Creativity, requirements and perspectives

Is there room for more creativity in information systems? This article grew out of an AWRE'04 panel discussion on creativity in requirements engineering, and the impact of requirements engineering on creativity in systems engineering and systems use. Both panel and article were motivated by the goal of identifying a framework for understanding creativity in a larger context and thus establishing a potential structure for future research. The authors' research backgrounds differ widely and, at times, our views conflict occasionally, quite sharply. We make underlying world views - our own and those of relevant disciplines - explicit; identify the paradox caused by the need to be functionally creative while leaving room for creativity in successive stages; and argue for a multi paradigm framework for resolving this paradox.

Disease fingerprinting with cDNA microarrays reveals distinct gene expression profiles in lethal type 1 and type 2 cytokine-mediated inflammatory reactions

Development of polarized immune responses controls resistance and susceptibility to many microorganisms. However, studies of several infectious, allergic, and autoimmune diseases have shown that chronic type-1 and type-2 cytokine responses can also cause significant morbidity and mortality if left unchecked. We used mouse cDNA microarrays to molecularly phenotype the gene expression patterns that characterize two disparate but equally lethal forms of liver pathology that develop in Schistosoma mansoni infected mice polarized for type-1 and type-2 cytokine responses. Hierarchical clustering analysis identified at least three groups of genes associated with a polarized type-2 response and two linked with an extreme type-1 cytokine phenotype. Predictions about liver fibrosis,  apoptosis, and granulocyte recruitment and activation generated by the microarray studies were confirmed later by traditional biological assays. The data show that cDNA microarrays are useful not only for determining  coordinated gene expression profiles but are also highly effective for molecularly “fingerprinting” diseased tissues. Moreover, they illustrate the potential of genome-wide approaches for generating comprehensive views on the molecular and biochemical mechanisms regulating infectious  disease pathogenesis.

Using competencies in human resource management : case studies in Australian companies

This study investigated the use of competencies for human resource management in seven Australian companies. Despite advocacy for the use of competencies by Government Committees and Task Forces (For example Carmichael (1992), Mayer, (1992) and Karpin, 1995), and the existence of competency standards for eighty per cent of the Australian workforce, the competency approach has not been widely adopted. A review of the literature indicated that the term competency had several meanings with different implications for its use depending on the meaning. The study looked at how individuals have defined the term and applied the approach to human resource management practices. Interviews were conducted with Human Resource and Training managers, and operative staff in companies using competencies. How they defined the term, described the rationale for using competencies, and applied competencies to selection, training, performance appraisal and remuneration were determined. Case studies were written for each company to describe their particular application of competencies. Competencies were found to be defined in several ways by those interviewed. Some advantages of using competencies in human resource management applications were found. The amount of work involved in introducing the competency approach was described as a reason why competencies have not been more widely adopted.

Getting your life back on track after stroke : a phase II multi-centered, single-blind, randomized, controlled trial of the Stroke Self-Management Program vs. the Stanford Chronic Condition Self-Management Program or standard care in stroke survivors

Background Self-management is seen as a primary mechanism to support the optimization of care for people with chronic diseases such as symptomatic vascular disease. There are no established and evidence-based stroke-specific chronic disease self-management programs. Our aim is to evaluate whether a stroke-specific program is safe and feasible as part of a Phase II randomized-controlled clinical trial.
Methods Stroke survivors are recruited from a variety of sources including: hospital stroke services, local paper advertisements, Stroke South Australia newsletter (volunteer peer support organization), Divisions of General Practice, and community service providers across Adelaide, South Australia. Subjects are invited to participate in a multi-center, single-blind, randomized, controlled trial. Eligible participants are randomized to either;
• standard care,
• standard care plus a six week generic chronic condition self-management group education program, or,
• standard care plus an eight week stroke specific self-management education group program.
Interventions are conducted after discharge from hospital. Participants are assessed at baseline, immediate post intervention and six months.
Study Outcomes The primary outcome measures determine study feasibility and safety, measuring, recruitment, participation, compliance and adverse events.
Secondary outcomes include:
• positive and active engagement in life measured by the Health Education Impact Questionnaire,
• improvements in quality of life measured by the Assessment of Quality of Life instrument,
• improvements in mood measured by the Irritability, Depression and Anxiety Scale,
• health resource utilization measured by a participant held diary and safety.

Conclusion The results of this study will determine whether a definitive Phase III efficacy trial is justified.

Declining woodland birds - Is our science making a difference?

Recent data from the Red List of the International Union for the Conservation of Nature show that 1240 of the world’s estimated 10 027 species of birds (12.4%) are listed as threatened (Hoffmann et al. 2010). Globally, many more are ‘declining’ in conservation status. In Europe, much attention has been given to the marked decline in the abundance and distributional extent of farmland birds associated with the intensification of agricultural production (Fuller et al. 1995; Donald et al. 2001). Recent analyses suggest woodland species alsomaynowbe experiencing significant declines (e.g. Hewson et al. 2007). In the Americas, the declining status of neotropical migrants has motivated considerable research over the last 30 years (e.g. Terborgh 1989; Robinson and Wilcove 1994). In the tropics, narrowly endemic land birds have been identified as those species most at risk of decline globally in coming decades owing to projected changes in land-use (Jetz et al. 2007). Particular taxonomic groups also are experiencing marked declines. Migratory shorebirds, for example, which depend on key stop-over sites for refuelling during intercontinental migration, are particularly vulnerable to the degradation and destruction of these sites (Barter 2002; Rogers et al. 2010). Such widespread change among the world’s avifauna has profound implications for global biodiversity, ecosystem function and the provision of ecosystem services (Sekercioglu 2006).

A phase II multicentered, single-blind, randomized, controlled trial of the stroke self-management program

Background and Purpose—The benefits of chronic disease self-management programs for stroke survivors are uncertain because individuals with severe impairments have been excluded from previous research. We undertook a phase II randomized controlled trial to determine whether a self-management program designed for survivors (SSMP; 8 weeks) was safe and feasible compared to standard care (control) or a generic self-management program (generic; 6 weeks).
Methods—Stroke survivors were recruited from 7 South Australian hospitals via a letter or indirectly (eg, newspapers). Eligible participants were randomized at a 1:1:1 ratio of 50 per group. Primary outcomes were recruitment, participation, and participant safety. Secondary outcomes were positive and active engagement in life using the Health Education Impact Questionnaire and characteristics of quality of life and mood at 6 months from program completion.
Results—Of 315 people screened, 149 were eligible and 143 were randomized (48 SSMP, 47 generic, 48 control); mean age was 69 years (SD, 11) and 59% were female. Demographic features were similar between groups and 41% had severe cognitive impairment; 57% accessed the interventions, with 52% SSMP and 38% generic completing >50% of sessions (P=0.18). Thirty-two participants reported adverse events (7 control, 12 generic, 13 SSMP; P=0.3; 34% severe); however, none was attributable to the interventions. Potential benefits for improved mood were found.
Conclusions—SSMP was safe and feasible. Benefits of the stroke-specific program over the generic program included greater participation and completion rates. An efficacy trial is warranted given the forecast growth in the stroke population and improved survival trends.

Microsatellite markers characterized in the barn owl (Tyto alba) and of high utility in other owls (Strigiformes: AVES)

We have identified 15 polymorphic microsatellite loci for the barn owl (Tyto alba), five from testing published owl loci and 10 from testing non-owl loci, including loci known to be of high utility in passerines and shorebirds. All 15 loci were sequenced in barn owl, and new primer sets were designed for eight loci. The 15 polymorphic loci displayed two to 26 alleles in 56–58 barn owls. When tested in 10 other owl species (n = 1–6 individuals), between four and nine loci were polymorphic per species. These loci are suitable for studies of population structure and parentage in owls.

Shared decision making: what do clinicians need to know and why should they bother?

Shared decision making enables a clinician and patient to participate jointly in making a health decision, having discussed the options and their benefits and harms, and having considered the patient's values, preferences and circumstances. It is not a single step to be added into a consultation, but a process that can be used to guide decisions about screening, investigations and treatments. The benefits of shared decision making include enabling evidence and patients' preferences to be incorporated into a consultation; improving patient knowledge, risk perception accuracy and patient-clinician communication; and reducing decisional conflict, feeling uninformed and inappropriate use of tests and treatments. Various approaches can be used to guide clinicians through the process. We elaborate on five simple questions that can be used: What will happen if the patient waits and watches? What are the test or treatment options? What are the benefits and harms of each option? How do the benefits and harms weigh up for the patient? Does the patient have enough information to make a choice? Although shared decision making can occur without tools, various types of decision support tools now exist to facilitate it. Misconceptions about shared decision making are hampering its implementation. We address the barriers, as perceived by clinicians. Despite numerous international initiatives to advance shared decision making, very little has occurred in Australia. Consequently, we are lagging behind many other countries and should act urgently.