Canadian National Institute For The Blind Research Articles

About time! A scoping review of public-facing emergency department wait time displays in Canada.

Waiting is a common experience for patients during an emergency department (ED) visit. While high acuity patients are seen with little delay, low acuity patients may experience dissatisfaction from prolonged wait times. One strategy to improve patient experience involves changing the perception of the wait by providing realistic expectations of wait times using public-facing wait time displays. The primary objective of this study is to quantify the number of Canadian EDs with online wait time displays and describe the features and type of information provided. A systematic online search of all Canadian EDs was completed to identify EDs with public-facing wait time displays. A scoping review was then performed to assess their message characteristics, translations offered, availability of multi-site information, and accessibility features. Data were summarized using descriptive statistics. Sixty (9.3%) of the 647 Canadian EDs identified provide public-facing real-time wait time displays. Thirteen of these (21.7%) were associated with a single proprietary system. Distribution of wait time displays differs across Canada, with a range of zero to 100% of EDs within each province utilizing this communication tool. Common characteristics include "average" wait time (95%), graphical trend data (32%), number of patients waiting (33%), longest wait time (12%), and expected length of stay (10%). Sixty-two percent of wait time displays provide a combination of these methods to inform wait times. Important accessibility features include language translation, compliance with Canadian National Institute for the Blind (CNIB) accessibility guidelines and availability on a mobile application. Currently, there is emerging use of wait time displays in Canada with considerable variability in the information communicated through these tools. Effectiveness of these displays and their content needs to be determined.

IDF21-0237 The Impact of the Current Accessibility of Insulin Pumps on the Lives of the Visually Impaired in Canada

Background: Over 1.5 million adult Canadians identify as living with some degree of sight loss, with an estimated 8 million diagnosed with a visual condition that may result in sight loss. Diabetic retinopathy is a leading cause of blindness associated with diabetes in Canada with the risk of blindness being 25 times greater for individuals with diabetic retinopathy. Vision problems and blindness associated with diabetic retinopathy can be prevented or mitigated with the proper control of blood sugar and blood pressure, yet, established methods for measuring and mediating such physiological states have proved inaccessible for the visually impaired community. Insulin pumps are rarely designed with input from visually impaired individuals, making effective insulin therapy near impossible using insulin pumps. Aim: Over the years, the Canadian National Institute for the Blind (CNIB) has received numerous anecdotal complaints from Canadians living with diabetes and sight loss regarding the inaccessibility of their insulin pumps. End users reported being unable to independently or safely use their insulin pump because the device must be navigated solely using visual features on a display screen. This study aimed to highlight issues currently faced by individuals with diabetes and sight loss that use insulin devices. Our research built on previous studies focusing on the accessibility of insulin devices and introduced an emphasis on first-hand testimonies from individuals with sight loss. Method: Data was collected from blind individuals, partially sighted individuals, or a proxy using a questionnaire, as well as through focus groups. Survey participants were recruited through CNIB’s and community partners’ networks of individuals who were blind or visually impaired, and who were also living with diabetes, as well as our networks of caregivers and healthcare providers. All qualitative responses were analyzed through categorical data analysis. Results: We identified accessibility challenges with current pumps such as a lack of haptic feedback (i.e., vibrations), a lack of tactile feedback (i.e., buttons designed for accessibility), and a lack of sufficient audio feedback and visual feedback. Our findings clearly demonstrate that visually impaired diabetics are distressed about this accessibility issue and would greatly benefit from making insulin devices more accessible. Participants of our study reported being fearful of causing self-harm by incorrectly administering their insulin doses or by not being able to operate the device alone. Respondents also reported that they would be more independent, confident, and better able to manage their condition if they could fully utilize features of insulin pumps alone. Discussion: Diabetic individuals with visual impairments have long been ignored and neglected in the development of insulin devices. Our research demonstrates that current insulin devices lack accessible visual, audio, and tactile feedback mechanisms. The testimonies of neglected individuals highlighted in our research demonstrate the negative impact of insulin pump manufacturers' choices on this 'forgotten' diabetic community. We suggest that insulin device manufacturers incorporate accessibility options such as meaningful audio and tactile device feedback. In considering the needs of every population, we can facilitate a world that promotes equal status, rights, and opportunities for all individuals, especially those in marginalized communities.

Guest Editorial Special Edition of the IEEE-CJECE

Welcome to a Special Issue of the IEEE Canadian Journal of Electrical and Computer Engineering (IEEE-CJECE), which presents articles in the research areas of the Journal’s Former Area Editor, Dr. Sameh Sourour, in his memorial. Sameh Sorour was with the School of Computing at Queen’s University, Kingston, ON, Canada, where he was leading research in mobile edge computing, edge learning and autonomous vehicles with funding from federal, provincial and industry sources. He received his B.Sc. and M.Sc. degrees from Alexandria University, Alexandria, Egypt, in 2002 and 2006, respectively, and the Ph.D. from the University of Toronto, Toronto, ON, Canada, in 2011. His Ph.D. thesis was nominated for the Governor General’s Gold Medal Award. After his graduation, he held a MITACS industrial postdoctoral fellowship with Siradel Canada and the University of Toronto. Prior to moving to Queen’s University in 2019, he held another postdoctoral fellowship at the King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia, a Lecturer position at the King Fahd University of Petroleum and Minerals (KFUPM), Dhahran, Saudi Arabia, and an Assistant Professor position at the University of Idaho, Moscow, ID, USA. During his Ph.D. degree and postdoctoral fellowships, he led several research projects with industrial partners and government agencies, such as LG Korea, the European Space Agency, the Canadian National Institute for the Blind (CNIB), and Siradel France. Dr. Sorour was a Senior Member of the IEEE and an Editor for IEEE Communications Letters. Also, he was an Area Editor in the IEEE-CJECE. His research and educational interests lied in the broad areas of advanced computing, learning, and networking technologies for cyber-physical and autonomous systems. The Guest Editors of this issue are 1) Prof. Hossam Hassanein, Director of School of Computing, Queen’s University, where Dr. Sorour held his last academic title; 2) Prof. Shahrokh Valaee, the Ph.D. advisor of Dr. Sourour at the University of Toronto.

Finding Your Way – A Breakout Session and Discussion about Wayfinding, Design and Learning from Those with Vision Loss ( breakout presentation )

Background Our presentation will raise awareness of what life is like for the thousands of Canadians who live with vision loss. We will discuss the basic concepts of wayfinding and universal accessibility, and how these notions relate to partially sighted individuals. Urban Systems has partnered with the Canadian National Institute for the Blind (CNIB) for this presentation to promote awareness and share the experience of the blind and partially sighted as they find their way through public and private infrastructure. Description of Program Urban Systems will discuss how ideas of wayfinding and accessibility influence our work as Landscape Architects, Environmental Designers and Urban Planners, and share local examples from environments that we design and encounter on a daily basis. We see the potential to explore concepts of wayfinding as a tool to navigate our pedestrian environment and how it can be adapted and designed to serve a broader community regardless of adversity. CNIB will discuss different levels of visual impairment and how the built environment affects the blind and partially sighted. To those with vision loss, walking can be equated with freedom. An Orientation and Mobility instructor from CNIB will discuss some of the issues and concerns that visually impaired people experience as they navigate through the built environment, as well as models to increase access. Outcomes Urban Systems and CNIB will share specific examples of everyday design elements that pose challenges and opportunities for those with vision loss. We will discuss how simple design changes or products can improve these challenges. Our team will also share examples where designers and CNIB have collaborated on inclusive projects, such as the CNIB Scent Garden, and the CNIB Sensory Playground. Our breakout session will conclude with a discussion to explore successful elements, lessons learned and potential considerations for the future to make the public realm and wayfinding elements accessible, diverse and useful to the communities they serve. Implications Through a shared discussion of experiences, participants will learn and converse. The intent is that all will leave with an awareness of how design decisions related to wayfinding and accessibility within the pedestrian environment affect people of all abilities and mobilities.

Engaging blind and partially sighted stakeholders in transformational change.

For non-profit organizations in the disability sector, engaging stakeholders with disabilities on matters of strategic planning is both a responsibility and an expectation. As part of our current strategic plan, which calls for organizational and systemic transformation, the Canadian National Institute for the Blind (CNIB) has engaged blind and partially sighted stakeholders alongside other interest groups to build and advocate for a more holistic model of vision healthcare and rehabilitation. This article describes the CNIB's multi-year process, including early-stage consultations, collaborative strategy development, and political advocacy and shares our organization's key success factors and learnings in creating meaningful, mutually beneficial engagement.

Prevalence of visual hallucinations in a national low vision client population

PurposeTo evaluate the prevalence of visual hallucinations (Charles Bonnet syndrome) in a national population undergoing vision rehabilitation. Study DesignCross-sectional survey. ParticipantsParticipants were 2565 new clients older than 40 years attending a Canadian National Institute for the Blind (CNIB) vision rehabilitation clinic. MethodsParticipants were asked the following question: “Many people who come to CNIB tell us that they see things they know are not there. Some see patterns or shapes. Others see images of people or animals. Have you ever experienced this?” Responses were cross-tabulated on the basis of age, sex, eye disease, visual acuity, and whether the clients lived alone. Multivariable logistic regression was used to analyze the responses. ResultsOverall, 18.8% of people surveyed indicated that they had experienced hallucinations. In the multivariable model, females showed higher odds of hallucinations than males did (odds ratio [OR] 1.32, 95% CI 1.06–1.64, p = 0.02). Clients with greater vision loss had higher chances of experiencing hallucinations than those with the lowest level of vision loss (OR 1.49, 95% CI 1.19–1.88, p = 0.0005). There was no significant difference in the chances of experiencing hallucinations between people with age-related macular degeneration, diabetic retinopathy, and glaucoma, or in older versus younger respondents. People who did not live alone had higher chances of experiencing hallucinations than those who lived alone (OR 1.54, 95% CI 1.19–1.98, p = 0.0009). ConclusionsVisual hallucinations are experienced by approximately 1 in 5 patients with vision loss caused by any eye disease, warranting greater awareness of the phenomenon among all vision health professionals and their patients.

A Proposed Model for Integrated Low-Vision Rehabilitation Services in Canada.

The provision and funding of low-vision rehabilitation (LVR) are very variable across Canada. Quebec is well served by 14 government-funded rehabilitation centers. In most provinces, there are no such multidisciplinary services-optometrists offer LVR from their offices to a greater or lesser degree or undertake assessments in centers run by CNIB (formerly Canadian National Institute for the Blind). No integrated model for LVR exists across Canada. This document proposes such a model, which focuses on the profession of optometry, but may also be applicable to ophthalmology. This article describes different models of LV provision, the evidence for their relative effectiveness, the current situation in Canada, including the variability between areas and the need to increase referrals to LVR, and the current international consensus for LV provision. With the projected increase in people with LV, a generally accepted LV model for Canada is required to improve patient care. It has become recognized in the global community that a tiered system may be required to provide for patients who range in their visual rehabilitation needs and geographic locations. The proposed LVR model includes three levels: 1. Screening/recognition of a potential patient with LV followed by appropriate triage. All optometrists should be involved at this level. 2. Management of the patient with minimum visual impairment/disability. This level of LVR can take place in a local optometry office with a minimal of extra equipment or devices. Level 3: Comprehensive LVR for patients with more vision loss and greater disabilities. Level 3 requires collaboration with other professionals, and three mechanisms are proposed by this which may take place. The proposed model is expected to be useful for future education, policy decisions, and collaboration in Canada, and it may also be of interest for the development of LV services in other countries.

Low-vision service provision by optometrists: a Canadian nationwide survey.

To document the degree to which Canadian optometrists are involved in the provision of low-vision (LV) care and their referral patterns. To investigate the barriers to providing optometric low-vision services (LVS). Practicing optometrists across Canada were randomly sampled and invited to participate in a questionnaire that included questions on personal profile, primary practice profile, levels of LV care offered, patterns of referral, and barriers to provision of LV care. Questions included a combination of multiple choice and open-ended formats, and included hypothetical cases. A total of 459 optometrists responded (response rate, 24.8%). Optometrists estimated that 1% (range, 0 to 100%) of their patients were LV patients yet also estimated that 10% of their patients had acuity equal to or worse than 20/40. Thirty-five percent of respondents indicated that their primary practice offered LV care, 75.6% would manage a patient with minimum disability and simple goals themselves, whereas 10.7% would manage a patient with more than minimal visual disability who needed more specialized LV devices (e.g., telescopes, electronic aids, and custom-designed microscopes); 84.3% of optometrists would assess for basic magnification and lighting in a hypothetical patient with early age-related macular degeneration, whereas 15% would undertake full LV rehabilitation in advanced age-related macular degeneration. Optometrists commonly referred to CNIB (formerly the Canadian National Institute for the Blind), yet only 10.7% of respondents almost always received a written report after referral. Those who would not undertake LV assessment stated that they lacked the knowledge, equipment, or experience; that LV assessment is too time consuming; and that the cost is too prohibitive. This is the first comprehensive study of LVS provision by optometrists in Canada. In order for optometrists to become more involved in LVS, there is a need for more LV education, provincial health coverage of optometric LVS, and better collaboration communication between LV providers.

Development and Adaptation of an Employment-Integration Program for People who are Visually Impaired in Quebec, Canada

Introduction In the Province of Quebec, Canada, it is estimated that only about one-third of working-age adults with visual impairments are part of the workforce, despite ongoing efforts of rehabilitation and government agencies to integrate these individuals. The present article describes the development and adaptation of a pre-employment program specifically designed for English-speaking visually impaired persons in Quebec. Methods Based on a model program introduced at the University of Texas in the United States, and further developed with the Royal National Institute of Blind People in the United Kingdom, the MAB-Mackay Rehabilitation Centre (MMRC) adapted the training materials for its pre-employment program to the local requirements. Its effectiveness was appraised using posttraining employment status as well as responses by participants, using the Canadian National Institute for the Blind (CNIB) Tool to Assess Preparedness for Employment (TAPE) measure of employment readiness. Results Of the eight participants who completed the four-week program, five had found employment and, of those, four had maintained employment within the eight-month follow-up period (one full-time, three part-time). Further, two of those employed part-time also returned to school part-time. An additional two participants chose to continue their education in order to improve their employability. Scores on the CNIB TAPE subscale of communication showed statistically significant post-training improvement (p = .01) that was maintained after eight months. A statistical trend indicated improvement on the technology subscale following participation in training (p = .10). Discussion MMRC's pre-employment training program was developed to address the need for a structured employment preparation program that was integrated with the available rehabilitation services for English-speaking visually impaired individuals in a predominantly French-speaking environment. Implications for practitioners The multidisciplinary nature of this approach facilitated a common language and shared perspective for practitioners across disciplines that are involved in preparing clients for the job market.

Indoor Tracking and Navigation Using Received Signal Strength and Compressive Sensing on a Mobile Device

An indoor tracking and navigation system based on measurements of received signal strength (RSS) in wireless local area network (WLAN) is proposed. In the system, the location determination problem is solved by first applying a proximity constraint to limit the distance between a coarse estimate of the current position and a previous estimate. Then, a Compressive Sensing-based (CS--based) positioning scheme, proposed in our previous work , , is applied to obtain a refined position estimate. The refined estimate is used with a map-adaptive Kalman filter, which assumes a linear motion between intersections on a map that describes the user's path, to obtain a more robust position estimate. Experimental results with the system that is implemented on a PDA with limited resources (HP iPAQ hx2750 PDA) show that the proposed tracking system outperforms the widely used traditional positioning and tracking systems. Meanwhile, the tracking system leads to 12.6 percent reduction in the mean position error compared to the CS-based stationary positioning system when three APs are used. A navigation module that is integrated with the tracking system provides users with instructions to guide them to predefined destinations. Thirty visually impaired subjects from the Canadian National Institute for the Blind (CNIB) were invited to further evaluate the performance of the navigation system. Testing results suggest that the proposed system can be used to guide visually impaired subjects to their desired destinations.

Anonymous Indoor Navigation System on Handheld Mobile Devices for Visually Impaired

An indoor positioning and navigation system based on measurements of received signal strength in wireless local area network is proposed. In the system, the location determination problem is solved by applying compressive sensing, which offers recovery of sparse signals from a small number of noisy measurements by solving an l1-minimization problem. The refined estimate is then used with a map-adaptive Kalman filter for real-time tracking. A navigation module integrated with the tracking system guides users to pre-defined destinations with voice instructions. Experimental results with a system that was implemented on a PDA shows that the proposed tracking system is lightweight so that it can be used on a resource constrained platform while outperforming the widely used traditional positioning and tracking systems. A pilot study was carried out with 30 visually impaired subjects from the Canadian National Institute for the Blind. Testing results show that the proposed system can be used to guide visually impaired subjects to their desired destinations with a very high success rate.

Veterans with a Vision: Canada’s War Blinded in Peace and War (review)

Reviewed by: Veterans with a Vision: Canada’s War Blinded in Peace and War Brian MacDowall Durflinger, Serge Marc – Veterans with a Vision: Canada’s War Blinded in Peace and War. Vancouver: University of British Columbia Press, 2010. Pp. 428. In Veterans with a Vision: Canada’s War Blinded in Peace and War, Serge Marc Durflinger recounts the experiences and co butions of war blinded veterans in twentieth-century Canada. Though the monograph covers the years between 1899 and 2002, it primarily focuses on the tumultuous aftermaths of the two world wars. Concerned with both institutions and government policy, Veterans with a Vision traces the development of the Canadian National Institute for the Blind (CNIB) and the Sir Arthur Pearson Association of War Blinded (SAPA) from their haphazard roots in the First World War into competent bureaucracies involved in both military and civilian initiatives. To do so, Durflinger draws on extensive archival holdings that include the CNIB and SAPA Archives as well as the records of the Departments of Militia and Defence and Veterans’ Affairs housed at Library and Archives of Canada. Veterans with a Vision contends that Canadian re-establishment organizations and veterans’ associations, while initially designed to temporarily ease the transition of war blinded soldiers into civil society, were transformed into efficient and permanent institutions over the twentieth century. “The war blind served,” writes Durflinger, “as a hinge not just between the civilian and military blind but between disabled and non-disabled veterans” (p. 9). This argument is sustained through six chronological chapters that often contain comparisons that situate Canada’s initiatives towards the war blinded alongside those of other countries. Though each chapter broadly focuses on institutional development, Durflinger also relies extensively on individual biographies as case studies of [End Page 203] Canadian war blinded veterans. Fifty-four excellent illustrations are included of these various personalities, while the efforts of Durflinger, the CNIB, and the UBC Press have ensured that the text itself is accessible to visually impaired readers. Yet this exclusive blend of personal biography and institutional development leaves the reader yearning for a deeper analysis of the socio-economic and cultural conditions that informed contemporary understanding of disability, veteranship, or gender. Durflinger’s focus on the personal and collective triumphs of war blinded veterans celebrates achievement in the face of severe adversity. The overall accomplishments of the war blinded are summarized as “lead[ing] the way in organizing Canada’s blinded population and in revolutionizing public perceptions of disability” (p. 32). Furthermore, Durflinger examines the collegial nature of the war blinded institutions, detailing the social nature of the many SAPA outings and reunions such as picnics, golf, boating trips, and banquets. More than simply social outings, Durflinger argues that these activities came to be seen as essential components of the rehabilitation process. However, one wonders if it is possible to read these sociable aftercare outings as quests for masculine respectability, where displays of physical prowess and socializing customs reinforced the middle-class respectable functionality of the war blinded while providing opportunities for veterans to commiserate. Veterans with a Vision is especially successful at illuminating how post-1945 responses to war blinded veterans and retraining programs were profoundly shaped by the experiences of the 1920s and 1930s. Durflinger argues that during the Second World War, “with the CNIB in full operation, Canada’s war blinded could return with the utmost confidence that their training and billeting needs would be met” (p. 170). Many of the men involved in the management of SAPA, Pearson Hall, and war blinded advocacy in general, were instrumental in guiding public policy. Their experiences in the aftermath of the Great War directly led to a greater anticipation of what would be required in the aftermath of the Second World War. Though such earlier experiences were undoubtedly important, Veterans with a Vision neither unpacks contemporary discourses on sight nor does it draw on the social and cultural implications of blindness that would have also shaped these veterans’ lives. The inclusion of this literature, coupled with closer attention to the gendered, cultural, and social components of disability, veteranship, and the emerging field of ‘sensory history’ would have only strengthened Durflinger’s arguments. Though this...

Nessie the Hydraulophone: A Water-Driven Musical Object for Children

Developed by Steve Mann, “Nessie” the Hydraulophone is a water-driven, interactive musical object that provides children with open-ended and unstructured creative play opportunities with water and sound. Children have interacted with Nessie in a variety of spaces including the Canadian National Institute for the Blind's (CNIB) outdoor classroom, Ryerson University's Early Learning Centre, the Ontario Science Centre, and various public outdoor play areas in the Toronto area. In collaboration with the Experiential Design and Gaming Environments Lab's research on sensory play and disability, this field report documents Nessie's development, implementation and potential as a research object.

Outcomes of Canadian National Institute for the Blind Baker research grants from 1998 to 2009

Objective To assess the outcome of Canadian National Institute for the Blind (CNIB) Baker research grants. Design Retrospective case series. Participants Eighty-six Canadian vision researchers who received 88 CNIB Baker grants from 1998 to 2009. Methods Grant recipients were invited to complete a survey relating to their CNIB Baker grant. Questions included the number of publications, presentations, patents, impact of the grant research on health policy, further research funding, and career advancement. For those not responding to the survey, a MEDLINE search was conducted to locate any potential publications. Each publication was reviewed to obtain the year of publication, journal impact factor, and to determine whether the CNIB Baker grant was acknowledged in the publication. Results Eighty-five (96.6%) of the grant recipients completed the survey. For the 3 nonrespondents the results for publications was obtained by conducting a MEDLINE search. Forty-seven (53.4%) grants resulted in 87 publications. This translates to an overall mean investment of $33 823 per publication. Seventy-one (83.5%) grants resulted in a total of 280 presentations, 9 (10.6%) in a health policy change, and 4 (4.7%) in a patent. Forty-seven (55.3%) investigators responded that the CNIB Baker grant assisted in obtaining subsequent research funding and 71 (91.7%) indicated that the grant contributed to their career advancement. Conclusions The goals of the CNIB Baker grants in furthering vision research, to assist in career advancement, and in obtaining future funding from other granting agencies seem to have been achieved. The expenditure per publication is consistent with the literature.

Adaptive Technologies for Individuals with Visual Impairments: Scholarly and Consumer Perspectives

Adaptive technologies allow people with visual impairments to access information, but problems surrounding access and availability to these technologies exist. Scholarly literature and reports by organizations, such as the Canadian National Institute for the Blind and the Canadian Library Association, have recognized and discussed these problems and the strategies to overcome them. Libraries are among the organizations that are making adaptive technologies more widely available to consumers. A number of adaptive technologies are discussed.

Notational Systems and Conceptualizing Music

[1] To be honest, I never gave much thought to Braille music notation until a few years ago when I was told to expect a blind student in my theory class. But before we could make arrangements, we got word that his funding fell through and he wouldn't be attending after all. You might imagine my surprise when Matt appeared on our doorstep in September, having solved his funding problems. What ensued was a mad scramble for materials and strategies to best meet his needs. I tried to read up on what I could find about college theory classroom techniques for blind students, including an article by Anne-Marie de Zeeuw from the 70s in College Music Symposium (de Zeeuw 1977), which, while not reflecting the latest technology, was quite helpful nonetheless. Our disability support office assured me that Matt would have everything he needed in the form of his transcribed textbook, a portable note-taker, and funds for a tutor for 10 hours per week. What I was least prepared for, though, was the differences I began to notice between Braille notation and print. I had naively assumed that Matt's version of our textbook and other scores, which had been quickly committed to Braille, would be somehow a direct translation of my print ones. But as the result of long office-hours in which he and I worked through his lessons, we realized that our two versions of notation were markedly different, and I determined that I would need to learn more about how Braille music works in order to better meet his needs.[2] My concern here is to acknowledge some of the differences between print and Braille music, and to take a deeper look at how the two notational systems represent music, especially with regard to the lessons undertaken in a music theory classroom. Before I do so, I want to make it clear that I'm not trying to privilege either system. I have corresponded with a number of tactile readers and transcribers as well as sighted musicians working with blind students while doing this research over the last few years, and I've found that perceptions of the two systems vary widely. Consider the following quotes, the first three of which are from personal email correspondence:"From the standpoint of someone who does not read Braille but has had to work with someone who does, Braille notation seems an impoverished method for transmitting visual musical scores.""Braille is digital, and as such, is far more logical to a blind reader .. print is graphic, and not consistently coded.""[Braille] is a code that has been designed to represent the same information as print."And from a leaflet published jointly by The National Library for the Blind (UK) and The Canadian National Institute for the Blind:"The music code uses Braille symbols to represent the music, and everything contained within the print version is shown in the Braille." (Baker and Murray)[3] The first two quotes express a range of opinions about the two systems, one with a print bias and the other, a Braille bias. The last two quotes reflect a perception of equivalence shared by many of the people with whom I corresponded, and who were understandably hesitant to acknowledge any differences between print and Braille at all, perhaps so as not to risk further marginalization of Braille notation. Due in part to mainstreaming, Braille music literacy has plummeted in recent decades. My student, for example, had no more than a cursory experience with Braille music when he arrived on campus. Efforts to make Braille scores and training available to students have been renewed in recent years, although much of this activity is directed toward younger children.[4] So, why is this an issue in a music theory class? Unlike courses with language-based content in which blind students are rarely asked to contemplate how the printed word looks on the page, music theory is at many levels a study that centers on notation. Much of the first semester of theory familiarizes students with the fundamentals of music literacy: key and meter signatures, unfamiliar clefs and the like. …

Vision 2008: the 9th International Conference on Low Vision

This Vision congress, organized by the University of Montreal (School of Optometry), Institut Nazareth & Louis-Braille and Canadian National Institute for the Blind under the responsibility of the International Society for Low-Vision Research and Rehabilitation (ISLRR), was the 9th triennial conference on research and rehabilitation of low vision. It is the world’s most important meeting in this field and was visited by a wide variety of professionals. More than 1400 attendees representing 72 countries joined this exciting conference.

Provision and utilization of low-vision rehabilitation services in Toronto

Background: Demographic changes expected to occur in the near future and the need for planning to address them are behind the urgent drive to assess present day provision and utilization of low-vision rehabilitation (LVR) services in the community. Current data available in Canada in this regard are mostly from Canadian National Institute for the Blind (CNIB) sources from clients accessing services, and are therefore incomplete. The purpose of this study, therefore, was to survey the provision and utilization of LVR services as reported by patients identified with low vision (LV) outside the CNIB system, specifically among those attending hospital-based ophthalmology clinics. Methods: The study design was a prospective, nonrandomized, observational case series based on interviews with LV patients. Cases with LV identified according to preset criteria were interviewed and tested for best-corrected visual acuity. The interview format included questions on multiple outcome measures of LVR, which provided answers addressing the theme of this study. A separate questionnaire was used to assess quality-of-life measures. Results: Thirty-four subjects were recruited for the study, 21 females and 13 males, with a mean age of 74 (SD 16) years. LV had been present for a mean of 8.26 (SD 12.2) years, mostly caused by age-related macular degeneration (44%) and other maculopathies (38%). Patients classified as having LV were referred to LVR services only in 50% of cases and mostly to CNIB offices (47%).The majority of cases (59%) used magnifiers as the most common remedy for LVR. A majority of cases (59%) felt that current rehabilitation services are insufficient and that more LVR interventions were warranted in their case. Interpretation: Many cases with LV are not referred to LVR services. Those referred are directed mainly to the CNIB, bypassing other advanced and comprehensive suppliers of LVR services. The majority of cases express dissatisfaction with the current LVR services provided. There is a clear and urgent need to expand and reform the delivery of current LVR services.

Where Are All the Clients? Barriers to Referral for Low Vision Rehabilitation

Background: As the prevalence of visual impairment rapidly increases, the services offered by the Canadian National Institute for the Blind (CNIB) will become even more important. As most clients are referred to the CNIB by their ophthalmologist or optometrist, maximising the efficiency of these referrals is the first step in the appropriate delivery of CNIB low vision rehabilitation services. This pilot study examined the barriers that prevent ideal referral practices by ophthalmologists in the Greater Toronto Area to the Toronto District CNIB. Methods: A survey questionnaire was completed by 29 Toronto-area ophthalmologists identified in a simple random sample. Results: Key barriers to referral included misconceptions regarding referral criterion and lack of information regarding CNIB services. Interpretation: Resulting recommendations included an educational campaign to teach Toronto-area ophthalmologists about CNIB services, as well as the necessary criteria for referring patients. There is no minimum...

The prevalence of low vision and blindness in a Canadian inner city

To ascertain the prevalence and primary causes of visual impairment in a sample of patients from Vancouver's downtown eastside (VDES). A total of 200 patients seeking nonophthalmic medical care at the Vancouver Native Health Society (VNHS) clinic in Vancouver's inner city (downtown eastside) participated in this observational case-series study. For each participant, we obtained demographic information, a medical and ocular history, and performed a complete eye exam. The prevalence of visual disability using standard North American criteria was reported. Causes of visual loss were also reported based on Canadian National Institute for the Blind (CNIB) guidelines. A total of 200 patients participated in our study. The median age of our sample was 46 years, 69% were male. There were very high rates of comorbid medical conditions including HIV, Hepatitis B/C, IV drug use, and diabetes. The raw prevalence of visual disability based on best-corrected visual acuity (BCVA) was 500 per 10,000; this was over nine times greater than in the general Canadian population. The raw prevalence rate of 'presenting visual disability' based on presenting visual acuity (PVA) was 2400 per 10,000. Major causes of visual disability were cataract and retinal disease. Although age-related macular degeneration and diabetic retinopathy represent major causes of vision loss in North America, no cases were noted in our sample. The overall prevalence of visual disability was alarmingly high in this disadvantaged community. These results identify both ophthalmic disease and access to refraction and prescription spectacles as a significant health concern among people living in the VDES.