Putting Value on Extracellular Vesicles : Practical Economies of Biomedical Research and Development

Several studies over the years have paid attention to the entanglement of biomedical research and the multiplicity of expectations for scientific breakthroughs and economic gains. However, science and economy are by no means the only values attributed to the biomedical endeavour in an actual R&D project. In this article, we present an analysis of a case we studied in Finland, in which academic and commercial partners jointly studied minuscule extracellular vesicles (EVs) to develop related technologies and explore their commercialisation potential. Thus, we ask, what is the spectrum of value in biomedical R&D? Our analysis highlights that in the rapidly developing, but still immature, scientific field of EVs, the dominant value of the research project are related to the expansion of future possibilities (e.g., funding and collaborations) and the sustainability of research. The subject of our study is a new domain of biomedicine that is quite unexplored in science and technology studies (STS), and our findings contribute to ongoing discussions on valuation and economies related to biomedical R&D. We focus on the multiplicity of value, and, by doing this, critically discuss the mainstream view emphasising the dominance of commercial value.Peer reviewe

Dataohjautuvaa terveydenhoitoa tarinoimalla tekemässä: Asiantuntijapuheen kertomuksellinen lupauksellisuus

Dataohjautuvan terveydenhoidon lupausta ja mielikuvastoja koostetaan ja pidetään yllä kertomusten avulla. Kehkeytyvää teknologiaa koskevat lupaukselliset kertomukset eivät pelkästään esitä tulevaisuudenmaisemia vaan myös huolehtivat mielikuvastojen ylläpidosta ja edistävät teknologian juurruttamista. Tämä artikkeli on narratologinen analyysi suomalaisesta asiantuntijapuheesta, joka koskee kehittyneen datalouhintateknologian käyttöä terveydenhoidossa. Se osoittaa kertomusten täyttävän edellä mainitut ylläpito- ja edistämistehtävät suojelemalla datalouhinnan lupausta, antamalla tilaa ja joustavuutta tulevaisuutta koskevien mielikuvien muokkaamiselle sekä kytkemällä tulevaisuudennäkymät toimintaan ja käytäntöihin, jotka pyrkivät tekemään lupauksista totta. Artikkeli nostaa esiin kaksi tärkeää kerronnallista ainesosaa: kertomusrakenteen avoimuus on väline edistää datalouhintateknologian käyttöä terveydenhoidossa kutsumalla ammattilaisia ja muita asianosaisia mukaan innovaatiopyrintöön. Dataa syyllistävä kerronta puolestaan tarjoaa suojaa terveydenhoidon kannalta keskeneräiselle ja kehitysprosessissa olevalle teknologialle ja sen lupaukselle. Datan syyttäminen myös kantaa kerronnassa mukaan julkilausuttua tai implisiittistä vaatimusta terveydenhoidon organisaatioille ja ammattikäytännöille muuttua dataohjautuvuuden mukaisiksi

Psykiatrian muodonmuutos ja depression nousu kansantaudiksi. Historiallis-sosiologinen interventio

Tämän päivän psykiatriassa ollaan liikekannalla, niin Suomessa kuin muuallakin. Yhtäältä tyytymättömyys psykiatrian ja mielenterveystyön nykytilaan on laajaa niin alan sisä- kuin ulkopuolellakin, ja arvostelun ala ulottuu voimavaroista hoitokäytäntöihin (ks. esim. Knapp ym. 2007). Toisaalta mielenterveystyö on ollut viime vuosikymmeninä kiihkeän kehittämistoiminnan ja uudistushankkeiden luvattu maa. Tässä kirjoituksessa tarkastelen psykiatrian kroonistunutta muutostilaa alan ja ammattikunnan ulkopuolelta, historioitsijan ja sosiologin silmin. Otan polttopisteeksi nykyisen masennusepidemian, jonka lähihistoriaa ja yhteiskunnallisia ulottuvuuksia analysoimalla valaisen kysymystä psykiatrian muutoksesta, kriisiytymisestä

Sustainable Value Creation in Commercialisation of Innovation : The Case Auria Biobank

The purpose of this study is to examine how different logics of commercialisation are part of sustainable value creation in an emerging area of healthcare. This paper presents an inductive interpretative case study to examine the emerging field of personalised medicine from the perspective of a biobank seeking to create value on its depository of tissue samples, patient records, and digitised data. This study increases our understanding of the challenges and opportunities faced by a company when developing innovations in healthcare. It contributes to the literature on the commercialisation of innovation by exploring how sustainable value creation in an emerging industry builds on both planned and emergent commercialisation activities and how different logics of commercialisation are a part of sustainable value creation in personalised medicine.Peer reviewe

Attitudes of blood donors to their sample and data donation for biobanking

Modern biomedical and genetic studies require large study cohorts; blood donors have been suggested to represent an appropriate group for recruiting healthy cohorts. The Blood Service Biobank (BSB) in Finland was recently established to recruit blood donors willing to give broad biobank consent. The aim of the present study is to understand how the blood bank context influences views on donating samples and health data. We organised 61 interviews and 10 group discussions with current and potential blood donors. Using qualitative content analysis, we identified three discussion frameworks that summarise the results. We found that frequent blood donors associated the voluntary act of donation with caring for patients. The blood donation experience was considered to accommodate biobank participation, but also allowed critical observations on the integration of research data collection into blood donation. Research participants identified an important difference between the blood bank and biobank contexts. In the biobank context, the focus shifts from donating blood to patients into donating personal and genetic data for research use. Blood donors' anxiety over data use was balanced with their experience of the trustworthiness of the Blood Service. These experiences indicated that the new biobanking activity could be trusted to a familiar organisation. To build donors' trust, biobanks should invest in their institutional reputation, donor experience and dialogue with donors. These findings can be applied to other institutions that are considering setting up biobanks with broad consent for personal data use.Peer reviewe

‘Well, I knew this already’ : explaining personal genetic risk information through narrative meaning‐making

This article presents results from a Finnish focus group's study conducted among participants of a project called GeneRISK, in which the participants received a personal risk score for having a cardiovascular event based on genetic analysis, lifestyle and laboratory results. In the discussions, interpretations of the genetic risk score and its meaning were incorporated into personal narratives of health and illness. We argue that instead of serving as an explanation for health and illness, which can help guide people's lives and choices, the genetic risk information became an object of explanation. Therefore, the risk information did not create new conceptions of personal risk, nor did it generate enough power to push people to change their lifestyles. Instead, the risk information was used to strengthen the existing impression of personal risk and the narrative of personal health and illness.Peer reviewe

The depression paradigm and beyond: The practical ontology of mood disorders

This paper is an analysis of three elements of which depression as the primary target of current Western psychiatry and mental health care is made: the quest of psychiatrists to identify a depressive disease proper; the category of ‘major depression’ as defined by the diagnostic manuals; and the epidemiological view emphasising risk factors of depression. These elements are pivotal to the present understanding and experience of what depression is since they delineate the space of reasoning in which claims about depression are presented, problematised, and disputed. The paper presents how these elements have historically evolved and coalesced, and how depression has been formed and transformed as an object of knowledge and treatment in psychiatry and how the claims about depressive disorders acquire objectivity in the current mental health discussions. The paper also demonstrates how the quest of depression as a neurophysiological disease, consolidation of Major Depression as the diagnostic core of mood disorders, and the central role of the epidemiological notion of risk are both interlocked and discordant with each other in the current depression paradigm. In addition, tendencies of subversion of the depression paradigm are discussed