Introduction: Medical errors are major hazards, and lapses in non-technical skills such as situational awareness contribute to most incidents. Risks are concentrated in acute care, and in crisis situations clinicians can apparently ignore vital information. Poor workplace ergonomics contributes to risk. Existing work into perceptual errors offers insights, but these phenomena have been little researched in medicine. This thesis considers medical non-technical skills and how they are taught, and explores vulnerability to inattentional and change blindness. Methods: Medical human factors and the psychology of perceptual error were reviewed, and a mixed-methods assessment of postgraduate medical curricula completed. Experiments assessed clinicians' interaction with clinical monitoring devices using eye-tracking, and studies were conducted exposing clinicians to various perceptual error stimuli using non-clinical and clinical videos, and simulation. A survey was also conducted to assess clinicians' insight into the phenomena of perceptual error. Results: Non-technical skills feature poorly in medical curricula, and equipment is poorly standardised in critical care areas. Unfamiliar devices slow response times and increase error rate. Clinical training confers no generalisable advantage in perceptual reliability. Even expert clinicians miss important events. Two out of every three life-support instructors for example missed a critical failure in the patient's oxygen supply when watching a recorded emergency simulation. The insight and understanding healthcare staff have of perceptual errors is poor, leading to significant overestimates of perceptual reliability that could have consequences for clinical practice. Conclusions: Perceptual errors represent a latent risk factor contributing to loss of situational awareness. High rates of perceptual error were observed in the video-based experiment. Although lower rates were observed in simulation, important events were still missed by participants that could have serious consequences. The incidence of perceptual error appears sensitive to the method used to test for it, and this has important implications for the design of future experiments testing for these phenomena. Mitigating perceptual error is likely to be challenging, but relatively simple adjustments to team practices in emergency situations may be fruitful.

Denna studie syftar till att bidra med ökade kunskaper om yngre skolelevers kännedom om växter samt växters betydelse i naturen med utgångspunkt i aspekter kopplade till fenomenet plant blindness. Plant blindness innefattar bland annat ett bristande intresse gentemot växter samt en oförmåga att identifiera och benämna dem. I denna kvalitativa intervjustudie av elever och klasslärare i årskurs tre har fokus ålagts elevers kunskaper om vanligt förekommande växtarter i elevernas närmiljö. Eleverna har intervjuats utifrån bildmaterial samt frågor rörande växters betydelse i naturen. Materialet har kodats, kategoriserats och satts i relation till människans sätt att värdera organismer i naturen. Studiens resultat visar i huvudsak att yngre elever har svårigheter att benämna flertalet vanliga växter även om deras artkännedom är mer omfattande än deras kunskaper om artnamn. Elevernas fritid utgör det sammanhang där eleverna främst möter växter medan undervisningssammanhang utvecklar elevernas artkännedom och begreppskunskap. Studien belyser ett omfattande intresse bland barn för olika organismer i naturen men även att en kulturell samhällssyn på växters värde återfinns i yngre elevers resonemang. Lärarens roll är därmed central i elevernas utveckling av artkännedom. En av studiens slutsatser är därmed att utforskande undervisning av växters naturliga kontext är positivt för elevers växtkännedom samt för deras förståelse av naturens ekosystem. / The purpose of this study is to contribute to increased knowledge about young learners' knowledge about plants and the importance of plants in nature, based on aspects linked to the phenomenon of plant blindness. Plant blindness includes a lack of interest in plants as well as an inability to identify and name them. In this qualitative interview study of learners in grade three and their teachers, focus has been placed on learners' knowledge of plant species that are commonly found in the learners' local environment. During the interviews, pictures of common plants were used as well as questions about the importance of plants in nature. The material was coded, categorized and put in relation to man's way of evaluating organisms in nature. The study mainly shows that young learners have difficulty naming common plants, but their species knowledge is more extensive than their ability of naming them. Learners' leisure time is the context where they primarily meet plants, while biology lessons develops learners' species- and conceptual knowledge. The results show that children have a wide interest in various organisms in nature, but also that a cultural societal view on the value of plants is found in young learners' reasoning. The teacher's role is thus central to the learners' development of species knowledge. One conclusion of the study is that teaching about plants in their natural environment is positive for learners' species knowledge and understanding of different ecosystems in nature.

PURPOSE:To assess if intensity-modulated radiotherapy (IMRT) can possibly lead to improved local control and lower incidence of vision impairment/blindness in comparison to non-IMRT techniques when treating sinonasal malignancies / what is the most optimal dose constraints for the optic pathway / and the impact of different IMRT strategies on optic pathway sparing in this setting.METHODS AND MATERIALS:A literature search in the PubMed databases was conducted in July, 2012.RESULTS:Clinical studies on IMRT and 2D/3D (2 dimensional/3 dimensional) RT for sinonasal malignancies suggest improved local control and lower incidence of severe vision impairment with IMRT in comparison to non-IMRT techniques. As observed in the non-IMRT studies, blindness due to disease progression may occur despite a lack of severe toxicity possibly due to the difficulty of controlling locally very advanced disease with a dose less than or equal to] 70Gy. Concurrent chemotherapy's influence on the the risk of severe optic toxicity after radiotherapy is unclear. A maximum dose of less than or equal to] 54Gy with conventional fractionation to the optic pathway may decrease the risk of blindness. Increased magnitude of intensity modulation through increasing the number of segments, beams, and using a combination of coplanar and non-coplanar arrangements may help increase dose conformality and optic pathway sparing when IMRT is used.CONCLUSION:IMRT optimized with appropriate strategies may be the treatment of choice for the most optimal local control and optic pathway sparing when treating sinonasal malignancy.

<p>The aim of this thesis is to develop an technical aid (software) to help people with colourblindness. Colour blind people have difficulties to differentiate between certain colours,so the implemented software will name a selected colour. The software is implementedas a Mozilla Firefox extension and also uses a XPCOM component. Furthermore canthe user select different colour databases and change the displaying properties.The aim of this thesis is to develop an technical aid (software) to help people with colourblindness. Colour blind people have difficulties to differentiate between certain colours,so the implemented software will name a selected colour. The software is implementedas a Mozilla Firefox extension and also uses a XPCOM component. Furthermore canthe user select different colour databases and change the displaying properties.</p>

The purpose of the study was to explore perceptual-motor differences between blind and sighted adults from a neuropsychological perspective, and to analyze differences within the blind group. Perceptual-motor abilities were examined using the Comprehensive Vocational Evaluation System (CVES), a vocational rehabilitation and neuropsychological battery designed for use with blind populations. The data were processed using Analysis of Covariance. Results showed that sighted persons had better motor abilities, while persons with blindness were more skilled at haptic identification of shape and texture. Analysis within the blind group showed that texture identification skills are better when blindness occurs earlier in life and to the extent that the blindness is total. Later onset blindness and the retention of some functional vision may not lead to a refocusing of attentional states necessary to develop haptic images. New neural connections may develop in persons with congenital/total blindness, a hypothesis in line with recent neuroradiological findings that occipital lobe activation occurs when congenitally blind individuals engage in tactile processing tasks. One implication of the findings is that teaching individuals who retain some functional vision to read Braille is probably counterproductive. These individuals would be better served by learning to use a CCTV and large print books. Future researchers should examine blindness from a multivariate perspective, examining subsets of blind groups based on age at onset, visual status, and other pertinent variables. Other implications are discussed and recommendations for future research are provided.

It is apparent from the historical perspective regarding the theories of cognitive development and the cognitive functioning of individuals with visual impairments, that sight plays a major role in the development of certain cognitive processes. However, the affects of visual impairment on cognitive development remain to be at issue. Since sight seems to be highly integral in cognitive development beginning in the early stages of physical development, about the sixth month of life, and then begins to diminish in importance as verbal communication develops around eighteen months, then it should stand to reason that significant visual impairment or blindness occurring prior to this time would adversely impact an individual's cognitive development. Conversely, the occurrence of visual impairment or blindness after this critical period of development would have less of an impact. Cognitive theorists have proposed that visually impaired or blind persons may have developed different cognitive pathways to acquire, process, and accommodate sensory information. As a result, visually impaired or blind (VI/B) persons may "think differently" than sighted individuals. The present study was designed to address these issues as they relate to cognitive and neuropsychological development at various stages of growth and to examine possible differences in neuropsychological functioning dependent on the level of visual functioning a person retains; e.g. both the issues of age at onset and degree of impairment. It was also designed to study the possible interaction effects of degree of impairment with the age of onset. Findings indicated that the only differences in cognitive functioning appear to be related to age of onset and not the level of visual impairment. The findings further suggested that congenitally blind individuals have indeed developed alternate methods of cognitively processing nonverbal, abstract, or complex information, especially information involving a high degree of spatial orientation. Implications of this study may influence the educational methods used to teach congenitally blind individuals in order to reinforce these alternate pathways and facilitate more effective means of negotiating in a sighted environment.

En años recientes, el uso de tabletas y teléfonos o dispositivos inteligentes ha incrementado continuamente gracias a la facilidad y disponibilidad de acceso a la información, entretenimiento y comunicación que ofrecen con su creciente variedad de aplicativos y especialmente su acceso a internet. A diferencia de computadoras o notebooks, estos dispositivos tienen tecnologías para mejorar la usabilidad para personas con dificultades visuales que también pueden ser utilizadas para crear nuevos aplicativos de asistencia sin la necesidad de aparatos externos. Esto genera oportunidades para un desarrollo inclusivo que mantiene la misma portabilidad. Sin embargo, estos dispositivos principalmente usan una pantalla táctil y aún entre sus tecnologías incorporadas, no tienen medios para ingresar datos que sean permitan que personas con ceguera ingresen información por otros medios que no sean su voz o un complejo teclado QWERTY. En este artículo, proponemos el uso de una solución adaptativa que permite al usuario usar la misma pantalla táctil como una alternativa para ingresar datos al simular un teclado Braille y demostramos su uso, además de tecnologías de lector de texto, con una aplicación que permite que una persona ciega chatee mediante mensajes instantáneos.

INTRODUÇÃO: A baixa visão na infância pode limitar as experiências de vida, a velocidade de realização de tarefas, o desenvolvimento motor, as habilidades, a educação e o desenvolvimento emocional e social, com comprometimento da qualidade de vida. O conhecimento de aspectos médico-sociais colaboram para a elaboração de ações efetivas para a reabilitação visual e a inclusão educacional. OBJETIVOS: 1)Identificar aspectos clínicos referentes a população com baixa visão em idade escolar atendida no Serviço de Visão Subnormal da Clínica Oftalmológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo e da Associação Brasileira de Assistência ao Deficiente Visual, com relação a causa da baixa visão, localização da anormalidade, classes de comprometimento visual, função visual atual, prescrição óptica para correção de ametropias e para auxílios para baixa visão; necessidades reabilitacionais; 2) Verificar percepção de mães ou responsáveis quanto a detecção da deficiência visual, encaminhamentos e condutas realizados por profissionais da área médica, acesso a serviços de atenção oftalmológica especializada à baixa visão, acesso a auxílios ópticos prescritos para baixa visão; 3) fornecer subsídios para desenvolvimento de ações para habilitação/reabilitação da baixa visão na infância. MÉTODOS: Realizou-se estudo transversal analítico, tendo sido estudadas a população de 115 escolares com baixa visão, sem outras deficiências associadas e a população de mães ou responsáveis pelos escolares, detectados no período de fevereiro a novembro de 2005. Realizou-se a avaliação oftalmológica dos escolares e aplicou-se questionário semi-estruturado às mães ou responsáveis. RESULTADOS: As principais causas da deficiência visual foram a retinocoroidite macular bilateral por toxoplasmose congênita (27,8%), a catarata congênita (11,3%), o albinismo oculocutâneo (7,8%) e o glaucoma congênito (6,1%); a retina foi a principal localização da afecção ocular causadora da deficiência visual (54,8%); as principais etiologias foram hereditárias (36,5%) e pré-natais infecciosas (32,1%); as classes de deficiência visual moderada(67,8%) e grave (27,0%) foram mais freqüentes;a correção óptica da ametropia foi prescrita para todos os casos de retinocoroidite macular bilateral, de amaurose congênita de Leber e de albinismo oculocutâneo; os auxílios ópticos para longe (87,8%) foram mais prescritos que os auxílios ópticos para perto (34,7%); a mãe foi a pessoa que percebeu primeiro a dificuldade visual em 53,0%; a escola foi importante na detecção de problemas visuais nos escolares com baixa visão (6,1%); o pediatra mostrou-se despreparado para a detecção de problemas visuais, tratamentos, orientação à família e encaminhamentos; diagnosticou-se a baixa visão no primeiro ano de vida em 83,0% dos casos; o encaminhamento a serviços de reabilitação visual foi realizado tardiamente ao diagnóstico e ocorreu principalmente na idade escolar (53,9%); o principal responsável pelo encaminhamento a serviços de reabilitação foi o oftalmologista(60%); a menor parte dos escolares havia sido atendida por outro serviço de reabilitação (23,0%); apesar da existência de outros serviços terciários de reabilitação visual na cidade de São Paulo, 67,0% dos responsáveis não tinha conhecimento dos mesmos. CONCLUSÕES: Verifica-se necessidade de: programas de detecção precoce de problemas visuais na infância, por meio de capacitação de pediatras em saúde ocular; programas de detecção de problemas oculares na idade escolar, em parceria com serviços de saúde e educação, como a Campanha Olho no Olho; capacitação de professores do sistema regular de ensino, quanto à saúde ocular e aspectos da baixa visão; maior acesso a auxílios ópticos prescritos à pessoa com baixa visão;educação continuada de oftalmologistas para atuação na área da baixa visão e maior divulgação das implicações da baixa visão na infância e na vida adulta e dos serviços disponíveis na comunidade. / INTRODUCTION: Low vision in childhood can limit experiences, speed in performing daily activities, sensory and motor development, educational, social and emotional improvement and compromise quality of life. Knowledge of medical and social features can cooperate to the development of effective actions to educational inclusion and visual rehabilitation. OBJECTIVES: 1. to identify clinical features of a population of school age children with low vision evaluated at the low vision service of the University of São Paulo Ophthalmology Department and the Brazilian Association for the Visually Impaired. (Laramara) concerning causes of low vision, anatomical site of the abnormality, classes of visual impairment, visual functions, use of optical correction, low vision devices and rehabiliattion needs. 2. to evaluate perceptions of mothers or the persons responsible concerning detection of the visual impairment, procedures of the professionals involved, access to low vision services and to the prescribed low vision aids. 3. to contribute to improve actions of habilitation or rehabilitation of visually impaired school children. METHODS: a population of 115 school children with visual impairment was submitted to ophthalmologic low vision evaluation and a semistructured questionnaire was applied to the mother or person responsible. RESULTS: main causes of visual impairment were presumed toxoplasmic retinochoroiditis(27,8%), congenital cataracts (11,3%), albinism (7,8%) and congenital glaucoma (6,1%). Retina (54,8%) was the main affected area and the main causes involved heredity (36,5%) or pre-natal infections (32,1%). Moderated (67,8%) and Severe (27,0%) low vision were more frequent. Glasses for refractive errors were prescribed to all with bilateral macular retinochoroiditis, Leber congenital amaurosis and albinism. Mothers were the first to notice visual impairment in the majority of cases (53,0%) and the school was also important (6,1%). Pediatricians were not very efficient in the detection of visual impaiment in these children. Low vision was detected in the first year of life in 83% and referral to visual rehabilitation unit ocurred chiefly at school age (53,9%), being the ophthalmologist the professional responsible for the majority of referrals(60%). These children, in general, never had a prior low vision examination (73%) and the mothers or responsibles had little knowledge of other available rehabilitation units in the area (67,0%). CONCLUSIONS: early detection programs for visual impairment in children and capacitation of pediatricians is important as well as the screening for refractive errors of children at school age. Regular school teachers should receive information on basic eye health and low vision. Improved access to low vision aids and increased awareness on the subject among ophthalmologists is a necessity as well as more information on community services and visual impairment should be available to the population.

INTRODUÇÃO: A baixa visão na infância pode limitar as experiências de vida, a velocidade de realização de tarefas, o desenvolvimento motor, as habilidades, a educação e o desenvolvimento emocional e social, com comprometimento da qualidade de vida. O conhecimento de aspectos médico-sociais colaboram para a elaboração de ações efetivas para a reabilitação visual e a inclusão educacional. OBJETIVOS: 1)Identificar aspectos clínicos referentes a população com baixa visão em idade escolar atendida no Serviço de Visão Subnormal da Clínica Oftalmológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo e da Associação Brasileira de Assistência ao Deficiente Visual, com relação a causa da baixa visão, localização da anormalidade, classes de comprometimento visual, função visual atual, prescrição óptica para correção de ametropias e para auxílios para baixa visão; necessidades reabilitacionais; 2) Verificar percepção de mães ou responsáveis quanto a detecção da deficiência visual, encaminhamentos e condutas realizados por profissionais da área médica, acesso a serviços de atenção oftalmológica especializada à baixa visão, acesso a auxílios ópticos prescritos para baixa visão; 3) fornecer subsídios para desenvolvimento de ações para habilitação/reabilitação da baixa visão na infância. MÉTODOS: Realizou-se estudo transversal analítico, tendo sido estudadas a população de 115 escolares com baixa visão, sem outras deficiências associadas e a população de mães ou responsáveis pelos escolares, detectados no período de fevereiro a novembro de 2005. Realizou-se a avaliação oftalmológica dos escolares e aplicou-se questionário semi-estruturado às mães ou responsáveis. RESULTADOS: As principais causas da deficiência visual foram a retinocoroidite macular bilateral por toxoplasmose congênita (27,8%), a catarata congênita (11,3%), o albinismo oculocutâneo (7,8%) e o glaucoma congênito (6,1%); a retina foi a principal localização da afecção ocular causadora da deficiência visual (54,8%); as principais etiologias foram hereditárias (36,5%) e pré-natais infecciosas (32,1%); as classes de deficiência visual moderada(67,8%) e grave (27,0%) foram mais freqüentes;a correção óptica da ametropia foi prescrita para todos os casos de retinocoroidite macular bilateral, de amaurose congênita de Leber e de albinismo oculocutâneo; os auxílios ópticos para longe (87,8%) foram mais prescritos que os auxílios ópticos para perto (34,7%); a mãe foi a pessoa que percebeu primeiro a dificuldade visual em 53,0%; a escola foi importante na detecção de problemas visuais nos escolares com baixa visão (6,1%); o pediatra mostrou-se despreparado para a detecção de problemas visuais, tratamentos, orientação à família e encaminhamentos; diagnosticou-se a baixa visão no primeiro ano de vida em 83,0% dos casos; o encaminhamento a serviços de reabilitação visual foi realizado tardiamente ao diagnóstico e ocorreu principalmente na idade escolar (53,9%); o principal responsável pelo encaminhamento a serviços de reabilitação foi o oftalmologista(60%); a menor parte dos escolares havia sido atendida por outro serviço de reabilitação (23,0%); apesar da existência de outros serviços terciários de reabilitação visual na cidade de São Paulo, 67,0% dos responsáveis não tinha conhecimento dos mesmos. CONCLUSÕES: Verifica-se necessidade de: programas de detecção precoce de problemas visuais na infância, por meio de capacitação de pediatras em saúde ocular; programas de detecção de problemas oculares na idade escolar, em parceria com serviços de saúde e educação, como a Campanha Olho no Olho; capacitação de professores do sistema regular de ensino, quanto à saúde ocular e aspectos da baixa visão; maior acesso a auxílios ópticos prescritos à pessoa com baixa visão;educação continuada de oftalmologistas para atuação na área da baixa visão e maior divulgação das implicações da baixa visão na infância e na vida adulta e dos serviços disponíveis na comunidade. / INTRODUCTION: Low vision in childhood can limit experiences, speed in performing daily activities, sensory and motor development, educational, social and emotional improvement and compromise quality of life. Knowledge of medical and social features can cooperate to the development of effective actions to educational inclusion and visual rehabilitation. OBJECTIVES: 1. to identify clinical features of a population of school age children with low vision evaluated at the low vision service of the University of São Paulo Ophthalmology Department and the Brazilian Association for the Visually Impaired. (Laramara) concerning causes of low vision, anatomical site of the abnormality, classes of visual impairment, visual functions, use of optical correction, low vision devices and rehabiliattion needs. 2. to evaluate perceptions of mothers or the persons responsible concerning detection of the visual impairment, procedures of the professionals involved, access to low vision services and to the prescribed low vision aids. 3. to contribute to improve actions of habilitation or rehabilitation of visually impaired school children. METHODS: a population of 115 school children with visual impairment was submitted to ophthalmologic low vision evaluation and a semistructured questionnaire was applied to the mother or person responsible. RESULTS: main causes of visual impairment were presumed toxoplasmic retinochoroiditis(27,8%), congenital cataracts (11,3%), albinism (7,8%) and congenital glaucoma (6,1%). Retina (54,8%) was the main affected area and the main causes involved heredity (36,5%) or pre-natal infections (32,1%). Moderated (67,8%) and Severe (27,0%) low vision were more frequent. Glasses for refractive errors were prescribed to all with bilateral macular retinochoroiditis, Leber congenital amaurosis and albinism. Mothers were the first to notice visual impairment in the majority of cases (53,0%) and the school was also important (6,1%). Pediatricians were not very efficient in the detection of visual impaiment in these children. Low vision was detected in the first year of life in 83% and referral to visual rehabilitation unit ocurred chiefly at school age (53,9%), being the ophthalmologist the professional responsible for the majority of referrals(60%). These children, in general, never had a prior low vision examination (73%) and the mothers or responsibles had little knowledge of other available rehabilitation units in the area (67,0%). CONCLUSIONS: early detection programs for visual impairment in children and capacitation of pediatricians is important as well as the screening for refractive errors of children at school age. Regular school teachers should receive information on basic eye health and low vision. Improved access to low vision aids and increased awareness on the subject among ophthalmologists is a necessity as well as more information on community services and visual impairment should be available to the population.

[pt] A proposta deste estudo exploratório é mostrar alguns aspectos estéticos da percepção háptica através de pesquisa teórica e prática. O trabalho questiona a interpretação da tradicional acepção estética ocidental que restringe aos olhos e ouvidos a capacidade de nos colocar em contato com o belo. A pesquisa prática consiste na experimentação com objetos de arte e de design em ambiente escuro buscando avaliar a possibilidade de fruição do belo háptico por pessoas cegas e não cegas. A experimentação realizou-se dentro de uma estrutura denominada domos geodésico construída com tecnologia desenvolvida pelo Laboratório de Investigação em Living Design (LILD) da Pontifícia Universidade Católica do Rio de Janeiro (PUC-RJ). A conclusão fundamentase no conceito de belo como sentimento estético sendo, portanto, um saber que se manifesta na liberdade do plano espiritual podendo, assim, ser denominado como conhecimento. A ascendência do sujeito ao campo estético do Outro se coloca, no trabalho, como principal caminho para a constituição dos princípios imaginativos, não só do Belo, mas também do Bem e da Verdade que integram a consciência do ser, ou seja, sua própria existência. / [en] The proposal of this study is to show some aesthetic aspects of the tactile perception through theoretical and practical research. This work questions the interpretation of the traditional-occidental aesthetic sense which restricts to eyes and ears the capacity of placing us in contact with beauty. The practical research consists of the experimentation with art and design objects, in a dark environment searching to evaluate the possibility of enjoyment of the tactile beauty for blind and seeing people. The experimentation was concluded inside a structure called Geodesic Domes, constructed with technology developed by the Laboratory of Inquiry in Living Design (LILD) of the Pontifical University Catholic of Rio de Janeiro (PUC-RJ). The conclusion is based on the concept of beauty as aesthetic feeling, a knowledge that manifests itself in the freedom of the spiritual level, thus, considered as knowledge. The ascendance of the subject to the aesthetic field of the Other is placed, in this work, as the principal way for the constitution of the imaginative principles, not only of Beuty, but also of Good and Truth that integrate the conscience of the being, that is, its proper existence.