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The purpose of this paper is to compare the fluid dynamic performance of two Aqueous Humor (AH) ocular drainage devices, the SOLX® Gold Micro Shunt (GMS) and the novel Silicon Shunt Device (SSD), implanted by surgeons in human eyes to reduce the IntraOcular Pressure towards physiological values, by draining the AH from the Anterior Chamber to the Suprachoroidal Space, to cure eyes with glaucoma.

The generalized porous medium model is solved to simulate the AH flow through the two ocular drainage devices and the surrounding porous tissues of the eye.

In the GMS, probable stagnation regions have been found, due to the very small AH velocity values inside the device and to the surrounding tissues, creating possible blockage and malfunction of the device. The simple microtubular geometry of the novel SSD allows to have a regular AH flow and to choose shunts with different diameters and/or with the presence of radial holes, based on patient needs, with consequent reduction of post-operative complications.

The present model will be further developed taking into account the insertion of the present drainage devices inside the anterior section of the eye. The present results show the comparative fluid dynamic performance of the two shunts considered, and can be useful for surgeons to choose the adequate shunt, based on the required AH flow rate for a specific patient.

The present numerical approach, employing the generalized porous medium model, represents a useful tool to study the fluid dynamics of ocular drainage devices and to design these shunts, to reduce post-operative complications.

The generalized porous medium model is here applied for the first time to simulate the interaction of ocular drainage devices with the surrounding porous tissues of the eye.

The purpose of this paper is to determine the safety of substituting the first day post-operative review after routine cataract surgery (phacoemulsification) with a telephone survey.

Prospective non-randomised cohort study. A standardised questionnaire of five common ocular symptoms (general condition, vision, eye pain, headache, nausea or vomiting) was administered by a trained nurse on the first post-operative day. The patients were reviewed in clinic two to 14 days later. Patient charts were retrospectively reviewed for complications (endophthalmitis, raised intra-ocular pressure, wound leaks and uveitis) requiring deviation from standard treatment.

Over 13 months, 256 eyes of 238 patients underwent uncomplicated phacoemulsification by four consultant surgeons. Only one patient reported poor general condition, blurred vision and eye pain. She was subsequently found to have corneal oedema and raised intra-ocular pressure when recalled for an earlier review. Best corrected visual acuity better than 20/40 was achieved in 80.5 per cent of patients. There were no other post-operative complications noted from medical records review.

Non-randomised nature, skewed surgical expertise, lack of a control group and patient experience data. In all, 22 patients (9.2 per cent) were also uncontactable for the telephone interview.

A nurse-administered telephone survey seemed to be a safe and effective alternative to first day post-operative review after routine phacoemulsification. The survey also enabled the detection of serious post-operative complications. The first day post-operative hospital visit may be safely substituted in a selected patient population with greater patient convenience achieved and liberation of clinic resources.

This is the first study which utilises a standardised questionnaire as a form of post-operative review in an Asian population.

Low‐level microwave (MW) fields may under certain conditions of exposure cause measurable effects in biological organisms. Exposure of the general public to MWs in the environment is generally below intensities which are considered as responsible for evoking bioeffects. Introduction of cellular phone (CP) systems has increased considerably MW exposure of CP users. Health consequences of long‐term use of CPs are not known in detail, but available data indicate that development of non‐specific health symptoms is possible, at least in “MW hypersensitive” subjects. In contrast to terminal CPs, transmitting antennas and base stations (BS) contribute to MW environmental contamination only with a small portion of the energy and do not pose any health risks. Health risks of CP use are underestimated and accepted, while risks of BS are generally overestimated by the public. Therefore, an improved risk communication as well as further studies of the risks are required.

We study three private hospital organizations in India that were set up to deliver affordable high quality, services to the poor. Their distinctive feature is that they have successfully balanced two apparently contradictory logics: financial (doing well) and social (doing good) through business model innovations. By analyzing abundant primary and secondary data, we document in detail the key features of their business models – customer identification, customer engagement, value chain and linkages, and monetization – and document how they contribute to the organizations’ ability to deliver high quality healthcare at very low prices. We analyze the impact of these organizations, both direct and indirect, on the healthcare delivery landscape in India. We show that while their direct impact is significant, their indirect impact could potentially transform healthcare delivery in India and in other developing countries.

A major challenge in teaching medicine in a rural setting is that long geographical distances separate students, instructors, and educational resources. Clinical schools within the University of Sydney Medical Program are geographically dispersed and face similar challenges. As a result, a virtual ophthalmology clinic (VOC) was developed (Succar et al., 2013) and it is being delivered online to enable equitable access and consistency in the foundations of ophthalmology education for rural-based students. The program allows students to sharpen their clinical reasoning skills by formulating a diagnosis and treatment plan on virtual patients with simulated conditions. To evaluate the educational effectiveness of VOC, a randomized controlled trial was conducted with the University of Sydney medical students (n = 188). The pre- and post-test and student satisfaction questionnaire were administered. Twelve months later, a follow-up test was conducted to determine the long-term retention rate of graduates. On the basis of a statistically significant improvement in academic performance and highly positive student feedback, it became clear that the online delivery of VOC can serve as a model for higher education institutions creating an all-inclusive learning environment experienced by rural students and staff regardless of location and distance, while making a positive impact on learning.

Peduncluar hallucinosis is a rare neurological disorder characterized by visual hallucinations, often described to be vivid and dream-like. While the exact pathophysiology has yet to be elucidated, most cases to date have suggested an etiology stemming from lesions to the thalamus or midbrain. Here presented is a case of a 54-year-old female with peduncular hallucinosis secondary to a pontine cavernoma hemorrhage in the setting of essential hypertension. The patient's vivid visual and auditory hallucinations aligned temporally with the lesion's discovery and resolved after pharmaceutical treatment. This case represents a rare form of peduncular hallucinosis secondary to a pontine cavernoma hemorrhage leading to vasospasm in the arteries feeding the brainstem.

Defines the number of recorded cases of Bovine Spongiform Encephalopathy (BSE) in the UK as comprising those reported to the Ministry of Agriculture, Fisheries and Food (MAFF) and checked by them using histopathological techniques. Proposes that, if it is assumed that BSE is a similar condition to other mammalian transmissible spongiform encephalopathies (TSEs), and if other specific assumptions are made, it is possible to estimate the true number of cases of BSE and, hence, the number of human beings who have been infected in the UK. States that approximately 6.87 per cent of cattle born in 1988 became infected with BSE, with lower numbers in antecedent years, and that BSE cases reported in the UK represent approximately 23 per cent of the cattle which have become infected and are hence potentially infective to other animals, including man. Discloses the fact that TSEs of animals, of which BSE is one, can be transmitted to a mean of at least 70 per cent of other species and that oral transmission has been successful. Uses the potential levels of infectivity of the bovine products present in human food in the UK from 1984 to 1997, together with data as to individual diets within the population, to assess the number of people who would be expected to have eaten the minimum potentially infective dose or more. Discusses the possible effects on human health.

This study aims to explore the use and relevance of WALYs (well-being-adjusted life years) in light of the utilitarian premises of neoclassical economics that continue to dominate health outcomes evaluation. QALYs (quality-adjusted life years) and DALYs (disability-adjusted life years) measure longevity and quality of life in terms of purely health-related aspects and outcomes of medical interventions. However, evaluative questions of subjective well-being may be equally important in comparing outcomes and cost-effectiveness of these interventions.

A two-phase online search strategy for refereed research on dry eye treatment with omega-3 fatty acids (omega-3s) was adopted. Phase I aimed to identify and contrast clinical parameters of efficacy in omega-3 dietary supplementation. Phase II aimed to find a preference-based, multi-attribute utility instrument specific and sensitive enough to dry eye and its consequences on patients’ subjective well-being. We then illustrate how WALYs can be conceptualized and calculated based on the search results.

Empiric therapies like omega-3s can be assessed in terms of reducing or relieving symptomatic discomfort and pain, and enabling the patient to enjoy life and derive satisfaction from daily activities. We find in VisQoL (Vision and Quality of Life Index) a viable alternative to conventional multi-attribute utility instruments, including those typically used in QALY and DALY calculations. Clinical efficacy indices of dry eye can be linked to VisQoL’s quality of life dimensions. Differently weighted outcomes can be aggregated. And WALYs per patient per year can be computed by scaling aggregated outcomes to match the WALY rating scale. The implications of subjective well-being for both patient and society can thus be approached from a broader and richer perspective.

To the best of our knowledge, this is the first study of its kind in pharmaceutical outcomes valuation and marketing. It offers a framework for analyzing life satisfaction and well-being among dry eye patients under treatment. It is also the first to use and adapt a multi-attribute utility measure to treatment outcomes of omega-3s in ocular diseases, from which this study suggests WALYs may be computed. However, it does not suggest that WALYs should supplant QALYs and DALYs in evaluating health outcomes. Medical economics is enriched if alternative methods of outcomes evaluations can help fill in the gaps in existing paradigms and do so by accounting for other effects of condition-specific interventions. Costs and benefits of interventions to the individual and society can then be valued not just more effectively, but also more equitably.

The objective of this study was to determine if exposure to a short-term ultrasound basic biology and anatomy course can promote interest in health careers and other science-related endeavors among DHH students.

This was a single-site, prospective observational study of DHH high school students at a Southern California high school. All participants took a pre-test survey prior to the course. Participants then took part in three teaching sessions which taught basic anatomy using point-of-care ultrasound (POCUS). Following instruction, a post-test survey was performed to determine if students had an increased interest in medicine, science and biology (p = 0.151).

28 students were enrolled in the study, with an equal distribution of boys and girls. Initially, subjects reported their interest in medicine at an average of 2.8 ± 1.10. The reported interest in science was 3.0 ± 1.13 and for biology was 3.0 ± 1.19. The change in participants' interest was not statistically significant for medicine (p = 0.791), science (p = 0.225) and biology.

While our data did not demonstrate a statistically significant difference in students' interest in STEM fields after the training course, there were several students who were interested in more hands-on shadow experience after the course. Regardless, this study demonstrates persistent barriers that exist for a person who is deaf or hard of hearing to engage in the STEM fields. Future studies are needed to determine the level of instructional activities that may impact the careers of these students.

Point of care ultrasound has been shown to be an effective teaching modality in medical education. However, to date, no studies have been done to assess the utility of ultrasound in teaching the Deaf and Hard of Hearing (DHH) population.

Less lethal weapons have become a critical tool for law enforcement when confronting dangerous, combative individuals in the field. The purpose of this paper is to review the medical aspects and implications of three different types of less lethal weapons.

The paper conducted a comprehensive medical literature review on blunt projectiles, irritant sprays including oleoresin capsicum (OC), and conducted energy devices such as the Taser™. It reviews the history, mechanisms of action, intended and other physiologic effects, and medical safety risks and precautions of these devices. In particular, the paper focuses on the issue of sudden in‐custody death and less lethal weapons, reviewing case reports, animal research and human investigative studies on this topic.

In general, these three different types of less lethal weapons have been effective for their intended use. Each type of less lethal weapon has a number of physiologic effects and specific medical issues that must be considered when the weapon is used. There is no clear evidence that these devices are inherently lethal, nor is there good evidence to suggest a causal link between sudden in‐custody death and the use of irritant sprays or conducted energy devices.

While further research on the physiologic effects of these devices is needed, this paper provides law enforcement with a medical review of less lethal weapons including blunt projectiles, irritant sprays such as OC, and conducted energy devices such as the Taser.