IT and the NHS: Investigating different perspectives of IT using soft systems methodology

The UK NHS National Programme for IT has been criticized for a lack of clinical engagement. This paper uses a soft systems methodology (SSM) analysis of a case study from the use of electronic systems within a National Health Service (NHS) Mental Health Trust in the United Kingdom (UK) to explore the legal and ethical implications of the failure to develop clinical systems which are fit for purpose. Soft systems methodology (SSM) was used as a theoretical model both to derive deeper insights into the survey data and suggest how communication between those producing information and those using it, could be improved. Multiple methods were employed which included a postal survey and participant interviews to triangulate the data The use of SSM reinforced the concept that the national IT programme is based on a 'hard' systems view and does not take local factors (which are related to 'soft systems' thinking) into account. The study found administrative staff to be a crucial link between clinicians and information departments and highlighted the need for a joint-up information strategy and integrated systems. The article concludes with a discussion of the legal and ethical implications of the findings and the lessons for the broader UK national programme. It argues that the failure to deliver systems that are fit for purpose is not value neutral but an ethical issue

A holistic multi-methodology for sustainable renovation

A review of the barriers for building renovation has revealed a lack of methodologies, which can promote sustainability objectives and assist various stakeholders during the design stage of building renovation/retrofitting projects. The purpose of this paper is to develop a Holistic Multi-methodology for Sustainable Renovation, which aims to deal with complexity of renovation projects. It provides a framework through which to involve the different stakeholders in the design process to improve group learning and group decision-making, and hence make the building renovation design process more robust and efficient. Therefore, the paper discusses the essence of multifaceted barriers in building renovation regarding cultural changes and technological/physical changes. The outcome is a proposal for a multi-methodology framework, which is developed by introducing, evaluating and mixing methods from Soft Systems Methodologies (SSM) with Multiple Criteria Decision Making (MCDM). The potential of applying the proposed methodology in renovation projects is demonstrated through a case study

Systemic intervention for computer-supported collaborative learning

This paper presents a systemic intervention approach as a means to overcome the methodological challenges involved in research into computer-supported collaborative learning applied to the promotion of mathematical problem-solving (CSCL-MPS) skills in schools. These challenges include how to develop an integrated analysis of several aspects of the learning process; and how to reflect on learning purposes, the context of application and participants' identities. The focus of systemic intervention is on processes for thinking through whose views and what issues and values should be considered pertinent in an analysis. Systemic intervention also advocates mixing methods from different traditions to address the purposes of multiple stakeholders. Consequently, a design for CSCL-MPS research is presented that includes several methods. This methodological design is used to analyse and reflect upon both a CSCL-MPS project with Colombian schools, and the identities of the participants in that project

Regulatory T cells in melanoma revisited by a computational clustering of FOXP3+ T cell subpopulations

CD4+ T cells that express the transcription factor FOXP3 (FOXP3+ T cells) are commonly regarded as immunosuppressive regulatory T cells (Treg). FOXP3+ T cells are reported to be increased in tumour-bearing patients or animals, and considered to suppress anti-tumour immunity, but the evidence is often contradictory. In addition, accumulating evidence indicates that FOXP3 is induced by antigenic stimulation, and that some non-Treg FOXP3+ T cells, especially memory-phenotype FOXP3low cells, produce proinflammatory cytokines. Accordingly, the subclassification of FOXP3+ T cells is fundamental for revealing the significance of FOXP3+ T cells in tumour immunity, but the arbitrariness and complexity of manual gating have complicated the issue. Here we report a computational method to automatically identify and classify FOXP3+ T cells into subsets using clustering algorithms. By analysing flow cytometric data of melanoma patients, the proposed method showed that the FOXP3+ subpopulation that had relatively high FOXP3, CD45RO, and CD25 expressions was increased in melanoma patients, whereas manual gating did not produce significant results on the FOXP3+ subpopulations. Interestingly, the computationally-identified FOXP3+ subpopulation included not only classical FOXP3high Treg but also memory-phenotype FOXP3low cells by manual gating. Furthermore, the proposed method successfully analysed an independent dataset, showing that the same FOXP3+ subpopulation was increased in melanoma patients, validating the method. Collectively, the proposed method successfully captured an important feature of melanoma without relying on the existing criteria of FOXP3+ T cells, revealing a hidden association between the T cell profile and melanoma, and providing new insights into FOXP3+ T cells and Treg

Tourism to religious sites, case studies from Hungary and England: exploring paradoxical views on tourism, commodification and cost–benefits

The application of systems theory to tourism development has a pedigree that has largely been derived from econometrics and macro–economic theory (Baggio et al., 2010; Franch et al., 2010; Choi and Sirakaya, 2006; Schianetz and Kavanagh, 2007, 2008; Dwyer et al., 2010). This paper identifies opportunities and some barriers to developing sites of religious worship for tourism to maximise income and engage appropriate resources allocation strategies. The authors have investigated tourism development that is sympathetic to sacred purposes at these sites over several years. Religious sites are now acknowledging that homogeneous supply responses may no longer be appropriate. Each special site demands a heterogeneous response of site guardians to changeable demand and careful evaluation of how to maximise income generated from very limited resources. This necessitates improved skills in guardians to build appropriate point of sale products and services that fit with consumption expectations and are congruent with sacred purpose

The role of user requirements research in medical device development

Aims and Objectives: This research aims to suggest a concise framework to help in the better conceptualisation and integration of users in the medical device development (MDD) process. The current economic, political and social climate concerning the matter of healthcare delivery has resulted in the emergence of numerous users and user groups for whom the healthcare system has not previously catered for. These users have created ambiguity for the designers and manufacturers of medical devices as the boundaries between their needs and requirements have blurred, outdating current methods of MDD to meet consumer needs. Research Design and Methodology: The research methodology begins primarily with conducting a literature search on the theories relating to user requirements and medical device development. The paper outlines these findings through initially describing users and user involvement and relating them to medical devices. The cross-disciplinary nature of healthcare influenced the investigation into multiple disciplines including; IT, Ergonomics – particularly participatory research, Psychology and Design. These disciplines expose various methods and processes, which are useful to user requirements research. These methods were analysed for their compatibility, and then used to construct a conceptual framework for user involvement in MDD. Results: The research insinuates the true significance of user involvement and hence resulted in the formation of a conceptual framework to aid user involvement in the MDD process. The framework is produced by the amalgamation of relevant methods examined across the disciplines, in a complimentary fashion. Conclusion: The originality of this research lies in its use of a multidisciplinary approach. Previous research claiming multi-methods has dealt with combining two disciplines or methods at a time i.e. Computer supported cooperative work (CSCW) with participatory research (Scandurra et al, 2008) for the needs analysis of healthcare professionals only. Collaboration across disciplines has also been investigated (Johnson et al, 2005), but this was for the purpose of redesign rather than initial designs. This framework can help medical device designers to fully access all user requirements through more extensive collaboration right at the start. It reduces the risk of high costs involved in device rejection, usually associated with belated recognition of user needs in the design cycle

Holding the Supervisor to Account: The European Parliament and the European Central Bank in Banking Supervision. Bertelsmann Stiftung Policy Paper 19 November 2018

In the aftermath of the euro crisis, the European Central Bank (ECB) took over responsibilities for banking supervision in the euro area in the framework of the Single Supervisory Mechanism (SSM). This expansion of the original ECB mandate in monetary policy was coupled with the establishment of additional accountability mechanisms to balance the newly acquired competences. In terms of political accountability, the relationship with the European Parliament (EP) was placed front and centre — with regular interactions between the two institutions since late 2013. This paper analyses the accountability interactions between the EP’s Economic and Monetary Affairs (ECON) Committee and ECB Banking Supervision in the first 4.5 years of the functioning of the SSM. In particular, it aims to: 1) situate the relationship between the ECB and the EP in the broader context of political accountability in banking supervision; 2) provide an overview of the frequency and patterns of interactions between the two institutions, describing types of questions asked and answers provided; and 3) identify strengths and weaknesses in the process, with a forward-looking focus on prospects for improvement

Metrics for ranking ontologies

Representing knowledge using domain ontologies has shown to be a useful mechanism and format for managing and exchanging information. Due to the difficulty and cost of building ontologies, a number of ontology libraries and search engines are coming to existence to facilitate reusing such knowledge structures. The need for ontology ranking techniques is becoming crucial as the number of ontologies available for reuse is continuing to grow. In this paper we present AKTiveRank, a prototype system for ranking ontologies based on the analysis of their structures. We describe the metrics used in the ranking system and present an experiment on ranking ontologies returned by a popular search engine for an example query