Low vision in the geriatric population: rehabilitation and management

Older persons represent the fastest growing segment of individuals with visual impairments in industrialized countries. This population is expected to grow dramatically in the coming years. This article discusses the common age-related changes in vision and the most prevalent visual impairments associated with aging, and the resulting functional implications. It includes information for health care professionals about preparing an older person to benefit from low-vision rehabilitation services, environmental evaluations and modifications, and orientation to the environment. The importance of functional assessment and instruction in the use of visual skills and vision devices is stressed. The article also emphasizes the need for teamwork to provide a full scope of rehabilitation services to older adults with low vision, and the importance of support by family members and caregivers to maximize coping, adjustment, independence and quality of life.

Medical student appraisal of interactive computer-assisted learning programs embedded in a general pathology course

Computer-assisted learning programs (CALs) were embedded in a course on general pathology for medical students at the University of Edinburgh Medical School. Students' reactions to the programs were evaluated. Students completed written questionnaires and were interviewed and observed as they used the CALs. Students liked the CALs and felt that they were integrated with other parts of their teaching and aided them in understanding the subject material. Different question styles were variably appreciated. The most useful aspects of the CALs were the interactive parts (questions and answers), summaries, pictures, learning at the individual's own pace, and question practice, especially with MCQs. Students found the CALs an effective learning tool, particularly when linked with other course components as a complement to, rather than a replacement for, other learning methods.

Veterans' use of low vision devices for reading

BACKGROUND

This report presents the results of a 2-year study of veterans' use of low vision devices (LVDs) which were prescribed and dispensed through the Blind Rehabilitation Centers (BRCs) and Visual Impairment Centers to Optimize Remaining Sight (VICTORS) of the Department of Veterans Affairs.

METHODS

Two-hundred veterans using 740 LVDs were surveyed by telephone 12 to 24 months after the prescription/dispensing of the devices. Reliability (test-retest) and validity (content, criterion-related, and construct) were established for the survey. Primary analysis of the data was accomplished through tabular presentations. Because most devices were used for reading, an exploratory data analysis was completed to further investigate successful use of LVDs for this task. Relationships of 21 variables with a definition of highly successful use, use and nonuse of LVDs for reading were evaluated.

RESULTS

Only visual acuity provided a statistically significant predictor of use of LVDs for reading. LVDs in the lowest visual acuity grouping tend to be used either highly successfully, or fall into the nonuse category. The highly successful LVDs are primarily video magnifiers; the nonused LVDs tended to be spectacle magnifiers.

CONCLUSIONS

This population is using devices extensively for reading, reporting frequencies of use of several times per day.

National survey of the impact of low vision device use among veterans

BACKGROUND

This report presents the results of a 2-year study of veterans' use of low vision devices (LVDs) which were prescribed and dispensed through he Blind Rehabilitation Centers (BRCs) and Visual Impairment Centers to Optimize Remaining Sight (VICTORS) of the Department of Veterans Affairs.

METHODS

Two-hundred veterans using 740 LVDs were surveyed by telephone 12 to 24 months after the prescription/dispensing of the devices. Reliability (test-retest) and validity (content, criterion-related, and construct) were established for the survey. Primary analysis of the data was accomplished through tabular presentations. Factor analyses were used to describe prescription and use patterns.

RESULTS

Most (85.4%) of the devices were still in use. Having a helper in the home was a demographic variable related to continued use. Neither age, acuity, nor etiology were related to continued use. Strong prescription and use patterns emerged. Most veterans reported receiving > 20 h of training and > 20 h of practice in the use of their LVDs.

CONCLUSIONS

Most veterans who receive LVDs through the service delivery system of the Department of Veterans Affairs appear to use them for a wide variety of daily tasks and reported that they obtain a great deal of benefit from their use.

Carcinoid disease: review of the literature

Carcinoid syndrome is the product of a rare but fascinating malignant neoplasm. Carcinoid syndrome was described more than 100 years ago, and recent advances in diagnostic localization, elucidation of the mechanisms of oncogenesis, treatment options, and, consequently, patient prognosis have been made. Current modalities of treatment, possible therapeutic implications of new avenues of research, and current literature on the chemotherapeutic combinations used are reviewed.

Scanning characters and reading with a central scotoma

Among the patients we tested, most of those who had lost normal macular function developed extrafoveal retinal loci which resulted in strongly preferred viewing angles for steady fixation. These patients used these extrafoveal retinal loci to scan lines of characters in patterns similar to patients with normal macular function. Although the scanning speed of these patients was adversely affected by their large size scotomas, their reading accuracy was not necessarily reduced. The assessment of scanning and reading performance in this population requires careful measurement of the visual skills involved in reading.

Galactolipid Synthesis in Vicia faba Leaves: II. Formation and Desaturation of Long Chain Fatty Acids in Phosphatidylcholine, Phosphatidylglycerol, and the Galactolipids

The labeling kinetics of the fatty acids of phosphatidylcholine (PC), phosphatidylglycerol (PG), monogalactosyldiglyceride (MGDG), and digalactosyldiglyceride (DGDG) were examined after (14)CO(2) feeding and incubation of leaf discs of Vicia faba over 72 hours in continuous light. The results indicate a rapid accumulation and turnover of radioactivity into PC and PG fatty acids (oleic acid in PC and oleic and palmitic acids in PG). Radioactivity accumulates in MGDG and DGDG fatty acids much more slowly and continuously over 72 hours. Most of this activity is found in linoleic and linolenic acids; very little activity is found in the more saturated fatty acids. Little or no desaturation occurs in situ in conjunction with the galactolipids. The results suggest that PC and PG may act as "carriers" for MGDG and DGDG fatty acid synthesis. Analyses of the labeling patterns of the molecular species of MGDG after (14)CO(2) and (14)C-acetate feeding confirm that MGDG is formed by galactosylation of a preformed diglyceride containing predominantly unsaturated fatty acids.

Galactolipid Synthesis in Vicia faba Leaves: I. Galactose, Glycerol, and Fatty Acid Labeling after CO(2) Feeding

The galactose, glycerol, and fatty acids of mono- and digalactosyl diglycerides (MGDG and DGDG) have been separated and analyzed for (14)C activity after (14)CO(2) feeding of Vicia faba leaf discs. Fully expanded and developing leaves were analyzed at time intervals following feeding during continuous illumination. In addition, fully expanded leaves were analyzed after similar times in complete darkness. In all cases, (14)C was incorporated very rapidly into galactose, whereas glycerol and fatty acids were labeled much more slowly and over a longer period of time. The data are consistent with the galactosylation of a diglyceride to MGDG which is in turn galactosylated to DGDG. The data suggest that the formation of diglycerides suitable for galactosylation to MGDG is slow in comparison to the galactosylation process. It is also suggested that DGDG may be formed from more than one pool of MGDG. The complete analysis of the (14)C incorporation into galactose appears to represent the only satisfactory method of comparing galactolipid synthesis by (14)C incorporation. Estimates of comparative rates of synthesis of MGDG and DGDG have been made on this basis.