Causes of Childhood Blindness in North Ghana: Results From a School for the Blind in Wa, Upper West Region

Background: Because most developing countries lack sufficient resources and infrastructure to conduct population-based studies on childhood blindness, it can be difficult to obtain epidemiologically reliable data available for planning public health strategies to effectively address the major determinants of childhood blindness. The major etiologies of blindness can differ regionally and intra-regionally. The objective of this retrospective study was to determine (1) the major causes of childhood blindness (BL) and severe visual impairment (SVI) in students who attend Wa Methodist School for the Blind in Upper West Region, North Ghana, and (2) any potential temporal trends in the causes of blindness for this region.

Methods: In this retrospective study, demographic data and clinical information from an eye screening at Wa Methodist School for the Blind were coded according to the World Health Organization/Prevention of Blindness standardized reporting methodology. Causes of BL and SVI were categorized anatomically and etiologically. We determined the major causes of BL/SVI over time using information provided about the age at onset of visual loss for each student.

Results: The major anatomical causes of BL/SVI among the 190 students screened were corneal opacity and phthisis bulbi (n=28, 15%), optic atrophy (n=23, 13%), glaucoma (n=18, 9%), microphthalmos (n=18, 9%), and cataract (n=18, 9%). Within the first year of life, students became blind mainly due to whole globe causes (n=23, 26%), cataract (n=15, 17%), and optic atrophy (n=11, 13%). Those who became blind after age one year had whole globe causes (n=26, 26%), corneal opacity (n=24, 24%), and optic atrophy (n=13, 13%).

Conclusion: At the Wa Methodist School for the Blind, the major anatomical causes of BL/SVI were corneal opacity and phthisis bulbi. About half of all students became blind within the first year of life, and were disproportionately affected by cataract and retinal causes in comparison to the other students who became blind after age one year. While research in blind schools has a number of implicit disadvantages and limitations, considering the temporal trends and other epidemiological factors of blindness may increase the usefulness and/or implications of the data that come from blind school studies in order to improve screening methods for newborns in hospitals and primary care centers, and to help tailor preventative and treatment programs to reduce avoidable childhood blindness in neonates and schoolchildren.

Into the Bends of Time and Musical Forces in Jazz: Group Interaction and Double-time in “My Foolish Heart” as performed by the Bill Evans Trio with Scott LaFaro and Paul Motian.

Into the Bends of Time is a 40-minute work in seven movements for a large chamber orchestra with electronics, utilizing real-time computer-assisted processing of music performed by live musicians. The piece explores various combinations of interactive relationships between players and electronics, ranging from relatively basic processing effects to musical gestures achieved through stages of computer analysis, in which resulting sounds are crafted according to parameters of the incoming musical material. Additionally, some elements of interaction are multi-dimensional, in that they rely on the participation of two or more performers fulfilling distinct roles in the interactive process with the computer in order to generate musical material. Through processes of controlled randomness, several electronic effects induce elements of chance into their realization so that no two performances of this work are exactly alike. The piece gets its name from the notion that real-time computer-assisted processing, in which sound pressure waves are transduced into electrical energy, converted to digital data, artfully modified, converted back into electrical energy and transduced into sound waves, represents a “bending” of time.

The Bill Evans Trio featuring bassist Scott LaFaro and drummer Paul Motian is widely regarded as one of the most important and influential piano trios in the history of jazz, lauded for its unparalleled level of group interaction. Most analyses of Bill Evans’ recordings, however, focus on his playing alone and fail to take group interaction into account. This paper examines one performance in particular, of Victor Young’s “My Foolish Heart” as recorded in a live performance by the Bill Evans Trio in 1961. In Part One, I discuss Steve Larson’s theory of musical forces (expanded by Robert S. Hatten) and its applicability to jazz performance. I examine other recordings of ballads by this same trio in order to draw observations about normative ballad performance practice. I discuss meter and phrase structure and show how the relationship between the two is fixed in a formal structure of repeated choruses. I then develop a model of perpetual motion based on the musical forces inherent in this structure. In Part Two, I offer a full transcription and close analysis of “My Foolish Heart,” showing how elements of group interaction work with and against the musical forces inherent in the model of perpetual motion to achieve an unconventional, dynamic use of double-time. I explore the concept of a unified agential persona and discuss its role in imparting the song’s inherent rhetorical tension to the instrumental musical discourse.