131 resultados para Visual impairment and blindness


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Introduction

Belfast has been a focus of academic attention for the last forty years with most interest centred on various aspects of ‘the Troubles’. Where there has been interest in the built environment, it has largely been about how the ‘security situation’ impacted directly on architecture and on the design and layout of social housing. This paper seeks to go beyond this to explore how the political- administrative culture of ‘the Troubles’ interacted with ‘normal’ market forces to shape the central area of the city, and to consider the responses of a recently formed activist group, known as the Forum for Alternative Belfast (hereafter referred to as the Forum). The paper is written by three of the directors of the Forum.1 Moreover, the empirical research presented here was undertaken by the Forum as part of a campaign to address issues relating to the design, layout and quality of Belfast’s built environment. In the longstanding tradition of participant observation working within an action-research paradigm, the participants have attempted to offer an account that is evidentially and purposefully selfcritical and reflective. It is of course recognised that while this approach offers many positive attributes, such as phenomenological access through immersion in the project, it also has the potential to bring compromise on research detachment and objectivity.2 To address the latter, the authors have attempted
to avoid polemical argument, and to support claims with primary or secondary research evidence. The authors also acknowledge that action-research has a chequered history; however, they would argue
that their approach is faithful to a concept that sees ‘research’ defined as understanding and ‘action’ defined as seeking change. The Forum’s very purpose is to seek change, but to do this requires evidence, collaboration and demonstration. And in this sense, it is a learning process for all participants, including the research activists, government officials, community organisations and students. The authors also recognise the complexity of factors that affect urban management and change, particularly in a city such as Belfast, which has had to cope with political violence for over thirty years. And they appreciate that in the context of conflict, governance is skewed to cope with political realities. Hamdi reminds us, however, that in practice there is an ‘important dialectic between top-down planning, with its formal and designed laws and structures, and bottom-up selforganizing collectivism—those “quantum and emergent systems” which Jane Jacobs argued long ago give cities their life and order.’3

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The hawari (local communities) of Old Cairo resemble a unique societal context whose history is actively involved in the contemporary everyday production of local habits, traditions and social practice. By the virtue of its durability and ability to survive, Architecture brings events and traditions of the past alive into the present through the spatial transformation, social practice and the value of the historical-fabric. The presence of buildings and houses from different historical periods has helped the local community’s memory to carry social practices over from one generation to another. This article explores the relationship between architecture, memory and everyday social practices through determining the way architecture moderates community experiences and communicates narratives among generations in haret al-Darb al-Asfar in old Cairo. Architecture emerges as a moderator of cross-time communication and as physical elements that help visualize history, situate values and materialize local traditions in old Cairo. Architecture, as process and product this article reports, works as agent of continuity, which in conjunction with the narrators, brings the full experience of the past alive in the present and helps guide future generations.

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In the early and mid-Victorian period public pronouncements by evangelicals were often described as the antithesis of rational speech. The voice of science, on the other hand, was routinely equated with the voice of reason. This disparity was particularly clear in satirical and critical commentary about the platform rhetoric associated with London’s Exeter Hall, a key meeting place for evangelicals and a metonym for evangelical expressions of Christian belief. It was against this backdrop that the fledgling Young Men’s Christian Association inaugurated a popular series of lectures in 1845. Held in Exeter Hall from 1848, the series ran until 1865 and proved to be immensely popular. By investigating the ways in which the promotion of science was combined with religious exhortation in the YMCA lectures, this paper examines how evangelicals positioned themselves with respect to the growing cultural authority of science. The paper also argues that these efforts were indelibly marked by the Hall and the communicative medium in which they were made. As such, the paper sheds light on the significance of platform culture within and beyond evangelicalism and on the importance of venue and audience in understanding science and religion relations in an age of lecturing.

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This article considers cows and dairying as the basis a17of value system in early societies, particularly in Ireland. Only in a very few instances is it possible to demonstrate that such systems existed. When it does, it can be shown that cows and dairying were imbedded in the social or religious institutions of these cultures. Cattle had a value and meaning much greater than their economic worth in terms of food, hides, tallow etc. Such a systems, however, does not allow economic development as dairy produce does not easily lend itself to the production, and accumulation, of significant surplus nor is dairy produce particularly suitable for economic expansion based on trade. Its perishable nature militates against both roles. In order to develop political power that is based on economic power and wealth it is necessary to change the emphasis from livestock to cereal production.

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Aim.  This paper is a report of a study conducted to describe the health of children with cerebral palsy and investigate predictors of stress in their parents. Background.  Children with severe cerebral palsy tend to have poorer health than their able-bodied peers, and their parents are more likely to be stressed and have poorer health. Method.  A cross-sectional survey with home visits using standard questionnaires was administered to parents in 2004–05. A total of 102/199 (51%) children and parents participated. The children were compared with a normative sample. Results.  Children with cerebral palsy had poorer physical health, and 79% of parents reported that their child had moderate to severe pain. Their poorer health, in comparison with the normal sample and measured by the Child Health Questionnaire, was related to feeding problems and seizures, general health perceptions to intellectual and feeding impairment, and family activities with severe motor, intellectual and feeding impairment. Poorer psychological well-being on the hyperactivity domain of the Strengths & Difficulties Questionnaire was related to feeding difficulties, on the prosocial domain to more severe forms of all child impairments, and on the social impairment scale to intellectual impairment. Children with psychological problems had statistically significantly increased odds (OR = 7·2, 95% CIs 2·6–20·3) of having parents with high stress. Conclusion.  Children with cerebral palsy and associated impairments are at higher risk of poorer health and family well-being. A family-centred approach to the care of children with cerebral palsy and their families is essential to ensure both receive adequate care and support.

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This article links Thomas Hardy’s exploration of sympathy in Jude the Obscure to contemporary scientific debates over moral evolution. Tracing the relationship between pessimism, progressivism, and determinism in Hardy’s understanding of sympathy, it also considers Hardy’s conception of the author as enlarger of “social sympathies”--a position, I argue, that was shaped by Leslie Stephen’s advocacy of novel writing as moral art. Considering Hardy’s engagement with writings by Charles Darwin, T. H. Huxley, Herbert Spencer, and others, I explore the novel’s participation in a debate about the evolutionary significance of sympathy and its implications for Hardy’s understanding of moral agency. Hardy, I suggest, offered a stronger defence of morality based on biological determinism than Darwin, but this determinism was linked to an unexpected evolutionary optimism.

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Aim.  This article is a report of recruitment bias in a sample of 5–25-year-old patients with severe cerebral palsy.

Background.  The way in which study participants are recruited into research can be a source of bias.

Method.  A cross-sectional survey of 5–25-year-old patients with severe cerebral palsy using standardized questionnaires with parents/carers was undertaken in 2007/2008. A case register was used as the sampling frame, and 260 families were approached: 178/260 (68%) responded and 82/260 families never replied (non-respondents). Among responders: 127/178 (71%) opted in to the study, but only 123/127 were assessed, and 82/178 were opted out (or refused). Multivariable logistic regression giving odds ratios was used to study the association between participant characteristics and study outcomes (responders vs. non-responders; opting in vs. opting out; assessed vs. eligible, but not assessed).

Results.  Responders (compared with non-responders) were significantly more likely to have a family member with cerebral palsy who was male and resident in more affluent areas. Families who opted in (compared with those opting out and refusing) were more likely to have a family member with cerebral palsy and intellectual impairment and to reside in certain geographical areas. Families who were actually assessed (compared with all eligible, but not assessed) were more likely to have a family member with cerebral palsy and intellectual impairment.

Conclusion.  Several sources of bias were identified during recruitment for this study. This has implications for the interpretation and conclusions of surveys of people with disabilities and complex needs.

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Age-related macular degeneration (AMD) is the most common cause of incurable visual impairment in high-income countries. Previous studies report inconsistent associations between AMD and apolipoprotein E (APOE), a lipid transport protein involved in low-density cholesterol modulation. Potential interaction between APOE and sex, and smoking status has been reported. We present a pooled analysis (n = 21,160) demonstrating associations between late AMD and APOe4 (odds ratio [OR] = 0.72 per haplotype; confidence interval [CI]: 0.65-0.74; P = 4.41×10(-11) ) and APOe2 (OR = 1.83 for homozygote carriers; CI: 1.04-3.23; P = 0.04), following adjustment for age group and sex within each study and smoking status. No evidence of interaction between APOE and sex or smoking was found. Ever smokers had significant increased risk relative to never smokers for both neovascular (OR = 1.54; CI: 1.38-1.72; P = 2.8×10(-15) ) and atrophic (OR = 1.38; CI: 1.18-1.61; P = 3.37×10(-5) ) AMD but not early AMD (OR = 0.94; CI: 0.86-1.03; P = 0.16), implicating smoking as a major contributing factor to disease progression from early signs to the visually disabling late forms. Extended haplotype analysis incorporating rs405509 did not identify additional risks beyond e2 and e4 haplotypes. Our expanded analysis substantially improves our understanding of the association between the APOE locus and AMD. It further provides evidence supporting the role of cholesterol modulation, and low-density cholesterol specifically, in AMD disease etiology.

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The films of Wes Anderson feature a peculiar attention to the representation of dwellings in relation to narrative development, filmic style and characters' identities. As is true of clothing, in Anderson's cinema homes with their architecture, furniture and objects strongly contribute to a nostalgic dislocation of the characters from contemporary time. Considering the house as the prime locus of identity and the core of the patriarchal family, the family home is often depicted by Anderson as the last physical trace left by the absent father; a utopian place that the characters aim to rebuild or to recall through its objectification. This paper aims to analyse the (re)construction of the family home in The Royal Tenenbaums, and will investigate its absence and surrogates in The Darjeeling Ltd.

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This article addresses the relative absence of class-based analysis in theatre and performance studies, and suggests the reconfiguration of class as performance rather than as it is traditionally conceived as an identity predicated solely on economic stratification. It engages with the occlusion of class by the ascendancy of identity politics based on race, gender and sexuality and its attendant theoretical counterparts in deconstruction and post-structuralism, which became axiomatic as they displaced earlier methodologies to become hegemonic in the arts and humanities. The article proceeds to an assessment of the development of sociological approaches to theatre, particularly the legacy of Raymond Williams and Pierre Bourdieu. The argument concludes with the application of an approach which reconfigures class as performance to the production of Declan Hughes's play Shiver of 2003, which dramatizes the consequences of the dot.com bubble of the late 1990s for ambitious members of the Irish middle class.

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Age-related macular degeneration (AMD), is the leading cause of blind registration in the Western World among individuals 65 years or older. Early AMD, a clinical state without overt functional loss, is said to be present clinically when yellowish deposits known as drusen and/or alterations of fundus pigmentation are seen in the macular retina. Although the etiopathogenesis of AMD remains uncertain, there is a growing body of evidence in support of the view that cumulative oxidative damage plays a causal role. Appropriate dietary antioxidant supplementation is likely to be beneficial in maintaining visual function in patients with AMD, and preventing or delaying the progression of early AMD to late AMD. The Carotenoids in Age-Related Maculopathy (CARMA) Study is a randomized and double-masked clinical trial of antioxidant supplementation versus placebo in 433 participants with either early AMD features of sufficient severity in at least one eye or any level of AMD in one eye with late AMD (neovascular AMD or central geographic atrophy) in the fellow eye. The aim of the CARMA Study is to investigate whether lutein and zeaxanthin, in combination with co-antioxidants (vitamin C, E, and zinc), has a beneficial effect on visual function and/or prevention of progression from early to late stages of disease. The primary outcome is improved or preserved distance visual acuity at 12 months. Secondary outcomes include improved or preserved interferometric acuity, contrast sensitivity, shape discrimination ability, and change in AMD severity as monitored by fundus photography. This article outlines the CARMA Study design and methodology, including its rationale.

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The study of urban and landscape history has recently questioned the peripheral condition of certain areas and re-examined them as valuable parts of an international network . In such a framework cities are not only recipients of foreign influences but active agents in their own urban transformations. Meanwhile, the regeneration of urban waterfronts appears increasingly in the spotlight globally , but the re-use of the waterfront as public space began more than a century ago.

Buenos Aires is an example of a ‘peripheral’ city, in which waterfront parks at the end of the nineteenth century were the product of international influences combined with local conditions, needs and expertise. Buenos Aires developed a continuous increase and diversity of leisure waterfront space, making it different from most European or ‘central’ cities. This paper will analyse the process of translation of landscape design on Buenos Aires’ waterfront while outlining the significance of waterfront parks to the city and its growing urban population.