Visual outcomes and astigmatism after sutureless, manual cataract extraction in rural China: study of cataract outcomes and up-take of services (SCOUTS) in the caring is hip project, report 1.

OBJECTIVE: To study the visual acuity and astigmatism of persons undergoing cataract extraction by local surgeons in rural China. METHODS: Visual acuity, keratometry, and refraction were measured 10 to 14 months postoperatively for all cataract cases during 4 months in Sanrao, China. RESULTS: Among 313 eligible subjects, 242 (77%) could be contacted, of whom 176 (73%) were examined. Of those who were examined, mean +/- SD age was 69.3 +/- 10.5 years, 66.5% were female, 35 had been operated on bilaterally at Sanrao, and 85.2% had a preoperative presenting visual acuity of 6/60 or worse. Presenting and best-corrected postoperative acuity in the eye that was operated on were 6/18 or better in 83.4% and 95.7%, respectively. Among 27 fellow eyes operated on elsewhere, 40.7% had a presenting acuity of 6/18 or better and 40.7% were blind (P < .001). Mean +/- SD postoperative astigmatism did not differ between 211 eyes that were operated on (-1.13 +/- 0.84 diopters) and 109 eyes that were not (-1.13 +/- 1.17 diopters; P = .27). Presence of operative complications (8.5%) and older age were associated with worse vision; bilateral surgery was associated with better vision. CONCLUSIONS: These results confirm the effectiveness of skill transfer in this setting, with superior outcomes to most studies in rural Asia and to eyes in this cohort operated on at other facilities.

Ocular comorbidities among cataract-operated patients in rural China: the caring is hip Study of Cataract Outcomes and Uptake of Services (SCOUTS), report No. 3.

PURPOSE: To determine the prevalence and impact on vision and visual function of ocular comorbidities in a rural Chinese cataract surgical program, and to devise strategies to reduce their associated burden. DESIGN: Cross-sectional cohort study. PARTICIPANTS: Persons undergoing cataract surgery by one of two recently trained local surgeons at a government-run village-level hospital in rural Guangdong between August 8 and December 31, 2005. INTERVENTIONS: Eligible subjects were invited to return for a comprehensive ocular examination and visual function interview 10 to 14 months after surgery. Prevalent ocular comorbid conditions were identified. MAIN OUTCOME MEASURES: Presenting and best-corrected vision, visual function, and treatability of the comorbidity. RESULTS: Of 313 persons operated within the study window, 242 (77%) could be contacted by telephone; study examinations and interviews were performed on 176 (74%). Examined subjects had a mean age of 69.4+/-10.5 years, 116 (66%) were female, and 149 (85%) had been blind (presenting vision < or = 6/60) in the operative eye before surgery. Among unoperated eyes, 89 of 109 (81.7%) had > or =1 ocular comorbidities, whereas for operated eyes the corresponding proportion was 72 of 211 (34.1%). The leading comorbidity among operated eyes was refractive error (43/72 [59.7%]), followed by glaucoma/glaucoma suspect (14/72 [19.4%]), whereas for unoperated eyes, it was cataract (80/92 [87.0%]), followed by refractive error (12/92 [13.0%]). Among operated eyes with comorbidities, 90.3% (65/72) had > or =1 comorbidities that were treatable. In separate models adjusting for age and gender, persons with > or =1 comorbidities in the operated eye had significantly worse presenting vision (P<0.001) than those without such findings, but visual function (P = 0.197) and satisfaction with surgery (P = 0.796) were unassociated with comorbidities. CONCLUSIONS: Ocular comorbidities are highly prevalent among persons undergoing cataract surgery in this rural Asian setting, and their presence is significantly associated with poorer visual outcomes. The fact that the great majority of comorbidities encountered in this program are treatable suggests that strategies to reduce their impact can be successful.

Sources of patient knowledge and financing of cataract surgery in rural China: the Sanrao Study of Cataract Outcomes and Up-Take of Services (SCOUTS), report 6.

AIM: To study patient sources of knowledge about cataract surgical services, and strategies for financing surgery in rural China. DESIGN: Cross-sectional case series. METHODS: Patients undergoing cataract surgery by local surgeons in a government, village-level facility in Sanrao, Guangdong between 8 August and 31 December 2005 were examined and had standardised interviews an average of 12 months after surgery. RESULTS: Of 313 eligible patients, 239 (76%) completed the questionnaire. Subjects had a mean (SD) age of 69.9 (10.2) years, 36.4% (87/239) were male, and 87.0% (208/239) had been blind (presenting visual acuity < or = 6/60) before surgery. Word-of-mouth advertising was particularly important: 198 (85.0%) of the subjects knew a person who had undergone cataract surgery, of whom 191 (96.5%) had had cataract surgery at Sanrao itself. Over 70% of subjects (166/239) watched TV daily, whereas 80.0% (188/239) "never" read the newspaper. Nearly two-thirds of suggestions from participants (n = 211, 59.6%) favoured either TV advertisements or word-of-mouth to publicise the programme. While the son or daughter had paid for surgery in over 70% of cases (164/233), the patient's having paid without help was the sole predictor of undergoing second-eye surgery (OR 2.27 (95% CI 1.01 to 5.0, p = 0.04)). DISCUSSION: Strategies to increase uptake of cataract surgery in rural China may benefit from enhancing word-of-mouth advertising (such as with pseudophakic motivators), using television advertising where affordable, and micro-credit or other programmes to enable patients to pay their own fees, thus increasing uptake of second-eye surgery.

Impact of posterior subcapsular opacification on vision and visual function among subjects undergoing cataract surgery in rural China: Study of Cataract Outcomes and Up-Take of Services (SCOUTS) in the Caring is Hip Project, report 5.

AIM: To study the effect of posterior capsular opacification (PCO) on vision and visual function in patients undergoing cataract surgery in rural China, and to compare this with the effect of refractive error. METHODS: Patients undergoing cataract surgery in at least one eye by local surgeons in a rural setting between 8 August and 31 December 2005 were examined with slit lamp grading of PCO 10-14 months after surgery. Subjects with any PCO associated with best-corrected visual acuity of 6/7.5 or worse, or with grade 2+ or worse PCO without visual decrement, were offered YAG laser capsulotomy. Vision and self-reported visual function were assessed, and various demographic and clinical factors potentially associated with PCO were recorded. RESULTS: Of 313 patients operated on within the study window, 239 (76%) could be contacted by telephone; study examinations were performed on 176 (74%). Examined subjects had a mean (SD) age of 69.4 (10.5) years, 116 (67%) were female, and 149 (86%) had been blind (presenting visual acuity < or = 6/60) in the operated eye before surgery. PCO of grade 1 or above was present in 34 of 204 operated eyes (16.7%). Those with PCO had significantly worse presenting vision (p = 0.007) but not visual function (p>0.3) than those without PCO. Women had a significantly higher prevalence of PCO (20.9%) than did men (8.6%, p<0.05). Of 19 eyes undergoing capsulotomy with best-corrected visual acuity measured the next day, 13 (68%) improved by one or more lines, and seven (37%) improved by two or more lines. Despite a higher uptake of capsulotomy (95%) as opposed to refraction (35%) in this cohort, the yield in terms of eyes with poor presenting visual acuity (< 6/18) that could be improved was higher for refraction (26% = 9/35) than for capsulotomy (9% = 3/35). CONCLUSION: The prevalence of PCO and impact on vision and visual function in this cohort was modest 1 year after surgery. However, PCO prevalence increases with time. Follow-up of this cohort is underway to determine the effectiveness of this early intervention in identifying and treating subjects who will eventually experience clinically significant PCO.

A population-based study of visual impairment among pre-school children in Beijing: the Beijing study of visual impairment in children.

PURPOSE: To evaluate the prevalence and causes of visual impairment among Chinese children aged 3 to 6 years in Beijing. DESIGN: Population-based prevalence survey. METHODS: Presenting and pinhole visual acuity were tested using picture optotypes or, in children with pinhole vision < 6/18, a Snellen tumbling E chart. Comprehensive eye examinations and cycloplegic refraction were carried out for children with pinhole vision < 6/18 in the better-seeing eye. RESULTS: All examinations were completed on 17,699 children aged 3 to 6 years (95.3% of sample). Subjects with bilateral correctable low vision (presenting vision < 6/18 correctable to >or= 6/18) numbered 57 (0.322%; 95% confidence interval [CI], 0.237% to 0.403%), while 14 (0.079%; 95% CI, 0.038% to 0.120%) had bilateral uncorrectable low vision (best-corrected vision of < 6/18 and >or= 3/60), and 5 subjects (0.028%; 95% CI, 0.004% to 0.054%) were bilaterally blind (best-corrected acuity < 3/60). The etiology of 76 cases of visual impairment included: refractive error in 57 children (75%), hereditary factors (microphthalmos, congenital cataract, congenital motor nystagmus, albinism, and optic nerve disease) in 13 children (17.1 %), amblyopia in 3 children (3.95%), and cortical blindness in 1 child (1.3%). The cause of visual impairment could not be established in 2 (2.63%) children. The prevalence of visual impairment did not differ by gender, but correctable low vision was significantly (P < .0001) more common among urban as compared with rural children. CONCLUSION: The leading causes of visual impairment among Chinese preschool-aged children are refractive error and hereditary eye diseases. A higher prevalence of refractive error is already present among urban as compared with rural children in this preschool population.

'This is a beautiful school.' 'This school is useless!' Explaining disengagement in a Greek vocational school through the examination of teacher ideologies

This multimethod case study of a Greek vocational school explored teachers’ culture (including beliefs about education, teachers’ role, and students’ nature) using the concept of Pupil Control Ideology to explain problems of disengagement and low morale among staff and students, as well as tensions in relationships. A prominent custodial culture was identified in the school using a functional/apolitical pedagogy to transmit ‘legitimate’ knowledge to students whose working-class background did not produce desired outcomes. This generated deficit views of students, teachers’ sympathy, and a seemingly caring school ethos which was, nevertheless, oppressive. Students’ failings were naturalised and vocational education misinterpreted as merely a streaming device in a system honouring academic achievement and middle-class ways. Teachers were blind to these cultural subtleties, believing they acted ‘rationally’ and altruistically. A humanistic subculture emphasising student empowerment and social transformation consisted of a minority of teachers and was rather marginalised. This disallowed meaningful dialogue and the identification of an alternative rationale for the sector, generating strong feelings of futility. Positive change in this school necessitated the deconstruction and (subsequent) reconstruction of custodial teachers’ worldview as embedded in their practice.

The placebo and nocebo effects on peak minute power during incremental arm crank ergometry

This investigation aimed to explore the effects of inert sugar-free drinks described as either ‘performance enhancing’ (placebo) or ‘fatigue inducing’ (nocebo) on peak minute power (PMP;W) during incremental arm crank ergometry (ACE). Twelve healthy, non-specifically trained individuals volunteered to take part. A single-blind randomised controlled trial with repeated measures was used to assess for differences in PMP;W, oxygen uptake, heart rate (HR), minute ventilation, respiratory exchange ratio (RER) and subjective reports of local ratings of perceived exertion (LRPE) and central ratings of perceived exertion (CRPE), between three separate, but identical ACE tests. Participants were required to drink either 500 ml of a ‘sports performance’ drink (placebo), a ‘fatigue-inducing’ drink (nocebo) or water prior to exercise. The placebo caused a significant increase in PMP;W, and a significant decrease in LRPE compared to the nocebo (p=0.01; p=0.001) and water trials (p=0.01). No significant differences in PMP;W between the nocebo and water were found. However, the nocebo drink did cause a significant increase in LRPE (p=0.01). These results suggest that the time has come to broaden our understanding of the placebo and nocebo effects and their potential to impact sports performance.

Effects of Prochlorperazine on Normal Vestibular Ocular and Perceptual Responses: A Randomised, Double-Blind, Crossover, Placebo-Controlled Study

Background: The present study investigated whether prochlorperazine affects vestibular-ocular reflex (VOR) and vestibulo-perceptual function. Methods: We studied 12 healthy naïve subjects 3 hours after a single dose of oral prochlorperazine 5mg in a randomised, placebo-controlled, double-blind, cross-over study in healthy young subjects. Two rotational tests in yaw were used: 1) a Threshold task investigating perceptual motion detection and nystagmic thresholds (acceleration steps of 0.5deg/s/s) and 2) Suprathreshold responses to velocity steps of 90deg/s in which vestibulo-ocular (VO) and vestibulo-perceptual (VP) time constants of decay, as well as VOR gain, were measured. Results: Prochlorperazine had no effect upon any measure of nystagmic or perceptual vestibular function compared to placebo. This lack of effects on vestibular-mediated motion perception suggests that the drug is likely to act more as an antiemetic than as an anti-vertiginous agent.

The effect of carbohydrate mouth rinse on a 30-minute arm cranking performance

The aim of this study was to examine the effect of carbohydrate mouth rinse on 30-min arm cranking performance. Twelve healthy, active males (age 21.6, standard deviation (SD)=3.1 years; mass 76.2, SD=12.2 kg) volunteered in a single-blind, randomised crossover design. Firstly they completed an incremental exercise test to exhaustion (VO2max test) on an arm crank (50W for 2 min, increasing by 10W every min). During visit 2 and 3 they arm cranked for maximal distance over 30 min at a resistance equivalent to 50% of their peak power, mouth rinsing for 5 s with either 25 ml of a tasteless 6.4% maltodextrin solution (CHO) or 25 ml of water (placebo) every 6 min. A letter cancellation test was performed pre and post exercise to measure cognitive function. The result showed that cognitive function was not significantly different between trials (P=0.874). There was no significant difference in distance arm cranked between trials (P=0.164) even though 9 out of 12 participants had improved performance on the CHO trial. In conclusion, further research is needed to determine the ergogenic effect of CHO mouth rinsing on upper body exercise performance.

The placebo and nocebo effects on peak minute power during incremental arm crank ergometry

This investigation aimed to explore the effects of inert sugar-free drinks described as either ‘performance enhancing’ (placebo) or ‘fatigue inducing’ (nocebo) on peak minute power (PMP;W) during incremental arm crank ergometry (ACE). Twelve healthy, non-specifically trained individuals volunteered to take part. A single-blind randomised controlled trial with repeated measures was used to assess for differences in PMP;W, oxygen uptake, heart rate (HR), minute ventilation, respiratory exchange ratio (RER) and subjective reports of local ratings of perceived exertion (LRPE) and central ratings of perceived exertion (CRPE), between three separate, but identical ACE tests. Participants were required to drink either 500 ml of a ‘sports performance’ drink (placebo), a ‘fatigue-inducing’ drink (nocebo) or water prior to exercise. The placebo caused a significant increase in PMP;W, and a significant decrease in LRPE compared to the nocebo (p=0.01; p=0.001) and water trials (p=0.01). No significant differences in PMP;W between the nocebo and water were found. However, the nocebo drink did cause a significant increase in LRPE (p=0.01). These results suggest that the time has come to broaden our understanding of the placebo and nocebo effects and their potential to impact sports performance.

Blavigator: a navigation aid for blind persons

Blavigator (blind navigator) is a vision aid for blind and visuaIIy impaired persons. It supports local navigation by detecting waIkable paths in the immediate vicinity of the user. It guides the user for centering on the path.

The rise and demise of a book-review magazine interpreting the cultural work of Books in Canada (1971-2008)

This interdisciplinary study examines the contribution that a book-review magazine makes to the cultural identity of its readers. It is the result of reflections on the cultural work of Books in Canada , on whether or not this periodical was a cultural worksite and if that is the case how it performed that cultural work. In addition, it interrogates factors that may have contributed to the magazine's demise. The study affirms that Books in Canada, a cultural enterprise from 1971 to 2008, mirrored and helped to shape book and literary culture in Canada through its circulation, through the personalities of its editors, through its front covers and through its reviewers and their reviews. Furthermore, it proposes that the demise of the enterprise was due to a combination of factors. The study begins with an introduction to book reviewing and special-interest magazines. Chapter I examines the interplay between selected visual and textual contents published in Books in Canada in its founding years. These components reflected and helped to fuel the cultural nationalism that was sweeping Canada subsequent to the 1967 World's Fair in Montreal. There were also persistent rumours and comments about the magazine that caused certain"cracks in the foundation" to appear. Chapter II compares the aims and editorial challenges of Val Clery, founder of Books in Canada , with those of Adrien Thério, founder of Lettres québécoises, and of the editors of the magazines' twentieth-anniversary issues, Paul Stuewe in the case of the former and André Vanasse in the case of the latter. Evidence in the content of the magazine, editorial and otherwise, indicated that the"contracts" that the editors made with their readers over the years were similar, to reflect and shape a cultural identity, but the result of their"projects," that is, the nature of those identities, was distinctly different. Evidently then, personal aims, preferences and political leanings of editors can have a major impact on the content of a book-review magazine and thus on the cultural work that it does. Therefore, in Chapter III, I focus on selected contents published during the tenures of two of Books in Canada 's key editors, Paul Stuewe and Olga Stein, in order to understand ways that their choices constituted a form of cultural work. The second part of this chapter moves from an analysis of the cultural work of editors to an examination of the cultural work of reviewers. Here, through a close-reading of a selection of reviews published in Books in Canada, and in other periodicals, I argue that reviewers do cultural work in the way that they negotiate their presence in a review, and in how they signal that presence through lexical choices and through the degree of intellectual interaction that they invite. Intellectual interaction is at the core of Chapter IV.This chapter consists of close readings of some of the"billboards" of the enterprise, that is, the front covers of Books in Canada , in order to show how these important components do cultural work by requiring readers to make an intellectual leap from image to text. Chapter V suggests that book reviews, the company's"bills of goods," do cultural work in much the same way as the paratexts of a book. One of my own reviews is offered as a case-study along with a number of other reviews of how central components of a book-review magazine do cultural work through the illocutionary force of their sentences. The first part of Chapter VI, the final chapter, measures the legacy of the magazine, in particular, the annual Books in Canada First Novel Award. Created in 1976, this prize is awarded to the author of the novel judged by a Books in Canada prize committee to be the best first novel in English of the year. The second part of Chapter VI sheds light on factors that may have contributed to the closure of the enterprise, including the copyright uproar that accompanied the agreement that Adrian Stein, publisher of Books in Canada and Olga Stein's husband, made in 2001 with the online book merchant, Amazon.com. Furthermore, this penultimate section of the study suggests that one of the most important factors in the magazine's demise was the decision by the Steins to exploit their position as owners, publisher, and editor of a book-review periodical, a government-subsidized one at that, to publish their own lengthy pre-trial defense of Conrad Black. The chapter then zooms back from the particular to the general with a broader consideration of the impact of technology and globalization on the book industry and on the ability of Books in Canada to survive in any form, print or digital.

A time frequency approach to blind deconvolution in multipath underwater channels

Blind deconvolution is studied in the underwater acoustic channel context, by time-frequency (TF) processing. The acoustic propagation environment is modelled by ray tracing and mathematically described by a multipath propagation channel. Representation of the received signal by means of a signal-dependent TF distribution (radially Gaussian kernel distribution) allowed to visualize the resolved replicas of the emitted signal, while signi cantly attenuating the inherent interferences of classic quadratic TF distributions. The source signal instantaneous frequency estimation was the starting point for both source and channel estimation. Source signature estimation was performed by either TF inversion, based on the Wigner-Ville distribution of the received signal, or a subspace- -based method. The channel estimate was obtained either via a TF formulation of the conventional matched- lter, or via matched- - ltering with the previously obtained source estimate. A shallow water realistic scenario is considered, comprising a 135-m depth water column and an acoustic source located at 90-m depth and 5.6-km range from the receiver. For the corresponding noiseless simulated data, the quality of the best estimates was 0.856 for the source signal, and 0.9664 and 0.9996 for the amplitudes and time-delays of the impulse response, respectively. Application of the proposed deconvolution method to real data of the INTIMATE '96 sea trial conduced to source and channel estimates with the quality of 0.530 and 0.843, respectively. TF processing has proved to remove the typical ill-conditioning of single sensor deterministic deconvolution techniques.

The petri dish

This quarterly publication from the South Carolina Department of Health and Environmental Control, Bureau of Laboratories was created to share information with clinical laboratories about the Laboratory Response Network (LRN) for Bioterrorism, to communicate our role in this network and to disseminate up-to-date information about services offered at the DHEC-BOL.

Performance of an adaptive homodyne receiver in the presence of multipath, Rayleigh-fading and time-varying quadrature errors

In this paper, we carry out a detailed performance analysis of the blind source separation based I/Q corrector operating at the baseband. Performance of the digital I/Q corrector is evaluated not only under time-varying phase and gain errors but also in the presence of multipath and Rayleigh fading channels. Performance under low-SNR and different modulation formats and constellation sizes is also evaluated. What is more, BER improvement after correction is illustrated. The results indicate that the adaptive algorithm offers adequate performance for most communication applications hence, reducing the matching requirements of the analog front-end enabling higher levels of integration.