Vibration exposure can occur at work, commuting between home and work, and in leisure activities. Any form of transportation will expose humans to some degree of vibration. Exposure to vibration can cause health problems, but more likely comfort problems. Health problems are normally related to back pain. Comfort on the other hand is related to both physiological and psychological factors, which can have a wide range of effects from a general annoyance to a reduced work capability. The standard ISO 2631-1 (1997) provides a guidance, which can be used to measure, evaluate and assess effects of whole-body vibration to discomfort. The standard allows several interpretations, which can lead to different results, as the standard does not provide an explicit guidance for selecting which axes and locations to measure and which averaging method to use for evaluating the axes. The suggested averaging method is the root mean square (r.m.s.) method, but additionally vibration dose value (VDV) can be used. This can lead to different results, as VDV emphasises shocks more than the r.m.s. method. The standard guides to measure and evaluate at least the seat translational axes, but the additional nine axes from the seat, backrest and floor are not mandatory. However, this can result in a different comfort value, as the values from the measured axes are combined. So taking into account all possible interpretations the assessment can vary significantly for the same environment. The selection of the averaging method is not a technical issue, as both methods are supported by all commercial equipment. However, it is rare that more than three axes are possible to be measured with typical whole-body vibration measurement equipment, thus the majority of studies have published results based on only the seat translational axes. Especially the rotational axes have been missing in most studies. The full method (i.e. using all possible axes to calculate the comfort value) of ISO 2631-1 (1997) has been rarely used and there is very little information on how accurate the method is for assessing discomfort in a multi-axis environment. There are only a few studies that have used the full method, but there are no known studies which have actually validated the full ISO 2631-1 method. The objective of the thesis was to validate and, if necessary, to improve the full method of the ISO 2631-1 standard for evaluating discomfort from whole-body vibration in a multi-axis environment. It was assumed that the ISO 2631-1 method can be used to predict discomfort in practice, but there are a relatively low number of studies to confirm this. Frequency weightings have been the focus of many published studies and it was assumed that these are broadly correct. Other aspects of the ISO 2631-1 method are the focus of this thesis. The goal was to keep a backward compatibility to previous studies and the current commercial equipment, thus several limitations were defined for the improvement of the standard. Several laboratory experiments, field measurements, and field and laboratory trials were conducted to validate the standard method. At first it was concluded that practical equipment for measuring 12-axis data was needed as there was no commercial system available. The equipment and software was validated in two experiments, which showed that simple and affordable components could be used to develop equipment for the full method. Even though the standard does not include information about a six-axis sensor for measuring both translational and rotational axes, there was a method to validate the sensor. The first field study included measuring several machines using all twelve axes. The analysis showed that the seat and backrest translational axes will contribute about 90 % of the overall vibration total value of the standard method, thus very little justification was found for including the seat rotational and floor translational axes. Similar results were found based on the data from the previous 12-axis studies. It was also found that the neglected axes could be compensated with a factor for estimating the overall vibration total value including all twelve axes. As the overall vibration total value is directly related to the number of used axes, the compensating factors can be used to compare results which used different axes. The laboratory trial confirmed the results from the field study, and it was concluded that sufficient accuracy to predict discomfort can be achieved using just the seat translational axes, even though the correlation improved when more axes were included. It was found that the evaluation of discomfort was improved by the use of the frequency weighting curves and the r.m.s. averaging method. However, as the multiplying factors degraded correlation, it was concluded that a new set of factors should be calculated. The new factors showed that a higher emphasis on the seat horizontal axes should be given (x=2.7, y=1.8 and z=1.0). The new factors improved the correlation systematically for all subjects. The field trial showed a similar trend, where optimised multiplying factors improved the correlation, but it was also noted that different multiplying factors are required for different environments, thus a procedure to optimise the standard method to different environments was developed. The trial showed systematic behaviour and the optimised multiplying factors were best for all subjects and groups. Keywords: Discomfort, whole-body vibration, standard, ISO 2631-1, multi-axis, multiplying factors

This thesis consisted of two main research themes: 1) The biomechanics of military load carriage, and 2) injuries and discomfort caused by load carriage. Although different in their methodological approaches, the two sections are linked and integral to each other. Harman et al (2000) suggest that the biomechanical analysis of military load carriage, and in particular the study of ground reaction forces (GRF), is relevant to the understanding and prevention oflower extremity injuries. The general aims of the biomechanical analysis of load carriage were to determine the effect that heavy load carriage, rifle carriage and load distribution has on GRF parameters. In addition to determining the mechanisms behind these potential changes, base-line data for British military load carriage systems (LCS) were also established. An important factor for the thesis was to consider the LCS as a single unit (where possible) and not its individual components, for example the backpack alone. The final biomechanical study involved a 3D, bi-Iateral gait analysis of load carriage; with this type of analysis being rare in the published literature. Results from the biomechanical studies showed that GRF parameters increased proportionally to applied load, even when heavy loads of up to 40 kg were carried. Also seen was an increase in mediolateral impulse and stance time with greater carried load. Another area which has received little or no attention in the literature is the effect of rifle carriage on gait. This thesis showed that rifle carriage changed basal gait patterns as observed in the GRF parameters. The most noteworthy results were an increase in impact peak and mediolateral impulse. The mechanism behind these changes is most likely to be a restriction of natural arm swing induced by rifle carriage. Distributing load more evenly around the body had limited effect on the GRF parameters measured. However, some important changes were observed. These were an increase in force minimum and a decrease in maximum braking force at the heaviest load. The latter effect has been strongly linked to an increase in the incidence of foot blisters within the literature. Finally, the gait analysis study showed significant increases in joint moments and torques with carried load. Also observed was a decrease in stride length and increase in percentage double support and stance. The main kinematic differences were a decrease in range of motion at the knee and pelvis rotation, and an increase in pelvis tilt as load is added. Four further studies were conducted in an effort to determine the discomfort and injury caused by load carriage. The first 3 studies collected sUbjective discomfort data via interviews, questionnaires and the use of comfort ratings. All of which were collected either during or after a prolonged period of load carriage by military personnel. Results gleaned from these studies showed that the upper limb is susceptible to short term discomfort following load carriage, whereas the lower limb is not. The lower limb may be at an increased risk of developing medium to long term injuries such as joint degradation and stress fractures. However, foot pain was rated as the most uncomfortable skeletal region of the body following a 1 hour field march with load, and blisters were experienced by around 60% of participants. Shoulder discomfort commences almost as soon as load is added and increases steadily with time. However, foot discomfort seems to increase more rapidly once the discomfort first materialises. This early development of shoulder or foot pain may be a risk factor for severe pain or non-completion of a period of prolonged load carriage. Finally, females experienced more discomfort in the hip joint and feet compared to males. (Continues...).

This thesis endeavours to investigate some of the many ways literary works can engage with the tradition of extremism. In so doing, the author hopes to demonstrate the importance of the tradition as a vessel for understanding the world around and within us. In an effort to show the breadth and endurance of this tradition, this thesis critically analyses selected works by Robert Browning, Harold Pinter, and Frank Bidart in context with various other literary works.

Critically ill patients who require MV are at risk for a number of complications, including the development of ventilator-associated events (VAE) and agitation that may require the use of sedation. Patients experience anxiety and discomfort during mechanical ventilation from a variety of sources including unfamiliar breathing assistance and an inability to communicate anxiety and pain verbally, but a primary cause of discomfort identified by these patients is the simply the presence of the endotracheal tube (ETT). Discomfort often leads to agitation and may be exacerbated by ETT movement. Management of agitation typically involves the use of sedative therapy and has been shown to increase the length of stay in the hospital. Additionally, when ETT cuff pressure is not adequately maintained, risk of microaspiration increases and these microaspirations increase the risk of ventilator-associated events. ETT movement may adversely affect the cuff seal against the tracheal mucosa, increasing leakage around the cuff and microaspiration. To date, no studies have described the effect of ETT movement on patient comfort and agitation. Noting the frequency of ETT movement during the provision of nursing care and plausible inadvertent consequences on discomfort and agitation, a research model was created and specific instruments selected in order to study this topic. This dissertation will provide a review of the literature regarding the role of the ETT in microaspiration, as well as detail a study that explores the frequency and amount of ETT movement and its potential effect on agitation.

Little is known about the recovery of patients after pneumonectomy and the impact of the surgery on the lifestyle of young, employed, ex-smokers and their families. This study was conducted to address this knowledge deficit, and gather information that would help health professionals to be able to assist people facing pneumonectomy. A qualitative study using van Manens methodological approach to interpretive phenomenology was chosen, in order to capture a full and rich understanding and meaning of the phenomenon that patients live. The names, age, operation, histological cell type, stage of disease, and disease free status of potential participants were obtained from a Lung Cancer Surgical Database after obtaining ethical approval for the study. Nine participants (three females and six males) met the inclusion criteria and gave informed consent for the study. Data collection comprised of open-ended interviews that were audiotaped, then transcribed verbatim into hard data. Data interpretation was based on the selective reading approach of van Manen from which six thematic statements arose. These are living the discomforts of treatment and recovery, discovering new limitations on myself; functional and emotional, my reliance on support, my financial security is threatened, my survival is at threat, and I wish I had known more. The study found that each participant had a unique experience of recovery and consequently the degree of recovery attained varied between participants. They all had a very strong desire to survive lung cancer and considered the risks of major surgery and loosing a lung to be insignificant compared to the certainty of loosing their life if they did not undergo surgery. This study provided a glimpse of what it was like for a group of patients to live the experience of life after a pneumonectomy and it provides a basis from which nurses can explore further the experiences of patients who are subjected to lung cancer surgery.

Background: Currently, if traveling the posted speed limit, the typical commuter driver in the Toronto Metropolitan area will travel round trip upwards of 60 minutes a day to work (Heisz and LaRochelle-Cote, 2005). As urban congestion continues to rise, commuting distances and times will progressively increase, placing commuter drivers at increased risk of developing musculoskeletal disorders (Porter and Gyi, 2002; Walsh et al., 1989; Chen et al., 2005; Sakakibara et al., 2006). As urban areas continue to expand, it is believed that a greater percentage of our urban populations will be defined as overweight or obese (Puska et al., 2003). To date the influence of body mass on driver posture, pressure distribution and discomfort during a prolonged driving situation has been left relatively untested. The purpose of this investigation is to determine the influence body mass has on driver posture, pressure distribution and discomfort during a prolonged driving situation. Methodology: Twelve male and 12 female participants, between 167 and 172 cm in stature were used in this investigation. Even numbers of males were assigned to either a light (51.3-57.7 kg), moderate (63.7-69.4 kg), or heavy (82.7-92.0 kg) body mass group. Participants were than placed in a 2 hour in lab driving simulation. During the simulation, lumbar flexion, pelvic angle, joint/segment angles, pressure distribution and discomfort were recorded. A three way mixed general linear model was used to determine if significant (α = 0.05) differences in discomfort, posture and/or interface pressure measurements existed over time. Results: Heavy drivers displayed increased total IT pressures and total seat pan/back pressures during driving. When normalizing these total pressures to area, differences in total IT pressure recorded from the seat pan, and total pressure recorded from the seat back were not significantly different (α = 0.05) across body mass groups. Due to the lack of seat pan accommodation with respect to surface area, the heavy body mass group’s total pressures per unit area for the seat pan was elevated relative to the lighter body mass groups. No differences in two-dimensional joint or segment kinematics and ratings of perceived discomfort were observed between body mass groups or between genders. Gender specific lumbo-pelvic postures and pressure distribution profiles were observed. Conclusion: With appropriate design of the seat pan to accommodate heavy body mass populations with respect to seat pan area, the influence of body mass as a potential risk factor in the development of discomfort would be reduced. With stature and body mass controlled between gender groups, biomechanical differences in both pressure distribution and lumbo-sacral postures were observed between males and females, verifying gender as a risk factor in the development of discomfort during prolonged driving. Recommendations to car seat manufacturers to recognize gender and body mass as important variables in the design of a car seat should be made.

Background: Currently, if traveling the posted speed limit, the typical commuter driver in the Toronto Metropolitan area will travel round trip upwards of 60 minutes a day to work (Heisz and LaRochelle-Cote, 2005). As urban congestion continues to rise, commuting distances and times will progressively increase, placing commuter drivers at increased risk of developing musculoskeletal disorders (Porter and Gyi, 2002; Walsh et al., 1989; Chen et al., 2005; Sakakibara et al., 2006). As urban areas continue to expand, it is believed that a greater percentage of our urban populations will be defined as overweight or obese (Puska et al., 2003). To date the influence of body mass on driver posture, pressure distribution and discomfort during a prolonged driving situation has been left relatively untested. The purpose of this investigation is to determine the influence body mass has on driver posture, pressure distribution and discomfort during a prolonged driving situation. Methodology: Twelve male and 12 female participants, between 167 and 172 cm in stature were used in this investigation. Even numbers of males were assigned to either a light (51.3-57.7 kg), moderate (63.7-69.4 kg), or heavy (82.7-92.0 kg) body mass group. Participants were than placed in a 2 hour in lab driving simulation. During the simulation, lumbar flexion, pelvic angle, joint/segment angles, pressure distribution and discomfort were recorded. A three way mixed general linear model was used to determine if significant (α = 0.05) differences in discomfort, posture and/or interface pressure measurements existed over time. Results: Heavy drivers displayed increased total IT pressures and total seat pan/back pressures during driving. When normalizing these total pressures to area, differences in total IT pressure recorded from the seat pan, and total pressure recorded from the seat back were not significantly different (α = 0.05) across body mass groups. Due to the lack of seat pan accommodation with respect to surface area, the heavy body mass group’s total pressures per unit area for the seat pan was elevated relative to the lighter body mass groups. No differences in two-dimensional joint or segment kinematics and ratings of perceived discomfort were observed between body mass groups or between genders. Gender specific lumbo-pelvic postures and pressure distribution profiles were observed. Conclusion: With appropriate design of the seat pan to accommodate heavy body mass populations with respect to seat pan area, the influence of body mass as a potential risk factor in the development of discomfort would be reduced. With stature and body mass controlled between gender groups, biomechanical differences in both pressure distribution and lumbo-sacral postures were observed between males and females, verifying gender as a risk factor in the development of discomfort during prolonged driving. Recommendations to car seat manufacturers to recognize gender and body mass as important variables in the design of a car seat should be made.

Purpose To investigate ocular surface sensations, specifically ocular discomfort using psychophysical and clinical techniques. The measurement of discomfort on the ocular surface has been limited to the use of traditional rating scales until recently. This thesis focuses on the scaling of discomfort using a psychophysical approach and also investigates the less explored area of the influence of blur on ocular discomfort. The specific aims of each chapter are: Chapter 2: To evaluate the difference thresholds of the central cornea in lens and non-lens wearers. Chapter 3: To devise a novel scale for ocular discomfort, relating subjective estimation of discomfort arising from contact lens wear to discomfort produced by the pneumatic stimuli delivered by a modified Belmonte esthesiometer. Chapter 4: To evaluate the influence of blur on ocular comfort while systematically manipulating vision using habitual refractive correction, induced spatial and optical blur, and under the absence of visual structure. Chapter 5: To examine if subjects rate discomfort and intensity of suprathreshold pneumatic stimuli differently when viewing clear and defocused targets and to examine the suprathreshold scaling of stimuli under the same visual conditions. Methods Chapter 2: The mechanical sensitivity of the central cornea was determined in 12 lens wearers and 12 non-lens wearers using a modified Belmonte pneumatic esthesiometer. The mechanical threshold of the central cornea was first estimated using the method of limits. Then, a series of systematically increasing stimuli were presented, with the first stimuli being 25% less than the threshold. The subjects were asked to compare the intensity of each stimulus with the preceding one and report if any difference in intensity was detectable. The intensities at which the subjects perceived an increased intensity from the previous was recorded. The difference threshold (DL) was the differences between the stimulus intensities at which an increase was perceived and five DLs were measured for each subject. Weber’s constants that relate the size of the difference thresholds to the stimulus intensity were derived for each DL level and repeated measures ANOVA was used to compare the Weber’s constants in the lens and non-lens wearing groups. Chapter 3: Twenty seven participants were enrolled for this magnitude matching study. Soft (HEMA) contact lenses of eight different lens designs varying in base curve and diameter were fit on all participants. The study was conducted on two separate days with four lenses randomly assigned on each day. The assigned soft contact lens was placed on the chosen eye and the sensations were measured using a numerical rating scale. Following this, the subjects were asked to regulate the intensity of the pneumatic stimulus using the control dial in order to match the discomfort from the stimulus to the discomfort from contact lens wear. At the completion of magnitude matching, ratings of sensations were again recorded. Pearson product moment correlation was used to correlate the objective esthesiometer matches to the subjective ratings of discomfort reported by each participant. The method of least log squares was used to derive the power exponents as defined by Stevens’ power law and analyze the psychophysical functions. Repeated measures ANOVA was used to investigate the effect of lens sequence and session on ocular discomfort with contact lens wear. The impact of lens type and time on discomfort was studied using linear mixed modeling. Chapter 4: Twenty emmetropic subjects rated ocular comfort, vision and sensation attributes (burning, itching and warmth) under conditions of normal vision, spatial blur and dioptric defocus, each session lasting for five minutes. Subjects viewed digital targets projected from a distance of 3m, and ocular surface sensations, vision were rated using magnitude estimation. Dioptric defocus was produced using +6.00DS contact lenses and equivalent spatial blur was created by spatially blurring the targets. Clear target images were used during dioptric defocus and blurred images during spatial blur session. Comfort was also rated under the absence of visual structure in fifteen of the participants using a ganzfeld and black occluders. Repeated measures ANOVA was used to compare vision and comfort ratings between the different experimental conditions. Chapter 5: Twenty one participants were enrolled. Ocular discomfort was produced by delivering mechanical stimuli from a pneumatic esthesiometer, and participants were asked to rate the intensity of stimulus and the discomfort induced by it under clear and defocused visual conditions. Esthesiometry was performed on one eye while the fellow eye viewed either a clear or blurred 6/60 fixation target through a trial lens. For the clear visual condition, the trial lens contained +0.25DS over their distance refractive correction and for the defocused condition, an additional +4.00DS was used. Mechanical thresholds from the central cornea were estimated using ascending methods of limits and then stimuli that were 25%, 50%, 75% and 100 % above threshold were presented in random order. Participants rated intensity and discomfort of each stimulus using a 0-100 numerical scale where 0 indicated no sensation and 100 indicated highest imaginable intensity/discomfort. There were 3 sessions with clear visual conditions and 3 sessions with defocus, in random order. Results Chapter 2: The functions relating Weber’s constants to stimulus intensities were slightly different in lens and non-lens wearing groups, although the absolute thresholds were similar. Repeated measures ANOVA revealed a significant main effect of DL level on Weber’s constant (p<0.001), with the Weber’s fraction at the first DL being higher than the following DLs. A significant main effect of the group type was also observed, with the lens wearers showing higher Weber’s constants than the non-lens wearers (p=0.02) However, there was no interaction between DL level and lens wearing group on Weber’s constants (p=0.38). Chapter 3: The average and individual psychophysical functions appeared to follow Stevens’ power function, with mechanical and chemical stimuli giving rise to different power exponents. Examination of the individual transducer functions revealed that only about half of the subjects were able to match the contact lens sensations to the pneumatic stimulus discomfort, with both mechanical and chemical stimulation. The lens types did not have any impact (p=0.65) on the session or sequence in which the lens was presented, although an effect of session and sequence on discomfort was observed. The average discomfort ratings produced by the different lens types were similar. There appeared to be significant effects of time (p<0.001) on the reporting of discomfort with lens wear, with the discomfort upon lens insertion rated to be higher than after lenses settling. Chapter 4: Ratings of vision under spatial blur and dioptric defocus were significantly different (p<0.001) from normal vision condition. Vision with dioptric defocus was rated worse (p<0.001) than spatial blur. Significant differences in comfort were observed between normal vision and blur, including spatial blur (p=0.02) and dioptric defocus (p=0.001). However, there was no significant difference (p=0.99) in comfort between spatial blur and dioptric defocus. Comfort remained unchanged between normal vision, occluders and ganzfeld although vision was absent in the later two conditions. Chapter 5: There was no significant difference in mechanical thresholds under clear and defocused conditions with a paired t-test (p=0.66) and similar results were obtained with repeated measures ANOVA, with no significant difference in discomfort (p=0.10) and intensity (p=0.075) ratings between the two visual conditions. However, paired t-test between the derived exponents under clear and defocused conditions showed significant differences for discomfort (p=0.05) and no significant difference for the ratings of intensity (p=0.22). Comparison of exponents between discomfort and intensity showed a significant difference in both clear (p=0.02) and defocus conditions (p<0.001). Conclusions: Chapter 2: The differential sensitivity of the ocular surface can be successfully measured with a pneumatic esthesiometer and it appears that Weber’s law holds true for corneal nociceptive sensory processing. There are subtle differences in mechanical difference thresholds between lens and non-lens wearers suggesting the possibility of different neural activity levels in the two groups. Chapter 3: Subjective ratings of discomfort can be scaled by corneal esthesiometry in a selective group of people. In the subset of subjects with poorer correlations, perhaps the pneumatic mechanical stimulus was too localized and specific to match the complex sensations experienced while wearing contact lenses. However, there is also a group of subjects who are poor at making judgments about ocular comfort. Hence, the use of special sensory panels should be considered when ocular comfort is the primary outcome. Chapter 4: There does seem to be an association between clarity of vision and ocular comfort, although the pathways for pain and vision are perhaps exclusive. Interactions between vision and other senses have been reported, but a similar inter-sensory interaction between pain and vision is yet to be clearly demonstrated. The decreased comfort observed in this study might perhaps be due to nocebo or Hawthorne effects. Chapter 5: Suprathreshold scaling of pneumatic stimuli can vary with the viewing conditions, with defocus associated with higher exponents than clear visual conditions. However, the ratings of comfort appear to be similar under both the conditions. If defocus does affect comfort, it is subtle and does not affect the sensory components, but tiny effects through the affective aspect of pain can contribute to the differences in power exponents. The differences in the perception of comfort do not appear to be attributable to the differences in threshold or sensory intensity.

This project is interested in the ways that second-generation Muslim women experience public space, in particular with respect to how their identities and sense of belonging are shaped through everyday encounters in public. This implicates the reactions and behaviours of strangers who they meet in public, their own bodily comportment, and the ideas and values communicated by their parents and other co-ethnics about women’s place in public space, as well as the ways that religiosity may enhance or hinder everyday belonging. Through the use of qualitative, one-on-one interviews, this research seeks to investigate daily experiences within Ottawa, Canada, particularly with respect to how such interactions inform a sense of (dis)comfort and belonging in public space in Canadian society. Moreover, this project is interested in the negotiation that many second-generation Muslim women undertake between family and ethno-religious community values and those of mainstream Canadian society in urban public spaces. In order to address these topics, the study examines Muslim women’s everyday experiences in public – the ways in which visibility and generational status can influence daily encounters and (dis)comfort, as well as women’s ability to actively negotiate their identity and belonging through engagement with strangers and acquaintances.

Purpose To investigate ocular surface sensations, specifically ocular discomfort using psychophysical and clinical techniques. The measurement of discomfort on the ocular surface has been limited to the use of traditional rating scales until recently. This thesis focuses on the scaling of discomfort using a psychophysical approach and also investigates the less explored area of the influence of blur on ocular discomfort. The specific aims of each chapter are: Chapter 2: To evaluate the difference thresholds of the central cornea in lens and non-lens wearers. Chapter 3: To devise a novel scale for ocular discomfort, relating subjective estimation of discomfort arising from contact lens wear to discomfort produced by the pneumatic stimuli delivered by a modified Belmonte esthesiometer. Chapter 4: To evaluate the influence of blur on ocular comfort while systematically manipulating vision using habitual refractive correction, induced spatial and optical blur, and under the absence of visual structure. Chapter 5: To examine if subjects rate discomfort and intensity of suprathreshold pneumatic stimuli differently when viewing clear and defocused targets and to examine the suprathreshold scaling of stimuli under the same visual conditions. Methods Chapter 2: The mechanical sensitivity of the central cornea was determined in 12 lens wearers and 12 non-lens wearers using a modified Belmonte pneumatic esthesiometer. The mechanical threshold of the central cornea was first estimated using the method of limits. Then, a series of systematically increasing stimuli were presented, with the first stimuli being 25% less than the threshold. The subjects were asked to compare the intensity of each stimulus with the preceding one and report if any difference in intensity was detectable. The intensities at which the subjects perceived an increased intensity from the previous was recorded. The difference threshold (DL) was the differences between the stimulus intensities at which an increase was perceived and five DLs were measured for each subject. Weber’s constants that relate the size of the difference thresholds to the stimulus intensity were derived for each DL level and repeated measures ANOVA was used to compare the Weber’s constants in the lens and non-lens wearing groups. Chapter 3: Twenty seven participants were enrolled for this magnitude matching study. Soft (HEMA) contact lenses of eight different lens designs varying in base curve and diameter were fit on all participants. The study was conducted on two separate days with four lenses randomly assigned on each day. The assigned soft contact lens was placed on the chosen eye and the sensations were measured using a numerical rating scale. Following this, the subjects were asked to regulate the intensity of the pneumatic stimulus using the control dial in order to match the discomfort from the stimulus to the discomfort from contact lens wear. At the completion of magnitude matching, ratings of sensations were again recorded. Pearson product moment correlation was used to correlate the objective esthesiometer matches to the subjective ratings of discomfort reported by each participant. The method of least log squares was used to derive the power exponents as defined by Stevens’ power law and analyze the psychophysical functions. Repeated measures ANOVA was used to investigate the effect of lens sequence and session on ocular discomfort with contact lens wear. The impact of lens type and time on discomfort was studied using linear mixed modeling. Chapter 4: Twenty emmetropic subjects rated ocular comfort, vision and sensation attributes (burning, itching and warmth) under conditions of normal vision, spatial blur and dioptric defocus, each session lasting for five minutes. Subjects viewed digital targets projected from a distance of 3m, and ocular surface sensations, vision were rated using magnitude estimation. Dioptric defocus was produced using +6.00DS contact lenses and equivalent spatial blur was created by spatially blurring the targets. Clear target images were used during dioptric defocus and blurred images during spatial blur session. Comfort was also rated under the absence of visual structure in fifteen of the participants using a ganzfeld and black occluders. Repeated measures ANOVA was used to compare vision and comfort ratings between the different experimental conditions. Chapter 5: Twenty one participants were enrolled. Ocular discomfort was produced by delivering mechanical stimuli from a pneumatic esthesiometer, and participants were asked to rate the intensity of stimulus and the discomfort induced by it under clear and defocused visual conditions. Esthesiometry was performed on one eye while the fellow eye viewed either a clear or blurred 6/60 fixation target through a trial lens. For the clear visual condition, the trial lens contained +0.25DS over their distance refractive correction and for the defocused condition, an additional +4.00DS was used. Mechanical thresholds from the central cornea were estimated using ascending methods of limits and then stimuli that were 25%, 50%, 75% and 100 % above threshold were presented in random order. Participants rated intensity and discomfort of each stimulus using a 0-100 numerical scale where 0 indicated no sensation and 100 indicated highest imaginable intensity/discomfort. There were 3 sessions with clear visual conditions and 3 sessions with defocus, in random order. Results Chapter 2: The functions relating Weber’s constants to stimulus intensities were slightly different in lens and non-lens wearing groups, although the absolute thresholds were similar. Repeated measures ANOVA revealed a significant main effect of DL level on Weber’s constant (p<0.001), with the Weber’s fraction at the first DL being higher than the following DLs. A significant main effect of the group type was also observed, with the lens wearers showing higher Weber’s constants than the non-lens wearers (p=0.02) However, there was no interaction between DL level and lens wearing group on Weber’s constants (p=0.38). Chapter 3: The average and individual psychophysical functions appeared to follow Stevens’ power function, with mechanical and chemical stimuli giving rise to different power exponents. Examination of the individual transducer functions revealed that only about half of the subjects were able to match the contact lens sensations to the pneumatic stimulus discomfort, with both mechanical and chemical stimulation. The lens types did not have any impact (p=0.65) on the session or sequence in which the lens was presented, although an effect of session and sequence on discomfort was observed. The average discomfort ratings produced by the different lens types were similar. There appeared to be significant effects of time (p<0.001) on the reporting of discomfort with lens wear, with the discomfort upon lens insertion rated to be higher than after lenses settling. Chapter 4: Ratings of vision under spatial blur and dioptric defocus were significantly different (p<0.001) from normal vision condition. Vision with dioptric defocus was rated worse (p<0.001) than spatial blur. Significant differences in comfort were observed between normal vision and blur, including spatial blur (p=0.02) and dioptric defocus (p=0.001). However, there was no significant difference (p=0.99) in comfort between spatial blur and dioptric defocus. Comfort remained unchanged between normal vision, occluders and ganzfeld although vision was absent in the later two conditions. Chapter 5: There was no significant difference in mechanical thresholds under clear and defocused conditions with a paired t-test (p=0.66) and similar results were obtained with repeated measures ANOVA, with no significant difference in discomfort (p=0.10) and intensity (p=0.075) ratings between the two visual conditions. However, paired t-test between the derived exponents under clear and defocused conditions showed significant differences for discomfort (p=0.05) and no significant difference for the ratings of intensity (p=0.22). Comparison of exponents between discomfort and intensity showed a significant difference in both clear (p=0.02) and defocus conditions (p<0.001). Conclusions: Chapter 2: The differential sensitivity of the ocular surface can be successfully measured with a pneumatic esthesiometer and it appears that Weber’s law holds true for corneal nociceptive sensory processing. There are subtle differences in mechanical difference thresholds between lens and non-lens wearers suggesting the possibility of different neural activity levels in the two groups. Chapter 3: Subjective ratings of discomfort can be scaled by corneal esthesiometry in a selective group of people. In the subset of subjects with poorer correlations, perhaps the pneumatic mechanical stimulus was too localized and specific to match the complex sensations experienced while wearing contact lenses. However, there is also a group of subjects who are poor at making judgments about ocular comfort. Hence, the use of special sensory panels should be considered when ocular comfort is the primary outcome. Chapter 4: There does seem to be an association between clarity of vision and ocular comfort, although the pathways for pain and vision are perhaps exclusive. Interactions between vision and other senses have been reported, but a similar inter-sensory interaction between pain and vision is yet to be clearly demonstrated. The decreased comfort observed in this study might perhaps be due to nocebo or Hawthorne effects. Chapter 5: Suprathreshold scaling of pneumatic stimuli can vary with the viewing conditions, with defocus associated with higher exponents than clear visual conditions. However, the ratings of comfort appear to be similar under both the conditions. If defocus does affect comfort, it is subtle and does not affect the sensory components, but tiny effects through the affective aspect of pain can contribute to the differences in power exponents. The differences in the perception of comfort do not appear to be attributable to the differences in threshold or sensory intensity.