Eyelid pressure and contact with the ocular surface

Purpose To investigate static upper eyelid pressure and contact with the ocular surface in a group of young adult subjects. Methods Static upper eyelid pressure was measured for 11 subjects using a piezoresistive pressure sensor attached to a rigid contact lens. Measures of eyelid pressure were derived from an active pressure cell (1.14 mm square) beneath the central upper eyelid margin. To investigate the contact region between the upper eyelid and ocular surface, we used pressure sensitive paper and the lissamine-green staining of Marx’s line. These measures combined with the pressure sensor readings were used to derive estimates of eyelid pressure. Results The mean contact width between the eyelids and ocular surface estimated using pressure sensitive paper was 0.60 ± 0.16 mm, while the mean width of Marx’s line was 0.09 ± 0.02 mm. The mean central upper eyelid pressure was calculated to be 3.8 ± 0.7 mmHg (assuming that the whole pressure cell was loaded), 8.0 ± 3.4 mmHg (derived using the pressure sensitive paper imprint widths) and 55 ± 26 mmHg (based on contact widths equivalent to Marx’s line). Conclusions The pressure sensitive paper measurements suggest that a band of the eyelid margin, significantly larger than the anatomical zone of the eyelid margin known as Marx’s line, has primary contact with the ocular surface. Using these measurements as the contact between the eyelid margin and ocular surface, we believe that the mean pressure of 8.0 ± 3.4 mmHg is the most reliable estimate of static upper eyelid pressure.

Young Children and the Environment : Early Learning for Sustainability

This world-first text book on early childhood edcuation for sustainabilty tackles one of the biggest contemporary issues of our times - the changing environmment - and demonstrates how early education can contribute to sustainable living. An essential text for students in early childhood teacher education and a practcial resource for child care practitioners and primary school teachers, it is designed to promote edcuation for sustainabilty from birth to eight years. the text refers to national and international initiatives such as 'sustainable Schools', 'Child Friendly Cities' and 'Health Promoting Schools' and explores their existing and potential links with early childhood education. Groundbreaking content draws on recent literature in the areas of organisational, educational and cultural chnage, and environmental sustainabilty. Specific chapters explore ethical challenges and the use of ICT to advance learning. Case studies and vignettes exemplify leadership in practice and 'provocations' are integrated throughout to inspire new ways of thinking about the environment, the wider world, young children and the transformative power of early edcuation.

Professional education in built environment and design

Early and rich conversations with a range of stakeholders – academics, professionals and graduates in their early years of practice – quickly clarified that the singular challenge for most parties centres on the ways in which courses prepare graduates for the pace, diversity and flux of contemporary professional practice.---------In pursuing understanding of this central challenge this study has focused on new graduates in BED disciplines by canvassing their views and those of two other major stakeholder groups (academic staff and professional practitioners in the disciplines studied). The first crucial years of a young graduate’s life in the workforce are shaped by a number of factors including the quality of the transition-to-work experience. The quality of this life-shaping transition is dependent on a range of factors including the ways in which graduates are educated in universities, their personal developmental characteristics and those of the professional people around them and the preparedness of workplaces and other professional groups to guide new recruits through the transition experience. This study makes recommendations about how the variations in transition experience, resulting from the vagaries of all these factors across a range of worksites, may be better understood, perhaps normalised, and, at least, supported. . Early and rich conversations with a range of stakeholders – academics, professionals and graduates in their early years of practice – quickly clarified that the singular challenge for most parties centres on the ways in which courses prepare graduates for the pace, diversity and flux of contemporary professional practice. The study proceeded through literature review, focus group interviews, national online survey and workshops. Through all these methods a number of challenges and factors essential to the transition experience, and the quality of education which precedes it, were identified. Firstly the study found further evidence of the importance of higher-order graduate capabilities, namely, the development of judgment, critical enquiry and strategic thinking. Alongside these capabilities the importance of the development of emotional intelligence, particularly interpersonal and social skills, was stressed by all stakeholders. At the time of writing the global economic crisis was providing challenges to the sector and its young graduates. This phenomenon proved the value of the development of resilience and persistence in graduates, the education system was called upon by all stakeholders as a place where the future-proofing of neophytes would ensure that the unknown challenges of the future could also be confronted. The study found that the challenges of transition to work are best supported by authentic undergraduate experiences both on and off campus, inside and outside classrooms, and that commencing professional life is made easier for new graduates when university courses and workplace settings develop, sustain and support high standards and high expectations of students. All these findings indicate the importance of stakeholder expectations, roles and responsibilities in respect of the transition-to-work experience. Whilst full agreement about how these things should occur is not necessary, a process (amongst stakeholders) which seeks value alignment around transition through discussion, debate and agenda-setting would probably assist to address what is seen as a major challenge in built environment and design education.

Development of a method to measure upper eyelid pressure on the cornea

Purpose: The cornea is known to be susceptible to forces exerted by eyelids. There have been previous attempts to quantify eyelid pressure but the reliability of the results is unclear. The purpose of this study was to develop a technique using piezoresistive pressure sensors to measure upper eyelid pressure on the cornea. Methods: The technique was based on the use of thin (0.18 mm) tactile piezoresistive pressure sensors, which generate a signal related to the applied pressure. A range of factors that influence the response of this pressure sensor were investigated along with the optimal method of placing the sensor in the eye. Results: Curvature of the pressure sensor was found to impart force, so the sensor needed to remain flat during measurements. A large rigid contact lens was designed to have a flat region to which the sensor was attached. To stabilise the contact lens during measurement, an apparatus was designed to hold and position the sensor and contact lens combination on the eye. A calibration system was designed to apply even pressure to the sensor when attached to the contact lens, so the raw digital output could be converted to actual pressure units. Conclusions: Several novel procedures were developed to use tactile sensors to measure eyelid pressure. The quantification of eyelid pressure has a number of applications including eyelid reconstructive surgery and the design of soft and rigid contact lenses.

Evaluation of contextual influences on the medication administration practice of paediatric nurses

Aim. This paper is a report of a study conducted to explore the impact of preidentified contextual themes (related to work environment and socialization) on nursing medication practice. Background. Medication administration is a complex aspect of paediatric nursing and an important component of day-to-day nursing practice. Many attempts are being made to improve patient safety, but many errors remain. Identifying and understanding factors that influence medication administration errors are of utmost importance. Method. A cross-sectional survey was conducted with a sample of 278 paediatric nurses from the emergency department, intensive care unit and medical and surgical wards of an Australian tertiary paediatric hospital in 2004. The response rate was 67%. Result. Contextual influences were important in determining how closely medication policy was followed. Completed questionnaires were returned by 185 nurses (67%). Younger nurses aged <34 years thought that their medication administration practice could be influenced by the person with whom they checked the drugs (P = 0·001), and that there were daily circumstances when it was acceptable not to adhere strictly to medication policy (P < 0·001), including choosing between following policy and acting in the best interests of the child (P = 0·002). Senior nurses agreed that senior staff dictate acceptable levels of medication policy adherence through role modelling (P = 0·01). Less experienced nurses reported greater confidence with computer literacy (P < 0·001). Conclusions. Organizations need to employ multidisciplinary education programmes to promote universal understanding of, and adherence to, medication policies. Skill mix should be closely monitored to ensure adequate support for new and junior staff.

Modeling corneal surfaces with three-dimensional basis functions

Purpose: To ascertain the effectiveness of object-centered three-dimensional representations for the modeling of corneal surfaces. Methods: Three-dimensional (3D) surface decomposition into series of basis functions including: (i) spherical harmonics, (ii) hemispherical harmonics, and (iii) 3D Zernike polynomials were considered and compared to the traditional viewer-centered representation of two-dimensional (2D) Zernike polynomial expansion for a range of retrospective videokeratoscopic height data from three clinical groups. The data were collected using the Medmont E300 videokeratoscope. The groups included 10 normal corneas with corneal astigmatism less than −0.75 D, 10 astigmatic corneas with corneal astigmatism between −1.07 D and 3.34 D (Mean = −1.83 D, SD = ±0.75 D), and 10 keratoconic corneas. Only data from the right eyes of the subjects were considered. Results: All object-centered decompositions led to significantly better fits to corneal surfaces (in terms of the RMS error values) than the corresponding 2D Zernike polynomial expansions with the same number of coefficients, for all considered corneal surfaces, corneal diameters (2, 4, 6, and 8 mm), and model orders (4th to 10th radial orders) The best results (smallest RMS fit error) were obtained with spherical harmonics decomposition which lead to about 22% reduction in the RMS fit error, as compared to the traditional 2D Zernike polynomials. Hemispherical harmonics and the 3D Zernike polynomials reduced the RMS fit error by about 15% and 12%, respectively. Larger reduction in RMS fit error was achieved for smaller corneral diameters and lower order fits. Conclusions: Object-centered 3D decompositions provide viable alternatives to traditional viewer-centered 2D Zernike polynomial expansion of a corneal surface. They achieve better fits to videokeratoscopic height data and could be particularly suited to the analysis of multiple corneal measurements, where there can be slight variations in the position of the cornea from one map acquisition to the next.

The population approach to falls injury prevention in older people : findings of a two community trial

Background: There is a sound rationale for the population-based approach to falls injury prevention but there is currently insufficient evidence to advise governments and communities on how they can use population-based strategies to achieve desired reductions in the burden of falls-related injury.---------- Aim: To quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective), population-based, multi-factorial falls injury prevention program for people over 60 years of age.---------- Methods: Population-based falls-prevention interventions were conducted at two geographically-defined and separate Australian sites: Wide Bay, Queensland, and Northern Rivers, NSW. Changes in the prevalence of key risk factors and changes in rates of injury outcomes within each community were compared before and after program implementation and changes in rates of injury outcomes in each community were also compared with the rates in their respective States.---------- Results: The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women. In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest.---------- Conclusion: The evidence suggests that low intensity population-based falls prevention programs may not be as effective as those are intensively implemented.

Dynamic load sharing for heavy vehicles : a new metric

Dynamic load sharing can be defined as a measure of the ability of a heavy vehicle multi-axle group to equalise load across its wheels under typical travel conditions; i.e. in the dynamic sense at typical travel speeds and operating conditions of that vehicle. Various attempts have been made to quantify the ability of heavy vehicles to equalise the load across their wheels during travel. One of these was the concept of the load sharing coefficient (LSC). Other metrics such as the dynamic load coefficient (DLC) have been used to compare one heavy vehicle suspension with another for potential road damage. This paper compares these metrics and determines a relationship between DLC and LSC with sensitivity analysis of this relationship. The shortcomings of these presently-available metrics are discussed with a new metric proposed - the dynamic load equalisation (DLE) measure.

Factors influencing paediatric nurses' responses to medication administration

Objective: To evaluate the importance of contextual and policy factors on nurses’ judgment about medication administration practice.---------- Design: A questionnaire survey of responses to a number of factorial vignettes in June 2004. These vignettes considered a combination of seven contextual and policy factors that were thought to influence nurses’ judgments relating to medication administration.---------- Participants: 185 (67% of eligible) clinical paediatric nursing staff returned completed questionnaires.--------- Setting: A tertiary paediatric hospital in Brisbane, Australia.---------- Results: Double checking the patient, double checking the drug and checking the legality of the prescription were the three strongest predictors of nurses’ actions regarding medication administration.--------- Conclusions: Policy factors and not contextual factors drive nurses’ judgment in response to hypothetical scenarios.

Healthy children, healthy planet : the case for transformative education in schools and early childhood from an Australian perspective

Climate change is an urgent global public health issue with substantial predicted impacts in the coming decades. Concurrently, global burden of disease studies highlight problems such as obesity, mental health problems and a range of other chronic diseases, many of which have origins in childhood. There is a unique opportunity to engage children in both health promotion and education for sustainability during their school years to help ameliorate both environmental and health issues. Evidence exists for the most effective ways to do this, through education that is empowering, action orientated and relevant to children’s day to day interests and concerns, and by tailoring such education to different educational sectors. The aim of this discussion paper is to argue the case for sustainability education in schools that links with health promotion and that adopts a practical approach to engaging children in these important public health and environmental issues. We describe two internationally implemented whole-school reform movements, Health Promoting Schools (HPS) and Sustainable Schools (SS) which seek to operationalise transformative educational processes. Drawing on international evidence and Australian case examples, we contend that children’s active involvement in such processes is not only educationally engaging and rewarding, it also contributes to human and environmental resilience and health. Further, school settings can play an important ecological public health role, incubating and amplifying the socially transformative changes urgently required to create pathways to healthy, just and sustainable human futures, on a viable planet.

Introduction

This is not a book about the perils of global warming and its impact on children, although climate change provides an impetus. Nor is it a response to environmental issues that shifts responsibilities from adults to children, asking them to fix what we leave behind. Instead, it is a book of positive ideas and actions that shows what early childhood educational communities can do when children, teachers and parents work together to address, arguably, one of the most serious issues of our time. It is about what early childhood education – and specifically, early childhood teacher education – can and must do to play its part in helping societies move towards sustainable living. It is about the emerging field of early childhood education for sustainability (ECEfS).

What is early childhood education for sustainability?

Julie Davis canvasses the literature to explain why sustainability issues are important for young children and why early childhood educators should become engaged with EfS. She outlines the short history of ECEfS in Australasia and internationally, emphasising its marginalised and fragile early phase that is now beginning to coalesce into a robust international movement. She then highlights two recent studies undertaken in child care centres that illustrate the learning and actions that are possible when education for sustainability is incorporated into early childhood curriculum and pedagogy. Julie ends the chapter by identifying the qualities that might characterise early childhood education for sustainability, stressing its requirement to be transformative education that builds the capabilities of young children as agents of change for sustainability. In so doing, she draws together theoretical strands from both early childhood education and EfS, beginning the process of constructing a theoretical framework for ECEfS.

Creating deep and broad change through research and systems approaches in early childhood education for sustainability

The co-authors raise two matters they consider essential for the future development of ECEfS. The first is the need to create deep foundations based in research. At a time of increasing practitioner interest, research in ECEfS is meagre. A robust research community is crucial to support quality in curriculum and pedagogy, and to promote learning and innovation in thinking and practice. The second 'essential' for the expansion and uptake of ECEfS is broad systemic change. All level within the early childhood education system - individual teachers and classrooms, whole centres and schools, professional associations and networks, accreditation and employing authorities, and teacher educators - must work together to create and reinforce the cultural and educational changes required for sustainability. This chapter provides explanations of processes to engender systemic change. It illustrates a systems approach, with reference to a recent study focused on embedding EfS into teacher education. This study emphasises the apparent contradiction that the answer to large-scale reform lies with small-scale reforms that build capacity and make connections.