Sample records for abuse accommodation syndrome

  1. Cultural Accommodation of Substance Abuse Treatment for Latino Adolescents

    PubMed Central

    Burrow-Sanchez, Jason; Martinez, Charles; Hops, Hyman; Wrona, Megan

    2011-01-01

    Collaborating with community stakeholders is an often suggested step when integrating cultural variables into psychological treatments for members of ethnic minority groups. However, there is a dearth of literature describing how to accomplish this process within the context of substance abuse treatment studies. This paper describes a qualitative study conducted through a series of focus groups with stakeholders in the Latino community. Data from focus groups were used by researchers to guide the integration of cultural variables into an empirically-supported substance abuse treatment for Latino adolescents currently being evaluated for efficacy. A model for culturally accommodating empirically-supported treatments for ethnic minority participants is also described. PMID:21888499

  2. A Theoretical Foundation for Understanding Clergy-Perpetrated Sexual Abuse

    ERIC Educational Resources Information Center

    Fogler, Jason M.; Shipherd, Jillian C.; Rowe, Erin; Jensen, Jennifer; Clarke, Stephanie

    2008-01-01

    Incorporating elements from broadband theories of psychological adaptation to extreme adversity, including Summit's (1983) Child Sexual Abuse Accommodation Syndrome, Finkelhor and Browne's (1986) Traumagenic Dynamics Model of sexual abuse, and Pyszczynski and colleagues' (1997) Terror Management Theory, this paper proposes a unified theoretical…

  3. False allegations of abuse and Munchausen syndrome by proxy.

    PubMed Central

    Meadow, R

    1993-01-01

    Fourteen children from seven families are reported for whom false allegations of abuse were made by the mother. Twelve children were alleged to have incurred sexual abuse, one both sexual and physical abuse, and one physical abuse alone. Thirteen of the children had incurred, or were currently victims of, factitious illness abuse invented by the mother. The one child with no history of factitious illness abuse had a sibling who had incurred definite factitious illness abuse. The false allegations of abuse did not occur in the context of parental separation, divorce, or custody disputes concerning the children. They occurred in the context of Munchausen syndrome by proxy abuse. The age of the children, 3 to 9 years, was older than the usual age for Munchausen syndrome by proxy abuse. The mother was the source of the false allegations and was the person who encouraged or taught six of the children to substantiate allegations of sexual abuse. PMID:8503664

  4. Forensic and family psychiatry in abuse dwarfism: Munchausen's syndrome by proxy, atonement, and addiction to abuse.

    PubMed

    Money, J; Annecillo, C; Hutchison, J W

    1985-01-01

    The syndrome of abuse dwarfism is characterized by gross impairment of statural and intellectual growth and social maturation while the abused child remains in the domicile of abuse. The parents collude as child abusers, and are medical impostors regarding the symptoms of abuse. The syndrome as a whole is appropriately named Munchausen's syndrome by proxy. Though the mother typically initiates abuse, she cannot give a rational explanation for doing so. In her own history there is a sin that is expiated or atoned for symbolically by the sacrifice of the child--explainable in terms of the theory of opponent-process learning. In the two cases presented, the sin was the mother's own birth out of wedlock, in one case as a sequel to incest. The child's addiction to abuse is a challenge to the program of rehabilitation. With respect to parents at risk, the data of this paper are relevant to the prevention of a predisposition toward, or the actual implementation of child abuse, though a program of prevention needs still to be formulated. The sexological relevance of this paper is that the data demonstrate that the effects of sexual abuse may be transmitted to the next generation and manifested as child abuse which is not necessarily sexual in content.

  5. Stockholm Syndrome and Child Sexual Abuse

    ERIC Educational Resources Information Center

    Julich, Shirley

    2005-01-01

    This article, based on an analysis of unstructured interviews, identifies that the emotional bond between survivors of child sexual abuse and the people who perpetrated the abuse against them is similar to that of the powerful bi-directional relationship central to Stockholm Syndrome as described by Graham (1994). Aspects of Stockholm Syndrome…

  6. Topical anesthetic abuse keratitis secondary to floppy eyelid syndrome.

    PubMed

    Goldich, Yakov; Zadok, David; Avni, Isaac; Hartstein, Morris

    2011-01-01

    To report the diagnosis and management of a patient with chronic ophthalmic topical anesthetic abuse and floppy eyelid syndrome. We describe the case of a 47-year-old man suffering from persistent bilateral ocular irritation and chronic corneal erosions. The patient was hospitalized in our ophthalmology department and underwent thorough ophthalmic, systemic, and psychiatric evaluation. Chronic topical anesthetic abuse was discovered. Removal of abused drops and copious lubricating treatment lead to partial improvement further permitting diagnosis of floppy eyelid syndrome. Definitive surgical treatment by horizontal eyelid tightening combined with continuous lubrication resulted in remission of symptoms. Uncommon conditions may coexist in 1 patient. In this case, floppy eyelid syndrome resulted in topical anesthetic abuse. Ophthalmologists should keep both these conditions in mind when treating patients with otherwise unexplained chronic persistent corneal erosions.

  7. Cultural Accommodation of Group Substance Abuse Treatment for Latino Adolescents: Results of an RCT

    PubMed Central

    Burrow-Sánchez, Jason J.; Minami, Takuya; Hops, Hyman

    2015-01-01

    Objectives Comparative studies examining the difference between empirically supported substance abuse treatments versus their culturally accommodated counterparts with participants from a single ethnic minority group are frequently called for in the literature but infrequently conducted in practice. This RCT was conducted to compare the efficacy of an empirically supported standard version of a group-based cognitive-behavioral treatment (S-CBT) to a culturally accommodated version (A-CBT) with a sample of Latino adolescents primarily recruited from the juvenile justice system. Development of the culturally accommodated treatment and testing was guided by the Cultural Accommodation Model for Substance Abuse Treatment (CAM-SAT). Methods Seventy Latino adolescents (mean age = 15.2; 90% male) were randomly assigned to one of two group-based treatment conditions (S-CBT = 36; A-CBT = 34) with assessments conducted at pretreatment, posttreatment, and 3-month follow-up. Longitudinal Poisson mixed models for count data were used to conduct the major analyses. The primary outcome variable in the analytic models was the number of days any substance was used (including alcohol, except tobacco) in the past 90 days. In addition, the variables ethnic identity, familism, and acculturation were included as cultural moderators in the analysis. Results Although both conditions produced significant decreases in substance use, the results did not support a time by treatment condition interaction; however, outcomes were moderated by ethnic identity and familism. Conclusions The findings are discussed with implications for research and practice within the context of providing culturally relevant treatment for Latino adolescents with substance use disorders. PMID:25602465

  8. The battered woman syndrome: effects of severity and intermittency of abuse.

    PubMed

    Dutton, D G; Painter, S

    1993-10-01

    The concept of a battered woman syndrome was tested by assessing 50 battered women and 25 emotionally abused women who had recently left their relationships. For both groups, essential features of the syndrome were present and were significantly interrelated. Dynamic features of the prior abusive relationship correlated significantly with these sequelae. The concept of intermittency is proposed as an alternative to the cycle of violence theory as main contributor to the syndrome. Predictability of abuse was found to be unrelated to the intermittency measure.

  9. Association between Elder Abuse and Metabolic Syndromes: Findings from the Chicago Health and Aging Project.

    PubMed

    Dong, XinQi; Simon, Melissa

    2015-01-01

    Elder abuse and metabolic syndromes are both important public health issues and are associated with increased morbidity and mortality. This study aimed to examine the associations between elder abuse and risk for metabolic syndromes. The Chicago Health and Aging Project (CHAP) cohort is a population-based study (n = 4,586). We identified 676 participants with some form of elder abuse reported to a social services agency. The primary independent variable was elder abuse reported to a social services agency. Outcomes were metabolic syndrome as categorized by World Health Organization (WHO), American Heart Association (AHA) and International Diabetes Federation (IDF) criteria. Bivariate and logistic regression analyses were used to assess the association between elder abuse and different definitions of metabolic syndromes. In the bivariate analyses, elder abuse victims were more likely than those without elder abuse to have metabolic syndromes [22.4 vs. 10.7% (WHO), 50.7 vs. 40.0% (AHA) and 47.7 vs. 33.5% (IDF)]. After adjusting for potential confounding factors, elder abuse was associated with an increased risk for metabolic syndromes according to WHO [OR, 3.95 (2.86-5.47)], AHA [OR, 2.03 (1.56-2.64)] and IDF [OR, 2.55 (1.97-3.29)] criteria. Interaction term analyses indicate that the association between elder abuse and metabolic syndromes may be moderated by sociodemographic characteristics but not by health-related or psychosocial factors. Elder abuse is associated with an increased risk for metabolic syndromes. Research is needed to examine the association between elder abuse and cardiovascular disease.

  10. Association Between Elder Abuse and Metabolic Syndromes: Findings from the Chicago Health and Aging Project

    PubMed Central

    Dong, XinQi; Simon, Melissa

    2014-01-01

    Background Elder abuse and metabolic syndromes are both important public health issues and are associated with increased morbidity and mortality. This study aimed to examine the associations between elder abuse and risk for metabolic syndromes. Methods Chicago Health and Aging Project (CHAP) cohort is a population-based study (N=4,586). We identified 676 participants with some form of elder abuse reported to a social services agency. The primary independent variable was elder abuse reported to a social services agency. Outcomes were metabolic syndrome as categorized by World Health Organization (WHO), American Heart Association (AHA) and International Diabetes Federation (IDF) criteria. Bivariate and logistic regression analyses were used to assess the association between elder abuse and different definitions of metabolic syndromes. Results In the bivariate analyses, elder abuse victims were more likely than those without elder abuse to have metabolic syndromes (22.4% vs. 10.7% [WHO], 50.7% vs. 40.0% [AHA], and 47.7% vs. 33.5% [IDF]). After adjusting for potential confounding factors, elder abuse was associated with increased risk for metabolic syndromes according to WHO (OR, 3.95 (2.86-5.47), AHA (OR, 2.03 (1.56-2.64) and IDF (OR, 2.55 (1.97-3.29) criteria. Interaction term analyses indicate that the association between elder abuse and metabolic syndromes may be moderated by sociodemographic characteristics, but not by health related or psychosocial factors. Conclusion Elder abuse is associated with increased risk for metabolic syndromes. Research is needed to examine the association between elder abuse and cardiovascular disease. PMID:25471532

  11. Ehlers-Danlos syndrome(s) mimicking child abuse: Is there an impact on clinical practice?

    PubMed

    Castori, Marco

    2015-12-01

    Ehlers-Danlos syndrome is a heterogeneous group of heritable connective tissue disorders characterized by increased fragility of various non-ossified tissues. It is usually ascertained due to abnormal skin texture, scarring complications, vascular fragility, or chronic symptoms, such as fatigue and musculoskeletal pain. Sometimes, Ehlers-Danlos syndrome remains undetected until the patient, usually in the pediatric age, shows extensive or severe mucocutaneous injuries after only minor traumas. In this scenario, the misdiagnosis of Ehlers-Danlos syndrome with child abuse is a possibility, as occasionally reported in the literature. Recently, more attention was posed by lay people between the possible association of Ehlers-Danlos syndrome and bone fragility. Literature and personal experience show a strong association between Ehlers-Danlos syndrome, generalized joint hypermobility and reduced bone mass density in older children and adults, especially fertile women. The existence of a true increased risk of fracture in Ehlers-Danlos syndrome is still a matter of debate in children and adults with little and conflicting evidence. In case of suspected child abuse, Ehlers-Danlos syndrome is certainly on the differential for bruising, especially in EDS types with marked cutaneous and capillary involvement. In suspected child abuse cases, careful examination of the index case and her/his extended family is routine, as well as exclusion of other disorders such as osteogenesis imperfecta. The hypothesis of Ehlers-Danlos syndrome as an alternative explanation for infantile fractures remains speculative. © 2015 Wiley Periodicals, Inc.

  12. STOP Abusive Behavior Syndrome: Developing a Community Response.

    ERIC Educational Resources Information Center

    Holzman, Lois; Rivera, Mary

    This paper discusses the social-therapeutic approach to preventing abusive behavior, and describes the implementation of specific STOP Abusive Behavior Syndrome (ABS) projects in New York City, New York. The projects' goal is to empower people to continually develop throughout their lifespans. Basic tenants include the following: (1) emotions are…

  13. Static and Dynamic Measurements of Accommodation in Individuals with Down Syndrome

    PubMed Central

    Manny, Ruth E.; Glasser, Adrian; Stuebing, Karla K.

    2011-01-01

    Purpose. To identify whether static and dynamic aspects of accommodation other than accuracy are deficient in individuals with Down syndrome (DS) and whether poor accommodation is related to sensory or motor pathway deficits. Methods. Static aspects of accommodation (maximum accommodative response and lag) were measured with an autorefractor for both proximal and minus lens demands. Dynamic aspects of accommodation (latency, peak velocity, microfluctuations) were recorded at 30 Hz with a custom-built photorefractor as subjects viewed a movie switching between 11 m and 50, 33, 25, or 20 cm. Thirty-six subjects with DS were recruited (age 3 to 39 years), and 24 (67%) had useable responses for at least one study measurement for comparison with 140 controls (3 to 40 years) from a previously published cohort. Results. DS subjects had lower maximum accommodative responses (mean = 2.52 ± 1.66 D) and higher lags (1.81 ± 1.30 D for 33 cm demand) than controls for both proximal and minus lens stimuli. DS subjects had greater microfluctuations (one-way ANCOVA, P < 0.001), and a small percentage of the total number of latency measurements (17% accommodative and 16% disaccommodative) were longer than controls. Peak velocities of accommodation and disaccommodation were not different between groups (one-way ANCOVA, P = 0.143). Conclusions. Peak velocities of accommodation and disaccommodation (primarily motor aspects) did not differ between controls and DS subjects; however, latencies (primarily sensory) and microfluctuations (combined motor and sensory) were poorer in DS subjects. These results suggest that poor accommodative accuracy in individuals with DS may be predominantly related to sensory deficits. PMID:20739471

  14. Suspicious scars: physical child abuse vs Ehlers-Danlos syndrome.

    PubMed

    Vadysinghe, Amal Nishantha; Wickramashinghe, Chatula Usari; Nanayakkara, Dineshi Nadira; Kaluarachchi, Chandishni Ishara

    2018-01-01

    Child abuse is a sensitive topic among many medical practitioners and the diagnosis of this entity requires awareness about conditions which can mimic physical child abuse. Here, the authors present a case of a 13-year-old school non-attendee who was referred due to multiple scars, over areas prone to accidental as well as non-accidental injury, who underwent medicolegal examination due to suspicion of physical child abuse. On further inquiry, it was discovered that she had easy bruising and poor wound healing. A diagnosis of Ehlers-Danlos syndrome was established and physical child abuse was excluded. This case emphasizes the importance of identifying conditions which may confound the diagnosis of physical child abuse. This is of utmost importance in avoiding adverse legal and psycho-social implications on the child, family and society.

  15. Childhood Sexual Abuse and Psychosomatic Symptoms in Irritable Bowel Syndrome

    ERIC Educational Resources Information Center

    Ross, Colin A.

    2005-01-01

    Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the…

  16. Patients Reporting Ritual Abuse in Childhood: A Clinical Syndrome. Report of 37 Cases.

    ERIC Educational Resources Information Center

    Young, Walter C.; And Others

    1991-01-01

    Thirty-seven adult dissociative disorder patients who reported ritual abuse in childhood by satanic cults are described. A clinical syndrome is presented that includes dissociative states with satanic overtones, posttraumatic stress disorder, survivor guilt, unusual fears, and substance abuse. Questions concerning reliability, credibility, and…

  17. [Munchausen's syndrome by proxy--a malignant form of child abuse].

    PubMed

    Wojaczyńska-Stanek, K; Skubacz, M; Marszał, E

    2000-11-01

    Munchhausen syndrome by proxy is a malignant form of child abuse in which illness in a child is fabricated and/or induced by a parent. It can result in serious illness and even death of the child and it is difficult to detect. The authors give a significant amount of literature examples. They try to find out the difference in ways of hurting by perpetrators. Various types of personalities and emotional disturbances in Munchhausen on proxy syndrome are shown. Child maltreatment and Munchhausen by proxy syndrome need to be part of the differential diagnosis when the clinical picture is atypical or does not appear medically plausible.

  18. High School General Education English Teachers' Perception of IEP Accommodations for Students with Asperger Syndrome

    ERIC Educational Resources Information Center

    Krones, Mary Patricia

    2016-01-01

    The purpose of this qualitative design study was to better understand the experiences of high school general education English teachers who have students with Asperger Syndrome in their classes. More specifically, this researcher wanted to better understand the teacher's perception of the IEP-denoted accommodations the general education teachers…

  19. Determining the relative contribution of retinal disparity and blur cues to ocular accommodation in Down syndrome.

    PubMed

    Doyle, Lesley; Saunders, Kathryn J; Little, Julie-Anne

    2017-01-10

    Individuals with Down syndrome (DS) often exhibit hypoaccommodation alongside accurate vergence. This study investigates the sensitivity of the two systems to retinal disparity and blur cues, establishing the relationship between the two in terms of accommodative-convergence to accommodation (AC/A) and convergence-accommodation to convergence (CA/C) ratios. An objective photorefraction system measured accommodation and vergence under binocular conditions and when retinal disparity and blur cues were removed. Participants were aged 6-16 years (DS n = 41, controls n = 76). Measures were obtained from 65.9% of participants with DS and 100% of controls. Accommodative and vergence responses were reduced with the removal of one or both cues in controls (p < 0.007). For participants with DS, removal of blur was less detrimental to accommodative responses than removal of disparity; accommodative responses being significantly better when all cues were available or when blur was removed in comparison to when proximity was the only available cue. AC/A ratios were larger and CA/C ratios smaller in participants with DS (p < 0.00001). This study demonstrates that retinal disparity is the main driver to both systems in DS and illustrates the diminished influence of retinal blur. High AC/A and low CA/C ratios in combination with disparity-driven responses suggest prioritisation of vergence over accurate accommodation.

  20. Determining the relative contribution of retinal disparity and blur cues to ocular accommodation in Down syndrome

    PubMed Central

    Doyle, Lesley; Saunders, Kathryn J.; Little, Julie-Anne

    2017-01-01

    Individuals with Down syndrome (DS) often exhibit hypoaccommodation alongside accurate vergence. This study investigates the sensitivity of the two systems to retinal disparity and blur cues, establishing the relationship between the two in terms of accommodative-convergence to accommodation (AC/A) and convergence-accommodation to convergence (CA/C) ratios. An objective photorefraction system measured accommodation and vergence under binocular conditions and when retinal disparity and blur cues were removed. Participants were aged 6–16 years (DS n = 41, controls n = 76). Measures were obtained from 65.9% of participants with DS and 100% of controls. Accommodative and vergence responses were reduced with the removal of one or both cues in controls (p < 0.007). For participants with DS, removal of blur was less detrimental to accommodative responses than removal of disparity; accommodative responses being significantly better when all cues were available or when blur was removed in comparison to when proximity was the only available cue. AC/A ratios were larger and CA/C ratios smaller in participants with DS (p < 0.00001). This study demonstrates that retinal disparity is the main driver to both systems in DS and illustrates the diminished influence of retinal blur. High AC/A and low CA/C ratios in combination with disparity-driven responses suggest prioritisation of vergence over accurate accommodation. PMID:28071728

  1. [When health care professionals become unwillingly involved in child abuse: the Munchhausen-by-proxy syndrome].

    PubMed

    Krupinski, Martin

    2006-08-01

    Reports on seemingly caring mothers, who at the same time fabricate or provoke clinical symptoms in their children and subsequently expose them to potentially harmful medical procedures, are hardly believable at first sight. Nevertheless the steadily growing number of reports on this kind of child abuse, known as Munchausen-by-proxy syndrome, points to a significant number of undetected cases. The interactional involvement of health care professionals in the abuse tends to impede diagnosis, and, as a consequence of the syndrome, usually leads to violent emotional reactions, which require careful analysis and professional handling.

  2. Grey matter abnormalities in methcathinone abusers with a Parkinsonian syndrome.

    PubMed

    Juurmaa, Julius; Menke, Ricarda A L; Vila, Pierre; Müürsepp, Andreas; Tomberg, Tiiu; Ilves, Pilvi; Nigul, Mait; Johansen-Berg, Heidi; Donaghy, Michael; Stagg, Charlotte J; Stepens, Ainārs; Taba, Pille

    2016-11-01

    A permanent Parkinsonian syndrome occurs in intravenous abusers of the designer psychostimulant methcathinone (ephedrone). It is attributed to deposition of contaminant manganese, as reflected by characteristic globus pallidus hyperintensity on T1-weighted MRI. We have investigated brain structure and function in methcathinone abusers ( n  = 12) compared to matched control subjects ( n  = 12) using T1-weighted structural and resting-state functional MRI. Segmentation analysis revealed significant ( p  < .05) subcortical grey matter atrophy in methcathinone abusers within putamen and thalamus bilaterally, and the left caudate nucleus. The volume of the caudate nuclei correlated inversely with duration of methcathinone abuse. Voxel-based morphometry showed patients to have significant grey matter loss ( p  < .05) bilaterally in the putamina and caudate nucleus. Surface-based analysis demonstrated nine clusters of cerebral cortical thinning in methcathinone abusers, with relative sparing of prefrontal, parieto-occipital, and temporal regions. Resting-state functional MRI analysis showed increased functional connectivity within the motor network of patients ( p  < .05), particularly within the right primary motor cortex. Taken together, these results suggest that the manganese exposure associated with prolonged methcathinone abuse results in widespread structural and functional changes affecting both subcortical and cortical grey matter and their connections. Underlying the distinctive movement disorder caused by methcathinone abuse, there is a more widespread pattern of brain involvement than is evident from the hyperintensity restricted to the basal ganglia as shown by T1-weighted structural MRI.

  3. Is the association between irritable bowel syndrome and abuse explained by neuroticism? A population based study

    PubMed Central

    Talley, N; Boyce, P; Jones, M

    1998-01-01

    Background—In outpatients and the community, an association between abuse (particularly sexual abuse) and irritable bowel syndrome (IBS) has been observed, but whether there is a causal link continues to be disputed. 
Aims—To test the hypothesis that psychological factors explain the apparent association between abuse and IBS. 
Methods—A sample of residents of Penrith (a Sydney suburb sociodemographically similar to the Australian population) selected randomly from the electoral rolls (that by law include the entire population of age 18 years and above) was mailed a validated self report questionnaire. Measured were gastrointestinal (GI) symptoms including the Rome criteria for IBS, abuse (including the standardised Drossman questions), neuroticism (Eysenck Personality Questionnaire), and psychological morbidity (General Health Questionnaire). 
Results—The response rate was 64% (n=730); 12% fulfilled the Rome criteria for IBS. Overall abuse in childhood (odds ratio (OR)=2.02, 95% confidence interval (CI) 1.29 to 3.15) but not adulthood (OR=1.39, 95% CI 0.88 to 2.19) was associazted with IBS univariately. Neuroticism and psychological morbidity were also univariately associated with abuse in childhood, abuse in adulthood, and IBS, respectively. However, by logistic regression, abuse in childhood was not associated with IBS after controlling for age, gender, and psychological factors (OR=1.34, 95% CI 0.83to 2.17). The results were not altered by restricting the analyses to more severe forms of abuse, and were not explained by interactions between abuse and psychological variables. 
Conclusion—There is an association between abuse and IBS in the community, but this may be explained in part by other psychological factors. Based on a path analysis, we postulate that abuse may induce the expression of neuroticism that in turn leads to IBS. 

 Keywords: epidemiology; irritable bowel syndrome; abuse; neuroticism PMID:9505885

  4. Independent and reciprocal accommodation in anisometropic amblyopia

    PubMed Central

    Horwood, Anna M.; Riddell, Patricia M

    2015-01-01

    Accommodation is considered to be a symmetrical response, and to be driven by the least ametropic and nonamblyopic eye in anisometropia. We report a case of a 4-year-old child with anisometropic amblyopia who accommodates asymmetrically, reliably demonstrating normal accommodation in the nonamblyopic eye and anti-accommodation of the amblyopic eye to near targets. The abnormal accommodation of the amblyopic eye remained largely unchanged over seven subsequent testing sessions undertaken over the course of therapy. We suggest that a congenital dysinnervation syndrome may result in relaxation of accommodation in relation to near cues and might be a hitherto-unconsidered additional etiologic factor in anisometropic amblyopia. PMID:20863728

  5. Munchausen syndrome by proxy abuse perpetrated by men

    PubMed Central

    Meadow, R.

    1998-01-01

    Fifteen families are described in which one or more child incurred factitious illness abuse as a result of the father's false story and actions. The degree of direct physical harm, and the chance of death, was high in those families in which the father had Munchausen syndrome or marked somatising disorder. Eleven children died and another six survived repetitive smothering or poisoning. Although the extent of the risk to children living with a parent who has marked somatising disorder is unsure, there must be vigilance on behalf of those children.

 PMID:9613349

  6. [Diagnostics and treatment of Wernicke-Korsakoff syndrome patients with an alcohol abuse].

    PubMed

    Nilsson, Maria; Sonne, Charlotte

    2013-04-01

    Wernicke-Korsakoff syndrome is a condition with high morbidity and mortality and occurs as a consequence of thiamine deficiency. Clinical symptoms are often ambiguous and post-mortem examinations show that the syndrome is underdiagnosed and probably undertreated. There is sparse clinical evidence concerning optimal dosage and duration of treatment. This article reviews the current literature and concludes that all patients with a history of alcohol abuse should be treated with high dosage IV thiamine for an extended period of time, albeit further research is needed.

  7. Concerns about research and prevention strategies in Munchausen Syndrome by Proxy (MSBP) abuse.

    PubMed

    Eminson, Mary; Jureidini, Jon

    2003-04-01

    There would seem to be three motives for research into Munchausen Syndrome by Proxy (MSBP) abuse; first to enhance treatment; second to enhance our understanding of the psychopathology of those who carry out the abuse; and third to find interventions to prevent its occurrence. We will argue that only the first justification is valid. The second and third should be questioned for several reasons including: MSBP abuse is the wrong kind of event to think of in terms of categorical diagnosis; rare events are inherently difficult to predict; and better research targets are available. We propose that research energy would be more productively directed towards furthering our understanding of somatization and certain problematic aspects of modern pediatric practice. We offer suggestions as to appropriate areas for research.

  8. [Child psychiatric assessment and the debate regarding the abuse of abuse].

    PubMed

    Fegert, J M

    1995-03-01

    The current discussion on false allegations in sexual abuse cases has led to a polarization in the views expressed about the credibility of children. Some authors even speak of a "child sexual accuse syndrome" or of a "sexual abuse allegation in divorce" (SAID) syndrome. A phenomenological analysis of the multiple reasons for misinterpretations is presented. Instead of stressing the importance only of false positives in child sexual abuse questions, an attempt is made to describe reasons for false negatives. Based on a retrospective analysis of 50 consecutive child psychiatric experts in connection with court cases, there does not appear to be an increase in false accusations. Rather, only about one third of the cases even involved suspected sexual abuse. Sexual abuse allegations were much more frequent in girls than in boys. Of 20 abuse allegations we judge four to be false allegations. In only one of these cases, that of an adolescent girl who had been abused in childhood, was the false allegation intended.

  9. Beyond Munchausen syndrome by proxy: identification and treatment of child abuse in a medical setting.

    PubMed

    Stirling, John

    2007-05-01

    The condition widely known as Munchausen syndrome by proxy comprises both physical abuse and medical neglect and is also a form of psychological maltreatment. Although it is a relatively rare form of child abuse, pediatricians need to have a high index of suspicion when faced with seemingly inexplicable findings or treatment failures. The fabrication of a pediatric illness is a form of child abuse and not merely a mental health disorder, and there is a possibility of an extremely poor prognosis if the child is left in the home. In this statement, factors are identified that may help the physician recognize this insidious type of child abuse that occurs in a medical setting, and recommendations are provided for physicians regarding when to report a case to their state's child protective service agency.

  10. Concerns about Research and Prevention Strategies in Munchausen Syndrome by Proxy (MSBP) Abuse.

    ERIC Educational Resources Information Center

    Eminson, Mary; Jureidini, Jon

    2003-01-01

    This article examines three motives for research into Munchausen Syndrome by Proxy child abuse, which are to enhance treatment, to understand the psychopathology of perpetrators, and to find interventions to prevent its occurrence. It argues that only the first justification is valid and proposes that research energy be directed toward…

  11. Magnetic resonance imaging findings in substance abuse: alcohol and alcoholism and syndromes associated with alcohol abuse.

    PubMed

    Spampinato, M Vittoria; Castillo, Mauricio; Rojas, Rafael; Palacios, Enrique; Frascheri, Laura; Descartes, Fernando

    2005-06-01

    Alcohol abuse is common among the population and results in significant diseases that shorten life span. Ethanol may result in chronic brain changes such as atrophy but may also result in neurologic disease that may be acute or chronic and sometimes life threatening. Accompanying vitamin deficiencies may lead to Wernicke's encephalopathy and changes in serum osmosis may lead to several acute demyelinating disorders. In addition, pregnant women who consume alcohol place their babies at high risk for the fetal alcohol syndrome. In this article we review these disorders and emphasize their imaging features.

  12. [Paralysis, organic brain syndrome, and cardiac dysrhythmias caused by chronic laxative abuse (author's transl)].

    PubMed

    Dahlmann, W; Volles, E; Lüderitz, B

    1977-10-28

    A 39-year-old woman developed generalised paralysis, reversible organic brain syndrome, and cardiac dysrhythmias after 15 years of laxative abuse. Under continuous and cautious administration of potassium the cardiac rhythm became normal within four days and two days later the paralysis and organic brain syndrome almost disappeared. The cause of the psychiatric symptoms is thought to be cerebral potassium deficiency and an abnormal sodium/potassium equilibrium. Other clinical signs and symptoms due to extreme potassium depletion are presented. The importance of Na+/K+-activated membrane ATP-ase in myocardium and CNS is discussed.

  13. Relationships between psychological state, abuse, somatization and visceral pain sensitivity in irritable bowel syndrome

    PubMed Central

    Grinsvall, Cecilia; Törnblom, Hans; Tack, Jan; Van Oudenhove, Lukas; Simrén, Magnus

    2018-01-01

    Background and objective Psychological states may interfere with visceral sensitivity. Here we investigate associations between psychosocial factors and visceral sensitivity in irritable bowel syndrome (IBS). Methods Two IBS patient cohorts (Cohort 1: n = 231, Rome II; Cohort 2: n = 141, Rome III) underwent rectal barostat testing, and completed questionnaires for anxiety, depression, somatization, and abuse. The associations between questionnaire measures and visceral sensitivity parameters were analyzed in three-step general linear models (step1: demographic and abuse variables; step 2: anxiety and depression; step 3: somatization). Results Cohort 1. Pain threshold was positively associated with age and female gender, and negatively with adult sexual abuse and somatization. Pain referral area was negatively associated with age and positively with somatization and GI-specific anxiety, the latter effect mediated by somatization. Cohort 2. Pain threshold was positively associated with age and male gender, and negatively with adult sexual abuse. Pain intensity ratings were positively associated with somatization, female gender and depression, the latter effect mediated by somatization. Conclusion Somatization is associated with most visceral sensitivity parameters, and mediates the effect of some psychological factors on visceral sensitivity. It may reflect a psychobiological sensitization process driving symptom generation in IBS. In addition, abuse history was found to independently affect some visceral sensitivity parameters. PMID:29511560

  14. Child Abuse and Cot Deaths.

    ERIC Educational Resources Information Center

    Newlands, Mary; Emery, John S.

    1991-01-01

    A search was made of confidential health department records in Great Britain for abused children, or children at risk for abuse, with siblings who had died of Sudden Infant Death Syndrome (SIDS). An association was found between child abuse and about 10 percent of deaths of children diagnosed as SIDS. (BRM)

  15. Is the association between irritable bowel syndrome and abuse explained by neuroticism? A population based study.

    PubMed

    Talley, N J; Boyce, P M; Jones, M

    1998-01-01

    In outpatients and the community, an association between abuse (particularly sexual abuse) and irritable bowel syndrome (IBS) has been observed, but whether there is a causal link continues to be disputed. To test the hypothesis that psychological factors explain the apparent association between abuse and IBS. A sample of residents of Penrith (a Sydney suburb sociodemographically similar to the Australian population) selected randomly from the electoral rolls (that by law include the entire population of age 18 years and above) was mailed a validated self report questionnaire. Measured were gastrointestinal (GI) symptoms including the Rome criteria for IBS, abuse (including the standardised Drossman questions), neuroticism (Eysenck Personality Questionnaire), and psychological morbidity (General Health Questionnaire). The response rate was 64% (n = 730); 12% fulfilled the Rome criteria for IBS. Overall abuse in childhood (odds ratio (OR) = 2.02, 95% confidence interval (CI) 1.29 to 3.15) but not adulthood (OR = 1.39, 95% CI 0.88 to 2.19) was associated with IBS univariately. Neuroticism and psychological morbidity were also univariately associated with abuse in childhood, abuse in adulthood and IBS, respectively. However, by logistic regression, abuse in childhood was not associated with IBS after controlling for age, gender, and psychological factors (OR = 1.34, 95% CI 0.83 to 2.17). The results were not altered by restricting the analyses to more severe forms of abuse, and were not explained by interactions between abuse and psychological variables. There is an association between abuse and IBS in the community, but this may be explained in part by other psychological factors. Based on a path analysis, we postulate that abuse may induce the expression of neuroticism that in turn leads to IBS.

  16. 'Munchausen syndrome by proxy' presenting as battered child syndrome: a report of two cases.

    PubMed

    Sugandhan, Selvendran; Gupta, Somesh; Khandpur, Sujay; Khanna, Neena; Mehta, Manju; Inna, Prashanth

    2010-06-01

    Child abuse is a major public health crisis and is on the rise. Dermatologists are frequently involved in its evaluation in differentiating abusive injuries from accidental injuries and in excluding pathological conditions that may mimic abuse. Battered child syndrome or physical abuse is not only a common form of child abuse but can also result from a rarer form of child abuse known as Munchausen syndrome by proxy. In this form of abuse, mother, who is the usual perpetrator, induces an illness or abuses the child for her own self-serving psychological needs. We report two cases of battered child syndrome. In both the cases, Psychiatric evaluation was performed on both parents. Observation through one-way mirror was done with the mother and the child alone. Routine hematological and biochemical investigations were done. Diagnosis of Munchausen syndrome by proxy was firmly established in one case and was considered as a possibility in the other. A multidisciplinary team effort is essential in evaluating such cases, and dermatologists should be aware and be well informed about this condition that can be potentially lethal but easily overlooked.

  17. Shaken Baby Syndrome

    MedlinePlus

    ... baby syndrome. Information from the National Library of Medicine’s MedlinePlus Child Abuse × What research is being done? The National ... baby syndrome. Information from the National Library of Medicine’s MedlinePlus Child Abuse See More About Research The National Institute ...

  18. Munchausen syndrome by proxy: an alarming face of child abuse.

    PubMed

    Gehlawat, Pratibha; Gehlawat, Virender Kumar; Singh, Priti; Gupta, Rajiv

    2015-01-01

    Munchausen syndrome by proxy (MSBP) is emerging as a serious form of child abuse. It is an intentional production of illness in another, usually children by mothers, to assume sick role by proxy. It is poorly understood and a controversial diagnosis. Treatment is very difficult. We present a case of 9-year-old boy brought to Pt. B. D. Sharma, PGIMS, Rohtak, a tertiary care hospital in northern India by his father and paternal uncle with complaints of hematemesis since July 2012. He underwent many invasive procedures until the diagnosis of MSBP was finally considered. The examination of the blood sample confirmed the diagnosis. The child was placed under custody of his mother. The case was reported to social services, which incorporated whole family in the management.

  19. Psychiatric co-morbidity associated with pheniramine abuse and dependence

    PubMed Central

    Pal, Hemraj; Kumar, Rajesh; Bhushan, Shashi; Berry, Neeraj

    2005-01-01

    The abuse of cough syrups containing antihistamines and codeine is being increasingly noted. The abuse of antihistamines alone has also been reported. The use of antihistamines alone or in combination with other substances of abuse may predispose individuals to develop psychiatric symptoms or syndromes as a part of intoxication, withdrawal or as co-morbid conditions. We present two case reports to highlight the occurrence of co-morbid psychopathology in association with antihistamine abuse and dependence. Case I used high doses of pheniramine for about 2 years and became suspicious of his wife; he even doubted the paternity of his yet-to-be-born child. The associated behavioural abnormalities suggested that he was acting out on the delusion. He also had seizures associated with the intake of a high dose of pheniramine. Case II had multiple substance use, and dependence on alcohol and pheniramine. He demonstrated abnormal behaviour suggestive of psychosis and organic brain syndrome that persisted for a few days and remitted on discontinuation of the substances. These two cases demonstrate the occurrence of psychotic syndromes associated with heavy pheniramine use. The psychopathology can vary from an independent psychotic syndrome to an organic brain syndrome-like disorder.

  20. Is Childhood Abuse or Neglect Associated with Symptom Reports and Physiological Measures in Women with Irritable Bowel Syndrome?

    PubMed Central

    Heitkemper, Margaret M.; Cain, Kevin C.; Burr, Robert L.; Jun, Sang-Eun; Jarrett, Monica E.

    2013-01-01

    Purpose Early childhood traumatic experiences (e.g., abuse or neglect) may contribute to sleep disturbances as well as other indicators of arousal found in patients with irritable bowel syndrome (IBS). This study compared women with IBS positive for a history of childhood abuse and/or neglect to IBS women without this history, on daily gastrointestinal (GI), sleep, somatic, and psychological symptom distress, polysomnographic sleep, urine catecholamines and cortisol, and nocturnal heart rate variability (HRV). Methods Adult women with IBS recruited from the community were divided into 21 IBS with abuse/neglect and 19 IBS without abuse/neglect based on responses to the Childhood Trauma Questionnaire (physical, emotional, sexual abuse or neglect). Women were interviewed, maintained a 30-day symptom diary, and slept in a sleep laboratory. Polysomnographic and nocturnal heart rate variability data were obtained. First voided urine samples were assayed for cortisol and catecholamine levels. Results Women with IBS positive for abuse/neglect history were older than women without this history. Among GI symptoms, only heartburn and nausea were significantly higher in women with IBS with abuse/neglect. Sleep, somatic and psychological symptoms were significantly higher in women in the IBS with abuse/neglect group. With the exception of percent time in REM sleep, there were few differences in sleep stage variables and urine hormone levels. Mean heart rate interval and the Ln SDNN values were lower in those who experienced childhood abuse/neglect. Conclusion Women with IBS who self report childhood abuse/neglect are more likely to report disturbed sleep, somatic symptoms, and psychological distress. Women with IBS should be screened for adverse childhood events including abuse/neglect. PMID:21196423

  1. The "Discovery" of Child Abuse

    ERIC Educational Resources Information Center

    Pfohl, Stephen J.

    1977-01-01

    Surveys the history of social reaction to child abuse, discusses the cultural values promoting the protection of children, points out how much pediatric radiology benefited from its "discovery" of "the battered child syndrome" in the early sixties, and concludes that the labeling of child abusers as "sick" has shielded them from criminal…

  2. Adjudication of Child Sexual Abuse Cases.

    ERIC Educational Resources Information Center

    Myers, John E. B.

    1994-01-01

    Discusses issues in the adjudication of child sexual abuse allegations and reviews research about the believability of child witnesses. It also examines accommodations for children that could assist the child witness and encourage accurate testimony, while continuing to protect the rights of the accused. Criminal, juvenile, and divorce court…

  3. Munchausen Syndrome by Proxy: An Alarming Face of Child Abuse

    PubMed Central

    Gehlawat, Pratibha; Gehlawat, Virender Kumar; Singh, Priti; Gupta, Rajiv

    2015-01-01

    Munchausen syndrome by proxy (MSBP) is emerging as a serious form of child abuse. It is an intentional production of illness in another, usually children by mothers, to assume sick role by proxy. It is poorly understood and a controversial diagnosis. Treatment is very difficult. We present a case of 9-year-old boy brought to Pt. B. D. Sharma, PGIMS, Rohtak, a tertiary care hospital in northern India by his father and paternal uncle with complaints of hematemesis since July 2012. He underwent many invasive procedures until the diagnosis of MSBP was finally considered. The examination of the blood sample confirmed the diagnosis. The child was placed under custody of his mother. The case was reported to social services, which incorporated whole family in the management. PMID:25722520

  4. Comparison of tests of accommodation for computer users.

    PubMed

    Kolker, David; Hutchinson, Robert; Nilsen, Erik

    2002-04-01

    With the increased use of computers in the workplace and at home, optometrists are finding more patients presenting with symptoms of Computer Vision Syndrome. Among these symptomatic individuals, research supports that accommodative disorders are the most common vision finding. A prepresbyopic group (N= 30) and a presbyopic group (N = 30) were selected from a private practice. Assignment to a group was determined by age, accommodative amplitude, and near visual acuity with their distance prescription. Each subject was given a thorough vision and ocular health examination, then administered several nearpoint tests of accommodation at a computer working distance. All the tests produced similar results in the presbyopic group. For the prepresbyopic group, the tests yielded very different results. To effectively treat symptomatic VDT users, optometrists must assess the accommodative system along with the binocular and refractive status. For presbyopic patients, all nearpoint tests studied will yield virtually the same result. However, the method of testing accommodation, as well as the test stimulus presented, will yield significantly different responses for prepresbyopic patients. Previous research indicates that a majority of patients prefer the higher plus prescription yielded by the Gaussian image test.

  5. Perinatal drug abuse in KK Women's and Children's Hospital.

    PubMed

    Agarwal, P; Rajadurai, V S; Bhavani, S; Tan, K W

    1999-11-01

    No local figures are available in Singapore on the incidence of perinatal drug abuse and its effect on the foetus and the neonate. The objectives of this study were to determine the incidence of perinatal drug abuse and neonatal abstinence syndrome; to identify a maternal profile at high risk for substance abuse and to document the presenting features and treatment of infants with neonatal abstinence syndrome. Out of 14,690 births during the period January 1994 to December 1996, 38 (0.25%) had evidence of perinatal drug abuse. The study revealed that a high-risk maternal profile for drug abuse comprised of single mothers (52%); history of smoking (52%); no antenatal care (37%) and belonging to the Malay ethnic group (82%); and younger maternal age. Self-reporting was uncommon, occurring only in 8% and in 40% of cases, there was no known history of maternal drug addiction. The drug abused in all cases was heroin. Human immunodeficiency virus (HIV) screening was done only in a minority (21%) of the mothers and it was negative in all. Eighteen (47%) infants had evidence of neonatal abstinence syndrome with neurological manifestations being the commonest. Urine toxicology screening was positive in 26% of cases and had only 70% sensitivity and 41% positive predictive value. On follow up, default rate was high with 42% babies not attending follow up at the outpatient clinic. In conclusion, there is a need to maintain a high index of suspicion of substance abuse in those with high-risk maternal profile and their neonates should be closely watched for features of neonatal abstinence syndrome. Alternative methods of toxicology screening apart from urine need to be evaluated in order to improve the drug detection rate.

  6. Noise coupling between accommodation and accommodative vergence

    NASA Technical Reports Server (NTRS)

    Wilson, D.

    1973-01-01

    For monocular viewing, the fluctuations in accommodative lens power in the frequency range from 0.5 to 3 Hz were found to be considerably greater than those in accommodative vergence movements of the covered eye. Considering the close synkinesis between these motor responses for step changes or slow variations in accommodative stimulus, this finding is unexpected. This apparent lack of synkinesis is found to result mainly from the fact that the decrease in small-signal linear gain with increasing frequency is more rapid in the case of the accommodative vergence system than in the case of the accommodation system, rather than from some nonlinear phenomenon.

  7. Differences in the Stimulus Accommodative Convergence/Accommodation Ratio using Various Techniques and Accommodative Stimuli.

    PubMed

    Satou, Tsukasa; Ito, Misae; Shinomiya, Yuma; Takahashi, Yoshiaki; Hara, Naoto; Niida, Takahiro

    2018-04-04

    To investigate differences in the stimulus accommodative convergence/accommodation (AC/A) ratio using various techniques and accommodative stimuli, and to describe a method for determining the stimulus AC/A ratio. A total of 81 subjects with a mean age of 21 years (range, 20-23 years) were enrolled. The relationship between ocular deviation and accommodation was assessed using two methods. Ocular deviation was measured by varying the accommodative requirement using spherical plus/minus lenses to create an accommodative stimulus of 10.00 diopters (D) (in 1.00 D steps). Ocular deviation was assessed using the alternate prism cover test in method 1 at distance (5 m) and near (1/3 m), and the major amblyoscope in method 2. The stimulus AC/A ratios obtained using methods 1 and 2 were calculated and defined as the stimulus AC/A ratios with low and high accommodation, respectively, using the following analysis method. The former was calculated as the difference between the convergence response to an accommodative stimulus of 3 D and 0 D, divided by 3. The latter was calculated as the difference between the convergence response to a maximum (max) accommodative stimulus with distinct vision of the subject and an accommodative stimulus of max minus 3.00 D, divided by 3. The median stimulus AC/A ratio with low accommodation (1.0 Δ/D for method 1 at distance, 2.0 Δ/D for method 1 at near, and 2.7 Δ/D for method 2) differed significantly among the measurement methods (P < 0.01). Differences in the median stimulus AC/A ratio with high accommodation (4.0 Δ/D for method 1 at distance, 3.7 Δ/D for method 1 at near, and 4.7 Δ/D for method 2) between method 1 at distance and method 2 were statistically significant (P < 0.05), while method 1 at near was not significantly different compared with other methods. Differences in the stimulus AC/A ratio value were significant according to measurement technique and accommodative stimuli. However, differences caused by

  8. Preventing the Consequences of Alcohol Abuse: Identification of Soldiers at High Risk for Fatal and Serious Injuries

    DTIC Science & Technology

    2005-07-01

    Drug/Alcohol Combo: 1980-1985 1986-1988 303.1 - Alcohol dependence with drug abuse 303.07 - Alcohol dependence syndrome - acute alcohol intoxication...with single drug use 303.10 - Alcohol dependence with drug abuse, unspecified 303.08 - Alcohol dependence syndrome - acute alcohol intoxication, with...multiple drug use 303.11 - Alcohol dependence with drug abuse, 303.97 - Alcohol dependence syndrome - other and continuous/habitual unspecified alcohol

  9. Psychosis risk syndrome comorbid with panic attack disorder in a cannabis-abusing patient affected by Arnold-Chiari malformation type I.

    PubMed

    Del Casale, Antonio; Serata, Daniele; Rapinesi, Chiara; Simonetti, Alessio; Tamorri, Stefano Maria; Comparelli, Anna; De Carolis, Antonella; Savoja, Valeria; Kotzalidis, Georgios D; Sani, Gabriele; Tatarelli, Roberto; Girardi, Paolo

    2012-01-01

    An 18-year-old man with Arnold-Chiari malformation (ACM) type I developed sudden panic attacks. He also manifested sleep disorder, cannabis abuse, and psychosis-risk syndrome (PRS). Although with average-superior intelligence, he had executive dysfunction. This prompted us to explore the relation between ACM, cannabis abuse, PRS and panic disorder. We report the case and briefly review the literature focusing on ACM and psychiatric disorders. Behavior therapy led to gradual abstinence from cannabis with disappearance of anxiety symptoms. The patient is currently well and maintained on omega-3 polyunsaturated fatty acids. Locus coeruleus compression and cannabis abuse may have triggered the symptoms, and the latter might also be PRS-related. PRS and anxiety symptoms should be explored in ACM patients to allow better prevention of psychosis and anxiety disorders. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. [Objective accommodation parameters depending on accommodation task].

    PubMed

    Tarutta, E P; Tarasova, N A; Dolzhenko, O O

    2011-01-01

    62 myopic patients were examined to study objective accommodation parameters in different conditions of accommodation stimulus presenting (use of convex lenses). Objective accommodation response (OAR) was studied using binocular open-field autorefractometer in different conditions of stimulus presenting: complete myopia correction and adding of convex lenses with increasing power from +1.0 till +3.0 D. In 88,5% of children and adolescents showed significant decrease of OAR for 1,5-2,75D in 3.0D stimulus. Additional correction with convex lenses with increasing power leads to further reduce of accommodation response. As a result induced dynamic refraction in eye-lens system is lower than accommodation task. Only addition of +2,5D lense approximates it to required index of -3.0D.

  11. [Child abuse: an interdisciplinary management experience].

    PubMed

    Seldes, José Julio; Ziperovich, Valentina; Viota, Alejandra; Leiva, Fernanda

    2008-12-01

    Child abuse constitutes one of the most frequent forms of family violence. The following study tries to demonstrate the situation that arises in the city of Mercedes, Corrientes, Argentina, and to establish some associations about that matter. A series of 128 cases of abused children is presented, between 0 and 19 years old, attended from November 1998 to November 2002, in Moiru, Center of prevention, direction, attendance and qualification in social conducts of risk that works in Mercedes. 56% of physical abuse; 30% of sexual abuse; 10% of neglect; 3% of emotional abuse and 1% of syndrome of Münchaussen was detected, with a similar distribution by sexes in the total population. Demographic variables and certain associations in cases of physical abuse and sexual abuse are indicated. A significant association between mothers victims of domestic violence and physical abuse towards their children was demonstrated. 128 young boys and girls were seen in our center. It is considered that a significant population was treated where physical abuse and sexual abuse appears as most relevant.

  12. Procedures, placement, and risks of further abuse after Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation

    PubMed Central

    Davis, P; McClure, R; Rolfe, K; Chessman, N; Pearson, S; Sibert, J; Meadow, R

    1998-01-01

    OBJECTIVES—To investigate outcome, management, and prevention in Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation.
DESIGN—Ascertainment through British Paediatric Surveillance Unit and questionnaires to responding paediatricians.
SETTING—The UK and Republic of Ireland, September 1992 to August 1994.
SUBJECTS—Children under 14 years diagnosed with the above.
MAIN OUTCOME MEASURES—Placement and child protection measures for victims and siblings; morbidity and reabuse rates for victims; abuse of siblings; prosecution of perpetrators.
RESULTS—Outcome data for 119 with median follow up of 24 months (range 12 to 44 months). No previously diagnosed factitious disease was found to have been caused by genuine disease. Forty six children were allowed home without conditions at follow up. Children who had suffered from suffocation, non-accidental poisoning, direct harm, and those under 5 years were less likely to go home.
 Twenty seven (24%) children still had symptoms or signs as a result of the abuse at follow up; 108/120 were originally on a child protection register and 35/111 at follow up. Twenty nine per cent (34/118) of the perpetrators had been prosecuted and most convicted; 17% of the milder cases of Munchausen syndrome by proxy allowed home were reabused. Evidence in siblings suggests that in 50% of families with a suffocated child and 40% with non-accidental poisoning there would be further abuse, some fatal.
CONCLUSIONS—This type of abuse is severe with high mortality, morbidity, family disruption, reabuse, and harm to siblings. A very cautious approach for child protection with reintroduction to home only if circumstances are especially favourable is advised. Paediatric follow up by an expert in child protection should also occur.

 PMID:9613350

  13. The impact of abuse and mood on bowel symptoms and health-related quality of life in irritable bowel syndrome (IBS).

    PubMed

    Kanuri, N; Cassell, B; Bruce, S E; White, K S; Gott, B M; Gyawali, C P; Sayuk, G S

    2016-10-01

    Irritable bowel syndrome (IBS) is a common abdominal pain disorder without an organic explanation. Abuse histories (physical, sexual, emotional) are prevalent in IBS. While abuse relates to mood disorders (depression and anxiety) also common in IBS, the influence of abuse on gastrointestinal (GI) symptoms and health-related quality of life (HRQOL) and its independence from psychological symptom comorbidity has not been studied. Consecutive GI outpatients completed the ROME III Research Diagnostic Questionnaire and questionnaires on trauma (Life-Stress Questionnaire), mood (Beck Depression/Anxiety Inventories), somatic symptoms (PHQ-12), and HRQOL (SF-36). Current GI symptom severity and bother were assessed using 10-cm Visual Analog Scales. 272 ROME-defined IBS (47.6 ± 0.9 years, 81% female) and 246 non-FGID (51.6 ± 1.0 years, 65% female) subjects participated. IBS patients reported greater rates of physical, sexual, and emotional abuse (p < 0.006 each), and higher depression, anxiety, and somatic symptoms (p < 0.001). Greater bowel symptom bother (7.4 ± 0.2 vs 6.7 ± 0.2, p = 0.040), severity (7.7 ± 0.2 vs 6.5 ± 0.2, p < 0.001), recent symptomatic days (9.8 ± 0.4 vs 8.5 ± 0.3, p = 0.02), and poorer HRQOL (40.9 ± 2.3 vs 55.5 ± 1.7, p < 0.001) were noted in IBS with abuse. Abuse effects were additive, with greater IBS symptom severity and poorer HRQOL noted in cases with multiple forms of abuse. Mediation analyses suggested that abuse effects on GI symptoms and HRQOL were partially mediated by mood. Abuse experiences common among IBS sufferers are associated with reports of greater GI symptoms and poorer HRQOL, particularly in those with multiple forms of abuse; this relationship may be partially mediated by concomitant mood disturbances. © 2016 John Wiley & Sons Ltd.

  14. Fluctuating residual limb volume accommodated with an adjustable, modular socket design: A novel case report.

    PubMed

    Mitton, Kay; Kulkarni, Jai; Dunn, Kenneth William; Ung, Anthony Hoang

    2017-10-01

    This novel case report describes the problems of prescribing a prosthetic socket in a left transfemoral amputee secondary to chronic patellofemoral instability compounded by complex regional pain syndrome. Case Description and Methods: Following the amputation, complex regional pain syndrome symptoms recurred in the residual limb, presenting mainly with oedema. Due to extreme daily volume fluctuations of the residual limb, a conventional, laminated thermoplastic socket fitting was not feasible. Findings and Outcomes: An adjustable, modular socket design was trialled. The residual limb volume fluctuations were accommodated within the socket. Amputee rehabilitation could be continued, and the rehabilitation goals were achieved. The patient was able to wear the prosthesis for 8 h daily and to walk unaided indoors and outdoors. An adjustable, modular socket design accommodated the daily residual limb volume fluctuations and provided a successful outcome in this case. It demonstrates the complexities of socket fitting and design with volume fluctuations. Clinical relevance Ongoing complex regional pain syndrome symptoms within the residual limb can lead to fitting difficulties in a conventional, laminated thermoplastic socket due to volume fluctuations. An adjustable, modular socket design can accommodate this and provide a successful outcome.

  15. Screening for abuse and mental health problems among illiterate runaway adolescents in an Indian metropolis.

    PubMed

    Bhat, Deepti Pagare; Singh, Meghachandra; Meena, Gajendra Singh

    2012-11-01

    To evaluate the prevalence of physical and sexual abuse, and their relation to mental health problems among the illiterate/semiliterate runaway adolescents in New Delhi, India. Cross sectional. New Delhi, India. Runaway adolescent boys (n=119) aged 11 to 18 years at an observation home. Study subjects were screened for physical and sexual abuse using the Child Maltreatment History Self Report and Finkelhor's sexual abuse scale. Mental health problems were identified using the Achenbach's Youth Self-Report scale. As the participants were illiterate or semiliterate with Hindi being their primary language, the screening tools were appropriately translated, read out to them and their responses recorded. A total of 72 (62%) boys experienced domestic violence, 70 (59%) had engaged in substance abuse and 103 (87%) boys had been employed as child labourers. Physical abuse was reported by 86 (72%) and sexual abuse by 42 (35%). Mental health problems were recognised in 83 (70%) boys, which included internalising syndromes (59%) and externalising syndromes (34%). Multivariate analysis demonstrated that physical abuse was an independent predictor of internalising syndromes (OR: 3.3; 95% CI 1.2 to 9.1; p<0.01), while substance abuse and sexual abuse were independent predictors of externalising syndromes. Our study demonstrates that childhood abuse and mental health disorders are widely prevalent among the runaway adolescents evaluated at an observation home in New Delhi. Appropriate modification of the standardised self-report screening tools may allow the identification of mental health disorders in this vulnerable illiterate/semiliterate population.

  16. Short-term adaptation of accommodation, accommodative vergence and disparity vergence facility.

    PubMed

    Maxwell, James; Tong, Jianliang; Schor, Clifton M

    2012-06-01

    Previous studies have found that subjects can increase the velocity of accommodation using visual exercises such as pencil push ups, flippers, Brock strings and the like and myriad papers have shown improvement in accommodation facility (speed) and sufficiency (amplitude) using subjective tests following vision training but few have objectively measured accommodation before and after training in either normal subjects or in patients diagnosed with accommodative infacility (abnormally slow dynamics). Accommodation is driven either directly by blur or indirectly by way of neural crosslinks from the vergence system. Until now, no study has objectively measured both accommodation and accommodative-vergence before and after vision training and the role vergence might play in modifying the speed of accommodation. In the present study, accommodation and accommodative-vergence were measured with a Purkinje Eye Tracker/optometer before and after normal subjects trained in a flipper-like task in which the stimulus stepped between 0 and 2.5 diopters and back for over 200 cycles. Most subjects increased their speed of accommodation as well as their speed of accommodative vergence. Accommodative vergence led the accommodation response by approximately 77 ms before training and 100 ms after training and the vergence lead was most prominent in subjects with high accommodation and vergence velocities and the vergence leads tended to increase in conjunction with increases in accommodation velocity. We surmise that volitional vergence may help increase accommodation velocity by way of vergence-accommodation cross links. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Short-Term Adaptation of Accommodation, Accommodative Vergence and Disparity Vergence Facility

    PubMed Central

    Maxwell, James; Tong, Jianliang; Schor, Clifton M.

    2012-01-01

    Previous studies have found that subjects can increase the velocity of accommodation using visual exercises such as pencil push ups, flippers, Brock strings and the like and myriad papers have shown improvement in accommodation facility (speed) and sufficiency (amplitude) using subjective tests following vision training but few have objectively measured accommodation before and after training in either normal subjects or in patients diagnosed with accommodative infacility (abnormally slow dynamics). Accommodation is driven either directly by blur or indirectly by way of neural crosslinks from the vergence system. Until now, no study has objectively measured both accommodation and accommodative-vergence before and after vision training and the role vergence might play in modifying the speed of accommodation. In the present study, accommodation and accommodative-vergence were measured with a Purkinje Eye Tracker/Optometer before and after normal subjects trained in a flipper-like task in which the stimulus stepped between 0 and 2.5 diopters and back for over 200 cycles. Most subjects increased their speed of accommodation as well as their speed of accommodative vergence. Accommodative vergence led the accommodation response by approximately 77 msec before training and 100 msec after training and the vergence lead was most prominent in subjects with high accommodation and vergence velocities and the vergence leads tended to increase in conjunction with increases in accommodation velocity. We surmise that volitional vergence may help increase accommodation velocity by way of vergence-accommodation cross links. PMID:22480879

  18. Temporal accommodation response measured by photorefractive accommodation measurement device

    NASA Astrophysics Data System (ADS)

    Song, Byoungsub; Leportier, Thibault; Park, Min-Chul

    2017-02-01

    Although accommodation response plays an important role in the human vision system for perception of distance, some three-dimensional (3D) displays offer depth stimuli regardless of the accommodation response. The consequence is that most observers watching 3D displays have complained about visual fatigue. The measurement of the accommodation response is therefore necessary to develop human-friendly 3D displays. However, only few studies about accommodation measurement have been reported. Most of the investigations have been focused on the measurement and analysis of monocular accommodation responses only because the accommodation response works individually in each eye. Moreover, a main eye perceives dominantly the object distance. However, the binocular accommodation response should be examined because both eyes are used to watch the 3D display in natural conditions. The ophthalmic instrument that we developed enabled to measure changes in the accommodation response of the two eyes simultaneously. Two cameras acquired separately the infrared images reflected from each eyes after the reflected beams passed through a cylindrical lens. The changes in the accommodation response could then be estimated from the changes in the astigmatism ratio of the infrared images that were acquired in real time. In this paper, we compared the accommodation responses of main eye between the monocular and the binocular conditions. The two eyes were measured one by one, with only one eye opened, during measurement for monocular condition. Then the two eyes were examined simultaneously for binocular condition. The results showed similar tendencies for main eye accommodation response in both cases.

  19. [Child abuse: a disturbing problem].

    PubMed

    Martínez-Martínez, E; Reyes-Rodrguez, R

    1993-08-01

    This current information on "battered child syndrome" (BCS) was obtained during 1990 from nine institutions in Tijuana, Baja California; 549 cases of BCS were studied, of which 338 were female, 203 male, eight of indeterminate sex due to loss documentation. Child abuse was manifested in all its forms: beatings, sexual abuse, neglect, and affective indifference. The victim's and perpetrator's characters were analyzed together with other factors which had to be taken into consideration in order to detect results which were similarly described in the literature. It is of utmost importance to alert all medical staff to this terrible social problem for the complete treatment of the affected child and the family environment. Community support, and legislation to adequately cover rights of minors and their protection are imperative to elimination of the battered child syndrome.

  20. Clinical importance of caffeine dependence and abuse.

    PubMed

    Ogawa, Naoshi; Ueki, Hirofumi

    2007-06-01

    Caffeine is the most widely consumed psychoactive substance and is a legal stimulant that is readily available to children. Caffeine has occasionally been considered a drug of abuse and the potential for dependence on caffeine has been debated. Presently, due to a paucity of clinical evidence on caffeine dependence or abuse, no such diagnosis is included in the Diagnostic and Statistical Manual of Mental Disorder-fourth edition. The authors present two cases of abuse or dependence on the caffeine contained in 'eutrophic' (energy/nutritional) beverages or caffeine preparations, followed by a review of clinical studies demonstrating evidence that some people can manifest a clinical syndrome of caffeine dependence or abuse. The cases suggest that caffeine can produce a clinical dependence syndrome similar to those produced by other psychoactive substances and has a potential for abuse. In a recent study using a structured interview and the Diagnostic and Statistical Manual of Mental Disorder-fourth edition criteria for substance dependence and abuse, a subset of the general population was found to demonstrate caffeine dependence or caffeine abuse. Therefore, the authors propose that companies or businesses manufacturing or marketing caffeine or products containing caffeine must meet the following guidelines: (i) clearly indicate the caffeine content of products containing comparatively higher quantities of caffeine; (ii) warn that such products should be avoided by infants and children wherever possible, and inform adult consumers about the precise quantity of caffeine that is considered safe for consumption; and (iii) clearly state that consuming large quantities of caffeine and the long-term use of caffeine carry health risks.

  1. [Substance abuse and toxicity. Fetal drug syndrome].

    PubMed

    Rodé, Magdolna

    2003-08-10

    24% of the 16 years old adolescents have already consumed so called substances suitable for abuse. We must make children, teachers, parents, lawyers, priests, physicians and family aware of the effects and outcomes of drug use. This is just one of the many similar unsolved problems of society like AIDS and smoking. It is imperative that education for healthy lifestyle should be thought at every level of social life. Fighting against the hard problems emerging from drug abuse must be continuously kept on the right place in teaching medicine and in our everyday activity.

  2. [Amotivational syndrome in organic solvent abusers].

    PubMed

    Ozaki, S; Wada, K

    2001-01-01

    Amotivational syndrome is a chronic psychiatric disorder characterized by a variety of changes in personality, emotions and cognitive functions such as lack of activity, inward-turning, avolition, apathy, incoherence, blunted affect, inability to concentrate and memory disturbance. The syndrome was first described among those patients with a history of longtime cannabis use in the 1960's. Since then, there have been several reports describing similar psychiatric disorders to amotivational syndrome among patients with the history of some other psychoactive substances use including solvents, methamphetamine and OTC cough syrups. Therefore, the syndrome has been recognized as one of the common psychiatric conditions that might develop in patients with a history of any psychoactive substance use. Recently, more attention has been paid to the biological basis of amotivational syndrome. Several studies using MRI, SPECT or neuropsychological measures have revealed white matter changes, hypoperfusion in the frontal cortex of the brain and impairment of frontal lobe function. Those findings suggest that amotivational syndrome might be related to "hypofrontality" of the brain. Although no specific treatments have been reported to be definitely effective for patients with amotivational syndrome, some neuroleptics with activating properties or antidepressants can be given appropriately to treat the chief symptoms of the patients.

  3. BUPRENORPHINE ABUSE IN INDIA : AN UPDATE

    PubMed Central

    Sharma, Yogesh; Mattoo, S.K.

    1999-01-01

    This study reviews the available Indian literature on buprenorphine abuse. Buprenorphine was introduced in 1986; the abuse, first noticed in 1987, increased rapidly till 1994, and then decreased gradually. Initiated through other addicts and medical practitioners, the abuse was mostly as a cheap, easily and legally available substitute for opioids. The typical young adult male abuser used an intravenous cocktail with diazepam, pheneramine or promethazine for a better kick. The withdrawal syndrome was typical of the opioids and without an expected delayed onset. Complications of pseudoaneurysm and recurrent koro in repeated withdrawal were reported. Buprenorphine as a detoxifying agent for opioids reportedly gave better symptom control in the first week but high rates of dependence induction were reported. The Indian data tends to caution against the Western enthusiasm to use buprenorphine for detoxification or maintenance of opioid abusers. PMID:21455379

  4. Pregabalin abuse among opiate addicted patients.

    PubMed

    Grosshans, Martin; Lemenager, Tagrid; Vollmert, Christian; Kaemmerer, Nina; Schreiner, Rupert; Mutschler, Jochen; Wagner, Xenija; Kiefer, Falk; Hermann, Derik

    2013-12-01

    Pregabalin is a novel GABA-analogue approved for the treatment of partial onset seizures, neuropathic pain, and general anxiety disorder. Pregabalin has been classified as a Schedule V drug with a low risk of inflicting abuse or addiction. However, some publications have indicated that pregabalin may have a potential for abuse among patients with past or current opiate addiction. Thus, we hypothesized that pregabalin might be abused by patients who were undergoing an opiate replacement therapy and never had an indication for taking pregabalin on medical grounds. Urine specimens from 124 patients with opiate dependency syndrome and from 111 patients with other addiction disorders (alcohol, benzodiazepines, cannabis, amphetamines) were screened for pregabalin by means of a mass spectrometer analysis. We found 12.1 % of all urine specimens from patients with opiate addiction to be positive for pregabalin. None of the patients concerned had a medical indication for using pregabalin. In the control group, 2.7 % of the patients were tested positively for pregabalin, due to their taking it regularly for chronic pain or general anxiety. Our data suggest that pregabalin is liable to be abused among individuals with opiate dependency syndrome Thus, vigilance and caution are called for when patients with a past or current opiate dependency are exposed to treatment with pregabalin.

  5. Assessment of AIDS Risk among Treatment Seeking Drug Abusers.

    ERIC Educational Resources Information Center

    Black, John L.; And Others

    Intravenous (IV) drug abusers are at risk for contracting transmittable diseases such as acquired immunodeficiency syndrome (AIDS) and hepatitis B. This study was conducted to investigate the prevalence of risk behaviors for acquiring and transmitting AIDS and hepatitis B among treatment-seeking drug abusers (N=168). Subjects participated in a…

  6. Refractive errors and strabismus in Down's syndrome in Korea.

    PubMed

    Han, Dae Heon; Kim, Kyun Hyung; Paik, Hae Jung

    2012-12-01

    The aims of this study were to examine the distribution of refractive errors and clinical characteristics of strabismus in Korean patients with Down's syndrome. A total of 41 Korean patients with Down's syndrome were screened for strabismus and refractive errors in 2009. A total of 41 patients with an average age of 11.9 years (range, 2 to 36 years) were screened. Eighteen patients (43.9%) had strabismus. Ten (23.4%) of 18 patients exhibited esotropia and the others had intermittent exotropia. The most frequently detected type of esotropia was acquired non-accommodative esotropia, and that of exotropia was the basic type. Fifteen patients (36.6%) had hypermetropia and 20 (48.8%) had myopia. The patients with esotropia had refractive errors of +4.89 diopters (D, ±3.73) and the patients with exotropia had refractive errors of -0.31 D (±1.78). Six of ten patients with esotropia had an accommodation weakness. Twenty one patients (63.4%) had astigmatism. Eleven (28.6%) of 21 patients had anisometropia and six (14.6%) of those had clinically significant anisometropia. In Korean patients with Down's syndrome, esotropia was more common than exotropia and hypermetropia more common than myopia. Especially, Down's syndrome patients with esotropia generally exhibit clinically significant hyperopic errors (>+3.00 D) and evidence of under-accommodation. Thus, hypermetropia and accommodation weakness could be possible factors in esotropia when it occurs in Down's syndrome patients. Based on the results of this study, eye examinations of Down's syndrome patients should routinely include a measure of accommodation at near distances, and bifocals should be considered for those with evidence of under-accommodation.

  7. "Syndrome in syndrome": Wernicke syndrome due to afferent loop syndrome. Case report and review of the literature.

    PubMed

    D'Abbicco, D; Praino, S; Amoruso, M; Notarnicola, A; Margari, A

    2011-01-01

    Wernicke syndrome is a rare neurological pathology due to a deficit in vitamin B1. The syndrome is common among alcohol abusers, patients with malignant tumor or gastrointestinal diseases, those who undergo hemodialysis or long-term peritoneal dialysis, pregnant women with hyperemesis, women who breast-feed, patients with hyperthyroidism or anorexia nervosa or gastric or jejunal-ileal bypass surgery for obesity, patients submitted to gastric surgery or prolonged total parenteral nutrition or prolonged intravenous therapy. We report a case of Wernicke syndrome due to afferent loop syndrome characterized by incoercible vomiting.

  8. STS payload data collection and accommodations analysis study. Volume 3: Accommodations analysis

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Payload requirements were compared to launch site accommodations and flight accommodations for a number of Spacelab payloads. Experiment computer operating system accommodations were also considered. A summary of accommodations in terms of resources available for payload discretionary use and recommendations for Spacelab/STS accommodation improvements are presented.

  9. Exploring the controversy in child abuse pediatrics and false accusations of abuse.

    PubMed

    Gabaeff, Steven C

    2016-01-01

    There is a controversy in child abuse pediatrics between an established corps of child abuse pediatricians aligned with hospital colleagues and law enforcement, and a multi-specialty challenger group of doctors and other medical professionals working with public interest lawyers. The latter group questions the scientific validity of the core beliefs of child abuse pediatricians and believes that there are a substantial number of false accusations of abuse occurring. An unproven primary hypothesis, crafted around 1975 by a small group of pediatricians with an interest in child abuse, lies at the foundation of child abuse pediatrics. With no scientific study, it was hypothesized that subdural hemorrhage (SDH) and retinal hemorrhage (RH) were diagnostic of shaking abuse. That hypothesis became the so-called "shaken baby syndrome." Through the period 1975-1985, in a coordinated manner, these child abuse specialists coalesced under the American Academy of Pediatrics and began working with district attorneys and social workers, informing them of the ways in which their hypothesis could be applied to prosecutions of child abuse and life-altering social service interventions. In a legal context, using then-prevailing evidentiary rules which treated scientific expert testimony as valid if it was "generally accepted" in the field, they represented falsely that there was general acceptance of their hypothesis and therefore it was valid science. As the ability to convict based on this unproven prime hypothesis (SDH and RH equals abuse) increased, some defense attorneys were professionally compelled by their own doubts to reach out to experts from other fields with experience with SDH and RH, trauma, and biomechanics, for second opinions. Medical and legal challenges to the established thinking soon emerged, based on both old and new evidenced-based literature. As the intensity of the controversy increased, the probability of false accusation became more apparent and the need

  10. The investigation of life-threatening child abuse and Munchausen syndrome by proxy.

    PubMed Central

    Evans, D

    1995-01-01

    The use of covert video surveillance in the investigation of suspected life-threatening child abuse and Munchausen syndrome by proxy raises important ethical questions. That the recently reported provision of this facility in North Staffordshire was not presented to a Local Research Ethics Committee (LREC) for approval as a research exercise raises important questions about the ethical review of research and practice. The case made for avoiding such review is first set out and then examined. The three main premisses which form the basis of the view that LREC approval is not required are identified and tested in turn. The conclusion is that there is an undeniable element of research involved in the procedure and that the welfare of all those subjected to the surveillance would be best protected by the submission of the protocol to an independent committee for ethical assessment. PMID:7776355

  11. Non-linearity of the response accommodative convergence to accommodation ratio.

    PubMed

    Johnston, Miriam S; Firth, Alison Y

    2013-09-01

    Previous studies have reported variation in stimulus accommodative convergence to accommodation (AC/A) ratio across differing accommodative stimuli. Response AC/A ratio was assessed across 4 accommodative demands to determine if these differences could be due to accommodative inaccuracies to stimuli. Twenty-three student participants aged 18 to 26 years (mean age 20.3 ± 1.7 years) successfully completed all testing conditions. The modified Thorington technique was used at 4 m to measure heterophoria. The Shin Nippon SRW 5000 infrared autorefractor was used to determine accommodative change to -1.50, -3.00, -4.50, and -6.00D lens stimuli. Significant differences were found in response AC/A ratio between different minus lens stimulated accommodative demands (p < 0.001). Mean AC/A ratio values were 3.11 ± 1.29 with the -1.50D lens stimulus; 4.03 ± 2.11 with -3.00D; 4.14 ± 1.40 with -4.50D; and 4.48 ± 1.56 with -6.00D. No differences in linearity were noted between myopes and non-myopic participants, but myopes tended to have higher response AC/A ratios than non-myopes, mean 4.88 ± 1.89 for myopes vs 3.61 ± 1.47 for non-myopes (p = 0.045). Response AC/A ratio did not display linearity across 4 minus lens accommodative stimuli, but tended to increase with accommodative demand. Significant variability in response AC/A ratio was found, both within individuals to different accommodative demands, and between individuals across the data set.

  12. Carisoprodol: update on abuse potential and legal status.

    PubMed

    Reeves, Roy R; Burke, Randy S; Kose, Samet

    2012-11-01

    Carisoprodol is a centrally acting skeletal muscle relaxant of which meprobamate, a controlled substance, is the primary active metabolite. The abuse of carisoprodol has increased dramatically in the last several years. A withdrawal syndrome occurs in some patients who abruptly cease carisoprodol intake. The symptoms of this syndrome are similar to those seen with meprobamate withdrawal, suggesting that they may result from withdrawal from meprobamate accumulated with intake of excessive carisoprodol; however, carisoprodol is capable of modulating GABAA function, which may contribute to its abuse potential.There has been considerable debate about whether carisoprodol should be considered a controlled substance. Carisoprodol was removed from the market in Norway on May 1, 2008, but may still be used by specially approved patients. Carisoprodol was classified as a controlled substance in several US states, and effective January 11, 2012, became a schedule IV controlled substance at the US federal level. This article updates the literature on abuse potential and examines recent developments regarding the legal status of carisoprodol.

  13. The perpetrators of medical child abuse (Munchausen Syndrome by Proxy) - A systematic review of 796 cases.

    PubMed

    Yates, Gregory; Bass, Christopher

    2017-10-01

    Little is known about the perpetrators of medical child abuse (MCA) which is often described as "Munchausen's syndrome by proxy" or "factitious disorder imposed on another". The demographic and clinical characteristics of these abusers have yet to be described in a sufficiently large sample. We aimed to address this issue through a systematic review of case reports and series in the professional literature. A systematic search for case reports and series published since 1965 was undertaken using MEDLINE, Web of Science and EMBASE. 4100 database records were screened. A supplementary search was then conducted using GoogleScholar and reference lists of eligible studies. Our search yielded a total sample of 796 perpetrators: 309 from case reports and 487 from case series. Information extracted included demographic and clinical characteristics, in addition to methods of abuse and case outcomes. Nearly all abusers were female (97.6%) and the victim's mother (95.6%). Most were married (75.8%). Mean caretaker age at the child's presentation was 27.6 years. Perpetrators were frequently reported to be in healthcare-related professions (45.6%), to have had obstetric complications (23.5%), or to have histories of childhood maltreatment (30%). The most common psychiatric diagnoses recorded were factitious disorder imposed on self (30.9%), personality disorder (18.6%), and depression (14.2%). From the largest analysis of MCA perpetrators to date, we provide several clinical recommendations. In particular, we urge clinicians to consider mothers with a personal history of childhood maltreatment, obstetric complications, and/or factitious disorder at heightened risk for MCA. Longitudinal studies are required to establish the true prognostic value of these factors as our method may have been vulnerable to publication bias. Copyright © 2017. Published by Elsevier Ltd.

  14. Can current models of accommodation and vergence predict accommodative behavior in myopic children?

    PubMed

    Sreenivasan, Vidhyapriya; Irving, Elizabeth L; Bobier, William R

    2014-08-01

    Investigations into the progression of myopia in children have long considered the role of accommodation as a cause and solution. Myopic children show high levels of accommodative adaptation, coupled with accommodative lag and high response AC/A (accommodative convergence per diopter of accommodation). This pattern differs from that predicted by current models of interaction between accommodation and vergence, where weakened reflex responses and a high AC/A would be associated with a low not high levels of accommodative adaptation. However, studies of young myopes were limited to only part of the accommodative vergence synkinesis and the reciprocal components of vergence adaptation and convergence accommodation were not studied in tandem. Accordingly, we test the hypothesis that the accommodative behavior of myopic children is not predicted by current models and whether that departure is explained by differences in the accommodative plant of the myopic child. Responses to incongruent stimuli (-2D, +2D adds, 10 prism diopter base-out prism) were investigated in 28 myopic and 25 non-myopic children aged 7-15 years. Subjects were divided into phoria groups - exo, ortho and eso based upon their near phoria. The school aged myopes showed high levels of accommodative adaptation but with reduced accommodation and high AC/A. This pattern is not explained by current adult models and could reflect a sluggish gain of the accommodative plant (ciliary muscle and lens), changes in near triad innervation or both. Further, vergence adaptation showed a predictable reciprocal relationship with the high accommodative adaptation, suggesting that departures from adult models were limited to accommodation not vergence behavior. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Hidden Disabilities: A Look at Alcohol and Other Drug Abuse Prevention.

    ERIC Educational Resources Information Center

    VSA Educational Services, Washington, DC. Resource Center on Substance Abuse Prevention and Disability.

    This leaflet discusses alcohol and other drug abuse prevention for individuals with hidden disabilities such as cancer, epilepsy, diabetes, kidney failure, hemophilia, hypertension, early stages of acquired immune deficiency syndrome (AIDS), or heart disease. Their increased risk for alcohol and other drug abuse and reasons for increased risk are…

  16. Accommodation and convergence during sustained computer work.

    PubMed

    Collier, Juanita D; Rosenfield, Mark

    2011-07-01

    With computer usage becoming almost universal in contemporary society, the reported prevalence of computer vision syndrome (CVS) is extremely high. However, the precise physiological mechanisms underlying CVS remain unclear. Although abnormal accommodation and vergence responses have been cited as being responsible for the symptoms produced, there is little objective evidence to support this claim. Accordingly, this study measured both of these oculomotor parameters during a sustained period of computer use. Subjects (N = 20) were required to read text aloud from a laptop computer at a viewing distance of 50 cm for a sustained 30-minute period through their habitual refractive correction. At 2-minute intervals, the accommodative response (AR) to the computer screen was measured objectively using a Grand Seiko WAM 5500 optometer (Grand Seiko, Hiroshima, Japan). Additionally, the vergence response was assessed by measuring the associated phoria (AP), i.e., prism to eliminate fixation disparity, using a customized fixation disparity target that appeared on the computer screen. Subjects were asked to rate the degree of difficulty of the reading task on a scale from 1 to 10. Mean accommodation and AP values during the task were 1.07 diopters and 0.74∆ base-in (BI), respectively. The mean discomfort score was 4.9. No significant changes in accommodation or vergence were observed during the course of the 30-minute test period. There was no significant difference in the AR as a function of subjective difficulty. However, the mean AP for the subjects who reported the least and greatest discomfort during the task was 1.55∆ BI and 0, respectively (P = 0.02). CVS, after 30 minutes was worse in subjects exhibiting zero fixation disparity when compared with those subjects having a BI AP but does not appear to be related to differences in accommodation. A slightly reduced vergence response increases subject comfort during the task. Copyright © 2011 American Optometric

  17. [Gardner syndrome--parent alienation syndrome (PAS). Diagnosis or family reality?].

    PubMed

    Namysłowska, Irena; Heitzman, Janusz; Siewierska, Anna

    2009-01-01

    The authors present characteristics of Parental Alienation Syndrome (PAS) proposed by Gardner as well as data, which may help to differentiate that syndrome with real psychological, physical and sexual abuse. The consequences of Gardner Syndrome for legal decisions in the court cases of child custody and the critique of this syndrome in forensic and psychiatric literature are also discussed, and several questions posed. Authors propose to treat Gardner Syndrome not as as a child disorder but as a specific, dynamic family situation, which occurs sometimes, during divorce and fight about child custody.

  18. Sexual Abuse: Somatic and Emotional Reactions.

    ERIC Educational Resources Information Center

    Rimza, Mary Ellen; And Others

    1988-01-01

    Chart reviews and telephone interviews with 72 sexual abuse victims found that 48 of the children had symptoms similar to the "rape trauma" syndrome. Two-thirds of victims commonly had somatic complaints (such as abdominal pain) and emotional/behavioral problems (runaway behavior, suicide attempts). (DB)

  19. Stability of the MCMI-III in a substance-abusing inpatient sample.

    PubMed

    Craig, R J; Olson, R

    1998-12-01

    The stability of the MCMI-III personality disorder and clinical syndrome scales was assessed in a substance-abusing inpatient sample of 35 African-American men over an average test-retest interval of 6 mo. Estimates were higher for the personality pattern scales than for the clinical syndrome scales. The Dependent personality pattern scale (.83) and the Narcissistic personality pattern scale (.80) were reliable after about six months, whereas Drug Abuse, Somatoform, and Major Depression showed lower stability. As in previous research using the MCMI-I/II, estimates were lower than those reported in the test manual.

  20. The influence of interactions between accommodation and convergence on the lag of accommodation.

    PubMed

    Schor, C

    1999-03-01

    Several models of myopia predict that growth of axial length is stimulated by blur. Accommodative lag has been suggested as an important source of blur in the development of myopia and this study has modeled how cross-link interactions between accommodation and convergence might interact with uncorrected distance heterophoria and refractive error to influence accommodative lag. Accommodative lag was simulated with two models of interactions between accommodation and convergence (one with and one without adaptable tonic elements). Simulations of both models indicate that both uncorrected hyperopia and esophoria increase the lag of accommodative and uncorrected myopia and exophoria decrease the lag or introduce a lead of accommodation in response to the near (40 cm) stimulus. These effects were increased when gain of either cross-link, accommodative convergence (AC/A) or convergence accommodation (CA/C), was increased within a moderate range of values while the other was fixed at a normal value (clamped condition). These effects were exaggerated when both the AC/A and CA/C ratios were increased (covaried condition) and affects of cross-link gain were negated when an increase of one cross-link (e.g. AC/A) was accompanied by a reduction of the other cross-link (e.g. CA/C) (reciprocal condition). The inclusion of tonic adaptation in the model reduced steady state errors of accommodation for all conditions except when the AC/A ratio was very high (2 MA/D). Combinations of cross-link interactions between accommodation and convergence that resemble either clamped or reciprocal patterns occur naturally in clinical populations. Simulations suggest that these two patterns of abnormal cross-link interactions could affect the progression of myopia differently. Adaptable tonic accommodation and tonic vergence could potentially reduce the progression of myopia by reducing the lag of accommodation.

  1. Vergence accommodation and monocular closed loop blur accommodation have similar dynamic characteristics.

    PubMed

    Suryakumar, Rajaraman; Meyers, Jason P; Irving, Elizabeth L; Bobier, William R

    2007-02-01

    Retinal blur and disparity are two different sensory signals known to cause a change in accommodative response. These inputs have differing neurological correlates that feed into a final common pathway. The purpose of this study was to investigate the dynamic properties of monocular blur driven accommodation and binocular disparity driven vergence-accommodation (VA) in human subjects. The results show that when response amplitudes are matched, blur accommodation and VA share similar dynamic properties.

  2. Random Changes of Accommodation Stimuli: An Automated Extension of the Flippers Accommodative Facility Test.

    PubMed

    Otero, Carles; Aldaba, Mikel; López, Silvia; Díaz-Doutón, Fernando; Vera-Díaz, Fuensanta A; Pujol, Jaume

    2018-06-01

    To study the accommodative dynamics for predictable and unpredictable stimuli using manual and automated accommodative facility tests Materials and Methods: Seventeen young healthy subjects were tested monocularly in two consecutive sessions, using five different conditions. Two conditions replicated the conventional monocular accommodative facility tests for far and near distances, performed with manually held flippers. The other three conditions were automated and conducted using an electro-optical system and open-field autorefractor. Two of the three automated conditions replicated the predictable manual accommodative facility tests. The last automated condition was a hybrid approach using a novel method whereby far and near-accommodative-facility tests were randomly integrated into a single test of four unpredictable accommodative demands. The within-subject standard deviations for far- and near-distance-accommodative reversals were (±1,±1) cycles per minute (cpm) for the manual flipper accommodative facility conditions and (±3, ±4) cpm for the automated conditions. The 95% limits of agreement between the manual and the automated conditions for far and near distances were poor: (-18, 12) and (-15, 3). During the hybrid unpredictable condition, the response time and accommodative response parameters were significantly (p < 0.05) larger for accommodation than disaccommodation responses for high accommodative demands only. The response times during the transitions 0.17/2.17 D and 0.50/4.50 D appeared to be indistinguishable between the hybrid unpredictable and the conventional predictable automated tests. The automated accommodative facility test does not agree with the manual flipper test results. Operator delays in flipping the lens may account for these differences. This novel test, using unpredictable stimuli, provides a more comprehensive examination of accommodative dynamics than conventional manual accommodative facility tests. Unexpectedly, the

  3. Disabling accommodation barriers: A study exploring how to better accommodate government employees with anxiety disorders.

    PubMed

    Mellifont, Damian; Smith-Merry, Jennifer; Scanlan, Justin Newton

    2016-11-22

    Accommodating mental health in the workplace is challenging. Despite policy efforts to encourage the availability of mental health accommodations in the workplace, employees experiencing mental illness are missing out on accommodations that they need. To inform vocational rehabilitation professionals and managers in the public service of best practice accommodations for government employees with anxiety disorders. Thematic analysis was applied to data collected from the online Accommodating Government Employees with Anxiety Disorders Survey undertaken by 71 Australian public service employees diagnosed with at least one anxiety disorder. Our research results include theme and sub-theme representations of accommodations received, accommodations reported as missing, accommodations that study participants felt they couldn't request, along with rejected accommodations. From the study participants' accounts, three key findings supporting desirable vocational outcomes become apparent. First, that the availability of 'standard' flexible work arrangements, along with personalised accommodations, can assist persons with anxiety disorders (where needed) to reach and retain government positions. Second, the chief barriers reported to making accommodation requests revolve around fears of being stigmatised and penalised. Finally, there is a need for managerial decision-makers to remain open-minded, particularly when assessing requests for accommodations that may break from government norms.

  4. Prevention and recognition of abusive head trauma: training for healthcare professionals in Vietnam.

    PubMed

    Fraser, Jennifer A; Flemington, Tara; Doan, Thi Ngoc Diep; Hoang, Minh Tu Van; Doan, Thi Le Binh; Ha, Manh Tuan

    2017-10-01

    This study presents results from an intervention designed to improve identification and response to abusive head trauma in a tertiary paediatric hospital in Vietnam. One hundred and sixteen healthcare professionals (paediatric medical and nursing staff) completed a clinical training programme and participated in its evaluation. A pre-post-test and follow-up design was used to evaluate the outcomes. Questionnaires were used to collect data prior to training, at six weeks and at six months. Generalised linear modelling was used to examine changes in diagnostic skills and knowledge of the consequences of shaken baby syndrome (SBS) (a form of abusive head trauma), its prevention and treatment. At baseline, awareness and knowledge reflected no former abusive head trauma training. Following the intervention, participants had an increased awareness of shaken baby syndrome and the potential consequences of shaking infants and had acquired techniques to inform parents how to manage the crying infant. The intervention was effective in raising awareness of shaken baby syndrome and its consequences amongst the participating healthcare professionals in Vietnam. Training can improve detection and prevention of abusive head trauma, and the intervention has the potential to be adapted for similar settings internationally. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  5. The concave iris in pigment dispersion syndrome.

    PubMed

    Liu, Lance; Ong, Ee Lin; Crowston, Jonathan

    2011-01-01

    To visualize the changes of the iris contour in patients with pigment dispersion syndrome after blinking, accommodation, and pharmacologic miosis using anterior segment optical coherence tomography. Observational case series. A total of 33 eyes of 20 patients with pigment dispersion syndrome. Each eye was imaged along the horizontal 0- to 180-degree meridian using the Visante Anterior Segment Imaging System (Carl Zeiss Meditec, Dublin, CA). Scans were performed at baseline and after focusing on an internal fixation target for 5 minutes, forced blinking, accommodation, and pharmacologic miosis with pilocarpine 2%. Quantitative analysis of the changes in the iris configuration. After 5 minutes of continual fixation, the iris became planar with the mean ± standard deviation curvature decreasing from 214 ± 74 μm to 67 ± 76 μm (P < 0.05). The iris remained planar in all patients with pigment dispersion syndrome after forced blinking, but the iris concavity recovered to 227 ± 113 μm (P = 0.34) and 238 ± 119 μm (P = 0.19) with the -3.0 and -6.0 diopter lenses, respectively. Pilocarpine-induced miosis caused the iris to assume a planar configuration in all subjects. This study shows that the iris in pigment dispersion syndrome assumes a planar configuration when fixating and that the concavity of the iris surface is not restored by blinking. Accommodation restored the iris concavity, suggesting that the posterior curvature of the iris in pigment dispersion syndrome is induced and probably maintained, at least in part, by accommodation. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  6. [Effects of orthokeratology lenses on the magnitude of accommodative lag and accommodativeconvergence/accommodation].

    PubMed

    Ren, Qiujin; Yue, Hui; Zhou, Qing

    2016-02-01

    To evaluate the change in accommodative lag and accommodation convergence/accommodation (AC/A) after patients with myopia wear orthokeratology lenses. 
 A total of 48 myopic subjects (a test group), who wore orthokeratology lenses regularly, and 48 myopic subjects (a control group), who wore spectacles regularly, were enrolled for this study from January 2011 to January 2013 in Optometric Center, the Forth Hospital of Changsha. Accommodative lag was measured by fused cross cylinder method, where the patients should gaze at the front optotypes 40 cm away. Gradient of the AC/A ratio was measured by Von Grafe method to check closer distance heterophoria. Accommodative lag and AC/A ratio were analyzed by statistics.
 After 1-year follow-up, accommodative lag and AC/A rate in patients with low or moderate myopia in the test group was decreased in 1, 3, 6 months or 1 year compared with that in the control group (P<0.05). 
 Compared with spectacles, orthokeratology lenses are able to decrease accommodative lag and high AC/A rate in patients with low or moderate myopia. The relationship between accommodation and convergence is improved by orthokeratology lenses. Orthokeratology is an effective way to control myopia.

  7. Improving Accommodations Outcomes: Monitoring Instructional and Assessment Accommodations for Students with Disabilities

    ERIC Educational Resources Information Center

    Christensen, Laurene L.; Thurlow, Martha L.; Wang, Ting

    2009-01-01

    This document presents a five-step process for schools, districts, and states to use in monitoring accommodations for instruction and assessment. This document was designed to be a companion to the "Council of Chief State School Officers' Accommodations Manual: How to Select, Administer, and Evaluate Use of Accommodations for Instruction and…

  8. Violence and Abuse Among HIV-Infected Women and Their Children in Zambia

    PubMed Central

    Murray, Laura K.; Haworth, Alan; Semrau, Katherine; Singh, Mini; Aldrovandi, Grace M.; Sinkala, Moses; Thea, Donald M.; Bolton, Paul A.

    2009-01-01

    HIV and violence are two major public health problems increasingly shown to be connected and relevant to international mental health issues and HIV-related services. Qualitative research is important due to the dearth of literature on this association in developing countries, cultural influences on mental health syndromes and presentations, and the sensitive nature of the topic. The study presented in this paper sought to investigate the mental health issues of an HIV-affected population of women and children in Lusaka, Zambia, through a systematic qualitative study. Two qualitative methods resulted in the identification of three major problems for women: domestic violence (DV), depression-like syndrome, and alcohol abuse; and children: defilement, DV, and behavior problems. DV and sexual abuse were found to be closely linked to HIV and alcohol abuse. This study shows the local perspective of the overlap between violence and HIV. Results are discussed in relation to the need for violence and abuse to be addressed as HIV services are implemented in sub-Saharan Africa. PMID:16909070

  9. Fetal Alcohol Syndrome "Chemical Genocide."

    ERIC Educational Resources Information Center

    Asetoyer, Charon

    In the Northern Plains of the United States, 100% of Indian reservations are affected by alcohol related problems. Approximately 90% of Native American adults are currently alcohol users or abusers or are recovering from alcohol abuse. Alcohol consumption has a devastating effect on the unborn. Fetal Alcohol Syndrome (FAS) is an irreversible birth…

  10. Visual accommodation trainer-tester

    NASA Technical Reports Server (NTRS)

    Randle, R. J., Jr. (Inventor)

    1983-01-01

    An apparatus for training of the human visual accommodation system is presented, specifically, useful for training a person to volitionally control his focus to his far point (normaly infinity) from a position of myopia due to functional causes. The functional causes could be due, for example, to a behavioral accommodative spasm or the effects of an empty field. The device may also be used to measure accommodation, the accommodation resting position and the near and far points of vision.

  11. The Accommodation Operation. Accommodation Management Module. Operational Management Programme.

    ERIC Educational Resources Information Center

    Chapman, Janet

    This module on accommodation operation is intended to help supervisors or managers achieve a balance in the day-to-day running of the premises and plan for a smooth and successful future. Much of the material is concerned with the housekeeping aspects of accommodation management. The material is presented in a self-instructional format in seven…

  12. [Energy and memory efficient calculation of the accommodation demand in the artificial accommodation system].

    PubMed

    Nagel, J A; Beck, C; Harms, H; Stiller, P; Guth, H; Stachs, O; Bretthauer, G

    2010-12-01

    Presbyopia and cataract are gaining more and more importance in the ageing society. Both age-related complaints are accompanied with a loss of the eye's ability to accommodate. A new approach to restore accommodation is the Artificial Accommodation System, an autonomous micro system, which will be implanted into the capsular bag instead of a rigid intraocular lens. The Artificial Accommodation System will, depending on the actual demand for accommodation, autonomously adapt the refractive power of its integrated optical element. One possibility to measure the demand for accommodation non-intrusively is to analyse eye movements. We present an efficient algorithm, based on the CORDIC technique, to calculate the demand for accommodation from magnetic field sensor data. It can be shown that specialised algorithms significantly shorten calculation time without violating precision requirements. Additionally, a communication strategy for the wireless exchange of sensor data between the implants of the left and right eye is introduced. The strategy allows for a one-sided calculation of the demand for accommodation, resulting in an overall reduction of calculation time by 50 %. The presented methods enable autonomous microsystems, such as the Artificial Accommodation System, to save significant amounts of energy, leading to extended autonomous run-times. © Georg Thieme Verlag KG Stuttgart · New York.

  13. [Dynamics of child suggestibility in accusations of sexual abuse in divorce proceedings].

    PubMed

    du Bois, R; Röcker, D

    1996-11-01

    A case of a mother confabulating an extended sexual abuse of her 13 and 15 year old children involving bizarre sadistic features is presented and discussed. The kinship to Munchhausen Syndrome by proxy, identity diffusion, Posttraumatic Stress Syndrome, folie à deux and other concepts is highlighted. It is suggested that sexual confabulations are generated within incestuous family structures as a means to stimulate and satisfy needs of personal closeness when losses and disruptive events have occurred. The disclosure or suspicion of sexual abuse may prove neither true nor false but may hint to an impending emotional breakdown of a parent and to ongoing subtle incestuous traumatisation of a child.

  14. Medical Child Abuse (Munchausen Syndrome by Proxy): Multidisciplinary Approach from a Pediatric Gastroenterology Perspective.

    PubMed

    Ali-Panzarella, Andrea Z; Bryant, Tamika J; Marcovitch, Hannah; Lewis, Jeffery D

    2017-04-01

    We highlight the need for a multidisciplinary approach to the diagnosis of medical child abuse, also known as factitious disorder imposed on another (FDIA) or Munchausen syndrome by proxy (MSP), and review our experience focusing on the variety of symptoms that often present to the pediatric gastroenterologist many months before the diagnosis is made. Recent literature on medical child abuse, mostly case reports, is markedly limited, highlighting a need for increased research on this topic. Articles agree on the value of a multidisciplinary approach to these cases and the importance of involving professionals outside the hospital setting. Given the technology-dependent nature of our current society, the use of social media to aid in making the diagnosis has emerged. Review of the literature shows that there are almost no data on long-term outcomes of the victims or perpetrators of MSP. Making the diagnosis of MSP involves a complicated process of piecing together inconsistencies among the history, examination, and clinical presentation. The diagnosis remains difficult and is not often considered during early presentation of symptoms. Once MSP is suspected, it is important that a multidisciplinary process is used, incorporating input from various sources: the outpatient care structure, the hospital, non-hospital agencies such as school and child protective services, and non-traditional sources such as social media. In our experience, a multidisciplinary approach augmented by thoughtful inpatient surveillance provides the greatest opportunity for confirming or excluding MSP. Pediatric gastroenterology is one of the most common services consulted prior to diagnosis and presents an opportunity for early intervention.

  15. Reasonable Accommodation Information Tracking System

    EPA Pesticide Factsheets

    The Reasonable Accommodation Information Tracking System (RAITS) is a case management system that allows the National Reasonable Accommodation Coordinator (NRAC) and the Local Reasonable Accommodation Coordinators (LORAC) to manage information related to Reasonable Accommodation (RA) requests. It provides a data base system in compliance with Executive Order 13164 and required by the Equal Employment Opportunity Commission (EEOC) Regulations and American Federation of Government Employees (AFGE) Bargaining Unit as described in the AFGE National Reasonable Accommodation Procedures. It is a tool that was internally developed in Lotus Notes to track requests for reasonable accommodation and was custom-configured to meet EPA's specific needs and infrastructure.

  16. Retinal Image Quality During Accommodation

    PubMed Central

    López-Gil, N.; Martin, J.; Liu, T.; Bradley, A.; Díaz-Muñoz, D.; Thibos, L.

    2013-01-01

    Purpose We asked if retinal image quality is maximum during accommodation, or sub-optimal due to accommodative error, when subjects perform an acuity task. Methods Subjects viewed a monochromatic (552nm), high-contrast letter target placed at various viewing distances. Wavefront aberrations of the accommodating eye were measured near the endpoint of an acuity staircase paradigm. Refractive state, defined as the optimum target vergence for maximising retinal image quality, was computed by through-focus wavefront analysis to find the power of the virtual correcting lens that maximizes visual Strehl ratio. Results Despite changes in ocular aberrations and pupil size during binocular viewing, retinal image quality and visual acuity typically remain high for all target vergences. When accommodative errors lead to sub-optimal retinal image quality, acuity and measured image quality both decline. However, the effect of accommodation errors of on visual acuity are mitigated by pupillary constriction associated with accommodation and binocular convergence and also to binocular summation of dissimilar retinal image blur. Under monocular viewing conditions some subjects displayed significant accommodative lag that reduced visual performance, an effect that was exacerbated by pharmacological dilation of the pupil. Conclusions Spurious measurement of accommodative error can be avoided when the image quality metric used to determine refractive state is compatible with the focusing criteria used by the visual system to control accommodation. Real focusing errors of the accommodating eye do not necessarily produce a reliably measurable loss of image quality or clinically significant loss of visual performance, probably because of increased depth-of-focus due to pupil constriction. When retinal image quality is close to maximum achievable (given the eye’s higher-order aberrations), acuity is also near maximum. A combination of accommodative lag, reduced image quality, and reduced

  17. Changes in dynamics of accommodation after accommodative facility training in myopes and emmetropes.

    PubMed

    Allen, Peter M; Charman, W Neil; Radhakrishnan, Hema

    2010-05-12

    This study evaluates the effect of accommodative facility training in myopes and emmetropes. Monocular accommodative facility was measured in nine myopes and nine emmetropes for distance and near. Subjective facility was recorded with automated flippers and objective measurements were simultaneously taken with a PowerRefractor. Accommodative facility training (a sequence of 5 min monocular right eye, 5 min monocular left eye, 5 min binocular) was given on three consecutive days and facility was re-assessed on the fifth day. The results showed that training improved the facility rate in both groups. The improvement in facility rates were linked to the time constants and peak velocity of accommodation. Some changes in amplitude seen in emmetropes indicate an improvement in facility rate at the expense of an accurate accommodation response. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. Asymmetrical accommodation in hyperopic anisometropic amblyopia

    PubMed Central

    Toor, Sonia; Riddell, Patricia

    2018-01-01

    Background/aims To investigate the presence of asymmetrical accommodation in hyperopic anisometropic amblyopia. Methods Accommodation in each eye and binocular vergence were measured simultaneously using a PlusoptiX SO4 photorefractor in 26 children aged 4–8 years with hyperopic anisometropic amblyopia and 13 controls (group age-matched) while they viewed a detailed target moving in depth. Results Without spectacles, only 5 (19%) anisometropes demonstrated symmetrical accommodation (within the 95% CI of the mean gain of the sound eye of the anisometropic group), whereas 21 (81%) demonstrated asymmetrical accommodation. Of those, 15 (58%) showed aniso-accommodation and 6 (23%) demonstrated ‘anti-accommodation’ (greater accommodation for distance than for near). In those with anti-accommodation, the response gain in the sound eye was (0.93±0.20) while that of the amblyopic eye showed a negative accommodation gain of (−0.44±0.23). Anti-accommodation resolved with spectacles. Vergence gains were typical in those with symmetrical and asymmetrical accommodation. Conclusion The majority of hyperopic anisometropic amblyopes demonstrated non-consensual asymmetrical accommodation. Approximately one in four demonstrated anti-accommodation. PMID:29051327

  19. Job Accommodation Network

    MedlinePlus

    ADA LIBRARY PUBLICATIONS AND RESOURCES SEARCH ACCOMMODATIONS DATABASE A-Z OF DISABILITIES AND ACCOMMODATIONS NEWS Hot Topics How to Use this Site JAN en Español Print this Page A A A Text Size Connect with JAN (800)526-7234 (Voice) (877)781-9403 ( ...

  20. Clinical study of the relation of borderline personality disorder to Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders.

    PubMed

    Hudziak, J J; Boffeli, T J; Kreisman, J J; Battaglia, M M; Stanger, C; Guze, S B; Kriesman, J J

    1996-12-01

    The criteria for borderline personality disorder seem to select patients with very high rates of Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders. This study was undertaken to determine whether systematic assessment of patients with borderline personality disorder would reveal characteristic features of that condition which would distinguish it from these other disorders. Eighty-seven white female patients (75 in St. Louis and 12 in Milan, Italy) who had borderline personality disorder according to both the DSM-III-R criteria and the Revised Diagnostic Interview for Borderlines were further examined with the DSM-III-R Checklist and the Perley-Guze Hysteria Checklist to determine their patterns of psychiatric comorbidity. Every patient had at least one additional DSM diagnosis. Patients in St. Louis and Milan averaged five and four additional diagnoses, respectively. Eighty-four percent of the patients in St. Louis met criteria for either somatization disorder, Briquet's syndrome, antisocial personality disorder, or substance abuse disorders. Patterns of comorbidity for panic (51%), generalized anxiety disorder (55%), and major depression (87%) in St. Louis were consistent with those in other studies. The data indicate that the boundaries for the borderline condition are not specific and identify a high percentage of patients with these other disorders. Furthermore, the comorbidity profiles closely resemble the psychiatric profiles of patients with these disorders. If the borderline syndrome is meant to include all of these disorders, its usefulness as a diagnosis is limited. Until the fundamental features of borderline personality disorder that distinguish it from the others are identified, it is recommended that clinicians carefully assess patients for these other diagnoses. Efforts should be made to change the borderline personality disorder criteria by shifting away from overlap with the

  1. Clinical pharmacokinetics of non-opiate abused drugs.

    PubMed

    Busto, U; Bendayan, R; Sellers, E M

    1989-01-01

    The present review discusses the available data on the kinetic properties of non-opiate abused drugs including psychomotor stimulants, hallucinogens and CNS-depressants. Some of the drugs of abuse reviewed here are illicit drugs (e.g. cannabis, cocaine), while others are effective pharmacological agents but have the potential to be abused (e.g. benzodiazepines). Although some of the drugs mentioned in this review have been in use for centuries (e.g. caffeine, nicotine, cocaine, cannabis), knowledge of their kinetics and metabolism is very recent and in some cases still incomplete. This is partially due to the difficulties inherent in studying drugs of abuse in humans, and to the complex metabolism of some of these drugs (e.g. cannabis, caffeine) which has made it difficult to develop sensitive assays to determine biological pathways. Although drugs of abuse may have entirely different intrinsic pharmacological effects, the kinetic properties of such drugs are factors contributing to abuse and dependence. The pharmacokinetic properties that presumably contribute to self-administration and drug abuse include rapid delivery of the drug into the central nervous system and high free drug clearance. Kinetic characteristics also play an important role in the development of physical dependence and on the appearance of a withdrawal syndrome: the longer the half-life, the greater the likelihood of the development of physical dependence; the shorter the half-life, the earlier and more severe the withdrawal. The balance between these 2 factors, which has not yet been carefully studied, will also influence abuse patterns. The clinical significance of kinetic characteristics with respect to abuse is discussed where possible.

  2. EBooks and Accommodations: Is This the Future of Print Accommodation?

    ERIC Educational Resources Information Center

    Cavanaugh, Terence

    2002-01-01

    This article explains the three components of eBooks: an eBook file, software to read the eBook, and a hardware device to read it on. The use of eBooks for students with special needs, the advantages of eBooks, built in accommodations, and creating accommodations are discussed. EBook resources are included. (Contains references.) (CR)

  3. Retinal image quality during accommodation.

    PubMed

    López-Gil, Norberto; Martin, Jesson; Liu, Tao; Bradley, Arthur; Díaz-Muñoz, David; Thibos, Larry N

    2013-07-01

    We asked if retinal image quality is maximum during accommodation, or sub-optimal due to accommodative error, when subjects perform an acuity task. Subjects viewed a monochromatic (552 nm), high-contrast letter target placed at various viewing distances. Wavefront aberrations of the accommodating eye were measured near the endpoint of an acuity staircase paradigm. Refractive state, defined as the optimum target vergence for maximising retinal image quality, was computed by through-focus wavefront analysis to find the power of the virtual correcting lens that maximizes visual Strehl ratio. Despite changes in ocular aberrations and pupil size during binocular viewing, retinal image quality and visual acuity typically remain high for all target vergences. When accommodative errors lead to sub-optimal retinal image quality, acuity and measured image quality both decline. However, the effect of accommodation errors of on visual acuity are mitigated by pupillary constriction associated with accommodation and binocular convergence and also to binocular summation of dissimilar retinal image blur. Under monocular viewing conditions some subjects displayed significant accommodative lag that reduced visual performance, an effect that was exacerbated by pharmacological dilation of the pupil. Spurious measurement of accommodative error can be avoided when the image quality metric used to determine refractive state is compatible with the focusing criteria used by the visual system to control accommodation. Real focusing errors of the accommodating eye do not necessarily produce a reliably measurable loss of image quality or clinically significant loss of visual performance, probably because of increased depth-of-focus due to pupil constriction. When retinal image quality is close to maximum achievable (given the eye's higher-order aberrations), acuity is also near maximum. A combination of accommodative lag, reduced image quality, and reduced visual function may be a useful

  4. Tonic accommodation predicts closed-loop accommodation responses.

    PubMed

    Liu, Chunming; Drew, Stefanie A; Borsting, Eric; Escobar, Amy; Stark, Lawrence; Chase, Christopher

    2016-12-01

    The purpose of this study is to examine the potential relationship between tonic accommodation (TA), near work induced TA-adaptation and the steady state closed-loop accommodation response (AR). Forty-two graduate students participated in the study. Various aspects of their accommodation system were objectively measured using an open-field infrared auto-refractor (Grand Seiko WAM-5500). Tonic accommodation was assessed in a completely dark environment. The association between TA and closed-loop AR was assessed using linear regression correlations and t-test comparisons. Initial mean baseline TA was 1.84diopter (D) (SD±1.29D) with a wide distribution range (-0.43D to 5.14D). For monocular visual tasks, baseline TA was significantly correlated with the closed-loop AR. The slope of the best fit line indicated that closed-loop AR varied by approximately 0.3D for every 1D change in TA. This ratio was consistent across a variety of viewing distances and different near work tasks, including both static targets and continuous reading. Binocular reading conditions weakened the correlation between baseline TA and AR, although results remained statistically significant. The 10min near reading task with a 3D demand did not reveal significant near work induced TA-adaptation for either monocular or binocular conditions. Consistently, the TA-adaptation did not show any correlation with AR during reading. This study found a strong association between open-loop TA and closed-loop AR across a variety of viewing distances and different near work tasks. Difference between the correlations under monocular and binocular reading condition suggests a potential role for vergence compensation during binocular closed-loop AR. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Shaken Baby Syndrome.

    ERIC Educational Resources Information Center

    Alexander, Randell C.; Smith, Wilbur L.

    1998-01-01

    Discusses the history, epidemiology, biomechanics, diagnosis, treatment, outcomes, long-term management, and prevention of shaken baby syndrome. It presents medical-legal issues as well as a discussion of programs aimed at prevention of physical abuse. (Author/DB)

  6. Habitability sleep accommodations

    NASA Technical Reports Server (NTRS)

    Fisher, H. T.

    1985-01-01

    Schematic outlines are presented with various design requirements for the accommodation of the spacecrew of Space Stations. The primary concern is for sleeping accommodations. Some other general requirements given are for a rest place, entertainment, dressing area, personal item stowage, body restraint, total privacy, external viewing, and grooming provisions. Several plans are given for sleep quarters concepts.

  7. Nonverbal Accommodation in Healthcare Communication

    PubMed Central

    D’Agostino, Thomas A.; Bylund, Carma L.

    2016-01-01

    This exploratory study examined patterns of nonverbal accommodation within healthcare interactions and investigated the impact of communication skills training and gender concordance on nonverbal accommodation behavior. The Nonverbal Accommodation Analysis System (NAAS) was used to code the nonverbal behavior of physicians and patients within 45 oncology consultations. Cases were then placed in one of seven categories based on patterns of accommodation observed across the interaction. Results indicated that across all NAAS behavior categories, physician-patient interactions were most frequently categorized as Joint Convergence, followed closely by Asymmetrical-Patient Convergence. Among paraverbal behaviors, talk time, interruption, and pausing were most frequently characterized by Joint Convergence. Among nonverbal behaviors, eye contact, laughing, and gesturing were most frequently categorized as Asymmetrical-Physician Convergence. Differences were predominantly non-significant in terms of accommodation behavior between pre and post-communication skills training interactions. Only gesturing proved significant, with post-communication skills training interactions more likely to be categorized as Joint Convergence or Asymmetrical-Physician Convergence. No differences in accommodation were noted between gender concordant and non-concordant interactions. The importance of accommodation behavior in healthcare communication is considered from a patient-centered care perspective. PMID:24138223

  8. Employer benefits from making workplace accommodations.

    PubMed

    Solovieva, Tatiana I; Dowler, Denetta L; Walls, Richard T

    2011-01-01

    This study explored workplace disability accommodations and their benefits. The participants were employers and human resource professionals who had not used the services of the Job Accommodation Network (JAN). The companies included large businesses (more than 499 employees) and small businesses (fewer than 500 employees). The intent of this investigation was to assess the disability accommodations and benefits for the employers. The study used responses to online survey from194 employers to discuss disability-related accommodations for an employee or potential employee. The survey included 128 employers who reported having had a person with a disability who requested an accommodation. As reported by the employers, the most frequently mentioned direct benefits from implementing workplace accommodations were (a) retained a qualified employee, (b) increased worker productivity, and (c) eliminated the cost of training a new employee. The most frequently mentioned indirect benefits from accommodations were (a) improved interactions with coworkers, (b) increased overall company morale, and (c) increased overall company productivity. The most frequently reported types of implemented accommodations were buying equipment and changing work schedules. Most of the respondents estimated the direct benefits of having made an accommodation at more than $1000. The findings heighten awareness of benefits associated with making accommodations for people with disabilities in the workplace. These benefits signify value for business, coworkers, and individuals with disabilities for whom accommodations are critical for successful employment. Published by Elsevier Inc.

  9. 43 CFR 17.211 - Reasonable accommodation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Reasonable accommodation. (a) A recipient shall make reasonable accommodation to the known physical or mental... that the accommodation would impose an undue hardship on the operation of its program or activity. (b... accommodation would impose an undue hardship on the operation of a recipient's program or activity, factors to...

  10. The economic impact of alcohol abuse and alcoholism.

    PubMed Central

    Burke, T R

    1988-01-01

    The economic effects of alcohol abuse are as damaging to the nation as the health effects, affecting the family, the community, and persons of all ages. Underaged drinking is interfering with children's development, affecting the nation's ability to respond to economic challenge in the future. The college aged may be the most difficult to educate about alcohol abuse because of drinking patterns established at an early age and susceptibility to advertising inducements. Health care costs for families with an alcoholic member are twice those for families without one, and up to half of all emergency room admissions are alcohol related. Fetal alcohol syndrome is one of the top three known causes of birth defects, and is totally preventable. Alcohol abuse and alcoholism are estimated to have cost the nation $117 billion in 1983, while nonalcoholic drug abuse that year cost $60 billion. Costs of alcohol abuse are expected to be $136 billion a year by 1990, mostly from lost productivity and employment. Between 6 and 7 million workers are alcoholic, with an undetermined loss of productivity, profits, and competitiveness of American business. Alcohol abuse contributes to the high health care costs of the elderly beneficiaries of Federal health financing programs. Heavily affected minorities include blacks, Hispanics, and Native Americans. Society tends to treat the medical and social consequences of alcohol abuse, rather than its causes. Although our experience with the consequences of alcohol abuse is greater than that for any other drug, public concern for its prevention and treatment is less than for other major illnesses or abuse of other drugs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3141948

  11. Pediatric condition falsification (Munchausen syndrome by Proxy) as a continuum of maternal factitious disorder (Munchausen syndrome).

    PubMed

    Kucuker, Hudaverdi; Demir, Tevfik; Oral, Resmiye

    2010-12-01

    Pediatric condition falsification (PCF), also known as Munchausen syndrome by Proxy or Medical Child Abuse, is a somewhat rare form of child abuse and neglect. Its association with a history of adult factitious disorder (AFD) or Munchausen syndrome in the perpetrator is also well known. Exogenous insulin injection to cause hypoglycemia both in the context of PCF and AFD has been reported in the literature. However, the coexistence of both conditions via insulin injection in the same family has not been reported in the literature. This paper presents a family, in which the mother was diagnosed with AFD and her three children with PCF perpetrated by their mother via exogenous insulin injection. © 2010 John Wiley & Sons A/S.

  12. Struggling with one's own parenting after an upbringing with substance abusing parents.

    PubMed

    Tedgård, Eva; Råstam, Maria; Wirtberg, Ingegerd

    2018-12-01

    To add to our knowledge concerning the key elements involved in the individual's experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children's ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents.

  13. Characteristics of substance abuse treatment programs providing services for HIV/AIDS, hepatitis C virus infection, and sexually transmitted infections: the National Drug Abuse Treatment Clinical Trials Network.

    PubMed

    Brown, Lawrence S; Kritz, Steven Allan; Goldsmith, R Jeffrey; Bini, Edmund J; Rotrosen, John; Baker, Sherryl; Robinson, Jim; McAuliffe, Patrick

    2006-06-01

    Illicit drug users sustain the epidemics of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), hepatitis C (HCV), and sexually transmitted infections (STIs). Substance abuse treatment programs present a major intervention point in stemming these epidemics. As a part of the "Infections and Substance Abuse" study, established by the National Drug Abuse Treatment Clinical Trials Network, sponsored by National Institute on Drug Abuse, three surveys were developed; for treatment program administrators, for clinicians, and for state and District of Columbia health and substance abuse department administrators, capturing service availability, government mandates, funding, and other key elements related to the three infection groups. Treatment programs varied in corporate structure, source of revenue, patient census, and medical and non-medical staffing; medical services, counseling services, and staff education targeted HIV/AIDS more often than HCV or STIs. The results from this study have the potential to generate hypotheses for further health services research to inform public policy.

  14. [Münchausen syndrome by proxy. A case report].

    PubMed

    Moussaoui, A; Fejjal, N; Ababou, K; Tourabi, K; Ennouhi, A; Ribag, Y; Slaoui, A; Sqalli, J; Ihrai, H

    2009-02-01

    The plastic surgeon rarely encounters patients with factitious disorders. The syndrome of Münchausen by proxy is a part of it. We put the point on this syndrome through a clinical observation of an eight-year-old girl victim of parental abuse.

  15. The Revictimization of Adult Women With Histories of Childhood Abuse

    PubMed Central

    CHU, JAMES A.

    1992-01-01

    Both clinical experience and recent research statistics support the observation that childhood abuse survivors are vulnerable to revictimization as adults. The responsibility for revictimization, such as physical or sexual assault, belongs to the perpetrators. However, the factors that make abuse survivors more vulnerable to exploitation need to be examined and understood in order to provide adequate treatment and protection. This discussion integrates an understanding of three powerful forces—the repetition compulsion, post-traumatic syndromes, and profound relational disturbances—that permit the process of revictimization to occur. PMID:22700102

  16. Vestibular-ocular accommodation reflex in man

    NASA Technical Reports Server (NTRS)

    Clark, B.; Randle, R. J.; Stewart, J. D.

    1975-01-01

    Stimulation of the vestibular system by angular acceleration produces widespread sensory and motor effects. The present paper studies a motor effect which has not been reported in the literature, i.e., the influence of rotary acceleration of the body on ocular accommodation. The accommodation of 10 young men was recorded before and after a high-level deceleration to zero velocity following 30 sec of rotating. Accommodation was recorded continuously on an infrared optometer for 110 sec under two conditions: while the subjects observed a target set at the far point, and while they viewed the same target through a 0.3-mm pinhole. Stimulation by high-level rotary deceleration produced positive accommodation or a pseudomyopia under both conditions, but the positive accommodation was substantially greater and lasted much longer during fixation through the pinhole. It is hypothesized that this increase in accommodation is a result of a vestibular-ocular accommodation reflex.

  17. Influence of accommodative lag upon the far-gradient measurement of accommodative convergence to accommodation ratio in strabismic patients.

    PubMed

    Miyata, Manabu; Hasebe, Satoshi; Ohtsuki, Hiroshi

    2006-01-01

    To determine the influence of the lag of accommodation (LOA) on the accommodative convergence to accommodation (AC/A) ratio measured by the far-gradient method in strabismic patients. The AC/A ratio was measured with a distance target viewed with and without -3.00 diopter (D) addition lenses in 63 patients with different types of strabismus (age range, 7-34 years; range of strabismic angle, -60 to +40 prism diopters; refractive error range, -7.33 to +6.63 D). The LOA for the same lens was measured with an open-view-type autorefractometer. The stimulus AC/A ratio and the AC/A ratio adjusted by the individually measured LOA (adjusted AC/A ratio) were compared. The mean +/- SD of the LOA to the -3.00 D lenses was 1.06 +/- 0.43 D. The mean adjusted AC/A ratio was 41% greater than the stimulus AC/A ratio. The LOA differed widely among patients (0.13 to 2.14 D), and a large LOA tended to appear in myopic or young patients. The AC/A ratio obtained using the conventional far-gradient method is significantly biased by the LOA, and thus does not always represent the actual relationship between accommodation and vergence control systems. Copyright Japanese Ophthalmological Society 2006.

  18. [Forensic Analysis of 20 Dead Cases Related to Heroin Abuse].

    PubMed

    Huang, W Q; Li, L H; Li, Z; Hong, S J

    2016-08-01

    To perform retrospective analysis on 20 dead cases related to heroin abuse, and to provide references for the forensic assessment of correlative cases. Among 20 dead cases related to heroin abuse, general situation, using method of drug, cause of death and result of forensic examination were analyzed by statistical analysis for summarizing the cause of death and pathologic changes. The dead were mostly young adults, with more male than female. The results of histopathological examinations showed non-specific pathological changes. There were four leading causes of death, including acute poisoning of heroin abuse or leakage (13 cases, 65%), concurrent diseases caused by heroin abuse (3 cases, 15%), inspiratory asphyxia caused by taking heroin (2 cases, 10%), and heroin withdrawal syndrome (2 cases, 10%). The forensic identification on dead related to heroin abuse must base on the comprehensive autopsy, and combine with the qualitative and quantitative analysis of heroin and its metabolites in death and the case information, as well as the scene investigation. Copyright© by the Editorial Department of Journal of Forensic Medicine

  19. Medial rectus Faden operations with or without recession for partially accommodative esotropia associated with a high accommodative convergence to accommodation ratio.

    PubMed

    Akar, Serpil; Gokyigit, Birsen; Sayin, Nihat; Demirok, Ahmet; Yilmaz, Omer Faruk

    2013-01-01

    To evaluate the results of Faden operations on the medial rectus (MR) muscles with or without recession for the treatment of partially accommodative esotropia associated with a high accommodative convergence to accommodation (AC : A) ratio and to determine whether there was a decrease in the effects of posterior fixation over time. In this retrospective study, 108 of 473 patients who underwent surgery for partially accommodative esotropia with a high AC : A ratio received Faden operations on both MR muscles, and 365 received symmetric MR muscle recessions combined with a Faden operation. For the Faden operation, a satisfactory outcome of 76.9% at 1 month postoperation, decreased to 71.3% by the final follow-up visit (mean 4.8 years). A moderate positive correlation was observed between the increase in the postoperative near deviation and postoperative time. For the Faden operations combined with MR recession, a satisfactory outcome of 78.9% at 1 month post-operation, decreased to 78.4% by the final follow-up visit. A Faden operation of the MR muscles with or without recession is an effective surgical option for treating partially accommodative esotropia associated with a high AC : A ratio. For Faden operations of the MR muscles without recession, the effects of the posterior fixation decline over time.

  20. Eponymous Psychiatric Syndromes Revisited.

    PubMed

    Naguy, Ahmed

    2018-02-22

    This report provides an anthology of psychiatric eponyms. Clinically, many of these described syndromes represent valid diagnostic constructs and may accommodate the atypical cases that defy the official diagnostic designation in the current classificatory systems in psychiatry. © Copyright 2018 Physicians Postgraduate Press, Inc.

  1. Parent abuse by adolescents with first-episode psychosis in Egypt.

    PubMed

    Fawzi, Mounir H; Fawzi, Mohab M; Fouad, Amira A

    2013-12-01

    To determine the rate of parent abuse in a sample of Egyptian adolescents with first-episode psychosis (FEP) and to identify the association between parent abuse and a number of sociodemographic and clinical factors of interest in these patients. As yet, the abuse of parents by their children, especially mentally ill children, in contrast to child abuse, has remained a research taboo. In a cross-sectional study in Zagazig (Egypt), a sample of 150 adolescent outpatients (82 boys; 68 girls), presenting with FEP, was assessed for the occurrence of parent abuse using both interview and questionnaire methods (Abused Parent Questionnaire, APQ). Univariate analyses were used to compare parent abusers and nonabusers along a number of sociodemographic and clinical variables. Variables that were associated with parent abuse were entered into a multivariate logistic regression analysis model. We found that 61 patients (40.7%) perpetrated abuse against parents, mostly mothers (55/61; 90.2%). Five significant risk factors for parent abuse were identified by multivariate analysis. These were parent's female gender (95% CI = 7.82-45.56), patient's male gender (95% CI = 3.15-37.14), Childhood Trauma Questionnaire - Short Form total score (95% CI = 1.48-14.91), Positive and Negative Syndrome Scale positive subscale score (95% CI = 1.26-9.59), and duration of untreated psychosis (95% CI = 1.01-4.72). The study indicates that parent abuse, particularly mother abuse, in untreated adolescents with FEP is an issue calling for increased awareness of the problem. The findings may have important implications for parental psychoeducation and support, and earlier access to treatment. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Vestibular-ocular accommodation reflex in man.

    PubMed

    Clark, B R; Randle, R J; Stewart, J D

    1975-11-01

    Stimulation of the vestibular system by angular acceleration produces widespread sensory and motor effects. The present study was designed to study a motor effect which has not been reported in the literature, i.e., the influence of rotary acceleration of the body on ocular accommodation. The accommodation of 10 young men was recorded before and after a high-level deceleration to zero velocity following 30 s of rotation. Accommodation was recorded continuously on an infrared optometer for 110 s under two conditions; while the subjects observed a target set at the far point, and while they viewed the same target through a 0.3-mm pinhole. Stimulation by high-level rotary deceleration produced positive accommodation or a pseudomyopia under both conditions, but the positive accommodation was substantially greater and lasted much longer during fixation through the pinhole. It is hypothesized that this increase in accommodation is a result of a vestibular-ocular accommodation reflex.

  3. A centre for accommodative vergence motor control

    NASA Technical Reports Server (NTRS)

    Wilson, D.

    1973-01-01

    Latencies in accommodation, accommodative-vergence, and pupil-diameter responses to changing accommodation stimuli, as well as latencies in pupil response to light-intensity changes were measured. From the information obtained, a block diagram has been derived that uses the least number of blocks for representing the accommodation, accommodative-vergence, and pupil systems. The signal transmission delays over the various circuits of the model have been determined and compared to known experimental physiological-delay data. The results suggest the existence of a motor center that controls the accommodative vergence and is completely independent of the accommodation system.

  4. Effects of Age on Dynamic Accommodation

    PubMed Central

    Lockhart, Thurmon E.; Shi, Wen

    2010-01-01

    Visual accommodation plays a critical role in one’s visual perception and activities of daily living. Age-related accommodation loss poses an increased risk to older adults’ safety and independence. Although extensive effort has been made towards understanding the effect of age on steady-state accommodation, dynamic aspects of accommodation is still unknown. A study was therefore conducted to investigate age-related dynamic accommodative characteristics utilizing a modified autorefractor. Ten individuals from each of three age groups (i.e., younger group: 20 to 29 years old, middle-aged group: 40 to 49 years old, and older group: 60 to 69 years old) were recruited and their dynamic accommodation responses were examined. The laboratory experiment was designed to assess dynamic accommodation associated with an abrupt change from a constant far target (400 cm, 50 cd/m2) to a near target (70 cm, 100 cd/m2 or 20 cd/m2), which aimed to simulate car dashboard reading behavior while driving. The results of the study indicated that age and target intensity both had a significant impact on dynamic accommodation. These effects were attributed to both the age-related physiological limitation of the eye as well as to central neural processing delay. A method of measuring dynamic accommodation and the implications of the study are discussed. PMID:20582770

  5. Experimental study of visual accommodation

    NASA Technical Reports Server (NTRS)

    Cornsweet, T. N.; Crane, H. D.

    1972-01-01

    A summary report of a research effort related to the human visual accommodation system is presented. A theoretical study of the accommodation system was made. Subsequent effort was aimed at the development of specialized instrumentation for experiments designed to lead to understanding the nature of the control system in human accommodation. The necessary instrumentation consisted primarily of: (1) an automatic optometer to measure the state of eye focus, (2) a focus stimulator device to control the apparent optical distance to any target, and (3) a two-dimensional eye tracker. The concepts and designs of the first two instruments have been published in the open literature, but this report contains the first detailed treatment of the Purkinje eye tracker developed under this program. The report also discusses an accommodation lag model to explain the ability of the eye to apparently know the polarity of focus error even though the blur on the retina is to a first-approximation an even function. The interaction of the accommodation and eye movement systems is also discussed, as is the ability to train the visual accommodation system to a surprisingly responsive condition in only a few hours of training.

  6. Handbook of Reasonable Accommodation.

    ERIC Educational Resources Information Center

    Heaton, Sandra M.; And Others

    The booklet discusses a basic concept in affirmative action and nondiscrimination for the handicapped, which requires federal agencies to make reasonable accommodation to the physical or mental limitations of a qualified handicapped applicant or employee unless the accommodation would impose an undue hardship on the agency. Reasonable…

  7. Accommodation-Amplitudes following an Accommodative Lens Refilling Procedure — an in vivo Update

    PubMed Central

    Nishi, Okihiro; Nishi, Yutaro; Chang, S.; Nishi, Kayo

    2014-01-01

    Purpose To investigate whether a newly developed lens refilling procedure can provide some accommodation in monkey eyes and to evaluate the difference in accommodation with different degrees of capsular bag refilling. Setting Jinshikai Medical Foundation, Nishi Eye Hospital, Osaka, Japan. Design Experimental monkey study. Methods Following a central 3–4 mm continuous curvilinear capsulorhexis, phacoemulsification was performed in the usual manner. A novel accommodative membrane intraocular lens for sealing capsular opening was implanted into the capsular bag. Silicone polymers were injected beneath the intraocular lens into the capsular bag through the delivery hole. In three study groups, each with six monkey eyes, the lens capsule was refilled with 0.08 ml corresponding to 65% bag volume, 0.1 ml corresponding to 80% bag volume, and 0.125 ml of silicone polymers corresponding to 100% bag volume, respectively. To calculate the accommodation-amplitudes achieved, automated refractometry was performed before and 1 hour after the topical 4% pilocarpine application before and four weeks after surgery. Results The refilling technique was successful in all monkeys without polymer leakage. Accommodation-amplitudes attained were 2.56 ± 0.74 dioptries (D), 2.42 ± 1.00D, and 2.71 ± 0.63D, respectively, 4 weeks after surgery in the three study groups. Conclusions Using the technique, some accommodation could be obtained in the young monkey eyes. Leakage of the injectable silicone polymer and anterior capsular opacification at least in the visual axis could be avoided. The results suggest that this lens refilling procedure warrants further studies for a possible clinical application. PMID:24461501

  8. Abusive head trauma in children: a literature review.

    PubMed

    Lopes, Nahara R L; Eisenstein, Evelyn; Williams, Lúcia C A

    2013-01-01

    To review the scientific literature on pediatric abusive head trauma as a form of physical abuse against infants and young children, highlighting the prevalence, signs and symptoms, consequences, risk factors for its occurrence, and prevention strategies. The MEDLINE, SciELO, LILACS, and Web of Science databases from 2001 to 2012 were reviewed, using the terms "shaken baby syndrome" and "abusive head trauma" in English, Spanish, and Portuguese. Pediatric abusive head trauma is defined as injury to the skull or intracranial contents of a infant or child younger than 5 years due to intentional abrupt impact and/or violent shaking. It occurs mainly in infants and children under 1 year of age, and may result in severe consequences, from physical or mental disabilities to death. Although there are specific signs for this form of abuse, they can be mistaken for common illnesses in children or accidental head injury; thus, clinical training of professionals involved in the assessment of cases to attain the correct diagnosis is crucial. Prevention strategies should include early identification of cases, as well as parental education on child development, especially on the infant's crying pattern. Considering the severity of abusive head trauma in children, it is critical that prevention strategies be implemented and evaluated in the Brazilian context. It is suggested that its incidence indicators be assessed at the national level. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  9. Epistatic interactions involving DRD2, DRD4, and COMT polymorphisms and risk of substance abuse in women with binge-purge eating disturbances.

    PubMed

    Steiger, Howard; Thaler, Lea; Gauvin, Lise; Joober, Ridha; Labbe, Aurelie; Israel, Mimi; Kucer, Audrey

    2016-06-01

    Substance abuse is common in individuals with bulimia-spectrum (binge-purge) eating disturbances, a co-occurrence that has been attributed to shared neurobiological substrates--notably alterations in dopaminergic activity. We examined the implications of variations of selected, dopamine-relevant polymorphisms (DRD2 Taq1A, DRD4 7R, and COMT) for risk of substance abuse in women with binge-purge eating syndromes. We genotyped 183 women (66.1% showing full-threshold BN and 33.9% showing sub-syndromic variants), and assessed lifetime presence of alcohol, cannabis, cocaine, and stimulant abuse or dependence using structured interviews. Tests for main and interaction effects of various allele combinations revealed that individuals who carried high function COMT and low-function DRD4 7R alleles (a combination expected to be associated with higher risk) did indeed show more lifetime substance abuse and, specifically, more cannabis abuse. Our findings suggest that a gene combination that, in theory, codes for low levels of dopaminergic neurotransmission coincides with sensitivity to substance abuse in a sample displaying binge-purge eating-disorder variants. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Fetal bilateral renal agenesis, phocomelia, and single umbilical artery associated with cocaine abuse in early pregnancy.

    PubMed

    Kashiwagi, Maki; Chaoui, Rabih; Stallmach, Thomas; Hürlimann, Sandra; Lauper, Urs; Hebisch, Gundula

    2003-11-01

    Maternal cocaine abuse in pregnancy is associated with complications such as intrauterine growth retardation, abruptio placentae, and preterm delivery. We report what is, to our knowledge, the first published observation of fetal bilateral renal agenesis associated with a vascular disruption syndrome comprising upper limb reduction defect and a single umbilical artery following maternal cocaine abuse in early pregnancy. This constellation in a fetus aborted at 18 weeks extends the spectrum of complications possibly associated with cocaine abuse in pregnancy. Copyright 2003 Wiley-Liss, Inc.

  11. Carpal Tunnel Syndrome

    PubMed Central

    Zimmerman, Gregory R.

    1994-01-01

    Carpal tunnel syndrome is a neuropathy resulting from compression of the median nerve as it passes through a narrow tunnel in the wrist on its way to the hand. The lack of precise objective and clinical tests, along with symptoms that are synonymous with other syndromes in the upper extremity, cause carpal tunnel syndrome to appear to be a rare entity in athletics. However, it should not be ruled out as a possible etiology of upper extremity paralysis in the athlete. More typically, carpal tunnel syndrome is the most common peripheral entrapment neuropathy encountered in industry. Treatment may include rest and/or splinting of the involved wrist, ice application, galvanic stimulation, or iontophoresis to reduce inflammation, and then transition to heat modalities and therapeutic exercises for developing flexibility, strength, and endurance. In addition, an ergonomic assessment should be conducted, resulting in modifications to accommodate the carpal tunnel syndrome patient. ImagesFig 3.Fig 4.Fig 5.Fig 6.Fig 7. PMID:16558255

  12. 24 CFR 8.11 - Reasonable accommodation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... make reasonable accommodation to the known physical or mental limitations of an otherwise qualified... accommodation would impose an undue hardship on the operation of its program. (b) Reasonable accommodation may... hardship on the operation of a recipient's program, factors to be considered include: (1) The overall size...

  13. The economic impact of alcohol abuse and alcoholism.

    PubMed

    Burke, T R

    1988-01-01

    The economic effects of alcohol abuse are as damaging to the nation as the health effects, affecting the family, the community, and persons of all ages. Underaged drinking is interfering with children's development, affecting the nation's ability to respond to economic challenge in the future. The college aged may be the most difficult to educate about alcohol abuse because of drinking patterns established at an early age and susceptibility to advertising inducements. Health care costs for families with an alcoholic member are twice those for families without one, and up to half of all emergency room admissions are alcohol related. Fetal alcohol syndrome is one of the top three known causes of birth defects, and is totally preventable. Alcohol abuse and alcoholism are estimated to have cost the nation $117 billion in 1983, while nonalcoholic drug abuse that year cost $60 billion. Costs of alcohol abuse are expected to be $136 billion a year by 1990, mostly from lost productivity and employment. Between 6 and 7 million workers are alcoholic, with an undetermined loss of productivity, profits, and competitiveness of American business. Alcohol abuse contributes to the high health care costs of the elderly beneficiaries of Federal health financing programs. Heavily affected minorities include blacks, Hispanics, and Native Americans. Society tends to treat the medical and social consequences of alcohol abuse, rather than its causes. Although our experience with the consequences of alcohol abuse is greater than that for any other drug, public concern for its prevention and treatment is less than for other major illnesses or abuse of other drugs. Alcohol abuse is a problem being given high priority within the Department in an effort to create a national agenda on the issue and to try to impart a greater sense of urgency about the problems. Ways are being explored to integrate alcoholism activities into more Departmental programs. Employee assistance programs for alcohol

  14. 22 CFR 217.12 - Reasonable accommodation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... accommodation. (a) A recipient shall make reasonable accommodation to the known physical or mental limitations... the accommodation would impose an undue hardship on the operation of its program or activity. (b... would impose an undue hardship on the operation of a recipient's program or activity, factors to be...

  15. Effect of heterophoria measurement technique on the clinical accommodative convergence to accommodation ratio.

    PubMed

    Escalante, Jaime Bernal; Rosenfield, Mark

    2006-05-01

    Measurement of the stimulus accommodative convergence to accommodation (AC/A) ratio is a standard procedure in clinical optometric practice. Typically, heterophoria is assessed at several accommodative stimulus levels, and the gradient of the vergence to accommodation function computed. A number of procedures are available for the subjective measurement of heterophoria, but it is unclear whether the use of different vergence measurement techniques will alter the obtained AC/A value. Accordingly, the current study compared AC/A ratios measured using 3 clinical subjective heterophoria tests, namely the von Graefe (VG), Maddox Rod (MR), and Modified Thorington (MT) procedures. The AC/A ratio was measured in 60 visually normal subjects between 20 and 25 years of age using each of the 3 procedures listed above. The accommodative stimulus was varied by the introduction of +/-1.00 diopter (D) spherical lenses over the distance refractive correction while subjects viewed a target at a viewing distance of 40 cm. To examine the repeatability of each procedure, the AC/A ratio was measured on 2 separate occasions for each measurement technique, with the 2 sessions being separated by at least 24 hours. Mean values of stimulus AC/A ratio measured using the VG, MR, and MT procedures were 3.47, 2.99, and 2.46Delta/D, respectively. These differences were significant (p=0.0001). In addition, the coefficient of repeatability for the 3 techniques was 2.22, 1.99, and 1.20 Delta/D, respectively. Ratios obtained using the Modified Thorington technique with +/-1.00 D lenses showed the best repeatability, whereas the poorest repeatability was found with the von Graefe technique when only +1.00 D lenses were used to vary the accommodative stimulus. Accordingly, we recommend that that Modified Thorington procedure with +/-1.00 D lenses be used to quantify heterophoria during clinical measurement of the stimulus AC/A ratio.

  16. [Parental Alienation (Syndrome) - A serious form of child psychological abuse].

    PubMed

    von Boch-Galhau, Wilfrid

    2018-04-13

    Induced parental alienation is a specific form of psychological child abuse, which is listed in DSM-5, the current Diagnostic and Statistical Manual of the American Psychiatric Association (APA), under diagnostic code V 995.51 "child psychological abuse". Untreated induced parental alienation can lead to long-term traumatic psychological and physical effects in the children concerned. This fact is still not given sufficient attention in family court cases. The article gives a condensed overview of parental alienation, summarising its definition, the symptoms and the various levels of severity. It also describes some major alienation techniques and possible psychosomatic and psychiatric effects of induced parental alienation. Finally, attention is drawn to programmes of prevention and intervention now used and evaluated in some countries. The article concludes with two real-life examples from psychiatric practice, and a comprehensive list of international references.

  17. 46 CFR 108.143 - Accommodation space.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Accommodation space. 108.143 Section 108.143 Shipping... EQUIPMENT Construction and Arrangement Structural Fire Protection § 108.143 Accommodation space. (a) Each corridor bulkhead in an accommodation space must be an A class or B class bulkhead except if an A class...

  18. 46 CFR 108.143 - Accommodation space.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Accommodation space. 108.143 Section 108.143 Shipping... EQUIPMENT Construction and Arrangement Structural Fire Protection § 108.143 Accommodation space. (a) Each corridor bulkhead in an accommodation space must be an A class or B class bulkhead except if an A class...

  19. 46 CFR 108.143 - Accommodation space.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Accommodation space. 108.143 Section 108.143 Shipping... EQUIPMENT Construction and Arrangement Structural Fire Protection § 108.143 Accommodation space. (a) Each corridor bulkhead in an accommodation space must be an A class or B class bulkhead except if an A class...

  20. 46 CFR 108.143 - Accommodation space.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Accommodation space. 108.143 Section 108.143 Shipping... EQUIPMENT Construction and Arrangement Structural Fire Protection § 108.143 Accommodation space. (a) Each corridor bulkhead in an accommodation space must be an A class or B class bulkhead except if an A class...

  1. 46 CFR 108.143 - Accommodation space.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Accommodation space. 108.143 Section 108.143 Shipping... EQUIPMENT Construction and Arrangement Structural Fire Protection § 108.143 Accommodation space. (a) Each corridor bulkhead in an accommodation space must be an A class or B class bulkhead except if an A class...

  2. The effect of bifocal add on accommodative lag in myopic children with high accommodative lag.

    PubMed

    Berntsen, David A; Mutti, Donald O; Zadnik, Karla

    2010-12-01

    To determine the effect of a bifocal add and manifest correction on accommodative lag in myopic children with high accommodative lag, who have been reported to have the greatest reduction in myopia progression with progressive addition lenses (PALs). Monocular accommodative lag to a 4-D Badal stimulus was measured on two occasions 6 months apart in 83 children (mean ± SD age, 9.9 ± 1.3 years) with high lag randomized to wearing single-vision lenses (SVLs) or PALs. Accommodative lag was measured with the following corrections: habitual, manifest, manifest with +2.00-D add, and habitual with +2.00-D add (6-month visit only). At baseline, accommodative lag was higher (1.72 ± 0.37 D; mean ± SD) when measured with manifest correction than with habitual correction (1.51 ± 0.50; P < 0.05). This higher lag with manifest correction correlated with a larger amount of habitual undercorrection at baseline (r = -0.29, P = 0.009). A +2.00-D add over the manifest correction reduced lag by 0.45 ± 0.34 D at baseline and 0.33 ± 0.38 D at the 6-month visit. Lag results at 6 months were not different between PAL and SVL wearers (P = 0.92). A +2.00-D bifocal add did not eliminate accommodative lag and reduced lag by less than 25% of the bifocal power, indicating that children mainly responded to a bifocal by decreasing accommodation. If myopic progression is substantial, measuring lag with full correction can overestimate the hyperopic retinal blur that a child most recently experienced. (ClinicalTrials.gov number, NCT00335049.).

  3. The Effect of Bifocal Add on Accommodative Lag in Myopic Children with High Accommodative Lag

    PubMed Central

    Mutti, Donald O.; Zadnik, Karla

    2010-01-01

    Purpose. To determine the effect of a bifocal add and manifest correction on accommodative lag in myopic children with high accommodative lag, who have been reported to have the greatest reduction in myopia progression with progressive addition lenses (PALs). Methods. Monocular accommodative lag to a 4-D Badal stimulus was measured on two occasions 6 months apart in 83 children (mean ± SD age, 9.9 ± 1.3 years) with high lag randomized to wearing single-vision lenses (SVLs) or PALs. Accommodative lag was measured with the following corrections: habitual, manifest, manifest with +2.00-D add, and habitual with +2.00-D add (6-month visit only). Results. At baseline, accommodative lag was higher (1.72 ± 0.37 D; mean ± SD) when measured with manifest correction than with habitual correction (1.51 ± 0.50; P < 0.05). This higher lag with manifest correction correlated with a larger amount of habitual undercorrection at baseline (r = −0.29, P = 0.009). A +2.00-D add over the manifest correction reduced lag by 0.45 ± 0.34 D at baseline and 0.33 ± 0.38 D at the 6-month visit. Lag results at 6 months were not different between PAL and SVL wearers (P = 0.92). Conclusions. A +2.00-D bifocal add did not eliminate accommodative lag and reduced lag by less than 25% of the bifocal power, indicating that children mainly responded to a bifocal by decreasing accommodation. If myopic progression is substantial, measuring lag with full correction can overestimate the hyperopic retinal blur that a child most recently experienced. (ClinicalTrials.gov number, NCT00335049.) PMID:20688729

  4. Stimulating human accommodation without changes in focus.

    PubMed

    Weiss, Monika; Seidemann, Anne; Schaeffel, Frank

    2004-05-01

    Inspired by the finding in chickens that preferential stimulation of the ON retinal system suppresses myopia induced by negative spectacle lens wear and that stimulation of the OFF system suppresses the hyperopia induced by positive lens wear, we sought to determine whether stimulation of the ON-OFF retinal systems could drive directional accommodation responses in humans. If emmetropisation and accommodation use similar image processing algorithms, more accommodation would be expected with OFF stimulation. Accommodation responses were measured while viewing a computer-generated pattern designed to stimulate the ON-OFF systems. The stimulus comprised a rectangular field (12 x 9.5 cm) on a black background filled with 196 discs (diameters: 0.4-1.0 cm). These were presented on an LCD monitor in a dark room at a viewing distance of 55 cm (1.8 D). Thirteen subjects aged 21-37 years took part. The individual discs had saw-tooth shaped temporal luminance profiles with the same time period but with random phases with respect to each other, so that the mean brightness of the stimulus was constant. To eliminate accommodation responses based on other cues (i.e. proximity) a 0.5 mm artificial pupil was used to open the accommodation loop. Refraction in the vertical pupil meridian was continuously recorded with an infrared photorefractor (the PowerRefractor). To verify that computer-based stimuli presented within our experimental design were effective in driving accommodation, previously studied stimuli were also tested: changes in size (looming) and incremental low pass filtering. Preferential stimulation of the ON or OFF subsystems produced a convincing depth illusion in all subjects (which was psychophysically confirmed in four subjects). Although the stimulus appeared to move in depth it did not produce accommodation responses that were consistent with that, i.e. the accommodation system did not appear to fluctuate in rhythm with the temporal oscillations of the stimulus

  5. Visual accommodation trainer-tester

    NASA Technical Reports Server (NTRS)

    Randle, Robert J. (Inventor)

    1988-01-01

    An apparatus for training the human visual accommodation system is described. Specifically, the apparatus is useful for training personnel to volitionally control focus to the far point (normally infinity) from a position of myopia due to functional causes. The functional causes could be due, for example, to a behavioral accommodative spasm or the effects of an empty field. The device may also be used to measure accommodation, the accommodation resting position and the near and far points of vision. The device comprises a number of optical elements arranged on a single optical axis. Several of the elements are arranged in order on a movable stage in fixed relationship to each other: a light source, a lens, a target, an aperture and/or a second lens. On a base and in fixed relationship to each other are eyepiece and third lens. A stage generates an image of the target and the stage is movable with respect to the base by means of a knob. The device is utilized for the various training and test functions by following a series of procedural steps, and interchanging the apertures as necessary for the selected procedure.

  6. Beyond abuse: the association among parenting style, abdominal pain, and somatization in IBS patients.

    PubMed

    Lackner, Jeffrey M; Gudleski, Gregory D; Blanchard, Edward B

    2004-01-01

    This study assessed the relative strength of the association between abuse, negative parenting style, and somatization in irritable bowel syndrome (IBS) patients. Drawing from preclinical stress physiology and abuse research identifying the family social climate as a frequently stronger and independent determinant of long-term health effects than abuse-specific variables, we predicted that negative parenting behaviors would more strongly correlate with somatization than abuse. Subjects were 81 consecutively evaluated patients, who at baseline underwent psychological testing, measuring perceived parental style, abuse history, somatization, and pain. Although abuse correlated with maternal and paternal rejection, abuse was not associated with somatization. Higher levels of rejection and/or hostility among fathers (not mothers) were more strongly correlated with somatization than was abuse. Further, paternal parenting behaviors were more predictive of somatization than abuse, age, and gender. The lack of an association between abuse and somatization is discussed in light of limitations of biopsychosocial IBS models, whose strong focus on "pathological stressors" (e.g., abuse, trauma) as risk factors may overlook the importance of "less extreme" parenting variables in influencing somatic complaints. The relationship between parenting and somatization is discussed in the context of broader behavioral science research linking disruptions in the quality of parenting to dramatic and long-term changes in patterns of stress reactivity and brain abnormalities seen in IBS patients.

  7. Validation of a Spanish Questionnaire on Mobile Phone Abuse

    PubMed Central

    Olivencia-Carrión, María A.; Ramírez-Uclés, Isabel; Holgado-Tello, Pablo; López-Torrecillas, Francisca

    2018-01-01

    Mobile phone addiction has attracted much attention recently and is showing similarity to other substance use disorders. Because no studies on mobile phone addiction had yet been conducted in Spain, we developed and validated a questionnaire (Cuestionario de Abuso del Teléfono Móvil, ATeMo) to measure mobile phone abuse among young adults in Spanish. The ATeMo questionnaire was designed based on relevant DSM-5 diagnostic criteria and included craving as a diagnostic symptom. Using stratified sampling, the ATeMo questionnaire was administered to 856 students (mean age 21, 62% women). The MULTICAGE questionnaire was administered to assess history of drug abuse and addiction. Using confirmatory factor analysis, we found evidence for the construct validity of the following factors: Craving, Loss of Control, Negative Life Consequences, and Withdrawal Syndrome, and their association with a second order factor related to mobile phone abuse. The four ATeMO factors were also associated with alcoholism, internet use, and compulsive buying. Important gender differences were found that should be considered when studying mobile phone addictions. The ATeMo is a valid and reliable instrument that can be used in further research on mobile phone abuse. PMID:29760674

  8. Validation of a Spanish Questionnaire on Mobile Phone Abuse.

    PubMed

    Olivencia-Carrión, María A; Ramírez-Uclés, Isabel; Holgado-Tello, Pablo; López-Torrecillas, Francisca

    2018-01-01

    Mobile phone addiction has attracted much attention recently and is showing similarity to other substance use disorders. Because no studies on mobile phone addiction had yet been conducted in Spain, we developed and validated a questionnaire (Cuestionario de Abuso del Teléfono Móvil, ATeMo) to measure mobile phone abuse among young adults in Spanish. The ATeMo questionnaire was designed based on relevant DSM-5 diagnostic criteria and included craving as a diagnostic symptom. Using stratified sampling, the ATeMo questionnaire was administered to 856 students (mean age 21, 62% women). The MULTICAGE questionnaire was administered to assess history of drug abuse and addiction. Using confirmatory factor analysis, we found evidence for the construct validity of the following factors: Craving, Loss of Control, Negative Life Consequences, and Withdrawal Syndrome, and their association with a second order factor related to mobile phone abuse. The four ATeMO factors were also associated with alcoholism, internet use, and compulsive buying. Important gender differences were found that should be considered when studying mobile phone addictions. The ATeMo is a valid and reliable instrument that can be used in further research on mobile phone abuse.

  9. Struggling with one’s own parenting after an upbringing with substance abusing parents

    PubMed Central

    Tedgård, Eva; Råstam, Maria; Wirtberg, Ingegerd

    2018-01-01

    ABSTRACT Aim: To add to our knowledge concerning the key elements involved in the individual’s experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. Methods: In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. Result: Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. Conclusions: All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children’s ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents. PMID:29482480

  10. [Munchausen syndrome by proxy].

    PubMed

    Goñi González, T; Martínez Roda, Maria J; de la Cerda Ojeda, F; Gómez de Terreros, I

    2008-06-01

    Munchausen syndrome by proxy is an illness which is very difficult to diagnose. It has a high morbidity and mortality rate. The knowledge of the characteristics of the victim and the perpetrator can be quite useful for its early recognition. The American Professional Society on the Abuse of Children, has recently brought the terms for the syndrome up to date. We look at this updating and present six cases diagnosed in our hospital, analysing their main features and comparing them with the medical literature.

  11. Characteristics of Hospital-Based Munchausen Syndrome by Proxy in Japan

    ERIC Educational Resources Information Center

    Fujiwara, Takeo; Okuyama, Makiko; Kasahara, Mari; Nakamura, Ayako

    2008-01-01

    Objective: This article explores characteristics of Munchausen Syndrome by Proxy (MSBP) in Japan, a country which provides an egalitarian, low cost, and easy-access health care system. Methods: We sent a questionnaire survey to 11 leading doctors in the child abuse field in Japan, each located in different hospital-based sites. Child abuse doctors…

  12. Dynamic accommodation responses following adaptation to defocus.

    PubMed

    Cufflin, Matthew P; Mallen, Edward A H

    2008-10-01

    Adaptation to defocus is known to influence the subjective sensitivity to blur in both emmetropes and myopes. Blur is a major contributing factor in the closed-loop dynamic accommodation response. Previous investigations have examined the magnitude of the accommodation response following blur adaptation. We have investigated whether a period of blur adaptation influences the dynamic accommodation response to step and sinusoidal changes in target vergence. Eighteen subjects (six emmetropes, six early onset myopes, and six late onset myopes) underwent 30 min of adaptation to 0.00 D (control), +1.00 D or +3.00 D myopic defocus. Following this adaptation period, accommodation responses to a 2.00 D step change and 2.00 D sinusoidal change (0.2 Hz) in target vergence were recorded continuously using an autorefractor. Adaptation to defocus failed to influence accommodation latency times, but did influence response times to a step change in target vergence. Adaptation to both +1.00 and +3.00 D induced significant increases in response times (p = 0.002 and p = 0.012, respectively) and adaptation to +3.00 D increased the change in accommodation response magnitude (p = 0.014) for a 2.00 D step change in demand. Blur adaptation also significantly increased the peak-to-peak phase lag for accommodation responses to a sinusoidally oscillating target, although failed to influence the accommodation gain. These changes in accommodative response were equivalent across all refractive groups. Adaptation to a degraded stimulus causes an increased level of accommodation for dynamic targets moving towards an observer and increases response times and phase lags. It is suggested that the contrast constancy theory may explain these changes in dynamic behavior.

  13. Employing and Accommodating Individuals with Histories of Alcohol and Drug Abuse. Implementing the Americans with Disabilities Act Series.

    ERIC Educational Resources Information Center

    Weber, Ellen M.

    One of a series of bulletins on implementing the Americans with Disabilities Act (ADA), this bulletin discusses protections for individuals with histories of alcohol and drug abuse. The material explains: (1) the ADA prohibits employment discrimination of individuals with past drug and alcohol problems and those who currently have alcohol problems…

  14. 46 CFR 169.317 - Accommodations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... of the stem. The space must not be located totally below the deepest load waterline. (b) Bulkheads separating accommodations from machinery spaces, paint lockers, storerooms, washrooms, and toilet facilities... and Arrangement Living Spaces § 169.317 Accommodations. (a) Quarters must have sufficient fresh air...

  15. 46 CFR 169.317 - Accommodations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... of the stem. The space must not be located totally below the deepest load waterline. (b) Bulkheads separating accommodations from machinery spaces, paint lockers, storerooms, washrooms, and toilet facilities... and Arrangement Living Spaces § 169.317 Accommodations. (a) Quarters must have sufficient fresh air...

  16. 46 CFR 169.317 - Accommodations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... of the stem. The space must not be located totally below the deepest load waterline. (b) Bulkheads separating accommodations from machinery spaces, paint lockers, storerooms, washrooms, and toilet facilities... and Arrangement Living Spaces § 169.317 Accommodations. (a) Quarters must have sufficient fresh air...

  17. 46 CFR 169.317 - Accommodations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Accommodations. 169.317 Section 169.317 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Living Spaces § 169.317 Accommodations. (a) Quarters must have sufficient fresh air...

  18. 46 CFR 169.317 - Accommodations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Accommodations. 169.317 Section 169.317 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Living Spaces § 169.317 Accommodations. (a) Quarters must have sufficient fresh air...

  19. Accommodation to wavefront vergence and chromatic aberration.

    PubMed

    Wang, Yinan; Kruger, Philip B; Li, James S; Lin, Peter L; Stark, Lawrence R

    2011-05-01

    Longitudinal chromatic aberration (LCA) provides a cue to accommodation with small pupils. However, large pupils increase monochromatic aberrations, which may obscure chromatic blur. In this study, we examined the effect of pupil size and LCA on accommodation. Accommodation was recorded by infrared optometer while observers (nine normal trichromats) viewed a sinusoidally moving Maltese cross target in a Badal stimulus system. There were two illumination conditions: white (3000 K; 20 cd/m) and monochromatic (550 nm with 10 nm bandwidth; 20 cd/m) and two artificial pupil conditions (3 and 5.7 mm). Separately, static measurements of wavefront aberration were made with the eye accommodating to targets between 0 and 4 D (COAS, Wavefront Sciences). Large individual differences in accommodation to wavefront vergence and to LCA are a hallmark of accommodation. LCA continues to provide a signal at large pupil sizes despite higher levels of monochromatic aberrations. Monochromatic aberrations may defend against chromatic blur at high spatial frequencies, but accommodation responds best to optical vergence and to LCA at 3 c/deg where blur from higher order aberrations is less.

  20. Anthropometric accommodation in USAF cockpits

    NASA Technical Reports Server (NTRS)

    Zehner, Gregory F.

    1994-01-01

    Over the past three years, a new set of methodologies has been developed to specify and evaluate anthropometric accommodation in USAF crewstation designs. These techniques are used to improve the ability of the pilot to reach controls, to safely escape the aircraft, to achieve adequate mobility and comfort, and to assure full access to the visual field both inside and outside the aircraft. This paper summarized commonly encountered aircraft accommodation problems, explains the failure of the traditional 'percentile man' design concept to resolve these difficulties, and suggests an alternative approach for improving cockpit design to better accommodate today's more heterogeneous flying population.

  1. Tourette Syndrome & the School Psychologist. Revised.

    ERIC Educational Resources Information Center

    Hagin, Rosa A.

    This pamphlet alerts school psychologists to the educational implications of Tourette Syndrome (TS) and provides information on: the nature of the disorder and its incidence, diagnostic criteria, etiology, treatment, and considerations in testing and classroom accommodations. TS is characterized as a complex neurobiological disorder with…

  2. Attitude and risk of substance use in adolescents diagnosed with Asperger syndrome.

    PubMed

    Ramos, M; Boada, L; Moreno, C; Llorente, C; Romo, J; Parellada, M

    2013-12-01

    Adolescence is a stage of development with increased risk of drug use. Individual personality traits are among those factors that influence the onset of substance use in adolescence and its psychiatric comorbidity. Little research has been done on the comorbidity between substance abuse risk and Asperger syndrome, and none specifically in adolescence. The objective of this study is to assess the risk of drug use by adolescents with Asperger syndrome and compare it with that risk in control subjects. A secondary objective was to analyze the personality factors that may be associated with substance use in the same two groups. We used three self-administered questionnaires, one for drug risk assessment (FRIDA) and the other two for personality trait assessment (MACI and SSS-V). Adolescents diagnosed with Asperger syndrome are at less risk for drug use derived from family and access to drugs factors. Subjects with Asperger syndrome did score higher on introversive, inhibited, doleful, and borderline tendency prototypes than healthy controls, and scored lower on all sensation-seeking traits. Being male, a diagnosis of Asperger syndrome, and unruly, introversive, and sensation-seeking traits were all independently associated with the risk of drug abuse. Both identified personality factors and other variables associated with the Asperger syndrome contribute to the low risk of drug abuse observed in this population. Exploring protective factors for drug use in these subjects may prove useful for interventions with adolescents at risk for consumption. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. [Münchausen syndrome by proxy].

    PubMed

    Berent, Dominika; Florkowski, Antoni; Gałecki, Piotr

    2010-01-01

    Münchausen syndrome by proxy (MSBP), is a psychiatric disorder, a particular form of child abuse. An impaired emotional relationship exists mainly between the mother and her child. According to the variety of victims' symptoms, all medicine doctors may deal with this syndrome in every day clinical practice. Still insufficient knowledge about the syndrome and its' rare consideration in the differential diagnosis result in only severe, potentially lethal cases recognition. For many years the rest remains a source of a long-term physical and mental injuries in victims. About 30 years from the first attempt to precisely point the signalling symptoms for a proper diagnosis, we present the current knowledge on epidemiology, aetiology, diagnostic criteria, advised management and psychological portrait of the mother with the syndrome and her child, the syndrome's victim.

  4. A Review of Worksite Lactation Accommodations.

    PubMed

    Hilliard, Elizabeth Dianne

    2017-01-01

    The purpose of this review was to examine workplace lactation accommodations, and their association with breastfeeding duration, and identify strategies occupational health professionals can use to promote lactation improvements. This study included literature published from 1985 through 2015 and listed in PubMed and CINAHL. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 11 articles were identified for review. Presence of a corporate lactation program, on-site child care, and return to work/telephone lactation consultation were consistently associated with breastfeeding at 6 months. Other breastfeeding accommodations (i.e., lactation spaces, lactation breaks, worksite lactation policies, and supervisor/coworker support) were not consistently associated with breastfeeding duration. Occupational health professionals can play key roles in improving the effectiveness of lactation accommodations. Assuring adequate implementation of accommodations, increasing communication and marketing of accommodations, and promoting supervisor and coworker support are areas that occupational health professionals should explore for improving lactation duration.

  5. Binocular Vision in Chronic Fatigue Syndrome.

    PubMed

    Godts, Daisy; Moorkens, Greta; Mathysen, Danny G P

    2016-01-01

    To compare binocular vision measurements between Chronic Fatigue Syndrome (CFS) patients and healthy controls. Forty-one CFS patients referred by the Reference Centre for Chronic Fatigue Syndrome of the Antwerp University Hospital and forty-one healthy volunteers, matched for age and gender, underwent a complete orthoptic examination. Data of visual acuity, eye position, fusion amplitude, stereopsis, ocular motility, convergence, and accommodation were compared between both groups. Patients with CFS showed highly significant smaller fusion amplitudes (P < 0.001), reduced convergence capacity (P < 0.001), and a smaller accommodation range (P < 0.001) compared to the control group. In patients with CFS binocular vision, convergence and accommodation should be routinely examined. CFS patients will benefit from reading glasses either with or without prism correction in an earlier stage compared to their healthy peers. Convergence exercises may be beneficial for CFS patients, despite the fact that they might be very tiring. Further research will be necessary to draw conclusions about the efficacy of treatment, especially regarding convergence exercises. To our knowledge, this is the first prospective study evaluating binocular vision in CFS patients. © 2016 Board of regents of the University of Wisconsin System, American Orthoptic Journal, Volume 66, 2016, ISSN 0065-955X, E-ISSN 1553-4448.

  6. Exploring the Relationship Between Students Needing Accommodations and Instructor Self-Efficacy in Complying with Accommodations

    ERIC Educational Resources Information Center

    Wright, Anna M.; Meyer, Kevin R.

    2017-01-01

    The willingness and flexibility of university instructors to comply with and provide accommodations for students with disabilities is critical to academic success. The authors examine how communication between students needing accommodations and university instructors impacts instructor self-efficacy, or instructors' perception that they can meet…

  7. Accommodative spasm in siblings: A unique finding

    PubMed Central

    Rutstein, Robert P

    2010-01-01

    Accommodative spasm is a rare condition occurring in children, adolescents, and young adults. A familial tendency for this binocular vision disorder has not been reported. I describe accommodative spasm occurring in a brother and sister. Both children presented on the same day with complaints of headaches and blurred vision. Treatment included cycloplegia drops and bifocals. Siblings of patients having accommodative spasm should receive a detailed eye exam with emphasis on recognition of accommodative spasm. PMID:20534925

  8. Accommodation, accommodative convergence, and response AC/A ratios before and at the onset of myopia in children.

    PubMed

    Gwiazda, Jane; Thorn, Frank; Held, Richard

    2005-04-01

    The purpose of this study was to investigate accommodation, accommodative convergence, and AC/A ratios before and at the onset of myopia in children. Refractive error, accommodation, and phorias were measured annually over a period of 3 years in 80 6- to 18-year-old children (mean age at first visit = 11.1 years), including 26 who acquired myopia of at least -0.50 D and 54 who remained emmetropic (-0.25 to + 0.75 D). Refraction was measured by noncycloplegic distance retinoscopy. Concomitant measures of accommodation and phorias were taken for letter targets at 4.0 m and 0.33 m using the Canon R-1 open field-of-view autorefractor with an attached motorized Risley prism and Maddox rod. The accommodation and phoria measurements were used to calculate response AC/A ratios. Compared with children who remained emmetropic, those who became myopic had elevated response AC/A ratios at 1 and 2 years before the onset of myopia, in addition to at onset and 1 year later (t's = -2.97 to -4.04, p < 0.01 at all times). The significantly higher AC/A ratios in the children who became myopic are a result of significantly reduced accommodation. Accommodative convergence was significantly greater in myopes only at onset. These findings suggest that the abnormal oculomotor factors found before the onset of myopia may contribute to myopigenesis by producing hyperopic retinal defocus when a child is engaged in near-viewing tasks.

  9. Accommodative Performance of Children With Unilateral Amblyopia

    PubMed Central

    Manh, Vivian; Chen, Angela M.; Tarczy-Hornoch, Kristina; Cotter, Susan A.; Candy, T. Rowan

    2015-01-01

    Purpose. The purpose of this study was to compare the accommodative performance of the amblyopic eye of children with unilateral amblyopia to that of their nonamblyopic eye, and also to that of children without amblyopia, during both monocular and binocular viewing. Methods. Modified Nott retinoscopy was used to measure accommodative performance of 38 subjects with unilateral amblyopia and 25 subjects with typical vision from 3 to 13 years of age during monocular and binocular viewing at target distances of 50, 33, and 25 cm. The relationship between accommodative demand and interocular difference (IOD) in accommodative error was assessed in each group. Results. The mean IOD in monocular accommodative error for amblyopic subjects across all three viewing distances was 0.49 diopters (D) (95% confidence interval [CI], ±1.12 D) in the 180° meridian and 0.54 D (95% CI, ±1.27 D) in the 90° meridian, with the amblyopic eye exhibiting greater accommodative errors on average. Interocular difference in monocular accommodative error increased significantly with increasing accommodative demand; 5%, 47%, and 58% of amblyopic subjects had monocular errors in the amblyopic eye that fell outside the upper 95% confidence limit for the better eye of control subjects at viewing distances of 50, 33, and 25 cm, respectively. Conclusions. When viewing monocularly, children with unilateral amblyopia had greater mean accommodative errors in their amblyopic eyes than in their nonamblyopic eyes, and when compared with control subjects. This could lead to unintended retinal image defocus during patching therapy for amblyopia. PMID:25626970

  10. Child-abusers face mob justice.

    PubMed

    Sebunya, C

    1996-06-01

    In Uganda, before the acquired immunodeficiency syndrome (AIDS) epidemic, rape or sexual abuse of children was not considered a serious offense by the public, although the maximum criminal offense for rape was death. Because so many young girls are testing positive for human immunodeficiency virus (HIV), and due to the efforts of women's groups, public opinion is changing. According to the United Nations International Children's Fund (UNICEF), girls aged 9-15 years are five times more likely to be infected with HIV than boys of the same age. Adults, who fear their peers may be infected with HIV, turn to children; some AIDS patients believe sleeping with a virgin girl will cure their illness. Uganda is targeting a $15 million project to protect children 5-15 years of age. A study commissioned by the Uganda National Council for Women and Children in 1994 found that in Kabale district 31% of girls and 15% of boys had been abused, many by teachers. In Masaka district, the Council found that 30% of women had been coerced into sex; bosses abuse their maids, and customers abuse alcohol sellers. According to police, rape is the second most common crime in Uganda. Victims are reluctant to come forward to testify; rape victims can be shunned in their communities and may be considered ineligible for marriage. Cases which make it to court rarely get a fair hearing, according to the Council of Women, because the men handling the cases often favor the culprits. FIDA, an association of women lawyers, Action for Development (ACFODE), and the National Association of Women's Organisations in Uganda (NAWOU) are lobbying for tougher laws on rape and closed courts. They are pressuring newspapers to not disclose the names of victims. Although many expect the Ministry of Women to take the lead in this area, it has been unable to do so, because of a lack of funds; it received two-thirds of its budget for 1994-95, an indication, perhaps, of the Ugandan government's intentions. Two figures

  11. 46 CFR 108.211 - Miscellaneous accommodation spaces.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Miscellaneous accommodation spaces. 108.211 Section 108... DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.211 Miscellaneous accommodation spaces. (a) Each unit must have enough facilities for personnel to wash their own clothes...

  12. 46 CFR 108.211 - Miscellaneous accommodation spaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Miscellaneous accommodation spaces. 108.211 Section 108... DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.211 Miscellaneous accommodation spaces. (a) Each unit must have enough facilities for personnel to wash their own clothes...

  13. 46 CFR 108.211 - Miscellaneous accommodation spaces.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Miscellaneous accommodation spaces. 108.211 Section 108... DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.211 Miscellaneous accommodation spaces. (a) Each unit must have enough facilities for personnel to wash their own clothes...

  14. 46 CFR 108.211 - Miscellaneous accommodation spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Miscellaneous accommodation spaces. 108.211 Section 108... DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.211 Miscellaneous accommodation spaces. (a) Each unit must have enough facilities for personnel to wash their own clothes...

  15. 46 CFR 108.211 - Miscellaneous accommodation spaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Miscellaneous accommodation spaces. 108.211 Section 108... DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.211 Miscellaneous accommodation spaces. (a) Each unit must have enough facilities for personnel to wash their own clothes...

  16. Employer Accommodation and Labor Supply of Disabled Workers*

    PubMed Central

    Hill, Matthew J.; Maestas, Nicole; Mullen, Kathleen J.

    2016-01-01

    We examine the factors that influence employer accommodation of newly disabled workers and how effective such accommodations are in retaining workers and discouraging disability insurance applications. Using the Health and Retirement Study, we find that only a quarter of newly disabled older workers in their 50s are accommodated by their employers in some way following onset of a disability. Importantly, we find that few employer characteristics explain which workers are accommodated; rather, employee characteristics, particularly the presence of personality traits correlated with assertiveness and open communication, are highly predictive of accommodation. We also find that if employer accommodation rates could be increased, disabled workers would be significantly more likely to delay labor force exit for up to two years. However, accommodation does not appear to reduce subsequent disability insurance claiming. PMID:27840560

  17. 46 CFR 108.195 - Location of accommodation spaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Location of accommodation spaces. 108.195 Section 108... DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.195 Location of accommodation spaces. (a) On surface type units, accommodation spaces must not be located forward of a vertical...

  18. 46 CFR 108.195 - Location of accommodation spaces.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Location of accommodation spaces. 108.195 Section 108... DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.195 Location of accommodation spaces. (a) On surface type units, accommodation spaces must not be located forward of a vertical...

  19. 46 CFR 108.195 - Location of accommodation spaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Location of accommodation spaces. 108.195 Section 108... DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.195 Location of accommodation spaces. (a) On surface type units, accommodation spaces must not be located forward of a vertical...

  20. 46 CFR 108.195 - Location of accommodation spaces.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Location of accommodation spaces. 108.195 Section 108... DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.195 Location of accommodation spaces. (a) On surface type units, accommodation spaces must not be located forward of a vertical...

  1. 46 CFR 108.195 - Location of accommodation spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Location of accommodation spaces. 108.195 Section 108... DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.195 Location of accommodation spaces. (a) On surface type units, accommodation spaces must not be located forward of a vertical...

  2. Accommodation to Wavefront Vergence and Chromatic Aberration

    PubMed Central

    Wang, Yinan; Kruger, Philip B.; Li, James S.; Lin, Peter L.; Stark, Lawrence R.

    2011-01-01

    Purpose Longitudinal chromatic aberration (LCA) provides a cue to accommodation with small pupils. However, large pupils increase monochromatic aberrations, which may obscure chromatic blur. In the present study, we examined the effect of pupil size and LCA on accommodation. Methods Accommodation was recorded by infrared optometer while observers (nine normal trichromats) viewed a sinusoidally moving Maltese cross target in a Badal stimulus system. There were two illumination conditions: white (3000 K; 20 cd/m2) and monochromatic (550 nm with 10 nm bandwidth; 20 cd/m2) and two artificial pupil conditions (3 mm and 5.7 mm). Separately, static measurements of wavefront aberration were made with the eye accommodating to targets between 0 and 4 D (COAS, Wavefront Sciences). Results Large individual differences in accommodation to wavefront vergence and to LCA are a hallmark of accommodation. LCA continues to provide a signal at large pupil sizes despite higher levels of monochromatic aberrations. Conclusions Monochromatic aberrations may defend against chromatic blur at high spatial frequencies, but accommodation responds best to optical vergence and to LCA at 3 c/deg where blur from higher order aberrations is less. PMID:21317666

  3. Munchausen syndrome by proxy: identification and diagnosis.

    PubMed

    Thomas, Kathy

    2003-06-01

    Child abuse claims the lives of three children daily in the United States; however, one form of child abuse frequently goes undiagnosed-the true incidence is not known. Munchausen Syndrome by Proxy (MSBP) is a hidden and deceitful abuse whereby a caretaker of a child, usually the mother, fabricates information concerning the child's health or intentionally makes the child ill for personal attention and psychologic gain. Because health care professionals are the child's first line of defense against MSBP, they must know all about the disorder to be able to identify MSBP and protect children from disability or death. Copyright 2003, Elsevier Inc. All rights reserved.

  4. Prior childhood sexual abuse in mothers of sexually abused children.

    PubMed

    Oates, R K; Tebbutt, J; Swanston, H; Lynch, D L; O'Toole, B I

    1998-11-01

    To see if mothers who were sexually abused in their own childhood are at increased risk of their children being sexually abused and to see if prior sexual abuse in mothers affects their parenting abilities. Sixty-seven mothers whose children had been sexually abused by others and 65 control mothers were asked about sexual abuse in their own childhood. The sexually abused children of mothers who had been sexually abused in their own childhood were compared with the sexually abused children of mothers who had not suffered child sexual abuse as children. Comparisons were made on self-esteem, depression and behavior in the children. Thirty-four percent of mothers of sexually abused children gave a history of sexual abuse in their own childhoods, compared with 12% of control mothers. Assessment of the sexually abused children for self-esteem, depression and behavior at the time of diagnosis, after 18 months and after 5 years showed no difference in any of these measures at any of the three time intervals between those whose mothers had suffered child sexual abuse and those whose mothers had not been abused. In this study, sexual abuse in a mother's own childhood was related to an increased risk of sexual abuse occurring in the next generation, although prior maternal sexual abuse did not effect outcome in children who were sexually abused.

  5. Munchausen syndrome by proxy and child's rights.

    PubMed

    Al-Haidar, Fatima A

    2008-03-01

    Munchausen syndrome by proxy (MSBP) is an extreme form of child abuse in which perpetrators induce life-threatening conditions in their children. A case of MSBP is described in detail. Difficulties in diagnosis and management in this part of the world are presented. Until now, no national legal guidelines exist in the Kingdom of Saudi Arabia (KSA) to child abuse in general and MSBP in particular. Urgent guidelines, policies, and legal system are required in the KSA.

  6. Reproducibility of carbachol stimulated accommodation in rhesus monkeys.

    PubMed

    Wendt, Mark; Glasser, Adrian

    2012-06-01

    Approaches are being explored to restore accommodation to the presbyopic eye. Some of these approaches can be tested in monkeys by stimulating accommodation in various ways including using carbachol iontophoresis. Knowledge of the repeatability of carbachol iontophoresis stimulated accommodation in the monkey phakic eye is necessary to understand the variability of this method of evaluating accommodation. Data from 9 to 10 separate carbachol iontophoresis experiments performed on phakic eyes from 8 monkeys were retrospectively analyzed. For each experiment, carbachol was applied iontophoretically to the eyes of anesthetized monkeys and refraction generally measured every two minutes until accommodation reached a plateau. Repeated experiments were performed in each monkey over periods ranging from 10 to 18 months. Maximum accommodation measured for each monkey ranged from 11.1 D to 18.3 D with standard deviations from 0.8 D to 2.1 D and differences in accommodative amplitude varying from 2.2 D to 7.5 D. Time to reach maximum accommodation ranged from 18 to 64 min in individual experiments. Averaged time-courses indicate that maximum accommodation is generally achieved between 10 and 20 min after carbachol administration. Although carbachol iontophoresis is considered a reliable method to stimulate maximum accommodation in anesthetized monkeys, the amplitude achieved typically varies by more than 2 D. Presbyopia treatments evaluated in this way in phakic monkeys would need to show an increase in accommodation of over 2 D to clearly demonstrate that the treatments work when being tested with carbachol iontophoresis stimulation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Psychiatric disorders, spouse abuse and child abuse.

    PubMed

    Bland, R C; Orn, H

    1986-01-01

    The results of 2000 standardized psychiatric diagnostic interviews of randomly selected adult household residents of Edmonton showed that having had any psychiatric diagnosis increased the risk for being involved in spouse and child abuse, particularly for those with alcohol abuse/dependence plus anti-social personality or depression. Altogether 56% of spouse abusers and 69% of child abusers had a lifetime psychiatric diagnosis.

  8. Elder abuse.

    PubMed

    Kurrle, Susan

    2004-10-01

    Elder abuse is a common and yet often unrecognised problem in our community. With up to 5% of the community dwelling older population being victims of abuse, the general practitioner has a pivotal role in identifying this abuse. This article provides an outline of the definition of elder abuse, describes the types of abuse seen and the reasons for occurrence of abuse. It summarises the role of the GP in the identification and management of abuse and provides guidance on intervention strategies. Case studies are used to illustrate the issues discussed. Elder abuse is defined as any pattern of behaviour which causes physical, psychological, financial or social harm to an older person. The role of the GP in identifying abuse is critical. The vast majority of older people visit their GP at least once a year, and the GP often has a long standing relationship with their patient and the patient's family. They are therefore ideally placed to identify elder abuse.

  9. Accommodation in Astigmatic Children During Visual Task Performance

    PubMed Central

    Harvey, Erin M.; Miller, Joseph M.; Apple, Howard P.; Parashar, Pavan; Twelker, J. Daniel; Crescioni, Mabel; Davis, Amy L.; Leonard-Green, Tina K.; Campus, Irene; Sherrill, Duane L.

    2014-01-01

    Purpose. To determine the accuracy and stability of accommodation in uncorrected children during visual task performance. Methods. Subjects were second- to seventh-grade children from a highly astigmatic population. Measurements of noncycloplegic right eye spherical equivalent (Mnc) were obtained while uncorrected subjects performed three visual tasks at near (40 cm) and distance (2 m). Tasks included reading sentences with stimulus letter size near acuity threshold and an age-appropriate letter size (high task demands) and viewing a video (low task demand). Repeated measures ANOVA assessed the influence of astigmatism, task demand, and accommodative demand on accuracy (mean Mnc) and variability (mean SD of Mnc) of accommodation. Results. For near and distance analyses, respectively, sample size was 321 and 247, mean age was 10.37 (SD 1.77) and 10.30 (SD 1.74) years, mean cycloplegic M was 0.48 (SD 1.10) and 0.79 diopters (D) (SD 1.00), and mean astigmatism was 0.99 (SD 1.15) and 0.75 D (SD 0.96). Poor accommodative accuracy was associated with high astigmatism, low task demand (video viewing), and high accommodative demand. The negative effect of accommodative demand on accuracy increased with increasing astigmatism, with the poorest accommodative accuracy observed in high astigmats (≥3.00 D) with high accommodative demand/high hyperopia (1.53 D and 2.05 D of underaccommodation for near and distant stimuli, respectively). Accommodative variability was greatest in high astigmats and was uniformly high across task condition. No/low and moderate astigmats showed higher variability for the video task than the reading tasks. Conclusions. Accuracy of accommodation is reduced in uncorrected children with high astigmatism and high accommodative demand/high hyperopia, but improves with increased visual task demand (reading). High astigmats showed the greatest variability in accommodation. PMID:25103265

  10. Cognitive and Emotional Differences between Abusive and Non-Abusive Fathers

    ERIC Educational Resources Information Center

    Francis, Karen J.; Wolfe, David A.

    2008-01-01

    Objective: Abusive fathers perpetrate a substantial portion of child physical abuse. Despite this, little is known about how they differ from non-abusive fathers. This study compared a broad range of cognitive and affective factors between physically abusive and non-abusive fathers. Methods: Abusive (n = 24) and non-abusive (n = 25) fathers…

  11. Decreased accommodation during decompensation of distance exotropia.

    PubMed

    Horwood, Anna M; Riddell, Patricia M

    2012-04-01

    Disparity cues can be a major drive to accommodation via the convergence accommodation to convergence (CA/C) linkage, but, on decompensation of exotropia, disparity cues are extinguished by suppression so this drive is lost. This study investigated accommodation and vergence responses to disparity, blur and proximal cues in a group of distance exotropes aged between 4 and 11 years both during decompensation and when exotropic. 19 participants with distance exotropia were tested using a PlusoptiXSO4 photo refractor set in a remote haploscopic device that assessed simultaneous vergence and accommodation to a range of targets incorporating different combinations of blur, disparity and proximal cues at four fixation distances between 2 m and 33 cm. Responses on decompensation were compared with those from the same children when their deviation was controlled. Manifest exotropia was more common in the more impoverished cue conditions. When decompensated for near, mean accommodation gain for the all-cue (naturalistic) target was significantly reduced (p<0.0001), with resultant mean under-accommodation of 2.33 D at 33 cm. The profile of near cues usage changed after decompensation, with blur and proximity driving residual responses, but these remaining cues did not compensate for loss of accommodation caused by the removal of disparity. Accommodation often reduces on decompensation of distance exotropia as the drive from convergence is extinguished, providing a further reason to try to prevent decompensation for near.

  12. Decreased accommodation during decompensation of distance exotropia

    PubMed Central

    Horwood, Anna M; Riddell, Patricia M

    2015-01-01

    Objective Disparity cues can be a major drive to accommodation via the CA/C (convergence accommodation to convergence) linkage but, on decompensation of exotropia, disparity cues are extinguished by suppression, so this drive is lost. This study investigated accommodation and vergence responses to disparity, blur and proximal cues in a group of distance exotropes aged between 4-11 years both during decompensation and when exotropic. Methods 19 participants with distance exotropia were tested using a PlusoptiXSO4 photorefractor set in a remote haploscopic device which assessed simultaneous vergence and accommodation to a range of targets incorporating different combinations of blur, disparity and proximal cues at four fixation distances between 2m and 33cm. Responses on decompensation were compared to those from the same children when their deviation was controlled. Results Manifest exotropia was more common in the more impoverished cue conditions. When decompensated for near, mean accommodation gain for the all-cue (naturalistic) target reduced significantly (p<0.0001), with resultant mean under-accommodation of 2.33D at 33cm. The profile of near cues usage changed after decompensation, with blur and proximity driving residual responses, but these remaining cues did not compensate for loss of accommodation caused by the removal of disparity. Conclusions Accommodation often reduces on decompensation of distance exotropia as the drive from convergence is extinguished, providing a further reason to try to prevent decompensation for near. PMID:21873311

  13. Effect of Phenylephrine on the Accommodative System

    PubMed Central

    Del Águila-Carrasco, Antonio J.; Bernal-Molina, Paula; Ferrer-Blasco, Teresa; López-Gil, Norberto; Montés-Micó, Robert

    2016-01-01

    Accommodation is controlled by the action of the ciliary muscle and mediated primarily by parasympathetic input through postganglionic fibers that originate from neurons in the ciliary and pterygopalatine ganglia. During accommodation the pupil constricts to increase the depth of focus of the eye and improve retinal image quality. Researchers have traditionally faced the challenge of measuring the accommodative properties of the eye through a small pupil and thus have relied on pharmacological agents to dilate the pupil. Achieving pupil dilation (mydriasis) without affecting the accommodative ability of the eye (cycloplegia) could be useful in many clinical and research contexts. Phenylephrine hydrochloride (PHCl) is a sympathomimetic agent that is used clinically to dilate the pupil. Nevertheless, first investigations suggested some loss of functional accommodation in the human eye after PHCl instillation. Subsequent studies, based on different measurement procedures, obtained contradictory conclusions, causing therefore an unexpected controversy that has been spread almost to the present days. This manuscript reviews and summarizes the main research studies that have been performed to analyze the effect of PHCl on the accommodative system and provides clear conclusions that could help clinicians know the real effects of PHCl on the accommodative system of the human eye. PMID:28053778

  14. Teleworkers with disabilities: characteristics and accommodation use.

    PubMed

    Linden, Maureen; Milchus, Karen

    2014-01-01

    The prevalence of telework among people with disabilities is not as great as the general population, despite the accommodative benefits of telework. This study of employment and accommodation use patterns of people with disabilities investigates relationships between functional abilities, work location and nature, and accommodation use. Currently employed subjects with disabilities were recruited from client lists of research, technical assistance, and service provision centers, as well as through over 100 social networking venues focused on individuals with disabilities. A national, cross-sectional survey was administered electronically. Details of accommodation use for 373 individuals were compared using Chi-Square distribution analysis. Those in white-collar and knowledge-based jobs were twice as likely to telework as other worker types, and teleworkers were twice as likely to use flexible scheduling. Only 47% of teleworkers reported telework as a job accommodation. Of those, 57% were satisfied with telework and 76% reported it as important to job task completion. Increased use of flexible scheduling, particularly among those who view telework as an accommodation, suggests the primary accommodative benefit of telework is to reduce pain and fatigue-related barriers to traditional employment. Relatively low satisfaction with telework suggests that it presents other employment-related barriers.

  15. Understanding and preventing computer vision syndrome.

    PubMed

    Loh, Ky; Redd, Sc

    2008-01-01

    The invention of computer and advancement in information technology has revolutionized and benefited the society but at the same time has caused symptoms related to its usage such as ocular sprain, irritation, redness, dryness, blurred vision and double vision. This cluster of symptoms is known as computer vision syndrome which is characterized by the visual symptoms which result from interaction with computer display or its environment. Three major mechanisms that lead to computer vision syndrome are extraocular mechanism, accommodative mechanism and ocular surface mechanism. The visual effects of the computer such as brightness, resolution, glare and quality all are known factors that contribute to computer vision syndrome. Prevention is the most important strategy in managing computer vision syndrome. Modification in the ergonomics of the working environment, patient education and proper eye care are crucial in managing computer vision syndrome.

  16. Behavioral characteristics and neurobiological substrates shared by Pavlovian sign-tracking and drug abuse.

    PubMed

    Tomie, Arthur; Grimes, Kathryn L; Pohorecky, Larissa A

    2008-06-01

    Drug abuse researchers have noted striking similarities between behaviors elicited by Pavlovian sign-tracking procedures and prominent symptoms of drug abuse. In Pavlovian sign-tracking procedures, repeated paired presentations of a small object (conditioned stimulus, CS) with a reward (unconditioned stimulus, US) elicits a conditioned response (CR) that typically consists of approaching the CS, contacting the CS, and expressing consummatory responses at the CS. Sign-tracking CR performance is poorly controlled and exhibits spontaneous recovery and long-term retention, effects that resemble relapse. Sign-tracking resembles psychomotor activation, a syndrome of behavioral responses evoked by addictive drugs, and the effects of sign-tracking on corticosterone levels and activation of dopamine pathways resemble the neurobiological effects of abused drugs. Finally, the neurobiological profile of individuals susceptible to sign-tracking resembles the pathophysiological profile of vulnerability to drug abuse, and vulnerability to sign-tracking predicts vulnerability to impulsive responding and alcohol self-administration. Implications of sign-tracking for models of drug addiction are considered.

  17. Behavioral Characteristics and Neurobiological Substrates Shared by Pavlovian Sign-Tracking and Drug Abuse

    PubMed Central

    Tomie, Arthur; Grimes, Kathryn L.; Pohorecky, Larissa A.

    2008-01-01

    Drug abuse researchers have noted striking similarities between behaviors elicited by Pavlovian sign-tracking procedures and prominent symptoms of drug abuse. In Pavlovian sign-tracking procedures, repeated paired presentations of a small object (conditioned stimulus, CS) with a reward (unconditioned stimulus, US) elicits a conditioned response (CR) that typically consists of approaching the CS, contacting the CS, and expressing consummatory responses at the CS. Sign-tracking CR performance is poorly controlled and exhibits spontaneous recovery and long-term retention, effects that resemble relapse. Sign-tracking resembles psychomotor activation, a syndrome of behavioral responses evoked by addictive drugs, and the effects of sign-tracking on corticosterone levels and activation of dopamine pathways resemble the neurobiological effects of abused drugs. Finally, the neurobiological profile of individuals susceptible to sign-tracking resembles the pathophysiological profile of vulnerability to drug abuse, and vulnerability to sign-tracking predicts vulnerability to impulsive responding and alcohol self-administration. Implications of sign-tracking for models of drug addiction are considered. PMID:18234349

  18. Children of substance abusers: overview of research findings.

    PubMed

    Johnson, J L; Leff, M

    1999-05-01

    A relationship between parental substance abuse and subsequent alcohol problems in their children has been documented extensively. Children of alcoholics (COAs) are considered to be at high risk because there is a greater likelihood that they will develop alcoholism compared with a randomly selected child from the same community. COAs and children of other drug-abusing parents are especially vulnerable to the risk for maladaptive behavior because they have combinations of many risk factors present in their lives. The single most potent risk factor is their parent's substance-abusing behavior. This single risk factor can place children of substance abusers at biologic, psychologic, and environmental risk. Since the turn of the century, many reports have described the deleterious influence of parental alcoholism on their children. A series of studies measured mortality, physiology, and general health in the offspring of alcoholic parents and concluded that when mothers stopped drinking during gestation, their children were healthier. Today, research on COAs can be classified into studies of fetal alcohol syndrome, the transmission of alcoholism, psychobiologic markers of vulnerability, and psychosocial characteristics. Each of these studies hypothesizes that differences between COAs and children of nonalcoholics influence maladaptive behaviors later in life, such as academic failure or alcoholism. This research supports the belief that COAs are at risk for a variety of problems that may include behavioral, psychologic, cognitive, or neuropsychologic deficits. The vast literature on COAs far outweighs the literature on children of other drug abusers. Relatively little is known about children of heroin addicts, cocaine abusers, or polydrug abusers. Nonetheless, many researchers suggest that the children of addicted parents are at greater risk for later dysfunctional behaviors and that they, too, deserve significant attention to prevent intergenerational transmission of

  19. [Caffeine: a nutrient, a drug or a drug of abuse].

    PubMed

    Pardo Lozano, Ricardo; Alvarez García, Yolanda; Barral Tafalla, Diego; Farré Albaladejo, Magí

    2007-01-01

    Coffee, tea, chocolate and caffeinated drinks are the main sources of caffeine, which is consumed in almost all ages and socioeconomic levels. Caffeine acts as a non-selective adenosine receptor antagonist in the central nervous system. Its main effects are as psychostimulant, acting in addition on the respiratory, muscular and cardiovascular systems. Basically, caffeine is metabolized by the hepatic cytochrome P-450 1A2 enzymes (CYP1A2). Several drugs can interact with its metabolism. The observed interindividual differences of its effects can be explained by variations in its metabolism. The main therapeutic use of caffeine is bronchodilator in respiratory diseases. Other possible uses are under investigation. Acute or chronic consumption of caffeine can induce several adverse effects, including intoxication that can be lethal. Finally, caffeine can be considered a drug of abuse. It has positive reinforcing actions, produces tolerance, and a withdrawal syndrome after stopping its consumption. Caffeine can cause different mental disorders such as dependence, which is not included in the DSM-IV-R, withdrawal syndrome and intoxication. Depending on its use, caffeine can be considered a nutrient, a drug or a drug of abuse.

  20. Wernicke-Korsakoff syndrome.

    PubMed Central

    Zubaran, C.; Fernandes, J. G.; Rodnight, R.

    1997-01-01

    Alcohol abuse is one of the most serious problems in public health and the Wernicke-Korsakoff syndrome is one of the gravest consequences of alcoholism. The pathology is often undiagnosed in its less evident presentations, therefore an accurate diagnostic approach is a critical step in treatment planning. Treatment is based on restoration of thiamine, although this is insufficient to prevent the psychological decline of a great number of patients. The cognitive impact of the pathology is derived from the interaction of alcoholic neurotoxicity, thiamine deficiency and personal susceptibility. In this article, the literature concerning Wernicke-Korsakoff syndrome is reviewed. Images p31-a PMID:9039406

  1. Surface accommodation of molecular contaminants

    NASA Technical Reports Server (NTRS)

    Chen, Philip T.; Hedgeland, Randy J.; Thomson, Shaun R.

    1990-01-01

    Theoretical consideration and supporting data are presented regarding the nature of the transport mechanisms which cause the adsorption of gases on spacecraft surfaces. Particular attention is given to the concept of a sticking coefficient which is the ratio of the thermally accommodated mass to the total incident mass. Existing molecular accommodation data are examined in terms of spacecraft applications and recent contamination-control data are introduced. Two distinct yet linked concepts emerge which are the accommodation and sticking coefficients, and surface roughness contributes significantly to both coefficients. A general equation regarding the coefficients is developed, and the data are found to fit the equation basically. It is concluded that a more precise characterization of the coefficients can be obtained through experimentation under simulated spacecraft conditions.

  2. Advanced Solar Observatory (ASO) accommodations requirements study

    NASA Technical Reports Server (NTRS)

    1989-01-01

    Results of an accommodations analysis for the Advanced Solar Observatory on Space Station Freedom are reported. Concepts for the High Resolution Telescope Cluster, Pinhole/Occulter Facility, and High Energy Cluster were developed which can be accommodated on Space Station Freedom. It is shown that workable accommodations concepts are possible. Areas of emphasis for the next stage of engineering development are identified.

  3. Gas sniffing as a form of substance abuse.

    PubMed

    Remington, G; Hoffman, B F

    1984-02-01

    The authors review the existing literature on inhalation of gasoline fumes, highlighting the acute and chronic physical and psychological effects. The clinical picture of gas sniffing includes visual hallucinations, changes in consciousness, euphoria, nystagmus, dizziness, weakness and tremors. There is the possibility of rapid recovery, sudden death or brain damage with chronic abuse. When leaded gasoline is abused then blood and urine lead levels and erythrocytic delta-aminolevulinic acid dehydrase (ALAD) levels may be helpful. Although the treatment of acute and chronic gas sniffing syndromes is often supportive and non-specific, when lead levels are high chelated therapy is indicated including British anti-lewisite, calcium disodium versenate or D-penicillamine. We also report our findings on an isolated native Indian population where intentional gas sniffing has reached epidemic proportions. Ten percent of the total population and 25% of the children between 5 and 15 years of age had been identified as gasoline inhalation abusers. In this population, the most important etiological factors included environmental, family and cultural components. The authors emphasize the need to correct the family and social deficiencies in such communities if the incidence of gas sniffing is to be decreased.

  4. 77 FR 38833 - Job Accommodation Network

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-29

    ... DEPARTMENT OF LABOR Job Accommodation Network AGENCY: Office of Disability Employment Policy, Department of Labor. Announcement Type: New Notice of Availability of Funds and Solicitation for Grant... cooperative agreement to manage and operate its Job Accommodation Network (JAN), a national technical...

  5. Child Abuse

    MedlinePlus

    ... puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical damage. An abused child may become ...

  6. Gender differences in early accommodation and vergence development.

    PubMed

    Horwood, Anna M; Riddell, Patricia M

    2008-03-01

    A remote haploscopic photorefractor was used to assess objective binocular vergence and accommodation responses in 157 full-term healthy infants aged 1-6 months while fixating a brightly coloured target moving between fixation distances at 2, 1, 0.5 and 0.33 m. Vergence and accommodation response gain matured rapidly from 'flat' neonatal responses at an intercept of approximately 2 dioptres (D) for accommodation and 2.5 metre angles(MA) for vergence, reaching adult-like values at 4 months. Vergence gain was marginally higher in females (p = 0.064), but accommodation gain (p = 0.034) was higher and accommodative intercept closer to zero (p = 0.004) in males in the first 3 months as they relaxed accommodation more appropriately for distant targets. More females showed flat accommodation responses (p = 0.029). More males behaved hypermetropically in the first two months of life, but when these hypermetropic infants were excluded from the analysis, the gender difference remained. Gender differences disappeared after three months. Data showed variable responses and infants could behave appropriately and simultaneously on both, neither or only one measure at all ages. If accommodation was appropriate (gain between 0.7 and 1.3; r(2) > 0.7) but vergence was not, males over- and under-converged equally, while the females who accommodated appropriately were more likely to overconverge (p = 0.008). The apparent earlier maturity of the male accommodative responses may be due to refractive error differences but could also reflect gender-specific male preference for blur cues while females show earlier preference for disparity, which may underpin the earlier emerging, disparity dependent, stereopsis and full vergence found in females in other studies.

  7. Chromatic aberration, accommodation, and color preference in asthenopia.

    PubMed

    Drew, Stefanie A; Borsting, Eric; Stark, Lawrence R; Chase, Chris

    2012-07-01

    Asthenopia is a common problem associated with near work and reports suggest that colored lenses or overlays may be applied to reduce symptoms. In this study, we examine the relationship between eyestrain, color preferences, and function of the accommodation and vergence system. Specifically, we examine whether symptomatic observers select colors that reduce accommodative demand based on longitudinal chromatic aberration (LCA). Forty-seven undergraduate students participated in this study. Visual discomfort symptoms were assessed using the Conlon survey. A Mark 2 Intuitive Colorimeter was used to obtain optimal colored light preferences. LCA was modeled using the Chromatic Eye and spectral power density data. A comprehensive evaluation of accommodation and vergence was performed following standard procedures. A significant negative correlation (r = -0.51) was found between eyestrain symptoms and the International Commission on Illumination (CIE) v' axis of colors preferences. Additionally, a significant negative correlation (r = -0.31) was found between eyestrain symptoms and LCA accommodation. Two thirds of the participants in the high discomfort group chose colors that decreased accommodative demand. Accommodative amplitude and vergence facility also correlated with LCA, accounting for 25% of the variance. The color preferences of individuals are systematically influenced by the functioning of their accommodation and vergence systems with increased symptomatology resulting in color selections that reduce LCA accommodative stimulus demand.

  8. Substance abuse associated with elder abuse in the United States.

    PubMed

    Jogerst, Gerald J; Daly, Jeanette M; Galloway, Lara J; Zheng, Shimin; Xu, Yinghui

    2012-01-01

    Substance abuse by either victim or perpetrator has long been associated with violence and abuse. Sparse research is available regarding elder abuse and its association with substance abuse. The objective of this study was to evaluate the association of state-reported domestic elder abuse with regional levels of substance abuse. Census demographic and elder abuse data were sorted into substate regions to align with the substance use treatment-planning regions for 2269 US counties. From the 2269 US counties there were 229 substate regions in which there were 213,444 investigations of abuse. For the other Ns (reports and substantiations) there were fewer counties and regions. See first sentence of data analyses and first sentence of results. Elder abuse report rates ranged from .03 to .41% (80 regions), investigation rates .001 to .34% (229 regions), and substantiation rates 0 to .22% (184 regions). Elder abuse investigations and substantiations were associated with various forms of substance abuse. Higher investigation rates were significantly associated with a higher rate of any illicit drug use in the past month, a lower median household income, lower proportion of the population graduated high school, and higher population of Hispanics. Higher substantiation rates were significantly associated with higher rate of illicit drug use in the past month and higher population of Hispanics. It may be worthwhile for administrators of violence programs to pay particular attention to substance abuse among their clients and in their community's environment, especially if older persons are involved. Measures of documented elder abuse at the county level are minimal. To be able to associate substance abuse with elder abuse is a significant finding, realizing that the substance abuse can be by the victim or the perpetrator of elder abuse.

  9. Adaptive Calibration of Dynamic Accommodation—Implications for Accommodating Intraocular Lenses

    PubMed Central

    Schor, Clifton M.; Bharadwaj, Shrikant R.

    2009-01-01

    PURPOSE When the aging lens is replaced with prosthetic accommodating intraocular lenses (IOLs), with effective viscoelasticities different from those of the natural lens, mismatches could arise between the neural control of accommodation and the biomechanical properties of the new lens. These mismatches could lead to either unstable oscillations or sluggishness of dynamic accommodation. Using computer simulations, we investigated whether optimal accommodative responses could be restored through recalibration of the neural control of accommodation. Using human experiments, we also investigated whether the accommodative system has the capacity for adaptive recalibration in response to changes in lens biomechanics. METHODS Dynamic performance of two accommodating IOL prototypes was simulated for a 45-year-old accommodative system, before and after neural recalibration, using a dynamic model of accommodation. Accommodating IOL I, a prototype for an injectable accommodating IOL, was less stiff and less viscous than the natural 45-year-old lens. Accommodating IOL II, a prototype for a translating accommodating IOL, was less stiff and more viscous than the natural 45-year-old lens. Short-term adaptive recalibration of dynamic accommodation was stimulated using a double-step adaptation paradigm that optically induced changes in neuromuscular effort mimicking responses to changes in lens biomechanics. RESULTS Model simulations indicate that the unstable oscillations or sluggishness of dynamic accommodation resulting from mismatches between neural control and lens biomechanics might be restored through neural recalibration. CONCLUSIONS Empirical measures reveal that the accommodative system is capable of adaptive recalibration in response to optical loads that simulate effects of changing lens biomechanics. PMID:19044245

  10. 14 CFR 1251.201 - Reasonable accommodation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... OF HANDICAP Employment Practices § 1251.201 Reasonable accommodation. (a) A recipient shall make reasonable accommodation to the known physical or mental limitations of an otherwise qualified handicapped... facilities used by employees readily accessible to and usable by handicapped persons; and (2) Job...

  11. 14 CFR 1251.201 - Reasonable accommodation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... OF HANDICAP Employment Practices § 1251.201 Reasonable accommodation. (a) A recipient shall make reasonable accommodation to the known physical or mental limitations of an otherwise qualified handicapped... facilities used by employees readily accessible to and usable by handicapped persons; and (2) Job...

  12. 14 CFR 1251.201 - Reasonable accommodation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... OF HANDICAP Employment Practices § 1251.201 Reasonable accommodation. (a) A recipient shall make reasonable accommodation to the known physical or mental limitations of an otherwise qualified handicapped... facilities used by employees readily accessible to and usable by handicapped persons; and (2) Job...

  13. 14 CFR 1251.201 - Reasonable accommodation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... OF HANDICAP Employment Practices § 1251.201 Reasonable accommodation. (a) A recipient shall make reasonable accommodation to the known physical or mental limitations of an otherwise qualified handicapped... facilities used by employees readily accessible to and usable by handicapped persons; and (2) Job...

  14. Screening for childhood physical and sexual abuse among outpatient substance abusers.

    PubMed

    Simpson, T L; Westerberg, V S; Little, L M; Trujillo, M

    1994-01-01

    Research demonstrates that substance-abusing individuals report substantially higher rates of childhood sexual and physical abuse than the general population. This study sought to test a method of identifying substance-abusing clients with histories of childhood sexual and/or physical abuse and to explore the differences between those reporting childhood abuse and those not. Files of substance abusing clients from two distinct time periods were examined for reports of childhood abuse. At Time 1 (n = 399) clients were not systematically asked about experiences of childhood abuse, and at Time 2 (n = 305) clients were routinely asked about this issue. Results indicate that significantly more male and female clients disclosed childhood abuse at Time 2. Additionally, male clients reporting childhood abuse appeared more distressed than those not reporting abuse; female clients reporting childhood abuse did not appear more distressed than their counterparts.

  15. Experimental investigations of pupil accommodation factors.

    PubMed

    Lee, Eui Chul; Lee, Ji Woo; Park, Kang Ryoung

    2011-08-17

    PURPOSE. The contraction and dilation of the iris muscle that controls the amount of light entering the retina causes pupil accommodation. In this study, experiments were performed and two of the three factors that influence pupil accommodation were analyzed: lighting conditions and depth fixations. The psychological benefits were not examined, because they could not be quantified. METHODS. A head-wearable eyeglasses-based, eye-capturing device was designed to measure pupil size. It included a near-infrared (NIR) camera and an NIR light-emitting diode. Twenty-four subjects watched two-dimensional (2D) and three-dimensional (3D) stereoscopic videos of the same content, and the changes in pupil size were measured by using the eye-capturing device and image-processing methods: RESULTS. The pupil size changed with the intensity of the videos and the disparities between the left and right images of a 3D stereoscopic video. There was correlation between the pupil size and average intensity. The pupil diameter could be estimated as being contracted from approximately 5.96 to 4.25 mm as the intensity varied from 0 to 255. Further, from the changes in the depth fixation for the pupil accommodation, it was confirmed that the depth fixation also affected accommodation of pupil size. CONCLUSIONS. It was confirmed that the lighting condition was an even more significant factor in pupil accommodation than was depth fixation (significance ratio: approximately 3.2:1) when watching 3D stereoscopic video. Pupil accommodation was more affected by depth fixation in the real world than was the binocular convergence in the 3D stereoscopic display.

  16. Acceleration characteristics of human ocular accommodation.

    PubMed

    Bharadwaj, Shrikant R; Schor, Clifton M

    2005-01-01

    Position and velocity of accommodation are known to increase with stimulus magnitude, however, little is known about acceleration properties. We investigated three acceleration properties: peak acceleration, time-to-peak acceleration and total duration of acceleration to step changes in defocus. Peak velocity and total duration of acceleration increased with response magnitude. Peak acceleration and time-to-peak acceleration remained independent of response magnitude. Independent first-order and second-order dynamic components of accommodation demonstrate that neural control of accommodation has an initial open-loop component that is independent of response magnitude and a closed-loop component that increases with response magnitude.

  17. Testing women's propensities to leave their abusive husbands using structural equation modeling.

    PubMed

    Choi, Myunghan; Belyea, Michael; Phillips, Linda R; Insel, Kathleen; Min, Sung-Kil

    2009-01-01

    Many Korean women are just beginning to recognize that what they considered to be normal treatment is actually domestic violence. Many are becoming more intolerant of the abuse and more likely to desire to leave an abusive relationship. The aim of this study was to test, using the framework of sociostructural and psychological-relational power (PRP), a model of Korean women's propensities to leave their abusive husbands. Multigroup structural equation modeling was used to test relationships between variables chosen from the sociostructural power and PRP to explain intolerance to abuse. Married Korean women (n = 184) who self-identified as being abused physically, psychologically, sexually, or financially participated in the study. The multigroup analysis revealed that the relationship of abuse and Hwa-Byung (a culture-bound syndrome that denotes Korean women's anger) with intolerance was supported for women with low education (defined as having an education of high school or less: < or =12 years); also for this group, particularly among the younger women, high power was related to high levels of reported abuse and abuse intolerance. For women in the high-education group (education beyond high school: > or =13 years), high power was related to abuse, Hwa-Byung, and abuse intolerance; age did not influence power. Overall, the multigroup model adequately fitted the sample data (chi2 = 92.057, degree of freedom = 50, p = .000; normal fit index = .926, comparative fix index = .964, root mean square error of approximation = .068, Hoelter's critical number = 152), demonstrating that education is a crucial moderator of Korean women's attitude toward the unacceptability of abuse and propensity to terminate the marriage. This study found support for a model of abuse intolerance using the framework of sociostructural power and PRP, primarily for the low-education group. Hwa-Byung was a mediating factor that contributed to intolerance to abuse in women with low education. This

  18. Overview for Attached Payload Accommodations and Environments

    NASA Technical Reports Server (NTRS)

    Schaffer, Craig; Cook, Gene; Nabizadeh, Rodney; Phillion, James

    2007-01-01

    External payload accommodations are provided at attach sites on the U.S provided ELC, U.S. Truss, the Japanese Experiment Module Exposed Facility (JEM EF) and the Columbus EPF (External Payload Facilities). The Integrated Truss Segment (ITS) provides the backbone structure for the ISS. It attaches the solar and thermal control arrays to the rest of the complex, and houses cable distribution trays Extravehicular Activity (EVA) support equipment such as handholds and lighting; and providing for Extravehicular Robotic (EVR) accommodations using the Mobile Servicing System (MSS). It also provides logistics and maintenance, and payload attachment sites. The attachment sites accommodate logistics and maintenance and payloads carriers, zenith and nadir. The JEM-EF, a back porch-like attachment to the JEM Pressurized Module, accommodates up to eight payloads, which can be serviced by the crew via the JEM PM's airlock and dedicated robotic arm. The Columbus-EPF is another porch-like platform that can accommodate two zenith and two nadir looking payloads.

  19. Fetal Alcohol Syndrome: A Behavioral Teratology.

    ERIC Educational Resources Information Center

    Kavale, Kenneth A.; Karge, Belinda D.

    1986-01-01

    The review examines the literature on the behaviorally teratogenic aspects of Fetal Alcohol Syndrome, including: (1) prevalence of alcohol abuse among women, (2) acute and chronic effects of alcohol on the fetus, (3) genetic susceptibility, (4) neuropathology, (5) correlative conditions, and (6) animal studies. (Author/DB)

  20. Appropriate Accommodations for Individual Needs Allowable by State Guidelines

    ERIC Educational Resources Information Center

    Jordan, Ashley Sokol

    2009-01-01

    Accommodation decisions should be based on the validity and accountability to provide the least restrictive accommodations for students with learning disabilities. Accommodations are based upon the allowable guidelines set by the Ohio Department of Education but the scribing accommodations do not meet the least restrictive criteria for many…

  1. [An integrated approach including paediatric and forensic medical expertise on suspicion of child abuse].

    PubMed

    Schouten, M C M; Karst, W A; van der Stel, H F; Teeuw, A H; van de Putte, E M

    2016-01-01

    A false accusation of child abuse has a major impact on child and family. Conversely, a missed diagnosis of child abuse may have significant and lifelong consequences for the child. For health professionals the assessment of the nature of the injury and differentiating between accidental and inflicted injury, disease manifestation or a physiological phenomenon can be challenging. For adequate determination of the cause of injury, an integrated approach including paediatric knowledge and forensic medical expertise is essential. Therefore, a national expertise centre for child abuse (LECK) was established in the Netherlands in 2014. The first results of this integrated approach are described and illustrated with three case reports. Case A, a 7-month-old boy with an accidental humerus fracture. Case B, an 8-year-old boy with a false positive suspicion of child abuse who was eventually diagnosed with Henoch-Schönlein syndrome. Case C, boy of 3 months with bruises and a metaphyseal fracture of the femur, both highly suspected of being inflicted injury.

  2. New EEOC guidance details responsibilities for job accommodation.

    PubMed

    1999-04-02

    The Equal Employment Opportunity Commission (EEOC) released new guidelines on how employers should accommodate the needs of workers with disabilities. Guidelines address using leave as an accommodation, the duty of offering reassignment as a form of reasonable accommodation, and an employer's cost of accommodation. Among the clarifications, the EEOC states that employers do not have to provide more paid leave than workers in similar situations receive. Employees must be qualified for reassignments, and the employer is not obligated to provide training for the new position. The EEOC disagrees with the Americans with Disabilities Act reasoning that employers should not be forced to accommodate if a cost-benefit analysis reveals undue hardship on the employer. Contact information is provided.

  3. [Pediatric radiological diagnostics in suspected child abuse].

    PubMed

    Erfurt, C; Hahn, G; Roesner, D; Schmidt, U

    2009-10-01

    Advanced and specialized radiological diagnostics are essential in the case of clinical suspicion of pediatric injuries to the head, thorax, abdomen, and extremities when there is no case history or when "battered child syndrome" is assumed on the basis of inadequate trauma. In particular, the aim of this sophisticated diagnostic procedure is the detection of lesions of the central nervous system (CNS) in order to initiate prompt medical treatment. If diagnostic imaging shows typical findings of child abuse, accurate documented evidence of the diagnostic results is required to prevent further endangerment of the child's welfare.

  4. 46 CFR 177.810 - Overnight accommodations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... TONS) CONSTRUCTION AND ARRANGEMENT Passenger Accommodations § 177.810 Overnight accommodations. (a) A... three high and must be constructed of wood, fiber reinforced plastic, or metal. A berth located more... construction and arrangement of berths and other furniture must allow free and unobstructed access to each...

  5. 10 CFR 1040.67 - Reasonable accommodation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... known physical or mental limitations of an otherwise qualified handicapped applicant or employee unless the recipient can demonstrate that the accommodation would impose an undue hardship on the operation... accommodation would impose an undue hardship on the operation of a recipient's program or activity, factors to...

  6. 45 CFR 84.12 - Reasonable accommodation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... physical or mental limitations of an otherwise qualified handicapped applicant or employee unless the recipient can demonstrate that the accommodation would impose an undue hardship on the operation of its... an accommodation would impose an undue hardship on the operation of a recipient's program or activity...

  7. 45 CFR 1232.10 - Reasonable accommodation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... shall make reasonable accommodation to the known physical or mental limitations of an otherwise... accommodation would impose an undue hardship on the operation of its program or activity. (b) Reasonable... would impose an undue hardship on the operation of a recipient's program or activity, factors to be...

  8. 10 CFR 4.123 - Reasonable accommodation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... shall make reasonable accommodation to the known physical or mental limitations of an otherwise... would impose an undue hardship on the operation of its program or activity. (b) Reasonable accommodation... on the operation of a recipient's program or activity, factors to be considered include: (1) The...

  9. [Comparison study on subjective and objective measurements of the accommodative convergence to accommodation ratio].

    PubMed

    Xu, Jing-jing; Xu, Dan; Huang, Tao; Jiang, Jian; Lü, Fan

    2012-05-01

    To detect the accommodative convergence to accommodation (AC/A) ratios measured respectively by objective and subjective methods. The differences and its relative factors were explored. Forty young volunteers were measured by eye tracker to get the amount of convergence when fixating at the target at 100 cm, 50 cm, 33 cm and 25 cm and were measured by infrared auto-refractor to get corresponding accommodative responses. AC/A ratio based on these two measurements were compared with the calculated and the gradient AC/A ratio from Von Graefe tests. Mean value of stimulated AC/A ratio measured by eye tracker was higher than the calculated and gradient AC/A ratio by Von Graefe method (P = 0.003, 0.001). There are statistic correlation (r = 0.871, P = 0.000) and difference (P = 0.000) between stimulated AC/A ratio and response AC/A ratios both measured by eye tracker, and the difference trends to be greater with the higher AC/A ratio. The objective AC/A ratio is usually higher than the clinical subjective measurement because of more proximal effect. The response AC/A ratio measured objectively may reveal realistically the mutual effect and relationship between accommodation and convergence and it seems to be more credible to be the monitor parameter on progression of myopia in clinics.

  10. 46 CFR 108.197 - Construction of accommodation spaces.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Construction of accommodation spaces. 108.197 Section... UNITS DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.197 Construction of accommodation spaces. (a) Each sleeping, mess, recreational, or hospital space that is adjacent to or...

  11. 46 CFR 108.197 - Construction of accommodation spaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Construction of accommodation spaces. 108.197 Section... UNITS DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.197 Construction of accommodation spaces. (a) Each sleeping, mess, recreational, or hospital space that is adjacent to or...

  12. 46 CFR 108.197 - Construction of accommodation spaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Construction of accommodation spaces. 108.197 Section... UNITS DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.197 Construction of accommodation spaces. (a) Each sleeping, mess, recreational, or hospital space that is adjacent to or...

  13. 46 CFR 108.197 - Construction of accommodation spaces.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Construction of accommodation spaces. 108.197 Section... UNITS DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.197 Construction of accommodation spaces. (a) Each sleeping, mess, recreational, or hospital space that is adjacent to or...

  14. 46 CFR 108.197 - Construction of accommodation spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Construction of accommodation spaces. 108.197 Section... UNITS DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.197 Construction of accommodation spaces. (a) Each sleeping, mess, recreational, or hospital space that is adjacent to or...

  15. Minus-Lens–Stimulated Accommodative Amplitude Decreases Sigmoidally with Age: A Study of Objectively Measured Accommodative Amplitudes from Age 3

    PubMed Central

    Anderson, Heather A.; Hentz, Gloria; Glasser, Adrian; Stuebing, Karla K.; Manny, Ruth E.

    2009-01-01

    Purpose Guidelines for predicting accommodative amplitude by age are often based on subjective push-up test data that overestimate the accommodative response. Studies in which objective measurements were used have defined expected amplitudes for adults, but expected amplitudes for children remain unknown. In this study, objective methods were used to measure accommodative amplitude in a wide age range of individuals, to define the relationship of amplitude and age from age 3. Methods Accommodative responses were measured in 140 subjects aged 3 to 40 years. Measurements were taken with the Grand Seiko autorefractor (RyuSyo Industrial Co., Ltd., Kagawa, Japan) as the subjects viewed a high-contrast target at 33 cm through minus lenses of increasing power until the responses showed no further increase in accommodation. Results The maximum accommodative amplitude of each subject was plotted by age, and a curvilinear function fit to the data: y = 7.33 − 0.0035(age − 3)2 (P < 0.001). Tangent analysis of the fit indicated that the accommodative amplitude remained relatively stable until age 20. Data from this study were then pooled with objective amplitudes from previous studies of adults up to age 70. A sigmoidal function was fit to the data: y = 7.083/(1 + e[0.2031(age-36.2)−0.6109]) (P < 0.001). The sigmoidal function indicated relatively stable amplitudes below age 20 years, a rapid linear decline between 20 and 50 years, and a taper to 0 beyond 50 years. Conclusions These data indicate that accommodative amplitude decreases in a curvilinear manner from 3 to 40 years. When combined with data from previous studies, a sigmoidal function describes the overall trend throughout life with the biggest decrease occurring between 20 and 50 years. PMID:18326693

  16. Long-term follow-up of acute isolated accommodation insufficiency.

    PubMed

    Lee, Jung Jin; Baek, Seung-Hee; Kim, Ungsoo Samuel

    2013-04-01

    To define the long-term results of accommodation insufficiency and to investigate the correlation between accommodation insufficiency and other factors including near point of convergence (NPC), age, and refractive errors. From January 2008 to December 2009, 11 patients with acute near vision disturbance and remote near point of accommodation (NPA) were evaluated. Full ophthalmologic examinations, including best corrected visual acuity, manifest refraction and prism cover tests were performed. Accommodation ability was measured by NPA using the push-up method. We compared accommodation insufficiency and factors including age, refractive errors and NPC. We also investigated the recovery from loss of accommodation in patients. Mean age of patients was 20 years (range, 9 to 34 years). Five of the 11 patients were female. Mean refractive error was -0.6 diopters (range, -3.5 to +0.25 diopters) and 8 of 11 patients (73%) had emmetropia (+0.50 to -0.50 diopters). No abnormalities were found in brain imaging tests. Refractive errors were not correlated with NPA or NPC (rho = 0.148, p = 0.511; rho = 0.319, p = 0.339; respectively). The correlation between age and NPA was not significant (rho = -395, p = 0.069). However, the correlation between age and NPC was negative (rho = -0.508, p = 0.016). Three of 11 patients were lost to follow-up, and 6 of 8 patients had permanent insufficiency of accommodation. Accommodation insufficiency is most common in emmetropia, however, refractive errors and age are not correlated with accommodation insufficiency. Dysfunction of accommodation can be permanent in the isolated accommodation insufficiency.

  17. Long-term Follow-up of Acute Isolated Accommodation Insufficiency

    PubMed Central

    Lee, Jung Jin; Baek, Seung-Hee

    2013-01-01

    Purpose To define the long-term results of accommodation insufficiency and to investigate the correlation between accommodation insufficiency and other factors including near point of convergence (NPC), age, and refractive errors. Methods From January 2008 to December 2009, 11 patients with acute near vision disturbance and remote near point of accommodation (NPA) were evaluated. Full ophthalmologic examinations, including best corrected visual acuity, manifest refraction and prism cover tests were performed. Accommodation ability was measured by NPA using the push-up method. We compared accommodation insufficiency and factors including age, refractive errors and NPC. We also investigated the recovery from loss of accommodation in patients. Results Mean age of patients was 20 years (range, 9 to 34 years). Five of the 11 patients were female. Mean refractive error was -0.6 diopters (range, -3.5 to +0.25 diopters) and 8 of 11 patients (73%) had emmetropia (+0.50 to -0.50 diopters). No abnormalities were found in brain imaging tests. Refractive errors were not correlated with NPA or NPC (rho = 0.148, p = 0.511; rho = 0.319, p = 0.339; respectively). The correlation between age and NPA was not significant (rho = -395, p = 0.069). However, the correlation between age and NPC was negative (rho = -0.508, p = 0.016). Three of 11 patients were lost to follow-up, and 6 of 8 patients had permanent insufficiency of accommodation. Conclusions Accommodation insufficiency is most common in emmetropia, however, refractive errors and age are not correlated with accommodation insufficiency. Dysfunction of accommodation can be permanent in the isolated accommodation insufficiency. PMID:23543051

  18. Accommodation training in foreign workers.

    PubMed

    Takada, Masumi; Miyao, Masaru; Matsuura, Yasuyuki; Takada, Hiroki

    2013-01-01

    By relaxing the contracted focus-adjustment muscles around the eyeball, known as the ciliary and extraocular muscles, the degree of pseudomyopia can be reduced. This understanding has led to accommodation training in which a visual target is presented in stereoscopic video clips. However, it has been pointed out that motion sickness can be induced by viewing stereoscopic video clips. In Measurement 1 of the present study, we verified whether the new 3D technology reduced the severity of motion sickness in accordance with stabilometry. We then evaluated the short-term effects of accommodation training using new stereoscopic video clips on foreign workers (11 females) suffering from eye fatigue in Measurement 2. The foreign workers were trained for three days. As a result, visual acuity was statistically improved by continuous accommodation training, which will help promote ciliary muscle stretching.

  19. 38 CFR 18.412 - Reasonable accommodation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... known physical or mental limitations of a handicapped applicant or employee if such accommodation would... that the accommodation would impose an undue hardship on the operation of its program or activity. (b... impose an undue hardship on the operation of a recipient's program or activity, factors to be considered...

  20. Accommodation Outcomes and the ICF Framework

    ERIC Educational Resources Information Center

    Schreuer, Naomi

    2009-01-01

    Accommodation of the environment and technology is one of the key mediators of adjustment to disability and participation in community. In this article, accommodations are tested empirically as facilitators of return to work and participation, as defined by the "International Classification of Disability, Function, and Health" (ICF) and…

  1. Beyond Psychometric Evaluation of the Student--Task Determinants of Accommodation: Why Students with Learning Disabilities May Not Need to Be Accommodated

    ERIC Educational Resources Information Center

    Roberts, Barbara L.

    2012-01-01

    Students with learning disabilities obtain a wide range of recommended accommodations in secondary school, which they anticipate will continue into postsecondary education. Although the student's specific learning disability (SLD) contributes to the accommodation planning process, it is not the sole determinant of appropriate accommodation.…

  2. Association of Drug Abuse and Child Abuse.

    ERIC Educational Resources Information Center

    Jaudes, Paula Kienberger; And Others

    1995-01-01

    Children born to mothers who used illicit drugs during pregnancy were assessed for subsequent abuse or neglect. Of the 513 children exposed inutero to drugs, 102 were substantiated as abused or neglected. Infants exposed inutero to drugs had a higher than expected risk of subsequent abuse compared to children in the general population. (Author/SW)

  3. The Genesis of Pedophilia: Testing the "Abuse-to-Abuser" Hypothesis.

    ERIC Educational Resources Information Center

    Fedoroff, J. Paul; Pinkus, Shari

    1996-01-01

    This study tested three versions of the "abuse-to-abuser" hypothesis by comparing men with personal histories of sexual abuse and men without sexual abuse histories. There was a statistically non-significant trend for assaulted offenders to be more likely as adults to commit genital assaults on children. Implications for the abuse-to-abuser…

  4. Job Accommodation System: Project TIE (Technology in Employment).

    ERIC Educational Resources Information Center

    Roberts, Gary; Zimbrich, Karen; Butterworth, John; Hart, Debra

    This manual presents a comprehensive evaluation tool that can be used by employees with disabilities, by rehabilitation practitioners, and by consultants to develop job accommodations in a variety of employment settings. The Job Accommodation System is designed to help in identifying, selecting, and implementing job accommodations and consists of…

  5. [Nutritional status in children victims of physical and sexual abuse].

    PubMed

    Martín-Martín, Verónica; Loredo-Abdalá, Arturo

    2010-01-01

    To assess and relate the nutritional status by type of abuse in a pediatric population diagnosed with physical abuse (PA) and sexual abuse (SA). It's a retrospective, cross-sectional, descriptive study of 178 clinical records of children aged less than 12 years, attended at the Clinic for the Integral Care of the Abused Child of the Instituto Nacional de Pediatría and the Universidad Nacional Autónoma de México (CAINM-INP-UNAM), during the period 1994 to 2005. The relationship of nutritional status with the type of abuse was analyzed in two age ranges (3 months to less than five years, and five to 11 years) and gender with Student t and chi-square tests. We identified that, in girls PA was associated with stunting (PA: 48% vs. SA: 12%, p < 0.005 and PA: 21% vs. SA: 0%, p < 0.002) and wasting (PA: 21% vs. SA: 0%, p < 0.01 and PA: 21% vs. SA: 0%, p < 0.002). Whereas in girls SA was associated with overweight and obesity in age range five to 11 years (PA: 0% vs. SA: 31%; p < 0.01). This study identified acute and chronic under nutrition in girls with PA, and overweight and obesity in girls with SA. These findings enrich the knowledge for the suspicion of maltreatment child syndrome during the search of the aetiology of the clinical expression studied.

  6. Accommodations Manual: How to Select, Administer, and Evaluate Use of Accommodations for Instruction and Assessment of Students with Disabilities. Third Edition

    ERIC Educational Resources Information Center

    Christensen, L.; Carver, W.; VanDeZande, J.; Lazarus, S.

    2011-01-01

    The Council of Chief State School Officers' "Accommodations Manual: How to Select, Administer, and Evaluate the Use of Accommodations for Instruction and Assessment of Students with Disabilities" was first developed to establish guidelines for states to use for the selection, administration, and evaluation of accommodations for…

  7. Lenticular accommodation in relation to ametropia: the chick model.

    PubMed

    Choh, Vivian; Sivak, Jacob G

    2005-03-04

    Our goal was to determine whether experimentally induced ametropias have an effect on lenticular accommodation and spherical aberration. Form-deprivation myopia and hyperopia were induced in one eye of hatchling chicks by application of a translucent goggle and +15 D lens, respectively. After 7 days, eyes were enucleated and lenses were optically scanned prior to accommodation, during accommodation, and after accommodation. Accommodation was induced by electrical stimulation of the ciliary nerve. Lenticular focal lengths for form-deprived eyes were significantly shorter than for their controls and accommodation-associated changes in focal length were significantly smaller in myopic eyes compared to their controls. For eyes imposed with +15 D blur, focal lengths were longer than those for their controls and accommodative changes were greater. Spherical aberration of the lens increased with accommodation in both form-deprived and lens-treated birds, but induction of ametropia had no effect on lenticular spherical aberration in general. Nonmonotonicity from lenticular spherical aberration increased during accommodation but effects of refractive error were equivocal. The crystalline lens contributes to refractive error changes of the eye both in the case of myopia and hyperopia. These changes are likely attributable to global changes in the size and shape of the eye.

  8. Transitions: Times of Change and Accommodation.

    ERIC Educational Resources Information Center

    Rice, Mabel L.; O'Brien, Marion

    1990-01-01

    The research literature is reviewed for transitions from birth to eight years. A model describes transition as a change in ecocultural niche, requiring accommodations in daily routines for a child, family, and service providers and transition impact measures the number of accommodations required and the sustainability of daily routines.…

  9. Abuse Characteristics and Psychiatric Consequences Associated with Online Sexual Abuse.

    PubMed

    Say, Gökçe Nur; Babadağı, Zehra; Karabekiroğlu, Koray; Yüce, Murat; Akbaş, Seher

    2015-06-01

    The current study examined the rate and psychiatric correlates of sexual abuse involving the use of digital technologies by the offender in a wide sample of juvenile victims. Sociodemographic, abuse, and psychiatric characteristics of 662 sexually abused children and adolescents were evaluated. Of these, 93 reported that digital devices were used by the offender in several ways to facilitate the sexual abuse. The offender-victim relationship was initiated through the Internet in 39 victims. Involvement of digital technologies in sexual abuse was significantly associated with penetrative and recurrent form of sexual abuse commited by multiple offenders with coexisting violence. Additionally, victims of sexual abuse with a digital component were 4.21 times more likely to develop any psychopathology, 3.77 times more likely to have depression, and 2.14 times more likely to have post-traumatic stress disorder as a result of sexual abuse. These results indicated that the offender's use of digital technology may aid the initiation and facilitation of the sexual abuse of youths and may relate to more severe outcomes. This study revealed the importance of raising the awareness of professionals and the community about the potential risks associated with digital technologies and sexual abuse. Mental health professionals should consider this additional form of victimization, especially when dealing with sexual abuse victims.

  10. Adie's syndrome: some new observations.

    PubMed Central

    Thompson, H S

    1977-01-01

    . 14. The near reaction of the pupil was often segmental and frequently involved segments which did not respond to light. 15. The segmental paralysis to light was randomly distributed around the sphincter (Figure 6B). 16. There was some tendency for the sphincter palsy to gradually become worse. This progression was also random (Figure 8). 17. Almost all patients with Adie's syndrome had an accommodative paresis at the time of onset. 18. Reading glasses given to a patient with a fresh Adie's pupil were soon discarded as accommodation recovered (Figure 9). 19. Accomodative effort induced an astigmatism in about half of the eyes with Adie's--presumably the result of a segmental palsy of the ciliary muscle. 20. Tonicity of accommodation was present in about 1/2 of the eyes with Adie's, making it difficut for the patient to maintain a steady level of ciliary muscle tone. 21. An occasional patient complained of brow ache from ciliary spasm with near work. 22. In most patients with Adie's syndrome the ciliary muscle was supersensitive to pilocarpine 0... PMID:613531

  11. Adie's syndrome: some new observations.

    PubMed

    Thompson, H S

    1977-01-01

    . 14. The near reaction of the pupil was often segmental and frequently involved segments which did not respond to light. 15. The segmental paralysis to light was randomly distributed around the sphincter (Figure 6B). 16. There was some tendency for the sphincter palsy to gradually become worse. This progression was also random (Figure 8). 17. Almost all patients with Adie's syndrome had an accommodative paresis at the time of onset. 18. Reading glasses given to a patient with a fresh Adie's pupil were soon discarded as accommodation recovered (Figure 9). 19. Accomodative effort induced an astigmatism in about half of the eyes with Adie's--presumably the result of a segmental palsy of the ciliary muscle. 20. Tonicity of accommodation was present in about 1/2 of the eyes with Adie's, making it difficut for the patient to maintain a steady level of ciliary muscle tone. 21. An occasional patient complained of brow ache from ciliary spasm with near work. 22. In most patients with Adie's syndrome the ciliary muscle was supersensitive to pilocarpine 0...

  12. Prescription Drug Abuse

    MedlinePlus

    ... drug abuse. And it's illegal, just like taking street drugs. Why Do People Abuse Prescription Drugs? Some people abuse prescription drugs ... common risk of prescription drug abuse is addiction . People who abuse ... as if they were taking street drugs. That's one reason most doctors won't ...

  13. Munchausen Syndrome by Proxy: Social Work's Role.

    ERIC Educational Resources Information Center

    Mercer, Susan O.; Perdue, Jeanette D.

    1993-01-01

    Describes Munchausen syndrome by proxy, diagnosis used to describe variation of child abuse whereby parent or adult caregiver fabricates medical history or induces symptoms in child, or both, resulting in unnecessary examinations, treatments, hospitalizations, and even death. Reviews assessment procedures, provides case studies, and describes…

  14. Elder Abuse

    MedlinePlus

    ... homes. The mistreatment may be Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs of elder abuse include unexplained bruises, burns, and injuries. There ...

  15. Cognitive and emotional differences between abusive and non-abusive fathers.

    PubMed

    Francis, Karen J; Wolfe, David A

    2008-12-01

    Abusive fathers perpetrate a substantial portion of child physical abuse. Despite this, little is known about how they differ from non-abusive fathers. This study compared a broad range of cognitive and affective factors between physically abusive and non-abusive fathers. Abusive (n=24) and non-abusive (n=25) fathers completed standard measures assessing their experience and expression of anger, mental health, parenting stress, and their empathy and perceptions of children's socio-emotional signals. Abusive fathers differed from comparisons on almost all constructs. They experienced more anger and were more likely to express that anger aggressively. They reported more mental health concerns (such as depression, hostility, and paranoid ideation), more stress in parenting, and significantly less empathy for their children. They were also more likely to perceive children's emotional expressions as depicting negative emotions, such as anger and disgust. Abusive fathers struggle with a myriad of difficulties that likely contribute to their problematic parenting. These difficulties are both inter- and intra-personal in nature. The findings suggest that abusive fathers require comprehensive assessment that includes mental health screening. Interventions should be selected carefully to target abusive fathers' high levels of negative affect and negative perceptions. Treatment strategies should address problems related to parenting style (e.g., managing stress and interpretation of children's socioemotional signals) as well as their personal adjustment (e.g., cognitive behavioral strategies for regulating affect and cognitive distortions).

  16. Repeated False Allegations of Sexual Abuse Presenting to Sheriffs: When Is It Munchausen by Proxy?

    ERIC Educational Resources Information Center

    Schreier, Herbert A.

    1996-01-01

    In cases of Munchausen Syndrome by Proxy, the perpetrator (generally the mother) simulates or fabricates child abuse in order to maintain an intense relationship with hospital personnel, police personnel, child protection workers, lawyers, or school personnel. A case involving law enforcement agents as a primary "target" illustrates…

  17. Phacoemulsification and implantation of an accommodating IOL after PRK.

    PubMed

    Aslanides, loannis M; Plainis, Sotiris; Kumar, Vinod; Ginis, Harilaos

    2006-01-01

    To present a case of phacoemulsification and implantation of an accommodating intraocular lens (IOL) in a patient with cataract formation after previous refractive surgery. A 50-year-old man, who initially had photorefractive keratectomy to correct moderate myopia, developed a cataract in one eye. He subsequently underwent phacoemulsification and implantation of a 1CU accommodating IOL, as he wished to remain spectacle independent. The patient's distance vision was fully restored. However, accommodative function, which was assessed using subjective and novice objective techniques, was only partially restored. Although the accommodating IOL fully restored the patient's distance vision, accommodative function was only partially restored.

  18. Framing Appropriate Accommodations in Terms of Individual Need: Examining the Fit of Four Approaches to Selecting Test Accommodations of English Language Learners

    ERIC Educational Resources Information Center

    Koran, Jennifer; Kopriva, Rebecca J.

    2017-01-01

    Providing appropriate test accommodations to most English language learners (ELLs) is important to facilitate meaningful inferences about learning. This study compared teacher large-scale test accommodation recommendations to those from a literature- and practitioner-grounded accommodation selection taxonomy. The taxonomy links student-specific…

  19. Types of abuse and risk factors associated with elder abuse.

    PubMed

    Simone, Lacher; Wettstein, Albert; Senn, Oliver; Rosemann, Thomas; Hasler, Susann

    2016-01-01

    Detecting elder abuse is challenging because it is a taboo, and many cases remain unreported. This study aimed to identify types of elder abuse and to investigate its associated risk factors. Retrospective analyses of 903 dossiers created at an Independent Complaints Authority for Old Age in the Canton of Zurich, Switzerland, from January 1, 2008 to October 31, 2012. Characteristics of victims and perpetrators, types of abuse, and associated risk factors related to the victim or the perpetrator were assessed. Bi- and multivariate analysis were used to identify abuse and neglect determinants. A total of 150 cases reflected at least one form of elder abuse or neglect; 104 cases were categorised as abuse with at least one type of abuse (overall 135 mentions), 46 cases were categorised as neglect (active or passive). Psychological abuse was the most reported form (47%), followed by financial (35%), physical (30%) and anticonstitutional abuse (18%). In 81% of the 150 cases at least two risk factors existed. In 13% no associated risk factor could be identified. Compared with neglect, elders with abuse were less likely to be a nursing home resident than living at home (odds ratio [OR] 0.02, 95% confidence interval [CI] 0.00-0.19). In addition, they were more likely to be cohabiting with their perpetrators (OR 18.01, 95% CI 4.43-73.19). For the majority of the reported elder abuse cases at least two associated risk factors could be identified. Knowledge about these red flags and a multifaceted strategy are needed to identify and prevent elder abuse.

  20. Bearing-Mounting Concept Accommodates Thermal Expansion

    NASA Technical Reports Server (NTRS)

    Nespodzany, Robert; Davis, Toren S.

    1995-01-01

    Pins or splines allow radial expansion without slippage. Design concept for mounting rotary bearing accommodates differential thermal expansion between bearing and any structure(s) to which bearing connected. Prevents buildup of thermal stresses by allowing thermal expansion to occur freely but accommodating expansion in such way not to introduce looseness. Pin-in-slot configuration also maintains concentricity.

  1. Thiamine for prevention and treatment of Wernicke-Korsakoff Syndrome in people who abuse alcohol.

    PubMed

    Day, Ed; Bentham, Peter W; Callaghan, Rhiannon; Kuruvilla, Tarun; George, Sanju

    2013-07-01

    Autopsy studies suggest that Wernicke-Korsakoff syndrome (WKS) is not a rare disorder, particularly in individuals who abuse alcohol. Thiamine has been established as the treatment of choice for over 50 years, but uncertainty remains about appropriate dosage and duration. Current practice guidelines are based on case reports and clinical experience. This is an update of a review first published in 2004 and last updated in 2008. • To assess the efficacy of thiamine in preventing and treating the manifestations of WKS due to excess alcohol consumption. • To determine the optimum form, dose and duration of thiamine treatment for this indication. ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS were searched on 6 September 2012 using the term thiamine OR aneurine. ALOIS contains records from all major health care databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trial databases and grey literature sources. Any randomised trials comparing thiamine with alternative interventions or comparing different thiamine regimens (varying in formulation, dose or duration of administration). All abstracts were independently inspected by two reviewers (ED and PWB), and relevant articles were retrieved and assessed for methodological quality using criteria provided in the Cochrane Handbook for Systematic Reviews of Interventions. Two studies were identified that met the inclusion criteria, but only one contained sufficient data for quantitative analysis. Ambrose (2001) randomly assigned participants (n = 107) to one of five doses of intramuscular thiamine and measured outcomes after 2 days of treatment. We compared the lowest dose (5 mg/day) with each of the other four doses. A significant difference favoured 200 mg/day compared with the 5-mg/day dose in determining the number of trials needed to meet inclusion criteria

  2. Corneal changes with accommodation using dual Scheimpflug photography.

    PubMed

    Sisó-Fuertes, Irene; Domínguez-Vicent, Alberto; del Águila-Carrasco, Antonio; Ferrer-Blasco, Teresa; Montés-Micó, Robert

    2015-05-01

    To assess whether corneal parameters and aberrations are affected by accommodation. Optics Department, University of Valencia, Valencia, Spain. Prospective cross-sectional study. The Galilei G4 dual Scheimpflug device was used to obtain data on the anterior and posterior axial curvatures, total corneal power (TCP), and corneal pachymetry from 3 corneal zones (central: 0.0 up to 4.0 mm; paracentral or mid: 4.0 up to 7.0 mm; peripheral: 7.0 up to 10.0 mm) in young emmetropic eyes in the unaccommodated and 4 accommodated states (from -1.0 to -4.0 diopters [D] in 1.0 D steps). The 2nd-, 3rd-, and 4th-order aberrations as well as the root mean square (RMS) were also determined for the entire cornea at the same accommodative demands. The study evaluated 7 subjects (12 eyes). No significant changes in any measured parameter were found during accommodation for any corneal zone (P > .05). Statistically significant differences were found in the various corneal zones when it was assumed they were constant with accommodation (P < .01). A stable linear trend with accommodation was also found for corneal aberrations, although individual variations existed because of the high standard deviation values. Different parameters in various zones of the cornea as well as corneal aberrations were stable during accommodation. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  3. Linezolid-induced serotonin syndrome

    PubMed Central

    Gupta, Vishal; Karnik, Niteen D; Deshpande, Rushikesh; Patil, Meenakshi Amit

    2013-01-01

    A young drug abuser was admitted to our intensive care unit for organophosphorus poisoning. He required mechanical ventilation and was started empirically on linezolid for suspected nosocomial infection. The patient developed high-grade fever with altered sensorium and clonus. Serotonin syndrome was suspected and the patient was started on cyproheptadine. He recovered within 3 days of withdrawing linezolide and administering cyproheptadine. PMID:23513014

  4. What Works? Toward a New Classification System for Mental Health Supported Accommodation Services: The Simple Taxonomy for Supported Accommodation (STAX-SA)

    PubMed Central

    McPherson, Peter; Krotofil, Joanna

    2018-01-01

    Inconsistent terminology and variation in service models have made synthesis of the supported accommodation literature challenging. To overcome this, we developed a brief, categorical taxonomy that aimed to capture the defining features of different supported accommodation models: the simple taxonomy for supported accommodation (STAX-SA). Data from a previous review of existing classification systems were used to develop the taxonomy structure. After initial testing and amendments, the STAX-SA and an existing taxonomy were applied to 132 supported accommodation service descriptions drawn from two systematic reviews and their performance compared. To assess external validity, the STAX-SA was distributed to a sample of supported accommodation managers in England and they were asked to use it to classify their services. The final version of the STAX-SA comprised of five supported accommodation ‘types’, based on four domains; Staffing location; Level of support; Emphasis on move-on; and Physical setting. The STAX-SA accurately categorized 71.1% (n = 94) of service descriptions, outperforming the comparison tool, and was not affected by publication date or research design. The STAX-SA effectively discriminated between ‘real world’ service models in England and 53.2% (n = 17) of service managers indicated that the taxonomy was ‘Very effective’ or ‘Extremely effective’ in capturing key characteristics of their service. The STAX-SA is an effective tool for classifying supported accommodation models and represents a promising approach to synthesizing the extant effectiveness literature. The authors recommend the development of reporting guidelines for future supported accommodation publications to facilitate comparison between models. PMID:29364171

  5. What Works? Toward a New Classification System for Mental Health Supported Accommodation Services: The Simple Taxonomy for Supported Accommodation (STAX-SA).

    PubMed

    McPherson, Peter; Krotofil, Joanna; Killaspy, Helen

    2018-01-24

    Inconsistent terminology and variation in service models have made synthesis of the supported accommodation literature challenging. To overcome this, we developed a brief, categorical taxonomy that aimed to capture the defining features of different supported accommodation models: the simple taxonomy for supported accommodation (STAX-SA). Data from a previous review of existing classification systems were used to develop the taxonomy structure. After initial testing and amendments, the STAX-SA and an existing taxonomy were applied to 132 supported accommodation service descriptions drawn from two systematic reviews and their performance compared. To assess external validity, the STAX-SA was distributed to a sample of supported accommodation managers in England and they were asked to use it to classify their services. The final version of the STAX-SA comprised of five supported accommodation 'types', based on four domains; Staffing location ; Level of support ; Emphasis on move-on ; and Physical setting . The STAX-SA accurately categorized 71.1% ( n = 94) of service descriptions, outperforming the comparison tool, and was not affected by publication date or research design. The STAX-SA effectively discriminated between 'real world' service models in England and 53.2% ( n = 17) of service managers indicated that the taxonomy was ' Very effective ' or ' Extremely effective ' in capturing key characteristics of their service. The STAX-SA is an effective tool for classifying supported accommodation models and represents a promising approach to synthesizing the extant effectiveness literature. The authors recommend the development of reporting guidelines for future supported accommodation publications to facilitate comparison between models.

  6. Functional spasm of accommodation: Changes on scheimpflug imaging

    PubMed Central

    Sukhija, Jaspreet; Dogra, Mangat R.; Zadeng, Thara; Ram, Jagat

    2014-01-01

    Spasm of accommodation is a rare condition characterized by a sudden increase in myopia. It can occur in emmetropes, hypermetropes and myopes. All the physiological changes that occur in normal accommodation are exaggerated. Mostly the cause is functional disorder and the condition gradually improves. We hereby present the changes occurring in spasm of accommodation as seen on Scheimpflug imaging. PMID:25378883

  7. Adolescent Abuse.

    ERIC Educational Resources Information Center

    Foreman, Susan; Seligman, Linda

    1983-01-01

    Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)

  8. Drug Abuse

    MedlinePlus

    ... drugs, including opioids Drug abuse also plays a role in many major social problems, such as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms ...

  9. Age-Related Changes in Accommodative Dynamics from Preschool to Adulthood

    PubMed Central

    Glasser, Adrian; Manny, Ruth E.; Stuebing, Karla K.

    2010-01-01

    Purpose. To study variations in dynamic measures of accommodation and disaccommodation with age in subjects ranging from preschool to adulthood. Methods. Accommodative responses to a step stimulus cartoon movie alternating from distance to near were recorded with a dynamic infrared photorefractor. Subjects viewed at least three stimulus cycles of far and near for four near stimulus demands (2, 3, 4, and 5 D). Latencies, peak velocities, and the magnitude of accommodative microfluctuations were calculated from the responses and compared in 41 subjects from 3 to 38 years of age. Results. Mean accommodative and disaccommodative latencies decreased linearly with age. The magnitude of accommodative microfluctuations during sustained near accommodation had a significant quadratic relationship to age, with subjects in the first decade of life having the largest fluctuations and subjects in the third decade of life having the smallest for all stimulus demands. Accommodative peak velocities were fastest in subjects in the first two decades of life, compared with subjects in the third and fourth decades; however, disaccommodative peak velocities showed no significant age differences. Conclusions. Age-related changes in dynamics occur in accommodative and disaccommodative latencies, accommodative peak velocities, and accommodative microfluctuations, all of which decrease with increasing age from preschool to adulthood. Disaccommodative peak velocities showed no change with age. PMID:19684002

  10. Parenting and children's externalizing problems in substance-abusing families.

    PubMed

    Stanger, Catherine; Dumenci, Levent; Kamon, Jody; Burstein, Marcy

    2004-09-01

    This study tested associations in path models among positive and negative parenting and children's rule-breaking behavior, aggressive and oppositional behavior, and attention problems for families with a drug-dependent parent. A structural model tested relations between parenting and children's externalizing problems for 251 families with 399 children between the ages of 6 and 18, controlling for nonindependence of ratings at the family level. The model also tested potential moderators, including child age, gender, and ethnicity (White vs. other), and caregiver gender (families with a female substance-abusing caregiver vs. families with a male substance-abusing caregiver). Results indicated that caregiver ratings of monitoring predicted rule-breaking behavior and use of inconsistent discipline predicted ratings of all 3 externalizing syndromes, after controlling parenting and externalizing problems for the effects of the moderators and after controlling significant relations among types of parenting and types of externalizing problems.

  11. Psychiatric Disorders of Children Living with Drug-Abusing, Alcohol-Abusing, and Non-Substance-Abusing Fathers.

    ERIC Educational Resources Information Center

    Kelley, Michelle L.; Fals-Stewart, William

    2004-01-01

    Objective: The present study examined lifetime psychiatric disorders and current emotional and behavioral problems of 8- to 12-year-old children living with drug-abusing (DA) fathers compared to children living in demographically matched homes with alcohol-abusing (AA) or non-substance-abusing fathers. Method: Children's lifetime psychiatric…

  12. Development of immunopharmacotherapy against drugs of abuse.

    PubMed

    Meijler, Michael M; Matsushita, Masayuki; Wirsching, Peter; Janda, Kim D

    2004-01-01

    Drug addiction is a major worldwide medical and social problem that continues to escalate. The addiction syndrome is remarkably similar between different drugs of abuse, and can be characterized as a chronic relapsing brain disorder with neurobiological changes that lead to a compulsion to take a drug with loss of control over drug intake. Presently used medications for the treatment of dependence disorders are based on drugs that are either agonists or antagonists of drugs of abuse, and have yielded only limited success. Immunopharmacotherapy is based on the generation or administration of antibodies that are capable of binding the targeted drug before it can reach the brain, whereas replacement strategies based on agonists or antagonists of these drugs generally cause many undesired side effects. A large amount of data has been gathered in recent years on the effects of active and passive immunization against cocaine, nicotine, PCP and methamphetamine in animal models, suggesting potential efficacy of these treatments in humans; and clinical trials are currently underway for vaccines against cocaine and nicotine.

  13. Communication Accommodation between Chinese and Australian Students and Academic Staff.

    ERIC Educational Resources Information Center

    Gallois, Cynthia; And Others

    A study tested paths predicted by Communication Accommodation Theory (CAT) in the context of interactions between 105 Chinese and 283 Anglo-Australian students and 98 academic staff in situations of potential conflict. Videotapes of student-lecturer interactions in which speakers accommodated, over-accommodated, or under-accommodated were rated by…

  14. 28 CFR 36.310 - Transportation provided by public accommodations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Transportation provided by public... BASIS OF DISABILITY BY PUBLIC ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Specific Requirements § 36.310 Transportation provided by public accommodations. (a) General. (1) A public accommodation that provides...

  15. [Monochromatic aberration in accommodation. Dynamic wavefront analysis].

    PubMed

    Fritzsch, M; Dawczynski, J; Jurkutat, S; Vollandt, R; Strobel, J

    2011-06-01

    Monochromatic aberrations may influence the visual acuity of the eye. They are not stable and can be affected by different factors. The subject of the following paper is the dynamic investigation of the changes in wavefront aberration with accommodation. Dynamic measurement of higher and lower order aberrations was performed with a WASCA Wavefront Analyzer (Carl-Zeiss-Meditec) and a specially constructed target device for aligning objects in far and near distances on 25 subjects aged from 15 to 27 years old. Wavefront aberrations showed some significant changes in accommodation. In addition to the characteristic sphere reaction accompanying miosis and changes in horizontal prism (Z(1) (1)) in the sense of a convergence movement of the eyeball also occurred. Furthermore defocus rose (Z(2) (0)) and astigmatism (Z(2) (-2)) changed. In higher-order aberrations a decrease in coma-like Zernike polynomials (Z(3) (-1), Z(3) (1)) was found. The most obvious change appeared in spherical aberration (Z(4) (0)) which increased and changed from positive to negative. In addition the secondary astigmatism (Z(4) (-2)) and quadrafoil (Z(4) (4)) rise also increased. The total root mean square (RMS), as well as the higher-order aberrations (RMS-HO) significantly increased in accommodation which is associated with a theoretical reduction of visual acuity. An analysis of the influence of pupil size on aberrations showed significant increases in defocus, spherical aberration, quadrafoil, RMS and RMS HO by increasing pupil diameter. By accommodation-associated miosis, the growing aberrations are partially compensated by focusing on near objects. Temporal analysis of the accommodation process with dynamic wavefront analysis revealed significant delays in pupil response and changing of prism in relation to the sphere reaction. In accommodation to near objects a discrete time ahead of third order aberrations in relation to the sphere response was found. Using dynamic wavefront measurement

  16. Operationalizing workplace accommodations for individuals with disabilities: A scoping review.

    PubMed

    Sundar, Vidya

    2017-01-01

    The provision of workplace accommodations is a proven strategy in supporting individuals with disabilities at work. Accommodations include a wide range of supports and strategies that are not very well defined beyond the Americans with Disabilities Act in the United States. Understanding the landscape of accommodations is important to measure the impact of programs that support employment of individuals with disabilities. To conduct a scoping review and thematic analysis of research literature to identify how workplace accommodations are operationalized and to identify knowledge gaps in its conceptualization. Keywords searches were conducted in seven electronic databases. Title, abstract, and full text screening was conducted followed by a thematic analysis of the content to identify how workplace accommodations are operationalized. Overall, 47 studies were selected for review. 433 different types of accommodations were identified, of which assistive technology and specialized equipment represented the most frequently reported type of accommodation (40%). A very small percentage of studies included policy changes (9%) and human assistance (5%) as an accommodation strategy. This scoping review aims to clarify how accommodations are operationalized in the research literature. Key knowledge gaps identified include the systematic exclusion of certain types of supports or disability types.

  17. Anthropometric Accommodation in Space Suit Design

    NASA Technical Reports Server (NTRS)

    Rajulu, Sudhakar; Thaxton, Sherry

    2007-01-01

    Design requirements for next generation hardware are in process at NASA. Anthropometry requirements are given in terms of minimum and maximum sizes for critical dimensions that hardware must accommodate. These dimensions drive vehicle design and suit design, and implicitly have an effect on crew selection and participation. At this stage in the process, stakeholders such as cockpit and suit designers were asked to provide lists of dimensions that will be critical for their design. In addition, they were asked to provide technically feasible minimum and maximum ranges for these dimensions. Using an adjusted 1988 Anthropometric Survey of U.S. Army (ANSUR) database to represent a future astronaut population, the accommodation ranges provided by the suit critical dimensions were calculated. This project involved participation from the Anthropometry and Biomechanics facility (ABF) as well as suit designers, with suit designers providing expertise about feasible hardware dimensions and the ABF providing accommodation analysis. The initial analysis provided the suit design team with the accommodation levels associated with the critical dimensions provided early in the study. Additional outcomes will include a comparison of principal components analysis as an alternate method for anthropometric analysis.

  18. Maximum human objectively measured pharmacologically stimulated accommodative amplitude.

    PubMed

    Grzybowski, Andrzej; Schachar, Ronald A; Gaca-Wysocka, Magdalena; Schachar, Ira H; Pierscionek, Barbara K

    2018-01-01

    To measure the maximum, objectively measured, accommodative amplitude, produced by pharmacologic stimulation. Thirty-seven healthy subjects were enrolled, with a mean age of 20.2±1.1 years, corrected visual acuity of 20/20, and mean spherical equivalent refraction (SER) =-0.83±1.60 diopters. For each subject, the right pupil was dilated with phenylephrine 10%. After 30 minutes, the pupil was measured, the left eye was patched, and the right eye was autorefracted. Pilocarpine 4% was then instilled in the right eye, followed by phenylephrine. At 45 minutes after the pilocarpine, autorefraction and pupil size were again measured. Mean pupil size pre- and postpilocarpine was 8.0±0.8 mm and 4.4±1.9 mm, respectively. Pre- and postpilocarpine, the mean SER was -0.83±1.60 and -10.55±4.26 diopters, respectively. The mean pilocarpine-induced accommodative amplitude was 9.73±3.64 diopters. Five subjects had accommodative amplitudes ≥14.00 diopters. Accommodative amplitude was not significantly related to baseline SER ( p -value =0.24), pre- or postpilocarpine pupil size ( p -values =0.13 and 0.74), or change in pupil size ( p -value =0.37). Iris color did not statistically significantly affect accommodative amplitude ( p -value =0.83). Following topically applied pilocarpine, the induced objectively measured accommodation in the young eye is greater than or equal to the reported subjectively measured voluntary maximum accommodative amplitude.

  19. Restoration of accommodation: surgical options for correction of presbyopia

    PubMed Central

    Glasser, Adrian

    2010-01-01

    Accommodation is a dioptric change in the power of the eye to see clearly at near. Ciliary muscle contraction causes a release in zonular tension at the lens equator, which permits the elastic capsule to mould the young lens into an accommodated form. Presbyopia, the gradual age-related loss of accommodation, occurs primarily through a gradual age-related stiffening of the lens. While there are many possible options for relieving the symptoms of presbyopia, only relatively recently has consideration been given to surgical restoration of accommodation to the presbyopic eye. To understand how this might be achieved, it is necessary to understand the accommodative anatomy, the mechanism of accommodation and the causes of presbyopia. A variety of different kinds of surgical procedures has been considered for restoring accommodation to the presbyopic eye, including surgical expansion of the sclera, using femtosecond lasers to treat the lens or with so-called accommodative intraocular lenses (IOLs). Evidence suggests that scleral expansion cannot and does not restore accommodation. Laser treatments of the lens are in their early infancy. Development and testing of accommodative IOLs are proliferating. They are designed to produce a myopic refractive change in the eye in response to ciliary muscle contraction either through a movement of an optic or through a change in surface curvature. Three general design principles are being considered. These are single optic IOLs that rely on a forward shift of the optic, dual optic IOLs that rely on an increased separation between the two optics, or IOLs that permit a change in surface curvature to produce an increase in optical power in response to ciliary muscle contraction. Several of these different IOLs are available and being used clinically, while many are still in research and development. PMID:18399800

  20. Dynamic accommodation with simulated targets blurred with high order aberrations

    PubMed Central

    Gambra, Enrique; Wang, Yinan; Yuan, Jing; Kruger, Philip B.; Marcos, Susana

    2010-01-01

    High order aberrations have been suggested to play a role in determining the direction of accommodation. We have explored the effect of retinal blur induced by high order aberrations on dynamic accommodation by measuring the accommodative response to sinusoidal variations in accommodative demand (1–3 D). The targets were blurred with 0.3 and 1 μm (for a 3-mm pupil) of defocus, coma, trefoil and spherical aberration. Accommodative gain decreased significantly when 1-μm of aberration was induced. We found a strong correlation between the relative accommodative gain (and phase lag) and the contrast degradation imposed on the target at relevant spatial frequencies. PMID:20600230

  1. Objective measurement of accommodative biometric changes using ultrasound biomicroscopy

    PubMed Central

    Ramasubramanian, Viswanathan; Glasser, Adrian

    2015-01-01

    PURPOSE To demonstrate that ultrasound biomicroscopy (UBM) can be used for objective quantitative measurements of anterior segment accommodative changes. SETTING College of Optometry, University of Houston, Houston, Texas, USA. DESIGN Prospective cross-sectional study. METHODS Anterior segment biometric changes in response to 0 to 6.0 diopters (D) of accommodative stimuli in 1.0 D steps were measured in eyes of human subjects aged 21 to 36 years. Imaging was performed in the left eye using a 35 MHz UBM (Vumax) and an A-scan ultrasound (A-5500) while the right eye viewed the accommodative stimuli. An automated Matlab image-analysis program was developed to measure the biometry parameters from the UBM images. RESULTS The UBM-measured accommodative changes in anterior chamber depth (ACD), lens thickness, anterior lens radius of curvature, posterior lens radius of curvature, and anterior segment length were statistically significantly (P < .0001) linearly correlated with accommodative stimulus amplitudes. Standard deviations of the UBM-measured parameters were independent of the accommodative stimulus demands (ACD 0.0176 mm, lens thickness 0.0294 mm, anterior lens radius of curvature 0.3350 mm, posterior lens radius of curvature 0.1580 mm, and anterior segment length 0.0340 mm). The mean difference between the A-scan and UBM measurements was −0.070 mm for ACD and 0.166 mm for lens thickness. CONCLUSIONS Accommodating phakic eyes imaged using UBM allowed visualization of the accommodative response, and automated image analysis of the UBM images allowed reliable, objective, quantitative measurements of the accommodative intraocular biometric changes. PMID:25804579

  2. [Role of physical, psychological and sexual abuse in functional digestive disorders. A case-controls trial.].

    PubMed

    Remes-Troche, J M; Cid-Juárez, S; Campos-Ramos, I; Ramos-de la Medina, A; Galmiche, A; Schmulson-Wasserman, M; Roesch-Dietlen, F

    2008-01-01

    Abuse has been considered a significant factor on the development of functional gastrointestinal disorders (FGID), especially for severe and treatment-refractory patients. The aim of our study was to evaluate the presence of all FGID according to Rome II criteria, in a group of women with history of physical, psychological and/or sexual abuse. A cross sectional study was performed in 96 women (37 +/- 12 years of age) with history of physical, psychological and/or sexual abuse (cases); and 96 open population women (36 +/- 14 years of age) (controls). The following evaluations were administered: Rome II questionnaire, a self-administered instrument to evaluate history of physical (beating), psychological(insults, public humiliation) and/or sexual abuse (rape, coercion), and HAD questionnaire. Among 96 women with history of abuse,91 (95%) reported to have suffered psychological abuse, 72 (75%) physical abuse, and 24 (25%)sexual abuse. Women with history of abuse had a higher prevalence of rumination (6% vs. 0%, p= 0.02), functional heartburn (26% vs. 13%, p =0.04), aerofagia (17% vs. 5%, p = 0.019), irritable bowel syndrome (38% vs. 18%, p = 0.002), fecalin continence (16% vs. 4%, p = 0.01), elevator anisyndrome (5% vs. 0%, p = 0.05), and proctalgia fugax (29% vs. 15%, p = 0.02) compared to controls. There was a positive correlation between anxiety (r = 0.5, p = 0.001) and depression scores(r = 0.45, p = 0.001), and the number of FGID. We demonstrated a high prevalence of FGID among women with history of physical,psychological, and/or sexual abuse. In this association,concomitant anxiety and depression play a significant role.

  3. Differences between U.S. substance abuse treatment facilities that do and do not offer domestic violence services.

    PubMed

    Cohn, Amy; Najavits, Lisa M

    2014-04-01

    Victimization by and perpetration of domestic violence are associated with co-occurring mental and substance use disorders. This study used data from the National Survey of Substance Abuse Treatment Services to examine differences in organizational factors, treatment approaches offered, and client-level factors among 13,342 substance abuse treatment facilities by whether or not they offered domestic violence services. Only 36% of the facilities offered domestic violence services. Those that offered such services were more likely than those that did not to treat clients with co-occurring disorders. Principal-components analysis reduced eight treatment approaches to two factors: psychosocial services and traditional substance abuse services. Regression models indicated that the frequency with which psychosocial services were offered depended on the percentage of clients with co-occurring disorders who were being treated in the facility and whether or not that facility offered domestic violence services. Specifically, facilities that did not offer domestic violence services and that had a high percentage of clients with co-occurring disorders were more likely to offer psychosocial services than facilities that offered domestic violence services. A larger proportion of facilities offering domestic violence services offered traditional substance abuse treatment services, compared with facilities not offering domestic violence services, but this relationship was not contingent on the percentage of clients with co-occurring disorders at each facility. Improved efforts should be made to tailor treatments to accommodate the links between domestic violence, mental disorders, and substance abuse.

  4. Assessment of launch site accommodations versus Spacelab payload requirements

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The Kennedy launch site capability for accommodating spacelab payload operations was assessed. Anomalies between facility accommodations and requirements for the Spacelab III (Strawman), OA Mission 83-2, Dedicated Life Sciences, and Combined Astronomy missions are noted. Recommendations for revision of the accommodations handbook are summarized.

  5. Computer-animated model of accommodation and presbyopia.

    PubMed

    Goldberg, Daniel B

    2015-02-01

    To understand, demonstrate, and further research the mechanisms of accommodation and presbyopia. Private practice, Little Silver, New Jersey, USA. Experimental study. The CAMA 2.0 computer-animated model of accommodation and presbyopia was produced in collaboration with an experienced medical animator using Autodesk Maya animation software and Adobe After Effects. The computer-animated model demonstrates the configuration and synchronous movements of all accommodative elements. A new classification of the zonular apparatus based on structure and function is proposed. There are 3 divisions of zonular fibers; that is, anterior, crossing, and posterior. The crossing zonular fibers form a scaffolding to support the lens; the anterior and posterior zonular fibers work reciprocally to achieve focused vision. The model demonstrates the important support function of Weiger ligament. Dynamic movement of the ora serrata demonstrates that the forces of ciliary muscle contraction store energy for disaccommodation in the elastic choroid. The flow of aqueous and vitreous provides strong evidence for our understanding of the hydrodynamic interactions during the accommodative cycle. The interaction may result from the elastic stretch in the choroid transmitted to the vitreous rather than from vitreous pressue. The model supports the concept that presbyopia results from loss of elasticity and increasing ocular rigidity in both the lenticular and extralenticular structures. The computer-animated model demonstrates the structures of accommodation moving in synchrony and might enhance understanding of the mechanisms of accommodation and presbyopia. Dr. Goldberg is a consultant to Acevision, Inc., and Bausch & Lomb. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. Ocular Aberrations Across the Visual Field During Accommodation

    NASA Astrophysics Data System (ADS)

    Liu, Tao

    Myopia is classically defined as a mismatch between the optical power of the relaxed eye and its dioptric length. This definition is entirely foveocentric without concern for the contributions of peripheral refractive errors to myopia development. Long periods of steady near-work was considered to cause myopia development due to inadequate accommodation. Consequently, not only the on-axis optical features but also off-axis ones should be probed to gain insight about myopia progression. Moreover, these features need to be understood not only for the relaxed eye, but also for the accommodating eye. To acquire complete data set, a custom-built Indiana Scanning Aberrometer for Wavefront (I SAW) was developed to measure wavefront aberration along 37 line-of-sights at 8 different accommodation states in the central 30 degree visual field. We found that ocular refractive state changed uniformly over the central visual field as the eye accommodates up to 6D, and the accuracy of accommodation across the central visual field is similar to that measured in the fovea. No systematic difference between emmetropic and myopic eyes was evident. Then, a linear vector-summation rule for axial and oblique astigmatism was found to account for their interaction over the central visual field. Using this combination rule, our experimental evidence revealed no systematic effect of accommodation on axial or oblique astigmatism for two adult populations. The axial and oblique astigmatism of the whole eye is less than for the cornea alone, indicating a compensatory role for internal optics at all accommodative states. This compensation mechanism was further validated theoretically with schematic eye model. Lastly, we developed a hybrid method yielding customized eye models that accurately reproduce the empirical measurements and reasonably represent the anatomical structure, thus providing a mechanistic explanation for the changes in the eye's aberration structure that occur over the central

  7. College Students' Hypothetical Responses to Suicidal Individuals Who Are HIV Positive, Substance Abusing, Depressed, or Anxious.

    ERIC Educational Resources Information Center

    O'Neal, Steven E.; Range, Lillian M.

    1993-01-01

    Undergraduates (n=141) read vignette about suicidal person with either Acquired Immune Deficiency Syndrome, depression, drug abuse, anxiety, or adjustment problems. Found that suicidal person who was human immunodeficiency virus-positive engendered significantly less helpful responses from students than did suicidal person who had panic attacks.…

  8. An Analysis and Rejection of Arguments for Religious Accommodation

    ERIC Educational Resources Information Center

    Kline, Lisa Anne

    2009-01-01

    This dissertation provides a comprehensive critical analysis of six main arguments for religious accommodation, with a specific focus on fundamentalist religious groups and the accommodation of their practices within liberal democratic societies. This analysis reveals that the types of practices that these arguments aim to accommodate primarily…

  9. Sexual abuses.

    PubMed

    Abel, G G; Rouleau, J L

    1995-03-01

    The sexual abuses described in this article are occurring so frequently that they constitute a public health problem. Superficially they appear to be quite dissimilar because they involve individuals of different ages, different settings, and different power relationships. Basic to each of them, however, is an absence of consent by the victim and the misuse of power by the perpetrator in order to accomplish the abuse. We now have an adequate understanding of each of these abuses and it is now time to make a concerted effort to stop these abuses. This will require the combined efforts of the education of the public, improved identification of the abuses, treatment of the victims, and an appropriate criminal justice response combined with treatment of the perpetrator.

  10. Multiple fractures in infants who have Ehlers-Danlos/hypermobility syndrome and or vitamin D deficiency: A case series of 72 infants whose parents were accused of child abuse and neglect

    PubMed Central

    Hossein-Nezhad, A.; Tabatabaei, F.

    2017-01-01

    ABSTRACT Objective: To increase the level of awareness that Ehlers-Danlos/hypermobility syndrome (EDS) and vitamin D deficiency are associated with infantile fragility fractures and radiologic features that may be mistakenly reported to be caused by non-accidental trauma due to Child Abuse and Neglect (CAN). Patients and Methods: We constructed a case series, the largest to date, of infants with EDS who were vitamin D sufficient, insufficient and deficient and infants without EDS but with documented vitamin D deficiency and radiologic evidence of rickets who presented with multiple fractures originally diagnosed as being non-accidental and caused by child abuse. These infants were referred to the outpatient Bone Health Care Clinic at Boston University Medical Campus over a 6-year (2010–2015) period. We also present 6 index cases in which the court concluded that there was no convincing evidence of child abuse and the infants were returned to their parents. Institutional Review Board (IRB) approval was obtained. Results: We present 72 cases of infants with multiple fractures diagnosed to be caused by non-accidental trauma. All infants were younger than one year of age. Among them, 93%(67) had clinical evidence of EDS and/or a family history with a confirmed clinical diagnosis of at least one parent having EDS and the other 7%(5) without evidence of EDS had vitamin D deficiency/infantile rickets. Three of the EDS infants were diagnosed as osteogenesis imperfecta (OI)/EDS overlap syndrome. The most common fractures noted at diagnosis were ribs and extremity fractures (including classic metaphyseal lesions). Serum levels of 25-hydroxyvitamin D [25(OH)D] were reported in 48 infants (18.0 ± 8.5 ng/ml) and in 30 mothers (21.3 ± 11.7 ng/ml). Sixty-three percent (27) of the EDS infants who had their serum 25(OH)D measured were vitamin D deficient 25(OH)D<20 ng/ml and 5 were vitamin D sufficient 25(OH)D>30 ng/ml. The mean serum level for infants with vitamin D deficiency

  11. Spouse Abuse, Child Abuse, and Substance Abuse Among Army Facilities: Co-Occurrence, Correlations and Service Delivery Issues

    DTIC Science & Technology

    2006-03-01

    refer spouse abuse or child abuse offenders with identified alcohol or other drug involvement to the on-base counseling center for a substance...abuse assessment. The military’s response to combat substance abuse involves a combination of education, prevention, random testing for illicit drug ...data from three Army sources: the Army Central Registry (ACR), the Drug and Alcohol Management Information System (DAMIS), and Army personnel data

  12. Long-term reproducibility of Edinger-Westphal stimulated accommodation in rhesus monkeys.

    PubMed

    He, Lin; Wendt, Mark; Glasser, Adrian

    2013-08-01

    If longitudinal studies of accommodation or accommodation restoration procedures are undertaken in rhesus monkeys, the methods used to induce and measure accommodation must remain reproducible over the study period. Stimulation of the Edinger-Westphal (EW) nucleus in anesthetized rhesus monkeys is a valuable method to understand various aspects of accommodation. A prior study showed reproducibility of EW-stimulated accommodation over 14 months after chronic electrode implantation. However, reproducibility over a period longer than this has not been investigated and therefore remains unknown. To address this, accommodation stimulation experiments in four eyes of two rhesus monkeys (13.7 and 13.8 years old) were evaluated over a period of 68 months. Carbachol iontophoresis stimulated accommodation was first measured with a Hartinger coincidence refractometer (HCR) two weeks before electrode implantation to determine maximum accommodative amplitudes. EW stimulus-response curves were initially measured with the HCR one month after electrode implantation and then repeated at least six times for each eye in the following 60 months. At 64 months, carbachol iontophoresis induced accommodation was measured again. At 68 months, EW stimulus-response curves were measured with an HCR and photorefraction every week over four consecutive weeks to evaluate the short-term reproducibility over one month. In the four eyes studied, long-term EW-stimulated accommodation decreased by 7.00 D, 3.33 D, 4.63 D, and 2.03 D, whereas carbachol stimulated accommodation increased by 0.18 D-0.49 D over the same time period. The short-term reproducibility of maximum EW-stimulated accommodation (standard deviations) over a period of four weeks at 68 months after electrode implantation was 0.48 D, 0.79 D, 0.55 D and 0.39 D in the four eyes. Since the long-term decrease in EW-stimulated accommodation is not matched by similar decreases in carbachol iontophoresis stimulated accommodation, the decline

  13. Household income is associated with the risk of metabolic syndrome in a sex-specific manner.

    PubMed

    Dallongeville, Jean; Cottel, Dominique; Ferrières, Jean; Arveiler, Dominique; Bingham, Annie; Ruidavets, Jean Bernard; Haas, Bernadette; Ducimetière, Pierre; Amouyel, Philippe

    2005-02-01

    To assess the relationship between household income and metabolic syndrome in men and women. A total of 1,695 men and 1,664 women, aged 35-64 years, from three distinct geographical areas of France were investigated. Waist girth, plasma triglycerides, HDL cholesterol, glucose, and systolic blood pressure were used to define metabolic syndrome according to the National Cholesterol Education Program (NCEP)/Adult Treatment Panel III (ATPIII) guidelines. Household income, educational level, occupational category, working status, consumption of psychotropic drugs, accommodation status, household composition, physical activity at work and during leisure time, alcohol consumption, and smoking habits were recorded with a standardized questionnaire. There were 390 (23.0%) men and 381 (16.9%) women who satisfied NCEP/ATPIII criteria for metabolic syndrome. Household income (P < 0.0001) and consumption of psychotropic drugs (P = 0.0005) were associated with metabolic syndrome in women but not in men. In contrast, educational level, occupational category, working status, and accommodation status were associated with metabolic syndrome in both men and women. After adjustment on lifestyle variables, household income (interaction P < 0.004) remained inversely associated with metabolic syndrome in women but not in men. These data suggest that limited household income, which reflects a complex unfavorable social and economic environment, may increase the risk of metabolic syndrome in a sex-specific manner.

  14. Prevalence and predictors of Axis I disorders in a large sample of treatment-seeking victims of sexual abuse and incest.

    PubMed

    McElroy, Eoin; Shevlin, Mark; Elklit, Ask; Hyland, Philip; Murphy, Siobhan; Murphy, Jamie

    2016-01-01

    Childhood sexual abuse (CSA) is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses. The participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434). Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts) and 10 adult clinical syndromes. There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses.

  15. Accommodations: Assisting Students with Disabilities. Third Edition

    ERIC Educational Resources Information Center

    Beech, Marty

    2010-01-01

    This document updates "Accommodations: Assisting Students with Disabilities. A Guide for Educators," published by the Florida Department of Education (FDOE) in 2003. This document is written to assist school district personnel and parents when making decisions about the use of accommodations by students with disabilities in instructional…

  16. 14 CFR § 1251.201 - Reasonable accommodation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ON BASIS OF HANDICAP Employment Practices § 1251.201 Reasonable accommodation. (a) A recipient shall... handicapped applicant or employee unless the recipient can demonstrate that the accommodation would impose an...) Making facilities used by employees readily accessible to and usable by handicapped persons; and (2) Job...

  17. 7 CFR 15b.13 - Reasonable accommodation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) A recipient shall make reasonable accommodation to the known physical or mental limitations of an... accommodation would impose an undue hardship on the operation of its program or activity. (b) Reasonable... undue hardship on the operation of a recipient's programs or activities, factors to be considered...

  18. Recommendations for Accommodations: Implications of (In)consistency

    ERIC Educational Resources Information Center

    Ketterlin-Geller, Leanne R.

    2007-01-01

    When accurately assigned and administered appropriately, testing accommodations help ameliorate the effects of personal characteristics that limit access to critical information and prevent a person from demonstrating his or her true abilities in the tested domain. Inaccurate assignment or misuse of accommodations may counteract the benefits of…

  19. 46 CFR 154.325 - Accommodation, service, and control spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Accommodation, service, and control spaces. 154.325... Equipment Ship Arrangements § 154.325 Accommodation, service, and control spaces. (a) Accommodation, service, and control spaces must be outside the cargo area. (b) If a hold space having a cargo containment...

  20. 46 CFR 154.325 - Accommodation, service, and control spaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 5 2011-10-01 2011-10-01 false Accommodation, service, and control spaces. 154.325... Equipment Ship Arrangements § 154.325 Accommodation, service, and control spaces. (a) Accommodation, service, and control spaces must be outside the cargo area. (b) If a hold space having a cargo containment...

  1. 46 CFR 154.325 - Accommodation, service, and control spaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 5 2013-10-01 2013-10-01 false Accommodation, service, and control spaces. 154.325... Equipment Ship Arrangements § 154.325 Accommodation, service, and control spaces. (a) Accommodation, service, and control spaces must be outside the cargo area. (b) If a hold space having a cargo containment...

  2. Effects of visual imagery on the accommodation response

    NASA Technical Reports Server (NTRS)

    Malmstrom, F. V.; Randle, R. J.

    1976-01-01

    Twenty-seven naive male subjects were tested to determine whether they could effect appropriate accommodation changes in an empty field by 'thinking near' and 'thinking far'. Evidence indicated that naive subjects could effect significant and appropriate accommodation changes, but only about a steady-state value of 1.0 diopter. Additionally, the data support the hypothesis that the resting state of accommodation is not at the visual far point, but, rather, at about 1.0 diopter.

  3. Workplace accommodations for people with mental illness: a scoping review.

    PubMed

    McDowell, Caitlin; Fossey, Ellie

    2015-03-01

    Disability discrimination legislation means that employees with a disability or mental illness are legally entitled to reasonable workplace accommodations that enable them to work effectively and safely. This scoping review aims to investigate the types of workplace accommodations provided for people with mental illness, and their costs and benefits. A literature search was conducted using five electronic databases. Peer reviewed research articles published between 1993 and June 2013 were included in this scoping review and their quality was assessed. Opinion papers, reports, and case descriptions were excluded. Nine studies explored workplace accommodations for people with mental illness. The most commonly reported work-related accommodations were flexible scheduling/reduced hours, modified training and supervision, and modified job duties/descriptions. The least common type of accommodation was physical modification to the workplace. For employees with persistent mental illness who were accessing a supported employment agency, the majority of accommodations related to support from the job coach or employment specialist, such as facilitating communication with the employer during hiring or on the job. The quality of the studies varied considerably and the benefits of the accommodations are not yet well documented. There is limited evidence that a larger number of workplace accommodations are associated with longer job tenure. Workplace accommodations appear to be important to support employees with mental illness, but more accessible information about how disability discrimination legislation applies to this population is needed. Future research should address the implementation and effectiveness of mental health-related workplace accommodations.

  4. Vergence driven accommodation with simulated disparity in myopia and emmetropia.

    PubMed

    Maiello, Guido; Kerber, Kristen L; Thorn, Frank; Bex, Peter J; Vera-Diaz, Fuensanta A

    2018-01-01

    The formation of focused and corresponding foveal images requires a close synergy between the accommodation and vergence systems. This linkage is usually decoupled in virtual reality systems and may be dysfunctional in people who are at risk of developing myopia. We study how refractive error affects vergence-accommodation interactions in stereoscopic displays. Vergence and accommodative responses were measured in 21 young healthy adults (n=9 myopes, 22-31 years) while subjects viewed naturalistic stimuli on a 3D display. In Step 1, vergence was driven behind the monitor using a blurred, non-accommodative, uncrossed disparity target. In Step 2, vergence and accommodation were driven back to the monitor plane using naturalistic images that contained structured depth and focus information from size, blur and/or disparity. In Step 1, both refractive groups converged towards the stereoscopic target depth plane, but the vergence-driven accommodative change was smaller in emmetropes than in myopes (F 1,19 =5.13, p=0.036). In Step 2, there was little effect of peripheral depth cues on accommodation or vergence in either refractive group. However, vergence responses were significantly slower (F 1,19 =4.55, p=0.046) and accommodation variability was higher (F 1,19 =12.9, p=0.0019) in myopes. Vergence and accommodation responses are disrupted in virtual reality displays in both refractive groups. Accommodation responses are less stable in myopes, perhaps due to a lower sensitivity to dioptric blur. Such inaccuracies of accommodation may cause long-term blur on the retina, which has been associated with a failure of emmetropization. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Extended Time Testing Accommodations: What Does the Research Say?

    ERIC Educational Resources Information Center

    Lovett, Benjamin J.

    2011-01-01

    Extended time is among the most common testing accommodations given to students with a wide range of disabilities. However, although school psychologists are often involved in accommodation decisions, many are unaware of research from the past decade that has changed their understanding of extended time. Used properly, testing accommodations let…

  6. Normal and Tangential Momentum Accommodation for Earth Satellite Conditions

    NASA Technical Reports Server (NTRS)

    Knechtel, Earl D.; Pitts, William C.

    1973-01-01

    Momentum accommodation was determined experimentally for gas-surface interactions simulating in a practical way those of near-earth satellites. Throughout the ranges of gas energies and incidence angles of interest for earth-conditions, two components of force were measured by means of a vacuum microbalance to determine the normal and tangential momentum-accommodation coefficients for nitrogen ions on technical-quality aluminum surfaces. For these experimental conditions, the electrodynamics of ion neutralization near the surface indicate that results for nitrogen ions should differ relatively little from those for nitrogen molecules, which comprise the largest component of momentum flux for near-earth satellites. The experimental results indicated that both normal and tangential momentum-accommodation coefficients varied widely with energy, tending to be relatively well accommodated at the higher energies, but becoming progressively less accommodated as the energy was reduced to and below that for earth-satellite speeds. Both coefficients also varied greatly with incidence angle, the normal momentum becoming less accommodated as the incidence angle became more glancing, whereas the tangential momentum generally became more fully accommodated. For each momentum coefficient, an empirical correlation function was obtained which closely approximated the experimental results over the ranges of energy and incidence angle. Most of the observed variations of momentum accommodation with energy and incidence angle were qualitatively indicated by a calculation using a three-dimensional model that simulated the target surface by a one-dimensional attractive potential and hard sphere reflectors.

  7. Substance abuse as a symptom of childhood sexual abuse.

    PubMed

    Teusch, R

    2001-11-01

    The recovery process of a 37-year-old woman with adult onset posttraumatic stress disorder (PTSD) is presented. The patient had suffered childhood sexual abuse and had self-medicated for many years with drugs and alcohol to maintain the dissociation of memories of abuse and to facilitate interpersonal functioning. Upon onset of PTSD, the patient's substance abuse became a full-blown addiction that was highly resistant to treatment. It became evident that her substance abuse symbolically repeated her traumatization. In reexperiencing the affects associated with her earlier trauma (despair, denial, shame, and helplessness) as part of her substance abuse and in the transference, the patient was able to gain mastery over these affects and, subsequently, was able to achieve a stable recovery from both illnesses.

  8. Other Drugs of Abuse

    MedlinePlus

    ... People Abuse » Other Drugs of Abuse Other Drugs of Abuse Listen There are many other drugs of abuse, ... and Rehab Resources About the National Institute on Drug Abuse (NIDA) | About This Website Tools and Resources | Contact ...

  9. 46 CFR 127.260 - Ventilation for accommodations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Ventilation for accommodations. 127.260 Section 127.260... ARRANGEMENTS Particular Construction and Arrangements § 127.260 Ventilation for accommodations. (a) Each... vessel of 100 or more gross tons must be provided with a mechanical ventilation system unless the...

  10. Self-Esteem and Attitudes toward Love in Abused and Non-Abused Women.

    ERIC Educational Resources Information Center

    Chambliss, Catherine; And Others

    This study sought to identify personality differences in abused versus non-abused women. Abused women (N=25) were from several centers for abused women and non-abused women (N=39) were students in evening psychology classes. All subjects completed Rubin's Love Scale, the abbreviated Dominance and Romanticism Scale, Rosenberg's Self-Esteem Scale,…

  11. Psychiatric Syndromes in Adolescents with Marijuana Abuse and Dependency in Outpatient Treatment

    ERIC Educational Resources Information Center

    Diamond, Guy; Panichelli-Mindel, Susan M.; Shera, David; Dennis, Mike; Tims, Frank; Ungemack, Jane

    2006-01-01

    Objective: The purpose of the current study to assist in understanding the prevalence and clinical correlates of psychiatric distress in adolescents seeking outpatient services for marijuana abuse or dependency. Methods: In a multi-site randomized clinical trial, 600 adolescents and their parents were assessed at intake using the Global Appraisals…

  12. The provision of workplace accommodations following cancer: survivor, provider, and employer perspectives.

    PubMed

    Stergiou-Kita, Mary; Pritlove, Cheryl; van Eerd, Dwayne; Holness, Linn D; Kirsh, Bonnie; Duncan, Andrea; Jones, Jennifer

    2016-06-01

    With improvements in screening, diagnosis, and treatment, the number of persons surviving cancer and staying at or returning to work is increasing. While workplace accommodations optimize workers' abilities to participate in the workforce, there has been little in-depth investigation of the types of accommodations reported to have been provided to cancer survivors and the processes relevant to ensuring their successful implementation. We employed an exploratory qualitative method and conducted 40 semi-structured interviews with three groups: (i) cancers survivors (n = 16), (ii) health/vocational service providers (n = 16), and (iii) employer representatives (n = 8) to explore return to work and accommodation processes, successes, and challenges. An inductive thematic analysis approach was used to analyze the data. Four types of accommodations were recommended: (1) graduated return to work plans and flexible scheduling, (2) modification of work duties and performance expectations, (3) retraining and supports at the workplace, and (4) modification of the physical work environment and/or the provision of adaptive aids/technologies. Processes relevant to ensuring effective accommodations included: (1) developing knowledge about accommodations, (2) employer's ability to accommodate, (3) negotiating reasonable accommodations, (4) customizing accommodations, and (5) implementing and monitoring accommodation plans. Accommodation challenges included: (1) survivors' fears requesting accommodations, (2) developing clear and specific accommodations, (3) difficult to accommodate jobs, and (4) workplace challenges, including strained pre-cancer workplace relationships, insufficient/inflexible workplace policies, employer concerns regarding productivity and precedent setting, and limited modified duties. Accommodations need to be customized and clearly linked to survivors' specific job demands, work context, and available workplace supports. Survivors need to feel

  13. Utility accommodation and conflict tracker (UACT) : user manual

    DOT National Transportation Integrated Search

    2009-02-01

    Project 0-5475 performed a comprehensive analysis of utility conflict data/information flows between utility : accommodation stakeholders in the Texas Department of Transportation project development process, : developed data models to accommodate wo...

  14. The Chameleon Syndrome: A Social Psychological Dimension of the Female Sex Role

    ERIC Educational Resources Information Center

    Rosen, Bernard C.; Aneshensel, Carol S.

    1976-01-01

    This study assesses the incidence and social correlates of the female form of the Chameleon Syndrome--an accommodative response to an environment perceived as hostile to inappropriate sex role behavior--among a sample of 3200 American adolescents. (Author)

  15. Expanding the Parameters of Parental Alienation Syndrome.

    ERIC Educational Resources Information Center

    Cartwright, Glenn F.

    1993-01-01

    Because parental alienation syndrome is newly recognized, it must be redefined as new cases are observed. Evidence suggests that alienation may be provoked by other than custodial matters, cases of alleged sexual abuse may be hinted, slow judgments by courts exacerbate problem, prolonged alienation of child may trigger mental illness, and little…

  16. [Münchhausen syndrome by proxy].

    PubMed

    Le Heuzey, M-F; Mouren, M-C

    2008-01-01

    Münchhausen syndrome by proxy is a factitious disorder, a disease produced or simulated by a parent, the mother in most cases. Clinical presentation is miscellaneous (factitious bleeding, epilepsy, apnea are frequent) and unusual. Physicians participate in the abuse by their therapeutic and diagnostical measures. It is very important to think about this diagnostic in any ambiguous situation in order to evaluate and protect the child.

  17. Teaching Children with Tourette Syndrome. ERIC Digest E570.

    ERIC Educational Resources Information Center

    Knoblauch, Bernadette

    This digest provides basic information on Tourette Syndrome (TS) as well as guidelines for appropriate classroom accommodations. It reports that about 100,000 Americans have diagnosed TS with symptoms including multiple motor and vocal tics; frequent (daily) occurrence of bouts of tics; periodic changes in the number, frequency, and severity of…

  18. 46 CFR 30.10-2 - Accommodation space-TB/ALL.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Accommodation space-TB/ALL. 30.10-2 Section 30.10-2... Accommodation space—TB/ALL. The term accommodation space means any public space such as a hall, dining room... that contains no cooking appliances, and a similar space open to the passengers and crew. [CGD 74-127...

  19. 46 CFR 30.10-2 - Accommodation space-TB/ALL.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Accommodation space-TB/ALL. 30.10-2 Section 30.10-2... Accommodation space—TB/ALL. The term accommodation space means any public space such as a hall, dining room... that contains no cooking appliances, and a similar space open to the passengers and crew. [CGD 74-127...

  20. 46 CFR 30.10-2 - Accommodation space-TB/ALL.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Accommodation space-TB/ALL. 30.10-2 Section 30.10-2... Accommodation space—TB/ALL. The term accommodation space means any public space such as a hall, dining room... that contains no cooking appliances, and a similar space open to the passengers and crew. [CGD 74-127...

  1. 46 CFR 30.10-2 - Accommodation space-TB/ALL.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Accommodation space-TB/ALL. 30.10-2 Section 30.10-2... Accommodation space—TB/ALL. The term accommodation space means any public space such as a hall, dining room... that contains no cooking appliances, and a similar space open to the passengers and crew. [CGD 74-127...

  2. 46 CFR 30.10-2 - Accommodation space-TB/ALL.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Accommodation space-TB/ALL. 30.10-2 Section 30.10-2... Accommodation space—TB/ALL. The term accommodation space means any public space such as a hall, dining room... that contains no cooking appliances, and a similar space open to the passengers and crew. [CGD 74-127...

  3. Accommodating Picky Palates

    ERIC Educational Resources Information Center

    Lum, Lydia

    2007-01-01

    Healthy gourmet offerings are fast becoming the norm at college dining halls around the country. At a time when the children of Baby Boomers are hitting higher education in record numbers, college officials have scrambled to accommodate their picky palates and their insistence for healthier meals than were served to past generations. At the same…

  4. Abuse potential and psychoactive effects of δ-9-tetrahydrocannabinol and cannabidiol oromucosal spray (Sativex), a new cannabinoid medicine.

    PubMed

    Robson, Philip

    2011-09-01

    There is a growing consensus that cannabis dependence is a substantial and underappreciated problem. The key component responsible for the euphoric effects of cannabis and its dependence potential is δ-9-tetrahydrocannabinol (THC). THC-containing cannabinoid medicines theoretically pose a risk of abuse and dependence. In order to evaluate the potential of Sativex to cause cannabis-like psychoactivity, abuse or dependence relevant data from all published papers have been reviewed along with the integrated safety analysis for Sativex use in multiple sclerosis (MS) patients on file at GW Pharmaceuticals. In clinical trials, intoxication scores have been low and euphoria reported by only 2.2% of patients. Tolerance has not occurred, abrupt withdrawal has not resulted in a formal withdrawal syndrome, and no cases of abuse or diversion have been reported to date. A formal abuse liability study of Sativex in experienced cannabis smokers showed some abuse potential in comparison with placebo at higher doses, but scores were consistently lower than equivalent doses of THC. Evidence to date suggests that abuse or dependence on Sativex is likely to occur in only a very small proportion of recipients.

  5. Ethical use of covert videoing techniques in detecting Munchausen syndrome by proxy.

    PubMed Central

    Foreman, D M; Farsides, C

    1993-01-01

    Munchausen syndrome by proxy is an especially malignant form of child abuse in which the carer (usually the mother) fabricates or exacerbates illness in the child to obtain medical attention. It can result in serious illness and even death of the child and it is difficult to detect. Some investigators have used video to monitor the carer's interaction with the child without obtaining consent--covert videoing. The technique presents several ethical problems, including exposure of the child to further abuse and a breach of trust between carer, child, and the professionals. Although covert videoing can be justified in restricted circumstances, new abuse procedures under the Children Act now seem to make its use unethical in most cases. Sufficient evidence should mostly be obtained from separation of the child and carer or videoing with consent to enable action to be taken to protect the child under an assessment order. If the new statutory instruments prove ineffective in Munchausen syndrome by proxy covert videoing may need to be re-evaluated. PMID:8401021

  6. Hidden Abuse within the Home: Recognizing and Responding to Sibling Abuse

    ERIC Educational Resources Information Center

    Stutey, Diane; Clemens, Elysia V.

    2015-01-01

    Sibling abuse is a serious phenomenon in our society that often goes unaddressed. Victims of sibling abuse experience psychological effects similar to those of child abuse (Caspi, 2012; Wiehe, 2002). The purpose of this article is to provide school counselors with a definition of sibling abuse and a five-step model to recognize and respond. A…

  7. Prediction of anthropometric accommodation in aircraft cockpits

    NASA Astrophysics Data System (ADS)

    Zehner, Gregory Franklin

    Designing aircraft cockpits to accommodate the wide range of body sizes existing in the U.S. population has always been a difficult problem for Crewstation Engineers. The approach taken in the design of military aircraft has been to restrict the range of body sizes allowed into flight training, and then to develop standards and specifications to ensure that the majority of the pilots are accommodated. Accommodation in this instance is defined as the ability to: (1) Adequately see, reach, and actuate controls; (2) Have external visual fields so that the pilot can see to land, clear for other aircraft, and perform a wide variety of missions (ground support/attack or air to air combat); and (3) Finally, if problems arise, the pilot has to be able to escape safely. Each of these areas is directly affected by the body size of the pilot. Unfortunately, accommodation problems persist and may get worse. Currently the USAF is considering relaxing body size entrance requirements so that smaller and larger people could become pilots. This will make existing accommodation problems much worse. This dissertation describes a methodology for correcting this problem and demonstrates the method by predicting pilot fit and performance in the USAF T-38A aircraft based on anthropometric data. The methods described can be applied to a variety of design applications where fitting the human operator into a system is a major concern. A systematic approach is described which includes: defining the user population, setting functional requirements that operators must be able to perform, testing the ability of the user population to perform the functional requirements, and developing predictive equations for selecting future users of the system. Also described is a process for the development of new anthropometric design criteria and cockpit design methods that assure body size accommodation is improved in the future.

  8. Instructional Accommodations for Students with Asperger Syndrome in the General High School Classroom

    ERIC Educational Resources Information Center

    Baylis, Myrna

    2011-01-01

    General education teachers in the secondary sector are held responsible for adapting their lessons and classroom environment for students with Asperger Syndrome. With the growing number of students with Autism Spectrum Disorder being placed in general education classrooms, teachers are faced with yet another challenge in making their curriculum…

  9. Evidence that convergence rather than accommodation controls intermittent distance exotropia

    PubMed Central

    Horwood, Anna M; Riddell, Patricia M

    2015-01-01

    Purpose This study considered whether vergence drives accommodation or accommodation drives vergence during the control of distance exotropia for near fixation. High accommodative convergence to accommodation (AC/A) ratios are often used to explain this control, but the role of convergence to drive accommodation (the CA/C relationship) is rarely considered. Atypical CA/C characteristics could equally, or better, explain common clinical findings. Methods 19 distance exotropes, aged 4-11 years, were compared while controlling their deviation with 27 non-exotropic controls aged 5-9 years. Simultaneous vergence and accommodation responses were measured to a range of targets incorporating different combinations of blur, disparity and looming cues at four fixation distances between 2m and 33cm. Stimulus and response AC/A and CA/C ratios were calculated. Results Accommodation responses for near targets (p=0.017) response gains (p=0.026) were greater in the exotropes than the controls. Despite higher clinical stimulus AC/A ratios, the distance exotropes showed lower laboratory response AC/A ratios (p=0.02), but significantly higher CA/C ratios (p=0.02). All the exotropes, whether the angle changed most with lenses (“controlled by accommodation”) or on occlusion (“controlled by fusion”), used binocular disparity not blur as their main cue to target distance. Conclusions Increased vergence demand to control intermittent distance exotropia for near also drives significantly more accommodation. Minus lens therapy is more likely to act by correcting over-accommodation driven by controlling convergence, rather than by inducing blur-driven vergence. The use of convergence as a major drive to accommodation explains many clinical characteristics of distance exotropia, including apparently high near stimulus AC/A ratios. PMID:22280437

  10. Accommodation measurements of horizontally scanning holographic display.

    PubMed

    Takaki, Yasuhiro; Yokouchi, Masahito

    2012-02-13

    Eye accommodation is considered to function properly for three-dimensional (3D) images generated by holography. We developed a horizontally scanning holographic display technique that enlarges both the screen size and viewing zone angle. A 3D image generated by this technique can be easily seen by both eyes. In this study, we measured the accommodation responses to a 3D image generated by the horizontally scanning holographic display technique that has a horizontal viewing zone angle of 14.6° and screen size of 4.3 in. We found that the accommodation responses to a 3D image displayed within 400 mm from the display screen were similar to those of a real object.

  11. Choosing Accommodations: Signed Language Interpreting and the Absence of Choice.

    PubMed

    Burke, Teresa Blankmeyer

    This paper carves out a topic space for discussion about the ethical question of whether input from signing Deaf consumers of interpreting services ought to be included in the provision of signed language interpreter accommodations. The first section provides background about disability accommodations and practices, including how signed language interpreting accommodations are similar and dissimilar to other kinds of disability accommodations. In the second section, I offer a personal narrative of my experience as a Deaf academic who has been excluded from the interpreter selection process, highlighting some of the harmful consequences of such exclusion. In the subsequent two sections, I describe and analyze the process of choosing interpreter accommodations, starting with the process of requesting signed language interpreters and the institutionalization of this process, followed by a brief overview of privacy and autonomy concerns from the standpoint of the signing Deaf consumer. The penultimate section considers some objections to the proposal of involving more consumer choice in signed language accommodations. I conclude the paper with some concrete suggestions for a more Deaf-centered, inclusive process for choosing interpreter accommodations.

  12. The effect of incipient presbyopia on the correspondence between accommodation and vergence.

    PubMed

    Baker, Fiona J; Gilmartin, Bernard

    2002-06-01

    To investigate the accommodation-convergence relationship during the incipient phase of presbyopia. The study aimed to differentiate between the current theories of presbyopia and to explore the mechanisms by which the oculomotor system compensates for the change in the accommodation-convergence relationship contingent on a declining amplitude of accommodation. Using a Canon R-1 open-view autorefractor and a haploscope device, measurements were made of the stimulus and response accommodative convergence/accommodation ratios and the convergence accommodation/convergence ratio of 28 subjects aged 35-45 years at the commencement of the study. Amplitude of accommodation was assessed using a push-down technique. The measurements were repeated at 4-monthly intervals over a 2-year period. The results showed that with the decline in the amplitude of accommodation there is an increase in the accommodative convergence response per unit of accommodative response and a decrease in the convergence accommodation response per unit of convergence. The results of this study fail to support the Hess-Gullstrand theory of presbyopia in that the ciliary muscle effort required to produce a unit change in accommodation increases, rather than stays constant, with age. Data show that the near vision response is limited to the maximum vergence response that can be tolerated and, despite being within the amplitude of accommodation, a stimulus may still appear blurred because the vergence component determines the proportion of available accommodation utilised during near vision.

  13. Wavefront aberration changes caused by a gradient of increasing accommodation stimuli

    PubMed Central

    Zhou, X-Y; Wang, L; Zhou, X-T; Yu, Z-Q

    2015-01-01

    Purpose The aim of this study was to investigate the wavefront aberration changes in human eyes caused by a gradient of increasing accommodation stimuli. Design This is a prospective, single-site study. Methods Healthy volunteers (n=22) aged 18–28 years whose refraction states were emmetropia or mild myopia, with astigmatism <1 diopter (D), were included in this study. After dilating the right pupil with 0.5% phenylephrine drops, the wavefront aberration of the right eye was measured continuously either without or with 1, 2, 3, 4, 5, or 6D accommodation stimuli (WFA1000B psychophysical aberrometer). The root mean square (RMS) values of the total wavefront aberrations, higher-order aberrations, and 35 individual Zernike aberrations under different accommodation stimuli were calculated and compared. Results The average induced accommodations using 1, 2, 3, 4, 5, or 6D accommodation stimuli were 0.848, 1.626, 2.375, 3.249, 4.181, or 5.085 D, respectively. The RMS of total wavefront aberrations, as well as higher-order aberrations, showed no significant effects with 1–3 D accommodation stimuli, but increased significantly under 4, 5, and 6 D accommodation stimuli compared with relaxed accommodation. Zernike coefficients of significantly decreased with increasing levels of accommodation. Conclusion Higher-order wavefront aberrations in human eyes changed with increased accommodation. These results are consistent with Schachar's accommodation theory. PMID:25341432

  14. Abuse Is Abuse: The Influence of Type of Abuse, Victim Age, and Defendant Age on Juror Decision Making.

    PubMed

    Sheahan, Chelsea L; Pica, Emily; Pozzulo, Joanna D

    2017-09-01

    The purpose of the current study was to examine the role of victim age, defendant age, and type of abuse on mock juror decision making. Mock jurors ( N = 556) read a trial transcript in which a soccer coach was accused of sexual abuse or physical abuse against a player. The victim's age (child, adolescent, or young adult), the defendant's age (young, middle age, or older adult), and the type of abuse (sexual or physical) were varied. Mock jurors provided a dichotomous and continuous verdict and rated their perceptions of the victim and the defendant. Although no differences on mock jurors' dichotomous verdict were found due to victim age, defendant age, or type of abuse, mock jurors provided higher guilt ratings when the abuse was sexual and both the victim and defendant were described as young adults. Similarly, mock jurors rated the victim more positively when the victim was described as a young adult (vs. child) for both sexual and physical abuse cases, and rated the defendant more positively when the victim was described as a child compared with young adult in sexual abuse cases. These findings suggest that mock jurors were largely influenced by victim age, particularly when the victim was described as an adult compared with a child.

  15. The radiologist's role in child abuse: imaging protocol and differential diagnosis.

    PubMed

    Delgado Álvarez, I; de la Torre, I Barber Martínez; Vázquez Méndez, É

    2016-05-01

    Child abuse or nonaccidental trauma is a major problem worldwide; in Spain, there are about 12,000 victims per year. The detection of specific lesions or findings that are incongruent with the reported mechanism of trauma mean that radiologists are often the physician responsible for sounding the alarm in cases of abuse. The triad consisting of subdural hematoma, metaphyseal fracture, and posterior rib fractures is very characteristic of the battered child syndrome. The finding of acute and chronic lesions in the same patient is highly specific for nonaccidental trauma. Fractures of long bones in patients who have yet begun to walk should also alert to possible child abuse. Lesions that are highly specific for abuse, such as classic metaphyseal fractures or posterior rib fractures, can be difficult to demonstrate radiographically and are usually clinically occult. The American College of Radiology (ACR) protocols recommend obtaining three separate X-rays of each upper and lower limb. It is important to use X-ray systems that give high resolution images with low kilovoltage (50-70 kvp) and appropriate milliamperage. A skeletal survey consisting of a series of images collimated to each body region is recommended for all children under the age of two years in whom abuse is suspected. A follow-up skeletal survey about two weeks after the initial survey is useful for detecting new fractures and for assessing the consolidation of others, which helps in dating the lesions. Head injuries are the leading cause of death in abused children. Although computed tomography is the first neuroimaging technique in nonaccidental trauma, magnetic resonance imaging of the head can better characterize the lesions seen on computed tomography and can help to estimate the age of the lesions. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  16. Acute compartment syndrome caused by uncontrolled hypothyroidism.

    PubMed

    Modi, Anar; Amin, Hari; Salzman, Matthew; Morgan, Farah

    2017-06-01

    Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures. No precipitating causes were readily identified. Further laboratory testing revealed uncontrolled hypothyroidism. Management included emergent fasciotomy and initiating thyroid hormone replacement. This case represents a rare association between acute compartment syndrome and uncontrolled hypothyroidism. We also discuss the pathogenesis of compartment syndrome in hypothyroid patients and emphasize the importance of evaluating for less common causes, particularly in setting of non-traumatic compartment syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. The management of abuse: 2. Child abuse.

    PubMed

    Panesear, Jaspel; Sinha, Karen Juggins Sonia; Acharya, Preeti; Jafar, Hima; Bower, Elizabeth J; Harrison, Victoria E; Newton, J Tim

    2006-09-01

    The role of the GDP and the dental team in the recognition and management of child abuse is discussed. Information on the current legislation and protocols for referral are provided. This paper discusses child abuse and offers information and practical advice for the dental team.

  18. Tic-related school problems: impact on functioning, accommodations, and interventions.

    PubMed

    Packer, Leslie E

    2005-11-01

    Children with Tourette's syndrome (TS) are statistically overrepresented in special education classes; however, the extent to which tics contribute to such placement is unclear. In this article, the results of a survey of parents or guardians of 71 children and adolescents with TS are described within the broader context of discussing the impact of tics and educational practices. One half of the respondents reported moderate to significant tic-related academic impact, and 48% reported moderate to significant tic-related peer problems. Peer education and in-school counseling were generally not offered nor provided. In the minority of cases where behavioral interventions for tics were reported, contingent aversive consequences were reported to be ineffective or counterproductive, while positive reinforcement for modifying tics reportedly produced some successful results. The identification of research-validated academic accommodations and increased involvement of school psychologists are suggested as necessary and potentially helpful supports for students with TS and their teachers.

  19. Occlusal accommodation and mouthguards for prevention of orofacial trauma.

    PubMed

    Geary, Julian Lindsay; Clifford, Thomas Joseph; Kinirons, Martin James

    2009-01-01

    The aim of this study was to investigate the effect of two types of occlusal accommodation on the arch separation in centric and eccentric arch positions and to assess the opposing tooth contacts in professionally made, thermoformed sports mouthguards. Maxillary and mandibular alginate impressions, a wax interocclusal record of centric occlusion together with maxillary/condylar face-bow registrations, were recorded clinically for 10 undergraduate dental students who are sports activist volunteers of the School of Medicine and Dentistry, Queen's University Belfast. Two ethylene vinyl acetate thermoformed maxillary mouthguards were made for each player (N = 20) using a standardised procedure. Ten mouthguards served both as the control (i.e. the non-accommodated) group and also the accommodated, occlusally 'imprinted' group. The other 10 mouthguards served as the accommodated, occlusally 'ground' group. Casts were articulated, each non-accommodated and accommodated mouthguard was seated and the extent of the interocclusal opening was recorded in all three arch relationships. The number of mouthguard and mandibular tooth contacts were also recorded in each position. The increased vertical occlusal dimension that was found in the presence of non-accommodated mouthguards equated to the full-sheet thickness of the material that was used to form the mouthguards. Only mouthguards accommodated by grinding retained high levels of occlusal contact in all arch relationships that were tested. Within the limitations of this study, the modification of the occlusal surface made by flat grinding reduced the arch separation in eccentric movements and increased the opposing tooth contacts in custom-made mouthguards. This may contribute to increased comfort, compliance and the protective effect of these appliances thus resulting in a reduction of injuries to the teeth, arches and soft tissues.

  20. Human dynamic closed-loop accommodation augmented by sympathetic inhibition.

    PubMed

    Culhane, H M; Winn, B; Gilmartin, B

    1999-05-01

    A ciliary alpha-adrenoceptor accommodative effect has been proposed, caused by a small population of alpha1-inhibitory receptors in excised human ciliary muscle. This study was intended to investigate the effect on the closed-loop dynamic accommodative process of modulating alpha1-adrenoceptor activity by topical instillation of the alpha1-adrenergic agonist, phenylephrine hydrochloride. A group of 10 visually normal subjects viewed a photopic (30 candela/m2) high-contrast Maltese cross, which was modulated sinusoidally (0.05-0.6Hz) and stepwise over a 2-D range (2-4 D). Monocular temporal accommodation responses were measured using a continuously recording dynamic tracking infrared optometer under two trial conditions: after instillation of saline control solution and 50 minutes subsequent to the instillation of 0.27 microl 0.4% benoxinate hydrochloride and 0.27 microl 2.5% phenylephrine hydrochloride. Pupil size and accommodative amplitude were measured at 90-second intervals for 50 minutes after drug instillation. All accommodative measurements were recorded through a fixed 4-mm pupil. A significant reduction in accommodative amplitude (11%; P < 0.05) was recorded, whereas pupil size showed a significant increase (33%; P < 0.05). No significant change in step-response dynamics was observed. However, phenylephrine hydrochloride caused a significant increase in accommodative gain in the low and midtemporal frequency ranges compared with the effect of a saline control treatment. No significant variation in phase lag was observed. For the first time in humans, this study shows that augmentation of the alpha1-inhibitory sympathetic contribution results in increased accommodative gain at low and midtemporal frequencies, which is consistent with findings in animal studies.

  1. Accommodation in pediatric oncology: parental experiences, preferences and unmet needs.

    PubMed

    Daniel, Gunar; Wakefield, Claire E; Ryan, Barbara; Fleming, Catharine Ak; Levett, Nicole; Cohn, Richard J

    2013-01-01

    For families of children diagnosed with cancer, proximity to the treatment center and staying close to immediate family members are essential for proper patient management. Accommodation services are therefore a key consideration in pediatric oncology. This descriptive study explored the accommodation used, and preferred, by parents of pediatric cancer patients at Sydney Children's Hospital, Randwick (SCH), Australia, and investigated their accommodation and practical needs. Forty-two parents from 25 families participated in individual semi-structured telephone interviews. Interviews were recorded, transcribed verbatim and coded line-by-line. Coding was facilitated by data analysis software QSR NVivo v8 (www.qsrinternational.com). Emergent themes were numerically assessed to minimize the potential for researcher bias. Nine families (36%) lived near SCH and were able to stay at their own residence during treatment (mean distance of 15.4 km from SCH). The remaining families were categorized 'local, but requiring accommodation' (n=3 families represented by five parent interviews; mean distance of 82.22 km from SCH),'inner regional' (IR) (n=8 families, 15 parent interviews; mean distance of 396.75 km from SCH) or 'outer regional' (OR) (n=3 families, 5 interviews; mean distance of 547.4 km from SCH) according to the Australian Standard Geographical Classification (ASGC) remoteness ratings. Accommodation provided for families from both IR and OR areas was mixed, with several families using multiple accommodation options during treatment, including Ronald Macdonald House (RMH), private accommodation or a rental property close to the hospital for the duration of the treatment. Six IR and one OR family utilized hotel or motel accommodation as an alternative to RMH due to unavailability of rooms. The majority of parents (37/42) preferred to stay on the hospital campus, near their child. Seven out of 11 IR and OR mothers preferred self-contained accommodation, while three out

  2. Accommodation and vergence latencies in human infants

    PubMed Central

    Tondel, Grazyna M.; Candy, T. Rowan

    2008-01-01

    Purpose Achieving simultaneous single and clear visual experience during postnatal development depends on the temporal relationship between accommodation and vergence, in addition to their accuracies. This study was designed to examine one component of the dynamic relationship, the latencies of the responses. Methods Infants and adults were tested in three conditions i) Binocular viewing of a target moving in depth at 5cm/s (closed loop) ii) monocular viewing of the same target (vergence open loop) iii) binocular viewing of a low spatial frequency Difference of Gaussian target during a prism induced step change in retinal disparity (accommodation open loop). Results There was a significant correlation between accommodation and vergence latencies in binocular conditions for infants from 7 to 23 weeks of age. Some of the infants, as young as 7 or 8 weeks, generated adult-like latencies of less than 0.5 s. Latencies in the vergence open loop and accommodation open loop conditions tended to be shorter for the stimulated system than the open loop system in both cases, and all latencies were typically less than 2 seconds across the infant age range. Conclusions Many infants between 7 and 23 weeks of age were able to generate accommodation and vergence responses with latencies of less than a second in full binocular closed loop conditions. The correlation between the latencies in the two systems suggests that they are limited by related factors from the earliest ages tested. PMID:18199466

  3. Accommodation and vergence latencies in human infants.

    PubMed

    Tondel, Grazyna M; Candy, T Rowan

    2008-02-01

    Achieving simultaneous single and clear visual experience during postnatal development depends on the temporal relationship between accommodation and vergence, in addition to their accuracies. This study was designed to examine one component of the dynamic relationship, the latencies of the responses. Infants and adults were tested in three conditions (i) binocular viewing of a target moving in depth at 5 cm/s (closed loop) (ii) monocular viewing of the same target (vergence open loop) (iii) binocular viewing of a low spatial frequency Difference of Gaussian target during a prism induced step change in retinal disparity (accommodation open loop). There was a significant correlation between accommodation and vergence latencies in binocular conditions for infants from 7 to 23 weeks of age. Some of the infants, as young as 7 or 8 weeks, generated adult-like latencies of less than 0.5 s. Latencies in the vergence open loop and accommodation open loop conditions tended to be shorter for the stimulated system than the open loop system in both cases, and all latencies were typically less than 2 s across the infant age range. Many infants between 7 and 23 weeks of age were able to generate accommodation and vergence responses with latencies of less than a second in full binocular closed loop conditions. The correlation between the latencies in the two systems suggests that they are limited by related factors from the earliest ages tested.

  4. Alcohol abuse as a risk factor for and consequence of child abuse.

    PubMed

    Widom, C S; Hiller-Sturmhöfel, S

    2001-01-01

    The relationship between child abuse and the use or abuse of alcohol has two aspects. First, some findings have indicated that parental alcohol abuse may be associated with the physical or sexual abuse of children. Research findings in this area remain inconsistent, however. Second, the experience of being abused as a child may increase a person's risk for alcohol-related problems as an adult. This relationship has best been demonstrated in women who had been victims of childhood abuse. Several factors most likely contribute to or influence this relationship, including coping skills; antisocial behavior; and psychological problems, such as posttraumatic stress disorder.

  5. A model to predict accommodations needed by disabled persons.

    PubMed

    Babski-Reeves, Kari; Williams, Sabrina; Waters, Tzer Nan; Crumpton-Young, Lesia L; McCauley-Bell, Pamela

    2005-09-01

    In this paper, several approaches to assist employers in the accommodation process for disabled employees are discussed and a mathematical model is proposed to assist employers in predicting the accommodation level needed by an individual with a mobility-related disability. This study investigates the validity and reliability of this model in assessing the accommodation level needed by individuals utilizing data collected from twelve individuals with mobility-related disabilities. Based on the results of the statistical analyses, this proposed model produces a feasible preliminary measure for assessing the accommodation level needed for persons with mobility-related disabilities. Suggestions for practical application of this model in an industrial setting are addressed.

  6. Child Sexual Abuse

    MedlinePlus

    Sexual abuse is one form of child abuse. It includes a wide range of actions between a child ... to children or pressuring them for sex is sexual abuse. Using a child for pornography is also sexual ...

  7. Evidence that convergence rather than accommodation controls intermittent distance exotropia.

    PubMed

    Horwood, Anna M; Riddell, Patricia M

    2012-03-01

    This study considered whether vergence drives accommodation or accommodation drives vergence during the control of distance exotropia for near fixation. High accommodative convergence to accommodation (AC/A) ratios are often used to explain this control, but the role of convergence to drive accommodation (the CA/C relationship) is rarely considered. Atypical CA/C characteristics could equally, or better, explain common clinical findings. Nineteen distance exotropes, aged 4-11 years, were compared while controlling their deviation with 27 non-exotropic controls aged 5-9 years. Simultaneous vergence and accommodation responses were measured to a range of targets incorporating different combinations of blur, disparity and looming cues at four fixation distances between 2 m and 33 cm. Stimulus and response AC/A and CA/C ratios were calculated. Accommodation responses for near targets (p = 0.017) and response gains (p = 0.026) were greater in the exotropes than in the controls. Despite higher clinical stimulus AC/A ratios, the distance exotropes showed lower laboratory response AC/A ratios (p = 0.02), but significantly higher CA/C ratios (p = 0.02). All the exotropes, whether the angle changed most with lenses ('controlled by accommodation') or on occlusion ('controlled by fusion'), used binocular disparity not blur as their main cue to target distance. Increased vergence demand to control intermittent distance exotropia for near also drives significantly more accommodation. Minus lens therapy is more likely to act by correcting overaccommodation driven by controlling convergence, rather than by inducing blur-driven vergence. The use of convergence as a major drive to accommodation explains many clinical characteristics of distance exotropia, including apparently high near stimulus AC/A ratios. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  8. Accommodation and Phoria in Children Wearing Multifocal Contact Lenses

    PubMed Central

    Gong, Celia R; Troilo, David; Richdale, Kathryn

    2017-01-01

    Purpose To determine the effect of multifocal contact lenses on accommodation and phoria in children. Methods This was a prospective, non-dispensing, randomized, crossover, single visit study. Myopic children with normal accommodation and binocularity and no history of myopia control treatment were enrolled and fitted with Coopervision Biofinity single vision (SV) and multifocal (MF, +2.50D center distance add) contact lenses. Accommodative responses (photorefraction) and phorias (Modified Thorington) were measured at 4 distances (>3m, 100cm, 40cm, 25cm). Secondary measures included high and low contrast logMAR acuity, accommodative amplitude and facility. Differences between contact lens designs were analyzed using repeated measures regression and paired t-tests. Results A total of 16 subjects, aged 10-15 years, completed the study. There was a small decrease in high (SV: -0.08, MF: +0.01) and low illumination (SV:-0.03, MF: +0.08) (both p<0.01) visual acuity, and contrast sensitivity (SV: 2.0, MF: 1.9 log units, p=0.015) with multifocals. Subjects were more exophoric at 40 cm (SV: -0.41, MF: -2.06 Δ) and 25cm (SV: -0.83, MF: -4.30 Δ) (both p<0.01). With multifocals, subjects had decreased accommodative responses at distance (SV: -0.04; MF: -0.37 D, p=0.02), 100 cm (SV: +0.37; MF: -0.35 D, p<0.01), 40 cm (SV: +1.82; MF: +0.62 D, p<0.01), and 25 cm (SV: +3.38; MF: +1.75 D, p<0.01). There were no significant differences in accommodative amplitude (p=0.66) or facility (p=0.54). Conclusions Children wearing multifocal contact lenses exhibited reduced accommodative responses and more exophoria at increasingly higher accommodative demands than with single vision contact lenses. This suggests that children may be relaxing their accommodation and using the positive addition or increased depth of focus from added spherical aberration of the multifocals. Further studies are needed to evaluate other lens designs, different amounts of positive addition and aberrations, and

  9. Study on accommodation by autorefraction and dynamic refraction in children.

    PubMed

    Krishnacharya, Prabhakar Srinivasapur

    2014-01-01

    Childhood accommodation interferes with accurate diagnosis of the latent refractive errors. Dynamic retinoscopy offers accurate measurements of accommodative response, while an autorefractometer can predict the accommodative system activation in children. A correlation of the accommodative effort with the dynamic refraction has been investigated in emmetropic children, before and after cycloplegia. A prospective clinical study of accommodative effort in 149 emmetropic children, in the age group 3-16 years, has been conducted using TOPCON AR RM-8000B autorefractor. Dynamic refraction was performed by monocular estimation method before and after cycloplegia, using the retinoscope mirror light as target. Retinoscopic reflex produced 'with the motion' was corrected with positive spherical lenses, and that 'against the motion' was corrected with negative spherical lenses, to achieve neutralization. Mean accommodative effort measured for 149 children included in the study was -0.63±0.69D and dynamic refraction was -0.07±0.44D before cycloplegia, while the mean was+0.52D after cycloplegia, irrespective of the method used. Autorefractor measured -0.17D of accommodative effort per unit change in dynamic refraction before cycloplegia and +0.90D after cycloplegia. The performance of TOPCON AR RM-8000B autorefractor was comparable to dynamic retinoscopy. Presence of many children, and in turn, large number of accommodative response data in 11-13 and 14-15 years group is probably linked to prolonged reading/writing. The accuracy and the agreement of the actual accommodative measurements revealed after cycloplegia. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  10. Munchausen syndrome by proxy: a family anthology.

    PubMed

    Pickford, E; Buchanan, N; McLaughlan, S

    1988-06-20

    While the Munchausen-by-proxy syndrome is well recognized, the story of one family has been related to describe some remarkable features. These include the psychopathology of the mother, the involvement of both children in the family, the great difficulty in obtaining proof of child abuse and, finally, the prosecution of the mother in the criminal court.

  11. Substance abuse in pregnant women. Experiences from a special child welfare clinic in Norway

    PubMed Central

    Hjerkinn, Bjørg; Lindbæk, Morten; Rosvold, Elin Olaug

    2007-01-01

    Background Substance abuse during pregnancy may harm the foetus and can cause neonatal abstinence syndrome. Exposure to alcohol and other substances can influence the child for the rest of its life. A special child welfare clinic was set up in 1994 in Kristiansand, Norway, targeting pregnant women with substance abuse problems in the county of Vest-Agder. Pregnancy is not an indication for opioid replacement therapy in Norway, and one of the clinic's aims was to support the drug dependent women through their pregnancy without any replacements. The object of this paper is to describe concurrent health and social problems, as well as the predictors for stopping drug abuse, in the clinic's user group. Methods Retrospective cohort study. Data was gathered from the medical records of all 102 women seen in the clinic in the period between 1992 and 2002. The study includes 59 out of 60 women that were followed until their children were two years old or placed in alternative care, and a comparison group of twice the size. Both groups were presented with a questionnaire concerning both the pregnancy and health and socio-economic issues. Results Four (4.5 percent) of the women that completed their pregnancies did not manage to reduce their substance abuse. All the others reduced their substance abuse considerably. The odds ratio for stopping substance abuse within the first trimester was significantly associated with stopping smoking (O.R. 9.7) or being victims of rape (O.R. 5.3). Conclusion A low cost and low threshold initiative organised as a child welfare clinic may support women with substance abuse problems in their efforts to stop or reduce their substance abuse during pregnancy. PMID:17996120

  12. Child Sexual Abuse

    MedlinePlus

    ... No child is prepared to cope with repeated sexual stimulation. Even a two or three year old, who ... abuse. Some signs can only be detected on physical exam by a physician. Sexual abuse can also include noncontact abuse, such as ...

  13. Accommodation Practices for English Language Learners in States' Mathematics Assessments

    ERIC Educational Resources Information Center

    Wolf, Mikyung Kim; Kao, Jenny C.; Rivera, Nichole M.; Chang, Sandy M.

    2012-01-01

    Background/Context: Testing accommodations have been widely utilized as a way of increasing the validity of content assessments for English language learner (ELL) students. However, concerns have also arisen regarding the appropriateness of accommodation use, including the accessibility and fairness of accommodations. While many states have…

  14. Sexual maturation and control issues among sexually abused and non-abused anorexia patients.

    PubMed

    Walsh, J; Burns, F

    2000-09-01

    To assess the relative salience of the maintenance of control and the avoidance of sexual maturation as sources of motivation for maintaining pathological eating behaviours among sexually abused anorexic patients. A two-factor mixed experimental design was employed. Three independent groups (sexually abused anorexics (N = 12); non-abused anorexics (N = 9); non-anorexic/non-abused controls (N = 12)) constituted the between-subjects factor. Allocation to abuse/non-abuse group was dependent upon replies to a questionnaire-based measure of unwanted sexual experience. The within-subjects factor comprised three conditions in which words of various colours were presented to participants for colour-naming (Stroop, 1935). The conditions were represented by lists of neutral words, sexual maturation words, and control-related words. Two trials were carried out in each condition and mean response times were measured. Within-group analyses revealed that interference was greater from sexual maturation words than from control-related words among the sexually-abused anorexics, but of equal magnitude among non-abused counterparts. Between-groups analyses found that abused patients experienced marginally greater cognitive interference from sexual maturation words than the non-abused patients. Theoretically, support is offered for elaborated schematic models of cognitive processing. Clinically, treatment interventions may need to pay particular attention to issues of sexual maturation among sexually abused anorexic patients.

  15. Supported Housing for People with Down's Syndrome

    ERIC Educational Resources Information Center

    Cumella, Stuart; Heslam, Sheila

    2014-01-01

    There has been limited research on the attitudes of family carers and the part they play in helping people with a learning disability choose accommodation. A postal questionnaire was sent to family carers of people with Down's Syndrome, to identify their attitudes to supported living, their experience of the application process, and the…

  16. Against the accommodation of subjective healthcare provider beliefs in medicine: counteracting supporters of conscientious objector accommodation arguments.

    PubMed

    Smalling, Ricardo; Schuklenk, Udo

    2017-04-01

    We respond in this paper to various counter arguments advanced against our stance on conscientious objection accommodation. Contra Maclure and Dumont, we show that it is impossible to develop reliable tests for conscientious objectors' claims with regard to the reasonableness of the ideological basis of their convictions, and, indeed, with regard to whether they actually hold they views they claim to hold. We demonstrate furthermore that, within the Canadian legal context, the refusal to accommodate conscientious objectors would not constitute undue hardship for such objectors. We reject concerns that refusing to accommodate conscientious objectors would limit the equality of opportunity for budding professionals holding particular ideological positions. We also clarify various misrepresentations of our views by respondents Symons, Glick and Jotkowitz, and Lyus. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Prevalence and predictors of Axis I disorders in a large sample of treatment-seeking victims of sexual abuse and incest

    PubMed Central

    McElroy, Eoin; Shevlin, Mark; Elklit, Ask; Hyland, Philip; Murphy, Siobhan; Murphy, Jamie

    2016-01-01

    Background Childhood sexual abuse (CSA) is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. Objective This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses. Method The participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434). Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts) and 10 adult clinical syndromes. Results There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. Conclusions The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses. Highlights of the article The prevalence of Axis I disorders were assessed in a large sample of sexual abuse and incest survivors. The impact of demographic and abuse characteristics were also examined. There was significant variation in the prevalence of disorders. Abuse characteristics were differentially associated with the disorders. Abuse from multiple perpetrators was the strongest overall predictor of psychopathology. PMID:27064976

  18. Unusual presentation of uncommon disease: anorexia nervosa presenting as wernicke-korsakoff syndrome-a case report from southeast Asia.

    PubMed

    Mushtaq, Raheel; Shoib, Sheikh; Shah, Tabindah; Bhat, Mudasir; Singh, Randhir; Mushtaq, Sahil

    2014-01-01

    Anorexia nervosa presenting as Wernicke-Korsakoff syndrome is rare. The causes of Wernicke-Korsakoff syndrome are multiple like alcohol abuse, thyrotoxicosis, haemodialysis, severe malnutrition because of gastric carcinoma and pyloric obstruction, hyperemesis gravidarum, and prolonged parenteral feeding. We report a case of anorexia nervosa, who presented with Wernicke's encephalopathy and progressed to Korsakoff's syndrome. Knowledge, awareness, and early intervention of anorexia nervosa by mental health professionals can prevent development of Wernicke-Korsakoff syndrome.

  19. The rate of change of vergence-accommodation conflict affects visual discomfort.

    PubMed

    Kim, Joohwan; Kane, David; Banks, Martin S

    2014-12-01

    Stereoscopic (S3D) displays create conflicts between the distance to which the eyes must converge and the distance to which the eyes must accommodate. Such conflicts require the viewer to overcome the normal coupling between vergence and accommodation, and this effort appears to cause viewer discomfort. Vergence-accommodation coupling is driven by the phasic components of the underlying control systems, and those components respond to relatively fast changes in vergence and accommodative stimuli. Given the relationship between phasic changes and vergence-accommodation coupling, we examined how the rate of change in the vergence-accommodation conflict affects viewer discomfort. We used a stereoscopic display that allows independent manipulation of the stimuli to vergence and accommodation. We presented stimuli that simulate natural viewing (i.e., vergence and accommodative stimuli changed together) and stimuli that simulate S3D viewing (i.e., vergence stimulus changes but accommodative stimulus remains fixed). The changes occurred at 0.01, 0.05, or 0.25 Hz. The lowest rate is too slow to stimulate the phasic components while the highest rate is well within the phasic range. The results were consistent with our expectation: somewhat greater discomfort was experienced when stimulus distance changed rapidly, particularly in S3D viewing when the vergence stimulus changed but the accommodative stimulus did not. These results may help in the generation of guidelines for the creation and viewing of stereo content with acceptable viewer comfort.

  20. The Rate of Change of Vergence-Accommodation Conflict Affects Visual Discomfort

    PubMed Central

    Kane, David; Banks, Martin S.

    2014-01-01

    Stereoscopic (S3D) displays create conflicts between the distance to which the eyes must converge and the distance to which the eyes must accommodate. Such conflicts require the viewer to overcome the normal coupling between vergence and accommodation, and this effort appears to cause viewer discomfort. Vergence-accommodation coupling is driven by the phasic components of the underlying control systems, and those components respond to relatively fast changes in vergence and accommodative stimuli. Given the relationship between phasic changes and vergence-accommodation coupling, we examined how the rate of change in the vergence-accommodation conflict affects viewer discomfort. We used a stereoscopic display that allows independent manipulation of the stimuli to vergence and accommodation. We presented stimuli that simulate natural viewing (i.e., vergence and accommodative stimuli changed together) and stimuli that simulate S3D viewing (i.e., vergence stimulus changes but accommodative stimulus remains fixed). The changes occurred at 0.01, 0.05, or 0.25Hz. The lowest rate is too slow to stimulate the phasic components while the highest rate is well within the phasic range. The results were consistent with our expectation: somewhat greater discomfort was experienced when stimulus distance changed rapidly, particularly in S3D viewing when the vergence stimulus changed but the accommodative stimulus did not. These results may help in the generation of guidelines for the creation and viewing of stereo content with acceptable viewer comfort. PMID:25448713

  1. The complexities of elder abuse.

    PubMed

    Roberto, Karen A

    2016-01-01

    Elder abuse is a growing societal concern, affecting at least 1 in 10 older Americans. Researchers and practitioners alike consistently assert that a dramatic discrepancy exists between the prevalence rates of elder abuse and the number of elder abuse cases reported. As a field of study, recognition and understanding of elder abuse is still emerging. Comparing findings of a small, but growing, body of literature on perceived and substantiated cases of elder abuse is challenging because there is no uniform term or agreed-upon definition used among state governments, researchers, health care and service providers, and advocates. This article summarizes current understanding of elder abuse, including what constitutes elder abuse, risk factors for elder abuse, perpetrators of elder abuse, and outcomes of elder abuse. Issues associated with the detection of elder abuse and intervention strategies for victims of abuse are addressed. In the final section, potential roles and contributions of psychologists for advancing elder abuse research, professional practice, and policy development are highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Wernicke-Korsakoff Syndrome as a Consequence of Delusional Food Refusal: A Case Study.

    PubMed

    Hargrave, David D; Schroeder, Ryan W; Heinrichs, Robin J; Baade, Lyle E

    2015-12-01

    Wernicke-Korsakoff syndrome is caused by thiamine (vitamin B1) deficiency, typically resulting from malnutrition secondary to chronic alcohol abuse. Less often, other conditions can lead to malnutrition and Wernicke-Korsakoff syndrome. We describe a 35-year-old man who developed Wernicke-Korsakoff syndrome with a typical neurologic and neuropsychological presentation after somatic delusions led him to refuse to eat. Cases like his serve to heighten awareness of the interplay between psychiatric and neurologic conditions, their sometimes atypical pathogenesis, and the value to primary care providers of consulting with psychiatrists, neurologists, and neuropsychologists when managing patients with possible Wernicke-Korsakoff syndrome.

  3. Triparental families: a new genetic-epidemiological design applied to drug abuse, alcohol use disorders, and criminal behavior in a Swedish national sample.

    PubMed

    Kendler, Kenneth S; Ohlsson, Henrik; Sundquist, Jan; Sundquist, Kristina

    2015-06-01

    The authors sought to clarify the sources of parent-offspring resemblance for drug abuse, alcohol use disorders, and criminal behavior, using a novel genetic-epidemiological design. Using national registries, the authors identified rates of drug abuse, alcohol use disorders, and criminal behavior in 41,360 Swedish individuals born between 1960 and 1990 and raised in triparental families comprising a biological mother who reared them, a "not-lived-with" biological father, and a stepfather. When each syndrome was examined individually, hazard rates for drug abuse in offspring of parents with drug abuse were highest for mothers (2.80, 95% CI=2.23-3.38), intermediate for not-lived-with fathers (2.45, 95% CI=2.14-2.79), and lowest for stepfathers (1.99, 95% CI=1.55-2.56). The same pattern was seen for alcohol use disorders (2.23, 95% CI=1.93-2.58; 1.84, 95% CI=1.69-2.00; and 1.27, 95% CI=1.12-1.43) and criminal behavior (1.55, 95% CI=1.44-1.66; 1.46, 95% CI=1.40-1.52; and 1.30, 95% CI=1.23-1.37). When all three syndromes were examined together, specificity of cross-generational transmission was highest for mothers, intermediate for not-lived-with fathers, and lowest for stepfathers. Analyses of intact families and other not-lived-with parents and stepparents showed similar cross-generation transmission for these syndromes in mothers and fathers, supporting the representativeness of results from triparental families. A major strength of the triparental design is its inclusion, within a single family, of parents who provide, to a first approximation, their offspring with genes plus rearing, genes only, and rearing only. For drug abuse, alcohol use disorders, and criminal behavior, the results of this study suggest that parent-offspring transmission involves both genetic and environmental processes, with genetic factors being somewhat more important. These results should be interpreted in the context of the strengths and limitations of national registry data.

  4. Psychological abuse, substance abuse distress, dissatisfaction with friendships, and incident psychiatric problems.

    PubMed

    Sheikh, Mashhood Ahmed

    2018-05-01

    The aim of this study was to assess the mediating role of dissatisfaction with friendships in adulthood in the associations between psychological abuse in childhood, substance abuse distress in childhood, and incident psychiatric problems (IPPs) in adulthood over 13 years of follow-up. We used data collected from 1994 to 2008 within the framework of the Tromsø Study (N = 9502), a representative, longitudinal, prospective cohort study. Poisson regression analysis was used to assess the associations between psychological abuse, substance abuse distress, dissatisfaction with friendships in adulthood, and IPPs in adulthood. Indirect effects and proportion mediated (%) were assessed with the difference-in-coefficients method. Psychological abuse (relative risk [RR] = 1.66, 95% confidence interval [CI]: 1.45-1.89) and substance abuse distress in childhood (RR = 1.38, 95% CI: 1.18-1.62) were associated with an increased risk of dissatisfaction with friendships in adulthood. Dissatisfaction with friendships in adulthood was associated with an increased risk of IPPs in adulthood (RR = 1.71, 95% CI: 1.33-2.20). Moreover, dissatisfaction with friendships in adulthood mediated 9.31% (95% CI: 4.25-14.57) of the association between psychological abuse in childhood and IPPs in adulthood, and 9.17% (95% CI: 4.35-16.33) of the association between substance abuse distress in childhood and IPPs in adulthood. Dissatisfaction with friendships in adulthood mediates a minor proportion of the associations between psychological abuse, substance abuse distress, and IPPs in adulthood. Interventions aimed at decreasing dissatisfaction with friendships may dampen some of the effect of psychological abuse and substance abuse distress in childhood on IPPs in adulthood. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Study on accommodation by autorefraction and dynamic refraction in children

    PubMed Central

    Krishnacharya, Prabhakar Srinivasapur

    2014-01-01

    Purpose Childhood accommodation interferes with accurate diagnosis of the latent refractive errors. Dynamic retinoscopy offers accurate measurements of accommodative response, while an autorefractometer can predict the accommodative system activation in children. A correlation of the accommodative effort with the dynamic refraction has been investigated in emmetropic children, before and after cycloplegia. Methods A prospective clinical study of accommodative effort in 149 emmetropic children, in the age group 3–16 years, has been conducted using TOPCON AR RM-8000B autorefractor. Dynamic refraction was performed by monocular estimation method before and after cycloplegia, using the retinoscope mirror light as target. Retinoscopic reflex produced ‘with the motion’ was corrected with positive spherical lenses, and that ‘against the motion’ was corrected with negative spherical lenses, to achieve neutralization. Results Mean accommodative effort measured for 149 children included in the study was −0.63 ± 0.69 D and dynamic refraction was −0.07 ± 0.44 D before cycloplegia, while the mean was + 0.52 D after cycloplegia, irrespective of the method used. Autorefractor measured −0.17 D of accommodative effort per unit change in dynamic refraction before cycloplegia and +0.90 D after cycloplegia. Conclusions The performance of TOPCON AR RM-8000B autorefractor was comparable to dynamic retinoscopy. Presence of many children, and in turn, large number of accommodative response data in 11–13 and 14–15 years group is probably linked to prolonged reading/writing. The accuracy and the agreement of the actual accommodative measurements revealed after cycloplegia. PMID:25130066

  6. The impact of testing accommodations on MCAT scores: descriptive results.

    PubMed

    Julian, Ellen R; Ingersoll, Deborah J; Etienne, Patricia M; Hilger, Anthony E

    2004-04-01

    Medical College Admission Test (MCAT) examinees with disabilities who receive accommodations receive flagged scores indicating nonstandard administration. This report compares MCAT examinees who received accommodations and their performances with standard examinees. Aggregate history records of all 1994-2000 MCAT examinees were identified as flagged (2,401) or standard (297,880), then further sorted by race/ethnicity (broadly identified as underrepresented minority and non-URM, at the time of testing) and gender. Those with flagged scores were also classified by disability (LD = learning disability, ADHD = attention deficit hyperactivity disorder, LD/ADHD = learning disability and attention deficit hyperactivity disorder, and Other = other disability) and type of accommodation. Mean MCAT scores were calculated for all groups. A group of 866 examinees took the MCAT first as a standard administration and subsequently with accommodations. In a separate analysis, their two sets of scores were compared. Less than 1% of examinees (2,401) had accommodations; of these, 55% were LD, 17% ADHD, 5% LD/ADHD, and 23% Other. Extended time was the most frequently provided accommodation. Mean flagged scores slightly exceeded mean standard scores on all MCAT sections. Examinees who retook the MCAT with accommodations after a standard administration increased their scores by six points, quadrupling the average gain Standard-Standard retest cohort from another study. The small but statistically significant different higher flagged scores may reflect either appropriate compensation or overly generous accommodations. Extended time had a positive impact on the scores of those who retested with this accommodation. The validity the flagged MCAT in predicting success in medical school is not known, and further investigation is underway.

  7. Drugs of abuse that cause developing neurons to commit suicide.

    PubMed

    Farber, Nuri B; Olney, John W

    2003-12-30

    When neuronal activity is abnormally suppressed during the developmental period of synaptogenesis, the timing and sequence of synaptic connections is disrupted, and this causes nerve cells to receive an internal signal to commit suicide, a form of cell death known as "apoptosis". By altering glutamate and GABA transmission alcohol suppresses neuronal activity, causing millions of nerve cells to commit suicide in the developing brain. This proapoptotic effect of alcohol provides a likely explanation for the diminished brain size and lifelong neurobehavioral disturbances associated with the human fetal alcohol syndrome. These findings have public health significance, not only in relation to fetal alcohol syndrome, but also in relation to several other drugs of abuse and various drugs used in obstetric and pediatric medicine, because these additional drugs (e.g. phencyclidine, ketamine, benzodiazepines, barbiturates) also suppress neuronal activity and drive developing neurons to commit suicide.

  8. Abuse of Older Men in Seven European Countries: A Multilevel Approach in the Framework of an Ecological Model.

    PubMed

    Melchiorre, Maria Gabriella; Di Rosa, Mirko; Lamura, Giovanni; Torres-Gonzales, Francisco; Lindert, Jutta; Stankunas, Mindaugas; Ioannidi-Kapolou, Elisabeth; Barros, Henrique; Macassa, Gloria; Soares, Joaquim J F

    2016-01-01

    Several studies on elder abuse indicate that a large number of victims are women, but others report that men in later life are also significantly abused, especially when they show symptoms of disability and poor health, and require help for their daily activities as a result. This study focused on the prevalence of different types of abuse experienced by men and on a comparison of male victims and non-victims concerning demographic/socio-economic characteristics, lifestyle/health variables, social support and quality of life. Additionally, the study identified factors associated with different types of abuse experienced by men and characteristics associated with the victims. The cross-sectional data concerning abuse in the past 12 months were collected by means of interviews and self-response during January-July 2009, from a sample of 4,467 not demented individuals aged between 60-84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain and Sweden). We used a multilevel approach, within the framework of an Ecological Model, to explore the phenomenon of abuse against males as the complex result of factors from multiple levels: individual, relational, community and societal. Multivariate analyses showed that older men educated to higher levels, blue-collar workers and men living in a rented accommodation were more often victims than those educated to lower levels, low-rank white-collar workers and home owners, respectively. In addition, high scores for factors such as somatic and anxiety symptoms seemed linked with an increased probability of being abused. Conversely, factors such as increased age, worries about daily expenses (financial strain) and greater social support seemed linked with a decreased probability of being abused. Male elder abuse is under-recognized, under-detected and under-reported, mainly due to the vulnerability of older men and to social/cultural norms supporting traditional male characteristics of

  9. Abuse of Older Men in Seven European Countries: A Multilevel Approach in the Framework of an Ecological Model

    PubMed Central

    Melchiorre, Maria Gabriella; Di Rosa, Mirko; Lamura, Giovanni; Torres-Gonzales, Francisco; Lindert, Jutta; Stankunas, Mindaugas; Ioannidi-Kapolou, Elisabeth; Barros, Henrique; Macassa, Gloria; Soares, Joaquim J. F.

    2016-01-01

    Background Several studies on elder abuse indicate that a large number of victims are women, but others report that men in later life are also significantly abused, especially when they show symptoms of disability and poor health, and require help for their daily activities as a result. This study focused on the prevalence of different types of abuse experienced by men and on a comparison of male victims and non-victims concerning demographic/socio-economic characteristics, lifestyle/health variables, social support and quality of life. Additionally, the study identified factors associated with different types of abuse experienced by men and characteristics associated with the victims. Methods The cross-sectional data concerning abuse in the past 12 months were collected by means of interviews and self-response during January-July 2009, from a sample of 4,467 not demented individuals aged between 60–84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain and Sweden). We used a multilevel approach, within the framework of an Ecological Model, to explore the phenomenon of abuse against males as the complex result of factors from multiple levels: individual, relational, community and societal. Results Multivariate analyses showed that older men educated to higher levels, blue-collar workers and men living in a rented accommodation were more often victims than those educated to lower levels, low-rank white-collar workers and home owners, respectively. In addition, high scores for factors such as somatic and anxiety symptoms seemed linked with an increased probability of being abused. Conversely, factors such as increased age, worries about daily expenses (financial strain) and greater social support seemed linked with a decreased probability of being abused. Conclusions Male elder abuse is under-recognized, under-detected and under-reported, mainly due to the vulnerability of older men and to social/cultural norms supporting

  10. A meta-analysis of family accommodation and OCD symptom severity.

    PubMed

    Wu, Monica S; McGuire, Joseph F; Martino, Charitie; Phares, Vicky; Selles, Robert R; Storch, Eric A

    2016-04-01

    Family accommodation in obsessive-compulsive disorder (OCD) is characterized by myriad behaviors, such as modifying family routines, facilitating avoidance, and engaging in compulsions to reduce obsessional distress. It has been linked to various deleterious outcomes including increased functional impairment and poorer treatment response for OCD. Although extant literature suggests a linear relationship between family accommodation and OCD symptom severity, the magnitude and statistical significance of this association has been inconsistent across studies, indicating that moderators may be influencing this relationship. The present study examined this relationship using meta-analytic techniques, and investigated sample-dependent (age, gender, comorbid anxiety/mood disorders) and methodological (administration method and number of items used in family accommodation measure, informant type, sample size, publication year) moderators. Forty-one studies were included in the present meta-analysis, and the overall effect size (ES) for the correlation between family accommodation and OCD symptom severity was moderate (r=.42). Moderator analyses revealed that the number of items on the family accommodation scale moderated the ES. No other sample-dependent or methodological characteristics emerged as moderators. In addition to being the first systematic examination of family accommodation moderators, these results highlight the moderate relationship between family accommodation and OCD severity that is influenced by measurement scales. Findings may be used to guide clinical care and inform future investigations by providing a more nuanced understanding of family accommodation in OCD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Syndromes, disorders and maternal risk factors associated with neural tube defects (VII).

    PubMed

    Chen, Chih-Ping

    2008-09-01

    Neural tube defects (NTDs) may be associated with syndromes, disorders and maternal risk factors. This article provides a comprehensive review of the syndromes, disorders and maternal risk factors associated with NTDs, including DK phocomelia syndrome (von Voss-Cherstvoy syndrome), Siegel-Bartlet syndrome, fetal warfarin syndrome, craniotelencephalic dysplasia, Czeizel-Losonci syndrome, maternal cocaine abuse, Weissenbacher- Zweymller syndrome, parietal foramina (cranium bifidum), Apert syndrome, craniomicromelic syndrome, XXagonadism with multiple dysraphic lesions including omphalocele and NTDs, Fryns microphthalmia syndrome, Gershoni-Baruch syndrome, PHAVER syndrome, periconceptional vitamin B6 deficiency, and autosomal dominant Dandy-Walker malformation with occipital cephalocele. NTDs associated with these syndromes, disorders and maternal risk factors are a rare but important cause of NTDs. The recurrence risk and the preventive effect of maternal folic acid intake in NTDs associated with syndromes, disorders and maternal risk factors may be different from those of nonsyndromic multifactorial NTDs. Perinatal diagnosis of NTDs should alert doctors to the syndromes, disorders and maternal risk factors associated with NTDs, and prompt thorough etiologic investigation and genetic counseling.

  12. Water Accommodation on Bare and Coated Ice

    NASA Astrophysics Data System (ADS)

    Kong, Xiangrui

    2015-04-01

    A good understanding of water accommodation on ice surfaces is essential for quantitatively predicting the evolution of clouds, and therefore influences the effectiveness of climate models. However, the accommodation coefficient is poorly constrained within the literature where reported values vary by up to three orders of magnitude. In addition, the complexity of the chemical composition of the atmosphere plays an important role in ice phase behavior and dynamics. We employ an environmental molecular beam (EMB) technique to investigate molecular water interactions with bare and impurity coated ice at temperatures from 170 K to 200 K. In this work, we summarize results of water accommodation experiments on bare ice (Kong et al., 2014) and on ice coated by methanol (Thomson et al., 2013), butanol (Thomson et al., 2013) and acetic acid (Papagiannakopoulos et al., 2014), and compare those results with analogous experiments using hexanol and nitric acid coatings. Hexanol is chosen as a complementary chain alcohol to methanol and butanol, while nitric acid is a common inorganic compound in the atmosphere. The results show a strong negative temperature dependence of water accommodation on bare ice, which can be quantitatively described by a precursor model. Acidic adlayers tend to enhance water uptake indicating that the system kinetics are thoroughly changed compared to bare ice. Adsorbed alcohols influence the temperature dependence of the accommodation coefficient and water molecules generally spend less time on the surfaces before desorbing, although the measured accommodation coefficients remain high and comparable to bare ice for the investigated systems. We conclude that impurities can either enhance or restrict water uptake in ways that are influenced by several factors including temperature and type of adsorbant, with potential implications for the description of ice particle growth in the atmosphere. This work was supported by the Swedish Research Council and

  13. Alienation and Domestic Abuse: How Abused Women Cope with Loneliness

    ERIC Educational Resources Information Center

    Arokach, Ami

    2006-01-01

    This study explored the manner in which abused women cope with loneliness. Eighty women, victims of domestic abuse, were compared to 84 women from the general population who have had no history of abusive relationships. A 34-item yes/no loneliness questionnaire was utilized in order to compare the "beneficial" ways of coping with loneliness in the…

  14. Spacelab payload accommodation handbook. Main volume

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The main characteristics of the Spacelab system are described to enable individual experimenters or payload planning groups to determine how their payload equipment can be accommodated by Spacelab. Spacelab/experiment interfaces, Spacelab payload support systems and requirements that the experiments have to comply with are described to allow experiment design and development. The basic operational aspects are outlined as far as they have an impact on experiment design. The relationship of the Spacelab Payload Accommodation Handbook to Space Transportation System documentation is outlined. Data concerning the space shuttle system are briefly described.

  15. [Attachment Quality of Young Children with Mentally Ill Parents on the Example of the Munchausen by Proxy Syndrome].

    PubMed

    Ramberg, Axel; Feldkötter, Sinja

    2015-01-01

    One of the most discussed questions in clinical literature concerns the impact of child abuse by mentally ill parents (cf. Mattejat, 1998). It's obvious that most children cannot understand such a parental behaviour and that this lack of understanding along with the lack of knowledge about their parents' emotional disorder results in childrens' fear, disorientation and uncertainty. The consequences are massive interferences in the relationship between parents and children, who could develop an anxious-resistant insecure or even a disorganized/disoriented attachment. But how does a child react, if the behaviour of its parents is ambivalent itself and alternates from abuse to care? Such a parental behaviour is described as the "Munchausen by Proxy Syndrome". This article regards the effects of a "Munchausen by Proxy Syndrome" on the childrens' attachment development. After discussing the basic assumptions about the "Munchhauen by Proxy Syndrome" and the attachment theory we draw conclusions about the syndrome's effect on childrens' attachment behaviour.

  16. An Accommodations Model for the Secondary Inclusive Classroom

    ERIC Educational Resources Information Center

    Scanlon, David; Baker, Diana

    2012-01-01

    Despite expectations for accommodations in inclusive classrooms, little guidance for effective practice is available. Most accommodations policies and evidence-based practices address assessments. High school regular and special educators collaborated in focus groups to articulate a model based on their practices and perceptions of best practice.…

  17. Religious Observance Accommodation in Ontario Universities. Discussion Paper.

    ERIC Educational Resources Information Center

    Reed, Carole Ann

    This paper highlights the religious accommodations that Ontario (Canada) universities have undertaken to create an inclusive, supportive learning community for all students, faculty, and staff. It outlines the demographic changes and public policy surrounding religious accommodation issues in Canada and in Ontario in particular, focusing on the…

  18. [Prevalence of sexual abuse in students and its relation with drug abuse].

    PubMed

    Ramos-Lira, L; Saldívar-Hernández, G; Medina-Mora, M E; Rojas-Guiot, E; Villatoro-Velázquez, J

    1998-01-01

    To determine the prevalence of sexual abuse among high school (secondary and preparatory) students, male and female, throughout Mexico, and its relationship with drug abuse. Data were obtained from the National Survey of Drug Use in Schools applied in November and December, 1991. A total of 61,779 students, 51.8% men and 47.1% women, with a mean age of 14.4 years completed the self-applied questionnaire. Sexual abuse was explored from the perspective of the abusers and of the victims. The prevalence of sexual abuse in adolescent victims was 4.3% and no statistically significant differences were found between sexes. The prevalence of sexual aggressors was 2.5%. Men coerced someone else in a higher proportion than women. Adolescent women experienced sexual abuse at a younger age than men and they also reported a higher percentage of intrafamily abuse. Men reported friends as the most frequent aggressors. Victims and aggressors of both sexes reported a significantly higher drug consumption than students without these antecedents. The differences in the experience of sexual abuse between men and women are described. In particular, the fact that sexual abuse in men mainly occurs outside the family sphere, while in women it is mainly within the family and at a younger age than in men. Additionally, the need for further research focusing on the consequences on mental health of infantile and adolescent sexual abuse and drug consumption is emphasized, considering the characteristics of each gender.

  19. Elder Abuse among African Americans

    ERIC Educational Resources Information Center

    Tauriac, Jesse J.; Scruggs, Natoschia

    2006-01-01

    Perceptions of extreme, moderate, and mild forms of elder abuse among African-American women (n=25) and men (n=10) were examined. African-American respondents emphasized physical abuse when giving examples of extremely abusive behavior. Along with physical abuse, verbal abuse was the most frequently identified form of abuse, and was significantly…

  20. Gain and movement time of convergence-accommodation in preschool children.

    PubMed

    Suryakumar, R; Bobier, W R

    2004-11-01

    Convergence-accommodation is the synkinetic change in accommodation driven by vergence. A few studies have investigated the static and dynamic properties of this cross-link in adults but little is known about convergence-accommodation in children. The purpose of this study was to develop a technique for measuring convergence-accommodation and to study its dynamics (gain and movement time) in a sample of pre-school children. Convergence-accommodation measures were examined on thiry-seven normal pre-school children (mean age = 4.0 +/- 1.31 yrs). Stimulus CA/C (sCA/C) ratios and movement time measures of convergence-accommodation were assessed using a photorefractor while subjects viewed a DOG target. Repeated measures were obtained on eight normal adults (mean age = 23 +/- 0.2 yrs). The mean sCA/C ratios and movement times were not significantly different between adults and children (0.10 D/Delta [0.61 D/M.A.], 743 +/- 70 ms and 0.11 D/Delta [0.50 D/M.A.], 787 +/- 216 ms). Repeated measures on adults showed a non-significant mean difference of 0.001 D/Delta. The results suggest that the possible differences in crystalline lens (plant) characteristics between children and adults do not appear to influence convergence-accommodation gain or duration.

  1. Quick and Easy Adaptations and Accommodations for Early Childhood Students

    ERIC Educational Resources Information Center

    Breitfelder, Leisa M.

    2008-01-01

    Research-based information is used to support the idea of the use of adaptations and accommodations for early childhood students who have varying disabilities. Multiple adaptations and accommodations are outlined. A step-by-step plan is provided on how to make specific adaptations and accommodations to fit the specific needs of early childhood…

  2. Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women.

    PubMed

    Peltan, Jessica R; Cellucci, Tony

    2011-10-01

    Incarcerated women have high rates of substance abuse problems and trauma. A variety of variables may influence whether these women seek help or are referred for substance abuse problems. This study reports an exploratory project on service utilization among incarcerated substance-dependent women (N = 40) in southeastern Idaho. Using self-report and interview tools, most participants reported some substance abuse treatment history, although extent and types of treatment varied. Most of the women also reported some type of childhood abuse. Age, income, and consequences of alcohol and other drug use related positively to substance abuse treatment. However, severity of childhood sexual abuse and current trauma symptoms were negatively correlated with substance abuse treatment episodes. These women may use substances to cope with childhood trauma or may not perceive the substance abuse system as responsive to their co-occurring trauma symptoms. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Accommodative Behavior of Young Eyes Wearing Multifocal Contact Lenses.

    PubMed

    Altoaimi, Basal H; Almutairi, Meznah S; Kollbaum, Pete S; Bradley, Arthur

    2018-05-01

    The effectiveness of multifocal contact lenses (MFCLs) at slowing myopia progression may hinge on the accommodative behavior of young eyes fit with these presbyopic style lenses. Can they remove hyperopic defocus? Convergence accommodation as well as pupil size and the zonal geometry are likely to contribute to the final accommodative responses. The aim of this study was to examine the accommodation behavior of young adult eyes wearing MFCLs and the effectiveness of these MFCLs at removing foveal hyperopic defocus when viewing near targets binocularly. Using a high-resolution Shack-Hartmann aberrometer, accommodation and pupil behavior of eight young adults (27.25 ± 2.05 years) were measured while subjects fixated a 20/40 character positioned between 2 m and 20 cm (0.50 to 5.00 diopters [D]) in 0.25-D steps. Refractive states were measured while viewing binocularly and monocularly with single-vision and both center-distance and center-near +2.00 D add MFCLs. Refractive state was defined using three criteria: the dioptric power that would (1) minimize the root mean square wavefront error, (2) focus the pupil center, and (3) provide the peak image quality. Refractive state pupil maps reveal the complex optics that exist in eyes wearing MFCLs. Reduced accommodative gain beyond the far point of the near add revealed that young subjects used the added plus power to help focus near targets. During accommodation to stimuli closer than the far point generated by the add power, a midperipheral region of the pupil was approximately focused, resulting in the smallest accommodative errors for the minimum root mean square-defined measures of refractive state. Paraxial images were always hyperopically or myopically defocused in eyes viewing binocularly with center-distance or center-near MFCLs, respectively. Because of zone geometry in the concentric MFCLs tested, the highly aberrated transition zone between the distance and near optics contributed a significant proportion and

  4. The effect of proximity on open-loop accommodation responses measured with pinholes.

    PubMed

    Morrison, K A; Seidel, D; Strang, N C; Gray, L S

    2010-07-01

    Open-loop accommodation levels were measured in 41 healthy, young subjects using a Shin-Nippon SRW-5000 autorefractor in the three viewing conditions: a small physical pinhole pupil (SP), an optically projected pinhole in Maxwellian view (MV) and in the dark (DF). The target viewed through the pinholes was a high-contrast letter presented at 0 D vergence in a +5 D Badal lens system. Overall, results showed that SP open-loop accommodation levels were significantly higher than MV and DF levels. Subjects could be divided into two distinct subgroups according to their response behaviour: responders to the proximal effect of the small physical pinhole (SP accommodation > MV accommodation) and non-responders to the proximal effect of the small physical pinhole (SP accommodation approximately MV accommodation). Correlation analysis demonstrated that open-loop accommodation for both pinhole conditions was correlated with DF for the responders, while for the non-responders SP and MV accommodation were correlated, but were not related to DF accommodation. This suggests that under open-loop conditions some individuals' accommodation levels are mainly affected by proximal and cognitive factors (responders) while others are guided primarily by the presence of the more distal target (non-responders). In conclusion, MV reduces the proximal effect of the physical pinhole and produces open-loop accommodation responses which are more consistent than SP and DF responses.

  5. Making the Case for 'Power Abuse Disorder' as a Nosologic Entity.

    PubMed

    Zernig, Gerald; Hiemke, Christoph

    2017-01-01

    The development of societies and cultures arguably is based on the ability of human primates to form hierarchies in which some individuals acquire and wield power, that is, control resources and influence and control the behavior of their conspecifics. In the following, we focus on the type of human primate power wielding that (a) harms and (b) produces excessive negative emotions in (1) the victim(s) of the power wielder and (2) the power wielder her/himself. If such a harmful behavior of the power wielder is not accompanied by an ethically justifiable benefit for the involved human primate groups, it can be considered "power abuse." We propose to term the associated behaviors, cognitions, and emotions of the power wielder as "power abuse disorder" (PAD). This behavior results from what we consider addictive behavior of the power abuse disordered (PADed) power wielder. PAD can be diagnosed on the basis of the World Health Organization's criteria for "dependence syndrome" as listed in the International Classification of Diseases version 10. We will demonstrate that many PADed individuals may very likely carry the Zeitgeist diagnosis "burnout." This article reviews the current understanding of the neural correlates of PAD and suggests future research. Based on the available evidence, PAD seems to be associated with a dysfunction of the mesocorticolimbic dopamine system, rendering PADed individuals vulnerable for psychostimulant abuse/dependence, and suggesting specific pharmacotherapeutic approaches to treat PAD. © 2017 S. Karger AG, Basel.

  6. Support Services for Students with Asperger's Syndrome in Higher Education

    ERIC Educational Resources Information Center

    Smith, Caroline P.

    2007-01-01

    The study examines the following research question: "What are the needs of students with Asperger's Syndrome (AS), and what are the services and accommodations available to them at the post-secondary level?" An increasing number of individuals diagnosed with AS are entering institutions of higher education. This study is exploratory in nature,…

  7. Are high lags of accommodation in myopic children due to motor deficits?

    PubMed

    Labhishetty, Vivek; Bobier, William R

    2017-01-01

    Children with a progressing myopia exhibit an abnormal pattern of high accommodative lags coupled with high accommodative convergence (AC/A) and high accommodative adaptation. This is not predicted by the current models of accommodation and vergence. Reduced accommodative plant gain and reduced sensitivity to blur have been suggested as potential causes for this abnormal behavior. These etiologies were tested by altering parameters (sensory, controller and plant gains) in the Simulink model of accommodation. Predictions were then compared to the static and dynamic blur accommodation (BA) measures taken using a Badal optical system on 12 children (6 emmetropes and 6 myopes, 8-13years) and 6 adults (20-35years). Other critical parameters such as CA/C, AC/A, and accommodative adaptation were also measured. Usable BA responses were classified as either typical or atypical. Typical accommodation data confirmed the abnormal pattern of myopia along with an unchanged CA/C. Main sequence relationship remained invariant between myopic and nonmyopic children. An overall reduction was noted in the response dynamics such as peak velocity and acceleration with age. Neither a reduced plant gain nor reduced blur sensitivity could predict the abnormal accommodative behavior. A model adjustment reflecting a reduced accommodative sensory gain (ASG) coupled with an increased AC cross-link gain and reduced vergence adaptive gain does predict the empirical findings. Empirical measures also showed a greater frequency of errors in accommodative response generation (atypical responses) in both myopic and control children compared to adults. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. "Helping Communities To Help Themselves." Twenty 1989 Exemplary Prevention Programs for Preventing Alcohol and Other Drug Abuse. Project Summaries.

    ERIC Educational Resources Information Center

    National Association of State Alcohol and Drug Abuse Directors, Inc.

    Twenty exemplary substance abuse prevention programs are presented in this document. These programs are included: (1) Tuba City, Arizona, Fetal Alcohol Syndrome (FAS) Prevention Program; (2) Chemical Addiction Course, University of Arkansas; (3) "Teens Are Concerned" of Arkansas; (4) "Dare to be You of Colorado"; (5) Winyan…

  9. Convergence and Accommodation Development Is Preprogrammed in Premature Infants.

    PubMed

    Horwood, Anna M; Toor, Sonia S; Riddell, Patricia M

    2015-08-01

    This study investigated whether vergence and accommodation development in preterm infants is preprogrammed or is driven by experience. Thirty-two healthy infants, born at mean 34 weeks gestation (range, 31.2-36 weeks), were compared with 45 healthy full-term infants (mean 40.0 weeks) over a 6-month period, starting at 4 to 6 weeks postnatally. Simultaneous accommodation and convergence to a detailed target were measured using a Plusoptix PowerRefII infrared photorefractor as a target moved between 0.33 and 2 m. Stimulus/response gains and responses at 0.33 and 2 m were compared by both corrected (gestational) age and chronological (postnatal) age. When compared by their corrected age, preterm and full-term infants showed few significant differences in vergence and accommodation responses after 6 to 7 weeks of age. However, when compared by chronological age, preterm infants' responses were more variable, with significantly reduced vergence gains, reduced vergence response at 0.33 m, reduced accommodation gain, and increased accommodation at 2 m compared to full-term infants between 8 and 13 weeks after birth. When matched by corrected age, vergence and accommodation in preterm infants show few differences from full-term infants' responses. Maturation appears preprogrammed and is not advanced by visual experience. Longer periods of immature visual responses might leave preterm infants more at risk of development of oculomotor deficits such as strabismus.

  10. Parental accommodation of child anxiety and related symptoms: Range, impact, and correlates

    PubMed Central

    Thompson-Hollands, Johanna; Kerns, Caroline E.; Pincus, Donna B.; Comer, Jonathan S.

    2014-01-01

    Parental accommodation—i.e., changes in parents’ behavior in attempts to prevent or reduce child distress—has been most studied in relation to OCD. Although recent work suggests parents of children with non-OCD anxiety diagnoses also engage in accommodation, little is known about the specific forms, correlates, and associated interference of such accommodation. The present study examined the range and associated interference of parental accommodation behaviors using the newly developed Family Accommodation Checklist and Interference Scale (FACLIS) in a sample of the parents of 71 clinic-referred children with anxiety disorders (NMothers = 68; NFathers= 51). The FACLIS demonstrated good reliability and validity. Ninety-seven percent of mothers and 88% of fathers reported engaging in at least one type of accommodation in the previous two weeks, with parents reporting an average of roughly 4 interfering parental accommodation behaviors. Greater parental accommodation and associated interference were associated with higher maternal distress. Among the anxiety disorders, accommodation was most strongly associated with generalized and separation anxiety disorder, as well as specific phobias. Findings (a) offer psychometric support for the FACLIS as a reliable and valid tool for the assessment of accommodation range and impact, and (b) help clarify the considerable scope and interference associated with parental accommodation of childhood anxiety. PMID:25261837

  11. Guillan-Barré syndrome in heroin addiction.

    PubMed

    SMith, W R; Wilson, A F

    1975-03-31

    In two cases of Guillain-Barré syndrome (acute polyneuritis) as a complication of narcotic abuse, the onset of paralysis began approximately 4 and 12 hours after self-administration of opiates intravenously. Bulbar and respiratory paralysis developed in one patient and required prolonged ventilation therapy; the other patient had peripheral muscular and unilateral facial weakness, with notable pleocytosis was present in both.

  12. Evaluating Computer-Based Test Accommodations for English Learners

    ERIC Educational Resources Information Center

    Roohr, Katrina Crotts; Sireci, Stephen G.

    2017-01-01

    Test accommodations for English learners (ELs) are intended to reduce the language barrier and level the playing field, allowing ELs to better demonstrate their true proficiencies. Computer-based accommodations for ELs show promising results for leveling that field while also providing us with additional data to more closely investigate the…

  13. Computer vision syndrome: a review.

    PubMed

    Blehm, Clayton; Vishnu, Seema; Khattak, Ashbala; Mitra, Shrabanee; Yee, Richard W

    2005-01-01

    As computers become part of our everyday life, more and more people are experiencing a variety of ocular symptoms related to computer use. These include eyestrain, tired eyes, irritation, redness, blurred vision, and double vision, collectively referred to as computer vision syndrome. This article describes both the characteristics and treatment modalities that are available at this time. Computer vision syndrome symptoms may be the cause of ocular (ocular-surface abnormalities or accommodative spasms) and/or extraocular (ergonomic) etiologies. However, the major contributor to computer vision syndrome symptoms by far appears to be dry eye. The visual effects of various display characteristics such as lighting, glare, display quality, refresh rates, and radiation are also discussed. Treatment requires a multidirectional approach combining ocular therapy with adjustment of the workstation. Proper lighting, anti-glare filters, ergonomic positioning of computer monitor and regular work breaks may help improve visual comfort. Lubricating eye drops and special computer glasses help relieve ocular surface-related symptoms. More work needs to be done to specifically define the processes that cause computer vision syndrome and to develop and improve effective treatments that successfully address these causes.

  14. Disability disclosure and workplace accommodations among youth with disabilities.

    PubMed

    Lindsay, Sally; Cagliostro, Elaine; Leck, Joanne; Shen, Winny; Stinson, Jennifer

    2018-03-20

    Many youths with disabilities find it challenging to disclose their medical condition and request workplace accommodations. Our objective was to explore when and how young people with disabilities disclose their condition and request workplace accommodations. We conducted 17 in-depth interviews (11 females, six males) with youth with disabilities aged 15-34 (mean age 26). We analyzed our data using an interpretive, qualitative, and thematic approach. Our results showed the timing of when youth disclosed their disability to their employer depended on disability type and severity, comfort level, type of job, and industry. Youth's strategies and reasons for disclosure included advocating for their needs, being knowledgeable about workplace rights, and accommodation solutions. Facilitators for disclosure included job preparation, self-confidence, and self-advocacy skills, and having an inclusive work environment. Challenges to disability disclosure included the fear of stigma and discrimination, lack of employer's knowledge about disability and accommodations, negative past experiences of disclosing, and not disclosing on your own terms. Our findings highlight that youth encounter several challenges and barriers to disclosing their condition and requesting workplace accommodations. The timing and process for disclosing is complex and further work is needed to help support youth with disclosing their condition. Implications for rehabilitation Clinicians, educators, and employers should emphasize the importance of mentoring and leadership programs to give youth the confidence and self-advocacy skills needed to disclose and ask for accommodations in the workplace. Clinicians should advocate for the inclusion of youth with disabilities in the workforce and educate employers on the importance of doing so. Youth with disabilities need more opportunities for employment training and particularly how to disclose their disability and request workplace accommodations.

  15. Elder physical abuse.

    PubMed

    Young, Lisa M

    2014-11-01

    Physical abuse of the elderly is a significant public health concern. The true prevalence of all types is unknown, and under-reporting is known to be significant. The geriatric population is projected to increase dramatically over the next 10 years, and the number of abused individuals is projected to increase also. It is critical that health care providers feel competent in addressing physical elder abuse. This article presents cases illustrating the variety of presenting symptoms that may be attributed to physical elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Prediction of accommodative optical response in prepresbyopic patients using ultrasound biomicroscopy

    PubMed Central

    Ramasubramanian, Viswanathan; Glasser, Adrian

    2015-01-01

    PURPOSE To determine whether relatively low-resolution ultrasound biomicroscopy (UBM) can predict the accommodative optical response in prepresbyopic eyes as well as in a previous study of young phakic subjects, despite lower accommodative amplitudes. SETTING College of Optometry, University of Houston, Houston, USA. DESIGN Observational cross-sectional study. METHODS Static accommodative optical response was measured with infrared photorefraction and an autorefractor (WR-5100K) in subjects aged 36 to 46 years. A 35 MHz UBM device (Vumax, Sonomed Escalon) was used to image the left eye, while the right eye viewed accommodative stimuli. Custom-developed Matlab image-analysis software was used to perform automated analysis of UBM images to measure the ocular biometry parameters. The accommodative optical response was predicted from biometry parameters using linear regression, 95% confidence intervals (CIs), and 95% prediction intervals. RESULTS The study evaluated 25 subjects. Per-diopter (D) accommodative changes in anterior chamber depth (ACD), lens thickness, anterior and posterior lens radii of curvature, and anterior segment length were similar to previous values from young subjects. The standard deviations (SDs) of accommodative optical response predicted from linear regressions for UBM-measured biometry parameters were ACD, 0.15 D; lens thickness, 0.25 D; anterior lens radii of curvature, 0.09 D; posterior lens radii of curvature, 0.37 D; and anterior segment length, 0.42 D. CONCLUSIONS Ultrasound biomicroscopy parameters can, on average, predict accommodative optical response with SDs of less than 0.55 D using linear regressions and 95% CIs. Ultrasound biomicroscopy can be used to visualize and quantify accommodative biometric changes and predict accommodative optical response in prepresbyopic eyes. PMID:26049831

  17. A Daily Diary Study of Posttraumatic Stress Symptoms and Romantic Partner Accommodation

    PubMed Central

    Campbell, Sarah B.; Renshaw, Keith D.; Kashdan, Todd B.; Curby, Timothy W.; Carter, Sarah P.

    2017-01-01

    Little is known about the role of romantic partner symptom accommodation in PTSD symptom maintenance. To explore the bidirectional associations of posttraumatic stress disorder (PTSD) symptoms and romantic partner symptom accommodation over time, military servicemen (n = 64) with symptoms of PTSD and their co-habiting heterosexual civilian romantic partners (n = 64) completed a 2-week daily diary study. Cross-lagged, autoregressive models assessed the stability of men’s PTSD symptoms and partners’ accommodation, as well as the prospective associations of earlier PTSD symptoms with later accommodation and vice versa. Analyses used Bayesian estimation to provide point estimates (b) and Credible Intervals (CIs). In all models, PTSD symptoms (total and individual clusters) were highly stable (b = 0.91; CI: 0.88–0.95), and accommodation was moderately stable (b = 0.48; CI: 0.40–0.54). In all models, earlier PTSD symptoms (total and clusters) were significantly, positively associated with later accommodation (b = 0.04; CI: 0.02–0.07). In contrast, earlier accommodation was significantly associated only with later situational avoidance (b = 0.02; CI: 0.00–0.07). Thus, PTSD symptoms may lead to subsequent accommodating behaviors in romantic partners, but partner accommodation seems to contribute only to survivors’ future situational avoidance symptoms. The findings reinforce the notion that PTSD symptoms have an impact on relationship behaviors, and that accommodation from partners may sustain avoidant behaviors in particular. Clinicians should attend to romantic partners’ accommodating behaviors when working with survivors. PMID:28270332

  18. Establishing "abuse-deterrence equivalence" for generic abuse-deterrent opioid formulations: A proposed development framework.

    PubMed

    Setnik, Beatrice; Cone, Edward J

    2016-01-01

    Abuse-deterrent formulations are one strategy for mitigating the epidemic of prescription opioid abuse. Regulatory guidance documents describe the requirements for developing abuse-deterrent formulations of novel drugs and formulations; however, they do not address "abuse-deterrence equivalence" for generic formulations. As generics may be produced with different excipients and formulations compared to reference drugs, differences in their properties may impact their abuse-deterrent features. Currently, it is unclear what specific studies are needed to support generic abuse-deterrence claims. This commentary outlines several recommendations on the in vitro and in vivo testing required, including the conditions for conducting a human abuse potential study.

  19. Measuring Economic Abuse in the Lives of Survivors: Revising the Scale of Economic Abuse.

    PubMed

    Postmus, Judy L; Plummer, Sara-Beth; Stylianou, Amanda M

    2016-05-01

    Recent attention has been given by researchers to understanding how abusers use economic abuse strategies. Unfortunately, limited measures are available to accurately understand the prevalence of economic abuse in the lives of survivors. Recently, researchers created the 28-item Scale of Economic Abuse (SEA) but further validation is needed. This article describes the psychometric evaluation of the SEA through confirmatory and exploratory factor analyses using data collected with 120 survivors of abuse. The findings provide evidence for the reliability and validity of the SEA-12 as a shorter instrument to measure economic abuse as a distinct form of abuse. © The Author(s) 2015.

  20. Toxigenic and metabolic causes of ketosis and ketoacidotic syndromes.

    PubMed

    Cartwright, Martina M; Hajja, Waddah; Al-Khatib, Sofian; Hazeghazam, Maryam; Sreedhar, Dharmashree; Li, Rebecca Na; Wong-McKinstry, Edna; Carlson, Richard W

    2012-10-01

    Ketoacidotic syndromes are frequently encountered in acute care medicine. This article focuses on ketosis and ketoacidotic syndromes associated with intoxications, alcohol abuse, starvation, and certain dietary supplements as well as inborn errors of metabolism. Although all of these various processes are characterized by the accumulation of ketone bodies and metabolic acidosis, there are differences in the mechanisms, clinical presentations, and principles of therapy for these heterogeneous disorders. Pathophysiologic mechanisms that account for these disorders are presented, as well as guidance regarding identification and management. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Attention-deficit/hyperactivity disorder children exhibit an impaired accommodative response.

    PubMed

    Redondo, Beatriz; Vera, Jesús; Molina, Rubén; García, José Antonio; Ouadi, Miriam; Muñoz-Hoyos, Antonio; Jiménez, Raimundo

    2018-05-01

    Attention-deficit/hyperactivity disorder (ADHD) is one of the most common paediatric neurobehavioural disorders causing multiple functional impairments in children. Based on the relationship between the neural system that controls attention and ocular dynamics, the present study compares the magnitude and variability of accommodation between a group of non-medicated ADHD children and an age-matched control group. The magnitude and variability of the accommodative response were objectively measured in 36 children using the WAM-5500 autorefractometer for 90 consecutive seconds at three static viewing distances (500, 40, and 20 cm). Participants were divided into ADHD (n = 18) or control (n = 18) groups based on clinically validated criteria. Children with ADHD exhibited higher lags of accommodation (p = 0.024), increasing at closer viewing distances, in comparison to the control group. Marginal statistical differences were found for the variability of accommodation (p = 0.066), with the ADHD group showing a trend towards higher variability. Our analysis showed that the magnitude and variability of accommodation did not vary over time between groups (p > 0.05). Our data suggest that children with ADHD have a less accurate accommodative response. These results provide a new ocular index that could help to clarify the relationship between accommodative response and attentional deficits, which could have a direct impact on the academic, cognitive, and visual performance of ADHD children.

  2. Testing Accommodations: Theory and Research to Inform Practice

    ERIC Educational Resources Information Center

    Kettler, Ryan J.

    2012-01-01

    This article presents a framework for practitioners in education and psychology to select accommodations based on student profiles and testing demands. A brief history of testing accommodations policy in the US and a definition of terms provide context for the discussion. A review of theory and empirical findings related to testing accommodations…

  3. Layout of personnel accommodations for the SOFIA

    NASA Astrophysics Data System (ADS)

    Daughters, David M.; Bruich, J. G.; Arceneaux, Gregory P.; Zirretta, Jason; Caton, William B.

    2000-06-01

    The NASA Stratospheric Observatory for Infrared Astronomy (SOFIA) Observatory is based upon a refurbished and heavily modified Boeing 747 SP aircraft. The Observatory, which provides accommodations for the Deutsches Zentrum Fur Luftund Raumfahrt 2.5 m telescope, science investigator teams, scientific instruments, mission crew and support systems. The US contractor team has removed most of the aircraft original furnishings and designed a new Layout of Personnel Accommodations (LOPA) tailored to SOFIA's needs.

  4. Space Station accommodation of attached payloads

    NASA Technical Reports Server (NTRS)

    Browning, Ronald K.; Gervin, Janette C.

    1987-01-01

    The Attached Payload Accommodation Equipment (APAE), which provides the structure to attach payloads to the Space Station truss assembly, to access Space Station resources, and to orient payloads relative to specified targets, is described. The main subelements of the APAE include a station interface adapter, payload interface adapter, subsystem support module, contamination monitoring system, payload pointing system, and attitude determination system. These components can be combined to provide accommodations for small single payloads, small multiple payloads, large self-supported payloads, carrier-mounted payloads, and articulated payloads. The discussion also covers the power, thermal, and data/communications subsystems and operations.

  5. Parent Abuse: A Review

    ERIC Educational Resources Information Center

    Kennair, Nicola; Mellor, David

    2007-01-01

    A recent focus of research and clinical practice has been on the issue of abuse of parents by their children (parent abuse). This paper reviews the literature on this phenomenon. While parent abuse falls under the umbrella of family violence, it appears to be qualitatively different from other forms of intra-family abuse. Research has primarily…

  6. Guidelines for Providing Accommodations Using CASAS Assessment for Learners with Disabilities

    ERIC Educational Resources Information Center

    CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2005

    2005-01-01

    These guidelines address methods for administering Comprehensive Adult Student Assessment System (CASAS) assessments using accommodations for learners with documented disabilities. The suggested accommodations for disability categories include provisions for: (1) Accommodations in test administration procedures; and (2) Use of appropriate CASAS…

  7. Accommodative performance for chromatic displays.

    PubMed

    Lovasik, J V; Kergoat, H

    1988-01-01

    Over the past few years, video display units (VDUs) have been incorporated into many varieties of workplaces and occupational demands. The success of electro-optical displays in facilitating and improving job performance has spawned interest in extracting further advantage from VDUs by incorporating colour coding into such communication systems. However, concerns have been raised about the effect of chromatic stimuli on the visual comfort and task efficiency, because of the chromatic aberration inherent in the optics of the human eye. In this study, we used a computer aided laser speckle optometer system to measure the accommodative responses to brightness-matched chromatic letters displayed on a high-resolution RGB monitor. Twenty, visually normal, paid volunteers in a 22-35 year age category served as subjects. Stimuli were 14, 21, 28 minutes of arc letters presented in a 'monochromatic' (white, red, green or blue, on a black background) or 'multichromatic' (blue-red, blue-green, red-green, foreground-background combinations) mode at 40 and 80 cm viewing distances. The results demonstrated that while the accommodative responses were strongly influenced by the foreground-background colour combination, the group-averaged dioptric difference across colours was relatively small. Further, accommodative responses were not guided in any systematic fashion by the size of letters presented for fixation. Implications of these findings for display designs are discussed.

  8. The Measures Contribution Researches on Renewable Energy Accommodation Based on Production Simulation

    NASA Astrophysics Data System (ADS)

    Zhe, MI; Jinfang, Zhang; Jun, Liu

    2018-06-01

    This paper presents the impacts of load, source and grid factors on renewable energy accommodation in the northern region of China. Renewable energy curtailment reasons and key measures to improve accommodations are also discussed. The production simulation method is utilized to analysis renewable energy accommodation and the Shapely value method is introduced to calculate the accommodation contribution rate of different factors. The result shows that the amount of renewable energy accommodation is 389 TWh in northern region of China by the year 2020. The contribution rate of load, source and grid factors to renewable energy accommodation are 39%, 35.8% and 25.1%, respectively.

  9. The Abuse-Related Beliefs Questionnaire for Survivors of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Ginzburg, Karni; Arnow, Bruce; Hart, Stacey; Gardner, William; Koopman, Cheryl; Classen, Catherine C.; Giese-Davis, Janine; Spiegel, David

    2006-01-01

    Objective: To evaluate the psychometric properties of a new measure, the Abuse-Related Beliefs Questionnaire (ARBQ), designed to assess abuse-related beliefs among adult survivors of childhood sexual abuse (CSA). Study 1 examined the structure of the scale, and Study 2 evaluated its reliability and validity. Method: One hundred and seventy female…

  10. Subjective vs Objective Accommodative Amplitude: Preschool to Presbyopia

    PubMed Central

    Anderson, Heather A.; Stuebing, Karla K.

    2014-01-01

    Purpose This study compared subjective and objective accommodative amplitudes to characterize changes from preschool to presbyopia. Methods Monocular accommodative amplitude was measured with three techniques in random order (subjective push-up, objective minus lens stimulated, and objective proximal stimulated) on 236 subjects 3–64 years using a 1.5mm letter. Subjective push-up amplitudes were the dioptric distance at which the target first blurred along a near-point rod. Objective minus lens stimulated amplitudes were the greatest accommodative response obtained by Grand Seiko autorefraction as subjects viewed the stimulus at 33cm through increasing minus lens powers. Objective proximal stimulated amplitudes were the greatest accommodative response obtained by Grand Seiko autorefraction as subjects viewed the stimulus at increasing proximity from 40cm up to 3.33cm. Results In comparison with subjective push-up amplitudes, objective amplitudes were lower at all ages, with the most dramatic difference occurring in the 3–5 year group (subjective push-up = 16.00 ± 4.98D versus objective proximal stimulated = 7.94 ± 2.37D and objective lens stimulated = 6.20 ± 1.99D). Objective proximal and lens stimulated amplitudes were largest in the 6–10 year group (8.81 ± 1.24D and 8.05 ± 1.82D, respectively) and gradually decreased until the fourth decade of life when a rapid decline to presbyopia occurred. There was a significant linear relationship between objective techniques (y = 0.74 + 0.96x, R2 = 0.85, p<0.001) with greater amplitudes measured for the proximal stimulated technique (mean difference = 0.55D). Conclusions Objective measurements of accommodation demonstrate that accommodative amplitude is substantially less than that measured by the subjective push-up technique, particularly in young children. These findings have important clinical implications for the management of uncorrected hyperopia. PMID:25602235

  11. Caffeine intake is associated with pupil dilation and enhanced accommodation

    PubMed Central

    Abokyi, S; Owusu-Mensah, J; Osei, K A

    2017-01-01

    Purpose It is purported that caffeine, an autonomic stimulant, affects visual performance. This study sought to assess whether caffeine intake was associated with changes in pupil size and/or amplitude of accommodation. Patients and methods A double-masked, crossover study was conducted in 50 healthy subjects of age range 19 to 25 years. Subjects were randomized to treatments such that subjects consumed either 250 mg caffeine drink or vehicle on separate days. Amplitude of accommodation was measured by the push-up technique, and pupil size using a millimeter ruler fixed to a slit lamp biomicroscope in dim illumination (5 lux). Amplitude of accommodation and pupil size were taken at baseline, and at 30, 60 and 90 min time points post treatment. Repeated measures one-way ANOVA and paired t-test were used in analyzing data. Results Amplitude of accommodation and pupil size after caffeine intake were significantly greater than vehicle (P<0.001) at each time point. Consumption of the caffeine beverage was associated with significant increases in amplitude of accommodation and pupil size with time (P<0.001). Amplitude of accommodation rose from 12.4 (±2.2 D) at baseline to 15.8(±2.6 D) at 90 min. Similarly, pupil size increased from 3.4 (±0.4 mm) at baseline to 4.5 (±0.72 mm) at 90 min. Consumption of vehicle was not associated with increase in amplitude of accommodation or pupil size with time. Conclusion Pupil size and accommodation are affected after ingestion of caffeine. This study suggests caffeine may have some influence on visual functions. PMID:27983733

  12. Measuring Changes in Ciliary Muscle Thickness with Accommodation in Young Adults

    PubMed Central

    Lossing, Laura Ashley; Sinnott, Loraine T.; Kao, Chiu-Yen; Richdale, Kathryn; Bailey, Melissa D.

    2012-01-01

    Purpose To develop a measurement protocol for changes in the shape and size of the ciliary muscle with accommodation using the Zeiss Visante™ Anterior Segment Optical Coherence Tomographer (AS-OCT) and to determine the test-retest repeatability of these measurements. Methods Subjects were 25 adults ages 23–28 years. The ciliary muscle was imaged at two visits with the Visante™ while accommodative response was monitored during imaging using the PowerRefractor. Ciliary muscle thickness was measured at 1 mm (CMT1), 2 mm (CMT2), and 3 mm (CMT3) posterior to the scleral spur and at the point of maximal thickness (CMTMAX). Thickness was measured at these locations while subjects viewed a target at distance and at a 4.00-D accommodative stimulus. Outcome measures were the change in thickness between distance and the 4.00-D stimulus and the change in thickness per diopter of accommodative response (PowerRefractor). Finally, the repeatability measurements between visit 1 and visit 2 were determined with a Bland-Altman analysis. Results The statistically significant modeled changes in ciliary muscle thickness were as follows: CMTMAX = 69.2 μm (4.00-D stimulus) and 18.1 μm (per diopter of accommodation); CMT1 = 45.2 μm (4.00-D stimulus) and 12.3 μm (per diopter of accommodation); and CMT3 = −45.9 μm (4.00-D stimulus) and −12.0 μm (per diopter of accommodation); p < 0.0001 for all. Conclusions The combination of the Visante™ and the PowerRefractor is a feasible tool for measuring thickening of ciliary muscle at more anterior locations and thinning at more posterior locations during accommodation. We noted a wide range of accommodative responses during the time of image capture in this study indicating that the most accurate estimates of the change in ciliary muscle dimensions with accommodation may be obtained by using accommodative response rather than stimulus values and by using measurements taken simultaneously with image capture. PMID:22504328

  13. An Atypical Presentation of Subacute Encephalopathy with Seizures in Chronic Alcoholism Syndrome.

    PubMed

    Kim, Tae-Kyoung; Jung, Eui Sung; Park, Jong-Moo; Kang, Kyusik; Lee, Woong-Woo; Lee, Jung-Ju

    2016-06-01

    Subacute encephalopathy with seizures in chronic alcoholism syndrome is a rare clinical manifestation in patients with chronic alcohol abuse. We report the case of a patient with chronic alcoholism who presented with partial nonconvulsive status epilepticus associated with a thalamic lesion.

  14. Neglected child with substance abuse leading to child abuse: a case report.

    PubMed

    Subramanian, E M G; Subhagya, B; Muthu, M S; Sivakumar, N

    2005-06-01

    Child abuse and neglect is any interaction or lack of interaction between a caregiver and a child resulting in nonaccidental harm to the child's physical and developmental state. Substance abuse is ingestion of any drug, which is capable of altering the mental functioning eventually leading to addiction. This paper presents a case report of a 12-year-old neglected girl with substance abuse for which she was physically abused by her mother.

  15. Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers.

    PubMed

    Barr, Ronald G

    2012-10-16

    Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant's caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant-caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally.

  16. Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers

    PubMed Central

    Barr, Ronald G.

    2012-01-01

    Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant’s caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant–caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally. PMID:23045677

  17. Comparison of the ocular wavefront aberration between pharmacologically-induced and stimulus-driven accommodation.

    PubMed

    Plainis, S; Plevridi, E; Pallikaris, I G

    2009-05-01

    To compare the ocular wavefront aberration between pharmacologically- and stimulus-driven accommodation in phakic eyes of young subjects. The aberration structure of the tested eye when accommodating was measured using the Complete Ophthalmic Analysis System (COAS; AMO WaveFront Sciences, Albuquerque, NM, USA). It was used in conjunction with a purposely-modified Badal optometer to allow blur-driven accommodation to be stimulated by a high contrast letter E with a vergence range between +0.84 D and -8.00 D. Pharmacological accommodation was induced with one drop of pilocarpine 4%. Data from six subjects (age range: 23-36 years) with dark irides were collected. No correlation was found between the maximal levels of accommodative response achieved with an 8 D blur-driven stimulus and pharmacological stimulation. Pharmacological accommodation varied considerably among subjects: maximum accommodation, achieved within 38-85 min following application of pilocarpine, ranged from 2.7 D to 10.0 D. Furthermore, although the changes of spherical aberration and coma as a function of accommodation were indistinguishable between the two methods for low levels of response, a characteristic break in the pattern of aberration occurred at higher levels of pilocarpine-induced accommodation. This probably resulted from differences in the time course of biometric changes occurring with the two methods. Measuring the pilocarpine-induced accommodative response at only one time point after its application may lead to misleading results. The considerable inter-individual differences in the time course of drug-induced accommodative response and its magnitude may lead to overestimation or underestimation of the corresponding amplitude of normal, blur-driven accommodation. Stimulating accommodation by topical application of pilocarpine is inappropriate for evaluating the efficacy of 'accommodating' IOLs.

  18. Childhood trauma and metabolic syndrome in men and women.

    PubMed

    Lee, Chioun; Tsenkova, Vera; Carr, Deborah

    2014-03-01

    The long-term effects of childhood trauma on health are well-documented, but few population-based studies have explored how childhood trauma affects the risk of developing metabolic syndrome (MetS) in adulthood. Using data from 1234 adults in the second wave of Midlife in the United States (MIDUS), we investigate (1) the extent to which childhood abuse affects the risk of developing MetS in adulthood; (2) how the severity of different types of abuse (emotional, physical, sexual, or cumulative abuse) affects this risk; and (3) the extent to which adult socioeconomic status (SES), maladaptive stress responses, and unhealthy behaviors mediate the association. We also test whether these associations differ significantly by sex. We find that emotional and physical abuse increase the risk of developing MetS for both sexes, whereas sexual abuse is a predictor for women only. For both sexes, individuals who experienced more cumulative abuse have a greater risk of developing MetS. Adult SES partially explains the association between childhood abuse and MetS. Maladaptive stress responses and unhealthy behaviors further explain the association. Among the potential mediators, poor sleep quality was a significant pathway for men and women, while stress-induced eating was a significant pathway for women only. Our findings suggest that the well-documented health consequences of early life trauma may vary by the nature of the trauma, the victim's sex, and the coping mechanisms that he or she employs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Sudden unexpected infant death: differentiating natural from abusive causes in the emergency department.

    PubMed

    Bechtel, Kirsten

    2012-10-01

    Sudden unexpected infant deaths (SUIDs) are deaths in infants younger than 12 months that occur suddenly, unexpectedly, and without obvious cause in the emergency department (ED). Sudden infant death syndrome, the leading cause of SUID in the United States, is much more common, but fatal child abuse and neglect have been sometimes mistaken for sudden infant death syndrome. The distinction between these 2 entities can only be made after a thorough investigation of the scene, interview of caregivers, and a complete forensic autopsy. Development of ED guidelines for the reporting and evaluation of SUID, in collaboration with the local medical examiner and child death review teams, will enable ED practitioners to collect important information in a compassionate manner that will be valuable to the investigating personnel.

  20. Topical and intravenous pilocarpine stimulated accommodation in anesthetized rhesus monkeys.

    PubMed

    Wendt, Mark; Glasser, Adrian

    2010-05-01

    Many studies have used pilocarpine to stimulate accommodation in both humans and monkeys. However, the concentrations of pilocarpine used and the methods of administration vary. In this study, three different methods of pilocarpine administration are evaluated for their effectiveness in stimulating accommodation in rhesus monkeys. Experiments were performed in 17 iridectomized, anesthetized rhesus monkeys aged 4-16 years. Maximum accommodation was stimulated in all these monkeys with a 2% pilocarpine solution maintained on the cornea for at least 30 min in a specially designed perfusion lens. In subsequent topical pilocarpine experiments, baseline refraction was measured with a Hartinger coincidence refractometer and then while the monkeys were upright and facing forward, commercially available pilocarpine (2, 4, or 6%) was applied topically to the cornea as 2 or 4 drops in two applications or 6 drops in three applications over a five minute period with the eyelids closed between applications. Alternatively, while supine, 10-12 drops of pilocarpine were maintained on the cornea in a scleral cup for 5 min. Refraction measurements were begun 5 min after the second application of pilocarpine and continued for at least 30 min after initial administration until no further change in refraction occurred. In intravenous experiments, pilocarpine was given either as boluses ranging from 0.1mg/kg to 2mg/kg or boluses followed by a constant infusion at rates between 3.06 mg/kg/h and 11.6 mg/kg/h. Constant 2% pilocarpine solution on the eye in the perfusion lens produced 10.88+/-2.73 D (mean+/-SD) of accommodation. Topically applied pilocarpine produced 3.81 D+/-2.41, 5.49 D+/-4.08, and 5.55 D+/-3.27 using 2%, 4%, and 6% solutions respectively. When expressed as a percentage of the accommodative response amplitude obtained in the same monkey with constant 2% pilocarpine solution on the eye, the responses were 34.7% for 2% pilocarpine, 48.4% for 4% pilocarpine, and 44.6% for 6

  1. Variations in accommodation and convergence responses in a minimally controlled photorefractive setting.

    PubMed

    Horwood, A M; Turner, J E; Houston, S M; Riddell, P M

    2001-11-01

    A remote haploscopic photorefractor, designed for assessment of accommodation and convergence in infants and clinical groups, was used to determine heterophoria accommodative convergence/accommodation (AC/A) ratios in normal naïve adults. These were compared with conventional clinical measures. Twenty-one naïve subjects were used to compare occluded and unoccluded prism cover test responses with the remote haploscopic photorefractor using a text and picture target. Although luminance was generally low for both targets, binocular vergences were appropriate for target demand in both studies. Binocular accommodation showed greater lag for the highest target accommodative demand and the less demanding target. Occlusion not only reduced vergence response, but also frequently caused a marked reduction in accommodation, especially to the picture target. Normal mean AC/A values were found, but with wide variations between individual subjects. Although mean accommodation, vergence, and AC/A values were comparable with published data, we suggest that in these conditions using naïve subjects, accommodation is frequently inaccurate, especially on occlusion, without concomitant loss of vergence, at least at low light levels. Accommodative convergence may play a less important part in, and other cues contribute more to, the near reflex than has been previously suggested.

  2. Accommodation and pupil responses to random-dot stereograms

    PubMed Central

    Suryakumar, Rajaraman; Allison, Robert

    2015-01-01

    We investigated the dynamics of accommodative and pupillary responses to random-dot stereograms presented in crossed and uncrossed disparity in six visually normal young adult subjects (mean age = 25.8 ± 3.1 years). Accommodation and pupil measures were monitored monocularly with a custom built photorefraction system while subjects fixated at the center of a random-dot stereogram. On each trial, the stereogram initially depicted a flat plane and then changed to depict a sinusoidal corrugation in depth while fixation remained constant. Increase in disparity specified depth resulted in pupil constriction during both crossed and uncrossed disparity presentations. The change in pupil size between crossed and uncrossed disparity conditions was not significantly different (p > 0.05). The change in pupil size was also accompanied by a small concomitant increase in accommodation. In addition, the dynamic properties of pupil responses varied as a function of their initial (starting) diameter. The finding that accommodation and pupil responses increased with disparity regardless of the sign of retinal disparity suggests that these responses were driven by apparent depth rather than shifts in mean simulated distance of the stimulus. Presumably the need for the increased depth of focus when viewing stimuli extended in depth results in pupil constriction which also results in a concomitant change in accommodation. Starting position effects in pupil response confirm the non-linearity in the operating range of the pupil. PMID:25891121

  3. New methods for the assessment of accommodative convergence.

    PubMed

    Asakawa, Ken; Ishikawa, Hitoshi; Shoji, Nobuyuki

    2009-01-01

    The authors introduced a new objective method for measuring horizontal eye movements based on the first Purkinje image with the use of infrared charge-coupled device (CCD) cameras and compared stimulus accommodative convergence to accommodation (AC/A) ratios as determined by a standard gradient method. The study included 20 patients, 5 to 9 years old, who had intermittent exotropia (10 eyes) and accommodative esotropia (10 eyes). Measurement of horizontal eye movements in millimeters (mm), based on the first Purkinje image, was obtained with a TriIRIS C9000 instrument (Hamamatsu Photonics K.K., Hamamatsu, Japan). The stimulus AC/A ratio was determined with the far gradient method. The average values of horizontal eye movements (mm) and eye deviation (Delta) (a) before and (b) after an accommodative stimulus of 3.00 diopters (D) were calculated with the following formula: horizontal eye movements (mm/D) and stimulus AC/A ratio (Delta/D) = (b - a)/3. The average values of the horizontal eye movements and the stimulus AC/A ratio were 0.5 mm/D and 3.8 Delta/D, respectively. Correlation analysis showed a strong positive correlation between these two parameters (r = 0.92). Moreover, horizontal eye movements are directly proportional to the AC/A ratio measured with the gradient method. The methods used in this study allow objective recordings of accommodative convergence to be obtained in many clinical situations. Copyright 2009, SLACK Incorporated.

  4. [Analysis of prenatal abuse in catalonia between the years 2011 and 2014].

    PubMed

    Garcia Garcia, Jordi; Campistol Mas, Elena; López-Vilchez, María Ángeles; Morcillo Buscato, María José; Mur Sierra, Antonio

    2018-03-01

    Foetal abuse is that intentional or negligent act that causes a harmful effect to the foetus. It is a type of abuse difficult to diagnose and handle. Some indicators of suspicion are the absence of gestational control, the maternal consumption of toxic substances, or the problematic maternal social environment. To analyse the cases of foetal abuse registered in Catalonia between 2011 and 2014 to identify the risk profile. A cross-sectional descriptive study was conducted on a sample of 222 cases of prenatal abuse registered in Catalonia between 2011 and 2014. The mean maternal age was 28.11 years, with 63% of Spanish nationality, 76% were unemployed, 60% had not followed correct gestational control, 76% had previous pregnancy interruptions, 20% reported to have been mistreated by the partner, had history of social problems (76% social intervention, 30.5% previous child retention, 13% custody of the mother by the administration, 7% deprivation of liberty), with high rates of mother-to-child transmission of infection (HIV 4.95%, HCV 9%, HIV+HCV co-infection 1.8%), and 73% reported toxic use (in order of frequency, cannabis, cocaine and heroin). In newborns, the rate of prematurity (26.3%) is highlighted, as well as the diagnosis of withdrawal syndrome in 34 cases. Just over half (51.6%) of the infants are currently with their mother. In our reference population with a diagnosis of prenatal abuse, there are high rates of maternal toxic consumption, HIV-HCV infection, unemployment, history of previous social intervention, and poor gestational control. Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Cultural value orientations, internalized homophobia, and accommodation in romantic relationships.

    PubMed

    Gaines, Stanley O; Henderson, Michael C; Kim, Mary; Gilstrap, Samuel; Yi, Jennifer; Rusbult, Caryl E; Hardin, Deletha P; Gaertner, Lowell

    2005-01-01

    In the present study, we examined the impact of cultural value orientations (i.e., the personally oriented value of individualism, and the socially oriented values of collectivism, familism, romanticism, and spiritualism) on accommodation (i.e., voice and loyalty, rather than exit and neglect, responses to partners' anger or criticism) in heterosexual and gay relationships; and we examined the impact of internalized homophobia (i.e., attitudes toward self, other, and disclosure) on accommodation specifically in gay relationships. A total of 262 heterosexuals (102 men and 162 women) and 857 gays (474 men and 383 women) participated in the present study. Consistent with hypotheses, among heterosexuals and gays, socially oriented values were significantly and positively related to accommodation (whereas the personally oriented value of individualism was unrelated to accommodation); and among gays in particular, internalized homophobia was significantly and negatively related to accommodation. Implications for the study of heterosexual and gay relationships are discussed.

  6. Barriers to Accommodation Use for Students with Disabilities in Postsecondary Education

    ERIC Educational Resources Information Center

    Lyman, Michael James

    2013-01-01

    Students with disabilities at the postsecondary level face a number of different barriers to accommodation use. Past research has shown that students with disabilities that use accommodations obtain greater academic achievement and higher graduation rates. Limited research has been conducted to identify barriers to accommodation use, and the…

  7. Teaching Adolescent Students with Learning Disabilities to Self-Advocate for Accommodations

    ERIC Educational Resources Information Center

    Prater, Mary Anne; Redman, Ashleigh Smith; Anderson, Darlene; Gibb, Gordon S.

    2014-01-01

    In the general education classroom students with learning disabilities (LD) often need academic accommodations to be successful. These accommodations are typically selected and implemented by their general education teachers, not by the students themselves. High school students with LD were taught to recognize when an accommodation was needed,…

  8. Accommodation of Symptoms in Anorexia Nervosa: A Qualitative Study.

    PubMed

    Fox, John R E; Whittlesea, Anna

    2017-03-01

    Anorexia nervosa (AN) continues to remain poorly understood within eating disorders. Recent research and theory have moved away from understanding its aetiological causes, addressing instead potential maintaining factors. This study is focused on interpersonal maintenance factors: the response of close others. Relatives of those with AN typically carry the main burden of care, and research has found high levels of carer distress and unmet needs. Recent theories have proposed this emotional impact to contribute to expressed emotion and other unhelpful caregiver interactions which inadvertently maintain AN. One such understudied response is accommodation, described as a 'process' whereby caregivers 'assist or participate' in symptomatic behaviours of the cared for individual. There is a dearth of research relating to accommodation within eating disorders, particularly qualitative accounts. This study utilized a grounded theory methodology to explore caregivers' responses to managing AN, focusing particularly on carers' experience of accommodation. Eight participants with experience of caring for an individual diagnosed with AN were interviewed. Participants were recruited from a national eating disorder charity and regional eating disorder service. A number of themes emerged, including the importance of caregivers' emotional resources in mediating accommodation responses. Low-perceived efficacy over AN contributed to caregiver burnout. Decreased emotional resources influenced a shift in caregiving aims conducive with accommodation. Nevertheless, carers perceived accommodation as counterproductive to recovery and consequently experienced internal conflict (cognitive dissonance). Dissonance was reduced using a number of cognitive and behavioural strategies. The implications of these findings are discussed with reference to existing literature. Copyright © 2016 John Wiley & Sons, Ltd. Anorexia nervosa (AN) can be difficult to manage. Over time, carers can feel

  9. Wife Abuse and the Wife Abuser: Review and Recommendations.

    ERIC Educational Resources Information Center

    Carden, Ann D.

    1994-01-01

    Reviews clinical, theoretical, and empirical literature on wife abuse/abusers. Presents historical and contextual information, overview of domestic violence, prevalence data, and descriptions of evolution and current status of public and professional awareness and response. Proposes integrative model for understanding etiologic, dynamic, and…

  10. Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update

    PubMed Central

    Lebowitz, Eli R.; Panza, Kaitlyn E.; Bloch, Michael H.

    2016-01-01

    Family accommodation describes changes that individuals make to their behavior, to help their relative who is dealing with a psychiatric and/or psychological disorder(s), avoid or alleviate distress related to the disorder. Research on family accommodation has advanced rapidly. In this update we aim to provide a synthesis of findings from the past five years. A search of available, peer-reviewed, English language papers was conducted through PubMed and PsycINFO, cross referencing psychiatric disorders with accommodation and other family-related terms. The resulting 121 papers were individually reviewed and evaluated and the main findings were discussed. Family accommodation is common in obsessive-compulsive disorder (OCD) and in anxiety disorders, and manifests similarly across these disorders. Family accommodation is associated with more severe psychopathology and poorer clinical outcomes. Treatments have begun to focus on the reduction of family accommodation as a primary therapeutic goal and finally, neurobiological underpinnings of family accommodation are beginning to be investigated. PMID:26613396

  11. Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update.

    PubMed

    Lebowitz, Eli R; Panza, Kaitlyn E; Bloch, Michael H

    2016-01-01

    Family accommodation describes changes that individuals make to their behavior, to help their relative who is dealing with a psychiatric and/or psychological disorder(s), avoid or alleviate distress related to the disorder. Research on family accommodation has advanced rapidly. In this update we aim to provide a synthesis of findings from the past five years. A search of available, peer-reviewed, English language papers was conducted through PubMed and PsycINFO, cross referencing psychiatric disorders with accommodation and other family-related terms. The resulting 121 papers were individually reviewed and evaluated and the main findings were discussed. Family accommodation is common in obsessive-compulsive disorder (OCD) and in anxiety disorders, and manifests similarly across these disorders. Family accommodation is associated with more severe psychopathology and poorer clinical outcomes. Treatments have begun to focus on the reduction of family accommodation as a primary therapeutic goal and finally, neurobiological underpinnings of family accommodation are beginning to be investigated.

  12. Amplitude, Latency, and Peak Velocity in Accommodation and Disaccommodation Dynamics

    PubMed Central

    Papadatou, Eleni; Ferrer-Blasco, Teresa; Montés-Micó, Robert

    2017-01-01

    The aim of this work was to ascertain whether there are differences in amplitude, latency, and peak velocity of accommodation and disaccommodation responses when different analysis strategies are used to compute them, such as fitting different functions to the responses or for smoothing them prior to computing the parameters. Accommodation and disaccommodation responses from four subjects to pulse changes in demand were recorded by means of aberrometry. Three different strategies were followed to analyze such responses: fitting an exponential function to the experimental data; fitting a Boltzmann sigmoid function to the data; and smoothing the data. Amplitude, latency, and peak velocity of the responses were extracted. Significant differences were found between the peak velocity in accommodation computed by fitting an exponential function and smoothing the experimental data (mean difference 2.36 D/s). Regarding disaccommodation, significant differences were found between latency and peak velocity, calculated with the two same strategies (mean difference of 0.15 s and −3.56 D/s, resp.). The strategy used to analyze accommodation and disaccommodation responses seems to affect the parameters that describe accommodation and disaccommodation dynamics. These results highlight the importance of choosing the most adequate analysis strategy in each individual to obtain the parameters that characterize accommodation and disaccommodation dynamics. PMID:29226128

  13. Fetal Abuse.

    ERIC Educational Resources Information Center

    Kent, Lindsey; And Others

    1997-01-01

    Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…

  14. Hyperelastic modelling of the crystalline lens: Accommodation and presbyopia

    PubMed Central

    Lanchares, Elena; Navarro, Rafael; Calvo, Begoña

    2012-01-01

    Purpose The modification of the mechanical properties of the human crystalline lens with age can be a major cause of presbyopia. Since these properties cannot be measured in vivo, numerical simulation can be used to estimate them. We propose an inverse method to determine age-dependent change in the material properties of the tissues composing the human crystalline lens. Methods A finite element model of a 30-year-old lens in the accommodated state was developed. The force necessary to achieve full accommodation in a 30-year-old lens of known external geometry was computed using this model. Two additional numerical models of the lens corresponding to the ages of 40 and 50 years were then built. Assuming that the accommodative force applied to the lens remains constant with age, the material properties of nucleus and cortex were estimated by inverse analysis. Results The zonular force necessary to reshape the model of a 30-year-old lens from the accommodated to the unaccommodated geometry was 0.078 newton (N). Both nucleus and cortex became stiffer with age. The stiffness of the nucleus increased with age at a higher rate than the cortex. Conclusions In agreement with the classical theory of Helmholtz, on which we based our model, our results indicate that a major cause of presbyopia is that both nucleus and cortex become stiffer with age; therefore, a constant value of the zonular forces with aging does not achieve full accommodation, that is, the accommodation capability decreases.

  15. Interactions of HIV and drugs of abuse: the importance of glia, neural progenitors, and host genetic factors.

    PubMed

    Hauser, Kurt F; Knapp, Pamela E

    2014-01-01

    Considerable insight has been gained into the comorbid, interactive effects of HIV and drug abuse in the brain using experimental models. This review, which considers opiates, methamphetamine, and cocaine, emphasizes the importance of host genetics and glial plasticity in driving the pathogenic neuron remodeling underlying neuro-acquired immunodeficiency syndrome and drug abuse comorbidity. Clinical findings are less concordant than experimental work, and the response of individuals to HIV and to drug abuse can vary tremendously. Host-genetic variability is important in determining viral tropism, neuropathogenesis, drug responses, and addictive behavior. However, genetic differences alone cannot account for individual variability in the brain "connectome." Environment and experience are critical determinants in the evolution of synaptic circuitry throughout life. Neurons and glia both exercise control over determinants of synaptic plasticity that are disrupted by HIV and drug abuse. Perivascular macrophages, microglia, and to a lesser extent astroglia can harbor the infection. Uninfected bystanders, especially astroglia, propagate and amplify inflammatory signals. Drug abuse by itself derails neuronal and glial function, and the outcome of chronic exposure is maladaptive plasticity. The negative consequences of coexposure to HIV and drug abuse are determined by numerous factors including genetics, sex, age, and multidrug exposure. Glia and some neurons are generated throughout life, and their progenitors appear to be targets of HIV and opiates/psychostimulants. The chronic nature of HIV and drug abuse appears to result in sustained alterations in the maturation and fate of neural progenitors, which may affect the balance of glial populations within multiple brain regions. © 2014 Elsevier Inc. All rights reserved.

  16. Interactions of HIV and drugs of abuse: the importance of glia, neural progenitors, and host genetic factors

    PubMed Central

    Hauser, Kurt F.; Knapp, Pamela E.

    2015-01-01

    Considerable insight has been gained into the comorbid, interactive effects of HIV and drug abuse in the brain using experimental models. This review, which considers opiates, methamphetamine, and cocaine, emphasizes the importance of host genetics and glial plasticity in driving the pathogenic neuron remodeling underlying neuro-acquired immunodeficiency syndrome (neuroAIDS) and drug abuse comorbidity. Clinical findings are less concordant than experimental work, and the response of individuals to HIV and to drug abuse can vary tremendously. Host-genetic variability is important in determining viral tropism, neuropathogenesis, drug responses, and addictive behavior. However, genetic differences alone cannot account for individual variability in the brain “connectome”. Environment and experience are critical determinants in the evolution of synaptic circuitry throughout life. Neurons and glia both exercise control over determinants of synaptic plasticity that are disrupted by HIV and drug abuse. Perivascular macrophages, microglia, and to a lesser extent astroglia can harbor the infection. Uninfected bystanders, especially astroglia, propagate and amplify inflammatory signals. Drug abuse by itself derails neuronal and glial function, and the outcome of chronic exposure is maladaptive plasticity. The negative consequences of coexposure to HIV and drug abuse are determined by numerous factors including genetics, sex, age, and multidrug exposure. Glia and some neurons are generated throughout life and their progenitors appear to be targets of HIV and opiates/psychostimulants. The chronic nature of HIV and drug abuse appears to result in sustained alterations in the maturation and fate of neural progenitors, which may affect the balance of glial populations within multiple brain regions. PMID:25175867

  17. Dextromethorphan Abuse in Adolescence

    PubMed Central

    Bryner, Jodi K.; Wang, Uerica K.; Hui, Jenny W.; Bedodo, Merilin; MacDougall, Conan; Anderson, Ilene B.

    2008-01-01

    Objectives To analyze the trend of dextromethorphan abuse in California and to compare these findings with national trends. Design A 6-year retrospective review. Setting California Poison Control System (CPCS), American Association of Poison Control Centers (AAPCC), and Drug Abuse Warning Network (DAWN) databases from January 1, 1999, to December 31, 2004. Participants All dextromethorphan abuse cases reported to the CPCS, AAPCC, and DAWN. The main exposures of dextromethorphan abuse cases included date of exposure, age, acute vs long-term use, coingestants, product formulation, and clinical outcome. Main Outcome Measure The annual proportion of dextromethorphan abuse cases among all exposures reported to the CPCS, AAPCC, and DAWN databases. Results A total of 1382 CPCS cases were included in the study. A 10-fold increase in CPCS dextromethorphan abuse cases from 1999 (0.23 cases per 1000 calls) to 2004 (2.15 cases per 1000 calls) (odds ratio, 1.48; 95% confidence interval, 1.43–1.54) was identified. Of all CPCS dextromethorphan abuse cases, 74.5% were aged 9 to 17 years; the frequency of cases among this age group increased more than 15-fold during the study (from 0.11 to 1.68 cases per 1000 calls). Similar trends were seen in the AAPCC and DAWN databases. The highest frequency of dextromethorphan abuse occurred among adolescents aged 15 and 16 years. The most commonly abused product was Coricidin HBP Cough & Cold Tablets. Conclusions Our study revealed an increasing trend of dextromethorphan abuse cases reported to the CPCS that is paralleled nationally as reported to the AAPCC and DAWN. This increase was most evident in the adolescent population. PMID:17146018

  18. Family accommodation mediates the association between anxiety symptoms in mothers and children.

    PubMed

    Jones, Johnna D; Lebowitz, Eli R; Marin, Carla E; Stark, Kevin D

    2015-01-01

    The link between child anxiety and maternal anxiety has been well established but the factors underlying this association are not well understood. One potential factor is family accommodation, which describes ways in which parents change their behaviour to help a child avoid or alleviate anxiety. Family accommodation has been associated with greater symptom severity, more impairment and poorer treatment outcomes in the child. The aim of this study was to investigate whether maternal accommodation mediates the relation between parent and child anxiety. Mothers of children (N = 85) aged 7-17 years (M = 11.79) completed measures of their own anxiety (State-Trait Anxiety Inventory (STAI)), their child's anxiety (Screen for Child Anxiety Related Disorders (SCARED)), and family accommodation (Family Accommodation Scale Anxiety (FASA)). Structural equation modelling (SEM) was used to test the mediational role of accommodation linking parent and child anxiety. Family accommodation was found to significantly mediate the link between maternal anxiety and child anxiety. These results inform theory and imply that the development of interventions designed to target family accommodation may improve the prognosis of those diagnosed with paediatric anxiety disorders and youth with subclinical anxiety symptoms by reducing both parent and child anxiety.

  19. Abuse-deterrent formulations, an evolving technology against the abuse and misuse of opioid analgesics.

    PubMed

    Schaeffer, Tammi

    2012-12-01

    The increased use of opioid pain medication has been mirrored by the increased misuse and abuse of these drugs. As part of a multidisciplinary approach to this epidemic, pharmaceutical companies, with the encouragement of the Food and Drug Administration, have increased the development of abuse-deterrent formulations. While all have the goal of treating pain while mitigating misuse and abuse, there are different technologies utilized to impart the abuse-deterrent properties. The goal of this paper is to review the basis of abuse-deterrent formulations, the different types and approaches of some of the abuse-deterrent products, and their current regulatory status in the USA.

  20. Growing up with Parental Alcohol Abuse: Exposure to Childhood Abuse, Neglect, and Household Dysfunction.

    ERIC Educational Resources Information Center

    Dube, Shanta R.; Anda, Robert F.; Felitti, Vincent J.; Croft, Janet B.; Edwards, Valerie J.; Giles, Wayne H.

    2001-01-01

    A study involving 8,629 adults examined the association between parental alcohol abuse and child abuse, neglect, and other household dysfunction. Compared to households without alcohol abuse, the adjusted odds ratio for each category of adverse childhood experience was 2 to 13 times higher if parents abused alcohol. (Contains references.) (CR)

  1. Inhalant Abuse and Dextromethorphan.

    PubMed

    Storck, Michael; Black, Laura; Liddell, Morgan

    2016-07-01

    Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. 14 CFR 1204.1510 - Efforts to accommodate intergovernmental concerns.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Efforts to accommodate intergovernmental concerns. 1204.1510 Section 1204.1510 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION... Programs and Activities § 1204.1510 Efforts to accommodate intergovernmental concerns. (a) If a state...

  3. Circadian rhythms of visual accommodation responses and physiological correlations.

    NASA Technical Reports Server (NTRS)

    Murphy, M. R.; Randle, R. J.; Williams, B. A.

    1972-01-01

    Use of a recently developed servocontrolled infrared optometer to continuously record the state of monocular focus while subjects viewed a visual target for which the stimulus to focus was systematically varied. Calculated parameters form recorded data - e.g., speeds of accommodation to approaching and receding targets, magnitude of accommodation to step changes in target distance, and amplitude and phase lag of response to sinusoidally varying stimuli were submitted to periodicity analyses. Ear canal temperature (ECT) and heart rate (HR) rhythms were also recorded for physiological correlation with accommodation rhythms. HR demonstrated a 24-hr rhythm, but ECT data did not.

  4. Effect of third-order aberrations on dynamic accommodation.

    PubMed

    López-Gil, Norberto; Rucker, Frances J; Stark, Lawrence R; Badar, Mustanser; Borgovan, Theodore; Burke, Sean; Kruger, Philip B

    2007-03-01

    We investigate the potential for the third-order aberrations coma and trefoil to provide a signed cue to accommodation. It is first demonstrated theoretically (with some assumptions) that the point spread function is insensitive to the sign of spherical defocus in the presence of odd-order aberrations. In an experimental investigation, the accommodation response to a sinusoidal change in vergence (1-3D, 0.2Hz) of a monochromatic stimulus was obtained with a dynamic infrared optometer. Measurements were obtained in 10 young visually normal individuals with and without custom contact lenses that induced low and high values of r.m.s. trefoil (0.25, 1.03 microm) and coma (0.34, 0.94 microm). Despite variation between subjects, we did not find any statistically significant increase or decrease in the accommodative gain for low levels of trefoil and coma, although effects approached or reached significance for the high levels of trefoil and coma. Theoretical and experimental results indicate that the presence of Zernike third-order aberrations on the eye does not seem to play a crucial role in the dynamics of the accommodation response.

  5. The Association Between Childhood Abuse and Elder Abuse Among Chinese Adult Children in the United States.

    PubMed

    Dong, XinQi; Li, Ge; Simon, Melissa A

    2017-07-01

    The previous researchers have postulated that an abused child may abuse his or her abuser parent when the parent is getting old, also known as the intergenerational transmission of violence. However, few studies use data to support this model, and it has yet to be examined in the U.S. Chinese community. This study aims to examine the association between childhood abuse and elder abuse reported by Chinese adult children in the United States. Guided by a community-based participatory research approach, 548 Chinese adult children aged 21 years and older participated in this study. Childhood abuse was assessed by four-item Hurt-Insult-Threaten-Scream (HITS) scale. Elder abuse was assessed by a 10-item instrument derived from the Caregiver Abuse Screen (CASE). Logistic regression analysis was performed. Childhood abuse was associated with caregiver abuse screen results (odds ratio = 1.92, 95% confidence interval = 1.24-2.95). Being physically hurt (r = .13, p < .01), insulted (r = .15, p < .001), threatened (r = .12, p < .01), and screamed at (r = .18, p < .001) as a child were significantly correlated with caregiver abuse screen results. This study suggests that childhood abuse is associated with increased risk of elder abuse among Chinese adult children in the United States. Longitudinal research should be conducted to explore the mechanisms through which childhood abuse and its subtypes links with elder abuse. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Estimating Local Child Abuse.

    ERIC Educational Resources Information Center

    Ards, Sheila

    1989-01-01

    Three conceptual approaches to estimating local child abuse rates using the National Incidence Study of Child Abuse and Neglect data set are evaluated. All three approaches yield estimates of actual abuse cases that exceed the number of reported cases. (SLD)

  7. Aerobrake assembly with minimum Space Station accommodation

    NASA Technical Reports Server (NTRS)

    Katzberg, Steven J.; Butler, David H.; Doggett, William R.; Russell, James W.; Hurban, Theresa

    1991-01-01

    The minimum Space Station Freedom accommodations required for initial assembly, repair, and refurbishment of the Lunar aerobrake were investigated. Baseline Space Station Freedom support services were assumed, as well as reasonable earth-to-orbit possibilities. A set of three aerobrake configurations representative of the major themes in aerobraking were developed. Structural assembly concepts, along with on-orbit assembly and refurbishment scenarios were created. The scenarios were exercised to identify required Space Station Freedom accommodations. Finally, important areas for follow-on study were also identified.

  8. Pediatric radiological diagnostic procedures in cases of suspected child abuse.

    PubMed

    Erfurt, C; Hahn, G; Roesner, D; Schmidt, U

    2011-03-01

    Advanced and specialized radiological diagnostic procedures are essential in cases of clinically diagnosed injuries to the head, thorax, abdomen or extremities of a child, especially if there is no case history or if the reporting of an inadequate trauma suggests battered child syndrome. In particular, these diagnostic procedures should aim at detecting lesions of the central nervous system (CNS), so that the treatment can be immediately initiated. If the diagnostic imaging reveals findings typically associated with child abuse, accurate documentation constituting evidence, which will stand up in court, is required to prevent any further endangerment of the child's welfare.

  9. Substance abuse and child maltreatment.

    PubMed

    Wells, Kathryn

    2009-04-01

    Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.

  10. Triparental Families: A New Genetic-Epidemiological Design Applied to Drug Abuse, Alcohol Use Disorders, and Criminal Behavior in a Swedish National Sample

    PubMed Central

    Kendler, Kenneth S.; Ohlsson, Henrik; Sundquist, Jan; Sundquist, Kristina

    2015-01-01

    Objective The authors sought to clarify the sources of parent-offspring resemblance for drug abuse, alcohol use disorders, and criminal behavior, using a novel genetic-epidemiological design. Method Using national registries, the authors identified rates of drug abuse, alcohol use disorders, and criminal behavior in 41,360 Swedish individuals born between 1960 and 1990 and raised in triparental families comprising a biological mother who reared them, a “not-lived-with” biological father, and a stepfather. Results When each syndrome was examined individually, hazard rates for drug abuse in offspring of parents with drug abuse were highest for mothers (2.80, 95% CI=2.23–3.38), intermediate for not-lived-with fathers (2.45,95%CI=2.14–2.79), and lowest for stepfathers (1.99, 95% CI=1.55–2.56). The same pattern was seen for alcohol use disorders (2.23, 95% CI=1.93–2.58; 1.84, 95% CI=1.69–2.00; and 1.27, 95% CI=1.12–1.43) and criminal behavior (1.55, 95% CI=1.44–1.66; 1.46, 95%CI=1.40–1.52; and1.30, 95% CI=1.23–1.37). When all three syndromes were examined together, specificity of cross-generational transmission was highest for mothers, intermediate for not-lived-with fathers, and lowest for stepfathers. Analyses of intact families and other not-lived-with parents and stepparents showed similar cross-generation transmission for these syndromes in mothers and fathers, supporting the representativeness of results from triparental families. Conclusions A major strength of the triparental design is its inclusion, within a single family, of parents who provide, to a first approximation, their offspring with genes plus rearing, genes only, and rearing only. For drug abuse, alcohol use disorders, and criminal behavior, the results of this study suggest that parent-offspring transmission involves both genetic and environmental processes, with genetic factors being somewhat more important. These results should be interpreted in the context of the strengths

  11. Child sexual abuse, attachment style, and depression: the role of the characteristics of abuse.

    PubMed

    Cantón-Cortés, David; Cortés, María Rosario; Cantón, José

    2015-02-01

    The aim of the current study was to examine the effects of secure, avoidant, and anxious attachment styles on depressive symptomatology in child sexual abuse (CSA) among young female adult victims. The role of attachment style was studied by considering possible interactive effects with the type of abuse, the relationship with the perpetrator, and the continuity of abuse. Participants were 168 female victims of CSA. Information about the abuse was obtained from a self-reported questionnaire. Attachment style was assessed with the Attachment Style Measure (ASM), and the Beck Depression Inventory (BDI) was used to assess depressive symptomatology. Secure and anxious attachment styles were correlated with low and high depression scores respectively. The effects of attachment style were stronger in cases where the abuse consisted of oral sex/penetration, a non-family member as perpetrator, and in isolated, compared with continued, abuse. These results confirm that characteristics of CSA (type of abuse, relationship with the perpetrator, and continuity of abuse) can affect the impact of attachment style on depressive symptomatology. © The Author(s) 2014.

  12. Frequency of convergence and accommodative disorders in a clinical population of Mashhad, Iran.

    PubMed

    Hoseini-Yazdi, Seyed Hosein; Yekta, AbbasAli; Nouri, Hosein; Heravian, Javad; Ostadimoghaddam, Hadi; Khabazkhoob, Mehdi

    2015-01-01

    To investigate the frequency of convergence and accommodation anomalies in an optometric clinical setting in Mashhad, Iran, and to determine tests with highest accuracy in diagnosing these anomalies. From 261 patients who came to the optometric clinics of Mashhad University of Medical Sciences during a month, 83 of them were included in the study based on the inclusion criteria. Near point of convergence (NPC), near and distance heterophoria, monocular and binocular accommodative facility (MAF and BAF, respectively), lag of accommodation, positive and negative fusional vergences (PFV and NFV, respectively), AC/A ratio, relative accommodation, and amplitude of accommodation (AA) were measured to diagnose the convergence and accommodation anomalies. The results were also compared between symptomatic and asymptomatic patients. The accuracy of these tests was explored using sensitivity (S), specificity (Sp), and positive and negative likelihood ratios (LR+, LR-). Mean age of the patients was 21.3 ± 3.5 years and 14.5% of them had specific binocular and accommodative symptoms. Convergence and accommodative anomalies were found in 19.3% of the patients; accommodative excess (4.8%) and convergence insufficiency (3.6%) were the most common accommodative and convergence disorders, respectively. Symptomatic patients showed lower values for BAF (p = .003), MAF (p = .001), as well as AA (p = .001) compared with asymptomatic patients. Moreover, BAF (S = 75%, Sp = 62%) and MAF (S = 62%, Sp = 89%) were the most accurate tests for detecting accommodative and convergence disorders in terms of both sensitivity and specificity. Convergence and accommodative anomalies are the most common binocular disorders in optometric patients. Including tests of monocular and binocular accommodative facility in routine eye examinations as accurate tests to diagnose these anomalies requires further investigation.

  13. The role of nonperpetrating fathers in Munchausen syndrome by proxy: a review of the literature.

    PubMed

    Morrell, Briyana; Tilley, Donna Scott

    2012-08-01

    Munchausen syndrome by proxy (MSBP) is a psychiatric condition and form of child abuse in which a caregiver, usually a mother, induces illness in a child to gain attention for herself. Because children that are abused by a MSBP perpetrator are likely to be hospitalized multiple times, it is important for the nurse to know warning signs and symptoms of MSBP. Of particular interest is the role of the child's parent that is not involved in the abuse, usually the father. This article presents a review of literature on MSBP, focusing on the role of the nonperpetrating fathers. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Accommodation in Untextured Stimulus Fields.

    DTIC Science & Technology

    1979-05-01

    that accommodation is notably inaccurate with reduced illumination, textural cue removal, or small aper ture viewing. These situational ametropias are...dark focus. Although, for any individual, large correlations exist among these ametropias , statistically reliable differen ces occur among them as well

  15. Success in baccalaureate nursing programs: a matter of accommodation?

    PubMed

    Haislett, J; Hughes, R B; Atkinson, G; Williams, C L

    1993-02-01

    This article explores student learning styles as an important variable in four-year baccalaureate nursing programs. Student learning styles were assessed by Kolb's Learning Style Inventory-1985 (LSI-1985), which identifies the accommodator, diverger, assimilator, and converger learning styles. The authors examined the relationship between learning style and academic performance as measured by grade-point ratio (GPR) and studied behaviors and attitudes as measured by Brown and Holtzman's (1964) Survey of Study Habits and Attitudes. Analysis indicated that this sample (N = 100) included mainly assimilators and divergers, making reflective observation the most common mode of learning. Compared to the accommodator/converger group, the assimilator/diverger group earned a significantly higher GPR, significantly better scores on the study habits variable of Work Methods (WM), and moderately better scores on the study attitude variable of Educational Acceptance (EA). Accommodators were identified as the most at-risk learning style group, and specific interventions were suggested to assist accommodators in adapting to the academic rigors of a nursing curriculum.

  16. Domestic abuse awareness and recognition among primary healthcare professionals and abused women: a qualitative investigation.

    PubMed

    Bradbury-Jones, Caroline; Taylor, Julie; Kroll, Thilo; Duncan, Fiona

    2014-11-01

    To investigate the dynamics of domestic abuse awareness and recognition among primary healthcare professionals and abused women. Domestic abuse is a serious, public health issue that crosses geographical and demographic boundaries. Health professionals are well placed to recognise and respond to domestic abuse, but empirical evidence suggests that they are reluctant to broach the issue. Moreover, research has shown that women are reluctant to disclose abuse. A two-phase, qualitative study was conducted in Scotland. Twenty-nine primary health professionals (midwives, health visitors and general practitioners) participated in the first phase of the study, and 14 abused women took part in phase two. Data were collected in 2011. Semi-structured, individual interviews were conducted with the health professionals, and three focus groups were facilitated with the abused women. Data were analysed using a framework analysis approach. Differing levels of awareness of the nature and existence of abuse are held by abused women and primary healthcare professionals. Specifically, many women do not identify their experiences as abusive. A conceptual representation of domestic abuse - the "abused women, awareness, recognition and empowerment' framework - arising from the study - presents a new way of capturing the complexity of the disclosure process. Further research is necessary to test and empirically validate the framework, but it has potential pedagogical use for the training and education of health professionals and clinical use with abused women. The framework may be used in clinical practice by nurses and other health professionals to facilitate open discussion between professionals and women. In turn, this may empower women to make choices regarding disclosure and safety planning. © 2014 John Wiley & Sons Ltd.

  17. Abusive families and character formation.

    PubMed

    McCarthy, J B

    1990-06-01

    Family research studies confirm that abusive parents tend to be undifferentiated partners who compete with each other and with their children for attention and nurturance. More or less healthy parents make demands on children to counteract their own injured narcissism, but they do so largely without devaluation and the sadistic use of projective identification. Under sufficient stress abusive parents attack the child who fails to gratify their needs, thereby giving vent to longstanding frustrations and feelings of being threatened by the child's individuation and competency. The emotional atmosphere in such families facilitates ego deficits like those of the borderline personality as it molds the child's efforts to avoid anxiety. Devaluation, loss, and defenses against mourning partially account for depression and paranoid traits in abused youngsters. Early neglect and abuse exposes them to influential models who act out rage and primitive defenses. Some abused individuals project their rage and later become paranoid or antisocial, whereas others fragment or retain infantile defenses. The destructiveness of severe psychological abuse lies in the constriction of the experiencing self and healthy character development, together with the conditioning to repeat abusive relationships and to avoid intimacy. Achieving individuation under these circumstances entails overcoming the internalized abusive relationships and relinquishing the unconscious wish to be transformed from the abused into the abuser.

  18. Accommodating Presuppositions Is Inappropriate in Implausible Contexts.

    PubMed

    Singh, Raj; Fedorenko, Evelina; Mahowald, Kyle; Gibson, Edward

    2016-04-01

    According to one view of linguistic information (Karttunen, 1974; Stalnaker, 1974), a speaker can convey contextually new information in one of two ways: (a) by asserting the content as new information; or (b) by presupposing the content as given information which would then have to be accommodated. This distinction predicts that it is conversationally more appropriate to assert implausible information rather than presuppose it (e.g., von Fintel, 2008; Heim, 1992; Stalnaker, 2002). A second view rejects the assumption that presuppositions are accommodated; instead, presuppositions are assimilated into asserted content and both are correspondingly open to challenge (e.g., Gazdar, 1979; van der Sandt, 1992). Under this view, we should not expect to find a difference in conversational appropriateness between asserting implausible information and presupposing it. To distinguish between these two views of linguistic information, we performed two self-paced reading experiments with an on-line stops-making-sense judgment. The results of the two experiments-using the presupposition triggers the and too-show that accommodation is inappropriate (makes less sense) relative to non-presuppositional controls when the presupposed information is implausible but not when it is plausible. These results provide support for the first view of linguistic information: the contrast in implausible contexts can only be explained if there is a presupposition-assertion distinction and accommodation is a mechanism dedicated to reasoning about presuppositions. Copyright © 2015 Cognitive Science Society, Inc.

  19. Extralenticular and lenticular aspects of accommodation and presbyopia in human versus monkey eyes.

    PubMed

    Croft, Mary Ann; McDonald, Jared P; Katz, Alexander; Lin, Ting-Li; Lütjen-Drecoll, Elke; Kaufman, Paul L

    2013-07-26

    To determine if the accommodative forward movements of the vitreous zonule and lens equator occur in the human eye, as they do in the rhesus monkey eye; to investigate the connection between the vitreous zonule posterior insertion zone and the posterior lens equator; and to determine which components-muscle apex width, lens thickness, lens equator position, vitreous zonule, circumlental space, and/or other intraocular dimensions, including those stated in the objectives above-are most important in predicting accommodative amplitude and presbyopia. Accommodation was induced pharmacologically in 12 visually normal human subjects (ages 19-65 years) and by midbrain electrical stimulation in 11 rhesus monkeys (ages 6-27 years). Ultrasound biomicroscopy imaged the entire ciliary body, anterior and posterior lens surfaces, and the zonule. Relevant distances were measured in the resting and accommodated eyes. Stepwise regression analysis determined which variables were the most important predictors. The human vitreous zonule and lens equator move forward (anteriorly) during accommodation, and their movements decline with age, as in the monkey. Over all ages studied, age could explain accommodative amplitude, but not as well as accommodative lens thickening and resting muscle apex thickness did together. Accommodative change in distances between the vitreous zonule insertion zone and the posterior lens equator or muscle apex were important for predicting accommodative lens thickening. Our findings quantify the movements of the zonule and ciliary muscle during accommodation, and identify their age-related changes that could impact the optical change that occurs during accommodation and IOL function.

  20. Relationships between parental alcohol abuse and social support, peer substance abuse risk and social support, and substance abuse risk among South Korean adolescents.

    PubMed

    Park, Sookyung; Kim, Haeryun; Kim, Haesung

    2009-01-01

    This study examined the roles played by parental alcohol abuse and social support, peer substance abuse risk and social support, and substance abuse risk among adolescents in South Korea. Participants were adolescents between the ages of 15 and 22 years (mean, 18), residing in Seoul city and in surrounding Kyung-gi Province. Of 259 participants, 41.3% scored 2 or more on the POSIT scale, which suggested they met the problematic criteria for substance abuse risk. Logistic regression results suggested that the influence of social support on substance abuse risk among adolescents depended on the source of support--parents or peers. These findings need to be considered in the development of intervention programs for adolescents at risk for substance abuse.

  1. Disabilities in the workplace: recruitment, accommodation, and retention.

    PubMed

    Davis, Linda

    2005-07-01

    Who has never had a need for accommodation to perform a job because of age-related changes, gender issues related to family care, religious practices, health status, or disability? Who has never had the benefit of universal accommodations designed to provide access for individuals with disabilities, such as using the handicap button to open a door when one's arms are loaded? All of society has had the benefit of inclusion of individuals with disabilities within the work force. Occupational health nurses are essential to accommodating new employees with disabilities, assisting ill or injured employees in returning to work, and changing attitudes toward disabled workers. Additionally, nurses have the skills and knowledge for leading and managing newly emerging disease management programs for workers with disabilities caused by chronic illness.

  2. Design Principles to Accommodate Older Adults

    PubMed Central

    Farage, Miranda A.; Miller, Kenneth W.; Ajayi, Funmi; Hutchins, Deborah

    2012-01-01

    The global population is aging. In many industrial countries, almost one in five people are over age 65. As people age, gradual changes ensue in vision, hearing, balance, coordination, and memory. Products, communication materials, and the physical environment must be thoughtfully designed to meet the needs of people of all ages. This article summarizes normal changes in sensory function, mobility, balance, memory, and attention that occur with age. It presents practical guidelines that allow design professionals to accommodate these changes and better meet the needs of older adults. Designing for older adults is inclusive design: it accommodates a range of physical and cognitive abilities and promotes simplicity, flexibility, and ease of use for people of any age. PMID:22980147

  3. Design principles to accommodate older adults.

    PubMed

    Farage, Miranda A; Miller, Kenneth W; Ajayi, Funmi; Hutchins, Deborah

    2012-02-29

    The global population is aging. In many industrial countries, almost one in five people are over age 65. As people age, gradual changes ensue in vision, hearing, balance, coordination, and memory. Products, communication materials, and the physical environment must be thoughtfully designed to meet the needs of people of all ages. This article summarizes normal changes in sensory function, mobility, balance, memory, and attention that occur with age. It presents practical guidelines that allow design professionals to accommodate these changes and better meet the needs of older adults. Designing for older adults is inclusive design: it accommodates a range of physical and cognitive abilities and promotes simplicity, flexibility, and ease of use for people of any age.

  4. Intraocular Pressure Changes during Accommodation in Progressing Myopes, Stable Myopes and Emmetropes

    PubMed Central

    Jiang, Xiaodan; Hu, Xiaodan; Zhang, Mingzhou; Li, Xuemin

    2015-01-01

    Purpose To investigate the changes of intraocular pressure (IOP) induced by 3-diopter (3 D) accommodation in progressing myopes, stable myopes and emmetropes. Design Cross-sectional study. Participants 318 subjects including 270 myopes and 48 emmetropes. Methods 195 progressing myopes, 75 stable myopes and 48 emmetropes participated in this study. All subjects had their IOP measured using iCare rebound tonometer while accommodative stimuli of 0 D and 3 D were presented. Main Outcome Measures IOP values without accommodation and with 3 D accommodation were measured in all subjects. Baseline IOPs and IOP changes were compared within and between groups. Results There was no significant difference in IOPs between progressing myopes, stable myopes and emmetropes when no accommodation was induced (17.47±3.46, 16.62±2.98 and 16.80±3.62 respectively, p>0.05). IOP experienced an insignificantly slight decrease after 3 D accommodation in three groups (mean change -0.19±2.16, -0.03±1.68 and -0.39±2.65 respectively, p>0.05). Subgroup analysis showed in progressing myopic group, IOP of children (<18 years old) declined with accommodation while IOP of adults (≥18 years) increased, and the difference was statistically significant (p = 0.008). However, after excluding the age factor, accommodation induced IOP changes of high progressing myopes (≤-6 D), low, moderate and non-myopes (>-6 D) was not significantly different after Bonferroni correction (p = 0.838). Conclusions Although no difference was detected between the baseline IOPs and accommodation induced IOP changes in progressing myopes, stable myopes and emmetropes, this study found accommodation could cause transient IOP elevation in adult progressing myopes. PMID:26517725

  5. Utility accommodation and conflict tracker (UACT) installation and configuration manual.

    DOT National Transportation Integrated Search

    2009-02-01

    Project 0-5475 performed a comprehensive analysis of utility conflict data/information flows between utility : accommodation stakeholders in the Texas Department of Transportation project development process, : developed data models to accommodate wo...

  6. 46 CFR 127.270 - Location of accommodations and pilothouse.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Section 127.270 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS... waterline. (d) No hawse pipe or chain pipe may pass through accommodations for crew members or offshore... accommodations and chain lockers, cargo spaces, or machinery spaces. (f) No sounding tubes, or vents from fuel...

  7. 46 CFR 127.270 - Location of accommodations and pilothouse.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Section 127.270 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS... waterline. (d) No hawse pipe or chain pipe may pass through accommodations for crew members or offshore... accommodations and chain lockers, cargo spaces, or machinery spaces. (f) No sounding tubes, or vents from fuel...

  8. 46 CFR 127.270 - Location of accommodations and pilothouse.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Section 127.270 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS... waterline. (d) No hawse pipe or chain pipe may pass through accommodations for crew members or offshore... accommodations and chain lockers, cargo spaces, or machinery spaces. (f) No sounding tubes, or vents from fuel...

  9. Testing the Contingency Theory of Accommodation in Public Relations.

    ERIC Educational Resources Information Center

    Cancel, Amanda E.; Mitrook, Michael A.; Cameron, Glen T.

    1999-01-01

    Interviews 18 public-relations professionals to provide grounding and refinement of the contingency theory of accommodation in public relations. Supports a continuum from pure accommodation to pure advocacy and a matrix of variables affecting the continuum. Concludes that the practitioners' view of their communication world offers validity to the…

  10. 46 CFR 127.270 - Location of accommodations and pilothouse.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Section 127.270 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS... waterline. (d) No hawse pipe or chain pipe may pass through accommodations for crew members or offshore... accommodations and chain lockers, cargo spaces, or machinery spaces. (f) No sounding tubes, or vents from fuel...

  11. 46 CFR 127.270 - Location of accommodations and pilothouse.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Section 127.270 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS... waterline. (d) No hawse pipe or chain pipe may pass through accommodations for crew members or offshore... accommodations and chain lockers, cargo spaces, or machinery spaces. (f) No sounding tubes, or vents from fuel...

  12. Relationship of ocular accommodation and motor skills performance in developmental coordination disorder.

    PubMed

    Rafique, Sara A; Northway, Nadia

    2015-08-01

    Ocular accommodation provides a well-focussed image, feedback for accurate eye movement control, and cues for depth perception. To accurately perform visually guided motor tasks, integration of ocular motor systems is essential. Children with motor coordination impairment are established to be at higher risk of accommodation anomalies. The aim of the present study was to examine the relationship between ocular accommodation and motor tasks, which are often overlooked, in order to better understand the problems experienced by children with motor coordination impairment. Visual function, gross and fine motor skills were assessed in children with developmental coordination disorder (DCD) and typically developing control children. Children with DCD had significantly poorer accommodation facility and amplitude dynamics compared to controls. Results indicate a relationship between impaired accommodation and motor skills. Specifically, accommodation anomalies correlated with visual motor, upper limb and fine dexterity task performance. Consequently, we argue accommodation anomalies influence the ineffective coordination of action and perception in DCD. Furthermore, reading disabilities were related to poorer motor performance. We postulate the role of the fastigial nucleus as a common pathway for accommodation and motor deficits. Implications of the findings and recommended visual screening protocols are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. The effects of a convex rear-view mirror on ocular accommodative responses.

    PubMed

    Nagata, Tatsuo; Iwasaki, Tsuneto; Kondo, Hiroyuki; Tawara, Akihiko

    2013-11-01

    Convex mirrors are universally used as rear-view mirrors in automobiles. However, the ocular accommodative responses during the use of these mirrors have not yet been examined. This study investigated the effects of a convex mirror on the ocular accommodative systems. Seven young adults with normal visual functions were ordered to binocularly watch an object in a convex or plane mirror. The accommodative responses were measured with an infrared optometer. The average of the accommodation of all subjects while viewing the object in the convex mirror were significantly nearer than in the plane mirror, although all subjects perceived the position of the object in the convex mirror as being farther away. Moreover, the fluctuations of accommodation were significantly larger for the convex mirror. The convex mirror caused the 'false recognition of distance', which induced the large accommodative fluctuations and blurred vision. Manufactures should consider the ocular accommodative responses as a new indicator for increasing automotive safety. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  14. Language competence in forensic interviews for suspected child sexual abuse.

    PubMed

    Fontes, Lisa A; Tishelman, Amy C

    2016-08-01

    Forensic interviews with children for suspected child sexual abuse require meeting children "where they are" in terms of their developmental level, readiness to disclose, culture, and language. The field lacks research indicating how to accommodate children's diverse cultural and linguistic backgrounds. This article focuses on language competence, defined here as the ability of an organization and its personnel (in this case, Child Advocacy Centers and forensic interviewers) to communicate effectively with clients regardless of their preferred language(s). In this qualitative study, 39 U.S. child forensic interviewers and child advocacy center directors discussed their experiences, practices, and opinions regarding interviews with children and families who are not native speakers of English. Topics include the importance of interviewing children in their preferred language, problems in interpreted interviews, bilingual interviews, and current and recommended procedures. Recommendations for practice and further research are included. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Trying to see, failing to focus: near visual impairment in Down syndrome

    PubMed Central

    Doyle, Lesley; Saunders, Kathryn J.; Little, Julie-Anne

    2016-01-01

    The majority of individuals with Down syndrome (DS) do not exhibit accurate accommodation, with the aetiology of this deficit unknown. This study examines the mechanism underlying hypoaccommodation in DS by simultaneously investigating the ‘near triad’ – accommodation, vergence and pupillary response. An objective photorefraction system measured accommodation, pupil size and gaze position (vergence) under binocular conditions while participants viewed an animated movie at 50, 33, 25 and 20 cm. Participants were aged 6–16 years (DS = 41, controls = 76). Measures were obtained from 59% of participants with DS and 99% of controls. Accommodative response was significantly less in DS (p < 0.001) and greater accommodative deficits were associated with worsening visual acuity (p = 0.02). Vergence responses were as accurate in DS as in controls (p = 0.90). Habitual pupil diameter did not differ between groups (p = 0.24) but reduced significantly with increasing accommodative demand in both participants with and without DS (p < 0.0001). This study is the first to report simultaneous binocular measurement of the near triad in DS demonstrating that hypoaccommodation is linked to poor visual acuity. Vergence responses were accurate indicating that hypoaccommodation cannot be dismissed as a failure to visually engage with near targets, but rather is a consequence of underlying neurological or physiological deficits. PMID:26847360

  16. Full-Field Accommodation in Rhesus Monkeys Measured Using Infrared Photorefraction

    PubMed Central

    He, Lin; Wendt, Mark

    2012-01-01

    Purpose. Full-field photorefraction was measured during accommodation in anesthetized monkeys to better understand the monkey as a model of human accommodation and how accommodation affects off-axis refraction. Methods. A photorefraction camera was rotated on a 30-cm-long rod in a horizontal arc, with the eye at the center of curvature of the arc so that the measurement distance remained constant. The resistance of a potentiometer attached to the rotation center of the rod changed proportionally with the rotation angle. Photorefraction and rotation angle were simultaneously measured at 30 Hz. Trial-lens calibrations were performed on-axis and across the full field in each eye. Full-field refraction measurements were compared using on-axis and full-field calibrations. In five iridectomized monkeys (mean age in years ± SD: 12.8 ± 0.9), full-field refraction was measured before and during carbachol iontophoresis stimulated accommodation, a total of seven times (with one repeat each in two monkeys). Results. Measurements over approximately 20 seconds had <0.1 D of variance and an angular resolution of 0.1°, from at least −30° to 30°. Photorefraction calibrations performed over the full field had a maximum variation in the calibration slopes within one eye of 90%. Applying full-field calibrations versus on-axis calibrations resulted in a decrease in the maximum SDs of the calculated refractions from 1.99 to 0.89 D for relative peripheral refractive error and from 4.68 to 1.99 D for relative accommodation. Conclusions. By applying full-field calibrations, relative accommodation in pharmacologically stimulated monkeys was found to be similar to that reported with voluntary accommodation in humans. PMID:22125278

  17. Accommodating Elementary Students' Learning Styles.

    ERIC Educational Resources Information Center

    Wallace, James

    1995-01-01

    Examines the perceptual learning style preferences of sixth- and seventh-grade students in the Philippines. Finds that the visual modality was the most preferred and the auditory modality was the least preferred. Offers suggestions for accommodating visual, tactile, and kinesthetic preferences. (RS)

  18. Cultural Accommodation Model of Counseling

    ERIC Educational Resources Information Center

    Leong, Frederick T. L.

    2011-01-01

    The current article provides an overview to the cultural accommodation model (CAM) of counseling (Leong & Lee, 2006) that may help guide employment counselors' work. The integrative multidimensional model of cross-cultural counseling (Leong, 1996), a precursor to the CAM, is also reviewed.

  19. The Development of a Sexual Abuse Severity Score: Characteristics of Childhood Sexual Abuse Associated with Trauma Symptomatology, Somatization, and Alcohol Abuse

    ERIC Educational Resources Information Center

    Zink, Therese; Klesges, Lisa; Stevens, Susanna; Decker, Paul

    2009-01-01

    Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age- and sex-stratified population survey of 600 Olmsted County, Minnesota, residents, a Sexual Abuse Severity Score was developed. The abuse characteristics of 156 CSA respondents were associated with…

  20. Child-Visiting and Domestic Abuse.

    ERIC Educational Resources Information Center

    Shepard, Melanie

    1992-01-01

    Explains problems with child visiting in cases of domestic abuse. Data on domestic abuse, child care concerns, and child adjustment problems were collected from 25 mothers and 22 fathers at a child visiting program serving separated and abusive families. Psychological abuse of mothers correlated with child adjustment problems. (BB)

  1. An Analysis of State Assessment Policies Addressing the Accommodation of English Language Learners

    ERIC Educational Resources Information Center

    Rivera, Carlene; Collum, Eric

    2004-01-01

    This paper reviews 15 research studies that: (1) examined effects of particular accommodations or groups of accommodations on performance: and (2) employed experimental and quasi-experimental research designs that allowed examination of the effect of the accommodation(s) on English Language Learners (ELLs) and non-ELLs. Studies looked at one or…

  2. Elder Abuse Awareness Project.

    ERIC Educational Resources Information Center

    Doyle, Kathleen; Morrow, Marilyn J.

    1985-01-01

    The Elder Abuse Awareness Project was undertaken: (1) to determine the incidence of abuse and neglect in seven Illinois counties; and (2) to develop, produce, and distribute educational materials on elder abuse for the service provider and for senior citizens. Results are presented and discussed. (MT)

  3. Frequency-Accommodating Manchester Decoder

    NASA Technical Reports Server (NTRS)

    Vasquez, Mario J.

    1988-01-01

    No adjustment necessary to cover a 10:1 frequency range. Decoding circuit converts biphase-level pulse-code modulation to nonreturn-to-zero (NRZ)-level pulse-code modulation plus clock signal. Circuit accommodates input data rate of 50 to 500 kb/s. Tracks gradual changes in rate automatically, eliminating need for extra circuits and manual switching to adjust to different rates.

  4. Mimics of child abuse: Can choking explain abusive head trauma?

    PubMed

    Edwards, George A

    2015-10-01

    Choking is one of the alternative explanations of abusive head trauma in children that have been offered in courtroom testimony and in the media. Most of these explanations - including choking - are not scientifically supported. This article highlights four points. (1) The origins of choking as an explanation for intracranial and retinal hemorrhages are speculative. (2) Choking has been used in high profile court testimony as an explanation for the death of a child thought to have been abused. (3) A case report that proposes choking as an alternative explanation for the death of a child diagnosed with abusive head trauma includes omissions and misrepresentations of facts. (4) There was a decision by the editor of the journal that published the case report that it was not necessary to include all the facts of the case; moreover, the editor indicated that facts are not required when presenting an alternative explanation. The use of scientifically unsupported alternative explanations for abusive head trauma based on inaccurate and biased information constitutes further victimization of the abused child and represents a travesty of justice. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  5. [A case of Munchausen Syndrome by proxy in the context of folie a famille].

    PubMed

    Foto Özdemir, Dilşad; Gökler, Bahar; Evinç, Ş Gülin; Balseven Odabaşı, Aysun

    2013-01-01

    The occurrence of similar psychotic symptoms in two or more people is called shared paranoid disorder. In this disease, the person who exhibits psychotic symptoms first is the "primary patient". The symptoms are contracted by the other people through persuasion. This disorder is seen among people who share the same house or are emotionally bound. In some cases, shared paranoid disorder may include other diagnoses, such as Munchausen Syndrome. This report discusses the case of a six-year-old, sexually abused boy who, when admitted to the hospital at the age of 10, claimed to have been repeatedly sexually harassed by several different people. His family's frequent changes in hospitals, negative perceptions of and accusations against medical staff, and improper methods of responding to harassment led clinicians to a diagnosis of Munchausen by proxy syndrome. In addition, both parents believed the abuse story, suggesting a potential diagnosis of shared psychotic disorder. In the literature, Munchausen by proxy has rarely been reported with symptoms of sexual abuse. The psychotic symptoms were shared by the family, complicating the case. This report emphasizes that psychodynamic evaluations of Munchausen by proxy and shared psychotic disorder may be helpful in understanding underlying factors.

  6. [Effects of visual optical stimuli for accommodation-convergence system on asthenopia].

    PubMed

    Iwasaki, Tsuneto; Tawara, Akihiko; Miyake, Nobuyuki

    2006-01-01

    We investigated the effect on eyestrain of optical stimuli that we designed for accommodation and convergence systems. Eight female students were given optical stimuli for accommodation and convergence systems for 1.5 min immediately after 20 min of a sustained task on a 3-D display. Before and after the trial, their ocular functions were measured and their symptoms were assessed. The optical stimuli were applied by moving targets of scenery images far and near around the far point position of both eyes on a horizonal place, which induced divergence in the direction of the eye position of rest. In a control group, subjects rested with closed eyes for 1.5 min instead of applying the optical stimuli. There were significant changes in the accommodative contraction time (from far to near) and the accommodative relaxation time (from near to far) and the lag of accommodation at near target, from 1.26 s to 1.62 s and from 1.49 s to 1.63 s and from 0.5 D to 0.65 D, respectively, and in the symptoms in the control group after the duration of closed-eye rest. In the stimulus group, however, the changes of those functions were smaller than in the control group. From these results, we suggest that our designed optical stimuli for accommodation and convergence systems are effective on asthenopia following accommodative dysfunction.

  7. Homicide and Klinefelter syndrome: a complex interaction.

    PubMed

    Richard-Devantoy, Stéphane; Jollant, Fabrice; Bouyer-Richard, Anne-Isabelle; Lhuillier, Jean-Paul; Gorwood, Philip

    2014-01-01

    Several studies have shown an association between homicide and sexual chromosomal abnormalities, but data are still lacking regarding Klinefelter syndrome. We retrospectively reviewed two cases of homicide perpetrators who were both diagnosed with Klinefelter syndrome on the basis of a karyotype analysis. A neurocognitive assessment was also performed (MMSE, Frontal Assessment Battery, brain CT, and electroencephalogram). Numerous intermediate risk factors of homicide were shared by our two cases, including dispositional (male gender, young age, low socioeconomic status), historical (prior arrest record and past conviction for any offense), contextual (unemployment), and clinical (alcohol abuse). It is important that clinicians go beyond obvious risk factors, such as chromosomal abnormalities, to pinpoint other meaningful risk factors and potentially facilitate preventive approaches.

  8. Child and Spouse Abuse Report

    DTIC Science & Technology

    1987-07-11

    child abuse . (c) SPouse (C) Military Child Care (4) Involvement n previous established case of spouse abuse (d) Sbl,ng (d) Other Child Care (5...program 16.j.(2) Referred to a drug rehabilitation program 4 16.j.(3) Previous involvement in child abuse 16.j.(4) Previous involvement in spouse abuse 16...investigation, whether "unsubstantiated," "suspected," or "substantiated." 8.a. Child Abuse /Neglect. The physical injury, sexual maltreatment, emotional

  9. Against the Odds: The Impact of Woman Abuse on Maternal Response to Disclosure of Child Sexual Abuse

    ERIC Educational Resources Information Center

    Alaggia, Ramona; Turton, Jennifer V.

    2005-01-01

    Although the co-occurrence of woman abuse and child sexual abuse is high little research exists exploring the impact of woman abuse on maternal response to child sexual abuse (CSA). Findings from two qualitative studies indicate the form of woman abuse to have differential impact on maternal response. Mothers who were abused in non-physical ways,…

  10. Abuse Characteristics and Individual Differences Related to Disclosing Childhood Sexual, Physical, and Emotional Abuse and Witnessed Domestic Violence.

    PubMed

    Bottoms, Bette L; Peter-Hagene, Liana C; Epstein, Michelle A; Wiley, Tisha R A; Reynolds, Carrie E; Rudnicki, Aaron G

    2016-04-01

    Many adult survivors of childhood abuse hide their victimization, avoiding disclosure that could identify perpetrators, end the abuse, and bring help to the victim. We surveyed 1,679 women undergraduates to understand disclosure of childhood sexual, physical, and emotional abuse, and, for the first time, witnessed domestic violence, which many consider to be emotionally abusive. A substantial minority of victims failed to ever disclose their sexual abuse (23%), physical abuse (34%), emotional abuse (20%), and witnessed domestic violence (29%). Overall, abuse-specific factors were better predictors of disclosure than individual-level characteristics. Disclosure of sexual abuse was related to experiencing more frequent abuse (by the same and by multiple perpetrators), being more worried about injury and more upset at the time of the abuse, and self-labeling as a victim of abuse. Disclosure of physical abuse was related to experiencing more frequent abuse (by the same and multiple perpetrators), being less emotionally close to the perpetrator, being older when the abuse ended, being more worried and upset, and self-labeling as a victim. Disclosure of emotional abuse was associated with being older when the abuse ended, and being more worried and upset. Disclosure was unrelated to victim demographic characteristics or defensive reactions (dissociative proneness, fantasy proneness, repressive coping style, and temporary forgetting), except that among physical and emotional abuse victims, repressors were less likely to disclose than non-repressors. Disclosure of witnessing domestic violence was not significantly related to any factors measured. © The Author(s) 2014.

  11. Magnifications of Single and Dual Element Accommodative Intraocular Lenses: Paraxial Optics Analysis

    PubMed Central

    Ale, Jit B; Manns, Fabrice; Ho, Arthur

    2010-01-01

    Purpose Using an analytical approach of paraxial optics, we evaluated the magnification of a model eye implanted with single-element (1E) and dual-element (2E) translating-optics accommodative intraocular lenses (AIOL) with an objective of understanding key control parameters relevant to their design. Potential clinical implications of the results arising from pseudophakic accommodation were also considered. Methods Lateral and angular magnifications in a pseudophakic model eye were analyzed using the matrix method of paraxial optics. The effects of key control parameters such as direction (forward or backward) and distance (0 to 2 mm) of translation, power combinations of the 2E-AIOL elements (front element power range +20.0 D to +40.0 D), and amplitudes of accommodation (0 to 4 D) were tested. Relative magnification, defined as the ratio of the retinal image size of the accommodated eye to that of unaccommodated phakic (rLM1) or pseudophakic (rLM2) model eyes, was computed to determine how retinal image size changes with pseudophakic accommodation. Results Both lateral and angular magnifications increased with increased power of the front element in 2E-AIOL and amplitude of accommodation. For a 2E-AIOL with front element power of +35 D, rLM1 and rLM2 increased by 17.0% and 16.3%, respectively, per millimetre of forward translation of the element, compared to the magnification at distance focus (unaccommodated). These changes correspond to a change of 9.4% and 6.5% per dioptre of accommodation, respectively. Angular magnification also increased with pseudophakic accommodation. 1E-AIOLs produced consistently less magnification than 2E-AIOLs. Relative retinal image size decreased at a rate of 0.25% with each dioptre of accommodation in the phakic model eye. The position of the image space nodal point shifted away from the retina (towards the cornea) with both phakic and pseudophakic accommodation. Conclusion Power of the mobile element, and amount and direction of

  12. Extralenticular and Lenticular Aspects of Accommodation and Presbyopia in Human Versus Monkey Eyes

    PubMed Central

    Croft, Mary Ann; McDonald, Jared P.; Katz, Alexander; Lin, Ting-Li; Lütjen-Drecoll, Elke; Kaufman, Paul L.

    2013-01-01

    Purpose. To determine if the accommodative forward movements of the vitreous zonule and lens equator occur in the human eye, as they do in the rhesus monkey eye; to investigate the connection between the vitreous zonule posterior insertion zone and the posterior lens equator; and to determine which components—muscle apex width, lens thickness, lens equator position, vitreous zonule, circumlental space, and/or other intraocular dimensions, including those stated in the objectives above—are most important in predicting accommodative amplitude and presbyopia. Methods. Accommodation was induced pharmacologically in 12 visually normal human subjects (ages 19–65 years) and by midbrain electrical stimulation in 11 rhesus monkeys (ages 6–27 years). Ultrasound biomicroscopy imaged the entire ciliary body, anterior and posterior lens surfaces, and the zonule. Relevant distances were measured in the resting and accommodated eyes. Stepwise regression analysis determined which variables were the most important predictors. Results. The human vitreous zonule and lens equator move forward (anteriorly) during accommodation, and their movements decline with age, as in the monkey. Over all ages studied, age could explain accommodative amplitude, but not as well as accommodative lens thickening and resting muscle apex thickness did together. Accommodative change in distances between the vitreous zonule insertion zone and the posterior lens equator or muscle apex were important for predicting accommodative lens thickening. Conclusions. Our findings quantify the movements of the zonule and ciliary muscle during accommodation, and identify their age-related changes that could impact the optical change that occurs during accommodation and IOL function. PMID:23745002

  13. Compliance with treatment in asthma and Munchausen syndrome by proxy.

    PubMed Central

    Godding, V; Kruth, M

    1991-01-01

    Among 1648 asthmatic patients, 17 families (1%) were identified as having Munchausen syndrome by proxy. Ten families did not treat their children's, attacks or refused medical care, and seven exaggerated the severity of symptoms to obtain invasive investigations and treatment. All the families had disturbed psychosocial backgrounds. The abuse consisted mainly of neglect, in that necessary treatment was not given. In some cases a more direct form of abuse was observed, when useless and sometimes harmful investigations and treatment were given. We conclude that medical control of the compliance of both parents and children is necessary in the management of childhood asthma. PMID:1929492

  14. Poppers: epidemiology and clinical management of inhaled nitrite abuse.

    PubMed

    Romanelli, Frank; Smith, Kelly M; Thornton, Alice C; Pomeroy, Claire

    2004-01-01

    Commonly referred to as "poppers," inhaled nitrites have a long history of abuse. Poppers are rapid-onset, short-acting potent vasodilators that produce a rush characterized by warm sensations and feelings of dizziness. Poppers sometimes are used to facilitate anal intercourse because of their actions on the anal sphincter. Epidemiologically, the frequent use of nitrites by men who have sex with men has led some experts to implicate these chemicals in the pathogenesis of Kaposi's sarcoma and acquired immunodeficiency syndrome. Controlled clinical trials to examine this potential correlation have not been conducted, and the use of nitrites simply may be a marker for other high-risk behaviors such as unprotected sex. Although regulated in the United States, many nitrite compounds and isomers are sold at various venues including bars, bookstores, and over the Internet. Adverse effects associated with these products vary from mild allergic reactions to life-threatening methemoglobinemia. The potential for drug-drug interactions and a propensity toward unsafe sex also exist. Clinicians should be familiar with the populations most likely to abuse these agents and with the clinical effects and management guidelines for acute ingestions.

  15. Short-Term Adaptive Modification of Dynamic Ocular Accommodation

    PubMed Central

    Bharadwaj, Shrikant R.; Vedamurthy, Indu; Schor, Clifton M.

    2009-01-01

    Purpose Indirect observations suggest that the neural control of accommodation may undergo adaptive recalibration in response to age-related biomechanical changes in the accommodative system. However, there has been no direct demonstration of such an adaptive capability. This investigation was conducted to demonstrate short-term adaptation of accommodative step response dynamics to optically induced changes in neuromuscular demands. Methods Repetitive changes in accommodative effort were induced in 15 subjects (18–34 years) with a double-step adaptation paradigm wherein an initial 2-D step change in blur was followed 350 ms later by either a 2-D step increase in blur (increasing-step paradigm) or a 1.75-D step decrease in blur (decreasing-step paradigm). Peak velocity, peak acceleration, and latency of 2-D single-step test responses were assessed before and after 1.5 hours of training with these paradigms. Results Peak velocity and peak acceleration of 2-D step responses increased after adaptation to the increasing-step paradigm (9/12 subjects), and they decreased after adaptation to the decreasing-step paradigm (4/9 subjects). Adaptive changes in peak velocity and peak acceleration generalized to responses that were smaller (1 D) and larger (3 D) than the 2-D adaptation stimulus. The magnitude of adaptation correlated poorly with the subject's age, but it was significantly negatively correlated with the preadaptation dynamics. Response latency decreased after adaptation, irrespective of the direction of adaptation. Conclusions Short-term adaptive changes in accommodative step response dynamics could be induced, at least in some of our subjects between 18 and 34 years, with a directional bias toward increasing rather than decreasing the dynamics. PMID:19255153

  16. Increased Childhood Abuse in Patients With Premenstrual Dysphoric Disorder in a Turkish Sample: A Cross-Sectional Study

    PubMed Central

    Albayrak, Yakup; Sahin, Basak

    2014-01-01

    Objective: Abuse is considered to have a place in the etiology of various psychiatric disorders. Premenstrual dysphoric disorder (PMDD) is one of the psychiatric disorders for which abuse could be an etiologic factor; however, few studies have investigated the relationship between abuse and PMDD. In this study, our aim was to investigate childhood abuse in patients with PMDD and compare them with healthy female subjects. Method: This cross-sectional study included 70 women with PMDD (DSM-IV-TR criteria) who were admitted to the outpatient psychiatry clinic of Ankara Yenimahalle State Hospital, Ankara, Turkey, between December 2012 and December 2013. Additionally, 78 healthy controls were included in the study. Sociodemographic, familial, and reproductive period characteristics of the women were recorded. All subjects were administered the Premenstrual Syndrome Scale (PMSS) and the Childhood Trauma Questionnaire (CTQ). Results: Among the sociodemographic characteristics, being a university graduate (76.9%) and being a public servant (70.5%) were significantly higher in the healthy control group (P = .01 and P = .01, respectively). A family history of PMDD (31.4%), a history of postpartum psychiatric disorders (11.4%), and a history of attempted suicide (7.1%) were higher in the PMDD group compared with the healthy control group (P = .001, P = .003, and P = .024, respectively). Significant differences were also found between PMDD and healthy controls in PMSS score (P ≤ .001), CTQ total scores (P = .002), and subscale scores including emotional abuse and emotional neglect (P = .004), physical abuse (P = .009), and sexual abuse (P = .012). Conclusions: To our knowledge, the present study is the first to investigate associations between PMDD and childhood abuse from Turkey. More comprehensive studies on this topic with larger sample sizes are required to enrich the literature and enable practitioners to be more effective in clinical practice. PMID:25664213

  17. [Clinical forensic examination findings and legal outcome in cases of suspected physical child abuse].

    PubMed

    Bode-Jänisch, Stefanie; Meyer, Yvonne; Schroeder, Günter; Günther, Detlef; Debertin, Anette Solveig

    2011-01-01

    Clinical forensic examinations performed at the Institute of Legal Medicine of the Hanover Medical School between 1999 and 2008 in cases of suspected physical abuse of children were analyzed retrospectively with special emphasis on the legal consequences. Altogether, 192 children (85 girls, 107 boys) with a median age of 4.4 years were examined. In 47 cases (24.5 %), the clinical forensic examination findings were interpreted as accidental injuries, birth traumas or unspecific findings. 29 victims (20.0 %) had suffered a shaken baby syndrome. Only part of the presented cases ended with conviction, which was more likely if the victims were aged between 7 and 11 years. Prison terms of 2 years and more were imposed only if the child suffered potentially or acute life-threatening injuries or if additional anogenital lesions were diagnosed indicating sexual child abuse.

  18. Accommodations for Multiple Choice Tests

    ERIC Educational Resources Information Center

    Trammell, Jack

    2011-01-01

    Students with learning or learning-related disabilities frequently struggle with multiple choice assessments due to difficulty discriminating between items, filtering out distracters, and framing a mental best answer. This Practice Brief suggests accommodations and strategies that disability service providers can utilize in conjunction with…

  19. Objective Amplitude of Accommodation Computed from Optical Quality Metrics Applied to Wavefront Outcomes

    PubMed Central

    López-Gil, Norberto; Fernández-Sánchez, Vicente; Thibos, Larry N.; Montés-Micó, Robert

    2010-01-01

    Purpose We studied the accuracy and precision of 32 objective wavefront methods for finding the amplitude of accommodation obtained in 180 eyes. Methods Ocular accommodation was stimulated with 0.5 D steps in target vergence spanning the full range of accommodation for each subject. Subjective monocular amplitude of accommodation was measured using two clinical methods, using negative lenses and with a custom Badal optometer. Results Both subjective methods gave similar results. Results obtained from the Badal optometer where used to test the accuracy of the objective methods. All objective methods showed lower amplitude of accommodation that the subjective ones by an amount that varied from 0.2 to 1.1 D depending on the method. The precision in this prediction also varied between subjects, with an average standard error of the mean of 0.1 D that decreased with age. Conclusions Depth of field increases subjective of amplitude of accommodation overestimating the objective amplitude obtained with all the metrics used. The change in the negative direction of spherical aberration during accommodation increases the amplitude of accommodation by an amount that varies with age.

  20. Comparison of early maladaptive schemas and parenting origins in patients with opioid abuse and non-abusers.

    PubMed

    Jalali, Mohammad Reza; Zargar, Mohammad; Salavati, Mojgan; Kakavand, Ali Reza

    2011-01-01

    The aim of this study was to examine the difference of early maladaptive schemas and parenting origins in opioid abusers and non-opioid abusers. The early maladaptive schemas and parenting origins were compared in 56 opioid abusers and 56 non-opioids abusers. Schemas were assessed by the Young Schema Questionnaire 3rd (short form); and parenting origins were assessed by the Young Parenting Inventory. Data were analyzed by multivariate analysis of variance (MANOVA). The analysis showed that the means for schemas between opioid abusers and non-opioid abusers were different. Chi square test showed that parenting origins were significantly associated with their related schemas. The early maladaptive schemas and parenting origins in opioid abusers were more than non-opioid abusers; and parenting origins were related to their Corresponding schemas.