111 resultados para CUTANEOUS MANIFESTATIONS


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Diabetes is an increasingly prevalent disease worldwide. Providing early management of the complications can prevent morbidity and mortality in this population. Peripheral neuropathy, a significant complication of diabetes, is the major cause of foot ulceration and amputation in diabetes. Delay in attending to complication of the disease contributes to significant medical expenses for diabetic patients and the community. Early structural changes to the neural components of the retina have been demonstrated to occur prior to the clinically visible retinal vasculature complication of diabetic retinopathy. Additionally visual functionloss has been shown to exist before the ophthalmoscopic manifestations of vasculature damage. The purpose of this thesis was to evaluate the relationship between diabetic peripheral neuropathy and both retinal structure and visual function. The key question was whether diabetic peripheral neuropathy is the potential underlying factor responsible for retinal anatomical change and visual functional loss in people with diabetes. This study was conducted on a cohort with type 2 diabetes. Retinal nerve fibre layer thickness was assessed by means of Optical Coherence Tomography (OCT). Visual function was assessed using two different methods; Standard Automated Perimetry (SAP) and flicker perimetry were performed within the central 30 degrees of fixation. The level of diabetic peripheral neuropathy (DPN) was assessed using two techniques - Quantitative Sensory Testing and Neuropathy Disability Score (NDS). These techniques are known to be capable of detecting DPN at very early stages. NDS has also been shown as a gold standard for detecting 'risk of foot ulceration'. Findings reported in this thesis showed that RNFL thickness, particularly in the inferior quadrant, has a significant association with severity of DPN when the condition has been assessed using NDS. More specifically it was observed that inferior RNFL thickness has the ability to differentiate individuals who are at higher risk of foot ulceration from those who are at lower risk, indicating that RNFL thickness can predict late-staged DPN. Investigating the association between RNFL and QST did not show any meaningful interaction, which indicates that RNFL thickness for this cohort was not as predictive of neuropathy status as NDS. In both of these studies, control participants did not have different results from the type 2 cohort who did not DPN suggesting that RNFL thickness is not a marker for diagnosing DPN at early stages. The latter finding also indicated that diabetes per se, is unlikely to affect the RNFL thickness. Visual function as measured by SAP and flicker perimetry was found to be associated with severity of peripheral neuropathy as measured by NDS. These findings were also capable of differentiating individuals at higher risk of foot ulceration; however, visual function also proved not to be a maker for early diagnosis of DPN. It was found that neither SAP, nor flicker sensitivity have meaningful associations with DPN when neuropathy status was measured using QST. Importantly diabetic retinopathy did not explain any of the findings in these experiments. The work described here is valuable as no other research to date has investigated the association between diabetic peripheral neuropathy and either retinal structure or visual function.

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In John Frazer's seminal book An Evolutionary Architecture (1995), from which this essay is extracted, a fundamental approach is established for have natural systems can unfold mechanisms for negotiating the complex design space inherent in architectural systems. In this essay, which forms a critical part of the book, Frazer draws both correlations and distinctions from natural processes as emulated in design processes and form as active manifestations within natural systems. Form is seen as an evolving agent generated via the rules of descriptive genetic coding, functioning as a part of a metabolic environment. Frazer's process-model establishes the realm in which computation must manoeuvre to produce a valid solution space, including the operations of self-organisation, complexity and emergent behaviour. Addressing design as an authored practice, he extends the transference of 'creativity' from the explicit impression into form, to the investment of though, organisation and strategy in the computational processes which produce form. Frazer's text concentrates astutely on the practising of the evolutionary paradigm, the output of which postulates an architecture born of the relationships to dynamic environmental and socio-economic contexts, and realised through morphogenetic materialisation.

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Students who experience high levels of anger both in and out of school are at risk of exhibiting multiple negative developmental outcomes including poor school performance, peer problems, behavioral difficulties, and concurrent emotional distress. Given this developmental trajectory, it is important for mental health professionals working within school settings to accurately identify those students manifesting anger-related problems at an early age. This chapter provides an overview of instruments designed to assess levels of anger and associated cognitive and behavioral manifestations in children and youth. Among those instruments highlighted is the Multidimensional School Anger Inventory (MSAI)specifically designed to measure anger, hostility, and aggressive behavioral expression in school settings. The role of anger assessment in developing appropriate early intervention and anger management treatment plans is also discussed.

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'The Landing was an exhibition of paintings held at Gallery Barry Keldoulis in Sydney in 2008. The exhibition comprised 7 paintings and a 3-channel video work. The show built upon the artist's interest in drawing parallels between, while simultaneously disrupting the hermetic integrity of both the painted and virtual surface. In this exhibition this was drawn out by the intentionally scratchy and blanched qualities of the painted surface contrasted against the careful delineations and gradation of their subject matter which was drawn exclusively from virtual 3D animated spaces. Conversely, the video work collapsed a series of picture-perfect objects into a dense and incoherent whole. These tensions and slippages act as manifestations of the indeterminacies that frame our subjectivity more broadly - as artist or viewer. As Barry Keldoulis writes: 'Alwast’s practice engages the construction of ‘reality’ in both the digital and painterly worlds. His seamless stitching together of the various modes of virtual reality... is in this exhibition contrasted with his paintings, which show a fondness for what many now see as the quaint naivety of the medium, and the foibles of humanity the painted surface exudes when compared to the clinical exactitude of the virtual world.'(2008, http://www.gbk.com.au/artists/peter-alwast/the-landing) Works from 'The Landing' were included in the exhibition 'Temperature 2: New Queensland Art' (2009, curated by Frank McBride) at the Museum of Brisbane.

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The convergence of Internet marketplaces and service-oriented architectures has spurred the growth of Web service ecosystems. This paper articulates a vision for Web service ecosystems, discusses early manifestations of this vision, and presents a unifying architecture to support the emergence of larger and more sophisticated ecosystems

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The Time magazine ‘Person of theYear’ award is a venerable institution. Established by Time’s founder Henry Luce in 1927 as ‘Man of the Year’, it is an annual award given to ‘a person, couple, group, idea, place, or machine that ‘for better or for worse ... has done the most to influence the events of the year’ (Time 2002, p. 1). In 2010, the award was given to Mark Zuckerberg, the founder and CEO of the social networking site Facebook.There was, however, a strong campaign for the ‘People’s Choice’ award to be given to Julian Assange, the founder and editor-in-chief of Wikileaks, the online whistleblowing site. Earlier in the year Wikileaks had released more than 250 000 US government diplomatic cables through the internet, and the subsequent controver- sies around the actions of Wikileaks and Assange came to be known worldwide as ‘Cablegate’. The focus of this chapter is not on the implications of ‘Cablegate’ for international diplomacy, which continue to have great significance, but rather upon what the emergence of Wikileaks has meant for journalism, and whether it provides insights into the future of journalism. Both Facebook and Wikileaks, as well as social media platforms such as Twitter and YouTube, and independent media practices such as blogging, citizen journalism and crowdsourcing, are manifestations of the rise of social media, or what has also been termed web 2.0.The term ‘web 2.0’ was coined by Tim O’Reilly, and captures the rise of online social media platforms and services, that better realise the collaborative potential of digitally networked media. They do this by moving from the relatively static, top-down notions of interactivity that informed early internet development, towards more open and evolutionary models that better harness collective intelligence by enabling users to become the creators and collaborators in the development of online media content (Musser and O’Reilly 2007; Bruns 2008).

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Creativity plays an increasingly important role in our personal, social, educational, and community lives. For adolescents, creativity can enable self-expression, be a means of pushing boundaries, and assist learning, achievement, and completion of everyday tasks. Moreover, adolescents who demonstrate creativity can potentially enhance their capacity to face unknown future challenges, address mounting social and ecological issues in our global society, and improve their career opportunities and contribution to the economy. For these reasons, creativity is an essential capacity for young people in their present and future, and is highlighted as a priority in current educational policy nationally and internationally. Despite growing recognition of creativity’s importance and attention to creativity in research, the creative experience from the perspectives of the creators themselves and the creativity of adolescents are neglected fields of study. Hence, this research investigated adolescents’ self-reported experiences of creativity to improve understandings of their creative processes and manifestations, and how these can be supported or inhibited. Although some aspects of creativity have been extensively researched, there were no comprehensive, multidisciplinary theoretical frameworks of adolescent creativity to provide a foundation for this study. Therefore, a grounded theory methodology was adopted for the purpose of constructing a new theory to describe and explain adolescents’ creativity in a range of domains. The study’s constructivist-interpretivist perspective viewed the data and findings as interpretations of adolescents’ creative experiences, co-constructed by the participants and the researcher. The research was conducted in two academically selective high schools in Australia: one arts school, and one science, mathematics, and technology school. Twenty adolescent participants (10 from each school) were selected using theoretical sampling. Data were collected via focus groups, individual interviews, an online discussion forum, and email communications. Grounded theory methods informed a process of concurrent data collection and analysis; each iteration of analysis informed subsequent data collection. Findings portray creativity as it was perceived and experienced by participants, presented in a Grounded Theory of Adolescent Creativity. The Grounded Theory of Adolescent Creativity comprises a core category, Perceiving and Pursuing Novelty: Not the Norm, which linked all findings in the study. This core category explains how creativity involved adolescents perceiving stimuli and experiences differently, approaching tasks or life unconventionally, and pursuing novel ideas to create outcomes that are not the norm when compared with outcomes by peers. Elaboration of the core category is provided by the major categories of findings. That is, adolescent creativity entailed utilising a network of Sub-Processes of Creativity, using strategies for Managing Constraints and Challenges, and drawing on different Approaches to Creativity – adaptation, transfer, synthesis, and genesis – to apply the sub-processes and produce creative outcomes. Potentially, there were Effects of Creativity on Creators and Audiences, depending on the adolescent and the task. Three Types of Creativity were identified as the manifestations of the creative process: creative personal expression, creative boundary pushing, and creative task achievement. Interactions among adolescents’ dispositions and environments were influential in their creativity. Patterns and variations of these interactions revealed a framework of four Contexts for Creativity that offered different levels of support for creativity: high creative disposition–supportive environment; high creative disposition–inhibiting environment; low creative disposition–supportive environment; and low creative disposition–inhibiting environment. These contexts represent dimensional ranges of how dispositions and environments supported or inhibited creativity, and reveal that the optimal context for creativity differed depending on the adolescent, task, domain, and environment. This study makes four main contributions, which have methodological and theoretical implications for researchers, as well as practical implications for adolescents, parents, teachers, policy and curriculum developers, and other interested stakeholders who aim to foster the creativity of adolescents. First, this study contributes methodologically through its constructivist-interpretivist grounded theory methodology combining the grounded theory approaches of Corbin and Strauss (2008) and Charmaz (2006). Innovative data collection was also demonstrated through integration of data from online and face-to-face interactions with adolescents, within the grounded theory design. These methodological contributions have broad applicability to researchers examining complex constructs and processes, and with populations who integrate multimedia as a natural form of communication. Second, applicable to creativity in diverse domains, the Grounded Theory of Adolescent Creativity supports a hybrid view of creativity as both domain-general and domain-specific. A third major contribution was identification of a new form of creativity, educational creativity (ed-c), which categorises creativity for learning or achievement within the constraints of formal educational contexts. These theoretical contributions inform further research about creativity in different domains or multidisciplinary areas, and with populations engaged in formal education. However, the key contribution of this research is that it presents an original Theory and Model of Adolescent Creativity to explain the complex, multifaceted phenomenon of adolescents’ creative experiences.

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A total histological grade does not necessarily distinguish between different manifestations of cartilage damage or degeneration. An accurate and reliable histological assessment method is required to separate normal and pathological tissue within a joint during treatment of degenerative joint conditions and to sub-classify the latter in meaningful ways. The Modified Mankin method may be adaptable for this purpose. We investigated how much detail may be lost by assigning one composite score/grade to represent different degenerative components of the osteoarthritic condition. We used four ovine injury models (sham surgery, anterior cruciate ligament/medial collateral ligament instability, simulated anatomic anterior cruciate ligament reconstruction and meniscal removal) to induce different degrees and potentially 'types' (mechanisms) of osteoarthritis. Articular cartilage was systematically harvested, prepared for histological examination and graded in a blinded fashion using a Modified Mankin grading method. Results showed that the possible permutations of cartilage damage were significant and far more varied than the current intended use that histological grading systems allow. Of 1352 cartilage specimens graded, 234 different manifestations of potential histological damage were observed across 23 potential individual grades of the Modified Mankin grading method. The results presented here show that current composite histological grading may contain additional information that could potentially discern different stages or mechanisms of cartilage damage and degeneration in a sheep model. This approach may be applicable to other grading systems.

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Background Type 1 Neurofibromatosis (NF1) is a genetic disorder linked to mutations of the NF1 gene. Clinical symptoms are varied, but hallmark features of the disease include skin pigmentation anomalies (café au lait macules, skinfold freckling) and dermal neurofibromas. Method These dermal manifestations of NF1 have previously been reported in a mouse model where Nf1+/− mice are topically treated with dimethylbenz[a]anthracene (DMBA) and 12-O-tetradecanoylphorbol-13-acetate (TPA). We adopted this mouse model to test the protective effects of a nitroxide antioxidant, 5-carboxy-1,1,3,3-tetramethylisoindolin-2-yloxyl (CTMIO). Antioxidants have previously been shown to increase longevity in nf1-deficient fruitflies. Doses of 4 μM and 40 μM CTMIO provided ad libitum in drinking water were given to Nf1-deficient mice. Results Consistent with previous reports, Nf1-deficient mice showed a 4.7-fold increase in papilloma formation (P < 0.036). However, neither dose of CTMIO had any significant affect on papilloma formation. A non-significant decrease in skin pigmentation abnormalities was seen with 4 μM but not 40 μM CTMIO. Subsequent analysis of genomic DNA isolated from papillomas indicated that DMBA/TPA induced tumors did not exhibit a local loss of heterozygosity (LOH) at the Nf1 locus. Conclusion These data reveal that oral antioxidant therapy with CTMIO does not reduce tumor formation in a multistage cancer model, but also that this model does not feature LOH for Nf1.

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The somatosensory system plays an important role in balance control and age-related changes to this system have been implicated in falls. Parkinson’s disease (PD) is a chronic and progressive disease of the brain, characterized by postural instability and gait disturbance. Previous research has shown that deficiencies in somatosensory feedback may contribute to the poorer postural control demonstrated by PD individuals. However, few studies have comprehensively explored differences in somatosensory function and postural control between PD participants and healthy older individuals. The soles of the feet contain many cutaneous mechanoreceptors that provide important somatosensory information sources for postural control. Different types of insole devices have been developed to enhance this somatosensory information and improve postural stability, but these devices are often too complex and expensive to integrate into daily life. Textured insoles provide a more passive intervention that may be an inexpensive and accessible means to enhance the somatosensory input from the plantar surface of the feet. However, to date, there has been little work conducted to test the efficacy of enhanced somatosensory input induced by textured insoles in both healthy and PD populations during standing and walking. Therefore, the aims of this thesis were to determine: 1) whether textured insole surfaces can improve postural stability by enhancing somatosensory information in younger and older adults, 2) the differences between healthy older participants and PD participants for measures of physiological function and postural stability during standing and walking, 3) how changes in somatosensory information affect postural stability in both groups during standing and walking; and 4), whether textured insoles can improve postural stability in both groups during standing and walking. To address these aims, Study 1 recruited seven older individuals and ten healthy young controls to investigate the effects of two textured insole surfaces on postural stability while performing standing balance tests on a force plate. Participants were tested under three insole surface conditions: 1) barefoot; 2) standing on a hard textured insole surface; and 3), standing on a soft textured insole surface. Measurements derived from the centre of pressure displacement included the range of anterior-posterior and medial-lateral displacement, path length and the 90% confidence elliptical area (C90 area). Results of study 1 revealed a significant Group*Surface*Insole interaction for the four measures. Both textured insole surfaces reduced postural sway for the older group, especially in the eyes closed condition on the foam surface. However, participants reported that the soft textured insole surface was more comfortable and, hence, the soft textured insoles were adopted for Studies 2 and 3. For Study 2, 20 healthy older adults (controls) and 20 participants with Parkinson’s disease were recruited. Participants were evaluated using a series of physiological assessments that included touch sensitivity, vibratory perception, and pain and temperature threshold detection. Furthermore, nerve function and somatosensory evoked potentials tests were utilized to provide detailed information regarding peripheral nerve function for these participants. Standing balance and walking were assessed on different surfaces using a force plate and the 3D Vicon motion analysis system, respectively. Data derived from the force plate included the range of anterior-posterior and medial-lateral sway, while measures of stride length, stride period, cadence, double support time, stance phase, velocity and stride timing variability were reported for the walking assessment. The results of this study demonstrated that the PD group had decrements in somatosensory function compared to the healthy older control group. For electrodiagnosis, PD participants had poorer nerve function than controls, as evidenced by slower nerve conduction velocities and longer latencies in sural nerve and prolonged latency in the P37 somatosensory evoked potential. Furthermore, the PD group displayed more postural sway in both the anterior-posterior and medial-lateral directions relative to controls and these differences were increased when standing on a foam surface. With respect to the gait assessment, the PD group took shorter strides and had a reduced stride period compared with the control group. Furthermore, the PD group spent more time in the stance phase and had increased cadence and stride timing variability than the controls. Compared with walking on the firm surface, the two groups demonstrated different gait adaptations while walking on the uneven surface. Controls increased their stride length and stride period and decreased their cadence, which resulted in a consistent walking velocity on both surfaces. Conversely, while the PD patients also increased their stride period and decreased their cadence and stance period on the uneven surface, they did not increase their stride length and, hence walked slower on the uneven surface. In the PD group, there was a strong positive association between decreased somatosensory function and decreased clinical balance, as assessed by the Tinetti test. Poorer somatosensory function was also strongly positively correlated with the temporospatial gait parameters, especially shorter stride length. Study 3 evaluated the effects of manipulating the somatosensory information from the plantar surface of the feet using textured insoles in the same populations assessed in Study 2. For this study, participants performed the standing and walking balance tests under three footwear conditions: 1) barefoot; 2) with smooth insoles; and 3), with textured insoles. Standing balance and walking were evaluated using a force plate and a Vicon motion analysis system and the data were analysed in the same way outlined for Study 2. The findings showed that the smooth and textured insoles caused different effects on postural control during both the standing and walking trials. Both insoles decreased medial-lateral sway to the same level on the firm surface. The greatest benefits were observed in the PD group while wearing the textured insole. When standing under a more challenging condition on the foam surface with eyes closed, only the textured insole decreased medial-lateral sway in the PD group. With respect to the gait trials, both insoles increased walking velocity, stride length and stride time and decreased cadence, but these changes were more pronounced for the textured insoles. The effects of the textured insoles were evident under challenging conditions in the PD group and increased walking velocity and stride length, while decreasing cadence. Textured insoles were also effective in reducing the time spent in the double support and stance phases of the gait cycle and did not increase stride timing variability, as was the case for the smooth insoles for the PD group. The results of this study suggest that textured insoles, such as those evaluated in this research, may provide a low-cost means of improving postural stability in high-risk groups, such as people with PD, which may act as an important intervention to prevent falls.

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Description ‘The second volume of the Handbook on the Knowledge Economy is a worthy companion to the highly successful original volume published in 2005, extending its theoretical depth and developing its coverage. Together the two volumes provide the single best work and reference point for knowledge economy studies. The second volume with fifteen original essays by renowned scholars in the field, provides insightful and robust analyses of the development potential of the knowledge economy in all its aspects, forms and manifestations.’ – Michael A. Peters, University of Illinois, US

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Abstract: This study explores the contradictions and ambivalences experienced by a working artist at a time when her age, her gender, and broader cultural shifts are all potential obstacles or liabilities to creative flourishing. It is the product of practice-led research into the creative process from the perspective of the female "late bloomer". In this phrase, I have in mind the mature-aged woman who is, in mid-life, suddenly seized with inspiration and fired with creative energy. At its heart is the question: If an Elizabeth Jolley were in our midst today, would we hear from her? The result is a full-length libretto and accompanying exegetical binoculars in the form of a Preface and an Afterword. The creative work, Things That Fall Over (TTFO) is conceived in two parts: a libretto and oratorio for performance. It begins as a play, but over three acts and into a coda, the work becomes something entirely other - an (anti-) musical. The work grew from a personal interest in the nexus between women, ageing and creative practice, via investigation into the oeuvre of two Australian artists, Elizabeth Jolley, author, first published at age 53, and Rosalie Gascoigne, sculptor, first exhibited at 58. A second strand of the research grew from a fascination for the stage musical, especially in its more alternative modes as in the hands of Stephen Sondheim, or in more provocative manifestations as witnessed in recent Tony Award winners Avenue Q and The Book of Mormon. Contextually, this research is conducted at a time when anecdotal evidence suggests that women’s work in the performing arts and in literature is being pushed to the margins after a late twentieth century Golden Age on page and stage. Using hybrid practice-led methodologies - bricolage, log-keeping - and working within queer and feminist paradigms, this study seeks to counter that push with a new work that is all-female, part-pantomime, part monstrous allegory. In illuminating the creative process of a mature-aged playwright it concludes that hybrid and interstitial forms still offer an inclusive and democratic space in which voices that may otherwise be muted will continue to be heard.

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Drawing on the work of Ian Hunter the authors argue that literary education continues a tradition of circularity of argument derived from the humanities. They propose that the school subject, English in all of its apparently different historical manifestations focuses on the ideals of self-discovery and freedom of expression through literary study. The idea that literary interpretation or the production of specific readings is a skill that is taught in English classrooms challenges traditional understandings of literary study as a means for uncovering or revealing that which is hidden – be it the secrets of the text (or society or culture) or the secrets of the self – in order to come to a fuller realisation of culture and the self. Using examples from their previous work in developing activities for use with students in English classrooms the authors explore what it means to produce one’s ‘own reading’ of a text.

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Research background: For decades the Chuck Taylor All Star basketball shoe (first designed in 1921 by Converse, an American shoe company), has been an iconic item of fashion apparel, particularly for the youth oriented market - as a form of self expression and identify, adolescents have for generations been customising their Converse sneakers to create innovative and unique footwear. Although originally developed purely for sport, sneakers gradually crossed over into fashion and the majority of athletic shoes are now purchased for street fashion or leisure wear. Artisan Gallery (Brisbane), in conjunction with the exhibition Reboot: Function, Fashion and the Sneaker, a history of the sneaker, selected 20 designers to customise and re-design the classic Converse Chuck Taylor All Stars shoe and in doing so highlighted the diversity of forms possible for creative outcomes. As Artisan Gallery Curator Kirsten Fitzpatrick states “the ‘sports show’, designed to coincide with the Olympics, is also about exploring the sneaker as a platform for creativity... and (one) of the more bazaar creations was Dean Brough's deconstructed shoes to make men’s underwear.” The exhibition ran from 21 June – 16 August 2012: http://artisan-ideaskillproduct.blogspot.com.au/2012/06/converse-blank-canvas-project.html Research question: Even though the sneaker is a fashion item, it still is fundamentally used for foot protection and historically was aligned to ball sports, principally Basketball - as a fashion designers/practitioner how can I connect (in a whimsical manner) this history of usage for ball sports to the sneaker and re-design and re-use all the physical elements of the shoe to produce a unique wearable item of clothing - the selected medium for this challenge and experimentation was the classic archetypal men’s white boxer shorts. Artisan Statement BALLS UP - The Converse Sneaker, it’s almost impossible to imagine a better rounded item to maintain peak performance for all types of ball sports. Gentlemen, your other most precious balls also deserve this level of comfort and support to sustain the hard times – the Converse Boxer, balls up, bats out, get ready to play hard. Research contribution: The project highlighted some of the unique and diverse creative manifestations that are possible from the classic sneaker. From a fashion practitioners’ perspective, the design outcomes (men’s boxer short made from converse sneakers) demonstrated the strong association to iconic fashion apparel, and recognised the connection to wearability and comfort that is requisite in both footwear and men’s underwear. Research significance: The exhibition was viewed by in excess of 1000 people and generated exceptional media coverage and public exposure/impact. As Artisan Gallery Curator Kirsten Fitzpatrick states “20 of Brisbane's best designers were given the opportunity to customise their own Converse Sneakers, with The Converse Blank Canvas Project.” And to be selected in this category demonstrates the calibre of importance for design prominence.

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The second volume of the Handbook on the Knowledge Economy is a worthy companion to the highly successful original volume published in 2005, extending its theoretical depth and developing its coverage. Together the two volumes provide the single best work and reference point for knowledge economy studies. The second volume with fifteen original essays by renowned scholars in the field, provides insightful and robust analyses of the development potential of the knowledge economy in all its aspects, forms and manifestations.