ABSTRACT
This paper outlines a role-based approach for conceptualizing and investigating the contention in some previous research that technologies change organizational and occupational structures by transforming patterns of action and interaction. Building on Nadel's theory of social structure, the paper argues that the microsocial dynamics occasioned by new technologies reverberate up levels of analysis in an orderly manner. Specifically, a technology's material attributes are said to have an immediate impact on the nonrelational elements of one or more work roles. These changes, in turn, influence the role's relational elements, which eventually affect the structure of an organization's social networks. Consequently, roles and social networks are held to mediate a technology's structural effects. The theory is illustrated by ethnographic and sociometric data drawn from a comparative field study of the use of traditional and computerized imaging devices in two radiology departments.
Subject(s)
Hospital Departments/organization & administration , Interprofessional Relations , Organization and Administration , Organizational Culture , Radiology Department, Hospital/organization & administration , Technology, Radiologic , Age Factors , Diagnostic Imaging/trends , Diffusion of Innovation , Evaluation Studies as Topic , Humans , Massachusetts , Models, Theoretical , Role , Social Change , Socioeconomic Factors , Surveys and Questionnaires , WorkforceSubject(s)
Family Practice , Interprofessional Relations , Societies, Medical , Humans , United KingdomABSTRACT
New medical imaging devices, such as the CT scanner, have begun to challenge traditional role relations among radiologists and radiological technologists. Under some conditions, these technologies may actually alter the organizational and occupational structure of radiological work. However, current theories of technology and organizational form are insensitive to the potential number of structural variations implicit in role-based change. This paper expands recent sociological thought on the link between institution and action to outline a theory of how technology might occasion different organizational structures by altering institutionalized roles and patterns of interaction. In so doing, technology is treated as a social rather than a physical object, and structure is conceptualized as a process rather than an entity. The implications of the theory are illustrated by showing how identical CT scanners occasioned similar structuring processes in two radiology departments and yet led to divergent forms of organization. The data suggest that to understand how technologies alter organizational structures researchers may need to integrate the study of social action and the study of social form.
Subject(s)
Decision Making, Organizational , Hospital Departments/organization & administration , Interprofessional Relations , Radiology Department, Hospital/organization & administration , Social Control, Informal , Technology, Radiologic , Tomography, X-Ray Computed , Communication , Hierarchy, Social , Humans , Massachusetts , RoleSubject(s)
Hypertension/therapy , Adult , Aged , Chronic Disease , Family Practice , Female , Humans , Hypertension/diagnosis , Hypertension/etiology , Male , Mass Screening , Middle AgedABSTRACT
The records of 26 patients in one practice who had had a partial gastrectomy were studied to see if a stated policy of follow-up had been successful. The policy aimed to detect by annual blood tests (birthday follow-up) the consequences of malabsorption of iron, folate, vitamin B12, and calcium. Of 198 possible tests (nine for each patient when seen for the first screening), only 87 (44 per cent) were done; 16 (18.2 per cent) were abnormal. At the 39 opportunities for annual follow-up, 71 per cent of the possible tests were done; 11 of the 62 tests (17.5 per cent) were abnormal. The most common abnormality was deficiency of iron (12 tests), followed by folate (four tests), serum B12 (two tests), and serum calcium (two tests). Appropriate action according to the review criteria was taken for 24 out of the 27 abnormalities found. The result of the review was to suggest a modified annual follow-up, with fewer than nine tests per year.
Subject(s)
Postgastrectomy Syndromes/diagnosis , Adult , Aged , England , Family Practice/methods , Female , Follow-Up Studies , Humans , Male , Medical Audit , Middle AgedSubject(s)
Community Health Nursing , Formularies as Topic , Drug Prescriptions , Family Practice , United KingdomSubject(s)
Family Practice , Hypertension/prevention & control , Adult , Humans , Mass Screening , Middle Aged , United KingdomSubject(s)
Home Care Services , Hospitalization , Adult , Aged , Child , Decision Making , Humans , Middle AgedABSTRACT
Blood specimens from members of the click-speaking Sandawe tribe of Tanzania and of the adjacent Bantu-speaking Nyaturu tribe have been tested for antigens of 11 blood group systems, for variants of 3 plasma-protein systems and 9 red-cell-enzyme systems, for haemoglobin variants. The results are tabulated and gene frequencies computed. For most systems, the frequencies in the two tribes are similar to one another and, in so far as data are available, similar to the neighbouring Bantu-speaking tribes. The principal genetic difference between the Sandawe and the Nyaturu is in their frequencies of haemoglobin S and of glucose-6-phosphate dehydrogenase deficiency, both of which characters are several times higher in the Nyaturu than in the Sandawe; both characters are protective against falciparum malaria, and this suggests that the Nyaturu have in the past been much more strongly exposed to this infection than the Sandawe.
