Power-relations and information systems development

University of Technology, Sydney. Faculty of Engineering and Information Technology.Problems of communication in the interplay between the information systems professional and their clients have resulted in a preponderance of methods and frameworks of structured interaction that have failed to produce consistently successful outcomes, and in the author’s professional experience are ignored as impractical to confront the chaos of the day to day micro level that shape outcomes. What seems to be more germane to understand in the problem of communication is the relations of power between participants. And, if we accept that perspective of power as a relation that is important to understand in analysing the problem of communication, we must necessarily choose to delve further than the mainstream IS literature where the power of A over B, or the power of A to enable B dominates, because such trajectories ignore three important aspects. Firstly, the entanglement of these IS researchers and authors themselves in a relation of power with power as an object which is itself party to rhetoric that seems to be concerned with ethical or partisan debate (cf. Lucas, 1984; Stahl, 2008, Rowlands and Kautz, 2013). Secondly, in treating power as an object, the network of possible complex relations where power could be said to happen is bypassed in favour of a simpler actor-centric model. Thirdly, and most importantly for this research, is the possibility that power must necessarily not only occur in the skills and techniques of the information systems professional (techne) but also in the interplay of knowledges (episteme) that are deployed at the times of communication with their embedded rationalities (cf. Bjorn-Andersen and Eason, 1980; Law, 1991; and Baunsgaard and Clegg 2013). Broadly speaking for us, power-relations are deployed in the potential interplay between discourses, where discourse defines the boundaries of potentially competing, simultaneously operating and conflicted epistemologies. In order to accommodate these points, we determined to conduct an interpretative epistemological analysis of the possible power-relations that the information systems professional may be subject to. To do this we broadly sought to follow Foucault (1969) and conduct an archaeology of the knowledge, obtained by open ended interview, of the narrative histories of eight ISD professionals, who came from a diverse set of backgrounds and perspectives spanning project management, systems programming, systems and business analysis, technology and business management, medicine, and systems infrastructure and networking. The approach we took was firstly to excavate their narratives for significant epistemological elements, elements that seem to hold epistemological significance for the person, horizontally identifying shared and non-shared elements as well. These elements are then vertically transposed to a maximum available set of possible epistemological meanings independent of their origin in the narrative, with identification of groupings of lexical siblings and antonyms becoming the discursive formations. This allows us to express an opinion as to the operative epistemological power-relations in terms of which are superordinate and thus whose knowledge has a possibility of realisation and which are subordinate and have less possibility of realisation depending on the other formations encountered. In brief, we found that those information systems professionals who know through discursive formation of Idealism, for example an ideal type of computer or database configuration, were subordinated in favour of those who know through Imperatives, for example the imperative of remuneration, profit or time commitments. Interestingly, many of the professionals had both formations present in their narrative, showing that more than one epistemological formation can be ‘inside’ or carried by one individual. We also found that information systems professionals who know through a Law type formation, for example, certainty of diagnosis, do not relate to the other formations, sitting superordinate, aloof and even ignorant of other formations. When different formations interact, it is possible that a traversal to another discursive formation occurs, or that the home formation is retained but it retreats or ‘shrinks’ away, so that it’s epistemological rules are perhaps forgotten for a while (Grint et al, 1996) in favour of the superordinate rules of knowing. We also found that there is a formation which distinctly marks boundaries between discourse, and that this was present in most instances, confirming the suspicion that discourses are multiple and in recurring conflict, creating the necessary possibility for power-relations to exist. Also, inspecting the behaviour or rules of the formations themselves, we also identified in the imperative formation epistemological strategies of trade-offs and adversaries, where other formations may also be that adversary (such as knowing through evidence as in the formation of enquiry). The presence of the Imperative formation was found to be the most regularly occurring superordinate function with the exception of the Law formation. This implies that if information systems professionals unconsciously choose or are educated to know through Idealism, such as the ideal to ‘love’ computing and revel in its perfection, this means that their thought will be subordinated frequently by other the formations of Imperatives which surround them and which they will be required to absorb in an industry and organisational context. Our research has therefore shown that epistemological power-relations is not only a theoretical notion but a reality that creates conflict and can disharmonise the best attempts of structured interaction by operating at a level beneath consciousness (Gutting, 2008), improving on the breadth of understanding in the IS literature on power. We do not support the ethical and partisan attempts to ‘neutralise’ power by relegating its status to an object level, but instead believe and have demonstrated that power as a network is a superior way to perceive power; unearthing the discursive formations of adversaries and tradeoffs, enquiry and idealism as a pathway to form an awareness of what is happening to knowledge. This has given us the discursive functions of forgetting, traversal and retreat, which has improved the understanding and potential use of Foucault’s archaeological analysis of power-relations under conditions of multiple and contemporary discourse

Traversing the Edge: Using Discourse Analysis to Understand IS Power Relations

Our project attempts to understand the operation of power in the development of computer-based information systems using Foucault's conception of discourse. Foucault's "genealogy" sees power not in the characteristics or resources of particular actors, but as a continuing chain of power/knowledge encounters. The "knowledge" aspect of these encounters is partly understood through Foucault's "archaeology". Thus long-term power/knowledge chains characterise systems of formation that pervade discourse, and influence immediate power/knowledge encounters. In particular we look at systems of formation that could be labeled "management" and "information technology" and their entanglement in the "process" of information systems development. This distinct understanding of "discourse analysis" influences our approach to our interpretive research methodology. In this paper we will demonstrate how our approach to interpretive analysis works for a pilot interview, positing several tests from the pilot interview for further investigation. This rarely seen approach to IS research presents a benefit when studying the topic of power, because we may be able to grasp through exteriority the deep structures that influence the narrative of an individual. This may represent a gain in the provability of the interpretative IS research choice

Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI.

OBJECTIVE: To identify abnormalities in asymptomatic sedentary individuals using 3.0 Tesla high-resolution MRI. MATERIALS AND METHODS: The cohort comprised of 230 knees of 115 uninjured sedentary adults (51 males, 64 females; median age: 44 years). All participants had bilateral knee 3.0 T MRIs. Two senior musculoskeletal radiologists graded all intraarticular knee structures using validated scoring systems. Participants completed Knee Injury and Osteoarthritis Outcome Score questionnaires at the time of the MRI scan. RESULTS: MRI showed abnormalities in the majority (97%) of knees. Thirty percent knees had meniscal tears: horizontal (23%), complex (3%), vertical (2%), radial (2%) and bucket handle (1%). Cartilage and bone marrow abnormalities were prevalent at the patellofemoral joint (57% knees and 48% knees, respectively). Moderate and severe cartilage lesions were common, in 19% and 31% knees, respectively, while moderate and severe bone marrow oedema in 19% and 31% knees, respectively. Moderate-intensity lesion in tendons was found in 21% knees and high-grade tendonitis in 6% knees-the patellar (11% and 2%, respectively) and quadriceps (7% and 2%, respectively) tendons being most affected. Three percent partial ligamentous ruptures were found, especially of the anterior cruciate ligament (2%). CONCLUSION: Nearly all knees of asymptomatic adults showed abnormalities in at least one knee structure on MRI. Meniscal tears, cartilage and bone marrow lesions of the patellofemoral joint were the most common pathological findings. Bucket handle and complex meniscal tears were reported for the first time in asymptomatic knees

Is the immediate effect of marathon running on novice runners' knee joints sustained within 6 months after the run? A follow-up 3.0 T MRI study.

OBJECTIVE: To evaluate changes in the knee joints of asymptomatic first-time marathon runners, using 3.0 T MRI, 6 months after finishing marathon training and run. MATERIALS AND METHODS: Six months after their participation in a baseline study regarding their knee joints, 44 asymptomatic novice marathoners (17 males, 27 females, mean age 46 years old) agreed to participate in a repeat MRI investigation: 37 completed both a standardized 4-month-long training programme and the marathon (marathon runners); and 7 dropped out during training (pre-race dropouts). The participants already underwent bilateral 3.0 T MRIs: 6 months before and 2 weeks after their first marathon, the London Marathon 2017. This study was a follow-up assessment of their knee joints. Each knee structure was assessed using validated scoring/grading systems at all time points. RESULTS: Two weeks after the marathon, 3 pre-marathon bone marrow lesions and 2 cartilage lesions showed decrease in radiological score on MRI, and the improvement was sustained at the 6-month follow-up. New improvements were observed on MRI at follow-up: 5 pre-existing bone marrow lesions and 3 cartilage lesions that remained unchanged immediately after the marathon reduced in their extent 6 months later. No further lesions appeared at follow-up, and the 2-week post-marathon lesions showed signs of reversibility: 10 of 18 bone marrow oedema-like signals and 3 of 21 cartilage lesions decreased on MRI. CONCLUSION: The knees of novice runners achieved sustained improvement, for at least 6 months post-marathon, in the condition of their bone marrow and articular cartilage

New approaches to genetic therapies for cystic fibrosis

Gene therapy offers great promise for cystic fibrosis which has never been quite fulfilled due to the challenges of delivering sufficient amounts of the CFTR gene and expression persistence for a sufficient period of time in the lungs to have any effect. Initial trials explored both viral and non-viral vectors but failed to achieve a significant breakthrough. However, in recent years, new opportunities have emerged that exploit our increased knowledge and understanding of the biology of CF and the airway epithelium. New technologies include new viral and non-viral vector approaches to delivery, but also alternative nucleic acid technologies including oligonucleotides and siRNA approaches for gene silencing and gene splicing, described in this review, as presented at the 2019 annual European CF Society Basic Science meeting (Dubrovnik, Croatia). We also briefly discuss other emerging technologies including mRNA and CRISPR gene editing that are advancing rapidly. The future prospects for genetic therapies for CF are now diverse and more promising probably than any time since the discovery of the CF gene

What happens to the lower lumbar spine after marathon running: a 3.0 T MRI study of 21 first-time marathoners

OBJECTIVE: To better understand the impact of long-distance running on runners' lumbar spines by assessing changes before and after their first marathon run. MATERIALS AND METHODS: The lumbar spines of 28 asymptomatic adults (14 males, 14 females, mean age: 30 years old), who registered for their first marathon, the 2019 London Richmond Marathon, were examined 16 weeks before (time point 1) and 2 weeks after (time point 2) the marathon. Participants undertook a pre-race 16-week training programme. Magnetic resonance imaging (MRI) of high-resolution 3.0 Tesla was used at each time point. Senior musculoskeletal radiologists assessed the lower lumbar spine condition. RESULTS: Out of 28 participants, 21 completed both the training and the race and 7 neither completed the training nor started the marathon but not due to spine-related issues. At time point 1, disc degeneration was detected in 17/28 (61%), most predominantly at spinal segments L4-L5 and L5-S1. No back pain/other symptoms were reported. When compared to time point 2, there was no progression in the extent of disc degeneration, including intervertebral disc (IVD) height (p = 0.234), width (p = 0.359), and intervertebral distance (p = 0.641). There was a regression in 2 out of 8 (25%) participants who had pre-marathon sacroiliac joint bone marrow oedema, and a small increase in the size of a pre-marathon subchondral cyst in one participant, all asymptomatic. CONCLUSION: Running 500 miles over 4 months plus a marathon for the first time had no adverse effects on the lumbar spine, even when early degenerative changes were present. Additionally, there was evidence of regression of sacroiliac joint abnormalities

A new transdisciplinary research model to investigate and improve the health of the public

Transdisciplinary research approaches are being applied to today's complex health problems, including the climate crisis and widening inequalities. Diverse forms of disciplinary and experiential knowledge are required to understand these challenges and develop workable solutions. We aimed to create an updated model reflective of the strengths and challenges of current transdisciplinary health research that can be a guide for future studies. We searched Medline using terms related to transdisciplinary, health and research. We coded data deductively and inductively using thematic analysis to develop a preliminary model of transdisciplinary research. The model was tested and improved through: (i) a workshop with 27 participants at an international conference in Xiamen, China and (ii) online questionnaire feedback from included study authors. Our revised model recommends the following approach: (i) co-learning, an ongoing phase that recognizes the distributed nature of knowledge generation and learning across partners; (ii) (pre-)development, activities that occur before and during project initiation to establish a shared mission and ways of working; (iii) reflection and refinement to evaluate and improve processes and results, responding to emergent information and priorities as an ongoing phase; (iv) conceptualization to develop goals and the study approach by combining diverse knowledge; (v) investigation to conduct the research; (vi) implementation to use new knowledge to solve societal problems. The model includes linear and cyclical processes that may cycle back to project development. Our new model will support transdisciplinary research teams and their partners by detailing the necessary ingredients to conduct such research and achieve health impact

Deficiency of functional mannose-binding lectin is not associated with infections in patients with systemic lupus erythematosus

Infection imposes a serious burden on patients with systemic lupus erythematosus (SLE). The increased infection rate in SLE patients has been attributed in part to defects of immune defence. Recently, the lectin pathway of complement activation has also been suggested to play a role in the occurrence of infections in SLE. In previous studies, SLE patients homozygous for mannose-binding lectin (MBL) variant alleles were at an increased risk of acquiring serious infections in comparison with patients who were heterozygous or homozygous for the normal allele. This association suggests a correlation between functional MBL level and occurrence of infections in SLE patients. We therefore investigated the biological activity of MBL and its relationship with the occurrence of infections in patients with SLE. Demographic and clinical data were collected in 103 patients with SLE. Functional MBL serum levels and MBL-induced C4 deposition were measured by enzyme-linked immunosorbent assay using mannan as coat and an MBL- or C4b-specific monoclonal antibody. The complete MBL-dependent pathway activity was determined by using an assay that measures the complete MBL pathway activity in serum, starting with binding of MBL to mannan, and was detected with a specific monoclonal antibody against C5b-9. Charts were systematically reviewed to obtain information on documented infections since diagnosis of SLE. Major infections were defined as infections requiring hospital admission and intravenous administration of antibiotics. In total, 115 infections since diagnosis of lupus, including 42 major infections, were documented in the 103 SLE patients (mean age 41 ± 13 years, mean disease duration 7 ± 4 years). The percentage of SLE patients with severe MBL deficiency was similar to that in 100 healthy controls: 13% versus 14%, respectively. Although deposition of C4 to mannan and MBL pathway activity were reduced in 21% and 43% of 103 SLE patients, respectively, neither functional MBL serum levels nor MBL pathway activity was associated with infections or major infections in regression analyses. In conclusion, SLE patients frequently suffer from infections, but deficiency of functional MBL does not confer additional risk

Comparing patient characteristics and treatment processes in patients receiving physical therapy in the United States, Israel and the Netherlands. Cross sectional analyses of data from three clinical databases

<p>Abstract</p> <p>Background</p> <p>Many assume that outcomes from physical therapy research in one country can be generalized to other countries. However, no well designed studies comparing outcomes among countries have been conducted. In this exploratory study, our goal was to compare patient demographics and treatment processes in outpatient physical therapy practice in the United States, Israel and the Netherlands.</p> <p>Methods</p> <p>Cross-sectional data from three different clinical databases were examined. Data were selected for patients aged 18 years and older and started an episode of outpatient therapy between January 1^st2005 and December 31^st2005. Results are based on data from approximately 63,000 patients from the United States, 100,000 from Israel and 12,000 from the Netherlands.</p> <p>Results</p> <p>Age, gender and the body part treated were similar in the three countries. Differences existed in episode duration of the health problem, with more patients with chronic complaints treated in the United States and Israel compared to the Netherlands. In the United States and Israel, physical agents and mechanical modalities were applied more often than in the Netherlands. The mean number of visits per treatment episode, adjusted for age, gender, and episode duration, varied from 8 in Israel to 11 in the United States and the Netherlands.</p> <p>Conclusion</p> <p>The current study showed that clinical databases can be used for comparing patient demographic characteristics and for identifying similarities and differences among countries in physical therapy practice. However, terminology used to describe treatment processes and classify patients was different among databases. More standardisation is required to enable more detailed comparisons. Nevertheless the differences found in number of treatment visits per episode imply that one has to be careful to generalize outcomes from physical therapy research from one country to another.</p