Clinical investigation of asmofilcon A silicone hydrogel lenses

Purpose. To investigate the clinical and subjective performance of asmofilcon A, a new third generation silicone hydrogel contact lens during 6-night extended wear (EW) over 6 months. Methods. A prospective, randomized, single-masked study was conducted. Sixty experienced daily wear soft contact lens wearers were randomly assigned to wear either asmofilcon A or senofilcon A contact lenses bilaterally for 6 months on an EW basis. Evaluations were conducted at contact lens delivery and after 1 week, 4 weeks, 3 and 6 months of EW. Results. Fifty subjects (83%) successfully completed the study. Two subjects experienced adverse events; one unilateral red eye with asmofilcon A and one asymptomatic infiltrate with senofilcon A. There were no significant differences in high or low contrast distance visual acuity between asmofilcon A and senofilcon A; however, low contrast distance visual acuity decreased significantly over time with both contact lens types (p < 0.05). The two lens types did not vary significantly with respect to any of the objective and subjective measures assessed (p > 0.05). Superior palpebral conjunctival injection showed a statistically significant increase over time with both lens types (p < 0.05). Both lens types were rated highly with respect to overall comfort, with subjects reporting 14 or 15 h of comfortable lens wearing time per day at each of the study visits (p > 0.05). Overall satisfaction ratings were also very high at all visits, with median scores of 95 (86 to 99) for asmofilcon A and 90 (85 to 96) for senofilcon A at 6 months (p > 0.05). Conclusions. Over 6 months of EW, the asmofilcon A contact lens performed in a similar manner to senofilcon A with respect to visual acuity, ocular health, and contact lens performance measures. Longer-term EW studies are required to investigate the changes over time observed with both lens types.

Immigration distress and associated factors among Vietnamese momen in transnational marriages in Taiwan

The purpose of this study was to explore the types and predictors of immigration distress among Vietnamese women in transnational marriages in Taiwan. A cross-sectional survey with face-toface interviews was conducted for data collection. A convenient sample of 203 Vietnamese women in transnational marriages in southern Taiwan was recruited. The Demographic Inventory measured the participants’ age, education, employment status, religion, length of residency and number of children, as well as their spouse’s age, education, employment status and religion. The Demand of Immigration Specific Distress scale measured the level of distress and had six subscales: loss, novelty, occupational adjustment, language accommodation, discrimination and alienation. Among the 203 participants, 6.4% had a high level of immigration distress; 91.1% had moderate distress; and 2.5% had minor distress. Higher mean scores were found for the loss, novelty and language accommodation subscales of the Demand of Immigration specific Distress scale. Participant’s (r = 0.321, p < 0.01) and spouse’s (r = 0.375, p < 0.01) unemployment, and more children (r = 0.129, p < 0.05) led to greater immigration distress. Length of residency in Taiwan (r = 0.576, p < 0.001) was an effective predictor of immigration distress. It indicated that the participants who had stayed fewer years in Taiwan had a higher level of immigrant distress. Health care professionals need to be aware that the female newcomers in transnational marriages are highly susceptible to immigration distress. The study suggests that healthcare professionals need to provide a comprehensive assessment of immigration distress to detect health problems early and administer culturally appropriate healthcare for immigrant women in transnational marriages.

Response shift, recall bias and their effect on measuring change in health-related quality of life amongst older hospital patients

Background: Assessments of change in subjective patient reported outcomes such as health-related quality of life (HRQoL) are a key component of many clinical and research evaluations. However, conventional longitudinal evaluation of change may not agree with patient perceived change if patients' understanding of the subjective construct under evaluation changes over time (response shift) or if patients' have inaccurate recollection (recall bias). This study examined whether older adults' perception of change is in agreement with conventional longitudinal evaluation of change in their HRQoL over the duration of their hospital stay. It also investigated this level of agreement after adjusting patient perceived change for recall bias that patients may have experienced. Methods: A prospective longitudinal cohort design nested within a larger randomised controlled trial was implemented. 103 hospitalised older adults participated in this investigation at a tertiary hospital facility. The EQ-5D utility and Visual Analogue Scale (VAS) scores were used to evaluate HRQoL. Participants completed EQ-5D reports as soon as they were medically stable (within three days of admission) then again immediately prior to discharge. Three methods of change score calculation were used (conventional change, patient perceived change and patient perceived change adjusted for recall bias). Agreement was primarily investigated using intraclass correlation coefficients (ICC) and limits of agreement. Results: Overall 101 (98%) participants completed both admission and discharge assessments. The mean (SD) age was 73.3 (11.2). The median (IQR) length of stay was 38 (20-60) days. For agreement between conventional longitudinal change and patient perceived change: ICCs were 0.34 and 0.40 for EQ-5D utility and VAS respectively. For agreement between conventional longitudinal change and patient perceived change adjusted for recall bias: ICCs were 0.98 and 0.90 respectively. Discrepancy between conventional longitudinal change and patient perceived change was considered clinically meaningful for 84 (83.2%) of participants, after adjusting for recall bias this reduced to 8 (7.9%). Conclusions: Agreement between conventional change and patient perceived change was not strong. A large proportion of this disagreement could be attributed to recall bias. To overcome the invalidating effect of response shift (on conventional change) and recall bias (on patient perceived change) a method of adjusting patient perceived change for recall bias has been described.

A virtual test assessment tool for second year signal processing students

The development and use of a virtual assessment tool for a signal processing unit is described. It allows students to take a test from anywhere using a web browser to connect to the university server that hosts the test. While student responses are of the multiple choice type, they have to work out problems to arrive at the answer to be entered. CGI programming is used to verify student identification information and record their scores as well as provide immediate feedback after the test is complete. The tool has been used at QUT for the past 3 years and student feedback is discussed. The virtual assessment tool is an efficient alternative to marking written assignment reports that can often take more hours than actual lecture hall contact from a lecturer or tutor. It is especially attractive for very large classes that are now the norm at many universities in the first two years.

Beyond sanctions : is there a need to treat first-time offenders?

Aims: Driving Under the Influence (DUI) enforcement can be a broad screening mechanism for alcohol and other drug problems. The current response to DUI is focused on using mechanical means to prevent inebriated persons from driving, with little attention the underlying substance abuse problems. ---------- Methods: This is a secondary analysis of an administrative dataset of over 345,000 individuals who entered Texas substance abuse treatment between 2005 and 2008. Of these, 36,372 were either on DUI probation, referred to treatment by probation, or had a DUI arrest in the past year. The DUI offenders were compared on demographic characteristics, substance use patterns, and levels of impairment with those who were not DUI offenders and first DUI offenders were compared with those with more than one past-year offense. T tests and chi square tests were used to determine significance. ---------- Results: DUI offenders were more likely to be employed, to have a problem with alcohol, to report more past-year arrests for any offense, to be older, and to have used alcohol and drugs longer than the non-DUI clients who reported higher ASI scores and were more likely to use daily. Those with one past-year DUI arrest were more likely to have problems with drugs other than alcohol and were less impaired than those with two or more arrests based on their ASI scores and daily use. Non-DUI clients reported higher levels of mood disorders than DUIs but there was no difference in their diagnosis of anxiety. Similar findings were found between those with one or multiple DUI arrests. ----------Conclusion: Although first-time DUIs were not as impaired as non-DUI clients, their levels of impairment were sufficient to cause treatment. Screening and brief intervention at arrest for all DUI offenders and treatment in combination with abstinence monitoring could decrease future recidivism.

Assessing cognitive development in early childhood : a comparison of the Bayley-III and the Stanford-Binet fifth edition

The Bayley Scales of Infant Development, Third Edition (Bayley-III) and Stanford-Binet Intelligence Scale, Fifth Edition (SB5) were administered in a sample of 26 typically developing children (12 males and 14 females) aged 24 – 42 months. Children completed the assessments in two separate sessions, counterbalanced for order of administration. Scores on the two instruments were not significantly related, with the exception of the SB5 Knowledge score, which was moderately correlated with the Language score on the Bayley-III (r = .41, p = 0.04). Despite no other significant correlations, for 22 of the 26 children, scores were very consistent across the two instruments. Implications for test selection are discussed.

A comparison of the 27-item and 12-item intolerance of uncertainty scales

The 27-item Intolerance of Uncertainty Scale (IUS) has become one of the most frequently used measure of Intolerance of Uncertainty. More recently, an abridged, 12-item version of the IUS has been developed. The current research used clinical (n = 50) and non-clinical (n = 56) samples to examine and compare the psychometric properties of both versions of the IUS. The two scales showed good internal consistency at both the total and subscale level and had satisfactory test-retest reliability. Both versions were correlated with worry and trait anxiety and had satisfactory concurrent validity. Significant differences between the scores of the clinical and non-clinical sample supported discriminant validity. Predictive validity was also supported for the two scales. Total scores, in the case of the clinical sample, and a subscale, in the case of the non-clinical sample, significantly predicted pathological worry and trait anxiety. Overall, the clinicians and researchers can use either version of the IUS with confidence, due to their sound psychometric properties.

Dysbindin (DTNBP1) : a role in psychotic depression?

Previous studies yielded evidence for dysbindin (DTNBP1) to impact the pathogenesis of schizophrenia on the one hand and affective disorders such as bipolar or major depressive disorder (MDD) on the other. Thus, in the present study we investigated whether DTNBP1 variation was associated with psychotic depression as a severe clinical manifestation of MDD possibly constituting an overlapping phenotype between affective disorders and schizophrenia. A sample of 243 Caucasian inpatients with MDD (SCID-I) was genotyped for 12 SNPs spanning 92% of the DTNBP1 gene region. Differences in DTNBP1 genotype distributions across diagnostic subgroups of psychotic (N = 131) vs. non-psychotic depression were estimated by Pearson Chi2 test and logistic regression analyses adjusted for age, gender, Beck Depression Inventory (BDI) and the Global Assessment of Functioning Scale (GAF). Overall, patients with psychotic depression presented with higher BDI and lower GAF scores expressing a higher severity of the illness as compared to depressed patients without psychotic features. Four DTNBP1 SNPs, particularly rs1997679 and rs9370822, and the corresponding haplotypes, respectively, were found to be significantly associated with the risk of psychotic depression in an allele-dose fashion. In summary, the present results provide preliminary support for dysbindin (DTNBP1) gene variation, particularly SNPs rs1997679 and rs9370822, to be associated with the clinical phenotype of psychotic depression suggesting a possible neurobiological mechanism for an intermediate trait on the continuum between affective disorders and schizophrenia.

Alcohol expectancy changes over a 12-week cognitive–behavioral therapy program are predictive of treatment success

This study examines if outcome expectancies (perceived consequences of engaging in certain behavior) and self- efficacy expectancies (confidence in personal capacity to regulate behavior) contribute to treatment outcome for alcohol dependence. Few clinical studies have examined these constructs. The Drinking Expectancy Profile (DEP), a psychometric measure of alcohol expectancy and drinking refusal selfefficacy, was administered to 298 alcohol-dependent patients (207 males) at assessment and on completion of a 12-week cognitive–behavioral therapy alcohol abstinence program. Baseline measures of expectancy and self-efficacy were not strong predictors of outcome. However, for the 164 patients who completed treatment, all alcohol expectancy and self-efficacy factors of the DEP showed change over time. The DEP scores approximated community norms at the end of treatment. Discriminant analysis indicated that change in social pressure drinking refusal self-efficacy, sexual enhancement expectancies, and assertion expectancies successfully discriminated those who successfully completed treatment from those who did not. Future research should examine the basis of expectancies related to social functioning as a possible mechanism of treatment response and a means to enhance treatment outcome.

Inferior visual field reductions are associated with poorer functional status among older adults with glaucoma

Purpose: To examine the relationship between visual impairment and functional status in a community-dwelling sample of older adults with glaucoma. Methods: This study included 74 community-dwelling older adults with open-angle glaucoma (aged 74 ± 6 years). Assessment of central vision included high-contrast visual acuity and Pelli-Robson contrast sensitivity. Binocular integrated visual fields were derived from merged monocular Humphrey Field Analyser visual field plots. Functional status outcome measures included physical performance tests (6-min walk test, timed up and go test and lower limb strength), a physical activity questionnaire (Physical Activity Scale for the Elderly) and an overall functional status score. Correlation and linear regression analyses, adjusting for age and gender, examined the association between visual impairment and functional status outcomes. Results: Greater levels of visual impairment were significantly associated with lower levels of functional status among community-dwelling older adults with glaucoma, independent of age and gender. Specifically, lower levels of visual function were associated with slower timed up and go performance, weaker lower limb strength, lower self-reported physical activity, and lower overall functional status scores. Of the components of vision examined, the inferior visual field and contrast factors were the strongest predictors of these functional outcomes, whereas the superior visual field factor was not related to functional status. Conclusions: Greater visual impairment, particularly in the inferior visual field and loss of contrast sensitivity, was associated with poorer functional status among older adults with glaucoma. The findings of this study highlight the potential links between visual impairment and the onset of functional decline. Interventions which promote physical activity among older adults with glaucoma may assist in preventing functional decline, frailty and falls, and improve overall health and well-being.

An investigation of the effect of individual cognitive preferences on learning through computer-based instruction

This paper reports a study investigating the effect of individual cognitive styles on learning through computer-based instruction. The study adopted a quasi-experimental design involving four groups which were presented with instructional material that either matched or mismatched with their preferred cognitive styles. Cognitive styles were measured by cognitive style assessment software (Riding, 1991). The instructional material was designed to cater for the four cognitive styles identified by Riding. Students' learning outcomes were measured by the time taken to perform test tasks and the number of marks scored. The results indicate no significant difference between the matched and mismatched groups on both time taken and scores on test tasks. However, there was significant difference between the four cognitive styles on test score. The Wholist/Verbaliser group performed better then all other groups. There was no significant difference between the other groups. An analysis of the performance on test task by each cognitive style showed significant difference between the groups on recall, labelling and explanation. Difference between the cognitive style groups did not reach significance level for problem-solving tasks. The findings of the study indicate a potential for cognitive style to influence learning outcomes measured by performance on test tasks.

Identifying rural disadvantage using a multiday travel diary

This paper identifies transport disadvantage using a 7 day activity-travel diary data from two rural case study areas. A composite participation index (PI) measure was developed for this study based on six indices measuring elements of travel and activity participation. Using the index the paper then goes on to compare these results, with the results obtained from other more traditional indicators used to identify transport disadvantage. These indicators are related to the size of activity space such as unique network distance travelled, number of unique locations visited, activity space area, activity duration, and fullness (shape) of activity spaces. The weaknesses of these indicator based measures are that: firstly, they do not take into account the relativity of the measure between different areas i.e. travel distance in terms of the wider context of available activities within an area; and secondly, these indicators are multi-dimensional and each represents a different qualitative aspect of travel and activity participation. As a result, six individual indices were developed to overcome these problems. These include: participation count index, participation length index, participation area index, participation duration index, participation type index, and participation frequency index. These are then aggregated to assess the relative performance in terms of these different indices and identify the nature of transport disadvantage. GIS was used to visualise individual travel patterns and to derive scores for both the indicator based measures and the index based measures. Factor analysis was conducted to derive weights of the individual indices to form the composite index measure. From this analysis, two intermediate indices were also derived using the underlying factors of the data related to these indices. Using the scores of all these measures, multiple regression analyses were conducted to identify patterns of transport disadvantage.

Mobility, accessibility and activity participation : a comparative assessment of methods to identify rural transport disadvantage

Traditionally, transport disadvantage has been identified using accessibility analysis although the effectiveness of the accessibility planning approach to improving access to goods and services is not known. This paper undertakes a comparative assessment of measures of mobility, accessibility, and participation used to identify transport disadvantage using the concept of activity spaces. A 7 day activity-travel diary data for 89 individuals was collected from two case study areas located in rural Northern Ireland. A spatial analysis was conducted to select the case study areas using criteria derived from the literature. The criteria are related to the levels of area accessibility and area mobility which are known to influence the nature of transport disadvantage. Using the activity-travel diary data individuals weekly as well as day to day variations in activity-travel patterns were visualised. A model was developed using the ArcGIS ModelBuilder tool and was run to derive scores related to individual levels of mobility, accessibility, and participation in activities from the geovisualisation. Using these scores a multiple regression analysis was conducted to identify patterns of transport disadvantage. This study found a positive association between mobility and accessibility, between mobility and participation, and between accessibility and participation in activities. However, area accessibility and area mobility were found to have little impact on individual mobility, accessibility, and participation in activities. Income vis-àvis ´ car-ownership was found to have a significant impact on individual levels of mobility, and accessibility; whereas participation in activities were found to be a function of individual levels of income and their occupational status.

Comparison of scoring systems for invasive pests using ROC analysis and Monte Carlo simulation

Different international plant protection organisations advocate different schemes for conducting pest risk assessments. Most of these schemes use structured questionnaire in which experts are asked to score several items using an ordinal scale. The scores are then combined using a range of procedures, such as simple arithmetic mean, weighted averages, multiplication of scores, and cumulative sums. The most useful schemes will correctly identify harmful pests and identify ones that are not. As the quality of a pest risk assessment can depend on the characteristics of the scoring system used by the risk assessors (i.e., on the number of points of the scale and on the method used for combining the component scores), it is important to assess and compare the performance of different scoring systems. In this article, we proposed a new method for assessing scoring systems. Its principle is to simulate virtual data using a stochastic model and, then, to estimate sensitivity and specificity values from these data for different scoring systems. The interest of our approach was illustrated in a case study where several scoring systems were compared. Data for this analysis were generated using a probabilistic model describing the pest introduction process. The generated data were then used to simulate the outcome of scoring systems and to assess the accuracy of the decisions about positive and negative introduction. The results showed that ordinal scales with at most 5 or 6 points were sufficient and that the multiplication-based scoring systems performed better than their sum-based counterparts. The proposed method could be used in the future to assess a great diversity of scoring systems.

Interactional competence in a paired speaking test : features salient to raters

Paired speaking tests are now commonly used in both high-stakes testing and classroom assessment contexts. The co-construction of discourse by candidates is regarded as a strength of paired speaking tests, as candidates have the opportunity to display a wider range of interactional competencies, including turn taking, initiating topics and engaging in extended discourse with a partner, rather than an examiner. However, the impact of the interlocutor in such jointly negotiated discourse and the implications for assessing interactional competence are areas of concern. This article reports on the features of interactional competence that were salient to four trained raters of 12 paired speaking tests through the analysis of rater notes, stimulated verbal recalls and rater discussions. Findings enabled the identification of features of the performance noted by raters when awarding scores for interactional competence, and the particular features associated with higher and lower scores. A number of these features were seen by the raters as mutual achievements, which raises the issue of the extent to which it is possible to assess individual contributions to the co-constructed performance. The findings have implications for defining the construct of interactional competence in paired speaking tests and operationalising this in rating scales.