Visual Dependency and Dizziness after Vestibular Neuritis

Symptomatic recovery after acute vestibular neuritis (VN) is variable, with around 50% of patients reporting long term vestibular symptoms; hence, it is essential to identify factors related to poor clinical outcome. Here we investigated whether excessive reliance on visual input for spatial orientation (visual dependence) was associated with long term vestibular symptoms following acute VN. Twenty-eight patients with VN and 25 normal control subjects were included. Patients were enrolled at least 6 months after acute illness. Recovery status was not a criterion for study entry, allowing recruitment of patients with a full range of persistent symptoms. We measured visual dependence with a laptop-based Rod-and-Disk Test and severity of symptoms with the Dizziness Handicap Inventory (DHI). The third of patients showing the worst clinical outcomes (mean DHI score 36–80) had significantly greater visual dependence than normal subjects (6.35° error vs. 3.39° respectively, p = 0.03). Asymptomatic patients and those with minor residual symptoms did not differ from controls. Visual dependence was associated with high levels of persistent vestibular symptoms after acute VN. Over-reliance on visual information for spatial orientation is one characteristic of poorly recovered vestibular neuritis patients. The finding may be clinically useful given that visual dependence may be modified through rehabilitation desensitization techniques.

Building Information Modelling in UK Construction Projects: A State of the Art Review

This paper aims to present a state-of-the-art review of the scope and practical implications of the Building Information Modelling (BIM) platform in the UK construction practice. Theoretical developments suggest that BIM is an integration of both product and process innovation, not just a disparate set of software tools. BIM provides effective collaboration, visual representation and data management, which enable the smooth flow of information throughout the project’s lifecycle. The most frequently reported benefits are related to Capital Cost (capex) and Operational costs (opex) and time savings. Key challenges, however, focus on the interoperability of software, capital installation costs, in-house experience, client preference and cultural issues within design teams and within the organisation. The paper concludes with a critical commentary on the changing roles and a process required to implement BIM in UK construction projects, and suggests areas for further research.