Government relations, government regulations: jumping through the hoops

Over the last decade, telehealth in Australia has been primarily facilitated and driven by government funding. The government now has a major policy initiative in online health. However, in pursuing the broad initiative there is a danger that some of the smaller components can get lost, and this is probably what has happened to telehealth. There appear to be a number of steps required if telehealth in Australia is to keep up the pace of development that occurred in the 1990s, as we move into what is now being called the era of e-health, involving broadband Internet health service delivery. This area is changing extremely rapidly and is increasingly migrating away from the public sector in Australia, where most of the developmental work has occurred, and into the private sector. Many of the issues that require consideration within the domain of e-health in Australia are also relevant to other countries. E-health will significantly change the way that health-care is practised in future, and it is clear that it is the human factors that are more difficult to overcome, rather than the technological ones.

Government relations, government regulations: Jumping through the hoops

Over the last decade, telehealth in Australia has been primarily facilitated and driven by government funding. The government now has a major policy initiative in online health. However, in pursuing the broad initiative there is a danger that some of the smaller components can get lost, and this is probably what has happened to telehealth. There appear to be a number of steps required if telehealth in Australia is to keep up the pace of development that occurred in the 1990s, as we move into what is now being called the era of e-health, involving broadband Internet health service delivery. This area is changing extremely rapidly and is increasingly migrating away from the public sector in Australia, where most of the developmental work has occurred, and into the private sector. Many of the issues that require consideration within the domain of e-health in Australia are also relevant to other countries. E-health will significantly change the way that health-care is practised in future, and it is clear that it is the human factors that are more difficult to overcome, rather than the technological ones.

Identification of optically clear regions of ternary polymer blends using a novel rapid screening method

The application of a rapid screening method for the construction of ternary phase diagrams is described for the first time, providing detailed visualization of phase boundaries in solvent-mediated blends. Our new approach rapidly identifies ternary blend compositions that afford optically clear materials, useful for applications where transparent films are necessary. The use of 96-well plates and a scanning plate reader has enabled rapid optical characterization to be carried out by transmission spectrophotometry (450 nm), whilst the nature and extent of crystallinity was examined subsequently by wide angle X-ray scattering (WAXS). The moderating effect of cellulose acetate butyrate can be visualized as driving the position of the phase boundaries in poly(l-lactic acid)/polycaprolactone (PLLA/PCL) blends. More surprisingly, the boundaries are critically dependent on the molecular weight of the crystallizable PLLA and PCL, with higher molecular weight polymers leading to blends with reduced phase separation. On the other hand, the propensity to crystallize was more evident in shorter chains. WAXS provides a convenient way of characterizing the contribution of the individual blend components to the crystalline regions across the range of blend compositions. © 2013 Society of Chemical Industry.

Specialist contact lens fitting

What is meant by the term ‘specialist contact lens fitting’? Or put another way, what would be considered non-specialist contact lens fitting? Is there such a thing as routine contact lens fitting? Soft or silicone hydrogel fitting for daily wear would probably be considered as routine contact lens fitting, but would extended or flexible wear remain in the same category or would they be considered a specialist fit? Different eras will classify different products as being ‘specialist’. Certainly twenty years ago soft toric contact lenses were considered as being speciality lenses but today would be thought of as routine lenses. Conversely, gas permeable lenses were thought of as mainstream twenty years ago but now are considered as speciality lenses. Although this would not be the same globally, as in some countries (such as Netherlands, France and Japan) gas permeable lens fitting remains popular and is not on the decline as in other countries (Canada, Australia and Sweden) [1]. Bandage soft lenses applied after surface laser refractive procedures would be considered as therapeutic lenses but in reality they are just plano thin hydrogel lenses worn constantly for 3–4 days to allow the underlying epithelium to convalesce and are then removed [2]. Some patients find that wearing hydrogel lenses during periods when they suffer from seasonal allergies actually improves their ocular comfort as the contact lens acts as a barrier to the allergen [3] and [4]. Scleral lenses have long been considered speciality lenses, apart from a time when they were the only lenses available but at that time all contact lens work would have been considered speciality practice! Nowadays we see the advent of mini-scleral designs and we see large diameter gas permeable lenses too. It is possible that these lenses increase the popularity of gas permeable lenses again and they become more main stream. So it would seem that the lines between routine and speciality contact lens fitting are not clear. Whether a lens is classed a specialist fit or not would depend on the lens type, why it was fitted, where in the world the fitting was being done and even the era in which it was fitted. This begs the question as to what would be considered entry level knowledge in contact lens fitting. This may not be an issue for most BCLA members or CLAE readers but certainly would be for bodies such as the College of Optometrists (UK) or the Association of British Dispensing Opticians when they are planning the final registration examinations for budding practitioners or when planning the level of higher level qualifications such as College Certificates or Diplomas. Similarly for training institutions when they are planning their course content. This becomes even trickier when trying to devise a qualification that spans across many countries, like the European Diploma in Optometry and Optics. How do we know if the training and examination level is correct? One way would be to analyse things when they go wrong and if patterns of malpractice are seen then maybe that could be used as an indicator to more training being needed. There were 162 Fitness to Practice Hearing at the General Optical Council between 2001 and 2010. Forty-seven of these were clinically related case, 39 fraud related, and 76 others. Of the clinical ones only 3 were contact lens related. So it would appear that as whole, in the profession, contact lens clinical skills are not being questioned too often (although it seems a few of us can’t keep our hands out the cookie jar!).

Fracture and viscoelastic properties of asphalt binders during fatigue and rest periods

Viscoelastic asphalt binder plays an important role in bonding individual aggregate particles and contributes to the durability and stability of asphalt pavement. When asphalt binder is subjected to cyclic loading, deformation and fracture may develop simultaneously within it, leading to the deterioration of material properties and eventually fatigue failure. Research has found that some degree of recovery may develop if rest periods are applied after fatigue deterioration. However, it is not clear whether such recovery is caused by fracture healing, viscoelastic recovery, or both. This paper presents an analysis to differentiate the contributions of fracture healing and viscoelastic recovery to the asphalt binder during rest periods. It also evaluates the damage caused by deformation and fracture during a fatigue process. It is found that viscoelastic recovery plays an important role in the instant increase in the dynamic shear modulus at the beginning of the rest period. The effect of fracture healing on dynamic shear modulus recovery is more dominant in the long term. A healing index is developed based only on the fracture healing of asphalt binder, excluding the effect of viscoelastic recovery. It can be used to evaluate the true healing properties of different asphalt binders. Copyright © 2014 by ASTM International.

Co-constructed caring research and intellectual disability:an exploration of friendship, intimacy and being human

For this paper, emotional and socio-political questions lie at the heart of relationships in understanding intellectual disability and what it is to be a human. While the sexual and intimate is more often than not based on a private and personal relationship with the self and (an)other, the sexual and intimate life of intellectually disabled people is more often a ‘public’ affair governed by parents and/or carers, destabilizing what we might consider ethical and caring practices. In the socio-political sphere, as an all-encompassing ‘care space’, social intolerance and aversion to difficult differences are played out, impacting upon the intimate lives of intellectually disabled people. As co-researchers (one intellectually disabled and one ‘non-disabled’), we discuss narratives from a small scale research project and our personal reflections. In sociological research and more specifically within disability research it is clear that we need to keep sex and intimacy on the agenda, yet also find ways of doing research in a meaningful, caring and co-constructed way.

Reliability-based calibration for a mechanics-based fatigue cracking design procedure

Most pavement design procedures incorporate reliability to account for design inputs-associated uncertainty and variability effect on predicted performance. The load and resistance factor design (LRFD) procedure, which delivers economical section while considering design inputs variability separately, has been recognised as an effective tool to incorporate reliability into design procedures. This paper presents a new reliability-based calibration in LRFD format for a mechanics-based fatigue cracking analysis framework. This paper employs a two-component reliability analysis methodology that utilises a central composite design-based response surface approach and a first-order reliability method. The reliability calibration was achieved based on a number of field pavement sections that have well-documented performance history and high-quality field and laboratory data. The effectiveness of the developed LRFD procedure was evaluated by performing pavement designs of various target reliabilities and design conditions. The result shows an excellent agreement between the target and actual reliabilities. Furthermore, it is clear from the results that more design features need to be included in the reliability calibration to minimise the deviation of the actual reliability from the target reliability.

Contradictions inherent in the management of natural and industrial disasters

These days people keep wondering whether the world is more dangerous now than it was before. Do natural disasters really happen more frequently or is it just that the damage they cause that has become greater? The situation is not quite clear. As a result of the globalizing world and advanced communication infrastructure, the number of known / reported catastrophes is relatively high, but that does not necessarily mean there has been an actual increase in frequency. The red mud spill in Hungary was a special combination of industrial and natural disasters. This is one of the reasons why it is very hard to pinpoint who is responsible for the event. Natural disasters tend to raise questions about responsibility that are different from those concerning industrial catastrophes. Interestingly enough, however, nature often plays an important role in industrial disasters. The present article is concerned with how the issues of responsibility are handled in the case of industrial disasters.

Optimization of pavement maintenance and rehabilitation programming using shuffled complex evolution algorithm

The major barrier to practical optimization of pavement preservation programming has always been that for formulations where the identity of individual projects is preserved, the solution space grows exponentially with the problem size to an extent where it can become unmanageable by the traditional analytical optimization techniques within reasonable limit. This has been attributed to the problem of combinatorial explosion that is, exponential growth of the number of combinations. The relatively large number of constraints often presents in a real-life pavement preservation programming problems and the trade-off considerations required between preventive maintenance, rehabilitation and reconstruction, present yet another factor that contributes to the solution complexity. In this research study, a new integrated multi-year optimization procedure was developed to solve network level pavement preservation programming problems, through cost-effectiveness based evolutionary programming analysis, using the Shuffled Complex Evolution (SCE) algorithm.^ A case study problem was analyzed to illustrate the robustness and consistency of the SCE technique in solving network level pavement preservation problems. The output from this program is a list of maintenance and rehabilitation treatment (M&R) strategies for each identified segment of the network in each programming year, and the impact on the overall performance of the network, in terms of the performance levels of the recommended optimal M&R strategy. ^ The results show that the SCE is very efficient and consistent in the simultaneous consideration of the trade-off between various pavement preservation strategies, while preserving the identity of the individual network segments. The flexibility of the technique is also demonstrated, in the sense that, by suitably coding the problem parameters, it can be used to solve several forms of pavement management programming problems. It is recommended that for large networks, some sort of decomposition technique should be applied to aggregate sections, which exhibit similar performance characteristics into links, such that whatever M&R alternative is recommended for a link can be applied to all the sections connected to it. In this way the problem size, and hence the solution time, can be greatly reduced to a more manageable solution space. ^ The study concludes that the robust search characteristics of SCE are well suited for solving the combinatorial problems in long-term network level pavement M&R programming and provides a rich area for future research. ^

Pavement performance prediction using adaptive logic networks

Pavement performance is one of the most important components of the pavement management system. Prediction of the future performance of a pavement section is important in programming maintenance and rehabilitation needs. Models for predicting pavement performance have been developed on the basis of traffic and age. The purpose of this research is to extend the use of a relatively new approach to performance prediction in pavement performance modeling using adaptive logic networks (ALN). Adaptive logic networks have recently emerged as an effective alternative to artificial neural networks for machine learning tasks. ^ The ALN predictive methodology is applicable to a wide variety of contexts including prediction of roughness based indices, composite rating indices and/or individual pavement distresses. The ALN program requires key information about a pavement section, including the current distress indexes, pavement age, climate region, traffic and other variables to predict yearly performance values into the future. ^ This research investigates the effect of different learning rates of the ALN in pavement performance modeling. It can be used at both the network and project level for predicting the long term performance of a road network. Results indicate that the ALN approach is well suited for pavement performance prediction modeling and shows a significant improvement over the results obtained from other artificial intelligence approaches. ^