Practitioner influence on contact lens prescribing in the UK

Contact lenses are mainly fitted by registered optometrists and contact lens opticians in the UK. Data we have gathered from annual contact lens fitting surveys over the past 12 years indicate that, on average, registered optometrists and contact lens opticians undertake 3.2 and 7.1 contact lens fits per week (p < 0.0001). More experienced practitioners tend to fit older patients. Practitioners fitting more lenses per year tend to fit a higher proportion of soft lenses. Contact lens opticians tend to fit a higher proportion of patients with planned replacement and daily disposable lenses compared with optometrists.

Context-Based Modelling of Interferometric Signals for the Assessment of Tear-Film Suface Quality

Modelling of interferometric signals related to tear film surface quality is considered. In the context of tear film surface quality estimation in normal healthy eyes, two clinical parameters are of interest: the build-up time, and the average interblink surface quality. The former is closely related to the signal derivative while the latter to the signal itself. Polynomial signal models, chosen for a particular set of noisy interferometric measurements, can be optimally selected, in some sense, with a range of information criteria such as AIC, MDL, Cp, and CME. Those criteria, however, do not always guarantee that the true derivative of the signal is accurately represented and they often overestimate it. Here, a practical method for judicious selection of model order in a polynomial fitting to a signal is proposed so that the derivative of the signal is adequately represented. The paper highlights the importance of context-based signal modelling in model order selection.

Labelled silhouettes for human pose estimation

This paper proposes a new method of using foreground silhouette images for human pose estimation. Labels are introduced to the silhouette images, providing an extra layer of information that can be used in the model fitting process. The pixels in the silhouettes are labelled according to the corresponding body part in the model of the current fit, with the labels propagated into the silhouette of the next frame to be used in the fitting for the next frame. Both single and multi-view implementations are detailed, with results showing performance improvements over only using standard unlabelled silhouettes.

Asia and the Commons : case studies 2008

A collection of case studies of individuals and organisations utilising open models in the Asia Pacific and associated regions. The case studies represent activities in nine countries, broader regions such as the Arab nations, and global efforts towards sustainability and social justice, revealing creative ways of participating in the commons. Featured are remix artists, performers, open source software programmers, film makers, collecting institutions and publishing houses focused on democracy and change, who demonstrate a diverse set of motivations to engage with the shared ideals of openness and community collaboration.

Contact lens correction of presbyopia

The ageing population highlights the need to provide effective optical solutions for presbyopic contact lens wearers. However, data gathered from annual contact lens fitting surveys demonstrate that fewer than 40% of contact lens wearers over 45 years of age (virtually all of whom can be presumed to suffer a partial or complete loss of accommodation) are prescribed a presbyopic correction. Furthermore, monovision is prescribed as frequently as multifocal lenses. These observations suggest that an optimal solution to the contact lens correction of presbyopia remains elusive.

Effectiveness of community-based nonpharmacological interventions for early-stage dementia : conclusions and recommendations

In 2007, a comprehensive review of the extant research on nonpharmacological interventions for persons with early-stage dementia was conducted. More than 150 research reports, centered on six major domains, were included: early-stage support groups, cognitive training and enhancement programs, exercise programs, exemplar programs, health promotion programs, and “other” programs not fitting into previous categories. Theories of neural regeneration and plasticity were most often used to support the tested interventions. Recommendations for practice, research, and health policy are outlined, including evidence-based, nonpharmacological treatment protocols for persons with mild cognitive impairment and early-stage dementia. A tested, community-based, multimodal treatment program is also described. Overall, findings identify well-supported nonpharmacological treatments for persons with early-stage dementia and implications for a national health care agenda to optimize outcomes for this growing population of older adults.

Cities in the airports 'shadow' : underlying interests and discretionary power in airport-region development

The previously distinct boundary between airports and their cities has become increasingly blurred as new interests and actors are identified as important stakeholders in the decision making process. As a consequence airport entities are more than ever seeking an integrated existence with their surrounding regions. While current planning strategies provide insights on how to improve and leverage land use planning in and around airports, emerging challenges for implementing and protecting these planning ideals stem from the governance shadows of development decisions. The thesis of this paper is that improving the identification, articulation and consideration of city and airport interests in the development approval process (between planning and implementation) can help avoid outcomes that hinder the ability of cities and their airports to meet their separate/mutual long-term objectives. By applying a network governance perspective to the pilot case study of Brisbane, analysis of overlapping and competing actor interests show how different governance arrangements facilitate (or impede) decision making that protects sustainable ‘airport region’ development. ---------- Contributions are made to airport and city development decision makers through the identification and analysis of effective and ineffective decision making pathways, and to governance literature by way of forwarding empirically derived frameworks for showing how actors protect their interests in the ‘crowded decision making domain’ of airport region development. This work was carried out through the Airport Metropolis Research Project under the Australian Research Council’s Linkage Projects funding scheme (LP0775225).

Bengali handwritten character recognition using modified syntactic method

Several approaches have been proposed to recognize handwritten Bengali characters using different curve fitting algorithms and curvature analysis. In this paper, a new algorithm (Curve-fitting Algorithm) to identify various strokes of a handwritten character is developed. The curve-fitting algorithm helps recognizing various strokes of different patterns (line, quadratic curve) precisely. This reduces the error elimination burden heavily. Implementation of this Modified Syntactic Method demonstrates significant improvement in the recognition of Bengali handwritten characters.

Reliability analysis with suspended items

Reliability analysis has several important engineering applications. Designers and operators of equipment are often interested in the probability of the equipment operating successfully to a given age - this probability is known as the equipment's reliability at that age. Reliability information is also important to those charged with maintaining an item of equipment, as it enables them to model and evaluate alternative maintenance policies for the equipment. In each case, information on failures and survivals of a typical sample of items is used to estimate the required probabilities as a function of the item's age, this process being one of many applications of the statistical techniques known as distribution fitting. In most engineering applications, the estimation procedure must deal with samples containing survivors (suspensions or censorings); this thesis focuses on several graphical estimation methods that are widely used for analysing such samples. Although these methods have been current for many years, they share a common shortcoming: none of them is continuously sensitive to changes in the ages of the suspensions, and we show that the resulting reliability estimates are therefore more pessimistic than necessary. We use a simple example to show that the existing graphical methods take no account of any service recorded by suspensions beyond their respective previous failures, and that this behaviour is inconsistent with one's intuitive expectations. In the course of this thesis, we demonstrate that the existing methods are only justified under restricted conditions. We present several improved methods and demonstrate that each of them overcomes the problem described above, while reducing to one of the existing methods where this is justified. Each of the improved methods thus provides a realistic set of reliability estimates for general (unrestricted) censored samples. Several related variations on these improved methods are also presented and justified. - i

Vibrational spectroscopic studies of wool

Fourier transfonn (FT) Raman, Raman microspectroscopy and Fourier transform infrared (FTIR) spectroscopy have been used for the structural analysis and characterisation of untreated and chemically treated wool fibres. For FT -Raman spectroscopy novel methods of sample presentation have been developed and optimised for the analysis of wool. No significant fluorescence was observed and the spectra could be obtained routinely. The stability of wool keratin to the laser source was investigated and the visual and spectroscopic signs of sample damage were established. Wool keratin was found to be extremely robust with no signs of sample degradation observed for laser powers of up to 600 m W and for exposure times of up to seven and half hours. Due to improvements in band resolution and signal-to-noise ratio, several previously unobserved spectral features have become apparent. The assignment of the Raman active vibrational modes of wool have been reviewed and updated to include these features. The infrared spectroscopic techniques of attenuated total reflectance (ATR) and photoacoustic (P A) have been used to examine shrinkproofed and mothproofed wool samples. Shrinkproofing is an oxidative chemical treatment used to selectively modifY the surface of a wool fibre. Mothproofing is a chemical treatment applied to wool for the prevention of insect attack. The ability of PAS and A TR to vary the penetration depth by varying certain instrumental parameters was used to obtain spectra of the near surface regions of these chemically treated samples. These spectra were compared with those taken with a greater penetration depth, which therefore represent more of the bulk wool sample. The PA and ATR spectra demonstrated that oxidation was restricted to the near-surface layer of wool. Extensive curve fitting of ATR spectra of untreated wool indicated that cuticle was composed of a mixed protein conformation, but was predominately that of an a.-helix. The cortex was proposed to be a mixture of both a.helical and ~-pleated sheet protein conformations. These findings were supported by PAS depth profiling results. Raman microspectroscopy was used in an extensive investigation of the molecular structure of the wool fibre. This included determining the orientation of certain functional groups within the wool fibre and the symmetry of particular vibrations. The orientation ofbonds within the wool fibre was investigated by orientating the wool fibre axis parallel and then perpendicular to the plane of polarisation of the electric vector of the incident radiation. It was experimentally determined that the majority of C=O and N-H bonds of the peptide bond of wool lie parallel to the fibre axis. Additionally, a number of the important vibrations associated with the a-helix were also found to lie parallel to the fibre axis. Further investigation into the molecular structure of wool involved determining what effect stretching the wool fibre had on bond orientation. Raman spectra of stretched and unstretched wool fibres indicated that extension altered the orientation ofthe aromatic rings, the CH2 and CH3 groups of the amino acids. Curve fitting results revealed that extension resulted in significant destruction of the a-helix structure a substantial increase in the P-pleated sheet structure. Finally, depolarisation ratios were calculated for Raman spectra. The vibrations associated with the aromatic rings of amino acids had very low ratios which indicated that the vibrations were highly symmetrical.

International rigid contact lens prescribing

Rigid lenses have been fitted less since the introduction of soft lenses nearly 40 years ago. Data that we have gathered from annual contact lens fitting surveys conducted in Australia, Canada, Japan, the Netherlands, Norway, the UK and the USA between 2000 and 2008 facilitate an accurate characterization of the pattern of the decline of rigid lens fitting during the first decade of this century. There is a trend for rigid lenses to be utilized primarily for refitting those patients who are already successful rigid lens wearers—most typically older females being refit with higher Dk materials. Rigid lenses are generally fitted on a full-time basis (four or more days of wear per week) without a planned replacement schedule. Orthokeratology is especially popular in the Netherlands, but is seldom prescribed in the other countries surveyed.

Conifer defence against insects: microarray gene expression profiling of Sitka spruce (Picea sitchensis) induced by mechanical wounding or feeding by spruce budworms (Choristoneura occidentalis) or white pine weevils (Pissodes strobi) reveals large

Conifers are resistant to attack from a large number of potential herbivores or pathogens. Previous molecular and biochemical characterization of selected conifer defence systems support a model of multigenic, constitutive and induced defences that act on invading insects via physical, chemical, biochemical or ecological (multitrophic) mechanisms. However, the genomic foundation of the complex defence and resistance mechanisms of conifers is largely unknown. As part of a genomics strategy to characterize inducible defences and possible resistance mechanisms of conifers against insect herbivory, we developed a cDNA microarray building upon a new spruce (Picea spp.) expressed sequence tag resource. This first-generation spruce cDNA microarray contains 9720 cDNA elements representing c. 5500 unique genes. We used this array to monitor gene expression in Sitka spruce (Picea sitchensis) bark in response to herbivory by white pine weevils (Pissodes strobi, Curculionidae) or wounding, and in young shoot tips in response to western spruce budworm (Choristoneura occidentalis, Lepidopterae) feeding. Weevils are stem-boring insects that feed on phloem, while budworms are foliage feeding larvae that consume needles and young shoot tips. Both insect species and wounding treatment caused substantial changes of the host plant transcriptome detected in each case by differential gene expression of several thousand array elements at 1 or 2 d after the onset of treatment. Overall, there was considerable overlap among differentially expressed gene sets from these three stress treatments. Functional classification of the induced transcripts revealed genes with roles in general plant defence, octadecanoid and ethylene signalling, transport, secondary metabolism, and transcriptional regulation. Several genes involved in primary metabolic processes such as photosynthesis were down-regulated upon insect feeding or wounding, fitting with the concept of dynamic resource allocation in plant defence. Refined expression analysis using gene-specific primers and real-time PCR for selected transcripts was in agreement with microarray results for most genes tested. This study provides the first large-scale survey of insect-induced defence transcripts in a gymnosperm and provides a platform for functional investigation of plant-insect interactions in spruce. Induction of spruce genes of octadecanoid and ethylene signalling, terpenoid biosynthesis, and phenolic secondary metabolism are discussed in more detail.

Central and peripheral oxygen transmissibility thresholds to avoid corneal swelling during open eye soft contact lens wear

This study was designed to derive central and peripheral oxygen transmissibility (Dk/t) thresholds for soft contact lenses to avoid hypoxia-induced corneal swelling (increased corneal thickness) during open eye wear. Central and peripheral corneal thicknesses were measured in a masked and randomized fashion for the left eye of each of seven subjects before and after 3 h of afternoon wear of five conventional hydrogel and silicone hydrogel contact lens types offering a range of Dk/t from 2.4 units to 115.3 units. Curve fitting for plots of change in corneal thickness versus central and peripheral Dk/t found threshold values of 19.8 and 32.6 units to avoid corneal swelling during open eye contact lens wear for a typical wearer. Although some conventional hydrogel soft lenses are able to achieve this criterion for either central or peripheral lens areas (depending on lens power), in general, no conventional hydrogel soft lenses meet both the central and peripheral thresholds. Silicone hydrogel contact lenses typically meet both the central and peripheral thresholds and use of these lenses therefore avoids swelling in all regions of the cornea. ' 2009 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 92B: 361–365, 2010

Global trends in prescribing contact lenses for extended wear

Extended wear has long been the ‘holy grail’ of contact lenses by virtue of the increased convenience and freedom of lifestyle which they accord; however, this modality enjoyed only limited market success during the last quarter of the 20th century. The introduction of silicone hydrogel materials into the market at the beginning of this century heralded the promise of successful extended wear due to the superior oxygen performance of this lens type. To assess patterns of contact lens fitting, including extended wear, over the past decade, up to 1000 survey forms were sent to contact lens fitters in Australia, Canada, Japan, the Netherlands, Norway, the UK and the USA each year between 2000 and 2009. Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Analysis of returned forms revealed that, averaged over this period, 9% of all soft lenses prescribed were for extended wear, with national figures ranging from 2% in Japan to 17% in Norway. The trend over the past decade has been for an increase from about 5% of all soft lens fits in 2000 to a peak of between 9 and 12% between 2002 and 2007, followed by a decline to around 7% in 2009. A person receiving extended wear lenses is likely to be an older female who is being refitted with silicone hydrogel lenses for full-time wear. Although extended wear has yet again failed to fulfil the promise of being the dominant contact lens wearing modality, it is still a viable option for many people.