Search

Purpose To determine the prevalence and morphologic features of reticular pseudodrusen (RPD) and their association with participant demographics and age-related macular degeneration (AMD) status in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2) sample, an ancillary study of the Women’s Health Initiative Observational Study. Design Cross-sectional, multicenter, natural history study. Participants Nine hundred and twenty-seven eyes from 466 postmenopausal women 69 to 101 years of age. Methods Multimodal imaging, including spectral-domain (SD) OCT and infrared reflectance (IR), were used to identify RPD characteristics, including location (within or outside the 6-mm diameter circle centered at the macula), presence of peripapillary RPD, pattern of RPD, and RPD area. Age-related macular degeneration features from SD OCT, IR, and color photographs also were assessed and AMD severity was categorized. Main Outcome Measures Reticular pseudodrusen prevalence using SD OCT and IR imaging and AMD status. Results Reticular pseudodrusen were present in 130 eyes (14% of eyes, 16% of participants), with increasing prevalence with age: 7% in those younger than 78 years, 14% in those 78 to 83 years of age, and 30% in those older than 83 years. Using clinical classification of AMD with color photography, RPD were seen in 2.4% of eyes with no AMD or aging changes, 11.5% in early AMD, 25.1% in intermediate AMD, and 51.1% in late AMD. Mean RPD area was 17.4 mm2 (standard deviation, 14.7 mm2). Ribbon morphologic RPD (53%) was more common than dot morphologic RPD (36%). Reticular pseudodrusen mostly were located both within and outside the 6-mm circle with primarily superior retinal distribution. Reticular pseudodrusen were visualized with corresponding color fundus photography in only 38 eyes (4% of total eyes). Participants with and without RPD had a visual acuity±standard error of 77.9 ± 1.4 letters and 81.3 ± 0.4 letters, respectively (P = 0.02). Conclusions The prevalence of RPD in CAREDS2 increased with age and was associated with AMD severity. Reticular pseudodrusen were detected in eyes without other features of AMD and could represent an earlier disease state. Multimodal imaging with SD OCT and IR has significantly greater sensitivity for visualizing RPD than color fundus photography.

A perioperative nurse leader's ability to effect positive change and inspire others to higher levels of achievement is related to his or her leadership style in the practice setting and the leadership style that is present across the organization. The American Nurses Credentialing Center's Magnet™ designation and redesignation process requires the demonstration of transformational leadership as one of the components of excellence. Transformational leadership can increase nurses' job satisfaction and commitment to the organization and organizational culture. Engaging staff members in the transition to transformational leadership and developing a common mission, vision, and goals are keys to success in the surgical setting. Bass's four interrelated leadership components-idealized influence, inspirational motivation, intellectual stimulation, and individual consideration-and associated behaviors were used by surgical services leaders in an East Coast, two-hospital system to successfully achieve redesignation as a Magnet facility.

A curvilinear relationship between extraversion and performance on an operant task for retarded adults was hypothesized. Following previous research with subjects with disturbed cognitive processes, the curve was hypothesized to be opposite from the usual Yerkes-Dodson relationship. The Eysenck-Withers Personality Inventory Extraversion scale was orally administered to 20 adult retardates. These subjects were then required to push a button on either the left or right side for M&M candies. The side that was reinforced changed five times. The number of errors made after the changes indicated the quality of performance. A significant curvilinear relationship between extraversion and errors was found, with moderately introverted subjects making more errors than either extremely introverted or extraverted subjects.