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nearly 2% of the world’s population at a cost of $26 Billion in the United States annually, and incalculable costs worldwide. AF causes no symptoms for some people. However, others with AF experience uncomfortable symptoms including palpitations, breathlessness, dizziness, and fatigue. AF can severely diminish quality of life for both AF sufferers and their loved ones. Beyond uncomfortable symptoms, AF is also linked to congestive heart failure and stroke, both of which can cause premature death. Medications often fail to control AF, leading patients and healthcare providers to seek other cures, including catheter ablation. To date, catheter ablation has yielded uneven results, but garners much attention in research and innovation in pursuit of a cure for AF. This dissertation examines the historical development and contemporary practices of AF ablation to identify opportunities to improve the innovation system for the disease. First, I trace the history of AF and AF ablation knowledge from the 2nd century B.C.E. through the present. This historical look identifies patterns of knowledge co-development between science, technology, and technique, as well as publication patterns impacting knowledge dissemination. Second, I examine the current practices of AF ablation knowledge translation from the perspective of clinical practitioners to characterize the demand-side of knowledge translation in real-world practice. Demand-side knowledge translation occurs in nested patterns, and requires data, experience, and trust in order to incorporate knowledge into a practice paradigm. Third, I use social network mapping and analysis to represent the full AF ablation knowledge-practice system and identify
opportunities to modify research and innovation practice in AF ablation based on i
measures of centrality and power. Finally, I outline six linked recommendations using raw data capture during ablation procedures and open big data analytics, coupled with multi-stakeholder social networking approaches, to maximize innovation potential in AF ablation research and practice.
This dissertation explores the contemporary politics of global transformation: the ways biological expertise and economic rationalities are positioned as agents of governance in the face of emerging global crisis. It examines visions for a new bioeconomy that are offered in response to impending global crisis. Leaders point to calculations of global population growth and resource depletion to predict future crises and call for a new bioeconomy as a pillar of sustainable and “good” governance.
Focusing on visions and practices of bioeconomy-making in the U.S. and Brazil, the dissertation examines bioeconomy discourse as a response to global crisis and a framework of global governance that promises resource abundance and human wellbeing. Bioeconomy discourse makes visible shared notions of how the world is and how it should be that animate the world-making practices of bioeconomy. The dissertation analyzes the bioeconomy as simultaneously a product of existing institutional and nationally situated values and rationalities, and a significant site of performative novelty. It is an effort to reformulate existing projects in the biosciences—from technology regulation to market formation—and establish new rationalities of governance in the name of producing thoroughgoing transformations to both the global economy and to life itself.
Framing existing scientific and economic rationalities as suppressed and misdirected in their power to govern, bioeconomy proponents envision a novel order derivable from the proper conjugation of biological and economic rationalities. Through the lens of bioconstitutionalism, the dissertation elucidates how national, scientific and public rights and responsibilities are coproduced in relation to a sociotechnical imaginary of vital conjuring. Underwritten by the imaginary of vital conjuring, visions of a future transformed promise that abundance and order can be called up from a tangle of crisis and decay. The imaginary of vital conjuring marries a vision of the technological potential of biological life and the forms of economy capable of unlocking that potential. This vision of bioeconomy, the dissertation argues, is a vision of governance: of the right relationships between state, citizen and science.
First, it shows that social, economic, and energy insecurity creates a complex energy-poverty nexus, undermining equitable, fair, and sustainable energy futures in marginalized communities. Indirect and access-based measures of energy poverty are a mismatch for the complexity of the energy-poverty nexus. The thesis, using the concept of social value of energy, develops a methodology for systematically mapping benefits, burdens and externalities of the energy system, illustrated using empirical investigations in communities in Nepal, India, Brazil, and Philippines. The thesis argues that key determinants of the energy-poverty nexus are the functional and economic capabilities of users, stressors and resulting thresholds of capabilities characterizing the energy and poverty relationship. It proposes ‘energy thriving’ as an alternative standard for evaluating project outcomes, requiring energy systems to not only remedy human well-being deficits but create enabling conditions for discovering higher forms of well-being.
Second, a novel, experimental approach to sustainability interventions is developed, to improve the outcomes of energy projects. The thesis presents results from a test bed for community sustainability interventions established in the village of Rio Claro in Brazil, to test innovative project design strategies and develop a primer for co-producing sustainable solutions. The Sustainable Rio Claro 2020 initiative served as a longitudinal experiment in participatory collective action for sustainable futures.
Finally, results are discussed from a collaborative project with grassroots practitioners to understand the energy-poverty nexus, map the social value of energy and develop energy thriving solutions. Partnering with local private and non-profit organizations in Uganda, Bolivia, Nepal and Philippines, the project evaluated and refined methods for designing and implementing innovative energy projects using the theoretical ideas developed in the thesis, subsequently developing a practitioner toolkit for the purpose.