The bright and dark sides of individual and group innovation:A Special Issue introduction

This introduction essay proposes a challenging program for researchers eager to explore factors and process mechanisms contributing to the benefits and costs individuals and groups incur from pursuing innovative approaches. With respect to individual innovation, such moderating factors might be found in the characteristics of the innovative idea, the innovator, co-workers, supervisors, the broader organizational context, and in national culture. Examples of factors that are likely to shape the beneficial and detrimental outcomes of group innovation include knowledge, skills and ability of group members, group tenure, diversity among group members, group processes (clarifying group objectives, participation, constructive management of competing perspectives), and external demands on groups. This Special Issue contains a state-of-the-science paper, three articles dealing with the benefits and costs of individual innovation, and three articles addressing the bright and dark sides of group innovation. Copyright © 2004 John Wiley & Sons, Ltd.

Management and outcome of cholesterol embolus identified in a diabetic retinopathy screening program

Purpose. We examined the incidence, management, and outcomes of patients known to be at high cardiovascular risk, and to assess whether specialist referral to an ophthalmic medical clinic is worthwhile. Methods. Patients in the East Birmingham area with cholesterolembolus who were identified on digital diabetic retinopathy screening over a 3-year period were referred to a specialist ophthalmic medicine clinic within Heart of England NHS Trust for management and investigation. Results. A total of 33 patients were referred for clinical management.(male:female = 22:11, mean age 72 years). A total of 28 patients were known to be receiving medication: 14 anti hypertensive therapy(42%), 19 aspirin (59%), and 21 statin (64%). A total of 18 patients had known cardiovascular disease, 10 of whom had received carotid stenting or coronary artery bypass surgery. Ten patients diagnosed with embolus required and consented to carotid Doppler studies. Six patients were confirmed with significant carotid stenosis and 2 (6%)of these patients required carotid endarterectomy surgery. Overall, 4patients died, a mortality rate of 12% over 3 years. Conclusions. Annual diabetic retinopathy screening provide sopportunistic identification of asymptomatic cholesterol emboli and provides an opportunity for review of medical management in the high-risk patient group with appropriate identification and referral for carotid stenosis surgery. A total of 11 patients were identified with sub optimal cardiovascular risk management: e.g., statin use.