Prometheus

Journal Name: Prometheus: Volume 21, Number 2, June 2003

Online ISSN: 1470-1030, Print ISSN: 0810-9028

Papers

Patient Power? Medical Perspectives on Patient Use of the Internet (pp145-160)
JENNIFER TANN (Director of the Innovation Management Research Unit, Business School, University of Birmingham, England), ADRIAN PLATTS (The Innovation Management Reseach Unit), SARAH WELCH ( The Women in Psychiatry Group, Royal College of Psychiatrists, England) & JUDY ALLEN (The Innovation Management Research Unit)
ABSTRACT:
Patients and carers now have unprecedented access to health information via specialist journals and the popular media, while the worldwide web has revolutionised public access to clinical information. Levels of patient demand for information about health have grown and there is evidence to suggest that patients wish to receive more information than is sometimes currently provided by clinicians. In secondary care, some specialisms have more readily adopted the use of information communication technologies (ICT) in clinician/patient communication than others. This paper focuses on clinicians' perceptions of client internet use for psychiatric conditions and studies the influence this has had on the consultation process in the United Kingdom. The research method consisted of a postal questionnaire distributed to the members of the Women in Psychiatry Group on the register of the Royal College of Psychiatry. Telephone interviews were conducted, employing the critical incident method, as well as a brief additional questionnaire. The data show that psychiatrists who used the Internet discerned client usage more readily. Where the client sought to discuss information acquired electronically with the consultant this tended to extend the consultation period, but a number of psychiatrists reported a greater sense of partnership as a result. The paper explores consultant perceptions of client motivations for Internet use and the perceived advantages and disadvantages for both client and psychiatrist. Overall, the psychiatry profession appears to be following the lead of clients in the use of ICT. Policy recommendations are offered with respect to the provision of profession-validated information on the Internet and psychiatrists' training in IT.
Keywords: ICT, Internet, psychiatrists, clients, consultation.

Sporadic Innovation and Historical Continuity (pp161-175)
J. L. ENOS (Fellow, of Magdalen College, Oxford and Visiting Professor, University of California, Davis)
ABSTRACT:
This article argues that, by appealing to technological factors, one can compare different innovations, even different economies, over time. An application is made to the development of steam engines and turbines over their history from 1700 to 2000, for which it is shown that four types of physical variables – temperatures, pressures, thermal efficiencies and power ratings – provide common measures of succeeding devices. Such measures can be incorporated in a technological analogue of an input-output system. In principle, an entire economy could be represented in technological form; and, since scientific variables are invariant through time, its evolution could be depicted in quantitative terms.

Telecommunication Basic Research: An Uncertain Future for the Bell Legacy (pp177-193)
A. MICHAEL NOLL (Professor of Communications, Annenberg School of Communications, University of Southern California, Los Angeles)
ABSTRACT:
The Bell Labs of decades ago was well recognized as a national treasure for its pioneering innovations and its creation of new knowledge. However, the breakup of the Bell System that occurred in 1984 resulted in considerable change for research and development in telecommunication. This paper reviews that history and, in anticipation of continuing uncertainty and a possible impending crisis, examines possible options for the future to assure leadership by the United States in basic research in telecommunication.
Keywords: research, Bell Labs, AT&T Labs, R&D, basic research, telecommunication research.

The Viagra Files: The Web as Anticipatory Medium (pp195-212)
RICHARD ROGERS (Assistant Professor in Media Studies, University of Amsterdam and Visiting Professor in the Philosophy and Social Study of Science, University of Vienna)
ABSTRACT:
The article introduces the research behind the making of Viagratool. org, the Lay Decision Support System on the World Wide Web. Viagratool.org is a 'web knowledge instrument' made to provide realities about a drug, available by searching, form-filling, online prescription, e-commerce and the post. Collaborative filtering, made famous by the disciples of Vannevar Bush, is used to ascertain information about Viagra. As we found with the aid of a group of collaborative filterers. Viagra comes across on the Web as a party drug, with distinct user groups – clubbers, sex tourists and others – not addressed by more official information providers – regulatory bodies, the medical industry or the manufacturer. Presented here are the findings that have led to two versions of the support system, one for the potential Viagra consumer, and another for the often overlooked second and third parties caught up in ‘Viagra situations’. In the first system, the collaborative filters found and kept information about its marketing (and re-selling), its serious harm in cocktail dosages, and insider accounts provided by seasoned aphrodisiac and other lifestyle drug users. The information is displayed in thought trajectories, each asking whether to consume it, from different angles. Importantly, the system is not a consumer-to-consumer information service or pure cohort support service. Rather, it allows a consumer to hear about Viagra from the marketeer, the emergency room medic, the humorist, and the user of Viagra and Viagra substitutes. Each could play a part in the Viagra decision. In the second version, we present Viagra situations, quite remote from the placid beach scenes with loving couples (on the Pfizer website), or a jogging Bob Dole, as seen on TV. Here, we move closer to employing the Web as an anticipatory medium by first resurrecting the second parties in Viagra situations, different from those in 'normal, loving' relationships. Finally, we call into existence third party observers, friends, onlookers, anticipating darker Viagra usage scenarios that are un available in the more official discourse.Keywords: anticipatory medium, collaborative filtering, knowledge itineraries, Viagra, Web.

The Hegemony of Microsoft®: An Australian Story (pp213-230)
KATHRYN MOYLE (E-Schooling Service Manager, Department of Education and Children’s Services, Government of South Australia)
ABSTRACT:
Each Australian state and the Australian Capital Territory has signed a 'whole of education department' contract with the Microsoft® Corporation for the provision of operating systems and other software. This contracted use of Microsoft® products is one story where the purchase of specific commodities is directly connected to the provision of public schooling. It is argued that through these contracts Microsoft® exercises a hegemonic relationship with the schooling systems in Australia. The legal relationships that exist between Microsoft® Corporation and the respective Australian states and territories schooling systems seem to mutually maintain and reinforce the monopolistic, or at best, oligopolistic position of Microsoft® Corporation and its hegemony over Australian public schooling. Further, it is argued that Microsoft's® hegemonic position in part is maintained by both establishing a 'commonsense' about its products and by receiving legitimation and authority through the State for its products used in Australian schools.
Keywords: Microsoft®, hegemony, Australian public schooling, narrative.

Phenomenological Turbulence and Innovation in Knowledge Systems (pp231-245)
GREG HEARN (Director of New Research, Creative Industries Faculty, Queensland University of Technology, Brisbane, Australia), DAVID ROONEY (Associate Director of the Cntre for Social Research in Communication and Senior Lecturer, UQ Business School, University of Queensland, Ipswich Campus, Queensland, Australia) & THOMAS MANDEVILLE (Senior Lecturer, Department of Economics, University of Queensland, St Lucia, Australia)
ABSTRACT:
Most considerations of knowledge management focus on corporations and, until recently, considered knowledge to be objective, stable, and asocial. In this paper we wish to move the focus away from corporations, and examine knowledge and national innovation systems. We argue that the knowledge systems in which innovation takes place are phenomenologically turbulent, a state not made explicit in the change, innovation and socio-economic studies of knowledge literature, and that this omission poses a serious limitation to the successful analysis of innovation and knowledge systems. To address this lack we suggest that three evolutionary processes must be considered: self-referencing, self-transformation and self-organisation. These processes, acting simultaneously, enable system cohesion, radical innovation and adaptation. More specifically, we argue that in knowledge-based economies the high levels of phenomenological turbulence drives these processes. Finally, we spell out important policy principles that derive from these processes.
Keywords: complexity theory, knowledge management; knowledge systems; public policy; self-organisation; self-referencing; self-transformation.