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Pictures in the substantiation of organisation: a study of radiology
(The University of Waikato, 1992) McArthur, William; Bettison, David; Goldsmith, Michael
The motivation for this study is an interest in technologically produced imagery and its effect on the contemporary world. Natural events, pictures, diagrams, paintings, spectacular performing arts, icons, etc, are persistent features in the repertoire of language for expressing and constituting knowledge. Much of present day common sense knowledge, however, is constituted through observation made in direct, yet technologically mediated ways. From television to computer graphics and radiographs, a plethora of technologies offer visual experience of a kind available only through techno-scientific means. Using technical instruments requires constructs created by user’s and see-er’s. Language that evolves, is often interpretable only through a unique cultural practice dependent on expertise. Technically produced imagery raises issues of individual and collective interpretation. The thesis method is eclectic to discern the complexity this involves. Intertwining of technical and scientific modes of professional conduct is examined through the implication of Galilean discovery, by way of the technical effects of glass in the 17th Century, and Roentgen’s accidental discovery through x-rays in the late 19th Century. Field work centers on issues pertinent to technologically mediated knowledge. This involved a small group of radiologists in the hospital of a provincial New Zealand city. Engaged variously in difficult radiographic interpretation, they are teaching newly qualified doctors entering the radiological profession to successfully “see” the imagery evoked by the radiograph. Medical practitioners, and especially radiologists, are a profession required specifically to develop skills of image and sign interpretation. Fundamental to their accountability is intersubjective agreement on what is “seen” on a radiograph and other technical equipment. The third dimension of “depth” has to be accurately imputed to a two dimensional radiograph. Radiological “objectivity” is the outcome of collective discourse. Central to this discourse is a specific employment of particular metaphors. Metaphorical transferrence occurs during the process of diagnosis as the interpreter moves between what is seen on the radiograph and his or her medical repertoire. Diagnosis through the inspection of visual items involves the skilled (but often intuitive) decoding of complex systems of iconic and symbolic (conventional, arbitrary) signs. Diagnosis is sanctioned by collective agreement accomplished through dialogue. The basis of the radiological code is an inextricable use of metaphor and metonymy in the syntagmatic construction of an image. The nature of what is seen on the radiograph is based on the notion of caricature. This implies that the person who can interpret a radiograph is able to “see” in it the embodiment of some image which may be completely obscure to the uninitiated. Caricature interpretation is fundamental to constituting the typifications of daily life. This has particular significance in what might be termed a “techno visual” life-world.
A systems analysis of an area mental health service
(The University of Waikato, 1992) Keith, Catherine B.
The mental health services existing in a defined geographic area in New Zealand were studied in an effort to establish priorities for service development. It was clear from a preliminary review of the services that while community based services were operating in the area, they were under-resourced and very poorly monitored. They did not provide care that was comprehensive and the population they were intended to service was not clearly specified. Information about who used the services, where they came from and why, was difficult to obtain. There were no psychiatric beds in the general hospital in the area which served a population of approximately 300,000. Acute inpatient care was provided in a 300 bed psychiatric hospital remote from the main centres of population. The acute area of this hospital provided 50 beds and appeared to be under strain most of the time. No standardised criteria for admission and discharge to and from the service were in place. The aims of the acute service, the boundaries of clinical responsibility between assessment, symptom control, treatment and continuing care were vague. To begin the study, a scale was developed and used to assess the feasibility of evaluating individual psychiatric services. A one day census of patients registered with the services was then carried out. The services included inpatient services, general hospital and court liaison services, community mental health centres, day hospital programmes, domicilliary nursing services, a substance abuse service, a rapid assessment service and a child and family service. The census uncovered a lack of adequate record systems for both patient and management information. As a consequence, a patient case register, based on a minimum data set of patient information, was developed. Meantime, a preliminary review of the acute services in the psychiatric hospital revealed a service under stress. Major sources of this stress were identified as inadequacies in the physical environment and a large and apparently uncontrollable variation in amount of service use by individuals admitted to the acute area. In the last phase of the research, the problem of uncontrollable variance in amount of acute inpatient service use was examined. This focus on acute inpatient care was justified because it was the most restrictive and expensive form of care offered and there was clearly a need to describe and explain how this service worked and whether it was cost effective. A study of five hundred and thirty eight people admitted to the acute inpatient service during 1988 was designed to determine the factors which predicted amount of service use. An instrument was constructed to record information on selected predictor variables. The instrument was built around the registration form developed in the process of establishing the patient information system. Predictor variables were chosen from an extensive literature review of factors determining service use, and from clinical and management opinion on what information was most necessary for service development and clinical management. Choices were also made to include information which was being gathered at the time, albeit unsystematically, by existing clinical history taking and admission and discharge procedures. The research method involved selecting a comprehensive range of predictor variables as potential indicators for amount of acute psychiatric service use, and dividing them into systems variables, which were by definition outside the control of the patient, socio-economic variables and behavioural variables which were consumer characteristics. A range of socioeconomic, systems and behavioural variables was approved for inclusion in the study by the researcher, clinicians and management. These variables were measured and related to the criterion variable, amount of service use (ASU). The criterion (ASU) was defined as number of bed days spent in the acute inpatient service during a twelve month period. Variables categorised as systems variables (environmental and service features over which the consumer had no control), were found to be the strongest predictors of service use, compared to sociodemographic factors or behavioural characteristics of the users. This suggested that the system of service was provider rather than consumer driven. The results also indicated that, in the absence of evidence to support the effectiveness of acute inpatient care, there was a need to develop alternatives. There was an equally urgent need to implement evaluation procedures which will begin to measure the effectiveness of care delivered in all mental health service settings. The methods developed in this thesis (to determine evaluation feasibility, to develop a client case register, to determine predictor variables for amount of service use) resulted in a useful general model which can be used to describe, explain and to some extent predict and control patterns of human service use in a variety of settings. The theoretical underpinnings for the work, which were originally derived from general systems theory, from the discipline of evaluation research and from the community psychology literature, are strengthened and endorsed by the results. The data obtained extend the case register system developed in the early phases of the project to provide a substantial foundation on which to build a comprehensive data base. This can be regularly updated and expanded allowing for ongoing service evaluation. For the first time in the region, clinical and service policy decisions can be based on information which is both objective and reliable.
Studies in the importance of accounting in New Zealand: a Foucauldian perspective
(The University of Waikato, 1992) Hooper, Keith; Lawrence, Stewart R.; Pratt, Michael
The aim of this thesis is to illustrate from three constructed cases why and how some knowledges that have been marginal (like accounting before the nineteenth century) become powerful (Hoskin and Macve, 1991, p. 10). In other words, to explain from a New Zealand context why and how the practice and profession of accounting grew to be so influential and important in relation to its comparatively humble 18th century bookkeeping and clerical origins. It is argued that the practice of accounting became more important in the nineteenth century because such practice facilitated the exercise of power and discipline in the context of a growing, European dominated society. According to Foucault (1977) the new human disciplines (e.g. medicine, law accounting, etc.) which appeared in the eighteenth and nineteenth centuries were not the product of emergent economic needs but rather the product of new disciplinary powers. Moreover, the importance of such new disciplines, Foucault (1977) claimed, should not be traced in a linear fashion relating, for example, legislation and institutional development, but from a postmodern perspective stressing diffuse and contingent origins. In other words, no single source of origin can fully explain such phenomena. The three studies examined in this thesis are not meant to be representative or necessarily typical of contemporary practice, rather they serve to illustrate the diffuse and separate sources of accounting’s power origins within a New Zealand. From the 1860s, three events took place which were to change the social and commercial structure of the new colony: the passing of the first New Zealand Companies Act 1860, the Native Lands Settlement Act 1865 (which individualised Māori land titles and permitted direct European purchase), and large scale European immigration into New Zealand. The colony during this period changed from a Māori dominated economy based on tribal ownership of land to a European capitalist economy based on individual land ownership. With limited manufacturing capacity and few mineral resources, land was the basis of wealth and economic power in New Zealand. The period from 1870 to 1930 was crucial because it was during those years that most land in New Zealand was transferred from Māori to European ownership. The common theme shared by the three separate cases depicted in this thesis is that to a greater or lesser extent they are about conflict over land - its acquisition and the power and wealth its ownership conveys. The overall aim is to provide a critical history of accounting in New Zealand in Foucauldian terms, and to provide an explanation of the present by tracing its genealogy. To achieve this end some consideration of New Zealand’s history is necessary and, in particular, the importance of the Treaty of Waitangi to New Zealand society. The cases are suited to a Foucauldian interpretation because they represent local, discontinuous histories concerning struggle and insurrection, elements which Foucault considered to be vital for genealogical research. The first case study (of three) examined in this thesis demonstrates how land was transferred to individual European ownership and the part played by an accountant and other professionals in executing land transactions. It also illustrates the close conceptual links of accounting practice with European values such as capital accumulation and shows how an accountant was able to use his knowledge to advance his employer/client’s interests. Thus the former explains the character of the discursive practices of accounting, while the latter illustrates how accounting practice served the ends of the ascendant power structure. The second case study continues to develop these themes by exploring the history of company formation in colonial New Zealand. The emphasis is on conflict between directors and shareholders and in particular the struggle for control of a land company. The study depicts the way in which the privileged use of accounting knowledge may serve the particular interests of a powerful business elite. The final study depicts the activities of a practising public accountant acting for an overseas client. Once again two themes are apparent: accounting as an instrument of European capital accumulation, and accounting as a modern power discipline. The latter theme explaining how power may be exercised. Research for these studies was conducted in various national archives containing collections of private papers. Use was also made of past newspaper accounts of company meetings and contemporary commentaries on business affairs. Secondary sources were used extensively in the first four chapters to furnish background material relevant to the themes and arguments developed.
Lateral electron disequilibrium in radiotherapy treatment planning
(The University of Waikato, 1991) Hoban, Peter William; Round, W. Howell
Lateral electron disequilibrium on the central-axis of small-diameter circular beams is investigated using the EGS4 Monte Carlo system, for 10 MV photons. Monte Carlo results generated using the reciprocity technique are presented. In water, disequilibrium is found to occur for beams with diameters of less than approximately 4 cm. In lung of density 0.25 g cm⁻³, disequilibrium occurs for diameters less than approximately 16 cm. The lateral electron equilibrium factor is defined and used to quantify the degree of disequilibrium. Convolution dose calculation for 10 MV photons, using polyenergetic energy deposition kernels, gives a slight error in central-axis dose, due to beam hardening with depth. Primary and scattered polyenergetic kernels formed for a surface primary photon spectrum contain less and more fractional energy respectively than primary and scattered kernels formed for a beam hardened spectrum. A beam hardening correction to the kernels used in the convolution is proposed. This correction improves the agreement of convolution results with Monte Carlo predictions. A superposition algorithm is developed and used to calculate dose in a lung phantom for 10 MV photons. Results show an overestimate in dose in the lung for a 5 cm square field when compared with experiment and Monte Carlo results. Disagreement is due to the assumption made in the density scaling method that secondary electrons travel in straight lines. A modification to the interaction voxel weighting in the density scaling procedure improves the result. The superposition method for 4 MV and 10 MV photons has been incorporated into the GRATIS treatment planning system. Two and three-dimensional electron pencil beam algorithms are used to calculate the dose distribution in a water medium containing a small cavity for a 12 MeV electron beam. The measured hot spot beneath the cavity is 122%. The 2-D method predicts 114% and the 3-D method predicts 127%. Both profile and depth dose curves produced by the 3-D method are superior to those produced by the 2-D method. The 3-D pencil beam algorithm has been incorporated into the GRATIS treatment planning system.
Oxygen control of nitrogen fixation in Frankia and Coriaria arborea
(The University of Waikato, 1992) Harris, Sharon L.; Silvester, Warwick B.
Oxygen has a central role in regulation of nitrogen fixation activity in both asymbiotic Frankia and Frankia - actinorhizal plant symbioses. Daily addition of fresh medium at a low dilution rate (D=0.125 day⁻¹) allowed Frankia to be maintained in continuous culture with a stable rate of growth and nitrogenase activity for periods of more than 30 days. Use of continuous cultures permitted the effects of oxygen on vesicle morphology and nitrogenase activity to be investigated independent of normal developmental changes occurring in batch culture. Frankia grown at higher oxygen concentrations formed thicker-walled vesicles which allowed adaptation of nitrogenase activity over a pO₂ range of 5 - 40 kPa O₂. Recovery of nitrogenase activity after oxygen shock (2 to 21 kPa O₂) followed formation of thicker-walled vesicles. Vesicle walls also showed a thickening response to pO₂ level under conditions where nitrogenase activity was inhibited (in Ar : O₂ atmospheres) or not detected (in cultures grown on nitrate-containing medium). These results indicated the presence of vesicles and the induction of nitrogenase activity in culture is not as synonymous as was originally believed. GC/MS analysis of lipid extracts from Frankia cultures and actinorhizal nodules confirmed the high hopanoid content of Frankia. Differences in the relative proportions of hopanoids present were also detected between samples and the total amount of hopanoids measured in Frankia cultures was slightly higher at higher oxygen concentrations. Most work on Frankia symbioses focussed on the Coriaria arborea association and highlighted startling similarities between this actinorhizal symbiosis and Rhizobium - legume associations. Coriaria showed a legume-like, non-recoverable decline in nitrogenase activity and nodule respiration following exposure to 10 kPa acetylene or argon. The extent of the acetylene-induced decline was diminished with increasing plant age and adaptation to above atmospheric oxygen concentrations. Lag-phase measurements indicated acetylene-induced declines in Coriaria are due to an apparent increase in nodule diffusion resistance which has also been observed in legumes. Defoliation of Coriaria also caused a decline in nitrogenase and respiratory activity associated with an apparent increase in nodule diffusion resistance although the effect was delayed for approximately two hours. Continuous flow assay of nitrogenase activity in several actinorhizal species and one legume, exposed to alternate gas streams of nitrogen and helium at varying oxygen tensions, indicated a small component of the diffusion pathway in Coriaria arborea and Myrica gale nodules is an air-filled pathway. In Alnus glutinosa, Casuarina cunninghamiana and Medicago sativa nodules the diffusion pathway has some “water-filled” or “solid” diffusion barrier. Speculation is offered on the location and functioning of fixed and variable diffusion resistance in Coriaria nodules based on results from this study and previous work.