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Many cognitive assessments include a visual component; however, adults may experience a decline in visual acuity with age. Scores on cognitive assessments of adults with visual impairments are typically lower than adults with normal vision, however, it is unclear if these lower scores are a consequence of cognitive or visual impairment. We measured the impact of simulated visual impairment on a cognitive screening measure. Undergraduate students were administered the Montreal Cognitive Assessment (MoCA) under three vision conditions (20/20, simulated 20/80, simulated 20/200). We found a main effect of vision condition on test performance such that there is a statistically significant difference between scores on the 20/20 and 20/80 conditions and 20/200. However, no differences were observed between 20/80 and 20/200. Participants' performance decreased with simulated impairments. A secondary between-subject analysis was conducted on a sample of older adults with and without vision impairment; no differences were found.

Purpose: This study examined how optimal colour/illumination conditions and the efficacy of the iPad, LuxIQ and Smart Bulb varied as a function of print size in younger, older and visually impaired adults., Methods: Participants with visual impairments and simulated low vision (SLV) read the MNRead using the iPad, LuxIQ and Smart Bulb., Results: In the impairment condition at 1.20 logMAR, the iPad (M = 9.49, 95% CI [3.18, 19.42]) and LuxIQ (M = 15.95, 95% CI [9.54, 24.86]) improved the reading speeds. At 0.80 logMAR (SLV), all devices improved reading speeds of older adults (iPad (M = 28.70, 95% CI [14.65, 42.51]); LuxIQ (M = 49.63, 95% CI [30.04, 69.68]); Smart Bulb (M = 23.11, 95% CI [3.33, 42.11])), but in younger adults only the LuxIQ (M = 13.04, 95% CI [3.21, 21.27]) did so. In the impairment condition, the iPad (M = 5.54, 95% CI [0.31, 12.13]) and LuxIQ (M = 13.90, 95% CI [7.88, 23.49]) improved reading speeds. In the SLV condition, age was a significant predictor of reading speed at 1.20 logMAR (F 3,164  = 10.74, p < 0.001, Adj. R 2  = 0.16). At 0.80 logMAR, age and luminance, but not colour, were significant predictors (F 3,164  = 52.52, p < 0.001, Adj. R 2  = 0.49). In the impairment condition, both age and lux were significant predictors of reading speed at 1.20 (F 3,85  = 7.14, p < 0.001, Adj. R 2  = 0.20) and 0.80 logMAR (F 3,85  = 7.97, p < 0.001, Adj. R 2  = 0.22), but colour was not., Conclusions: Light source effectiveness and optimal colour/illumination vary as a function of print size. It appears that print size is the most important factor for improving reading speed. As print size decreases, luminance becomes crucial, and only at the smallest print sizes does the effect of colour become useful., (© 2021 The Authors Ophthalmic and Physiological Optics © 2021 The College of Optometrists.)

Significance: On average, older adults (60+) with normal vision read the International Reading Speed Texts (IReST) 37.8 words per minute slower than the standardized values provided by the IReST manufacturer. When assessing reading speed in older adults, clinicians should bear in mind that the IReST norms do not account for these age-related differences., Purpose: The purpose of this study was to validate the IReST in an English-speaking Canadian sample of older adults (60+)., Methods: Canadian English-speaking older adults (n = 25) read all 10 IReST aloud using the same protocol from the original IReST validation study., Results: There were significant differences between the older adult sample and the published IReST values for each text (mean difference, -37.84; 95% confidence interval, -41.34 to -34.34)., Conclusions: Reading speeds of older (60+) Canadian adults fell outside of the standardized values of the English language IReST. Researchers/clinicians who wish to assess older adults' reading speed using the IReST ought to take this discrepancy into account., Competing Interests: Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest., (Copyright © 2021 American Academy of Optometry.)

Significance: The International Reading Speed Texts (IReST) is a valid measure of reading speed in a Canadian sample. However, if clinicians desire to assess reading comprehension using the IReST, this will significantly reduce reading speeds of individuals with normal vision or reduced visual acuity and therefore should use the values presented here., Purpose: The purposes of this study are (1) to validate the IReST in an English-speaking Canadian sample and (2) to examine how reading comprehension questions and reduced visual acuity affect reading speed on the IReST., Methods: For study 1, Canadian English speakers (n = 25) read all 10 IReST following the procedures used in the original IReST validation. For study 2, Canadian English speakers (n = 50) read all 10 IReST, half with normal/corrected-to-normal vision and half with reduced visual acuity, and were asked reading comprehension questions., Results: No significant differences were found between Canadian sample and the published IReST values (in all cases, P > .05; mean difference [Mdiff] = -5.30 to +11.43; Cohen d = -0.15 to +0.27; Bayes factors = 0.41, 0.09). Assessing reading comprehension with multiple-choice questions on the IReST significantly reduced reading speeds in the normal vision condition (Mdiff = 25.3; 95% confidence interval, -16.7 to -34.1) and in the simulated impairment condition (Mdiff = 59.3; 95% confidence interval, -47.7 to -71)., Conclusions: The IReST is a valid measure that can be used to assess reading speed in a Canadian English-speaking sample. If researchers/clinicians wish to assess both reading speed and comprehension, using multiple-choice reading comprehension questions, then the values provided by the IReST will likely underestimate an individual's true reading speed in individuals with normal/corrected-to-normal vision or reduced visual acuity.

Issue Addressed: Australian efforts to tackle the burden from chronic diseases through prevention have included numerous strategies, committees, policies and programs. This research reflects on this changing landscape, with focus on the most recent, and most significant, investment and subsequent disinvestment in preventive health, the National Partnership Agreement on Preventive Health (NPAPH). The purpose is to better understand the place of the NPAPH in Australia's prevention landscape, explore views from senior health department personnel on the NPAPH and identify lessons for the future., Methods: Individual and small group semi-structured interviews were undertaken with 19 senior public health managers and program implementation staff from State and Territory health departments across Australia. A grounded theory approach was used to generate themes relevant to the research., Results: Participants reflected positively on the NPAPH, mostly that it established a strong platform for the national roll out of programs supporting healthy lifestyles, it created core infrastructure that elevated the rigour and sophistication of prevention activities and it was achieving or on the way to achieving its desired outputs. However, despite promising potential, governance arrangements over chronic disease prevention were not clearer either throughout or post the NPAPH. While partnerships between State and Territory governments, as well as with other sectors, were seen as a strength of the NPAPH, many viewed the role of the Commonwealth in the NPAPH as limited to funding., Conclusion: Longer term investment in, and leadership for, chronic disease prevention is necessary. The NPAPH built on positive reforms at the time, creating opportunities for implementing programs at scale, building workforce capacity and improving evaluations. Early termination of the NPAPH meant potential return on investment was unrealised, new partnerships could not always be sustained and the prevention workforce was again under threat. Furthermore, responsibility for prevention, which was never clear, became even more opaque. SO WHAT?: The NPAPH, as a national initiative for achieving improvements to the prevention of chronic disease, was a welcome investment. Disinvestment in the NPAPH, as well as other promising reforms of the time, led to a loss of credibility in outcomes focussed funding collaborations as well as missed opportunities for the future health and wellbeing of the Australian population. Australia needs a recommitment at all levels of government to investment and action in prevention and a restoration of funding in prevention commensurate with the size of the health burden., (© 2017 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Ltd on behalf of Australian Health Promotion Association.)

Significance: There are no data available comparing the iPad as a portable magnification device with a portable video magnifier. Our study supports the use and integration of mainstream tablet computers into vision rehabilitation to overcome potential barriers to device uptake due to the stigma attached to traditional devices., Purpose: Portable personal tablet computers have taken on an important role as assistive devices for individuals with visual impairment; however, their use is rarely supported by independent data. Our study aims to contribute to evidence-based practice by comparing a tablet computer with a portable video magnifier in their use as spot-reading devices., Methods: We compared the Optelec Compact 5 HD portable video magnifier (Optelec, Longueuil, Canada) and the Apple iPad Air tablet computer (Apple Inc, Cupertino, CA) using the SuperVision+ Magnifier app by asking 60 adults with low vision (age range, 19 to 97 years; mean visual acuity, 20/136) to spot read information on a bill, a medication box, and a food label. Their ability to complete each task was timed; they completed the Quebec User Evaluation of Satisfaction with assistive Technology questionnaire and indicated their preferred device., Results: Performance speed indicated that easier tasks were completed faster; however, there were no statistically significant differences in performance between the two device conditions. The highest satisfaction scores for both devices were identical: dimensions, ease of use, and effectiveness. Preference between the two devices was split at 25 for iPad, 33 for the portable closed-circuit television, and 2 for undecided., Conclusions: The results indicate that performance speed on our spot-reading tasks was comparable across the two devices. In addition, subjective judgment of the device features and personal preferences lead us to conclude that both the iPad and the portable magnifier may have certain equivalence in their functionality, depending on the user and the task for which they are used.

Objective Despite being a healthy country by international standards, Australia has a growing and serious burden from chronic diseases. There have been several national efforts to tackle this problem, but despite some important advances much more needs to be done. From the viewpoint of diverse stakeholders, the present study examined two approaches to controlling chronic disease in Australia: (1) the 2005 National Chronic Disease Strategy (NCDS); and (2) the 2008 National Partnership Agreement on Preventive Health (NPAPH). Methods Individual and small group semistructured interviews were undertaken with 29 leaders across Australia, reflecting a diverse cross-section of senior public health managers and program implementation staff from state and territory health departments, as well as academics, thought leaders and public health advocates. A grounded theory approach was used to generate themes relevant to the research. Results There is general support for national approaches to the prevention of chronic disease. The NCDS was viewed as necessary and useful for national coordination, setting a common agenda and serving as an anchor to align jurisdictional priorities and action. However, without funding or other infrastructure commitments or implementation plans, any expectations as to what could be meaningfully achieved were limited. In contrast, although jurisdictions welcomed the NPAPH, its associated funding and the opportunity to tailor strategy to their unique needs and populations, there were calls for greater national leadership as well as guidance on the evidence base to inform decision making. Key aspects of successful national action were strong Australian Government leadership and coordination, setting a common agenda, national alignment on priorities, evidence-informed implementation strategies, partnerships within and across governments, as well as with other sectors, and funding and infrastructure to support implementation. Conclusions Both the NCDS and NPAPH were seen to have overlapping strengths and weaknesses. A key need identified was for future approaches to focus on generating more sustainable, system-wide change. What is known about the topic? Despite some important advances, chronic diseases remain Australia's greatest health challenge. In efforts to tackle this increasing burden from chronic diseases, several large-scale, national initiatives have been released in Australia over recent years, including the 2005 NCDS and the 2008 NPAPH. What does this paper add? From the viewpoint of practitioners, policy makers, advocates, researchers and public health thought leaders, this paper examines the usefulness and significance of the NCDS and NPAPH as national initiatives for achieving improvements to the prevention of chronic disease. What are the implications for practitioners? By better understanding how previous countrywide chronic disease initiatives were viewed and used at national, state and local levels, this research is well placed to inform current, planned and future large-scale, population-level health initiatives.

Introduction: There is a need and desire to improve chronic disease prevention efforts across Australia. Increasingly, scientists are urging the use of systems thinking and its methods to significantly shift the way we think about, and intervene in, chronic diseases. This research aimed to examine the convergence between the systems science literature and the views of those working in and advocating for prevention, in relation to the value of systems thinking and its methods for the prevention of chronic diseases., Methods: Individual and small-group semistructured interviews were undertaken with 29 individuals across Australia. The interviewees reflected a diverse cross-section of senior public health managers and program implementation staff from state and territory health departments, and senior thought leaders and public health advocates. Interviews were audio recorded and coded into key themes., Results and Discussion: Feedback from informants illustrated that, among those working in and advocating for prevention, there is a mix of support for systems thinking for chronic disease prevention, and some healthy scepticism. The lack of consistent confluence between those promoting the value of systems science, and those responsible for working in and advocating for prevention indicates a level of confusion about language and definitions. It also reflects a desire for published evidence about systems methods that have proven effectiveness., Conclusion: Systems thinking and its methods have a promising and important role to play in creating a robust, effective and sustainable strategy for prevention of chronic diseases throughout Australia. However, the method requires further development and refinement, and promotion of case studies of effectiveness. We also need to heed lessons learnt overseas.

Climate change and non-communicable diseases (NCDs) are arguably the greatest global challenges of the 21st Century. However, the confluence between them remains under-examined and there is little evidence of a comprehensive, systematic approach to identifying research priorities to mitigate their joint impact. Consequently, we: (i) convened a workshop of academics (n = 25) from the Worldwide Universities Network to identify priority areas at the interface between NCDs and climate change; (ii) conducted a Delphi survey of international opinion leaders in public health and relevant other disciplines; and (iii) convened an expert panel to review and advise on final priorities. Three research areas (water security; transport; conceptualising NCD harms to support policy formation) were listed among the top 10 priorities by >90% of Delphi respondents, and ranked among the top 12 priorities by >60% of respondents who ranked the order of priority. A fourth area (reducing the carbon footprint of cities) was ranked highest by the same >60% of respondents. Our results are consistent with existing frameworks on health and climate change, and extends them by focusing specifically on NCDs. Researching these priorities could progress understanding of climate change and NCDs, and inform global and national policy decisions for mitigating associated harms.

Given the current insatiable demand for coal to build and fuel the world's burgeoning cities the debate about mining-related social, environmental and health injustices remains eminently salient. Furthermore, the core issues appear universally consistent. This paper combines the theoretical base for defining these injustices with reports in the international health literature about the impact of coal mining on local communities. It explores and analyses mechanisms of coal mining related injustice, conflicting priorities and power asymmetries between political and industry interests versus inhabitants of mining communities, and asks what would be required for considerations of health to take precedence over wealth., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The Pulfrich effect can occur spontaneously, giving severe symptoms of changed visual perception in a variety of conditions in which an interocular latency difference has occurred. The symptoms principally involve misjudgements on the location of objects, especially when driving. Interocular latency differences can inadvertently be created in patients in practice and this study has investigated the Pulfrich effect in anisocoria, uniocular mydriasis, and with uniocular tint (X-chrom lens). In all cases a Pulfrich effect was consistently evident and compared to the size of the effect provoked by neutral density filters. The results show that with anisocoria, uniocular mydriasis and the X-chrom lens, the provoked Pulfrich effect is similar to that found reported previously in cases of trauma. These cases had severe visual symptoms so that care should be exercised in practice, where procedures likely to provoke the Pulfrich effect are contemplated. Specifically, patients who have received uniocular mydriasis in practice should be cautioned about the possible visual effects and advised not to drive until the effect of the mydriatic has finished and equal pupil sizes have been restored.