Temporal multiplexing with adaptive optics for simultaneous vision.

We present and test a methodology for generating simultaneous vision with a deformable mirror that changed shape at 50 Hz between two vergences: 0 D (far vision) and -2.5 D (near vision). Different bifocal designs, including toric and combinations of spherical aberration, were simulated and assessed objectively. We found that typical corneal aberrations of a 60-year-old subject changes the shape of objective through-focus curves of a perfect bifocal lens. This methodology can be used to investigate subjective visual performance for different multifocal contact or intraocular lens designs

Survey to Inform the Development of an Online Support System for Higher Education Students - Higher Education and Online Support

An increasing number of higher education students face mental health difficulties, but the universities’ student support services (SSS) struggle to meet demand with limited resources. Web-based alternatives hold promise as a novel medium through which students could access support. Online interventions appear to be effective and may therefore provide a cost-effective alternative, relieving some of the burden on struggling SSS. This paper presents results from an explorative survey of 61 students questioned about their opinion of online support systems. The majority of students indicated that they would use such a system and that it should be interactive and personalized, focusing on time and money management, relaxation exercises, and building social skills. Future directions towards the development of such a system are discussed

Home or hospital as the place of end-of-life care and death: A grounded theory study of parents' decision-making

BACKGROUND: While several studies have examined 'what' families want with regard to the place of a child's end-of-life care and death, few have explored 'how' parents reach a decision. AIMS: (1) to develop a model explaining how parents of a child with a life-threatening illness in Greece decide about the place of end-of-life care and death; (2) to identify the factors affecting decision-making; (3) to consider the implications for clinical practice. DESIGN: Grounded theory study of bereaved parents using semi-structured open-ended interviews following Strauss and Corbin's principles of data collection and analysis. SETTING/PARTICIPANTS: Semi-structured interviews with 36 bereaved parents of 22 children who died at home (n = 9) or in a paediatric hospital (n = 13) in Athens, Greece. RESULTS: (1) Decisions regarding place of care and death were reached in one of four ways: consensus, accommodation, imposition of professional decisions on parents or imposition of parents' decisions without including professionals. (2) Six factors were identified as affecting decisions: awareness of dying, perceived parental caregiving competence, perceived professional competence, parents' view of symptom management, timing of decision-making, and being a 'good parent'. (3) Decisions were clear-cut or shifting. Few parents did not engage in decisions. CONCLUSION: Parents' decisions about place of end-of-life care and death are affected by personal, interpersonal, timing and disease-related factors. Parents are best supported in decision-making when information is presented clearly and honestly with recognition of what acting as 'good parents' means to them, and opportunities to enhance their caregiving competence to care for their child at home, if they choose so

Online intervention, ‘MePlusMe’, supporting mood, wellbeing, study skills, and everyday functioning in students in higher education: a protocol for a feasibility study

Background: Psychological and study skill difficulties faced by students in higher education can lead to poor academic performance, sub-optimal mental health, reduced study satisfaction, and drop out from study. At the same time, higher education institutions’ support services are costly, oversubscribed, and struggle to meet demand whilst facing budget reductions. The purpose of the proposed study is to evaluate the acceptability of a new online intervention, MePlusMe, aimed at students in higher education facing mild to moderate psychological and/or study skill difficulties. The study will also assess the feasibility of proposed recruitment and outcome assessment protocols for a future trial of effectiveness. The system supports self-management strategies alongside ongoing monitoring facilitated by a messaging service, as well as featuring a built-in community of student users. It is based on current clinical guidelines for the management of common mental health problems, together with best practice from the educational field. Methods/design: Two hundred and forty two students will be recruited to a within-subjects, repeated measures study conducted over 8 weeks. Self-report measures of depression and anxiety symptoms, mental wellbeing, academic self-efficacy, and everyday functioning will be collected at baseline, and then at 2, 4, and 8 weeks. During this period, students will have access to the intervention system. UK higher education institutions Bournemouth University and University of Warwick will participate in the study. Data on student satisfaction and engagement will also be collected. Study findings will help to determine the most appropriate primary outcome and the required sample size for a future trial. Discussion: This study will evaluate the acceptability of an online intervention system for students facing psychological and/or study skill difficulties and will test recruitment procedures and outcome measures for a future trial of effectiveness. The system is designed to be implemented as a stand-alone service or a service complementary to student support services, which is accessible to the majority of students and effective in improving student experience at higher education institutions

Objective assessment of the effect of pupil size upon the power distribution of multifocal contact lenses.

AIM: To analytically assess the effect of pupil size upon the refractive power distributions of different designs of multifocal contact lenses. METHODS: Two multifocal contact lenses of center-near design and one multifocal contact lens of center-distance design were used in this study. Their power profiles were measured using the NIMO TR1504 device (LAMBDA-X, Belgium). Based on their power profiles, the power distribution was assessed as a function of pupil size. For the high addition lenses, the resulting refractive power as a function of viewing distance (far, intermediate, and near) and pupil size was also analyzed. RESULTS: The power distribution of the lenses was affected by pupil size differently. One of the lenses showed a significant spread in refractive power distribution, from about -3 D to 0 D. Generally, the power distribution of the lenses expanded as the pupil diameter became greater. The surface of the lens dedicated for each distance varied substantially with the design of the lens. CONCLUSION: In an experimental basis, our results show how the lenses power distribution is affected by the pupil size and underlined the necessity of careful evaluation of the patient's visual needs and the optical properties of a multifocal contact lens for achieving the optimal visual outcome

Exploring the feasibility and acceptability of the contents, design, and functionalities of an online intervention promoting mental health, wellbeing, and study skills in Higher Education students

Background: Substantial numbers of students in Higher Education (HE) are reporting mental health difficulties, such as mild to moderate symptoms of depression and anxiety. Coupled with academic skills challenges, these difficulties can lead to decreased academic performance, low levels of study satisfaction, and eventually drop out. Student support services are facing budget cuts and can only attend to limited numbers of students, usually the ones who present with more severe mental health problems. Moreover, face-to-face contact may not appeal to those students who feel embarrassed by their problems or are afraid of being stigmatised. To address this important problem, an online psychological wellbeing and study skills support system called MePlusMe, has been developed to provide personalised support to its users. In the present study we investigated the feasibility and acceptability of the contents, design, and functionalities of the system. Methods: An offline version of the system was introduced to 13 postgraduate and undergraduate students (mean age = 31.3 years, SD = 10.25 years; 4 males) in a UK HE Institution, who presented with mild or moderate mental health difficulties. The participants evaluated the design of the system, its functionalities, and contents at Baseline and at Weeks 2, 4, and 8. Results: Participants found the system easy to use, professional, and efficient and its contents non-judgemental and informative. Participants stated that engaging with and practicing the techniques targeted at mental health difficulties led to improvements in positive thinking and self-confidence, while the study skills techniques were practical. Suggestions for further improvement included the development of an app and an option for direct engagement with professionals. Conclusions: The findings confirmed the acceptability of the contents, design and functionalities of the system, while providing useful information to inform its further development. Next steps include a feasibility study, which will test and quantify the effects on everyday functioning, mood, mental wellbeing, and academic self-efficacy after using the system, and subsequently a randomized controlled trial, which will evaluate its effectiveness

Amplitude, Latency, and Peak Velocity in Accommodation and Disaccommodation Dynamics.

The aim of this work was to ascertain whether there are differences in amplitude, latency, and peak velocity of accommodation and disaccommodation responses when different analysis strategies are used to compute them, such as fitting different functions to the responses or for smoothing them prior to computing the parameters. Accommodation and disaccommodation responses from four subjects to pulse changes in demand were recorded by means of aberrometry. Three different strategies were followed to analyze such responses: fitting an exponential function to the experimental data; fitting a Boltzmann sigmoid function to the data; and smoothing the data. Amplitude, latency, and peak velocity of the responses were extracted. Significant differences were found between the peak velocity in accommodation computed by fitting an exponential function and smoothing the experimental data (mean difference 2.36 D/s). Regarding disaccommodation, significant differences were found between latency and peak velocity, calculated with the two same strategies (mean difference of 0.15 s and -3.56 D/s, resp.). The strategy used to analyze accommodation and disaccommodation responses seems to affect the parameters that describe accommodation and disaccommodation dynamics. These results highlight the importance of choosing the most adequate analysis strategy in each individual to obtain the parameters that characterize accommodation and disaccommodation dynamics