Re-imagining the future in finance capitalism

What is the role of imagination in the constitution of finance capitalism? How do the fictions, myths, and (ir)rationalities of finance shape society's ability to imagine the future in the face of mounting political instability? Well over a decade since the Global Financial Crisis of 2008, today's financialised economies are still marred by stagnation and uncertainty. Against this backdrop, the increasingly speculative nature of economic forecasting, and the accelerated trading of promises of all sorts (from algorithmic and derivative markets to contemporary electoral politics) put the role of imagination centre stage. This special issue contends that, contrary to conventional wisdom, imagining the future is not necessarily equal to ‘fantasising' or to ‘irrational exuberance' or the ‘animal spirits'. Rather, it points to something much more fundamental: the power of finance to produce new social and political morphologies under conditions of radical uncertainty. The articles of the special issue confront these issues by mapping out a novel field of investigation into different, unique types of imagination undergirding finance capitalism in the years since its most recent crisis: from the future-making practices of mineral exploration and agricultural derivative markets, to the imagined futures of financial education programmes, the financialisation of creative work, and the role of future-oriented legitimacy in today’s populist politics

Can Patient Safety Incident Reports Be Used to Compare Hospital Safety? Results from a Quantitative Analysis of the English National Reporting and Learning System Data.

BACKGROUND: The National Reporting and Learning System (NRLS) collects reports about patient safety incidents in England. Government regulators use NRLS data to assess the safety of hospitals. This study aims to examine whether annual hospital incident reporting rates can be used as a surrogate indicator of individual hospital safety. Secondly assesses which hospital characteristics are correlated with high incident reporting rates and whether a high reporting hospital is safer than those lower reporting hospitals. Finally, it assesses which health-care professionals report more incidents of patient harm, which report more near miss incidents and what hospital factors encourage reporting. These findings may suggest methods for increasing the utility of reporting systems. METHODS: This study used a mix methods approach for assessing NRLS data. The data were investigated using Pareto analysis and regression models to establish which patients are most vulnerable to reported harm. Hospital factors were correlated with institutional reporting rates over one year to examine what factors influenced reporting. Staff survey findings regarding hospital safety culture were correlated with reported rates of incidents causing harm; no harm and death to understand what barriers influence error disclosure. FINDINGS: 5,879,954 incident reports were collected from acute hospitals over the decade. 70.3% of incidents produced no harm to the patient and 0.9% were judged by the reporter to have caused severe harm or death. Obstetrics and Gynaecology reported the most no harm events [OR 1.61(95%CI: 1.12 to 2.27), p<0.01] and pharmacy was the hospital location where most near-misses were captured [OR 3.03(95%CI: 2.04 to 4.55), p<0.01]. Clinicians were significantly more likely to report death than other staff [OR 3.04(95%CI: 2.43 to 3.80) p<0.01]. A higher ratio of clinicians to beds correlated with reduced rate of harm reported [RR = -1.78(95%Cl: -3.33 to -0.23), p = 0.03]. Litigation claims per bed were significantly negatively associated with incident reports. Patient satisfaction and mortality outcomes were not significantly associated with reporting rates. Staff survey responses revealed that keeping reports confidential, keeping staff informed about incidents and giving feedback on safety initiatives increased reporting rates [r = 0.26 (p<0.01), r = 0.17 (p = 0.04), r = 0.23 (p = 0.01), r = 0.20 (p = 0.02)]. CONCLUSION: The NRLS is the largest patient safety reporting system in the world. This study did not demonstrate many hospital characteristics to significantly influence overall reporting rate. There were no association between size of hospital, number of staff, mortality outcomes or patient satisfaction outcomes and incident reporting rate. The study did show that hospitals where staff reported more incidents had reduced litigation claims and when clinician staffing is increased fewer incidents reporting patient harm are reported, whilst near misses remain the same. Certain specialties report more near misses than others, and doctors report more harm incidents than near misses. Staff survey results showed that open environments and reduced fear of punitive response increases incident reporting. We suggest that reporting rates should not be used to assess hospital safety. Different healthcare professionals focus on different types of safety incidents and focusing on these areas whilst creating a responsive, confidential learning environment will increase staff engagement with error disclosure

Learning subversion in the business school: An ‘improbable’ encounter

Entrepreneurs develop activities that aim to challenge the status quo, break rules and subvert systems. How can such a thing be taught/learnt in a business school? This article contributes to current debates within entrepreneurship studies that seek to address the subversive nature of entrepreneurial activity. It presents an ethnographic case study of an entrepreneurship course that attempts to re-define the teaching and learning boundaries of subversive activities in a leading European business school. Drawing on the theory of Bakhtin, which has thus far been overlooked in entrepreneurship studies, we unpick the potentiality of art practices in the learning and experiencing of the subversive dimension of entrepreneurship. We employ the concept of ‘dialogical pedagogy’ in order to address calls for more ‘relationally experienced’ approaches to management learning that foreground the conflicts, emotional strains and uncertainties that are embedded in the fabric of entrepreneurial practice. We show how ‘subversive dialogues’ are enacted between students and teachers as they engage in the learning process, and we discuss implications for critical entrepreneurship teaching in an increasingly commoditized education environment

An Anxiety Epidemic in the Financialized University: Critical questions and Unexpected Resistance

Financialization is transforming social subjects and institutions, including the university. This article explores overlooked links between the financialization of public postsecondary education on both sides of the North Atlantic and the ongoing “anxiety epidemic” among students (and, indeed, staff). The article argues that the “anxious university” represents a unique space to study the economic, political, social, and cultural impact of the rise in power and influence of the financial sector. By unraveling the complex sociological dimensions of the anxiety epidemic, we offer a vantage on the emergence of new forms an

Experience as Evidence: The Dialogic Construction of Health Professional Knowledge through Patient Involvement

This article investigates how healthcare professionals articulate the relationship between patient experience and ‘evidence’, creating hybrid forms of knowledge. We propose a Bakhtinian dialogical framework to theorise this process. Drawing on ethnographic work from patient involvement initiatives in England, we show how patient experiences are re-articulated by professionals who add their own intentions and accents in a dialogical process which incorporates diverse forms of knowledge and the conflicting demands of healthcare services. In this process, patient experiences become useful epistemic commodities, helping professionals to respond to workplace pressures by abstracting experiences from patients’ biographies, instrumentalising experiences and privileging ‘disembodied’ forms of involvement. Understanding knowledge as relational and hybrid helps move beyond the assumption that there is a clear dichotomy between ‘objective science’ and ‘subjective experience’. This article illuminates how new knowledge is produced when professionals engage with ‘lay’ patient knowledge, and helps inform the sociology of knowledge production more widely

Passage and reversal effects on gene expression of bovine meniscal fibrochondrocytes

The knee meniscus contains a mixed population of cells that exhibit fibroblastic as well as chondrocytic characteristics. Tissue engineering studies and future therapies for the meniscus require a large population of cells that are seeded on scaffolds. To achieve this, monolayer expansion is often used as a technique to increase cell number. However, the phenotype of these cells may be significantly different from that of the primary population. The objective of this study was to investigate changes in meniscal fibrochondrocytes at the gene expression level over four passages using quantitative real-time reverse transcriptase polymerase chain reaction. Cells from the inner two-thirds of bovine medial menisci were used. Four extracellular matrix (ECM) molecules, commonly found in the meniscus, were investigated, namely collagen I, collagen II, aggrecan and cartilage oligomeric matrix protein (COMP). In addition, primary and passaged meniscus fibrochondrocytes were placed on surfaces coated with collagen I or aggrecan protein to investigate whether any gene expression changes resulting from passage could be reversed. Collagen I expression was found to increase with the number of passages, whereas collagen II and COMP expression decreased. Collagen I and aggrecan surface coatings were shown to downregulate and upregulate collagen I and COMP expression levels, respectively, in passaged cells. However, decreases in collagen II expression could not be reversed by either protein coating. These results indicate that although monolayer expansion results in significant changes in gene expression in meniscal fibrochondrocytes, protein coatings may be used to regain the primary cell expression of several ECM molecules