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The Complexity Matters blog features the Thursday Complexity Post as well as other complexity inspired news items.

 

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Community Health Vital for Healthy People

Posted By Prucia Buscell, Thursday, August 28, 2014

Leana Wen, MD, an emergency physician who has worked in inner city hospitals in St. Louis, Boston and Washington, D.C., writes in her blog about the painful experience of administering short term fixes to patients whose long term afflictions lie beyond her realm.

She describes a 19-year-old who has come to the emergency room three times with cuts and broken bones and gunshot wounds. An 8-year-old without an inhaler living among relatives in an overcrowded house with lots of smokers comes to the emergency room struggling to breathe. A 38-year-old single mother diagnosed with cervical cancer four years ago never got to see a doctor as she struggled with three part time jobs, the care of four children and inadequate insurance. By the time Dr. Wen saw her in the emergency room, her cancer had spread to her lungs and intestines.

"We in the ER provide a necessary service, but it's far from being sufficient," she writes in her blog The Doctor is Listening. "We need to recognize that health does not exist in a vacuum, that it is intimately tied to issues such as literacy, employment, transportation, crime and poverty. An MRI here, a prescription there, these are Band-Aids not lasting solutions. Our communities need innovative approaches to issues like homelessness, drug addiction, obesity and lack of mental health services." The route to good health, Dr. Wen says, is in the community. Dr. Wen is coauthor of the book When Doctors Don't Listen.

When he was still writing the Wonkblog for the Washington Post, Ezra Klein described an experiment in Oregon to rebuild the state's Medicaid program around community health rather than individual fee for service treatments. Klein tells a story Oregon Gov. John Kitzhaber loves to tell. Kitzhaber, a former emergency room physician himself, calls it an illustration of what's wrong with our healthcare system. A 90-year-old woman with well-managed congestive heart failure lives in an apartment without air conditioning. When her apartment gets too hot, the strain on her cardiovascular system causes heart failure. Medicare will pay for an ambulance and $50,000 to stabilize her, but not $200 for a window air conditioner.

The 90-year-old may be hypothetical, but the story illuminates a common paradox, and Oregon's experimental approach starts with creation of 16 Coordinated Care Organizations (CCOs) that are responsible for assessing the health of their communities. Kitzhaber has given the CCOs flexibility on how they can spend Medicaid money. They can buy that air conditioner. An NPR story describes a Medicaid purchase of a minivan for community health workers who can be available around the clock to pregnant women trying to stop substance abuse, and to help mothers get to doctors' appointments, school and jobs. What makes CCOs different from accountable care organizations, or managed care, is the community component. Once they assess needs, they have to come up with ways to address them. So money can be spent on care coordination and community health workers with the aim of preventing some expensive emergency care. Gov. Kitzhaber told Klein, "We're investing in health. It's just a paradigm shift."

With thanks to Annette Garner, who teaches in the nursing program at the Health & Science University, Portland, Oregon.

Tags:  buscell  complexity matters  health  healthcare  medicine 

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Surprising Return on Enrichment for Babies

Posted By Prucia Buscell, Thursday, August 21, 2014

Policy makers concerned with income inequality need to focus more attention on improving the early environment of disadvantaged babies and toddlers, recent economic analysis suggests. Being born into poverty doesn't have to mean a lifetime of deprivation, researchers say, and the earlier the helpful intervention, the higher society's return on the investment.

High quality early childhood programs have been shown in numerous studies to have substantial benefits in reducing crime, raising earnings, and improving educational outcomes, Frances Campbell, Gabriella Conti, James Heckman and colleagues wrote recently in Science magazine, and now research shows that life's earliest experiences strongly effect adult health.

Heckman and Conti are among the top economists who have done extensive studies on human development. They have found that wealthy children and those from deprived environments have disparities in cognitive performance even before they start kindergarten, and the gap doesn't close with time. Research by Heckman and Flavio Cunha at the University of Pennsylvania shows that the divergence between rich and poor kids in math ability is about the same at age 12 as it was at age six.

Eduardo Porter writes in The New York Times that the achievement gap between rich and poor American students is one of the widest among the 65 countries that take part in the Program for International Student Assessment run by the Organization for Economic Cooperation and Development. Porter suggests the acrimonious debate over how to improve American education misses the most important time-the years from infancy though pre-school. Heckman, Conti and others report that interventions from infancy through age five pay extremely high returns. Good early programs improve cognitive skills and foster softer skills such as sociability, motivation, perseverance and self-regulation. Heckman and colleagues say those are the traits that enable kids to use their cognitive skills for future learning and adult success.

Two well documented programs are illustrative. The Perry Preschool Project offered intensive social and cognitive skills building for disadvantaged three and four year olds from 1962 to 1967 in Ypslanti, Michigan. A study found Perry graduates at age 40 were more likely than those in a control group to have finished high school, to hold jobs, and have higher earnings.

The Abecedarian Project in North Carolina started in 1972 with 111 infants who were followed from birth through their mid 30s. The children were randomly assigned with half in an intervention group and half in a control group. Children in the treatment group received regular pediatric care, good nutrition, and stimulation in language, cognition, and emotional self-regulation from infancy through age five. Parents also were trained. In the second phase, through age eight, the focus was on math and reading. The group that received the special early care did better educationally, and by age 30, members of this group were four times more likely than those in the control group to have graduated from college, be employed and have health insurance.

The health findings were a surprise. Men in the treatment group had less hypertension and none had metabolic syndrome, the cluster of conditions that raise the risk of heart disease, diabetes and stroke. One in four of the control group had metabolic syndrome. Women in the treatment group were less likely to be obese, less likely to drink before age 17, and they had healthier habits.

What about the small size of these samples? Heckman says the dramatic disparities between these treatment and control groups actually strengthen results because such differences are unusual in small sample experiments.

In a New York Times article, Heckman wrote that "the economic rate of return from Perry is in the range of 6 percent to 10 percent per year per dollar invested, based on greater productivity, and savings in expenditures on remediation, criminal justice and social dependency. This compares favorably to the estimated 6.9 percent annual rate of return of the U.S. stock market from the end of World War II to the 2008 meltdown." The Abecedarian Project lasted five years and cost $67,000 in 2002 dollars, he said, and produced substantial adult health benefits and cost savings. In Heckman's view: "Early childhood interventions are an unexplored and promising new avenue of health policy."

Tags:  buscell  complexity matters  culture  health 

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Disruption, 'Dematurity' and Cooperative Commercialization

Posted By Prucia Buscell, Thursday, August 14, 2014
Updated: Sunday, August 17, 2014

Disruption in an industry often comes from the gradually accumulated effects of many interacting forces rather than a sudden change, business analyst John Sviokla writes, and what happens to industries impacted by this multifaceted dynamic is a phenomenon he calls "dematurity."

"You can think of dematurity as a crescendo of mini disruptions that add up to great effect," Sviokla writes in Strategy+Business. "It will hit most industries sooner or later; it has struck sectors as varied as soft ware development, entertainment and defense contracting. It's happening right now in the U.S. in healthcare and electric power generation." And results can be surprising.

The term, coined in the early 1990s by former Harvard Business School professors William Abernathy and Kim Clark, describes what happens when many small companies rapidly adopt multiple innovations that can rejuvenate practices in an old industry. Sviokla explains the professors were thinking of the U.S. auto industry, which was profoundly challenged by Japanese competition, the quality movement and lean management. But instead of collapsing, the big three Detroit automakers adopted the tools and techniques of their competition and aimed for better quality and customer satisfaction.

Sometimes disruption actually helps market leaders. Wharton Management Professor David Hsu, MIT Professor Matthew Marx, and University of Toronto Professor Joshua Gans studied the speech recognition industry and found start-ups that introduce disruptive technologies with long term potential are more likely to end up licensing their innovations to established businesses, or agreeing to be acquired, than they are to become rivals. They say that's because start-ups are eager to prove the value of their innovation, and once they do, they often form alliances with the established businesses or merge with them. These authors call that a cooperative commercialization strategy that sometimes has the effect of preserving the status quo. Read their paper here.

Sviokla says while dematurity can make industries young again, it can also threaten individual industries if leaders haven't seen it coming in time to prepare. He cites five "often overlooked but genuinely prescient" signals of change:

New customer habits: Mobile phones used only for voice communication in the 1990s didn't dramatically change people's habits. When people began to use phones for text messages, reading magazines and books, listening to music, and playing games, habits changed. They began taking pictures, shopping online and using multiple apps so business and pricing models changed in a large group of industries that once operated independently. The same thing happened in IT when access to services by high speed cloud connections began to replace web based software.

New Production Technologies: A recent survey showed more than two thirds of 100 manufacturers report some use of 3D printing, a burgeoning technology that will have major impact in many industries in the manufacture of goods, supply chains, product development, and transportation.

New Lateral Competition: The emergence of healthcare outlets in bog box stores and retail clinics is creating competition for primary care providers and hospital emergency rooms, which will have to adapt. Old and new businesses in healthcare are trying to keep people out of doctors' offices with services to promote exercise, control weight, manage disease and offer advice.

New Regulations: When regulations appear to pave the way for self-driving cars, major dematurity can be expected in public mass transit and private transportation-related industries.

New Means of Distribution: Digital infrastructure has already dematured media and entertainment. Regulations allowing expanded commercial use of unarmed aerial vehicles-drones-would have major impact in fields such as law enforcement, insurance, and delivery of emergency supplies to remote areas. Amazon plans to use drones to deliver merchandize, and some analysts predict drones are the transportation of the future.

Sviokla is co-author of The Billionaire Effect: What Extreme Producers Can Teach Us about Breakthrough Value. He is a principal and advisory innovation leader with PwC. Read his Strategy +Business article here and the David Hsu article here.

Tags:  buscell  business  complexity matters 

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For Children Born Poor, Poverty’s Shadow Lingers

Posted By Prucia Buscell, Thursday, August 07, 2014

After following nearly 800 Baltimore school children for almost three decades, researchers at Johns Hopkins University found most of the children grew up to have about the same socio-economic status as their parents. Those born poor stayed poor. Those born to more economically successful families fared better.

Johns Hopkins sociologist Karl Alexander PhD, and fellow researchers, the late Doris Entwisle, PhD, and Linda Olson MA, tracked 790 Baltimore children from the time they entered first grade through their late 20s. They repeatedly interviewed the students, their parents and their teachers through their school careers, and continued conversations with the maturing students as they entered the work force and started families. Their research is presented in their book, The Long Shadow: Family Background, Disadvantaged Urban Youth, and Transition to Adulthood.

The findings are described on the Johns Hopkins website. Only 33 children born to impoverished families earned high incomes as young adults, whereas 70 would have been expected to have high incomes if the family of origin did not impact the children's prospect for upward mobility, the researchers reported. Only 19 of those born to well off families dropped into the low income bracket as adults.

Only four percent of those from low income backgrounds had a college degree by age 28, a figure Alexander found shocking. By contrast, 45 percent of children born to higher income families had college degrees. And race played a significant role in adult outcomes. While 45 percent of white men from low income families had landed one of the shrinking number of industrial jobs in the area, only 15 percent of black man from low income families had such jobs. White men self-reported having the highest rates of drinking, smoking and drug use, though black men had slightly higher arrest rates and white men were more likely to be employed despite their records and substance use. Alexander said white men were more likely to have social networks that helped them find jobs.

In an interview with NPR, Alexander said we expect that if we "Play by the rules, work hard, apply yourself and do well in school ...that will open doors for you." But the Baltimore study suggests that what makes the difference between success and failure is money and family. Still, a few defy the odds against them. NPR interviewed one young woman in the study whose harrowing childhood included drug addicted parents and neighborhood chaos. "I remember being so immune to death, so immune to shootings and killings. I just remember wanting them to rush, like get the body out of the way so we can get back to playing hopscotch or dodgeball," she said. But she managed to get a well-paying job and give her two children more stability and motherly support. She says she has a strong relationship and plans to be married.

Tags:  buscell  complexity matters  culture  education  research 

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The Smell of Fear and Inherited Trauma

Posted By Prucia Buscell, Thursday, July 31, 2014
Updated: Friday, August 01, 2014

Babies can learn very early in life to fear something that frightened their mothers even before they were born. Scientists have known for some time that trauma can ripple through generations. New research on fear transmission may help explain how that happens.

A team of researchers from the University of Michigan Medical School taught a group of female rats to fear the smell of peppermint by repeatedly accompanying the smell with mild but unpleasant electric shocks. That was before they were pregnant. After the rats became pregnant and gave birth, the team exposed them to the peppermint smell again, without the shocks, to induce the fear response again.

A story on the university website by Kara Gavin explains that the babies of fearful mother rats, and a comparable group of rat pups whose mothers had no fear of peppermint, were exposed to the smell under many conditions with and without their mothers. When babies were separated from their mothers and exposed to the minty smell along with air piped to them from a nearby container occupied by their frightened mothers, they quickly learned to fear the smell. The trigger for learning apparently was the scent the mothers give off when they are fearful.

"Our research demonstrates that infants can learn from maternal expression of fear very early in life," said Jacek Debiec, MD, PhD, the psychiatrist and neuroscientist who led the research. "Before they can even make their own experiences, they basically acquire their mothers' experiences. Most important, these maternally transmitted memories are long-lived, where other types of infant learning, if not repeated, rapidly perish."

In a paper published in Proceedings of the National Academy of Science, Debiec and colleague Regina Marie Sullivan PhD, describe how brain imaging, studies of the genetic activity of individual brain cells, and monitoring blood levels of cortisol, the stress hormone, were used to examine the working of fear in the brain. They found a brain structure called the lateral amygdale was the key location for learning fears, and when they gave baby rats something that blocked activity in that region, they did not learn their mothers' fear. That could help explain why some offspring of traumatized mothers don't inherit fears. The authors hope the work will aid understanding of post-traumatic stress and other mental ills in humans.

Debiec, recalls working with adult children of Holocaust survivors who had nightmares and flashbacks related to experiences they had not endured themselves. Rachel Yehuda, a psychiatrist at Mount Sinai Hospital in New York, has studied descendants of Holocaust survivors and the children of women who were pregnant and in or near the World Trade Center on 9/11/2001. She found evidence of intergenerational trauma transmission that could not have occurred through storytelling. She was not involved in Debiec's work, but she told Arielle Duhaime-Ross of Verge magazine that the study is valuable because it provides molecular analysis that would not be possible in living human brains. She said understanding the brain changes that occur with intergenerational transmission could help people understand the long-term impact of parental experiences. "Your fears are not only a response to your personal experiences," Yehuda told Verge, "but those that your parents had as well."

Tags:  buscell  complexity matters  research  resilience 

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Surprising Links between Friendships and Genes

Posted By Prucia Buscell, Thursday, July 24, 2014

We tend to choose friends who share our interests and outlooks, but our selections may have less conscious and more ancient roots. Recent research suggests friends share genetic similarities and that resulting social networks play an important role in human evolution.

In their paper "Friendship and Natural Selection," published in the Proceedings of the National Academy of Science, Nicholas Christakis, a physician and social scientist at Yale, and James Fowler, a professor of medical genetics and political science at the University of California at San Diego, write that the number of genetic markers shared by two friends is about what they would have if they were fourth cousins.

That amounts to about one percent of a human's genetic markers. That doesn't sound like much, but Fowler explains in a Washington Post story that has huge implications for human evolution. Researchers found the genes that friends have in common seem to be evolving faster than other genes, so our social environments and social networks could be a key evolutionary force.

There's no gene for friendship, and no way to predict friendship among people because of a particular genetic trait. But the genetic data of two people provides clues to whether they will become friends. The researchers developed a genetic "friendship score" that suggests the likelihood of friendship. Individuals don't consciously recognize these similarities, but they are statistically measurable in huge data sets.

Friends are likely to share genes associated with the sense of smell. Being drawn to the same scent could attract us to certain environments, the authors suggest: people who like the smell of coffee might be drawn to coffee shops where they meet others who like the smell. The authors think our sense of smell may be one of the mechanisms humans use to identify genetically similar friends, though they emphasize more research is needed to discover how that happens.

Christakis and Fowler examined genetic information and details of social relationships documented among nearly 2,000 people who participated in the Framingham Heart Study that began in 1948. They and colleagues analyzed nearly 1.5 million markers of gene variations, and compared the data for pairs of unrelated friends and pairs of unrelated strangers. Because nearly all the people in the study had similar European origins, the findings weren't explainable by the tendency to gravitate to others of similar background.

Interestingly, friends are less likely to share genes associated with immunity to specific diseases, the authors note, and that that could be an evolutionary advantage. We're somewhat less susceptible to the things that sicken our friends.

In their book Connected, Christakis and Fowler write that social networks are in our genes. After studying friendship networks among 1,110 twins drawn from national health data of 90,115 adolescents, they discovered that social network structure was influenced by genes: kids located at the center of their networks had a different genetic makeup than those located at the periphery, and those whose friends were closely connected had different genetic make than those with friends in divergent groups.

In the new paper they discuss the role of genes in a broader social environment where we interact and collaborate with friends and strangers. "Our results support the idea that humans might be seen as metagenomic not just with respect to the microbes within them, but with respect to the humans around them. It may be useful to view a person's genetic landscape as a summation of the genes within the individual and within the people surrounding the individual, just as in certain other organisms."

Tags:  buscell  complexity matters  relationships  research 

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Do Mobile Devices Derail Human Empathy?

Posted By Prucia Buscell, Thursday, July 17, 2014

Networked technologies allow us to be "in a persistent state of absent presence" that can erode empathy and connection, according to Virginia Tech researchers.

In fact, researchers found just having a mobile device within easy reach-even if you're not holding it or using it-can lessen the quality of a face to face conversation, reduce empathy among friends, and deflect our attention from what is happening right before our eyes.

"Mobile phones hold symbolic meaning in advanced technological societies," a research team led by Shalini Misra of Virginia Tech wrote in an article in the journal Environment and Behavior. "In their presence people have the constant urge to seek out information, check for communication and direct their thoughts to other people and words."

In the study, 200 participants were divided into pairs and asked to chat for 10 minutes on either a meaningful topic or a trivial one. Nearby researchers recorded their nonverbal behavior and the presence or use of any mobile device at any time during the conversation. Afterwards, participants were asked about their feelings of personal connectedness and empathy with their conversational partners. When a mobile device was visible, participants rated the encounter less fulfilling and less empathetic. That finding held for trivial and substantial topics, and the negative relationship between the presence of devices and empathy was even more pronounced when the conversation was between people who knew each other. Apparently the mere presence of a mobile device can derail the natural empathy between friends.

Earlier research by Andrew Przybylski and Netta Weinstein of the University in Essex in the UK produced similar findings. Pairs of strangers conversed while seated facing each other. A nearby table, out of their direct line of vision, held a book and one other item. When the other item was a cell phone, participants reported lower connectedness and a lower quality encounter than when the other item was a notebook.

Research by Sara Konrath and colleagues, reported in Scientific American and at the University of Michigan website, indicates college students of today are less empathetic than they were 30 years, ago, and that empathy has declined the most in the last decade. Konrath conducted meta-analysis combining the results of 72 different studies of American college students between 1979 and 2009. While reasons are uncertain, researchers note the trend has accompanied the rise of social media and mobile communications.

But scientists say those results aren't necessarily discouraging. They show our brains are plastic and subject to experiential influence. And as Konrath writes in a Psychology Today blog, mobile communications can make people feel closer to distant loved ones, and that they have tremendous still fully untapped potential to help people manage physical and mental illnesses. She notes that paradoxically the same technology associated with our being stressed and distracted can be used for people to provide electronic encouragement, kindness and support to each other.

Tags:  buscell  complexity matters  connection  culture  engagement  relationships 

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Our Hands May Say More Than We Know

Posted By Prucia Buscell, Thursday, July 10, 2014

Forget Descartes' mind-body duality. A more recent perspective known as embodied cognition is based on growing recognition that thinking isn't confined to our brain cells. Our understanding of the world is profoundly influenced by our bodies and our experiences in physical reality. Research shows even the way we use our hands offers clues to how we think, what we know, and when we're ready to learn.

Susan Goldin-Meadow, a psychology professor at the University of Chicago, studied hand gestures used by adults and children and discovered that when gestures accompany language, they can provide visual and intuitive evidence of important meanings not explicitly put into words. She reports an experiment in which young children were asked whether two identical rows of checkers had the same number of pieces. The experimenter then spread out the second row and asked again whether the number was the same. One child said the number was different because the checkers were moved, and made a spreading gesture with her hands. The answer is wrong but the gesture matched the speech. Another child gave the same answer, but pointed at the first checker in each row, and continued moving his finger between the rows. In that case, the child's gesture conveyed different information from what he said, so speech and gesture were mismatched.

Interestingly, kids who mismatched benefited more from instruction, and learned faster than kids who matched. Further, when experimenters taught a strategy for solving a math problem correctly, with matching and mismatching gestures, kids taught with the mismatching gestures were more successful. Why? Goldin-Meadow wrote in Current Directions in Psychological Science that a conversation in gesture seemed to be taking place along side a conversation in speech, perhaps adding information, perhaps lightening the cognitive load, and perhaps aiding memory. Gestures let speakers convey thoughts they may not have words for, and mismatches may signal readiness to change a thought or learn new information.

Researchers from Michigan State showed 184 elementary school children a video about mathematical equivalence (an equation: 7+2+9=7+__________.) Half of the kids saw the teacher sweep her left hand beneath the left side of the equation as she spoke about that side, and her right hand under the right side when she spoke of the "other" side. The rest of the kids just heard her talk. When the children were given a different problem based on the same principle, those who saw the hand gestures were more successful.

Annie Murphy Paul, in the Business Insider Brilliant Blog, notes that the act of gesturing "seems to accelerate learning, bring nascent knowledge into consciousness" and aid understanding of new concepts. She cites Goldin-Meadow's work and a 2007 study by Susan Wagner Cook of the University of Iowa, in which third graders who gestured as they learned algebra were three times more likely to remember what they learned than classmates who did not gesture. In another study, Cook found that college students who gestured as they retold short stories remembered the story details better.

Embodied cognition is a relatively young concept. A Scientific American story by Samuel McNemey explains its roots in early twentieth century philosophy and its later development by George Lakoff, a professor of cognitive linguistics at the University of California at Berkeley.

Tags:  buscell  complexity matters  education  research 

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Disruptive Innovation Debate

Posted By Prucia Buscell, Thursday, July 03, 2014
Updated: Friday, July 04, 2014
Clayton Christensen, the business scholar who developed the concept of disruptive innovation, and historian Jill Lepore are Harvard faculty colleagues. The two professors don't agree on much, and Lepore's sharply written assault on Christensen's theory has ignited an uproar in academic and business circles.

In his 1997 book the Innovator's Dilemma, Christensen lays out his theory of disruptive innovation, which holds that products or services that begin simply and inexpensively at the bottom of market, often using new technology, can eventually displace those of established companies that seem to be doing all the right things to maintain their success.

The Thinkers50, a biennial ranking of the world's most influential management theorists, last year for the second time named Christensen the top "thought leader" in the world, and disruptive innovation has been one of the most widely celebrated ideas in modern business.

According to Lepore, the theory's celebration is one of its problems: she thinks it has escaped critical examination and been carelessly applied to explain too much. In her New Yorker article "The Disruption Machine," Lepore analyzes how we understand innovation and disruption. Every age has its theory of history, she writes. The eighteenth century had the idea of progress, the nineteenth had evolution, and the twentieth had growth and innovation. "Our era has disruption," she writes, "which despite its futurism is atavistic. It's a theory of history founded on a profound anxiety about financial collapse, an apocalyptic fear of global devastation and shaky evidence." 

Innovation used to have negative connotations, she says, but the idea was redeemed by its use to describe bringing new products to market. Still, she writes, "The idea of innovation is the idea of progress stripped of the aspiration of enlightenment, scrubbed clean of the horrors of the 20th century, and relieved of its critics. Disruptive innovation goes further, holding out the hope of salvation against the very damnation it describes: disrupt and you will be saved."

In his book, Christensen supports his theory with industrial case histories. Mainframe computer manufacturers were disrupted when they missed the market for personal computers. Mini steel mills disrupted the operations of big steel companies, and a healthy department store industry—the number of stores in U.S. plunged from 316 to fewer than 10—was disrupted by growth of discount stores. Lepore asserts that Christensen handpicked his examples, and she introduces evidence to challenge or complicate his much of his analysis. She notes, for instance, that companies and divisions that dominated the disc drive industry in the 1980s dominate today, despite facing disruption Christensen describes from makers of smaller hard drives .She also points out a high failure rate among would-be disruptive start ups.

In an interview with Drake Bennett at Bloomberg Business Week, Christensen agrees with Lepore that the word disruption has become a cliché. But agreement ends there. He calls her story "a criminal act of dishonesty." Slate's technology writer Will Oremus says that’s overstating his case, which is what he accuses Lepore of doing. Oremus concludes that Lepore's cherry picked examples don't overthrow Christensen's theory any more than Christensen's cherry-picked examples definitely prove it. In a piece in Forbes, Clark Gilbert, chief executive of the Deseret News and Deseret Digital Media, vigorously defends Christensen’s theory and the scholarship behind it, as does business consultant John Hegel in his blog.

Salon's Andrew Leonard, New York Times columnist Paul Krugman, and New York Magazine's Kevin Roose, sympathize with Lepore's views with some caveats. Richard Feloni at Business Insider reviewed reactions, including tweets from Steven Sinofsky, the former president of Microsoft's Windows division, who suggests that both professors are right. He says disruptive innovation has plenty of exceptions but it's still a useful theory.

What do disruptive innovation theory and its critique look like through a complexity lens? If you have thoughts on that, we’d love to hear from you.

 

Thank you Peter Jones, David Hurst and John Kenagy for your thoughts on disruption and innovation!

Peter Jones, PhD, of OCAD University in Toronto, addresses the issues raised by Jill Lepore and Clayton Christensen in his blog post Reproduction of Disruption, How Innovation Regimes Reproduce Culture.

Reproduction of Disruption  

Business consultant and author David K. Hurst, BA, MBA  has written two parts of a three part post interpreting disruption from an ecological perspective. He comments, "With the continual emergence of antibiotic-resistant bugs threatening to disrupt healthcare, it seems to me that the ecological/complex systems view is essential."

Disrupting Disruption Theory [Part I]: Storm in a Modernist Teacup

Disrupting Disruption Theory [Part II]: Ecological Transformation


See commentary of John Kenagy, MD, MBA, ScD, FACS  "Fireworks: The Disruption of Disruptive Innovation" at his m2s2 e club site.

Tags:  buscell  complexity matters  disruptive  innovation  news 

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Family Photos Hold Clues to Medical Diagnoses

Posted By Prucia Buscell, Thursday, June 26, 2014
Updated: Wednesday, July 02, 2014

Family pictures may record more than milestone events and the little incidents we love to remember. New technology may help doctors identify rare genetic conditions by analyzing ordinary digital photos of faces. Facial recognition software may even be useful in identifying presently unknown rare disorders with symptoms that baffle families and doctors.

A New Scientist story by Andy Coghlan explains that while genetic tests exist for common conditions, such as Down's syndrome, genetic tests for many more unusual conditions aren't available because the gene variants that cause them haven't been discovered. A story in The Independent by Charlie Cooper explains that 30 to 40 percent of genetic disorders involve some kind of change to the face or skull. Software developed at Oxford University by medical researchers collaborating with the university's Department of Engineering Science was initially "trained" by analyzing thousands of photos of people diagnosed with eight genetic disorders. Coughlin's story explains that the computer "learned" to identify each condition from a pattern of 36 features in each face.

Christoffer Nellaker, who designed the software with Oxford colleague Andrew Zisserman, believes it can help family doctors and general pediatricians make preliminary diagnoses of health conditions that may have puzzled them. In the future, Nellaker told The Independent, a doctor anywhere in the world should be able to take an ordinary smartphone picture of a patient, run a computer analysis, and find out which genetic disorder a patient is likely to have. The technology isn't meant to replace traditional diagnoses, but to aid it by giving doctors information not otherwise available to them.

Alastair Kent, director of the Genetic Alliance UK, a charitable organization dedicated to helping people with genetic disorders, told New Scientist that because few physicians are skilled in the diagnostic use of facial analysis, families often wait years to learn the cause of their children's problems. Many of the combinations of facial characteristics that have diagnostic significance would be undetectable to a layman.

The Oxford database now has nearly 3,000 photos, and the software can recognize 90 disorders. As the database grows, the software will enable researchers to study groups of patients with undiagnosed problems who share similar facial features and skull structures. That could allow researchers to identify presently unknown disorders and the explore the gene variants that cause them, which could potentially improvement treatment.

Some visual characteristics associated with genetic disorders are well documented. Scientists studying Abraham Lincoln's height, long arms, and big hands and feet believe he had Marfan syndrome, a genetic disorder that also impacts the connective tissue and heart. NBA prospect Isaiah Austin's dreams of a basketball career were dashed by a diagnosis of Marfan syndrome. Williams syndrome and DiGeorge syndrome, both genetic disorders that impact learning and behavior, have been associated with certain combinations of facial characteristics.

Tags:  buscell  complexity matters  health  research 

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