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The MAB-Mackay Rehabilitation Centre runs a Day Centre Programme whose objectives are to maintain or improve the seniors' biological, psychological, and social health while delaying or avoiding institutionalization. Activities include walking groups, language courses, and memory games, supervised by an interdisciplinary team. Services include rehabilitation follow-up and referrals to community resources. The present study reports on the impact of the Day Centre on the holistic health of older adults with visual impairment. Between September 2011 and October 2012, 30 newly referred clients (age = 71–98 years, M = 85, visual acuity [VA] 20/50 to no-light-perception [NLP], M = 20/126) were evaluated at intake, and after 6 and 12 months, including the Visual Function Questionnaire-14, Hearing Handicap Inventory for the Elderly, Geriatric Depression Scale, Friendship Scale, Timed Up and Go Test, and Montreal Cognitive Assessment (MoCA). In all, 19 participants completed the 1-year follow-up and continued to live independently in the community 12 months after entering the Day Centre. Only one person was transferred into long-term care. Comorbid conditions included high blood pressure, asthma, cardiac problems, diabetes, stroke, arthritis, and osteoporosis. Participants reported statistically unchanged scores on all the measures, except for improved MoCA scores, p < .05. Considering the vulnerability of this population, the data indicate that the Day Centre contributes to prevent decline in its clients' general well-being. The increase in cognitive scores is possibly linked to practice effects and reduced test anxiety. Participation in adapted Day Centre activities, as an integrated part of rehabilitation services, may support independent living in older adults with vision loss.

Since the mid-twentieth century, 'international law' and 'international development' have become two of the most prominent secular languages through which aspirations about a better world are articulated. They have shaped the both the treatment and self-understanding of the 'developing' world, often by positing the West as a universal model against which developing states, their citizens, and natural environments should be measured and disciplined. In recent years, however, critical scholars have investigated the deep linkages between the concept of development, the doctrines and institutions of international law, and broader projects of ordering at the international level. They have shown how the leading models de-radicalise, if not derail, initiatives to redefine development and pursue other forms of global well-being. Bringing together scholars from both the Global South and the Global North, the contributions in this Handbook invite readers to consider the limits of common normative and developmentalist assumptions. At the same time, the Handbook demonstrates how disparate but still identifiable set of ideas, imaginaries, norms, and institutional practices - related to law, development and international governance - shape today's profoundly unequal material conditions, threatening the future of human and nonhuman life on the planet. The book focuses on five distinct areas: existing disciplinary frameworks, institutions and actors, regional theatres of international law and development, competing social and economic agendas, and alternative futures.

Introduction Sleep is important for optimal physical health and vitality. Recent studies have shown that individuals with visual impairments may be at risk for sleep problems. This research examines the prevalence of sleep problems among those with retinal disorders and the possibility of a genetic link. Methods Subjects with retinitis pigmentosa ( n = 33), Stargardt's disease ( n = 31) and age-related macular degeneration ( n = 43) were recruited from the ophthalmology department of Montreal Children's Hospital. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Genetic testing was conducted by the Radboud University Medical Center in Nijmegen, Netherlands. Retinal genes were identified as having retina only or pineal and retinal expression. Results The expression patterns of genes causing retinal disorders did not predict sleep quality. The PSQI indicated poor sleep quality in 56% of participants with retinitis pigmentosa, 48% of those with Stargardt's disease, and 53% of those with age-related macular degeneration. The ESS showed that daytime sleepiness was experienced by 20% of individuals with retinitis pigmentosa or Stargardt's disease, and by only one individual with age-related macular degeneration. Discussion Approximately 50% of people with retinal disease have sleep problems. This number compares with up to one-third of the general population. Gene expression did not correlate with sleep quality, and the explanation for such a large percentage of sleep disorders needs further investigation. Implications for practitioners Eye care and rehabilitation specialists need to be aware of the high prevalence of poor sleep quality in individuals with retinal disorders, since this situation may have an important impact on memory and learning, both of which are vital in successful rehabilitation.

BACKGROUND: Colorectal cancer (CRC) screening (CRCS) facilitates early detection and lowers CRC mortality. OBJECTIVES: To increase CRCS in a randomized trial of stepped interventions. Step 1 compared three modes of delivery of theory-informed minimal cue interventions. Step 2 was designed to more intensively engage those not completing CRCS after Step 1. METHODS: Recruitment packets (60,332) were mailed to a random sample of individuals with a record of U.S. military service during the Vietnam-era. Respondents not up-to-date with CRCS were randomized to one of four Step 1 groups: automated telephone, telephone, letter, or survey-only control. Those not completing screening after Step 1 were randomized to one of three Step 2 groups: automated motivational interviewing (MI) call, counselor-delivered MI call, or Step 2 control. Intention-to-treat (ITT) analyses assessed CRCS on follow-up surveys mailed after each step. RESULTS: After Step 1 (n=1784), CRCS was higher in the letter, telephone, and automated telephone groups (by 1%, 5%, 7%) than in survey-only controls (43%), although differences were not statistically significant. After Step 2 (n=516), there were nonsignificant increases in CRCS in the two intervention groups compared with the controls. CRCS following any combination of stepped interventions overall was 7% higher (P=0.024) than in survey-only controls (55.6%). CONCLUSIONS: In a nationwide study of veterans, CRCS after each of two stepped interventions of varying modes of delivery did not differ significantly from that in controls. However, combined overall, the sequence of stepped interventions significantly increased CRCS.