Hypoxic corneal changes following 8 hours of scleral contact lens wear

- Purpose To examine the change in corneal thickness and posterior curvature following 8 hours of miniscleral contact lens wear. - Methods Scheimpflug imaging (Pentacam HR, Oculus) was captured before, and immediately following, 8 hours of miniscleral contact lens wear for 15 young (mean age 22 ± 3 years), healthy participants with normal corneae. Natural diurnal variations were considered by measuring baseline corneal changes obtained on a separate control day without contact lens wear. - Results Over the central 6 mm of the cornea, a small, but highly statistically significant amount of edema was observed following 8 hours of miniscleral lens wear, after accounting for normal diurnal fluctuations (mean ± standard deviation percentage swelling 1.70 ± 0.98%, p < 0.0001). Posterior corneal topography remained stable following lens wear (-0.01 ± 0.07 mm steepening over the central 6 mm, p = 0.60). The magnitude of posterior corneal topographical changes following lens wear did not correlate with the extent of lens-related corneal edema (r = -0.16, p = 0.57). Similarly, the initial central corneal vault (maximum post-lens tear layer depth) was not associated with corneal swelling following lens removal (r = 0.27, p = 0.33). - Conclusions While a small amount of corneal swelling was induced following 8 hours of miniscleral lens wear (on average <2%), modern high Dk miniscleral contact lenses that vault the cornea do not induce clinically significant corneal edema or hypoxic related posterior corneal curvature changes during short-term wear. Longer-term studies of compromised eyes (e.g. corneal ectasia) are still required to inform the optimum lens and fitting characteristics for safe scleral lens wear to minimize corneal hypoxia.

Implementing music therapy on an adolescent inpatient unit: A mixed-methods evaluation of acceptability, experience of participation and perceived impact

Objective: We aimed to assess the feasibility of delivering a music therapy program on adolescent psychiatric wards. Method: We undertook a mixed-methods evaluation of a pilot program. Various active and receptive techniques were employed in group music therapy sessions delivered as part of a structured clinical program. Data collected in interviews with participants and staff and feedback questionnaires were thematically and descriptively analysed and triangulated. Results: Data from 62 questionnaires returned by 43 patients who took part in 16 music therapy sessions, and seven staff, evidenced strong support for music therapy. Patients typically reported experiencing sessions as relaxing, comforting, uplifting, and empowering; >90% would participate by choice and use music therapeutically in the future. Staff endorsed music therapy as valuable therapeutically, reporting that patients engaged enthusiastically and identified sessions as improving their own moods and ward milieu. Conclusions: Integration of music therapy in inpatient treatment of adolescents is feasible and acceptable, and is valued by staff and patients as a complement to ‘talking therapies’. Participation is enjoyed and associated with outcomes including improvement in mood, expression of feelings and social engagement consistent with recovery.

Finite element analysis of moving contact in mechanically fastened joints

The Finite Element Method (FEM) has made a number of otherwise intractable problems solvable. An important aspect for achieving an economical and accurate solution through FEM is matching the formulation and the computational organisation to the problem. This was realised forcefully in the present case of the solution of a class of moving contact boundary value problems of fastener joints. This paper deals with the problem of changing contact at the pin-hole interface of a fastener joint. Due to moving contact, the stresses and displacements are nonlinear with load. This would, in general, need an interactive-incremental approach for solution. However, by posing the problem in an inverse way, a solution is sought for obtaining loads to suit given contact configuration. Numerical results are given for typical isotropic and composite plates with rigid pins. Two cases of loading are considered: (i) load applied only at the edges of the plate and (ii) load applied at the pin and reacted at a part of the edge of the plate. Load-contact relationships, compliance and stress-patterns are investigated. This paper clearly demonstrates the simplification achieved by a suitable formulation of the problem. The results are of significance to the design and analysis of fastener joints.

Finite element analysis of moving contact in mechanically fastened joints

The Finite Element Method (FEM) has made a number of otherwise intractable problems solvable. An important aspect for achieving an economical and accurate solution through FEM is matching the formulation and the computational organisation to the problem. This was realised forcefully in the present case of the solution of a class of moving contact boundary value problems of fastener joints. This paper deals with the problem of changing contact at the pin-hole interface of a fastener joint. Due to moving contact, the stresses and displacements are nonlinear with load. This would, in general, need an interactive-incremental approach for solution. However, by posing the problem in an inverse way, a solution is sought for obtaining loads to suit given contact configuration. Numerical results are given for typical isotropic and composite plates with rigid pins. Two cases of loading are considered: (i) load applied only at the edges of the plate and (ii) load applied at the pin and reacted at a part of the edge of the plate. Load-contact relationships, compliance and stress-patterns are investigated. This paper clearly demonstrates the simplification achieved by a suitable formulation of the problem. The results are of significance to the design and analysis of fastener joints.

The lived experience of diagnosis delivery in motor neurone disease: A sociological-phenomenological study

Relatively few previous studies of individuals receiving a diagnosis of Motor Neurone Disease within the UK health care system have employed qualitative approaches to examine the diagnostic journey from a patient perspective. A qualitative sociological study was undertaken, involving interviews with 42 participants diagnosed with MND, to provide insight into their experiences of undergoing testing and receiving a diagnosis. Adopting a sociological-phenomenological perspective, this article examines key themes that emerged from participant accounts surrounding the lived experience of the diagnostic journey. The key themes that emerged were: The diagnostic quest; living with uncertainty; hearing bad news; communication difficulties; and a reified body of medical interest. In general, doctor-patient communication both at pre and post diagnosis was experienced as highly stressful, distressing and profoundly upsetting. Participants reported such distress as being due to the mode of delivery and communication strategies used by health professionals. We therefore suggest that professional training needs to emphasize the importance to health professionals of fostering greater levels of tact, sensitivity and empathy towards patients diagnosed with devastating, life-limiting illnesses such as MND.

The experience of Indigenous students in a Bachelor of Nursing Program in Australia: cultural safety and decolonising nurse education

Background In Australia significant health inequalities, such as an 11year life expectancy gap, impact on the continent’s traditional owners, the Aboriginal peoples and Torres Strait Islanders. Evidence suggests links between improved Indigenous health and a greater proportion of Indigenous people employed in all sectors. Achieving a greater proportion of Indigenous people in health services and in the health education workforce, requires improved higher education completion rates. Currently Indigenous people are under-represented in higher education and attrition rates amongst those who do participate are high. We argue these circumstances make health and education matters of social justice, largely related to unexamined relations of power within universities where the pedagogical and social environment revolve around the norms and common-sense of the dominant culture. Project Research at Queensland University of Technology in 2010-2012, aimed to gain insights into attrition/retention in the Bachelor of Nursing. A literature review on Indigenous participation in higher education in nursing contextualised a mixed methods study. The project examined enrolment, attrition and success by an analysis of enrolment data from 1984-2012. Using Indigenous Research Assistants we then conducted 20 in-depth interviews with Indigenous students followed by a thematic analysis seeking to gain insights into the impact of students’ university experience on retention. Our findings indicate that cultural safety, mentorship, acceptance and support are crucial in student academic success. They also indicate that inflexible systems based on ethnocentric assumptions exacerbate the structural issues that impact on the students’ everyday life and are also part of the story of attrition. The findings reinforced the assumption that educational environments and processes are inherently cultural and political. This perspective calls into question the role of the students’ cultural experience at university in attrition rates. A partnership between the School of Nursing and the Indigenous Education Unit is working to better support Indigenous students.

Being chased by zombies!: Understanding the experience of mixed reality quests

Both researchers and practitioners show increasing interest in exploring mixed reality games: games, where physical environments blend together with digital technologies. In this paper we have extended earlier work by bringing attention to the role of narrative in mixed reality games. For our case study we chose a mobile phone application Zombies Run!, which is designed to support actual running. This application contains a fictional story about a zombie apocalypse and provides runners with various quests (in the form of missions) to complete during their run. We investigated different aspects of participants' experience with the application and how it changed their running. Our findings show how the app changed running in three major ways. Firstly, it changed the way runs were organised. Secondly, it shook up established running routines. And lastly, it shaped the meanings associated with running.

Inpatient experience of anorexia nervosa

Anorexia nervosa (AN) is an extremely serious mental illness, with a high mortality rate and many debilitating physical and psychological symptoms. While hospitalisation is sometimes required for patients with AN there remains no evidence base for “best practice’ inpatient treatment. With patients’ views recognised as critical to improving efficiency and outcomes, calls have been made for more qualitative research into inpatients’ experiences. In light of this the current paper utilised thematic analysis to examine 16 semi-structured interviews with inpatients diagnosed with AN, at a specialised eating disorders hospital unit. The study found an overarching theme of relationship ambivalence in connection with sub-themes of patients’ eating disorders, eating disorder co-patients, staff and treatment. Participants’ goals in relationship to their eating disorder and engagement in treatment shaped and were shaped by interactions with other inpatients with AN and staff. Clinical implications for this study and future research directions are discussed.

The schooling experience of adolescent boys with AD/HD: An Australian case study

This study explored the experience of schooling of six adolescent boys diagnosed with AD/HD from the perspectives of the boys, their mothers and their teachers. The study utilised social constructionism as the theoretical orientation and the Dynamic Developmental Theory (DDT) of AD/HD as the explanatory framework. Utilising a multiple, instrumental case-study, data were collected by means of semi-structured individual and focus group interviews as well as a review of school reports across a two year period. Findings of the study suggest that taking medication as prescribed together with supporting the students to make and manage friendships, utilising classroom strategies that support learning, and providing an engaging classroom environment are important considerations to promote a positive schooling experience for adolescents with AD/HD.

Cooperative game play with avatars and agents: Differences in brain activity and the experience of play

The current study sought to identify the impact of whether teammates in a cooperative videogame were controlled by other humans (avatars) or by the game (agents). The impact on player experience was explored through both subjective questionnaire measures and brain wave activity measurement (electroencephalography). Play with human teammates was associated with a greater sense of relatedness, but less competence and flow than play with other computer-controlled teammates. In terms of brain activity, play with human teammates was associated with greater activity in the alpha, theta and beta power bands than play with computer-controlled teammates. Overall, the results suggest that play with human teammates involves greater cognitive activity in terms of 'mentalising' than play with computer-controlled teammates. Additionally, the associations between subjective measures of player experience and brain activity are described. Limitations of the current study are identified and key directions for future research are discussed.

Price Inflation, Unemployment and Devaluations: The Finnish Experience of the 1990s

In this paper I provide some empirical answers to important questions such as the determinants of price inflation and the role of inflation polices. The results indicate that monetary policy is surprisingly impotent as a device for controlling inflation and there is little support that it influences the real variables. The low inflation after the Finnish devaluations in the beginning of 90s is foremost due to a previous imbalance in the labor markets and depressed aggregate demand.

Thermomechanical generalization of partial contact in pin joints

Mechanical fasteners introduce structural weakness, still they are an essential constituent of most structures as they permit interchangeability of parts and flexible construction programs; Variable temperature operations of Aerospace and Nuclear structures make it imperative to investigate the thermoelastic behaviour of joints. This paper explores analytically similar mechanical and thermal parameters to generalise the thermomechanical behaviour of a pin joint in an isotropic Sheet for a class of configurations. This generalization enables virtually direct application of existing information regarding joints under pure mechanical loading to joints subjected to combined thermomechanical loading, thus reducing the efforts of both the analyst and the designer by an order of magnitude. Copyright (C) 1996 Published by Elsevier Science Ltd.

EXPERIENCE OF OPERATING OPEN TOP BIOMASS GASIFIER USING A LOW DENSITY FUEL-COCONUT FRONDS

Use of fuel other than woody generally has been limited to rice husk and other residues are rarely tried as a fuel in a gasification system. With the availability of woody biomass in most countries like India, alternates fuels are being explored for sustainable supply of fuel. Use of agro residues has been explored after briquetting. There are few feedstock's like coconut fronts, maize cobs, etc, that might require lesser preprocessing steps compared to briquetting. The paper presents a detailed investigation into using coconut fronds as a fuel in an open top down draft gasification system. The fuel has ash content of 7% and was dried to moisture levels of 12 %. The average bulk density was found to be 230 kg/m3 with a fuel size particle of an average size 40 mm as compared to 350 kg/m3 for a standard wood pieces. A typical dry coconut fronds weighs about 2.5kgs and on an average 6 m long and 90 % of the frond is the petiole which is generally used as a fuel. The focus was also to compare the overall process with respect to operating with a typical woody biomass like subabul whose ash content is 1 %. The open top gasification system consists of a reactor, cooling and cleaning system along with water treatment. The performance parameters studied were the gas composition, tar and particulates in the clean gas, water quality and reactor pressure drop apart from other standard data collection of fuel flow rate, etc. The average gas composition was found to be CO 15 1.0 % H-2 16 +/- 1% CH4 0.5 +/- 0.1 % CO2 12.0 +/- 1.0 % and rest N2 compared to CO 19 +/- 1.0 % H-2 17 +/- 1.0 %, CH4 1 +/- 0.2 %, CO2 12 +/- 1.0 % and rest N2. The tar and particulate content in the clean gas has been found to be about 10 and 12 mg/m3 in both cases. The presence of high ash content material increased the pressure drop with coconut frond compared to woody biomass.