Use of prescribed optical devices in age-related macular degeneration.

PURPOSE: To evaluate prescribed optical device use in terms of frequency and perceived usefulness among people with age-related macular degeneration (AMD). We also sought to determine the tasks for which they were using their prescribed low vision device(s). METHODS: One hundred ninety-nine patients with AMD presenting for the first time to the low vision service were recruited from a university-based clinic. Prior to the low vision evaluation and device prescription, they completed the National Eye Institute Visual Function Questionnaire 25, Center for Epidemiological Studies Depression Scale, Short Portable Mental Status Questionnaire, and a general health questionnaire. The low vision evaluation included best-corrected Early Treatment of Diabetic Retinopathy Study visual acuity, MNREAD testing, microperimetry, prescription, and dispensing of optical low vision devices. Telephone follow-up interviews were conducted about device usage 1-week, 1-month, and 3-months postintervention. RESULTS: One hundred eighty-one participants were prescribed low vision devices. Of them, 93% completed all 3 follow-up interviews. Intensive users (≥1 hours/day) of devices were similar in demographic and visual characteristics to non-intensive users (<1 hours/day), except for habitual reading acuity and speed as well as contrast sensitivity. Overall, device use increased slightly over 3 months of follow-up. Magnifiers were reported to be moderately-to-extremely useful by >80% of participants at all time points except the 1-month follow-up for hand magnifiers (75%). High plus spectacles were the least frequently prescribed device and rated as moderately-to-extremely useful by 70%, 74%, and 59% at 1 week, 1 month, and 3 months, respectively. Most participants used their devices for leisure reading, followed by managing bills. Very few devices (n = 3, <1%) were not used at any time point. CONCLUSIONS: Patients with AMD who are provided with prescribed optical low vision devices do use them and perceive them as useful, especially for leisure reading activities. High rates of usage were maintained over 3 month.

A randomized trial of screening for relationship violence in young women.

OBJECTIVES: We conducted a randomized controlled trial of three screening approaches to assess relationship violence disclosure among young women as well as patient and provider satisfaction. METHODS: Reproductive healthcare patients (n=699) aged 15 to 24 years completed one of three approaches to violence screening, that is, basic, healthy relationship, and bidirectional. Screening was embedded in a comprehensive health history using an audio-assisted computer interview (ACASI). Afterward, the patient met with the provider, who reviewed screening results. The patient and provider independently completed an assessment of the process. RESULTS: Medical and violence screening took about 8 minutes with those in the basic screening finishing significantly more quickly. We did detect a significant difference by screening approach for recent physical violence victimization, but no other significant differences emerged between screening approaches. Although patients' or providers' satisfaction and comfort with the screening process were positive, no differences were detected. CONCLUSIONS: An approach that frames questioning within a birectional context enhances detection of recent physical victimization, and can be completed in busy reproductive healthcare setting. All screens were equally and highly regarded by participants and adequately rated by providers.

Attitudes about intimate partner violence screening among an ethnically diverse sample of young women.

PURPOSE: This clinic-based study investigated attitudes about intimate partner violence (IPV) screening among an ethnically diverse population of adolescent and young adult women (n = 645). METHODS: A cross-sectional quantitative and qualitative survey assessed experiences with and attitudes toward IPV screening. RESULTS: Almost all participants supported universal IPV screening and over 90% believed that a health care provider was the most appropriate adult to ask them about interpersonal violence. Young women's concerns toward screening varied by age and violence experience; those most likely to mind being screened were younger, had a history of childhood sexual abuse, and were victims of physical violence in the last year. However, even in these groups, over 70% supported IPV screening. Qualitative analyses suggested that provider qualities and confidentiality will affect the amount of disclosure to provider-initiated screening. Women also raised important questions about how to define IPV in relationships. CONCLUSIONS: Young women generally favor universal screening of interpersonal violence, but provider qualities and confidentiality issues affect responses to screening questions.