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1
Gilman, Elizabeth R. "Towards an eye-movement model of music sight-reading." Thesis, University of Nottingham, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.342467.
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Tutt, Joanne. "Type two diabetes and eye health." Thesis, Aston University, 2016. http://publications.aston.ac.uk/30073/.
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This thesis contributes to the understanding of how people with Type 2 Diabetes (T2D) negotiate self-care and management of diabetes and eye health. The study aims to deliver an Enhanced Diabetic Optometric Practice (EDOP) which involves a graphic portrayal of diabetic retinopathy, as it manifests itself in the eye and in the patient’s own eyes, whereby retinal images will be discussed within a normal optometric practice environment. This PhD research study used the qualitative method of thematic and Foucauldian discourse analysis (FDA) to investigate if an EDOP is able to heighten the participant’s concern of sight loss and thus lead to better diabetic control, and improved self-motivation and management. The research progressed in three stages; Study (1) A systematic review and meta-synthesis of qualitative research investigating the barriers to self-care for people with T2D, Study (2) A qualitative analysis of diabetes self-help literature and eye health, and Study (3) Evaluation of an Enhanced Diabetic Optometric Practice (EDOP). A review of the literature evaluates research in the field of optometry and ophthalmology with regard to the use of retinal images for educating people with T2D about their diabetes and the ocular complications. The findings of the three studies revealed, valuable insight into the barriers and constraints to self-care that people with T2D routinely face, enabling greater understanding of how to facilitate effective diabetes self-management Study (1). Study (2) discerned that self-help texts cannot facilitate the empowerment of people with diabetes who aspire to selfregulation, as they are constrained by the dominant compliant discourse of the expert-patient relationship. Finally, in Study (3) EDOP, optometrists can provide an enhanced optometric service, educating and motivating people with T2D to better self-care practices. This thesis concludes that the optometrist, by way of the EDOP and the pertinent threat of sight loss can assist people with T2D to gain the confidence to apply the skills to effective self-management and so prevent blindness.
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Furneaux, Sophia-Louise Maria. "The role of eye movements during music reading." Thesis, University of Sussex, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.360499.
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Patel, Sudhir. "An investigation of the optical zone of the human cornea and changes induced by excimer laser surgery." Thesis, Glasgow Caledonian University, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316647.
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Sparrow, John Martin. "The lens in diabetes." Thesis, University of Oxford, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.238162.
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Hadley, Lauren Victoria. "Musical prediction in the performer and the listener : evidence from eye movements, reaction time, and TMS." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/21009.
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Musical engagement can take many forms, from the lone pianist rehearsing in their study, to the headphone-wielding teenager on the bus, or even the orchestral musician on stage. Although much music research dissociates the performer from the listener (a differentiation starkly demonstrated in the layout of the concert hall), in this thesis I consider the performer and listener as two sides of the same coin. This thesis therefore empirically investigates musical prediction in the solo performer and the solo listener, then brings these together by investigating musical predictions in a turn-taking musical interaction. I begin by presenting a theoretical account of musical prediction. I propose a common mechanism to underlie predictions during both music performance and music listening, based on motor simulation of observed (seen or heard) music. This theory is developed from that of Pickering and Garrod (2013), and is suggested to span communicative joint action contexts. I then present three sets of experiments. In the first, I use eye-tracking to show that pianists incrementally process musical progressions during sight-reading. By measuring the rate of regression from an anomalous musical bar, I demonstrate that musicians look back to earlier portions of a melody more often when they read a bar that forms a less common musical progression than when they read a bar that forms a more common musical progression. This effect parallels that found for anomalous word reading in language, and provides a promising new paradigm through which to investigate music processing. In the second set of experiments, I use the timing of turn-end judgements to show that non-expert music listeners use tonality cues to predict the end of a musical solo. By presenting listeners with musical turns in two different styles: jazz improvisation or free improvisation, I show that the use of a tonal framework facilitates the accuracy of turn-end judgements. I confirm that this benefit is based on tonal information by filtering the extracts to either include or exclude pitch information. When pitch information is removed from the (tonal) jazz improvisations, turn-end accuracy falls. No such detriment is induced by removing pitch information for the (non-tonal) free improvisations, or by removing other spectral information. In the third set of experiments, I use transcranial magnetic stimulation (TMS) to investigate turn-taking. Turn-taking involves listening to a partner, predicting when they will end and hence when to come in oneself, and finally entering for one’s own part accurately. In my first experiment I apply TMS to the primary motor cortex and suggest that the predictability of a partner’s part modulates the timecourse of one’s own motor preparation. In my second experiment I apply TMS to the dorsal premotor cortex (involved in motor simulation) and demonstrate that when a partner’s part is in one’s own motor repertoire, the dPMC plays a causal role in the accuracy of one’s own performance. This involvement of the dPMC is consistent with motor simulation being used to predict a partner’s ending in a turn-taking context. Together this set of experiments explores prediction in music production and comprehension. My studies of music reading and music listening indicate that prediction is similar across comprehension domains. My studies of interaction indicate that comprehension may depend on production processes. I suggest that together my findings therefore imply that predictions made by performers and listeners are based on similar processes, and more specifically, that prediction during comprehension may involve motor simulation.
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Göransson, Anne. "Vision in sight : the relationships between knowledge, health beliefs and treatment outcomes : the case of amblyopia /." Linköping : Univ, 1999. http://www.bibl.liu.se/liupubl/disp/disp99/ipp65s.htm.
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Lundhe, Adrian. "Diabetic Eye Screening : Eye mapping examination application." Thesis, KTH, Skolan för informations- och kommunikationsteknik (ICT), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-211720.
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According to the World Health Organization, in 1980 there was 108 millions diabetes patients around the world, and in 2014 the number increased to 422 millions. This is a percentage rise from 4,7 to 8,5 in the same time period. According to the report Vision 2020, about 5% of the blindness in the world is contributed to diabetic retinopathy. 4% of these people will never get treated for their diseases. Different people get different treatments depending on where they are in the world. The different costs mainly depend on available equipment, salaries, and countries currency stand on the world market. Out of 37 million cases of blindness, about 1.8 million are related to diabetic retinopathy. After 15 years of carrying this disease 2% will be blind and 10% will have severe visual loss. 20 years down the line of having diabetes, 75% will have some form of diabetic retinopathy. Governments, insurance companies and health facilities around the world have trouble keeping up with the costs and availability of medical personnel for treatment of patients. There is a need for a new way of thinking. An alternative. A cheap, reliable and quick method of discovering diseased at its earlier stages that will dramatically lower the cost and pressure on the health industry. The mobile phone application market is a somewhat untapped market when it comes medical equipment. To relieve the absence of this kind of application the Diabetic Eye Screening program was created. The application maps anomalies within the retina and provides statistical data for the patients in their own mobile phones and tablets without any need of meeting medical professionals. The information can safely and reliably be shared between partners quickly for evaluation of a patient's immediate health status.Enligt Världshälsoorganisationen fanns det under 1980-talet 108 miljoner diabetespatienter runt om i världen och 2014 höjdes antalet till 422 miljoner. Detta är en procentuell ökning från 4,7 till 8,5 under samma tidsperiod. Enligt rapporten Vision 2020 bidrar cirka 5% av blindheten i världen till diabetisk retinopati. 4% av dessa människor kommer aldrig att bli behandlade för deras sjukdom. Olika människor får olika behandlingar beroende på var de är i världen. De olika kostnaderna beror främst på tillgänglig utrustning, löner och länders valutor på världsmarknaden. Av 37 miljoner fall av blindhet är ca 1,8 miljoner relaterade till diabetisk retinopati. Efter 15 år med denna sjukdom kommer 2% att vara blinda och 10% kommer att ha en allvarlig visuell förlust. Vid 20 års av diabetes kommer 75% att få någon form av diabetisk retinopati. Regeringar, försäkringsbolag och sjukhus runt om i världen har problem med att hålla nere kostnaderna och bidra med tillgänglighet av medicinsk personal för behandling av patienter. Det finns ett behov av ett nytt sätt att tänka. Ett alternativ. En billig, tillförlitlig och snabb metod att upptäcka sjukdomar i tidigt skede kommer dramatiskt sänka kostnader och minska på trycket i vården behövs. Mobilapplikations marknaden är något av en outnyttjad marknad när det gäller medicinsk utrustning. För att avhjälpa frånvaron av denna typ av applikation skapades Diabetic Eye Screeningprogrammet. Applikationen kartlägger avvikelser i näthinnan och ger statistiska data för patienterna i sina egna mobiltelefoner och tablets utan att behöva möta medicinsk personal. Informationen kan på ett säkert och tillförlitligt sätt snabbt delas mellan partner för utvärdering av patientens omedelbara hälsotillstånd.
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Barbieri, Gillian Sylvia Anna-Stasia. "The role of spatial derivatives in feature detection." Thesis, University of Birmingham, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368742.
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Brown, Elizabeth Jean. "The quest for whole sight or seeing with the eye of the mind and the eye of the heart : a place for imagination in moral education." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ37194.pdf.
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Cady, Paul Stevens. "THE EFFECTS OF AGING ON COLOR DISCRIMINATION OF CAPSULES (DIABETES, MEDICATION, VISION)." Thesis, The University of Arizona, 1985. http://hdl.handle.net/10150/291334.
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Zheng, Qi. "BARRIERS TO EYE CARE AMONG PATIENTS WITH DIABETES IN THE GREATER NEW HAVEN AREA." Yale University, 2010. http://ymtdl.med.yale.edu/theses/available/etd-03222010-151332/.
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This study aims to identify the perceived barriers to eye care and to evaluate concerns about vision and eye care among patients with diabetes in the greater New Haven area. A qualitative study applying one-on-one semi-structured interviews and non-participatory observations was conducted to identify the factors that deter diabetics from seeking eye care. Patients were recruited at the Yale Primary Care Center, Diabetes Center and Eye Center, who met the following criteria: 1) have been diagnosed with type 1 or type 2 diabetes and 2) have been referred to an eye center for dilated eye exam and/or treatment. All interviews and discussions were recorded and transcribed. The transcripts were then analyzed to detect recurrent themes. Data collection continued until no new themes emerged. This study showed that lack of awareness and lack of adequate referral to regular diabetic eye exam were viewed as the most common barriers. Many patients had limited awareness that diabetes could affect the eye or lead to blindness. Patients had little knowledge of diabetic retinopathy, or the significance of early screening and intervention. Primary care providers usually emphasized diet and blood sugar control to prevent future complications; diabetic eye care education was not often prioritized. Other barriers included cost, lack of insurance, immobility due to diabetic complications, reluctance to receive medical intervention, and distrust of the services. A strong family history of diabetes and blindness due to diabetes contributed to the awareness of diabetic retinopathy, and as a result motivated patients to seek regular eye care. Raising the awareness of diabetic retinopathy and the risk of vision loss, offering more diabetic eye care education, tracking the status of patients eye exam attendance, and providing adequate eye exam referral to a patient friendly eye clinic may encourage diabetics to attend regular eye exams.
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Marahrens, Lydia, Focke Ziemssen, Andreas Fritsche, Tjalf Ziemssen, Raimar Kern, Peter Martus, and Daniel Roeck. "Limited Time from the Diabetes Patients’ Perspective: Need for Conversation with the Eye Specialist." Karger, 2016. https://tud.qucosa.de/id/qucosa%3A70609.
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Purpose: Facing the lack of time, busy retina consultants should be aware of how the patients would prefer that time is spent and whether they wish the specialist to talk more at the expense of other medical activities. Methods: 810 persons with diabetes were asked to divide the time of 10 min between examination, consultation and treatment when envisioning a real-life scenario of diabetic retinopathy (NCT02311504). Results: With the increasing duration of diabetes, patients wanted significantly more time for diagnostics (p = 0.028), while age was found to be associated with less time for treatment (p = 0.009). Female subjects tended to prefer only little more time for talking (p = 0.051) in comparison with males, who slightly favored therapy (p = 0.025). Conclusions: The large majority recognized the need for diagnostics in their allocation of time. If individual patients are confronted with the health care perspective of time constraints, this might improve the understanding of prioritization.
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Mackie, Scott W. "Ophthalmic dysfunction in patients with diabetes mellitus and the relation to driving performance." Thesis, Glasgow Caledonian University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309401.
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Hook, Darren W. A. "Protection of enzymes by the molecular chaperone #alpha#-Crystalline." Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.300133.
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Feder, Samantha. "Facing the Public Eye: Analyzing Discourse on the Niqab and the Visibility of the Face In Canada." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37654.
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The niqab is a veil worn by some Muslim women that covers the face except the area around the eyes, which can be seen through a rectangular slit in the fabric. In recent years, a number of countries have enacted measures against the niqab in public spaces. Canadian law and policy makers have made significant contributions to ongoing debates about the niqab as well as the acts of facial covering and uncovering. While objections to the niqab have been framed in many different ways, the guiding premise of this dissertation is that negative reactions to the niqab are grounded within the expectation and demand to see the human face. Drawing upon the case of R. v. N.S, the niqab ban during the Canadian citizenship oath, and Bill 62: An Act to foster adherence to State religious neutrality and, in particular, to provide a framework for requests for accommodations on religious grounds in certain bodies, this dissertation considers how Canadian legal and political actors have justified restrictions against the niqab by invoking the idea that the visibility of the face is a central part of Western cultural values. Ultimately, my research questions the kind of work that the human face and the sense of sight is expected to do by examining how demands to see people’s faces reflect and maintain interlocking cites of privilege and oppression such as racism, sexism, ableism, imperialism, and colonialism.
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Hodges, Elizabeth Violet. "An exploration of sight, and its relationship with reality, in literature from both world wars." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:de3c749e-b7b2-49bc-a25e-4c3f28eea47d.
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Writers from both world wars, concerned with the representation of war, wrestled with the predicament of partial sight. Their work reveals the problematic dichotomy that exists between the individual’s selective range of vision and the immense scale of conflict. Central to this authorial dilemma is the question of the visual frame: how do you contain – within the written word – sight that resists containment and expression? The scale of the two world wars accentuated the representative problem of warfare. This thesis, by examining a wide range of World War One and World War Two literature, explores the varied literary responses to the topical relationship between sight and reality in wartime. It examines the war poetry of Wilfred Owen, Ford Madox Ford’s tetralogy Parade’s End, The Return of the Soldier by Rebecca West, Elizabeth Bowen’s The Heat of the Day, and Virginia Woolf’s novels Mrs Dalloway and Between the Acts alongside less well-known works such as David Jones’s prose-poem In Parenthesis, the two short stories ‘The Soldier Looks for His Family’ by John Prebble and ‘The Blind Man’ by D.H. Lawrence, as well as William Sansom’s collection of short stories Fireman Flower, and Louis Simpson’s war poetry. This thesis, by focussing on the inherent difficulties of reconciling perception and representation in war, interrogates the boundaries of sight and the limits of representation. The changing place of sight in writing from the two world wars is examined and the extent to which discourses of vision were shaped and developed, in the early decades of the twentieth century, by war experience is explored. The critical containment and categorisation of sight that often dominates readings of sight in texts from both world wars is questioned suggesting the need for a more flexible understanding of, and approach towards, sight.
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Hope, Mackline. "Assessing the Knowledge and Practices regarding eye care and complications of Diabetes among Diabetic Patients 18 years and older, attending a tertiary Diabetic Clinic in Kampala, Uganda." Master's thesis, Faculty of Health Sciences, 2019. https://hdl.handle.net/11427/31823.
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Purpose
The aim of this study was to audit the knowledge and practices regarding eye care and eye complications of diabetes mellitus (DM) among diabetic patients 18 years and above in Kampala, Uganda.
Methods.
A cross-sectional study was done to collect data on the demographics, level of awareness and practices of the 409 diabetic patients regarding eye care and eye complications of DM. Data collected was captured in EPIDATA version 3.1, exported to STATA version 15.0 for further management and analysis. Participants characteristics were summarized using summary statistics and graphs. Using a standard questionnaire, scores for knowledge and practice for diabetes; knowledge and practice on diabetic retinopathy were generated and in all the four scores aforesaid, participants were classified as having good or poor knowledge and practice1. Proportions of participants demonstrating good awareness and good practice were reported. Fishers and Pearson chi- square tests were used to test for associations between patient’s characteristics and knowledge and practice on DM. Bivariable and logistic regression analysis was performed and variables with a p-value of < 0.2 of the unadjusted odds ratio were further analyzed at multivariate logistic regression analysis to find out factors that significantly predict patient’s knowledge and practice on diabetes mellitus.
Results.
A total of 409 participants were interviewed in the study, majority were females 293 (71.6%) and mean age (SD) was 50 (12) years. A high proportion of participants 314 (76.9%) was aware that DM could affect the eyes but only 24 (5.9%) stated diabetic retinopathy as an eye complication in diabetic patients. Good knowledge about diabetes mellitus was demonstrated by 178 (43.5%) of the study participants. However, only 33.3% had good knowledge on eye care and diabetic retinopathy. It was determined that female diabetic patients and those who stayed with DM for 10 years and beyond were less likely to have good practice on DM compared to male patients and those who had been with DM for less than five years (OR, 95% CI: 0.58, 0.36-0.95, P=0.029: OR, 95% CI: 0.53, 0.32-0.87, P=0.011). It was also found that diabetic patients with good knowledge of DM were at least three times more likely to have good practice compared to those with the poor knowledge (OR, 95% CI: 3.2, 2.1 -4.8, P <0.001).
Conclusion
Lack of knowledge regarding the importance and need for periodic eye check-up for diabetic retinopathy was a significant finding in his study. Good knowledge on diabetes, gender and duration of DM had significant association with the patients practice patterns.
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Werner, Jennifer Eilleen. "Barriers to initiation and continuation of vision care among diabetics." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2259.
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Kawamura, Taichi. "Influence of comorbidities on the implementation of the fundus examination in patients with newly diagnosed type 2 diabetes." Kyoto University, 2018. http://hdl.handle.net/2433/232479.
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Kleveback, Gunilla, and Nina Hellquist. "Ögonbottenfotografering : Faktorer som bidrar till låg följsamhet till ögonbottenfotografering hos patienter med diabetes-En systematisk litteraturstudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-85315.
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Bakgrund Diabetes är en av de sjukdomar som ökar mest i hela världen, detta medför att även följdsjukdomar förknippade med diabetes ökar. Diabetesretinopati [DRP] är en av dessa följdsjukdomar. Regelbunden ögonbottenfotografering gör att förändringar upptäcks i tid. Följsamheten till ögonbottenfotografering bland patienter med diabetes är dock inte optimal. Syfte Syftet med studien var att identifiera faktorer som bidrar till att patienter med diabetes har låg följsamhet till ögonbottenfotografering. Metod Studien utfördes som en systematisk litteraturstudie, med kvalitativa och kvantitativa artiklar för att sammanställa tidigare forskning. Resultat Studien resulterade i tre huvudkategorier Faktorer relaterade till interaktionen med sjukvården, faktorer relaterade till patientens livssituation och personlighet och faktorer relaterade till det omgivande samhället samt åtta underkategorier. De huvudsakliga faktorer som framkom var brist på information, ekonomiska aspekter samt känslor relaterade till undersökningarna. Slutsats Genom att identifiera försvårande faktorer kan denna studies resultat användas som utgångspunkt för att utveckla hälsofrämjande åtgärder för en ökad följsamhet. Även annan vårdpersonal, till exempel diabetessjuksköterskan kan få nytta av kunskapen som framkommer. Vidare forskning behövs som behandlar nordiska förhållanden.Background Diabetes is an increasing health problem all around the world. This means that health problems associated with diabetes are also increasing. Diabetic retinopathy [DRP] is one of these problems. To detect DRP at an early stage, regular fundus examinations are recommended. However, compliance among diabetic patients is not optimal. Purpose The purpose of the study was to identify factors that contribute to patients' with diabetes low compliance to fundus examinations. Method The study was a systematic literature review, including both qualitative and quantitative research in order for a comprehensive compilation of previous studies. Results The result showed three main categories. Factors related to the interaction with the healthcare system, factors related to the patient's life situation and personality and factors related to the surrounding society. There were also eight subcategories. The main factors that emerged were lack on information, economic aspects and emotions related to the examinations. Conclusions By identifying aggravating factors, the result in this study may be useful as a starting point to develop health-promoting actions to increase compliance. Other healthcare professionals, such as the diabetic nurse, may also benefit from the knowledge that emerges. Further research about the conditions in Scandinavia is required.
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dePillis-Lindheim, Lydia. "Disease Correlation Model: Application to Cataract Incidence in the Presence of Diabetes." Scholarship @ Claremont, 2013. http://scholarship.claremont.edu/scripps_theses/294.
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Diabetes is a major risk factor for the development of cataract [3,14,20,22]. In this thesis, we create a model that allows us to understand the incidence of one disease in the context of another; in particular, cataract in the presence of diabetes. The World Health Organization's Vision 2020 blindness-prevention initiative administers surgeries to remove cataracts, the leading cause of blindness worldwide [24]. One of the geographic areas most impacted by cataract-related blindness is Sub-Saharan Africa. In order to plan the number of surgeries to administer, the World Health Organization uses data on cataract prevalence. However, an estimation of the incidence of cataract is more useful than prevalence data for the purpose of resource planning. In 2012, Dray and Williams developed a method for estimating incidence based on prevalence data [5]. Incidence estimates can be further refined by considering associated risk factors such as diabetes. We therefore extend the Dray and Williams model to include diabetes prevalence when calculating cataract incidence estimates. We explore two possible approaches to our model construction, one a detailed extension, and the other, a simplification of that extension. We provide a discussion comparing the two approaches.
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Nakhla, Meranda. "Transitioning from Pediatric to Adult Care: impact on hospitalizations and eye examinations in adolescents and young adults with diabetes mellitus in Ontario." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=21955.
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During the transition to adult healthcare, young adults with diabetes mellitus (DM) are at an increased risk of leaving medical supervision. Previous studies have been mostly descriptive, with low sample sizes, and poor attention to selection and other types of biases. The objectives of this study were to describe the rates of acute diabetes-related complications and the proportion of patients receiving eye examinations before and after age 18 years (age of transfer to adult care), and to test whether different methods of transfer are associated with improved outcomes and processes of care. This study was a retrospective cohort study of 1507 young adults with prevalent diabetes mellitus of at least 5 years duration by age 16 years between 1996 and 2002 with follow-up until aged 20 years. Data was obtained from administrative health care databases and a census of pediatric diabetes centers in Ontario, Canada. DM-related hospitalization rates increased from 7.6 per 100 patient-years to 9.5 per 100 patient-years in the 2 years prior to and after transfer to adult care (p =0.03). After controlling for other factors patients who were transitioned to a new physician and allied health care team were more likely to be hospitalized than those who had continuity with at least part of the pediatric team (RR 1.50; 95% confidence interval [CI], 1.02-2.22). Predictors of hospitalizations included prior DM hospitalizations (RR 2.30; 95% CI, 1.88-2.90), decreased socioeconomic status (RR 2.11; 95% CI 1.23-3.86), females (RR 1.50; 95% CI, 1.07-2.11) and low level of physician supply (RR 1.71; 95% CI, 1.04-2.82). The proportion of individuals having at least one eye-care examination decreased slightly from 72% during the two years prior to transition to 70% following transition (p = 0.06). The odds of having an eye-care visit after transition was associated with decreasing neighborhood income (OR 0.49; 95% CI 0.33-0.73), female gender (OR 1.95; 95% CI, 1.53- 2.48) and previous eyeAu cours de la transition vers les soins de santé pour adultes, les jeunes adultes souffrant de diabète sucré courent un risque plus élevé de délaisser la supervision médicale. Les études antérieures ont majoritairement été descriptives; la taille des échantillons était petite et on accordait peu d'attention à la sélection et aux autres types de biais. Les objectifs de cette étude étaient de décrire les taux de complication attribuable au diabète aigu et la proportion des patients ayant subi des examens de la vue avant et après 18 ans (âge du transfert aux soins pour adultes) ainsi que d'établir si les différentes méthodes de transfert entraînent de meilleurs résultats et de meilleurs processus de soins. Cette étude est une étude de cohorte rétrospective menée auprès de 1 507 jeunes adultes souffrant d'un diabète sucré prévalent d'au moins cinq ans avant l'âge de 16 ans, entre 1996 et 2002, assortie d'un suivi jusqu'à l'âge de 20 ans. Les données sont tirées de bases de données administratives sur les soins de santé et d'un recensement des centres de diabète pédiatriques de l'Ontario, au Canada. Les taux d'hospitalisation causée par le diabète sucré sont passés de 7,6 pour cent années-malades à 9,5 pour cent années-malades au cours des deux années précédant le transfert aux soins pour adultes et après ce transfert (p=0,03). Après contrôle des autres facteurs, les patients qui ont effectué une transition vers un nouveau médecin et une équipe de soins de santé affiliée étaient plus susceptibles d'être hospitalisés que ceux qui présentaient une continuité avec au moins une partie de l'équipe pédiatrique (RR 1,50; intervalle de confiance [IC] de 95 %, 1,02-2,22). Les variables explicatives des hospitalisations comprenaient les hospitalisations antérieures attribuables au diabète sucré (RR 2,30; IC de 95 %, 1,88-2,90), la situation socioéconomique en baisse (RR 2,11; IC de 95 %, 1,23-3,86), le fai
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Allison, Jessica Chung. "Four-year incidence of diabetic retinopathy in the Los Angeles Latino Eye Study (LALES) evaluation of how biologic risk indicators and barriers to treatment contribute to disease development /." Columbus, Ohio : Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1211549705.
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Fridman, Daniel. "Associação entre hipoestesia corneana, olho seco e outros fatores em portadores de diabetes melito tipo 2." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2002. http://hdl.handle.net/10183/6830.
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Portadores de diabetes parecem ter mais queixas de olho seco do que o resto da população. Acredita-se que isto possa estar associado a uma forma de neuropatia diabética expressa por uma redução na sensibilidade corneana desses pacientes. Nossos principais objetivos neste estudo foram avaliar a influência da diabetes melito tipo 2 na sensibilidade corneana central e verificar se há uma associação entre a sensibilidade corneana central e a síndrome do olho seco em indivíduos com a doença. Assim, 62 portadores de diabetes tipo 2 foram submetidos a um exame oftalmológico de rotina, a uma ceratoestesiometria e a testes específicos para avaliar olho seco e polineuropatia distal simétrica. Num outro grupo, 20 voluntários saudáveis tiveram seus olhos avaliados da mesma forma, exceto pela não realização dos testes específicos para disfunção lacrimal. Entre os indivíduos diabéticos avaliados, foram observados 53.2% com hipoestesia corneana, 54.2% com retinopatia diabética, 45.9% com polineuropatia distal simétrica e 51.6% com a síndrome do olho seco. Entre os principais achados, observamos associações significativas envolvendo: diabetes tipo 2 e hipoestesia corneana central, síndrome do olho seco e hipoestesia corneana central, produção lacrimal reflexa (avaliada pelo teste de Schirmer II) e sensibilidade corneana central e retinopatia diabética proliferativa e sensibilidade corneana central. Uma possível associação foi encontrada envolvendo síndrome do olho seco retinopatia diabética proliferativa. Os autores discutem os resultados obtidos e os mecanismos envolvidos.Diabetes bearers seem to have more complaints of dry eye than the rest of the population. It`s believed that this fact might be associated to a kind of diabetes neuropathy wich is represented by a reduction in corneal sensibility of these patients. Our main target in this study was to evaluate the influence of type 2 diabetes mellitus in central corneal sensibility and to determine if there is an association among central corneal sensibility and the dry eye syndrome in individuals suffering of this disease. Therefore, 62 type 2 diabetic patients were submitted to an ophthalmological routine examination, to corneal esthesiometry and to specific tests to evaluate dry eye and peripheral polineurophaty. In other group, 20 healthy volunteers had their eyes evaluated in the same way, except for the non accomplishment of the specific tests for dry eye. Among the examined diabetic individuals, 53.2% had corneal hypoesthesia, 54.2% presented diabetic retinopathy, 45.9% presented periferal polineuropathy and 51.6% presented the dry eye syndrome. Among the main findings, we observed associations between: type 2 diabetes and central corneal hypoesthesia, dry eye syndrome and central corneal hypoesthesia, reflex tear production (evaluated by Schirmer 2 test) and central corneal esthesiometry and also between proliferative diabetic retinopathy and central corneal sensibility. A possible association was found involving dry eye syndrome and proliferative diabetic retinophaty. The authors discuss the results obtained and the involved mechanisms.
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Castellar, Leonardo dos Santos. "Modelo de transplante de ilhotas pancreáticas para a câmara anterior do olho em camundongos diabéticos." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/9/9136/tde-12062015-161511/.
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Estima-se que, em 2013, cerca de 382 milhões de pessoas eram portadoras de diabetes mundialmente. Já o diabetes mellitus do tipo 1 (DMT1) representa de 5-10% desse total de casos, cujo tratamento atual se pauta na administração de insulina exógena. Contudo, desde a publicação do protocolo de Edmonton, o transplante de ilhotas pancreáticas se apresenta como nova técnica no tratamento para o DMT1, inclusive obtendo a independência de insulina em alguns casos. Apesar disso, a escolha do sítio receptor ainda é essencial para diminuir efeitos adversos e permitir o acompanhamento do enxerto. Nesse sentido, destaca-se o transplante de ilhotas para a câmara anterior do olho, pois permite, além do restabelecimento do controle glicêmico, o estudo da fisiologia dos enxertos in vivo. Dessa forma, o objetivo foi estabelecer metodologia de isolamento e transplante de ilhotas de alta reprodutibilidade e baixo custo, utilizando a câmara anterior do olho como sítio receptor. O isolamento foi realizado via injeção de solução de colagenase (1 mg/mL via ducto colédoco) em camundongos machos C57BL/6 hígidos de 8 semanas de idade e posterior transplante dessas ilhotas para camundongos machos da mesma espécie com diabetes induzido por injeção de aloxana (60 mg/kg, i.v.). Esses camundongos foram submetidos a infusão de aproximadamente 250 equivalentes de ilhotas (IEQs) para a câmara anterior do olho e tiveram sua glicemia e alteração de massa corpórea acompanhadas por 14 dias após o transplante. Também foi realizado teste de tolerância a glicose via injeção de solução de glicose (2g/kg i.p.) e realização da curva glicêmica. Obteve-se, na etapa de padronização, que a adição de 0,5% (%p/v) de albumina de soro bovino à solução de colagenase foi capaz de aumentar o número de IEQs isolados por animal. Quanto ao transplante, obteve-se que 50% dos animais submetidos à técnica tiveram diminuição significativa na sua glicemia (172,5 ± 6,4 mg/dL), quando comparados com o grupo controle diabético (582,8 ± 27,5 mg/dL) (p < 0,05). Entretanto, todos os animais tiveram aumento significativo da massa corpórea no período de acompanhamento e glicemia de jejum significativamente menor que os animais diabéticos (p < 0,05). Ademais, a curva glicêmica dos animais que tiveram transplante considerado bem sucedido, no teste de tolerância a glicose, se aproxima da curva do grupo controle sadio. Conclui-se que o modelo de transplante de ilhotas pancreáticas para a câmara anterior do olho foi bem estabelecido neste projeto, confirmado pelos resultados que evidenciam o transplante de ilhotas funcionais capazes de reduzir sensivelmente a glicemia e promover o ganho de peso em camundongos diabéticos.It is estimated that, in 2013, around 382 million people had diabetes worldwide. Of that number, 5-10% represented cases of T1DM, which treatment is based in the administration of exogenous insulin. However, since the Edmonton protocol was published, islet transplantation presented itself as novel technique for T1DM treatment, achieving insulin independence in some cases. Although, recipient site choice is still essential to diminish side effects and enable graft follow up. In that sense, transplantation to the anterior chamber of the eye stands out, since it allows, beyond the reestablishment of glycemic control, study of islet physiology in vivo. That way, the objective was to establish a low cost and high reproducible model of islet isolation and transplantation, using the anterior chamber of the eye as receptor site. Islet isolation was made by injection of collagenase solution (1 mg/mL via common bile duct) in 8 week old healthy male C57BL/6 mice and followed by transplantation of these islets to male mice of the same age and species with diabetes induced by alloxan injection (60 mg/kg i.v.). These mice were subject of 250 islet equivalents (IEQs) infusion to the anterior chamber of the eye and had their blood glucose and change in body mass monitored for 14 days after transplantation. A glucose tolerance test (GTT) was also made, by injection of glucose solution (2g/kg i.p.) and a glycemic curve was plotted. In the standardization period, was observed that the addition of 0,5% (%w/v) bovine serum albumin is capable of increasing the number of IEQs isolated from each animal. About the transplants, was obtained that 50% of animals subject to transplantation had their blood glucose decreased significantly (172,5 ± 6,4 mg/dL), when compared to the diabetic control group (582,8 ± 27,5 mg/dL) (p < 0,05). However, all animals subject to the procedure had significant body mass increase, when compared to the same control group and fasting blood glucose significantly lower than diabetic animals (p < 0,05). Moreover, the glycemic curve of animals, who had their transplantation considered successful, was similar to that found in healthy control animals, in the GTT. We conclude that the model of transplant to the anterior chamber of the eye is well established in this project, which is confirmed by results that shows transplantation of functional islets, capable of promoting a significant decrease in blood glucose and an increase in total body mass in diabetic animals.
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Alves, Monica de Cassia. "Avaliação dos produtos finais de glicosilação e o fator nuclear K-B em glandulas lacrimais e superficie ocular de modelos animais de diabetes e envelhecimento." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308968.
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Orientador: Eduardo Melani RochaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Este estudo avaliou as possíveis vias comuns na fisiopatogênese da síndrome do olho seco no Diabetes Mellitus (DM) e no envelhecimento, envolvendo o acúmulo dos produtos de glicosilação ("Advanced Glycation End-products" - AGEs), seu receptor RAGE e a ativação do Fator Nuclear-?B (NF-?B) na glândula lacrimal (GL) e alterações do filme lacrimal nessas condições. Modelos animais de DM induzido com estreptozotocina e animais senis (24 meses de vida) foram comparados a animais controle tratados com tampão citrato e adultos jovens (2 meses de vida). Foram avaliadas vias de sinalização, envolvendo AGEs, RAGE e a ativação do NF-?B na GL e alterações no filme lacrimal em ratos Wistar de todos os grupos. A análise do filme lacrimal foi realizada através de medidas de volume de secreção basal e dosagem de citocinas como a Interleucina-1 ß (IL-1 ß) e Fator de Necrose Tumoral - a (TNF- a). A capacidade secretória da GL foi avaliada através de medidas da atividade de peroxidase. Técnicas de "western blot" foram utilizadas para avaliar a expressão e ativação do NF-?B na GL. A expressão de AGE, RAGE e NF-?B na GL e córnea nos grupos estudados, foi avaliada através de microscopia confocal com imunofluorescência. O volume lacrimal foi significativamente menor nos animais diabéticos e senis (P=0,02 e 0,016, respectivamente). Concentrações de IL-1ß e TNF-a na lágrima foram mais altas nos ratos diabéticos e senis do que nos controles e adultos jovens (P=0,007 e 0,02 nos diabéticos e P= 0,007 e P= 0,05 nos senis). A atividade de peroxidase foi significativamente mais baixa no grupo senil (P=0,016), mas não nos experimentos, comparando animais diabéticos e controles (P=0,34). A expressão de AGE, RAGE e NF-?B na GL foi aumentada nos animais diabéticos e senis. O DM e a senilidade induzem alterações estruturais e secretórias significativas na GL e nos tecidos da superfície ocular e associa-se a maior incidência de olho seco. A expressão aumentada de AGE, RAGE e NF-?B na GL sugere a participação desses fatores nas vias de sinalização e subseqüentes alterações inflamatórias relacionadas ao olho seco nessas condições.
Abstract: The present study evaluates the dry eye syndrome related to diabetes and aging through the involvement of the Advanced Glycation End-product (AGEs), the Advanced Glycation End-product Receptor (RAGE) axis and Nuclear Factor-?B (NF-?B) activation in lacrimal gland (LG) and tear film dysfunction in these conditions. To evaluate whether AGE, RAGE and NF-?B signaling in LG are altered in diabetes and aging, streptozotocin-induced diabetic, normoglicaemic, aging (24 month-old) and young adults (2 month-old) male Wistar rats were compared. Tear film alterations and the expression of AGE, RAGE and NF-?B in ocular tissues were evaluated in all considered groups. Tear secretion parameters as basal tear secretion volume, Interleukin-1 ß (IL-1 ß) and Tumor Necrosis Factor- a (TNF- a) levels and LG and peroxidase activity in LG tissue were measured. NF-?B expression and activation was evaluated in LG by western blot. Immunohistochemistry with confocal microscopy was used to assess AGE, RAGE and NF-?B expression in LG of all groups. Tear volume was significantly lower in diabetic and aging rats (P=0.02 and 0.016, respectively). IL-1ß and TNF-a concentrations in tears were higher in diabetic and aging than in control and young rats (P=0.007 and 0.02 in diabetic and P= 0.007 and P= 0.05 in aging). Peroxidase activity was significantly lower in the aging group (P=0.016) but not the assays with diabetic rats (P=0.34). AGE, RAGE and NF-?B expressions were increased in LG of diabetic and aging rats. Diabetes and aging induce significant alterations in rat LG structure and secretion. The higher expression of AGE, RAGE and NF-?B in LG may suggest that these factors are involved in signalling and in subsequent inflammatory alterations related to dry eye related to these conditions.
Doutorado
Clinica Medica
Doutor em Clínica Médica
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Oliveira, Inês Paula Regina Mainini [UNESP]. "Resolubilidade do cuidado oftalmológico em centro de atendimento secundário sob a ótica dos pacientes diabéticos e não diabéticos." Universidade Estadual Paulista (UNESP), 2017. http://hdl.handle.net/11449/151737.
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Introdução: A resolubilidade em saúde é a resposta satisfatória que o serviço fornece ao usuário quando busca atendimento para alguma necessidade. Frente ao exposto este estudo teve como objetivo principal avaliar a resolubilidade do cuidado oftalmológico em Centro Integrado de Saúde, sob a ótica dos usuários diabéticos e não diabéticos. E, como objetivos secundários: identificar as principais causas de solicitação de avaliação oftalmológica em ambos os grupos; identificar o tempo de espera para o atendimento oftalmológico; identificar os pacientes que tiveram indicação de cuidado oftalmológico para a rede de atenção à saúde, em ambos os grupos; conhecer os motivos que dificultam/atrasam a realização do cuidado, na rede de atenção à saúde, sob a ótica dos mesmos; propor estratégias para otimizar o cuidado aos pacientes que necessitam de cuidado oftalmológico. Método: estudo descritivo, exploratório, transversal e com abordagem mista. Uma amostra não probabilística foi constituída por todos os pacientes atendidos no Centro Integrado de Saúde do interior de São Paulo, no período de novembro de 2013 ao mesmo mês de 2015. Para responder os objetivos do estudo os participantes foram divididos em dois grupos: diabéticos e não diabéticos. A coleta de dados foi realizada em duas etapas: consulta a um banco de dados institucional para caracterização dos participantes e do atendimento médico; e entrevista com os pacientes que tiveram indicação de cuidado oftalmológico no Centro Integrado de Saúde e na rede. Os dados qualitativos foram transcritos e analisados por meio da estratégia metodológica do Discurso do Sujeito Coletivo. Resultados: Na primeira fase foram identificados 816 pacientes, em 920 consultas. A maioria não diabéticos (76,2%), do sexo feminino (61,6%), com nível médio de ensino (65,1%), brancos (92%) e com companheiro (75,7%). A principal causa de solicitação de avaliação oftalmológica, em ambos os grupos, foi a consulta com o especialista, cujo tempo de espera foi menor para os não diabéticos, com diferença estatisticamente significante (p=0,0268). Do total de pacientes, 241 (29,5%) receberam indicação de cuidado oftalmológico, sendo o maior percentual de não diabéticos (69,2%). Na segunda fase do estudo foram entrevistados 208 pacientes cuja síntese das entrevistas contribuíram para elaboração do discurso do sujeito coletivo, agrupado em três temas: Resolubilidade do cuidado oftalmológico sob a ótica dos pacientes; Obstáculos para a realização do cuidado proposto na rede de atenção a saúde e Contribuições para a melhoria do cuidado oftalmológico. Conclusão: Os resultados apresentados evidenciaram que o Centro Integrado de Saúde onde a pesquisa foi realizada apresenta condição de resolubilidade para atender, em grande parte, as reais necessidades oftalmológicas dos usuários do Sistema Único de Saúde. Do total de pacientes atendidos no período do estudo praticamente 30% receberam indicação de cuidado oftalmológico na rede de atenção à saúde, e destes, 69% não eram diabéticos. O principal motivo de avaliação oftalmológica foi a consulta com o especialista, em ambos os grupos, cujo tempo de espera foi maior para os pacientes diabéticos, demonstrando que não há critérios que priorizem o atendimento. Os discursos apontaram que o município não tem controle sobre os desfechos dos cuidados oftalmológicos referenciados a outros serviços, e tão pouco, da contrarreferência. As dificuldades de resolução na rede, sob a ótica dos participantes, referem-se a problemas de gestão, burocráticos e a falta de recursos materiais que dificultam a realização de procedimentos diagnósticos e terapêuticos. Produto da dissertação: Desta forma, o estudo tem como produto a proposição de um protocolo para reorganização do cuidado oftalmológico no Centro Integrado de Saúde tendo como premissas ações regulatórias pautadas em classificação de risco e estabelecimento de fluxo de referência e contrarreferência na rede de atenção à saúde do interior de São Paulo. Outro produto foi o desenvolvimento de uma cartilha sobre as principais complicações oculares ocasionadas pelo diabetes para treinamento da equipe multiprofissional.
Introduction: Resolubility in health is the satisfactory answer that the service provides to the user when seeking care for some need. In view of the above, the main objective of this study was to evaluate the resolubility of ophthalmologic care in the Integrated Health Center, from the perspective of diabetic and non-diabetic users. And, as secondary objectives: to identify the main causes of request of ophthalmological evaluation in both groups; Identify the waiting time for ophthalmologic care; Identify the patients who had an indication of ophthalmologic care for the health care network in both groups; To know the reasons that hinder / delay the performance of care in the health care network, from the point of view of care; Propose strategies to optimize care for patients who need eye care. Method: descriptive, exploratory, transversal study with mixed approach. A non-probabilistic sample consisted of all patients attended at the Integrated Health Center from the interior of São Paulo, from November 2013 to the same month of 2015. In order to respond to the objectives of the study, participants were divided into two groups: diabetic and non-diabetic. Diabetics. Data collection was carried out in two stages: consultation of an institutional database to characterize participants and medical care; And interview with the patients who had indication of ophthalmologic care in the Integrated Health Center and in the network. The qualitative data were transcribed and analyzed through the methodological strategy of the Discourse of the Collective Subject. Results: In the first phase, 816 patients were identified, in 920 consultations. The majority were non-diabetic (76.2%), female (61.6%), with a mean level of education (65.1%), whites (92%) and partners (75.7%). The main cause of request for ophthalmologic evaluation in both groups was consultation with the specialist, whose waiting time was lower for non-diabetics, with a statistically significant difference (p = 0.0268). Of the total number of patients, 241 (29.5%) received an indication for ophthalmologic care, the highest percentage being non-diabetic (69.2%). In the second phase of the study, 208 patients were interviewed whose synthesis of the interviews contributed to the elaboration of Discourse of the Collective Subject, grouped into three themes: Resolubility of ophthalmological care from the perspective of the patients; Obstacles to the realization of the proposed care in the network of health care and Contributions for the improvement of ophthalmological care. Conclusion: The presented results showed that the Integrated Health Center where the research was performed presents a resolubility condition to meet, in large part, the real ophthalmological needs of Unique Health System users. Of the total number of patients seen in the study period, almost 30% received an indication of ophthalmological care in the health care network, of which 69% were non-diabetic. The main reason for ophthalmologic evaluation was consultation with the specialist, in both groups, whose waiting time was higher for diabetic patients, demonstrating that there are no criteria that prioritize the care. The speeches pointed out that the municipality has no control over the outcomes of ophthalmological care referenced to other services, and so little, of the counterreference. The difficulties of solving in the network, from the perspective of the participants, refer to problems of management, bureaucratic and the lack of material resources that make difficult the accomplishment of diagnostic and therapeutic procedures. Product of the dissertation: In this way, the study has as a product the proposal of a protocol for the reorganization of ophthalmologic care in Integrated Health Center, based on regulatory actions based on risk classification and establishment of referral flow and counter-referral in the health care network from the interior of São Paulo. Another product was the development of a playbook on the main ocular complications caused by diabetes for multiprofessional team training.
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Oliveira, Inês Paula Regina Mainini. "Resolubilidade do cuidado oftalmológico em centro de atendimento secundário sob a ótica dos pacientes diabéticos e não diabéticos." Botucatu, 2017. http://hdl.handle.net/11449/151737.
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Orientador: Silmara MeneguinResumo: Introdução: A resolubilidade em saúde é a resposta satisfatória que o serviço fornece ao usuário quando busca atendimento para alguma necessidade. Frente ao exposto este estudo teve como objetivo principal avaliar a resolubilidade do cuidado oftalmológico em Centro Integrado de Saúde, sob a ótica dos usuários diabéticos e não diabéticos. E, como objetivos secundários: identificar as principais causas de solicitação de avaliação oftalmológica em ambos os grupos; identificar o tempo de espera para o atendimento oftalmológico; identificar os pacientes que tiveram indicação de cuidado oftalmológico para a rede de atenção à saúde, em ambos os grupos; conhecer os motivos que dificultam/atrasam a realização do cuidado, na rede de atenção à saúde, sob a ótica dos mesmos; propor estratégias para otimizar o cuidado aos pacientes que necessitam de cuidado oftalmológico. Método: estudo descritivo, exploratório, transversal e com abordagem mista. Uma amostra não probabilística foi constituída por todos os pacientes atendidos no Centro Integrado de Saúde do interior de São Paulo, no período de novembro de 2013 ao mesmo mês de 2015. Para responder os objetivos do estudo os participantes foram divididos em dois grupos: diabéticos e não diabéticos. A coleta de dados foi realizada em duas etapas: consulta a um banco de dados institucional para caracterização dos participantes e do atendimento médico; e entrevista com os pacientes que tiveram indicação de cuidado oftalmológico no Centro Integra... (Resumo completo, clicar acesso eletrônico abaixo)
Mestre
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Jalkebo, Charlotte. "Placement of Controls in Construction Equipment Using Operators´Sitting Postures : Process and Recommendations." Thesis, Linköpings universitet, Maskinkonstruktion, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-108980.
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An ergonomically designed work environment may decrease work related musculoskeletal disorders, lead to less sick leaves and increase production time for operators and companies all around the world. Volvo Construction Equipment wants to deepen the knowledge and investigate more carefully how operators are actually sitting whilst operating the machines, how this affects placement of controls and furthermore optimize controls placements accordingly. The purpose is to enhance their product development process by suggesting guidelines for control placement with improved ergonomics based on operators’ sitting postures. The goal is to deliver a process which identifies and transfers sitting postures to RAMSIS and uses them for control placement recommendations in the cab and operator environments. Delimitations concerns: physical ergonomics, 80% usability of the resulted process on the machine types, and the level of detail for controls and their placements. Research, analysis, interviews, test driving of machines, video recordings of operators and the ergonomic software RAMSIS has served as base for analysis. The analysis led to (i) the conclusion that sitting postures affect optimal ergonomic placement of controls, though not ISO-standards, (ii) the conclusion that RAMSIS heavy truck postures does not seem to correspond to Volvo CE’s operators’ sitting postures and (iii) and to an advanced engineering project process suitable for all machine types and applicable in the product development process. The result can also be used for other machines than construction equipment. The resulted process consists of three independent sub-processes with step by step explanations and recommendations of; (i) what information that needs to be gathered, (ii) how to identify and transfer sitting postures into RAMSIS, (iii) how to use RAMSIS to create e design aid for recommended control placement. The thesis also contains additional enhancements to Volvo CE’s product development process with focus on ergonomics. A conclusion is that the use of motion capture could not be verified to work for Volvo Construction Equipment, though it was verified that if motion capture works, the process works. Another conclusion is that the suggested body landmarks not could be verified that they are all needed for this purpose except for those needed for control placement. Though they are based on previous sitting posture identification in vehicles and only those that also occur in RAMSIS are recommended, and therefore they can be used. This thesis also questions the most important parameters for interior vehicle design (hip- and eye locations) and suggests that shoulder locations are just as important. The thesis concluded five parameters for control categorization, and added seven categories in addition to those mentioned in the ISO-standards. Other contradictions and loopholes in the ISO-standards were identified, highlighted and discussed. Suggestions for improving the ergonomic analyses in RAMSIS can also be found in this report. More future research mentioned is more details on control placement as well as research regarding sitting postures are suggested. If the resulted process is delimited to concern upper body postures, other methods for posture identification may be used.
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Söder, Madeleine. "In-sight." Thesis, 2005. http://hdl.handle.net/10125/12094.
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Goolsby, Thomas Watson. "The parameters of eye movement in vocal music reading." 1987. http://catalog.hathitrust.org/api/volumes/oclc/22282067.html.
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黃致潔. "Tracking Eye Movements in Sight Translation – the comprehension process in interpreting." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/94791121680925903883.
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碩士國立臺灣師範大學
翻譯研究所
99
While the three components of interpreting have been identified as comprehension, reformulation, and production, the process of how these components occur has remained relatively unexplored. The present study employed the eye-tracking method to investigate the process of sight translation, a mode of interpreting in which the input is written rather than oral. The research focused especially on the comprehension component in sight translation, addressed the validity of the horizontal and the vertical perspectives of interpreting, and ascertained whether reading ahead exists in sight translation. Eye movements of 18 interpreting students were recorded during silent reading of a Chinese speech, reading aloud a Chinese speech, and Chinese to English sight translation. Since silent reading consists of the comprehension component while reading aloud consists of the comprehension and production components, the two tasks served as a basis of comparison for investigating comprehension in sight translation. The findings suggested that sight translation and silent reading were no different in the initial stage of reading, as reflected by similar first fixation duration, single fixation duration, gaze duration, fixation probability, and refixation probability. Sight translation only began to demonstrate differences from silent reading after first-pass reading, as shown by higher rereading time and rereading rate. Also, reading ahead occurred in 72.8% of cases in this experiment, indicating the overlap between reading and oral production in Chinese to English sight translation. The results supported the vertical perspective in interpreting as well as the claim of reading ahead. Implications for interpreter training are to attach more importance to paraphrasing skills and to focus more on the similarities between sight translation and simultaneous interpreting.
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WANG, SIAO-JIA, and 王孝家. "Board games for eye sight disabled people - sample ：suntzu's art of war." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/3w6u4b.
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碩士東方設計大學
文化創意設計研究所
106
Population with sight disabilities is increasing in Taiwan during recent years. Related welfare organizations is increasing as well. However studies of sight disabled people only focus on school and careers, rarely pay attention to their spiritual and entertainment requirements. Sight disabled people absolutely entitled to have hobbies and social life just like ordinary people. Writer interviewed with many seriuos sight disabled people and learned that the variation of their recreation activities is limited due to sight disabilities. Normally only verbal communication, difficult to join group activities. This is mainly because of our society does not value entertainment rights of sight disabled people. Board games became popular during recent years in Taiwan. The biggest difference between board games and other recreation activities is it does not require big space as well as no age limitation. Game players are able to play it face to face therefore more interactive with other people. Compare with the isolation and separation of internet world, playing board games is much easier to feel the real emotions and to well behaved. But current board games are mostly depend on good eye sight to observe and proceed. Majority of sight disabled people are unable to experience the fun part. Hence it is difficult to improve social skill and expand social relationships via board games for sight disabled people Writer participated board games design and creation training classes to learn structures and categories of board games. And collect all kind of reports and sight disabled people friendly games in order to well developed this research. Furthermore, writer interviewed 3 board game experts (sight disabled player, experienced player and game lecturer) to gather. Necessary information to confirm my design concept to let sight disabled people fit in the scenario and rules of the board game created by writer. Through physical game playing and questionaire to analyze if this board game is appropriate. Of course this game is also suitable for ordinary people in order to allow sight disabled people obtain the opportunity to interactive with other people. No matter sight disabled people play alone or play with other normal people, everyone could fit in easily. Hopefully there will be more similar games to be circulated in the market to facilitate sight disabled people social life.
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Su, Ya-Wei, and 蘇雅薇. "Cognitive process during pauses in interpreting output: from eye movements in sight translation." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/37379w.
Full textAbstract:
碩士國立臺灣師範大學
翻譯研究所
101
Pause studies have raised the assumption that juncture pauses, pause that occurs at sentence junctures, and hesitation pauses, pause that occurs elsewhere in the sentence, could possess distinct functions and indicate different cognitive processes. However, so far little research has focused on examining the speaker / interpreter’s cognitive reaction right at the moment of pausing, nor has additional data been used to triangulate the oral production analyses. The present study incorporates eye movement data, which has been commonly used in reading studies as indicators of cognitive processes, into the study of pausing in sight translation. The research focused on examining eye fixation location and saccade trajectory at the time of pausing, and comparing eye movement data with oral production. Oral outputs and eye movements of 11 trainee interpreters were recorded during a task of Chinese to English sight translation. Results showed that the eye is usually in the first or second reading pass during juncture pause, and tend to fixate on the upcoming segment after the pause, suggesting the interpreter is engaged in early stages of interpreting, comprehending and reformulating the upcoming text. During hesitation pause, the eye tends to fall in the third reading pass and on, and the pause is likely to begin with a regression, which indicates the interpreter is involved in the error detection stage, solving lexical, syntactic and strategic problems causing production difficulties. The results support the assumption that distinct cognitive processes go on during juncture and hesitation pause. This study may help refine the pause criteria in assessment of interpretation quality, and produce a more systematic way of instructing the control of pauses to interpretation students.
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Luo, Ji, and 羅姞. "Challenges and Strategies in English-to-Mandarin Sight Translation: An Eye Movement Study." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/7b3g6c.
Full textAbstract:
碩士國立彰化師範大學
翻譯研究所
105
Learning sight translation can be frustrating for many student interpreters. In order to overcome the cross-media and cross-cultural barriers unique to sight translation, this study attempts to investigate the differences among seven Linguistic Features and to look for their corresponding strategies based on the visualizations of participants’ eye movements. In particular, with eye-tracking technology, the present study is designed to look for patterns of attentional allocation during sight translation. Twelve participants were instructed to sight translate four English articles into Mandarin Chinese. The text types included a speech transcript, a news article, an academic lecture, and a magazine article. Text difficulties in terms of grammatical complexity and translatability were measured and balanced across the 4 texts. Average number of sentences per text was 13 with completion time of 3 to 4 minutes, and average number of words per sentence was less than 23. The magazine article was on religion and culture. The purpose of choosing such a topic was to challenge participants’ reaction toward culture-loaded terms. Participants’ eye movements were recorded for statistical analyses. In addition, renditions were documented, and strategies such as chunking, simplification, strategic omission, and localization at the expense of faithfulness to the source text, were identified. Linguistic Features was the independent variable of the study, including relative clauses, prepositional phrases, past participles, reference to a reflexive pronoun, low-frequency words, culture-loaded terms, and polysemous words. Key areas of interest (AOIs) group referred to words/phrases that possessed the mentioned Linguistic Features. Each key AOI had a corresponding control AOI that was of the same word length and part of speech. Paired t tests were conducted to investigate the mean differences between key and control AOIs in fixation duration (FD) and regression duration (RD) for each of the seven categories of Linguistic Features. The results supported that key AOIs indeed exhibited longer fixation and regression for most of the features in question. Moreover, according to heat maps and gaze plots, relative pronouns, such as which, that, and who, were found not to be great targets of attention. Instead, adjacent content words after a relative pronoun were the main areas that received more attention. Long fixation duration was found in cultural terms (e.g. throwing divination blocks “擲茭” zhì jiāo, a religious ritual practiced among Chinese), polysemous words (e.g. engage), relative clauses, prepositional phrases, and past participles. Eye regression duration was longer in processing prepositional phrases (e.g. experience in using social media), relative clauses, and low-frequency words than their control counterparts. Moreover, misinterpretation and omission were more frequent during recognition of the referents of reflexive pronouns and during resolution of thematic roles in a relative clause. In summary, the results of this study have provided empirical data describing Taiwanese student interpreters’ attentional allocation to different Linguistic Features. These results will provide future interpreting learners with scalable strategies for reference.
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TAI, SHENG-YAO, and 戴聖耀. "Effect of Sight Reading Ability and Score Difficulty Level on Eye Movement Pattern." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/15165200526581403164.
Full textAbstract:
碩士亞洲大學
心理學系碩士班
98
Nowadays the majority of eye movement studies focus on text or scene/picture, only a few studies aims to understand change in eye movement pattern of score sight-reading, not mentioned the effect of proficiency level and difficulty on it. Therefore the purpose of present study was to understand how different sight reading ability and score difficulty level affect eye movement pattern and the performance of score error-detection task. Concerning the consistency of definitions of proficiency level and difficulty level, the teaching material of YAMAHA music training system was modified to fit the needs of the study and the learners were recruited as experiment participants in both experiments. Experiment I investigated the effect of sight reading proficiency and score difficulty level on initial and later processing stages of eye movement. Results showed that more fixation number and more regression were used to extract the information in the score by proficient and less proficient readers, respectively. In addition, while reading difficult scores, more fixation number and fixation duration were found in both groups of readers, which is consistent with the studies in reading text. Taken together, with different proficient level or reading different difficulty level materials, readers would take use of different strategies to gain the information. Furthermore, the average fixation duration in the initial stage, re-reading time, and regression rate would decreased as the progress of music score in sight reading task. It suggested that the expectation was developed in this process. Thus, experiment II aimed to understand the effect of proficiency and score difficulty on the performance of score error-detection task. Results showed that proficient readers can develop the expectation after 12 measures, but less proficient reader can’t develop the expectation at all. Comparing the results of both experiments and text-reading studies, several eye movement parameters were found to correlated with the development of expectation in either score or text reading. But further research is need to validate the relationship between eye movement parameters and expectation.
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Hsieh, Jen-hsuan, and 謝忍翾. "Comparing cognitive processes during pauses between experienced interpreters and novice interpreters: Eye movements in sight translation." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/94j7j2.
Full textAbstract:
碩士國立臺灣師範大學
翻譯研究所
102
Previous studies on pauses in spontaneous speech believed that juncture pauses, which occurred at syntactic junctures, allowed speakers more time to plan their speech while the rest pauses in a speech, i.e. hesitation pauses, were signs of delivery difficulties and higher cognitive load mostly from lexical retrieval. However, most of the conclusion was made solely from oral output analysis and inference. The current research is a follow-up to Huang (2011), Chen (2013) and Su (2013). This study examined and triangulated pause and eye-movement data from 18 experienced interpreters during sight translation tasks. The data was analyzed and compared with the previous findings from novice interpreters. Inter-group comparison showed that the experienced interpreters made fewer juncture pauses and hesitation pauses than novices. Intra-group comparisons, on the other hand, indicated that the novices made significantly more hesitation pauses than juncture pauses, while no significant difference was found in the experienced interpreters' data. Triangulation of the oral and the eye-movement data showed great divergence between the two groups in where they fixated during pauses, which passes the fixations were in, and direction in which their eyes moved to the positions, indicating very different reading and, possibly, cognitive processes during pauses. Su's findings supported the assumptions in the literature on pauses in spontaneous speech. However, the findings of the current research suggested that the experienced interpreters' cognition process may be different from that in spontaneous speech.
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Ho, Chen-En, and 何承恩. "An Integrated Eye-tracking Study into the Cognitive Process of English-Chinese Sight Translation: Impacts of Training and Experience." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/syv677.
Full textAbstract:
博士國立臺灣師範大學
翻譯研究所
105
Sight translation has long been regarded as nothing more than a pedagogical tool. However, the role of sight translation has become more important in practice, and even necessary for certain fields such as community interpreting. What’s more, with a growing number of studies proving this task to be no easier than other modes of interpreting, we are now granted an opportunity to further develop the discipline of interpreting studies by looking into the cognitive process of sight translation, which can be directly observed with an eye tracker. This study analyzed data of 17 experienced interpreters, 18 interpreting students, and 18 untrained bilinguals, hoping to 1) find out if reading purpose affects reading behavior in different ways, 2) understand the impacts of training and experience, and 3) look more closely at the behavior of reading ahead and pausing during sight translation. The results showed that, different reading purposes did change reading behavior, but there were still similarities between tasks. Reading for comprehension was similar to reading for sight translation in the first pass of reading, while the two started to diverge in the second pass. On the other hand, reading aloud, a task requiring more efforts in the first pass, began to resemble silent reading more than sight translation in the second pass. Generally speaking, the cognitive load imposed on silent reading was similar to (and a little less than) reading aloud, and sight translation was significantly more strenuous. Turning to the impacts of training and experience, it was found that the quality of sight translation was the highest for experts, followed by trainees and then untrained bilinguals. Global data showed less total time and fewer fixations for trained participants than bilinguals. Nevertheless, word counts, mean fixation duration in all local reading indices, and even reading span failed to show any difference. As it turned out, the difference lay in how each group proceeded with the task. Trained participants started sight-translating the text shortly after each trial began, with few fixations of reading ahead, when bilinguals mostly read through the text first, leaving a rather long silence at the outset. In addition, participants with training had significantly fewer fixations before uttering each Chinese character. Experts were extreme in that they rarely got bogged down, even when encountering contrastive linguistic structures. Trainees also manifested a similar tendency, though not as adept at the reformulation skills as experts. Bilinguals, on the opposite, showed much more fixations and longer pauses from time to time. Overall, observable pauses were fewer for those with training, and average verbal gaps were shorter as well, leading to higher fluency and a quicker pace. While the impacts of training were obviously on quality and speed, experience seemed to mainly affect accuracy and the behavior of reading ahead and pausing once sight translation began. Experts, with ample experience, had a non-significant gap between the percentage of hesitation pause and that of juncture pause, whereas the other two groups had significantly more hesitation pauses. Notwithstanding, all groups tended to fixate on principal branching direction (PBD) units at least 50% of the time during pauses. Finally, trained participants (i.e., both experts and interpreting students) did not show any difference between the time spent on processing PBD and non-PBD units in all three tasks. On the other hand, untrained bilinguals already inclined to spend significantly longer time on PBD units during silent reading in a relatively later stage of first-pass processing and for meaning integration in non-first-pass reading. When performing sight translation, the results during silent reading were replicated; what was more, total viewing time on PBD units was also significantly longer, indicating that processing PBD units were more effortful for untrained bilinguals.
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Lin, Jen-Chieh, and 林人傑. "Association of Insulin Analogue and Antihypertensive Drug Use with Sight-Threatening Diabetic Retinopathy in Type 2 Diabetes." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/11074019666950049637.
Full textAbstract:
博士國立臺灣大學
流行病學與預防醫學研究所
102
Objectives: The aims of the study are to estimate age- and sex-specific prevalence and incidence of sight-threatening diabetic retinopathy in Taiwan and evaluate the effect of systemic drugs on prevention of diabetic retinopathy progression, focusing on antihypertensive drugs and long-acting insulin analogues. Materials and Methods: Data was collected from a representative database, Longitudinal Health Insurance Database (LHID) 2005, during 2005, on a total of 222 incident cases of patients with sight-threatening diabetic retinopathy (STDR) among 29,165 type 2 diabetic patients. Sight-threatening diabetic retinopathy was defined as clinically significant macular edema or severe nonproliferative diabetic retinopathy or proliferative diabetic retinopathy according to the classification of the Early Treatment Diabetic Retinopathy Study Research Group. Gender-specific and age-adjusted incidence and prevalence rates of STDR were analyzed for the patients with type 2 diabetes and STDR identified using ICD-9-CM codes and procedure codes. Type 2 diabetic patients aged 20-100 years, with at least one prescription for antihypertensive drugs between 2000 and 2011 were identified from Longitudinal Health Insurance Database (LHID) 2005. The incidence rates of STDR were followed and Cox proportional hazards models were used to analyze the risk associated with antihypertensive drugs. A retrospective cohort consisting of patients with type 2 diabetes aged &;#8805; 20 years and newly initiated on long-acting insulin analogues (glargine and detemir) and intermediate-acting human insulin were identified from the National Health Insurance database between January 2004 and December 2006 and categorized into different cohorts. Risk of developing STDR was determined by Cox proportional hazards models and compared between different cohorts. Results: The number of incident cases of STDR increased in line with the increasing diabetic population during 2005-2011. During 2005, no gender differences in the age-adjusted incidence and prevalence rates were observed. The prevalence of sight-threatening DR was significantly higher when patients were aged 40-59 and 60-79. The crude incidence rates of STDR among patients received thiazide diuretics, alpha-blockers, beta-blockers, angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and calcium channel blockers (CCB) were 16.45, 9.49, 12.81, 19.19, 17.63, and 18.15 per 1,000 person-years. Users of ACEI and ARB were associated with a significantly higher risk than CCB users, independent of baseline characteristics. After adjusting time-varying use of concomitant medications for propensity score (PS) matched or unmatched cohorts, the results showed that patients receiving ACEI, ARB and CCB were associated with a significantly greater risk compared with beta-blocker users. The hazard ratio varied from 1.18 to 1.55 with statistical significance. Of the 32,395 eligible patients, initiators of insulin glargine, insulin detemir and NPH insulin were identified for comparison through propensity score matching. Long-acting insulin analogue, glargine, was not associated with changed risk for STDR by intention-to-treat and time-varying use approaches between either matched or unmatched cohorts. However, patients treated with insulin detemir, were associated with significantly changed risk for sight-threatening DR while analyses were performed by different approach for matched and unmatched cohort. Conclusions: There was no significant difference in the incidence between genders. Our findings provide the evidence that the incident cases of STDR increased among identified type 2 diabetic patients, but the overall prevalence of STDR was in a declining trend in Taiwan, suggesting that decreased mortality rate, better diabetes management, and early detection of treatable DR might contribute to the prevalence patterns. Our study did not support a superiority of ACEI, ARB and CCB over beta-blockers for lowering the progression of DR over 11-year follow-up. While comparing long-acting insulin analogue, glargine, with NPH insulin, no significant difference in the risk of sight-threatening DR was found. However, significantly increased risk was detected in insulin detemir initiators compared with NPH insulin initiators. The strategies that aim at preventing DR by treating type 2 diabetic patients with long-acting insulin analogues remain further prospective studies with longer follow-up period to validate our observations within an appropriate dosage range and to further evaluate the safety of long-acting insulin analogues on reducing the progression of DR.
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Hsu, Yu-chang, and 許育彰. "Factors affecting the use of eye examinations by the patients with diabetes in Taiwan." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/21746349156857195486.
Full textAbstract:
碩士國立中山大學
企業管理學系醫務管理碩士班
104
Background: Diabetic retinopathy is one of major causes of visual disturbance and blindness in the patients with diabetes. Early treatment for retinopathy could be achieved by early detection through eye examinations and reduce the patient’s visual loss. However, the rate of eye examinations was low in the patients with diabetes in Taiwan. It’s needed to further study about the reasons for poor compliance of eye examinations in the patients with diabetes. Objectives: To estimate compliance of eye examinations in the patients with diabetes, to examine factors that affect compliance, and to determine reasons for compliance and non-compliance. Data source and Sample size: Data were obtained from the 2009 Nation Health Interview Survey (NHIS) in Taiwan. A total of 1040 patients with diabetes 12 years of age or older were enrolled in this study. Methods: A cross-sectional population study. The Andersen model was used as the analytic framework, and all variables were categorized into three factors: predisposing, need, and enabling factors. The chi-square test, independent-sample t test, and logistic regression were used to analyze the association between these variables and the use of eye examinations. Results: Of all patients with diabetes, only 45.2% had an eye examination in the past years. By logistic regression, the probability of an eye examination among the patients with diabetes increased with checking sugar level themselves, taking care of their feet, having attended diabetes support group, not living in a rural area, having eye symptoms, having longer duration of diabetes, and taking insulin for sugar control. Hakka people and patients with frequent hospitalizations were less likely to use eye examinations. Conclusion: The study results showed that the utilization rate of eye examinations was low. It’s important to improve the utilization of eye examinations through education about diabetic retinopathy and eye examination. We must aggressively transfer the patients with no any symptoms of eye, early stage of diabetes, mild degree of diabetes and frequent hospitalization to ophthalmology clinic for eye examinations. At last, it’s also needed to resolve the problems of insufficient resources of ophthalmology in a rural area.
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Sukha, Anusha Yasvantrai. "Demographic, medical and visual aspects of diabetic retinopathy and diabetic macular edema." Thesis, 2014. http://hdl.handle.net/10210/9990.
Full textAbstract:
M.Phil. (Optometry)Despite many years of research, diabetic retinopathy (DR), and diabetic macular edema (DME) remain difficult to diagnose, prevent, and treat. The complicated nature of the disease, the limited information on DR and DME and the increasing prevalence of diabetes mellitus (DM) in South Africa, provided motivation for this study. To the best of my knowledge, this is the first study in our country to identify demographic, medical and visual aspects ofDR and DME collectively. A further incentive was the availability in optometry of recently developed computer software based upon multivariate statistics, which provided a unique opportunity to analyze, for example, tri-variate contrast sensitivity acuities using stereo-pair scatter plots. All refractive status measurements were also analyzed and compared with the same method. Together, the results from this study provide a broader clinical and research perceptive on DR and DME. In this cross-sectional study, 202 diabetic patients at the Helen Joseph Hospital in Johannesburg were recruited. Demographic variables included age, gender, race, age of diagnosis, duration of DM, and social habits. Medical variables included systemic conditions present, blood pressures, body mass index (BMI), lipid profiles, glycerated haemoglobin (HbAlc), and other available biochemical data (for example cholesterol, urea and creatinine levels). Visual variables included, distance, pinhole and near visual acuities, contrast sensitivity acuities, refractive status measured with autorefraction, colour vision, Amsler grid, intraocular pressures (lOP), and fundus photography. Administration of the Impact of Visuallmpainnent (IVI) questionnaire provided new information concerning the restrictions in daily living participation caused by DR or DME. The predominant characteristics of the study population consisted of Type 1DM among female Coloured subjects. Approximately 66% of all subjects had also been diagnosed with hypertension. The mean age ofthe subjects was 52 (± 14) years, age of diagnosis 41 (± 13) years, and duration ofDM 10.8 (± 9.7) years. Mean blood pressures (136/81 ± 20.5/11 mmHg) and glycated haemoglobin (HbAlc, 9.9 ± 3.4%) values were slightly higher than the recommended control levels (BP= 120/80 mmHg and HbAlc = 6 to 7%).
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Meyer, Jenna. "Eye-solating corneal innervation profiles to examine epithelial wound healing in a model of type II diabetes." Thesis, 2016. https://hdl.handle.net/2144/19491.
Full textAbstract:
INTRODUCTION: The cornea forms the anterior-most barrier of the eye, consisting of a non-keratinized pseudostratified squamous epithelium, a collagen-based stroma, and an endothelium. It is completely avascular, yet the most densely innervated structure in the human body. The sensory nerves project from the ophthalmic branch of the trigeminal cranial nerve into the limbal/stromal interface. From there, the nerves branch and ascend into Bowman’s membrane, a basal lamina delineating the epithelium from the stroma, and project into the epithelium as free nerve endings. Injury to the corneal epithelium can potentially lead to impaired vision if the wound healing process is not properly initiated. Immediately after injury, nucleotides such as ATP are released and bind to purinergic receptors known to be located in epithelial cell membranes, thereby initiating epithelial cell migration to close the wound. Malfunctions in the interactions between the corneal nerves and their epithelial counterparts during the wound healing process are thought to contribute to the attenuated wound healing characteristic of diabetes. However, the precise nature of these interactions, how they facilitate wound healing, and how they are impaired in diabetes, is not well understood.
OBJECTIVES: Previously, our lab has shown that a member of purinergic family receptors (P2X7) is localized in the basal epithelial cells and becomes relocated to the leading edge of the wound after injury. When the relocation is inhibited, migration is attenuated. Additionally, it is known that diabetic mouse models display slower wound healing rates. The present study has three aims: (1) to replicate the characteristic sub-basal whorl organization of the corneal nerves in organ-cultured corneas; (2) to elucidate the connections between patterns of corneal innervation and purinergic receptor expression; and (3) to understand how these patterns interact to facilitate normal wound healing and how these interactions are disrupted in a diabetic model.
METHODS: Our approach was to use immunohistochemistry of dissected mouse and to visualize the tissue using confocal microscopy. Sensory innervation profiles from diet induced obesity (DIO) mouse corneas and their wildtype C57Bl6 counterparts were compared in unwounded and wounded tissue. To image the nerves a methanol fixation protocol was optimized to examine the sub-basal plexus and the apical nerves. Corneas were dissected, stained with beta III-tubulin, which identifies nerves, and with an antibody to the P2X7 purinergic receptor, which is expressed in the epithelium and nerves. Trephine induced epithelial abrasion injuries were made on separate DIO and control models to compare re-epithelialization and re-innervation between the diseased and healthy states. Corneas were imaged using a Zeiss LSM 700 laser scanning confocal microscope and optical images were taken through the cornea over a distance averaging 115 microns. Corneas were imaged using a macro tiling plugin, stitching 3x3 optical z-stacks into composite images. The 3x3 tiles were created to image the central whorl, as well as the peripheral nerve fibers. Co-localization of P2X7 and betaIII tubulin were determined by thresholding using ImageJ/FIJI software.
RESULTS: The elegant organization of the centralized sub-basal whorl of the control mouse was disrupted in the DIO mouse cornea, appearing fragmented and incomplete. Analysis of 7.5 and 15 wk corneas showed the whorl to be present at 7.5 wks. Average apical nerve fiber projection length was decreased in DIO cornea. Yet, analyses at each epithelial layer demonstrated overall increased apical nerve density in the DIO corneas as compared to control while sub-basal nerve density decreased dramatically. Stromal nerves remained equivalent. P2X7 did co-localize to the large stromal nerve fibers but it was difficult to show the localization along the sub-basal nerve plexus. However in cross-section images, P2X7 displayed an intracellular polarity, and was present along the apical surface of the columnar basal epithelial cells lining the basement membrane. This localization may suggest the presence of P2X7 expressing sensory nerves, which may be ideally poised for communication with the basal cells after injury.
CONCLUSIONS: These data support the hypothesis that there is indeed a difference between diabetic and control corneal innervation. While wound healing differences due to the interaction between sensory nerves and the localization of P2X7 in epithelium at the leading edge remain to be fully elucidated, the novel finding of P2X7 expression in corneal nerves confirms a potential role of purinergic receptor and nerve coordination in conducting the wound healing response.
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Li, Hsiao-Han, and 李小含. "The prevalence and medical utilization of patients with of type 2 diabetes mellitus combine with eye complications." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/77772110707585305251.
Full textAbstract:
碩士國立陽明大學
醫務管理研究所
101
Background and Objective：Diabetic patients increasing in number has become a trend around the world. Statistics from the National Health Insurance Research Database show that the standardized incidence rate in Taiwan rose from 0.805% in 2000 to 0.823% in 2008, and that the prevalence rose from 3.15% in 2000 to 4.22% in 2008. However, in the past research in Taiwan mostly discussed one or a few specifics eye diseases, in particular diabetic retinopathy. As a result, this study attempts to understand the current status of ophthalmic complications which occur after a patient is diagnosed with diabetes in Taiwan. Moreover, it discussed the trend of utilization of medical resources of each eye-related disease which occurs with diabetic patients. Hopefully this study can make some contribution to related policies over prevention and treatment of eye diseases which take place more easily with diabetic patients. Research Method：We conducted a retrospective longitudinal study and analyzed the incidence rate and prevalence rate of diabetes among 1 million samples in 2002-2008. Diabetic patients who were diagnosed in 2003 and who were excluded from suffering from diabetes and eye related disease numbered 10,028 persons. Through Propensity Score Matching by sex, age, residence of living, and Charlson Comorbidity Index (CCI), a total of 10,028 persons were found to be in the non-diabetes group. This study assessed the difference in utilization of medical resources between the diabetes group and the non-diabetes group. Moreover, it estimated survival functions by Kaplan-Meier and compared survival curves for statistically significant difference through Log-Rank test. Regarding prevalence of eye related diseases, Generalized Estimating Equations (GEE) were employed to analyze data which had been followed for long-term. And Wald chi-square test was used to analyze variables to determine if eye related diseases had reached a statistically significant difference. Eye related diseases mentioned in this study include retinopathy, vascular disease in the iris and ciliary body, damage in optic nerves and optic pathway, cataract, glaucoma, visual disturbance, low vision, ablepsia, and vitreous hemorrhage. Results：Among the diabetes group, the highest prevalence in ophthalmic complications was cataract (26%), followed by retinal disorder (13%), visual disturbance, low vision, and ablepsia. Among the non-diabetes group, the highest prevalence in ophthalmic complications was cataract (18%), followed by retinal disorder (13%), visual disturbance, low vision, and ablepsia (12%), and vitreous hemorrhage (8%). Compared with non-diabetic patients, diabetic patients had a higher risk of suffering from ophthalmic complications as follows in order from high to low: retinal disorder (OR=2.88-4.46), glaucoma (OR=1.87-1.96), and disorders in optic nerves, and visual pathways (OR=1.64-1.90). In respect of medical utilization of patients with ophthalmic complications, average annual outpatient visits, average annual cost of outpatient, average annual inpatient visits, average annual cost of inpatient for diabetic patients were 1.18~1.30, 1.05~1.32, 1.19~1.50, 1.27~1.65 times higher than non-diabetic patients, respectively. Conclusion：Compared with non-diabetic patients, diabetic patients were higher in risk of suffering from ophthalmic complications and medical utilization; ophthalmic complications were retinal disorder, glaucoma, disorder of optic nerves and visual pathways, vascular disorder of the iris and ciliary body, etc. We suggest that those patients receive a follow-up and inspection on a regular basis and that they pay particular attention to the incidence and prognosis of eye disease. In so doing, they can receive medical service timely to avoid delaying their treatment and causing inestimable medical costs and loss to society. In the diabetes group, compared to patients without eye disease, patients with eye disease were higher in medical utilization; their eye diseases were retinal disorder, cataract, vascular disorders of the iris and ciliary body, glaucoma, etc. We suggest that, with limited medical resources, the authorities make more proper adjustment and correction to the existing medical care model and the medical cost payment system in order to enhance diabetic patients’ living quality and control medical costs.
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Jeganathan, V. Swetha. "Retinal associations of diabetes and vascular disease." 2009. http://repository.unimelb.edu.au/10187/7056.
Full textAbstract:
Background: Diabetes mellitus and vascular diseases have a significant impact on the eye.Aim: To determine the prevalence, risk factors, and racial/ethnic differences of major eye conditions, particularly retinal conditions, associated with diabetes and vascular diseases.
Scope: To date, the majority of studies have examined the association of retinal vascular calibre and diabetes in predominantly white Caucasian populations. Further elucidation of ethnic differences in effects of hyperglycaemia on early microvascular disease is relevant, particularly amongst Asians where diabetes is likely to see the largest increase in prevalence over the next decade. We therefore examined these findings from three Asian population-based studies, the Singapore Malay Eye Study (n=3280), Singapore Prospective Cohort Study and Singapore Cardiovascular Cohort Study 2 (n=3748).
Results: The prevalence of diabetic retinopathy in the Singapore Malay Eye Study was 35%, and associated with longer duration of diabetes, poorer glycemic and blood pressure control. More importantly, 9.0% had vision-threatening retinopathy, and retinopathy was found in 6.0% of people without diabetes. Retinal vascular calibre changes were incriminated in diseases such as diabetes and hypertension, independent of traditional cardiovascular risk factors. Wider venular calibre was independently associated with early age-related macular degeneration. We also found a novel association between peripheral artery disease and glaucoma, stronger in persons with diabetes, independent of vascular risk factors, supporting the vascular theory of glaucoma.
Implications: Subtle changes in retina, including retinal vascular calibre may be early markers of widespread microvascular changes in diabetes, resulting from chronic hyperglycaemia and other pathogenic processes. These results will have broad implications for understanding the impact of both microvascular and macrovascular complications of diabetes in the Asia Pacific region and targeting relevant therapeutic interventions.
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Chauderlot, Fabienne-Sophie. "Des mots et des corps en Denis Diderot, philosophe, or, I to eye, sight, sense(s) and discourse an essay on body presence and representation in Diderot's Salons and other texts /." 1995. http://catalog.hathitrust.org/api/volumes/oclc/33183291.html.
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Chen, Wan-Hsing, and 陳萬興. "The Factors Study of Children''s Poor Eye Sight and Parents'' concerns Attitude - A Case Study of Low-Grade Students of an Elementary School in Taoyuan County." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/6ypy6g.
Full textAbstract:
碩士健行科技大學
企業管理系碩士班
103
Vision care has usually been a topic that was discussed by the society in Taiwan rcently. The trend of children''s myopia is increasing in Taiwan year by year and the rate of children''s myopia at the age of 7 was up to 20.2% in 2000.The factor that cause myopia are very complicated and good behaviors of vision care are the key points to prevent children''s myopia.We want to find out the relationship between children''s myopia and the attitude of vision care that children and their parents have,and then we want to find out the way to prevent children''s myopia. The purpose of this study is to discuss the relation between children''s eyesight and the care and behavior that children and their parents pay attention to.The examples of this study are from 200 students at 2ndgrade and their parents at a public school that is chosen to promote children''s health in Taoyuan county.The tool of this study is the Likert 5 points questionnaire that adopts children''s life of vision care questionnaire(written by their parents),and children''s knowledge of vision care questionnaire(written by children)that are developed by a project that guide a school to prmote student''s health. The information from the Likert 5 points questionnaire is treated by spss.17 and then treated by descripics T-test and have some conclusions below: 1.Children''s eyesight is very poor at 2nd grade at a public elementary school and the rate of poor eyesight of two eyes is as high as 44.5% and the rate of poor eyesight of girl''s is worse than the rate of boy''s. 2.The attitude to children''s vision care that their parents have is good and the average xcore is 4.26 that reveals a positive attitude.Most student''s parents approve that children shoud have good behavior of vision care,but parents usually ignore the question that whether their children go outside the classroom after a class or not. 3.Children at 2nd grade at a public elementary school in Taoyuan County have good attitude and behavior for their vision care, and the average score is 3.49.The modern 3C have great influence on children''s eyesight and children are hard to restrain thenselves to play the 3C product.The investigation of this study reaveals a fact that children at lower grade like to exercise outdoors after a class and this hobby is good for children eyesights. 4.Children''s eyesight is related to parents care and it''s more effective for children''s good eyesight that their parents pay more attention to children''s vision care. 5.The more the children have good behavior for their vision care the better the children''s eyesight is.The children that use 3C product for a long time a day have a poor eyesight. According to the conclusions above we can dind some facts.Parents care has the influence on children''svision care.The way children exercise their eyes has influence on children''s eyesight.This study advice our government can propagate good ideas for children''s eyesight vision care to the education at home and school,and plan some activities that can urge students do more exercise outdoors.
48
Yeh, Shang-Min, and 葉上民. "Establishment of Alloxan-induced Diabetic New Zealand White Rabbit Model and the Assessment of Taurine on the Protection of Diabetes-Related Eye Disorders." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/00635727731614686600.
Full textAbstract:
碩士中興大學
生命科學院碩士在職專班
99
Diabetes is highly related to eye disorders of patients. Taurine, a conditionally essential amino acid, is capable of scavenging free radicals and exists in the retina of mammals. The objectives of this study were to establish a rabbit model of diabetes-related eye disorders and evaluate the protective effects of taurine on the diabetes-related eye disorders. Type I diabetes were induced in 10-week-old New Zealand White rabbits by a 100 mg/kg alloxan injection. Hyperglycemia (blood glucose concentration over 200 mg/dl for 3 weeks) rabbits were randomly allocated to two groups, i.e., with (DT, n=8) or without (DW, n=8) supplementation with 1% (w/v) taurine in their drinking water. Healthy rabbits without alloxan administration were served as the Control group (CON, n=6). Related parameters including body weight, blood glucose concentrations, refraction, lens and fundus examinations were measured during the 24-week trial period, and electroretinography (ERG) was recorded every 4 weeks. The histological examinations were evaluated in end of the trial. Results showed that increased blood glucose concentration and refraction as well as decreased body weight are observed in DW and DT groups compared to the CON group (P＜0.05). The percentage of cataract in DT group is lower than that in DW group (P<0.05). In addition, a functional evaluation of the retina by ERG revealed that the amplitude of a-wave in DT group is higher (P<0.05) than that in DW group which were not different (P>0.05) from that in the CON group. The abnormity of lens and retina in DW group is higher than that in DT group by histological examination. Based on our data, the diabetes-related eye disorders can be recapitulated in rabbit model and taurine shows its protective roles in diabetes-related eye disorders.
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Chibuga, Emeritus Bugimbi. "Prevalence, severity, risk indicators and impact of visual impairment among diabetic patients in Mkuranga district, Tanzania." Thesis, 2012. http://hdl.handle.net/11394/3959.
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Neto, Inês Ribeiro. "Caracterização de cataratas numa população canina, em ambiente hospitalar." Master's thesis, 2017. http://hdl.handle.net/10437/8262.
Full textAbstract:
Orientação: Margarida AlvesA catarata é uma opacidade parcial ou total das fibras da lente e/ou da sua cápsula. Comum nos cães, constitui uma das principais causas de cegueira nesta espécie. Actualmente, a facoemulsificação é a técnica cirúrgica indicada para o seu tratamento. Este estudo teve como objectivo caracterizar cataratas observadas numa população canina e determinar o estímulo iatotrópico, visão consciente e indicação cirúrgica. A amostra foi constituída por 161 olhos de cães com cataratas diagnosticadas num hospital de referência de Lisboa, entre Março de 2012 e Março de 2015. Observou-se que as cataratas ocorrem sobretudo em cães geriátricos, apresentando distribuição ocular predominantemente bilateral, representando 80% (128/161) da amostra com localizações anatómicas variadas, sendo o envolvimento da totalidade da lente a mais observada com 35,4% (57/161). A etiologia mais prevalente, desconhecida, constituiu 32,9% (53/161) da amostra e o estádio de desenvolvimento revelou-se, sobretudo, incipiente com 57,8% (93/161). Relativamente ao estímulo iatotrópico, o desconhecido foi o mais frequente com 58,4% (94/161); já a visão demonstrou-se maioritariamente preservada com 67,9% (108/159). O tratamento cirúrgico de cataratas foi contra-indicado em 62,1% (100/161) da amostra. Este trabalho realça a importância da sensibilização para o diagnóstico precoce das cataratas, a fim de preservar capacidade visual e bem-estar animal.
A cataract is a partial or total opacity of the lens fibers and/or their capsule. Common in dogs, it is one of the main causes of blindness in the species. Currently, phacoemulsification is the surgical technique indicated for its treatment. The purpose of this study was to characterize cataracts observed in a canine population and determine the iatotropic stimulus, conscious vision and surgical indication. The sample consisted of 161 eyes of dogs with cataracts diagnosed in a reference hospital in Lisbon between March 2012 and March 2015. It was observed that cataracts occur mainly in geriatric dogs, presenting predominantly bilateral ocular distribution, representing 80% (128/161) of the sample with varied anatomic locations, being the entire lens mainly observed with 35.4% (57/161). The most prevalent etiology, unknown, consisted of 32.9% (53/161) of the sample and the developmental stage revealed to be mainly incipient with 57.8% (93/161). Regarding the iatotropic stimulus, the unknown was the most frequent with 58.4% (94/161); yet vision was mostly preserved with 67.9% (108/159). Surgical treatment of cataracts was contra-indicated in 62.1% (100/161) of the sample. This work highlights the importance of sensitization early diagnosis of cataracts, in order to preserve vision and animal welfare.