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At least 235 records · Page 13Linked to original sources

Altered auditory-tactile interactions in congenitally blind humans: an event-related potential study.

It has been shown that stimuli of a task-irrelevant modality receive enhanced processing when they are presented at an attended location in space (crossmodal attention). The present study investigated the effects of visual deprivation on the interaction of the intact sensory systems. Random streams of tactile and auditory stimuli were presented at the left or right index finger of congenitally blind participants. They had to attend to one modality (auditory or tactile) of one side (left or right) and had to respond to deviant stimuli of the attended modality and side. While in a group of sighted participants, early event-related potentials (ERPs) were negatively displaced to stimuli presented at the attended position, compared to the unattended, for both the task-relevant and the task-irrelevant modality, starting as early as 80 ms after stimulus onset (unimodal and crossmodal spatial attention effects, respectively), corresponding crossmodal effects could not be detected in the blind. In the sighted, spatial attention effects after 200 ms were only significant for the task-relevant modality, whereas a crossmodal effect for this late time window was observed in the blind. This positive rather than negative effect possibly indicates an active suppression of task-irrelevant stimuli at an attended location in space. The present data suggest that developmental visual input is essential for the use of space to integrate input of the non-visual modalities, possibly because of its high spatial resolution. Alternatively, enhanced perceptual skills of the blind within the intact modalities may result in reduced multisensory interactions ("inverse effectiveness of multisensory integration").

Acoustic Stimulation↗

[Cycling with a visual handicap].

PURPOSE OF THE STUDY: To examine bicycling habits of visually handicapped people in order to learn about the visual requirements. MATERIAL AND METHODS: Survey of patients (age range: 14-60 years) suffering from macular or tapetoretinal degeneration with no additional relevant handicap using a questionnaire. RESULTS: A total of 232 questionnaires were returned (62% of the questionnaires received by the participants). The results showed that if visual acuity dropped below 0.1, only 15% of the patients were able to ride a bicycle without accidents or near-accidents. This percentage increased for higher acuities between 33% (<0.2 > or = 0.1) and 67% (> or = 0.2 < or = 0.4). For visual field diameters <60 degrees and > or = 20 degrees approximately 18% were able to ride a bicycle safely and only 8% if the visual field diameter was below 20 degrees. For visual fields larger than 60 degrees diameter approximately 40% were able to ride a bicycle without problems. With a central scotoma of more than 10 degrees diameter only 21% of the patients could cycle safely, whereas with a central scotoma of 10 degrees and less this percentage increased to 47%. CONCLUSIONS: A visual acuity of less than 0.1 is not sufficient to ride a bicycle, and a visual acuity of less than 0.2 leads to a higher accident rate. A visual field diameter of less than 60 degrees or a central scotoma of more than 10 degrees diameter for the vast majority of patients does not allow safe cycling

Accidents, Traffic↗

[Adaptation of a dementia test for use in visually handicapped persons exemplified by SIDAM (Structured Interview for the Diagnosis of Alzheimer disease, Multi-Infarct Dementia and Dementias of other Etiology)].

In epidemiological field studies on the prevalence and incidence of dementia, the problem of cognitive testing of visually impaired individuals is rarely discussed. In the Leipzig Longitudinal Study of the Aged (LEILA 75+) a version of the SIDAM (SIDAM-Structured Interview for the Diagnosis of dementia of the Alzheimer type, Multi-infarct dementia and dementias of other etiology) for the visually impaired was employed from which all items requiring image processing had been omitted (SIDAM-blind). In order to be able to interpret the test results, the final scores for the full SIDAM were estimated by linear transformation of the scores in the blind-version. The method of linear transformation is based on certain theoretical assumptions which are examined in this paper. Linear transformation of scores has proved to be a valid procedure only for individuals with high cognitive performances. Thus, an evaluation of estimated scores based on the norms for the original SIDAM has limitations. Consequently, age-specific norms for the SIDAM-blind are presented. Sensitivities and specificities for different cut-off points used to discriminate between demented and non-demented vision-impaired individuals are given.

Aged↗

Frequency of under-corrected refractive errors in elderly Chinese in Beijing.

PURPOSE: The aim of the study was to evaluate the prevalence of under-corrected refractive error among elderly Chinese in the Beijing area. METHODS: The population-based, cross-sectional, cohort study comprised 4,439 subjects out of 5,324 subjects asked to participate (response rate 83.4%) with an age of 40+ years. It was divided into a rural part [1,973 (44.4%) subjects] and an urban part [2,466 (55.6%) subjects]. Habitual and best-corrected visual acuity was measured. Under-corrected refractive error was defined as an improvement in visual acuity of the better eye of at least two lines with best possible refractive correction. RESULTS: The rate of under-corrected refractive error was 19.4% (95% confidence interval, 18.2, 20.6). In a multiple regression analysis, prevalence and size of under-corrected refractive error in the better eye was significantly associated with lower level of education (P<0.001), female gender (P<0.001), and age (P=0.001). CONCLUSIONS: Under-correction of refractive error is relatively common among elderly Chinese in the Beijing area when compared with data from other populations.

Adult↗

Nonmedical economic consequences attributable to visual impairment: a nation-wide approach in France.

The nonmedical costs of visual impairment are crucial when allocating resources for prevention or treatment programs. Were analyzed the data from two representative nationwide French surveys aimed at documenting impairments that included 14,603 subjects living in institutions and 16,945 in the community. Three groups were identified: blind (light perception), low vision (loss of shape perception, LV), and controls. Item consumption was standardized on confounding factors using logistic regression. Costs attributable to visual impairment were estimated from control subjects. National nonmedical costs due to visual impairment were euro 9,806 million, arising mostly from LV (euro 8,735 million). The annual average cost/subject was euro 7,242 for LV and euro 15,679 for blindness. Loss of family income was euro 4,552 million, the burden on the caregiver euro 2,525 million, paid assistance euro 2,025 million, social allowances euro 0,942 million, and unmet needs euro 5,553 million. Resource allocation strategies aimed at controlling visual impairment should cover all relevant economic dimensions, including nonmedical items.

Activities of Daily Living↗

Visual acuity in a community-dwelling Japanese population and factors associated with visual impairment.

PURPOSE: The aim of this study was to describe the distribution of visual acuity and investigate the predictors of visual impairment in a Japanese population. METHODS: Best-corrected visual acuity was measured in 2263 subjects aged 40-79 years randomly selected from a local community. Relations between visual impairment and possible risk factors were investigated. RESULTS: Among these subjects, 41 individuals (1.8%) were identified as visually impaired (best-corrected visual acuity in the better eye <0.5). Both sexes in the older age groups had a higher frequency of visual impairment (Mantel-Haenszel chi-square test: P<0.001). A multiple logistic regression indicated that an increase in age of 10 years [odds ratio (OR) 3.9; 95% confidence interval (CI) 2.3-6.7] and myopia (OR 2.9; 95%CI 1.4-6.0) were independent risk factors for visual impairment. Individuals with the highest level of education (college or higher) had a lower risk of visual impairment (OR 0.1; 95%CI 0-0.7) compared to individuals with the lowest level of education. CONCLUSIONS: As expected, visual impairment increased with advancing age, although the prevalence of visual impairment in our population was lower than in other surveys. Racial and regional differences and differences in study design may be responsible for discrepancies between surveys. It is noteworthy that myopia was a significant risk factor for visual impairment, although the reasons for this association are uncertain and need further investigation.

Adult↗

A tool for improving the Web accessibility of visually handicapped persons.

Abstract Much has been written concerning the difficulties faced by visually handicapped persons when they access the internet. To solve some of the problems and to make web pages more accessible, we developed a tool we call the "Easy Bar," which works as a toolbar on the web browser. The functions of the Easy Bar are to change the size of web texts and images, to adjust the color, and to clear cached data that is automatically saved by the web browser. These functions are executed with ease by clicking buttons and operating a pull-down list. Since the icons built into Easy Bar are quite large, it is not necessary for the user to deal with delicate operations. The functions of Easy Bar run on any web page without increasing the processing time. For the visually handicapped, Easy Bar would contribute greatly to improved web accessibility to medical information.

Humans↗

Prevalence and risk factors of work-related musculoskeletal disorders in massage practitioners.

INTRODUCTION: Massage practitioners are at high risk for work-related musculoskeletal disorders (WMSDs). We investigated the prevalence and risk factors. METHODS: We randomly selected 161 visually impaired practitioners. Demographics, musculoskeletal symptoms, and working postures were analyzed with multivariate logistic regression. RESULTS: Results indicated that about 71.4% had at least one WMSD in 12 months. Prevalence rates were finger or thumb, 50.3%; shoulder, 31.7%; wrist, 28.6%; neck, 25.5%; arm or elbow, 23.6%; forearm, 20.5%; and back, 19.3%. Working duration >20 years had an adjusted odds ratio (OR) for finger or thumb 4.0-4.5 with 95% confidence interval (CI) 1.5-13.8, client contact >4 h/day (adjusted OR for finger = 3.2, 95% CI=1.3-8.1), and < or =7-kg pulp-pinch strength (adjusted OR for upper extremity = 2.9-3.2, 95% CI=1.2-8.3). Adjusted ORs for lower-back symptoms were 3.1 (95% CI=1.3-7.8) and 3.6 (95% CI=1.4-9.6), respectively, for lack of neutral neck posture and for inappropriate working-table height. CONCLUSION: WMSDs were prevalent among massage practitioners.

Adult↗

Development and psychometric tests of the Chinese-version Low Vision Quality of Life Questionnaire.

BACKGROUND/AIMS: To develop and assess the psychometric validity of a Chinese language Vision Health related quality-of-life (VRQoL) measurement instrument for the Chinese visually impaired. METHODS: The Low Vision Quality of Life Questionnaire (LVQOL) was translated and adapted into the Chinese-version Low Vision Quality of Life Questionnaire (CLVQOL). The CLVQOL was completed by 100 randomly selected people with low vision (primary group) and 100 people with normal vision (control group). Ninety-four participants from the primary group completed the CLVQOL a second time 2 weeks later (test-retest group). The internal consistency reliability, test-retest reliability, item-internal consistency, item-discrimination validity, construct validity and discriminatory power of the CLVQOL were calculated. RESULTS: The review committee agreed that the CLVQOL replicated the meaning of the LVQOL and was sensitive to cultural differences. The Cronbach's alpha coefficient and the split-half coefficient for the four scales and total CLVQOL scales were 0.75-0.97. The test-retest reliability as estimated by the intraclass correlations coefficient was 0.69-0.95. Item-internal consistency was > 0.4 and item-discrimination validity was generally < 0.40. The Varimax rotation factor analysis of the CLVQOL identified four principal factors. the quality-of-life rating of four subscales and the total score of the CLVQOL of the primary group were lower than those of the Control group, both in hospital-based subjects and community-based subjects. CONCLUSION: The CLVQOL Chinese is a culturally specific vision-related quality-of-life measure instrument. It satisfies conventional psychometric criteria, discriminates visually healthy populations from low vision patients and may be valuable in screening the local community as well as for use in clinical practice or research.

Aged↗

A new condition specific quality of life measure for the blind and the partially sighted in Sub-Saharan Africa, the IOTAQOL: methodological aspects of the development procedure.

In Mali, blind and partially sighted people represent 1.2% of the population. Good quality and low cost ophthalmologic care is available, but, unfortunately, is insufficiently taken advantage of. In order to contribute to the analysis of this situation a valid and reliable questionnaire was needed to take the patient's perspective into account. Because of face validity concerns, it was not possible to merely translate an existing questionnaire. Thus we decided to develop a new questionnaire directly in one of the main languages of Mali: Bambara. This involved the setting of a study team composed of social and health science specialists, the majority of whom were native Bambara speakers. The overall project consisted in the iteration of three main steps (1) Conceptual clarification and operationalization of this concept. (2) Qualitative steps: qualitative interviews, focus groups and content analysis. (3) Quantitative steps: statistical analysis of an initial try-out survey (143 participants) and a validation survey (420 participants). This approach yields satisfying results. Indeed, the final version of the IOTAQOL has good psychometric properties. Thus, this interviewer administered instrument can be used to measure health-related quality-of-life in Mali and the methodology that we used could serve as a basis for similar projects.

Adolescent↗

The determinants of participation in activities of daily living in people with impaired vision.

PURPOSE: To investigate the determinants of participation in daily activities in people with impaired vision using the Impact of Vision Impairment (IVI) instrument. DESIGN: Cross-sectional study. METHODS: We recruited 319 participants with no vision rehabilitation history, distance visual acuity (VA) <6/12 (better eye), the ability to converse in English, and 18 years or older. Participants completed the 32-item IVI questionnaire and provided demographic, personal, cultural, and environmental details on vision-related functioning. Visual acuity data were either abstracted from the participants' files or assessed by qualified personnel. Participants also completed the SF-12 to evaluate physical (PCS-12) and mental health (MCS-12). RESULTS: The areas of greatest restriction of participation were associated with reading, outdoor mobility, participation in leisure activities, and shopping. In stepwise linear regression presenting VA, the PCS-12 and MCS-12 explained the variance in leisure and work (60 participants or 19%), consumer and social interaction (92 participants or 30%), household and personal care (76 participants or 24%), mobility (92 participants or 30%), emotional reaction to visual loss and (106 participants or 33%), and total IVI score (114 participants or 36%). Having age-related macular degeneration contributed marginally to the IVI domains and total score (P <.05-.01), except for the emotional domain. Belonging to a social group explained 3% and 2% of the variance in the consumer and social interaction and emotional domains, respectively (P <.05). CONCLUSIONS: Distance VA and physical and mental health explained more than a third of the variance of the total score, suggesting that an intervention aimed at improving quality of life may include strategies to improve not only vision-related rehabilitation but also mental and physical health.

Activities of Daily Living↗

Prevalence of visual impairment among adults in China: the Beijing Eye Study.

PURPOSE: To estimate the prevalence and distribution of blindness and low vision in Northern China. DESIGN: Population-based cohort study. METHODS: The Beijing Eye Study included 4438 subjects with an age of 40+ years. Mean age was 56.2 +/- 10.6 years (range, 40 to 101 years). RESULTS: Forty-three (1.0%) individuals had low vision (<20/60 and >/=20/400 best-corrected vision), and 17 (0.4%) individuals were blind (best-corrected visual acuity in the better-seeing eye <20/400). Low vision/blindness were significantly associated with age (P < .001), myopic refractive error (P < .001), and level of educational background (P = .035). It was not associated with gender (P = .76) and rural vs urban area (P = .88). CONCLUSIONS: Blindness or low vision affects approximately one in 100 Chinese older than 40 years. An estimated 4.1 million Chinese older than 40 years have low vision, and an estimated 1.6 million Chinese older than 40 years are blind.

Adult↗

Correctable and non-correctable visual impairment in a population-based sample of 12-year-old Australian children.

PURPOSE: To document the prevalence of correctable and non-correctable visual impairment in a representative sample of Australian children, predominantly age 12 years. DESIGN: Population-based cross-sectional study. METHODS: Logarithm of the minimum angle of resolution (logMAR) visual acuity was measured in both eyes unaided, with spectacles if worn, and after subjective refraction if required, in 2353 children, examined during 2004 to 2005. Cycloplegic autorefraction (using cyclopentolate) and dilated fundus examination were performed. Using a cut-off of 0.3 logMAR units (<20/40), presenting visual impairment was defined using unaided visual acuity if spectacles were not worn or with usual correction if spectacles were worn. Impairment not eliminated by refraction was considered non-correctable; any difference between this and presenting impairment was defined as correctable impairment. Myopia was defined as spherical equivalent refraction (SER) < or =-0.50 diopters (D), hyperopia as SER > or =+2.0 diopters, anisometropia as SER difference > or =1.00 diopters, and astigmatism as cylinder > or =1.0 diopters. Amblyopia was defined as corrected visual acuity <0.3 logMAR not attributable to an underlying structural eye or visual pathway abnormality. RESULTS: Visual impairment was found in the worse eye of 117 children (5.0%) and comprised correctable (82%) and non-correctable impairment (18%). Correctable impairment was due to myopia in 67 (69.8%), hyperopia in 11 (11.5%) and astigmatism in 32 subjects (33.3%). Causes of non-correctable impairment were: amblyopia 66.7%, congenital glaucoma 9.5%, optic nerve hypoplasia 9.5%, congenital nystagmus 4.8%, and cortical blindness 4.8%. CONCLUSIONS: Visual impairment had a relatively low prevalence in this older childhood population, a large proportion of which was correctable by refraction alone.

Adolescent↗