Causes of congenital corneal opacities and their management in a tertiary care center.

PURPOSE: To evaluate causes and management of congenital corneal opacities (CCO) diagnosed in a tertiary care eye center and to compare the data with a previous study at the same institution. METHODS: Computerized medical records in all patients with congenital corneal opacities diagnosed in the Cornea Service at Wills Eye Hospital (Philadelphia, PA) between January 1, 2007, and December 31, 2015, were retrospectively reviewed. Children aged 12 years and younger at the first visit were included in the study. Patients\u27 demographics, ocular diagnosis, laterality, associated ocular abnormalities, other ocular surgery performed prior or subsequent to the first visit, and their treatment were extracted from the medical records. RESULTS: A total of 77 eyes in 56 patients were examined. The mean age at presentation was 32.8 ± 44.2 months, with the mean follow-up period of 26.7 ± 30.1 months. The most frequent diagnosis was Peters anomaly (53.2%), followed by limbal dermoid (13.0%), aniridia with glaucoma and microphthalmos (6.5%), sclerocornea and congenital glaucoma (5.2%), idiopathic (3.9%), Axenfeld-Rieger anomaly and Hurler syndrome (2.6%), and microcornea (1.3%). Primary keratoplasty was performed in 26 eyes, with the outcome rate in the clear cornea of 76.0% during the follow-up. CONCLUSION: Peters anomaly is the most common cause of congenital corneal opacities encountered at our institution. Penetrating keratoplasty is the most frequent choice of corneal surgery to treat congenital corneal opacities. Additional interventions during penetrating keratoplasty were moderately positively correlated with graft failure. This study also shows the rates of some etiologies of that changed over the recent decades in our tertiary care Cornea Service. Although Peters anomaly remains the most common presenting reason for congenital corneal opacities, its rate appears to be increasing over the recent decade. Congenital corneal opacities due to birth trauma, which is one of the preventable causes, were observed in a previous study in our clinic; however, no new cases were noted in this study

Tom, Dick, and Harry

Presumed dead, a cantankerous retired assassin hides out in a senior living home. When the CIA tracks him down, he enlists his fellow residents to trade in their walkers for weapons to protect the facility from a death squad

Chapter 15: Family Caregiving

The United States’ aging population has led to a greater need for caregivers. This responsibility often falls to family members. Social workers can support family caregivers, but mindfulness about group and individual differences is crucial. Understanding diverse needs of family caregivers and recipients will help social workers effectively implement interventions

The Indian in Saskatchewan elementary school social studies textbooks : a content analysis

The purpose of this study was to examine eight elementary school social studies textbooks using the method of content analysis to analyze the treatment of Indians in the books selected for the study. It was conceded at the outset that not all teaching about Indians is done in social studies programs and not all information about Indians is presented through textbooks. However, it was recognized that the textbook is the basic guide for many teachers and students, and often the single source for historical information presented in social studies courses in elementary school classrooms. For the purposes of content analysis of the textbooks the guidelines of Berelson for content analysis were used to develop the categories. The procedures developed by Dr. Hargopal Dhand of the University of Saskatchewan, Saskatoon were modified to suit the purpose of this study.Data Work Sheets and Data Summary Sheets were used to gather and record information concerning frequency of occurrence of paragraphs devoted to Indians in the textbooks, topical classification of the paragraphs, illustrative and decorative features of the textbooks, classification of Indians presented, tribes selected, major topics discussed and approval or disapproval of Indians presented. The data were tabulated in both numerical and percentage form.A pilot study and validation procedure were carried out with students and professors of the College of Education, University of Saskatchewan in order to validate the method.It was found that generally the books analyzed gave an incomplete historical picture of Indian-Canadians. It was also found that Indian themes received low priority in the number and quality of illustrative and decorative features in the books. Indians were presented in such a manner as to detract from an understanding of the diversity of Indian cultures, languages and personalities. Indians were presented in a manner that lends itself to the encouragement of broad generalizations concerning an extremely wide variety of people that are classified as Indians.It was also found that there was a lack of variation in the tribes presented; there was a failure to reflect the richness and variety of Indian cultures in Canada; there was a high degree of unfavourable or negative presentation of Indian characters. For the most part Indians just are not there except for the initial contact-with Europeans, the beginning of the fur trade and a brief re-emergence during the Northwest Rebellion of 1885. It was concluded that for the most part the textbooks analyzed will not contribute positively to helping Indian and non-Indian elementary school students in Saskatchewan know and understand the Indian dimension of Canadian history and culture

Active Learning Classroom Observation Tool: A Practical Tool for Classroom Observation and Instructor Reflection in Active Learning Classrooms

Centers for Teaching and Learning (CTLs) have long offered the service of classroom observations to instructors who seek to improve in-class teaching effectiveness. Classroom observations, however, have not explicitly addressed the recent emergence of "active learning classrooms," classrooms that are designed to support active and collaborative learning approaches. Given the absence of an observation protocol explicitly designed to address instructional approaches within active learning classrooms, in spring and fall of 2015, CTL faculty developers and researchers at Indiana University-Bloomington created the Active Learning Classroom Observation Tool (ALCOT). The ALCOT allows a holistic consideration of the learning experience, providing a view to the instructor’s attempt to combine the spatial and technological affordances of a classroom with active and collaborative learning pedagogies. Faculty developers and researchers developed and piloted the Active Learning Classroom Observation Tool to elicit thoughtful reflection and meaningful feedback on teaching and learning undertaken within these new learning spaces

Urgent Care in the Dental School Setting: Analysis of Current Environment and Future Challenges in Emergency Dental Education

Urgent dental care education is a critical aspect of the D.D.S. curriculum as dental students must be adequately prepared to face real-world dental emergency challenges in practice. Dental emergency education is likely the most variable component of the dental curriculum. To assess potential differences in emergency education, a sixteen-question survey was sent to directors of urgent care of all fifty-six U.S. dental schools addressing clinic operation, demographics, treatment, integration into the D.D.S. curriculum, and provision of care for indigent populations. The response rate was 88 percent. Results indicate a need for earlier integration of urgent dental care education into the D.D.S. curriculum, more pediatric emergency experiences for D.D.S. students, and a more rigorous academic approach in assessing student competency while on rotation in the urgent care service. In addition, access to emergency dental care has become increasingly difficult for indigent populations due to lack of state-supported funds; further exploration of sources of external funding for such care is warranted

Anterior Chamber Characteristics, Endothelial Parameters, and Corneal Densitometry After Descemet Stripping Automated Endothelial Keratoplasty in Patients With Fuchs Dystrophy

Purpose: To compare anterior segment parameters in patients with Fuchs endothelial dystrophy (FED) who underwent Descemet stripping automated endothelial keratoplasty (DSAEK) in one eye and no corneal surgery in the fellow eye. Methods: This prospective study was conducted on 28 eyes of 14 patients with FED who underwent DSAEK in one eye at least one year prior (DSAEK group) and no corneal surgery in the fellow eye (control group). Each eye was analyzed with the anterior segment optical coherence tomography, specular microscopy, and Scheimpflug imaging systems. Data were compared between the two groups. Results: The mean age of the patients was 76.9 ± 7.0 years. There were no statistically significant differences in the mean central corneal thickness (CCT), central anterior chamber depth, anterior chamber angle parameters, cylinder and keratometry values between two groups (all P-values > 0.05). The paracentral corneal thickness, corneal volume, endothelial cell density, and hexagonal cell ratio measurements were statistically significantly higher in the DSAEK group than the control (all P-values < 0.05), and anterior chamber volume in the DSAEK group was significantly less than the control (P = 0.046). While posterior and total corneal densitometry values in the DSAEK group were statistically significantly lower than the control (P < 0.001 and P = 0.011, respectively), there were no statistically significant differences in the anterior or middle corneal densities (P = 0.108 and P = 0.134, respectively). Conclusion: We found that total corneal densitometry value decreased in DSAEK group. Although DSAEK surgery did not affect the anterior chamber angle parameters, it reduced the anterior chamber volume and increased the corneal volume and paracentral corneal thickness due to the addition of the DSAEK graft