Biomedical subjects

Stuart I Brown

Publications and source records attributed to Stuart I Brown.

3 recordsLinked to original sources

PubMed2005

Self-management of age-related macular degeneration at the 6-month follow-up: a randomized controlled trial.

OBJECTIVE: To assess the effectiveness at the 6-month follow-up of an age-related macular degeneration (AMD) self-management program consisting of health education and enhancement of problem-solving skills in improving quality of life as shown by measures of mood and function. METHODS: Six-month follow-up data were analyzed from 214 of 252 older adult volunteers (mean age, 80.8 years) with advanced AMD who had been randomly assigned to a 12-hour self-management program (n = 82), a series of 12 hours of tape-recorded health lectures (n = 66), or a waiting list (n = 66). The primary outcome measure was emotional distress (Profile of Mood States). Secondary outcome measures included function (National Eye Institute Visual Function Questionnaire), self-confidence to handle AMD-specific challenges in daily life (AMD Self-efficacy Questionnaire), and depression status on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. RESULTS: At the 6-month follow-up, participants in the self-management program reported significantly less emotional distress (P=.008), better function (P=.05), and increased self-efficacy (P=.006) compared with control subjects. The latter effects were more pronounced in the depressed than in the nondepressed subjects. Finally, the incidence of clinical depression at the 6-month follow-up was significantly lower in the self-management group (P=.05) than in the control group. CONCLUSION: The sustained positive effects at the 6-month follow-up provide support for the effectiveness of the AMD self-management program in reducing distress and disability, improving self-efficacy, and preventing depression in poorly sighted elderly patients with AMD.

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PubMed2004

Optimum shadow-casting illumination for endoscopic task performance.

HYPOTHESES: Task performance improves with the use of a balanced degree of shadow and illumination compared with no or maximum shadow contrast; and overhead shadow-casting illumination is better than side illumination. DESIGN: The standard task entailed touching target points on an undulating surface by using a surgical hook. Each run consisted of 13 target points in a random sequence. Five settings were investigated: no shadow; 22%, 42%, and 65% shadow contrast created by overhead illumination; and 22% shadow contrast produced by side illumination. Each surgeon completed 3 runs with each setting in a random order. SETTING: Research laboratory at the Surgical Skills Unit, Ninewells Hospital, Dundee, Scotland. PARTICIPANTS: Ten surgical trainees. MAIN OUTCOME MEASURES: Number of errors and execution time. RESULTS: Shadow contrast settings had fewer errors than shadowless imaging (P<.001). Work with overhead 22% shadow contrast had a lower error rate than side illumination (P<.001). With overhead illumination, 22% and 42% shadow contrast were accompanied by a lower error rate than maximum shadow contrast of 65% (P<.001 and P =.005, respectively). No significant difference was found in the execution time. CONCLUSION: Optimum endoscopic task performance is obtained with overhead shadow-casting illumination and a balanced degree of illumination and shadow contrast.

Analysis of Variance↗

PubMed2002

Self-management of age-related macular degeneration and quality of life: a randomized controlled trial.

OBJECTIVE: To assess the effectiveness of an age-related macular degeneration (AMD) self-management program, consisting of health education and enhancement of problem-solving skills, to improve quality of life as shown by measures of mood and function. METHODS: Two hundred thirty-one community-dwelling cognitively intact volunteers (mean age, 80.6 years) with advanced macular degeneration were randomly assigned to a 12-hour self-management program (n = 86), a series of 12 hours of tape-recorded health lectures (n = 74), or to a waiting list (n = 72). MAIN OUTCOME MEASURES: The primary outcome measure was emotional distress (Profile of Mood States). Secondary outcome measures included function (National Eye Institute Visual Function Questionnaire), social support (Duke Social Support Index), outlook on life (Life Optimism Test-Revised), and self-confidence to handle AMD-specific challenges in daily life (AMD Self-Efficacy Questionnaire). Clinical depression was determined in accord with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Axis I, Fourth Edition, Research Version. RESULTS: The self-management group showed significant improvement in measures of mood and function compared with controls. These changes were significantly greater for the depressed than for the nondepressed subjects. Decreased emotional distress was associated with increased self-efficacy, while improvements in function were associated with increases in self-efficacy and perceived social support. CONCLUSIONS: These findings suggest that the AMD self-management program was an effective intervention to enhance well-being in older persons with poor eyesight due to AMD, particularly in those who were initially depressed.

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