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