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2012年8月26日 星期日

Sensory Loss in Older Adults - Vision - Behavioral Approaches For Caregivers


As we age, our sensory systems gradually lose their sharpness. Because our brain requires a minimal amount of input to remain alert and functioning, sensory loss for older adults puts them at risk for sensory deprivation. Severe sensory impairments, such as in vision or hearing, may result in behavior similar to dementia and psychosis, such as increased disorientation and confusion. Added restrictions, such as confinement to bed or a Geri-chair, increases this risk. With nothing to show the passage of time, or changes in the environment, the sensory deprived person may resort to repetitive problem behaviors (calling out, chanting, rhythmic pounding/rocking) as an attempt to reduce the sense of deprivation and to create internal stimulation/sensations.

This article is the first in a series of three articles that discuss the prominent sensory changes that accompany aging, and considers the necessary behavioral adjustments or accommodations that should be made by professional, paraprofessional, and family caregivers who interact with older adults. Though the medical conditions are not reviewed in depth, the purpose of this article is to introduce many of the behavioral health insights, principles, and approaches that should influence our caregiving roles. This article addresses age-related visual changes.

CHANGES IN VISION THAT ACCOMPANY AGING

A. The changes in vision that accompany aging include:

1. A loss of elasticity of the lens; this means the person is no longer able to focus or accommodate to changes in lighting conditions. (Starting in our 40's, glasses are needed to see fine print). It also means the older person cannot adjust to sudden changes in lighting, resulting in an uneasiness when leaving a bright room to enter a dark hallway, or finding seats in the dark in recreation rooms, or theater. Going in the reverse direction can be equally difficult: from a dark room to a bright area.

2. Decreased pupil size; the light reaching the retina is reduced, requiring more light to see. This results in the need for lighting 3x to 4x what younger people need to see clearly

3. A loss of transparency; with age, there is a yellowing of the lens in the eyes, making color discrimination more difficult, especially blue and green. Warmer colors, such as reds and yellows are perceived best, explaining why bright colors are preferred.

4. More susceptibility to glare, and longer time is needed to recover from the effects of glare;

5. Eye diseases and disorders, such as cataracts causing a clouding of the lens; glaucoma, resulting from increased pressure of fluids in the eye, damaging the optic nerve and impairing vision. Glaucoma, the number one cause of blindness in U.S., in advanced stages results in yellow halos around images. Macular degeneration may occur, where vision is distorted, and images appear different sizes or different shapes, and are missing a central element. Visual disorders may be secondary to stroke, in which the eye can see the image but the brain cannot interpret the images. Diabetes may result in disrupted blood flow to the retina, causing diabetic retinopathy and a loss of vision, and blindness, in extreme cases.

B. What are the effects of visual loss on the older adult?

1. An increased dependency on others;

2. A sharply reduced quality of life (changes in activities in daily living and instrumental activities of daily living, reduced connection with outside world);

3. And, a fearfulness and reduced tendency to venture outside.

C. What are the effects of vision changes on demented elderly?

1. With the losses in visual acuity, other problems in cognitive functioning are heightened, such as difficulty processing unfamiliar faces and settings;

2. Because the person with dementia already has difficulty learning new behaviors, he or she is less able to learn new habits to compensate for the visual losses (e.g., learning to use visual aids to identify articles of clothing or other possessions;

3. There is likely to be an increased disorientation and confusion, as the search for structure and external cues is strained.

PRINCIPLES FOR CAREGIVERS

The following principles apply to caregiving approaches with older adults who have diminished sensory function. Increased sensitivity and insight to the needs of these individuals improves their quality of life and improves our effectiveness:

1. Observe the behavior of the person, and look for cues and signs of pain or discomfort;

2. Help the person work through the emotional impact of the sensory changes, allowing expression, acceptance, and support of the grief and sadness accompanying these losses;

3. Do not try to fix the unpleasantness; acceptance and support goes a longer way toward healing than a quick fix or a patronizing attitude;

4. Reduce excess disability by maximizing whatever functioning is still left, such as proper eyeglass prescriptions, or functioning hearing aids;

5. Consider assistive devices (phone amplifiers, large text books, headphones, and the Braille Institute for a variety of useful visual aids).

Approaches for impairments in vision:

1. Address the person before you touch him or her, identify yourself, let him or her know when you are leaving, speak normally, and do not shout;

2. Describe his or her surroundings to help orient and familiarize the person to the environment, tell him or her location of belongings, and if things have been moved;

3. Use as much contrast as possible, e.g., red objects on white background is better than black on a gray background, or blue on green background, (consider switch plates on walls, toothbrushes, combs);

4. Avoid moving quickly from a bright room to a darkened room, or v.v. Make sure the visually-impaired person takes the time for the pupils to adapt to the changes in lighting;

5. Introduce yourself every time you come into contact with the person, and explain what you are going to do because there are no visual cues;

6. Help to identify others in their environment with colored clothing, name tags with large print, etc.

7. Clean eyeglasses regularly, provide adequate lighting, and avoid glare;

8. Provide night lights, and arrange furnishings in the environment for safety and ease of mobility.

Even with normal aging, functioning of our five senses is not like it was when we were younger adults. This article offers caregivers who work with visually-impaired older adults some insights into the special needs and adjustments that will turn unpleasant, frustrating situations into more caring, helpful, and sensitive interactions. By integrating these behavioral approaches in the delivery of the health care with older adults, we can favorably impact the management of these conditions.

Copyright 2008 Concept Healthcare, LLC




Joseph M. Casciani, PhD, is a geropsychologist who has devoted his professional career to working with older adults and their caregivers. His company, Concept Healthcare, http://www.cohealth.org, offers online resources to integrate behavioral health approaches in the health care of older adults.





This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

張貼者： 於 凌晨4:32 0 意見
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2012年6月28日 星期四

Sensory Loss in Older Adults - Vision - Behavioral Approaches For Caregivers


As we age, our sensory systems gradually lose their sharpness. Because our brain requires a minimal amount of input to remain alert and functioning, sensory loss for older adults puts them at risk for sensory deprivation. Severe sensory impairments, such as in vision or hearing, may result in behavior similar to dementia and psychosis, such as increased disorientation and confusion. Added restrictions, such as confinement to bed or a Geri-chair, increases this risk. With nothing to show the passage of time, or changes in the environment, the sensory deprived person may resort to repetitive problem behaviors (calling out, chanting, rhythmic pounding/rocking) as an attempt to reduce the sense of deprivation and to create internal stimulation/sensations.

This article is the first in a series of three articles that discuss the prominent sensory changes that accompany aging, and considers the necessary behavioral adjustments or accommodations that should be made by professional, paraprofessional, and family caregivers who interact with older adults. Though the medical conditions are not reviewed in depth, the purpose of this article is to introduce many of the behavioral health insights, principles, and approaches that should influence our caregiving roles. This article addresses age-related visual changes.

CHANGES IN VISION THAT ACCOMPANY AGING

A. The changes in vision that accompany aging include:

1. A loss of elasticity of the lens; this means the person is no longer able to focus or accommodate to changes in lighting conditions. (Starting in our 40's, glasses are needed to see fine print). It also means the older person cannot adjust to sudden changes in lighting, resulting in an uneasiness when leaving a bright room to enter a dark hallway, or finding seats in the dark in recreation rooms, or theater. Going in the reverse direction can be equally difficult: from a dark room to a bright area.

2. Decreased pupil size; the light reaching the retina is reduced, requiring more light to see. This results in the need for lighting 3x to 4x what younger people need to see clearly

3. A loss of transparency; with age, there is a yellowing of the lens in the eyes, making color discrimination more difficult, especially blue and green. Warmer colors, such as reds and yellows are perceived best, explaining why bright colors are preferred.

4. More susceptibility to glare, and longer time is needed to recover from the effects of glare;

5. Eye diseases and disorders, such as cataracts causing a clouding of the lens; glaucoma, resulting from increased pressure of fluids in the eye, damaging the optic nerve and impairing vision. Glaucoma, the number one cause of blindness in U.S., in advanced stages results in yellow halos around images. Macular degeneration may occur, where vision is distorted, and images appear different sizes or different shapes, and are missing a central element. Visual disorders may be secondary to stroke, in which the eye can see the image but the brain cannot interpret the images. Diabetes may result in disrupted blood flow to the retina, causing diabetic retinopathy and a loss of vision, and blindness, in extreme cases.

B. What are the effects of visual loss on the older adult?

1. An increased dependency on others;

2. A sharply reduced quality of life (changes in activities in daily living and instrumental activities of daily living, reduced connection with outside world);

3. And, a fearfulness and reduced tendency to venture outside.

C. What are the effects of vision changes on demented elderly?

1. With the losses in visual acuity, other problems in cognitive functioning are heightened, such as difficulty processing unfamiliar faces and settings;

2. Because the person with dementia already has difficulty learning new behaviors, he or she is less able to learn new habits to compensate for the visual losses (e.g., learning to use visual aids to identify articles of clothing or other possessions;

3. There is likely to be an increased disorientation and confusion, as the search for structure and external cues is strained.

PRINCIPLES FOR CAREGIVERS

The following principles apply to caregiving approaches with older adults who have diminished sensory function. Increased sensitivity and insight to the needs of these individuals improves their quality of life and improves our effectiveness:

1. Observe the behavior of the person, and look for cues and signs of pain or discomfort;

2. Help the person work through the emotional impact of the sensory changes, allowing expression, acceptance, and support of the grief and sadness accompanying these losses;

3. Do not try to fix the unpleasantness; acceptance and support goes a longer way toward healing than a quick fix or a patronizing attitude;

4. Reduce excess disability by maximizing whatever functioning is still left, such as proper eyeglass prescriptions, or functioning hearing aids;

5. Consider assistive devices (phone amplifiers, large text books, headphones, and the Braille Institute for a variety of useful visual aids).

Approaches for impairments in vision:

1. Address the person before you touch him or her, identify yourself, let him or her know when you are leaving, speak normally, and do not shout;

2. Describe his or her surroundings to help orient and familiarize the person to the environment, tell him or her location of belongings, and if things have been moved;

3. Use as much contrast as possible, e.g., red objects on white background is better than black on a gray background, or blue on green background, (consider switch plates on walls, toothbrushes, combs);

4. Avoid moving quickly from a bright room to a darkened room, or v.v. Make sure the visually-impaired person takes the time for the pupils to adapt to the changes in lighting;

5. Introduce yourself every time you come into contact with the person, and explain what you are going to do because there are no visual cues;

6. Help to identify others in their environment with colored clothing, name tags with large print, etc.

7. Clean eyeglasses regularly, provide adequate lighting, and avoid glare;

8. Provide night lights, and arrange furnishings in the environment for safety and ease of mobility.

Even with normal aging, functioning of our five senses is not like it was when we were younger adults. This article offers caregivers who work with visually-impaired older adults some insights into the special needs and adjustments that will turn unpleasant, frustrating situations into more caring, helpful, and sensitive interactions. By integrating these behavioral approaches in the delivery of the health care with older adults, we can favorably impact the management of these conditions.

Copyright 2008 Concept Healthcare, LLC




Joseph M. Casciani, PhD, is a geropsychologist who has devoted his professional career to working with older adults and their caregivers. His company, Concept Healthcare, http://www.cohealth.org, offers online resources to integrate behavioral health approaches in the health care of older adults.





This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

張貼者： 於 下午5:21 0 意見
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2012年6月1日 星期五

Sensory Loss in Older Adults - Vision - Behavioral Approaches For Caregivers


As we age, our sensory systems gradually lose their sharpness. Because our brain requires a minimal amount of input to remain alert and functioning, sensory loss for older adults puts them at risk for sensory deprivation. Severe sensory impairments, such as in vision or hearing, may result in behavior similar to dementia and psychosis, such as increased disorientation and confusion. Added restrictions, such as confinement to bed or a Geri-chair, increases this risk. With nothing to show the passage of time, or changes in the environment, the sensory deprived person may resort to repetitive problem behaviors (calling out, chanting, rhythmic pounding/rocking) as an attempt to reduce the sense of deprivation and to create internal stimulation/sensations.

This article is the first in a series of three articles that discuss the prominent sensory changes that accompany aging, and considers the necessary behavioral adjustments or accommodations that should be made by professional, paraprofessional, and family caregivers who interact with older adults. Though the medical conditions are not reviewed in depth, the purpose of this article is to introduce many of the behavioral health insights, principles, and approaches that should influence our caregiving roles. This article addresses age-related visual changes.

CHANGES IN VISION THAT ACCOMPANY AGING

A. The changes in vision that accompany aging include:

1. A loss of elasticity of the lens; this means the person is no longer able to focus or accommodate to changes in lighting conditions. (Starting in our 40's, glasses are needed to see fine print). It also means the older person cannot adjust to sudden changes in lighting, resulting in an uneasiness when leaving a bright room to enter a dark hallway, or finding seats in the dark in recreation rooms, or theater. Going in the reverse direction can be equally difficult: from a dark room to a bright area.

2. Decreased pupil size; the light reaching the retina is reduced, requiring more light to see. This results in the need for lighting 3x to 4x what younger people need to see clearly

3. A loss of transparency; with age, there is a yellowing of the lens in the eyes, making color discrimination more difficult, especially blue and green. Warmer colors, such as reds and yellows are perceived best, explaining why bright colors are preferred.

4. More susceptibility to glare, and longer time is needed to recover from the effects of glare;

5. Eye diseases and disorders, such as cataracts causing a clouding of the lens; glaucoma, resulting from increased pressure of fluids in the eye, damaging the optic nerve and impairing vision. Glaucoma, the number one cause of blindness in U.S., in advanced stages results in yellow halos around images. Macular degeneration may occur, where vision is distorted, and images appear different sizes or different shapes, and are missing a central element. Visual disorders may be secondary to stroke, in which the eye can see the image but the brain cannot interpret the images. Diabetes may result in disrupted blood flow to the retina, causing diabetic retinopathy and a loss of vision, and blindness, in extreme cases.

B. What are the effects of visual loss on the older adult?

1. An increased dependency on others;

2. A sharply reduced quality of life (changes in activities in daily living and instrumental activities of daily living, reduced connection with outside world);

3. And, a fearfulness and reduced tendency to venture outside.

C. What are the effects of vision changes on demented elderly?

1. With the losses in visual acuity, other problems in cognitive functioning are heightened, such as difficulty processing unfamiliar faces and settings;

2. Because the person with dementia already has difficulty learning new behaviors, he or she is less able to learn new habits to compensate for the visual losses (e.g., learning to use visual aids to identify articles of clothing or other possessions;

3. There is likely to be an increased disorientation and confusion, as the search for structure and external cues is strained.

PRINCIPLES FOR CAREGIVERS

The following principles apply to caregiving approaches with older adults who have diminished sensory function. Increased sensitivity and insight to the needs of these individuals improves their quality of life and improves our effectiveness:

1. Observe the behavior of the person, and look for cues and signs of pain or discomfort;

2. Help the person work through the emotional impact of the sensory changes, allowing expression, acceptance, and support of the grief and sadness accompanying these losses;

3. Do not try to fix the unpleasantness; acceptance and support goes a longer way toward healing than a quick fix or a patronizing attitude;

4. Reduce excess disability by maximizing whatever functioning is still left, such as proper eyeglass prescriptions, or functioning hearing aids;

5. Consider assistive devices (phone amplifiers, large text books, headphones, and the Braille Institute for a variety of useful visual aids).

Approaches for impairments in vision:

1. Address the person before you touch him or her, identify yourself, let him or her know when you are leaving, speak normally, and do not shout;

2. Describe his or her surroundings to help orient and familiarize the person to the environment, tell him or her location of belongings, and if things have been moved;

3. Use as much contrast as possible, e.g., red objects on white background is better than black on a gray background, or blue on green background, (consider switch plates on walls, toothbrushes, combs);

4. Avoid moving quickly from a bright room to a darkened room, or v.v. Make sure the visually-impaired person takes the time for the pupils to adapt to the changes in lighting;

5. Introduce yourself every time you come into contact with the person, and explain what you are going to do because there are no visual cues;

6. Help to identify others in their environment with colored clothing, name tags with large print, etc.

7. Clean eyeglasses regularly, provide adequate lighting, and avoid glare;

8. Provide night lights, and arrange furnishings in the environment for safety and ease of mobility.

Even with normal aging, functioning of our five senses is not like it was when we were younger adults. This article offers caregivers who work with visually-impaired older adults some insights into the special needs and adjustments that will turn unpleasant, frustrating situations into more caring, helpful, and sensitive interactions. By integrating these behavioral approaches in the delivery of the health care with older adults, we can favorably impact the management of these conditions.

Copyright 2008 Concept Healthcare, LLC




Joseph M. Casciani, PhD, is a geropsychologist who has devoted his professional career to working with older adults and their caregivers. His company, Concept Healthcare, http://www.cohealth.org, offers online resources to integrate behavioral health approaches in the health care of older adults.





This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

張貼者： 於 清晨7:19 0 意見
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2012年5月23日 星期三

Sensory Loss in Older Adults - Vision - Behavioral Approaches For Caregivers


As we age, our sensory systems gradually lose their sharpness. Because our brain requires a minimal amount of input to remain alert and functioning, sensory loss for older adults puts them at risk for sensory deprivation. Severe sensory impairments, such as in vision or hearing, may result in behavior similar to dementia and psychosis, such as increased disorientation and confusion. Added restrictions, such as confinement to bed or a Geri-chair, increases this risk. With nothing to show the passage of time, or changes in the environment, the sensory deprived person may resort to repetitive problem behaviors (calling out, chanting, rhythmic pounding/rocking) as an attempt to reduce the sense of deprivation and to create internal stimulation/sensations.

This article is the first in a series of three articles that discuss the prominent sensory changes that accompany aging, and considers the necessary behavioral adjustments or accommodations that should be made by professional, paraprofessional, and family caregivers who interact with older adults. Though the medical conditions are not reviewed in depth, the purpose of this article is to introduce many of the behavioral health insights, principles, and approaches that should influence our caregiving roles. This article addresses age-related visual changes.

CHANGES IN VISION THAT ACCOMPANY AGING

A. The changes in vision that accompany aging include:

1. A loss of elasticity of the lens; this means the person is no longer able to focus or accommodate to changes in lighting conditions. (Starting in our 40's, glasses are needed to see fine print). It also means the older person cannot adjust to sudden changes in lighting, resulting in an uneasiness when leaving a bright room to enter a dark hallway, or finding seats in the dark in recreation rooms, or theater. Going in the reverse direction can be equally difficult: from a dark room to a bright area.

2. Decreased pupil size; the light reaching the retina is reduced, requiring more light to see. This results in the need for lighting 3x to 4x what younger people need to see clearly

3. A loss of transparency; with age, there is a yellowing of the lens in the eyes, making color discrimination more difficult, especially blue and green. Warmer colors, such as reds and yellows are perceived best, explaining why bright colors are preferred.

4. More susceptibility to glare, and longer time is needed to recover from the effects of glare;

5. Eye diseases and disorders, such as cataracts causing a clouding of the lens; glaucoma, resulting from increased pressure of fluids in the eye, damaging the optic nerve and impairing vision. Glaucoma, the number one cause of blindness in U.S., in advanced stages results in yellow halos around images. Macular degeneration may occur, where vision is distorted, and images appear different sizes or different shapes, and are missing a central element. Visual disorders may be secondary to stroke, in which the eye can see the image but the brain cannot interpret the images. Diabetes may result in disrupted blood flow to the retina, causing diabetic retinopathy and a loss of vision, and blindness, in extreme cases.

B. What are the effects of visual loss on the older adult?

1. An increased dependency on others;

2. A sharply reduced quality of life (changes in activities in daily living and instrumental activities of daily living, reduced connection with outside world);

3. And, a fearfulness and reduced tendency to venture outside.

C. What are the effects of vision changes on demented elderly?

1. With the losses in visual acuity, other problems in cognitive functioning are heightened, such as difficulty processing unfamiliar faces and settings;

2. Because the person with dementia already has difficulty learning new behaviors, he or she is less able to learn new habits to compensate for the visual losses (e.g., learning to use visual aids to identify articles of clothing or other possessions;

3. There is likely to be an increased disorientation and confusion, as the search for structure and external cues is strained.

PRINCIPLES FOR CAREGIVERS

The following principles apply to caregiving approaches with older adults who have diminished sensory function. Increased sensitivity and insight to the needs of these individuals improves their quality of life and improves our effectiveness:

1. Observe the behavior of the person, and look for cues and signs of pain or discomfort;

2. Help the person work through the emotional impact of the sensory changes, allowing expression, acceptance, and support of the grief and sadness accompanying these losses;

3. Do not try to fix the unpleasantness; acceptance and support goes a longer way toward healing than a quick fix or a patronizing attitude;

4. Reduce excess disability by maximizing whatever functioning is still left, such as proper eyeglass prescriptions, or functioning hearing aids;

5. Consider assistive devices (phone amplifiers, large text books, headphones, and the Braille Institute for a variety of useful visual aids).

Approaches for impairments in vision:

1. Address the person before you touch him or her, identify yourself, let him or her know when you are leaving, speak normally, and do not shout;

2. Describe his or her surroundings to help orient and familiarize the person to the environment, tell him or her location of belongings, and if things have been moved;

3. Use as much contrast as possible, e.g., red objects on white background is better than black on a gray background, or blue on green background, (consider switch plates on walls, toothbrushes, combs);

4. Avoid moving quickly from a bright room to a darkened room, or v.v. Make sure the visually-impaired person takes the time for the pupils to adapt to the changes in lighting;

5. Introduce yourself every time you come into contact with the person, and explain what you are going to do because there are no visual cues;

6. Help to identify others in their environment with colored clothing, name tags with large print, etc.

7. Clean eyeglasses regularly, provide adequate lighting, and avoid glare;

8. Provide night lights, and arrange furnishings in the environment for safety and ease of mobility.

Even with normal aging, functioning of our five senses is not like it was when we were younger adults. This article offers caregivers who work with visually-impaired older adults some insights into the special needs and adjustments that will turn unpleasant, frustrating situations into more caring, helpful, and sensitive interactions. By integrating these behavioral approaches in the delivery of the health care with older adults, we can favorably impact the management of these conditions.

Copyright 2008 Concept Healthcare, LLC




Joseph M. Casciani, PhD, is a geropsychologist who has devoted his professional career to working with older adults and their caregivers. His company, Concept Healthcare, http://www.cohealth.org, offers online resources to integrate behavioral health approaches in the health care of older adults.





This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

張貼者： 於 下午3:08 0 意見
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2012年4月17日 星期二

Retinal Implants, Still in Their Infancy, Provide a New Vision of the Future


The challenge of restoring sight is immense, and the advances in this area seem to go hand in hand with advances in technology. As with most electrical prostheses, these advances cross many scientific disciplines, from biophysics to electrical engineering. Of equal importance is the surgical aspect of being able to successfully implant such devices.

Two approaches are being employed. One is the subretinal implant, which is implanted at the level of the photoreceptors. Several thousand photodiodes are arrayed in a sheet and are connected to microelectrodes that in turn stimulate ganglion cells (the output neurons) in the retina. Light shining on this array generates a current that depolarizes the ganglion cells, via these microelectrodes. The second approach is the epiretinal implant, which is placed on the inner or opposite layer of the retina. In this, a conventional (external) camera and processing unit are connected to a readout chip that is secured to the inner retina, at the level of the ganglion cells.

Complexity and Inaccessibility

Given the hard-to-access location of the retina, at the back of the eye, and the inherent complexity of this nervous structure, the procedure is incredibly delicate. The retina is only 0.5 mm thick, and neuroscientists consider it to be the most complex sensory organ we have. Several neuronal cell types constitute the retina, including photoreceptors, bipolar cells, horizontal cells and ganglion cells.

Key to vision is the transduction of photons by the photoreceptors, which have some exceptional properties. Among those is the "dark current," which is a constant depolarization in the dark. That, in turn, releases glutamate, at the synaptic terminals of photoreceptors. In darkness, the membrane of the outer segment is permeable to sodium ions. The higher concentration of sodium ions outside the cell allows positively charged sodium ions to enter the cell in darkness, causing the cell to be partially depolarized. Light decreases the permeability of the outer segment membrane to sodium, thereby decreasing the flow of positive ions into the cell and causing the inside of the cell to become more negative (i.e., to hyperpolarize).

All vertebrate photoreceptors hyperpolarize in response to light (i.e., the inside of the cell becomes more negative). This is a unique situation that is then relayed to vertical or lateral pathways, within the retina. The final output is the ganglion cells, which lie on the inner surface of the retina. The light passes through several neuronal layers before reaching the photoreceptors, and the retina relays all the information collected by the photoreceptors in the form of coded streams of action potentials. This coded information includes form, movement, contrast and color. These signals are then transferred via the optic nerves to various brain regions, finally ending in the visual cortex.

Sight Disorders and the Retina

Many disorders of the eye are related to the retina; for instance age-related macular degeneration, retinitis pigmentosa, and diabetic retinopathy. They often involve serious disruptions in the collection of light, and may lead to blindness. Some, such as retinitis pigmentosa, in which there is a gradual deterioration of rods within the retina, eventually leaving only the central fovea intact (which is concentrated with cones), have no known cure.

Currently much of the focus is on the subretinal implant, and many groups are investing in this technology. The hurdles are huge, of course, not least of which is the surgical implantation onto the back of the retina. In general, two surgical approaches are currently employed; the first is through the cornea and into the vitreous humor, and the second is through the sclera. Both techniques are challenging, as can be imagined. The biggest challenges involve maintaining internal pressure within the eye and contrast illumination of the surgical site during the procedure.

Once in place, there is about 50 to 100 ¼m between the subretinal implant array and the ganglion cells, which is sufficient to excite these cells. Even so, most of the other important neuronal elements that refine the retinal image in normal sight within the retina are bypassed. In animal models, the subretinal implants seem to produce action potentials in the visual cortex of the brain, and the spatial resolution is around 1 degree-a remarkable achievement. Nonetheless, the electrical stimulation of the ganglion cells is crude, and there is concurrent stimulation of their optic nerves, resulting in distorted images and cancellations of output from the photodiodes. Additionally, spatial resolution is adequate, at best, to achieve a recognizable image.

Boston Project Sees Progress

The Boston Retinal Implant Project, which is a collaborative effort with multiple academic, clinical and research institutions throughout the nation, has a novel engineering solution to treat blinding diseases with retinal implants (see http://www.bostonretinalimplant.org/). Their current prosthesis includes an external camera that is mounted onto a pair of eyeglasses. The camera transmits images wirelessly through a coil within the glasses. The scene captured by the camera is then relayed to receiving coils on the prosthesis. The retinal stimulating array consists of a row of several hundred electrodes that are capable of stimulating ganglion cells in their immediate vicinity. The result is a pixilated array of lights that appear much like a large scoreboard image, at best. With such information, however, it is anticipated that a blind person will not require the use of a guide dog or cane.

Surgical methods have been applied in animal models and so far have shown reliable success using a combination of vitreoretinal surgery and ab externo procedures. The project's retinal implant has been tested in six humans, and several of the patients who had been legally blind for decades were able to distinguish small spots of light upon low level stimulation of parts of the electrode array. (The original paper can be found at http://www.bostonretinalimplant.org/pdf/20031200-preceptual-thresholds.pdf.)

It is also noteworthy that close to 300 patents have been filed and granted on this topic. Over the past 12 months, 15 patents were filed naming various assignees, such as the Doheny Eye Institute, Neurosystec Corporation, The Pennsylvania College of Optometry, Retina Implant GMBH, Second Sight Medical Products Inc., W.C.Heraeus GMBH & Co., and Wayne State University.

Implants Currently Offer Best Hope

So, will these implants be the pathway to restoring sight in the future? In the absence of other approaches, they offer the best hope of restoring sight. Nonetheless, we are a long way off from achieving this goal. The retina is an exquisitely complex nervous structure that has many intricate levels of image processing. Our achievements to date represent a very crude approach at imitating its capabilities.

Nonetheless, several research institutes and companies, such as the Doheny Retina Institute, and Intelligent Medical Implants AG, are making truly remarkable headway in this area, and they may indeed achieve some significant milestones in the coming years. However, until micro-engineering approaches that employ either transplant technologies or neural-electrode interfaces at the single cell level are developed, science will not get close to anything capable of restoring full vision within the blind.

Alternately, it is quite likely that future advances in the current microelectrode array design will be large enough to significantly improve the visual image. I see that advance being related to the integration of smaller, more numerous electrodes and probably multiplying the current density by a factor of 10. Before that happens, however, it is premature to talk about restoring the ability to read or recognize faces, for instance. In the meantime, I suspect that we may see FDA-approved retinal implants within the not-too-distant future, with these exciting bio-prostheses continuing to improve with each additional clinical trial.




Nerac Inc. is a global research and advisory firm for companies developing innovative products and technologies. Nerac Analysts deliver custom assessments of product and technology development opportunities, competitor intelligence, intellectual property strategies, and compliance requirements through a proven blended approach to custom analysis: review of technical knowledge, investigation of intellectual property, and appraisal of business impacts. Nerac deploys analysts in diverse disciplines to help clients discover new applications, serving as a catalyst for new thinking and creative approaches to business problems or identifying strategic growth opportunities. On the web at http://www.nerac.com





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2012年2月26日 星期日

Natural ADHD Treatment: Vision Therapy


Not all cases of ADHD are caused by a deficiency in the neurotransmitters dopamine and norepinephrine. New research shows that inattention and the learning disorder problems common in ADHD children may actually be caused by a vision disorder. When this is the case, an ADHD natural treatment called vision therapy might help.

It's easy for undiagnosed vision problems to be mistaken for symptoms of ADHD. Vision problems make it difficult for a child to read for extended periods of time, focus on schoolwork, and achieve high grades. Around 20% of school-aged children are afflicted by different types of undiagnosed vision disorders, even if conventional eye exams show that they have perfect 20/20 vision. The reason behind this is that problems with eye focusing, eye teaming, eye alignment, and visual endurance cannot be detected by the conventional Snellen chart. These can only be identified by comprehensive eye exams that test for visual acuity, visual motor integration, and eye tracking, among other things.

Problematic vision and the ADHD symptoms that come with it may be treated with vision therapy or vision training. This highly individualized treatment program aims to correct visual motor deficiencies caused by a number of factors, including nervous system trauma (i.e., from birth injury or head trauma), delayed sensory-motor development, and genetic factors (i.e., lazy eyes, crossed-eyes). Vision therapy doesn't just focus on the eyes; it re-trains the whole visual system, which also includes the brain and the body. In a sense, it is a type of neurological rehabilitation. Aside from correcting these problems, this treatment also aims to help the child's brain process visual information correctly so that the child can comprehend and react quickly.

Approaches to improving vision vary according to the child's specific problems and the doctor that provides it. Generally speaking, the treatment includes techniques that enhance eye movement control, binocular vision, focusing ability, and eye movement. Computer software and specialized optical devices like therapeutic prisms develop the child's visual endurance and motor skills. During the last leg of the program, the child's new visual skills are continually reinforced and made habitual through repetitive tasks and activities that integrate vision skills with motor skills. These exercises guarantee the long-term effects of the program and the benefits of improved visual performance.

Unlike the traditional medical treatment for ADHD, which involves administering a one-size-fits-all medication, vision therapy is designed around the child's conditions and symptoms, and the parents' goals. As such, the length of vision therapy programs varies from several months to a year. The benefit of this approach is that your child is working towards a goal and towards health benefits that will last for the rest of his or her life. To avail yourself of vision therapy, look for a doctor who specializes in rehabilitating vision disorders or in learning-related vision problems.




Dr. Yannick Pauli is an expert on natural approaches to ADHD and the author of the popular self-help home-program The Unritalin Solution. He is Director of the Centre Neurofit in Lausanne, Switzerland and has a passion taking care of children with ADHD. Click on the link for more great information about what is ADHD.





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2012年2月24日 星期五

Internal X Ray Vision - What Is It? How Is It Used In Intuitive Healing, Medical Intuitive Diagnosis


Superman had it!, X-ray vision, the ability to see through walls (which are just a dense gathering of energy that creates its form). In today's world, internal x-ray vision is a reality and not a cartoon myth.

The ability to visualize energy fields through the mind's eye is called clairvoyance. The actual ability to perceive a physical body's exterior energy field (called an aura) or internal bimolecular energy fields is called HSP (Higher Sensory Perception) internal vision by Barbara Brennan author of "Hands of Light." By directing your brain to focus at a higher vibrational frequency level one can see the bimolecular energy formation of cells, tissue, bones, organs and other subtle bioenergy systems (example: the nervous system with neural pathways and nerve damage or electromagnetic misfiring disorders) inside of the human body at whatever depth or resolution they choose. Dr. Mehmet Oz stated on Oprah, "everything is pure energy, you are a mass of vibrating frequencies gathered into the physical form that you call your body."

How do we access the information stored within our energy fields? Traditional medicine uses MRI's, CAT scan, PET images, MUGA and Trilogy data, and X-ray technology. Internal X-ray vision coupled with intuitive anatomical medical diagnosis is a relatively new information gathering method that is gaining ground as part the comprehensive diagnostic process for integrative holistic medical teams and facilities.

The 2007 Rhine Research Center's (founder by J B Rhine who identified and validated ESP) International Spring Conference CONSCIOUSNESS TODAY featured an Intuitive Medical Diagnosis Panel Discussion about scientific and clinical intuitive medical diagnosis chaired by Larry Burk, MD, Moderator, Radiologist, Intuitive Diagnosis Researcher. Brent Atwater one of the panelists, is a documented and published peer reviewed and respected medical intuitive who uses internal x-ray vision to perform intuitive anatomical medical diagnosis. Other participants were Leon Curry, MD, Internist, Intuitive Diagnosis Researcher who worked with Greta Alexander an intuitive diagnostic pioneer, and Mary Jo Bulbrook, RN, EdD.

Ms. Atwater (whose friends call her a human MRI), points out that internal X-ray vision contributes the following to medical diagnostic procedures:

o Can be performed from a distant location, also know as remote internal viewing.

o SAVES TIME! in catastrophic or trauma injury, critical or intensive care or

emergency medicine situations.

o Determines the "urgency" of your physical situation.

o Finds medical conditions and health issue locations, and determines the extent and

severity in the body.

o Clarifies critical disease areas and identifies other contributing energy imbalances

within each client's physical systems at all levels-cellular, organs, muscular,

vascular, nervous, etc..

o Continuously monitors the client's condition without interfering or creating

complications during medical treatments and procedures.

o Has no side effects and is non-invasive.

o Provides a detailed physical and all systems analysis of what is happening at any time.

o Can confirm or raise valuable concerns about test results, medications, treatments

and procedures.

o Can be used in conjunction or comparison with current MRIs, PETs, MUGAs,

Cat Scans, Trilogy and X rays.

o Provides an alternative medicine assessment.

o Can identify areas that have not yet become detectable by traditional medical

examinations or testing methods or procedures. This information can assist one in

making decisions about current and future medical treatment, and health care.

o Can provide information about future health issues.

In her book, Thru My Eyes as a Medical Intuitive, Ms Atwater states that learning techniques to have internal x-ray vision can sometimes be taught to those individuals who are capable of focusing at higher energy levels, and to those who are inherently gifted with intuitive gifts. She notes that intuitive anatomical medical diagnostic (Body Scan) workshops usually include:

o Techniques to look inside a body and interpret what you see.

o Learn the electromagnetic frequency colors of the various bio energy patterns of various health issues and medical conditions and their positions in the body's energy field.

Using internal x ray vision, reputable and evidence based intuitive anatomical medical diagnostic research is providing valuable scientific documentation about energy medicine in order to help bridge and create the integration of traditional and alternative medicine so that each patient will benefit from all healing and diagnostic modalities that are available!

Feel free to reprint this article in its original format.




Contact Information:
Brent Atwater, Alternative Medical Specialist
Medical Intuitive, Distance Energy Healing
ATL, GA Phone: 404.242.9022 USA
NC Phone: 910.692.5206 USA
Website: http://www.brentatwater.com
Email: mailto:Brent@BrentAtwater.com

Disclaimer: Brent Atwater collaborates with and participates in ongoing energy medicine and intuitive diagnostic medical research, and independent case studies with the world's leading doctors, physicians, researchers, scientists, and medical facilities. Her work is creating evidence based research that documents the bridging of traditional and alternative healthcare into integrative medicine. Atwater is not a medical doctor nor associated with any branch of medicine, she works in Alternative Healing, Healthcare and Medicine - Integrative Medicine. She offers her opinions based on her intuition, and her personal energy healing work, which is not a substitute for medical procedures or treatments. Always consult a physician or trained health care professional concerning any medical problem or condition before undertaking any diet, health related or lifestyle change programs. As in traditional medicine, there are no guarantees with medical intuition, intuitive anatomical medical diagnosis or energy medicine.





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2011年12月14日 星期三

Sensory Loss in Older Adults - Vision - Behavioral Approaches For Caregivers


As we age, our sensory systems gradually lose their sharpness. Because our brain requires a minimal amount of input to remain alert and functioning, sensory loss for older adults puts them at risk for sensory deprivation. Severe sensory impairments, such as in vision or hearing, may result in behavior similar to dementia and psychosis, such as increased disorientation and confusion. Added restrictions, such as confinement to bed or a Geri-chair, increases this risk. With nothing to show the passage of time, or changes in the environment, the sensory deprived person may resort to repetitive problem behaviors (calling out, chanting, rhythmic pounding/rocking) as an attempt to reduce the sense of deprivation and to create internal stimulation/sensations.

This article is the first in a series of three articles that discuss the prominent sensory changes that accompany aging, and considers the necessary behavioral adjustments or accommodations that should be made by professional, paraprofessional, and family caregivers who interact with older adults. Though the medical conditions are not reviewed in depth, the purpose of this article is to introduce many of the behavioral health insights, principles, and approaches that should influence our caregiving roles. This article addresses age-related visual changes.

CHANGES IN VISION THAT ACCOMPANY AGING

A. The changes in vision that accompany aging include:

1. A loss of elasticity of the lens; this means the person is no longer able to focus or accommodate to changes in lighting conditions. (Starting in our 40's, glasses are needed to see fine print). It also means the older person cannot adjust to sudden changes in lighting, resulting in an uneasiness when leaving a bright room to enter a dark hallway, or finding seats in the dark in recreation rooms, or theater. Going in the reverse direction can be equally difficult: from a dark room to a bright area.

2. Decreased pupil size; the light reaching the retina is reduced, requiring more light to see. This results in the need for lighting 3x to 4x what younger people need to see clearly

3. A loss of transparency; with age, there is a yellowing of the lens in the eyes, making color discrimination more difficult, especially blue and green. Warmer colors, such as reds and yellows are perceived best, explaining why bright colors are preferred.

4. More susceptibility to glare, and longer time is needed to recover from the effects of glare;

5. Eye diseases and disorders, such as cataracts causing a clouding of the lens; glaucoma, resulting from increased pressure of fluids in the eye, damaging the optic nerve and impairing vision. Glaucoma, the number one cause of blindness in U.S., in advanced stages results in yellow halos around images. Macular degeneration may occur, where vision is distorted, and images appear different sizes or different shapes, and are missing a central element. Visual disorders may be secondary to stroke, in which the eye can see the image but the brain cannot interpret the images. Diabetes may result in disrupted blood flow to the retina, causing diabetic retinopathy and a loss of vision, and blindness, in extreme cases.

B. What are the effects of visual loss on the older adult?

1. An increased dependency on others;

2. A sharply reduced quality of life (changes in activities in daily living and instrumental activities of daily living, reduced connection with outside world);

3. And, a fearfulness and reduced tendency to venture outside.

C. What are the effects of vision changes on demented elderly?

1. With the losses in visual acuity, other problems in cognitive functioning are heightened, such as difficulty processing unfamiliar faces and settings;

2. Because the person with dementia already has difficulty learning new behaviors, he or she is less able to learn new habits to compensate for the visual losses (e.g., learning to use visual aids to identify articles of clothing or other possessions;

3. There is likely to be an increased disorientation and confusion, as the search for structure and external cues is strained.

PRINCIPLES FOR CAREGIVERS

The following principles apply to caregiving approaches with older adults who have diminished sensory function. Increased sensitivity and insight to the needs of these individuals improves their quality of life and improves our effectiveness:

1. Observe the behavior of the person, and look for cues and signs of pain or discomfort;

2. Help the person work through the emotional impact of the sensory changes, allowing expression, acceptance, and support of the grief and sadness accompanying these losses;

3. Do not try to fix the unpleasantness; acceptance and support goes a longer way toward healing than a quick fix or a patronizing attitude;

4. Reduce excess disability by maximizing whatever functioning is still left, such as proper eyeglass prescriptions, or functioning hearing aids;

5. Consider assistive devices (phone amplifiers, large text books, headphones, and the Braille Institute for a variety of useful visual aids).

Approaches for impairments in vision:

1. Address the person before you touch him or her, identify yourself, let him or her know when you are leaving, speak normally, and do not shout;

2. Describe his or her surroundings to help orient and familiarize the person to the environment, tell him or her location of belongings, and if things have been moved;

3. Use as much contrast as possible, e.g., red objects on white background is better than black on a gray background, or blue on green background, (consider switch plates on walls, toothbrushes, combs);

4. Avoid moving quickly from a bright room to a darkened room, or v.v. Make sure the visually-impaired person takes the time for the pupils to adapt to the changes in lighting;

5. Introduce yourself every time you come into contact with the person, and explain what you are going to do because there are no visual cues;

6. Help to identify others in their environment with colored clothing, name tags with large print, etc.

7. Clean eyeglasses regularly, provide adequate lighting, and avoid glare;

8. Provide night lights, and arrange furnishings in the environment for safety and ease of mobility.

Even with normal aging, functioning of our five senses is not like it was when we were younger adults. This article offers caregivers who work with visually-impaired older adults some insights into the special needs and adjustments that will turn unpleasant, frustrating situations into more caring, helpful, and sensitive interactions. By integrating these behavioral approaches in the delivery of the health care with older adults, we can favorably impact the management of these conditions.

Copyright 2008 Concept Healthcare, LLC




Joseph M. Casciani, PhD, is a geropsychologist who has devoted his professional career to working with older adults and their caregivers. His company, Concept Healthcare, http://www.cohealth.org, offers online resources to integrate behavioral health approaches in the health care of older adults.





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