Key biological issues in contact lens development

A contact lens is a medical device widely used as an alternative to spectacles in order to correct refractive vision problems. The evolution of polymeric biomaterials has heralded a continuous development in the materials used to produce contact lenses and maximize patient comfort and limit adverse events. Microbial keratitis (MK) is a relatively rare but potentially devastating condition associated with contact lens use, particularly with the extended wear of hydrogel lenses. It is the principal complication related to contact lens wear and the large population at risk make it a public health concern. Bacterial binding to the contact lens material is a precursor to the development of MK and is influenced by properties of the material and the bacteria. In order for bacteria to infiltrate the cornea there must be some degree of corneal damage, usually caused by trauma or hypoxia. The most recent materials available aim to allow the continuous wear of lenses while limiting corneal hypoxia, thus helping to prevent the development of MK. Limitations to the treatment of MK require that novel approaches may be necessary in order to limit bacterial adhesion to contact lens materials.

Tolstoy, stories, and facilitating insight in end of life care: Exploring ethics through vicarious experience (with Glackin M and Henry R)

Facilitating moral insight in end of life care can be challenging, and the purpose of this paper is to illustrate how this can be nurtured by means of creative literature. Tolstoy's Death of Ivan Ilych is presented as an example of such literature. Aristotle's Nichomean Ethics provides the philosophical underpinning for the method used. Sources also include the nursing literature, and students' evaluations of the impact of Tolstoy's novella on their ability to perceive the ethical issues arising in end of life care. Comments from evaluations were analysed and significant themes emerged. Students' comments clearly support the suggestion that use of this novella has facilitated insight into ethical issues at the end of life. Evaluations also indicate that vicarious experience gained through reading this novella has helped to nurture sensitivity and professional insight into the importance of compassion and offering ‘comfort’ to the dying person.

RFID based Efficient Lighting Control

The Kyoto Protocol and the European Energy Performance of Buildings Directive put an onus on governments
and organisations to lower carbon footprint in order to contribute towards reducing global warming. A key
parameter to be considered in buildings towards energy and cost savings is its indoor lighting that has a major
impact on overall energy usage and Carbon Dioxide emissions. Lighting control in buildings using Passive
Infrared sensors is a reliable and well established approach; however, the use of only Passive Infrared does not
offer much savings towards reducing carbon, energy, and cost. Accurate occupancy monitoring information can
greatly affect a building’s lighting control strategy towards a greener usage. This paper presents an approach for
data fusion of Passive Infrared sensors and passive Radio Frequency Identification (RFID) based occupancy
monitoring. The idea is to have efficient, need-based, and reliable control of lighting towards a green indoor
environment, all while considering visual comfort of occupants. The proposed approach provides an estimated
13% electrical energy savings in one open-plan office of a University building in one working day. Practical
implementation of RFID gateways provide real-world occupancy profiling data to be fused with Passive
Infrared sensing towards analysis and improvement of building lighting usage and control.

The Emotional Paradoxes of Adverse Possession

Property lawyers are generally viewed as a serious lot, not prone to feverish bursts of excitement as we seek comfort and solace in established legal rules and precepts. In the same way, property law disputes tend to have a fairly low profile and fail to capture the public imagination in the same way as, for example, those involving criminal or human rights law. Such apparent indifference might seem a little strange, given the centrality of property in everyday human life and the significance which legal systems and individuals attach to property rights. However, there is one issue which always inflames passions amongst lawyers and non-lawyers alike: the acquisition of land through the doctrine of adverse possession, often described as ‘squatter’s rights’. No property-related topic is likely to light up a radio show phone-in switchboard quite like squatting

Energy efficiency investments in the home: Swiss homeowners and expectations about future energy prices

Using conjoint choice experiments, we surveyed 473 Swiss homeowners about their preferences for energy efficiency home renovations.We find that homeowners are responsive to the upfront costs of the renovation projects, governmentoffered rebates, savings in energy expenses, time horizon over which such savings would be realized, and thermal comfort improvement. The implicit discount rate is low, ranging from 1.5 to 3%, depending on model specification. This is consistent with Hassett and Metcalf (1993) and Metcalf and Rosenthal (1995), and with the fact that our scenarios contain no uncertainty. Respondents who feel completely uncertain about future energy prices are more likely to select the status quo (no renovations) in any given choice task and weight the costs of the investments more heavily than the financial gains (subsidies and savings on the energy bills). Renovations are more likely when respondents believe that climate change considerations are important determinants of home renovations. Copyright © 2013 by the IAEE. All rights reserved.

Family perceptions of end-of-life care in long-term care facilities

The study examined the utility of the Family Perception of Care Scale (FPCS), which consists of four subscales: resident care, family support, communication, and rooming. This instrument was developed for the purposes of this study. Overall, family members were satisfied with end-of-life care. Satisfaction did not have a statistically significant relationship to family and resident characteristics. Survey questions with the highest number of low satisfaction ratings included staffing levels, updating families and involving them in care planning, and decision making. Family members considered pain control an important priority, followed by comfort care that included caring for a family member with dignity and sensitivity. Family members also valued it when staff were able to inform them that the death of their family member was near. Place of death was significantly associated with satisfaction, family members being more satisfied with end-of-life care when their family member died in the LTC facility as opposed to in hospital.

Educating families about end-of-life care in advanced dementia:Acceptability of a Canadian family booklet to nurses from Canada, France, and Japan

Background: The families of people with late-stage dementia need to be informed about the course of the dementia and the comfort/ palliative care option. A booklet was written for that purpose and can be provided to family members by physicians and nurses. Methods: The acceptability of the booklet for nurses was tested in Canada (French and English version), France (French Canadian version) and Japan (translated and adapted version). Results: Overall, 188 nurses completed a survey questionnaire. The booklet was accepted best in Canada and less so in France and Japan. Despite regional variation, the majority of the nurses perceived the booklet as useful for families. The French and Japanese nurses also reported a greater need for palliative care education in advanced dementia. Conclusion: The booklet may help nurses educate families about end-of-life issues in dementia palliative care, but local adaptation of the booklet content and physician engagement are necessary.

Ocular anesthesia in the new millennium

In the new millennium anesthetic agents will be safer and more efficient. Topical anesthesia will be the most frequently used technique. Time- and cost-saving measures will expand the current trend of outpatient surgery and anesthesia will be reduced. Patients' perioperative comfort will improve.

Fit to Burst

A single drama for BBC Radio 3 The Wire: Andy has hit a mid-life crisis. His career is a mess, his relationship is falling apart and despite, or perhaps because of this, he seems intent on eating himself into an early grave. The Voice in his head has warned him, clearly, and a nightmarish tour of his inner organs has left him in no doubt that he is headed for, at best, a coronary arrest; at worst, something that he can't bear to think about it.

And yet he persists. Drowning in despair he grasps at crumbs of comfort, ingesting enough food to support a small country and doubling his waist and his weight in just one month, terrifying his wife and his work colleagues and rendering the average doorway inadequate for his desperate attempts at escape.

Exploring public awareness and perceptions of palliative care: a qualitative study

Background: Research suggests that the public appear to be confused about the meaning of palliative care. Given the ageing population and associated increase in the number of patients requiring palliative care, it is vital to explore the public's understanding of this concept. Health-promoting palliative care seeks to translate hospice and palliative care ideals into broader public health practice.

Aim: To explore public perceptions of palliative care and identify strategies to raise awareness.

Design: An exploratory qualitative approach. Participants: Semi-structured telephone interviews were undertaken (N = 50) with members of the public who volunteered to participate in the study. The interviews focused on knowledge and perceptions of palliative care, expectations of palliative care services and the identification of strategies to raise public awareness of palliative care. The interviews were audio recorded and content analysed.

Results: Most participants had a general knowledge of palliative care, largely influenced by their own personal experience. They identified that palliative care was about caring for people who were dying and maintaining comfort in the last days of life. Participants expectations of services included the following: holistic support, symptom management, good communication and practical support to enable choice and carer support. Key aspects identified for promoting palliative care were the development of understanding and use of the term itself and targeted educational strategies.

Conclusion: Experience of palliative care generates understanding in the general public who also have ideas for increasing knowledge and awareness. The findings can inform policymakers about strategies to raise public awareness of palliative care.

Combination of CFD and DOE to analyze and improve the mass flow rate in urinary catheters

The urinary catheter is a thin plastic tube that has been designed to empty the bladder artificially, effortlessly, and with minimum discomfort. The current CH14 male catheter design was examined with a view to optimizing the mass flow rate. The literature imposed constraints to the analysis of the urinary catheter to ensure that a compromise between optimal flow, patient comfort, and everyday practicality from manufacture to use was achieved in the new design. As a result a total of six design characteristics were examined. The input variables in question were the length and width of eyelets 1 and 2 (four variables), the distance between the eyelets, and the angle of rotation between the eyelets. Due to the high number of possible input combinations a structured approach to the analysis of data was necessary. A combination of computational fluid dynamics (CFD) and design of experiments (DOE) has been used to evaluate the "optimal configuration." The use of CFD couple with DOE is a novel concept, which harnesses the computational power of CFD in the most efficient manner for prediction of the mass flow rate in the catheter. Copyright © 2009 by ASME.

Caractérisation des matériaux latéritiques pour une meilleure utilisation en Afrique

In spite of the fact that the laterite masonry was often used for building, during the colonial period, the laterite rock is rarely studied. To resolve the economic and environmental problems, concerning the concrete or cinder block construction in Africa, this material can be again a local resource. The objective is to determine the hydro-thermo-mechanical properties of laterite rocks linking with the local geological conditions, to investigate the possibilities to be used in construction housing, sufficiently able to resist to limited loads and to give thermal comfort inside. Some preliminary results are presented here.

Solvent induced phase inversion-based in situ forming controlled release drug delivery implants

In situ forming (ISF) drug delivery implants have gained tremendous levels of interest over the last few decades. This is due to their wide range of biomedical applications such as in tissue engineering, cell encapsulation, microfluidics, bioengineering and drug delivery. Drug delivery implants forming upon injection has shown a range of advantages which include localized drug delivery, easy and less invasive application, sustained drug action, ability to tailor drug delivery, reduction in side effects associated with systemic delivery and also improved patient compliance and comfort. Different factors such as temperature, pH, ions, and exchange of solvents are involved in in situ implant formation. This review especially focuses on ISF implants that are formed through solvent induced phase inversion (SPI) technique. The article critically reviews and compares a wide range of polymers, solvents, and co-solvents that have been used in SPI implant preparation for control release of a range of drug molecules. Major drawback of SPI systems has been their high burst release. In this regard, the article exhaustively discusses factors that affect the burst release and different modification strategies that has been utilised to reduce the burst effect from these implants. Performance and controversial issues associated with the use of different biocompatible solvents in SPI systems is also discussed. Biodegradation, formulation stability, methods of characterisation and sterilisation techniques of SPI systems is comprehensively reviewed. Furthermore, the review also examines current SPI-based marketed products, their therapeutic application and associated clinical data. It also exemplifies the interest of multi-billion dollar pharma companies worldwide for further developments of SPI systems to a range of therapeutic applications. The authors believe that this will be the first review article that extensively investigate and discusses studies done to date on SPI systems. In so doing, this article will undoubtedly serve as an enlightening tool for the scientists working in the concerned area.

IDEAhaus: A Comfortable Home for the UK’s Future Climate

IDEAhaus:
A Comfortable Home for the UK’s Future Climate

This paper describes the result of a project to develop climate adaptation design strategies funded by the UK’s Technology Strategy Board. The aim of the project was to look at the threats and opportunities presented by industrialised and lightweight housebuilding techniques in the light of predicted increases in flooding and overheating. This case study presents detailed concept designs for a future systemised housing product which can be Industrialised, Delightful, Efficient and Adaptable; an IDEAhaus.
Keywords: climate change adaptation, thermal comfort, passive cooling, flood residence, industrialised housing, mass customisation

Developing mathematics support for first-year engineering students with non-traditional mathematics backgrounds

A maths support system for first-year engineering students with non-traditional entry qualifications has involved students working through practice questions structured to correspond with the maths module which runs in parallel. The setting was informal and there was significant one-to-one assistance. The non-traditional students (who are known to be less well prepared mathematically) were explicitly contacted in the first week of their university studies regarding the maths support and they generally seemed keen to participate. However, attendance at support classes was relatively low, on average, but varied greatly between students. Students appreciated the personal help and having time to ask questions. It seemed that having a small group of friends within the class promoted attendance – perhaps the mutual support or comfort that they all had similar mathematical difficulties was a factor. The classes helped develop confidence. Attendance was hindered by the class being timetabled too soon after the relevant lecture and students were reluctant to come with no work done beforehand. Although students at risk due to their mathematical unpreparedness can easily be identified at an early stage of their university career, encouraging them to partake of the maths support is an ongoing, major problem.