No abstract

Elevated intraocular pressure (IOP) is a major risk factor for glaucoma and is influenced by genetic and environmental factors. Recent genome-wide association studies (GWAS) reported associations with IOP at TMCO1 and GAS7, and with primary open-angle glaucoma (POAG) at CDKN2B-AS1, CAV1/CAV2, and SIX1/SIX6. To identify novel genetic variants and replicate the published findings, we performed GWAS and meta-analysis of IOP in >6,000 subjects of European ancestry collected in three datasets: the NEI Glaucoma Human genetics collaBORation, GLAUcoma Genes and ENvironment study, and a subset of the Age-related Macular Degeneration-Michigan, Mayo, AREDS and Pennsylvania study. While no signal achieved genome-wide significance in individual datasets, a meta-analysis identified significant associations with IOP at TMCO1 (rs7518099-G, p = 8.0 × 10−8). Focused analyses of five loci previously reported for IOP and/or POAG, i.e., TMCO1, CDKN2B-AS1, GAS7, CAV1/CAV2, and SIX1/SIX6, revealed associations with IOP that were largely consistent across our three datasets, and replicated the previously reported associations in both effect size and direction. These results confirm the involvement of common variants in multiple genomic regions in regulating IOP and/or glaucoma risk.

This article provides an overview of family involvement in care intervention and its implementation with African American and Caucasian family members of persons with dementia in nursing home settings.

The results indicate the types of information that can result from analysis of actual clinical nursing data documented with standardized language (Nursing Interventions Classification) in a nursing information system. The knowledge of nursing interventions used in clinical practice has major implications for staff development and nursing education. The information is also useful in making staffing decisions for different types of patient populations.

Purpose : To evaluate the content validity and nursing sensitivity of six community‐level outcomes from the Nursing Outcomes Classification (NOC; Johnson, Maas, & Moorhead, 2000). Design and Methods : A survey research design was used. Questionnaires were mailed to 300 public health nursing experts; 102 nurses responded. Experts evaluated between 11 and 30 indicators for each of the six outcomes for: (a) importance of the indicators for measuring the outcome, and (b) influence of nursing on the indicators. Content validity and nursing sensitivity of the outcomes were estimated with a modified Fehring technique. Findings : All outcomes were deemed important; only Community Competence had an outcome content validity score <.80. The outcome sensitivity score for Community Health: Immunity was .80; other outcome scores ranged from .62‐.70. Indicator ratios for all 102 indicators met the study criterion for importance, with 87% designated as critical and 13% as supplemental. Sensitivity ratios reflected judgments that 45% of the indicators were sensitive to nursing intervention. Conclusions : The study provided evidence of outcome content validity and nursing sensitivity of the study outcomes; further validation research is recommended, followed by testing of the study outcomes in clinical practice. Community‐level nursing‐sensitive outcomes will potentially enable study of the efficacy and effectiveness of public health interventions focused on improving health of populations and communities.

The purpose of this quasi-experimental study was to examine the effect of an intervention for caregivers of individuals with Alzheimer's disease and related dementias (ADRD) on nursing home residents' functional and cognitive status. Fourteen special care units (SCUs) in 14 midwestern nursing homes were paired according to size, ownership, and staff turnover. The paired nursing homes were randomly assigned to either experimental or control groups. The intervention consisted of the Family Involvement in Care (FIC) protocol. The FIC intervention was designed to help family caregivers of nursing home residents with dementia negotiate and establish a partnership with the staff caregivers for the care of residents. One hundred sixty-four residents participated in the study, 71 in the control group and 93 in the experimental group. Sixty-three residents were lost to attrition (38%). The experimental group exhibited less global deterioration throughout the study. Inappropriate behavior, cognition, and functional status remained relatively unchanged over time within and between the groups. Increased family involvement did slow global deterioration in individuals with ADRD. The findings of the study show that more factors need to be examined to discover those interventions that preserve functional and cognitive abilities.

In this study, we examined the role of Fas apoptotic inhibitory molecule 2 (Faim2), an inhibitor of the Fas signaling pathway, and its regulation by stress kinase signaling during Fas-mediated apoptosis of 661W cells, an immortalized photoreceptor-like cell line Treatment of 661W cells with a Fas-activating antibody led to increased levels of Faim2. Both ERK and JNK stress kinase pathways were activated in Fas-treated 661W cells, but only the inhibition of the ERK pathway reduced the levels of Faim2. Blocking the ERK pathway using a pharmacological inhibitor increased the susceptibility of 661W cells to Fas-induced caspase activation and apoptosis. When the levels of Faim2 were reduced in 661W cells by siRNA knockdown, Fas activating antibody treatment resulted in earlier and more robust caspase activation, and increased cell death. These results demonstrate that Faim2 acts as a neuroprotectant during Fas-mediated apoptosis of 661W cells. The expression of Faim2 is triggered, at least in part, by Fas-receptor activation and subsequent ERK signaling. Our findings identify a novel protective pathway that auto-regulates Fas-induced photoreceptor apoptosis in vitro. Modulation of this pathway to increase Faim2 expression may be a potential therapeutic option to prevent photoreceptor death.

Purpose of review: Approximately 10% of patients become blind despite using evidence-based guidelines developed from clinical trials and epidemiology studies. Our purpose is to review opportunities to decrease glaucoma-related blindness using the emerging principles of precision medicine.Recent findings: This review focuses on three topics: 1) candidate biomarkers for angle-based surgeries, 2) head-mounted display (HMD) technology for vision and testing, and 3) glaucoma risk alleles discovered by genome-wide association studies (GWAS). First, in angle-based surgeries, tracers injected into the anterior chamber or Schlemm's canal (SC) have allowed visualization of aqueous veins. We describe an innovative use of optical coherence tomography angiography (OCTA) to visualize aqueous veins in a case with 6-year successful outcome following catheter-based trabeculotomy. Second, HMD technology can augment perceived vision and can be used for perimetry testing. Third, developing genetic risk scores that characterize