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.

Effects of task lighting on visual function in age-related macular degeneration

The purpose was to investigate the effects of the spectral power distribution (SPD) and illuminance of task lighting on visual function in age-related macular degeneration (ARMD) compared to normal healthy eyes. Twenty-eight subjects with ARMD and 18 age-matched normal subjects were studied. The effects on visual function were determined for four common task light sources: standard pearl coat incandescent (SP), daylight blue incandescent (DL), warm white fluorescent (WW) and cool white fluorescent (CW). Apart from a small, statistically significant improvement in contrast sensitivity with DL compared to SP lighting (0.5 dB, p = 0.01), there were no significant effects of SPD on other visual functions and no differences in the effects for subjects with ARMD and those with normal vision. Thus, for task lighting typically used in low vision rehabilitation, the SPD would seem to be of minimal clinical importance to visual function. However, increasing the task illuminance had a greater effect on visual function, in particular for subjects with ARMD (p < 0.01). For an increase in illuminance from 300 to 3000 lux, the mean increase in contrast sensitivity and near visual acuity was 1.5 dB and 0.13 log MAR, respectively. Although this effect is not large, we suggest that it is clinically relevant and supports the provision of additional task illuminance as an important part of low vision rehabilitation for patients with ARMD.

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.

Monumental vision : a confrontation with the image of the Eternal Return

"Monumental Vision” is a nuanced summary of Nietzschean nihilism and the Eternal Return as rite of passage for free subjects and as condensed image of speculative intelligence proper. Utilizing Gerhard Richter’s “Sheet 692” from Atlas, a series of photographs of the mountains and lake at Sils Maria, Switzerland, as summary judgment of the limit imposed by this condition on all systems of representation, this form of vision discloses the chiasmus embedded in consciousness itself. In constantly revisiting Sils, the very location where Nietzsche “suffered” the vision of the Eternal Return, Richter has engaged repeatedly this origin for what has come into his work via Nietzsche – that is, an elective veil that refuses all compromises with transcendence until such is merged with immanence.

As situated amidst modernist “ideology as intellection”, and subsequent nascent forms of anti-modernism, the Eternal Return as image also signals the return of the Kantian “aesthetic-teleological” synthesis in non-discursive or purely visual agency. As an elective form of aesthetic vision, and as image of time insofar as it registers an overwhelming externality (Other) that nominally swallows and empowers the subject at once, this excoriating sense of universal praxis underwrites artistic and architectural production of the highest order, renegotiating concepts of the paradigmatic.

Utilizing Georg Simmel’s late work on Rembrandt (1916) and his encounter with Schopenhauer and Nietzsche (1907), the essay suggests that by the 1920s the avant-garde premises of modernism had already come under attack by an ahistorical and synoptic vision here denoted “monumental vision,” which also contains the imprint of eschatological time (invoking a schism present in rationality as such). The two readings of this image perpetrated by Karl Löwith in Nietzsche’s Philosophy of the Eternal Recurrence of the Same (Nietzsches Philosophie der ewigen Wiederkehr des Gleichen, 1935), or the cosmological and the ethical, while considered irreconcilable by Löwith, have since the 1960s been recalibrated through the figure of the event to pose possible scenarios out of the stalemate of the confrontation between Self and Other (ipseity and alterity) buried within this image as limit. In this manner, the image of the Eternal Return stands at the boundary between two forms of time (or two worlds) and signals the irreducible confrontation present in speculative thought and the necessity of closure through an aesthetic vision that produces a unitary field for all creative acts.

Notably, Nietzsche’s startling vision from Zarathustra suggests that the limit imposed by the Eternal Return is also a mask for an austere condition within subjectivity closely resembling the conundrum of Fichte’s I facing I, or thought turned toward thought itself (absolute subjectivity as cipher for Being). In Alenka Zupančič’s reading, in The Shortest Shadow: Nietzsche’s Philosophy of the Two (2003), the Eternal Return effectively contains a secret formal function that grinds all “error” to dust – a highly suggestive interpretation that also neutralizes the schism introduced by Löwith between the cosmological and the ethical.

Modeling of a stereo vision system using a genetic algorithm based fuzzy linear regression

In this paper a fuzzy linear regression (FLR) model integrated with a genetic algorithm (GA) is proposed. The proposed GA-FLR model is applied to modeling of a stereo vision system. A set of empirical data from stereo vision object measurement is collected based on the full factorial design technique. Three regression models, namely ordinary least-squares regression (OLS), FLR, and GA-FLR, are developed, and with their performances compared. The results show that the proposed GA-FLR model performs better than OLS and FLR in modeling of a stereo vision system.

Instrumental vision

This chapter interrogates stereo-immersive ‘virtual reality’ (VR), the technology that enables a perceiver to experience what it is like to be immersed in a simulated environment. While the simulation is powered by the “geometry engine” (Cutting, 1997: 31) associated with high-end computer imaging technology, the visual experience itself is powered by ordinary human vision: the vision system’s innate capacity to see “in 3D”. To understand and critically appraise stereo-immersive VR, we should study not its purported ‘virtuality’, but its specific visuality, because the ‘reality’ of a so-called ‘virtual environment’ is afforded by the stereoacuity of binocular vision itself. By way of such a critique of the visuality of stereo-immersive VR, this chapter suggests that we think about the ‘practice’ of vision, and consider on what basis vision can have its own ‘materiality’. Pictorial perception is proposed as an exemplary visual mode in which the possibilities of perception might emerge. Against the ‘possibilities’ of vision associated with pictures, the visuality of stereo-immersive VR emerges as a harnessing, or ‘instrumentalisation’ of vision’s innate capabilities. James J. Gibson’s ‘ecological’ approach to vision studies is referenced to show the degree to which developers of VR have sought — and succeeded — to mimic the ‘realness’ of ordinary perceptual reality. This raises a question concerning whether the success of stereo-immersive VR is simultaneously the source of its own perceptual redundancy: for to bring into being the perceptual basis of ordinary ‘real’ reality, is to return the perceiver to what is already familiar and known.

Embedded vision-based autonomous move-to-grasp approach for a mobile manipulator

This paper proposes a vision‐based autonomous move‐to‐grasp approach for a compact mobile manipulator under some low and small environments. The visual information of specified object with a radial symbol and an overhead colour block is extracted from two CMOS cameras in an embedded way. Furthermore, the mobile platform and the postures of the manipulator are adjusted continuously by vision‐based control, which drives the mobile manipulator approaching the object. When the mobile manipulator is sufficiently close to the object, only the manipulator moves to grasp the object based on the incremental movement with its head end centre of the end‐effector conforming to a Bezier curve. The effectiveness of the proposed approach is verified by experiments.

Adaptive, eclectic and democratic : an alternative year 2020 vision of the place of psychiatry

It was the end of the academic year in 2020. On the third floor of the Southern Health University's administrative building, the five Vice-Chancellors of the Health Universities were gathering. Outside it was raining, but the patter of drops on the window only served to enhance the coziness of the meeting room. This annual event would take three days. The Vice-Chancellors enjoyed this meeting. They seldom saw each other during the busy academic year and under Professor Hope Brightview's 6 years of chairmanship they had been able to work well together to formulate a rational and profitable distribution of teaching, research and consultation services.

Image reduction operators based on non-monotonic averaging functions

Image reduction is a crucial task in image processing, underpinning many practical applications. This work proposes novel image reduction operators based on non-monotonic averaging aggregation functions. The technique of penalty function minimisation is used to derive a novel mode-like estimator capable of identifying the most appropriate pixel value for representing a subset of the original image. Performance of this aggregation function and several traditional robust estimators of location are objectively assessed by applying image reduction within a facial recognition task. The FERET evaluation protocol is applied to confirm that these non-monotonic functions are able to sustain task performance compared to recognition using nonreduced images, as well as significantly improve performance on query images corrupted by noise. These results extend the state of the art in image reduction based on aggregation functions and provide a basis for efficiency and accuracy improvements in practical computer vision applications.

In-home monitoring of older adults with vision impairment: exploring patients', caregivers' and professionals' views

Objective
To develop a conceptual framework for the design of an in-home monitoring system (IMS) based on the requirements of older adults with vision impairment (VI), informal caregivers and eye-care rehabilitation professionals.

Materials and Methods
Concept mapping, a mixed-methods statistical research tool, was used in the construction of the framework. Overall, 40 participants brainstormed or sorted and rated 83 statements concerning an IMS for older adults with VI. Multidimensional scaling and hierarchical cluster analysis were employed to construct the framework. A questionnaire yielded further insights into the views of a wider sample of older adults with VI (n=78) and caregivers (n=25) regarding IMS.

Results
Concept mapping revealed a nine-cluster model of IMS-related aspects including affordability, awareness of system capabilities, simplicity of installation, operation and maintenance, system integrity and reliability, fall detection and safe movement, user customization, user preferences regarding information delivery, and safety alerts for patients and caregivers. From the questionnaire, independence, safety and fall detection were the most commonly reported reasons for older adults and caregivers to accept an IMS. Concerns included cost, privacy, security of the information obtained through monitoring, system accuracy, and ease of use.

Discussion
Older adults with VI, caregivers and professionals are receptive to in-home monitoring, mainly for fall detection and safety monitoring, but have concerns that must be addressed when developing an IMS.

Conclusion
Our study provides a novel conceptual framework for the design of an IMS that will be maximally acceptable and beneficial to our ageing and vision-impaired population.

The gardens on Anlaby - a utopian dream

Anlaby Station is the oldest sheep stud in South Australia (SA) dating back to 1839. The gardens have been noted as significant exemplars, Beames & Whitehill (1992), Swinbourne (1982), and in Pastoral Homes of Australia (1911) published by The Pastoral Review, wherein Anlaby was described as “being of no particular beauty architecturally . But the gardens are unique.” The Anlaby property is on the SA State Heritage Register and the Anlaby Gardens are listed in the Oxford Companion to Australian Gardens (2002). The beginnings of Anlaby in 1839 are integral to the colonial expansion of the interior of South Australia. Anlaby at this time was a completely self-contained community within a sheep station containing a survival garden, much like a self- contained English manor-village. The process of land sales offered by the SA government enabled Anlaby to expand, wherein wealth flowed and gradually the survival garden style at Anlaby was transformed into an extensive decorative garden style. This enabled the garden to act as a backdrop for major South Australian society and public gatherings. The driving force behind the garden during its height was the fashionable plant trends in the United Kingdom. This is evidenced by the inclusion of an extensive stove house, grotto, roses and the Gardenesque style of plantings. Traditional English head gardeners were also employed to manage the garden. The realisation of the beauty of native plants was never allowed in the inner world of this landscape; it always remained on the perimeter. The owner’s vision of the garden was Utopian, however, due to climatic forces, the dream was not fully realised. The challenge now lies in preserving this Utopian dream for future generations. This paper considers the historical evolution of the property, its context as a historical exemplar and the challenges facing its future conservation having regard to Adelaide peri-urban, climate change, and differing owner economic circumstances.