Australian Unity wellbeing index survey 25.1 part A : report "The wellbeing of Australians - bushfires and floods : following up the effects of fires in Victoria and floods in Queensland"

The Australian Unity Wellbeing Index monitors the subjective wellbeing of the Australian population. Our first survey was conducted in April 2001 and this report concerns a special Survey 25.1, undertaken in October 2011. The survey was commissioned to detect whether the disastrous floods in North Queensland in the period December 2010 through February 2011, and fires in Victoria in the period January through February 2009, continued to affect the subjective wellbeing of people continuing to live in the disaster areas.

This survey involved 1,215 respondents, with 600 drawn from Victoria and 615 from Queensland. The questionnaire comprised only the Personal Wellbeing Index and a small set of demographic questions. In all other respects the methodology of the survey followed our normal procedures.1

Measurement of the refractive index of soft contact lenses during wear

Purpose: To determine whether the refractive index (RI) of a soft contact lens can be evaluated using refractometry while the lens remains on the eye and to compare this with more traditional ex vivo RI measurements.

Methods: A slitlamp apparatus was modified to incorporate a customized Atago hand refractometer. With a double-masked study design, nine adapted symptomatic soft contact lens wearers wore a contact lens in each eye (lotrafilcon B and etafilcon A) in a randomized order. In vivo RI was determined from the relative Brix scale measurements immediately after lens insertion and after 1 and 10 hr of lens wear. Ex vivo refractometry was performed after 10 hr of lens wear for comparison. Means ± standard errors of the means are reported.

Results: In vivo RI values at baseline were 1.422 ± 0.0004 (lotrafilcon B) and 1.405 ± 0.0021 (etafilcon A); after 1 hr of lens wear, values were 1.423 ± 0.0006 and 1.408 ± 0.0007, respectively; and after 10 hr of lens wear, values were 1.424 ± 0.0004 and 1.411 ± 0.0010, respectively. Ex vivo RI values at the end of the 10 hr wearing period were 1.424 ± 0.0003 (lotrafilcon B) and 1.412 ± 0.0017 (etafilcon A). The change in in vivo RI across the day was statistically significant for the etafilcon A lens (repeated-measures analysis of variance, P<0.01) but not for the lotrafilcon B lens (P>0.05).

Conclusions: This novel adaptation of refractometry was able to measure the RI of soft contact lenses during wear (without lens removal). End of day RI measurements using in vivo and ex vivo refractometry were comparable with each other. Future work is required to determine whether this in vivo method can improve our understanding of the relationships between soft contact lens RI, hydration, on-eye lens performance, and symptomology.

The development of the Melbourne low vision ADL index : a measure of vision disability

PURPOSE. To develop a new test of activities of daily living (ADLs) appropriate for the low-vision population: the Melbourne Low-Vision ADL Index (MLVAI).

METHODS. The MLVAI was designed as a desk-based clinical assessment, comprising 18 observed items on complex ADLs in part (a) and 9 questions on broad self-care ADLs in part (b). Each item was rated on a five-level descriptive scale from 0 to 4, based on independence, speed, and accuracy of performance. It was designed to be administered under standardized conditions with regard to the instructions, illumination, and working distances. The validity and reliability of the new MLVAI was determined for 122 subjects who were representative of the general low-vision population, in a cross-sectional study.

RESULTS. Two items were found to be redundant and were eliminated from the test. Thus, the final test comprised 25 items, with 100 being the highest possible score. Cronbach’s α indicated an internal reliability of 0.96, and an intraclass correlation coefficient indicated an overall reliability of 0.95. The SE of measurement was 4.5. According to Spearman’s correlation coefficient, the test–retest reliability was 0.94 (P < 0.001), and the interpractitioner reliability for five different pairs of practitioners was 0.90 or higher (P < 0.001). With regard to validity, there was a moderately high correlation with vision impairment (r = −0.68, P < 0.001). Using Rasch analysis, content validity was also demonstrated by good separation indexes (4.70 and 9.88) and high reliability scores (0.96 and 0.99) for the person and items parameters, respectively. Separate calculation of indexes and reliability scores for parts (a) and (b) indicated high content validity and reliability of each part. However, the separation indexes and reliability scores were higher for part (a) than for part (b). The correlation coefficient for part (a) and part (b) was 0.68.

CONCLUSIONS. The MLVAI is a highly valid and reliable standardized test of ADL performance for the general low-vision population. It may be used to assess patients with low vision and has the potential to be used as a measure of low-vision rehabilitation outcomes.

Preliminary investigation of the responsiveness of the Melbourne low vision ADL index to low-vision rehabilitation

Purpose. To conduct a preliminary investigation on the ability of the Melbourne Low Vision ADL Index to detect changes in functional ability as a result of low-vision rehabilitation.

Methods. Twenty two subjects with age-related macular degeneration (ARMD) who were newly referred to the Kooyong Low Vision Clinic were recruited. The Melbourne Low Vision ADL Index was administered prerehabilitation and postrehabilitation. Changes in scores and effect size statistics were analyzed.

Results. The median total score for the subjects prerehabilitation was 67, and the median total score postrehabilitation was 76. The difference in prerehabilitation and postrehabilitation scores was statistically significant (Wilcoxon signed rank test = 248.5, p < 0.001). The mean change score for the total Melbourne Low Vision ADL Index was 9.3 (SD, 5.6). Thus the overall effect size statistic (mean change score divided by SD of prerehabilitation score) was 0.78.

Conclusions. This preliminary investigation indicates that the Melbourne Low Vision ADL Index is responsive to a rehabilitation program for patients with ARMD. It has potential to be used as a measure of low-vision rehabilitation outcomes.

A weighted version of the Melbourne low-vision ADL index : a measure of disability impact

Objective. To develop a version of the Melbourne Low-Vision ADL Index that measures the personal impact of disability in activities of daily living (ADL's). Also, to determine the relationship between clinical measures of vision impairment and disability impact.

Methods. The Melbourne Low-Vision ADL Index (MLVAI) is a desk-based clinical assessment of disability in ADL's. Ability to perform each item is rated on a five-level descriptive scale from zero to four. In this study, the original version of the MLVAI was modified to measure disability impact. The simple modification involved weighting each item by the importance of that item to the person being tested. Importance was also rated on a five-level scale from zero to four. The validity and reliability of the Weighted Melbourne Low-Vision ADL Index (MLVAIW) was determined for 97 vision-impaired subjects in a cross-sectional study.

Results. Cronbach's alpha coefficient indicated an internal reliability of 0.94, and an intraclass correlation coefficient indicated an overall reliability of 0.88. The standard error of measurement was 24.7 points (out of a possible score of 400). There was a statistically significant difference in test scores between normal subjects and vision-impaired subjects. All vision measures had a high, statistically significant correlation with MLVAIW score. Near-word acuity had the strongest correlation (rs = 0.78, p < 0.001), followed by Melbourne Edge Test contrast sensitivity (rs = -0.72, p < 0.001). Visual field had the weakest correlation (rs = -0.52, p < 0.001). The best predictive model of MLVAIW score incorporated the variables age, near-word acuity, and visual field. Together, these variables accounted for 65.1% of the variance in MLVAIW score.

Conclusions. The MLVAI is highly valid and reliable when weighted by a scale that reflects the personal importance of ADL's. The MLVAIW can provide information over and above that obtained with the usual clinical vision measures and may be used to assess low-vision patients and to measure low-vision rehabilitation outcomes. It is suggested that the assessment of disability using the original MLVAI and the assessment of the impact of disability using the MLVAIW should be kept separate to facilitate the clear interpretation of the outcomes of low-vision rehabilitation.

Building monotonicity-preserving fuzzy inference models with optimization-based similarity reasoning and a monotonicity index

In this paper, a novel approach to building a Fuzzy Inference System (FIS) that preserves the monotonicity property is proposed. A new fuzzy re-labeling technique to re-label the consequents of fuzzy rules in the database (before the Similarity Reasoning process) and a monotonicity index for use in FIS modeling are introduced. The proposed approach is able to overcome several restrictions in our previous work that uses mathematical conditions in building monotonicity-preserving FIS models. Here, we show that the proposed approach is applicable to different FIS models, which include the zero-order Sugeno FIS and Mamdani models. Besides, the proposed approach can be extended to undertake problems related to the local monotonicity property of FIS models. A number of examples to demonstrate the usefulness of the proposed approach are presented. The results indicate the usefulness of the proposed approach in constructing monotonicity-preserving FIS models.

A monotonicity index for the monotone fuzzy modeling problem

In this paper, the problem of maintaining the (global) monotonicity and local monotonicity properties between the input(s) and the output of an FIS model is addressed. This is known as the monotone fuzzy modeling problem. In our previous work, this problem has been tackled by developing some mathematical conditions for an FIS model to observe the monotonicity property. These mathematical conditions are used as a set of governing equations for undertaking FIS modeling problems, and have been extended to some advanced FIS modeling techniques. Here, we examine an alternative to the monotone fuzzy modeling problem by introducing a monotonicity index. The monotonicity index is employed as an approximate indicator to measure the fulfillment of an FIS model to the monotonicity property. It allows the FIS model to be constructed using an optimization method, or be tuned to achieve a better performance, without knowing the exact mathematical conditions of the FIS model to satisfy the monotonicity property. Besides, the monotonicity index can be extended to FIS modeling that involves the local monotonicity problem. We also analyze the relationship between the FIS model and its monotonicity property fulfillment, as well as derived mathematical conditions, using the Monte Carlo method.

Construction of strong equality index from implication operators

We present the concept of strong equality index, staring from the definition of strong inclusion given by Dubois and Prade in 1980, We also present a construction method based on the use of implication operators and two specific properties of the implications.

Body mass index, sexual difficulties and sexual satisfaction among people in regular heterosexual relationships : a population-based study

Background/Aims:  The aims of this study were to clarify the relationship between body mass index (BMI) and sexual difficulties and to investigate if BMI influenced sexual satisfaction, over and above the effects of sexual difficulties.

Methods:  Cross-sectional analyses of a nationally representative computer-assisted telephone interview. Eight thousand, six hundred and fifty-six respondents were recruited by random digit dialling in 2004–2005. Only those in a sexually active, heterosexual relationship were included in the current analyses.

Results:  After adjustments for demographic factors, both overweight and obese male and female participants were more likely to report worrying during sex about whether their body was unattractive. Among women, associations were also found between higher BMI and lack of interest in sex. No other significant associations between BMI and sexual difficulties were evident. There was an association between BMI and extreme physical pleasure for women but not men over and above the effects of sexual difficulties, with obese women being more likely than normal weight women to report extreme physical pleasure. No associations were found for either men or women between BMI and whether or not they reported extreme emotional or sexual satisfaction with their relationship.

Conclusions:  With the exception of body image difficulties, there is little association between BMI and self-reported sexual difficulties. Furthermore, extreme sexual and emotional satisfaction appeared to be associated with the presence or absence of sexual difficulties and not overly influenced by BMI. Overall, clinicians and patients should be aware that being overweight is not necessarily detrimental to sexual functioning.