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  • 文章类型: Journal Article
    原发性脑肿瘤是罕见的,但具有显著的发病率和死亡率负担。恶性胶质瘤是最常见的亚型,在我们的老龄化人口中,其发病率正在增加。胶质瘤的诊断和治疗涉及多个专业之间的实质性相互作用,包括普通医生,放射科医生,病理学家,外科医生,肿瘤学家和专职卫生专业人员。在沿着这条途径的任何一点上,患者都可以向急性医学展示其癌症或抗癌治疗的并发症。提高普通医生对恶性神经胶质瘤的认识对于提供及时的放射学和组织病理学诊断至关重要,促进获得早期和个性化的治疗选择,并允许有效识别和管理预期的并发症。本文讨论了恶性神经胶质瘤的循证现实实践,包括患者表现,诊断途径,治疗及其并发症,和预后,以指导专科中心以外的管理。
    Primary brain tumours are rare but carry a significant morbidity and mortality burden. Malignant gliomas are the most common subtype and their incidence is increasing within our ageing population. The diagnosis and treatment of gliomas involves substantial interplay between multiple specialities, including general medical physicians, radiologists, pathologists, surgeons, oncologists and allied health professionals. At any point along this pathway patients can present to acute medicine with complications of their cancer or anti-cancer therapy. Increasing the awareness of malignant gliomas amongst general physicians is paramount to delivering prompt radiological and histopathological diagnoses, facilitating access to earlier and individualised treatment options and allows for effective recognition and management of anticipated complications. This article discusses evidence-based real-world practice for malignant gliomas, encompassing patient presentation, diagnostic pathways, treatments and their complications, and prognosis to guide management outside of specialist centres.
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  • 文章类型: Journal Article
    背景:眼神交流是最基本的人际交流形式之一。然而,到目前为止,目前还没有全面的研究比较如何在全球所有可能的人群中进行和解释眼神交流.这项研究总结了有关这些模式的现有文献,这些模式分为社会分类和精神疾病。
    方法:根据JoannaBriggsInstitute(JBI)方法对文献进行批判性评估的范围审查。数据库AnthroSource,Medline,CINAHL,搜索了心理学与行为科学收藏(EBSCO)和PsychInfo。
    结果:从灰色文献和参考列表中筛选了7068篇文章,其中包括385个,282用于社会分类,103用于精神疾病。总的来说,包括603个主题分类的变异结果。方法学质量一般为中等至良好。
    结论:人群之间和人群内部的眼神交流的表现和解释存在很大程度的差异。尚不清楚为什么在人群中会发生特定的变化。此外,研究中没有出现应如何使用或解释眼神交流的金标准.建议进一步研究人群之间和内部眼神接触差异的原因。
    BACKGROUND: Eye contact is one of the most fundamental forms of interhuman communication. However, to date, there has been no comprehensive research comparing how eye contact is made and interpreted in all possible populations worldwide. This study presents a summary of the existing literature on these modalities stratified to social categorizations and psychiatric disorders.
    METHODS: A scoping review with critical appraisal of the literature according to the Joanna Briggs Institute (JBI) methodology. Databases AnthroSource, Medline, CINAHL, the Psychology and Behavioral Sciences Collection (EBSCO) and PsychInfo were searched.
    RESULTS: 7068 articles were screened for both the grey literature and reference lists, of which 385 were included, 282 for social categorizations and 103 for psychiatric disorders. In total, 603 thematic clustered outcomes of variations were included. Methodological quality was generally moderate to good.
    CONCLUSIONS: There is a great degree of variation in the presentation and interpretation of eye contact between and within populations. It remains unclear why specific variations occur in populations. Additionally, no gold standard for how eye contact should be used or interpreted emerged from the studies. Further research into the reason for differences in eye contact between and within populations is recommended.
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  • 文章类型: Journal Article
    这项工作旨在探索飞行中膳食的食品质量属性,并检查积极情绪和持续使用这些膳食的前因。作为一个子维度,这项研究使用了多个属性:菜单多样性,熟悉度,温度,营养,和介绍。这项工作的另一个目的是研究菜单多样性对营养与持续使用之间关系的调节作用。通过clickworker进行的调查用于收集这项工作的数据。有317个有效的统计推断观察。本研究使用结构方程模型来检验假设,并采用Hayes过程模型宏1对调节作用进行了检验。结果表明,除熟悉度外,所有独立变量均显着占积极情绪。此外,所有这些属性都对持续使用产生了积极影响.这项工作揭示了菜单多样性对营养与持续使用之间关系的显着调节作用。本研究通过阐明飞行餐产品领域中情绪和持续使用意图的影响属性并讨论实际意义来阐明文献。
    This work aimed to explore the food quality attributes of in-flight meals and to examine the antecedents of positive emotion and continuous usage of these meals. As a subdimension, this study uses multiple attributes: menu diversity, familiarity, temperature, nutrition, and presentation. Another purpose of this work is to examine the moderating effect of menu diversity on the relationship between nutrition and continuance usage. A survey via clickworker was used to collect the data for this work. There were 317 valid observations for statistical inference. This study used a structural equation model to test the hypotheses, and the Hayes process model macro 1 was adopted to test the moderating effect. The results showed that all independent variables other than familiarity significantly accounted for positive emotion. Moreover, all of these attributes had a positive impact on continuous usage. This work unveiled a significant moderating effect of menu diversity on the relationship between nutrition and continuance usage. This research elucidates the literature by clarifying the influential attributes of emotion and continuous usage intention in the domain of in-flight meal products and discussing practical implications.
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  • 文章类型: Journal Article
    期刊俱乐部的成功取决于发表相关且科学可靠的文章。对于演讲者来说,仅仅通读一篇文章并强调几点而没有明确的重点是不够的。一个强有力的陈述应该彻底描述研究的相关性和有效性,提出批评,建议进一步的研究如何解决这个问题,并讨论对病人护理的影响。选择正确的文章至关重要。建议以病例方案开始演示,以强调文章的临床相关性,并在演示结束时重新审视病例。文章介绍的组成部分应包括背景资料,方法和结果,和作者讨论。此外,主持人应该批评文章的有效性,注意到任何潜在的偏见,评估拟议干预措施的风险和成本,并评估文章对其假设的支持程度。陈述应以包括结论的摘要声明结束,含义,和未来的方向。具有期刊俱乐部演示文稿的结构化过程可指导演示者,并确保与会者从教育活动中获得最大收益。这种有组织的方法促进了更深入的理解,并鼓励参与者进行批判性思考。
    The success of a journal club hinges on the presentation of articles that are both relevant and scientifically robust. It\'s insufficient for presenters to merely read through an article and highlight a few points without a clear focus. A strong presentation should thoroughly describe the relevance and validity of the study, offer a critique, suggest how further research might address the issue, and discuss the implications for patient care. Selecting the right article is crucial. It is recommended to begin the presentation with a case scenario to emphasize the article\'s clinical relevance and to revisit the case at the conclusion of the presentation. The components of the article presentation should include background information, methodology and results, and the authors\' discussion. Additionally, the presenter should critique the article\'s validity, noting any potential biases, evaluating the risks and costs of the proposed intervention, and assessing how well the article supports its hypothesis. The presentation should conclude with a summary statement that includes conclusions, implications, and future directions. Having a structured process for journal club presentations guides presenters and ensures that attendees derive maximum benefit from the educational activity. This organized approach fosters a deeper understanding and encourages critical thinking among participants.
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  • 文章类型: Journal Article
    脑转移瘤(BMs)是最常见的脑肿瘤类型,显著影响生存。在成年人中,肺癌,乳腺癌,黑色素瘤是与BMs相关的原发性癌症。症状通常是由大脑压迫引起的,患者可能会出现危及生命的情况到急诊科(ED)。BMs的治疗目标是通过选择毒性最小的疗法来最大限度地提高生存率和生活质量。手术切除后进行腔内放射或明确的立体定向放射外科仍是标准方法。取决于病人的病情。相反,全脑放射治疗越来越仅限于多个无法手术的BM的病例,用于术后控制的频率较低。BMS通常预示着晚期全身性疾病,患者通常出现在ED上,症状控制不佳,为住院辩护。超过一半的急诊室患者入院,使有效的基于ED的管理成为挑战。本文回顾了流行病学,临床表现,以及目前BMs患者的治疗选择。此外,它概述了ED管理,并强调了在这种情况下面临的挑战。需要更好地了解BMs癌症患者可能可避免住院的原因,并可以帮助急诊医师区分可以安全出院的患者与需要观察或住院的患者。
    Brain metastases (BMs) are the most prevalent type of cerebral tumor, significantly affecting survival. In adults, lung cancer, breast cancer, and melanoma are the primary cancers associated with BMs. Symptoms often result from brain compression, and patients may present to the emergency department (ED) with life-threatening conditions. The goal of treatment of BMs is to maximize survival and quality of life by choosing the least toxic therapy. Surgical resection followed by cavity radiation or definitive stereotactic radiosurgery remains the standard approach, depending on the patient\'s condition. Conversely, whole brain radiation therapy is becoming more limited to cases with multiple inoperable BMs and is less frequently used for postoperative control. BMs often signal advanced systemic disease, and patients usually present to the ED with poorly controlled symptoms, justifying hospitalization. Over half of patients with BMs in the ED are admitted, making effective ED-based management a challenge. This article reviews the epidemiology, clinical manifestations, and current treatment options of patients with BMs. Additionally, it provides an overview of ED management and highlights the challenges faced in this setting. An improved understanding of the reasons for potentially avoidable hospitalizations in cancer patients with BMs is needed and could help emergency physicians distinguish patients who can be safely discharged from those who require observation or hospitalization.
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  • 文章类型: Journal Article
    通过培训学生在职业生涯早期进行负责任的研究来增强科学家的专业发展。负责任的研究行为的一个方面是作者伦理,这涉及向那些对研究做出智力贡献的人提供信贷。本文讨论的活动强调了作者伦理如何与基于课程的本科研究经验(CURE)相结合,并包括也可用于独立研究学生的改编。该活动使学生能够反思科学作者中的不平等和问题,包括性别偏见,不信任努力(代笔),并纳入对工作没有有意义贡献的作者(荣誉/礼物作者)。在学生反思中看到的关于他们如何证明作者身份的伦理的主题包括:按贡献确定作者身份,对课程简历(CV)和海报的适当归因,不同的信用水平,理解作者身份标准,跟踪贡献。在学生对作者身份重要性的反思中看到的主题是适当的作者身份信用分配,作者身份影响职业机会,和研究中的问责制。在活动中,学生们还创建了一张海报的归因,从他们的研究。我们发现大多数学生能够创建正确格式的归因,包括相同的作者,并以与其他组成员相同的顺序定位作者,与最终海报上呈现的内容相匹配。我们发现,学生对作者身份的反思和他们在CURE中活动的专业化导致他们对自己作为科学家的看法适度增加。
    Professional development of scientists is enhanced by training students in responsible conduct of research earlier in their careers. One aspect of responsible conduct of research is authorship ethics, which concerns granting of credit to those who make intellectual contributions to the research. The activity discussed in this article emphasizes how authorship ethics can be integrated with Course-based Undergraduate Research Experience (CURE) and includes an adaption that could also be used for independent research students. The activity allows students to reflect upon inequalities and problems seen in scientific authorship, including gender bias, failure to credit effort (ghostwriters), and inclusion of authors that did not meaningfully contribute to the work (honorary/gift authorship). Themes seen in student reflections on how they could demonstrate ethics in authorship included: determining authorship by contribution, appropriate attributions on curriculum vitas (CV) and posters, different credit levels, understanding authorship criteria, and tracking contributions. Themes seen in student reflections on the importance of authorship were proper authorship credit distribution, authorship impacting career opportunities, and accountability in research. In the activity, students also created attributions for a poster to be presented from their research. We found that most students were able to create attributions that were correctly formatted, included the same authors, and positioned authors in the same order as other group members, matching what was presented on the finalized poster. We found that students\' reflection on authorship and this professionalization of their activities in their CURE led to modest increases in their view of themselves as scientists.
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  • 文章类型: Journal Article
    这项工作的重点是对飞行中膳食的食物健康的感知。这项工作采用陈述作为决定因素。这项工作还采用了态度作为食物健康的结果。这项研究还考察了熟悉度对食物呈现与食物健康之间关系的调节作用。这项研究使用了一项调查,调查参与者是通过Clickworker平台服务招募的。调查参与者经历了飞行中的膳食。观察次数为317次。此外,本研究使用Hayes过程宏模型7检验了研究假设。结果表明,食物健康受到呈现的积极影响,食物健康对态度有积极影响。此外,结果显示,演讲类型对态度有积极影响。熟悉程度是食物呈现与食物健康之间关系的重要调节变量。这项工作通过确定飞行中膳食的四个属性之间的关联,为文献提供了启示。此外,这项研究的结果可以作为开发更好的飞行餐的参考。
    This work focused on the perception of the food healthiness of in-flight meals. This work adopts presentation as the determinant. This work also employs attitude as the consequence of food healthiness. This research also examines the moderating effect of familiarity on the relationship between food presentation and food healthiness. This research used a survey, and survey participants were recruited via a Clickworker platform service. Survey participants were experienced with in-flight meals. The number of observations was 317. Moreover, this research tested the research hypotheses using the Hayes process macro Model 7. The results revealed that food healthiness is positively influenced by presentation and that food healthiness positively affects attitude. Moreover, the results revealed that the type of presentation has a positive influence on attitude. Familiarity was a significant moderating variable for the relationship between food presentation and food healthiness. This work sheds light on the literature by identifying the associations among four attributes of in-flight meals. Additionally, the results of this study could be used as a reference to develop better in-flight meals.
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  • 文章类型: Journal Article
    背景:美国髋关节和膝关节外科医生协会(AAHKS)年会允许传播有关髋关节和膝关节置换术的研究。这项研究的目的是提供2016年至2019年AAHKS年度会议的海报和讲台发表率,并评估在此期间最终发表的会议演示文稿的质量。
    方法:2016年至2019年的海报和讲台演示文稿通过AAHKS电子海报和会议档案进行定位。在Google上查询了演示文稿标题,谷歌学者,和PubMed。演示文稿标题,主题类型,作者数量,第一作者持有的学位,并收集了奖励状态。对于每个确定的全文出版物,期刊名称,研究类型,在线和印刷出版的日期,并获得了期刊影响因子(JIF)。
    结果:在2016年至2019年AAHKS年度会议上共发表了1,274份摘要,总体发表率为67.8%(1,274份中的864份)。2016年至2019年,论文摘要数量有所增加(P<0.001)。最早出版媒体(在线或印刷)的中位出版时间为6.0个月(95%CI[置信区间]5.0至6.0)。讲台演讲(4.0个月,95%CI3.0至4.0)更有可能比海报演示更早发布(7.0个月,95%CI6.0至7.0)(P<0.001)已发表摘要的JIF中位数为3.3(95%CI3.3-3.7),已发表海报或讲台演示文稿的JIF均值无显着差异(3.3±1.0对3.3±1.0,P=0.554)。发表演讲的可能性明显更高(OR[比值比]3.41,95%CI2.29至5.07,P<0.001),获奖演讲(OR4.78,95%CI1.69至13.55,P=0.003),作者较多(OR1.09,95%CI1.02至1.16,P=0.014)。
    结论:这项分析表明,在2016年至2019年的AAHKS年度会议上发表的摘要的总体发表率为67.8%。讲台(86.4%)是海报(63.6%)的三倍。如果被选中出席AAHKS年会,个人可以确信他们的作品有很高的最终出版机会。
    BACKGROUND: The objective of this study was to provide the poster and podium publication rates from the 2016 to 2019 American Association of Hip and Knee Surgeons (AAHKS) annual meetings and assess the quality of presentations ultimately published during this time.
    METHODS: Posters and podiums from 2016 to 2019 were located through the AAHKS e-poster and meeting archives. Titles were queried on Google, Google Scholar, and PubMed. Presentation title, topic type, number of authors, degrees held by first author, and award status were collected. For each identified full-text publication, journal name, study type, dates of online and print publication, and journal impact factor (JIF) were also obtained.
    RESULTS: A total of 1,274 abstracts were presented at the 2016 to 2019 AAHKS annual meetings with an overall publication rate of 67.8% (864 of 1,274). Podiums (4.0 months, 95% confidence interval [CI]: 3.0 to 4.0) were more likely to be published earlier than posters (7.0 months, 95% CI: 6.0 to 7.0) (P < .001). The median JIF of published abstracts was 3.3 (95% CI: 3.3 to 3.7) with no significant difference in mean JIF of published posters or podiums (3.3 ± 1.0 versus 3.3 ± 1.0, P = .554). The likelihood of publication was significantly higher for podiums (odds ratio [OR]: 3.41, 95% CI: 2.29 to 5.07, P < .001), award-winning presentations (OR: 4.78, 95% CI: 1.69 to 13.55, P = .003), and with more authors (OR: 1.09, 95% CI: 1.02 to 1.16, P = .014).
    CONCLUSIONS: This analysis demonstrates abstracts presented at the AAHKS annual meetings from 2016 to 2019 had an overall publication rate of 67.8%, with podiums (86.4%) 3 times as likely to be published as posters (63.6%). If selected to present at the AAHKS annual meeting, individuals can be confident that their work has a high chance of eventual publication.
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  • 文章类型: Journal Article
    背景:心脏病学会议是学习的主要途径,职业发展,专业网络。然而,参加这些会议的费用是一个主要障碍,特别是针对来自中低收入国家(LMICs)的学员和参与者。我们的研究旨在分析全球主要心脏病学会议的注册费。
    方法:我们纳入了国际心血管学会和代表全球区域的会议。由于无法系统地确定个别国家或机构会议,我们没有包括这些会议。我们从官方会议网站收取2024年注册费,如果没有,则收取2023年或2022年的费用,并根据职业阶段和社会成员身份对其进行分类。如果指定,我们选择了“早起的鸟”费用。所有费用均根据2023年12月4日国际货币基金组织的货币汇率转换为美元,或者如果没有,根据上次报告的美国财政部数据。收集的其他数据包括东道国,虚拟选项可用性,和LMIC折扣。
    结果:30次(65.2%)会议为医学生提供了折扣,无论成员身份如何,而1人(2.2%)只为学生会员提供折扣。36次(78.2%)会议为居民/研究员提供折扣,而2人(4.3%)只为居民/同胞会员提供折扣。拥有会员资格的学生和居民/研究员的中位数费用为255美元和287美元(以美元计),非会员的费用中位数分别为303.5元和397元。31次(67.4%)会议为员工提供折扣。工作人员的费用中位数为701美元,会员和非会员的费用中位数为800美元,分别。只有12次(26.1%)会议提到了虚拟组件,有11人提供折扣注册,与当面利率相比。7次(15.2%)会议对基于LMIC的注册者有特殊的现场费用。5提供相同的折扣率,无论培训阶段,而2人为学员提供额外折扣。
    结论:我们发现会议注册费用很高,包括学员,只有少数会议为低收入国家提供折扣率。专业社团必须降低注册费用,可能通过实施基于培训阶段和原籍国的分层系统。Further,为了增加LMIC的参与,需要为基于LMIC的注册者提供专门的奖学金和指导计划。
    BACKGROUND: Cardiology conferences represent a major avenue for learning, career advancement, and professional networking. Yet, costs of attending these conferences represent a major barrier, particularly for trainees and participants from low-middle-income countries (LMICs). Our study aimed to analyze the registration fees of major cardiology conferences worldwide.
    METHODS: We included conferences organized by international cardiovascular societies and those representing global regions. We did not include individual national or institutional conferences due to inability to systematically identify them. We collected 2024 registration fees from official conference websites, taking 2023 or 2022 fees if unavailable, and categorized them according to career stage and society membership status. Where specified, we chose \'early-bird\' fees. All fees were converted to US dollars according to currency exchange rates per the International Monetary Fund on December 4, 2023, or if unavailable, per the last reported US Treasury Data. Other data collected included host country, virtual option availability, and LMIC discounts.
    RESULTS: 30 (65.2 %) conferences provided discounts for medical students, regardless of membership status, while 1 (2.2 %) provided discounts only for student-members. 36 (78.2 %) conferences offered discounts for residents/fellows, while 2 (4.3 %) offered discounts only for resident/fellow-members. Median fees for students and residents/fellows with membership were $255 and $287 (in US dollars), respectively while median fees for non-members were $303.5 and $397, respectively. 31 (67.4 %) conferences provided discounts for staff- members. Median fees for staff were $701 and $800 for members and non-members, respectively. Only 12 (26.1 %) conferences mentioned a virtual component, with 11 offering discounted registration compared with in-person rates. 7 (15.2 %) conferences had special in-person fees for LMIC-based registrants. 5 offered the same discounted rate regardless of training stage, while 2 offered additional discounts for trainees.
    CONCLUSIONS: We found that conference registration costs were substantial, including for trainees, with only a minority of conferences providing discounted rates for LMICs. Professional societies must reduce registration costs, potentially by implementing a tiered system based on training stage and country of origin. Further, to augment LMIC participation, dedicated scholarships and mentorship programs for LMIC-based registrants are needed.
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  • 文章类型: Journal Article
    有针对性的转诊和及时开始治疗对于限制青光眼的视力丧失至关重要。验光师,初级保健提供者,公共卫生政策制定者可以利用最近的预测因素来识别和瞄准高危人群。
    这项研究,其目的是在澳大利亚农村人口的眼科医生首次就诊时评估青光眼的严重程度,是澳大利亚人口中的第一个。
    来自麦格理港一家大型眼科诊所的患者记录,使用抗青光眼失明注册表对新南威尔士州进行了回顾性审查,以确定在2020年或2021年眼科实践中首次诊断为青光眼的患者。演示时与青光眼严重程度的关联,用视野指数(VFI)测量,使用β回归模型进行了分析。使用线性回归评估视网膜神经纤维层测量值作为次要结果测量值。
    从3548名新患者中,诊断青光眼110例,其中95人符合纳入标准。其中包括41.8%的原发性开角型青光眼,32.7%正常眼压性青光眼,11.8%继发性开角型青光眼,12.7%原发性闭角型青光眼,和0.9%继发性闭角型青光眼。演示时的VFI中位数为94.5%,71.9%的患者VFI≥90%。然而,6.3%的患者VFI低于50%。年纪大了,眼内压较高,视力较差与就诊时的严重程度显着相关。没有发现偏远的关联,性别,家族史,或青光眼类型。
    青光眼似乎在该人群中诊断相对较早。演示时的严重程度与年龄有关,眼内压,和视力,但不受评估的社会决定因素的影响。这些发现强调了老年患者频繁全面眼科检查的重要性。由于这些发现的普遍性有限,因此建议在其他澳大利亚人群中进行复制。
    UNASSIGNED: Well-targeted referrals and timely commencement of treatment are essential to limiting vision loss in glaucoma. Optometrists, primary care providers, and public health policymakers can utilise predictors of late to identify and target at-risk populations.
    UNASSIGNED: This study, which aimed to evaluate glaucoma severity at first presentation to an ophthalmologist in a rural Australian population, is the first of its kind in an Australian population.
    UNASSIGNED: Patient records from a large ophthalmology clinic in Port Macquarie, NSW were retrospectively reviewed using the Fight Glaucoma Blindness registry to identify patients who were first diagnosed with glaucoma at an ophthalmology practice in 2020 or 2021. Associations with glaucoma severity at presentation, measured with visual field index (VFI), were analysed using a beta-regression model. Retinal nerve fibre layer measurements were evaluated as a secondary outcome measure using linear regression.
    UNASSIGNED: From 3548 new patients seen, 110 cases of glaucoma were diagnosed, 95 of whom met inclusion criteria. These comprised 41.8% primary open-angle glaucoma, 32.7% normal-tension glaucoma, 11.8% secondary open-angle glaucoma, 12.7% primary angle closure glaucoma, and 0.9% secondary angle closure glaucoma. The median VFI at presentation was 94.5%, and 71.9% of patients had a VFI ≥ 90%. However, 6.3% of patients presented with a VFI below 50%. Older age, higher intraocular pressure, and worse visual acuity were significantly associated with severity at presentation. No associations were found for remoteness, sex, family history, or glaucoma type.
    UNASSIGNED: Glaucoma appears to be diagnosed relatively early in this population. Severity at presentation was associated with age, intraocular pressure, and visual acuity, but not influenced by the social determinants assessed. These findings underscore the importance of frequent comprehensive eye examinations in older patients. Replication in other Australian populations is recommended as the generalisability of these findings is limited.
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