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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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When Death is a Technical Problem

Posted By Prucia Buscell, Friday, March 06, 2015

How will the world change when human brains and computers can interact directly? “That’s the end of history, that’s the end of biology as we know it,” says Yuval Noah Harari, an author and historian. “Nobody has a clue what will happen.” If we break out of the organic realm into the vastness of the inorganic realm, he says, we can’t even imagine the consequences because our imaginations are organic.

Harari, a lecturer in history at Hebrew University and the author of Sapiens: A Brief History of Humankind,  doesn’t predict any specific future, but does believe it’s the first time in history that our present knowledge and understanding are insufficient to give us a good idea of what coming decades will be like.  Harari discusses his ideas in an conversation with Daniel Kahneman, recipient of a Nobel Prize in economics and ad the Presidential Medal of Freedom.

While the nineteenth and twentieth centuries featured egalitarian trends, with emerging power for large groups and mass movements, he suggests the possibility that twenty-first century may be more elitist with gaps between rich and poor individuals and countries wider than ever before. As technology replaces the need for large numbers of humans in the economy and the military, he says, the age of the masses is over.  He goes further. Throughout history, he says, intelligence and consciousness were a combined human quality; when computers can drive cars and diagnose diseases better than humans, the two are “decoupled.” Intelligence is what’s needed to run things, consciousness isn’t, and large numbers of people become unnecessary.

He cites medicine as an example of unprecedented change beset with uncertainties. Medicine of the last two centuries has focused on healing the sick, which he calls an egalitarian enterprise, while recent medical trends are to upgrade the healthy, which he says has elitist potential.  Throughout history, he says, death was the great equalizer. In the Middle Ages, people summoned by the Angel of Death had no choice. They died. But he says a revolutionary change in thinking has transformed death and disease from metaphysical problems to technical problems. Technical things can be fixed, and the privileged are likely to get the best fixes.

 Kahneman asked the social implications of a potential for mass unemployment, anger, unrest, and large numbers of people who could become economically and militarily superfluous. .

Harari said the industrial revolution—and all revolutionary change—has brought about the emergence of new classes of people, and with them new political and social issues that take time to settle. In his view, the biggest political and social question of coming decades may be what happens to people who become unnecessary. “I don’t think we have an economic model for that,” Harari says. People don’t like boredom, and they want meaning in their lives; Harari thinks many may try to solve those inner needs with computer games and drugs.  People are focused on ISIS and the Middle East he observes, but the most interesting place in the world today is Silicon Valley, not only for technology, but for the ideas and trends with emerge with it.  Read this provocative conversation here.

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Can Literature in Lock Up Reduce Recidivism?

Posted By Prucia Buscell, Monday, March 02, 2015


Free Minds is a prison book club started 13 years ago by Tara Libert and Kelli Taylor, former journalists who believed that reading good books, discussing them, and putting private thoughts into prose and poetry could help prisoners change their lives during incarceration and after release.


In a Washington Post story by Robert Samuels, three club members in their 20s, recently released after years behind bars in Washington, D.C., tell how reading and writing helped them turn their lives around. All three began getting in trouble in their early teens. They were charged with serious crimes, tried as adults, convicted and sentenced to lengthy terms. According to a 2007 report by the CDC, juveniles tried as adults are 34 percent more likely than youth tried as juveniles to return to prison.


Adult recidivism rates are also discouraging. The Bureau of Justice Statistics tracked 404,638 state prisoners from 30 states who were released between 2005 and 2010 and found more than two thirds of them were re-arrested within three years of their release and more than three quarters were re-arrested within five years. Studies showed the most perilous time for getting into trouble was in prisoners' first year getting out of prison.

 Many teachers and researchers think reading and discussing literature can help people convicted of crimes develop empathy, expand their horizons and reflect on their own lives. An Urban Institute report found prisoners who took post secondary education reoffended at significantly lower rates.
Robert Waxler, an English professor at the University of Massachusetts Dartmouth and Jean Trounstine, professor of humanities at Middlesex Community College in Massachusetts, co-founded Changing Lives Through Literature. Trounstine taught literature and writing at a high security women's prison, and eventually directed women inmates in their own plays based on classic themes. Waxler, concerned that our culture seems to marginalize literature, convinced a judge to sentence male offenders aged 18 through 44 to a literature course rather than jail. Individual changes were encouraging and the program grew. Early evaluations showed literature students had a 19 percent re-arrest rate compared with a 45 percent re-arrest rate for a control group of similar offenders. Authors studied included Jane Austen, Jack London, Earnest Hemingway, Maocolm X, and Shakespeare.


Many prisons lack libraries, and The Prisoners Literature Project has been sending books to inmates for years. A Capitol Hill Times story by Leigh Ann Smith notes the strong relationship between literature and incarceration-Miguel de Cervantes wrote Don Quixote when he was behind bars. The story describes the work of Seattle-based Books to Prisoners, which sends thousands of books to incarcerated people in Washington and across the country. A note from a grateful recipient, quoted in the story, read, "Books allow us to live vicariously, to feel, to acknowledge, emotions that have much scar tissue.


The three young members of Free Minds spoke at a Washington D.C high school, not only to warn about the consequences of their own wrong turns, but to read memoirs and poems they had written and tell students of the comfort and wisdom they found in books. Nathan McCall's Makes Me Wanna Holler was a favorite. Reading together also created relationships that became a support network for life and job hunting after jail. When a skeptical student asked why a former offender had let himself succumb to chaos rather than taking charge of his life, the  young man replied, "you have a good head on your shoulders." The Free Minds website has several success stories. One offender had been incarcerated at 12, another had done time in solitary. Another, Antwan, talked about maintaining optimism, saying, "Shoot for the moon. If you miss you're still gonna land among the stars. ".


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Small Acts Matter

Posted By Prucia Buscell, Friday, February 20, 2015

For the Future of Democracy and the Planet, Small Acts Matter


Mass movements and big social changes, whether they are to topple dictators or protect the environment, often start with carefully planned small actions.


The huge demonstrations in Egypt’s Tahrir Square that culminated in the ouster of Hosni Mubarak were the result of two years of careful planning and hard work, Tina Rosenberg writes in her New York Times column “Fixes.” They weren’t just a spontaneous happening. Mass demonstrations aren’t the beginning of a movement, she writes, they’re the victory lap.


Rosenberg describes the work of Srdja Popovic and Slobodan Djinovic, leaders of Otpor, a Serbian student movement that aided the overthrow of Slobodan Milosevic in 2000. The two founded the Center for Applied Nonviolent Action and Strategies (CANVAS), an organization devoted to training activists committed to nonviolent ways of achieving democracy and human rights. Otpor, Rosenberg writes, began with 11 people and grew to 70,000 in two years, starting with a few activists who staged humorous anti-Milosevic street theater.  Popovic calls that “laughtivism,” and says one of Otpor’s guiding spirits was Monty Python.  Humor can puncture the invincibility of authority.


When Turkish officials inveighed against kissing in the Ankara subway,  Popovic has written by way of example,  100 protesters gathered the subway in pairs, kissed mightily, and carried signs advertising free kisses. Police were surprised and lawmakers were prompted to wonder who had the right to ban kissing.


Popovic and Djinovic have trained nonviolent activists in 46 countries, and have been invited to lecture and teach at several American colleges, including Grinnell, Harvard, Columbia, NYU and Rutgers. They say nonviolence is not only morally superior to brutality, but it’s really the only tool small groups have against raw power.  Dictators are good at violence, they assert, so advocates for democracy can’t compete in the same way. They have to think strategically and start small.  


Burmese who attended a CANVAS workshop knew a big demonstration for political goals would be dangerous. So they organized to get the Yangon government to collect garbage. In a similar vein, Gandhi began a massive civil protest against the British Salt Tax. CANVAS also teaches the value of “tactics of dispersal,” such as coordinated pot banging and traffic in which everyone drives at half speed. They show widespread support, which encourages larger participation.  


 The Earth Day Network’s A Million Acts of Green describes individual actions, large and small, that can impact the environment.  And if you think individual acts don’t matter much, watch the FutureEnvironment.Org YouTube presentation on how atmospheric pollutants could be reduced by millions of tons if one percent of the population left some lights burning for five fewer minutes.

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What Makes a Better Team? More Women

Posted By Prucia Buscell, Thursday, February 12, 2015
The teams with the smartest members aren't necessarily the smartest teams.

Researchers who teamed up with Alex Pentland and Nada Hashmi of MIT grouped 697 volunteers into teams with two to five members and studied how they performed several short tasks that required such common skills as logical analysis, brainstorming, planning, coordination and moral reasoning. Volunteers took individual IQ tests, but teams with the highest average IQs weren't necessarily the most successful. Nor were the teams with most extroverts nor the most highly motivated members.

The most successful teams with the best collective intelligence, it turned out, had three characteristics. Their members contributed equally to group discussions rather than having a few members who dominated. Teams with more women outperformed teams with more men. And the most successful teams had members who scored highest on a test called Reading the Mind in the Eyes. That test is designed to measure how well people can read emotional states by looking at facial images that only show the eyes. The study is described in a New York Times story by researchers Anita Woolley, Thomas W. Malone, and Christopher F. Chabris.

An Atlantic story by Derek Thompson stresses the importance empathy and social sensitivity. Generally, the story says, women outperform men on the Eyes test, which helps explain why teams with more women tend to have higher collective intelligence. Elements of that trait include an ability to read complex emotions and skill at interpreting nonverbal clues.

Interestingly, another study showed that good collective intelligence was just as important for teams working virtually as it is for teams working face to face. A study by Woolley, Malone, Chabris, David Engel and Lisa X. Jing in PLoS One examined teams that worked together face to face and teams that worked virtually. Emotion reading skill was just as important in the success of online teams. The other characteristics that helped in person teams-frequent good quality conversation and equal participation-also were crucial online.

Henri Lipmanowicz and Keith McCandless wrote the book The Surprising Power of Liberating Structures and created the Liberating Structures website, which describes simple methods to improve the way we meet, interact and collaborate. Lipmanowicz says the use of Liberating Structures (LS) can help people learn the communication, participation and emotion reading skills that create good teamwork. While traditional paths to learning these skills is slow, expensive and unreliable, Lipmanowicz says, people who experience using LS can learn them quickly.

Are you skilled at reading emotions? Take the Reading the Mind in the Eyes test here. Read some thoughts on the test here.

Tags:  buscell  complexity matters  liberating structures  research 

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Collaboration May Improve Medical Diagnoses

Posted By Prucia Buscell, Thursday, February 05, 2015

Doctors working in teams may make more accurate diagnoses than doctors working alone, a recent study suggests.

German researchers recruited 88 fourth year medical student volunteers and showed them videos of simulated patient cases. They then asked the volunteers to select one of 20 possible diagnoses, and order from a menu of 30 possible tests. Twenty eight of the students worked individually and the remaining 60 worked in pairs. Those working in pairs were 18 percent more accurate in their diagnoses. The study also found that pairs were more likely to differ in confidence about the diagnosis when the diagnosis was incorrect.

The researchers said superior accuracy of the pairs could not be explained by differences in knowledge or relevant information. "Collaboration may have helped correct errors, fill knowledge gaps and counteract reasoning flaws," researcher Dr. Wolf E. Hautz and colleagues said. The findings appeared in a research letter in the Journal of the American Medical Association.

A story by Sabriya Rice in reports that as many as one out of 20 adults in the U.S. may be misdiagnosed in outpatient visits, and about half of those errors could be harmful.

While hospitals have developed systems for monitoring healthcare acquired infections and surgical errors and other patient safety issues, experts say systems for tracking diagnostic mistakes barely exist and causes of diagnostic error have not been thoroughly researched. The 1999 Institute of Medicine Report "To Err is Human" brought medical error into public consciousness but did not focus on diagnostic error. The IOM report due this fall is expected to probe diagnostic error. Complicating the issue, Rice writes, is that there is no universally accepted definition of a diagnostic error.

According to a 2014 study by CRICO Strategies, a Cambridge, Mass.-based risk-management group, about 20 percent of 23,527 medical malpractice cases filed between 2008 and 2012 were related to diagnostic concerns, she reports, and about 73 percent of the 4,705 diagnostic claims alleged lapses in clinical judgment, such as failure to order diagnostic tests, establish a differential diagnoses or give a referral.

Some surveys and research indicate time and scheduling pressures contribute to the potential for error.

At Maine Medical Center, a part of MaineHealth in Portland, began an innovative initiative to get clinicians thinking about diagnoses. The hospital's patient-safety officer and clinical educator started a pilot project that ran from January to July 2011 where doctors voluntarily discussed examples of diagnostic mistakes. During the trial period, doctors found 36 instances where diseases such as cancer, stroke and pneumonia were missed, misdiagnosed or not identified in a timely fashion. "Just about every time you talk to clinicians involved in diagnostic errors, it seems like time and volume is an issue," said Dr. Robert Trowbridge, an internal medicine physician who teaches clinical reasoning at Maine Medical Center.

Dr. Gordon Schiff, a diagnostic error researcher at Brigham and Women's Hospital in Boston, told that diagnosis is really a team effort. He said the idea that diagnosis is "this heroic, lone ranger thing" that doctors do behind closed doors is romantic and outdated.

Tags:  buscell  collaboration  complexity matters  health  research 

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Our Genes May Know More Than Our Minds

Posted By Prucia Buscell, Thursday, January 29, 2015

Human happiness influences human gene expression, researchers have found, and different kinds of happiness have surprisingly different effects on our physical health.

Researchers at the UCLA Cousins Center for Psychoneuroimmunology and the University of North Carolina note that philosophers since antiquity have distinguished between hedonic wellbeing-the kind of happiness that comes from satisfaction from pleasurable experiences-and eudaimonic wellbeing-the kind that comes from striving toward meaning and noble purpose beyond self gratification. It turns out the molecular mechanics of good health tend to favor people who find happiness striving for higher goals.

Steven Cole, PhD, a professor of medicine, psychiatry and behavioral sciences at UCLA and a member of the Cousins Center, and colleagues including Barbara Frederickson, director of the Positive Emotions and Psychology Lab at the University of North Carolina, have spent a decade studying how stress, fear, loneliness and other miseries impact the human genome. In his paper "Social Regulation of Human Gene Expression: Mechanisms and Implications for Public Health," Cole reported that people who experienced long term loneliness had a gene expression profile showing high inflammation and lower immune function. Inflammation related illnesses include heart disease, neurodegenerative diseases and some types of cancer.

The stress-related gene expression profile characterized by high inflammation and low immunity is known as CTRA, for "conserved transcriptional response to adversity." Cole and colleagues wanted to find whether happiness is just the opposite of misery, or whether it would activate a different kind of gene expression. They took blood samples from 80 healthy adults assessed as having either hedonic or eudaimonic happiness, and used the CTRA gene expression profile to examine potential biological differences. Both groups had high levels of positive emotion. Those in the eudaimonic wellbeing group had favorable gene expression profiles, with low inflammation and functioning immunity, while those in the hedonic wellbeing group showed the opposite gene expression profiles. The study appears in the Proceedings of the National Academy of Sciences.

"What this study shows is that doing good and feeling good have very different effects on the human genome, even though they generate similar levels of positive emotion," Cole, the lead author, said in a UCLA release. "Apparently the human genome is much more sensitive to different ways of achieving happiness than are our conscious minds." The UCLA release says this research, showing specific signals and pathways associated with a positive state of mind and gene expression, is the first of its kind.

In his paper on social regulation of genes, Cole wrote that the human genome is influenced by social environment, and that the "regulatory architecture" of the genome lies outside the cell "in the constraints and affordances present in the social ecology."

Increasing knowledge and technological advances that allow researchers to examine the way genes and environment interact on a molecular level can have profound impact in public health, he suggests. "Social regulation of gene expression implies many aspects of individual health actually constitute a form of public health in the sense that they emerge as properties of an interconnected system of human beings," the paper says.

In an interview, Frederickson suggested our bodies may respond better to happiness related to human connectedness and purpose than to hedonic wellbeing, which she called the emotional equivalent of empty calories.

Tags:  buscell  complexity matters  culture  health  research 

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Lion and Calf, Dog and Cheetah, Tiger and Bear: If They Can Get Along, Can We?

Posted By Prucia Buscell, Wednesday, January 28, 2015

Scientists Examine Interspecies Interactions

The tender togetherness of the 100 year old tortoise and the baby hippo captures the imagination. A Budweiser commercial showing friendship between a Clydesdale horse and a Labrador puppy got more than 55 million views on YouTube. What makes some animals able to form relationships with animals from other species? How can some creatures adopt behavior of other species and even learn to understand  how to communicate with others? Scientists studying interspecies interaction hope to learn more about animal behavior and perhaps find new insights about humans. Read the New York Times story by Erica Goode "Learning from Animal Friendships."

Tags:  news 

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Vaccine Fears and the Return of Old Diseases

Posted By Prucia Buscell, Thursday, January 22, 2015

Measles, whooping cough and other diseases thought to have been eliminated decades ago are reappearing in California and other states and health officials worry that widespread resistance to childhood vaccinations raises potential for dangerous outbreaks of infectious illnesses.

A New York Times story by Adam Nagourney and Abby Goodnough reports a measles outbreak at Disneyland infected 42 of the 59 people in California whose illnesses were reported to the state this week. The Center for Disease Control and Prevention (CDC) reported 644 cases of measles in 27 states in 2014, the biggest number since 2000. Before common use of measles vaccine in 1963, the story reports, measles infected three to four million Americans a year and 400 to 500 people died.

Stories by Gary Baum of the Hollywood Reporter document childhood immunization rates as low 57 percent and 68 percent in some in some elite preschools in wealthy neighborhoods, numbers that are on a par with immunization in Chad and South Sudan. And nearly 8,000 cases of whooping cough, including 267 that needed hospitalization, had been reported to the state during the first nine months of 2014. Whooping cough, also called pertussis, once killed thousands of people annually, but introduction of the DPT (diptheria, tetanus and pertussis) vaccine nearly eliminated the disease.

During the current measles outbreak, unvaccinated children have been banned from going to public school in Orange County. A Washington Post Wonkblog identifies Orange County as "ground zero in the current epidemic of anti-vaccine hysteria." California allows parents to avoid vaccinating their children by filling out personal belief exemptions, and Baum reports an alarmingly high number of families in many of the wealthiest communities have made that choice. The CDC recommends vaccinations, some of which need multiple doses, against 14 diseases.

Radio station WBUR in Boston reported on a study showing vaccination rates in some states, including Oregon, West Virginia and Colorado, have dropped below the level required for herd immunity. Thresholds differ based on how infectious different illnesses are. The CDC suggests that threshold is crossed for whooping cough and measles when more than six percent of the population is not immunized. Herd immunity means that where a high percentage of the population is immune, the chance of an infected person meeting a susceptible person is low, so disease is unlikely to spread. Diseases spread rapidly among people who are not immunized.

Some parents worry about discredited research linking vaccines to autism, and some have religious or philosophical objections. The National Vaccine Information Center raises concerns about vaccines and the Times story quotes a spokesperson as minimizing the hazard of rejecting vaccination. Why do many resist? A 2014 AP-GfK survey reports only 53 percent of adults are "very confident" that childhood vaccines are safe and effective. The Post Wonkblog notes wryly that's about the same percentage who think houses can be haunted by ghosts.

The World Health Organization, urging universal immunizations, asserts that vaccines save lives and prevent disability, as well as mitigating severity of many diseases, reducing secondary infections. Some vaccines provide protection against related diseases. WHO says, for instance, that measles vaccination protects against multiple complications including dysentery and bacterial pneumonia.

Tags:  buscell  complexity matters  disease  health 

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Community Health Saves Lives and Money

Posted By Prucia Buscell, Thursday, January 15, 2015

A 40 year community-wide effort to promote heart health and healthier habits in a rural low-income county in Maine has resulted in less illness, lower mortality, and millions of dollars in savings according to a study published in the Journal of the American Medical Association. Authors believe the initiative can be widely adapted and that today's new data sources and technologies can make implementation even more feasible than when the program began in the 1970s.

Franklin County Court House

Franklin County Court House

In the late 1960s community groups in Franklin County, which then had a population of about 22,000, identified cardiovascular disease prevention as a priority. A Community Action Agency and Rural Health Associates (RHA), a non profit medical group practice, which were both new at the time, coordinated their efforts with the community hospital. With the hospital's sponsorship, RHA established the Franklin Cardiovascular Health Program (FCHP), which targeted hypertension, cholesterol, smoking, diet and exercise. FCHP used county health data from the past decade as a baseline and compared Franklin with other Maine counties and state averages.

Dr. Daniel Onion, a MaineGeneral Health physician and one of the researchers, told Kaitlin Schroeder of the Kennebec Journal & Morning Sentinel the project was powered by volunteers who worked in the community to help people quit smoking and adopt other healthy behavior. An HPLive story by Gale Scott describes other details. Federal funds were used to start an insurance plan for 3,000 indigent residents. The University of Maine developed a health education degree program and trained local people to be outreach workers. Hundreds of volunteers, including 200 nurses, did health screenings and educated residents. Schools were persuaded to serve healthier meals. A health fitness center with the area's only indoor swimming pool was built with funds raised by the community. Over the years, 150,000 people had an average of five contacts each with a program worker.

A ScienceDaily story reports that between 1994 and 2006 lower than expected hospitalizations saved an estimated $5.4 million per year in hospital charges for Franklin County residents. The program, which continued through 2010, had many successes. Among people with hypertension there was a 24.7 increase in the portion of people in control of their blood pressure. Control of cholesterol increased 28.5 percent. The quit rate for smoking improved from 48.5 percent to 69.5 percent. The overall death rate and the cardiovascular death rate dropped below state levels during most of the study period.

Darwin R. Labarthe, MD, MPH, PhD, and Jerome Stamler, MD, of the Northwestern University Feinberg School of Medicine in Chicago say in a JAMA editorial that the Franklin County experience deserves to be examined and copied. They say the results reinforce importance of disease prevention at the local level. They call on communities to document and publish past experiences in community health to "inform ongoing work and foster wider application of program evaluation and implementation research, exploiting new data sources and technologies to accelerate replication and scaling up of community-based prevention. Intervening developments-not least among them the Affordable Care Act-have made this task clearly more achievable today."

Tags:  buscell  community  complexity matters  health 

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Nature Editorial: Science and Satire Flourish Together

Posted By Prucia Buscell, Wednesday, January 14, 2015

Fanaticism Stifles Satire, Free Speech and Science

The heritage of the eighteenth century French writer Voltaire and the Enlightenment help explain why four million people poured into the streets of France after terrorists murdered 17 people, including eight staff members of the weekly satirical magazine Charlie Hebdo, an editorial in Nature asserts. Crowds in Paris surpassed the size of the demonstrations welcoming allied troops that liberated the city in World War II. The Nature editorial says freedom of speech and satire are crucial in challenging the authoritarianism and dogma that undermine science and scientific inquiry. The editorial also calls for social science research to understand origins of violent fanaticism so that terrorism can be addressed by long term policies and initiatives without relying solely on repressive measures. Read the editorial here. Huffington Post writer Lex Paulson summarizes Voltaire’s message: Tolerate others, think for yourself.

Tags:  news 

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