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Fixationsdisparitet : En jämförelse av tre olika testerFinnström, Caroline January 2017 (has links)
Syfte: Syftet med studien var att jämföra tre olika metoder (Mallettenheten, Saladinkortet och Wessonkortet) för att mäta fixationsdisparitet, se ifall metoderna hade en bra repeterbarhet samt jämföra resultaten från fixationsdisparitetstesterna med den uppmätta forin.Material och metod: I studien deltog 19 personer mellan 20–31 år, alla hade samsyn. Undersökningen utfördes i en ordning som gjorde att ögonen skulle tröttas ut så lite som möjligt för att inte påverka resultatet. Den började med anamnes, refraktion, forimätningar med modifierad Thorington på avstånd och på nära håll och sedan utfördes mätningar av fixationsdisparitet, varje metod utfördes tre gånger för att få fram ett medelvärde. Undersökningen avslutades med mätning av KNP, ackommodationsamplitud och vergensmätningar.Resultat: 11 av 19 försökspersoner hade någon fixationsdisparitet (FD) enligt Mallett, Saladin eller Wesson. Då Mallett endast mäter den associerade forin och inte FD så användes inte den i jämförelserna. Studien visar en statistiskt signifikant skillnad i uppmätt FD mellan Wesson och Saladin (p = 0,027). En Bland-Altman analys visade att skillnaden mellan mätresultaten blev högre ju högre fixationsdispariteten var. Repeterbarheten var god för Wesson (ICC = 0,95) och Mallett (ICC = 0,87), men något lägre för Saladin (ICC = 0,71). En envägs- RM ANOVA visade inga signifikanta skillnader mellan de tre mätningarna för någon av metoderna. 47 % av försökspersonerna hade en FD som gick åt samma håll som den uppmätta forin. 10 % hade FD som gick åt motsatt håll från forin. Varken Wesson eller Saladin visade någon signifikant korrelation med forin: Wesson (p = 0,11, R = 0,15) och Saladin (p = 0,08, R = 0,17).Slutsats: Studien visar att det fanns en signifikant skillnad mellan Saladintestet och Wessontestet och att de således inte är utbytbara med varandra. Repeterbarheten har varit god för två av tre metoder. Det här studien har visat att om fixationsdispariteten ska mätas kliniskt kan det vara bra för undersökaren att bestämma sig för ett test och bara använda det, det går inte att dra slutsatsen helt då detta bör testas på en större grupp försökspersoner. / The aim of this study was to compare three clinical tests used for measuring fixation disparity. The correlation between fixation disparity and phoria was evaluated and the repeatability for each method.This study included 19 subjects (aged from 20 to 31 years); all had functional binocular vision. The order of the tests in the examination was chosen to prevent fatigue from effecting the results. Following case history, binocular refraction, and phoria measurements at distance and near, the examination proceeded in measurement of fixation disparity with each of the three tests; three measurements were performed for each, and averaged. The examination concluded with measurements of NPC, amplitude of accommodation and vergences.Eleven of 19 subjects had FD to some degree according to Mallett, Saladin or Wesson. Since the Mallett unit only measures the associated phoria, the results could not be used in this study.This study shows a significant difference in measured FD between Wesson and Saladin (p=0.027). A Bland-Altman analysis showed a significant difference between the results; it showed that the higher the fixation disparity the greater the difference between the two measurements (p <0.0001). The repeatability was good for Wesson (ICC = 0.95) and Mallett (ICC = 0.87), however lower for Saladin (ICC = 0.71). A One Way- RM ANOVA showed no significant difference between the three measurements for each method. FD deviated in the same direction as the measured phoria for 47 % of the subjects; 10 % had FD that deviated in the opposite direction from the measured phoria. Wesson and Saladin showed no significant correlation to the phoria: Wesson (Pearsson r = 0.15; p = 0.11), and Saladin (Pearsson r = 0.17; p= 0.08).The study shows that there is a significant difference in the results of fixation disparity between the Saladin card and the Wesson card indicating that these methods can’t be used interchangeably. Repeatability was better for Mallett and Wesson but not so good for Saladin. There was a significant correlation between phoria and fixation disparity in means of the direction of deviation i.e. an exophoria is often followed by an exo fixation disparity.In a clinical setting, it might be advisable to adopt one single method and not compare results with those obtained by other instruments.
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A Systematic Review of Intervention Efforts to Reduce Indoor TanningTurrisi, Rob, Hillhouse, Joel J., Mallett, Kimberly, Stapleton, Jerod L., Robinson, June K. 01 January 2012 (has links)
This chapter reviews the literature examining interventions to reduce indoor tanning (IT). The first objective was to highlight programs that show promise for large scale dissemination. The second objective was to promote criteria and standards for future intervention research efforts. The scope of interest for this review includes universal (for everyone in the population), selective (for those in the population who are at a greater risk), and indicated (for those who already are experiencing conditions that identify them as at risk) programs. The evaluation of the interventions resulted in three levels of evidence: (1) most promising, (2) emerging, and (3) mixed. For an intervention to be considered “most promising”, it was required that ten criteria be met through examination of research findings in published reports consistent with Flay and colleagues (Prev Sci 6(3):151–175, 2005). Interventions that were classified as “emerging” met most of the criteria. Finally, interventions classified as “mixed” did not reach threshold on more than two criteria that were deemed critical. The results revealed that there was very limited research on IT interventions that meet all the evaluation criteria. Only one intervention approach met all of the criteria (Appearance Booklet) (Hillhouse and Turrisi, Behav Med 25(4):395–409, 2002; Hillhouse et al., Cancer 113(11):3257–3266, 2008). Although the number of published papers in the IT area has increased dramatically over the past decade, these efforts have yet to translate into rigorously conducted intervention trials. The review points to important issues that need to be addressed in future research on the prevention of IT. Keywords
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