Global trends in myopia management attitudes and strategies in clinical practice

PURPOSE: Myopia is a global public health issue; however, no information exists as to how potential myopia retardation strategies are being adopted globally. METHODS: A self-administrated, internet-based questionnaire was distributed in six languages, through professional bodies to eye care practitioners globally. The questions examined: awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies. RESULTS: Of the 971 respondents, concern was higher (median 9/10) in Asia than in any other continent (7/10, p<0.001) and they considered themselves more active in implementing myopia control strategies (8/10) than Australasia and Europe (7/10), with North (4/10) and South America (5/10) being least proactive (p<0.001). Orthokeratology was perceived to be the most effective method of myopia control, followed by increased time outdoors and pharmaceutical approaches, with under-correction and single vision spectacles felt to be the least effective (p<0.05). Although significant intra-regional differences existed, overall most practitioners 67.5 (±37.8)% prescribed single vision spectacles or contact lenses as the primary mode of correction for myopic patients. The main justifications for their reluctance to prescribe alternatives to single vision refractive corrections were increased cost (35.6%), inadequate information (33.3%) and the unpredictability of outcomes (28.2%). CONCLUSIONS: Regardless of practitioners' awareness of the efficacy of myopia control techniques, the vast majority still prescribe single vision interventions to young myopes. In view of the increasing prevalence of myopia and existing evidence for interventions to slow myopia progression, clear guidelines for myopia management need to be established.

Development of real-time process control systems using formal techniques

A major application of computers has been to control physical processes in which the computer is embedded within some large physical process and is required to control concurrent physical processes. The main difficulty with these systems is their event-driven characteristics, which complicate their modelling and analysis. Although a number of researchers in the process system community have approached the problems of modelling and analysis of such systems, there is still a lack of standardised software development formalisms for the system (controller) development, particular at early stage of the system design cycle. This research forms part of a larger research programme which is concerned with the development of real-time process-control systems in which software is used to control concurrent physical processes. The general objective of the research in this thesis is to investigate the use of formal techniques in the analysis of such systems at their early stages of development, with a particular bias towards an application to high speed machinery. Specifically, the research aims to generate a standardised software development formalism for real-time process-control systems, particularly for software controller synthesis. In this research, a graphical modelling formalism called Sequential Function Chart (SFC), a variant of Grafcet, is examined. SFC, which is defined in the international standard IEC1131 as a graphical description language, has been used widely in industry and has achieved an acceptable level of maturity and acceptance. A comparative study between SFC and Petri nets is presented in this thesis. To overcome identified inaccuracies in the SFC, a formal definition of the firing rules for SFC is given. To provide a framework in which SFC models can be analysed formally, an extended time-related Petri net model for SFC is proposed and the transformation method is defined. The SFC notation lacks a systematic way of synthesising system models from the real world systems. Thus a standardised approach to the development of real-time process control systems is required such that the system (software) functional requirements can be identified, captured, analysed. A rule-based approach and a method called system behaviour driven method (SBDM) are proposed as a development formalism for real-time process-control systems.

An evaluation of task analysis techniques for industrial process control

The concept of a task is fundamental to the discipline of ergonomics. Approaches to the analysis of tasks began in the early 1900's. These approaches have evolved and developed to the present day, when there is a vast array of methods available. Some of these methods are specific to particular contexts or applications, others more general. However, whilst many of these analyses allow tasks to be examined in detail, they do not act as tools to aid the design process or the designer. The present thesis examines the use of task analysis in a process control context, and in particular the use of task analysis to specify operator information and display requirements in such systems. The first part of the thesis examines the theoretical aspect of task analysis and presents a review of the methods, issues and concepts relating to task analysis. A review of over 80 methods of task analysis was carried out to form a basis for the development of a task analysis method to specify operator information requirements in industrial process control contexts. Of the methods reviewed Hierarchical Task Analysis was selected to provide such a basis and developed to meet the criteria outlined for such a method of task analysis. The second section outlines the practical application and evolution of the developed task analysis method. Four case studies were used to examine the method in an empirical context. The case studies represent a range of plant contexts and types, both complex and more simple, batch and continuous and high risk and low risk processes. The theoretical and empirical issues are drawn together and a method developed to provide a task analysis technique to specify operator information requirements and to provide the first stages of a tool to aid the design of VDU displays for process control.

A methodology for analysis and control of discrete event dynamic systems

The rapid developments in computer technology have resulted in a widespread use of discrete event dynamic systems (DEDSs). This type of system is complex because it exhibits properties such as concurrency, conflict and non-determinism. It is therefore important to model and analyse such systems before implementation to ensure safe, deadlock free and optimal operation. This thesis investigates current modelling techniques and describes Petri net theory in more detail. It reviews top down, bottom up and hybrid Petri net synthesis techniques that are used to model large systems and introduces on object oriented methodology to enable modelling of larger and more complex systems. Designs obtained by this methodology are modular, easy to understand and allow re-use of designs. Control is the next logical step in the design process. This thesis reviews recent developments in control DEDSs and investigates the use of Petri nets in the design of supervisory controllers. The scheduling of exclusive use of resources is investigated and an efficient Petri net based scheduling algorithm is designed and a re-configurable controller is proposed. To enable the analysis and control of large and complex DEDSs, an object oriented C++ software tool kit was developed and used to implement a Petri net analysis tool, Petri net scheduling and control algorithms. Finally, the methodology was applied to two industrial DEDSs: a prototype can sorting machine developed by Eurotherm Controls Ltd., and a semiconductor testing plant belonging to SGS Thomson Microelectronics Ltd.

Computer control of machines utilising independent drive mechanisms

The thesis describes an investigation into methods for the specification, design and implementation of computer control systems for flexible manufacturing machines comprising multiple, independent, electromechanically-driven mechanisms. An analysis is made of the elements of conventional mechanically-coupled machines in order that the operational functions of these elements may be identified. This analysis is used to define the scope of requirements necessary to specify the format, function and operation of a flexible, independently driven mechanism machine. A discussion of how this type of machine can accommodate modern manufacturing needs of high-speed and flexibility is presented. A sequential method of capturing requirements for such machines is detailed based on a hierarchical partitioning of machine requirements from product to independent drive mechanism. A classification of mechanisms using notations, including Data flow diagrams and Petri-nets, is described which supports capture and allows validation of requirements. A generic design for a modular, IDM machine controller is derived based upon hierarchy of control identified in these machines. A two mechanism experimental machine is detailed which is used to demonstrate the application of the specification, design and implementation techniques. A computer controller prototype and a fully flexible implementation for the IDM machine, based on Petri-net models described using the concurrent programming language Occam, is detailed. The ability of this modular computer controller to support flexible, safe and fault-tolerant operation of the two intermittent motion, discrete-synchronisation independent drive mechanisms is presented. The application of the machine development methodology to industrial projects is established.

Forecasting and risk analysis applied to management planning and control

The aim of this research was to improve the quantitative support to project planning and control principally through the use of more accurate forecasting for which new techniques were developed. This study arose from the observation that in most cases construction project forecasts were based on a methodology (c.1980) which relied on the DHSS cumulative cubic cost model and network based risk analysis (PERT). The former of these, in particular, imposes severe limitations which this study overcomes. Three areas of study were identified, namely growth curve forecasting, risk analysis and the interface of these quantitative techniques with project management. These fields have been used as a basis for the research programme. In order to give a sound basis for the research, industrial support was sought. This resulted in both the acquisition of cost profiles for a large number of projects and the opportunity to validate practical implementation. The outcome of this research project was deemed successful both in theory and practice. The new forecasting theory was shown to give major reductions in projection errors. The integration of the new predictive and risk analysis technologies with management principles, allowed the development of a viable software management aid which fills an acknowledged gap in current technology.

Computer-assisted production scheduling, planning and control in foundries

The present study describes a pragmatic approach to the implementation of production planning and scheduling techniques in foundries of all types and looks at the use of `state-of-the-art' management control and information systems. Following a review of systems for the classification of manufacturing companies, a definitive statement is made which highlights the important differences between foundries (i.e. `component makers') and other manufacturing companies (i.e. `component buyers'). An investigation of the manual procedures which are used to plan and control the manufacture of components reveals the inherent problems facing foundry production management staff, which suggests the unsuitability of many manufacturing techniques which have been applied to general engineering companies. From the literature it was discovered that computer-assisted systems are required which are primarily `information-based' rather than `decision based', whilst the availability of low-cost computers and `packaged-software' has enabled foundries to `get their feet wet' without the financial penalties which characterized many of the early attempts at computer-assistance (i.e. pre-1980). Moreover, no evidence of a single methodology for foundry scheduling emerged from the review. A philosophy for the development of a CAPM system is presented, which details the essential information requirements and puts forward proposals for the subsequent interactions between types of information and the sub-system of CAPM which they support. The work developed was oriented specifically at the functions of production planning and scheduling and introduces the concept of `manual interaction' for effective scheduling. The techniques developed were designed to use the information which is readily available in foundries and were found to be practically successful following the implementation of the techniques into a wide variety of foundries. The limitations of the techniques developed are subsequently discussed within the wider issues which form a CAPM system, prior to a presentation of the conclusions which can be drawn from the study.

Aspects of the design and operation of production control systems in manufacturing industry

Computerised production control developments have concentrated on Manufacturing Resources Planning (MRP II) systems. The literature suggests however, that despite the massive investment in hardware, software and management education, successful implementation of such systems in manufacturing industries has proved difficult. This thesis reviews the development of production planning and control systems, in particular, investigates the causes of failures in implementing MRP/MRP II systems in industrial environments and argues that the centralised and top-down planning structure, as well as the routine operational methodology of such systems, is inherently prone to failure. The thesis reviews the control benefits of cellular manufacturing systems but concludes that in more dynamic manufacturing environments, techniques such as Kanban are inappropriate. The basic shortcomings of MRP II systems are highlighted and a new enhanced operational methodology based on distributed planning and control principles is introduced. Distributed Manufacturing Resources Planning (DMRP), was developed as a capacity sensitive production planning and control solution for cellular manufacturing environments. The system utilises cell based, independently operated MRP II systems, integrated into a plant-wide control system through a Local Area Network. The potential benefits of adopting the system in industrial environments is discussed and the results of computer simulation experiments to compare the performance of the DMRP system against the conventional MRP II systems presented. DMRP methodology is shown to offer significant potential advantages which include ease of implementation, cost effectiveness, capacity sensitivity, shorter manufacturing lead times, lower working in progress levels and improved customer service.

The application of computerised modelling techniques in manufacturing system design

The absence of a definitive approach to the design of manufacturing systems signifies the importance of a control mechanism to ensure the timely application of relevant design techniques. To provide effective control, design development needs to be continually assessed in relation to the required system performance, which can only be achieved analytically through computer simulation. The technique providing the only method of accurately replicating the highly complex and dynamic interrelationships inherent within manufacturing facilities and realistically predicting system behaviour. Owing to the unique capabilities of computer simulation, its application should support and encourage a thorough investigation of all alternative designs. Allowing attention to focus specifically on critical design areas and enabling continuous assessment of system evolution. To achieve this system analysis needs to efficient, in terms of data requirements and both speed and accuracy of evaluation. To provide an effective control mechanism a hierarchical or multi-level modelling procedure has therefore been developed, specifying the appropriate degree of evaluation support necessary at each phase of design. An underlying assumption of the proposal being that evaluation is quick, easy and allows models to expand in line with design developments. However, current approaches to computer simulation are totally inappropriate to support the hierarchical evaluation. Implementation of computer simulation through traditional approaches is typically characterized by a requirement for very specialist expertise, a lengthy model development phase, and a correspondingly high expenditure. Resulting in very little and rather inappropriate use of the technique. Simulation, when used, is generally only applied to check or verify a final design proposal. Rarely is the full potential of computer simulation utilized to aid, support or complement the manufacturing system design procedure. To implement the proposed modelling procedure therefore the concept of a generic simulator was adopted, as such systems require no specialist expertise, instead facilitating quick and easy model creation, execution and modification, through simple data inputs. Previously generic simulators have tended to be too restricted, lacking the necessary flexibility to be generally applicable to manufacturing systems. Development of the ATOMS manufacturing simulator, however, has proven that such systems can be relevant to a wide range of applications, besides verifying the benefits of multi-level modelling.

Development of techniques to predict production line efficiency

This industrial based research project was undertaken for British Leyland and arose as a result of poor system efficiency on the Maxi and Marina vehicle body build lines. The major factors in the deterioration of system efficiency were identified as: a) The introduction of a 'Gateline' system of vehicle body build. b) The degeneration of a newly introduced measured daywork payment scheme. By relating the conclusions of past work on payment systems to the situation at Cowley, it was concluded that a combination of poor industrial relations and a lack of managerial control had caused the measured daywork scheme to degenerate into a straightforward payment for time at work. This ellminated the monetary incentive to achieve schedule with the consequence that both inefficiency and operating costs increased. To analyse further the cause of inefficiency, a study of Marina gateline stoppage logs was carried out. This revealed that poor system efficiency on the gateline was caused more by the nature of its design than poor reliability on individual items of' plant. The consideration given to system efficiency at the design stage was found to be negligible, the main obstacles being: a) A lack of understanding pertaining to the influence of certain design factors on the efficiency of a production line. b) The absence of data and techniques to predict system efficiency at the design stage. To remedy this situation, a computer simulation study of' the design factors was carried out from which relationships with system efficiency were established and empirical efficiency equations developed. Sets of tables were compiled from the equations and efficiency data relevant to vehicle body building established from the gateline stoppage logs. Computer simulation, the equations and the tables,when used in conjunction. with good efficiency data, are shown to be accurate methods of predicting production line system.efficiency.

A combination of cyclone and vert techniques for the management of construction projects

Many planning and control tools, especially network analysis, have been developed in the last four decades. The majority of them were created in military organization to solve the problem of planning and controlling research and development projects. The original version of the network model (i.e. C.P.M/PERT) was transplanted to the construction industry without the consideration of the special nature and environment of construction projects. It suited the purpose of setting up targets and defining objectives, but it failed in satisfying the requirement of detailed planning and control at the site level. Several analytical and heuristic rules based methods were designed and combined with the structure of C.P.M. to eliminate its deficiencies. None of them provides a complete solution to the problem of resource, time and cost control. VERT was designed to deal with new ventures. It is suitable for project evaluation at the development stage. CYCLONE, on the other hand, is concerned with the design and micro-analysis of the production process. This work introduces an extensive critical review of the available planning techniques and addresses the problem of planning for site operation and control. Based on the outline of the nature of site control, this research developed a simulation based network model which combines part of the logics of both VERT and CYCLONE. Several new nodes were designed to model the availability and flow of resources, the overhead and operating cost and special nodes for evaluating time and cost. A large software package is written to handle the input, the simulation process and the output of the model. This package is designed to be used on any microcomputer using MS-DOS operating system. Data from real life projects were used to demonstrate the capability of the technique. Finally, a set of conclusions are drawn regarding the features and limitations of the proposed model, and recommendations for future work are outlined at the end of this thesis.

Clinical studies of spatial and temporal aspects of vision: an investigation using psychophysical and electrophysiological techniques

Separate physiological mechanisms which respond to spatial and temporal stimulation have been identified in the visual system. Some pathological conditions may selectively affect these mechanisms, offering a unique opportunity to investigate how psychophysical and electrophysiological tests reflect these visual processes, and thus enhance the use of the tests in clinical diagnosis. Amblyopia and optical blur were studied, representing spatial visual defects of neural and optical origin, respectively. Selective defects of the visual pathways were also studied - optic neuritis which affects the optic nerve, and dementia of the Alzheimer type in which the higher association areas are believed to be affected, but the primary projections spared. Seventy control subjects from 10 to 79 years of age were investigated. This provided material for an additional study of the effect of age on the psychophysical and electrophysiological responses. Spatial processing was measured by visual acuity, the contrast sensitivity function, or spatial modulation transfer function (MTF), and the pattern reversal and pattern onset-offset visual evoked potential (VEP). Temporal, or luminance, processing was measured by the de Lange curve, or temporal MTF, and the flash VEP. The pattern VEP was shown to reflect the integrity of the optic nerve, geniculo striate pathway and primary projections, and was related to high temporal frequency processing. The individual components of the flash VEP differed in their characteristics. The results suggested that the P2 component reflects the function of the higher association areas and is related to low temporal frequency processing, while the Pl component reflects the primary projection areas. The combination of a delayed flash P2 component and a normal latency pattern VEP appears to be specific to dementia of the Alzheimer type and represents an important diagnostic test for this condition.

The control of technological change in the motor industry:a case study

This thesis is based upon a case study of the introduction of automated production technologies at the Longbridge plant of British Leyland in the period 1978 to 1980.The investment in automation was part of an overall programme of modernization to manufacture the new 'Mini Metro' model. In the first Section of the thesis, the different theoretical perspectives on technological change are discussed. Particular emphasis is placed upon the social role of management as the primary controllers of technological change. Their actions are seen to be oriented towards the overall strategy of the firm, integrating the firm's competitive strategy with production methods and techniques.This analysis is grounded in an examination of British Leyland's strategies during the 1970s.. The greater part of the thesis deals with the efforts made by management to secure their strategic objectives in the process of technological change against the conflicting claims of their work-force. Examination of these efforts is linked to the development of industrial relations conflict at Longbridge and in British Leyland as a whole.Emphasis is placed upon the struggle between management in pursuit of their version of efficiency and the trade unions in defence of job controls and demarcations. The thesis concludes that the process of technological change in the motor industry is controlled by social forces,with the introduction of new technologies being closely intertwined with management!s political relations with the trade unions.

Modelling manufacturing planning and control systems:the application of object-oriented principles and discrete-event simulation

Manufacturing planning and control systems are fundamental to the successful operations of a manufacturing organisation. 10 order to improve their business performance, significant investment is made by companies into planning and control systems; however, not all companies realise the benefits sought Many companies continue to suffer from high levels of inventory, shortages, obsolete parts, poor resource utilisation and poor delivery performance. This thesis argues that the fit between the planning and control system and the manufacturing organisation is a crucial element of success. The design of appropriate control systems is, therefore, important. The different approaches to the design of manufacturing planning and control systems are investigated. It is concluded that there is no provision within these design methodologies to properly assess the impact of a proposed design on the manufacturing facility. Consequently, an understanding of how a new (or modified) planning and control system will perform in the context of the complete manufacturing system is unlikely to be gained until after the system has been implemented and is running. There are many modelling techniques available, however discrete-event simulation is unique in its ability to model the complex dynamics inherent in manufacturing systems, of which the planning and control system is an integral component. The existing application of simulation to manufacturing control system issues is limited: although operational issues are addressed, application to the more fundamental design of control systems is rarely, if at all, considered. The lack of a suitable simulation-based modelling tool does not help matters. The requirements of a simulation tool capable of modelling a host of different planning and control systems is presented. It is argued that only through the application of object-oriented principles can these extensive requirements be achieved. This thesis reports on the development of an extensible class library called WBS/Control, which is based on object-oriented principles and discrete-event simulation. The functionality, both current and future, offered by WBS/Control means that different planning and control systems can be modelled: not only the more standard implementations but also hybrid systems and new designs. The flexibility implicit in the development of WBS/Control supports its application to design and operational issues. WBS/Control wholly integrates with an existing manufacturing simulator to provide a more complete modelling environment.