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From Selection to Shelf: A Process Improvement Experience
No full textAfter Hillsboro Public Library (HPL) used design thinking to build a collaborative service model on the public floor, we wanted to extend it behind the scenes. How could we achieve our goal of getting items from door to floor in under 48 hours? How could we improve the workflow with selection, acquisitions, cataloging, and processing to create a 7-day-a-week operation? The library teamed up with the City’s Eureka! Project to use process improvement tools to analyze our systems and workflow. We involved non-library staff on the team to get an outsider’s perspective, and we asked the staff doing the work lots and lots of questions. After three days we identified short, medium, and long-term action items to meet our goals and ultimately provide better service to patrons
Trauma, Crime, and Competency Restoration: The Impact of Trauma in a Forensic Setting
No full textCompetency restoration is an important process for individuals diagnosed with mental illness who have been accused of a crime. The Incompetent to Stand Trial (IST) population continues to rise, increasing the need for services. Currently, focus is placed on regaining competency through pharmaceutical treatment and legal skills training. Competency evaluations require IST patients to learn legal information, and regulate their emotions enough to participate in the evaluation process. Trauma has been found to impact multiple areas of life, including learning, and emotional regulation. Thus far, there has not been any research conducted on how trauma impacts competency restoration. This dissertation is part of an ongoing study at the Oregon State Hospital (OSH), using competency evaluation reports to derive data from. It was hypothesized that having a history of trauma would lead to longer lengths of stay (LOS), and evaluation outcomes of ‘non-restorable.’ While trauma did not correlate to increased LOS at the OSH, other significant correlations were found during exploratory analyses. Specific types of trauma correlated to prior hospitalizations, current felony charge(s), having an Individual Education Plan (IEP) and obtaining a General Education Degree (GED). The IST population presents with multiple challenging factors including homelessness (35.3%), unemployment (89.1%), prior arrests (73.4%), prior hospitalizations (70.5%), severe mental illnesses such as psychotic disorders (61.3%), trauma throughout lifetime (67%) and a history of childhood trauma (53.8%). Results indicate a need for increased trauma treatment in the OSH, more community resources for IST patients, and improved trauma-informed training for arresting officers and healthcare providers
Visual Fatigue and the Corresponding Changes on the Accommodative System after Digital Viewing
No full textPurpose
Visual fatigue symptoms are associated with a reduction in accommodative performance. The study aimed to understand the impact of near viewing on visual fatigue and the accommodative system. A custom-made program was created for the free-space facility test to objectively measure dynamic changes of the accommodative accuracy and stability and obtain response accuracy and reaction time.
Methods
Real-time measurements of accommodation were obtained with an open-field autorefractor from 23 young adults while reading and performing a free-space facility test (targets at 500 and 25 cm) using a computer program which measured subjects\u27 Reaction Time (RT), response accuracy, and accommodative accuracy and stability while maintaining focus at the targets for 8 seconds. In a crossover design, each subject performed a fatigue-inducing task (digital gaming) for 25 minutes in three viewing conditions tested on three different days: near-binocular (NB), far-binocular (FB), near-monocular (NM). Pairwise comparison was conducted to compare visual discomfort rating, RT, response accuracy, accommodative, and pupillary measurements before and after gaming. Mixed-Model ANCOVA was used to compare the effects of the fatigue-inducing task (Conditions), symptomatic vs. asymptomatic group (Group), post-task order (Order), and their interactions on all target measurements with the pre-test measurement as covariate.
Results
After the fatigue-inducing task, subjective discomfort rating on Visual Discomfort Survey (VDS) increased significantly (P = P P= .001), and facility at near (P = .001). The overall score of VDS was significantly different between conditions (P = 0.04) with higher discomfort rating after the NB condition. In the facility test, accommodative instability was higher after FB than after NB and NM with both far facility (P = .03 and .04, respectively) and near facility (P = .004 and .001, respectively) tasks. The symptomatic group showed higher pupillary (P = .002) and accommodative (P = .04) instability than the asymptomatic group at near facility. At near facility, pupil size and accommodation were more unstable under the 2nd post-task order (free-space facility then reading) than under the 1st post-task order (reading then free-space facility).
Discussion
Increased VDS total score after the fatigue-inducing task partially supported our hypothesis that sustained near viewing of digital devices would cause visual discomfort though we cannot attribute the effect to the accommodative system alone. Consistent with previous findings, pupil diameter decreased significantly after the fatigue-inducing task in both tests (reading and facility); however, no accommodative changes were observed. It is possible that the effect of the fatigue-inducing task was not strong enough to change all oculomotor functions; still, the pupil constricted increasing the depth of focus, but without a measurable change in accommodative power. The finding that higher subjective discomfort was reported after NB than after NM suggests that the involvement of both near-focusing (accommodation) and binocular coordination (convergence) is more stressful than the accommodative system alone. Similarly, it’s more challenging for an anomalous oculomotor system to cope with visual stress, which may explain the finding of the higher pupillary and accommodative instability with the symptomatic group compared to the asymptomatic group, especially when the test occurred immediately after the fatigue-inducing task.
Conclusions
Even with brief near digital viewing, visual discomfort significantly increased as measured by VDS in all subjects. This impact was more evident in symotomatic subjects. The pupillary response seemed to readily respond when following the fatigue-inducing task. The effect of the visual stress was stronger among symptomatic subjects and was manifest clearly when measured immediately after the fatigue-inducing task. Interruption from other tasks may mitigate the effect of near-viewing stress to the oculomotor system and make it harder to diagnose. No accommodative changes were observed except the increment of accommodative instability among symptomatic subjects during the dynamic facility test. The free-space facility program, created for this study, allows accurate assessment of the subject’s response accuracy, RT, and accommodative dynamics (speed, accuracy, and stability of response) when shifting focusing distances in a naturalistic environment. Future studies should consider an increase in the fatigue-inducing level and duration which may elicit more changes in the accommodative system to aid in understanding accommodative behavior under visual stress. With a simple modification of the testing protocol (such as the fixation time), the program will allow for assessment of different components in the oculomotor models.
Keywords
Visual fatigue, Accommodation, Free-space accommodative facility, Accommodation stabilit
Intrinsically photosensitive retinal ganglion cells and its role on Human Alertness
No full textINTRINSICALLY PHOTOSENSITIVE RETINAL GANGLION CELLS AND ITS ROLE HUMAN ALERTNESS
LALITHA SAHI NANDINI WUPPUKONDUR
MASTER OF SCIENCE IN VISION SCIENCE
PACIFIC UNIVERSITY, 2019
ABSTRACT
PURPOSE: To investigate if exposure to cool (blue) light with a peak wavelength at 450nm can affect alertness, performance and EEG brain waves.
METHODS: Twenty healthy individuals were studied in a balanced cross-over design with exposure to two different light settings of equal illumination (1000 lux): cool blue light (7000K, peaked at 450nm) vs. warm orange light (1800K, peaked at 612 nm). Morning or afternoon sessions had 30-minute dark adaptation and 30-minute light exposure. Alertness was quantified by accuracy and reaction time in a two-back memory task, and performance was quantified by accuracy in a memory recall task (word pair task). Amplitudes of EEG brain waves (delta, theta, alpha, beta, and gamma) were measured during the one hour using a MUSE headband with two temporal (TP9, TP10) and two frontal electrodes (AF7, AF8). Paired t-tests compared the differences between the dark adaptation and experimental light. Mixed model Analysis of covariances was used to compare color temperatures. Factor analysis was used to reduce the dimensionality of the 16 different brain waves and locations.
RESULTS: Exposure to cool light showed a faster reaction time on the two-back memory task (Mean Blue light =1226.3, Mean Orange Light =1317.9,Effect size= 0.5 ) and a Word-Pair task had higher performance (Mean Blue light =81.8 %, Mean Orange Light =78.4 %, Effect size= 0.9) when compared to warm light at p\u3c0.05. Accuracy on the two-back memory task did not differ significantly between light conditions. Increase in amplitudes from dark adaptation to light was seen in TP gamma and beta factor (Mean Blue light =0.28, Mean No light= -0.40, Effect size=0.74)in cool light (p=0.002) but not in warm light (p=0.5). Theta, delta and alpha factor showed increase in amplitudes in both AF and TP with warm light exposure (Mean Orange light=0.01, Mean No Light= -0.45, Effect size=0.56, p\u3c0.05) but not in cool light. EEG during learning word pairs, factor AF 8 theta, delta, and alpha showed an increase in amplitudes in both cool light and warm light conditions (p\u3c0.05). During the two-back task, increase in amplitudes of AF8 beta and gamma was seen under warm light.
CONCLUSION: Our findings from the performance in the two-back memory task, the word pair task as well as the EEG data recorded during the tasks suggest that exposure to cool light may enhance the alertness and performance relative to warm light. Results were consistent with the hypothesis that these effects may be mediated by Intrinsically photosensitive Retinal Ganglion Cells which are sensitive to 450 - 480 nm light.
KEYWORDS: Non-image functions of light, IpRGC, EEG Brain waves, Alertness
Decreasing the incidence of dementia through treatment of herpes virus with antiviral therapy
Full text linkBackground: Dementia is the fifth leading cause of death worldwide with significant effects on healthcare costs and caregiver demands. Therapy up to this point has only shown marginal benefit in delaying the disease. Focus on preventative treatment now is of upmost importance. The link between herpes virus infection and the development of dementia has been well researched, and is an area of focus that may result in preventative therapy. The aim of this study is to assess the efficacy of herpes antiviral treatment in the prevention of dementia.
Methods: An exhaustive search of medical literature, including the databases Medline: Pubmed, ClinicalKey, Web of Science and CINAHL, was completed using the following search terms: alzheimer OR alzheimer\u27s OR dementia AND herpes AND risk AND antiviral OR anti- herpetic. Studies were assessed for quality using GRADE criteria.
Results: A total of 14 articles were screened, 2 of which met inclusion criteria. Both were population-based retrospective cohort studies based in Taiwan. Both studies found a significant association between antiviral therapy for HSV and HZV infections and decreased risk of dementia. Due to the limitations of the current studies further research is required which address a broader population and utilize more sensitive study protocols such as a randomized controlled trial.
Conclusion: Antiviral therapy is associated with a significant decrease in the development of dementia. Further research is warranted to assess the link between these findings
The Relationship Between Attention, Dyslexia, and Convergence Insufficiency
Full text linkDyslexia and attention deficit hyperactivity disorder are two distinct conditions belonging to the same class of frequently and comorbidly diagnosed childhood and adolescent developmental disorders. Further complicating treatment and diagnoses is convergence insufficiency, a visual disorder, with symptoms that can appear similar to dyslexia’s diagnostic criteria. ADHD and dyslexia have a worldwide prevalence of 5-12% each among the school-age population and 4-10% of young adults. As many as 1 million U.S. ADHD diagnoses are situational with undocumented, pre-existing conditions (e.g., convergence insufficiency, dyslexia). Convergence insufficiency, characterized by an inability to converge the eyes smoothly as a focal object moves from distance to near, affects 2-8% of the worldwide population. Given the number of people worldwide who may be diagnosed, misdiagnosed, or undiagnosed by these three disorders, it is of value to explore the intersectionality of these conditions among college-aged students. This project investigated the relationship between self-reported scores on a standard ADHD measure, as well as ADHD diagnoses, dyslexia, and convergence insufficiency using optometric and neuropsychological assessments. We found ADHD diagnosis and its self-reported symptoms were significantly correlated with total scores on the Adult Reading History Questionnaire, dyslexia diagnoses, and the Convergence Insufficiency Symptom Survey. All three self-report assessments and near visual acuity significantly correlated; indicating that as visual acuity improves, total assessment scores decrease. These combined results highlight a distinct and important relationship between vision, attention, and reading and support a more holistic assessment in the identification, diagnosis, intervention, and treatment of cognitive problems pertaining to reading and learning
Review of Elizabeth Anderson’s “Private Government: How Employers Rule Our Lives (and Why We Don’t Talk about It)”
Full text linkEducators\u27 Use of Data-Informed Decision Making
Full text linkData-driven decision making includes a set of skills that is necessary for educators to make decisions concerning the allocation of teacher time and financial resources. Without these skills teachers do not have the tools necessary to allocate resources in a way that enhances equity and increases student achievement