Visual symptoms and retinal straylight after laser peripheral iridotomy: the Zhongshan Angle-Closure Prevention Trial.

OBJECTIVE: To assess the impact of laser peripheral iridotomy (LPI) on forward-scatter of light and subjective visual symptoms and to identify LPI parameters influencing these phenomena. DESIGN: Cohort study derived from a randomized trial, using an external control group. PARTICIPANTS: Chinese subjects initially aged 50 or older and 70 years or younger with bilateral narrow angles undergoing LPI in 1 eye selected at random, and age- and gender-matched controls. METHODS: Eighteen months after laser, LPI-treated subjects underwent digital iris photography and photogrammetry to characterize the size and location of the LPI, Lens Opacity Classification System III cataract grading, and measurement of retinal straylight (C-Quant; OCULUS, Wetzlar, Germany) in the treated and untreated eyes and completed a visual symptoms questionnaire. Controls answered the questionnaire and underwent straylight measurement and (in a random one-sixth sample) cataract grading. MAIN OUTCOME MEASURES: Retinal straylight levels and subjective visual symptoms. RESULTS: Among 230 LPI-treated subjects (121 [58.8%] with LPI totally covered by the lid, 43 [19.8%] with LPI partly covered by the lid, 53 [24.4%] with LPI uncovered by the lid), 217 (94.3%) completed all testing, as did 250 (93.3%) of 268 controls. Age, gender, and prevalence of visual symptoms did not differ between treated subjects and controls, although nuclear (P<0.01) and cortical (P = 0.03) cataract were less common among controls. Neither presenting visual acuity nor straylight score differed between the treated and untreated eyes among all treated persons, nor among those (n = 96) with LPI partially or totally uncovered. Prevalence of subjective glare did not differ significantly between participants with totally covered LPI (6.61%; 95% confidence interval [CI], 3.39%-12.5%), partially covered LPI (11.6%; 95% CI, 5.07%-24.5%), or totally uncovered LPI (9.43%; 95% CI, 4.10%-10.3%). In regression models, only worse cortical cataract grade (P = 0.01) was associated significantly with straylight score, and no predictors were associated with subjective glare. None of the LPI size or location parameters were associated with straylight or subjective symptoms. CONCLUSIONS: These results suggests that LPI is safe regarding measures of straylight and visual symptoms. This randomized design provides strong evidence that treatment programs for narrow angles would be unlikely to result in important medium-term visual disability.

Impact of age, various forms of cataract, and visual acuity on whole-field scotopic sensitivity screening for glaucoma in rural Taiwan.

OBJECTIVE: To evaluate the impact of age, various forms of cataract, and visual acuity on whole-field scotopic sensitivity screening for glaucoma in a rural population. DESIGN: Clinic-based study with population-based recruitment. SETTING: Jin Shan Township near Taipei, Taiwan. SUBJECTS: Three hundred forty-six residents (ages, > or = 40 years) of Jin Shan Township. INTERVENTIONS: Whole-field scotopic testing, ophthalmoscopy with dilation of the pupils, cataract grading against photographic standards, and screening visual field testing in a random one-third subsample. MAIN OUTCOME MEASURES: Whole-field scotopic sensitivity (in decibels) and diagnostic status as a case of glaucoma, glaucoma suspect, or normal. RESULTS: Participants in Jin Shan Township did not differ significantly in the rate of blindness, low visual acuity, or family history of glaucoma from a random sample of nonrespondents. Scotopic sensitivity testing detected 100% (6/6) of subjects with open-angle glaucoma at a specificity of 80.2%. The mean +/- SE scotopic sensitivity for six subjects with open-angle glaucoma (32.78 +/- 1.51 dB) differed significantly from that of 315 normal individuals (38.51 +/- 0.22 dB), when adjusted for age and visual acuity (P = .05, t test). With linear regression modeling, factors that correlated significantly with scotopic sensitivity were intraocular pressure, screening visual field, best corrected visual acuity, presence of cortical cataract, and increasing age. CONCLUSIONS: Although cataract affects the whole-field scotopic threshold, it appears that scotopic testing may be of value in field-based screening for glaucoma.

The association between refractive cutoffs for spectacle provision and visual improvement among school-aged children in South Africa.

OBJECTIVES: To evaluate different refractive cutoffs for spectacle provision with regards to their impact on visual improvement and spectacle compliance. DESIGN: Prospective study of visual improvement and spectacle compliance. PARTICIPANTS: South African school children aged 6-19 years receiving free spectacles in a programme supported by Helen Keller International. METHODS: Refractive error, age, gender, urban versus rural residence, presenting and best-corrected vision were recorded for participants. Spectacle wear was observed directly at an unannounced follow-up examination 4-11 months after initial provision of spectacles. The association between five proposed refractive cutoff protocols and visual improvement and spectacle compliance were examined in separate multivariate models. MAIN OUTCOMES: Refractive cutoffs for spectacle distribution which would effectively identify children with improved vision, and those more likely to comply with spectacle wear. RESULTS: Among 8520 children screened, 810 (9.5%) received spectacles, of whom 636 (79%) were aged 10-14 years, 530 (65%) were girls, 324 (40%) had vision improvement > or = 3 lines, and 483 (60%) were examined 6.4+/-1.5 (range 4.6 to 10.9) months after spectacle dispensing. Among examined children, 149 (31%) were wearing or carrying their glasses. Children meeting cutoffs < or = -0.75 D of myopia, > or = +1.00 D of hyperopia and > or = +0.75 D of astigmatism had significantly greater improvement in vision than children failing to meet these criteria, when adjusting for age, gender and urban versus rural residence. None of the proposed refractive protocols discriminated between children wearing and not wearing spectacles. Presenting vision and improvement in vision were unassociated with subsequent spectacle wear, but girls (p < or = 0.0006 for all models) were more likely to be wearing glasses than were boys. CONCLUSIONS: To the best of our knowledge, this is the first suggested refractive cutoff for glasses dispensing validated with respect to key programme outcomes. The lack of association between spectacle retention and either refractive error or vision may have been due to the relatively modest degree of refractive error in this African population.

A population-based study of visual impairment among pre-school children in Beijing: the Beijing study of visual impairment in children.

PURPOSE: To evaluate the prevalence and causes of visual impairment among Chinese children aged 3 to 6 years in Beijing. DESIGN: Population-based prevalence survey. METHODS: Presenting and pinhole visual acuity were tested using picture optotypes or, in children with pinhole vision < 6/18, a Snellen tumbling E chart. Comprehensive eye examinations and cycloplegic refraction were carried out for children with pinhole vision < 6/18 in the better-seeing eye. RESULTS: All examinations were completed on 17,699 children aged 3 to 6 years (95.3% of sample). Subjects with bilateral correctable low vision (presenting vision < 6/18 correctable to >or= 6/18) numbered 57 (0.322%; 95% confidence interval [CI], 0.237% to 0.403%), while 14 (0.079%; 95% CI, 0.038% to 0.120%) had bilateral uncorrectable low vision (best-corrected vision of < 6/18 and >or= 3/60), and 5 subjects (0.028%; 95% CI, 0.004% to 0.054%) were bilaterally blind (best-corrected acuity < 3/60). The etiology of 76 cases of visual impairment included: refractive error in 57 children (75%), hereditary factors (microphthalmos, congenital cataract, congenital motor nystagmus, albinism, and optic nerve disease) in 13 children (17.1 %), amblyopia in 3 children (3.95%), and cortical blindness in 1 child (1.3%). The cause of visual impairment could not be established in 2 (2.63%) children. The prevalence of visual impairment did not differ by gender, but correctable low vision was significantly (P < .0001) more common among urban as compared with rural children. CONCLUSION: The leading causes of visual impairment among Chinese preschool-aged children are refractive error and hereditary eye diseases. A higher prevalence of refractive error is already present among urban as compared with rural children in this preschool population.

Cataract surgical outcomes, visual function and quality of life in four rural districts in Vietnam.

BACKGROUND: To evaluate cataract surgical outcomes in four rural districts of Ha Tinh Province, Vietnam. DESIGN: Cross-sectional study. PARTICIPANTS: Post-cataract surgery patients sampled randomly from facilities in four rural districts of Ha Tinh Province >3 months after surgery. MAIN OUTCOME MEASURES: Postoperative visual acuity (VA), visual function and quality of life. RESULTS: Among 412 patients, the mean age was 74.5 ± 9.4 years, 67% (276) were female, and 377 (91.5%) received intraocular lenses (IOL). Nearly two-thirds of patients had no postoperative visits after discharge. Postoperatively, more than 40% of eyes had presenting VA <6/18, while 20% remained <6/60. The mean self-reported visual function and quality of life for all patients were 68.7 ± 23.8 and 73.8 ± 21.6, respectively. Most patients (89.5%) were satisfied with surgery and the majority (94.4%) would recommend surgery to others. One-third of patients paid ≥$US50 for surgery. In multiple regression modelling, older age (P < 0.01), intraoperative complications (P < 0.01) and failure to receive an IOL (P < 0.01) were associated with postoperative VA <6/60. CONCLUSION: Satisfaction with surgery was high, and many patients were willing to pay for their operations. Poor visual outcomes were common; however, and better surgical training is needed to reduce complications and their impact on visual outcomes. More intensive postoperative follow-up may also be beneficial. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Early assessment of visual acuity after cataract surgery in rural Indonesia.

BACKGROUND: The accuracy and impact on service uptake of early examination after cataract surgery is not known. DESIGN:   Prospective cohort study. PARTICIPANTS: Cataract patients in rural Indonesia. METHODS: Visual acuity was measured preoperatively, 1day, 1-3, 4-6 and >12weeks after surgery, and 6-8months postoperatively at an outreach examination. Acceptance of second-eye surgery and spectacles was evaluated. MAIN OUTCOME MEASURE: Presenting visual acuity in the operated eye. RESULTS: Among 241 subjects (extracapsular surgery 84%), examinations at 1day, 1-3, 4-6 and >12weeks and 6-8months were completed for 100% (241), 90.9% (219), 67.6% (163), 22.0% (53) and 80.0% (193), respectively. Among subjects at the final examination (mean age 65.8±10.6years, 51.8% male), 73.6% had bilateral preoperative presenting visual acuity≤6/60. By 4-6weeks, the proportion with good (≥6/18) or poor (≤6/60) visual acuity did not differ significantly from the final examination. Among 49 persons accepting free second-eye surgery, 69.4% (34) and 16.3% (8) returned to clinic at 4-6 and >12weeks, respectively. Among 131 patients (67.9%) paying US$7 for glasses, 94 (71.8%) and 30 (22.9%) attended 4- to 6- and >12-week examinations, respectively. CONCLUSION: Even with large-incision surgery, early assessment of postoperative vision is representative of final vision, and may help deliver postoperative services to more of those needing them. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

TELL ME Design: Protective Behaviour During an Epidemic

The TELL ME agent based model simulates the connections between health agency communication, personal decisions to adopt protective behaviour during an influenza epidemic, and the effect of those decisions on epidemic progress. The behaviour decisions are modelled with a combination of personal attitude, behaviour adoption by neighbours, and the local recent incidence of influenza. This paper sets out and justifies the model design, including how these decision factors have been operationalised. By exploring the effects of different communication strategies, the model is intended to assist health authorities with their influenza epidemic communication plans. It can both assist users to understand the complex interactions between communication, personal behaviour and epidemic progress, and guide future data collection to improve communication planning.

A Systematic Review of End-of-Life Visual Impairment in Open-Angle Glaucoma: An Epidemiological Autopsy

PURPOSE: Glaucoma patients are still at risk of becoming blind. It is of clinical significance to determine the risk of blindness and its causes to prevent its occurrence. This systematic review estimates the number of treated glaucoma patients with end-of-life visual impairment (VI) and blindness and the factors that are associated with this.

METHODS: A systematic literature search in relevant databases was conducted in August 2014 on end-of-life VI. A total of 2574 articles were identified, of which 5 on end-of-life VI. Several data items were extracted from the reports and presented in tables.

RESULTS: All studies had a retrospective design. A considerable number of glaucoma patients were found to be blind at the end of their life; with up to 24% unilateral and 10% bilateral blindness. The following factors were associated with blindness: (1) baseline severity of visual field loss: advanced stage of glaucoma or substantial visual field loss at the initial visit; (2) factors influencing progression: fluctuation of intraocular pressure (IOP) during treatment, presence of pseudoexfoliation, poor patient compliance, higher IOP; (3) longer time period: longer duration of disease and older age at death because of a longer life expectancy; and (4) coexistence of other ocular pathology.

CONCLUSIONS: Further prevention of blindness in glaucoma patients is needed. To reach this goal, it is important to address the risk factors for blindness identified in this review, especially those that can be modified, such as advanced disease at diagnosis, high and fluctuating IOP, and poor compliance.

Design of an OFDM Physical Layer Encryption Scheme

This paper presents a new encryption scheme implemented at the physical layer of wireless networks employing orthogonal frequency-division multiplexing (OFDM). The new scheme obfuscates the subcarriers by randomly reserving several subcarriers for dummy data and resequences the training symbol by a new secure sequence. Subcarrier obfuscation renders the OFDM transmission more secure and random, while training symbol resequencing protects the entire physical layer packet, but does not affect the normal functions of synchronization and channel estimation of legitimate users while preventing eavesdroppers from performing these functions. The security analysis shows the system is robust to various attacks by analyzing the search space using an exhaustive key search. Our scheme is shown to have a better performance in terms of search space, key rate and complexity in comparison with other OFDM physical layer encryption schemes. The scheme offers options for users to customize the security level and key rate according to the hardware resource. Its low complexity nature also makes the scheme suitable for resource limited devices. Details of practical design considerations are highlighted by applying the approach to an IEEE 802.11 OFDM system case study.

O design dos jornais diários e generalistas portugueses

O presente trabalho é um estudo comparativo de imagem gráfica que visa analisar o estado actual do design gráfico dos jornais diários nacionais de cariz generalista – Público, Diário de Notícias, Jornal de Notícias, Correio da Manhã e 24 Horas. Efectuada a análise dos jornais, é proposto o redesign do Jornal de Notícias, com o objectivo de aplicar as conclusões obtidas de forma teórica num projecto prático. As opiniões resultantes deste trabalho apresentam dois tipos de contributo: em primeiro lugar, permitem caracterizar num determinado período de tempo a apresentação visual das publicações diárias e generalistas em Portugal. Em segundo lugar, contribuem para ultrapassar as soluções de menor eficácia, potenciando a apresentação visual do conteúdo informativo das publicações acima referidas, com o objectivo de fidelizar e aumentar o número de leitores e potenciar as vendas. A metodologia utilizada para a realização da presente tese desenvolve-se em três partes: na primeira parte, a leitura bibliográfica, a investigação e o registo de informações, distribuída ao longo de treze áreas fundamentais para a compreensão e posterior aplicação às restantes partes; na segunda parte, o recurso a entrevistas a profissionais ligados ao design de publicações jornalísticas, bem como a análise de jornais diários nacionais e estrangeiros, tendo como base os resultados obtidos pelo Poynter Institute for Media Sudies no projecto Eye-Trac Research, um dos maiores estudos realizados sobre a importância da cor nas publicações jornalísticas e da forma como o leitor percorre as páginas de um jornal; na terceira parte, a realização de um projecto de redesign para o Jornal de Notícias. Na opinião de alguns especialistas, como Mario García e Rodrigo Fino, no futuro os jornais terão uma função de complementaridade relativamente às restantes plataformas de informação e o público será simultaneamente leitor no ecrã e no papel. Nesse sentido, os designers deverão encontrar novas formas de potenciar o conteúdo e de estabelecer graficamente meios eficazes de ligação entre as diferentes plataformas de informação. Independentemente do suporte, em papel ou no ecrã, a função do designer será sempre a de encontrar soluções mais eficazes para cada caso concreto.

Metodologia de selecção de materiais em design: base de dados nacional

Desde a Pré-História que a escolha de materiais esteve relacionada com a Arte. Mais tarde, durante a Idade Moderna vai ganhando uma importância cada vez maior. Atingida que foi a Idade Contemporânea, nomeadamente após a Revolução Industrial e durante a Segunda Guerra Mundial, devido ao aumento do número de materiais disponíveis, é que se pode falar de uma verdadeira seleção de materiais. É também após a Revolução Industrial que se clarificam as relações entre a evolução dos materiais e os movimentos e correntes das Artes Plásticas. Neste contexto, estudaram-se as interligações entre o processo de design e as metodologias de seleção, assim como as diversas tipologias de ferramentas existentes para esse efeito. Deste estudo, consideradas as respetivas vantagens e limitações, foi possível identificar bases de dados essencialmente técnicas, ou ao invés, ferramentas para inspiração com muitas imagens e pouca informação sobre as propriedades dos materiais. Para completar este levantamento crítico sobre processos e ferramentas de seleção, inquiriram-se cinquenta e três profissionais que trabalhavam em diferentes gabinetes de design portugueses. As perguntas dirigidas aos designers portugueses versaram sobre problemas relacionados com a escolha de materiais, abrangendo o tipo de matériasprimas empregues, processos utilizados e a qualidade da informação obtida. Na sequência deste estudo, verificou-se a existência de diversas lacunas relativamente aos meios disponíveis, rotinas de seleção, qualidade da informação existente e metodologias utilizadas. Foi neste contexto que se iniciou o projeto de criação de uma nova metodologia suportada por uma ferramenta digital. Os principais aspetos inovadores são: uma melhor interligação entre a metodologia de design e o processo de seleção de materiais e a sua sincronização; a informação necessária em cada etapa e o destaque dos fatores catalisadores da seleção de materiais. Outro elemento inovador foi a conjugação de três formas deferentes de seleção de materiais numa só ferramenta (a geral, a visual e a específica) e a hipótese de aceder a diferentes graus de informação. A metodologia, no contexto dos recursos disponíveis, foi materializada sob a forma de ferramenta digital (ptmaterials.com). O protótipo foi aferido com testes de usabilidade de cariz heurístico, com a participação de dezanove utilizadores. Foram detetadas diversas falhas de interação que condicionaram a liberdade e o controlo da navegação no seio da interface. Os utilizadores também mencionaram a existência de lacunas na prevenção de erros e a ligação do sistema à lógica habitual de outras aplicações já existentes. No entanto, também constituiu um estímulo a circunstância da maioria dos designers avaliarem o sistema como eficaz, eficiente, satisfatório e confirmarem o interesse da existência dos três tipos de seleção. Posteriormente, ao analisar os restantes resultados dos testes de usabilidade, também foram evidenciadas as vantagens dos diferentes tipos de informação disponibilizada e a utilidade de uma ferramenta desta natureza para a Indústria e Economia Nacionais. Esta ferramenta é apenas um ponto de partida, existindo espaço para melhorar a proposta, apesar da concretização de uma ferramenta digital ser um trabalho de grande complexidade. Não obstante se tratar de um protótipo, esta ferramenta está adequada aos dias de hoje e é passível de evoluir no futuro, tendo também a possibilidade de vir a ser preferencialmente utilizada por outros países de língua portuguesa.

Beyond the artefact and techno-centricity: towards process-centric understanding of architecture - alternative facilitation strategies and proposals

The artefact and techno-centricity of the research into the architecture process needs to be counterbalanced by other approaches. An increasing amount of information is collected and used in the process, resulting in challenges related to information and knowledge management, as this research evidences through interviews with practicing architects. However, emerging technologies are expected to resolve many of the traditional challenges, opening up new avenues for research. This research suggests that among them novel techniques addressing how architects interact with project information, especially that indirectly related to the artefacts, and tools which better address the social nature of work, notably communication between participants, become a higher priority. In the fields associated with the Human Computer Interaction generic solutions still frequently prevail, whereas it appears that specific alternative approaches would be particularly in demand for the dynamic and context dependent design process. This research identifies an opportunity for a process-centric and integrative approach for architectural practice and proposes an information management and communication software application, developed for the needs discovered in close collaboration with architects. Departing from the architects’ challenges, an information management software application, Mneme, was designed and developed until a working prototype. It proposes the use of visualizations as an interface to provide an overview of the process, facilitate project information retrieval and access, and visualize relationships between the pieces of information. Challenges with communication about visual content, such as images and 3D files, led to a development of a communication feature allowing discussions attached to any file format and searchable from a database. Based on the architects testing the prototype and literature recognizing the subjective side of usability, this thesis argues that visualizations, even 3D visualizations, present potential as an interface for information management in the architecture process. The architects confirmed that Mneme allowed them to have a better project overview, to easier locate heterogeneous content, and provided context for the project information. Communication feature in Mneme was seen to offer a lot of potential in design projects where diverse file formats are typically used. Through empirical understanding of the challenges in the architecture process, and through testing the resulting software proposal, this thesis suggests promising directions for future research into the architecture and design process.

Design and performance of wireless cooperative relaying

In recent years, a new paradigm for communication called cooperative communications has been proposed for which initial information theoretic studies have shown the potential for improvements in capacity over traditional multi-hop wireless networks. Extensive research has been done to mitigate the impact of fading in wireless networks, being mostly focused on Multiple-Input Multiple-Output (MIMO) systems. Recently, cooperative relaying techniques have been investigated to increase the performance of wireless systems by using diversity created by different single antenna devices, aiming to reach the same level of performance of MIMO systems with low cost devices. Cooperative communication is a promising method to achieve high spectrum efficiency and improve transmission capacity for wireless networks. Cooperative communications is the general idea of pooling the resources of distributed nodes to improve the overall performance of a wireless network. In cooperative networks the nodes cooperate to help each other. A cooperative node offering help is acting like a middle man or proxy and can convey messages from source to destination. Cooperative communication involves exploiting the broadcast nature of the wireless medium to form virtual antenna arrays out of independent singleantenna network nodes for transmission. This research aims at contributing to the field of cooperative wireless networks. The focus of this research is on the relay-based Medium Access Control (MAC) protocol. Specifically, I provide a framework for cooperative relaying called RelaySpot which comprises on opportunistic relay selection, cooperative relay scheduling and relay switching. RelaySpot-based solutions are expected to minimize signaling exchange, remove estimation of channel conditions, and improve the utilization of spatial diversity, minimizing outage and increasing reliability.

Analysis, modeling, design and optimization of future communications systems: from theory to practice

Esta tese descreve uma framework de trabalho assente no paradigma multi-camada para analisar, modelar, projectar e optimizar sistemas de comunicação. Nela se explora uma nova perspectiva acerca da camada física que nasce das relações entre a teoria de informação, estimação, métodos probabilísticos, teoria da comunicação e codificação. Esta framework conduz a métodos de projecto para a próxima geração de sistemas de comunicação de alto débito. Além disso, a tese explora várias técnicas de camada de acesso com base na relação entre atraso e débito para o projeto de redes sem fio tolerantes a atrasos. Alguns resultados fundamentais sobre a interação entre a teoria da informação e teoria da estimação conduzem a propostas de um paradigma alternativo para a análise, projecto e optimização de sistemas de comunicação. Com base em estudos sobre a relação entre a informação recíproca e MMSE, a abordagem descrita na tese permite ultrapassar, de forma inovadora, as dificuldades inerentes à optimização das taxas de transmissão de informação confiáveis em sistemas de comunicação, e permite a exploração da atribuição óptima de potência e estruturas óptimas de pre-codificação para diferentes modelos de canal: com fios, sem fios e ópticos. A tese aborda também o problema do atraso, numa tentativa de responder a questões levantadas pela enorme procura de débitos elevados em sistemas de comunicação. Isso é feito através da proposta de novos modelos para sistemas com codificação de rede (network coding) em camadas acima da sua camada física. Em particular, aborda-se a utilização de sistemas de codificação em rede para canais que variam no tempo e são sensíveis a atrasos. Isso foi demonstrado através da proposta de um novo modelo e esquema adaptativo, cujos algoritmos foram aplicados a sistemas sem fios com desvanecimento (fading) complexo, de que são exemplos os sistemas de comunicação via satélite. A tese aborda ainda o uso de sistemas de codificação de rede em cenários de transferência (handover) exigentes. Isso é feito através da proposta de novos modelos de transmissão WiFi IEEE 801.11 MAC, que são comparados com codificação de rede, e que se demonstram possibilitar transferência sem descontinuidades. Pode assim dizer-se que esta tese, através de trabalho de análise e de propostas suportadas por simulações, defende que na concepção de sistemas de comunicação se devem considerar estratégias de transmissão e codificação que sejam não só próximas da capacidade dos canais, mas também tolerantes a atrasos, e que tais estratégias têm de ser concebidas tendo em vista características do canal e a camada física.

Design e avaliação de pictogramas farmacêuticos

A informação inerente aos medicamentos no processo de medicação e prescrição tem revelado insuficiências relativamente às necessidades do utilizador. Este projecto aborda essas dificuldades e procura contribuir, através do design e avaliação de pictogramas farmacêuticos, para um melhor acesso das pessoas à informação, oral e escrita, prestada por médicos, farmacêuticos e pela literatura inclusa dos medicamentos. Verificámos que, nos últimos 40 anos, se desenvolveram quase mil representações gráficas, provenientes de 20 países, sobre mensagens relativas a perigos, precauções e informações de como tomar o medicamento. Com base nesse conjunto mundial colectado, tão alargado e diversificado, procedeu-se à analise, agrupamento e comparação dessas representações com vista a apurar a diversidade gráfica e escrita das 75 mensagens farmacêuticas identificadas nesta investigação. Foi seguidamente consultada uma centena de profissionais de saúde dentro da área farmacêutica para selecção e definição da informação a ser projectada em pictogramas. Algumas das mensagens seleccionadas foram, por ordem de importância: “Não aplicar nos olhos”, “Não beber álcool enquanto estiver a tomar o medicamento” e “Guardar no frigorífico”. Foi concebido um sistema PictoPharma, bilingue (Português e Inglês), composto por 32 pictogramas farmacêuticos, com várias possibilidades cromáticas de acordo com as diversas aplicações para suportes de impressão e ecrã (Registo de Propriedade Industrial – marca e design). Embora o sistema projectado possa aumentar a capacidade de recordar as informações importantes pelas pessoas em geral, os públicos-alvo que mais beneficiarão com o sistema são: pessoas que apresentam especiais dificuldades de leitura - analfabetos, pessoas com nenhum conhecimento ou um conhecimento limitado da língua; pessoas com dificuldades para relembrar e / ou compreender o tratamento - população envelhecida, sob múltiplos tratamentos ou com menores capacidades intelectuais; pessoas que não falam a língua local ou são de uma cultura diferente - estrangeiros, turistas, imigrantes. Foram feitos testes de usabilidade com os públicos-alvo específicos, de forma a verificar a percentagem de compreensão dos pictogramas, sem a respectiva legenda e de acordo com as normas internacionais de normalização. Os resultados dos testes indicaram que metade do sistema atingiu os 100% de compreensão e a outra metade atingiu mais de 88%. O sistema PictoPharma criado caracteriza-se: pelo design gráfico no seu contraste visual e na possibilidade de leitura numa escala reduzida; pelo conceito de familiaridade gráfica representada no seu conjunto, de forma a tornar os pictogramas mais facilmente memorizáveis; pelo estudo feito para minimizar especificidades culturais visuais; pelas diversas aplicações possíveis na indústria; pelas direcções que aponta para futuras investigações sobre as escolhas visuais culturais inerentes a um projecto de design com este.