The effect of prolonged reading on visual functions and reading performance in students with low vision

This study is the first to investigate the effect of prolonged reading on reading performance and visual functions in students with low vision. The study focuses on one of the most common modes of achieving adequate magnification for reading by students with low vision, their close reading distance (proximal or relative distance magnification). Close reading distances impose high demands on near visual functions, such as accommodation and convergence. Previous research on accommodation in children with low vision shows that their accommodative responses are reduced compared to normal vision. In addition, there is an increased lag of accommodation for higher stimulus levels as may occur at close reading distance. Reduced accommodative responses in low vision and higher lag of accommodation at close reading distances together could impact on reading performance of students with low vision especially during prolonged reading tasks. The presence of convergence anomalies could further affect reading performance. Therefore, the aims of the present study were 1) To investigate the effect of prolonged reading on reading performance in students with low vision 2) To investigate the effect of prolonged reading on visual functions in students with low vision. This study was conducted as cross-sectional research on 42 students with low vision and a comparison group of 20 students with normal vision, aged 7 to 20 years. The students with low vision had vision impairments arising from a range of causes and represented a typical group of students with low vision, with no significant developmental delays, attending school in Brisbane, Australia. All participants underwent a battery of clinical tests before and after a prolonged reading task. An initial reading-specific history and pre-task measurements that included Bailey-Lovie distance and near visual acuities, Pelli-Robson contrast sensitivity, ocular deviations, sensory fusion, ocular motility, near point of accommodation (pull-away method), accuracy of accommodation (Monocular Estimation Method (MEM)) retinoscopy and Near Point of Convergence (NPC) (push-up method) were recorded for all participants. Reading performance measures were Maximum Oral Reading Rates (MORR), Near Text Visual Acuity (NTVA) and acuity reserves using Bailey-Lovie text charts. Symptoms of visual fatigue were assessed using the Convergence Insufficiency Symptom Survey (CISS) for all participants. Pre-task measurements of reading performance and accuracy of accommodation and NPC were compared with post-task measurements, to test for any effects of prolonged reading. The prolonged reading task involved reading a storybook silently for at least 30 minutes. The task was controlled for print size, contrast, difficulty level and content of the reading material. Silent Reading Rate (SRR) was recorded every 2 minutes during prolonged reading. Symptom scores and visual fatigue scores were also obtained for all participants. A visual fatigue analogue scale (VAS) was used to assess visual fatigue during the task, once at the beginning, once at the middle and once at the end of the task. In addition to the subjective assessments of visual fatigue, tonic accommodation was monitored using a photorefractor (PlusoptiX CR03™) every 6 minutes during the task, as an objective assessment of visual fatigue. Reading measures were done at the habitual reading distance of students with low vision and at 25 cms for students with normal vision. The initial history showed that the students with low vision read for significantly shorter periods at home compared to the students with normal vision. The working distances of participants with low vision ranged from 3-25 cms and half of them were not using any optical devices for magnification. Nearly half of the participants with low vision were able to resolve 8-point print (1M) at 25 cms. Half of the participants in the low vision group had ocular deviations and suppression at near. Reading rates were significantly reduced in students with low vision compared to those of students with normal vision. In addition, there were a significantly larger number of participants in the low vision group who could not sustain the 30-minute task compared to the normal vision group. However, there were no significant changes in reading rates during or following prolonged reading in either the low vision or normal vision groups. Individual changes in reading rates were independent of their baseline reading rates, indicating that the changes in reading rates during prolonged reading cannot be predicted from a typical clinical assessment of reading using brief reading tasks. Contrary to previous reports the silent reading rates of the students with low vision were significantly lower than their oral reading rates, although oral and silent reading was assessed using different methods. Although the visual acuity, contrast sensitivity, near point of convergence and accuracy of accommodation were significantly poorer for the low vision group compared to those of the normal vision group, there were no significant changes in any of these visual functions following prolonged reading in either group. Interestingly, a few students with low vision (n =10) were found to be reading at a distance closer than their near point of accommodation. This suggests a decreased sensitivity to blur. Further evaluation revealed that the equivalent intrinsic refractive errors (an estimate of the spherical dioptirc defocus which would be expected to yield a patient’s visual acuity in normal subjects) were significantly larger for the low vision group compared to those of the normal vision group. As expected, accommodative responses were significantly reduced for the low vision group compared to the expected norms, which is consistent with their close reading distances, reduced visual acuity and contrast sensitivity. For those in the low vision group who had an accommodative error exceeding their equivalent intrinsic refractive errors, a significant decrease in MORR was found following prolonged reading. The silent reading rates however were not significantly affected by accommodative errors in the present study. Suppression also had a significant impact on the changes in reading rates during prolonged reading. The participants who did not have suppression at near showed significant decreases in silent reading rates during and following prolonged reading. This impact of binocular vision at near on prolonged reading was possibly due to the high demands on convergence. The significant predictors of MORR in the low vision group were age, NTVA, reading interest and reading comprehension, accounting for 61.7% of the variances in MORR. SRR was not significantly influenced by any factors, except for the duration of the reading task sustained; participants with higher reading rates were able to sustain a longer reading duration. In students with normal vision, age was the only predictor of MORR. Participants with low vision also reported significantly greater visual fatigue compared to the normal vision group. Measures of tonic accommodation however were little influenced by visual fatigue in the present study. Visual fatigue analogue scores were found to be significantly associated with reading rates in students with low vision and normal vision. However, the patterns of association between visual fatigue and reading rates were different for SRR and MORR. The participants with low vision with higher symptom scores had lower SRRs and participants with higher visual fatigue had lower MORRs. As hypothesized, visual functions such as accuracy of accommodation and convergence did have an impact on prolonged reading in students with low vision, for students whose accommodative errors were greater than their equivalent intrinsic refractive errors, and for those who did not suppress one eye. Those students with low vision who have accommodative errors higher than their equivalent intrinsic refractive errors might significantly benefit from reading glasses. Similarly, considering prisms or occlusion for those without suppression might reduce the convergence demands in these students while using their close reading distances. The impact of these prescriptions on reading rates, reading interest and visual fatigue is an area of promising future research. Most importantly, it is evident from the present study that a combination of factors such as accommodative errors, near point of convergence and suppression should be considered when prescribing reading devices for students with low vision. Considering these factors would also assist rehabilitation specialists in identifying those students who are likely to experience difficulty in prolonged reading, which is otherwise not reflected during typical clinical reading assessments.

Continuous infusion of ticarcillin-clavulanate for home treatment of serious infections : clinical efficacy, safety, pharmacokinetics and pharmacodynamics

Continuous infusion (CI) ticarcillin–clavulanate is a potential therapeutic improvement over conventional intermittent dosing because the major pharmacodynamic (PD) predictor of efficacy of β-lactams is the time that free drug levels exceed the MIC. This study incorporated a 6-year retrospective arm evaluating efficacy and safety of CI ticarcillin–clavulanate in the home treatment of serious infections and a prospective arm additionally evaluating pharmacokinetics (PK) and PD. In the prospective arm, steady-state serum ticarcillin and clavulanate levels and MIC testing of significant pathogens were performed. One hundred and twelve patients (median age, 56 years) were treated with a CI dose of 9.3–12.4 g/day and mean CI duration of 18.0 days. Infections treated included osteomyelitis (50 patients), septic arthritis (6), cellulitis (17), pulmonary infections (12), febrile neutropenia (7), vascular infections (7), intra-abdominal infections (2), and Gram-negative endocarditis (2); 91/112 (81%) of patients were cured, 14 (13%) had partial response and 7 (6%) failed therapy. Nine patients had PICC line complications and five patients had drug adverse events. Eighteen patients had prospective PK/PD assessment although only four patients had sufficient data for a full PK/PD evaluation (both serum steady-state drug levels and ticarcillin and clavulanate MICs from a bacteriological isolate), as this was difficult to obtain in home-based patients, particularly as serum clavulanate levels were found to deteriorate rapidly on storage. Three of four patients with matched PK/PD assessment had free drug levels exceeding the MIC of the pathogen. Home CI of ticarcillin–clavulanate is a safe, effective, convenient and practical therapy and is a therapeutic advance over traditional intermittent dosing when used in the home setting.

Channel blurring and consumer expectations : evidence in Chile

An important trend in Chilean retailing industry is the increase in channel blurring. This investigation attempts to identify the relevant store attributes for different retail formats (grocery, department store, drug store, and home improvement). Do consumer store attribute saliency vary for different retail formats? Interviews identified twelve salient store attributes for the different retail formats. Survey results showed differences in store attribute saliencies for consumers when shopping at different formats. Seven of the twelve variables showed significant differences across formats. However, two attributes were relatively important for all four retail formats: product quality and responsiveness of employees.

Home depot in Chile: case study

Retailing is rapidly becoming a global industry and many retailers are expanding to foreign markets. However, several retailers successful in their home countries have failed in emerging markets such as Chile. Little is known why these retailers succeed in some venues and not others. A case study of the failed operations of Home Depot in that Chilean market was developed in order to understand this issue in more depth. This case study included an analysis of the Chilean marketplace, expert and consumer interviews, and analysis of data from secondary sources. Finding showed difference in that institutional environment between Chile and the U.S., due to a higher family and relational orientation in Chile. Home Depot defied institutional pressures and maintained standardized retail practices.

Discharge planning in the emergency department : a comprehensive approach

Discharge planning has become increasingly important, with current trends toward shorter hospital stays, increased health care costs, and more community-based health services. Effective discharge planning ensures the safety and ongoing care for patients,1 and it also benefits health care providers and organizations. It results in shorter hospital stays, fewer readmissions, higher access rates to post-hospitalization services, greater patient satisfaction with the discharge, and improved quality of life and continuity of care.[2] and [3] All acute care patients and their caregivers require some degree of preparation for discharge home—education about their health status, risks, and treatment; help setting health goals and maintaining a good level of self-care; information about community resources; and follow-up appointments and referrals to appropriate community health providers. Inadequate preparation exposes the patient to unnecessary risks of recurrence or complications of the acute complaint, neglect of nonacute comorbidities, mismanagement and side effects of medication, disruption of family and social life, emotional distress, and financial loss.[2], [3] and [4] The result may be re-presentation to the emergency department. It is noteworthy that up to 18% of ED presentations are revisits within 72 hours of the original visit5; many of these are considered preventable.6 It is a primary responsibility of nurses to ensure that patients return to the community adequately prepared and with appropriate support in place. Up to 65% of ED patients are discharged home from the emergency department,7 and the characteristics of the emergency department and its patient population make the provision of a high standard of discharge planning uniquely difficult. In addition, discharge planning is neglected in contemporary emergency nursing—there are no monographs devoted to the subject, and there is little published research. In this article 3 issues are explored: the importance of emergency nurses’ participation in the discharge-planning process, impediments to their participation; and strategies to improve discharge planning in the emergency department.

Destination brand positions of a competitive set of near-home destinations

Although the branding literature commenced during the 1940s, the first publications related to destination branding did not emerge until half a century later. A review of 74 destination branding publications by 102 authors from the first 10 years of destination branding literature (1998-2007) found at least nine potential research gaps warranting attention by researchers. In particular, there has been a lack of research examining the extent to which brand positioning campaigns have been successful in enhancing brand equity in the manner intended in the brand identity. The purpose of this paper is to report the results of an investigation of brand equity tracking for a competitive set of destinations in Queensland, Australia between 2003 and 2007. A hierarchy of consumer-based brand equity (CBBE) provided an effective means to monitor destination brand positions over time. A key implication of the results was the finding that there was no change in brand positions for any of the five destinations over the four year period. This leads to the proposition that destination position change within a competitive set will only occur slowly over a long period of time. The tabulation of 74 destination branding case studies, research papers, conceptual papers and web content analyses provides students and researchers with a useful resource on the current state of the field.

The 2006 CSRC guidelines for articles of Association of Chinese listed companies : critiquing from an Australian perspective

Compares the Chinese Securities and Regulatory Commission's guidelines for articles of association of listed companies issued in 2006 with 'replaceable' rules in the Australian Corporations Act 2001. Discusses the provisions of the Chinese guidelines and the Australian rules on corporate constitution, interpretation, a company's representative, object clauses, shareholders' powers and meetings and directors. Questions whether the Chinese guidelines facilitate effective corporate governance.

Collaborative business process modeling using 3D virtual environments

Process modeling is a complex organizational task that requires many iterations and communication between the business analysts and the domain specialists involved in the process modeling. The challenge of process modeling is exacerbated, when the process of modeling has to be performed in a cross-organizational, distributed environment. Some systems have been developed to support collaborative process modeling, all of which use traditional 2D interfaces. We present an environment for collaborative process modeling, using 3D virtual environment technology. We make use of avatar instantiations of user ego centres, to allow for the spatial embodiment of the user with reference to the process model. We describe an innovative prototype collaborative process modeling approach, implemented as a modeling environment in Second Life. This approach leverages the use of virtual environments to provide user context for editing and collaborative exercises. We present a positive preliminary report on a case study, in which a test group modelled a business process using the system in Second Life.

Enablers and barriers to the organizational adoption of sustainable business practices

Individuals, organizations, and governments are increasingly becoming aware of the necessity of sustainability in living, organizing, performing, and managing work. In this context, “green IS” has become an established colloquial term, acknowledging that information technology, corporate information systems, and the surrounding practices are both a contributor to the sustainability challenge and a potential enabler for green and sustainable practices. To date, however, there are few reported studies on the role of information systems for the challenge, and solution, of sustainability. This paper presents results from a case study of a world-wide operating IT software solution provider that is engaged in the development and adoption of sustainable practices. Our study suggests that the adoption of sustainable practices comes along with a number of particularities. We found information technology to be a key enabler of transparency about the progress of sustainability operations. We further found personal, motivator factors as well as organizational factors such as business inclusion, strategy definition, and a dialectic top-management and bottom-up support, to play a role in enabling a company to manage their sustainability. We describe a set of conjectures forthcoming from our case analysis, and detail some implications for further research in this area.

An Integrative framework of the factors affecting process model understanding : a learning perspective

Process models are used by information professionals to convey semantics about the business operations in a real world domain intended to be supported by an information system. The understandability of these models is vital to them actually being used. After all, what is not understood cannot be acted upon. Yet until now, understandability has primarily been defined as an intrinsic quality of the models themselves. Moreover, those studies that looked at understandability from a user perspective have mainly conceptualized users through rather arbitrary sets of variables. In this paper we advance an integrative framework to understand the role of the user in the process of understanding process models. Building on cognitive psychology, goal-setting theory and multimedia learning theory, we identify three stages of learning required to realize model understanding, these being Presage, Process, and Product. We define eight relevant user characteristics in the Presage stage of learning, three knowledge construction variables in the Process stage and three potential learning outcomes in the Product stage. To illustrate the benefits of the framework, we review existing process modeling work to identify where our framework can complement and extend existing studies.

The home stigma : adverse selection in ADRs and the home capital market environment

We investigate whether characteristics of the home country capital environment, such as information disclosure and investor rights protection continue to affect ADRs cross-listed in the U.S. Using microstructure measures as proxies for adverse selection, we find that characteristics of the home markets continue to be relevant, especially for emerging market firms. Less transparent disclosure, poorer protection of investor rights and weaker legal institutions are associated with higher levels of information asymmetry. Developed market firms appear to be affected by whether or not home business laws are common law or civil law legal origin. Our finding contributes to the bonding literature. It suggests that cross-listing in the U.S. should not be viewed as a substitute for improvement in the quality of local institutions, and attention must be paid to improve investor protection in order to achieve the full benefits of improved disclosure. Improvement in the domestic capital market environment can attract more investors even for U.S. cross-listed firms.

Home advantage

This article discusses a house located in Bowen Hills, Brisbane, Queensland, that was designed by its owner, architect Paul Curran of Push. The house features a zinc clad multipurpose structure in front of the living areas that also acts to provide privacy to the house from its busy street.

Augmenting RatSLAM using FAB-MAP-based visual data association

This paper investigates the use of the FAB-MAP appearance-only SLAM algorithm as a method for performing visual data association for RatSLAM, a semi-metric full SLAM system. While both systems have shown the ability to map large (60-70km) outdoor locations of approximately the same scale, for either larger areas or across longer time periods both algorithms encounter difficulties with false positive matches. By combining these algorithms using a mapping between appearance and pose space, both false positives and false negatives generated by FAB-MAP are significantly reduced during outdoor mapping using a forward-facing camera. The hybrid FAB-MAP-RatSLAM system developed demonstrates the potential for successful SLAM over large periods of time.

Social Participation of Community Dwelling Stroke Survivors [Published Abstract: From the Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference 2009]

Disability following a stroke can impose various restrictions on patients’ attempts at participating in life roles. The measurement of social participation, for instance, is important in estimating recovery and assessing quality of care at the community level. Thus, the identification of factors influencing social participation is essential in developing effective measures for promoting the reintegration of stroke survivors into the community. Data were collected from 188 stroke survivors (mean age 71.7 years) 12 months after discharge from a stroke rehabilitation hospital. Of these survivors, 128 (61 %) had suffered a first ever stroke, and 81 (43 %) had a right hemisphere lesion. Most (n = 156, 83 %) were living in their own home, though 32 (17 %) were living in residential care facilities. Path analysis was used to test a hypothesized model of participation restriction which included the direct and indirect effects between social, psychological and physical outcomes and demographic variables. Participation restriction was the dependent variable. Exogenous independent variables were age, functional ability, living arrangement and gender. Endogenous independent variables were depressive symptoms, state self-esteem and social support satisfaction. The path coefficients showed functional ability having the largest direct effect on participation restriction. The results also showed that more depressive symptoms, low state self-esteem, female gender, older age and living in a residential care facility had a direct effect on participation restriction. The explanatory variables accounted for 71% of the variance in explaining participation restriction. Prediction models have empirical and practical applications such as suggesting important factors to be considered in promoting stroke recovery. The findings suggest that interventions offered over the course of rehabilitation should be aimed at improving functional ability and promoting psychological aspects of recovery. These are likely to enhance stroke survivors resume or maximize their social participation so that they may fulfill productive and positive life roles.

The 2010 Native American and Indigenous Studies Association Conference

The 2010 Native American Indigenous Studies Conference was held at The Westin La Paloma Resort, Tucson, Arizona, USA from 20-22 May. The conference was scholarly and interdisciplinary and intended for Indigenous and non-Indigenous scholars who work in American Indian/ Native American/ First Nations/ Aboriginal/ Indigenous Studies. The 2010 gathering attracted 768 registrations from the USA, Canada, Hawaii, Mexico, New Zealand and Australia and other countries. This paper is a personal reflection and overview of the 2010 Conference.