Atrial fibrillation ablation: history, practice, and innovation

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Description
Atrial fibrillation (AF) is the most common abnormal heart rhythm, affecting

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

Atrial fibrillation (AF) is the most common abnormal heart rhythm, affecting

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.
Date Created
2016
Agent

Art-science for sustainability

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Description
The complexity and interconnectedness of sustainability issues has led to the joining of disciplines. This effort has been primarily within the sciences with minimal attention given to the relationship between science and art. The exclusion of art is problematic since

The complexity and interconnectedness of sustainability issues has led to the joining of disciplines. This effort has been primarily within the sciences with minimal attention given to the relationship between science and art. The exclusion of art is problematic since sustainability challenges are not only scientific and technical; they are also cultural, so the arts, as shapers of culture, are critical components that warrant representation. In addition to contributing to the production of culture, arts have also been credited as catalysts for scientific breakthroughs; thus it stands to reason that understanding art-science integration will benefit sustainability’s focus on use-inspired basic research. I focus on placing art and science on equal footing to enhance understanding of how individual artists-scientists and collaborative artist-scientist teams creatively address sustainability challenges. In other words, I address the question “What does it take to develop high functioning artists-scientists or artist-scientist collaborations?”

To answer this question, I used a multipronged approach to triangulate a richer understanding of what art-science synthesis offers sustainability and how it functions. First, I performed an historical analysis of a maladapted wilderness aesthetic and turned to the work Aldo Leopold – an exemplar of an artist-scientist – for a new sustainability aesthetic. Then, I engaged in an individual contemporary art practice, culminating in a gallery exhibit, which displayed ecologically-informed work from a three year study of my backyard. Finally, I conducted small group research of artist-scientist teams tasked with developing interpretive signage for the Tres Rios wetland site. For this final element, I collected survey, wearable sensor, and ethnographic data.

Through this composite research, I found that successful art-science practices require significant energy and time investment. Although art-science is most intensive in an individual practice where the person must become “fluent” in two disciplines, it is still challenging in a group setting where members must become “conversational” in each other’s work. However, successful art-science syntheses appear to result in improved communication skills, better problem articulation, more creative problem solving, and the questioning of personal and disciplinary mental models. Thus, the outcomes of such syntheses warrant the effort required at both the individual and collaborative level.
Date Created
2015
Agent