How optometrists record corneal staining

Purpose: The aim of this study was to determine current approaches adopted by optometrists to the recording of corneal staining following fluorescein instillation. Methods: An anonymous ‘record-keeping task’ was sent to all 756 practitioners who are members of the Queensland Division of Optometrists Association Australia. This task comprised a form on which appeared a colour photograph depicting contact lens solution-induced corneal staining. Next to the photograph was an empty box, in which practitioners were asked to record their observations. Practitioners were also asked to indicate the level of severity of the condition at which treatment would be instigated. Results: Completed task forms were returned by 228 optometrists, representing a 30 per cent response rate. Ninety-two per cent of respondents offered a diagnosis. The most commonly used descriptive terms were ‘superficial punctate keratitis’ (36 per cent of respondents) and ‘punctate staining’ (29 per cent). The level of severity and location of corneal staining were noted by 69 and 68 per cent of respondents, respectively. A numerical grade was assigned by 44 per cent of respondents. Only three per cent nominated the grading scale used. The standard deviation of assigned grades was � 0.6. The condition was sketched by 35 per cent of respondents and two per cent stated that they would take a photograph of the eye. Ten per cent noted the eye in which the condition was being observed. Opinions of the level of severity at which treatment for corneal staining should be instigated varied considerably between practitioners, ranging from ‘any sign of corneal staining’ to ‘grade 4 staining’. Conclusion: Although most practitioners made a sensible note of the condition and properly recorded the location of corneal staining, serious deficiencies were evident regarding other aspects of record-keeping. Ongoing programs of professional optometric education should reinforce good practice in relation to clinical record-keeping.

Patterns

In recent years there has been widespread interest in patterns, perhaps provoked by a realisation that they constitute a fundamental brain activity and underpin many artificial intelligence systems. Theorised concepts of spatial patterns including scale, proportion, and symmetry, as well as social and psychological understandings are being revived through digital/parametric means of visualisation and production. The effect of pattern as an ornamental device has also changed from applied styling to mediated dynamic effect. The interior has also seen patterned motifs applied to wall coverings, linen, furniture and artefacts with the effect of enhancing aesthetic appreciation, or in some cases causing psychological and/or perceptual distress (Rodemann 1999). ----- ----- While much of this work concerns a repeating array of surface treatment, Philip Ball’s The Self- Made Tapestry: Pattern Formation in Nature (1999) suggests a number of ways that patterns are present at the macro and micro level, both in their formation and disposition. Unlike the conventional notion of a pattern being the regular repetition of a motif (geometrical or pictorial) he suggests that in nature they are not necessarily restricted to a repeating array of identical units, but also include those that are similar rather than identical (Ball 1999, 9). From his observations Ball argues that they need not necessarily all be the same size, but do share similar features that we recognise as typical. Examples include self-organized patterns on a grand scale such as sand dunes, or fractal networks caused by rivers on hills and mountains, through to patterns of flow observed in both scientific experiments and the drawings of Leonardo da Vinci.

Elevated plasma fibronectin levels associated with venous thromboembolism

Elevated plasma fibronectin levels occur in various clinical states including arterial disease. Increasing evidence suggests that atherothrombosis and venous thromboembolism (VTE) share common risk factors. To assess the hypothesis that high plasma fibronectin levels are associated with VTE, we compared plasma fibronectin levels in the Scripps Venous Thrombosis Registry for 113 VTE cases vs. age and sex matched controls. VTE cases had significantly higher mean fibronectin concentration compared to controls (127% vs. 103%, p<0.0001); the difference was greater for idiopathic VTE cases compared to secondary VTE cases (133% vs. 120%, respectively). Using a cut-off of >90% of the control values, the odds ratio (OR) for association of VTE for fibronectin plasma levels above the 90th percentile were 9.37 (95% CI 2.73-32.2; p<0.001) and this OR remained significant after adjustment for sex, age, body mass index (BMI), factor V Leiden and prothrombin nt20210A (OR 7.60, 95% CI 2.14-27.0; p=0.002). In particular, the OR was statistically significant for idiopathic VTE before and after these statistical adjustments. For the total male cohort, the OR was significant before and after statistical adjustments and was not significant for the total female cohort. In summary, our results suggest that elevated plasma fibronectin levels are associated with VTE especially in males, and extend the potential association between biomarkers and risk factors for arterial atherothrombosis and VTE. © 2008 Schattauer GmbH.

Natural convection and heat transfer in attics subject to periodic thermal forcing

The heat transfer through the attics of buildings under realistic thermal forcing has been considered in this study. A periodic temperature boundary condition is applied on the sloping walls of the attic to show the basic flow features in the attic space over diurnal cycles. The numerical results reveal that, during the daytime heating stage, the flow in the attic space is stratified; whereas at the night-time cooling stage, the flow becomes unstable. A symmetrical solution is seen for relatively low Rayleigh numbers. However, as the Ra gradually increases, a transition occurs at a critical value of Ra. Above this critical value, an asymmetrical solution exhibiting a pitchfork bifurcation arises at the night-time. It is also found that the calculated heat transfer rate at the night-time cooling stage is much higher than that during the daytime heating stage.

Scaling of thermo-magnetic convection

The scaling to characterize unsteady boundary layer development for thermo-magnetic convection of paramagnetic fluids with the Prandtl number greater than one is developed. Under the consideration is a square cavity with initially quiescent isothermal fluid placed in microgravity condition (g = 0) and subject to a uniform, vertical gradient magnetic field. A distinct magnetic thermal-boundary layer is produced by sudden imposing of a higher temperature on the vertical sidewall and as an effect of magnetic body force generated on paramagnetic fluid. The transient flow behavior of the resulting boundary layer is shown to be described by three stages: the start-up stage, the transitional stage and the steady state. The scaling is verified by numerical simulations with the magnetic momentum parameter m variation and the parameter γRa variation.

Planning volunteer responses to low-volume mass gatherings: do event characteristics predict patient workload?

INTRODUCTION: Workforce planning for first aid and medical coverage of mass gatherings is hampered by limited research. In particular, the characteristics and likely presentation patterns of low-volume mass gatherings of between several hundred to several thousand people are poorly described in the existing literature. OBJECTIVES: This study was conducted to: 1. Describe key patient and event characteristics of medical presentations at a series of mass gatherings, including events smaller than those previously described in the literature; 2. Determine whether event type and event size affect the mean number of patients presenting for treatment per event, and specifically, whether the 1:2,000 deployment rule used by St John Ambulance Australia is appropriate; and 3. Identify factors that are predictive of injury at mass gatherings. METHODS: A retrospective, observational, case-series design was used to examine all cases treated by two Divisions of St John Ambulance (Queensland) in the greater metropolitan Brisbane region over a three-year period (01 January 2002-31 December 2004). Data were obtained from routinely collected patient treatment forms completed by St John officers at the time of treatment. Event-related data (e.g., weather, event size) were obtained from event forms designed for this study. Outcome measures include: total and average number of patient presentations for each event; event type; and event size category. Descriptive analyses were conducted using chi-square tests, and mean presentations per event and event type were investigated using Kruskal-Wallis tests. Logistic regression analyses were used to identify variables independently associated with injury presentation (compared with non-injury presentations). RESULTS: Over the three-year study period, St John Ambulance officers treated 705 patients over 156 separate events. The mean number of patients who presented with any medical condition at small events (less than or equal to 2,000 attendees) did not differ significantly from that of large (>2,000 attendees) events (4.44 vs. 4.67, F = 0.72, df = 1, 154, p = 0.79). Logistic regression analyses indicated that presentation with an injury compared with non-injury was independently associated with male gender, winter season, and sporting events, even after adjusting for relevant variables. CONCLUSIONS: In this study of low-volume mass gatherings, a similar number of patients sought medical treatment at small (<2,000 patrons) and large (>2,000 patrons) events. This demonstrates that for low-volume mass gatherings, planning based solely on anticipated event size may be flawed, and could lead to inappropriate levels of first-aid coverage. This study also highlights the importance of considering other factors, such as event type and patient characteristics, when determining appropriate first-aid resourcing for low-volume events. Additionally, identification of factors predictive of injury presentations at mass gatherings has the potential to significantly enhance the ability of event coordinators to plan effective prevention strategies and response capability for these events.

Water sensitive urban design through the lens of urban metabolism

Stormwater pollution has been recognised as one of the main causes of aquatic ecosystem degradation and poses a significant threat to both the goal of ecological sustainable development as well as human health and wellbeing. In response, water sensitive urban design (WSUD) practices have been put forward as a strategy to mitigate the detrimental impacts of urban stormwater runoff quality and to safeguard ecosystem functions. However, despite studies that support its efficiency in urban stormwater management, the mainstreaming of WSUD remains a significant challenge. This paper proposes that viewing WSUD through the lens of the integrated urban metabolism framework which encourages an interdisciplinary approach and facilitates dialogue through knowledge transfer is a strategy in which the implementation of WSUD can be mainstreamed.

Business leadership development in Iran

Throughout the twentieth century the economics of the Middle East rose and fell many times in response to the external environment, including European de-colonization and the US and former USSR competing to provide military and economic aid after World War II. Throughout these upheavals the Middle East has remained internationally significant politically and economically not least for the region's large reserves of oil and gas, as discussed in the Introduction to this volume. In recent decades, Western nations have moved to invest into the Middle East in the rapidly developing technology, tourism and education industries that have proliferated. For its part, Iran has been the world's fourth largest provider of petroleum and second largest provider of natural gas and, despite years of political unrest, has made rapid expansion into information technology and telecommunications. Increased involvement in the global economy has meant that Iran has invested heavily in education and training and moved to modernize its management practices. Hitherto there has been little academic research into management in either Western or local organizations in Iran. This chapter seeks to address that gap in knowledge by exploring business leadership in Iran, with particular reference to cultural and institutional impacts.

Effect of differentially heating and consequent transient behaviour for natural convection within an enclosure of sinusoidal corrugated side walls

Unsteady natural convection due to differentially heating of the sinusoidal corrugated side walls of a modified square enclosure has been numerically investigated. The fluid inside the enclosure is air, initially as quiescent. The flat top and bottom surfaces are considered as adiabatic. The numerical scheme is based on the finite element method adapted to triangular non-uniform mesh element by a non-linear parametric solution algorithm. The results are obtained for the Rayleigh number, Ra ranging from 1e+05 to 1e+08 for different corrugation amplitude and frequency with constant physical properties for the fluid medium considered. The streamlines, isotherms and average Nusselt numbers are presented to observe the effect of sudden heating and its consequent transient behavior on fluid flow and heat transfer characteristics for the range of governing parameters. The present results show that the transient phenomena are greatly influenced by the variation of the aforementioned parameters.

Designing and evaluating mobile multimedia user experiences in public urban places : Making sense of the field

The majority of the world’s population now lives in cities (United Nations, 2008) resulting in an urban densification requiring people to live in closer proximity and share urban infrastructure such as streets, public transport, and parks within cities. However, “physical closeness does not mean social closeness” (Wellman, 2001, p. 234). Whereas it is a common practice to greet and chat with people you cross paths with in smaller villages, urban life is mainly anonymous and does not automatically come with a sense of community per se. Wellman (2001, p. 228) defines community “as networks of interpersonal ties that provide sociability, support, information, a sense of belonging and social identity.” While on the move or during leisure time, urban dwellers use their interactive information communication technology (ICT) devices to connect to their spatially distributed community while in an anonymous space. Putnam (1995) argues that available technology privatises and individualises the leisure time of urban dwellers. Furthermore, ICT is sometimes used to build a “cocoon” while in public to avoid direct contact with collocated people (Mainwaring et al., 2005; Bassoli et al., 2007; Crawford, 2008). Instead of using ICT devices to seclude oneself from the surrounding urban environment and the collocated people within, such devices could also be utilised to engage urban dwellers more with the urban environment and the urban dwellers within. Urban sociologists found that “what attracts people most, it would appear, is other people” (Whyte, 1980, p. 19) and “people and human activity are the greatest object of attention and interest” (Gehl, 1987, p. 31). On the other hand, sociologist Erving Goffman describes the concept of civil inattention, acknowledging strangers’ presence while in public but not interacting with them (Goffman, 1966). With this in mind, it appears that there is a contradiction between how people are using ICT in urban public places and for what reasons and how people use public urban places and how they behave and react to other collocated people. On the other hand there is an opportunity to employ ICT to create and influence experiences of people collocated in public urban places. The widespread use of location aware mobile devices equipped with Internet access is creating networked localities, a digital layer of geo-coded information on top of the physical world (Gordon & de Souza e Silva, 2011). Foursquare.com is an example of a location based 118 Mobile Multimedia – User and Technology Perspectives social network (LBSN) that enables urban dwellers to virtually check-in into places at which they are physically present in an urban space. Users compete over ‘mayorships’ of places with Foursquare friends as well as strangers and can share recommendations about the space. The research field of Urban Informatics is interested in these kinds of digital urban multimedia augmentations and how such augmentations, mediated through technology, can create or influence the UX of public urban places. “Urban informatics is the study, design, and practice of urban experiences across different urban contexts that are created by new opportunities of real-time, ubiquitous technology and the augmentation that mediates the physical and digital layers of people networks and urban infrastructures” (Foth et al., 2011, p. 4). One possibility to augment the urban space is to enable citizens to digitally interact with spaces and urban dwellers collocated in the past, present, and future. “Adding digital layer to the existing physical and social layers could facilitate new forms of interaction that reshape urban life” (Kjeldskov & Paay, 2006, p. 60). This methodological chapter investigates how the design of UX through such digital placebased mobile multimedia augmentations can be guided and evaluated. First, we describe three different applications that aim to create and influence the urban UX through mobile mediated interactions. Based on a review of literature, we describe how our integrated framework for designing and evaluating urban informatics experiences has been constructed. We conclude the chapter with a reflective discussion on the proposed framework.

Effect of MHD and heat generation on natural convection flow in an open square cavity under microgravity condition

Purpose - Thermo-magnetic convection and heat transfer of paramagnetic fluid placed in a micro-gravity condition (g = 0) and under a uniform vertical gradient magnetic field in an open square cavity with three cold sidewalls have been studied numerically. Design/methodology/approach - This magnetic force is proportional to the magnetic susceptibility and the gradient of the square of the magnetic induction. The magnetic susceptibility is inversely proportional to the absolute temperature based on Curie’s law. Thermal convection of a paramagnetic fluid can therefore take place even in zero-gravity environment as a direct consequence of temperature differences occurring within the fluid due to a constant internal heat generation placed within a magnetic field gradient. Findings - Effects of magnetic Rayleigh number, Ra, Prandtl number, Pr, and paramagnetic fluid parameter, m, on the flow pattern and isotherms as well as on the heat absorption are presented graphically. It is found that the heat transfer rate is suppressed in increased of the magnetic Rayleigh number and the paramagnetic fluid parameter for the present investigation. Originality/value - It is possible to control the buoyancy force by using the super conducting magnet. To the best knowledge of the author no literature related to magnetic convection for this configuration is available.