Optical And Nonoptical Aids For Reading And Writing In Individuals With Acquired Low Vision

Purpose: To evaluate the use of optical and nonoptical aids during reading and writing activities in individuals with acquired low vision. Methods: This study was performed using descriptive and cross-sectional surveys. The data collection instrument was created with structured questions that were developed from an exploratory study and a previous test based on interviews, and it evaluated the following variables: personal characteristics, use of optical and nonoptical aids, and activities that required the use of optical and nonoptical aids. Results: The study population included 30 subjects with acquired low vision and visual acuities of 20/200-20/400. Most subjects reported the use of some optical aids (60.0%). Of these 60.0%, the majority (83.3%) cited spectacles as the most widely used optical aid. The majority (63.3%) of subjects also reported the use of nonoptical aids, the most frequent ones being letter magnification (68.4%), followed by bringing the objects closer to the eyes (57.8%). Subjects often used more than one nonoptical aid. Conclusions: The majority of participants reported the use of optical and nonoptical aids during reading activities, highlighting the use of spectacles, magnifying glasses, and letter magnification; however, even after the use of these aids, we found that the subjects often needed to read the text more than once to understand it. During writing activities, all subjects reported the use of optical aids, while most stated that they did not use nonoptical aids for such activities.7729194Sanches, P.A., Deficiências visuales y psicomotricidade: teoria y pratica (1994) Organización Nacional de Ciegos Españoles, p. 255Alves, M.R., Kara-Jose, N., O olho e a visão: o que fazer pela saúde ocular das nossas crianças (1996) Rio de Janeiro: Vozeshttp://whqlibdoc.who.int/hq/2003/WHO_PBL_03.91.pdf?ua=1, World Health Organization. Consultation on development of standards for characterization for vision loss and visual functioning [Internet]. Geneva: WHO/PBL2003. [cited 2013 Dec 21]. Available fromBruno, M.M., A inclusão da criança com baixa visão na educação infantil (2007) São Paulo: Vetor, p. 84. , Masini EF, Gasparetto ME. Visão subnormal: um enfoque educacionalMontilha, R.C., Temporini, E.R., Nobre, M.I., Gasparetto, M.E., Kara-Jose, N., Utilização de recursos ópticos e equipamentos por escolares com deficiência visual (2006) Arq Bras Oftalmol, 69 (2), pp. 207-211http://www.mj.gov.br/sedh/ct/corde/dpdh/corde/comite_at.asp, Brasil. Ministério da Justiça. CORDE. Comitê de Ajudas Técnicas. Ata VII. Brasília: MJ. [citado 2009 Ago 5]. Disponível emBrito, P.R., Veitzman, S., Causas de cegueira e baixa visão em craianças (2000) Arq Bras Oftalmol, 63 (1), pp. 49-54Thylefors, B., Négrel, A.D., Pararajasegaram, R., Dadzie, Ky., Global date on blindness (1995) Bull World Health Organ, 73 (1), pp. 115-120Oliveira, L.L., Uma possibilidade de intervenção psicopedagógica no processo dialético de mediação entre o sujeito que aprende e o objeto do conhecimento (2002) São Paulo: Manole, pp. 169-190. , Santos MT, Navas AL. Distúrbios de leitura e escrita: teoria e práticaPiovesan, A., Temporini, E.R., Pesquisa exploratória: procedimento metodológico para o estudo de fatores humanos no campo da saúde pública (1995) Rev Saúde Pública, 29 (4), pp. 318-325Temporini, E.R., Pesquisa de oftalmologia em saúde pública: considerações metodológicas sobre fatores humanos (1991) Arq Bras Oftalmol, 54 (6), pp. 279-281Corn, A., Wall, R.S., Jose, R.T., Bell, J.K., Wilcox, K., Perez, A., An initial study of reading and comprehension rates for students who received optical devices (2002) J Vis Impair Blind, 96 (5), pp. 322-333Montilha, R.C., O atendimento de terapia ocupacional com o adulto portador de cegueira adquirida (2000) Sinopse de Oftalmologia, 2 (1), pp. 24-25Lucas, M.B., Leal, M.O., Tavares, S.S., Barros, E.A., Aranha, S.T., Condutas reabilitacionais em pacientes com baixa visão (2003) Arq Bras Oftalmol, 66 (1), pp. 77-82Montilha, R.C., Temporini, E.R., Kara-Jose, N., Nobre, M.I., Deficiência visual: características e expectativas da clientela de serviço de reabilitação (2000) Rev Ciênc Méd (Campinas), 9 (3), pp. 123-128Carvalho, K.M., Monteiro, G.B., Isaac, C.R., Shiroma, L.O., Amaral, M.S., Causes of low vision and use of optical aids in the elderly (2004) Rev Hosp Clin Fac Med Sao Paulo, 59 (4), pp. 157-160Burman-Lindelow, P., Magnificação e auxílios ópticos em baixa visão. In: Veitzman S. Visão subnormal. Rio de Janeiro (2000) Cultura Médica, pp. 111-122Bonatti, F.A.S., Bonatti, J.A., Sampaio, M.W., Haddad, M.A., Souza, P.R., Kara-Jose, N., Evaluation of patients using an innovative low-vison aid (2008) Arq Bras Oftalmol, 71 (3), pp. 385-388. , PortugueseSacks, S.Z., Psychological and social implications of low vision (1966) New York: American Foundation for the Blind press, pp. 26-42. , Corn AL, Koenig AJ. Foundation of low vision: clinical and functional perspectiveMargrain, T.H., Helping blind and partially sighted people to read: the effectiveness of low vision aids (2000) Br J Ophthalmol, 84 (8), pp. 919-921Haddad, M.A.O., Sampaio, M.W., Estudo da acuidade visual e da velocidade de leitura na baixa visão (2010) Rio de Janeiro: Cultura Médica, pp. 79-96. , Sampaio MW, Haddad MA, Filho HA, Siaulys MO, organizadores. Baixa visão e cegueira: os caminhos para a reabilitação, a educação e a inclusãoMonteiro, M.M., Montilha, R.C., Gasparetto, M.E., Atenção fonoaudiológica e a linguagem escrita de pessoa com baixa visão: estudo exploratório (2011) Rev Bras Educ Esp, 17 (1), pp. 121-136Castro, C.T., Método de avaliação da acuidade e velocidade de leitura- Tabela MNREAD (2012) Rio de janeiro: Cultura Medica, pp. 175-182. , Ventura OL, Travassos SB, Silva AO, Dolan MA. Dislexia e distúrbios de AprendizagemCagliari, C.L., (2001) Alfabetização & Lingüística, , 10a ed. São Paulo: Sapion

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17 : analysis for the Global Burden of Disease Study 2017

Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1–65·8), 17·4% (7·7–28·4), and 59·5% (34·2–86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health

A Study To Determine: Should Conventional Amounts Of Eye Muscle Surgery For Horizontal Binocular Deviations Be Changed When Oblique Muscle Weakening Procedures Are Simultaneously Performed?

Purpose: To investigate the final surgical outcome in horizontal strabismus correction, measured in primary position of gaze, in two situations: 1. When surgery was performed only on the horizontal rectus muscles; and 2. When inferior or superior oblique muscle weakening procedures were simultaneously performed. Methods: Two hundred thirty cases were analyzed retrospectively: 172 esotropias (110 without oblique overaction; 23 with inferior oblique overaction; and 39 with superior oblique overaction), and 58 exotropias (25 without oblique overaction; 19 with inferior oblique overaction; and 14 with superior oblique overaction). Initial and final deviations, as well as the amount of correction achieved, was compared in six groups. Results: No differences in outcomes and final results were found between any of the major or minor groups of patients. Conclusions: Oblique muscle weakening, in combination with horizontal muscle strabismus surgery did not affect the final results of the horizonal surgery in primary position. This study did suggest that there might not be a need for increasing or decreasing amounts of surgery on the horizonal rectus muscles to correct eso- or exotropia when oblique weakening procedures are included.2012125Stager, D.R., Parks, M.M., Inferior oblique weakening procedures. Effect on primary postiion horizontal alignment (1973) Arch Ophthalmol, 90, pp. 15-16Shuey, T.F., Parks, M.M., Friendly, D.S., Results of combined surgery on the superior obqliue and horizontal rectus muscles for A-pattern horizontal strabismus (1992) J Pediatr Ophthalmol, 29, pp. 199-201Curi, R.L.N., Hipertropias - Disfuncoes de retos e obliquos (1993) Estrabismo, pp. 154-162. , Souza-Dias CR, Almeida HC eds. Roca, Sao PauloPrieto-Diaz, J., Souza-Dias, C.R., Las anisotropias en a y V com disfunctiones de los musculos obliquos. Consideraciones clinico-quirurgicas (1996) Estrabismo, p. 355. , Prieto-Diaz J, Souza-Dias CR eds. La Plata, Jorge de PochBerke, R.N., Tenotomy of the superior oblqiue for hypertropia (1946) Trans Am Ophthalmol Soc, 44, p. 304Jin, Y.H., Sung, K.R., Kook, M.S., The immediate effet of bilateral superior oblique tenotomy on primary position horizontal binocular alignment (1999) Binocul Vis Strabismus Q, 41, pp. 33-38Prieto-Diaz, J., Tenectomia parcial posterior del obliquo superior (1976) Arch Oftalmol B Aires, 51, p. 267Prieto-Diaz, J., Disinsertion of the superior oblique for A pattern anisotropia (1987) Binocul Vis, 2, pp. 7-14Apt, L., Call, B., Inferior oblique muscle recession (1978) Am J Ophthalmol, 85, pp. 95-100Monteiro De Carvalho, K.M., Simoes, A.M., Moreira Filho, D.C., Kara-Jose, N., Efficacy of posterior tenectomy of the superior oblique for a pattern anisotropia (1995) Update on Stabismus and Pediatric Ophthalmology, pp. 322-325. , CRC Press, Boca RatonMinguini, N., Carvalho, K.M.M., Surgical treatment of "A" anisotroipa by superior oblqiue weakening: Posterior tenectomy in comparison with disinsertion (1997) Arq Bras Oftal, 60, pp. 502-50

Occlusion Therapy In Amblyopia: Factors That Influence The Outcome [terapia Oclusiva Em Ambliopia: Fatores Prognósticos]

Purpose: Amblyopia is the most common form of visual problem in children and for more than 250 years occlusion therapy is the standard treatment. Thus our purpose is to identify the factors that influence the outcome of amblyopia treatment with occlusion therapy. Methods: We reviewed 169 amblyopic children seen in the outpatient clinic of amblyopia of the Campinas State University, between January 1996 and May 1998. Patients were analyzed regarding sex, age at start of treatment (3 groups), affected eye, type of amblyopia (strabismic, anisometropic, visual deprivation, associated), follow-up, initial visual acuity (light, moderate, severe), compliance with treatment (good, poor) and outcome (fully treated, partially treated, not treated). Results: Compliance was not seen to be significantly related to age at start of treatment (p=0.68) or initial visual acuity (p=0.82). 52.67% of the patients were fully treated while 19.52% were partially treated and 27.81% were not treated. Children recorded as showing good compliance had a significantly better outcome than those with poor compliance (p=0.0009). Neither the age at start of treatment (p=0.39) nor the initial visual acuity (p=0.30) were significantly correlated with the final outcome. Conclusions: We concluded that the main factor affecting the final outcome of amblyopia treatment is compliance.642123126Von Noorden, G.K., (1990) Binocular Vision and Ocular Motility: Theory and Management of Strabismus, pp. 208-245. , 4th ed. St. Louis, USA, C.V. MosbyKara-José, N., Carvalho, K.M., Caldato, R., Pereira, V., Oliveira, A.M., Fonseca, N.J.C., Atendimento de amblíopes e prevalência na população pré-escolar (1984) Bol. Oficina Sanit Panam, 96, pp. 31-37. , Campinas, São Paulo, BrasilSmith, L.K., Thompson, J.R., Woodruff, G., Hiscox, F., Factors affecting treatment compliance in amblyopia (1995) J Pediatr Ophthalmol Strabismus, 32, pp. 98-101Souza, E.C., Carvalho, A.K.R., Pulchinelli, A., Gass, C., Rothe, E., Vanzella, L.L., Cura e recorrência da ambliopia após terapia oclusiva (1994) Arq Bras Oftalmol, 57, pp. 16-19Monteiro De Carvalho, K.M., Tratamiento de la ambliopía (1998) Actualidades del Estrabismo Latinoamericano. México: Consejo Latinoamericano de Estrabismo, pp. 19-24. , Yllanes MEA, Prieto Diaz J, Souza Dias C, Restrepo GVFielder, A.R., Auld, R., Irwin, M., Cocker, K.D., Jones, H.S., Moseley, M.J., Compliance monitoring in amblyopia therapy (1994) Lancet, 343, p. 547Hiscox, F., Strong, N., Thompson, J.R., Minshull, C., Woodruff, G., Occlusion for amblyopia: A comprehensive survey of outcome (1992) Eye, 6, pp. 300-304Monteiro De Carvalho, K.M., Simões, M.S.T., Sanabria, L.B.G., Kara-José, N., Ambliopia: Necessidade de prevenção pré-escolar (1996) Arq Bras Oftalmol, 59, p. 354Campos, E.C., Update on strabismus and amblyopia (1995) Acta Ophthalmol Scand, 214, pp. 17-24Gurovich, L., Ambliopia (1996) Estrabismo, pp. 55-91. , Prieto-Diaz J, Souza-Dias C., Argentina: La PlataSerpa, G., Carvalho, K.M.M., Kara-José, N., Ambliopia: Aderência ao tratamento (1995) Arq Bras Oftalmol, 58, p. 226Nucci, P., Alfarano, R., Piantadina, A., Brancato, R., Compliance in antiamblyopia occlusion therapy (1992) Acta Ophthalmol, 70, pp. 128-131Beardsell, R., Clarke, S., Hill, M., Outcome of occlusion treatment for amblyopia (1999) J Pediatr Ophthalmol Strabismus, 36, pp. 19-24Woodruff, G., Hiscox, F., Thompson, J.R., Smith, L.K., Factors affecting the outcome of children treated for amblyopia (1994) Eye, 8, pp. 627-631Campos, E., Amblyopia (1995) Surv Ophthalmol, 40, pp. 23-3

Success Attitudes Of Young Ophthalmologists In The First Decade Of Their Career

Purpose: To describe the main success attitudes of young ophthalmologists in the first decade of their career. Methods: This descriptive study comprised subjects selected from a sample of ophthalmologists who were participating in a congress, using a semi-structured questionnaire. The inclusion criteria were as follows: ophthalmologists under the age of 40 years, within 5-10 years from ophthalmology residency conclusion. The subjects wereasked about the three main success attitudes in their personal experience during the first years of ophthalmology practice. After the initial results, the 10 most frequently mentioned attitudes were listed and volunteers were again interviewed to choose, within the latter list, the three main attitudes. Results: Forty-eight ophthalmologists were interviewed, 24 (50%) were male; the mean age was 37 years (SD: 2 years, range: 33-40 years) and the mean time from ophthalmology residency conclusion was 8 years (SD: 1 year, range: 5-10years). The frequency of such mentioned success attitudes were as follows: to invest in professional updating (22.9%), to have a good relationship with patients and professional partners (18.8%), to prioritize individual and family happiness (12.5%),initially to work in an established group (11.1%), to work in public service (9.7%), to have their own business with a homogeneous group (7.6%), to save money (7.6%),to be ready to resume work (4.2%), to get business administration skills (4.2%), and to have professional insurance (0.7%). Conclusions: The three main success attitudes consisted in investing in professional updating (22.9%), maintaining a good relationship with patients and professional partners(18.8%), and prioritizing individual and family happiness (12.5%). Although these resultsshould not be generalized, they are helpful not only for those ophthalmologists at the beginning of a career but also those who want to reflect on what to prioritize in their professional practice.754256258Morinaga, C.V., Konno, S.N., Aisawa, R.K., Vieira, J.E., Martins, M.A., Frases que resumem os atributos na relação médico-paciente (2002) Rev Bras Educ Med., 26 (1), pp. 21-27Ismael, J.C., O médico e o paciente: breve história de uma relação delicada (2002) São Paulo: Queiroz EditorLeite, M.T., Carlini, A.L., Ramos, M.P., Sigulem, D., Educação médica continuada online: potencial e desafios no cenário brasileiro (2010) Rev Bras Educ Med., 34 (1), pp. 141-149Bernardo, W.M., Jatene, F.B., Nobre, M.R., Experiência clínica, educação médica continuadae qualidade da atenção em saúde (2005) Rev Assoc Med Bras., 51 (2), pp. 63-64Sackett, D.L., Haynes, R.B., On the need for evidence-based medicine (EBM Trends) (1995) Evidence-Based Medicine, 1, p. 5(2012) ACCME [Internet], , http://www.accme.org, Accreditation Council for Continuing Medical Education,hicago, IL2012 [cited 2012 Feb 20]. 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(2004) Einstein., 2 (3), pp. 228-229Nassar, M.R., Princípios de comunicação excelente para o bom relacionamento médico - paciente [tese] (2003) São Paulo: Universidade Estadual PaulistaPereira, M.G., Azevedo, E.S., A relação médico-paciente em Rio Branco/AC sob a ótica dos pacientes (2005) Rev Assoc Med Bras., 51 (3), pp. 153-157Mckenna, R., Marketing de relacionamento (1992) Rio de Janeiro: CampusSouza, F.A., Marketing trends 2004 (2004) São Paulo: Makron BooksGummesson, E., Marketing de relacionamento total: gerenciamento de marketing, estratégias de relacionamento e abordagem de CRM para economias de rede (2005) Porto Alegre: BookmanStaw, B.M., Sutton, R.I., Pelled, L.H., Employee positive emotions and favorable outcomes at the workplace (1994) Organization Science., 5 (1), pp. 51-71Villablanca, A.C., Beckett, L., Nettiksimmons, J., Howell, L.P., Career flexibility and family-friendly policies: an NIH-funded study to enhance women's careers in biomedical sciences (2011) J Womens Health (Larchmt), 20 (10), pp. 1485-1496Machado, M.H., Os médicos no Brasil um retrato da realidade (1997) Rio de Janeiro: FiocruzMaciel, R.H., Santos, J.B., Sales, T.B., Alves, M.A., Luna, A.P., Feitosa, L.B., Multiplicidade de vínculos de médicos no Estado do Ceará (2010) Rev Saúde Pública., 44 (5), pp. 950-956Rocha, T., As 6 características de um bom gerenciamento em um serviço médico com vários sócios [Internet], , http://www.sbao.com.br/artigosLeiaMais.php?ID_ARTIGO=00000000068, citado 2012 Fev 20, Disponível emEducação é um projeto de todos [Internet], , http://www.corecon-pb.org.br, CORECON-PB, citado 2012 Fev 17, Disponível emClark, R.L., D'ambrosio, M.B., Mcdermed, A.A., Sawant, K., Retirement plans and saving decisions: the role of information and education (2006) J Pension Econ Finance., 5 (1), pp. 45-67Perktold, C., A cultura da confiança: a história do crédito no Brasil (2008) Belo Horizonte: Arte e CulturaBruni, A.L., Mercados Financeiros: para a certificação profissional ANBID 10 (2005) São Paulo: AtlasSavoia, J.R., Saito, A.T., Santana, F.A., Paradigmas da educação financeira no Brasil (2007) Rev Adm Pública., 41 (6), pp. 1121-1141Pinheiro, R.P., Educação financeira e previdenciária, a nova fronteira dos fundos de pensão (2008) São Paulo: Peixoto NetoLeahy, R.L., Como lidar com as preocupaçóes: sete passos para impedir que elas paralisem você (2007) Porto Alegre: ArtmedGedde, S.J., Budenz, D.L., Haft, P., Tielsch, J.M., Lee, Y., Quigley, H.A., Factors influencing career choices among graduating ophthalmology residents (2005) Ophthalmology., 112 (7), pp. 1247-1254Bertachini, A., Especialização no setor em franca evolução Gazeta Mercantil 2007, , http://www.abraidi.com.br/docs/pdf_not/Especializacao_no_setor_em_franca_evolucao_Gazeta_Mercantil_301107.doc, citado 2012 Fev 23. 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Diabetic Retinopathy And Visual Disabilities Among Patients In A Rehabilitation Program

Objective: To assess the prevalence of diabetic retinopathy and to evaluate the management of patients with visual disabilities attending at the CEPRE Rehabilitation Program of University of Campinas. Methods: A retrospective study was carried out based on medical records of patients with visual disabilities attending a vision rehabilitation program. The following variables were studied: gender, age, marital status, level of schooling, social security status, origin, type and cause of visual disability and vision rehabilitation actions. Results: The sample consisted of 155 patients, 55.5% males, aged between 12 and 88 years, mean age 41 years old, 34.8% were blind and 65.2% with low vision disability. Of those blind patients, 81.8% reported acquired blindness, and the leading cause was diabetic retinopathy (33.3%), followed by glaucoma (16.6%), and retinal detachment (15.0%). Of those patients with low vision disability, 14.9% had diabetic retinopathy, 14.9% hereditary syndromes, and 10.9% age-related macular degeneration. Vision rehabilitation therapy included interdisciplinary team consultations helping patients go through the mourning process for the loss or impairment of vision, and promoting the enhancement of their skills for performing activities of daily living independently. The management of patients with low vision was also focused on vision rehabilitation. Conclusion: The health of the eyes of patients with chronic diseases such as diabetes is at risk. The prevalence of diabetic retinopathy was found to be a cause for visual disability, suggesting the need to assess these patients' access to health care and rehabilitation and promote health education for changing habits and improving quality of life.706342348Assunção, M.C.F., Santos, I.S., Gigante, D.P., Atenção primária em diabetes no Sul do Brasil: estrutura, processo e resultado (2001) J Public Health, 35 (1), pp. 88-95Narayan, K.M., Gregg, E.W., Fagot-Campagna, A., Engelgau, M.M., Vinicor, F., Diabetes- a common, growing, serious, costly, and potentially preventable public health problem (2000) Diabetes Rev Clin Pract, 50 (SUPPL. 2), pp. S77-84(1994) Prevention of diabetes mellitus. Report of a WHO Study Group, , World Health Organization. Geneva: World Health Organization(WHOTechnical Report Series 844)Bosco, A., Lerário, A.C., Soriano, D., Santos, R.F., Massote, P., Galvão, D., Retinopatia diabética (2005) Arq Bras Endocrinol Metab, 49 (2), pp. 217-227Media Centre. 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