This project explores the dynamics of medical innovation using the development of deep brain stimulation therapy in paediatric neurology as a case study. Ethnographic research was conducted with a multidisciplinary clinical team developing a novel clinical service that uses deep brain stimulation (DBS) to treat children and young people with movement disorders. Interviews and observations were carried out to identify key challenges encountered by team members, and to explore the way in which team members attempt to manage these challenges in day-to-day clinical practice. Four key challenges were identified: coordinating multidisciplinary teamwork, identifying suitable candidates for deep brain stimulation; managing the expectations of patients and families; and measuring clinical outcomes. By exploring the strategies used by team members to overcome these challenges, this thesis develops the Complex Model of Medical Innovation which challenges prevalent, linear ‘bench-to-bedside’ understandings of innovation. While scientific ‘discovery’ is one source of medical innovation, new therapies in medicine also emerge from technology transfer (the transfer of technology from one sector into another) and clinicians’ learning-in-practice (the ability of clinician to learn ‘on the spot’). Importantly, this thesis demonstrates that technology transfer, learning-in-practice, and medical innovation in general are shaped by various socio-political trends. The activities of the multidisciplinary team and their novel DBS service, for example, have been shaped by the evidence based medicine movement, commercial interests, and a movement that promotes multidisciplinary approaches to paediatric service provision. A consequence of these influences is that the team subjects their patients to a broad clinical gaze. Adopting the Complex Model of Medical Innovation has important consequences: First, it draws attention to the innovative activities of clinicians, activities that may be worth disseminating in other contexts. Second, it highlights the role of existing social and material factors in shaping the development of new clinical services. The social impact of new technologies will be influenced by these contextual factors and cannot be attributed to the technology alone.

The thesis explores the role of inscription in the management of social work and the effect of this on front-line practice. Inscription is a response to current trends in public sector management, in particular the focus on transparency, accountability and performance management, which drive an increasing demand for the documentation of work in areas of professional practice, traditionally assumed to be at odds with codification. The research investigates the effect of new documenting procedures in social work, specifically, the introduction of a ‘standard assessment format’ and responses to this by social work practitioners. The thesis uses a constructivist theoretical framework drawn from Actor Network Theory, which understands inscription as a performative technology, which is used to manage the process and content of practice through representation and translation. The thesis is based upon an exploratory, critical case study in a Local Authority Children and Families Social Work Service between November 2004 and May 2006. The thesis explores the translations between practice (doing), articulation (describing) and textual representation (documenting). For front-line practitioners, practice is understood as the ‘doing’ of work whilst the ‘describing’ and ‘documenting’ of work are categorised as secondary, bureaucratic concerns, with no material effect on the core processes and outcomes of social work practice. The research indicates that social work practice is in fact is a series of practices, which include the doing, describing and documenting of work. The research suggests that the conceptualisation of practice as ‘doing’, rather than ‘describing’ and ‘documenting’ work determines practitioner responses to the use of inscription in managing social work practice.

<p>The purpose of this study is to examine how the learning process of four Swedish firms in the emerging market Angola works. Theoretical framework developed identified different theory streams such as; experiential learning, networks and incremental steps derived from internationalization theory. These theories we believed would explain the learning process in a market characterized by growth and risk factors. We have interviewed managers operating in Angola at four Swedish MNC‟s, in which we identified patterns of learning between the firms. Having analyzed elements from empirical and theoretical framework it can be clearly seen that firms learn through experiential learning and networks. These two factors can take different pattern forms as it depend on the MNC‟s industry and the firms experience from previous activities in Angola and nearby countries i.e. incremental steps. Added to the developed framework are previous experience and the institutions in the market. These five elements are interrelated, however, firms can learn about the market in a more effective way by understanding the institutional factors that are present.</p>

This thesis investigates the role of accounting information in the automotive industry restructuring of 2008 and 2009 in Canada. The crisis in the automotive industry led to government-funded restructurings for two of the top manufacturers in North America, effectively adding the government as a third party to the negotiations. Following a series of negotiations that occurred between AutoCo and UnionA, I conduct a case study that examines the individual actors’ use of accounting inscriptions in negotiations, as well as explore the dynamic interaction between accounting and trust at the negotiation table. The use of actor network theory highlights the individual actors, their actor-networks, accounting inscriptions and the continuous translation process inherent in labour-management negotiations. Accounting inscriptions are shown to play a central role in negotiations, particularly as a forum for bringing the actor-networks together. Furthermore, I explicate the notion of tactical trust, as it emphasizes the assessment, monitoring, and adjustment inherent in decisions to trust actors within dynamic business contexts. I also investigate the roles that the Canadian government played throughout the restructuring of the automotive industry. Through an in-depth case study of the restructuring from its antecedents through to outcomes, the research focuses on the roles of the government officials in the negotiations between the company and the unions, and their use of accounting information. The empirics highlight that the government not only acted at a distance but utilized sovereign power and direct intervention to achieve their objectives in the automotive industry restructuring. I find that the accounting served as the flexible substitute for the government’s presence at the negotiations table while they were acting at a distance and is used as an immutable parameter when the government directly intervened. This paper extends the governmentality literature by highlighting the coercive character of government actions, technologies and programs, and the notion of government in action. I consider the implications of these research findings on the labour-management negotiations, accounting, actor network theory and governmentality literature. In conclusion I also highlight various avenues of future research. / Thesis (Ph.D, Management) -- Queen's University, 2013-10-09 20:46:13.009

The term ‘prosthetic’ is used increasingly across the social sciences and has taken on a theoretical life as a result of debates springing from contemporary studies of science and technology, medical anthropology and citizenship. This research considers whether the usage of ‘prosthetic’ and ‘prosthesis’ has however, become all too distanced from a grounded understanding of these terms, and is now in many ways synonymous with the term ‘cyborg’, therefore obscuring the specific relationships that prostheses represent. It asks if these terms have become a ‘catchall’ of technological subjectivities, without any basis in lived experience. Through ethnographic research into the manufacture, marketing and usage of medical prostheses in a Serbian inpatient rehabilitation centre, as well as interviews with prosthesis manufacturers, salespeople, as well with various citizens young and old, I present a nuanced view of the way in which citizenship itself is enacted. Citizenship is also a process of augmenting the body, both explicitly, such as in the (re)construction of socially acceptable bodies who have the capacity to labour, and implicitly, such as in the process of acquiring passports and identity documents. This process of externalising, and of the distributing of elements of the self into objects and relationships outside of the biological body forms the basis of what I term prosthetic citizenship. In my search for a grounded and ethnographically informed understanding of prostheses, and of prosthetic citizenship, key themes emerge, such as hope, normality, morality and the relationship of technology to the bodies. I find that prostheses are always sites of entanglement and paradox, but that they are also equally full of promise, and that in understanding how, why and in what capacities they are used, they emerge as capable of bridging the divide between theoretically complex abstract relationships, and the pragmatic realities of daily life.

Corporate codes of ethics (CCEs) have become increasingly prevalent as overarching ethical guidelines for multinational corporations doing business around the globe. As formal documents, governing corporations’ work, policies, and ways of doing business, CCEs are meant to guide all business activities and apply to all of the corporation’s employees, suppliers, and business partners. In multinational corporations, this means that diverse countries, cultures, and a myriad of heterogeneous actors are expected to abide by the same standards and guidelines, as stipulated in the CCE. Despite this empirical reality, CCEs have previously been approached by academics mainly as passive company documents or as marketing or management tools, in the contexts of their country of origin. Building on Actor-Network Theory this thesis applies an interactionist ontology, and relational epistemology, seeing the code as a sociomaterial object with both material and immaterial characteristics, and moving in a global arena. Furthermore, the CCEs are assumed to be susceptible to change, i.e. translations. With these assumptions, the CCE of a multinational corporation is followed as it travels between its country of origin (Sweden) and another country (China) and goes to work in different contexts. Heterogeneous empirical materials such as interviews, company documents, observations, shadowing, and emails are used to present stories from different contexts where the CCE is at work. The overall purpose of the thesis is to contribute to the theorizing of CCEs, thereby providing further understanding of the possible consequences of CCEs in contextually diverse settings. By following traces of a CCE, this study posits the need for a simultaneous understanding of three dimensions of CCEs for CCEs to be understood in contextually dispersed settings. The three dimensions are a) material translations of the code, b) enactments of these translations, and c) ideas associated with the material and enacted code.  The study contributes to the understanding of CCEs by highlighting a specific country-context (China), by putting together knowledge from codes in various contexts, and the overarching contribution lies in highlighting codes as different kinds of objects and adding to the existing literature – specifically, contextualizing the CCE as a vaporous object.

Despite the broad discourse on fragile states and the threat they pose to the contemporary world order, the literature on the subject does to a large extent ignore the material factors behind the causes of state fragility. Scholars and organizations in the field have almost exclusively adopted the Social Contract Theory (SCT) in order to explain state fragility as a problem caused by social factors. This study broadens the discourse by applying SCT as well as the Actor-Network Theory (ANT) on the case study of Sudan, in order to do a deductive theory testing of the added value of each theory. The results of this study show that while the Social Contract Theory does explain many factors behind state fragility, the application of the Actor-Network Theory adds to this by also incorporating the networks between the social and material determinants in societies. This research contributes to the debate on fragile states by adding to the scarce research on the materiality of fragility through the use of the Actor-Network Theory. The positive results of this thesis encourage future use of this theory in the field as it has the potential to give new insights in how to deal with fragile states.

Biofuels have caught the attention of the world as a source of renewable energy which can provide energy security, advance rural development, mitigate climate change, and foster international trade. India developed the National Mission on Biodiesel (NMB) as a rural development policy option to produce biodiesel from Jatropha curcas and promoted it as a pro-poor and pro-growth initiative. This thesis examines the emergence, trajectory, and the consequences of the NMB to assess how the NMB worked as a test development policy programme in India. The thesis focuses on the policy-making process in India, particularly the role of narratives in development policy-making and how it leads to blueprint development. It argues that the narratives supporting the NMB were based on shaky scientific facts and did not represent the needs of the rural people. The thesis takes into account that policy processes involve various actors, networks, their interactions and their knowledge, communication of knowledge and politics. It traces the role of various actors such as policy-makers, bureaucrats, researchers, professionals from private companies and NGOs, farmers, and landless labourers involved in the biodiesel mission. This thesis is anchored in the discipline of Science and Technology Studies (STS) and it draws from Actor Network Theory (ANT) and Social Construction of Technology (SCOT) to analyse how the NMB progressed as a test policy model and whether it really was a ‘pro-poor’, ‘pro-growth’ development initiative. Hence this thesis studies how development narratives were used to promote the biodiesel initiative, how networks were created to establish the biodiesel mission as a policy option and advocate its adoption, and in turn how the NMB progressed as a development initiative. As the thesis draws from SCOT the discussion will emphasise on the practices of a society adopting a technology/development initiative, the importance of users (scientists, policy-makers, farmers, labourers, representatives from the industry and NGOs), how users are represented, and in turn how the NMB had an impact on the people adopting it. This thesis contributes to the understanding of the policy-making process of development renewable policies in India and it also examines the apparent inevitability of technological solutions to development challenges. It also contributes to the literature of narratives serving as ‘blueprints’ for development policy-making. Additionally it adds to the literature on biofuels and reveals the complex nature of regional and national networks that comprise a part of the rising Global Biofuel Network.

The sociotechnical system of print-on-paper for the dissemination of textual information prevails despite widespread concerns about its sustainability. On the basis of sociotechnical transitions theory the print-on-paper system is perceived as a regime. Information technology is identified as one of the generic technologies that has the potential to address the unsustainability of the incumbent regime. Its potential effects are examined through the development of the electronic book, which is defined as those IT applications providing an alternative form of textual display to printed paper. Yet, such applications have remained marginal. According to sociotechnical transitions theory the electronic book can be seen as a niche in relation to the print-on-paper regime. An alternative conceptualisation of transitions as a process of network reconfiguration is suggested. On that basis, the electronic book is depicted as a number of emergent innovation networks. Social Network Analysis methods informed by network approaches to innovation theory are applied to visualise and discuss these emergent networks. In one of the representations, the electronic book is mapped as a sociotechnical network including organisations, users and technologies. It emerges that network formation often transgresses a distinct niche-regime divide. Patterns of network interaction are explored and assessed as to whether they represent a sociotechnical transition in progress. The analysis reveals different patterns of network formation which are indicative of prospective sociotechnical trajectories where different concepts of the electronic book are emphasised. It emerges that the discussion of sustainability and the emergence of the electronic book remain largely unlinked.

Implementation of the Foreign Account Tax Compliance Act (FATCA) goes beyond a technological modification to automate the identification of US clients and report their information to the IRS. FATCA implementation requires foreign financial institutions (FFIs) to learn the new requirements, to modify their organizational structures and their employees’ relationships and responsibilities, and to adjust the technology that helps the employees collect new FATCA-related information and to process that information so that it can be reported to the IRS in the correct format. In spite of that, research on FATCA implementation has focused on studying each constituent separately. However, according to the information systems (IS) body of research and from a systems thinking perspective, the whole (the bank that is complying with FATCA as a system) is more than the sum of its parts (the information, technology, and social structures that it includes). For this reason, this dissertation argues that in order to achieve an effective FATCA implementation and reduce tax evasion activity, FATCA implementation should be studied from an IS perspective. This will assist in appreciating the complexity of FATCA implementation and compliance and will help practitioners to better anticipate future uncertainties. The dissertation uses actor-network theory (ANT), as it is a socio-technical theory, to investigate the implementation of and compliance with FATCA in a Jordanian local bank. Our interpretation revealed a number of problems in the bank’s compliance initiative; among them were the issues of overlooking technology, information, and the bank’s customers as actors with interests of their own. Accordingly, we provide eight propositions that can enhance the effectiveness of FATCA compliance. Tax-evasion has been shown in the literature to be a predicate crime involving money laundering (ML), i.e., a crime that generates proceeds that need to be treated in secretive ways so that they can be falsely legitimized. We argue in this dissertation that the findings of our case study could provide lessons for the anti-money-laundering (AML) domain in relation to its structurally coupled domain of ML. Thus, we presented some lessons that can be tested in the ML/AML domains.