Managing Concurrent Futures: Prospective Action in Cardiology Care

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There is a paradox in clinical uncertainty management. While contemporary medical education and training dismisses prognosis in favor of diagnostic and treatment skills, prognosis is ever present in daily medical life. In fact, physicians arguably engage in more prognostic behavior than most other professionals because, bound by their duty to heal, they are routinely called upon to concurrently navigate short-term and long-term care goals. With new accumulating evidence establishing prospection (i.e., the mental simulation of possible futures) as a central organizing principle of cognition and behavior, and with more clinicians warning about the central role of prognosis in clinical decision making, concerns about the relative neglect of prognostic training are becoming louder. Yet, although there is much writing and some fairly robust guidelines about how physicians should do prognosis, very little is currently known about what the process of medical prognosis actually looks like on the groundI begin to fill this gap in my forthcoming book How Doctors Make Decisions, based on a three-year ethnographic study of hospital cardiology.

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Doomsday Arks

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With a trillion-ton iceberg cleaving from Antartica, and debate over the exact causes seems never to end, I wonder “what is the infrastructural equivalent of it?” 

One immediate answer is found the giant, offshore seed vault Svalbard (Norway), which was colorfully referred to as one of the “Arks of the Apocalypse” in the New York Times Magazine. The anthropocene stirs, no matter what the International Union of Geological Sciences (IUGS) suggests, and seed banks are a fascinating reflection of this transition for so many reasons. 

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US: D+

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We have written about this previously, the state of American infrastructure and the problem that is not appealing to the masses, and we can report that not a lot has changed. According to ASCE, the US got a 2017 report card for infrastructure and the outcome is pretty static … D+ (same as it has been for the past half-decade or more). Part of that story has to do with the grading system in the first place, but most (near all) has to do with the dwindling state of infrastructure in the past decade of austerity policy that effectively kicks the proverbial can down the road such that the next generation inherits suboptimal infrastructure in the US.

New infrastructure paper

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Introduction: Infrastructural Complications

Penny Harvey, Casper Bruun Jensen & Atsuro Morita

Over the past decade, infrastructures have emerged as compelling sites for qualitative social research. This occurs in a general situation where the race for infrastructural investment has become quite frenzied, as world superpowers compete for the most effective means to circulate energy, goods and money. At the same time, millions of people disenfranchised by trade corridors, securitized production sites, and privatized service provision seek to establish their own possibilities that intersect, disrupt or otherwise engage the high level investments that now routinely re-configure their worlds. The projects of the powerful and the engagements of the poor are thus thoroughly entangled in this contemporary drive to “leverage the future.”

Read the rest here.

Growing link between STS and Futures Studies

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There is a growing connection between a small research area in the business school literature called “futures studies” (wherein forecasting, scenario planning, etc.) and STS. Early thinkers in (what is now) this area are folks like Toffler; you might remember his books Future Shock or the Third Wave. In the link to STS, foundational thinkers that readers might recall are folks like Cynthia Selin (who I wrote about back in 2011).

Since then, I spent some time reading in “the sociology of the future” and we had a guest that spoke about forecasting (related to weather, Phaedra Daipha), although we have had some other perspectives, namely, some commentary about the future and rubbish.

Well, inspired by this, I started writing with a colleague at Roskilde University (Denmark) named Matthew Spaniol. Our first paper linked STS and futures studies through the notion of multiplicity in “The Future Multiple.” Our new paper, which is nearly out now, deepens this linkage, drawing upon some STS insights to address issues voiced from within futures studies about scenario planning, a process that unfolds, in the standard account, through a series of stages, phases, and steps. We offer a much more tentative understand of that process in “Social Foundations of Scenario Planning.”

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