Knowledge systems and public health

The knowledge and information systems (KIS) perspective arose from reflections on agricultural development. In the health sector, it is not quite as common to think in terms of KIS. Yet in this complex field, in which health education and promotion play increasingly important roles, the KIS perspective might be very useful. In this article, the authors attempt to apply ideas about KIS and knowledge management to health, by paying attention to the historical development, especially of public health, and by exploring the contribution these ideas could make to the field. Some of the observations made in this attempt are: upstream information flows often are developed poorly, interaction and exchange among the different KIS parties require ongoing stimulation, in special projects and complex communication situations, a system-integrator is needed. Maria Koelen is a staff member of the Department of Extension Science, Wageningen Agricultural University, Hollandseweg 1, 6706 KN Wageningen, The Netherlands, and is responsible for the department's research and courses on health education.     

Moving forces: External pressure and the dynamics of technology systems

Knowledge Information Systems (KIS) institutions must receive strong and focused external pressure to function synergetically over sustained periods. This external pressure should be exercised by other elements in the system. Without such pressure, institutions and personnel act to fulfill their own social and political needs more than those of their clients, and their effectiveness is inevitably reduced. This article is concerned with the “moving forces” that instill public agricultural knowledge systems with particular dynamics. The article's objectives are to predict under what circumstances external pressures will occur and their likely outcomes, and to advise KIS managers on how they can be managed. The first section reviews the evolution of the concept of external pressure as a moving force in the dynamics of technology systems. The next four sections examine the roles of policy makers, foreign agencies, farmers, and the private sector, respectively, in pressuring KIS institutions. The sixth section explores how institutions behave without external pressure. A final section looks at what all this implies for KIS managers' “room to maneuver.” David Kaimowitz can be reached at ISNAR, P.O. Box 93375, 2509 AJ, The Hague, The Netherlands. His interests include agricultural research and technology transfer.     

The emergence of knowledge systems thinking: A changing perception of relationships among innovation,knowledge process and configuration

As agriculture develops, policy and management decisions increasingly focus on agricultural innovation emerging from utilizing knowledge and/or technology. This paper considers models for underpinning knowledge and technology policy and management. It describes the emergence of knowledge systems thinking. The system construct is applied to actors (individuals, networks and institutions) involved in knowledge processes. These actors potentially form a highly articulated and complex whole. Knowledge policy and management focus on measures that enhance the synergy between actors. Knowledge systems are viewed as “soft systems,” i.e., they only become systems as a result of active construction and joint learning. The soft systems perspective facilitates the identification of various knowledge system models, which have consequences for policy and management decisions with respect to investment, design, and training. In an attempt to create a unifying theory for these models, it is posited that these models are consistent combinations of innovation, knowledge process and structural configuration. Currently, he is the director of an international program on “Comparative research in knowledge systems in support of sustainable agriculture.”     

EPISTEMOLOGY EXTENDED

A common presupposition in epistemology is that the processes contributing to the generation of knowledge do not extend beyond the knower's skin. This paper challenges this presupposition. I adduce a novel kind case that causes trouble for a number of even the most promising accounts of knowledge in current literature (virtue epistemological and modal accounts), at least so long as the presupposition is in place. I then look at a couple of recent accounts of knowledge that drop the presupposition and expressly allow the relevant processes to extended beyond the knower's skin. While these accounts can handle the problem case, they encounter difficulties elsewhere: extension occurs too easily and so the accounts predict knowledge where they ought not. Finally, I offer a novel way of extending epistemology and argue that it can steer clear of the problems on both sides.     

What you know can hurt you: effects of age and prior knowledge on the accuracy of judgments of learning

How do aging and prior knowledge affect memory and metamemory? We explored this question in the context of a dual-process approach to Judgments of Learning (JOLs), which require people to predict their ability to remember information at a later time. Young and older adults (n = 36, mean ages = 20.2 & 73.1) studied the names of actors who were famous in the 1950s or 1990s, providing a JOL for each. Recognition memory for studied and unstudied actors was then assessed using a Recollect/Know/No-Memory (R/K/N) judgment task. Results showed that prior knowledge increased recollection in both age groups such that older adults recollected significantly more 1950s actors than younger adults. Also, for both age groups and both decades, actors judged R at test garnered significantly higher JOLs at study than actors judged K or N. However, while the young showed benefits of prior knowledge on relative JOL accuracy, older adults did not, showing lower levels of JOL accuracy for 1950s actors despite having higher recollection for, and knowledge about, those actors. Overall, the data suggest that prior knowledge can be a double-edged sword, increasing the availability of details that can support later recollection, but also increasing nondiagnostic feelings of familiarity that can reduce the accuracy of memory predictions.     

Equivocations on knowledge systems theory: An actor-oriented critique

Knowledge systems theory, in our view, tends to obscure rather than illuminate an understanding of the fundamentals of knowledge processes in society. This tendency occurs primarily because both the theory, and the methodologies that are derived from it, fail to recognize that knowledge processes are social processes, and thereby that knowledge itself has to be envisaged as a social construction. As a result of this omission, knowledge systems theory and methodology can only deal poorly with issues of power and social conflict, and, at the same time, tend to make use of several inappropriate teleological and reifying notions. According to our view, the understanding of knowledge processes will benefit greatly from a more actor-oriented perspective. In such an approach, emphasis is accorded to human agency and the concept of multiple knowledge networks. Central purposes of actor-oriented methodologies then, are to clarify how actors attempt to create space for their own ‘projects’ and to determine which elements contribute to or impede the successful creation of such space for maneuver. Norman Long is a member of the Department of Rural Sociology of the Tropics and Subtropics at Wageningen Agricultural University, P.O. Box 8130, 6700 EW, Wageningen, The Netherlands. He is known for his work in the sociology of rural development. Magdalena Villarreal recently acquired her M.S. in “Management of Agricultural Knowledge Systems” at Wageningen Agricultural University. She is presently working on a Ph.D. proposal on issues of power, gender, and intervention.     

Establishing a relational field that fosters learning processes: Some tentative propositions derived from trainee experiences

In this article, we look at the recent introduction of more relational-oriented learning principles and how they translate into practice by documenting the experiences of both trainees and instructors. It became clear that actors held different opinions and viewpoints on learning objectives and process ingredients for achieving these objectives. This divergence in opinions resulted in an “impoverished” learning trajectory. We suggest that remedying this situation implies introducing reflexivity regarding learning processes or, stated otherwise, addressing “meta-cognitions” that participants inevitably bring to the process as they affect the way in which people engage in the relational field that encompasses the learning trajectory. Despite some recent arguments in favour of a distinction between cognitive and meta-cognitive mediation, we argue for a similar approach with respect to both types of mediation. We end this article by suggesting that designing learning trajectories with this dual concern in mind might open the road to “learning to learn”.     

Giving Voice to Patients: Developing a Discussion Method to Involve Patients in Translational Research

Biomedical research policy in recent years has often tried to make such research more ‘translational’, aiming to facilitate the transfer of insights from research and development (R&D) to health care for the benefit of future users. Involving patients in deliberations about and design of biomedical research may increase the quality of R&D and of resulting innovations and thus contribute to translation. However, patient involvement in biomedical research is not an easy feat. This paper discusses the development of a method for involving patients in (translational) biomedical research aiming to address its main challenges.After reviewing the potential challenges of patient involvement, we formulate three requirements for any method to meaningfully involve patients in (translational) biomedical research. It should enable patients (1) to put forward their experiential knowledge, (2) to develop a rich view of what an envisioned innovation might look like and do, and (3) to connect their experiential knowledge with the envisioned innovation. We then describe how we developed the card-based discussion method ‘Voice of patients’, and discuss to what extent the method, when used in four focus groups, satisfied these requirements. We conclude that the method is quite successful in mobilising patients’ experiential knowledge, in stimulating their imaginaries of the innovation under discussion and to some extent also in connecting these two. More work is needed to translate patients’ considerations into recommendations relevant to researchers’ activities. It also seems wise to broaden the audience for patients’ considerations to other actors working on a specific innovation.     

The role of preschoolers' social understanding in evaluating the informativeness of causal interventions

Preschoolers use information from interventions, namely intentional actions, to make causal inferences. We asked whether children consider some interventions to be more informative than others based on two components of an actor’s knowledge state: whether an actor possesses causal knowledge, and whether an actor is allowed to use their knowledge in a given situation. Three- and four-year-olds saw a novel toy that activated in the presence of certain objects. Two actors, one knowledgeable about the toy and one ignorant, each tried to activate the toy with an object. In Experiment 1, either the actors chose objects or the child chose for them. In Experiment 2, the actors chose objects blindfolded. Objects were always placed on the toy simultaneously, and thus were equally associated with the effect. Preschoolers’ causal inferences favored the knowledgeable actor’s object only when he was allowed to choose it (Experiment 1). Thus, children consider both personal and situational constraints on knowledge when evaluating the informativeness of causal interventions.     

Episodic processes in emotional labor: perceptions of affective delivery and regulation strategies

This study examined emotional labor processes from a within-person, episodic framework. The authors hypothesized that the influence of negative emotions on affective delivery would be lessened by regulation strategies for supervisor perceptions but not self-perceptions. In addition, difficulty maintaining display rules was hypothesized to mediate the relation between negative emotions and self-perceptions of affective delivery. Finally, the influence of surface acting strategies on these processes as well as correlations with individual differences was investigated. Hypotheses were tested using ecological momentary assessment of a sample of cheerleading instructors. Results suggest that surface actors can regulate emotions effectively on an episode-to-episode basis but find the episode more difficult. In addition, surface actors exhibit more general tendencies to devalue themselves and experience fewer positive emotions.     

Understanding understanding mathematics

In this paper we look at some of the ingredients and processes involved in the understanding of mathematics. We analyze elements of mathematical knowledge, organize them in a coherent way and take note of certain classes of items that share noteworthy roles in understanding. We thus build a conceptual framework in which to talk about mathematical knowledge. We then use this representation to describe the acquisition of understanding. We also report on classroom experience with these ideas.     

Situating Standards in Practices: Multi Drug-Resistant Tuberculosis Treatment in India

Public health care needs to cope with a basic dilemma between providing standardized care within public programmes across entire and at times resource-constrained countries and adapting this care locally when responding to individual needs. This tension between standardization and local adaptation becomes particularly obvious for the prolonged and complicated treatment of multidrug-resistant tuberculosis (MDR-TB). Situated standardization, as introduced by Zuiderent-Jerak [2007a, 2007b] offers a way out of this dilemma. It helps to focus on how standards need to be situated in practice rather than viewing standardization and local adaptation as mutually exclusive practices. How do actors relate standardization and individual care in their practices of treating MDR-TB? Results from qualitative fieldwork at the first MDR-TB treatment sites of the Indian TB programme show that actors situate standards in a particular way. They assess the role of guidelines in a particular situation and on that basis recognize the core recommendations of guidelines or go beyond the guidelines. This allows actors to negotiate how standards should be situated and reconciles the dilemma between local adaptation and standardization. Having guidelines internalized, as is common for Indian TB control, bears both promises and pitfalls for engaging in standardization processes in a situated manner. The results contribute to science and technology study scholarship on guideline development. They highlight how actors coordinate the situating of standards and how this depends upon cultures of control. This illustrates the potential of qualitative studies on local adaptation for guideline developers by revealing existing practices of relating and negotiating local adaptation and standardization.     

La recherche d’efficacité dans les actions de santé au travail. Le « travail sur le travail » comme alternative a la formation sur les risques psychosociaux

Based on a significant experience of interventions and research interventions in the field of occupational health, the authors wished, based on the assessment of several psychosocial risk prevention action plans, provide several reflections to build a risk-based alternative approach. This approach promoted “a work on a work” by the actors. This work becomes a source of knowledge and transformation. Here, the professionals in the field are not only informants on the work and adresses of recommendations, but also producers of knowledge, understood for them. The program presented involves the actors of work to overcome the obstacle of the transition from diagnosis to action.     

Convention in joint activity

Conventional behaviors develop from practice for regularly occurring problems of coordination within a community of actors. Reusing and extending conventional methods for coordinating behavior is the task of everyday reasoning .
The computational model presented in the paper details the emergence of convention in circumstances where there is no ruling body of knowledge developed by prior generations of actors within the community to guide behavior. The framework we assume combines social theories of cognition with human information processing models that have been developed within Cognitive Science. The model presented reflects both elements of the framework. Conventional behaviors are partially coded in the predisposition of participants in a joint activity to expect certain points of coordination to develop during the course of the activity. The expected points of coordination that are commonly assumed form a design for an activity . Because of uncertainty, interruptions, and numerous other opportunities to get off-track and out-of-synch, the participants must work jointly and continuously to achieve conventional coordination.
One feature of the model is that the community improves its performance despite the fact that individual actors reason independently about their experiences. Another important feature of the model is that the mechanisms for improving behavior are tied to the memory function of individual actors. A third important feature is that the social interaction among the participants simplifies and drives the everyday reasoning processes. An analysis of a large set of computational experiments supports the theoretical position that is developed regarding everyday reasoning and convention.     

Elaboration and Attitude Strength: The New Meta‐cognitive Perspective

The effect of elaboration (i.e., information processing) on attitude strength has been a key prediction of some of the most influential theories of persuasion over the past few decades. This article provides a new look at this relationship. After reviewing support for the notion that structural processes (i.e., knowledge acquisition, structural consistency, and attitude accessibility) drive the effect of elaboration on attitude strength, we examine recent work investigating the role of meta‐cognitive factors in this domain. Based on recent evidence, we propose that the effect of elaboration on attitude strength depends largely on people's perceptions of their own elaboration and their beliefs that more elaboration produces better judgments that can be held with greater certainty. We highlight the role of naïve theories in these effects, suggesting that they might be more malleable than previously known, and call for future research into some of the important remaining questions in this area that have yet to be fully explored.     

Engineers and Active Responsibility

Knowing that technologies are inherently value-laden and systemically interwoven with society, the question is how individual engineers can take up the challenge of accepting the responsibility for their work? This paper will argue that engineers have no institutional structure at the level of society that allows them to recognize, reflect upon, and actively integrate the value-laden character of their designs. Instead, engineers have to tap on the different institutional realms of market, science, and state, making their work a ‘hybrid’ activity combining elements from the different institutional realms. To deal with this institutional hybridity, engineers develop routines and heuristics in their professional network, which do not allow societal values to be expressed in a satisfactory manner. To allow forms of ‘active’ responsibility, there have to be so-called ‘accountability forums’ that guide moral reflections of individual actors. The paper will subsequently look at the methodologies of value-sensitive design (VSD) and constructive technology assessment (CTA) and explore whether and how these methodologies allow engineers to integrate societal values into the design technological artifacts and systems. As VSD and CTA are methodologies that look at the process of technological design, whereas the focus of this paper is on the designer, they can only be used indirectly, namely as frameworks which help to identify the contours of a framework for active responsibility of engineers.     

Top-Down Attentional Guidance Based On Implicit Learning of Visual Covariation

The visual environment is extremely rich and complex, producing information overload for the visual system. But the environment also embodies structure in the form of redundancies and regularities that may serve to reduce complexity. How do perceivers internalize this complex informational structure? We present new evidence of visual learning that illustrates how observers learn how objects and events covary in the visual world. This information serves to guide visual processes such as object recognition and search. Our first experiment demonstrates that search and object recognition are facilitated by learned associations (covariation) between novel visual shapes. Our second experiment shows that regularities in dynamic visual environments can also be learned to guide search behavior. In both experiments, learning occurred incidentally and the memory representations were implicit. These experiments show how top-down visual knowledge, acquired through implicit learning, constrains what to expect and guides where to attend and look.     

A Network Perspective on the Processes of Empowered Organizations

Organizational empowerment is a multi-faceted concept that involves processes occurring both within and between organizations that facilitate achievement of their goals. This paper takes a closer look at three interorganizational processes that lead to empowered organizations: building alliances, getting the word out, and capturing others’ attention. These processes are located within the broader nomological network of empowerment and organizational empowerment, and are linked to particular patterns of interorganizational relationships that facilitate organizations’ ability to engage in them. A new network-based measure, γ-centrality, is introduced to capture the particular network structure associated with each process to be assessed. It is demonstrated first in a hypothetical organizational network, then applied to take a closer look at organizational empowerment in the context of a coordinating council composed of human service agencies. The paper concludes with a discussion of the implications of relationships between these processes, and the potential for unintended consequences in the empowerment of organizations.     

Moving beyond ethical decision-making: a practice-based view to study unethical sales behavior

Changes in the business environment are rapidly transforming sales practice and pressuring the integrity of key actors in sales. Given that unethical sales behavior is a social activity produced and reproduced by various actors in a complex sales task environment, we introduce a novel research perspective to the study of unethical sales behavior, namely a practice-based view. With knowledge from a systematic literature review and a practice-based view from organization research, we suggest that unethical behavior should be studied as a practice formed through socialization and interaction with relevant others. This view provides an important alternative as well as a complementary perspective to the ethical decision-making paradigm that has dominated the field for several decades. The study answers scholars’ recent calls to strengthen the theoretical foundation of sales ethics research and further extend its perspective toward the social context of sales. With a focus on dynamics, social relations, and the enactment of practices, the practice-based view produces new types of knowledge on unethical behavior and potential new means for addressing it. The article makes suggestions for future practice-based research and proposes several theories for use in studying unethical behavior in currently important sales contexts.