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Biomedical subjects

R N Bailey

Publications and source records attributed to R N Bailey.

14 recordsLinked to original sources
PubMed1998

Assessing the predictive ability of the test-positive findings of an elementary school vision screening.

PURPOSE: The purpose of this study is to assess the predictive ability of the test-positive findings of an elementary school vision screening program, conducted by 2nd-year optometry students, in identifying children with eye or vision disorders. METHODS: A modified version of the Modified Clinical Technique (MCT) vision screening was administered to elementary children from a below-average socioeconomic neighborhood in Houston, Texas. Comprehensive eye and vision examinations were provided to the available children who failed the vision screening. The screening was administered by groups of 2nd-year optometry students with the assistance of a 4th-year optometry student, and supervised by a faculty member licensed to practice optometry. The follow-up examinations were provided by supervised 4th-year optometry students in a clinical setting based at the elementary school. Positive predictive values calculated from the screening and examination findings estimate the probability that a failure on one or more of the screening tests would identify children with eye or vision disorders. RESULTS: Sixty-nine percent of the test-positive children examined were found to be true positives by the criteria developed in a study of vision screening methods in Orinda, California from 1954 through 1956. CONCLUSIONS: The predictive ability of this study's test-positive findings for identifying eye and vision disorders was found to be less than the predictive ability of the Orinda Study findings. This reduced predictive ability of the present study resulted in a larger number of children being overreferred for examinations than had occurred in the Orinda Study. The reduction in the ability of the test-positive findings of the current study's screening program to identify accurately children with eye and vision problems is most likely due to the limited experience of the optometry students conducting the screening program. The inability of this retrospective study to evaluate the accuracy of the test-negatives is a major limitation in assessing the total effectiveness of this vision screening program. Although the present study may indicate some value in optometry students conducting elementary vision screening programs, a prospective study which could assess the predictive ability of both test-positive and test-negative findings, as well as determine the sensitivity and specificity of the screening program, is needed to assess more fully the effectiveness of school vision screening programs using professional students.

Adolescent↗
PubMed1997

Professional behavior and the optometric profession.

BACKGROUND: Optometry has been recognized as a profession within the United States, both legally and socially, for the better part of the past century. Historically, there have been expectations placed on the behavior of individuals within the professions that would not generally be placed on the general business person. These expectations have existed to protect the clients or patients of professionals from incompetence, uncaring, or selfish excesses. Behavior of an exceptional nature is expected of professionals because of the unusual vulnerability of clients and patients to unprofessional conduct. Doctors of Optometry, as members of the optometric profession, have professional standards placed on their behavior. METHODS: A search of the literature was conducted to discover the historical and current bases for setting standards for professional behavior. RESULTS: The literature search reinforces the rationale for the optometric professions long-standing practice of setting standards for professional conduct. CONCLUSIONS: Individual Doctors of Optometry will find that the trust resulting from high standards of professional conduct bring many positive benefits to the doctor-patient relationship. The rewards that come to both the doctor and patient from these trusting relationships make the practice of optometry truly an exceptional experience.

Behavior↗
PubMed1995

Community-oriented primary care programs.

BACKGROUND: Systems are being proposed by health planners in an effort to improve access to health care for the uninsured and underinsured, including the vulnerable and indigent populations. The lack of affordable and adequate health care for significant numbers of our citizens raises the potential for a serious economic crisis for our nation. Modern medicine has been more interested in developing high tech care for the well insured than in preventive and early intervention health care. While the development of this high technology is of great value and will be beneficial to many, it is out of financial reach for increasing numbers of individuals. As a nation we must reduce the demand for high priced medical care by providing a system that keeps people healthy or intervenes in their illness at a stage when less dramatic medical measures are able to restore them to health. To maintain a population that is healthy and productive in the school setting and in the work place, systems must be developed that reach out into the community with prevention-oriented health education programs and health care services at the primary care level. METHODS: A limited literature review was made in order to present to the optometric community the concept of Community Oriented Primary Care (COPC) as a cost-effective method of improving access to primary care services. RESULTS: The literature review demonstrated that Community Oriented Primary Care (COPC) as a health-oriented strategy brings the benefits of primary care closer to those in need. The history of the development of community oriented primary care services as a health delivery methodology, as well as the current utilization of the COPC concept, is presented in this paper. CONCLUSIONS: Optometry, as a provider of primary eye and vision care services should be included in these cost effective programs.

Community Health Services↗
PubMed1994

The doctor-patient relationship: communication, informed consent and the optometric patient.

BACKGROUND: The communication between doctor and patient contributes to the benefit that the patient derives from the treatment provided. METHODS: Two-way conversation gives the doctor knowledge about the patient that is essential to diagnosis and treatment, and provides information needed by the patient to participate in eye care decisions. Moreover, the doctor and patient develop a relationship of mutual trust and respect through this communication that is central to good health care. CONCLUSIONS: We often hear of the legal reasons for seeking the patient's consent to our proposed treatment, but the ethical reasons are equally compelling.

Communication↗
PubMed1994

The history of ethics in the American Optometric Association 1898-1994.

BACKGROUND: The history surrounding the development of codes of ethics and other official statements of desired professional conduct adopted by the American Optometric Association reveals the interesting struggle optometry faced in establishing itself as a leading primary health care profession. METHODS: Information regarding the events and documents reported in this paper were obtained through research of the historical literature and achieves at the International Library, Archives and Museum of Optometry located at the American Optometry Association's offices at 243 N. Lindbergh Boulevard, St. Louis, MO. RESULTS: Forces outside as well as within the profession were found to have influenced the drafting and redrafting of the official ethical and professional conduct statements that were meant to guide the professional behavior of the membership of the AOA. CONCLUSIONS: Ethical codes and other statements of desired conduct have been essential to the establishment of the profession of optometry. As optometry has grown and matured as a provider of primary eye and vision care services, so have its ethical emphases.

Codes of Ethics↗
PubMed1993

The surgical removal of a subfoveal choroidal neovascular membrane: an alternative treatment to laser photocoagulation.

Whenever hypoxia occurs as the result of a pathologic condition in or near the highly metabolic retinal tissue, there often is an attempt by the vascular tissue in the area to offset this loss through the development of a neovascular membrane. If the affected tissue is the choroid/retinal pigment epithelium/Bruch's membrane complex, or outer 1/3 of the sensory retina, the source of these new vessels is the choriocapillaris. The vessels in the neovascular membrane are fragile, leak serum profusely and tend to hemorrhage. The natural history of these choroidal neovascular membranes (CNVMs), when they are located in the center of the macula, is the formation of a disciform scar resulting in the severe loss of central vision (20/200 or worse). Laser photocoagulation has been successful in treating neovascular membranes and limiting visual loss when they have been either extrafoveal, i.e., no closer than 200 mu o to the center of the foveal avascular zone (FAZ), or juxtafoveal, i.e., no closer than 1 mu o to the center of the FAZ. Until recently, laser treatment of subfoveal CNVMs was not considered an acceptable option due to its destructive effects on foveal vision. The surgical removal of subfoveal neovascular membranes has been recently described as an attempt to spare more vision.

Aged↗
PubMed1990

Diagnosis and management of conjunctival papillomas.

Lumps and bumps have been seen on the ocular surface or adnexa of many of our patients. Most of these are readily identified; however, we may occasionally see an unusual "growth" and wonder about its pathological significance. The topic of epithelial neoplastic growths with special emphasis on the subclass of papillomas is reviewed. The question of histopathological significance is raised in a case of epibulbar conjunctival growths. The differential diagnosis, which leads to the definitive diagnosis of viral conjunctival papillomas, is discussed. The management of viral conjunctival papillomas is reviewed.

Adult↗