Mattias Höjer
email: hojer@kth.se

Katarina Larsen
email: katarina.larsen@abe.kth.se

Helene Wintzell
email: helene@helenewintzell.se

Sustainable Communications and Innovation: Different Types of Effects from Collaborative Research Including University and Companies in the ICT-sector

Keywords: added value, benefit, collaboration, effects, environment, ICT

This paper presents experiences from the Centre for Sustainable Communications (CESC) located at KTH -The Royal Institute of Technology in Stockholm. Since 2007, the centre has carried out research in collaboration with private firms in the information and communication technology (ICT) and media sectors as well as with public sector organizations in the city of Stockholm. The aim is to share experiences from how the partners of the centre describe benefits and effects from collaborative research. Since the centre is focusing on use of ICT and media technology, rather than technology development per se, this provides an account of a wide range of effects from universityindustry collaborations and new insights into the innovation processes targeting sustainability in the ICT and media sectors. This is an important perspective of sustainable and responsible innovation that is not captured in traditional innovation surveys (counting the number of new products or patents). Areas examined here include: increased knowledge and competence, new contacts and networks, publications, methods and new technology as well as changes in business operations and behaviour targeting sustainable solutions. The results also confirm firm-level business value as a driver for sustainability and provide experiences from involving users in the quest for sustainable and responsible innovation.

Sustainable Communications: Collaboration with Public and Private

The Centre for Sustainable Communications (CESC) was established in 2007 as one of 18 so-called Vinnova Centres of Excellence in Sweden. Centres within the Vinnova Excellence Centre programme receive core funding from the Swedish Governmental Agency for Innovation Systems (Vinnova) complemented with contributions from the Universities and a group of partners. The programme aim is "… to create and develop vigorous academic research milieus in which industrial and/or public partners actively participate in order to derive long-term benefits for society. The programme is also a link in the governmental effort to develop university-industry interaction." [START_REF]Vinnova: Guidelines for the Second evaluation of VINN Excellence Centres[END_REF]. The objective of the Vinnova Excellence Centre programme is to promote sustainable growth in Sweden. This is expected to happen through concentrating experts from different fields in interdisciplinary research centres, and developing products, processes and services [START_REF]Vinnova: Guidelines for the Second evaluation of VINN Excellence Centres[END_REF].

It can be noted that the "long-term benefit for the society" that is mentioned as the aim of the programme is translated into a "development of products, processes and services" in the formulation of the objective. This slight change of words is interesting for centres working towards societal benefits, but not necessarily directly linked to products, processes and services, like CESC. Can societal benefits always be measured in products, processes and services? Is this always what industrial partners in university-industry partnerships demand?

This leads to a bigger question about the usefulness of university-based research, the third mission of universities and, more specifically, research and innovation processes that lead to other types of results than development of new technology or products that are close to market.

The excellence centres, such as CESC, that have been established have to find forms of interaction that will enable collaborative projects to address some of these major challenges ahead and create added value for both industry and academia. The user perspective is important in this work in order to face the challenges of new needs defined by different types of user groups, as well as for private actors' needs, so as to catalyse new innovation processes and create new products.

The areas of activity for CESC include information and communication technology (ICT), media and sustainable development where focus of the areas of activity is environmental issues linked to ICT and media, but also social effects. The research is carried out in collaboration between researchers based at the Royal Institute of Technology (KTH), private firms and regional authorities. This includes collaborative research with people from larger telecommunication firms (such as Ericsson and Teli-aSonera), from the City of Stockholm and Stockholm county, as well as major organizations from the media sector (such as Bonnier, Stampen, SVT -Swedish public service TV, and the Swedish media publishers association).

Taking the objective of development of products, processes and services into consideration, it is likely that many partners join Vinnova Excellence centres with an ambition of getting rather direct benefits for business. With a centre like CESC focusing on environmental research, the link may not be as direct and, therefore, the partners might have other reasons for joining. Instead, they may be in the collaborative research venture in order to increase the understanding of ICT's potential environmental impacts and to increase knowledge about how it can be analysed. In that case, the focus is to get a better understanding of environmental impacts of ICTrather than focusing on development of new short-term businesses and technology. This would go hand in hand with the fact that innovation processes aiming for more sustainable solutions naturally are informed by an increased understanding of environ-mental impacts and how these can be analysed to capture barriers for introducing more sustainable solutions as well as understanding behavioural change when new technology solutions are introduced. With this background, the management of CESC decided to examine how the partners looked upon benefits of being a part of CESC, and started an initiative in 2011 to analyse this.

The aim of this paper is to investigate what benefits partners see in industrysociety-university collaborations on environmental research, and how this relates to long-term benefits for society. The case used here is the VinnEx Centre for Sustainable Communications, CESC. We are using the CESC internal study on partner benefit from 2011 as our main empirical material.

The Investigation of Effects from Collaboration with CESC

In this paper we report on an examination of how the research partners engaged in collaborative research in CESC have expressed different dimensions of "usefulness" or "effects" from the joint research activities. The immediate outcomes of CESC may not be products, processes or services. This enables an examination of other dimensions of expected and perceived benefits from collaborative research.

There may be many reasons for research partners to collaborate with universitiessince there are many different domains of activity that they can refer to their own organization or their members. In order to find these reasons, CESC performed an interview study during 2011 with researchers in academia, and their collaborators in the private sector, about their views on different types of "usefulness" stemming from the collaborative projects at CESC.

One reason for raising these issues at CESC is the variety in the forms of collaboration that the centre has with different types of project partners including collaboration with larger companies in the traditional ICT industry, service companies (in media technology) and public sector organizations at the municipal and county level with an interest in developing new ICT solutions targeting more sustainable communication.

Partners are a crucial and indispensable part of any excellence centre, and there is an outspoken demand on excellence centres to create added-value and to be useful. The interview study at CESC in 2011 had several goals. They were to:

 Show what use and which results were the outcome of the collaboration.  Describe how the collaboration is operating and suggest improvements.  Describe partners' preferences on future activities.

The investigation was mainly undertaken through interviewing CESC participants, and using literature to analyse and interpret the interviews. The interview guide was developed during the period of interviews, and thus the responses are not directly comparable. It was an explicit aim of the study to get as much information from each interview as possible, and to do so by using experiences from previous interviews to improve the questionnaire. Moreover, in parallel with the interviews, some literature was used mainly as a help to navigate and structure the responses. When summarizing the results, a Canadian study [START_REF] Robinson | Report from project: Measuring societal impacts from participatory sustainability research[END_REF] was important for structuring the results. This study, and other studies, were used when developing the interview guide, in order to find ways of identifying the partner benefits. Forty-four people were interviewed (see table 1), including representatives from virtually all partners. Most of the interviews were group interviews, so that several people from the same partner were interviewed at the same time. One of the authors of this paper (Wintzell) made all the interviews. She had deep knowledge regarding CESC and its partners, since she had been director of the centre 2008-2009 and is currently a member of the CESC board of managers. She continuously discussed the interviews with the other two authors of this paper. One of those authors (Höjer) is the current director of CESC, and the other is a researcher on innovation and environment.

Thus, the interview study should not be seen as an objective attempt to define the pros and cons of the partnership, but rather as a way of searching for reasons for the partners to take part in CESC. Each of them pays about 25,000 Euro per year and allocates 0.5-3 full-time employees to CESC activities. Since CESC does not produce so many direct products, processes and services, the rationale for the partnership must be another.

What is Added Value and Usefulness?

A set of categories of "added value" was developed as a framework for analysis based on a review of literature on university-industry collaboration [START_REF] Jacobsson | Universities and industrial transformation: an interpretative and selective literature study with special emphasis on Sweden[END_REF], an analysis of effects from collaborative research and channels for knowledge transfers [START_REF] Faulkner | Making sense of diversity: public-private sector research linkage in three technologies[END_REF] and a study about measuring societal impacts from participatory sustainability research [START_REF] Robinson | Report from project: Measuring societal impacts from participatory sustainability research[END_REF]. The study about channels of knowledge transfer was carried out in three areas of technology innovation and was designed to reveal the variety and broad scope of areas of interaction between university-based researchers and industry in the United Kingdom (UK). The wide range of activities originating from a great variety of research partners is also relevant to take into consideration when analysing the added value that partners see from participating in projects hosted by CESC. In summary, there are two take-home messages from the study on channels for knowledge transfer. Firstly, that the private sector collaborates with academia to get access to networks (that they would not have access to otherwise) and skills relating to methods and problem formulations in an academic setting. Secondly, that the types of interaction and, therefore, the perceived benefit from collaboration is highly specific to the type of company (and their customers, need for skills, and knowledge).

Another more recent initiative in UK is the "Pathways to impact" launched by the Research Councils of UK (RCUK) which describes different domains of effects from research carried out at universities and technical colleges. One of these domains is "interaction with companies" and another domain describes effects in terms of shaping public policy and services [START_REF]Pathways to impacts[END_REF] for example, benefits of research contributing to UK policies on how to change peoples' travelling behaviour. Statements regarding this type of broader description of usefulness of research is requested from researchers' activities in governmentally funded projects and although it may be difficult to foresee what the impact is (or may be) from planned research collaboration, it raises questions about knowledge transfer and perceived usefulness by private and public sector from collaborative projects with researchers based at universities. This example from the UK can, with a broader view of different categories of impacts, be important as a step towards incorporating different types of users' views of benefits from engaging in collaborative research. This issue of capturing impacts in evaluation of social sciences has received renewed attention [START_REF]SSHRC: What have we learned about 'capturing impacts[END_REF] and can benefit from incorporating the collaborative effects and benefits as they are articulated by different user groups engaging in collaborative research.

The discussion about effects of collaborative research also raises questions about the value of including users of services or products early in the innovation process. Studies of innovation and invention networks describe this in terms of "userinnovation" or "open innovation" [START_REF] Chesbrough | Open Innovation: A New Paradigm for Understanding Industrial Innovation[END_REF]. These concepts can also be used to describe user-interaction in the area of climate change policy [START_REF] Larsen | Environmental scenarios and localglobal level of community engagementenvironmental justice, jams, institutions and innovation[END_REF] and roles of users in the innovation process [START_REF] Bienkowska | Public-private innovation: Mediating roles and ICT niches of industrial research institutes[END_REF], [START_REF] Larsen | Climate change scenarios and citizen-participation: Mitigation and adaptation perspectives in constructing sustainable futures, Habitat International[END_REF]. Other methods for engaging users in the innovation process are developed in the field of environmental futures studies, where citizens can have a say in describing what new services and ICT solutions they consider to be important to solve the environmental challenges of tomorrow for transport and mobility [START_REF] Larsen | Technological innovation and transformation perspectives in environmental futures studies for transport and mobility[END_REF]. Actively incorporating experiences from ICT companies themselves is another way of integrating the user perspective on how private firms are perceiving environmental challenges and what solutions they can see on the horizon from a business point of view [START_REF] Kramers | How telecom could save the planet[END_REF], [START_REF] Larsen | Science and technology parks and the integration of environmental policy[END_REF] in the area of ICT and new media for sustainable solutions in a future society.

The expectations of ICT as a "key enabling technology" that can solve many problems in future society is not new. From a Swedish and European perspective there is however a renewed attention to this issue. This can be seen in the reply by the Swedish Agency for Innovation System (Vinnova) to the European Union's Green paper about European research and innovation 1 where research is expected to respond to and solve several of the Europe's futures challenges. Among these Grand Societal Challenges are questions related to finding solutions to environmental problems by the increased use of ICT and other key enabling technologies to face challenges by industry [START_REF]Vinnova: Vinnova position paper on the common strategic framework[END_REF]. These challenges are described in terms of finding energy efficient solutions, sustainable cities, and using the potential in the interaction achieved by partnerships between actors to enhance competitiveness.

One reason for studying innovation systems, from an environmental policy perspective, is to identify system weaknesses that require different kinds of policy interventions to balance the inertia for change and other barriers for new markets to evolve [START_REF] Jacobsson | Innovation system analysis and sustainability transitions[END_REF]. Some areas of policy interventions (that seek to reduce the system weaknesses) that are described aim to improve the framework conditions for development of new knowledge, create arenas for entrepreneurial experimentation, resources and incentives for actors in the innovation system develop new more environmentally efficient technology. This can, in turn, be an important part of the puzzle to facilitate the emergence of new markets for environmentally compatible technology solutions and to enhance the legitimacy for new sustainability-oriented innovations. For the innovation system as a whole, the knowledge that is generated in interaction between actors in certain domains of technology, in centres such as the CESC, can serve as a way to cater for the transfer of knowledge between actors in the system (between users, producers, universities, and firms etc.). In the case of the CESC, an operational and practical task is to explore the potential for interdisciplinary teams to understand processes of behavioural change in both citizens and firms (through ethnography, sociology, and business management), and how to integrate that knowledge with tools for environmental management in companies (Life Cycle Assessment, environmental strategies) with technical skills relating to ICT and new use of media technology in sustainable communication.

So in conclusion to the policy perspective on collaboration, this brief review indicates that research partnerships and collaborative projects in ICT carry expectations to solve some major challenges in industry and societal challenges relating to seeking more environmentally compatible ways of living, travelling and sustainable communication. The next question is how we can describe the dimensions of different types of benefit or "usefulness" that the different partners and consortiums see from examples of collaboration carried out by CESC?

The categories used for analysis of interaction benefitted from a framework developed in a study about measuring societal impacts from participatory sustainability research [START_REF] Robinson | Report from project: Measuring societal impacts from participatory sustainability research[END_REF]. The categories are further described in the following section outlining the scope of the investigation carried out by CESC about different types of effects from collaborative research including university and companies in the ICT sector.

The literature study resulted in the conclusion that partner benefit can be classified into six categories:

1. Increased knowledge and competence.

2. New contacts and network. 3. Increased credibility. 4. New products in the form of publications, methods and technology. 5. Processual and behavioural changes towards more sustainability. 6. Business value/Operational value. These were not formulated as six distinctive categories when the interviews started, but came out of a combination of the development of the interviews and the literature.

Results

When partners describe in what ways the CESC collaboration has been of use to them, the aspect given most importance is the increased knowledge and competence within the area of sustainability and ICT that they have gained. The second most important outcome that partners consider is the credibility of the value added to their internal sustainability work when meeting clients, chief executive officers and coworkers, and also the extended network between partners, KTH and the companies, and within KTH internally. Scientific articles that result from the collaborative research are considered important mainly by the industrial CESC partners. Processual and behavioural/routine changes are harder to link to the partnership, while the internal sustainability work is considered as strengthened. It is seen as being too early to evaluate business value, but the partners all agree that they see a lot of potential for this in the future. Two corporate partners note that they have made cost savings due to decreased travelling partly as a consequence of focusing more on mediated meetings and highlighting the environmental effects of travel. Another aspect mentioned by partners is that research is more efficient when done in collaboration rather than on their own. Partners also maintain that the primary outcome of the collaboration is not seen necessarily as new products per se, but rather learning new methods, technology and getting new knowledge, which then can lead to learning loops within the partners' internal organization. Below some of the different categories mentioned above are described more in-depth.

Increased Knowledge and Competence

Increased knowledge and competence is a key result area emphasised by the partners when discussing the outcome of the CESC partnership. Some of the outcomes brought up and estimated by the partners are, for instance, learning a new way of doing things, working long-term and having the possibility to become immersed in a topic or research area and learn the process of publishing articles. Other important aspects related to increased knowledge are getting wider and deeper approaches to the concept of sustainability that also includes areas as behaviour and other social aspects. Getting more knowledge concerning environmental issues with related quantifiable measures is yet another important factor raised by the partners. It is seen as something positive

to gain knowledge about how large the environmental impacts of their specific activities and specific products are. One company explained the value of the broad range of competence of the centre and the analytic approach applied in the collaboration with the KTH-based centre CESC:

"The way of thinking at KTH/CESC is differentanother time perspective.

There is an analytical capacity and you get time to think and re-consider different aspects and not just accept a number. Our data is more credible when including different aspects (of the problem). It is also good that the project teams are not just including engineersbut also sociologists, psychologists, behavioural scientistswhich is competence that we do not have at the company."

New Contacts and Networks

Partners find being part of the CESC network as a great value. To be able to exchange ideas and experiences, and have a platform for discussing complicated issues with people that have a variety of backgrounds, knowledge, experiences and motives, is treasured. The CESC partnership has also led to many new contacts between the different corporate partners. New contacts have also been established between researchers and companies and internally within KTH. The new networks have also resulted in several new collaborations that have been set up around common issues. For example, companies express that they have gained "a natural collaboration with other companies" and, from the university perspective, the collaboration with firms also provides new research questions that would not have been formulated otherwise.

One company expressed a value from new contacts and networks in terms of exchange of experiences and sharing knowledge:

"There is a great value in being able to network with collaboration partners, interesting partners, some of which are competitors." A public sector partner involved in traffic and infrastructure plans in the Stockholm region explained:

"The collaboration creates discussion and a dialogue that helps us to find arguments or new questions that will be interesting to respond to in the future".

Increased Credibility

Collaborating with CESC gives the partners (both corporate and internal to KTH) increased credibility, an increased legitimacy within the area of sustainable ICT, a better position on the market and good public relations. Quality assured data gives an increased credibility and a better image to the companies' sustainability work both internally towards management and co-workers, and externally towards clients and suppliers. One concrete example of how this works is quantified environmental assessments and Life Cycle Assessments. When working with technological issues, it is a major credibility factor to be involved in collaboration with KTH. Credible research results give the corporate partners a position on the market. CESC has also helped to position KTH in the areas of ICT and sustainability. To KTH partners, and CESC itself, the collaboration with established and well-known corporate partners gives increased status and legitimacy. The partnership with CESC is often mentioned in annual reports and in relation to lectures, something that has great public relation's value. CESC's partners express that it is important to review their own organization (environmental impact, etc.) if they want to maintain their credibility. Credibility is also mentioned in terms of CESC becoming a recognized competence centre internationally through collaboration with some leading institutions. According to a KTH researcher:

"CESC now has a position as one of the world's most interesting centres in the area …as shown by collaboration with Waterloo in Canada and MediaLab at MIT".

New Products in the Form of Publications, Methods and Technology

Several scientific articles, reports and dissertations have been produced as a result of the collaboration between CESC and the partners. The corporate partners have participated in the projects in all phases of the projects. The publications (i.e. reports, articles, and so on) are emphasized time and again in the interviews as one of the most important results of the collaboration. Another significant result is the development of a detailed Life Cycle Assessment, different methods for studying city climate goals, and how to measure quantitatively a climate neutral city.

Various partners point out that the aim of their CESC partnership lies beyond mere technological development. Instead they request a broader scope and an opportunity to grasp and understand the complex processes of ICT, media and sustainability and how this can be linked to behavioural changes, both ongoing and coming. Some partners state that it is too soon to show results yet, but they are looking forward to seeing what the results will be. One type of activity, also mentioned by partners is seminars arranged by CESC.

Processual and Behavioural Changes towards more Sustainability

It is quite difficult for partners to assess the extension of impact on internal processes (such as policies and routines) towards increased sustainability that is the outcome of the CESC collaboration, and to know what would have been gradual changes in a more sustainable direction anyway. It is, however, likely that the partnership has speeded up the process in the internal organization of some partners. KTH has certainly been influenced, particularly the division of environmental strategies research (fms). The central organization of KTH has also created several positions and added organizations in relation to increased sustainability. Many project members state that they have experienced a personal growth as part of the collaboration, and it has been stressed that the work is meritorious on an individual level. The potential of cross-recruitment, i.e. recruiting of employees between partner organizations, is also something mentioned in the evaluation as well as implementation of ICT solutions in pilot projects.

"The collaboration with CESC has enabled us to start our digital conference system. There is a room and a pilot-project is launched. This has facilitated daily meetings between cities replacing daily travels within Sweden." Other partners of CESC emphasize changing procurement of services where a travel agency was replaced to obtain feedback about environmental impact from travels and changes in travel patterns (favouring train options when possible) as a result of the travel policy.

Business Value/Operational Value

Several corporate partners think that there is potential business value in the collaboration with CESC because the clients are attracted by the fact that there is quantitative published Two corporate partners have noticed savings on travel, something that is related to impacts on company policy by the CESC collaboration. However, some corporate partners say it is too soon to present commercial results, a fact referenced to short-term collaboration, but long-time corporate partners also state that it is too soon to see any economic results. The private sector partners also express the differences between their (daily) activities and the nature of the research process in relation to the expectations about "applicability" of research reports directly to their business activity, concluding that:

"The journey is more rewarding than the result, and maybe that is the way it has to be". Other private sector partners of CESC describe that the collaboration with CESC in projects has also opened up other types of networks as a result of interest from other firms relating to collaborative research with CESC.

Conclusions

Some conclusions can be drawn from the experiences of the CESC at KTH in Stockholm. These conclusions both relate to different types of benefits that can be discerned from collaborative projects involving CESC and also from some practical lessons from collaborative projects between university-based researchers, firms and partners from public sector. Some practical lessons from the work at CESC and reviewing effects from collaborative projects are:  It takes time to develop collaborative projects, so any evaluation of results or expected outcomes needs to take that into consideration.  Involving people with decision power in the organization is of key importance.

Making changes in organizations is not done easilyeven if it is motivated by sustainability objectives.  The importance of tracking different dimensions of what are the expected benefits of collaboration rather than either a general "usefulness" or alternatively reliance on traditional indicators (patents, spin-offs) that may not capture the differ-ent domains of benefits that comes out from collaborative projects that involves such a diverse set of public-private actors.

Experiences from CESC about the benefits from the viewpoint of the private sector partners reveal a number of different effects that the collaborative projects generated:

 The collaboration with CESC catalysed contacts with other firms.  Access to a broad range of knowledge domains relevant to understand travel behaviour.  An analytical 'mind set' about environmental impact of the firm.  New routines for the firm's own travel plans to reduce environmental impact These points indicate some benefits at the firm-level arising from collaborative projects, as described by the companies themselves, in terms of processes of change within the firm that are necessary for credibility towards customers and markets. In a wider policy context these results reflect some aspects of business value in sustainability as well as respond to grand societal challenges described by the European Union and at national level. This wider policy discussion about the potential of key enabling technologies, such as ICT, emphasizes the importance of involving users in the quest for sustainable and environmentally responsible innovation. The examples and experiences shown here from CESC offer a small step towards operationalizing these grand words into practices that can provide some guidance on how to describe, in a meaningful way, different types of effects from collaborative projects about environmental sustainability.

The broad range of different types of effects raised by the private CESC partners relates to the theme of partner benefit that is defined in the general goals for CESC; to be a resource when it comes to ICT and sustainability; that CESC activities lead to a continuous growth in importance when it comes to positive sustainability effects; and that CESC partners find the activities within CESC beneficial for long-term business. Other goals stated by CESC relate to societal impact and can be mirrored in the responses regarding, for example, visibility of CESC nationally and internationally (visible through collaboration with leading institutions). The use of results from CESC leads to sustainable practices in society. Examples of the latter are found both by responses by public sector partners (identifying new questions in travel and infrastructure planning) and private firms (procedural changes and individual travel choices) with benefits for sustainable communications.

There are some broader lessons from this case that can be valuable for other centres engaged in collaborative research and development that targets sustainable communications or planning when setting up collaborative projects aiming for integrating environmental sustainability with innovation. To catalyse some of the benefits from new networks (with universities, but also with firms and public sector partners) that we have discussed here, the centres can benefit from introducing regular seminar activities in addition to specific project collaboration in teams. This creates forums for interaction that facilitate spontaneous interaction and sharing the "odd idea" that may be an inspiration to a joint initiative in the future. Public-private collaboration involving university-based Centres of Excellence is targeting collaborative projects, but is also ultimately about meetings between people so that seminars can be an important arena for exploring areas of shared interest.

Another lesson is to encourage collaboration partners to express their expectations in greater detail rather than in general terms about "being useful" to the company. This will the centre to identify and define process values in partner organizations and see where the centre can play a rolewhether it is to reduce environmental impact, create pilots for ICT solutions; understand processes of behavioural change for travels; and how to make these aspects visible to the organization as a whole.

Table 1 .

 1 Number of interviewees at each partner.

	Partner	Number of interviewees
	Bonnier	4
	Ericsson	7
	Community hub Foundation	2
	Institute for Futures studies	1
	Stockholm County Council	2
	Stampen	4
	City of Stockholm	2
	SVT	3
	TeliaSonera	3
	Swedish Media Publishers Association	3
	KTH Holding	1
	KTH heads of units	7
	KTH project leaders	5
	Sum	44

European Commission, From Challenges to Opportunities: Towards a Common Strategic Framework for EU Research and Innovation funding, Green Paper, COM(2011) 48


Tony Cornford
email: t.cornford@lse.ac.uk

Valentina Lichtner
email: v.lichtner@lse.ac.uk

Sustainable and Responsible ICT Innovation in Healthcare: A Long View and Continuous Ethical Watch Required

Keywords: healthcare, ICT, technological innovation, sustainability, ethics, redistribution, externalities

des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Introduction

Today's healthcare challenges and their potential technological 'solutions' are well known. They appear as an often-repeated 'mantra' in the opening paragraph of publications on health policy and information technology (e.g. [START_REF] Jha | The use of health information technology in seven nations[END_REF]). The basic themes are low-growth and aging western economies facing a future with an increasingly expensive and less affordable healthcare system. Important drivers of the growing burden placed on these systems, and on public health and economic life in general, comes from the complex mixture of an aging population with multiple care and medical needs, and the availability of expensive new treatments. These themes are combined in the rising numbers of people with chronic but increasingly treatable conditions such as diabetes or COPD which are life-style related and require treatments 'for life'. As a consequence, the mission of healthcare is increasingly directed towards assisting people to live well, a matter of prevention and quality of life rather than narrowly medical concerns of diagnosis and treatment, or matters of 'life or death'.

These pressures are compounded in a globalised world by movement of people across borders, which leads to concern over faster and wider spread of diseases and epidemics (e.g. [START_REF] Suk | Future Infectious Disease Threats to Europe[END_REF], [START_REF] Hanvoravongchai | Early reporting of pandemic flu and the challenge of global surveillance: a lesson for Southeast Asia[END_REF]). London, for example, has now a substantial programme to combat TB [4], a disease that was considered exceptional a generation ago. We also see migration among healthcare professionals, with many developed countries dependent on doctors and nurses recruited away from countries with greater health needs.

Against this background it is perhaps unsurprising that information and communication technologies (ICT), ubiquitous access to networks and data , and the rapid growth of mobile and distributed computing, offers enticing opportunities for reducing costs of service provision, raising effectiveness of interventions and improving access to healthcare [START_REF] Bates | Improving Safety with Information Technology[END_REF], [START_REF] Jackson | Defining Core Issues in Utilizing Information Technology to Improve Access: Evaluation and Research Agenda[END_REF]. In this paper we discuss some of the consequences of increased reliance on ICT innovations in healthcare systemsthe socio-technical consequences across time and space. We thus consider the sustainability of the deepening engagement of healthcare systems with digital technologies and consider the ethical questions posed. In presenting this analysis we develop our argument around the twin themes of redistribution and externalities.

ICT Innovation in Healthcare

The penetration of healthcare by digital technologies occurs at many levels and in many places. Here we highlight three contemporary and contrasting examples.

Digital imaging.

There has been in the last decade a move from film based x-rays to digital imaging technologies. There is reasonable evidence of immediate clinical benefit arising from networked sharing of this information, credible expectation of cost saving over time, and real environmental benefits from the use of fewer chemicals in film processing [START_REF]P2 Opportunity Handbook[END_REF]. Digital images and scans also are available to become part of an electronic patient record, which can serve clinical decisions making that draws upon more complete patient information.

Telemedicine ('consultation at a distance').

Telecommunications and networks can obviate patient travel (e.g. to hospital), and optimize access to and sharing of medical expertise. Telemedicine has found successful implementations in geographically remote regions, improving access to care and expertise, but also in reorganization of emergency services such as stroke care (e.g. [START_REF] Mathieson | Videoconference consultants boost emergency stroke care[END_REF]) or more generally interlinking primary and secondary care. We may also extend the definition to technologies for assisted living (telecare), with technologies serving to allow people to remain in their homes longer thus avoiding hospitalization costs and improving quality of life. Telecare, in its various forms, has been reported in England to generate potential savings such as "45% reduction in mortality rates, 20% reduction in emergency admissions, 15% reduction in A&E visits, 14% reduction in elective admissions, 14% reduction in bed days, 8% reduction in tariff costs" [9].

Patient centered care. Patient accessed and managed health services are now provided digitally. While telemedicine and telecare maintain broadly the traditional service model (doctornursepatient), there are a set of technological innovations applied in healthcare, often delivered on the Internet or by mobile phones, that embody greater patient/citizen participation and ownership of health matters. This can lead to a rebalanced (we might even say more equal) doctor-patient relationship, with greater responsibility taken by patient-citizens and their families for their own health and care, or allowing them to by-pass healthcare professionals and healthcare institutions altogether [START_REF]Bioethics: Medical profiling and online medicine: the ethics of personalised healthcare in a consumer age[END_REF]. Online citizen participation can also be a driver of new public health strategies such as online smoking cessation initiatives, the monitoring of epidemics by crowd-sourcing (see http://healthmap.org) or the use of two-way SMS phone messaging to monitor emergencies [START_REF] Magee | Mobile phones and short message service texts to collect situational awareness data during simulated public health critical events[END_REF]. Finally, a new form of participatory health research is emerging, with crowd-sourced health research studies complementing, if not yet replacing, more traditional clinical trials [START_REF] Swan | Crowdsourced Health Research Studies: An Important Emerging Complement to Clinical Trials in the Public Health Research Ecosystem[END_REF]. The three broad examples of contemporary technological innovations sketched above suggest distinct aspects of the move to digitalize. First, the gains that derives from new ways to carry out or extend the range of existing types of task (e.g. x-ray imaging) within an established institutional setting. Second, the redistribution of resources across space so as to reconfigure and improve services and support equality of access, and finally a (potential) systemic change as healthcare takes a turn towards the patient-consumer and is less about a 'do to' or 'do for' model and more 'do with' [START_REF] Leadbeater | We-Think: Mass innovation, not mass production: The Power of Mass Creativity[END_REF] even 'do alone'.

The most innovative but also potentially disruptive aspects of ICT in healthcare derive from the inherent characteristics of digital innovations to generate, store and share large amounts of data (sometimes described as 'big data') and connect and serve multiple people in both tight or loose social structures. In all these examples we see digital data being generated and changing or rebalancing the way healthcare is delivered, experienced and how and by who control is exercised. Digital data is drawn upon and influences decisions, at large scale as in healthcare planning, pharmaceutical research or population surveillance, clinically as in a clinical decision support systems (DSS), or less formally as in a patient group based discussion forums.

In this sense digital innovation in healthcare is founded on both technical and social networkingsometimes known as web 2.0 (and hence health 2.0)and embraces in some mix data aggregation and analysis, user-generated content and new business models (open innovation, social networking and the economy of 'free' [START_REF] Anderson | Free : how today's smartest businesses profit by giving something for nothing[END_REF]).

Sustainability and Responsibility: Redistribution and Externalities

It is certainly not foolish to believe in the potential of digital technologies for changing the nature of service provision across all economic and administrative sectors. In our own lives we see pertinent examples in business (e.g. travel, music) and in the public realm (e-government, e-petitions). And ICT may well offer entirely new 'solutions' to both the old and the new healthcare and public health problems.

No technology is, however, politically or ethically neutral [START_REF] Winner | Do Artifacts Have Politics? In: The Whale and the Reactor: A Search for Limits in an Age of High Technology[END_REF]. All innovation embodies certain interests and neglects others, and there is a risk that digitally innovated systems may not be, in the long term, sustainable whatever specific improvements in aspects of healthcare they deliver. We should apply to digital development within healthcare the spirit of the United Nations definition for sustainable development -"[S]ustainable development is development that meets the needs of the present without compromising the ability of future generations to meet their own needs" ( [START_REF]UN General Assembly: Our Common Future, Report of the World Commission on Environment and Development[END_REF], emphasis added).

Developmental interventions in society or the economy have effects on the distribution of income or access to resources both within, and given globalisation, beyond national borders, as well as across time. By distributional effects we mean the "modifications of the holdings of particular persons, collective agents, or groups […] with respect to a 'baseline'" [START_REF] Barry | Redistribution[END_REF]. What is redistributed may not be only access to resources but roles, risks, and responsibilities. Barry goes on to suggest that redistribution should be understood relative to some defined set of subjects. In healthcare these groups may be, for instance: types of clinicians (e.g. nurses versus doctors), clinical staff versus other healthcare employees (e.g. administrative staff), clinicians versus patients, or in a more macro dimension, healthcare providers (e.g. hospitals versus community care or self-care). It may also be, indeed should be, seen in terms of citizens and generations (e.g. the old versus the young, or the healthy versus the ill).

Some distributional effects are expected from most policies or initiatives, not just those 'purposively' launched for redistributive goals, such as national welfare policies. All of the types of digital interventions in healthcare introduced above have distributional effects across many domains; on access to care, on labour and workload, on professional roles and autonomy, on who bears risk and takes responsibilities, and on doctor-patient relationships [START_REF] Vikkelsø | Subtle Redistribution of Work, Attention and Risks: Electronic Patient Records and Organisational Consequences[END_REF][START_REF] Ash | An unintended consequence of CPOE implementation: shifts in power, control, and autonomy[END_REF][START_REF] Mcalearney | The story behind the story: Physician skepticism about relying on clinical information technologies to reduce medical errors[END_REF][START_REF] Motulsky | Electronic prescriptions and disruptions to the jurisdiction of community pharmacists[END_REF]. Berg [START_REF] Berg | Lessons from a Dinosaur: Mediating IS Research Through an Analysis of the Medical Record[END_REF] for example speaks of the unpredictable and unknown redistribution of responsibilities in future systems built to support a patient-centric workflow and notes that this would probably, "ensure a conflictrife implementation process; yet it could be an important part of a more patientoriented care process." [START_REF] Berg | Lessons from a Dinosaur: Mediating IS Research Through an Analysis of the Medical Record[END_REF] Redistributive effects of ICT use may be expected and desired, others may occur as 'unexpected consequences' [START_REF] Ash | The Extent and Importance of Unintended Consequences Related to Computerized Provider Order Entry[END_REF] or what economists would call externalities. The term 'externalities' refers not simply to effects beyond the intended but to "situations when the effect of production or consumption of goods and services imposes costs or benefits on others which are not reflected in the prices charged for the goods and services being provided" [START_REF]Glossary of statistical terms[END_REF]. The concept originates from Pigou [START_REF] Pigou | The Economics of Welfare[END_REF] who identified that the actions of economic agents can and will influence the utility of others without mechanisms for compensation [START_REF] Cornes | The theory of externalities, public goods, and club goods[END_REF] and were later known as external (dis)economies or externalities [START_REF] Samuelson | Foundations of economic analysis[END_REF].

Externalities may be negativee.g. social costs that counterbalance private benefitsor positivee.g. social benefits that counterbalance private costs. The motorcar is a well-understood example of externalities of the first kind. The technological invention of the combustion engine brought, in the last century in Western countries, freedom of movement to the masses and contributed to women's emancipation. Yet new problems emergedfrom accidents, to traffic jams and air and noise pollution.

Thus the cost for the individual of driving a car does not take adequately into account society's coststhe externalities. Similarly it can be argued that the unfettered use of insurance markets in healthcare cause externalities in the social cost of the uninsured. When private cars were the luxury of a few, their impact on the environment did not present the sustainability challenges that emerge when it becomes a technology for the masses. An example of positive externalities might be the inoculation of children for diseases such as mumps, measles or chicken pox. This has a private cost and benefit for the child or family, but also strong social benefit in the 'herd immunity' it helps to create.

As in the case of the motorcar, also in healthcare, when a technology reaches a significant scale of implementation, the related negative externalities may have longterm consequences for sustainability. By sustainability we refer to both the capacity of the services (and associated technology) to be sustained economically through time (e.g. [START_REF]Health Information Exchange Economic Sustainability Panel: Final Report[END_REF]) as well as the impact on the sustainability of the wider context (social, economical, and environmental) and hence on the ethical worth. Fig. 1. ICT innovations have a life of their own -what 'can be built' often gets built. But pressures on healthcare lead to ICT innovations intended as a solution to some of these pressure. ICT investments can also constitute one of the pressures on healthcare, e.g. in terms of financial resources. ICT have consequences in terms of externalities and redistributive effects, with ethical implications, and in the long term, sustainability repercussions on other aspects of life (e.g. environment, or social agreements) as well as health itself.

Here we apply this analytical lens of redistribution and externalities to the digitalization of healthcare. We accept that these technologies will deliver individual and current benefits, but also assume that they will present their own distributional effects and externalities -leaving a legacy. Furthermore, the effects of today's technological choice will last through future phases of innovation constraining what is possible (what has been referred to as the 'durability of the present' [START_REF] Aanestad | Information Systems Innovation Research: Between Novel Futures and Durable Presents Researching the Future in Information Systems[END_REF]).

For example, the benefits of telemedicine for patients and carers may be seen in terms of access, convenience and efficiency of clinical services. However, telemedicine will also involve a redistribution of clinical tasks and roles (for example nurses taking over some medical tasks from doctors); a greater social and physical distance between doctor and patient (transforming the doctor-patient relationship); a redistribu-tion of associated responsibilities and changes in risks [START_REF] Mort | Remote Doctors and Absent Patients: Acting at a Distance in Telemedicine?[END_REF]. In telecare the increased efficiency of service provision through a central locationfor example a central monitoring station or call centre -potentially produces negative externalities at the periphery as patients lose human contact. In the longer term telecare may bear the risk of exacerbating the medical 'brain drain' and promoting imbalances in distribution of the health workforce [START_REF]Bioethics: Medical profiling and online medicine: the ethics of personalised healthcare in a consumer age[END_REF], [START_REF] Dussault | Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce[END_REF], with sustainability and ethical repercussions for healthcare global (in)equity.

Reliance on digital 'solutions' may also negatively influence the development of other servicesdriving out basic health provision. As Rao and Lombardi [START_REF] Rao | Telemedicine: current status in developed and developing countries[END_REF] note, while "telemedicine [projects] have demonstrated positive effects in countries in need, they have not substantially reduced or compensated for a fundamental lack of healthcare". Investments in forms other than face-to-face healthcare provision, may drive healthcare away from holistic care and patient intimacy with the doctor or nurse [START_REF] Mort | Beyond Information: Intimate Relations in Sociotechnical Practice[END_REF], and leave an unsustainable legacy of fragmentation of care and remoteness of relationships. This is at the very least a very different form of healthcare provision and one that may in time become dislodged from the central place in social and political life that healthcare now enjoys.

Social networks and other web 2.0 technologies show potential as a support structure for patients with chronic conditions and may offer valuable information sources for patients and health professionals [START_REF] Sarasohn-Kahn | The wisdom of patients: Health care meets online social media[END_REF]. Furthermore, crowd-sourcing is starting to show potential in healthcare as a means to collect and share patient narratives and ratings, used as 'evidence' "for product development, quality improvement, or policy reform" [START_REF] Adams | Sourcing the crowd for health services improvement: The reflexive patient and "share-your-experience" websites[END_REF]. Though, as the scale of this increases, the 'option' of participating in the social network may be transforming into an 'obligation' -"an obligatory activity" for patients as good citizens [START_REF]Letting the people speak" or obliging voice through choice?[END_REF]. This reminds us that online participation "involves work" [START_REF] Adams | Sourcing the crowd for health services improvement: The reflexive patient and "share-your-experience" websites[END_REF]specifically work that is redistributed ("shifted") from healthcare providers and government to patients and carers. This redistribution of work and new areas of responsibility/obligation is not in general financially recognized and suggests that we need to ask if crowd-sourcing is always economically fair?

Online participation also has evident consequences (i.e. externalities) for anonymity and privacy of individuals [START_REF] Zimmer | The Externalities of Search 2.0: The Emerging Privacy Threats when the Drive for the Perfect Search Engine meets Web 2.0[END_REF] and presents challenging implications in terms of surveillance. Today the law is still inadequate in most jurisdictions to protect individuals from (possibly incorrect, incomplete, or misleading) information posted online by individuals or companies [START_REF] Edwards | Privacy and data protection online: The laws don't work?[END_REF]. Thus the world of social media and online marketing may create new challenges to public health policies, such as undermining stop smoking initiatives [START_REF] Ribisl | Tobacco control is losing ground in the Web 2.0 era: invited commentary[END_REF] or influencing negatively suicide or eating disorders [START_REF] Luxton | Social Media and Suicide: A Public Health Perspective[END_REF].

Data protection laws are also often seen as inadequate for protecting individual's privacy, particularly so when policy is to integrate health data across organizations (within and outside healthcare) and patients are given little choice in the matter. In the United States this concern is a major element of resistance to President Obama's healthcare reforms and one that suggests legitimate ethical concern [START_REF] Trotter | The Moral Basis for Healthcare Reform in the United States[END_REF].

Aggregate data collected through the ubiquity of online devices and social media can usefully inform public health debate and support surveillance, providing early warning of emergencies, serving clinical research, tracking progress of interventions or informing strategies. However, data aggregation and surveillance evoke easily the image of 'big brother', or the fear that those who are monitoring gain power over people, "including the power to reprimand or punish" [START_REF] Dobson | Big Brother has evolved[END_REF]. Privacy and associated issues of trust have become central to many health information systems initiatives and are tackled in a number of ways and to various degrees in different jurisdictions. It is unclear today if this concern is or can be adequately addressed by the various professional codes, data protection laws and technical measures availableadequately in the sense of gaining and sustaining public acceptance, minimizing harm, releasing the beneficial potential of digital technologies and retaining choice as to future development. Beyond the many 'solutions' available for aspects of health care practice, there remains a more fundamental set of questions as to the appropriate tests for legitimacy of the use of big data, for example in research, service management, for subpopulation monitoring or for public or private benefits beyond healthcare.

4

Concluding Remark -Science and Trans-Scientific Questions

Robert Oppenheimer, discussing the ethical dilemmas of the Manhattan Project says: "when you see something that is technically sweet, you go ahead and do it and you argue what to do about it only after you have had your technical success. That is the way it was with the atomic bomb" (cited in [START_REF] Sennett | The craftsman[END_REF]). So too we suspect with health information systems. If it can be built, it will be built, and they will come, not least because there is often a persuasive short-term case to justify the investment and motivate use. But there is or should be more. Sustainable digital investments in healthcare, a category we introduce here, do need to respond to the immediate needs of citizens for appropriate healthcare provision and the wider concerns of public health, as well as governments' concern for efficiency and value-for-money. But it must do so taking into account distributional effects, externalities, and the technical and societal legacy left to future generations. This is a legacy that will then constrain or promote further innovation.

Taking account of distribution and externalities implies making ethical choices, and hence raise matters of values. The burgeoning investments in ICT and implementation projects in healthcare are matters of politics and ethics, ultimately becoming trans-scientific questions [START_REF] Weinberg | Science and trans-science[END_REF] that cannot be answered by science alone. Enid Mumford makes a similar point, quoting Vickers as saying "technology always make ethical demands in what it requires people to expect of each other and therefore of themselves" [START_REF] Mumford | Systems design: ethical tools for ethical change[END_REF], citing [START_REF] Vickers | Making Institutions Work. Associated Business Programmes[END_REF] and she goes on to note that "Ethical principles are particularly hard to develop and apply when times are hard, as economic pressures tend to overcome others" [START_REF] Mumford | Systems design: ethical tools for ethical change[END_REF].

Thus, while policy makers and healthcare organizations keep solving today's problems and looking for 'scientific evidence' (on efficiency and effectiveness) to guide their investments in digital health, they face similar issues to those encountered by NASA on their Challenger missions: "Observational data, backed by an intuitive argument, were unacceptable in NASA's science-based, positivistic, rule-bound system. Arguments that could not be supported by data did not meet engineering standards and would not pass the adversarial challenges of the FRR process. [so the hunch on the effect of cold weather on the o-ring was not reported]... Phillip Thompkins ... observed that 'only the easy decisions at Marshall were made by scientific evidence or demonstration. The difficult decisions created a rhetorical problem because the solution could not be demonstrated scientifically'" [START_REF] Vaughan | The Challenger launch decision : risky technology, culture, and deviance at NASA[END_REF].

Charles Perrow expresses this as a more overtly political concern. Writing about risk in civil nuclear technologies he says: "…where body counting replaces social and cultural values and excludes us from participating in decisions about the risks that a few have decided the many cannot do without. The issue is not risk, but power" [START_REF] Perrow | Normal accidents: living with high-risk technologies[END_REF] Change cannot stop, indeed probably should not. So accommodations and intelligent reflection and response to these issues (but we would argue not 'solutions'!) will have to be found, pragmatically, while and during the time that digital innovations are introduced into healthcare systemsrather than solving them ex-ante as a priori conditions for technological innovation. The incessant, perhaps even deterministic, pace of technological innovation in any case does not wait for society's considered ethical answers. Indeed, these are old and enduring questions that have been applied to technological innovations of the past, in a variety of fields, and for which, in the past society has had to struggle to find appropriate accommodations. The industrial revolution in Britain and its societal and political consequences are written across at least a century in intense reflection found in literature, natural and political science and the arts.

The new types of ICT innovations we are encountering today -especially the 'free' and participatory models mentioned aboveare changing structurally and fundamentally these questions, in their nature and in their possible answers. Even the most straightforward and traditional computer implementations in healthcare require complex judgments [START_REF] Cornford | Ethical Perspectives in Evaluation of Telehealth[END_REF]. How do we develop the ethical apparatus to deal with them?

Walsham [START_REF] Walsham | Are we making a better world with ICTs? Reflections on a future agenda for the IS field[END_REF] offers some modest ideas as to how we might move in this direction when he asks of the IS community, "Are we making a better world with ICTs?". He goes on suggest that we do not have very convincing answers to this question and thus argues for "a strong ethical agenda" and "…a sharper critical agenda towards existing approaches and power structures...". Interestingly he makes these comments while contrasting the wider IS field with the firmer ethical underpinning of architects who want to build better buildings, or doctors who want people to live longer and healthier lives.

Thus we suggest here a simple research agenda for sustainability in digital healthcare. This is based on addressing three core ideas:  Redistribution of risk and responsibility across social actors including the patientcitizen, healthcare professions and the state  Accounting for externalities in design of systems and in operational practices  Application of an intergenerational model that can account for constraints placed on possible futures.


Gunilla Bradley
email: gbradley@ug.kth.se

Diane Whitehouse
email: diane.whitehouse@thecastlegateconsultancy.com

Challenges to Peace in the 21st Century: Working towards a Good Information and Communication Society

Keywords: action, education, good information and communication society, electronic violent games, information and communication technologies, international, peace

ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Introduction

Conference panels often provide opportunities to explore difficult and sensitive subjects in much more open and flexible ways than do standard conferences tracks and themes. Hence, they often contain not only academic papers but also reflection and position papers. This panel on information and communication technologies (ICT) for peace and war, and the imperatives of achieving cyber peace, to which this paper is a contribution, is no exception. Opportunities and threats related to ICT have been classic themes of many ICT gatherings, conferences and workshops over the past decades. This reflection paperon issues pertaining to war, ICT, cyber warfare and infrastructuremay well provide a contrast in its freedom of thought and approach to other more academic pieces. It proposes a deliberate focus on the study of ICT and its constructive use in the fields of democracy, education, effective organisation, equity, enhancement, human devel-opment, justice, learning, and sound policy development. Overall, ICT can help to reduce risks by enhancing discussion between people. The ultimate goal is to build a Good Information and Communication Society. As this conference panel intends, it can do so by "taking into consideration [people's] mutual interests in living a peaceful life". 1This paper is structured in the following way. It introduces the background to ICT use in peace and war in a very general way (Section 2). It covers the relationship of ICT with vulnerable ICT critical infrastructures, and it emphasises the way in which ICT can be used in terms of aggression, violence and war whether directly as an instrument or as a support structure. It introduces (in Section 3) the growth in institutions, investigation, and studies relating to violence and war and their links with ICT: for this, it draws especially on the European and Scandinavian contexts. It also highlights current trends in the investigation of the relationship between use of violent electronic games and behaviour. As a result, several potential possibilities for areas of study are listed (Section 3.4). A plea is then made for alternative thinking and acting in many more positive directions (Section 4). The authors have brainstormed a list of issues that researchers who seek to examine the positive dimensions of ICT might wish to explore (Section 5): the four principal domains are those of awarenessbuilding, education and development, software and games, and adopting an international perspective. Some emerging conclusions are highlighted (Section 6).

This approach does not yet constitute an agenda for a programme of action. Nevertheless, it is hoped that it may provide a helpful set of possibilities to those networks, organisations and institutions that are already working in this field of activity or may go on to do so in the future.

Some Observations on War, ICT, Cyber Warfare and Infrastructure

War is scarcely a new phenomenon although, in its early stages, it has been associated more simply with tribal raids. Yet many of the most destructive wars in human history took place in the last century. This growth in destructiveness is assumed to be due directly to the expansion and the efficiency of the technologies used, includingat the end of the Second World Warthe use of the atomic bomb. 2Two approaches appear to have become necessary. It is now imperative to study not only how war takes place, and with what methods, but also how to resolve war and grow beyond its basis in conflict: nations can thereby be restored to conditions under which they respect and honour peace [START_REF]Building Peace, Creating Conflict. Conflictual Dimensions of Local and International Peacebuilding[END_REF].

Even if war is state-based organised violence, there are many other examples of potential and actual violence that are coming to the fore today. Many ad hoc groups are involved in the use of violence whether for "need, greed or creed" [START_REF] Zartmann | Pronouncement at event entitled Civil War: Need, Creed and Greed[END_REF] 3 . While violent actions may come from individuals, loosely-organised groups or organised crime, they can also emerge from autocraticand other types ofstates. There will always be countries and regimes interested in exploring the fragilities of other nations. 4

ICT and Infrastructure

Critical information infrastructures can be used to avoid engagement in war, but are also implicit in supporting engagement in warfare. Security aspects that support this infrastructure, which can be called "cyber security", can help to maintain national and international security. However, cyber security can also be used to effect in both espionage and sabotage. Some uses of ICT pose threats of quite new dimensions whether as a result of conscious intent, error or ultimately through the very vulnerability of ICT [START_REF]Facing the Challenge of Risk and Vulnerability in an Information Society[END_REF]. It is all too horribly easy to imagine an extreme, and potentially final, catastrophe that could result, for examplewhether deliberately or ad hoc -from today's combination of ICT and nuclear power. Indeed, while it can be said that nuclear power is only usable and controllable through the use of ICT, ICT's shortcomings can lead to errors, failures and disasters not only in the nuclear domain but also in many other fields [START_REF] Kajtazi | An Exploration of Information Inadequacy: the Lack of Needed Information in Human, Social and Industrial Affairs[END_REF]. Of course, atomicand othercrises may occur as a result of natural and unanticipated phenomena: environmental disasters can happen as a result of solar flares, earthquakes or tsunami. In contemporary society, particularly in developed countries but also increasingly in emerging economies, critical infrastructures based on ICT can be conceived as being fundamental to the capacity to live in peace and prosperity. Society is so reliant on the use of ICT and its critical infrastructures that the collapse of these systems could leave whole populations without structures, services and applications. Sheer demand, resulting from the expected growth in consumption, may have dire consequences for the capacity to continue to provide energy supplies [START_REF] Whitehouse | Introduction[END_REF]. Almost all domains of people's lives are dependent on ICT: a situation that we may wish to avoid or at least to counterbalance [START_REF] Bradley | Från fildelning till sakdelning (From sharing files to sharing things)[END_REF], [START_REF] Cameron | A Survival Kit for Resilient Citizens in the Information Society[END_REF].

This generalised movement towards complete ICT dependency is perceived as meaning that entire societies and nations could collapse with great speed if there were ever to be a massive failure in their ICT infrastructures. Whole societies and civilisations and their infrastructures could quickly be destroyed or rendered inoperable. Societies, communications and people could be left without sustenance and support. Such a crisis could affect the capacity to use any form of ICT, and thereby compromise the financial, business, and public sectors as well as people's working lives (for example, in the fields of health services and public health [START_REF] Whitehouse | Benchmarking eHealth in the European Union[END_REF]). It could inhibit the ability to communicate among family members, friends and acquaintances. It could also impair the continuity of human existence in those communities that are located in either very hot or very cold climates or countries that experience both extreme heat and cold. The implications for peace and harmony, in general, are considerable, since many of these threats could lead to complete societal breakdown.

ICT is directly implicit in these risks. This challenge is perhaps particularly hard for people and politicians to envisage.

A Growth in ICT and War Research, Study and Action

At some level, it is to be acknowledged that developments in ICT-related research, study and action around warfare, and cyber warfare particularly, are occurring both quantitatively and qualitatively.

There are more and more institutions dealing with combating warfare and building peace. The trend is very much also to an international and national focus on cyber warfare. However, various broadcasting and other media are also playing a role in this domain in terms of the ways in which they present developments to the public. More than that, they are influential in the manner in which they encourage children, young people and adults to viewand even potentially get involved inviolence, aggression, and even war.

These developments are reviewed before a set of potential research questions is laid out for possible investigation by traditional peace institutes.

Contemporary Developments in Peace and War Research

To take the Scandinavian countries as just one example, they now have a variety of peace research institutes: a few are mentioned here. On the global level, it can be assumed that each nation has its own similar institutions that research these challenges on some level or in some aspect, and that the United Nations are working on such tasks [START_REF] Doyle | Making War and Building Peace: United Nations Peace Operations[END_REF].

In Norway, there is the Peace Research Institute Oslo; Sweden has the Stockholm International Peace Research Institute and, in Uppsala, there is the Uppsala University Department of Peace and Conflict Research, and its Peace Research Programme. The first is known for both its basic research and its policy-relevant research and the way in which it has engaged itself in promoting peace through the resolution of conflict by means of dialogue, reconciliation, public information and policy-making. The second is an internationally-renowned think-tank. As an independent international institute dedicated to research into conflict, armaments, arms control and disarmament, it bases its work on openly-available data sources. The third has a research programme on governance, conflict and peace-building. It concentrates on internal, state-based peace-building in weaker regions and countries around the globe, with a focus on Africa, and the relationship between governance and resources.

The daily press shows that new collaborations are being initiated with the purpose of defending nation states and preventing new potential catastrophes. In the Svenska Dagbladet, a major Swedish broadsheet newspaper, headlines announced that Sweden and the United States of America (US) are collaborating on strategies related to cyber warfare [16]. These kinds of efforts are also being pursued at European and international levels.

Expansion of European and International Focus on Cyber Crime

Peace depends at least to some extent on investing in cyber security.

On the very day of finalisation of this reflection paper, the European Commission launched a proposal for a European Cyber Crime Centre to tackle cyber crime [START_REF]Tackling Crime in our Digital Age: Establishing a European Cybercrime Centre[END_REF]. Cyber crime is essentially seamless or borderless. Its perpetrators prefer to ignore deliberately the locations and countries of the victims of their crimes. This centre will gather together some of Europe's brightest minds in cyber security. Its task will be to warn the Member States of the European Union about any major cyber threats on the horizon and any weaknesses in their online performance. It will identify crime through discerning patterns, for example, in virus attacks. The centre will be located in The Hague in the Netherlands, and will be run by Europol. In the Swedish broadsheet newspaper, the Svenska Dagbladet, European Commissioner Cecilia Malmström stated that knowledge about cyber crime is fragmented throughout the authorities of the Member States of the Union, andto this time at least-co-operation across borders to fight this crime is infrequent [16].

Groups of Scandinavian (and other) investigators have also explored, for example, the growth in profiling by corporations, tracking of suspects, electronic tagging of prisoners at work, and the monitoring of paedophilia, money-laundering, information warfare, and cyber crime as well as assessed the benefits and costs of surveillance, and its future developments [START_REF]The Intensification of Surveillance: Crime, Terrorism and Warfare in the Information Era[END_REF].

A Growth in Research on Aggression and Violence in Childhood

Research developments are always in process, and benefit from dynamic discussion in order to progress [START_REF] Kuhn | The Structure of Scientific Revolutions[END_REF].

A Swedish Media Council report [START_REF]The violent computer games and aggression -an overview of the research 2000-2011[END_REF] examines decade-long work on the part of several international expert bodies (including the US Department of Health and Human Services and children's medical associations in Australia, Canada and the US). Collectively, these take the position that very violent games increase the likelihood of aggressive behaviour.

In a recent article in the Dagens Nyheter [START_REF] Olsson | Sä ska EU stoppa cyberbrotten[END_REF], three researchers further debate these issues. They agree that it is not easy to distinguish violent games as the unique factor that generates violence and aggressiveness in young people. Among the stronger predictors of violence are family relationships, genetic disposition, personality, and socialisation. For children who grow up in an environment where inter-personal violence is normal, violent games are yet another source of learning aggressive behaviours and stifling empathic development.

The notion of "game dependency" has to be considered in depth through research, study and discussion on the relationship between violent computer games and aggressive behaviour.

Similarly, research indicates a gradual loss of empathy alongside extreme use of mobile phones [START_REF] Konrath | Changes in Dispositional Empathy in American College Students over Time. A Meta-Analysis[END_REF], [START_REF] Zaki | What, Me Care? Young are less Empathetic. A recent study finds a decline in empathy among young people in the U[END_REF]. It too is a subject deserving of in-depth investigation.

3.4

Proposals for a First set of Questions to be Explored

Work to reach peace is now increasingly institutionalised. There are surely plenty of theoretical questions that can be studied in the fields of research on war, peace, and violence. Many of the issues raised and questions posed in these fields, and their institutes, are based on experiences with conflicts involving weapons that have either occurred or are on-going.

Based on discussions first initiated in July 2011 in Rome, Italy at the International Association for the Development of the Information Society (IADIS) ICT, Society and Human Beings conference [START_REF] Bradley | Proceedings of the IADIS International Conferences ICT, Society and Human Beings 2011 and e-Democracy, Equity and Social Justice[END_REF], we propose a first set of questions to experts who work within the field of study on ICT and warfare. An attempt has been made to formulate a number of questions that can help analyse issues that are threatening peace in the "here and now". The topics listed strike us as ones that are already deserving of intellectual coverage. The extent to which these issues are currently under investigation in actuality is, however, unknown to us.

It is our hope that these kinds of ideas can help to strengthen the many commendable efforts that are already taking place throughout the globe (not simply in the US, Europe or the other countries of the Organisation of Economic Co-operation and Development), an example of which is under the leadership of the International Telecommunications Union [START_REF] Touré | The Quest for Cyber Peace[END_REF].  Same or different: Is cyber warfare different from orthodox or classic warfare?

Or is it -even if apparently "non-violent"just a form of war, adapted to the conditions of contemporary society? Does it require special actions to combat it? What are the "small" or "limited" experiences of cyber attacks that have taken place, for example, in Estonia [START_REF] Economist | War in the Fifth Domain. Are the Mouse and the Keyboard the New Weapons of Conflict? July 1st[END_REF]?  Traditional concerns transposed into modern society: What kind of relationship exists between "attack" and "defence" in various political systems? How do the hierarchies that exist in traditional military domains correspond to the relative lack of hierarchy that exists in cyber warfare? How much does the variability in control of the Internet influence the networks that operate across national borders (i.e., its apparent lack of centralised control or its relative freedom from control)? How do traditional hierarchies complicate these matters?  New fields of warfare: Are there any comparisons to be made between countrybased attacks and attacks on global financial systems? What parallels are there between cyber warfare and attacks on international trade? What about attacks that can be made on specific infrastructures such as utilities or energy systems? How similar to each other are threats connected to nuclear power and those associated with cyber warfare?  Play versus actuality: What degree of influence is there on developments in aggression and violence through playing electronic war games and electronic games of extreme violence?

These are, we assume, somewhat classic questions that enable an analysis of the field. However, concern and consideration for these issues can become the startingpoint for alternatives in terms of both thinking and acting. From the perspective of the authors, it is a major challenge not to restrict such questioning purely to the military domain.

A Need for Growth in Alternative Thinking and Acting

A "nonviolence movement" against non-violent cyber warfare is needed: this would be a form of grass roots movementor network of networksthat shares the same vision of reaching the Good Information and Communication Society. Historically, advocates of activist philosophies of nonviolence have used a range of methods in their campaigns for social change. These have included critical forms of education and persuasion, civil disobedience and nonviolent direct action, and social, political, cultural and economic forms of intervention. In recent centuries, and also within the first decade of the twenty-first century, nonviolent methods of action have acted as powerful tools for social protest and revolutionary social and political change.

For example, people today need to know how to be resilient even in the most dire of tragic circumstances [START_REF] Cameron | A Survival Kit for Resilient Citizens in the Information Society[END_REF]. Alongside personal, organisational, and national resilience, we need, as a counter-movement, to start a new phase for ICT that is used for peace, harmony and collaboration. The passive acceptance of inappropriate and illconsidered -some might even say, "evil"use of ICT has to be prevented. If and when secure and sustainable, ICT may actually help to reduce risks.

ICT can and should be used to narrow the gap between subcultures, and to bridge the differences between different religious systems. It could, instead, show their similarities, emphasise the synergies among the various cultural and faith-based blocks, and bring us all into a thrilling, fruitful dialogue with each other. We need quite a different approach which would be based on the achievement of a future "unity and diversity" in the world [START_REF] Bradley | Proceedings of the IADIS International Conferences ICT, Society and Human Beings 2011 and e-Democracy, Equity and Social Justice[END_REF].

This would be a much more cross-disciplinary approach based on broader theoretical perspectives than in times past. It should, first, be feasible to be put into practice and, second, help all people to work on preventive action strategies.

5

Constructive Considerations (for a Positive Turnaround?)

People in general, together with academics, need to start a new movement for ICT that is used for peace, harmony and collaboration. The latest forms of ICT can be used for constructive interaction, dialogue and the enrichment of human feelings and thinking. Here, therefore, are some initial thoughts on "tools" that can be used, in particular, to prevent and fight cyber warfare. A mutual brainstorming, another of the outcomes of the IADIS July 2011 conference [START_REF] Bradley | Proceedings of the IADIS International Conferences ICT, Society and Human Beings 2011 and e-Democracy, Equity and Social Justice[END_REF], highlighted the formulation of an initial set of possible positive positions and tools. These tools relate principally to four domains. They are awareness-building; education and development; software and games; and seeing the issues from an international perspective. These four sets of proposals are laid out here: there is no particular prioritisation to the issues. All are important, and would benefit from further investigation and, moreover, action.

In terms of awareness-building, it is important not just to increase the consciousness of the threats of cyber warfare, but also to:  Create an understanding of how contemporary society is built and its underpinning, invisible infrastructures (for example, based on the economy, electricity, transportation and water). From this understanding, build an awareness of the vulnerability of society.  Create the potential for positive, new uses of ICT. The 2011 International Association for the Development of the Information Society (IADIS) ICT, Society and Human Beings conference [START_REF] Bradley | Proceedings of the IADIS International Conferences ICT, Society and Human Beings 2011 and e-Democracy, Equity and Social Justice[END_REF], for example, dealt with many examples of ICT use that can help to make people aware of what could be done to combat global warming; what can be done ecologically and environmentally in a positive way; helping people at the bottom of the pyramid; enhancing the lives of the very young and especially the very elderly; and using ICT in health, welfare and wellbeing.  Work together to create space and time for constructive discussion and debate in forums and agora, as much physically and in real-time as in cyberspace and on the Internet.  Use cyberspace for dialogue and for the search for the common essence of all faiths, religions and philosophical and spiritual endeavours.  Hold dialogues about common value systems. Again, for example, the 2011 IADIS ICT, Society and Human Beings conference held inspirational panels on human rights and on "unity and diversity" [START_REF] Bradley | Proceedings of the IADIS International Conferences ICT, Society and Human Beings 2011 and e-Democracy, Equity and Social Justice[END_REF].

In terms of education and development, employ ICT directly and indirectly to:

 Examine the experience of early childhood in relation to ICT and its influence on childhood and adult development.5  Explore strategies to encourage human and humane roles instead of further strengthening traditional "male" and "female" roles. Emancipation is needed for men and women, boys and girls. Until now, emancipation has focused largely on what it means for women.  Emphasise an assessment of ICT's influence on boys and men because it is so much more often the male gender that wages war. While all of us are the victims of warfare, war often particularly affects women and children.  Consider education more and more in the context of global learning.

 Ensure that global and international trade shifts instead towards a "Global and International Educational System".  Explore the potential for "commoning" (sharing) in the ICT society.

In terms of software and electronic games, to:  Begin to use multimedia products in a positive peace-oriented way.  Focus on developing "peace games" across cultures and religions.  Develop a role and purpose for anti-war games.  Stop developing games based on extreme violence.

From an international perspective, to:  Explore the power of good examples. 6 Explore what kinds of wise, preventative actions formal international bodies, could take, and compare these with disarmament campaigns.  Re-think the basis of formal international bodies based on the character of today's and tomorrow's threats.  Explore the collaboration potential between formal bodies and the informal organisations, bodies and networks. Examine how the work and relationships between the non-governmental organisations, bodies and informal networks operating in the field of peace-building could be co-ordinated and strengthened.  Stop the "robotisation" of international, economic transactions that involve an increase in the risk of conflict development.  Explore specifically what an organisation like the International Federation for Information Processing could begin to do about these challenges.

Emerging Conclusions

In the authors' opinion, there are some phenomenal tools available to help build a Good Information and Communication Society. That society starts within ourselves and with ourselves, and in the networks of which we are members. It also relates to civil society as a whole, and the formal organisations that function in society. We all have a responsibility in our roles as researchers, policy-makers, citizens and human beings to consider how we can leave after us a society where human rights and peace form its essential elements. Stakeholders, along with ICT experts, can help society to start to answer a vast number of important questions pertaining to the potential turnaround of contemporary society.

Leynah Gbowee, and Tanakkol Karman who have applied innovative strategies to strive for democracy and to reach peace. Over the more than one hundred years that the prize has been awarded, there have been fewer than ten women who have received it. Many more have been nominated. http://www.nobelprize.org/nobel_prizes/peace/articles/heroines/html. Accessed 28 March, 2012.

A set of fundamental points, and a number of possible actions are immediately evident:  Never before in history has there been such a great opportunity for peace. Let us build on that opportunity.  Rethinking is required to deal with today's global problems, and transparent, rapid action too is needed.  Visionary strategic tools are needed to help transform dictatorships into democracies, to overcome not only present conflicts but also future risks.

ICT should help people to appreciate diversity. To capture an old saying of Gunilla Bradley's: when we design, work with and use these technologies the focus should be on "ICT for deepening human and societal qualities" [START_REF]Humans on the Net. Information and Communication Technology (ICT) Work Organization and Human Beings[END_REF], [START_REF] Bradley | Social and Community Informatics -Humans on the Net[END_REF].

A major re-thinking is needed to deal with today's problems. Transparent, rapid action is needed. Let us act on it!

Text of Human Choice and Computers 10 (HCC10) Conference Call.

These reflections were concluded after a reading of texts located in Wikipedia on, for example, peace-building, pre-requisites for peace, and war.

This expression was first used by Professor William Zartmann, Jacob Blaustein Professor of International Organizations and Conflict Resolution, Paul H. Nitze School of Advanced International Studies, Johns Hopkins University. It was the title of a public event entitled Civil War: Need, Creed and Greed which took place on October 21, 2004.

Text of Human Choice and Computers 10 (HCC10) Conference Call.

In this respect, the pedagogical work of Maria Montessori, and schools which follow in the tradition of her thinking, is of especial importance. The celebrated Italian physician and educator devoted her life to developing a learning philosophy for children that has become widespread internationally. Debate about the approach became a hot issue before, during and after World War II. Indeed, she was nominated several times for the Nobel Peace Prize. One of her books dealt with education and peace.

In 2011, the Nobel Peace Prize was given to three African woman, Ellen Johnson Sirleaf,

Acknowledgements

The authors are especially grateful to Mr. Jackie Phahlamohlaka, Chair of the International Federation for Information Processing (IFIP)'s Technical Committee 9 on ICT and Society. He chaired a panel on peace and war at the 2011 IADIS ICT, Society and Human Beings conference in Rome, Italy in July 2011 at which a very preliminary version of this reflection paper was first presented. We also wish to thank Mr. Willny Bradley who has assisted us with background desk research, and Mr. Marc Griffiths and several anonymous reviewers for their careful, constructive criticism and commentary.