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The existential entrepreneur: Stop driving! (The gospel of Mister Jensen)
Full text linkThis research note explores a possible bridge between entrepreneurship, existentialism, and music through the life of Jesus-Jensen, a fictional character in Vilhelm Moberg’s novel A Time on Earth (1963) whom we have musically and lyrically interpreted in the song “Stop Driving (The Gospel of Mister Jensen)”
Screening for visual deficits at a rehabilitation unit early in the rehabilitation process after stroke
Full text linkStroke patients are not routinely screened for visual deficits despite recommendations on the importance of vision for safety and design of rehabilitation plans. The aim was to examine if it was feasible to expose rehabilitation patients to vision screening. Secondly, we aimed to examine the agreement between the vision screening and items from a neurological stroke screening tool specifically targeting vision and neglect. Over a period of 6 months, patients arriving at a rehabilitation unit after having had a stroke were consecutively included. Data on aetiology, severity, and location of the stroke, time since the original admission, scores on the National Institutes of Health Stroke Scale (NIHSS), and results from a short screening/observation battery were registered. Cohen’s kappa was calculated to examine the agreement between results from the screening/observation battery and NIHSS items. Nighty-six percent of the patients were able to undergo screening of basic visual functions. Impairment was found in 52% of the patients, and 67% of these showed impairment in more than one function. Visual impairment occurred for all levels of stroke severity. Reduced distance visual acuity was found in 15% of all patients. Accordance between the screening/observation battery and NIHSS items varied between κ = 0.36 and κ = 0.64. Screening battery vs NIHSS items showed impairment in 31% vs. 21% of patients for oculomotor deficits, 31% vs. 34% for visual field deficits and 31% vs. 29% for neglect. Results show that patients are assessable for basic visual functions early in the rehabilitation process. Items from the NIHSS cannot replace a dedicated vision screening tool because they exclude essential functions such as visual acuity, and oculomotor deficits may go undetected. Only the visual field assessment indicates substantial agreement and high sensitivity. Regarding stroke severity, agreement was substantial only in the severe group. In summary, we conclude that the NIHSS items cannot be recommended to replace systematic screening of visual function and neglect
The Pediatric Cataract Register (PECARE): Challenges in scientific evaluation of visual development
Full text linkThe purpose of this study was to analyse visual acuity tests and methods used in children who have undergone cataract surgery in Sweden as well as the success rate of visual acuity testing, in order to improve current treatment.
Children registered in PECARE who underwent cataract surgery between 1st January 2007 and 31st July 2016 were included. Visual acuity test methods were analysed at the follow-up ages of 1, 2, 5 and 10 years.
A total of 424 children were operated, 209 girls (49%) and 215 boys (51%). The number of operated eyes was 584, of which 320 (55%) were bilateral cataracts and 264 (45%) unilateral. A total of 660 follow-up visits took place, and successful visual acuity measurements were achieved in 416 of these cases: 106/228 (46%) at 1 year of age, 128/226 (57%) at 2 years of age, 169/193 (88%) at 5 years of age, and 13/13 (100%) at 10 years of age.
Visual acuity test methods differed among the follow-up clinics, making comparisons challenging. The Kasper test was widely used before the age of 2, and has been validated, but not been published scientifically. The success rate was higher for Kasper than for other tests.
A challenging diversity of methods for testing visual acuity are used in Swedish paediatric cataract care. Age-related national guidelines regarding visual acuity tests methods are needed for the development and improvement of current treatment. Scientific evaluation of visual development is an important outcome in order to reach equal care. Furthermore, the Kasper test needs to be scientifically re-validated.
Keywords: paediatric cataract, congenital, visual acuity tes
