Visual results with the use of prismatic lenses in the treatment of congenital nystagmus: a clinical case

Purpose: It is important to establish a differential diagnosis between the different types of nystagmus, in order to give the appropriate clinical approach to every situation and to improve visual acuity. The nystagmus is normally blocked when the eyes are positioned in a particular way. This makes the child adopt a posture of ocular torticollis that reduces the nistagmiformes movements, improving the vision in this position. A way to promote the blocking of the nystagmic movements is by using prismatic lenses with opposite bases, to block or minimize the oscillatory movements. This results in a vision improvement and it reduces the anomalous head position. There is limited research on the visual results in children with nystagmus after using prisms with opposing bases. Our aim is to describe the impact on the visual acuity (VA ) of theprescription prism lenses in a nystagmus patient starting at 3 months of age. Methods: Case report on thirty month old caucasian male infant, with normal growth and development for their age, with an early onset of horizontal nystagmus at 3 months of age. Ophthalmic examination included slit lamp examination, fundus, refractive study, electrophysiological and magnetic resonance tests, measurement of VA over time with the Teller Acuity Cards (TAC ) in the distance agreed for the age. At age ten months, the mother noted a persistent turn to the right of the child’s head, which became increasingly more severe along the months. There’s no oscillopcia. At 24 months, an atropine refraction showed the following refractive error: 0D.: -1,50, OS: -0,50 and prismatic lens adapting OD 8 Δ nasal base and OE 8 Δ temporal base. Results: Thirty month old child, with adequate development for their age, with onset of idiopatic horizontal nystagmus, at 3 months of age. Normal ocular fundus and magnetic ressoance without alterations, sub-normal results in electrophysiological tests and VA with values below normal for age. At 6 months OD 20/300; OE 20/400; OU 20/300. At 9 months OD 20/250; OE 20/300; OU 20/150 (TAC a 38 cm). At 18 months OD 20/200; OE 20/100; OU 20/80 (TAC at 38 cm), when the head is turned to the right and the eyes in levoversão, the nystagmus decreases in a “neutral” area. At 24 month, with the prismatic glasses, OD 20/200 OE 20/100, OU20/80 (TAC at 54 cm, reference value is 20/30 – 20/100 para OU e 20/40 – 20/100 monocular), there was an increase in the visual acuity. The child did visual stimulation with multimedia devices and using glasses. After adaptation of prisms: at 30 months VA (with Cambridge cards) OD e OE = 6/18. The child improved the VA and reduced the anomalous head position. There is also improvement in mobility and fine motricity. Conclusion: Prisms with opposing bases., were used in the treatment of idiopathic nystagmus. Said prisms were adapted to reduce the skewed position of the head, and to improve VA and binocular function. Monitoring of visual acuity and visual stimulation was done using electronic devices. Following the use of prismatic, the patient improved significantly VA and the anomalous head position was reduced.

Military map of the United States of America : showing location of all forces in training /

Relief shown by hachures.

Map of the village of Jamaica, Queens County, N.Y. : showing every lot and building.

Cadastral map showing lot lines, property-owners' names, and planned streets.

The role of the school library: resource center in the current educational environment

Principle 7 of the Declaration of the Rights of the Child (UN General Assembly, 1959) states in part: "The child has the right to receive education which will be free and compulsory ... You will be given an education that promotes their general education and training on an equal opportunity to develop their individual judgment skills and sense of moral and social responsibility, and to become a useful member of society. " I will expose to you that the school library resource center is the general instrument essential to fulfill this right of the child. Within the comprehensive range of materials and acquisition objective of their materials, school library complements and supports all aspects of the educational program.

A MORE COMPLETE STREET A STREET FOR EVERYONE TO ENJOY, NORTH EAST STREET, FREDERICK, MARYLAND – A DESIGN INVESTIGATION OF DIFFERENT STREET DESIGN THEORIES

This design-research thesis suggests that the improvement of North East Street performances by using Complete Streets, Green Street, Place Making and Context Sensitive Solution principles and practices. Heavily used by a variety of users, often conflicting with one another, University of Maryland Campus Drive would benefit from a major planning and design amelioration to meet the increasing demands of serving as a city main street. The goal of this thesis project is to prioritize the benefits for pedestrians in the right-of-way and improve the pedestrian experience. This goal also responds to the recent North East Street Extension Phrase I of economic renaissances. The goal of this design-research thesis will be achieved focusing on four aspects. First, the plans and designs will suggest to building mixed use blocks, increase the diversity of street economic types and convenience of people’s living. Second, design and plans will propose bike lanes, separate driving lanes from sidewalks and bike lanes by street tree planters, and narrow driving lanes to reduce vehicular traffic volume and speed in order to reduce pedestrian and vehicle conflicts. Third, plans and designs will introduce bioswales, living walls and raingardens to treat and reuse rain water. Finally, the plans and designs will seek to preserve local culture and history by adding murals and farmers market. The outcome of the design-research thesis project is expected to serve as an example of implementing Complete Streets, Green Street, Place Making and Context Sensitive Solution principles and practices in urban landscape, where transportation, environment and social needs interact with each other.

In-vehicle avatars to elicit social response and change driving behaviour

Social and psychological theories have provided a plethora of evidence showing that the physical difficulty to express appropriate social interactions between drivers expresses itself in aggression, selfish driving and anti-social behaviour. Therefore there is a need to improve interactions between drivers and allow clearer collective decision making between them. Personal characteristics and the driving situations play strong roles in driver’s aggression. Our approach is centered around the driving situation as opposed to focusing on personality characteristics. It examines aggression and manipulates contextual variables such as driver’s eye contact exchanges. This paper presents a new unobtrusive in-vehicle system that aims at communicating drivers’ intentions, elicit social responses and increasing mutual awareness. It uses eye gaze as a social cue to affect collective decision making with the view to contribute to safe driving. The authors used a driving simulator to design a case control experiment in which eye gaze movements are conveyed with an avatar. Participants were asked to drive through different types of intersections. An avatar representing the head of the other driver was displayed and driver behaviour was analysed. Significant eye gaze pattern difference where observed when an avatar was displayed. Drivers cautiously refer to the avatar when information is required on the intention of others (e.g. when they do not have the right of way). The majority of participants reported the perception of “being looked at”. The number of glances and time spent gazing at the avatar did not indicate an unsafe distraction by standards of in-vehicle device ergonomic design. Avatars were visually consulted primarily in less demanding driving situations, which underlines their non-distractive nature.

Withholding and withdrawing life-sustaining treatment : criminal responsibility for established medical practice?

The law recognises the right of a competent adult to refuse medical treatment even if this will lead to death. Guardianship and other legislation also facilitates the making of decisions to withhold or withdraw life-sustaining treatment in certain circumstances. Despite this apparent endorsement that such decisions can be lawful, doubts have been raised in Queensland about whether decisions to withhold or withdraw life-sustaining treatment would contravene the criminal law, and particularly the duty imposed by the Criminal Code (Qld) to provide the “necessaries of life”. This article considers this tension in the law and examines various arguments that might allow for such decisions to be made lawfully. It ultimately concludes, however, that criminal responsibility may still arise and so reform is needed.

Reparations for Indigenous People: International and Comparative Perspectives

Published in concomitance with the adoption of the United Nations Declaration on the Rights of Indigenous Peoples, this volume brings together a group of renowned legal experts and activists from different parts of the world who, from international and comparative perspectives, investigate the right of indigenous peoples to reparation for breaches of their individual and collective rights. The first part of the book is devoted to general aspects of this important matter, providing a comprehensive assessment of the relevant international legal framework and including overviews of the topic of reparations for human rights violations, the status of indigenous peoples in international law, and the vision of reparations as conceived by the communities concerned. The second part embraces a comprehensive investigation of the relevant practice at the international, regional, and national level, examining the best practices of reparations according to the ideologies and expectations of indigenous peoples and offering a comparative perspective on the ways in which the right of these peoples to redress for the injuries suffered is realized worldwide. The global picture painted by these contributions provides a view of the status of relevant international law that is synthesized in the two final chapters of the book, which include a concrete example of how a judicial claim for reparation is to be structured and prescribes the best practices and strategies to be adopted in order to maximize the opportunities for indigenous peoples to obtain effective redress. As a whole, this volume offers a comprehensive vision of its subject matter in international and comparative law, with a practical approach aimed at supporting legal academics, administrators, and practitioners in improving the avenues and modalities of reparations for indigenous peoples

Railway junction traffic control by heuristic methods

Traffic conflicts at railway junctions are very conmon, particularly on congested rail lines. While safe passage through the junction is well maintained by the signalling and interlocking systems, minimising the delays imposed on the trains by assigning the right-of-way sequence sensibly is a bonus to the quality of service. A deterministic method has been adopted to resolve the conflict, with the objective of minimising the total weighted delay. However, the computational demand remains significant. The applications of different heuristic methods to tackle this problem are reviewed and explored, elaborating their feasibility in various aspects and comparing their relative merits for further studies. As most heuristic methods do not guarantee a global optimum, this study focuses on the trade-off between computation time and optimality of the resolution.

Optimal traffic control at railway junctions

Conflict occurs when two or more trains approach the same junction within a specified time. Such conflicts result in delays. Current practices to assign the right of way at junctions achieve orderly and safe passage of the trains, but do not attempt to reduce the delays. A traffic controller developed in the paper assigns right of way to impose minimum total weighted delay on the trains. The traffic flow model and the optimisation technique used in this controller are described. Simulation studies of the performance of the controller are given.

The conflict resolution in connected railway junctions

Purpose of study: Traffic conflicts occur when trains on different routes approach a converging junction in a railway network at the same time. To prevent collisions, a right-of-way assignment is needed to control the order in which the trains should pass the junction. Such control action inevitably requires the braking and/or stopping of trains, which lengthens their travelling times and leads to delays. Train delays cause a loss of punctuality and hence directly affect the quality of service. It is therefore important to minimise the delays by devising a suitable right-of-way assignment. One of the major difficulties in attaining the optimal right-of-way assignment is that the number of feasible assignments increases dramatically with the number of trains. Connected-junctions further complicate the problem. Exhaustive search for the optimal solution is time-consuming and infeasible for area control (multi-junction). Even with the more intelligent deterministic optimisation method revealed in [1], the computation demand is still considerable, which hinders real-time control. In practice, as suggested in [2], the optimality may be traded off by shorter computation time, and heuristic searches provide alternatives for this optimisation problem.

Railway junction conflict resolution by local search method

This study investigates the application of local search methods on the railway junction traffic conflict-resolution problem, with the objective of attaining a quick and reasonable solution. A procedure based on local search relies on finding a better solution than the current one by a search in the neighbourhood of the current one. The structure of neighbourhood is therefore very important to an efficient local search procedure. In this paper, the formulation of the structure of the solution, which is the right-of-way sequence assignment, is first described. Two new neighbourhood definitions are then proposed and the performance of the corresponding local search procedures is evaluated by simulation. It has been shown that they provide similar results but they can be used to handle different traffic conditions and system requirements.

Government : charity boundaries

The Preamble1 was the initial legislative statement of matters construed by government to constitute charitable purposes in a common law context. It provided an outline of what was to become the core agenda for government’s relationship with charity. The resulting implied partnership, as viewed by government, endured for four centuries and in many different cultural contexts across the common law world. During that period, judicial mediation on the balance to be struck between government interest in acquiring value for granting tax exempt privileges and the right of individuals to freely dispose of property in accordance with their particular altruistic wishes steadily broadened the range of purposes deemed to be charitable, the vagaries of donor choice often prevailing over government interest in acquiring value for tax exemption.

Global Creative Industries

The creative industries are the subject of growing attention among policy-makers, academics, activists, artists and development specialists worldwide. This engaging book provides a global overview of developments in the creative industries, and analyses how these developments relate to wider debates about globalization, cities, culture and the global creative economy. Flew considers creative industries from six angles: industries; production; consumption; markets; places; and policies. Designed for the non-specialist, the text includes insightful and wide-ranging case studies on topics such as: fashion; design thinking; global culture; creative occupations; monopoly and competition; Shanghai and Seoul as creative cities; popular music and urban cultural policy; and the rise of “Nollywood”. Global Creative Industries will be of great interest to students and scholars of media and communications, cultural studies, economics, geography, sociology, design, public policy, and the arts. It will also be of value to those working in the creative industries, and involved in their development.

Valuation methods for resident funded retirement villages in Australia : a practitioner's perspective

Designed for independent living, retirement villages provide either detached or semi-detached residential dwellings with car parking and small private yards. Retirement village developments usually include a mix of independent living units (ILUs) and serviced apartments (SAs) with community facilities providing a shared congregational area for village activities and socialising. Retirement Village assets differ from traditional residential assets due to their operation in accordance with statutory legislation. In Australia, each State and Territory has its own Retirement Village Act and Regulations. In essence, the village operator provides the land and buildings to the residents who pay an amount on entry for the right of occupation. On departure from the units an agreed proportion of either the original purchase price or the sale price is paid to the outgoing resident. The market value of the operator’s interest in the Retirement Village is therefore based upon the estimated future income from Deferred Management Fees and Capital Gain upon roll-over receivable by the operator in accordance with the respective residency agreements. Given the lumpiness of these payments, there is general acceptance that the most appropriate approach to valuation is through Discounted Cash Flow (DCF) analysis. There is however inconsistency between valuers across Australia in how they undertake their DCF analysis, leading to differences in reported values and subsequent confusion among users of valuation services. To give guidance to valuers and enhance confidence from users of valuation services this paper investigates the five major elements of discounted cash flow methodology, namely cash flows, escalation factors, holding period, terminal value and discount rate. Whilst there is dissatisfaction with the financial structuring of the DMF in residency agreements, as long as there are future financial returns receivable by the Village owner/operator, then DCF will continue to be the most appropriate valuation methodology for resident funded retirement villages.