Casemix accounting systems and medical coding:organisational actors balanced on "leaky black boxes"

The adoption of DRG coding may be seen as a central feature of the mechanisms of the health reforms in New Zealand. This paper presents a story of the use of DRG coding by describing the experience of one major health provider. The conventional literature portrays casemix accounting and medical coding systems as rational techniques for the collection and provision of information for management and contracting decisions/negotiations. Presents a different perspective on the implications and effects of the adoption of DRG technology, in particular the part played by DRG coding technology as a part of a casemix system is explicated from an actor network theory perspective. Medical coding and the DRG methodology will be argued to represent ``black boxes''. Such technological ``knowledge objects'' provide strong points in the networks which are so important to the processes of change in contemporary organisations.

Education and racism:a study of the teachers' and the pupils' relations in the schooling of black boys

This thesis examines the teachers' and the pupils' relations in the schooling of black boys. The study using the methodology of participant observation focusses on one school (Kilby) in an area of black population in an English city. The thesis’s intentions are two fold: firstly, in order to examine these relations, two major aspects of their interaction are addressed, that of the absence of teachers from conventional 'race-relations' research, and, the identification and examination of the anti-school pupils' sub-cultures. Two substantive questions are asked: what is the response of the teachers to the schooling of black pupils? and, what is the meaning of the pupils' resistance to schooling? Secondly, in attempting to answer these questions and offer a critique of the dominant 'race-relations' culturalist explanation of black youth's response to schooling, a theoretical framework has been developed which takes account of both the 'economic' and the 'sociological' perspectives. Methodology allowed and pointed to the importance of examining the teachers' ideologies and practices as well as those of the black boys. It is argued that a class analysis of the racially structured British society is more adequate than the conventional ethnic approach in explaining the black boys' location within Kilby School. Hence, it is posited that the major problem in the schooling of black youth is not that of their culture but of racism, which pervasively structures the social reality at Kilby school. Racism is mediated both through the existing institutional framework that discriminates against working-class youth and through the operation of race specific mechanisms, such as the process of racist stereotyping. It is thus further argued that the Kilby school teachers are of central causal significance to the - problems that the boys encounter. Furthermore, it is in response to these racist ideologies and practices that both West Indian and Asian pupils develop specific forms of collective resistance, which are seen to be linked to the wider black community, as legitimate strategies of survival.

The effect of stimulus location on the major components of the visual evoked response

The topographical distribution of the pattern reversal Visual Evoked Response (VER) was recorded from a localised montage of 20 electrodes over the visual cortex. The response was recorded after stimulation with a black and white checkerboard stimulus. The effect of field location on the major components was investigated in 11 subjects (age range (23-55). The major components of the half field response were; a negative around 75ms (N75) followed by a positivity around 80ms (P80), then a positivity around 100ms (P100) followed by another positivity at around 120ms (P120) and a negativity at approximately 145ms (N145). No effect of field size could be demonstrated on either the amplitude or latency of the late negativity, N145. No significant effect of field size or location was shown on the latency of the P100 response. A delay previously shown in the upper half field response was therefore not substantiated. In contrast the amplitude of the major positivity, P100 was significantly affected by the field size and location. The amplitude of both P100 and N145 were significantly reduced following upper field stimulation when compared with the lower field response. No significant amplitude difference between the upper and lower field responses was demonstrated using electroretinography, the amplitude may therefore be reduced as a result of the ventral position of the upper field representation on the visual cortex. The lateral half field VEP was compared with the distribution of the visual evoked magnetic response (VEMR). The distribution of the VEMR supported the proposal that the paradoxical lateralisation of the VEP half field response is the result of the source being directed ipsilaterally. The morphology of the VEP following octant and double octant stimulation suggests that the response is generated in the striate cortex, with a reversal in response distribution following stimulation of the upper vertical and horizontal meridia.