Manager’s and citizen’s perspective of positive and negative risks for small probabilities

So far „risk‟ has been mostly defined as the expected value of a loss, mathematically PL, being P the probability of an adverse event and L the loss incurred as a consequence of the event. The so called risk matrix is based on this definition. Also for favorable events one usually refers to the expected gain PG, being G the gain incurred as a consequence of the positive event. These “measures” are generally violated in practice. The case of insurances (on the side of losses, negative risk) and the case of lotteries (on the side of gains, positive risk) are the most obvious. In these cases a single person is available to pay a higher price than that stated by the mathematical expected value, according to (more or less theoretically justified) measures. The higher the risk, the higher the unfair accepted price. The definition of risk as expected value is justified in a long term “manager‟s” perspective, in which it is conceivable to distribute the effects of an adverse event on a large number of subjects or a large number of recurrences. In other words, this definition is mostly justified on frequentist terms. Moreover, according to this definition, in two extreme situations (high-probability/low-consequence and low-probability/high-consequence), the estimated risk is low. This logic is against the principles of sustainability and continuous improvement, which should impose instead both a continuous search for lower probabilities of adverse events (higher and higher reliability) and a continuous search for lower impact of adverse events (in accordance with the fail-safe principle). In this work a different definition of risk is proposed, which stems from the idea of safeguard: (1Risk)=(1P)(1L). According to this definition, the risk levels can be considered low only when both the probability of the adverse event and the loss are small. Such perspective, in which the calculation of safeguard is privileged to the calculation of risk, would possibly avoid exposing the Society to catastrophic consequences, sometimes due to wrong or oversimplified use of probabilistic models. Therefore, it can be seen as the citizen‟s perspective to the definition of risk

Plug-in healthcare:Development, ruination, and repair in health information exchange

This dissertation explores the work done by people and things in emerging infrastructures for health information exchange. It shows how this work relates to processes of development, production, and growth, as well as to abandonment, ruination, and loss. It argues for a revaluation of repair work: a form of articulation work that attends to gaps and disruptions in the margins of technological development. Often ignored by engineers, policy makers, and researchers, repair sensitizes us to different ways of caring for people and things that do not fit, fall in between categories, and resist social norms and conventions. It reminds us that infrastructures emerge in messy and unevenly distributed sociotechnical configurations, and that technological solutions cannot be simply ‘plugged in’ at will, but require all kinds of work. With that, repair emphasizes the need for more democratic, critical, and reflexive engagements with (and interventions in) health information exchange. Empirically, this study aims to understand how ‘integration’ in health information exchange is done in practice, and to develop concepts and insights that may help us to rethink technological development accordingly. It starts from the premise that the introduction of IT in healthcare is all too often regarded as a neutral process, and as a rational implementation challenge. These widespread views among professionals, managers, and policy makers need to be addressed, as they have very real – and mostly undesirable – consequences. Spanning a period of more than ten years, this study traces the birth and demise of an online regional health portal in the Netherlands (2009-2019). Combining ethnographic research with an experimental form of archive work, it describes sociotechnical networks that expanded, collapsed, and reconfigured around a variety of problems – from access to information and data ownership to business cases, financial sustainability, and regional care. It puts a spotlight on the integration of standards, infrastructures, and users in the portal project, and on elements of collapsing networks that quietly resurfaced elsewhere. The reconstruction of these processes foregrounds different instances of repair work in the portal’s development and subsequent abandonment, repurposing, and erasure. Conceptually, this study contributes to academic debates in health information exchange, including the politics of technology, practices of participatory design, and the role of language in emerging information infrastructures. It latches on to ethnographic studies on information systems and infrastructural work, and brings together insights from actor-network theory, science and technology studies, and figurational sociology to rethink and extend current (reflexive and critical) understandings of technological development. It raises three questions: What work is done in the development and demise of an online health portal? How are relations between people and things shaped in that process? And how can insights from this study help us to understand changing sociotechnical figurations in health information exchange? The final analysis includes five key concepts: the act of building network extensions, the method of tracing phantom networks, the notion of sociotechnical figurations, the logic of plug-in healthcare, and repair as a heuristic device.<br/

Movement of knowledge

Medical knowledge is always in motion. It moves from the lab to the office, from a press release to a patient, from an academic journal to a civil servant’s desk and then on to a policymaker. Knowledge is deconstructed, reconstructed, and transformed as it moves. The dynamic, ever-evolving nature of medical knowledge has given rise to different concepts to explain it: diffusion, translation, circulation, transit, co-production. At the same time, its movements—and the ways in which we conceptualize and describe them—have material consequences. For instance, value judgements on the validity of certain forms of knowledge determine the direction of clinical research. Policy decisions are taken in relation to existing knowledge. The acceptance or rejection of treatment protocols based on medical ‘facts’ impacts on patients, dependents, health providers, and society at large. Simply put, knowledge and the movement of knowledge matter. How do they matter, though? The contributors to this volume examine the complexity of medical knowledge in everyday life. We demonstrate not only the pervasive influence of knowledge in medical and public health settings, but also the range of methodological and theoretical tools to study knowledge. Ours is a multidisciplinary approach to the medical humanities, presenting both contemporary and historical perspectives in order to explore the borderlands between expertise and common knowledge

Biohacking, Bodies and Do-It-Yourself

From self-help books and nootropics, to self-tracking and home health tests, to the tinkering with technology and biological particles - biohacking brings biology, medicine, and the material foundation of life into the sphere of »do-it-yourself«. This trend has the potential to fundamentally change people's relationship with their bodies and biology but it also creates new cultural narratives of responsibility, authority, and differentiation. Covering a broad range of examples, this book explores practices and representations of biohacking in popular culture, discussing their ambiguous position between empowerment and requirement, promise and prescription

Semantic discovery and reuse of business process patterns

Patterns currently play an important role in modern information systems (IS) development and their use has mainly been restricted to the design and implementation phases of the development lifecycle. Given the increasing significance of business modelling in IS development, patterns have the potential of providing a viable solution for promoting reusability of recurrent generalized models in the very early stages of development. As a statement of research-in-progress this paper focuses on business process patterns and proposes an initial methodological framework for the discovery and reuse of business process patterns within the IS development lifecycle. The framework borrows ideas from the domain engineering literature and proposes the use of semantics to drive both the discovery of patterns as well as their reuse

High-Performance Modelling and Simulation for Big Data Applications

This open access book was prepared as a Final Publication of the COST Action IC1406 “High-Performance Modelling and Simulation for Big Data Applications (cHiPSet)“ project. Long considered important pillars of the scientific method, Modelling and Simulation have evolved from traditional discrete numerical methods to complex data-intensive continuous analytical optimisations. Resolution, scale, and accuracy have become essential to predict and analyse natural and complex systems in science and engineering. When their level of abstraction raises to have a better discernment of the domain at hand, their representation gets increasingly demanding for computational and data resources. On the other hand, High Performance Computing typically entails the effective use of parallel and distributed processing units coupled with efficient storage, communication and visualisation systems to underpin complex data-intensive applications in distinct scientific and technical domains. It is then arguably required to have a seamless interaction of High Performance Computing with Modelling and Simulation in order to store, compute, analyse, and visualise large data sets in science and engineering. Funded by the European Commission, cHiPSet has provided a dynamic trans-European forum for their members and distinguished guests to openly discuss novel perspectives and topics of interests for these two communities. This cHiPSet compendium presents a set of selected case studies related to healthcare, biological data, computational advertising, multimedia, finance, bioinformatics, and telecommunications

Knowledge for better health:How to enhance the impact of research?

Science has contributed to dramatic improvements in health worldwide. The application of knowledge from research has prevented a tremendous amount of suffering and misery, and allowed billions of people to live longer, healthier lives. During the past decades, the global investment in research for health has grown to an estimated 300 billion USD per year. While the investment in research, and the expectations of its benefits continue to increase, there are constant signals of problems and disappointments with the relevance, acceptance and use of research. Researchers, and those who identify with their results, report that a lot of valuable knowledge and applications are hardly used, or only after a long time. In numerous publications, they point to the gap between today’s scientific advances and their application: between what is known and what is actually being done. Some well-known examples are studies that show that up to half of the patients in the United States and Europe are not receiving care according to best scientific evidence, and a major study on child survival in low-income countries, which concludes that 60% of the 10.8 million deaths among children could be prevented by simple, effective and affordable interventions. In this thesis, I try to present a richer, empirically ground and more useful perspective on KtA, which I refer to as the ‘pragmatist process perspective’. To develop this perspective, I drew upon insights from diverse fields such as science and technology studies, cognitive psychology, management and innovation studies, public administration, and epistemology. These diverse fields offer a rich mosaic of insights into KtA, in which a phenomenological theory of KtA is embedded. In chapter two, I present this perspective on how knowledge is produced, transferred and used to contribute to better action for health. The aim in this thesis is to explore how insights into producing, appraising, transferring and using knowledge, can be used to improve the contribution of knowledge practices to action for health. In diverse empirical case studies in the Netherlands, Guinea Bissau and Ghana, I explore how the process perspective can help to better analyze problems with KtA, and develop new and more productive approaches

High-Performance Modelling and Simulation for Big Data Applications

This open access book was prepared as a Final Publication of the COST Action IC1406 “High-Performance Modelling and Simulation for Big Data Applications (cHiPSet)“ project. Long considered important pillars of the scientific method, Modelling and Simulation have evolved from traditional discrete numerical methods to complex data-intensive continuous analytical optimisations. Resolution, scale, and accuracy have become essential to predict and analyse natural and complex systems in science and engineering. When their level of abstraction raises to have a better discernment of the domain at hand, their representation gets increasingly demanding for computational and data resources. On the other hand, High Performance Computing typically entails the effective use of parallel and distributed processing units coupled with efficient storage, communication and visualisation systems to underpin complex data-intensive applications in distinct scientific and technical domains. It is then arguably required to have a seamless interaction of High Performance Computing with Modelling and Simulation in order to store, compute, analyse, and visualise large data sets in science and engineering. Funded by the European Commission, cHiPSet has provided a dynamic trans-European forum for their members and distinguished guests to openly discuss novel perspectives and topics of interests for these two communities. This cHiPSet compendium presents a set of selected case studies related to healthcare, biological data, computational advertising, multimedia, finance, bioinformatics, and telecommunications