Dissertationen zum Thema „Vision of life“

Hildegard von Bingen, a visionary abbess living in the tumultuous 12th century, recorded and interpreted three very powerful visions pertaining to Christianity. This dissertation is limited to the first image of Hildegard’s last vision called De Operatione Dei, the Works of God, a cosmological vision about creation. Hildegard named this image On the Origin of Life.

The thesis of this dissertation suggests the four main characters in the first image of Hildegard’s cosmological vision—the two-headed and four-winged red figure named Caritas standing on the serpent-wrapped monster—correspond to the four stages of Jung’s individuation—encounter with the shadow (serpent), encounter with the soulimage (monster as Adam), encounter with the god-image (Caritas), emergence of the Self (godhead). Each of these characters and stages represent a level in what has been called by perennial philosophy the Great Chain of Being. Hildegard’s vision represents the unfolding of Spirit into matter. Jung’s individuation process describes the soul’s journey back towards Spirit.

This work starts by introducing the vision and Hildegard’s interpretation. Next it moves to what other authors have written. Since the vision is about creation the interpretation starts with the literalists’ view of Genesis and moves to the mystical interpretations of Genesis. Other creation stories including a serpent and a goddess amplify the interpretation. Then, using Jungian and alchemical symbols the images of this iv vision are further elaborated. The research follows the logic of the axiom of Maria, from the uroboros, to the hermaphrodite, to the trinity and ending with the marriage quaternio—two pairs of hermaphrodites. Byington’s symbolic elaboration process is used to interpret the dramatic action of the vision thereby bringing the vision back to life as Hildegard might have experienced it. Finally, the parallel between Hildegard’s vision and Jung’s individuation process is explained in detail. The work ends with Hildegard’s interpretation of why god created the world showing how it aligns with the goal of individuation, and how both are critical for the life of the soul in the 21^st century.

This work is based upon fieldwork carried out among indigenous Pehuenche people living in the Andes in Southern Chile. It is an ethnographic investigation of the relations between Pehuenche vision and healing practices in different local settings. The first part of this thesis focuses on Pehuenche vision from a cosmo-political angle. In order to set the scene for my overall argument, I explore the constitutive relation between mutual vision among real people (Ch. che) and the emergence of the Pehuenche person, which I call the ‘dynamic personal composition.’ With mutual vision between people being a precondition for the emergence of social relations, I examine the experience of particular witchcraft actions in which mutual vision is not possible. This leads to the conceptualization of ‘unilateral vision’ as a key phenomenon associated with the emergence of illnesses and the alteration of the shared plane of Pehuenche visibility. I also explore how mutual vision can be restored only through the assemblage of particular visual capacities known in the vernacular as ‘the gift of vision.’ In the second part of the thesis, I analyze the ways in which public health services respond to particular illnesses not detectable or treatable by medical technicians. In particular, I focus on the implications of ‘the visualization of traditional healers,’ inherent in the State’s approach to intercultural health. Through the examination of both particular intercultural health projects, as well as local expressions of discontent and animosity towards the State, this thesis seeks to create awareness about the ontological relevance of mutual vision in relations among real people. By pointing out the equivocal understandings of the visible and the invisible domains within intercultural relations, the analysis as a whole seeks to explain why Pehuenche vision must be understood through ontological examination rather than through a multicultural approach.

A child's health-related quality of life (HRQOL) is a multidimensional, subjective construct that is perceived as a result of the impact that a condition has on the child's physical, emotional, social, and cognitive functioning (WHO, 1995). This study measured HRQOL for a culturally diverse sample of children with cleft lip and/or palate to include parent proxy reports and child self reports. A descriptive quantitative design was utilized. One hundred subjects participated in the study, including 62 parents and 38 children who completed the PedsQL instrument. Results revealed that parents of children with an oral cleft rated their children's Physical Health higher than a normative sample of parents of healthy children which was an unexpected finding. Otherwise, parents of children with an oral cleft and the children themselves rated their Emotional Functioning, Social Functioning, School Functioning, overall Psychosocial Functioning, and Total HRQOL lower than healthy children and higher than children with a chronic condition. Parent-child concordance was quite low in all domains with the highest correlation being only .20 on the Emotional Functioning scale. Demographic variables, speech impairment, and hearing severity did not affect HRQOL scores. Wearing a hearing aid had a significant affect on School Functioning according to the parent's perspective. Overall, the PedsQL was found to be an effective and quick measure of HRQOL for children with an oral cleft that could be utilized during the multidisciplinary cleft clinic to identify children who are at-risk for impaired HRQOL. Since parent-child agreement was low, children should be given every opportunity to rate their own HRQOL. Once individual concerns have been identified, health care providers can then implement care and treatment to maximize the child's satisfaction with health and well-being.

Thesis (M.L.S.)--University of Toledo, 2009.
Typescript. "Submitted as partial fulfillment of the requirements for The Master of Liberal Studies." "A thesis titled"--at head of title. Bibliography: leaves 92-99.

Computer vision is becoming a ubiquitous technology in many industries on account of its speed, accuracy, and long-term cost efficacy. The ability of a computer vision system to quickly and efficiently make quality decisions has made computer vision a popular technology on inspection lines. However, few companies in the agriculture industry use computer vision because of the non-uniformity of sellable produce. The small number of agriculture companies that do utilize computer vision use it to extract features for size sorting or for a binary grading system: if the piece of fruit has a certain color, certain shape, and certain size, then it passes and is sold. If any of the above criteria are not met, then the fruit is discarded. This is a highly wasteful and relatively subjective process. This thesis proposes a process to undergo to use computer vision techniques to extract features of fruit and build a model to predict shelf-life based on the extracted features. Fundamentally, the existing agricultural processes that do use computer vision base their distribution decisions on current produce characteristics. The process proposed in this thesis uses current characteristics to predict future characteristics, which leads to more informed distribution decisions. By modeling future characteristics, the process proposed will allow fruit characterized as “unfit to sell” by existing standards to still be utilized (i.e. if the fruit is too ripe to ship across the country, it can still be sold locally) which decreases food waste and increases profit. The process described also removes the subjectivity present in current fruit grading systems. Further, better informed distribution decisions will save money in storage costs and excess inventory. The proposed process consists of discrete steps to follow. The first step is to choose a fruit of interest to model. Then, the first of two experiments is performed. Sugar content of a large sample of fruit are destructively measured (using a refractometer) to correlate sugar content to a color range. This step is necessary to determine the end-point of data collection because stages of ripeness are fundamentally subjective. The literature is consulted to determine “ripe” sugar content of the fruit and the first experiment is undertaken to correlate a color range that corresponds to the “ripe” sugar content. This feature range serves as the end-point of the second experiment. The second experiment is large-scale data collection of the fruit of interest, with features being recorded every day, until the fruit reaches end-of-life as determined by the first experiment. Then, computer vision is used to perform feature extraction and features are recorded over each sample fruit’s lifetime. The recorded data is then analyzed with regression and other techniques to build a model of the fruit’s shelf-life. The model is finally validated. This thesis uses bananas as a proof of concept of the proposed process.

Background: Childhood obesity is epidemic, and Hispanic children bear a particularly high health burden because of it. Evidence suggests that obesity prevention is a better option than intervention. Because schools have decreased the amount of time spent in physical education classes, leisure time has become the time to engage in physical activity, which may prevent obesity. Social ecology theory posits that a person’s interaction with the environment has a strong influence on health promoting behavior. Further, this theory suggests that cultural values also play a role. The extant literature points to the sedentary nature of Hispanic children. However, it does not provide a description of the activities that children engage in during their leisure time, or how they are influenced by their family, culture, and community’s environment. Purpose: The purpose of this study was to describe and provide an understanding of how leisure time is viewed by Hispanic families, and how family and culture influences Hispanic children’s participation in leisure time activity. Two broad research questions were addressed: 1) How do Hispanic families describe leisure time activities? and 2) How do culture, family and the community environment influence a Hispanic child’s participation in leisure time activities? Methods: This ethnographic study incorporated photographs taken by English-speaking Hispanic mothers of children between 6 and 10 years old (n=10) as they engaged in leisure activities for one week. The participants engaged in photo-elicited interviews, describing the children’s activities and performed initial data analysis by sorting the photos in the categories of activities. Findings: Girls were more sedentary, engaging in intellectually stimulating and creative play activities inside, with family members or alone. Boys were more active, engaging in unstructured play activities outside with family members or friends. The children engaged in these activities to promote their health, prepare for their adult lives, and for fun. Cultural tensions experienced by the children’s parents had a profound influence on their leisure time choices and decisions. Activities were used to prepare the children for a better life, and to teach them to balance work and fun. Ultimately, the participants wanted their children to live a balanced life; one that is happy, healthy, and successful. Relevance: The children engaged in purposefully planned leisure activities aimed to ensure their health, happiness, and success in the U.S. The participants acknowledged that to achieve a better life, the children must become expert multicultural navigators. While many of the activities were sedentary, they had important implications for the children’s future. Health care providers must consider how patients view leisure time, and enlist their ideas in order to make children’s activities more physically active.

This PhD examines the life and work of a remarkable woman – a mother, lover, artist, friend, daughter and sister who did not follow the rules of any establishment and liver her life as she saw fit. Vanessa Bell was a woman who broke the rules but remained almost entirely transfixed by a world dominated by domesticity.  As this PhD will show, radical choices, innovative art, and intellectual stimulation can co-exist with the domestic world and in a person devoted to domesticity. This PhD questions what it means to be a feminist and an avant-garde artist in the early 20^th century. It questions how art history has treated the roles available to women and to the space they occupied. For Bell, art was not a way to live vicariously in other worlds; it was always a reflection of her world and her reality interpreted through her kaleidoscopic vision. For a painter interested in modern artistic movements, limiting one’s scope to the home would have seemed a defeat of one’s ideals since it was not in the home that most avant-garde artists saw modern life taking place. Yet it was the home and domestic life from which Bell drew inspiration and where she saw modern life taking place. This PhD examines Vanessa Bell’s relationship to domesticity in four sections. The first discusses her work in the decorative arts and its influence on her work in the fine arts. The second deals with how marriage both limited and opened up a new world to her, a world in which she would learn to develop human relationships within her own standards. The third concerns the importance she placed on being a mother and the ways that maternity impacted upon her painting. But also important is how her roles as wife, sister, lover and friend also influenced her work. And the final section discusses how she manipulated and depicted domestic space in her art.

Fluorescence microscopy is an essential tool in biomedical sciences that allows specific molecules to be visualized in the complex and crowded environment of cells. The continuous introduction of new imaging techniques makes microscopes more powerful and versatile, but there is more than meets the eye. In addition to develop- ing new methods, we can work towards getting the most out of existing data and technologies. By harnessing unused potential, this work aims to increase the richness, reliability, and power of fluorescence microscopy data in three key ways: through standardization, evaluation and innovation. A universal standard makes it easier to assess, compare and analyze imaging data – from the level of a single laboratory to the broader life sciences community. We propose a data-standard for fluorescence microscopy that can increase the confidence in experimental results, facilitate the exchange of data, and maximize compatibility with current and future data analysis techniques. Cutting-edge imaging technologies often rely on sophisticated hardware and multi-layered algorithms for reconstruction and analysis. Consequently, the trustworthiness of new methods can be difficult to assess. To evaluate the reliability and limitations of complex methods, quantitative analyses – such as the one present here for the 3D SPEED method – are paramount. The limited resolution of optical microscopes prevents direct observation of macro- molecules like DNA and RNA. We present a multi-color, achromatic, cryogenic fluorescence microscope that has the potential to produce multi-color images with sub-nanometer precision. This innovation would move fluorescence imaging beyond the limitations of optics and into the world of molecular resolution.

This thesis presents novel solutions for two fundamental problems associated with autonomous road driving. The first is accurate and persistent localisation and the second is automatic extrinsic sensor calibration. We start by describing a stereo Visual Odometry (VO) system, which forms the basis of later chapters. This sparse approach to ego-motion estimation leverages the efficacy and speed of the BRIEF descriptor to measure frame-to-frame correspondences and infer subsequent motion. The system is able to output locally metric trajectory estimates as demonstrated on many kilometres of data. We then present a robust vision only localisation system based on a two-stage approach. Firstly we gather a representative survey in ideal weather and lighting conditions. We then leverage locally accurate VO trajectories to synthesise a high resolution orthographic image strip of the road surface. This road image provides a highly descriptive and stable template against which to match subsequent traversals. During the second phase, localisation, we use the VO to provide high frequency pose updates, but correct for the drift inherent in all locally derived pose estimates with low frequency updates from a dense image matching technique. Here a live image stream is registered against synthesised views of the road image generated form the survey. We use an information theoretic measure, Mutual Information, to determine the alignment of live images and synthesised views. Using this measure we are able to successfully localise subsequent traversals of surveyed routes under even the most intense lighting changes expected in outdoor applications. We demonstrate our system localising in multiple environments with accuracy commensurate to that of an Inertial Navigation System. Finally we present a technique for automatically determining the extrinsic calibration between a camera and Light Detection And Ranging (LIDAR) sensor in natural scenes. Rather than requiring a stationary platform as with prior art, we actually exploit platform motion allowing us to aggregate data and adopt a retrospective approach to calibration. Coupled with accurate timing this retrospective approach allows for sensors with non-overlapping fields of view to be calibrated as long as at some point the observed workspaces overlap. We then show how we can improve the accuracy of our calibration estimates by treating each single shot estimate as a noisy measurement and fusing them together using a recursive Bayes filter. We evaluate the calibration algorithm in multiple environments and demonstrate millimetre precision in translation and deci-degrees in rotation.

Many individuals with impaired vision experience a decreased quality of life. Quality of life is defined as "the degree to which an individual enjoys the important possibilities of their life. " Vision rehabilitation outcomes primarily focus on the functional impacts of interventions, with less attention being paid to any associated psychosocial impacts. This study examines the relationship between measures of visual function status and psychosocial status in individuals acquiring low vision assistive devices for the first time. One hundred and twenty subjects were evaluated after purchasing their first low vision device from a University-based low vision clinic. The measures used were the National Eye Institute Visual Function Questionnaire (NEI-VFQ 25) and the Psychosocial Impact of Assistive Devices Scales (PIADS). The NEI-VFQ 25 measures the status of visual function, while PIADS is a device impact measure, which explores the psychosocial impact of devices on three domains: competence, adaptability, and self-esteem. This study determines the strength of association between these two measures at initial and follow-up administrations, and between each subsequent measure as a result of the time interval between administrations, in addition to assessing whether or not a change in stability for the measures occurred over time. Modest strengths of associations were anticipated and the short time interval was not expected to be a factor in change in stability of the measures. The expectation was that subjective reports of functional changes should have a moderate correlation with psychosocial impact.

Thesis advisor: Melissa M. Kelley
Thesis advisor: Lisa Sowle Cahill
Thesis (STL) — Boston College, 2016
Submitted to: Boston College. School of Theology and Ministry
Discipline: Sacred Theology

Quality of life (QoL) questionnaires have been suggested as the most appropriate way to measure the effectiveness of low vision rehabilitation. However, several research studies have not been able to detect differences in effectiveness between rehabilitation strategies. The hypothesis of this study is that there are other factors, unrelated to vision, influencing the scores obtained in these questionnaires and masking the changes achieved by rehabilitation. The suggestion is that patients' realistic acceptance of, and successful adaptation to, their visual loss is influenced by psychosocial factors such as; personality, religious beliefs, social support, general health (i.e. mental and physical), understanding of their eye condition, level of education, and financial status. Concurrently, a parallel study was conducted with children. As with the adult arm, the aim of the study was to understand whether quality of life, and social behaviour and relationships in children with a visual impairment were related to the vision loss, vision rehabilitation, or non-visual factors. Patients attending the Manchester Royal Eye Hospital low vision clinic between May 2009 and August 2010, were recruited: 448 patients between 18 and 96 years old, with best-corrected binocular visual acuity smaller or equal to6/18, and 62 children between 5 and 16 years old. Telephone delivery of previously validated questionnaires was used with adult patients and parents of child patients; face-to-face interviews were completed by children. Both studies showed how psychosocial factors were stronger determinants of quality of life in people with low vision, than traditional low vision rehabilitation using optical aids. In the case of adults, physical and mental health appeared to be major predictors of quality of life, adaptation to the vision loss and participation restriction. In the case of children, visual acuity at distance and near, contrast sensitivity (CS), age, and parents' coping strategies appeared to determine quality of life and children behaviours. The final element of this work was a pilot study to attempt to address issues causing poor quality of life. Seventy-one participants who scored low in the Low Vision Quality of Life Questionnaire (LVQOL-25) (i.e. below 62.5) were given the opportunity to enrol for the Expert Patient Programme, which is a self-management programme aimed at adults with chronic health problems or disabilities. Only 2 participants expressed an interest in the programme, and none of them actually took part.

Myopia is a serious health problem that has reached epidemic levels in Asian cities such as Taiwan, South Korea, and Singapore. However, there is a lack of cross-sectional and longitudinal data on refractive error and ocular biometry in young adults, especially in Singapore. Despite the high prevalence of myopia in Singapore, vision-related quality of life (VRQOL) is also inadequately examined. This longitudinal study sets out to examine the refraction, ocular biometry and VRQOL over a 24-month period. Participants were recruited from the student pool of a tertiary education institution. Subjective refraction, ocular biometry, and accommodative response measurements were performed for participants. The NEI-RQL-42 questionnaire and a bespoke questionnaire were completed by participants. Out of 99 participants (age range 16 to 22 year) at the baseline visit, 86.8 % were myopic. The age of initial refractive correction was significantly associated with refractive error, while near work, sports activities, outdoor activities, accommodative responses, and primary school leaving examinations were not. Among the 88 participants who completed the 24 month visit, the percentage of myopes remained stable, with no increase in myopia. Ocular biometric parameters also remained stable, with only a non-clinically significant increase of 0.02mm in axial length. Non-Myopes exhibited the highest VRQOL, while Mod/High-Myopes had the lowest VRQOL. Myopia and contact lens wear were found to be the main contributors towards poorer VRQOL. VRQOL remained stable over the 24 month period, with the exception that moderate and high myopes exhibited an improvement in VRQOL on their dependence of correction. In conclusion, this study presented novel findings on stable refraction and ocular biometry in Singapore young adults over a 24 month period, which was contrary to previous findings on university students. In addition, VRQOL remained unchanged over a 24 month period, where myopia and contact lens wear were found to cause poorer VRQOL in participants.

Low vision impacts on Quality of Life (QoL). Thus, low vision services are essential to enhance the QoL of people with functional low vision. However, of the estimated 70 out of the 124 million people with low vision who require services, approximately 5-10% has access to services. The demands for low vision services will continue to grow due to the emerging global trends in ageing populations and changes in the epidemiology of vision impairment. While critical data and information are available for other forms of vision impairment, there is a paucity of information on the distribution, needs, and priorities for improving low vision service delivery at the national, regional, and global levels.
This thesis addressed the problem by first developing and distributing a survey to Vision 2020 contacts, government, and non government organisations in 195 countries during 2006-2008 to assess the current situation of low vision services globally. The survey was first pilot tested leading to improvements in the length, layout, and content of its form. Specifically, the survey topics included: epidemiology, policies, human resources, service provision, barriers, equipment, and monitoring and evaluation.
The Classification Analysis and Regression Tree (CART), logistic regression methodology and grounded theory analysis were used to present the findings and identify the critical success factors of low vision service coverage. The qualitative component consisted of case studies in three countries (India, Ghana, and Cameroon) during November 2007 and 2008. A total of 101 interviews were carried out. The case studies provided an overview and historical perspective of services, effectiveness, cost, efficiency, acceptability, access, equity, sustainability, and ideal situations as recommended by interviewees. Qualitative findings from the case studies were produced with the assistance of the NVivo software.
The primary results are that the majority (80%) of countries have poor (≤10%) coverage. Key issues pertinent to the current situation of service coverage are: human resources (number and combination of disciplines), funding (sustainability and arrangements), type of services provided (comprehensive and multidisciplinary) and its locations (NGOs or government facilities), and the sociodemographic and economic barriers (costs, awareness, and rural areas) to accessing services.
The critical success factors found in this research are represented by the ‘FRAME’: Funding (sustainable source, public and private mix), Rehabilitation workers (e.g., adequate numbers of multidisciplinary personnel), Access to low vision devices, Multidisciplinary services; and External contextual influences in which low vision services operate in. The case studies identified seven major themes that further build on the FRAME: sustainability, governance, advocacy, human resources, access, awareness, and service delivery.
The conclusion of the thesis is that a global picture of the current situation of low vision services was acquired and it is now known which countries have poor (≤10%) and better (>10%) coverage. It also found the critical success factors that will assist the WHO Low Vision Working Group and Vision 2020 to improve the current models of service delivery, future planning, training curriculum development, and priorities setting. Specifically, these need to be achieved through three areas of action: human resources development, sustainability, and advocacy.

Background: Age-related macular degeneration (ARMD) is a major cause of irreversible visual loss in the elderly and a significant threat to their quality of life. Although low vision services often improve the functional outcomes of individuals with macular disease, it remains unclear whether or not they have any impact on quality of life. The principal aim of this study was to determine the effect of a hospital-based low vision clinic on the quality of life of individuals with ARMD. Methods: Forty patients with ARMD attended the low vision clinic at Milton Keynes University Hospital. Quality of life was measured with the vision-specific Low Vision Quality of Life (LVQOL) questionnaire and the general health EuroQol (EQ-5D-5L) questionnaire. Measures were completed at baseline (time zero, T0), and at three- (T3) and six-month (T6) follow-up visits. Results: The near visual acuity of individuals attending the low vision clinic for the first time improved significantly between visits T0 and T3 (p=0.005), reflecting the practiced use of their newly-dispensed low vision aids. As expected, there was no significant change in near acuity over this time period for existing patients. For both new and existing patients, a significant increase in LVQOL score was evident between visits T0 and T3, with a further significant improvement between T3 and T6. Similarly, there was a significant decrease in EQ-5D-5L questionnaire scores between visits T0 and T6. Conclusions: The higher LVQOL scores obtained at the end of the study period (T6) provide evidence that low vision services at Milton Keynes University Hospital served to improve patient quality of life. The reduction in EQ-5D-5L scores over the same time period suggests that low vision services also provide for an improvement in general health-related quality of life. Impact: The findings support the cause of low vision services to improve not only the vision and functional outcomes of individuals with macular disease but also their quality of life. Moreover, the findings suggest that a more efficient allocation of resources at low vision clinics may be possible through the standardisation of patient follow-up frequency.

People aged 65 and older account for 12.8% of the population and for 30% of all visually impaired individuals. Age-related Macular Degeneration (ARMD) has been identified as a significant public health issue, with a potential 8 million Americans at risk. While the literature supports a connection between LOC and adaptation to ARMD, there is a gap in the current literature supporting this relationship even when other factors are controlled (i.e. age, sex, education, type of ARMD, when diagnosed, the use of medical treatments, the use of visual assistance devices, participant engagement in rehabilitation, and depression). The present survey study used hierarchical regression to examine the relationship between LOC and adjustment to ARMD while controlling for these factors. A sample of 75 adults aged 60 and older diagnosed with ARMD for at least 6 months completed the Multidimensional Health Locus of Control Scale-Form C (MHLC), the Adaptation to Age-Related Vision Loss Scale (AVL) and the Geriatric Depression Scale-Short Form (GDS). LOC accounted for 30% of the variance in adjustment beyond what was explained by the control variables, with higher internal LOC being associated with greater adaptation to loss. The present results add to the existing literature and enhance social change initiatives by guiding the development of interventions to mitigate the difficulties experienced by people with ARMD, reduce their dependency on others, and improve their ability to maintain their quality of life.

Dizziness is a common, multifactorial problem that causes reductions in quality of life and is a major risk factor for falls, but the role of vision is a very under-researched area. This study aimed to investigate any link between dizziness and vision and to establish if changes in spectacle lens correction could elicit dizziness symptoms. A link between dizziness and self-reported poor vision was indicated in the epidemiological literature as shown by a systematic review, provided lightheadedness was not included in the definition of dizziness. Cases of individuals who reported vision-related dizziness were investigated to determine potential areas of research for this thesis and subsequently two studies investigated the effects of refractive correction changes on dizziness status. The first study was limited by logistical problems, although it highlighted limitations in the short form of the Dizziness Handicap Inventory that was used to quantify dizziness. Results of an optometry practice recheck study found that oblique cylindrical changes were significantly more likely to be associated with dizziness symptoms than other spectacle lens changes. It also highlighted that optometrists do not ask/record about dizziness symptoms with only 4% of records including “dizziness” as a problem when 38% of patients reported dizziness symptoms when directly asked. All studies highlighted a need for a patient-reported outcome measure to be designed to assess vision-related dizziness. Literature review, interviews with experts and patients and focus groups led to the development of a pilot questionnaire and subsequently a 25-item Vision-Related Dizziness instrument, the VRD-25. This was validated using responses from 223 respondents, with 79 participants completing the questionnaire a second time to provide test-retest data. Two subscales of VRD-12-frequency (VRD-12f) and VRD-13-severity (VRD-13s) were shown to be unidimensional and had good psychometric properties, convergent validity and test-retest repeatability. The VRD-25 is the only patient-reported outcome measure developed to date to assess vision related dizziness and will hopefully provide the platform to further grow this under-researched area that seems likely to provide important clinical information.
College of Optometrists sponsored the research with a Postgraduate Research Scholarship

The number of individuals facing vision loss as adults is increasing, and the need for these adults to have access to training and skills to aid in their adjustment process is prevalent. Guided by the tenets of connectivism, this phenomenological study examined current trends in social networking and the possibilities that are available to adults adjusting to low vision by using technology as a means for continued learning, social interaction, and professional connections. The main research question focused on the participants' perception of the adjustment process and their ability to learn and use technology. Data were collected through semi-structured interviews of 10 adults who had low vision and had attended some form of intervention. The experiences were recorded through the use of reflection that included memoing and inductive coding where themes emerged during the field process. NVivo software was utilized to clarify and present details about themes and patterns presented during the interview discussions. These themes detailed the participants' feelings of confidence and self expressed level of skills needed to use technology; the barriers to using technology, such as cost and time; and benefits of staying connected with technology. The findings from this study suggested that the ability to stay connected and to access information outweighed the barriers, although the participants expressed frustration with technological issues. The study contributed to an area of research that supports the benefits of continued training for adults adjusting to low vision. A process of training could be implemented that would involve general technology as well as assistive technology assisting individuals with continued success in their daily lives.

My ultimate goal in writing this thesis is to define the uniqueness of Zhang Ailing's vision of life, based on specific meanings detected in the formal aspects of her fiction, and to assess Zhang's artistry in the context of Chinese literature. I proceed, first, by analyzing the reciprocal relationship of form and meaning in Zhang Ailing's short stories. The formal aspects of Zhang's works reveal meaningful details about the oppressive situations of her female characters. The way they each respond to their situations differs by their aggressive or submissive characters, and conformist, independent or rebellious thoughts. Their antiromantic attitude characteristically reflects the author's vision of life. Zhang's thoughts and emotions which constitute this vision of life will be inferred, next, from details related to her female characterization, but also beyond these confines. It is interesting to peel off Zhang's reputation of being a stern, emotionless writer and perceive underneath it her psychological and moral preoccupations, and underlying emotions. Conversely, I will elicit the influence of Zhang's vision of life on her aesthetic expression. Finally, Zhang's originality and talent can only be assessed accurately in light of the traditional and modern Chinese literary background. Continuities can be established regarding her female topics and characterization; but a stronger feminine consciousness is discovered in Zhang's works. The traditional Chinese lyrical expression is creatively dissimulated behind her symbolic use of environment and impressionistic description of people. Zhang's mastery of the unity of form and content, her vivid style and use of cinematic techniques in literature greatly enhance her artistry.
Arts, Faculty of
Asian Studies, Department of
Graduate

L'expression faciale de peur constitue un important vecteur d'information sociale mais aussi environnementale. En condition naturelle, les visages apeurés apparaissent principalement dans notre champ visuel périphérique. Cependant, les mécanismes cérébraux qui sous-tendent la perception de l'expression faciale de peur en périphérie restent largement méconnus. Nous avons démontré, grâce à des études comportementales, des enregistrements magnétoencéphalographiques et intracrâniens, que la perception de l'expression faciale de peur est efficace en grande périphérie. La perception de la peur en périphérie génère une réponse rapide de l'amygdale et du cortex frontal, mais également une réponse plus tardive dans les aires visuelles occipitales et temporales ventrales. Le contrôle attentionnel est capable d'inhiber la réponse précoce à l'expression de peur, mais également d'augmenter les activités postérieures plus tardives liées à la perception des visages. Nos résultats montrent non seulement que les réseaux impliqués dans la perception de la peur sont adaptés à la vision périphérique, mais ils mettent également en avant une nouvelle forme d'investigation des mécanismes de traitement de l'expression faciale, pouvant conduire à une meilleure compréhension des mécanismes de traitement des messages sociaux dans des situations plus écologiques.

This phenomenological study examines the work–life balance of Nigerian women leaders who are instrumental in visioning and shaping the future of Nigeria’s public education. The research delves into the past, present, and future of Nigerian public education based on the perception and life course of key Nigerian women educational leaders located in Nigeria and in the diaspora. Further, the study explores the work–life balance of these women leaders and their vision for public education in Nigeria. This study also explores the experiences; relational style, drive, and motivation, identity, and adaptive style that shape the life course and impact the decisions in these women’s life course. The study was prompted by the perceived change in the state of the Nigerian public educational system from pre-independence to post-independence. Public education is essential to offering hope and equity to all, including the poor. Education is a fundamental good rooted in the concept of human capital. Human capital is concerned with the human skills factor of production in the development process. The development process depends on quality education that determines one’s earnings in market economies.

The study goes into the archives of public education in Nigeria to examine the experiences, past and present, of the sample of Nigerian women leaders and their impact on—and vision for—the future of Nigerian education. The data examine how the Nigerian government embraced the United Nations Millennium Development Goals (MDGs) and how the women played the dual roles of leaders and managers of their households. To better understand the dual roles of women, it was essential to review the decentralization and privatization of education in Nigeria as it related to the politicization of education expenditures.

La présence d'un scotome maculaire dans le champ visuel oblige les patients à utiliser la vision excentrée ce qui provoque notamment une difficulté à coordonner les systèmes oculomoteur et visuo-attentionnel. La lecture devient alors une des plaintes majeures chez ces patients, et à ce jour, les processus impliqués dans la baisse des performances de lecture restent mal connus. Dans la plupart des cas, l'utilisation de la vision excentrée amène le patient à développer une ou plusieurs zones de la rétine excentrée dites préférentielles, et dénommées couramment PRLs. Les caractéristiques de la PRL sont bien connues pour des tâches de fixation mais restent difficiles à mesurer et à interpréter dans le cas de la lecture, ce qui rend les stratégies de lecture en vision excentrée encore mal comprises. Nous nous proposons ici d'utiliser une approche psychophysique afin d'étudier les processus de la lecture en vision excentrée. Nous nous sommes tout d'abord intéressés à l'évaluation de nouveaux prédicteurs de la vitesse maximale de lecture. Nous avons tout d'abord élaboré un test de lecture francophone informatisé suivant les principes des MNRead Acuity Charts afin de pouvoir évaluer la vitesse maximale de lecture chez des patients porteurs de scotomes centraux binoculaires dont l'atteinte avait été mesurée à l'aide d'un micropérimètre MP-1. Deux analyses distinctes utilisant des modèles statistiques à effets mixtes nous ont permis de mettre en évidence des prédicteurs efficaces de la vitesse maximale de lecture et d'estimer leur influence réelle: 1) l'espace interligne; 2) le type de DMLA ; 3) la surface du scot; 4) la distance entre la PRL de fixation et la fovéa; 5) le statut du cristallin. Dans un deuxième temps, nous nous sommes intéressés aux stratégies de lecture déployées en l'absence de vision centrale. L'analyse de la distribution verticale des fixations, enregistrées pendant la lecture de phrases, nous a permis de mettre en évidence que dans la majorité des cas (97 %), les patients utilisent une zone préférentielle de la rétine unique dans le plan vertical pour lire. Ces résultats présentent des intérêts théoriques et pratiques dans la création de nouveaux supports visuels et l'élaboration de techniques de réadaptation visuelle optimales.

There is a growing need in the western world to know the quality of life (QoL) of patients affected by ocular pathologies that cause visual impairment (VI). In this type of pathologies, objective data such as visual acuity (VA), or diagnostic tests such as retinography or optical coherence tomography (OCT), offer important information, but do not reflect the effect of visual limitation on the life of the patient. Thus, in numerous studies, the use of specific instruments to assess QoL that indirectly measure the actual consequences of visual disability is becoming more important. The quality of life questionnaire related to vision (CVRV) Low Vision Quality of Life (LVQOL, Wolffsohn JS, Cochrane AL, 2000) was one of the first instruments designed specifically to measure QoL in patients with Low Vision (LV). The LVQOL consists of 25 questions subdivided into four different categories and, in its original version, has proved to be a reliable tool in patients with LV, measuring the initial baseline QoL, and subsequently in the evolution of the pathology, or to assess the success of a visual rehabilitation. Due to the lack of a properly validated instrument in Spanish to assess QoL in patients with LV, the main objective of this study is to validate the Low Vision Quality of Life questionnaire in Spanish and to evaluate its psychometric properties. Methods: After a cross-cultural adaptation of the questionnaire, a quantitative, longitudinal, multicentre study (a public hospital and a private clinic in Barcelona), a prospective cohort and a psychometric study was carried out to evaluate the psychometric properties. A total of 170 patients with DV and 195 healthy patients participated in the study. Sociodemographic and clinical variables were collected, as well as the responses to the QoL instruments: LVQOL, NEI VFQ-25 and EQ 5D-5L. Reliability was assessed by internal consistency (Cronbach's alpha) of the total sample, and by assessing the test-retest reproducibility (Spearman’s correlation coefficient (¿)) in stable patients at the baseline measurement and after 15 days (n = 73) in the sample of the public H. The validity was studied in the baseline test (n = 257) by means of the correlations with clinical, psychosocial variables and with the subscales of the QoL instruments administered. Finally, a factorial analysis (n = 170) was carried out to assess the structure of the instrument. Likewise, the psychometric properties of the NEI VFQ-25 were evaluated and the relationship of the results of the LVQOL with various sociodemographic, clinical and psychosocial variables was analysed. Results: The psychometric properties of the new instrument presented a Cronbach's alpha of 0.981 (95% CI: 0.978-0.985) and a reproducibility of 0.864, p <0.001. The score of the instrument was correlated with the score of the NEI VFQ-25 (0.96) and its subscales (all with values> 0.78), except for Driving (0.58) and Ocular pain, which presented divergence (0.23). As compared to the EQ 5D-5L, it showed convergence with the items Self-care (-0.41) and Daily activities (-0.73), and divergence with the rest of the items and with the total score. The results of the factorial analysis did not confirm the structure proposed by the author in the original version. Correlations with age, income level and type of pathology causing DV were found. Conclusions: The Spanish version of the LVQOL is semantically and conceptually equivalent to the original version. The results of the psychometric properties suggest that it presents an excellent validity, internal consistency and reproducibility. The introduction of this instrument in daily clinical practice may be very useful to evaluate, and thus improve, the quality of life of patients with DV.
Existe una necesidad creciente en el mundo occidental de conocer la calidad de vida (CdV) de los pacientes afectados de patologías oculares que ocasionan discapacidad visual (DV). En este tipo de patologías, los datos objetivos, como la agudeza visual (AV) o las pruebas diagnósticas como retinografías o tomografías de coherencia óptica (OCT), ofrecen información importante, pero no reflejan el efecto de la limitación visual en la vida del paciente. Así, en numerosos estudios va cobrando más importancia el uso de instrumentos específicos para valorar la CdV que miden indirectamente la realidad visual de la persona. El cuestionario de calidad de vida relacionado con la visión (CVRV) Low Vision Quality of Life (LVQOL, Wolffsohn JS, Cochrane AL, 2000) fue de los primeros instrumentos diseñados específicamente para conocer la CdV en pacientes afectados de Baja Visión (BV). El LVQOL consta de 25 preguntas subdivididas en cuatro categorías distintas y, en su versión original, ha demostrado ser una herramienta fiable en pacientes con BV, midiendo la CdV base inicial y posteriormente en la evolución de la patología, o ayudando a valorar el éxito de una rehabilitación visual. Debido a la carencia de un instrumento debidamente validado en castellano para valorar la CdV en pacientes con BV, el objetivo principal de este estudio es validar en español el cuestionario Low Vision Quality of Life y evaluar sus propiedades psicométricas. Métodos: Tras un proceso de adaptación transcultural del cuestionario, para la evaluación de las propiedades psicométricas se realizó un estudio cuantitativo, longitudinal, multicéntrico (un Hospital público y una Clínica privada de Barcelona), prospectivo de cohortes y de tipo psicométrico, en el que se analizaron 170 pacientes con DV y 195 sanos. Se recogieron variables sociodemográficas y clínicas, así como las respuestas de los instrumentos de CdV: LVQOL, NEI VFQ-25 y EQ 5D-5L. La fiabilidad se evaluó mediante la consistencia interna (alfa de Cronbach) del total de la muestra, y valorando la reproducibilidad test-retest (mediante el coeficiente de correlación de Spearman (¿)) en pacientes estables, administrando un cuestionario basal y otro al cabo de 15 días (n = 73) en la muestra del H. público. La validez se estudió en el test basal (n = 257) mediante las correlaciones con variables clínicas, psicosociales y con las subescalas de los instrumentos de CdV administrados. Finalmente, se realizó un análisis factorial (n = 170) para valorar la estructura del instrumento. Igualmente, se evaluaron las propiedades psicométricas del NEI VFQ-25 y se analizaron las relaciones del instrumento con el resto de las variables sociodemográficas, clínicas y psicosociales. Resultados: Las propiedades psicométricas del nuevo instrumento presentaron un alfa de Cronbach de 0,981 (IC 95%: 0,978-0,985) y una reproducibilidad de 0,864, p<0,001. La puntuación del instrumento se correlacionó con la puntuación del NEI VFQ-25 (0,96) y de sus subescalas (todas con valores > 0,78), exceptuando Conducción (0,58) y Dolor ocular, que presentaron divergencia (0,23); en el caso del EQ 5D-5L, mostró convergencia con los ítems Autocuidado (-0,41) y Actividades cotidianas (-0,73), y divergencia con el resto de los ítems y la puntuación total. Los resultados del análisis factorial no confirmaron la estructura propuesta por el autor en la versión original. Se hallaron correlaciones con la edad, nivel de ingresos y tipo de patología causante de DV. Conclusiones: La versión española del LVQOL es semántica y conceptualmente equivalente a la versión original. Los resultados de las propiedades psicométricas sugieren que presenta una excelente validez, consistencia interna y reproducibilidad. El uso de este instrumento puede resultar de gran utilidad en la práctica clínica diaria para evaluar, y así mejorar, la calidad de vida de pacientes con DV.
Existeix una necessitat creixent en el món occidental de conèixer la qualitat de vida (QdV) dels pacients afectats per patologies oculars que ocasionen discapacitat visual (DV). A causa de l'increment de l'esperança de vida en aquests països, la prevalença de patologies degeneratives com la Degeneració Macular Associada a l'Edat (DMAE) ha augmentat, conduint a un nombre creixent de pacients amb DV. Molts d'aquests pacients estan sense diagnosticar, i la major part d'aquesta població acudirà a un centre sanitari d'atenció primària, sent possiblement el metge de família o l'òptic optometrista qui primer els atengui abans de ser remesos i visitats per l'oftalmòleg. En aquest tipus de patologies, les dades objectives, com l'agudesa visual (AV), o les proves diagnostiques, com retinografies o tomografies de coherència òptica (OCT), proporcionen informació rellevant, però no reflecteixen l’efecte de la limitació visual en la vida del pacient. Així, en nombrosos estudis va cobrant més importància l'ús d’instruments específics per valorar la QdV, que mesuren indirectament la realitat visual de la persona. L’instrument de qualitat de vida relacionat amb la visió (QVRV) Low Vision Quality of Life (LVQOL), desenvolupat per Wolffsohn y Cochrane en l’any 2000, va ser un dels primers a ser dissenyat específicament per conèixer la QdV en pacients afectats de baixa visió (BV). Aquest instrument el va traduir i publicar al castellà el propi autor James Stuart Wolffsohn (JSW), si bé sense seguir el procés normalitzat de traducció i adaptació cultural, i sense estar validat mai al castellà. El LVQOL consta de 25 preguntes subdividides en quatre categories diferents i, en la seva versió original ha demostrat ser una eina fiable en pacients amb BV, mesurant la QdV base inicial i posteriorment en l'evolució de la patologia, o ajudant a valorar l'èxit d’una rehabilitació visual (RV). A causa de la manca d'un instrument degudament validat en castellà per valorar la QdV en pacients amb BV, el nostre grup investigador es va plantejar aquesta tesi amb els objectius que es detallen a continuació i amb la finalitat de poder oferir als òptics optometristes especialitzats en BV i als oftalmòlegs, una eina útil i validada per a mesurar la QdV en pacients de parla castellana amb DV. Es van plantejar 3 objectius globals. El primer va ser validar a l'espanyol el qüestionari Low Vision Quality of Life que avalua la CVRV en pacients afectats de discapacitat visual i evaluar les seves propietats psicomètriques. La resta d’objectius van ser la comparació del LVQOL amb l’instrument NEI VFQ-25, considerat gold estàndard en el camp de l'oftalmologia, i l’anàlisi de la possible correlació entre els resultats del LVQOL i diverses variables sociodemogràfiques.

En dissociant les images rétiniennes, une orthophorie et une hétérophorie verticales (OV et HV) correspondent respectivement à l'absence ou la présence d'une déviation de l'axe visuel verticalement, déviation annulée en vision binoculaire. Pour maintenir le corps en équilibre en position debout orthostatique, le SNC doit réaliser les transformations appropriées et coordonnées des informations visuelles, vestibulaires et somesthésiques, et générer en permanence les réponses musculaires adaptées. Des observations cliniques ont rapporté l'existence d'un lien entre phories verticales, douleurs chroniques et qualité du contrôle postural. Ce travail de thèse s'attache à tester ces observations cliniques sur la stabilité posturale orthostatique. La 1ère étude montre qu'une HV expérimentalement induite par un prisme vertical d'environ un degré, chez l'adulte jeune en bonne santé, influence la stabilité posturale, l'améliorant ou principalement la détériorant, dépendant de l'œil impliqué (i.e dominant ou non-dominant) et de la distance de fixation d'une cible. Nous suggérons que cet effet puisse être le fait de la qualité de la réponse oculomotrice. La 2e étude étudie l'effet de la dominance oculaire sur le mouvement de vergence verticale induit par ce même prisme lors de la station debout. Elle montre que les mouvements sont plus importants et excessifs par rapport à la déviation induite d'un degré lorsque le prisme est placé devant l'œil non-dominant quelle que soit la distance, et plus appropriés lorsque le prisme est placé devant l'œil dominant. Ces résultats suggèrent que les processus sensoriels, liés à la disparité induite et les réponses oculomotrices de vergence verticale, soient modulés par la dominance oculaire. La 3e étude investigue le comportement postural en termes de stabilité, toujours chez l'adulte jeune en bonne santé, selon la présence ou non d'une HV. Clairement, les sujets avec une HV sont moins stables. Une étude complémentaire montre qu'en annulant l'HV à l'aide d'un prisme approprié, la stabilité posturale est significativement améliorée. Une 4e étude traite de l'équilibre postural chez de jeunes adultes présentant des rachialgies chroniques non spécifiques associées à une HV, comparé à celui d'un groupe contrôle. Les sujets douloureux sont moins stables, et l'annulation de leurs HV par un prisme approprié renforce leur stabilité. Ainsi, l'HV, même minime, pourrait indiquer une perturbation au niveau d'informations somesthésiques impliquées dans les boucles sensorimotrices requises dans le contrôle postural via les afférences et efférences du cervelet et son rôle de calibration, les phories verticales indiqueraient alors la capacité du SNC à les intégrer de façon optimale. Il est connu que des conflits sensorimoteurs expérimentaux puissent induire des douleurs et modifier la perception sensorielle chez des sujets sains. Peut-être que des rachialgies chroniques non spécifiques résultent de tels conflits prolongés dont l'HV pourrait être un signe, ouvrant de nouvelles perspectives théoriques et cliniques.

O estudo apresentado trata da forma como a morte é entendida no contexto hospitalar junto dos profissionais, e como eles vêem o processo de fim de vida de seus doentes. Descobrir se existe humanização no cuidar e se o tratamento oferecido nos hospitais concede ao doente respeito e dignidade pela sua situação, foram os objetivos da pesquisa. Foi realizada no Serviço de Oncologia do Hospital de Santa Maria da Feira, em Portugal, junto de 6 profissionais (3 médicos, 1 enfermeira, 1 psicóloga e 1 assistente social). O que se observou é que a morte é entendida como algo inevitável, um processo de aceitação para uns, e uma derrota e frustração para outros. No entanto, por parte dos profissionais não se observa desprezo ou afastamento em relação ao doente. Outra observação foi o fato de não existir um assistente social permanente no serviço, o que constitui um lapso na equipe multidisciplinar existente. A comunicação, a solidariedade, bem como a preocupação de proporcionar uma boa qualidade de vida que se traduz em autonomia, liberdade de escolha e o poder de decidir sobre suas coisas, assim como conferir dignidade ao doente, mostraram ser as prioridades dos profissionais deste serviço.
The present study deals with the way death is understood in hospital context by professionals and how they feel the process of life ending of their patients. The goals of this research were to find out if there is humanization in the way patients are taken care and if the treatment offered by hospitals to sick people gives them respect and dignity. This research was carried out in the Oncology Department of Santa Maria da Feira Hospital in Portugal, in connection with 6 professionals ( 3 Doctors, 1 Nurse, 1 Psychologist and 1 Social Assistant). After the research the conclusion is that death is understood as something inevitable, an acceptance process for some people and a defeat and frustration for others. Nevertheless contempt or exclusion for patients was not observed by professionals. Another conclusion was the fact of the inexistence of a permanent Social Assistant in the Department, which is a lack in the multidisciplinary team. Communication, solidarity, as well as the concern of providing a good quality of life in terms of autonomy, freedom of choice and the power of deciding about their things and giving dignity to the patients were the main priorities of the professionals of this Department.