Well, members, winter has certainly made its presence known. At Alaska Independent Blind, though, I'd like to think it is warm with our caring for ourselves, and caring for each other, which was the theme for this year's 2001 convention. To show that, five plaques, and one more still waiting to be given out, were given out to those we have relied on. Pat Meek, our wonderful librarian, was given the one that was prepared last year when she, unfortunately could not join us in Kenai. Another was given to John Clare, who has steadfastly supported university training for orientation and mobility instructors, and who is certified. Members might recall, he started out in Fairbanks, when Sandy Sanderson called David Jacobson to alert him a certified instructor had contacted our office. Representative Kevin Meyer received a plaque for Alaska Information Radio Reading and Education Service, for his support and help with projects. Lisa Demer, a caring, wonderful reporter, received a plaque for her reporting on disability issues in a positive and poignant way. Laurie Kosizek received a plaque for her help in making the round-about tactile designs last year, and for her work helping us support the idea of pedestrian accessible signals.
We are hard at work on priorities for voting access legislation that will put into place certification standards, which have not been approved in this state. There will be a committee, appointed by Janet Kowalski, Division of Elections Director, to go through accessible machines. Some legislators are already interested in signing onto a bill that will incorporate the machines the committee decides upon. This is one of the priorities the American Council of the Blind has set for states to implement. Dr. Ed Bradley did a wonderful job bringing the E-Slate machine, which is produced by Hart Intercivic, to the convention, for members and officials to see. It had only a few buttons, clear speech, and was easy to understand for even the novice at technology.
After nearly six years, and with letters back and forth, the Division of Elections, brought us two representatives. One was the dynamic, spunky director, Janet Kowalski, who spoke at the legislative dinner and the Friday morning session. It is heartening that Frank Haas' dream of accessible ballots will finally be a reality. Frank Haas along with seven other members went to Juneau in 1994, where he and another member spoke to Fran Ulmer about this and thus began the process. This indeed is an exciting time for this organization.
There will be at least one article our editor, Trudy Boissonneau, will put in the newsletter about voting access.
Most of us were rubbed raw by the sad, terrible events of September 11, 2001. Let this holiday season be a healing time for all of us. Happy holidays and Happy New Year for 2002!
1) On November 27, the "Anchorage Daily News," alerted us to two articles members should be aware of. In 2002, Vision USA, which is a program for optometrists to donate exams to low income people, is coming to Alaska. If you have no insurance, and your income is low, you may be able to sign up for free family eye care in 2002.
To learn more about this program, log on to www.aoanet.org/visionusa.html or get information from Vision USA at 243 N. Lindbergh Blvd. St. Louis, MO 63141. Screening can be done by telephone between 4 A.M. and 6 P.M. in Alaska, during the week between January 2 and January 31. The number to call is 1-800 766-4466. Written applications must be postmarked by January 23. The Alaska Optometric Association suggests that written applications are sent in early, since phone lines will be busy in January. This article had been compiled by news reporter Ann Potempa.
2) In another article, Korky Vann says that older Americans may benefit from high doses of antioxidants. The National Eye Institute scientists add zinc to antioxidants that may help anyone at risk for developing advanced age-related macular degeneration keep their vision.
Researchers found that those in the intermediate stages of the dry form of age-related macular degeneration lowered their risk by about 25 percent with a combination of Vitamin C, E, Beta-carotene and zinc. This study was published in "Archives of Ophthalmology" in October.
Macular degeneration is the leading cause of visual impairment and blindness in those people over 65. If one eye has progressed to advanced macular degeneration already, or or intermediate disease in one or both eyes, these nutrients will delay advanced disease. Symptoms might include: loss of detailed vision either at a distance or nearby, if not corrected by glasses or other visual problems which were mentioned which might include having cataracts. Straight lines may look wavy, and blank or gray spots might occur in the central visual area. Distortion of objects is also common.
The "dry" form of the disease, accounting for about 90% of the cases of macular degeneration, causes progression of thinning of the layers of the retina. Vision may seem blurry, and objects might look distorted. It might change to the wet form of the disease over time.
The "wet" form causes new blood vessels to grow beneath the retina and bleed. Rapid changes in vision occur, and objects become distorted.
Bausch and Lomb has introduced the supplement used in this long-term well-controlled study called Ocuvite PreserVision, and other companies are formulating their own supplements.
The Department of Health and Human Services (HHS) recently announced legally mandated increases in the Medicare premium, deductible and coinsurance amounts to be paid by beneficiaries in 2002.
For Medicare Part A, which pays for hospital, skilled nursing, hospice care and some home health care, the beneficiary deductible will increase to $812, up 2.5 percent from $792 in 2001. The premium for Medicare Part B, which helps pay for physician services, ambulatory care and other services, will rise to $54 per month, up 8 percent from $50 per month for 2001.
The Medicare statute requires that the deductibles and premiums be updated annually in accordance with statutory formulas. Medicare law sets Part B premium at the amount needed to cover 25 percent of estimated program costs for aged enrollees; general revenue tax dollars cover the other 75 percent of the cost. The Part A deductible applies only to those enrolled in the original fee-for-service Medicare program. Beneficiaries who choose to enroll in private Medicare+Choice plans may not be affected by the Part A increase, and may receive additional benefits with different cost-sharing arrangements.
The Part A deductible is a beneficiary's only cost for up to 60 days of Medicare-covered inpatient hospital care. However, for extended Medicare-covered hospital stays, beneficiaries must pay an additional $203 per day for days 61 through 90 and $406 per day for hospital stays from the 90th day to the 150th days in a benefit period-up from $198 per day and $396 per day, respectively. For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 will be $101.50, up from $99 in 2001.
Most of Medicare's 40 million beneficiaries choose the option Plan B coverage, which helps pay for physician services, hospital outpatient care, durable medical equipment and other services, including some home health care. Moreover, nearly 90 percent of Medicare beneficiaries have some form of third-party payer (such as Medigap, Medicaid, or Medicare+Choice) to help reduce out-of pocket medical costs.
To read the full press release, please see http://www.hhs.gov/news/press/2001pres/20011019.html
Beginning January 1, 2002, Medical Nutrition Therapy is a covered Medicare Part B service when provided by a qualifying registered dietitian or nutrition professional. The benefit is available for people with Medicare who have diabetes or renal (kidney) disease when a physician makes a referral. Medicare will help pay for an initial assessment visit, follow-up visits for interventions, and reassessments as necessary during the 12-month period beginning with the initial visit to assure the patient is complying with the dietary plan.
Also, beginning January 1, 2002, annual Glaucoma Screening will be a Medicare Part B benefit for those with diabetes mellitus, a family history of glaucoma and certain other individuals determined to be at high risk for glaucoma. Medicare will help pay for glaucoma screening exams when they are furnished by or under the direct supervision of an ophthalmologist or optometrist.
Screening for glaucoma is defined to include:
For those enrolled in Original (fee-for-service) Medicare, payment for both of these new benefits will be subject to the $100 annual Part B deductible and a 20 percent coinsurance will apply. Those enrolled in a Medicare HMO or private fee-for-service plan should check with the plan for co-pays.
Did you know that for certain drugs and diabetic supplies, suppliers are required to bill Medicare? This means that when a beneficiary purchases these items from a physician, pharmacy, retailer or Internet company, the supplier is required by law to send the claim to the Medicare carrier or plan. Beneficiaries should not have to submit the claim themselves. In the Original Medicare plan, supplies must also accept assignment on all claims for drugs covered by Medicare with the exception of the dispensing fee for nebulizer drugs. Examples of covered drugs are immunosuppressuve drugs after a Medicare-covered organ transplant, drugs used in nebulizers and oral cancer drugs. Suppliers can only collect Part B deductible and coinsurance amounts from beneficiaries. If a beneficiary pays for the drugs and send in the claim, Medicare will not be able to reimburse them. The Medicare payment must go directly to the supplier. So if a beneficiary paid in full for the drugs he or she can request a refund (less any unmet deductible and coinsurance amounts) from the supplier.
Diabetics should be aware that if they are holding any claims for diabetic supplies such as blood glucose monitor supplies or test strips, they should be sent to the Medicare contractor for payment as soon as possible. Effective April 1, 2002, Medicare will deny claims sent by beneficiaries and they will be reminded on the Medicare Summary Notices (MSNs) that the supplier is required by law to submit the claim. Beneficiaries should make sure they purchase their supplies form a supplier who will bill Medicare and who has a valid Medicare supplier number.
American democracy rests on the participation of the citizenry in the selection of elected officials. By choosing their representatives, citizens express their views about what matters to them and what should be done about it. Not every American citizen has an equal opportunity to cast a ballot, however. Many thousands of voters and potential voters are disenfranchised by barriers to electoral participation.
These barriers are a threat to the potential of our democracy to realize its promise of equality and justice for all. When some voters cannot participate in an equal footing, all Americans lose. When some citizens are left out, democracy suffers.
For many disabled citizens, elections represent another example of society's inaccessibility. This report is intended to clarify the experiences of people with disabilities in American electoral politics.
To investigate the relationship between voter turnout, voting difficulties, and disability, a national random-household telephone survey of 1,002 Americans citizens of voting age was conducted through the Rutgers Center for Public Interest Polling following the November, 2000 elections. A broad definition of disability was used, based on questions from the 2000 Census. For more meaningful comparisons the sample was stratified so that interviews were conducted with 432 people with disabilities and 570 people without disabilities. Survey respondents were asked standard questions about voting, voter registration, and factors that could help explain turnout and registration. They were also asked questions concerning actual or expected difficulties in voting at a polling place, and views of several voting methods often used by people with disabilities.
The General Accounting Office released a report on November 14, 2001 finding that only 16% of polling places in 2000 had no potential impediments to access by people with disabilities. This fact sheet complements the GAO study by providing individual-level information on the voting experiences of people with disabilities, with comparison of voter turnout, voting difficulties, and views of curbside voting between people with and without disabilities.
Voter Turnout
If people with disabilities voted at the same rate as those without disabilities, there would have been 3.2 million additional voters in 2000, raising the overall turnout rate by 1.7 percentage points.
Absentee Voting and Voting Difficulties
Encountered difficulties, if last voted at polling place since 1990:
Citizens with disabilities: 5.8%
Citizens without disabilities: 2.0%
Would expect difficulties, if haven't voted at polling place since 1990:
Citizens with disabilities: 32.6%
Citizens without disabilities: 2.4%
Problems encountered if voted in past 10 years:
Problems expected if haven't voted in past 10 years:
Any difficulty in voting at polling place: 32.6%
Getting to polling place: 5.7%
At polling place (getting inside, using booth/machine, long lines, seeing/understanding ballot): 17.9%
General mobility (walking, standing): 6.3%
* Based on these results, an estimated 1.3 million citizens with disabilities encountered problems in voting since 1990 during the last time they voted at a polling place, while an additional 1.7 million citizens who have not voted at a polling place since 1990 would expect to encounter difficulties in voting at a polling place.
Views About Curbside Voting
Respondents were asked their view of whether "voting a ballot in an automobile at curbside" is "just as good as voting in person inside the polling station, or not as good?" Majorities of people with and without disabilities feel that it is not as good:
Curbside voting is just as good:
Citizens with disabilities: 36.1%
Citizens without disabilities: 36.8%
Curbside voting is not as good:
Citizens with disabilities: 54.9%
Citizens without disabilities: 57.8%
Implications of Findings
The research summarized here contain both good news and bad news. The good new is that "the disability gap" - the difference in participation rates between individuals with disabilities and nondisabled individuals - may be narrowing. In the 2000 presidential election, the gap was 12 percentage points (compared to 20 percentage points in the 1998 election). This should increase politicians' attention to the views of people with disabilities.
Unfortunately, Americans with disabilities continue to experience and anticipate difficulties in voting. Three million citizens with disabilities have encountered problems in voting, or would expect to encounter problems. If impediments were removed and people with disabilities began voting in the same proportion as other Americans, fully 3.2 million more people would be casting ballots. Policymakers must take immediate and effective steps to remove the barriers to participation for individuals with disabilities.
These findings lay a challenge at democracy's door. The stability and responsiveness of any democracy depends on its ability to fully represent its citizens. America must find the will to open democracy's door - to all.
November 16, 2001
The House of Representatives is about to pass legislation that denies an accessible secret ballot to voters with visual and or manual disabilities and allows polling places to remain physically inaccessible. Yesterday, with Congressman Steny Hoyer's support, HR3295, The Help America Vote Act of 2001, cleared committee and is expected to be on the House floor right after Thanksgiving.
Contact your Congressman and insist that they vote against HR 3295 because it does not have the following:
Background:
This week the House Administration Committee voted out HR 3295 "Help America Vote Act of 2001" a bill to reform our election system. The bill ignores the facts that people with disabilities have been denied access to polling places for years and that voters who are blind or visually impaired have been denied the right to a private secret vote forever. The bill does not require polling places to be accessible nor does it require that any standards be developed to define what accessibility means. It only asks that states find an "effective and practical" means for people with disabilities to vote privately. Such a standard of "effective and practical" is less than what is required in current law and will result in many local officials not making the basic accommodations as it is not practical. At this point in history we can demand better, the knowledge and technology exist to assure that all Americans including those with disabilities can get to vote and vote privately and independently.
This outrageous act occurred the day after the Government Accounting Office (GAO) released a special report conducted during the November 2000 election where they found at least 84% of the polling places in America had at least one barrier to persons using wheelchairs and no polling place offered persons who were blind or visually impaired the opportunity to cast a vote privately.
There has been substantial opposition by state and local election officials to making polling places and equipment accessible to persons with disabilities. Their reasons vary between too costly, they don't now how, or they don't want to be bothered. We need to show Congress that the disability community represents more votes than state officials. When it comes to costs, most of the bills in the Congress provide millions of dollars for states to purchase equipment so the cost is not on the local official. Secondly, if there were standards by the Access Board that would give the information on how to make places accessible for voting purposes and if they don't want to be bothered about Americans with disabilities then they will need to be educated that people with disabilities have the same rights as all other voters. This bill unfortunately perpetuates the discrimination and must be defeated.
(Vision World Wide, Inc., Indianapolis, IN November 26, 2001) - A new edition of the award-winning publication, Vision Enhancement, is now available via e-mail. Vision Enhancement is a publication of Vision World Wide, Inc, a not-for-profit organization disseminating information, encouragement and support to individuals experiencing vision loss, their family members, and caregivers. In addition to Vision Enhancement, the organization provides a Referral Helpline (1-800-431-17390, Website (http://www.visionww.org), Vision Webletter and Vision Tek-Talk, Internet mailings and E-Mail: info@visionww.org..
The new electronic format contains all the text of the 68- to 78-page print edition but with the added convenience of using current technology to search, cut, paste, and print specific articles of special interest to the reader. According to a spokesperson at Vision World Wide, "Receiving our comprehensive journal electronically will allow more timely distribution and will be of tremendous assistance to individuals coping with impaired vision and to their families, support group leaders, and the professionals who serve them. Each issue contains highly relevant information on a variety of topics, a resource directory with complete contact information, bold, honest discussions of emotional and physical issues, current medical research, latest technological assistive devices, tips on handling vision loss, new books, videos, magazines, noteworthy events, consumer-protection, and more.
The new edition will be available in Adobe Acrobat PDF format and/or in ASCII format, with special file for Braille output, and sent as an attachment to an e-mail message. The annual subscription rate is $25 (US$) for USA, Canada and all International Countries.
Managing Editor, Patricia Price, commented: "We are very excited about the possibilities afforded by this new version. We are in our seventh year of production and already issue the publication in large print, 2-track, tone-indexed audiocassette, computer disk, and in Enhanced Letter Format-ELF (30pt and 48pt type), but many readers have asked for an electronic edition. We are pleased we now have the expertise to reach out to the more than 16 million individuals in the U.S. along experiencing vision loss."
The following was an e-mail sent
by Serena Dowling who forwarded this e-mail from Ruth L'Hommedieu,
Chair/Alaska State Independent Living Council
The following message came to me this morning and I feel it is important to forward this on to all of you. If you do not need this information, you may know someone who does. Please pass and share this message. Diabetes is one of the larger growing medical situations, and it effects people of all ages, to include late adult diabetes.
Source: American Diabetes Association http://www.diabetes.org/
The Federal Aviation Administration (FAA) has implemented stepped-up security measures at the nation's airports in response to last month's tragic events. Some of the new security measures may affect airline passengers with diabetes. The American Diabetes Association recognizes the added inconvenience this may pose for individuals with diabetes, but understands the necessity to secure airline passenger safety.
Below please find a list of the most current information that the Association has received regarding people with diabetes who need to fly with their supplies and equipment within the 50 United States. We received this information verbally from a representative of the FAA's Aviation, Security Policy & Planning Division (Washington, D.C. headquarters). We have been told that the FAA will be issuing the security measures to air carriers within a few days in the form of a "security directive."
Since the prescription label is on the outside of the box containing the vial of insulin, the FAA recommends that passengers refrain from discarding their insulin box and come prepared with their vial of insulin in its original pharmaceutically labeled box.
The above list of measures is a minimum requirement only and air carriers may have other requirements that may impact a passenger's ability to board with diabetes equipment and supplies.
Accordingly, the FAA and the Association strongly urge each passenger to call the airline carrier at least one day in advance of his or her scheduled flight to confirm what the airline's policy is with regard to diabetes medication and supplies. Be advised that each airline's policy is subject to change.
The Association has received a small number of complaints from passengers who have encountered difficulty when trying to pass through airport security with syringes and lancets. Should a passenger be denied boarding a flight or be faced with any other unforeseen diabetes related difficulty because of security measures, he or she should ask to speak to the security screener's supervisor or contact the FAA grounds security commissioner at the departing airport.
In addition, please contact the American Diabetes Association at 703-549-1500 ext. 2108 so that we may be kept informed of airline protocols and security measures. The Civil Aviation Security division of the FAA may also be contacted at 202-267-9863.
The Association will continue to monitor this situation and keep you informed of new developments.
The Washington Post and New York
Times have been devoting considerable attention to disability issues
in the last several months. Here's an excellent analysis of
disability-based harassment and the challenges of seeing coverage by
the ADA.
For five years, Philip Lanni, partly disabled by dyslexia and other neurological impairments, worked as a radio dispatcher for the New Jersey Department of Environmental Protection. And from his early days, the rangers Mr. Lanni sent to their jobs made him a target of pranks and ridicule, according to a lawsuit he won against the department in 1999.
The rangers highlighted his spelling mistakes in his log book, he said, and tried to blame him for errors that were not his fault. "We become the scapegoat, he said.
Eventually, the harassment began to escalate. "It jumped from verbal to physical," he said. One ranger brandished a gun at him, and another sprayed his face with Mace.
When he complained, the suit contended, Mr. Lanni was told he worked in a "locker room atmosphere" and should not be "so sensitive."
The department declined to comment.
Mr. Lanni is in the vanguard of an issue that has emerged with full force only recently: the harassment of disabled employees at work. Federal courts and juries are starting to treat it just as seriously as traditional cases of sexual or racial harassment.
But many companies are still slow to respond to the challenges, according to lawyers involved with the issue. "There has been a great deal more time spent educating people on harassment on the basis of sex and race," said Margaret Hart Edwards, a lawyer with Littler Mendelson in San Francisco who advises corporations.
"Employers," said Claudia Center, a lawyer for the Legal Aid Society Employment Law Center in San Francisco, "have not even gotten it on the radar screen yet."
According to the complaints-some 2,400 are now filed annually with the Equal Employment Opportunity Commission-many disabled employees say they are constantly berated by co-workers and managers who accuse them of faking their injuries. Others say their colleagues gang up on them as they would in the schoolyard. Still others say they are shunned by managers, who try to force them to quit.
Disability-based harassment is now the fourth most frequent claim behind racial harassment, sexual harassment, and claims for harassment based on national origin, according to preliminary figures from the EEOC for the year ended Sept. 30.
But lawsuits under the 1990 Americans With Disabilities Act have proved extremely difficult to win, according to legal experts. "The standard of proof is made so high that almost no one can meet it," said Ruth Colker, a law professor at Ohio State University. Employers prevailed in more than 93 percent of cases reaching the trial court level from 1992 through mid-1998 and 84 percent of the time on appeal, according to her research.
Moreover, many disabled employees facing harassment do not sue at all for fear of losing their jobs. They may depend on their employer for health insurance or worry about their ability to find another position. "Folks who are disabled have enormous external pressures," said Jill L. Craft, a plaintiff's lawyer in Baton Rouge, La.
While that makes it harder to show a repeated pattern of discrimination and harassment, several highly publicized lawsuits have recently overcome these hurdles. Mr. Lanni, who was represented by the law firm of Wong Fleming, won a six-figure jury award for disability-based harassment. Two cases that were appealed in federal courts earlier this year were affirmed.
More decisions are the first instances since the disabilities law formally went into effect in 1992 that appellate courts have explicitly recognized this kind of harassment as a form of discrimination, just as other harassment is viewed under the 1964 Civil Rights Act.
As disabled employees gain greater access to the ordinary workplace, they face many of the same obstacles experienced by other members of a minority.
"Kids with disabilities are harassed all the time," said Andrew J. Imparato, the president of the American Association of People with Disabilities in Washington. "Why wouldn't it go on in the workplace?"
Despite recent progress, only 29 percent of people who are disabled and are of working age are employed, compared with 79 percent of those who are not disabled, according to a recent survey.
"There needs to be more follow-up," said Annela Soran, a senior recruiter for Just One Break, a New York nonprofit organization that helps people with disabilities find employment. "A lot of people land jobs, but they can't keep them."
Many consultants recommend that companies broaden their diversity efforts to include people with disabilities explicitly. J.P. Morgan Chase (news/quote), for example, has an employee network for people with disabilities that meets monthly. It alerts the company to issues it may not have considered, like the difficulty of navigating carpet with a wheelchair.
"If you're speaking about diversity, this is yet another culture," said Joan Imperiale, a company vice president.
Harassment of people with disabilities takes different forms, but it can sometimes be a matter of sheer cruelty. The equal employment commission recently brought a lawsuit against the Olive Garden, a chain of Italian restaurants owned by Darden Restaurants (News/quote), on behalf of a former employee, Jody Terrio, who is mentally retarded.
"Examples of the physical abuse," the commission claimed in its suit, "include putting Terrio in headlocks and other physically painful wrestling positions, pulling down Terrio's pants in front of co-workers, and hiding or riding around on Terrio's bicycle because they knew it would upset Terrio."
Olive Garden said it could not discuss the case, but defended its record in employing people with disabilities and reaching out to disabled customers. "We're looking forward to getting all the facts on the table," said Steve Coe, a company spokesman.
Sometimes the discovery of a condition can ignite an outbreak of hostility. Sandra Flowers, for example, worked as a medical assistant at a doctor's office in Baton Rouge for six years. But as soon as her office manager discovered that Ms. Flowers was infected with HIV, "her whole attitude and demeanor changed," Ms. Flowers said.
Although the two were once friends, the office manager told colleagues not to touch the food Ms. Flowers brought to an office gathering. She repeatedly cleaned Ms. Flower's telephone with rubbing alcohol. In a single week, according to the lawsuit Ms. Flowers brought against Southern Regional Physician Services, she was forced to take four random drug tests.
After Ms. Flowers was accused of mistreating patients and was the subject of written complaints about various infractions, she was fired.
In 1998, a jury awarded Ms. Flowers $350,000 for disability-based harassment, and the case was appealed. The federal appeals court in New Orleans affirmed the decision, although it ruled that Ms. Flowers should receive minimal damages because the harassment did not cause substantial enough injury. Her lawyer, Ms. Craft, is currently asking the court to award her lawyer's fees, which she says she will give to Ms. Flowers.
Our Lady of the Lakes Regional Medical Center, which owned Southern Regional, said Ms. Craft's termination was unrelated to her HIV status. The hospital would not comment further on the case but it said it took allegations of harassment seriously.
Many of the people bringing complaints have disabilities that carry considerable stigma, like mental illness. Others confront questions about whether they are truly disabled. About 40 percent of the complaints involve mental disabilities or back injuries, according to federal statistics.
In some cases, supervisors are frustrated at having employees who are restricted from performing all aspects of their jobs. Robert J. Fox, for example, injured his back, limiting him to light-duty work at a General Motors (news/quote) plant in Martinsburg, W. Va. A supervisor there routinely referred to disabled employees as "911 hospital people," according to Mr. Fox's lawsuit. He said he was frequently asked to do work that could further injure his back. When he refused, one manager asked him how he was suppose to take someone "with these restrictions," according to the suit.
A jury awarded Mr. Fox $200,000 in damages; an appeals court affirmed it this year. G.M. has paid Mr. Fox, who still works for the company, according to a spokesman. The company says it has various initiatives to help disabled employees feel more comfortable.
Someone who has a psychiatric disability can also become vulnerable to the hostilities of co-workers. Eric R. Stewart worked for Bally Total Fitness when he suffered a breakdown and was diagnosed with bipolar illness. When Mr. Stewart returned to work, his colleagues called him "pyscho," "wild man" and "freak," according to a lawsuit he filed against Bally in 1999. He was eventually fired.
A federal court in Philadelphia ruled last year that the case could proceed to trial. While Bally said it could not comment on the litigation, the company said it did not tolerate any kind of harassment.
Advocates say employers' efforts to make the workplace more hospitable are more important than their attempts not to run afoul of the disabilities act. "The spirit of the law," said Matthew Spolin, co-executive director of the Queens Independent Living Center, "is much better than the letter of the law."
Dietary supplements reduce risk of vision loss from age-related macular degeneration: Some supplements have no effect on the development of Cataract.
A dietary supplement of high levels of antioxidants and zinc significantly reduces the risk of advanced age-related macular degeneration (AMD) and its associated vision loss. These same supplements had no significant effect on the development or progression of cataracts. These findings from a nationwide clinical trial are reported in the October 2001 issue of Archives of Ophthalmology.
Scientists found that people at high risk of developing advanced stages of AMD, a leading cause of vision loss, lowered their risk by about 25 percent when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene, and zinc. In the same high risk group which includes people with intermediate AMD, or advanced AMD in one eye but not the other eye the supplements reduced the risk of vision loss caused by advanced AMD by about 19 percent. For those study participants who had either no AMD or early AMD, the supplements did not provide an apparent benefit. The clinical trial called the Age-Related Eye Disease Study (AREDS) was sponsored by the National Eye Institute (NEI), one of the Federal government's National Institutes of Health.
"This is an exciting discovery because, for people at high risk for developing advanced AMD, these dietary supplements are the first effective treatment to slow the progression of the disease," said Paul A. Sieving, M.D., Ph.D., Director of the NEI. "AMD is a leading cause of visual impairment and blindness in Americans 65 years of age and older. Currently, treatment for advanced AMD in people who are at high risk - those with intermediate AMD in one or both eyes, or those with advanced AMD in one eye already.
"The supplements are not a cure for AMD, nor will they restore vision already lost from the disease," Dr. Sieving said. "But they will play a key role in helping people at high risk for developing advanced AMD keep their vision."
A common feature of AMD is the presence of drusen, which are yellow deposits under the retina. Often found in people over age 60, drusen can be seen by an eye care professional during an eye exam in which the pupils are dilated. Drusen by themselves do not usually cause vision loss, but an increase in their size and/or number increases a person's risk of developing advanced AMD, which can cause serious vision loss.
The three stages of AMD analyzed in this study are:
1. Early AMD. People with early AMD have, in one or both eyes either several small drusen or a few medium-sized drusen; these people do not have vision loss from AMD.
2. Intermediate AMD. People with intermediate AMD have, in one or both eyes, either many medium-sized drusen or one or more large drusen; in these people, there is usually little or no vision loss.
3. Advanced AMD. In addition to drusen, people with advanced AMD have, in one or both eyes, either:
These two forms of advanced AMD can cause serious vision loss. Scientists are unsure about how or why an increase in the size and/or number of drusen can sometimes lead to advanced AMD, which affects the sharp, central vision required for the "straight ahead" activities in our daily routine, such as reading, driving, and recognizing faces of friends. One observation is that the larger and more numerous the drusen, the higher the risk of developing either form of advanced AMD.
People who have advanced AMD in one eye are at especially high risk of developing advanced AMD in the other eye. The dietary supplements used in the study contained several antioxidant vitamins, which are nutrients that can help maintain healthy cells and tissues. They also contained zinc, which is an important mineral incorporated into many body tissues.
The supplements evaluated by the AREDS researchers contained 500 milligrams of vitamin C; 400 IU of vitamin E; 15 milligrams of beta-carotene; 80 milligrams of zinc as zinc oxide; and two milligrams of copper as cupric oxide (Copper was added to the AREDS formulations containing zinc to prevent copper deficiency, which may be associated with high levels of zinc supplementation). In this trial, the NEI collaborated with Bausch & Lomb, an eye care company that provided the supplements evaluated by the AREDS researchers and financially supported the laboratory testing and distribution of study medications.
"Previous studies have suggested that people who have diets rich in green, leafy vegetables have a lower risk of developing AMD," said Frederic Ferris, MD, director of clinical research at the NEI and chairman of this AREDS. "However, the high levels of dietary supplements that were evaluated in the AREDS are very difficult to achieve from diet alone.
"Almost two-thirds of AREDS participants chose to take a daily multivitamin in addition to their assigned study treatment," Dr. Ferris said. "The AREDS also showed that, even with a daily multivitamin, people at high risk for developing advanced AMD can lower the risk of vision loss by adding a dietary supplement with the same high levels of antioxidants and zinc used in the study."
The Age-Related Eye Disease Study involved 4,757 participants, 55-80 years of age, in 11 clinical centers nationwide. Participants in the study were given one of four treatments: 1) zinc alone; 2) antioxidants alone; 3) a combination of antioxidants and zinc; or 4) a placebo, a harmless substance that has no medical effect.
The benefits of the dietary supplements were seen only in people who began the study at high risk for developing advanced AMD - those with intermediate AMD, and those with advanced AMD in one eye only. In this group, those taking "antioxidants plus zinc" had the lowest risk of developing advanced stages of AMD and its accompanying visual loss. Those in the "zinc alone" or "antioxidant alone" groups also reduced their risk of developing advanced AMD, but at more moderate rates compared to the "antioxidants plus zinc" group. Those in the placebo group had the highest risk of developing advanced AMD.
Dr. Ferris said some people with intermediate AMD may not wish to take large doses of antioxidant supplements or zinc because of medical reasons. "For example, beta-carotene has been shown to increase the risk of lung cancer among smokers," he said. "These people may want to discuss with their primary care doctor the best combination of supplements for them. With any supplements containing zinc, it is important to add appropriate amounts of copper to the diet to prevent copper deficiency."
In the cataract portion of the study, researchers discovered that the same supplements had no significant effect on the development or progression of age-related cataracts. A cataract is a clouding of the eye's lens that blocks some light from reaching the retina and interferes with vision. "Participants taking the "zinc alone" treatment, the "antioxidants alone" treatment, or the combination of zinc and antioxidants were all about as likely to develop a cataract as those taking a placebo," Dr. Ferris said.
"At the time the study was planned, laboratory and animal research had suggested that antioxidants might be of benefit in treating or preventing cataracts," he said. "Also at that time, limited epidemiologic and clinical trial data suggested that antioxidants might affect the development of cataracts. However, our analyses did not find any connection between the antioxidant supplements used in the AREDS and cataract development."
Despite the evidence that these supplements did not lower the risk of cataract development over the seven-year period of the study, Dr. Ferris noted that an effect over a longer period of time, or with different doses of these or other antioxidants, cannot be ruled out.
The AREDS participants reported minor side effects from the treatments. About 7.5 percent of participants assigned to the zinc treatments compared with five percent who did not have zinc in their assigned treatment had urinary tract problems that required hospitalization. Participants in the two groups that took zinc also reported anemia at a slightly higher rate; however, testing of all patients for this disorder showed no difference among treatment groups. Yellowing of the skin, a well-known side effect of large doses of beta-carotene, was reported slightly more often by participants taking antioxidants.
The AREDS dietary supplements are the first demonstrated treatment for people at high risk for developing advanced AMD," he said. "Slowing the progression of AMD to its advanced stage will save the vision of many who would otherwise have had serious vision impairment."
A list of the study centers is available at AREDS.doc.
The National Eye institute (NEI) is part of the National Institutes of Health (NIH) and is the Federal government's lead agency for vision research. NEI-supported research leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness. The NIH is an agency of the US Department of Health and Human Services.
For more information on macular degeneration, please call our toll free number at 1-800-393-7634 or check our web site at http://www.maculardegeneraton.org. You can e-mail us at info@maculardegeneration.org.
Editor's Note: As an ongoing feature to keep you all informed about various eye diseases and problems, we will be including articles from Vision World Wide on common eye problems. Even if you don't have the problem or disease discussed in this issue, please go ahead and read it as it contains quite a bit of useful information.
According to the National Center for Health Statistics, there are over 8 million head injuries each year with over 1.5 million of them classified as major injuries. The vast majority of people are saved by advances in modern medicine while only about 100,000 suffer fatal injuries. Another 500,000 people suffer from strokes each year, and it is estimated that there are over 3 million stroke survivors in the United States alone.
Millions of stroke and traumatic brain injury survivors suffer from visual problems. These visual problems range from dry eyes to visual field loss to double vision. Each case is different and the difficulty each patient has depends on the severity and location of the injury. Unfortunately, many patients with visual problems after a stroke or head injury fail to receive adequate vision rehabilitation.
Brain injury may affect vision in many ways. Below are some of the most common visual problems associated with stroke and traumatic brain injury.
Loss of Visual Field: A common visual effect of brain injury is the loss of one's visual field or our ability to see the side. There are many types of visual field losses that can occur, but the most common form is a homonymous hemianopsia or loss of half of the field of vision in each eye. If the posterior portion of the brain is damaged on one side of the brain, a loss of visual field occurs to the opposite side of both eyes. Patients often mistakenly believe the loss is just in one eye.
Patients frequently bump into objects, and easily trip or fall over objects in their field loss. Going into crowded stores may become quite difficult, because people and objects suddenly appear in front of them from the blind side. Patients become afraid of leaving their homes and may even experience panic attacks. Additionally, the loss of visual field may also cause patients to miss words and have difficulty reading.
Patients with hemanoptic field loss may benefit from the Visual Field Awareness System developed by Dr. Daniel Gottlieb or the Peli Lens developed by Dr. Eli Peli, senior researcher at Harvard. Both of these systems increase the patient's ability to detect objects on the side of their vision loss. Training the patient in scanning techniques is also an important part of the treatment.
Visual Spatial Disorders and Visual Neglect: Patient may experience a variety of visual spatial disorders. When certain portions of the brain are damaged, the patient may fail to appreciate space to one side, which is usually to the left. Unlike visual field loss, this problem is not a physical loss of sensation, but rather a loss of attention to the area. A man with neglect may no longer shave one side of his face. Patients with visual neglect have more difficulties than those with only visual field loss. Unfortunately, both neglect and field vision loss may occur together. Other visual-spatial disorders may occur as well. Patients may experience difficulty navigating themselves even in familiar areas. Patients also misjudge the straight-ahead position and can confuse right versus left.
Vertigo, Dizziness and Impaired Eye Movements: Smooth and accurate eye movements are essential in reading, tracking objects and compensating for body movements. Following injury to the brain, movements may become more jerky in nature. As we move or tilt our head, our inner ears sense the angle at which we are tilting and cause compensatory eye movements. After head injury, these compensatory movements may become impaired. Nystagmus, a jerky motion of the eyes, may also occur. When acquired later in life, nystagmus results in a vertigo-like sensation or a feeling that the world is moving. Damage to the brain stem often results in dizziness.
Double Vision: Our eyes must point precisely at the same point in space to prevent diplopia or double vision. Each eye has six external muscles that move the eyes together as a team. If control is impaired to one or more muscles, the eyes cannot maintain alignment in all positions of gaze. This may occur due to damage to the control centers for the III, IV and VI cranial nerves. Double vision may be constant or intermittent. The patient may experience normal single vision in the straight-ahead position, but suddenly have double vision on looking to one side.
Eyestrain and difficulty in reading: As we bring reading material close to our eyes, both eyes must turn in together as a team. It is called ocular convergence. This ability is frequently impaired in brain injury resulting in fatigue or discomfort while reading. Orthoptic therapy and prism lenses may aid this problem.
After injury, younger patients may experience more problems focusing at near. This may present simply as difficulty in reading. This is usually due to damage to the oculomotor nerve (CN III). This nerve is responsible for controlling the eye's ability to focus by changing the shape of the crystalline lens. Patients benefit from the use of bifocals to help compensate.
Eye movements called saccades are used to jump from word to word as we read. Impairments in saccades may result in difficulty reading smoothly along a line of print. Visual field loss may also impair reading. When the loss of field borders on the central area of the retina used in reading, patients may lose their place or have difficulty in reading long words. Impairments in cognitive skills and memory may also limit reading. Some patients may acquire an alexia, a loss of reading ability. Therapists may be able to rebuild reading skills for some patients. For those still unable to read, electronic scanner/reading machines like the Kurweil Omni system can read to the patient.
Light sensitivity: Light sensitivity is quite variable. Some patients experience no problems while others have severe light sensitivity. Much like the volume control on a radio being broken, patients seen to have difficulty adjusting to the various lighting levels. Tinted eyewear, especially amber filters, may aid the patient and light sensitivity may improve with treatment of other vision problems.
Dry eyes: Dry, burning or gritty eyes may occur after brain injury. It may result from a decrease in the blink rate, or poor closure of the lids. Artificial tears or tear duct plugs will usually control the problem.
Visual hallucinations: Visual hallucinations may be formed objects such as a person or figure or may be unformed such as flashes of lights, stars or flickering distortions.
Impaired visual memory: Memory is often impaired after stroke or head injury. In rare cases very specific types of memory processing is impaired. A patient may no longer be able to recognize faces, objects or letters.
Summary: The visual problems of acquired brain injury may affect nearly all aspects of vision and can hinder normal recovery. Early vision evaluation is crucial. A clinician skilled in both low vision and brain injury is often needed to understand the interaction of all of these visual problems in order to make the appropriate low vision rehabilitation plan for each patient with acquired brain injury. The long road back from brain injury requires the teamwork of many doctors and therapists and most of all time and patience throughout the rehabilitative process.
As I promised in the last issue, we will consider more kitchen tips this time and then some very interesting uses for baking soda.
Kitchen Tips
Keep a nutcracker in a kitchen drawer. It is a perfect "gripper" for unscrewing tight lids on small bottles such as vanilla extract, hot sauce, etc.
Use dinner towels or napkins to make covers for kitchen appliances such as waffle irons, skillets, and dinner plates. Sew napkins together on three sides or fold kitchen towels in half and sew on two sides.
The items you use together, such as mixing bowls, spoons, cups, and baking pans, pots and other cooking utensils, should be kept in the cabinet near the stove or in the stove's storage space. Keep potholders decoratively hung on hangers near the stove but not over burners where they might fall and catch on fire.
Leave nightlight on in the kitchen somewhere for those frequent trips to get water from the refrigerator. Even better, keep a carafe (with lid) alongside the bed, as well as a flashlight for trips during the night to other areas of the house.
Place a small lamp on the wall above the kitchen table to illuminate the table more clearly.
If you have a large kitchen, place track lights at one end for more light.
If you are blessed with a rolling cabinet (kitchen island), you will use it more effectively if it is organized with items you need for food preparation tasks.
There are no rules that say all spices have to be in one place. Keep the ones you use most frequently in a small attractive container on your counter. You can always go get seldom-used ones from the pantry.
Thank goodness they have come up with stainless steel coffee servers so that you can replace the glass coffee carafes that get broken so often. The stainless steel ones fit most coffeemakers and cost about $10 to $18, depending on the size.
Tips Using Baking Soda
To test for baking soda freshness, put a small amount (just a few drops) of vinegar or lemon juice over ½ teaspoon of baking soda. If it does not bubble actively, it is too old.
To make a fluffy omelet, and ½ teaspoon baking soda for every three eggs. Add a pinch of baking soda to buttermilk (used instead of whole milk) to make waffles light and soft.
Add fluff to the mashed potatoes with a pinch of baking soda during mashing.
A pinch of baking soda added to any boiled syrup will prevent crystallizing.
Avoid curdling of boiled milk by adding a pinch of baking soda.
When gravy separates, add a pinch or two of baking soda to emulsify those fat globules in seconds.
If you have added too much vinegar to a recipe, add a pinch of baking soda to counteract the excess acidity.
Out of yeast? Substitute equal parts of baking soda and powdered Vitamin C or citric acid. This dough does not need to rise before baking. (This combination is a form of homemade baking powder you can use in place of yeast to help dough rise).
Soften boiled drinking water with one-teaspoon baking soda per gallon.
That's it for this time. I hope you will find these tips useful.
If you have any questions, comments, or whatever please contact the offices of AIB through the methods of e-mail which is aiblink@ak.net, phone or in writing. I will try to answer your concerns in our next newsletter.
Look for us again in the Spring of 2002.
Have a Happy Holiday Season.
Trudy Boissonneau, Editor
Alaska Independent Blind Office:
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Updated: June 17, 2002