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.

The personal wellbeing index : psychometric equivalance for adults and school children

Despite the wealth of accumulated research evaluating subjective wellbeing (SWB) in children and adults, the validity of scores from parallel forms of SWB measures for each age group has yet to be empirically tested. This study examines the psychometric equivalence of the child and adult forms of the personal wellbeing index (PWI) using multiple-group confirmatory factor analysis. The child sample comprised 1,029 Victorian high-school students (aged 11–20) sampled across three independent studies. The adult sample comprised 1,965 Australian adults drawn from the Australian Unity Wellbeing Index. The results demonstrated strict factorial invariance between both versions, suggesting that the PWI measures the same underlying construct in adolescent and adult populations. These findings provide support for quantitative comparisons between adult and adolescent SWB data as valid.

Body mass index and dental caries in children and adolescents : a systematic review of literature published 2004 to 2011

The objective
The authors undertook an updated systematic review of the relationship between body mass index and dental caries in children and adolescents.
Method
The authors searched Medline, ISI, Cochrane, Scopus, Global Health and CINAHL databases and conducted lateral searches from reference lists for papers published from 2004 to 2011, inclusive. All empirical papers that tested associations between body mass index and dental caries in child and adolescent populations (aged 0 to 18 years) were included.
Results
Dental caries is associated with both high and low body mass index.
Conclusion
A non-linear association between body mass index and dental caries may account for inconsistent findings in previous research. We recommend future research investigate the nature of the association between body mass index and dental caries in samples that include a full range of body mass index scores, and explore how factors such as socioeconomic status mediate the association between body mass index and dental caries.

Consumption of a low glycaemic index diet in late life extends lifespan of Balb/c mice with differential effects on DNA damage

Background : Caloric restriction is known to extend the lifespan of all organisms in which it has been tested. Consequently, current research is investigating the role of various foods to improve health and lifespan. The role of various diets has received less attention however, and in some cases may have more capacity to improve health and longevity than specific foods alone. We examined the benefits to longevity of a low glycaemic index (GI) diet in aged Balb/c mice and examined markers of oxidative stress and subsequent effects on telomere dynamics.

Results : In an aged population of mice, a low GI diet extended average lifespan by 12%, improved glucose tolerance and had impressive effects on amelioration of oxidative damage to DNA in white blood cells. Telomere length in quadriceps muscle showed no improvement in the dieted group, nor was telomerase reactivated.

Conclusion : The beneficial effects of a low GI diet are evident from the current study and although the impact to telomere dynamics late in life is minimal, we expect that earlier intervention with a low GI diet would provide significant improvement in health and longevity with associated effects to telomere homeostasis.

Combined joint fusion for index and middle carpometacarpal instability in elite boxers

Isolated instability of the index and middle finger carpometacarpal joints is uncommon. An unpublished injury pattern in a consecutive series of 13 elite boxers is described, with mid-term radiological and functional results of two novel surgical treatments. All the boxers (from Australia and the UK) were unable to compete owing to pain and weakness. Four boxers were managed initially by open reduction and temporary K-wire fixation. Nine boxers underwent primary carpometacarpal arthrodesis. All were able to return to their previous level of competition. One boxer who had undergone a soft tissue reconstruction competed at international level but required an arthrodesis because of recurrent symptoms. In elite boxers, simple reduction and wiring may be appropriate for an acute injury causing index or middle finger carpometacarpal joint instability, however, arthrodesis is the treatment of choice when instability and degenerative changes are present.