Does rebound tonometry probe misalignment modify intraocular pressure measurements in human eyes?

Purpose. To examine the influence of positional misalignments on intraocular pressure (IOP) measurement with a rebound tonometer. Methods. Using the iCare rebound tonometer, IOP readings were taken from the right eye of 36 healthy subjects at the central corneal apex (CC) and compared to IOP measures using the Goldmann applanation tonometer (GAT). Using a bespoke rig, iCare IOP readings were also taken 2 mm laterally from CC, both nasally and temporally, along with angular deviations of 5 and 10 degrees, both nasally and temporally to the visual axis. Results. Mean IOP ± SD, as measured by GAT, was 14.7±2.5 mmHg versus iCare tonometer readings of 17.4±3.6 mmHg at CC, representing an iCare IOP overestimation of 2.7±2.8 mmHg (P<0.001), which increased at higher average IOPs. IOP at CC using the iCare tonometer was not significantly different to values at lateral displacements. IOP was marginally underestimated with angular deviation of the probe but only reaching significance at 10 degrees nasally. Conclusions. As shown previously, the iCare tonometer overestimates IOP compared to GAT. However, IOP measurement in normal, healthy subjects using the iCare rebound tonometer appears insensitive to misalignments. An IOP underestimation of <1 mmHg with the probe deviated 10 degrees nasally reached statistical but not clinical significance levels. © 2013 Ian G. Beasley et al.

Building the hybrid organisation through ERP and enterprise social software

This research traces the implementation of an information system in the form of ERP modules covering tenant and contract management in a Chinese service company. Misalignments between the ERP system specification and user needs led to the adoption of informal processes within the organisation. These processes are facilitated within an informal organisational structure and are based on human interactions undertaken within the formal organisation. Rather than to attempt to suppress the emergence of the informal organisation the company decided to channel the energies of staff involved in informal processes towards organisational goals. The company achieved this by harnessing the capabilities of what we term a hybrid ERP system, combining the functionality of a traditional (formal) ERP installation with the capabilities of Enterprise Social Software (ESS). However the company recognised that the successful operation of the hybrid ERP system would require a number of changes in organisational design in areas such as reporting structures and communication channels. A narrative provided by interviews with company personnel is thematised around the formal and informal characteristics of the organisation as defined in the literature. This leads to a definition of the characteristics of the hybrid organisation and strategies for enabling a hybrid organisation, facilitated by a hybrid ERP system, which directs formal and informal behaviour towards organisational goals and provides a template for future hybrid implementations.