Accommodation Process Research Articles

Pharmacological Accommodative Changes of the Anterior Segment and Its Impact on the Vault in Implantable Collamer Lens Implantation.

To estimate the accommodative changes of the anterior segment and its impact on the central and peripheral vaults after Visian Implantable Collamer Lens (ICL) (STAAR Surgical) implantation. Eighty eyes of 40 consecutive patients (mean age: 28.05 years; range: 19 to 42 years) were examined 3 months after ICL implantation. Eyes were randomly divided into a mydriasis group and a miosis group. Anterior chamber depth (ACD) to crystalline lens (ACD-L), anterior chamber depth to ICL (ACD-ICL), central distance from endothelium to sulcus to sulcus (ASL), central distance from sulcus to sulcus to crystalline lens (STS-L), central distance from ICL to sulcus to sulcus (STS-ICL), and central (cICL-L), midperipheral (mICL-L), and peripheral (pICL-L) vaults were measured by ultrasound biomicroscopy at baseline and after induction with tropicamide or pilocarpine. After tropicamide treatment, cICL-L, mICL-L, and pICL-L decreased from 0.531 ± 0.200, 0.419 ± 0.173, and 0.362 ± 0.150 mm to 0.488 ± 0.171, 0.373 ± 0.153, and 0.311 ± 0.131 mm, respectively. The values decreased from 0.540 ± 0.185, 0.445 ± 0.172, and 0.388 ± 0.149 mm to 0.464 ± 0.199, 0.378 ± 0.156, and 0.324 ± 0.137 mm after pilocarpine administration, respectively. The ASL and STS showed a significant increase in the mydriasis group (all P ≤ .038), but a decrease in the miosis group (all P < .001). The ACD-L increased and STS-L decreased in the mydriasis group (all P < .001), indicating the backward shift of the crystalline lens, whereas crystalline lens forward shift was observed in the miosis group. Additionally, the STS-ICL decreased in both groups (all P ≤ .021), suggesting the ICL backward shift. Both central and peripheral vaults decreased during the pharmacological accommodation process, and the ciliaris-iris-lens complex contributed to the changes. [J Refract Surg. 2023;39(6):414-420.].

A review of the treatment of drug induced presbyopia

Presbyopia is characterized by accommodative loss that leads to negative effects on vision-targeted health-related quality of life. It occurs in people who gradually lose the ability to adapt after the age of 40. Accommodation depends on the contraction of the ciliary muscle and the iris, the change and the convergence of the lens. The parasympathetic nervous system regulates the degree of contraction of the ciliary muscle and the iris necessary to alter the shape and position of the lens, and its stimulation is effective by activating the muscarinic receptors present in both structures. The hypothesis presented here suggests that patients with emmetropic presbyopia correct accommodation with pharmacotherapy that includes a combination of cholinergic drugs and non-steroidal anti-inflammatory drugs (NSAIDs). Topical treatment deals with drug combinations to modify one or more factors involved in the accommodative process and have been proposed to be instilled either monocular/ binocularly. Result shows para-sympathomimetic stimulation of parasympathetic innervation (accommodation) and NSAID: Prolonging the effect of the para-sympathomimetic action and modulates the accommodation. The drug combination restores near vision without affecting distance vision. It is important to note that the drug form used has no inflammatory effects or other side effects. Despite the lack of a completely well understood mechanism, pharmacological control of presbyopia seems to be a possible and very attractive alternative for presbyopia patients. The studies mentioned in this review are to be considered pilot investigations as they involve either a small number of subjects or are single case series.

Experiences of genetic counseling students with disabilities and chronic illnesses: A qualitative study.

While many patients with disabilities or chronic illnesses are served by genetic counselors, little effort has been made to promote the inclusion of individuals with disabilities and chronic illnesses as professionals in the genetic counseling field. Genetic counselors with disabilities and chronic illnesses have reported insufficient support from their colleagues throughout all stages of their professional journeys, but there is a lack of research exploring these challenges. To gain an understanding of the experiences of this community during graduate training, we conducted semi-structured interviews with 13 recent graduates of genetic counseling programs who identify as having a disability or chronic illness. Questions explored various aspects of the graduate school experience including challenges, strengths, relationships, disclosure, and accommodations. Qualitative thematic analysis of interview transcripts resulted in six themes: (1) decisions around disclosure are complex, (2) interactions with others contribute to feeling misunderstood, (3) the high-performance culture in graduate programs makes it challenging to meet personal needs, (4) interpersonal relationships provide support, (5) the accommodation process is often disappointing, and (6) lived experiences are valuable to patients. This study reveals opportunities to better support genetic counseling students with disabilities and chronic illnesses through strengthening inclusion efforts, shifting away from ableist ideologies, and promoting more flexible training options.

Exploring Elements of Workplace Social Capital that Impact the Accommodation Negotiation Process: A Qualitative Descriptive Study

The concept of social capital may shed light on challenges experienced by employees with mental health conditions (MHC) in sustaining employment. This article presents findings from a qualitative descriptive study exploring the concept of workplace social capital and its impact on how employees with MHC negotiate workplace accommodations. The findings reveal that social capital consists of various elements that impact how accommodations are negotiated in the workplace; some are dynamic and can be built, rebuilt, and spent such as employee self-confidence, reputation, and likeability. Future research is needed to explore how social capital can be developed to facilitate the accommodation process.

Uniaxial plastic strain effect on the corrosion-fatigue resistance of ISO 5832-1 stainless steel biomaterial

Orthopaedic implants are used for fracture stabilization or orthopaedic reconstruction. During implantation and even in the implant accommodation process, there may be plastic strain and induction of residual stresses. This information creates a test procedure involving pre-strain, pre-conditioning in the corrosive environment and corrosion-fatigue tests. Two solutions were used, PBS (phosphate-buffered saline, neutral pH, recommended for corrosion evaluation tests) and SHA (saline solution with hydrogen peroxide and albumin pH 3.0). The results showed that, differently from PBS, SHA promoted localized corrosion, reducing fatigue resistance in all tested conditions. In addition, plastic pre-strain influenced the failure process.

Monocular transcorneal electrical stimulation induces ciliary muscle thickening in contralateral eye

Transcorneal electrical stimulation (TES) is used as therapy for retinal diseases such as retinitis pigmentosa (RP) and was suggested for assessing retinal sensitivity by determining phosphene thresholds, subjective luminance impressions caused by retinal stimulation. Further applications concerned the accommodation process, revealing an improved accommodative amplitude in presbyopic eyes after TES treatment. The respective changes of the ciliary muscle (CM), the structure most important for near vision, during TES are yet unknown. In a pilot study, we aimed to assess whether monocular TES leads to morphological and functional CM changes and whether central accommodation control is affected. Ten healthy, near-emmetropic adults participated in the trial (4 females, age 26.3 ± 3.6 years). Using a wavefront and a stimulus generator, a biphasic square-wave stimulus (2 s positive and 6 s negative amplitude) of 0 μA average current was produced and transferred to the eye by means of a Dawson-Trick & Litzkow electrode. Prior to the stimulation, an individual determination of phosphene thresholds served to define individual TES current amplitudes, which ranged between 60 and 100 μA. Optical coherence tomography (OCT) imaging of the right eye's temporal ciliary muscle was performed before and during ipsi- as well as contralateral monocular TES in randomized order in the morning and afternoon of the same day. During imaging, subjects fixated a target at 4 m distance and refraction was simultaneously recorded via eccentric infrared photorefraction. OCT images were assessed using previously published custom-developed software, allowing the definition of selective CM thickness (CMT) readings, and plotting of continuous CMT profiles along the muscle border. CMT profiles revealed that both stimulations, on the ipsi- and contralateral eye, induced a thickening of the CM compared to the non-stimulated state. The selective CMT readings confirmed a significant increase with ipsi- (31 ± 30 μm; p = 0.010) and contralateral (25 ± 16 μm; p = 0.001) TES. However, refraction during far vision was not significantly affected by either stimulation (ipsilateral [n = 5]: median Δw/-w/o = 0 D; contralateral [n = 7]: Δw/-w/o = 0.13 D). Pupil size on average increased during TES, but without reaching significance (ipsilateral [n = 5] median Δw/-w/o = 0.23 mm, contralateral [n = 7] Δw/-w/o = 0.39 mm). Ipsilateral CM thickening could be explained by local changes within the stimulated ciliary muscle, such as increased blood flow or interstitial fluid rise induced by TES. However, the CMT increase in the right eye when TES was performed contralaterally, on the left eye, indicates an involvement of the central control circuit of accommodation. Further possible explanations for this finding are a synchronization of neuronal activities in the visual pathway, the release of vasoactive neuropeptides, or effects on the central blood pressure regulation. Given a neuromodulation effect on the CM function, TES might have implications for children with accommodation insufficiencies and as additional therapy in myopia control management, e.g. in combination with multifocal contact lens treatment. Our study is important for the clinical application of TES, and the outcome might add crucial knowledge to the current understanding of the accommodation process and inform research and treatment of both myopia and presbyopia.

The lens capsule significantly affects the viscoelastic properties of the lens as quantified by optical coherence elastography.

The crystalline lens is a transparent, biconvex structure that has its curvature and refractive power modulated to focus light onto the retina. This intrinsic morphological adjustment of the lens to fulfill changing visual demands is achieved by the coordinated interaction between the lens and its suspension system, which includes the lens capsule. Thus, characterizing the influence of the lens capsule on the whole lens's biomechanical properties is important for understanding the physiological process of accommodation and early diagnosis and treatment of lenticular diseases. In this study, we assessed the viscoelastic properties of the lens using phase-sensitive optical coherence elastography (PhS-OCE) coupled with acoustic radiation force (ARF) excitation. The elastic wave propagation induced by ARF excitation, which was focused on the surface of the lens, was tracked with phase-sensitive optical coherence tomography. Experiments were conducted on eight freshly excised porcine lenses before and after the capsular bag was dissected away. Results showed that the group velocity of the surface elastic wave, , in the lens with the capsule intact ( ) was significantly higher (p < 0.001) than after the capsule was removed ( ). Similarly, the viscoelastic assessment using a model that utilizes the dispersion of a surface wave showed that both Young's modulus, E, and shear viscosity coefficient, η, of the encapsulated lens ( ) were significantly higher than that of the decapsulated lens ( ). These findings, together with the geometrical change upon removal of the capsule, indicate that the capsule plays a critical role in determining the viscoelastic properties of the crystalline lens.

“Understand where you're coming from”: Positionality and higher education disability resources

AbstractDespite their significant influence on the experiences of disabled college students, disability resource professionals are provided limited guidance on how to carry out the functions of their role. As a result, during the accommodations process, disability resource professionals generally rely on their instincts and “gut” reactions when responding to accommodation requests after quickly processing information from a student's self‐report and relevant medical documentation. However, hidden within these quick decisions are disability resource professionals' positionalities—or frameworks for considering the world—that have an innate influence on the outcome of accommodation decisions and, ultimately, disabled students’ access to higher education. Therefore, the purpose of this study was to explore disability resource professionals’ views on positionality in the context of higher education disability resources and its relationship to accommodation decision‐making. After a review of findings from interviews with 13 disability resource professionals, the authors conclude with recommendations for higher education disability resources and directions for future research.Practical Implications It is important for disability resource professionals to cyclically examine their positionalities (e.g., identities, experiences) before, during, and following the accommodations process and working with disabled college students. When examining their positionalities, disability resource professionals should critically examine their positions in relation to power and privilege, with a focus on their reactions to students’ identities and experiences. Leadership in the field of higher education disability resources should also create time and space for disability resource professionals to engage in meaningful positionality‐focused professional development opportunities.

Struggling with and against the Governance of Islam in Spain

The process of accommodation of Islam in Spain is based on the Constitution of 1978, which guarantees the freedom of religion. Regarding Islam, the Cooperation Agreement signed in 1992 between the State and the Islamic Commission of Spain brought with it a formal recognition of the practice of the Islamic faith. Thirty years later, the sole interlocutor appointed by the State seems to be ineffective in the pursuance of compliance with Islamic religious rights. In various regions other actors have engaged in claims-making for rights that include, among others, the access to cemetery space for Islamic burials and Islamic religious education and halal food in publicly funded schools. This paper explores the governance of Islam and Muslims in Spain by presenting a case in which a number of grassroots organizations in the northern region of La Rioja have combined their efforts to achieve compliance with the religious rights they were granted decades ago. Through claims-making outside the institutionalized structure of interlocution with the State, they are contesting the external and internal top-down governance of Islam in Spain. Based on empirical data, we analyzed the nature of their claims, the varied ways of responding to specific practices of governance, as well as the spaces in which this claims-making takes place.

How ‘should’ the majority group acculturate? Acculturation expectations and their correlates among minority- and majority-group members

Do minority-group members welcome or reject that majority-group members adopt other cultures? Acculturation is commonly defined as a process of mutual accommodation. Yet, the acculturation of majority-group members has only recently received research attention. To date, we do not know the extent to which minority-group members expect majority-group members to adopt the culture of minority groups and/or to maintain their mainstream culture. Knowledge is also lacking about how these expectations relate to minority-group members’ own acculturation orientations and symbolic and realistic threat perceptions. We further do not know whether such associations are similar among minority- and majority-group members. To address these gaps, we surveyed 246 Muslim minority-group members and 247 White Christian majority-group members in the United Kingdom. Muslim minority-group members’ acculturation expectations towards majority-group members were normally distributed around the midpoint of the scale, suggesting that they did not reject majority-group acculturation on average. Acculturation expectations were correlated with symbolic and realistic threat perceptions among majority-group members but not among minority-group members. Cluster analyses showed that integrated Muslim minority-group members found it relatively important for majority-group members to adopt minority-group culture and to maintain their own culture. In sum, the results support the idea that minority-group members, at least in some contexts and settings, view acculturation as a mutual cultural change rather than as cultural appropriation.

Identidades religiosas y consumo

In this article we will historicize the process of accommodation of the Evangelical Churches Assembly of God - ADs to the consumer society. Process that we call the aggiornamento of Pentecostalism. For this purpose, we will analyze the main characteristics of Brazilian Neo-Pentecostalism, based in the concepts of postmodernity, market and consumption, as well as the influence and level of penetration of its practices and beliefs in the practices and beliefs of the ADs. In this context, we will verify how these elements, together with the characteristics of the consumer society, were decisive for the ADs in Brazil to start an aggiornamento process. We will analyze the phases and official instruments (resolutions, declarations, and manifestos) responsible for legitimizing changes in their identity and ethos, in internal relations and with society.

Adjustment, mismatches and accommodation of procedural and conceptual meaning

Abstract This contribution aims to set out the effects of discourse marking on processing. On the basis of examples from Spanish, we try to show the principles governing the interplay between the procedural meaning of discourse markers (connectives) and the conceptual meaning of the discourse segments linked by them. To determine these principles, two types of experiments were performed: one comparing marked and unmarked utterances, and a second one comparing utterances that activate mental representations that pragmatically match or clash with the instruction encoded by the connective. Evidence shows that (a) discourse marking by means of a connective generates a new route for accessing information; (b) procedural meaning is a definitory feature of connectives; (c) the procedural meaning of connectives introduces asymmetry and rigidity into discourse as to conceptual meanings; (d) in mismatches between the assumption activated by the instructions of a connective and mind-stored assumptions, accommodation processes may take place, which are effortful but seek to guarantee the retrieval of cognitive effects from the utterance.

The Compound Area of Quadrilaterals and Triangles: A Worked Example Based Learning Design

Complex yet hierarchical mathematical material in fact does not mean that the process of schema acquisition and accommodation in long-term memory is easy. For an instance, year seven students learn to solve problems related to the compound area of quadrilaterals and triangles. This problem may be categorized as a well-structured problem, therefore, it might be procedurally obvious to reach the solution, for those who have possessed sufficient prior knowledge of the aspects of the shapes. This study aims to discuss instructional strategy for novices when learning to solve problems like these. Based on a cognitive load theory, the strategy of worked example could be applied effectively for novices. The design of the worked example must be presented in such a way it could minimize extraneous cognitive load. The composite shapes of quadrilateral and triangles might be challenging to be described in an integrated format to avoid the split attention effect. This paper shows how this can be done by using techniques, such as (1) number sequences of the solution steps; (2) different colors for prompting attention resource; (3) less wording, more procedure application; and (4) consistency of layout within overall material. In order to apply these, the instructional designers should follow ADD steps, (1) Analyze the learning content, arrange them accordingly; (2) Design one worked example, evaluate its accuracy and niche; and (3) Develop into several worked example pairs. Two worked example with paired problems have been successfully developed and declare valid. Eventually, it might be suggested that comprehensive consideration when designing worked example that contain pictures should reflects how students use their cognitive resource during learning.

“I Was a Stranger and You Welcomed Me”. The Role of Religion and Faith-Based Organizations in Refugee Accommodation

Abstract Support for strangers is deeply anchored in the social ethics of various religious traditions. Based on a qualitative content analysis of interviews with refugees and immigration executives. the article focuses on the role of religion and religious communities in refugee accommodation in Germany between 2011 and 2018. It sheds light on different schemes and measures of support offered by religious communities and explores the significance of religious and cultural differences for processes of accommodation and early integration. The empirical analysis is embedded in conceptual debates on the re-emergence of faith-based service providers in the crisis of the late modern welfare state. The findings suggest that the so called ‘refugee crisis’ has served as an opportunity structure for Christian refugee aid. At the same time, refugee accommodation centres in Germany have responded to an increase of non-Christian refugees (notably: Muslims) by a more restrictive handling of religious freedom.

OCR concerned with university's accommodations process

Case name: Letter re: New England Law – Boston, No. 01‐22‐2036 (OCR 05/18/22).

Grain Size Dependence of Secondary Creep Rate in Pure Metals and Single-phase Alloys

Grain size dependence of secondary creep rate in pure metals and single-phase alloys and the mechanisms/models to interpret the dependence have been reviewed. Two types of the grain size dependence were reported, both of which show a negative dependence approximately below 100 μm. The model proposed by Garofalo in 1960s assumes that the density of dislocations generated at grain boundaries and sub-boundaries determines the secondary creep rate, which is not experimentally supported. Mclean’s model considers preferential subgrain growth near grain boundaries, which might be important in practical steels and alloys with sub-grains such as high Cr ferritic heat resistant steels. Grain boundary sliding (GBS) and its accommodation process in grain is considered as a source of the negative grain size dependence. A finite element modeling performed by Crossman and Ashby, which simulated a deformation process where GBS is accommodated by the power law creep process in the grain interior, indicates that the negative grain size dependence cannot be interpreted by the accommodation process. Based on substructure observation and internal stress measurements, Terada established a “core and mantle” model where the mantle region near grain boundary has no internal stress. This model reasonably interprets the negative grain size dependence.

Best practices to support inflammatory bowel disease patients in higher education and the workplace: A clinician’s guide

The rising prevalence of inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, among adolescents and young adults illuminates the growing need for psychosocial and structural support for these patients as they navigate both higher education and entering the workforce. In a roundtable discussion hosted by the Crohn’s and Colitis Young Adults Network (CCYAN), medical professionals (physicians, nurses, psychologists, trainees/medical students) and young adult patients with IBD came together to identify best practices for leveraging existing resources to support patients in higher education and their early careers. The discussion explored the topics of ableism and existing barriers in higher education and the workplace, including accommodation processes and the significance of proactive planning and collaboration between patients and their pediatric or adult care providers; the crucial role of establishing a therapeutic alliance; highlighting the importance of adopting a "whole person" care approach and normalizing discussions about the psychosocial facets of IBD; and finally, addressing the challenges associated with disease disclosure to empower patients and further build their self-efficacy.

Особенности аккомодационной функции у детей при различных видах рефракционных нарушений

Nowadays, no single concept has been found that could interpret all morphological and functional changes in the eye during accommodation. This review of Russian and foreign publications is devoted to the analysis of accommodation function in various children's refractive disorders. The analysis shows that each refractive change is characterized by certain features in the accommodation process. The most significant changes in accommodation were found in anisotropic children, it's characterized by anisoacomodation, low accommodation response, and weak unstable accommodation. To exclude persistent functional disorders, it is necessary to diagnosis refractive disorders on early stages and manage their treatment. Key words: accommodation, anisoaccomodation, hyperopia, myopia, anisometropia

OCR concerned with college's accommodations process

Case name: Letter re: Lafayette College, No. 03‐21‐2190 (OCR 03/10/22).

The Consumption of Photovoltaic Energy Based on the Theory of Practice and Sociotechnical Transitions

This paper seeks to advance the discussions involving the articulation between the theory of Sociotechnical Transitions and Practice Theory. The text tries to develop this articulation considering that it is possible to find in the literature notes that the Theory of Sociotechnical Transitions is a suitable partner to be articulated with the Theory of Practice. The proposition was tested in empirical research in which we sought to understand how consumption practices change from adopting photovoltaic energy consumption. The research is categorized as qualitative research. The study offers an interpretation of the object from the theoretical lens provided by Social Practice Theory and Sociotechnical Transitions, also known as Multilevel Perspective or “MLP.” In total, 24 interviews were executed, 7 with integrators, 7 with quasi-prosumers, and 10 with prosumers. To analyze the data, content analysis was used. The study's findings demonstrate that sociotechnical systems are reconfigured from the introduction of a new practice to accommodate this newly incorporated practice. Additionally, some of the pre-existing methods are modified during this accommodation process. It is also possible to conclude that the sociotechnical dimensions can be helpful in studies of phenomena that involve the transition of habits, routines, behavior patterns, and practices, as they provide a model of assumptions for sociotechnical change.