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We are each unique – our brains make us so. At the microlevel the network in our heads is then tickled out into the the Web in, at first. the simplest of ways. Our first post, our first comment is that first baby-step. Unlike our firsf steps though, online everything we do is saved, is monitored, is shared. It takes on a life of its own. Multiplied billions of times now many millions of us have learnt to crawl, then walk, then run online. As we are virtual we can split into many versions or parts of ourselves too – the professional and private the immediate split, but then into hobby groups and as here, a study group. The network of networks is a living thing that mathematics can help to weight and categorize, even to visualise, but crucially – the point made here, humanising the maths requires the insight of someone asking questions, seeking to interpret what it taking place. I see currents in a digital ocean that transpires into a cloud that then precipitates digital artefacts in a myriad of other places. Others, like Yrjo Engegstrom, see the growing tendrils of a funghi. Either way it is fascinating to condense, simplify and sharing the thinking.
WebScience is the scientific study i.e. the identity of problems, the formulation of hypotheses and their in depth scrutiny and analysis, written up and published for sharing, discussion and further debate. This should mean publishing findings with the broadest possible variety of audiences in mind not just to the academic community, from whom further research should be expected, building on the work already done, but to other audiences who through the Web or serendipity, would find the work either appealing, appalling or inspiring.
To help with ‘meaning making’ (Conole, 2011) the metaphor I use to describe the Web is to compare it to the earth’s water cycle where the ocean is awash with digital content, and akin to Web 1.0 influenced by currents and tides, then evaporating into the atmosphere where it forms clouds is shared and transformed (Web 2.0) only to fall as precipitation and return to the ocean.
How much the Web conforms or differs from this pattern helps my analysis and comprehension of what is taking place.
Fig. 1 How we learn behaviourism (Vygotsky) to third generation activity theory (Engeström ) and the World Wide Web. (Doodle by J Vernon, 2013)
A more organic metaphor that places the Web in one context that interests me the workplace is that used by Yrjo Engeström (2008), in which a transmogrification of the model of an Activity System (Fig. 2) becomes like the ‘fingers’ of a funghi. The web after all is alive and growing. Here, an Activity System should be seen not as a static entity, but rather a living and growing thing. KnorrCetina (2003) talks of ‘flow architecture’ and if neither of these concepts ring true for you in then Zerubavel (1997) talks of ‘a mindscape’ while Cussins (1992) talks of ‘cognitive trails’.
Such patterns help describe, explain and predict what is happening in the Web, indeed a third metaphor, building on the ideas of Vannevar Bush from the 1940s, would be to think of the Web as a brain and to draw on lessons being learnt from neuroscience on how complex systems form connections and clusters. In turn, the brain would be an additional important area of study in relation to assistive technologies in relation to chronic illness and memory loss such as with. Alzheimers or Parkinsons.
In relation to WebSciences at the University of Southampton (SOTON) my interest in the iPhD begins with the lofty desire to ‘make a difference’ and to do so drawing on a combination of interests, professional experience, training and study.
It is from a career identifying problems, devising a synopsis, writing treatments, then scripts where amongst a plethora of industry and government an interest in health has developed. This can be pinpointed further to an interest in what role the Web can play in medicine, to inform and support health workers and patients, in particular patients with chronic illnesses such as Alzheimers, Parkinsons, asthma, diabetes and epilepsy.
Focusing even further to one illness and a particular group I have been considering what role e-learning might play to improve adherence to drugs.
I have produced training videos for pharmaceutical companies on the use of preventer inhalers.
My interest with e-learning is to use an inexpensive and readily accessed platform such as Qstream (Kerfoot & Baker, 2012) to deliver appropriate content, including video, through mobile and other devices in order to improve adherence to medication. A literature research has not shown the use of video in this way but there a number of studies where text messaging has been used to improve weight loss (Haapala, 2009), smoking cessation (Rodgers, 2005; Bramley, 2005) and diabetes management (Benhamou, 2007; Cho, 2009; Franklin et al, 2006; Hanauer, 2009; Rami, 2006) which suggests that e-learning initiatives to patients could change behaviours (Cochrane, 1992; Rand, 1994), while emails to multiple-choice questions are used to support medical students. (Kerfoot, 2008, 2009, 2009b, 2010).
A research question I would like to consider is:
‘Can the health of moderate persistent asthmatics aged 14-25 be improved through an e-learning programme that uses targeted emails linked to tailored short videos online (under 90 seconds) in order to achieve adherence to taking their prescribed asthma preventer inhalers to 80% or more?
The appropriateness and relevance to me of such an approach to research is to start with a clearly define problem and place it in a context where scrutiny can occur. In relation to the Web
increasingly the opportunity exists to use and gather ‘big data’, in this instance therefore to have at one level the belief that the globally, all those being treated for asthma form the data set.
Indeed, patients defined as anyone with a chronic illness who should be regularly and consistently taking preventative drugs for a chronic illness would embrace diabetics, those with epilepsy, Parkinson’s and Alzheimers. It is this bigger cohort, and the the role the Web can play to improve the prognosis of those with chronic illnesses that may be the focus of my interest for doctoral research.
It is vital to understand how people learn insights gained studying for a Masters in Open and Distance Education can in part be summarised in Fig. 6 as from each learning theory comes an appropriate research methodology. How therefore are patients with a chronic illness becoming informed about their condition and why in many cases are they failing to act upon it?
Fig. 2 Learning Theories drawn from multiple sources (Authors given). J Vernon (2013)
Benhamou PY, Melki V, Boizel R, et al. Oneyear efficacy and safety of web-based follow up using cellular phone in type 1 diabetic patients under insulin pump therapy: the PumpNet Study.
Diabetes Metab. 2007;33(3):220–226.
Bramley D, Riddell T, Whittaker R, et al. (2005) Smoking cessation using mobile phone text messaging is as effective in Maori as non-Maori. N Z Med J. 2005;118(1216):U1494.
Cho JH, Lee HC, Lim DJ, et al. Mobile communication using a mobile phone with a glucometer for glucose control in type 2 patients with diabetes: as effective as an internet-based glucose monitoring system. J Telemed Telecare. 2009;15(2):77–82.
Cochrane, G.M. (1992) Therapeutic compliance in asthma; its magnitude and implications. Eur Respir J 1992;5:122458/
Conole, G (2011) Designing for learning in a digital world. Last accessed 30 May 2013 http://www.slideshare.net/grainne/conolekeynoteicdesept28
Cussins, A. (1992). Content, embodiment and objectivity: The theory of cognitive trails. Mind,
Engeström.Y (2008) From Teams to Knots: Activity theoretical studies of Collaboration and Learning at Work. Learning in doing: Social, Cognitive & Computational Perspectives.
Cambridge University Press. Series Editor Emeritus. John Seely Brown.
Franklin, V, Waller, A, Pagliari, C, & Greene, S (2006), ‘A randomized controlled trial of Sweet Talk, a textmessaging system to support young people with diabetes’, Diabetic Medicine, 23, 12, pp. 13321338, Academic Search Complete, EBSCOhost, viewed 16th March 2013
Hanauer DA, Wentzell K, Laffel N, et al. Computerized automated reminder diabetes system
(CARDS): email and SMS cell phone text messaging reminders to support diabetes management. Diabetes Technol Ther. 2009;11(2):99–106.
Haapala I, Barengo NC, Biggs S, et al. (2009) Weight loss by mobile phone: a 1y ear effectiveness study. Public Health Nutr. 2009;12(12):2382–2391.
Kerfoot BP, Armstrong EG, O’Sullivan PN. (2008) Interactive spaced education to teach the physical examination: a randomized controlled trial. J Gen Intern Med 2008;23:973–978. Kerfoot BP. (2009a) Learning benefits of online spaced education persist for 2 years. J Urol 2009;181:2671–2673.
Kerfoot BP, Kearney MC, Connelly D, Ritchey ML. (2009b) Interactive spaced education to assess and improve knowledge of clinical practice guidelines: a randomized controlled trial. Ann
Kerfoot BP, Lawler EV, Sokolovskaya G, et al. (2010) Durable improvements in prostate cancer screening from online spaced education a randomized controlled trial. Am J Prev Med 2010;39:472– 478.
Kerfoot, BP., Baker, H., (2012) An Online SpacedEducation Game for Global Continuing Medical Education: A Randomized Trial. Annals of Surgery Volume 256, Number 1, July 2012. pp.12271232 http://www.annalsofsurgery.com
Kerfoot, BP., Baker, H., Pangaro, L., Agarwal, K., Taffet,G., Mechaber, A.J., Armstrong, E.G. (2012) An Online Spaced Education Game to Teach and Assess Medical Students: A Multi-national Prospective Trial. Technology and Learning. Academic Medicine, Vol. 87, No. 10 / October 2012 pp. 1443 -1449
KnorrCetina, K. (2003). From pipes to scopes: The flow architecture of financial markets. Distinktion, 7, 7–23.
Rand, C.S., Wise, R.A. (1994) Measuring adherence to asthma medication regimens. Am J Respir Crit Care Med 1994; 149:6976
Rami B, Popow C, Horn W, et al. (2006) Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus. Eur J Pediatr. 2006;165(10):701–705.
Rodgers A, Corbett T, Bramley D, et al. Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging. Tob Control. 2005;14(4):255–261.
Zerubavel, E. (1997). Social mindscapes: An invitation to cognitive sociology. Cambridge, MA: Harvard University Press.
- Living with Chronic Illness Changes Your Life (theadventuresofarthritisnfibromyalgia.wordpress.com)
- The Ingredients of being chronically ill (brainlesionandme.com)
- An A to Z of chronic illness: Part 5 (brainlesionandme.com)
When I think if learning, I think of the minuscule intricacies of the component parts of the brain and at the same time the immense vastness of the known universe.
As humans we are eager to understand everything.
It seems appropriate to marry neuroscience with astrophysics, like brackets that enclose everything. From a learning point of view then ask as you look at a person or group of people, ‘what is going on?’ specifically, ‘what is going on in there? (the brains) and between them to foster insight, understanding, innovation and advancement.
The best interface for this, a confluence for it all, is the Internet and the connectedness of it all.
What has the impact of the Internet been and based on everything we currently know, where do we presume it is going?