Health care technology. Evolution toward revolution

The assessment process has a significant effect on the development and diffusion of any new technology. An assessment during the infancy of a new technology may have to be updated as more experience and data accumulate and change the analysis of the technology's safety and effectiveness. An outdated assessment can result in inappropriate utilization either by hindering diffusion of a valuable technology or by promoting utilization of an inappropriate technology. Those who conduct technology assessments must recognize that technologies have life cycles of their own.     

Microstructural analysis in interorganizational systems

This paper argues that network analyses of interorganizational relations should begin by examining the way in which relations are organized at the local level. It posits that systematic departures from random models for dyad and triad censuses should be found before interpreting structural patterns isolated by analytic techniques concerned with overall network structure. Three principles of organizational bonding (resource inequality, reciprocity, and redundancy) are identified, and the implications of these for dyadic and triadic microstructures are detailed. Particular attention is given to differentiating between microstructural patterns to be anticipated when a system consists of autonomous actors approximately equal in power and resources and those expected when a system is highly centralized.     

Consumers' subjective perception of price in times of inflation

This article suggests that inflation blurs the information content of prices, affecting consumers' subjective perception of prices. Preliminary evidence is provided by examining consumers' upper and lower price limits—concepts closely related to price quality perceptions—under extreme inflationary conditions taking place in Israel in 1980. The findings indicate that lower price limit distributions exhibit consistently greater dispersion across three income groups and the overall sample, compared to upper price limits. This effect is attributed to consumers' greater difficulties to provide lower price limits which are based solely on quality judgements, compared to upper limit responses which are partly anchored in more clearly defined budget constraints.     

Halfway technologies

An extraordinary gamut of medical and surgical therapies could be considered "halfway technologies," addressing mere symptoms or manifestations of disease, rather than the underlying pathogenesis. When a "halfway" technology is also lifesaving, its value cannot be underestimated by the individual patient. The example of organ transplantation explored in this column represents a halfway technology. It does not treat the underlying disease itself, but reflects the absolute failure of all efforts at medical and conservative therapy and is a last ditch, gerry-rigged lifesaving solution. And what about "quarter technologies"--the bridge to transplant devices--designed to get the patient halfway to the final halfway procedure?     

Knowledge gap effects in a health information campaign

The evaluation of a campaign to increase cardiovascular health knowledge indicates that within the treatment community, education was a significant predictor of knowledge before the campaign but was not a significant predictor after the campaign. Two variables related to motivation to acquire information about cardiovascular health (age and perceived threat of heart attack) were not significant predictors of knowledge before the campaign but were significant predictors afterwards. These results suggest that the infusion of information into a social system via the mass media can close as well as open knowledge gaps and that motivation to acquire information in a specific knowledge domain is a factor controlling gap effects.     

Dropouts and continuers in Gamblers Anonymous: Part four. Evaluation and summary

In this fourth part of a study of dropouts from Gamblers Anonymous, the design, aims and rationale of which are outlined in part 1 (Brown, 1985b) experiences of GA by a sample of dropouts who had attended more than one meeting are analyzed and compared with similarly obtained responses from a group of continuing attenders who had not gambled for at least one year. The overall pattern of findings from the three prior parts of the study is interpreted as suggesting that

1. Gamblers anonymous may be better at coping with those whose gambling has been severely excessive and had led to many problems. However GA's approach is not so easily accepted and therefore not so effective with those who seek help at an earlier stage in the development of their problems.
2. Gamblers Anonymous may work better with those who have few relapses or best with those who have none at all. Although it may be very helpful in avoiding relapses, it may be less helpful in dealing with them when they do occur.

problems of the representativeness of the sample, of generalizing to Gamblers Anonymous as a whole, and of arguing from associations to causes are discussed. A general picture of the organization as a whole is presented.