Non-invasive techniques for imaging in-vivo human corneal sub basal nerve mapping and migration rate in diabetic neuropathy

Purpose Corneal confocal microscopy (CCM) is a rapid non-invasive ophthalmic technique, which has been shown to diagnose and stratify the severity of diabetic neuropathy. Current morphometric techniques assess individual static images of the subbasal nerve plexus; this work explores the potential for non-invasive assessment of the wide-field morphology and dynamic changes of this plexus in vivo. Methods In this pilot study, laser scanning CCM was used to acquire maps (using a dynamic fixation target and semi-automated tiling software) of the central corneal sub-basal nerve plexus in 4 diabetic patients with and 6 without neuropathy and in 2 control subjects. Nerve migration was measured in an additional 7 diabetic patients with neuropathy, 4 without neuropathy and in 2 control subjects by repeating a modified version of the mapping procedure within 2-8 weeks, thus facilitating re-identification of distinctive nerve landmarks in the 2 montages. The rate of nerve movement was determined from these data and normalised to a weekly rate (µm/week), using customised software. Results Wide-field corneal nerve fibre length correlated significantly with the Neuropathy Disability Score (r = -0.58, p < 0.05), vibration perception (r = -0.66, p < 0.05) and peroneal conduction velocity (r = 0.67, p < 0.05). Central corneal nerve fibre length did not correlate with any of these measures of neuropathy (p > 0.05 for all). The rate of corneal nerve migration was 14.3 ± 1.1 µm/week in diabetic patients with neuropathy, 19.7 ± 13.3µm/week in diabetic patients without neuropathy, and 24.4 ± 9.8µm/week in control subjects; however, these differences were not significantly different (p = 0.543). Conclusions Our data demonstrate that it is possible to capture wide-field images of the corneal nerve plexus, and to quantify the rate of corneal nerve migration by repeating this procedure over a number of weeks. Further studies on larger sample sizes are required to determine the utility of this approach for the diagnosis and monitoring of diabetic neuropathy.

Evaluating operational cloud enterprise systems success : an organizational perspective

This paper presents a formative measurement index to assess cloud enterprise systems success. The scale development procedure is based on Moore and Benbasat (1991), including newer scale development elements which focus on the creation and assessment of formative constructs. The data is analysed using SmartPLS with a sample of 103 IT decision makers. The results show that the perception of net benefits is shaped not only by enterprise-system-specific factors like productivity improvements and higher quality of business processes, but also by factors which are specifically attributed to cloud systems, such as higher strategic flexibility. Reliability, user requirements and customization contribute most to the overall perception of system quality. Information quality shows no cloud-specific facets and is robust in the context of cloud enterprise systems.

A business perspective of legacy systems

Abstract Legacy information systems evolved incrementally in response to changes in business strategy and information technology. Organizations are now being forced to change much more radically and quickly than previously and this change places new demands on information systems. Legacy information systems are usually considered from a technical perspective, addressing issues such as age, complexity, maintainability, design and technology. We wish to demonstrate that the business dimension to legacy information systems, represented by the organisation structure, business processes and procedures that are bound up in the design and operation of the existing IT systems, is also significant. This paper identifies the important role of legacy information systems in the formation of new strategies. We show that the move away from a stable to an unstable business environment accelerates the rate of change. Furthermore, the gap between what the legacy information systems can deliver and the strategic vision of the organization widens when the legacy information systems are unable to adapt to meet the new requirements. An analysis of fifteen case studies provides evidence that legacy information systems include business and technical dimensions and that the systems can present problems when there is a misalignment between the strategic vision of the business, the IT legacy and the old business model embodied in the legacy.

The knowing client : a processual perspective on knowledge shaping in consulting engagements

This thesis extends current understanding in management consulting research by investigating the ways in which management consultants and their clients shaped knowing over the course of nine different consulting engagements. The research illuminates the client experience of using consulting knowledge in organisations, and proposes a theoretical reconceptualisation of knowledge shaping in consulting engagements which incorporates how the knowing client is enacted. The research shows that knowledge shaping activities are planned and enacted to support novelty reduction in consulting engagements; that asymmetries in the structuring of the consultant–client relationship hamper knowledge transformation and the establishment of knowing; and that understanding of how the role identities of consultants and clients are established and maintained over the course of an engagement is integral to understanding knowledge shaping in consulting engagements.

Knowledge integration within innovation process : a technopreneurial perspective

Knowledge Integration (KI) is one of the major aspects driving innovation within an organisation. In this paper, we attempt to develop a better understanding of responses to the challenges of knowledge integration within the innovation process in technology-based firms. Using four technology-based Australian firms, we investigated how knowledge integration may be managed within the context of innovation in technology firms. Previous research highlights the role of four KI tasks that affect the innovation capability within technology-oriented firms, namely team building capability, capturing tacit knowledge, role of Knowledge Management (KM) systems and technological systemic integration. Our findings indicate that in addition to these four tasks, a strategic approach to integrating knowledge for innovation, as well as leadership and management, are essential to achieving effective KI across multiple levels of engagement. Our findings also offer practical insights into how knowledge can be integrated within innovation process, with specific implications for managers.

Performance Measurement in Perspective: An exploratory study of Australian foundations’ approaches to performance measurement

Performance measurement in Australian philanthropic foundations is a hot topic. Foundation staff and board members are concerned with striking the right balance between their need for information with which to assess the effectiveness of their grant-making programs, and the costs in both time and money for grantees. Influenced by normative pressures, the increasing size and professionalism of the Australian philanthropic sector, and trends from the U.S.A and the U.K, foundations are talking amongst themselves, seeking expert advice and training, consulting with grantees and trying different approaches. Many resources examine methods of data collection, measurement or analysis. Our study instead treads into less charted but important territory: the motivations and values that are shaping the debate about performance measurement. In a series of 40 interviews with foundations from Queensland, New South Wales, Victoria and South Australia, we asked whether they felt under pressure to measure performance and if so, why. We queried whether everyone in the foundation shared the same views on the purposes of performance measurement; and the ways in which the act of performance measurement changed their grant-making, their attitude to risk, their relationship with grantees and their collaborations with other funders. Unsurprisingly, a very diverse set of approaches to performance measurement were revealed.

The development and evaluation of a medical imaging training immersive environment

Introduction A novel realistic 3D virtual reality (VR) application has been developed to allow medical imaging students at Queensland University of Technology to practice radiographic techniques independently outside the usual radiography laboratory. Methods A flexible agile development methodology was used to create the software rapidly and effectively. A 3D gaming environment and realistic models were used to engender presence in the software while tutor-determined gold standards enabled students to compare their performance and learn in a problem-based learning pedagogy. Results Students reported high levels of satisfaction and perceived value and the software enabled up to 40 concurrent users to prepare for clinical practice. Student feedback also indicated that they found 3D to be of limited value in the desktop version compared to the usual 2D approach. A randomised comparison between groups receiving software-based and traditional practice measured performance in a formative role play with real equipment. The results of this work indicated superior performance with the equipment for the VR trained students (P = 0.0366) and confirmed the value of VR for enhancing 3D equipment-based problem-solving skills. Conclusions Students practising projection techniques virtually performed better at role play assessments than students practising in a traditional radiography laboratory only. The application particularly helped with 3D equipment configuration, suggesting that teaching 3D problem solving is an ideal use of such medical equipment simulators. Ongoing development work aims to establish the role of VR software in preparing students for clinical practice with a range of medical imaging equipment.

Organisational culture, change readiness and retention : a human services perspective

The Third Sector is experiencing unprecedented change as nonprofit organisations pursue their mission, organisational excellence and sustainability. This research collected data from employees of Australian nonprofit human service organisations. Instruments to measure organisational culture and change readiness were validated. The relationships between perceptions of organisational cultures, change readiness, job satisfaction and intentions to leave were explored. Findings indicate flexible organisational cultures influence employee attitudes more positively than control cultures. It identified that leaders have a significant role to play in developing and fostering change readiness and job satisfaction. This improves employees' adaptation to change, increases staff retention and organisational sustainability.

An urban design perspective to classify knowledge precincts : a typological analysis of global best practices

Purpose: The paper seeks to investigate emerging knowledge precincts under the urban design lens in order to identify recurrent spatial patterns of urban forms and functions to gather an understanding of physical aspects that contribute to the creation of place quality. Scope: This paper focuses on the physical design and layout of specific precincts. Although socio-economic and other factors come into play imparting the distinctiveness; this paper only focuses on the spatial dimensions. Method: The research first develops a design typology framework through the lead of literature, and then utilizes it to identify recurrent elements in knowledge precinct design in order to develop taxonomy of patterns and layouts. Results: The research reported in this paper provides preliminary insights into the various form and functional factors playing role in the design of knowledge precincts and evaluates the elements that contribute to the success of these urban interventions. Recommendations: The paper recommends the use of particular design-based solutions in order to enhance the place making in knowledge precincts. Conclusions: The study concludes that despite the locational, regulatory and other contextual differences, the underlying driving principle of providing place quality to people leads to the emergence of identifiable spatial patterns across the knowledge precincts.

Wearable neuroimaging and emotion : investigating emotional responses to architectural environments with functional near-infrared spectroscopy (fNIRS)

Supported by contemporary theories of architectural aesthetics and neuro-aesthetics this paper presents a case for the use of portable fNIRS imaging in the assessment of emotional responses to spatial environments experienced by both blind and sighted. The aim of the paper is to outline the implications of fNIRS for spatial research and practice within the field of architecture, thereby suggesting a potential taxonomy of particular formations of space and affect. Empirical neurological study of affect and spatial experience from an architectural design perspective remains in many instances unchartered. Clinical research using the portable non-invasive neuro-imaging device, functional near infrared spectroscopy (fNIRS) is proving convincing in its ability to detect emotional responses to visual, spatio-auditory and task based stimuli, providing a firm basis to potentially track cortical activity in the appraisal of architectural environments. Additionally, recent neurological studies have sought to explore the manifold sensory abilities of the visually impaired to better understand spatial perception in general. Key studies reveal that early blind participants perform as well as sighted due to higher auditory and somato-sensory spatial acuity. For instance, face vision enables the visually impaired to detect environments through skin pressure, enabling at times an instantaneous impression of the layout of an unfamiliar environment. Studies also report pleasant and unpleasant emotional responses such as ‘weightedness’ or ‘claustrophobia’ within certain interior environments, revealing a deeper perceptual sensitivity then would be expected. We conclude with justification that comparative fNIRS studies between the sighted and blind concerning spatial experience have the potential to provide greater understanding of emotional responses to architectural environments.

Understanding declining science participation in Australia : a systemic perspective

In this chapter we describe the substantial declines in student participation in senior high school physics, chemistry and biology classes in Australia over the last two decades. We outline some of the explanations commonly offered to account for these declines, focusing on two contrasting positions: first, that they are due to today’s students holding less positive attitudes towards science classes and careers than their predecessors, and second, that the declines are related to policy and structural changes at the upper secondary and tertiary education levels which have affected the relative status of subjects and the dynamics of choice. We describe how the Choosing Science study investigated the extent to which the two hypotheses were supported by empirical evidence, and discuss our findings in the light of a third result from the study concerning the role of self-identity in subject choice. We conclude that the declines in high school science enrolments are most likely related to changes in school and university curriculum options and that within this expanded curriculum marketplace, identity becomes a very important reference point in students’ decisions about whether to take science in the final years of high school.

The role of counselling in healing from sexual assault in childhood from the phenomenological perspective of men and women

Serious Childhood Sexual Assault (CSA) has the potential for a wide range of extreme difficulties, not only in childhood but for many years to come. However, the lasting negative impacts are not inevitable and with the right help, those who have experienced CSA can go on to enjoy whole and fulfilling lives. The question posed in this research is “What comprises “the right help”? The present study qualitatively investigated the narratives of men and women with regard to what was deemed important components of counselling which facilitated their healing from childhood sexual assault. Participants consisted of 21 women and 11 men who had sought both individual and group counselling to work through issues stemming from traumatic sexual assault in childhood. Findings presented here describe three superordinate themes which were essential in the healing process, incorporating abuse-specific, client-specific and practitioner-specific components. A final superordinate theme of negative experiences in counselling is also presented, describing unhelpful or negative counselling experiences. Similarities between men and women as to the important components of counselling was remarkable, however important gender differences were also observed.