Near Vision Aids In Geriatric Patients With Reduced Visual Acuity

ABSTRACT The usefulness of near vision aids was studied in one hundred and forty-one patients in a geriatric hospital. The patients were over 65 years of age and had reduced vision. Where lens power exceeded +10DS spectacle lenses seldom worked well. Aspheric stand magnifiers were the most useful device in cases where greater magnification was needed. Elderly patients had difficulty in adapting to optical aids over 5X. Impaired cerebral function was the main reason for failure of the low vision aids of lower magnification.     

An Exploration of the Uses of Children's Books as an Approach for Enhancing Cultural Diversity

Children's books can be used as an effective tool for teaching able-bodied children about the unique needs of children with disabilities. This article offers strategies for using books as a tool for helping able-bodied children understand that disabilities are an important aspect of cultural diversity. A list of children's books focusing on the topic of disabilities is offered.     

Research and development of additional aids for dermatologic and plastic surgery

Increasing numbers of accessories continue to be found to make laser surgery more effective for dermatologic and plastic surgery. Argon laser surgery aids are available to increase the dilatation of the superficial vessels and to localize increasing numbers of red cell masses. Laser probes for intravascular thrombogenesis and thrombolysis have now been adapted for intradermal and deep dermal tissues and for cardiology. Studies on laser effects on platelets and heat transmission and thromboembolic phenomena are lacking. Investigative studies are developing for laser fiber optic probes for laser-induced fluorescence, not only for oncology, but also for studies of metabolism of tissues and also for spectroscopy. The use of different wavelengths and shorter pulses, more flexible fiber-optics transmission for all laser systems, combinations of laser systems into a single operating probe, as well as the increased use of lasers for diagnosis and treatment will all stimulate the development of new aids for laser surgery. Cooperative programs developed jointly by dermatologic and plastic surgeons will make for great progress in skin and soft-tissue laser surgery.     

A miniature gas-pressure valve

A thin, small, nonbleeding gas-pressure valve has been specially developed for prosthetic applications. With the introduction of a special membrane design, the difficulties in the miniaturisation of pressure valves could be overcome. A mathematical model of the pressure valve is presented. It shows that a fundamental relationship exists between the force acting on the membrane and the hysteresis in the input/ output characteristic; the product of these two quantities depends mainly on the inlet-valve diameter. Therefore, miniaturisation led to the construction of a pressure valve with a low operating force and reasonable hysteresis. In the prototype, a special valve-forming technique has been used. With this technique the valve nozzles are made from metal foil, permitting the construction of a thin, miniature (7×9×2·5 mm) pressure valve.     

A pharmacokinetic slide rule for more accurate drug treatment

Summary A slide rule has been devised which is based on the general mathematical models of pharmacokinetics. It permits calculation of exact dosage regimens for individual patients from certain basic parameters. First, from the patient's renal clearance, the proportionality constant characterizing renal excretion of a certain drug (a) and its non-renal rate constant of elimination (k _nr), the rate constant of total elimination (k _e) can be calculated. Second, fromk _e, the apparent volume of distribution (V _d) and the desired final mean concentration of a drug (c), exact values can readily be obtained for the loading dose (D*) and the dosage schedule, which consists of the maintenance dose (D), the dosing intervals () and the infusion rate for intravenous administration. In addition the slide rule provides information about the rate at which c is reached ifD alone is administered at , and the fluctuation in the concentration around c to be anticipated during . By use of this calculation, the slide rule facilitates the decision whether a loading dose should be given, and what dosage schedule is best suited to the therapeutic problem. It is possible, therefore, to calculate exact dosage regimens for individual patients, even for those with excretory dysfunction. The slide rule should also help physicians to comprehend the nature and significance of pharmacokinetic mechanisms.     

Reliability of a geriatric assessment instrument with illustrations

Background:   The Typology of the Aged with Illustrations is a four-scale geriatric assessment measure of elderly function and activity of daily living. Illustrations are incorporated to facilitate the understanding of elderly function and activity status. The purpose of the study was to test the reliability and validity of the instrument and the effectiveness of the illustrations in improving performance.
Methods:   Reliability of the typology was investigated using the test–retest procedure, with a sample of 240 elderly persons. The effectiveness of the illustrations was measured, using the instrument with and without the illustrations, by kappa statistics and the χ² test. The results were stratified to assess differences in reliability between experienced and nonexperienced evaluators, and for elderly persons in residential institutions compared with day care facilities. Both constructive and concurrent validities were also evaluated.
Results:   The intra-rater reliability (re-assessment by the same evaluator 1 week later) of the instrument was increased significantly on all four scales (average kappa statistics: 0.82 with illustrations, 0.65 without illustrations) with the inclusion of illustrations vs no illustrations, and the inter-rater reliability (re-assessment by a second evaluator within 24 hours) was significantly increased for the mobility and eating scales. There was no difference in reliability for experienced and inexperienced evaluators, or for different care situations.
Conclusion:   The inclusion of illustrations in the instrument facilitated the understanding of elderly persons' activity of daily living and increased its reliability. This instrument has wide applicability and can be used for communication between health care professionals and for on-the-job training in geriatric functional assessment.     

The effect of practical portion size measurement aids on the accuracy of portion size estimates made by young adults

A barrier to controlling the amount of food consumed may be the difficulty consumers have in accurately estimating portion sizes. Although portion size measurement aids (PSMAs) can improve estimation accuracy, their bulk and/or cost tends to make them impractical for regular use. The purpose of this study was to investigate the effect on portion size estimation accuracy of two practical PSMAs: a 2-D PSMA (life size picture of tennis and golf balls) and 3-D PSMAs (tennis and golf balls). Young adults were randomly assigned to one of two groups and estimated the portion sizes of 36 foods divided into three equal sets. PSMAs were not used to estimate portion sizes in Food Set 1. Study group 1 (n = 57) used the 2-D PSMA and study group 2 (n = 56) used the 3-D PSMAs to estimate the portion sizes in Food Set 2. Neither group used PSMAs to estimate portion sizes in Food Set 3. Repeated measures anova indicated that both groups significantly improved estimation accuracy between Food Sets 1 and 2 and between Foods Sets 1 and 3. Thus, even short-term exposure to practical PSMAs may improve estimation accuracy and these improvements persist when the PSMA is no longer available. However, the accuracy rate for Food Set 2 was only about 60% indicating that a great deal of estimation error remains.     

Rehabilitation of the hearing impaired adult in Denmark

An outline is given of the rehabilitation of the hearing impaired adult in Denmark. Emphasis is put on the comprehensiveness and the professionalism of the services provided.