Does lymphedema following breast cancer warrant clinical attention?

Secondary lymphedema (swelling) after breast cancer treatment usually develops on the hand, arm, shoulder, and/or breast on the treated side. It is commonly associated with the presence of other upper-body symptoms, such as pain and aching1; it impacts physical and psychosocial functioning and adversely influences quality of life.2 Moreover, it is considered incurable, progressive, and difficult to treat. Arguably, lymphedema is the most problematic and dreaded treatment-related complication of breast cancer.3

The impact of flooding on residential property values in England

Severe flooding throughout England in Autumn 1998 and 2000, has seen an increase in the extent of flood liable residential areas throughout England, as well as an increase in the actual levels of flood damage in all previously recognised flood prone residential areas. The increasing cost of rectifying the damage caused to residential properties from flooding has been of some concern to the residential property valuation profession and sales and leasing agency practices. However, the increasing trend in the frequency of flooding in England, combined with an increase in severity of flooding is now causing some degree of concern in the residential insurance and housing finance sectors. In order to determine and quantify the impact of flooding and flood damage on the residential property market in England, a survey of Chartered Surveyors and Chartered Real Estate Valuers has been carried out across the main flood affected counties of England. This survey will provide similar details to the research completed by Eves (1999, 2001) and Fibbens (1993) in relation to residential property flooding in Australia. This survey provides comprehensive responses in relation to the degree of flood affectation across counties, the effect of flooding on residential property values, the impact of flooding on building insurance premiums and possible difficulties in obtaining finance to purchase residential property in recognised flood areas.

Constructing quality : the Hong Kong Housing Department journey

This paper explores the ‘journey’ along the ‘never ending quality road’ undertaken by the Hong Kong Housing Department over the last 15 years. It briefly covers the early history of public housing in Hong Kong, the catalytic effect brought about by the discovery of the infamous 26 sub-standard blocks in the mid-80s leading to the subsequent major improvements to process control and structural quality in the period 1985-1990. It then moves onto a discussion of initiatives taken since 1991, including the formation of the List of Building Contractors and the implementation of the Performance Assessment Scoring System (PASS). The paper ends with a discussion of the current status of quality issues within the Department and touches on future initiatives being developed to further enhance the quality of public housing in Hong Kong.

Patterns of fitting cosmetically tinted contact lenses

Cosmetically tinted soft contact lenses are an attractive option for contact lens wearers. Data that we have gathered from annual contact lens fitting surveys demonstrate that those wearing tinted lenses are more likely to be female (4.6% of all soft lenses fitted vs. 1.6% for males; p < 0.0001) and younger (27 11 years vs. 33 13 years for those wearing non-tinted lenses; p < 0.0001). Tinted lenses tend to be worn more on a part-time basis and are replaced less frequently than non-tinted lenses. The decline in fitting tinted lenses over the past 12 years may be due to (a) the current limited availability of tinted lenses in silicone hydrogel materials and daily disposable replacement frequencies, which together represent a significant majority (78%) of new soft lenses fits today, (b) growing concerns among lens wearers and practitioners relating to the risks of complications associated with the wearing of tinted lenses, and (c) reduced promotion of such lenses by the contact lens industry.

The studio sans frontières : the open-studio as an answer to the challenges of teaching contemporary art

Since at least the 1960s, art has assumed a breadth of form and medium as diverse as social reality itself. Where once it was marginal and transgressive for artists to work across a spectrum of media, today it is common practice. In this ‘post-medium’ age, fidelity to a specific branch of media is a matter of preference, rather than a code of practice policed by gallerists, curators and critics. Despite the openness of contemporary art practice, the teaching of art at most universities remains steadfastly discipline-based. Discipline-based art teaching, while offering the promise of focussed ‘mastery’ of a particular set of technical skills and theoretical concerns, does so at the expense of a deeper and more complex understanding of the possibilities of creative experimentation in the artist’s studio. By maintaining an hermetic approach to medium, it does not prepare students sufficiently for the reality of art making in the twenty-first century. In fact, by pretending that there is a select range of techniques fundamental to the artist’s trade, discipline-based teaching can often appear to be more engaged with the notion of skills preservation than purposeful art training. If art schools are to survive and prosper in an increasingly vocationally-oriented university environment, they need to fully synthesise the professional reality of contemporary art practice into their approach to teaching and learning. This paper discusses the way in which the ‘open’ studio approach to visual art study at QUT endeavours to incorporate the diversity and complexity of contemporary art while preserving the sense of collective purpose that discipline-based teaching fosters. By allowing students to independently develop their own art practices while also applying collaborative models of learning and assessment, the QUT studio program aims to equip students with a strong sense of self-reliance, a broad awareness and appreciation of contemporary art, and a deep understanding of studio-based experimentation unfettered by the boundaries of traditional media: all skills fundamental to the practice of contemporary art.

Corneal confocal microscopy : a novel noninvasive means to diagnose neuropathy in patients with Fabry disease

ABSTRACT: Neuropathy is a cause of significant disability in patients with Fabry disease, yet its diagnosis is difficult. In this study we compared the novel noninvasive techniques of corneal confocal microscopy (CCM) to quantify small-fiber pathology, and non-contact corneal esthesiometry (NCCA) to quantify loss of corneal sensation, with established tests of neuropathy in patients with Fabry disease. Ten heterozygous females with Fabry disease not on enzyme replacement therapy (ERT), 6 heterozygous females, 6 hemizygous males on ERT, and 14 age-matched, healthy volunteers underwent detailed quantification of neuropathic symptoms, neurological deficits, neurophysiology, quantitative sensory testing (QST), NCCA, and CCM. All patients with Fabry disease had significant neuropathic symptoms and an elevated Mainz score. Peroneal nerve amplitude was reduced in all patients and vibration perception threshold was elevated in both male and female patients on ERT. Cold sensation (CS) threshold was significantly reduced in both male and female patients on ERT (P < 0.02), but warm sensation (WS)and heat-induced pain (HIP) were only significantly increased in males onERT (P<0.01). However, corneal sensation assessed withNCCAwas significantly reduced in female (P < 0.02) and male (P < 0.04) patients on ERT compared with control subjects. According to CCM, corneal nerve fiber and branch density was significantly reduced in female (P < 0.03) and male (P < 0.02) patients on ERT compared with control subjects. Furthermore, the severity of neuropathic symptoms and the neurological component of the Mainz Severity Score Index correlated significantly with QSTand CCM. This study shows that CCM and NCCA provide a novel means to detect early nerve fiber damage and dysfunction, respectively, in patients with Fabry disease.

Factors influencing the prescribing of hydrogel contact lenses

Despite the current market popularity of silicone hydrogel contact lenses, conventional hydrogel lenses still represent a significant proportion of the overall contact lens market. Data gathered from annual UK contact lens fitting surveys over the past 13 years indicate that 64% of hydrogel lenses prescribed during this period were of low/medium water content (<60% water). Whereas, in the past, practitioners would choose the water content of a hydrogel lens to meet specific clinical needs, this choice appears today to be largely governed by product availability.

Performance of public private partnerships : an evolutionary perspective

PPPs are held to be a powerful way of mobilising private finance and resources to deliver public infrastructure. Theoretically, research into procurement has begun to acknowledge difficulties with the classification and assessment of different types of procurement, particularly those which do not sufficiently acknowledge variety within specific types of procurement methods. This paper advances a theoretical framework based on an evolutionary economic conceptualisation of a routine, which can accommodate the variety evident in procurement projects, in particular PPPs. The paper tests how the various elements of a PPP, as advanced in the theoretical framework, affect performance across 10 case studies. It concludes, that a limited number of elements of a PPP affect their performance, and provides strong evidence for the theoretical model advanced in this paper.

Assessing organizational culture? value management to the rescue

As part of a Doctor of Business Administration degree programme jointly run by Curtin University, Perth, Australia and Lingnan University, Hong Kong, a research thesis relating organizational effectiveness to the organizational culture of Hong Kong construction firms involved in public housing is being undertaken. Organizational effectiveness is measured by the Housing Department (HD) Performance Assessment Scoring System (PASS) and organizational culture traits and strengths have been measured by using the Denison Organizational Culture Survey (OCS), developed by Daniel Denison and William S. Neale and based on 16 years of research involving over 1,000 organizations. The PASS scores of building contractors are compared with the OCS scores to determine if there is any significant correlation between highly effective companies and particular organizational strengths and traits. Profiles are then drawn using the Denison Model and can be compared against ‘norms’ for the industry sector on which the survey has been carried out. The next stage of the work is to present the results of the survey to individual companies, conduct focus group interviews to test the results, discover more detail on that company’s culture and discuss possible actions based on the results. It is in this latter stage that certain value management techniques may well prove very useful.

Exploring the impact of context-specific job stressors on employee work outcomes

A path model was developed to examine the impact of context-specific job stressors on the work outcomes of 132 customer service employees. Respondents who reported a moderate and high level of context-specific stressors report a higher level of job demand and work family conflict. Respondents who reported a higher level of job control tend to receive more work-related support and are more satisfied with their job. Surprisingly, respondents who experienced a higher level of work family conflict tend to receive less work-related support. We found that respondents who obtained more work-related support tend to report a higher level of job satisfaction. There was also a positive relationship between positive job satisfaction and a lower level of intention to quit.

Frameworks in regulating company directors : rethinking the philosophical foundations to enhance accountability

Sets out a system of corporate governance regulation, aimed at combining legal and social methods of governing director behaviour and at creating a framework flexible enough to accommodate different business and ethical cultures. Outlines the theoretical basis of corporate governance and the broad responsibilities of directors, and discusses the extent to which they can and should be regulated. Discusses the constitution of a regulatory framework encompassing law, soft law and best practice, and ethics.

New Approach on Robust Delay-Dependent H∞ Control for Uncertain T-S Fuzzy Systems With Interval Time-Varying Delay

This paper investigates the robust H∞ control for Takagi-Sugeno (T-S) fuzzy systems with interval time-varying delay. By employing a new and tighter integral inequality and constructing an appropriate type of Lyapunov functional, delay-dependent stability criteria are derived for the control problem. Because neither any model transformation nor free weighting matrices are employed in our theoretical derivation, the developed stability criteria significantly improve and simplify the existing stability conditions. Also, the maximum allowable upper delay bound and controller feedback gains can be obtained simultaneously from the developed approach by solving a constrained convex optimization problem. Numerical examples are given to demonstrate the effectiveness of the proposed methods.

Subjective fit with organizational culture : an investigation of moderating effects in the work stressor-employee adjustment relationship

Occupational stress has been a concern for human resource managers in light of research investigating the work stressor-employee adjustment relationship. This research has consistently demonstrated many negative effects between stressors in the workplace and employee adjustment. A considerable amount of literature also describes potential moderators of this relationship. Subjective fit with organizational culture has been established as a significant predictor of employee job-related attitudes; however, research has neglected investigation of the potential moderating effect of subjective fit in the work stressor-employee adjustment process. It was predicted that perceptions of subjective fit with the organization’s values and goals would mitigate the negative effect of work stressors on employee adjustment in an employee sample from three organizations (N ¼ 256). Hierarchical multiple regression analyses revealed support for the stress-buffering effects of high subjective fit in the prediction of physical symptoms, job satisfaction, and intentions to leave. The theoretical and practical implications of the results are discussed.

Changing the rules in use? An examination of social enterprise in local governance

As multi-stakeholder entities that explicitly inhabit both social and economic domains, social enterprises pose new challenges and possibilities for local governance. In this paper, we draw on new institutional theory to examine the ways in which locally-focused social enterprises disrupt path dependencies and rules in use within local government. Rather than examining the more commonly asked question of the influence of the state on social enterprise, our purpose here is to examine the impacts of social enterprise on governmental institutions at the local level. Our discussion is based on a mixed-methods study, including an online survey of 66 local government staff, document analysis, and in-depth interviews with 24 social enterprise practitioners and local government actors working to support social enterprise development in Victoria, Australia. We find that, in some instances, the hybrid nature of social enterprise facilitates ‘joining up’ between different functional areas of local government. Beyond organisational relationships, social enterprise also influences local governance through the reinterpretation and regeneration of institutionalised public spaces.