or positive images (smiling faces) that contrast with the negative text. It is not clear, however, how different types of ad images influence memory for the message and attitudes about domestic violence, and what role affect may play in such responses. Moreover, the extent to which individual differences (trauma history, posttraumatic distress - PTSD symptoms) influence outcomes is not known. In three studies with undergraduate and community samples, using methods ranging from psychophysiology to self-report, the impact of images on attitudes and memory for ad content are investigated, also considering affect and individual differences. Results indicate graphic negative images enhanced memory for ad content, are rated as more persuasive, and are more likely to compel the viewer to act. Affective responses to ads also differed based on image type, and in some cases, partially mediated the relationship between ads and outcomes. Trends in the data suggest further study of the role of individual differences (trauma history, PTSD symptoms) is needed. This research provides information specifically relevant to the design of domestic violence public service campaigns and broadly relevant to understanding the role of emotional responses and individual differences on outcomes associated with public service ads.

Self-regulation of environmental quality : impact analysis in California local government /

Mode of access: Internet.

Maintaining and donning the self-contained breathing apparatus (SCBA) /

"April 1982."

Self-evaluation of occupational safety and health programs /

Mode of access: Internet.

Self-care and self-help groups for the elderly : a directory /

Mode of access: Internet.