Validation of the eyeTelemed IOPvet indentation tonometer for use in dogs.

OBJECTIVE: To assess the accuracy of canine intraocular pressure (IOP) estimates from the eyeTelemed IOPvet indentation tonometer. ANIMALS STUDIED: Part 1 included 54 eyes from 28 Beagle dogs-23 ADAMTS10-mutants with open-angle glaucoma and 5 normals. Part 2 involved five normal canine ex vivo globes. PROCEDURE: Part 1 (in vivo) compared IOPvet estimates in normal and glaucomatous dogs to Reichert Tono-Vera® Vet rebound tonometry. The three IOPvet estimates were green (normal; <20 mmHg, according to the manufacturer), yellow (elevated; 20-30 mmHg), and red (high; >30 mmHg). In Part 2 (ex vivo), the pressure inside freshly enucleated normal canine eyes was progressively increased from 5 to 80 mmHg and compared to IOPvet estimates. Descriptive statistics compared IOPvet estimates to rebound tonometry and direct manometry, with the threshold from normal to glaucoma set at 30 mmHg. RESULTS: In Part 1 (in vivo), normal pressures (≤30 mmHg) were mainly identified correctly as green or yellow-110 of 111 estimates, corresponding to a specificity of 99%. Only 16 of 125 affected estimates were correctly displayed in the >30-mmHg range; the remaining 109 showed ≤30 mmHg, corresponding to a sensitivity of 13%. In Part 2 (ex vivo), all normal pressures were correctly estimated with green, but 64 of 88 manometric IOPs >30 mmHg were falsely estimated as 20-30 mmHg. CONCLUSIONS: The IOPvet is inaccurate in estimating canine IOP with a low sensitivity at identifying dogs with IOP > 30 mmHg. Canine-specific instrument revision is required to correctly identify elevated (yellow = 20-30 mmHg) and high (red >30 mmHg) IOPs.

Resolving Dimensionality in a Child Assessment Tool: An Application of the Multilevel Bifactor Model.

Multidimensionality and hierarchical data structure are common in assessment data. These design features, if not accounted for, can threaten the validity of the results and inferences generated from factor analysis, a method frequently employed to assess test dimensionality. In this article, we describe and demonstrate the application of the multilevel bifactor model to address these features in examining test dimensionality. The tool for this exposition is the Child Observation Record Advantage 1.5 (COR-Adv1.5), a child assessment instrument widely used in Head Start programs. Previous studies on this assessment tool reported highly correlated factors and did not account for the nesting of children in classrooms. Results from this study show how the flexibility of the multilevel bifactor model, together with useful model-based statistics, can be harnessed to judge the dimensionality of a test instrument and inform the interpretability of the associated factor scores.

Evaluation of Active Warming and Surgical Draping for Perioperative Thermal Support in Laboratory Mice.

Surgical procedures are commonly performed using mice but can have major effects on their core body temperature, including development of hypothermia. In this study, we evaluated active perioperative warming with and without surgical draping with adherent plastic wrap to refine practices, improve animal welfare, and optimize research experiments. Mice were randomized into treatment groups (n = 6; 8 CD1 mice per group). Treatments included placement within a small-animal forced-air incubator at 38 ° C for 30 min before surgery (Pre), after surgery (Post), or before and after surgery (Both). To explore the effect of surgical draping, one group received incubator warming before and after surgery in addition to surgical draping (Both/ Drape), whereas another group received surgical draping only without incubator warming (Control/Drape). The final group of mice received neither warming nor draping (Control). Subcutaneous temperature transponders were placed in all mice. Approximately 5 d after transponder placement, mice were anesthetized with ketamine-xylazine and underwent laparotomy. Subcutaneous body temperatures were collected perioperatively from transponders, and rectal temperatures were taken every minute during surgery. For recovery from anesthesia, mice were placed either in a standard cage on a warm water blanket set to 38 °C (100.4 °F) or in the incubator. Subcutaneous body temperatures were significantly higher in mice prewarmed for 30 min (Pre, Both, Both/Drape) as compared with mice that were not prewarmed. Anesthetic recovery times were significantly longer for mice placed in the incubator (Pre, Post, Both, Both/Drape) than for those that did not receive incubator warming (Control, Control/Drape). Mean intraoperative rectal temperatures of Both/Drape mice tended to be greater than those of mice in the Both group, suggesting a warming benefit of surgical draping. Using a forced air incubator and adherent plastic draping mitigated body temperature loss in mice during both surgery and postoperative recovery.

Using Waterless Alcohol-based Antiseptic for Skin Preparation and Active Thermal Support in Laboratory Rats.

Rodents are frequently used for models that require surgical procedures. At our institution, laboratory rats are increasingly preferred for investigations of neurologic disorders, cardiovascular interventions, and assessment and treatment of addictive and depressive behaviors. For these types of studies, surgical preparations of the head and neck areas are necessary for catheterization and instrumentation. Based upon our former work in laboratory mice, we sought to improve rat surgery outcomes and confirm the efficacy of a waterless alcohol-based (WAB) antiseptic for skin disinfection prior to incision. In addition, we wanted to investigate whether active warming efforts improved perioperative body temperatures for rats to aid in return to consciousness. Prior to cranial surgical incision and placement in stereotactic equipment, rats were assessed after skin preparation with WAB and after thermal interventions, including prewarming cages for 30 min before anesthesia and delivery of warmed fluid (NaCl) supplementation. Core temperatures were recorded and aerobic culture swabs collected from surgical sites at multiple time points. As previously shown in mice, bacterial counts in rats were effectively diminished by WAB agents. Assessment of intraoperative body temperature trajectories did not identify appreciable differences between control rats and rats that were exposed to prewarming or warmed fluid supplementation or both. However, heavier male rats recovered more rapidly from isoflurane anesthesia than did lighter male and female rats. Although these thermal support measures did not significantly improve anesthetic recovery times in rats, animals warmed for 30 min trended toward a faster return to righting reflex after exposure to isoflurane. These findings confirm that WAB antiseptic is an acceptable option for skin preparation in rats and suggest that continued evaluation of thermal interventions remains of interest for improved outcomes in rat surgery.

Inferior Vena Cava Filters in Patients with Recurrent Pulmonary Embolism.

BACKGROUND: There are sparse data to support the recommendation for inferior vena cava (IVC) filters in patients with recurrent pulmonary embolism while on anticoagulant therapy. METHODS: This was a retrospective cohort study of administrative data from the Premier Healthcare Database, 2009-2014. All-cause mortality according to the use of IVC filters was evaluated in patients who suffered a recurrent pulmonary embolism within 3 months of an index pulmonary embolism. Patients were identified by International Classification of Disease, 9th Clinical Modification codes. A time-dependent analysis controlled for immortal time bias. RESULTS: An IVC filter was inserted in 603 of 814 (74.1%) of patients hospitalized for recurrent pulmonary embolism within 3 months of an index pulmonary embolism. Mortality with an IVC filter was 18 of 603 (3.0%) vs 83 of 211 (39.3%) (P < .0001) without a filter. Among patients with recurrent pulmonary embolism who were stable and did not receive thrombolytic therapy or undergo pulmonary embolectomy, mortality with an IVC filter was 15 of 572 (2.6%) vs 72 of 169 (42.6%) (P < .0001) without a filter. CONCLUSION: In the United States, usual practice was to insert an IVC filter in patients with early recurrent pulmonary embolism. Mortality was lower in those who received an IVC filter. Even stable patients with early recurrent pulmonary embolism showed a decreased mortality with IVC filters, even though in other circumstances, IVC filters do not reduce mortality in stable patients. Additional cohort studies would be useful in the absence of a randomized controlled trial.

Comparison of Aqueous and Alcohol-based Agents for Presurgical Skin Preparation Methods in Mice.

Preparing the skin of rodents for surgery often involves multiple applications of antiseptic agents. However, fewer applications may achieve the same antiseptic outcome. We evaluated the antimicrobial efficacy and effects on intraoperative body temperature of various surgical scrub agents, including novel waterless alcohol-based (WAB) options. Prior to ventral laparotomy, female C57BL/6 mice were treated with 0.9% saline (control); 70% ethanol; 10% povidone-iodine alternated with saline or 70% ethanol; 2% chlorhexidine digluconate alternated with saline or 70% ethanol; or 1 of 3 WAB products-commercial surgical scrub A, commercial surgical scrub B, or a common commercial hand sanitizer. Core temperatures were recorded, and aerobic culture swabs were collected from the surgical site at multiple time points. Intraoperative temperature trajectories for animals treated with scrub B, 10% povidone-iodine with saline, or hand sanitizer did not differ from saline (control). Temperature trajectories of mice treated with other scrub agents did differ significantly from saline. Bacteria were not detected at the operative site after 3 scrubs of 70% ethanol or 10% povidone-iodine alternated with ethanol, 2 scrubs of scrub A or B, 1 scrub of hand sanitizer, and both 1 and 3 scrubs of 2% chlorhexidine alternated with ethanol. Scrub B and 2% chlorhexidine-ethanol demonstrated prolonged antibacterial efficacy. Histology of corresponding haired skin sections revealed no differences in postoperative healing between groups, and no postoperative infections occurred. These results indicate that various novel WAB disinfectants, particularly scrub B (61% ethanol and 1% chlorhexidine gluconate), mitigate intraoperative temperature effects associated with several traditional agents and combinations. Furthermore, reduction of skin bacterial load without adverse effects on healing was seen with fewer than triplicate applications of most tested agents. Ultimately effective skin preparation can be achieved by using only 1 or 2 applications of scrub, thus rendering the triplicate skin-prep method unnecessary in laboratory mice.

Importance of Early Insertion of Inferior Vena Cava Filters in Unstable Patients with Acute Pulmonary Embolism.

BACKGROUND: Immortal time bias is a possible confounding factor in cohort studies. In this investigation, we assessed mortality with inferior vena cava (IVC) filters in unstable patients with pulmonary embolism using a design to control for immortal time bias. METHODS: Data were from the Premier Healthcare Database, 2010-2014. International Classification of Diseases-Ninth Revision-Clinical Modification codes were used. Unstable patients with pulmonary embolism and an admitting diagnosis of pulmonary embolism, as well as a primary diagnosis of pulmonary embolism, were included. A time-dependent analysis was used according to the day of insertion of the IVC filter to control for immortal time bias. RESULTS: Among all unstable patients, irrespective of the use of thrombolytic therapy, in-hospital all-cause mortality was 35 of 180 (19.4%) in those who received an IVC filter vs 122 of 299 (40.8%) with no filter (P < .0001). Mortality was lower in patients in whom the IVC filter was inserted on days 1 or 2 (on day 1, 21.4% compared with 40.8%, P = .017, and on day 2, 14.8% compared with 29.2%, P = .023), but it was not lower in those in whom the filter was inserted on subsequent days. CONCLUSIONS: Mortality in unstable patients with pulmonary embolism appeared to be reduced with IVC filters only when the filter was inserted on the first or second day of admission. The design used for these analyses controlled for immortal time bias as a cause of the lower mortality with IVC filters.

Usefulness of Inferior Vena Cava Filters in Unstable Patients With Acute Pulmonary Embolism and Patients Who Underwent Pulmonary Embolectomy.

Administrative data were analyzed from the Premier Healthcare Database, 2010 to 2014, to assess whether inferior vena cava (IVC) filters reduce mortality in unstable patients (in shock or on ventilator support) with acute pulmonary embolism and in stable patients who undergo surgical pulmonary embolectomy. Mortality was assumed to be due to pulmonary embolism in patients who had none of the co-morbid conditions listed in the Charlson Comorbidity Index. Data were determined on the basis of International Classification of Disease-9th Clinical Modification (ICD-9-CM) codes. All-cause mortality in unstable patients was lower with IVC filters in-hospital, 288 of 1,972 (23%) versus 1339 of 3002 (45%) (p <0.0001), and at 3 months, all-cause mortality was 316 of 1,272 (25%) versus 1,428 of 3,002 (48%) (p <0.0001). Pulmonary embolism mortality was lower with IVC filters in unstable patients in-hospital, 191 of 926 (21%) versus 913 of 2,138 (43%) (p <0.0001) and at 3 months, 215 of 926 (23%) versus 971 of 2,138 (45%) (p <0.0001). A lower in-hospital and 3-month all-cause mortality and pulmonary embolism mortality was also shown with IVC filters in stable patients who underwent pulmonary embolectomy. These data, in concert with previous retrospective data, suggest that unstable patients with pulmonary embolism and stable patients who undergo pulmonary embolectomy may benefit from an IVC filter. Further investigations would be useful.

Inferior Vena Cava Filters in Patients with Acute Pulmonary Embolism and Cancer.

BACKGROUND: Administrative data have shown a lower mortality in hospitalized patients with pulmonary embolism and cancer who receive a vena cava filter. In the absence of a randomized controlled trial of vena cava filters in such patients, further investigation is necessary. Therefore, we performed this investigation using administrative data from a different database than used previously, and we investigate patients hospitalized in more recent years. METHODS: We analyzed administrative data from the Premier Healthcare Database, 2010-2014, in patients hospitalized with pulmonary embolism and solid malignant tumors. Patients were identified on the basis of International Classification of Disease, Ninth Revision, Clinical Modification codes. RESULTS: Patients aged >60 years had a lower in-hospital all-cause mortality with vena cava filters than those who did not have filters, 346 of 4648 (7.4%) compared with 2216 of 19,847 (11.2%) (P < .0001) (relative risk 0.67). Among patients aged >60 years who received an inferior vena cava, all-cause mortality within 3 months was 704 of 4648 (15.1%), compared with 3444 of 19,847 (17.4%) among those who did not receive a filter (P < .0001) (relative risk 0.86). CONCLUSION: Elderly patients with pulmonary embolism and cancer may be a special population in whom inferior vena cava filters reduce in-hospital and 3-month all-cause mortality. Further investigation is needed, particularly in younger patients.

Pulse consumption in Canadian adults influences nutrient intakes.

Pulses (dry beans, peas, lentils) are nutrient-dense foods that are recommended as good choices in either the vegetable or meat and alternative food groups in Canada's Food Guide. To examine the prevalence and the effect of pulse consumption on nutrient intake in Canadian adults ( ≥ 19 years), we analysed cross-sectional data (n 20,156) from the 2004 Canadian Community Health Survey, Cycle 2·2. Participants were divided into non-consumers and quartiles of pulse intake. Sample weights were applied and logistic regression analysis was used to explore the association of nutrient intakes and pulse consumption, with cultural background, sex, age and economic status included as covariates. On any given day, 13 % of Canadians consume pulses, with the highest consumption in the Asian population. The pulse intake of consumers in the highest quartile was 294 (se 40) g/d and, compared with non-consumers, these individuals had higher intakes of carbohydrate, fibre and protein. As well, the micronutrient intake of pulse consumers was enhanced, resulting in fewer individuals who were below the estimated average requirement for thiamin, vitamin B6, folate, Fe, Mg, P and Zn, compared with non-consumers. Although pulses are generally low in Na, its intake also was higher in pulse consumers. Among the higher quartiles of pulse consumers, fruit and vegetable intake was one serving higher. These data indicate that pulse consumption supports dietary advice that pulses be included in healthful diets. Further studies elucidating the sources of increased Na in pulse consumers will be necessary so that dietary advice to increase consumption of pulses will maximise their nutritional benefits.

Associations between preschool language and first grade reading outcomes in bilingual children.

It is well established that monolingual preschoolers' oral language development (vocabulary and oral comprehension) contributes to their later reading abilities; however, less is known about this relationship in bilingual populations where children are developing knowledge of two languages. It may be that children's abilities in one language do not contribute to their reading abilities in their other language or that children's experiences with either language assist them in developing a common underlying proficiency that they draw upon when learning to read. The purpose of this study was to investigate the relationship among bilingual children's receptive language development and reading outcomes in first grade. Eighty-one bilingual children who were attending Head Start participated in the study. Growth curve models were used to examine the relationship between children's language abilities during two years in Head Start and reading outcomes at the end of first grade. Children's growth in both English and Spanish receptive vocabulary and oral comprehension predicted their English and Spanish reading abilities at the end of first grade within languages. Associations were also observed between languages with growth in English receptive language predicting Spanish reading comprehension and growth in Spanish receptive language predicting English reading comprehension.

Assessing media campaigns linking marijuana non-use with autonomy and aspirations: "Be Under Your Own Influence" and ONDCP's "Above the Influence".

Two media-based interventions designed to reduce adolescent marijuana use ran concurrently from 2005 to 2009. Both interventions used similar message strategies, emphasizing marijuana's inconsistency with personal aspirations and autonomy. "Be Under Your Own Influence" was a randomized community and school trial replicating and extending a successful earlier intervention of the same name (Slater et al. Health Education Research 21:157-167, 2006). "Above the Influence" is a continuing national television, radio, and print campaign sponsored by the Office of National Drug Control Policy (ONDCP). This study assessed the simultaneous impact of the interventions in the 20 U.S. communities. Results indicate that earlier effects of the "Be Under Your Own Influence" intervention replicated only in part and that the most plausible explanation of the weaker effects is high exposure to the similar but more extensive ONDCP "Above the Influence" national campaign. Self-reported exposure to the ONDCP campaign predicted reduced marijuana use, and analyses partially support indirect effects of the two campaigns via aspirations and autonomy.

Predicting bilingual Spanish-English children's phonological awareness abilities from their preschool English and Spanish oral language.

This longitudinal study investigated the relationship between oral language abilities and phonological awareness in 85 typically developing, Spanish-English preschool children (average age in preschool was 3 years, 9 months). Receptive language skills in Spanish and English were assessed in the autumn and spring during the children's 2 years in Head Start for a total of four measurement occasions. Phonological awareness was assessed during the spring of children's kindergarten year. Results indicated that English receptive vocabulary at the end of preschool predicted English phonological awareness abilities in kindergarten, whereas Spanish vocabulary was observed to have a negative predictive relationship with children's English phonological awareness abilities. However, after controlling for English vocabulary, Spanish vocabulary no longer had an effect on English phonological awareness. Broad receptive language abilities in English and Spanish did not predict later English phonological awareness skills.

Dietary screening tool identifies nutritional risk in older adults.

BACKGROUND: No rapid methods exist for screening overall dietary intakes in older adults. OBJECTIVE: The purpose of this study was to develop and evaluate a scoring system for a diet screening tool to identify nutritional risk in community-dwelling older adults. DESIGN: This cross-sectional study in older adults (n = 204) who reside in rural areas examined nutrition status by using an in-person interview, biochemical measures, and four 24-h recalls that included the use of dietary supplements. RESULTS: The dietary screening tool was able to characterize 3 levels of nutritional risk: at risk, possible risk, and not at risk. Individuals classified as at nutritional risk had significantly lower indicators of diet quality (Healthy Eating Index and Mean Adequacy Ratio) and intakes of protein, most micronutrients, dietary fiber, fruit, and vegetables. The at-risk group had higher intakes of fats and oils and refined grains. The at-risk group also had the lowest serum vitamin B-12, folate, beta-cryptoxanthin, lutein, and zeaxanthin concentrations. The not-at-nutritional-risk group had significantly higher lycopene and beta-carotene and lower homocysteine and methylmalonic acid concentrations. CONCLUSION: The dietary screening tool is a simple and practical tool that can help to detect nutritional risk in older adults.

Consumption of dry beans, peas, and lentils could improve diet quality in the US population.

The US Department of Agriculture's MyPyramid guidelines introduced a near doubling of the dietary recommendations for vegetables. These recommendations target specific subgroups of vegetables, including dry beans and peas. Dry beans and peas provide an array of nutrients and phytochemicals that have been shown to have beneficial health effects, yet consumption levels in the United States are quite low. Few studies have examined the influence of legume consumption on nutrient intakes. Therefore, the purpose of this study was to assess nutrient and food group intakes of dry bean and pea consumers compared to nonconsumers. Dietary intake data from the 1999-2002 National Health and Nutrition Examination Survey for adults aged > or =19 years was used. Results show that on any given day only 7.9% of adults are consuming dry beans and peas; Mexican Americans or other Hispanics are more likely to be consumers than nonconsumers. Consuming approximately (1/2) c dry beans or peas resulted in higher intakes of fiber, protein, folate, zinc, iron, and magnesium with lower intakes of saturated fat and total fat. These data support the specific recommendation for dry beans and peas as part of the overall vegetable recommendation. Increased consumption of dry beans and peas-economical and nutrient-rich foods-could improve the diet quality of Americans.

A randomized behavioural trial targeting glycaemic index improves dietary, weight and metabolic outcomes in patients with type 2 diabetes.

OBJECTIVE: Glycaemic index (GI) reflects the postprandial glucose response of carbohydrate-containing foods. A diet with lower GI may improve glycaemic control in people with diabetes. The purpose of the present study was to evaluate the change in outcomes following a behavioural intervention which promoted lower-GI foods among adults with diabetes. DESIGN: A pre-test-post-test control group design was used with participants randomly assigned to an immediate (experimental) or delayed (control) treatment group. The intervention included a 9-week, group-based intervention about carbohydrate and the glycaemic index. Dietary, anthropometric and metabolic measures were obtained pre/post-intervention in both groups and at 18-week follow-up for the immediate group. SETTING: The study was conducted in a rural community in the north-eastern USA. SUBJECTS: Adults having type 2 diabetes mellitus for > or =1 year, aged 40-70 years and not requiring insulin therapy (n 109) were recruited. RESULTS: Following the intervention, mean dietary GI (P < 0.001), percentage of energy from total fat (P < 0.01) and total dietary fibre (P < 0.01) improved in the immediate compared with the delayed group. Mean BMI (P < 0.0001), fasting plasma glucose (P = 0.03), postprandial glucose (P = 0.02), fructosamine (P = 0.02) and insulin sensitivity factor (P = 0.04) also improved in the immediate group compared with the delayed group. Mean waist circumference among males (P < 0.01) and body weight among males and females (P < 0.01) were significantly different between treatment groups. CONCLUSIONS: Educating clients about carbohydrate and the glycaemic index can improve dietary intake and health outcomes among adults with type 2 diabetes.

Parent Reading Belief Inventory: Reliability and Validity With a Sample of Mexican American Mothers.

RESEARCH FINDINGS: The purpose of the current study was to (a) evaluate the internal consistency of the 7 scales of the Parent Reading Belief Inventory (PRBI), (b) assess the factor structure, and (c) examine concurrent validity in a sample of Mexican American mothers from low-income homes. Two hundred and seventy-four mothers of preschool children completed the PRBI and the Home Literacy Activities Questionnaire. Five of the seven scales demonstrated adequate internal consistency. Principal component and parallel analyses revealed that one component provided the best summary of the observed variables. Preliminary evidence of concurrent validity was revealed. PRACTICE OR POLICY: Future qualitative research is needed to explore mothers' interpretations of the items and to examine modifications to the PRBI.

The Effect of Maternal Language on Bilingual Children's Vocabulary and Emergent Literacy Development During Head Start and Kindergarten.

This investigation examined the impact of maternal language and children's gender on bilingual children's vocabulary and emergent literacy development during 2 years in Head Start and kindergarten. Seventy-two mothers and their children who attended English immersion programs participated. Questionnaires administered annually over a 3-year period revealed that mothers increased their usage of English to their children. In addition, more mothers of sons reported using "More or All English" with their children than mothers of daughters. Growth curve modeling indicated that increased usage of English did not impact children's English vocabulary or emergent literacy development. However, increased usage of English slowed the growth of children's Spanish vocabulary. Despite differences in mother-to-child language usage, gender did not impact growth in either language. These findings provide evidence that maternal usage of Spanish does not negatively affect children's developing English vocabulary or emergent literacy abilities. Maternal usage of Spanish appears necessary to maximize children's developing Spanish vocabulary.

The effect of summer vacation on bilingual preschoolers' language development.

The purpose of the investigation was to examine the developmental trajectories of bilingual preschoolers' comprehension of Spanish and English and to determine whether a lengthy summer vacation impacted children's development during the preschool years. Participants included 83 bilingual children who were followed over a 2-year period during which time children attended a federally funded preschool programme for children from low-income homes living in the US. Children were divided into two groups based on whether their scores on receptive language measures increased or decreased during their first year of Head Start. Results revealed that children whose scores increased experienced positive growth in their language comprehension in Spanish and English over the 2-year period, whereas children whose scores decreased during the first year continued to experience a negative developmental trajectory in their second year. Additionally, it was found that a lengthy summer vacation had a differential effect on children's development. Summer vacation had a negative effect on the developmental trajectories of children who experienced gains in their comprehension of English and Spanish and a positive impact on children whose scores declined during the school year. Clinical implications suggest that children may require differential support during the school year and summer vacation depending upon their developmental trajectories during the first year in preschool.