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Vol. 9, No. 4, Fall 1992

NASA SCIENTISTS
INVESTIGATE
VESTIBULAR FUNCTION

By Jane Mahoney

(Editor's Note: Jane Mahoney is a VEDA
member who lives in Rhode Island. She is
recovering from a perilymph fistula.)

What effect does space travel have on the
vestibular system, and how do inner-ear
mechanisms adapt to conditions of
weightlessness? NASA researchers are
studying these and other important
questions, the answers to which will have
a powerful impact on vestibular science as
well as the exploration of space.

For many years neuroscientists speculated
about the effects of zero gravity on the
vestibular system. They wondered what
might happen to humans in the absence of
normal clues about direction and
gravitational pull. When space travel
became a reality and astronauts reported
varying levels of motion sickness, these
speculations gained practical importance.
NASA enlisted leading American scientists
to offer insight.

NASA has termed the astronauts'
temporary problems space adaptation
syndrome. Some of the symptoms include
nausea, vomiting, and general malaise.
These symptoms have been experienced
by more than half the astronauts. Because
the vestibular system can be so remarkably
adaptive, the symptoms generally subside
after several days of travel.

Why do the problems occur? A simple
answer would be as follows. Organs in the
human vestibular system detect changes in
motion. Some of these organs detect
rotational motion, while others detect
changes in straight-line motion. Some
detect gravity and give humans a sense of
which way is down. Working together,
these organs send signals to the brain
about body orientation. However, under
conditions of weightlessness, the vestibular
system receives no information about
gravity or which way is down. Astronauts
must therefore rely on other information
for spatial orientation and personal
navigation. Space adaptation syndrome
develops from the brain's temporary
confusion in the microgravity environment
of space.

Dr. Joseph Kerwin, the first physician
astronaut, described his experience aboard
Skylab II in 1973 like this, "I would say
that there was no vestibular sense of the
upright whatsoever. I certainly had no idea
where the Earth was at any time unless I
happened to be looking at it. I had no
idea of the relationship between one
compartment of the spacecraft or another
in terms of 'up or down.'"

The remarkable adaptation that the brain
makes to zero gravity must be reversed
when the astronauts return to Earth's
atmosphere. Dr. F. Owen Black, one of
VEDA's scientific and medical advisors,
has spent several years studying this
phenomenon. In order to understand the
post-flight adjustments, Dr. Black and his
associates conducted platform balance
tests on astronauts 60, 30, and 10 days
before and two, four, and eight days after
space travel. The scientists measured how
balance strategies developed from
complementary forms of sensory
information; that is, from visual and
vestibular systems, and from
proprioceptive information relayed to the
brain from the muscles, skin, and joints.

Test scores showed an increased reliance
on both vision and touch (contact surface)
input for balance immediately upon return
to Earth from orbital space flight. All test
scores showed a decrease in balance. In
four to eight days after touchdown,
however, all test scores returned to pre-
flight levels, indicating that the astronauts
had successfully readapted to the gravity
of Earth.





NEWS AND
REVIEWS

By Susan L. Engel-Arieli, M.D.

The following are summaries of articles
that appeared in recent medical and
professional journals:

1. Benign Paroxysmal Positional Nystagmus
(BPPN) -- BPPN is a common diagnosis in
patients presenting with vertigo. BPPN is
often but not always self-limiting.
Vestibular suppressing medications may
provide relief but don't alter the course of
the disease. Head exercises and
positioning maneuvers may be beneficial,
and time alone often brings relief. Some
cases persist, and when conservative
treatment is not helpful, surgical
sectioning of the posterior ampullary
nerve may be effective.

Dr. Eric Smouha retrospectively reviewed
the records of 57 patients with BPPN. He
found that BPPN most often resulted from
an unknown cause or a primary ear
disorder. BPPN can also rarely arise from
disease of the central nervous system. See
Smouha, Eric, "BPPN: Etiology and
Natural History," Micromedical
Technologies Vestibular Update, No. 9,
Summer 1992, pages 1-5.

2. Seasickness -- Seasickness is
characterized by nausea, increased motility
of the abdomen, dizziness, and sweating.
Physical symptoms can include pallor, fast
heart rate, and fast breathing.
Susceptibility to seasickness varies, but the
incidence is high. According to reports, 10
to 30 percent of a naval crew experienced
seasickness during normal sea conditions,
and 50 to 90 percent were sick in heavy
seas.

Many factors influence whether someone
becomes seasick. They include wind,
waves, the ship's shape and size, and the
person's location on the ship. Research
indicates that space sickness, a similar
ailment, involves asymmetrical otolith
function between the two labyrinths. A
person with an existing imbalance in
otolith input to the brain will be more
likely to experience motion sickness.

Some of the most commonly used anti-
sickness medications are anticholinergics
such as scopolamine. Other medications,
calcium channel blockers such as
nifedipine, may not be appropriate for
patients with low blood pressure or who
take other blood pressure pills. Other
useful medicines can include
antihistamines.

"Old time advice" suggests that to avoid
seasickness you should stay on the deck of
the boat, have warm clothes, and eat
coarse, simple, and solid food. Small
snacks and sips of clear liquids are
preferable to large meals. See Mick, J.,
and Rund, D., "Casting Off Seasickness,"
The Physician and Sportsmedicine, Vol. 20,
No. 7, July 1992, pages 35-43.

3. Managing Dizziness -- Dr. V. Dayal has
written that examination of patients with
dizziness should include examination of
the ears, hearing, the vestibular system,
cerebellar function, eye movements,
cranial nerves, the cardiovascular system,
and the nervous system. In a recent
article, he states that various drugs are
used in the treatment of acute episodes of
vertigo. He commonly uses diazepam,
antihistamines, scopolamine, and innovar.
He believes the most effective of these is
diazepam. Innovar, although very effective,
has the potential serious side effect of
respiratory depression, and its use must be
monitored. Scopolamine, although used
frequently, has significant side effects that
detract from its routine use.

Dr. Dayal says there has been little
progress in the understanding of Meniere's
disease. Debilitating vertigo associated
with Meniere's can sometimes be treated
by vestibular nerve section; the treatment
for acoustic neuroma, a tumor, involves
surgical excision. Treatment for perilymph
fistula involves identifying and grafting the
site of perilymphatic fluid leakage.
Autoimmune inner ear disorders may
occur in the absence or presence of
systemic disease. Steroids have been used
in the treatment of these problems. See
Dayal, V., "Management of the Dizzy
Patient," Chicago Medicine, Vol. 95, No.
14, July 21, 1992, pages 30-32.

4. Team Approach to Dizziness -- A recent
article reports how a rehabilitation team
at the Medical College of Ohio in Toledo
treats vestibular disorders. Team members
include nurses, physicians, audiologists,
physical therapists, occupational therapists,
and a research scientist. They believe the
team approach is of great benefit in the
treatment of vestibular and balance
disorders. See Cohen, H., et al., "The
Team Approach to Treatment of Dizzy
Patients," Archives of Physical Medicine
and Rehabilitation, Vol. 73, No. 8, Aug.
1992, pages 703-708.

5. Vestibular Neurectomy -- During the last
10 years, vestibular neurectomy has
become a more frequently performed
procedure to relieve inner ear vertigo,
according to a recent article. Investigators
sent a questionnaire to 350 members of
the American Otologic Society and the
American Neurotology Society and
reported results on 2,820 vestibular
neurectomies performed by 58 surgeons.
Classic Meniere's disease was the most
common indication and resulted in the
best vertigo cure rate, 91 percent. Other
inner ear diseases such as labyrinthitis and
vestibular neuronitis had a lower cure rate
of 74 to 81 percent. No deaths from
surgery were reported. Unwanted surgical
side effects included 11 cases of meningitis
and 16 cases of face paralysis. See
Silverstein, H., et al., "Vestibular
Neurectomy in the U.S. -- 1990," American
Journal of Otology, Vol. 13, No. 1, 1992,
pages 23-30.

6. Homeopathy and Vertigo -- A recent
homeopathic journal reported on
Vertigoheel, a homeopathic preparation
for vertigo. It was used in 188 patients
with vertigo secondary to circulatory
problems, post-concussion problems,
Meniere's syndrome, central nervous-
system disorders, and motion sickness. The
author said there were no recorded cases
of unsuccessful therapy. It took several
days or longer (in chronic cases) to see
results, and no side effects were noted. It
should be noted that the article is not
detailed, does not discuss the severity of
vertigo in these patients or the duration of
their vertigo or say if they were taking
other medications. See Herzberger, G.,
"Vertigoheel as Administered in Therapy
by Internists," Biological Therapy, Vol. 10,
No. 3, 1992, pages 272-274. A related
article is Zenner, S., et al., "The Therapy
of Vertigo with a Combination
Homeopathic Preparation," Biological
Therapy, Vol. 10, No. 3, 1992, pages 281-
288.

Non-technical publications recently
reported the following:

1. Easing Severe Morning Sickness --
Expectant mothers suffering from the
nausea, vomiting, and dizziness of severe
morning sickness may find relief in
vitamin B-6, according to a study at the
University of Iowa. A group of pregnant
women, half of whom took 25 milligrams
of vitamin B-6 every eight hours and half
of whom took a placebo, were studied.
After three days, the women treated with
B-6 had reduced symptoms, while the
placebo group had increased symptoms.

Scientists are still not certain what causes
morning sickness, but some believe it is
associated with elevated hormone levels.
The investigators believe vitamin B-6 may
be a cheap and effective treatment but
caution patients against taking large doses
on their own. See "Easing Severe Morning
Sickness," American Health, Sept. 1992,
page 86.

2. Olympic Vertigo -- Mary Ellen Clark, a
recent Olympic medalist diver, first
developed vertigo in 1988. The dizziness
began when her head was whipped back
hard during a dive. For months afterwards,
her balance was irregular, and she couldn't
always tell the difference between up and
down. Mary Ellen kept training, but it
wasn't easy. The vertigo started fading two
years ago. Since then she has reportedly
grown from an inconsistent diver with
"flashes of excellence" to a steady
performer. See Allen, Karen, "Clark Doing
Swimmingly After Overcoming Vertigo,"
U.S.A. Today, Monday, July 27, 1992, page
3E.

3. More on Ginger -- Prevention magazine
reported that English doctors recently
looked at ginger's ability to reduce the
nausea that afflicts 30 percent of people
who undergo anesthesia. Working with 60
patients who had gynecological surgery,
the doctors compared the results of ginger,
a placebo, and the standard drug,
metoclopramide. They found that ginger
was just as good as the drug, and they
suggest the possibility of giving ginger
before surgery to prevent nausea. In
addition, they found no side effects. See
Bricklin, Mark, "On the Spice Route,"
Prevention, July 1992, pages 31-32.

4. Chronic Dizziness -- Dr Dennis O'Leary,
director of the balance center of the
University of Southern California, has
developed a device that helps pinpoint
what part of the brain or inner ear is
affected with vertigo, according to a recent
tabloid news article. After the tests, the
balance center is able to devise an
exercise program that teaches the patient
to regain his or her balance. The article
includes an interview with Dr. James
Benecke, chief of otology and neurotology
at the St. Louis University School of
Medicine. He said that patients who
couldn't be helped with surgery or drugs
might be helped by specialized physical
therapy. The article, "Good News for
Millions Who Suffer from Chronic
Dizziness," appeared in a recent issue of
National Enquirer.

Author's Note: Please note that neither Dr.
Engel-Arieli or VEDA can recommend or
be responsible for an individual's reaction
to a particular treatment. These reviews
are not intended as a substitute for
professional health care by your own
physician.

_________________________


STORIES NEEDED

Only three people responded to our call
last quarter for personal written accounts
of coping successfully with vestibular
disorders. We need many more stories and
lists of coping strategies before we can
publish them under one cover and offer
them to VEDA members. Please write
your story today and send it to VEDA, PO
Box 4467, Portland, OR 97208-4467.

                                          _________________________


THANKS FOR STAMPS

Thanks to the VEDA members who have
included return postage with their requests
for materials. We spent about $10,000 on
postage and freight last year. Every 29-
cent stamp you send us helps reduce this
part of our operating expense.

THANK YOU

We thank all of the following for their
contributions to VEDA through Sept. 30:

Associates ($100 to $499): Dr. Jeffrey Kramer,
Wilmette, Ill.; Barbara Strongin, Sayreville, N.J.; Carol Kanter,
New York, N.Y.; Hearing Health Services, Alexandria, Va.;
Mary Ann Neumann, Knoxville, Tenn.

Contributors ($10 to $99):

ALASKA: Nancy Stivers, Patience Campbell, Susan Rodriguez,
Mary Martin.

ARKANSAS: Billie Reynolds, Bonnie Conner.

ARIZONA: Philip Welker, Louine Steffel, Marjorie Rolfe, Mr.
& Mrs. Keith Curtis, Gary Ehlenberger, Norma Raya, Debra
Farnsworth.

CALIFORNIA: Jerry Carter, Barbara Gore, Fred Meinzen,
Susan Atchley, Christa Sressenger, Dr. Donald Tormey, Ruth
Corson, Wanda Berke, Edward Wellman, Dorothy Fields, Carol
Springer, Jerome Spector, Vivian Hauck, Debbie Ritchey,
Russell Morrow, Mary Bushnell, Dorothy Blair, Laurence
McLaughlin, Julie Takeda, Christine Sullivan, Helen Thorington,
Vangie Calciano, Spencer Santage, Lois McCarty, John Pino,
Peggy Dunn, Elaine Kaufmann, Judy Hall, Mary Gugino, Mary
Walker, Karolyn Zebarth, Charles Kuhns, Hans Hartwig, Arvind
Saklikar, Charles Helm, Tali Barbosa, Ann Ulrich, Josephine
Hamlin, Shirley Leon, Karolyn Zebarth, Opal Tucker, Vee
Robinson.

COLORADO: Dana & Lou Switzer, Bernard Shahan, Lydia
Coulter, Kenneth Valis, Marilyn Girouard, Patty Haybach,
James Gliozzi, Bill & Jeanie Swartz, Sharon Brechtl, Paul &
Myrna Sunberg, Lois Jensen, Michael Derr.

CONNECTICUT: Lisa Knapp, Barbara Searles, Nancy Howie,
Mona Mehta, Laura Lane, Pamela Post.

DELAWARE: Luise Harris, Janice Traynor, Bernadine Lunski,
Rupert Davis, W.R. Richmond.

DISTRICT OF COLUMBIA: Allen Johnson, Richard Gambaro.

FLORIDA: Phyllis Pokorney, Delbert Gilleland, Lois Levinson,
Lillian Archer, Donna Clark, Judith Hudlow, Polly O'Neill, Dr.
Robert Percy, Nancy Schultz, Dr. Norman Foote, A.H. Duvall,
Patti Thompson, Linda Mason, Phyllis Hartzman, Tess Cole,
Norman Ahlswede, Pearl Handler, R.F. Lee, Wilfred Starr.

GEORGIA: Evelyn Thompson, Patrick May, Lula Chapin, Alice
Grantham, Sally Foster, Howard Lewis, James McCloskey.

HAWAII: Jeanette Ohigashi, Jane Parrish.
ILLINOIS: Chester Moculeski, Beverly Richmond, Sara Walters,
Nancy Behnke, Jim Gonzalez, Jack Merchant, Ruth Fullerton,
Teresa Campana, Richard Wasser, Valerie Hirschboeck, Howard
Beede, Jesse Irick, Darlene Carrier, Elsie Ryan, John
Blankenburg, Wanda Morales, Richard Wasser.

INDIANA: Grama Bhagavan, Lewis Richardson, Violet
Scribner, Ann Sagarsee, Harold Price, Robin Schultz, Walter
Smith, G.K. Bhagavan, Aletha Pettijohn.

IOWA: Mrs. William Clark, Jill Avery, Lloyd Shelangoski.

KANSAS: John Webb, Imogene McCosh, John Voss, Richard
Hawkins, John Peterson, Connie DeWeese, Jack & Shirley
Warner, Barbara Cosner, Phyllis Stroud.

KENTUCKY: Kenneth Cann, Mary Williams.

LOUISIANA: Gina Bush, Sidney Sandoz.

MAINE: Bonnie Hackett, William Truesdell.

MARYLAND: Mary Nelson, Lavern Riggs, Clara Kahler, Ruth
Ross, Elizabeth Garmatz, Celia Weinstein, Phyllis Zheutlin, John
Erskine, Mary Wilson, William Simpson, Nancy Roberts, John
Rosensteel, Ann Taylor, Vivian Hartenau.

MASSACHUSETTS: Ann Karnofsky, Mr. & Mrs. John
Kendrick, Vicky Slavin, Mary-Ellen Gagnon, Marion Coughlin,
Evelyn Manning, Elizabeth Hill, Bruno Carmen, William
Brackman, Beulah Morrison, Walter Wise Sr., Marguerite
Parker, Elizabeth Woodbridge, Betty Latner, Eunice Good,
Molly-Jane Isaacson Rubinger, Mary Ann Coyne, Michael
Kelleher, Jane Raymond, Christine Sheehy, Patricia Turke,
Constance Thayer, Judy Reiser, Marilyn Steele, Irene Atkinson,
Michael Impastato, Nancyann Brothers, Lisa Ginsburg,
Alexandra Pollard, Leona Moore, Martha Plotkin, Christine
Sheehy, Henrietta Guzzi, Margo Blake, Jane Walsh, Digital
Equipment Corporation.

MICHIGAN: Earl Zetterholm, Paul Dummer, Joni Rainbolt,
Joseph Bulone, Sheryl Stefanski, Marty Honaker, Fran Lewis,
Dorothy Houston, Angeline Grigorian, R.C. Stewart, Marie Key,
Bernadine Westcott, William Drake, Paul Olson, Katherine
Kerr, Steven & Karen Eisenberg, Evelyn Brown, Peter Ianni
Ph.D., Dana Fortinberry, Kenneth Aldrich, Doreen Wise-
Friedenberg, Patricia McCabe.

MINNESOTA: Peter Rech, Teresa Bischoff, Charles Olson,
Jane Trenary, Patricia Jensen.

MISSISSIPPI: Clement Coggin, Edith Welch.

MISSOURI: Janet Brown, Shirley Smith, Gary Sosnoff.

NEBRASKA: Paul Kreuscher.

NEVADA: Mary Brown, Rosemary Blakey, Lucille Mulder,
Alan Desmond.

NEW HAMPSHIRE: Norma Moore, Mr. and Mrs. Norman
Forand, Mary Brick, Ruth Ginsburg, Gioia Cattabriga, Rose
Matarazzo, Joan Desrosiers.

NEW JERSEY: Charles Rauschert, Theresa McAvoy, Patrice
McDermott, Winnie Wright, Dr. Alex Hochheiser, Marjorie
Bartlett, Anthony Celentano, Mr. & Mrs. John Boese, Dr. Joel
Lehrer, Doyle Smith, Emma Trombly, Mary Burkman, Gail
Greenbaum, Barbara Strongin, Susan Fryer.

NEW MEXICO: Bette Richards, Lucy Foreman, C.D.
Lundergan, Mildred Althaus.

NEW YORK: Jean Maffucci, Doreit Bialer, Istvan Deak, Betty
Potash, Shirley Weiss, Roscha Folger, Mary Corrado, Francis
Tomik, Jean Giglio, Jessie Cicchelli, Naomi Lederer, Jean
Vincent, Abraham Berkowitz, Leon Quat, Robert Marsin, Janet
Wisner, Michael Thomas, Donna Troisi, Mr. & Mrs. George
Holzmann, Carol Lee Taylor, Rita Demers, Barton Sholod,
Barbara Adler, Margaret Wood, Maria Parlato, Jeremiah Daly,
Elsa Ennis, Michael Kaplan, Nancy Mesh, John Herring Jr.,
Lydia Chang, Albert Allard, Dr. Daniel Cohen, Nancy Mahler,
Carola Michael, Sherwin Cerini, Michael Thompson, Ann
Atwell, Jonah Schwartz, Joseph Haydasz, Fayette Valone, Janis
Rosenbaum, Shirley Weiss, Sheila Bernard, Edwin Haines, Jean
Krill, Mr. & Mrs. Peter Lofrumento, Marvin Osias.

NORTH CAROLINA: Mrs. M.F. Kremer, Sigrid Lowman, Mary
Zamecki, Elizabeth Keating, Linda Marker.

NORTH DAKOTA: Candace Ripplinger.

OHIO: George Tyler, John Brush, Jeanne Griffin, Maria Will,
Linda Currie, Donna Simon, Greta Riebe, Thomas Hogle, Betty
Willson, Elizabeth Rayner, Sharon Burnbrier, Wende Graves,
Lee Colley-Brown, R. Thomas Heusser, John Phillips, George
Pridemore.

OKLAHOMA: Gene Halverson.

OREGON: Karen Swezey, Mr. & Mrs. Elmer Griser, Pat
Waalkes, Catherine Nicewood, Jackie Pollack, Ida Barbeau,
Grieke Moran, Shirley Dejong, Connie Pilcher, Dawn Hanson,
Margaret Hudson, Betty Sheets.

PENNSYLVANIA: Wendy Schoenewald, Doris Africa, Carol
Swales, Sara Casoy, Frances Padwa, Dr. J. Martino, Barbara
Chant, Dr. R.R. Pottash, John Kowalski, Dorothy Yarnell, Jerri
Thompson, Antoinette McLain, Janet Slifkin, David Showers,
Neil Hopkins, Lorraine Wescott, Valarie Giambrone.

RHODE ISLAND: Louise Bottone, Ann Oller & Ann Loffredo,
Edward Carosi.

SOUTH CAROLINA: Barbara Auvenshine.

SOUTH DAKOTA: Dolores Shanks.

TENNESSEE: Dorothy Lundquist.

TEXAS: Stayton Bonner, Gail Sachson, Helen Barr, Joanne
Smith, Sarah Chalk, Gale Robertson, Amy Cooper, Helen
Ewing, Dr. Mark Winter, Sherman Warner, June Anderson.

VERMONT: Mildred Drown, Karen Towslee.

VIRGINIA: Lola Engleman, Maurizio Melegari, June Battaile,
Donna Mayer, Willis Boone, Elizabeth David, Kathy Cardinal,
Richard Bloomfield, Jeanne Webb.

WASHINGTON: Lizanne Schader, The Richard Williams
family, Dr. Arthur Rudd, Gail Roberton, Mary Bartell, Linda
Williams, Wendy Runnels, Ardath Peterson, Eloise Heald,
Vickie Ernst, Marvin Carmichael, Bob Ledbetter.

WISCONSIN: LaVerna Berton, Ellen Ellefson, Pat Grinnell,
Linda Keller, Pat Prissel, Cathy Westover.

WYOMING: Edna Johnson.

BERMUDA: Patricia Smith.

CANADA: Anne Marie McDonald, Mary Johnston, Kellie Van
Solkema, Sheila Gurevitch, Tanis Doe, William Tapp, Carla
Krens.

                                          _________________________

QUESTIONS?

If you have questions for Dr. Susan Engel-
Arieli for possible inclusion in her
"Questions and Answers" column, please
address them to her at P.O. Box 171, Park
Ridge, IL 60068.




VEDA ELECTIONS,
ANNUAL MEETING,
AMENDED BYLAWS

VEDA election procedures are simpler
this year thanks to a ruling by the board
of directors at its quarterly meeting in
September.

The board amended the VEDA bylaws to
move the VEDA annual meeting date
from April to the second Wednesday in
June. In addition, the board approved a
simpler schedule for members to file
nominations, to receive ballots, and to
vote and return their ballots. Nominations
will be accepted throughout January and
February. Ballots will be mailed to
members no later than March 31 and must
be returned to VEDA by May 15. Results
will be announced in June at the annual
meeting.

In the past, the VEDA staff mailed
nomination forms to members. This year,
we have printed the nomination form in
this newsletter. It's simpler than last year's
form in that it must be signed by only two
people, the nominator and the nominee,
instead of five. If you want to nominate
more than one person, you may duplicate
the nomination form. It is perfectly
acceptable to nominate yourself. Mail
completed nomination forms to us so that
we receive them anytime in January or
February.

In the spring of 1992, VEDA members
elected the following people to the VEDA
board of directors through 1994: Cari
Bennett, the current board secretary;
Susan Engel-Arieli; Dotti Gray; Joanne
Huston; Charlotte L. Shupert, the
president, and Mary Ann Watson, the
treasurer. These six join six others whose
terms run through April 1993. They are
Rick Braithwaite, the vice president; John
Niemitz; Ted Norton; Virginia Strauss;
June Underwood, and George Zarzana.
Dr. Engel-Arieli is from Illinois; Ms.
Strauss is from Massachusetts; the other
10 are from Oregon.

At its September
meeting, the board
also added a
nondiscrimination
policy to the
VEDA bylaws.
VEDA had
already been
following the
policy in practice
but wanted to
declare it formally.
The policy reads,
"The Vestibular
Disorders
Association shall
not discriminate in
its staff, board,
volunteer
committees, or
recipients of
services on the
basis of a person's race, religion, sex,
sexual orientation, age, national origin,
ancestry, veteran status, or mental or
physical disability."

In December, the board will discuss the
1993 budget, board development, brochure
redesign, and personnel policies.


                            NOMINATION FORM

Nominations are open for election of VEDA board members for two-year terms starting in
June. To nominate someone, use the form below or an identical copy. Send completed forms
to us postmarked no later than the last day of February. You may nominate any VEDA
members, including yourself. Your nominees must verify in writing their willingness to serve.

Prospective board members should be willing to commit up to three hours per quarter for
regular board meetings and from five to 10 additional hours per month for related activities
during the term June 1993 through June 1995.

Retiring board members who can be nominated for re-election are John Niemitz, Theadore
Norton, Virginia Strauss, June Underwood, and Rick Braithwaite.

Board members serving until 1994 are Cari Bennett, Susan L. Engel-Arieli, M.D., Dotti
Gray, Joanne Huston, Charlotte L. Shupert, Ph.D., and Mary Ann Watson.

Completed forms should be mailed to: Secretary, VEDA, P.O. Box 4467, Portland, OR
97208-4467.

I wish to nominate the following to serve as a member of the VEDA Board of Directors for
the period June 1993 through June 1995.

Nominee                                         Phone (         )

Address

City                                                              State             Zip

Your signature                                                           Date


STATEMENT BY NOMINEE

I verify that if elected I am willing and able to serve as a director of VEDA for the term
June 1993 to June 1995 and that I am a member in good standing.

(Please use the space below to summarize your interest in VEDA and the skills you would
bring to the board).



Signature of nominee                                                   Date