Theorising the design-reality gap in ICTD: matters of care in mobile learning for Kenyan community health workers

This thesis examines the sociomaterial relations of “design practice” in order to advance new perspectives on success and failure in Information and Communication Technology for Development (ICTD). I conduct an ethnographic case study of an academic research intervention and update the widely-cited theory of design-reality gaps (Heeks, 2002). Using methods from classic actor-network theory and post-structural material-semiotic tools, the analysis: 1) disentangles the entwined sociomaterial practices around design, production, and use of technology; and 2) integrates these insights into more elaborate conceptualisations of gaps, sustainability, scalability, and project failure. In doing so, my study answers the research question: What are the sociomaterial relations of “design practice” in a globally-distributed, multi-stakeholder, and technologicallymediated ICTD project for poverty alleviation? My research narrative describes how an array of humans and non-humans participated as designers in a transnational, interdisciplinary Participatory Action Research project to train Kenyan health workers using mobile phones. At least six different patterns of sociomaterial relations operated through a given set of people and things, enacting the material-discursive apparatuses (Barad, 1998) of educational research, healthcare, the market, the state, and the local community. I assert that in this Participatory Action Research project for mobile learning, the design-reality gap was not so much a matter of geographic or socio-cultural divides, but was instead constituted as fluid space (Mol, 2002) separating the educational researchers’ designerly practices from the multiplicity of ways in which health workers, mobile phones, and other actors lived in relation to one another. I conclude that these ontological politics enacted design as an empirical matter of care – an affective and morally-charged sociomaterial practice with an ethico-political commitment to the marginalised (Puig de la Bellacasa, 2011). I therefore present a conceptual model of success and failure in participatory ICTD projects that explicitly incorporates the affective and material dimensions of care, and conceptualises social justice – not solely in terms of universal claims or global standards – but as embodied, sociomaterial enactments

Tensions and paradoxes in electronic patient record research: a systematic literature review using the meta-narrative method

Background: The extensive and rapidly expanding research literature on electronic patient records (EPRs) presents challenges to systematic reviewers. This literature is heterogeneous and at times conflicting, not least because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches. Aim: To map, interpret and critique the range of concepts, theories, methods and empirical findings on EPRs, with a particular emphasis on the implementation and use of EPR systems. Method: Using the meta-narrative method of systematic review, and applying search strategies that took us beyond the Medline-indexed literature, we identified over 500 full-text sources. We used ‘conflicting’ findings to address higher-order questions about how the EPR and its implementation were differently conceptualised and studied by different communities of researchers. Main findings: Our final synthesis included 24 previous systematic reviews and 94 additional primary studies, most of the latter from outside the biomedical literature. A number of tensions were evident, particularly in relation to: [1] the EPR (‘container’ or ‘itinerary’); [2] the EPR user (‘information-processer’ or ‘member of socio-technical network’); [3] organizational context (‘the setting within which the EPR is implemented’ or ‘the EPR-in-use’); [4] clinical work (‘decision-making’ or ‘situated practice’); [5] the process of change (‘the logic of determinism’ or ‘the logic of opposition’); [6] implementation success (‘objectively defined’ or ‘socially negotiated’); and [7] complexity and scale (‘the bigger the better’ or ‘small is beautiful’). Findings suggest that integration of EPRs will always require human work to re-contextualize knowledge for different uses; that whilst secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper, far from being technologically obsolete, currently offers greater ecological flexibility than most forms of electronic record; and that smaller systems may sometimes be more efficient and effective than larger ones. Conclusions: The tensions and paradoxes revealed in this study extend and challenge previous reviews and suggest that the evidence base for some EPR programs is more limited than is often assumed. We offer this paper as a preliminary contribution to a much-needed debate on this evidence and its implications, and suggest avenues for new research

Blockchain Adoption Framework Using Innovation Translation Approach - The preliminary study

Given the rapid move of organisations towards blockchain adoption, this paper focuses on the niche area associated with blockchain technology adoption. Literature is scarce around the explorative view of the blockchain adoption process and a need to identify the interplay of human and non-human elements at several points that influence the actions and ultimately the decision to adopt a blockchain application. This study investigates the blockchain adoption process from an explorative view and determines yet uncovered aspects to be considered before and while adopting blockchain. For this purpose, the study employed an Innovation Translation approach informed by Actor-Network Theory to identify the interactions among actors at each moment of blockchain adoption. The results of the study are crucial for blockchain literature as it fills gaps of empirically investigated, explorative and dynamic insight into the process and assists potential adopters in realising the interactions required before and during successful adoption process

Re-theorising the core: a ‘globalized’ business elite in Santiago, Chile

World systems theory continues to be a widely adopted approach in theorisations of the contemporary world economy. An important epistemological component to world systems theory is the metaphor of core-periphery. Recent work within the approach has sought to transcend earlier criticisms of regional conceptions of cores, peripheries and semi-peripheries by an increasing sensitivity to local differences and an increasing emphasis on Wallerstein's original idea of core-periphery as process, operating at all scales in the contemporary world system. However, this paper argues that the core-periphery metaphor currently used by world systems theorists is founded around a restrictively narrow spatial epistemology. Such a narrow epistemology implements the core-periphery metaphor only as something which produces territorial outcomes in the physical world. This paper contends that recent work within the social services, concerned with the globalization debate and issues of spatial epistemology, should inform world systems theory in producing a reformulated spatial understanding of the core-periphery metaphor, embodying a wider conception of space to include abstract social spaces. This argument is developed in the notion that the world economy must also be understood as having a ‘social core’: a transnational diasporic business elite exercising decision-making power over the capitalist world system. The contention is grounded in the presentation of research into a case study of such a ‘globalized’ business elite in the capital city of Chile, Santiago

Motivations for innovation in the built environment: new directions for research

Innovation in the built environment involves multiple actors with diverse motivations. Policy-makers find it difficult to promote changes that require cooperation from these numerous and dispersed actors and to align their sometimes divergent interests. Established research traditions on the economics and management of innovation pay only limited attention to stakeholder choices, engagement and motivation. This paper reviews the insights that emerge as research in these traditions comes into contact with work on innovation from sociological and political perspectives. It contributes by highlighting growing areas of research on user involvement in complex innovation, collective action, distributed innovation and transition management. To differing extents, these provide approaches to incorporate the motivations of different actors into theoretical understanding. These indicate new directions for research that promise to enrich understanding of innovation

Face masks for the public during Covid-19: an appeal for caution in policy

As the Covid-19 crisis deepens, some researchers have argued for the widespread routine use of face masks in community settings, despite acknowledged gaps in the evidence base for the effectiveness of such a measure. We argue that such calls are premature, and risk neglecting important potential harms and negative consequences, known and unknown. We identify potential unintended consequences at multiple levels, from individual-behavioural to macrosocial, and suggest that it is far from clear that the benefits of widespread uptake of face masks, whether encouraged or enforced by public authorities, outweigh the downsides. Finally, we make the case for caution in communicating unequivocal messages about the scientific evidence for face mask use to policy, practitioner and public audiences, given continued scientific disagreement on the questio

Fundamental Fields of: Post-Schumpeterian Evolutionary Economics

Although the branch of economics that deals with economic evolution has become established during the last couple of decades, its aims and potentials can most easily be understood on the background of the work of early pioneers. Joseph A. Schumpeter’s contribution not only analysed capitalist economic evolution as a process of the innovative renewal of business routines. He also explored the idea that the development of economics requires coordinated efforts within the “fundamental fields” of theory, history, statistics, and economic sociology. The paper applies this idea in an analysis of the development of modern evolutionary economics. The focus is on the characteristics and interdependencies of evolutionary history, evolutionary theory, and evolutionary statistics.Evolutionary economics; fundamental fields; Joseph A. Schumpeter

Considering Teaching Excellence in Higher Education: 2007-2013: A Literature Review Since the CHERI Report 2007

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