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There has been little progress in development of evidence-based interventions to improve sexuality outcomes for individuals with traumatic brain injury (TBI). This study aimed to evaluate the preliminary efficacy of an individualised intervention using a cognitive behaviour therapy (CBT) framework to treat sexuality problems after TBI. A nonconcurrent multiple baseline single-case design with 8-week follow-up and randomisation to multiple baseline lengths (3, 4, or 6 weeks) was repeated across nine participants (five female) with complicated mild–severe TBI (mean age = 46.44 years (SD = 12.67), mean post-traumatic amnesia = 29.14 days (SD = 29.76), mean time post-injury = 6.56 years (median = 2.50 years, SD = 10.11)). Treatment comprised eight weekly, individual sessions, combining behavioural, cognitive, and educational strategies to address diverse sexuality problems. Clinical psychologists adopted a flexible, patient-centred, and goal-orientated approach whilst following a treatment guide and accommodating TBI-related impairments. Target behaviour was subjective ratings of satisfaction with sexuality, measured three times weekly. Secondary outcomes included measures of sexuality, mood, self-esteem, and participation. Goal attainment scaling (GAS) was used to measure personally meaningful goals. Preliminary support was shown for intervention effectiveness, with most cases demonstrating sustained improvements in subjective sexuality satisfaction and GAS goal attainment. Based on the current findings, larger clinical trials are warranted.

This study tests the assertion that the online dissemination of theses has a positive impact on the research profile of the institution and sets out to gain a greater understanding of how digital theses fit into the scholarly resources landscape. The year-long study combined primary and secondary research and was undertaken with the London School of Economics, based on its programme of theses digitization. The paper outlines the types of metrics an institution may use to measure the impact of its corpus of digitized dissertations and examines how these metrics may be generated. Findings included: a higher volume of theses attracts more traffic; Google’s strong indexing capabilities make it the most frequentlyused tool for discovery of digital theses; primary conclusions are that there is little correlation between downloads and citations of digitized theses; having a digital thesis collection enhances the reputation of the institution; although they recognize that digital theses are a valuable research tool, postgraduates and academics widely believe that making them available affects future publication opportunities; building and maintaining a digital thesis collection makes considerable ‘hidden’ work for librarians in terms of training about copyright and permissions. Some conclusions: better statistics are needed, especially of citations; institutions need to promote digital thesis collections better; more work needs to be done on whether digitizing theses impairs authors’ chances of traditional publication and on how digital theses affect and are affected by the open access movement.

Contact lens comfort has been the focus of many clinical studies and review articles.1–6 This is not surprising as it is estimated that, while there are 3.5 million new contact lens wearers each year, approximately two to three million established lens wearers drop out of contact lens wear. Dryness and discomfort are cited as key reasons.7,8 For those who remain in contact lenses, ocular dryness continues to be a significant complaint, with up to four out of five lens wearers affected,3 and one in four contact lens wearers finding that it adversely affects their wearing time.9 Comfort in successful contact lens wearers should not be taken for granted.9 A patient who wears their lenses on a full-time basis over a certain wearing period is commonly considered to be a successful lens wearer. Comfort is a dependent variable and therefore subject to fluctuations during contact lens wear. Patient-specific factors as well as external factors can influence subjective comfort to varying degrees, even in successful full-time contact lens wearers.9 Most commonly, successful contact lens wearers experience a decrease in comfort towards the end of the day.2,10 While it may or may not be enough to reduce wearing time, this decrease in comfort is undesirable nonetheless. Maintaining and optimizing lens-wearing comfort for successful contact lens wearers is crucial to minimize contact lens dropout, and is the focus of the current study.5 Contact lens practitioners have an important role in supporting and maintaining the success of their contact lens wearers. This can be particularly difficult when patients do not voice complaints during their annual exams. Effective questioning at contact lens visits can elucidate otherwise unrecognized issues and generate possible opportunities for improvement in patient comfort. Similarly, a solid understanding of a patient’s medical history, environment and lifestyle are valuable tools for predicting and managing a patient’s ongoing success. In addition, thoughtful choice of a contact lens and its partner solution contribute to contact lens-wearing success. Advances in contact lens material technology, providing greater flexibility in lens wear schedules and improved health benefits, allow practitioners to choose lenses ideally suited to a patient’s individual requirements. These new materials have demonstrated tangible improvements in patient comfort, as well as in a patient’s overall satisfaction.11–16 While the optimal choice of contact lens is directly related to a patient’s satisfaction, it is very important to consider the synergistic relationship between contact lens and lens care solution. Multipurpose solutions comprise different formulations that may provide additional benefits, extending contact lens-wearing success.17 In this investigation into lens-wearing comfort, two polyhexamethylene biguanide (PHMB) (0.0001%)-preserved lens care solutions, Complete® Multi-Purpose Solution (MPS) Easy Rub® (AMO, Santa Ana, CA, USA) and ReNu MultiPlus® MPS (Bausch & Lomb, Rochester, NY, USA), were compared with a third solution, OPTI-FREE® RepleniSH® Multi-Purpose Disinfecting Solution (MPDS; Alcon Laboratories Inc, Fort Worth, TX, USA), preserved with Polyquaternium-1 (POLYQUAD®) and myristamidopropyl dimethylamine (ALDOX®) 0.0005%. PHMB is a broadspectrum cationic antimicrobial agent. It electrostatically binds to (and in turn destroys) the cytoplasmic membranes of microbes, disrupting metabolic activity and resulting in irreversible loss of intracellular components.18 POLYQUAD® is a quaternary ammonium compound. An antimicrobial agent with attenuated toxicity, it reduces the surface tension at interfaces and denatures microbial cell wall proteins, causing microbial cell death.18 ALDOX®, a cationic amidoamine, is an antifungal/anti-amoebic that works in synergy with POLYQUAD® in OPTI-FREE® RepleniSH® MPDS to meet the highest standard of ISO and FDA criteria for the disinfection of bacteria and fungi.19 Additionally, OPTI-FREE® RepleniSH® MPDS contains a TearGlyde® reconditioning system, incorporating Tetronic 1304 and C9-ED3A (nonanoyl ethylenediaminetriacetic acid). The components are attracted to the surface and matrix of silicone hydrogel and traditional hydrogel lenses and form a network to maintain a thin layer of moisture on the lens surface throughout the day. OPTI-FREE® RepleniSH® MPDS has been shown to increase contact lens comfort in the most common hydrogel material among those who experience discomfort20 and maintain a low wetting angle after 14 hours of lens wear as demonstrated in ex vivo clinical studies.21 OPTI-FREE® RepleniSH® MPDS is a new generation contact lens solution formulated to provide benefits in the key areas of lens wettability,22–25 lens cleaning,19,26 and biocompatible disinfection.27 In addition, it has demonstrated clinical biocompatibility with both traditional hydrogel and silicone hydrogel lens materials.25,26 The current study investigates the patient benefit of transitioning successful full-time, daily wear, soft contact lens wearers currently using competitive older-generation multipurpose solutions to OPTI-FREE® RepleniSH® MPDS.