Gergana Kodjebacheva

Binocular Visual-Field Loss Increases the Risk of Future Falls in Older White Women

OBJECTIVES: To examine the relationship between binocular visual field loss and the risk of incident frequent falls in older white women.

Glaucoma Risk and the Consumption of Fruits and Vegetables Among Older Women in the Study of Osteoporotic Fractures

PURPOSE To explore the association between the consumption of fruits and vegetables and the presence of glaucoma. DESIGN Cross-sectional cohort study. METHODS In a sample of 1,155 women located in multiple centers in the United States, glaucoma specialists diagnosed glaucoma in at least one eye by assessing optic nerve head photographs and 76-point suprathreshold screening visual fields. Consumption of fruits and vegetables was assessed using the Block Food Frequency Questionnaire. The relationship between selected fruit and vegetable consumption and glaucoma was investigated using adjusted logistic regression models. RESULTS Among 1,155 women, 95 (8.2%) were diagnosed with glaucoma. In adjusted analysis, the odds of glaucoma risk were decreased by 69% (odds ratio [OR], 0.31; 95% confidence interval [CI], 0.11 to 0.91) in women who consumed at least one serving per month of green collards and kale compared with those who consumed fewer than one serving per month, by 64% (OR, 0.36; 95% CI, 0.17 to 0.77) in women who consumed more than two servings per week of carrots compared with those who consumed fewer than one serving per week, and by 47% (OR, 0.53; 95% CI, 0.29 to 0.97) in women who consumed at least one serving per week of canned or dried peaches compared with those who consumed fewer than one serving per month. CONCLUSIONS A higher intake of certain fruits and vegetables may be associated with a decreased risk of glaucoma. More studies are needed to investigate this relationship.

Risk Factors for Glaucoma Needing More Attention

Glaucoma is defined as a chronic progressive optic neuropathy, for which elevated intraocular pressure (IOP) is the only modifiable risk factor. Emerging research indicates that modifiable factors besides IOP may be associated with the presence of glaucoma. In this review, we discuss the role of modifiable determinants, specifically socioeconomic status, nutritional intake, body mass index and obesity, exercise, smoking, and sleep apnea, in the presence of glaucoma. Preliminary studies suggest that associations may exist between these non-inherent factors and glaucoma although research had significant limitations. The mechanisms of influence are unknown or understudied. Research needs to incorporate the broader behavioral and social factors that may affect glaucoma status.

Uncorrected refractive error among first-grade students of different racial/ethnic groups in southern California: results a year after school-mandated vision screening.

CONTEXT The California Department of Education requires that kindergartners receive vision screening in preparation for school. Information is not available in the literature, however, on the prevalence of and factors associated with uncorrected refractive error (ie, the lack of eyeglasses), which is the primary cause of decreased visual acuity in children, among first-grade students of different racial/ethnic groups in California. OBJECTIVE To determine the proportion of first-grade students with decreased visual acuity who need eyeglasses but do not have any and whether the lack of eyeglasses is associated with racial/ethnic and other factors. SETTING Three school districts in Southern California. PARTICIPANTS The University of California, Los Angeles Mobile Eye Clinic examined the eyes of 11 332 first-grade students over a 7-year period. Statistical analyses included adjusted logistic regression and linear trend models. FINDINGS Among 11 332 first-grade students, 6973 (61.5%) were Latino, 1511 (13.3%) were Asian/Pacific Islander, 1422 (12.5%) were African American, 310 (2.7%) were non-Hispanic white, and 1116 (9.8%) were from other or mixed races/ethnicities. The prevalence of decreased visual acuity was 8.0%; 95% of children with decreased visual acuity (858 of 906 children) lacked eyeglasses that would have helped them attain normal vision. The lack of eyeglasses was more common in boys and African American/Latino children compared with that in girls and non-Hispanic white children, respectively. The percentage of children lacking eyeglasses over the years exhibited an increasing linear trend (R = 0.86). CONCLUSIONS Most first-grade students with decreased visual acuity, especially African American and Latino children, need eyeglasses but do not have any. Interventions to correct decreased visual acuity in first-grade students are important because the first grade is a period of critical academic development.

Racial/ethnic and gender differences in the association between depressive symptoms and higher body mass index

AIM The study investigated the socio-demographic differences in the association between depressive symptoms and higher body mass index (BMI). SUBJECTS AND METHODS In Genesee County, Michigan, random samples of households were drawn from all residential census tracts. The Speak to Your Health! Survey was administered among adults aged 18 years and older in these households. To conduct this cross-sectional study, data from three waves of survey data collection (2007, 2009 and 2011) were combined resulting in a sample of 3381 adults. Self-reported height and weight were used to calculate BMI. Depressive symptoms were assessed with Brief Symptoms Inventory items. Socio-demographic factors included age, race/ethnicity, gender and education. RESULTS Using stepwise linear regression, gender (β = 0.04, P = 0.02) and the interaction terms of race/ethnicity × depressive symptoms (β = 0.15, P < 0.001) and gender × depressive symptoms (β = 0.05, P = 0.01) uniquely predicted BMI. CONCLUSION Women had a higher BMI than men, and depressive symptoms were more strongly associated with BMI among African Americans and women than among non-Latino Whites and men. Tailored interventions to alleviate depressive symptoms in African Americans and females may help decrease racial/ethnic and gender differences in depressive symptoms and obesity.

Use of eyeglasses among children in elementary school: perceptions, behaviors, and interventions discussed by parents, school nurses, and teachers during focus groups.

Purpose. To investigate the perceptions, behaviors, and recommendations that parents, school nurses, and teachers have regarding childrens use of eyeglasses. Approach. Focus groups with parents, school nurses, and teachers were conducted. Setting. The study took place in one Southern California school district. Participants. There were 39 participants, including 24 parents, seven school nurses, and eight teachers. Method. An experienced moderator guided the focus group discussions. Transcripts were analyzed using grounded theory techniques. Results. Participants perceive visual impairment as a serious problem in the development of children. The lack of eyeglasses may lead to problems such as tiredness, headaches, inability to focus on school work, and decreased reading speed. Participants experienced disappointment, unhappiness, worry, and concern when they realized they needed eyeglasses at a young age. Negative societal perceptions toward eyeglasses, lack of eye doctors in minority communities, parental perceptions that children do not need eyeglasses, and peer bullying of children wearing eyeglasses are key obstacles to childrens use of eyeglasses. Participants suggest school and national campaigns featuring respected public figures who wear eyeglasses to promote positive attitudes toward eyeglasses. Conclusion. Parents and teachers who closely follow the academic development of children have observed that visual impairment has negative consequences for the scholastic achievement of children. They recommend interventions to promote the attractiveness of eyeglasses in society. The participants discuss the need for a national preventative message for eye care similar to the message for dental care. The public health message should emphasize the importance of embracing and respecting differences among individuals.

Reliability and validity of abbreviated surveys derived from the National Eye Institute Visual Function Questionnaire: The Study of Osteoporotic Fractures

PURPOSE To test the reliability and validity of questionnaires shortened from the National Eye Institute 25-item Vision Function Questionnaire (NEI VFQ-25). DESIGN Cross-sectional, multicenter cohort study. METHODS Reliability was assessed by Cronbach alpha coefficients. Validity was evaluated by studying the association of vision-targeted quality-of-life composite scores with objective visual function measurements. A total of 5482 women between the ages of 65 and 100 years participated in the year-10 clinic visit in the Study of Osteoporotic Fractures (SOF). A total of 3631 women with complete data were included in the visual acuity (VA) and visual field (VF) analyses of the 9-item NEI VFQ (NEI VFQ-9), which is defined for those who care to drive, and a total of 5311 women with complete data were included in the VA and VF in the analyses of the 8-item NEI VFQ (NEI VFQ-8). To assess differences in prevalent eye diseases, which were ascertained for a random sample of SOF participants, 853 and 1237 women were included in the NEI VFQ-9 and the NEI VFQ-8 analyses, respectively. RESULTS The Cronbach alpha coefficient for the NEI VFQ-9 scale was 0.83, and that of the NEI VFQ-8 was 0.84. Using both questionnaires, women with VA worse than 20/40 had lower composite scores compared with those with VA of 20/40 or better (P < .001). Participants with mild, moderate, and severe binocular VF loss had lower composite scores compared with those with no binocular VF loss (P < .001). Compared with women without chronic eye diseases in both eyes, women with at least 1 chronic eye disease in at least 1 eye had lower composite scores. CONCLUSIONS Both questionnaires showed high reliability across items and validity with respect to clinical markers of eye disease. Future research should compare the properties of these shortened surveys with those of the NEI VFQ-25.

Influence of premature birth on the health conditions, receipt of special education and sport participation of children aged 6–17 years in the USA

BACKGROUND To investigate the influence of premature birth on conditions among children aged 6-17 years. METHODS The National Survey of Childrens Health in the USA added a question on premature birth for the first time in the 2011-12 wave. The influence of being born premature on different conditions while controlling for sociodemographic factors was assessed using logistic regression. A total of 6882 out of 62 078 (11.1%) of children aged 6-17 years were born premature. RESULTS Compared with children who were not born premature, those who were born premature were more likely to have cerebral palsy [odds ratio (OR) = 9.6, confidence interval (CI): 7.4-12.4], vision problems (OR = 2.3, CI: 2.0-2.6), hearing problems (OR = 1.7, CI: 1.6-2.0) and a special healthcare need (OR = 1.7, CI: 1.6-1.8). Children who were born premature had an increased likelihood of not being on a sports team or not taking sports lessons after school or on weekends during the past 12 months than those who were not born premature (OR = 1.2, CI: 1.1-1.3). CONCLUSIONS Prematurity may be associated with negative outcomes as infants transition into childhood and adolescence. Interventions within the life-course perspective are needed to alleviate the long-term consequences of prematurity.

Decreasing Uncorrected Refractive Error in the Classroom Through a Multifactorial Pilot Intervention

The study assessed the effectiveness of a pilot intervention to promote the use of eyeglasses in one school in California. The intervention used a one-group pretest, posttest design. Between January and June 2011, during the intervention, all first- and second-grade children received eye evaluations and the children with refractive error received two pairs of attractive eyeglasses. Parents received eye care education. Teachers monitored the use of eyeglasses in the classroom. Prior to the intervention in January 2011, 1 of the 15 children with refractive error (6.7%) wore eyeglasses in the classroom and the remaining 14 (93.3%) lacked eyeglasses altogether; 6 months following the end of the intervention in December 2011, 11 of the 15 children (73.3%) wore eyeglasses in the classroom and the remaining 4 (26.7%) did not (p = .002). The multifactorial intervention increased the use of eyeglasses in the classroom even months after the end of the summer vacation.

Poor tap water quality experiences and poor sleep quality during the Flint, Michigan Municipal Water Crisis

Objectives: After inadequate official response to community concerns over water quality following changes in Flints municipal water supply, this study sought evidence for a relationship between water quality and community mental health. Design: The Speak to Your Health Community Survey is a community‐based participatory component of the health surveillance system in Genesee County, Michigan. This cross‐sectional survey recruits participants from every residential Census Tract of the county and strives for demographic representativeness. Results: Respondents (n = 834) rated their tap water quality (taste, smell, appearance) as poor (36%), fair (18%), good (20%), very good (17%), and excellent (10%). They rated their sleep quality as poor (12%), fair (28%), good (39%), very good (18%), and excellent (4%), and had an average (SD) sleep length of 408 (90) minutes. Controlling for age, sex, years of education, and whether respondents were African American and Hispanic/Latino/a, lower perceived tap water quality was associated with lower sleep quality and shorter sleep length. Conclusion: Results indicate that adverse health conditions related to the water crisis extend beyond lead poisoning in children and include deterioration of sleep conditions among adult residents.