Impact in contact lenses and the anterior eye:challenges prevailing in 2015

As we settle into a new year, this second issue of Contact Lens and Anterior Eye allows us to reflect on how new research in this field impacts our understanding, but more importantly, how we use this evidence basis to enhance our day to day practice, to educate the next generation of students and to construct the research studies to deepen our knowledge still further. The end of 2014 saw the publication of the UK governments Research Exercise Framework (REF) which ranks Universities in terms of their outputs (which includes their paper, publications and research income), environment (infrastructure and staff support) and for the first time impact (defined as “any effect on, change or benefit to the economy, society, culture, public policy or services, health, the environment or quality of life, beyond academia” [8]). The REF is a process of expert review, carried out in 36 subject-based units of assessment, of which our field is typically submitted to the Allied Health, Dentistry, Nursing and Pharmacy panel. Universities that offer Optometry did very well with Cardiff, Manchester and Aston in the top 10% out of the 94 Universities that submitted to this panel (Grade point Average ranked order). While the format of the new exercise (probably in 2010) to allocate the more than £2 billion of UK government research funds is yet to be determined, it is already rumoured that impact will contribute an even larger proportion to the weighting. Hence it is even more important to reflect on the impact of our research. In this issue, Elisseef and colleagues [5] examine the intriguing potential of modifying a lens surface to allow it to bind to known wetting agents (in this case hyaluronic acid) to enhance water retention. Such a technique has the capacity to reduced friction between the lens surface and the eyelids/ocular surface, presumably leading to higher comfort and less reason for patients to discontinue with lens wear. Several papers in this issue report on the validity of new high precision, fast scanning imaging and quantification equipment, utilising techniques such as Scheimpflug, partial coherence interferometry, aberrometry and video allowing detailed assessment of anterior chamber biometry, corneal topography, corneal biomechanics, peripheral refraction, ocular aberrations and lens fit. The challenge is how to use this advanced instrumentation which is becoming increasingly available to create real impact. Many challenges in contact lenses and the anterior eye still prevail in 2015 such as: -While contact lens and refractive surgery complications are relatively rare, they are still too often devastating to the individual and their quality of life (such as the impact and prognosis of patients with Acanthmoeba Keratitis reported by Jhanji and colleagues in this issue [7]). How can we detect those patients who are going to be affected and what modifications do we need to make to contact lenses and patient management prevent this occurring? -Drop out from contact lenses still occurs at a rapid rate and symptoms of dry eye seem to be the leading cause driving this discontinuation of wear [1] and [2]. What design, coating, material and lubricant release mechanism will make a step change in end of day comfort in particular? -Presbyopia is a major challenge to hassle free quality vision and is one of the first signs of ageing noticed by many people. As an emmetrope approaching presbyopia, I have a vested interest in new medical devices that will give me high quality vision at all distances when my arms won’t stretch any further. Perhaps a new definition of presbyopia could be when you start to orientate your smartphone in the landscape direction to gain the small increase in print size needed to read! Effective accommodating intraocular lenses that truly mimic the pre-presbyopic crystalline lenses are still a way off [3] and hence simultaneous images achieved through contact lenses, intraocular lenses or refractive surgery still have a secure future. However, splitting light reaching the retina and requiring the brain to supress blurred images will always be a compromise on contrast sensitivity and is liable to cause dysphotopsia; so how will new designs account for differences in a patient's task demands and own optical aberrations to allow focused patient selection, optimising satisfaction? -Drug delivery from contact lenses offers much in terms of compliance and quality of life for patients with chronic ocular conditions such as glaucoma, dry eye and perhaps in the future, dry age-related macular degeneration; but scientific proof-of-concept publications (see EIShaer et al. [6]) have not yet led to commercial products. Part of this is presumably the regulatory complexity of combining a medical device (the contact lens) and a pharmaceutical agent. Will 2015 be the year when this innovation finally becomes a reality for patients, bringing them an enhanced quality of life through their eye care practitioners and allowing researchers to further validate the use of pharmaceutical contact lenses and propose enhancements as the technology matures? -Last, but no means least is the field of myopia control, the topic of the first day of the BCLA's Conference in Liverpool, June 6–9th 2015. The epidemic of myopia is a blight, particularly in Asia, with significant concerns over sight threatening pathology resulting from the elongated eye. This is a field where real impact is already being realised through new soft contact lens optics, orthokeratology and low dose pharmaceuticals [4], but we still need to be able to better predict which technique will work best for an individual and to develop new techniques to retard myopia progression in those who don’t respond to current treatments, without increasing their risk of complications or the treatment impacting their quality of life So what will your New Year's resolution be to make 2015 a year of real impact, whether by advancing science or applying the findings published in journals such as Contact Lens and Anterior Eye to make a real difference to your patients’ lives?

CLAE to move to online format

Editorial: The 2015 BCLA annual conference was another fantastic affair. It was the first time the conference was held in the beautiful city of Liverpool. The venue was great and the programme was excellent. The venue overlooked the River Mersey and many of the hotels were local boutique hotels. I stayed in one which was formerly the offices of White Star Liners—where the RMS Titanic was originally registered. The hotel decor was consistent with its historic significance. The BCLA gala dinner was held in the hugely impressive Anglican Cathedral with entertainment from a Beatles tribute band. That will certainly be a hard act to follow at the next conference in 2017. Brian Tompkins took the reigns as the new BCLA president. Professor Fiona Stapleton was the recipient of the BCLA Gold Medal Award. The winner of the poster competition was Dorota Szczesna-Iskander with a poster entitled ‘Dry Contact lens poor wettability and visual performance’. Second place was Renee Reeder with her poster entitled ‘Abnormal Rosacea as a differential diagnosis in corneal scarring’. And third place was Maria Jesus Gonzalez-Garcia with her poster entitled ‘Dry Effect of the Environmental Conditions on Tear Inflammatory Mediators Concentration in Contact Lens Wearers’. The photographic competition winner was Professor Wolfgang Sickenberger from Jena in Germany. The Editorial Panel of CLAE met at the BCLA conference for their first biannual meeting. The journal metrics were discussed. In terms of number of submissions of new papers CLAE seems to have plateaued after seeing a rapid growth in the number of submissions over the last few years. The increase over the last few years could be attributed to the fact that CLAE was awarded an impact factor for the first time in 2012. This year it seems that impact factors across nearly all ophthalmic related journals has dropped. This could in part be due to the fact that last year was a ‘Research Exercise Framework (REF) year for UK universities, where they are judged on quality of their research output. The next REF is in 2020 so we may see changes nearing that time. Looking at article downloads, there seems to be a continued rise in figures. Currently CLAE attracts around 85,000 downloads per year (this is an increase of around 10,000 per year for the last few years) and the 2015 prediction is 120,000! With this in mind and with other contributing factors too, the BCLA has decided to move to online delivery of CLAE to its members starting from issue 5 of 2015. Some members do like to flick through the pages of a hard copy of the journal so members will still have the option of receiving a hard copy through the post but the default journal delivery method will now be online. The BCLA office will send various alerts and content details to members email addresses. To access CLAE online you will need to log in via the BCLA web page, currently you then click on ‘Resources’ and then under ‘Free and Discounted Publications’ you will see CLAE. This actually takes you to CLAE’s own webpage (www.contactlensjournal.com) but you need to log in via the BCLA web page. The BCLA plans to change these weblinks so that from the BCLA web page you can link to the journal website much more easily and you have the choice of going directly into the general website for CLAE or straight to the current issue. In 2016 you will see an even easier way of accessing CLAE online as the BCLA will launch a CLAE application for mobile devices where the journal can be downloaded as a ‘flick-book’. This is a great way of bringing CLAE into the modern era where people access their information in newer ways. For many the BCLA conference was part of a very busy conference week as it was preceded by the International Association of Contact Lens Educators’ (IACLE) Third World Congress, held in Manchester on the 4 days before the BCLA conference. The first and second IACE World Congresses were held in Waterloo, Canada in 1994 and 2000 respectively and hosted by Professor Des Fonn. Professor Fonn was the recipient of the first ever IACLE lifetime achievement award. The Third IACLE World Congress saw more than 100 contact lens educators and industry representatives from around 30 countries gather in the UK for the four-day event, hosted by The University of Manchester. Delegates gained hands-on experience of innovations in teaching, such as learning delivery systems, the use of iPads in the classroom and for creating ePub content, and augmented and virtual reality technologies. IACLE members around the world also took part via a live online broadcast. The Third IACLE World Congress was made possible by the generous support of Sponsors Alcon, CooperVision and Johnson & Johnson Vision Care., for more information look at the IACLE web page (www.iacle.org).

Improving the economic value of photographic screening for optical coherence tomography-detectable macular oedema:a prospective, multicentre, UK study

Objectives: To determine the best photographic surrogate markers for detecting sight-threatening macular oedema (MO) in people with diabetes attending UK national screening programmes. Design: A multicentre, prospective, observational cohort study of 3170 patients with photographic signs of diabetic retinopathy visible within the macular region [exudates within two disc diameters, microaneurysms/dot haemorrhages (M/DHs) and blot haemorrhages (BHs)] who were recruited from seven study centres. Setting: All patients were recruited and imaged at one of seven study centres in Aberdeen, Birmingham, Dundee, Dunfermline, Edinburgh, Liverpool and Oxford. Participants: Subjects with features of diabetic retinopathy visible within the macular region attending one of seven diabetic retinal screening programmes. Interventions: Alternative referral criteria for suspected MO based on photographic surrogate markers; an optical coherence tomographic examination in addition to the standard digital retinal photograph. Main outcome measures: (1) To determine the best method to detect sight-threatening MO in people with diabetes using photographic surrogate markers. (2) Sensitivity and specificity estimates to assess the costs and consequences of using alternative strategies. (3) Modelled long-term costs and quality-adjusted life-years (QALYs). Results: Prevalence of MO was strongly related to the presence of lesions and was roughly five times higher in subjects with exudates or BHs or more than two M/DHs within one disc diameter. Having worse visual acuity was associated with about a fivefold higher prevalence of MO. Current manual screening grading schemes that ignore visual acuity or the presence of M/DHs could be improved by taking these into account. Health service costs increase substantially with more sensitive/less specific strategies. A fully automated strategy, using the automated detection of patterns of photographic surrogate markers, is superior to all current manual grading schemes for detecting MO in people with diabetes. The addition of optical coherence tomography (OCT) to each strategy, prior to referral, results in a reduction in costs to the health service with no decrement in the number of MO cases detected. Conclusions: Compared with all current manual grading schemes, for the same sensitivity, a fully automated strategy, using the automated detection of patterns of photographic surrogate markers, achieves a higher specificity for detecting MO in people with diabetes, especially if visual acuity is included in the automated strategy. Overall, costs to the health service are likely to increase if more sensitive referral strategies are adopted over more specific screening strategies for MO, for only very small gains in QALYs. The addition of OCT to each screening strategy, prior to referral, results in a reduction in costs to the health service with no decrement in the number of MO cases detected. © Queen's Printer and Controller of HMSO 2013.

Message from MultiCom-2012 workshop chairs

Welcome to the Second International Workshop on Multimedia Communications and Networking held in conjunction with IUCC-2012 during 25 June – 27 June 2012 in Liverpool, UK. MultiCom-2012 is dedicated to address the challenges in the areas of elivering multimedia content using modern communication and networking techniques. The multimedia & networking computing domain emerges from the integration of multimedia content such as audio and video with content distribution technologies. This workshop aims to cover contributions in both design and analysis aspects in the context of multimedia, wired/wireless/heterogeneous networks, and quality evaluation. It also intends to bring together researchers and practitioners from academia and industry to share their latest achievements in this field with others and establish new collaborations for future developments. All papers received are peer reviewed by three members of the Technical Programme Committee. The papers are assessed by their originality, technical quality, presentation and relevance to the theme of the workshop. Based on the criteria set, four papers have been accepted for presentation at the workshop and will appear in the IUCC conference proceedings. We would like to take this opportunity to thank the IUCC-2012 Organizing Committee, the TPC members of MultiCom-2012 and the authors for their s upport, dedicated work and contributions. Finally, we look forward to meeting you at the workshop in Liverpool.

French linguistics research and teaching in UK and Irish HE institutions

Introduction: The research and teaching of French linguistics in UK higher education (HE) institutions have a venerable history; a number of universities have traditionally offered philology or history of the language courses, which complement literary study. A deeper understanding of the way that the phonology, syntax and semantics of the French language have evolved gives students linguistic insights that dovetail with their study of the Roman de Renart, Rabelais, Racine or the nouveau roman. There was, in the past, some coverage of contemporary French phonetics but little on sociolinguistic issues. More recently, new areas of research and teaching have been developed, with a particular focus on contemporary spoken French and on sociolinguistics. Well supported by funding councils, UK researchers are also making an important contribution in other areas: phonetics and phonology, syntax, pragmatics and second-language acquisition. A fair proportion of French linguistics research occurs outside French sections in psychology or applied linguistics departments. In addition, the UK plays a particular role in bringing together European and North American intellectual traditions and methodologies and in promoting the internationalisation of French linguistics research through the strength of its subject associations, and that of the Journal of French Language Studies. The following sections treat each of these areas in turn. History of the French Language There is a long and distinguished tradition in Britain of teaching and research on the history of the French language, particularly, but by no means exclusively, at the universities of Cambridge, Manchester and Oxford.

The impact of family forms on interpersonal influence between single parent and full families

The relationship between individual thoughts and the social environment has been widely studied in sociology (Weber, 1968), psychology (Lewin, 1951) and social psychology. The influence of reference groups on individual behaviour is often manifested in the decisions made by consumers while members of these reference groups are often the individual’s friends and acquaintances. Their decisions, their values and norms serve as an example for the individual. In this study the influences of reference groups are examined within the context of the family form in Hungary. The paper focuses on the nature of peer influence in single parent households and full families, to analyse the normative and informational dimensions of peer pressure and communication patterns within the family.

Targeted sequencing for high-resolution evolutionary analyses following genome duplication in salmonid fish : Proof of concept for key components of the insulin-like growth factor axis

Acknowledgements This study was funded by a Natural Environment Research Council grant (NERC, project code: NBAF704). FML is funded by a NERC Doctoral Training Grant (Project Reference: NE/L50175X/1). RLS was an undergraduate student at the University of Aberdeen and benefitted from financial support from the School of Biological Sciences. DJM is indebted to Dr. Steven Weiss (University of Graz, Austria), Dr. Takashi Yada (National Research Institute of Fisheries Science, Japan), Dr. Robert Devlin (Fisheries and Oceans Canada, Canada), Prof. Samuel Martin (University of Aberdeen, UK), Mr. Neil Lincoln (Environment Agency, UK) and Prof. Colin Adams/Mr. Stuart Wilson (University of Glasgow, UK) for providing salmonid material or assisting with its sampling. We are grateful to staff at the Centre for Genomics Research (University of Liverpool, UK) (i.e. NERC Biomolecular Analysis Facility – Liverpool; NBAF-Liverpool) for performing sequence capture/Illumina sequencing and providing us with details on associated methods that were incorporated into the manuscript. Finally, we are grateful to the organizers of the Society of Experimental Biology Satellite meeting 'Genome-powered perspectives in integrative physiology and evolutionary biology' (held in Prague, July 2015) for inviting us to contribute to this special edition of Marine Genomics and hosting a really stimulating meeting.

Eventos como promotores culturais de um destino turístico

O estudo da imagem de um destino turístico bem como os eventos são áreas cada vez mais importantes na investigação do turismo, pois apresentam uma função relevante na tomada de decisão e consequente satisfação do turista. Adquirindo uma importância também cada vez mais significativa, a cultura é hoje em dia usada como ferramenta estratégica de diferenciação entre destinos. Aglomerando estas três áreas, destinos turísticos, eventos e cultura, a presente dissertação tem como objetivo geral, perceber quais os principais benefícios para a imagem de um destino turístico, usando os eventos como promotores culturais desse mesmo destino. A metodologia adotada para chegar a estas conclusões, teve como base a investigação qualitativa, através da realização e análise de entrevistas semi-estruturadas a um conjunto de especialistas na área dos eventos culturais e criativos, que residam em cidade que já foram Capitais Europeias da Cultura (CEC), em questão, Graz, Génova, Liverpool e Maribor. Após a recolha e análise dos dados, verificou-se que os principais benefícios passam sobretudo pela reconfiguração, (re) posicionamento destes destinos, um maior reconhecimento do lugar, maior poder de atracção e sobretudo, uma perceção modificada positivamente.

TPEA good practice guide: lessons for cross-border MSP from transboundary planning in the European Atlantic

This Good Practice Guide is the outcome of a project co-funded by the European Commission (DG Mare) called Transboundary Planning in the European Atlantic (TPEA), which ran from December 2012 to May 2014. The aim of the project was to demonstrate approaches to transboundary maritime spatial planning (MSP) in the European Atlantic region. This is one of a series of projects exploring the opportunities and challenges of carrying out cross-border MSP in Europe’s regional seas, making connections with integrated coastal management (ICM). TPEA focused on two pilot areas: one involving Portugal and Spain and the other Ireland and the United Kingdom. Despite distinct identities in the region relating to different traditions of planning and stages of MSP implementation, TPEA worked towards a commonly-agreed approach to transboundary MSP and developed principles of cross-border working which it is hoped will be of wider benefit. This guide presents these principles, illustrated with examples from the TPEA project.

Sensor Intelligence for Tackling Energy-Drain Attacks on Wireless Sensor Networks

In this paper we propose a model for intelligent agents (sensors) on a Wireless Sensor Network to guard against energy-drain attacks in an energy-efficient and autonomous manner. This is intended to be achieved via an energy-harvested Wireless Sensor Network using a novel architecture to propagate knowledge to other sensors based on automated reasoning from an attacked sensor.

The Art of the State

When we talk of culture we are talking about a source of enormous historical social power. Why did the GLC commitment to Popular Culture upset the rules of the unelected arts and sports quangos? How did the now abolished GLC get politics into arts policy?