Thursday, November 30, 2006

One Laptop per Child - grid computing for the poor

Negroponte's dream project for $100 computers for every poor child in developing nations, "One Laptop per Child", has a critical vision beyond that perceived in the popular press.

The New York Times covered this yesterday (november 30,2006) in an article "For $150, Third world laptop stirs a Big Debate" by John Markoff. Compare to "Microsoft would put Poor Online by Cellphone", also by John Markoff, Jan 30, 2006.

According to Markoff's article yesterday "Five countries — Argentina, Brazil, Libya, Nigeria and Thailand — have made tentative commitments to put the computers into the hands of millions of students, with production in Taiwan expected to begin by mid-2007." Much of the rest of the article deals with pricing, technology, and competing views about the impact of this computer on education.

That misses the most important aspect of this, in my mind, which Markoff mentions near the end of the piece:

One factor setting the project apart from earlier efforts to create inexpensive computers for education is the inclusion of a wireless network capability in each machine.

The project leaders say they will employ a variety of methods for connecting to the Internet, depending on local conditions. In some countries, like Libya, satellite downlinks will be used. In others, like Nigeria, the existing cellular data network will provide connections, and in some places specially designed long-range Wi-Fi antennas will extend the wireless Internet to rural areas.

When students take their computers home after school, each machine will stay connected wirelessly to its neighbors in a self-assembling “mesh” at ranges up to a third of a mile. In the process each computer can potentially become an Internet repeater, allowing the Internet to flow out into communities that have not previously had access to it.

“The soldiers inside this Trojan horse are children with laptops,” said Walter Bender, a computer researcher who served as director of the Media Laboratory after Mr. Negroponte and now heads software development for the laptop project.

Each machine will come with a simple mechanism for recharging itself when a standard power outlet is not available. The designers experimented with a crank, but eventually discarded that idea because it seemed too fragile. Now they have settled on several alternatives, including a foot pedal as well as a hand-pulled device that works like a salad spinner....

“They should buy Dell’s $499 laptop for now,” he said. “Ours is really designed for developing nations — dusty, dirty, no or unreliable power and so on.”

In his two decades as director of the Media Laboratory, Mr. Negroponte often faced criticism because the institution’s impressive demonstrations of technology only occasionally led to commercial applications.

So, a few observations and comments

First, and most importantly, this technology should be immediately incorporated into Homeland Security and emergency preparedness infrastructure. It is astounding that, during Katrina, because of the damage, for the most part the people in the Superdome, and elsewhere, were simply cut off from communications with the outside world.

This technology demonstrates that we don't need all that infrastructure. We don't need a power grid, or satellites, or cell phones, in an emergency, if we have hardware that assembles its own network and passes messages from one user to another. This won't handle normal computing, but it sure would handle emergency traffic better than occurred during Katrina.

Stephenson points out the need for this type of infrastructure repeatedly. Yesterday he posted "Communications Strategy Emphasizes Reslience" . He has a marvelous cache of his best posts on Homeland Security and the first of those, "Why doesn't DHS have a netwars strategy to avoid future debacles?" (June 26, 2006) makes these points:


Fostering emergent behavior by a networked homeland security strategy: chaos or community?

By W. David Stephenson International Conference on Complex Systems June 26, 2006

This presentation will examine the possibility of extending the netwar concept to domestic homeland security. In particular, the author's thesis is that a combination of two factors that have only become widespread during the past 15 years:

  • the development and widespread adoption of networked communications technologies and applications on one hand
  • and the growing body of scientific understanding of emergent behavior on the other,
present a new opportunity that, to my knowledge, has not been formally analyzed in this regard: using networked communications technologies that were unavailable as recently as when Arquilla and Ronfeldt wrote "The Advent of Netwar" only a decade ago, to not just make emergent behavior possible, but actually foster it. To the author's knowledge, this is an option that has not received any serious scrutiny by the Department of Homeland Security, let alone consideration of it as a basic operating principle.

The presentation will conclude with an example providing a sense of how a networked homeland security strategy designed specifically to encourage emergent behavior might be structured and function.

...

individuals participating in emergent behavior produce results that are far greater than the sum of their parts. In the case of Katrina, still others spontaneously came together to craft imaginative Google Map mashups to allow identification of homes in New Orleans, or to create unified databases of those needing assistance.

So we know that emergent behavior is possible even under the trying circumstances of a terrorist attack or a natural disaster.

... Equally important but less understood by decision makers, unlike landline phones or the broadcast media, these devices are themselves increasing networked, self-organizing, and self-healing. In many cases, such as mesh networks that were originally developed for the military in battlefield conditions and now are being used by civilians, the networks don't require any kind of external networking: simply turn them on and the network self organizes.

I am convinced that such a networked homeland security strategy is feasible today, using existing technology and requiring much less time to create and deploy than some of the costly, dedicated emergency communications systems government is creating. Equally important, by facilitating those three qualities needed in a crisis: flexibility, robustness, and self-organizing, it could transform the general public from hopeless victims, waiting for aid that may never come, into self-reliant components of the overall response. To paraphrase Dr. King, which will it be, chaos, or community? [emphasis added]

So why isn't a networked homeland security strategy under consideration?

(photo by GustavoG at Flickr)

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Wednesday, November 29, 2006

Is short-sighted greed the best we can manage?



Emergent solutions are good, but some are way better than others. This post is an academic musing on why that is and what solutions it suggests to many organizational problems.

The term emergence is used to describe large-scale results that aren't built in by the local rules, but that end up happening as a downstream effect of those rules being applied locally millions or billions of times. A tornado is an example.

Emergent solutions can be very powerful, and much more adaptive than consciously programmed solutions, as computer scientists are revealing.

To a large extent, the theoretical underpinnings of what economists call "free markets" are based on emergence, on "the invisible hand of Adam Smith", with the explicit assumption that billions of local transactions made by self-serving, self-centered, short-sighted individuals will add up to the best possible outcome.

Given the complexity of modern problems, it seems clear that "planned economies" or top-down driven organizations of any type are becoming increasingly extinct and incapable of responding or adapting to the speed of change around us. The questions are less "who" should be "at the top" as to whether there needs to be "a top", and, if so, what the role is of "the top."

It is clear that the role of the top management is not to know all things and have all wisdom. The old "Theory X" is being replaced by "Theory Y", although not without bloodshed. In large organizations, in hospitals, in the US Army, it is increasingly clear that knowledge of what's going on is increasingly at the front lines or the "bottom" of the organization, not at the top.

Still, we have only replicated on a larger scale the same problem of global versus local. Now the problem in large organizations is "silos", multiple internal departments that, gasp, try to follow short-sighted, self-centered rules or algorithms. It is clear to many in leadership that this type of operation has very clear limits.

So, while emergent solutions may be far better than planned ones, there may also be different kinds of emergent solutions, some of which are far better than others. How do we proceed?

One theme that is visible in corporations, or universities, is the constant cyclical battle between "centralization" and 'decentralization" of services, such as Information Technology (IT) which in universities tends to be about a 7 year pendulum swing from one "side'" to the "other."

Advance accounting systems have been invented that try to "make the global local" by altering the perceived price of goods internally, so that the short-sighted, self-centered ("greedy") decision makers will result, through emergence, in globally optimal solutions. That hasn't worked very well.

So, we have managed to get the planet to this point, but as expansion space runs out globally, we have on many scales the problems of silos - competing groups that each want to try to reshape the world in their own image, and that's resulted in figurative and literal wars.

What to do?

"Homogenization" has been proposed - the idea that, if everyone were like us, it would work. The problem is that the specialization evolved for a reason, and serves a purpose. There is great value for the species and long-term in diversity.

So, we need something that does both at once - a mystical unification of purposes on a global sense, while leaving diversity on a local scene. Are such solutions conceptually possible? Have we ever seen any examples? And how would we know?

One metric is looking at what class of difficulty cannot be solved by a particular set of rules, even used emergently. For example, the "greedy algorithm" solutions may not be able to solve problems such as "tragedy of the commons," where each actor would have to behave a little less selfishly locally in order to achieve a longer-term mutual benefit.

That problem, however, is precisely the problem we are faced with on all sides. The development of, say, an Electronic Health Record (EHR) requires that each department, with its own definitions of everything, will have to yield a little bit and take the cost hit of changing to a set of common definitions of terms, a change that, in the short run, in any one budget year, will be a pure cost with no tangible benefit. Further, much of the EHR seeks to achieve collaboration via dull-witted, least-common-denominator homogenization, precisely the evil that departments evolved specializations and specialized vocabularies to overcome.

So, if "overcoming silos" means everyone has to change to match silo X, you can forget it, unless we're silo X, in which case we agree.

What we need is more of a dynamic, almost fractal EHR format where the complexities of specialized areas are retained within the silo, and accessible within that area as the local working language and reference frame, but are ALSO summarized, and simplified, to something that makes sense, albeit with far less precision, and is shareable outside the silo.

The key issue that has to be solved is that the detailed view and the (over)simplified global view have to be linked, under the covers, so that if one changes, the other changes as well.

For mathematicians, it is similar to a metric where data tensors have rank N at each department, but are represented as reduced rank tensors at larger scale views. The internal complexity has to evaporate gracefully, leaving just the validly simplified essence at each higher level of scale. This is, of course, what we wish any management reporting system would do, but seldom does. In practice, there is over-simplification and distortion at each management reporting level, so that what makes it to the top is close to useless.

Emergent organizational solutions are required, because there is no reshuffling of reporting relationships that can fix that problem, and no restaffing plan with new competencies that will resolve it. What FEMA delivered in Kartrina is what top-down organizations are capable of, period. It doesn't get any better than that. The whole design is broken, the architecture doesn't work, the algorithm is too weak for the task.

So, because of bandwidth, speed, agility, response-time, adaptiveness, and robustness to broken units (i.e., corruption), decision making in organizations has to be pushed out and decentralized BUT, and this is a big but, it still has to have some kind of over-arching central unity and coherence, a coherence that doesn't come from billions of short-sighted, self-centered decisions.

The solution, it seems to me, comes from looking at what I've called the four levels of decision making that networks of mutually interacting feedback-controlled dynamic systems involve. They can battle over data, the first level. They can disagree on the model or framework in which the world is interpreted, the second level. They can disagree on their temporarily assigned goals and interests the third level. And they can disagree on their identity, the fourth level.

Safety cultures and highly-reliable organizations recognize that they have to get above disputing facts to challenging frameworks and mental models. So far so good. Books like "Getting to Yes" describe how to get past locked in "positions" and move to finding underlying common "Interests", which address the third level.

But, this fourth level I suggest is the critical one. For humans, there is a flexibility in identity itself. Some call this a feature, some call it a bug. A person can change, almost in an instant, from thinking of "me" to thinking of a larger "us", whether driven by protection of children, of family, of culture, of a nation in a patriotic effort, or defending the species against alien insect invaders. People can and do willingly sacrifice their body and life for a larger "us" that, at that moment, is really perceived as "me". This gets into the whole social evolution of altruism question, which I'm aware of but not going into.

The relevance is that the peak solutions for innovative, reliable, powerful groups of people require, unambigously, that the people be capable, at least at times, of working as one, of each person actually perceiving that the team as a whole is them, and the interests of the whole group are their own interests, so that it is no big deal, EVEN IF DRIVEN BY GREEDY SHORTSIGHTEDNESS, to give up some asset or resource or take some pain for a different protoplasmic unit (person) who is, at that moment, perceived to be as much me as my own hand or foot is.

This is the state of activity that Professor Kim Cameron and Positive Organizational Scholarshiop at the University of MIchigan are studying. This is a mode of operation that actually works in practice, and has saved billions of dollars on the bottom line when it hits critical mass and takes over.

We need to learn more about that. If there is a way to deal with silos, and to get what the Institute of Medicine calls "microsystems" to work together, it needs something like that, supported with the sort of fractal-tensor IT structure I also touch on above for sharing "data", especially data that are context-dependent, where we need to retain not only the data, but also the context, and where transmitting data involves transforming it validly to account for the different contexts of the viewer and the submitter of the data. We need a "context processor" not just a "data processing" solution, at a minimum.

What we really need is the whole four levels, a data processor, a context-processor, a goal-processor, and an identity processor. Then we can overcome silos without requiring homogenization, let people work in familiar worlds, but still communcate between silos and achieve not only collaboration, but actual ability to overcome "tragedy of the commons" level problems that current systems and approaches cannot.

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Tuesday, November 28, 2006

New York State hospital closings - report

You can download the final report from the New York State Commission on Health Care in the 21st Century here.
http://www.nyhealthcarecommission.org/

New York Times
November 28 2006

A long-awaited plan to shrink New York State’s hospital industry landed yesterday with the force of an earthquake, with proposals that could effectively eliminate 20 or more hospitals and thousands of jobs, and force dozens of other hospitals to shrink, merge or take on new roles.

The recommendations by the Commission on Health Care Facilities in the 21st Century, go far beyond the 9 hospital closures and downsizings that state officials reported late Monday, after being briefed by the commission.

Monday, November 27, 2006

Bring back Saddam Hussein?

The Army's move to expand their thinking and actions to include development of order, not just the removal of the old order, seems to be a good thing.

We need to learn how to transition from one order to a better order without chaos breaking out in the middle. This is getting way too expensive and risky.

Lack of it has led to more than the removal of Donald Rumsfield. Now, we have people in the LA Times actively suggesting the return of Saddam Hussein to power.

Only dealing with part of the problem is increasingly looking like thousands or hundreds of thousands of people, depending on how you count, have sacrificed in vain. We really owe it to them to learn the lessons this is trying to teach us and give meaning to their sacrifice.


See one of the most viewed opinion pieces in the LA Times:

Johnathan Chait: Bring back Saddam Hussein

LA Times

Nov 26, 2006

Excerpt:

------------------------

At the outset of the war, I had no high hopes for Iraqi democracy, but I paid no attention to the possibility that the Iraqis would end up with a worse government than the one they had. It turns out, however, that there is something more awful than totalitarianism, and that is endless chaos and civil war.

know why restoring a brutal tyrant to power is a bad idea. Somebody explain to me why it's worse than all the others.

------------------------

Actually, while it dominates the headlines today, Iraq is just one example of a larger class of problems that we face as a planet. Charles Perrow, in his book Normal Accidents- Living with High-Risk Technologies, make several key points.

  • We keep making the world riskier by our efforts to make it safer, on many fronts. When we master building 100 story buildings, someone says great, let's build a 200 story one. When we get cars that are safe at 60 MPH, people go, great, let's go 85 mph now.
  • This problem is everywhere, and it will just keep on getting worse.
  • In most cases, the best thing we can do is learn how "safety cultures" work and how "high reliability organizations" function.
  • In some cases, the only thing to do is to back away from that technology and say, "No, we're not organized enough as a species to manage that safely."
  • That last thing is a really unfamiliar and hard thing to do.

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What relates public health and the US Army?


A question came up as to why a weblog on "public health" had postings on the US Army field manuals. Good question - stick around for the answer.

Probably the most common misperception of "public health" is to think that the field is about "health care for poor people." In fact, the field is about whatever is out there that is a health threat to the public. That means looking at people thousands or millions at a time, instead of one at a time in a doctor's office or hospital.

So, Homeland Security issues are part of that perspective. Anything that might lead to or prevent World War III is part of that perspective. Reimbursement rates for doctors or hospitals is part of that. The size of your co-pay for your health benefits at work is part of that.

Operations of the US Army and government decision making, especially in crisis situations is part of that. Why was the FEMA response to hurricane Katrina such a disaster? How will the Red Cross, the Coast Guard, ahd the Natioinal Guard work together? Who's doing what to make that better for the next natural or man-made disaster? Those are part of public health too.

Another major difference between public health and routine health care is that public health is less interested in how to fix the person in the ER with a gunshot wound, and more interested in why so many people with gunshot wounds are showing up lately. Inteventions have very little funding, as "prevention" is notoriously hard to sell to the public, so the researchers are forced to keep looking further and further upstream to find "root-causes' and high-leverage points.

What's clear from the Katrina response is that organizational decision making can neutralize or ruin even large quantities of resources or assets on hand. So, the quality of decision making in crises is fair game.

One thing the US Army has specialized in is being a "learning organization". They spend a great deal of time learning by observing what actually works in practice, and they get a lot of practice. General wide-spread disaster response is way less frequent, thank goodness, but that also means that the feedback loop that generates learning is far less powerful.

In short, if public health doesn't learn from the Army's lessons what it takes to respond to a crisis under fire and chaotic conditions, then those lessons will be learned the hard way and millions of people will suffer with more Katrina-type screwups.

In fact, there is some evidence that the whole concept of trying to concentrate decision-making "at the top" of a corporation or the civilian government is a bad idea in general. The visibility of actual reality decreases with each level of administration. There are serious bandwidth problems meaning, in a crisis, there are simply not enough people at the top to make all the necessary decisions if they wanted to and were 100% competent and motivated. There are massive priority problems as people at the top will be instantly preoccupied with "very big questions" and shut off their phones to "lesser questions", such as, oh, whether one particular state or city is at risk.

In short, a case can be made that the Katrina response by FEMA was not an aberration, but is totally representative of any response by any government that tries to concentrate all decision-making at the top, period, regardless who is in power at the time. The problem is a "systems problem", not a people problem. It won't be fixed by replacing Michael Brown in FEMA, or some general in Iraq.

In the human body, for example, touch typing on a keyboard would be impossible if every decision had to be checked with the brain. It takes about 100 milliseconds for a nerve impulse to make it from the finger up to the brain and back, whereas keys have to be struck in the right order as short as 15 milliseconds apart. There is no choice - much of the decision making has to be delegated to the hand.

This is the sort of life-science question that crosses all scales. How do organizations and organisms push and delegate decision-making down to the front, while retaining central control of the mission, and all the while remaining flexible and open to news that the situation out there at the front, on the ground, at the fingertips is not the one everyone thought it was.

The US Army is the best example around of a group that is trying to learn what is actually connected to what, and how it works, based on both academic theory and actual practice.
We can learn a lot from it that can be applied to public health. We better - we'll need it.



Photo by Giampaolo Macorig from Flickr.







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New York hospitals to close - drastic restructuring

Another item of note from the New York Times

No Clues Yet as Health Industry Awaits Report on Downsizing

November 27, 2006


Richard Perez-Pena

An economic shock wave, years in the making, is expected to hit New York this week. It could alter or eliminate tens of thousands of jobs, and change the way millions of people receive health care.

Yet the moment will catch most New Yorkers by surprise, and even those who know of it and care deeply have little real idea what to expect.

On Tuesday, a commission created by state lawmakers will release a plan for downsizing the hospital and nursing home industries across the state. Under the law that created the panel, the recommendations will become law unless the governor or the Legislature acts in December to reject the entire plan — it cannot approve some pieces and not others.

It goes on

Officials hope that downsizing will shore up the surviving hospitals by leaving them with more patients and putting them in a stronger position to bargain with health insurance companies. They predict that economically sound hospitals will invest more in computer systems — an area where New York lags behind much of the country — and other innovations that will make them more efficient.

David Sandman, the commission’s executive director, said he was sympathetic, but he disagreed. Last week, a published report speculated as to which hospitals might be closed, prompting panicked responses from their executives and employees.

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Does goodness pay?

On my continuing quest to examine the common ground between religions, sciences and business, I'm looking for good research questions. A "good" question would be about something that all three areas claimed to know something about and have some different perspective and expertise to bring to bear.

The point wouldn't be to prove one side right and the others wrong, but to try to figure out what reality might explain all three viewpoints.

Even better, the topic should have clear medical, health, and public health consequences. And, people should care about the answer, but so should larger groups of people such as families, teams, businesses, neighborhoods, communities, cultures, and nations.

That restriction is from my general rule that if it's not true across multiple scales, it's probably not the right place to start looking for stable truths.

So, this morning's candidate research question is: Does goodness pay?

This complements an earlier posting on "Does crime pay?" and, of course, after those two soon come a post on "Which pays better - crime or goodness?"


Why does any stakeholder care?

At every level, people are looking for clues or rules about 'what works." CEO's and investors want to know whether there is some rule of thumb that lets them look at a proposed action and go "yes" or "no." Is "goodness" defined at a corporate level, and if so how, and if so is it a good guide to profitable action or investments? As Gil Grissom on CSI would say, what's the evidence?


First, what exactly does "pay" mean?

We need to sharpen the question more to make it suitable for an academic research study.

Researchers might ask whether goodness and financial rewards are "associated." That is, if we make a graph of goodness on the horizontal axis and financial rewards on the vertical axis, will we get pretty much a rising curve or straight line? Are "poor" people "bad" and are "rich" people "good"? (I'm asking that loaded question somewhat tongue in cheek.)

Then, we could ask whether this association if there is one, might be causal. Have we picked out of all possible choices just two variables that are causally related and not in some feedback loop, so that either goodness causes wealth, or wealth causes goodness? if there is some phenomenon that the religious might refer to as "God rewards the virtuous", we might see goodness preceding wealth. Or, it may be that rich people can afford to be "nice" because it doesn't really cost them much, relative to their total net worth. In that case we might see wealth precede goodness.

But, it would be frustrating to find an association without knowing which way the causality went. Certainly there are rich people who feel all wealth is justified because, almost by definition, they themselves must be rich because they are good and, of course, poor people must be poor because "God is punishing them for their sinful behavior." This was quite a popular view among the rich in England in the 1800's, and all the poor were considered "undeserving poor."

So, to get around the questions of causality and shorten the study, we could ask "Does an increase in goodness result in an increase in wealth?" If we study people who recently became "gooder" would we also find that, in general, they shortly thereafter became richer?

With any "psychosocial study" we're well advised to have at least half of the equation well defined. So, maybe, measuring dollars is not very satisfactory, but at least it can be done done, and many people would think they understand what is being measured.


Second, what exactly does "goodness" mean?

But, we still have a problem with the left side of the equation. There is no accepted scientific standard for what "goodness" means, or how to measure it reliably and reproducibly, let alone quantitatively.

A related question is "What is the entity is whose goodness we're trying to measure?" This is a systems thinking question of scale, of boundaries, of connectedness, and of our model of what a person, group, and society are.

So, for example, if "people" are actually tightly bound up in their local family, neighborhood, business, culture, and nation, then the "entity" whose goodness is being measured might get all smeared out. And, we can easily imagine that. If a whole neighborhood gets a boost because some new business moved in and pays taxes and hires people, individuals in that area might improve in wealth through no "fault of their own." How are we going to deal with this multi-level effect?

For example, Professor Kim Cameron's Positive Organizational Scholarship site has examples of businesses where an entire company "got religion", or, more precisely, changed their culture together to one that is more interactive, loving, compassionate, and cross-supportive and, as a result, it would appear, the whole group was vastly more successful and really boosted the financial "bottom line."

So, it may be that "goodness" has to be rather wide-spread across many people for it to have an "emergent effect" on outcomes.

Or, on an even larger scale, maybe people, businesses, etc. are only capable of fighting battles, and the outcome of the whole war, figuratively or the literal "war on terrorism" depends not on those battles, but on the larger scale goodness of the mission and purpose of the USA as a whole. Those "multi-level" effects may overlap and need to be teased apart.

This is no different than walking into the boss's office just after she's had a fight with the prior visitor and getting a harsh reaction to an innocent question - you're getting the feedback that was really someone else's fault.

Some feedback appears to spill over to innocent bystanders - both good and bad

It may be that even excellent morality and the best of efforts by individuals can be undone by corruption or incompetence at higher levels of the organization, so their work is wasted and more or less blood spilled on the sand. The "people" as individuals are "good", but collectively, the aggregate is "bad."

That makes it really hard to measure, if there is some bad financial outcome, whether it's because the person wasn't "good" enough, or whether the boss wasn't "good" enough, or whether the company as a whole wasn't "good" enough -- assuming that goodness causes profit.

Maybe some thing, on some scale, got what "it" deserved, and "you" just happen to be caught in the larger-scale cross-fire. We all know that does happen to people, in some cases the entire populations of countries seem to be suffering from acts of a few at the top. How do we separate those effects? Do the good people get less of the bad stuff?

The model is now looking like "goodness" of individuals may be beneficial, and would result in a net profit if everyone had it, but it is also rather easily defeated if not everyone joins in. So, in that scenario, bad outcomes financially, locally, can result despite good behavior. Maybe the people have earned a palace in Heaven after they die, but that is not measurable and not a scientific research question where everything has to be measurable in this life.


Where do we put the cut-off boundary?

The scale and boundary effects actually change the right side of the equation as well - the financial outcomes. When do we stop measuring? If there are effects, how long do they take? Is there a "lag time" before there is the amplifying effect of an influx in "wealth" resulting from an input of an increase in "goodness"?

Or, if the outside environment is active and reactive, the result may be hard to see. If the local tax rate is very regressive and goes up to capture, in an extreme case, 105% of the increase in wealth, the person or company may have done very well, but had it all taken away leaving it now poorer, net, than when it started. That would mess up the measurement. Or, the person may gain much wealth but give it away to the poor, and, again, on a financial scale they didn't benefit, net. (Which shows that dollars are not capturing all the important things that are going on.)

Designing a study that doesn't isolate the actor from society is the only way to make the effect, if any, occur - but it also makes it challenging to be trying to sift out what is a response, and what is a counter-response from that environment by some other actor.

And, regardless, tracing out the pathways for 'emergent behaviors" and "synergy" are a whole area we are just beginning to understand how to study. So, in many cases where Positive Organizational Scholarship or "Theory Y" has been implemented in some division of, say, Ford, upper management remains skeptical because it's just not clear exactly WHAT got changed, or HOW that change percolated through to CAUSE the change in the output or bottom line.

So, the question remains open and actually, despite the Templeton Foundation's research efforts, rather poorly studied. The World Bank and others are studying "social capital" to try to figure out how social goodness in that form makes sustainable development work, and how corruption tends to instantly destroy most of that good impact. Those studies are ongoing.


================

References and further readings

Morality and Foreign Policy

George Kennan, Foreign Affairs


Professor Kim Cameron's work at the University of Michigan has certainly shown that psychosocial factors (squishy stuff with people being nice to each other and supporting each other) can make a $billion improvement in outcomes and make the impossible possible. That's a significant data point.

Video: "Making the impossible possible"


























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Sunday, November 26, 2006

US Army Full Spectrum Operations Field Manual FM 3-0

The New York Times editorial today rejoices in the new US Army Field manual, whicih would be the new version of FM 3-0 Ground Operations.    A key to Army field manuals follows below.

While I agree with the Times that there was, indeed, a catastrophic planning failure, I think it is worth while backing up further upstream and asking how on earth that could have happened.

The real issue here isn't whether the Army knew what to do, but what the Army should do when it tries to do what it should and the civilian leadership refuses to listen to the discussion and doesn't want to listen to inconvenient facts.

This gets into the subject of High Reliability OrganizationsSafety Cultures, and the
US Army Leadership Field Manual FM 22-100, previously discussed here.

Here's a glimpse into the articles and source documents.  I was unable to find a copy of the new, revised, draft FM 3-0 online for the general public at this time.

====================


The New York Times, Op Ed

Learning From Iraq

Nov 26, 2006

While politicians from both parties spin out their versions of Iraqs that should have been, could have been and just maybe still might be, the Army has taken on a far more useful project: figuring out why the Bush administration’s military plans worked out so badly and drawing lessons for future conflicts.

...Two hopeful examples are the latest draft of a new Army field manual ...Last week, The Los Angeles Times published details of some of the major changes being incorporated into the new field manual, while The Washington Post reported on some of the lessons learned in the Iraqi training programs.

The field manual, the Army’s basic guidebook for war, peacekeeping and counterinsurgency, quietly jettisons the single most disastrous innovation of the Rumsfeld era. That is the misconceived notion that the size and composition of an American intervention force should be based only on what is needed to defeat the organized armed forces of an enemy government, instead of also taking into account the needs of providing security and stability for the civilian population for which the United States will then be responsible.

Almost every post-invasion problem in Iraq can be directly traced to this one catastrophic planning failure, which left too few troops in Iraq to prevent rampant looting, restore basic services and move decisively against the insurgency before it took root and spread.

==============


What are Army Field Manuals? (From Slate Nov 16, 2006)

FMs—for just about everything a member of the Army might need to do,from handling nuclear material to cooking dinner. As of a few yearsago, there were over 650 different manuals. Some cover broad topics(for instance, FM 1 "The Army," and FM 3-0 "Operations") while others focus on more specific issues—like FM 8-50,"Prevention and Medical Management of Laser Injuries." The standardfield manual is written at a sixth-grade level and broken intochapters, and adorned with charts, tables, and hand-drawnillustrations. Some of the books come with appendices of examples orreal-life vignettes. Many—but not all—of them are available to thepublic on Web sites like this one.

Commentary

Commentary on field manuals

Officer of Engineers

02-09-2004, 02:29 AM

...
FM 3.0 - OPERATIONS (...)- By far, this is the most important document in the USArmy. It detailsthe strategic intent. Without this document as a reference, the rest of thearticles would be of little use.


LA Times article Nov 20, 2006

FT. LEAVENWORTH, KAN. — Defense Secretary Donald H. Rumsfeld may be leaving under a cloud of criticism over his handling of the Iraq war, but his invasion plan — emphasizing speed over massive troop numbers — has consistently been held up as a resounding success.

Yet with Iraq near chaos 3 1/2 years later, a key Army manual now is being rewritten in a way that rejects the Rumsfeld doctrine and counsels against using it again.The draft version of the Army's Full Spectrum Operations field manual argues that in addition to defeating the enemy, military units must focus on providing security for the population — even during major combat.


TRADOC- Army Training and Doctrine Command

FORT LEAVENWORTH, Kan. (TRADOC News Service, August 25, 2006) -- In future conflicts, the United States will continue to face adversaries who use asymmetric approaches to warfare.

Col. Bob Johnson, chief of the Future Warfare Division Concept Development and Experimentation Directorate at Fort Monroe, Va., made this point at the Training and Doctrine Command Doctrine and Concept Conference II Aug. 16-17 at Fort Leavenworth.

The purpose of the conference was to discuss outstanding issues in Army Field Manual 3-0 Operations: Full Spectrum Operations, which is being revised, and to look at future operational and tactical maneuver operating concepts, said Lt. Col. Jeff La Face, division chief for the Operational Level Doctrine, Combined Arms Doctrine Directorate, here.

Full spectrum operations refer to simultaneous offensive, defensive, stability operations and civil support. FM 3-0 covers the fundamentals and principles that the Army uses in today's military operations, said La Face, whose CADD team is revising the manual

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Business redefines science to suit


Science a la Joe Camel

Washington Post

By Laurie David
Sunday, November 26, 2006; B01

At hundreds of screenings this year of "An Inconvenient Truth," the first thing many viewers said after the lights came up was that every student in every school in the United States needed to see this movie.

The producers of former vice president Al Gore's film about global warming, myself included, certainly agreed. So the company that made the documentary decided to offer 50,000 free DVDs to the National Science Teachers Association NSTA for educators to use in their classrooms. It seemed like a no-brainer.

The teachers had a different idea: Thanks but no thanks, they said.

In their e-mail rejection, they expressed concern that other "special interests" might ask to distribute materials, too; they said they didn't want to offer "political" endorsement of the film; and they saw "little, if any, benefit to NSTA or its members" in accepting the free DVDs.

Gore, however, is not running for office, and the film's theatrical run is long since over. As for classroom benefits, the movie has been enthusiastically endorsed by leading climate scientists worldwide, and is required viewing for all students in Norway and Sweden.

Still, maybe the NSTA just being extra cautious. But there was one more curious argument in the e-mail: Accepting the DVDs, they wrote, would place "unnecessary risk upon the NTSA capital campaign, especially certain targeted supporters." One of those supporters, it turns out, is the Exxon Mobil Corp.

That's the same Exxon Mobil that for more than a decade has done everything possible to muddle public understanding of global warming and stifle any serious effort to solve it. It has run ads in leading newspapers (including this one) questioning the role of manmade emissions in global warming, and financed the work of a small band of scientific skeptics who have tried to challenge the consensus that heat-trapping pollution is drastically altering our atmosphere. The company spends millions to support groups such as the Competitive Enterprise Institute that aggressively pressure lawmakers to oppose emission limits.

It's bad enough when a company tries to sell junk science to a bunch of grown-ups. But, like a tobacco company using cartoons to peddle cigarettes, Exxon Mobil is going after our kids, too.

And it has been doing so for longer than you may think. ...


(Photo by m.o.m.o.)

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Saturday, November 25, 2006

The Penguin Revolution - Students in Chile




Amish Barn-raising by "heyburn3".

You have to wonder to what extent text messaging and internet connectivity powered this non-violent social movement, and where it will go from here. It has the earmarks of social cohesion that surprised most participants, including the student leaders.

Perhaps this is an example of how interacting people form the "water" on which self-sustaining waves can take form, which then take on a life of their own and "might as well be alive (MAWBA)" in the sense that they have most of the rest of the behaviors of what we call life - goal seeking, energy consumption, awareness, etc. That would make it less "artificial life" and more "meta-life" - that is, life occurring on top of other life, as human consciousness rides somehow on top of our body's cells, supported, interacting, but also independently alive.

Or, it might be an example of the computing phenomenon of connectionism in action, where non-programmed learning takes place in large networks, sort of on its own.
The question is, in a democracy, can a collection of normal, intensely communicating people synthesize more wisdom and capacity to produce change than a few very bright people? (need for collective problem solving in today's world)

See posts on social intelligence, unity with diversity, psychiatric treament for high school students in the USA, intellect versus action, role of feedback loops in sustaining a thought,
need for collective thinking in today's world, the importance of social relationships, Lewis Thomas on complex system interventions,
Chile's Student Activists - A Course in Democracy
By Monte Reel
Washington Post Foreign Service
Saturday, November 25, 2006; A01

SANTIAGO, Chile -- When the Class of 2006 graduates in a few weeks, its members will look back at a year in which some of the most important lessons took place outside the classroom.

In their black and white school uniforms, they launched what became known here as the "Penguin Revolution," filling the streets, calling for educational reforms, occupying school buildings and sparking a nationwide debate that was quickly labeled a milestone for the nation's young democracy.

Extracurricular activities for student leaders this year meant negotiating with senior government officials. When they text-messaged friends, at times it was to organize rallies that attracted as many as 800,000 people. A few became nationally known public figures in their own right.

"Graduation will be hard, and there are going to be a lot of emotions that come back from this year," said Karina Delfino, 17, who became one of the voices of the student movement during her senior year. "All the friends made, the difficulties and the successes -- this was one stage in life that has been good, but very tough. The only thing I can do now is to try to end this stage as best I can and get ready for whatever is next."
...
The students' actions turned them into the most powerful social movement since the strict military dictatorship of Gen. Augusto Pinochet was replaced by democracy 16 years ago. They forced the government to increase education spending and -- more important for many of the protesters -- prompted it to reexamine the roots of an educational system flawed by vast inequalities between the country's rich and poor populations.

Not everyone has approved of the students' methods at all times, but it's difficult to find anyone who hasn't come to accept them as a significant part of the country's social and political landscape.

"I believe their greatest achievement was to change the way people think of the youth of the country," said Rodrigo Cornejo, with the Chilean Observatory of Educational Policy at the University of Chile. "A lot of people thought the young people were simply individualistic, selfish consumers. But the long-term changes the students were pressing for this year weren't going to directly benefit them -- it was for their younger brothers and sisters."

...
Instead of plotting a grand revolution, the students said, they simply decided to take what they'd been taught at face value. If Chile's economy was so good -- as they had been hearing repeatedly during the presidential election campaigns in 2005 -- why did some schools lack essential supplies, like books and desks? Why should public schools be managed at the municipal level when that system encourages disparities between rich and poor neighborhoods? If Chile is a participatory democracy, why not participate?

"As the movement started to grow, we had everyone involved -- hippies, evangelicals, all the groups," said Delfino, who belongs to her school's social circle of organizers, those drawn to student government and academic organizations. "We all wanted the same thing, which was change. So we were trying to respect different opinions while at the same time working for consensus. That's all."

...The Education Ministry soon began holding negotiations with student leaders, and Bachelet eventually promised more funding to help the poorest students and created a panel, which included student representatives, to discuss broad reforms of the national educational system.
...
"The decision I have to make is whether I want to try to make changes through working directly with the community, or through politics," Huerta said. "If I work in the community, I can change the lives of a small group of people. With politics, you can do it on a macro level. But I don't want to join a political party."

...

"My age group started it, with the idea that you can be supportive of Chile and democracy without having to agree with everything the government does, that it's okay to be critical," Huerta said. "Now we have to see where the students in the first and second years of the high schools take it. I'm eager to see it."




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Friday, November 24, 2006

When something is nothing


Active feedback systems can also have the frustrating property of revealing change that evaporates again as if it had never been there.

So, competent reliable observers may first measure something to be there, and they are correct, but then it goes away again and future measurements show it was "never there."

There are fewer examples here that most people recognize, although the phenomenon is fairly wide spread, because it is subtle.

Still, in the suburbs, anyone can easily see that the process of putting garbage cans out next to the curb causes garbage trucks to arrive. What's up with that?

The cleanest and least ambiguous example, physically, is the middle-range field of a radiating antenna. As discussed in a prior post, very near teh antenna one set of laws appear to apply, where the stable radiation pattern falls off as the inverse of distance. At long distances, the stable pattern can be measured to be falling off as the inverse cube of distance. And, in between, in the really annoying and complicated mid-range field, the pattern is unstable and appears, if measured, to fall off as the inverse square of distance. Worse, in the mid-range, some fields build up that behave as if they are about to be radiated into space, but then sort of change their mind and get basically sucked back into the antenna.

An analogy from the database world is a transaction in some system such as Oracle that is started, figures out it can't complete, and, rather than leave things in a mess, is rolled back out again. This "rollback" is a standard, required operation in database systems - that something can get started, then the application decides midcourse this isn't working, and the world is restored to a state as if the transaction had never started in the first place. In the local world, all trace that this even began is erased. This turns out to be a necessary process for retaining coherence in a database world. There are even more fascinating "two-phase commits" in distributed database worlds. This is a design feature that adds great value, and if evolution was making databases, it would preserve this if it ever found it.

And, another physical example from the realm of tiny-scale physics, and the behavior of light packets known as photons. When a photon approaches a barrier that has a "double slit" in it, the photon has to decide what to do. If it were a particle, it would either bounce off the barrier, or go through one slit or the other. But, waves behave differently. In a very real sense, the photon looks ahead to the future, sees that there are two slits, sees that if it went a certain way it would result in conflict and interference, so it never goes that way in the first place. The exact same interference pattern is generated as if the slit, acting as a wave, went through BOTH slits, except that, if you measure it, no, photons only are measured going through one slit OR the other.

Yet another example from stage magic is the behavior of perception in a crowd. It is well known among stage magicians that observations are reversible. That is, a few people in a crowd may actually see something happen they weren't supposed to see, but if no one around them sees or responds to it, the initial perception "goes away" again, and, if asked later, the people will claim they never saw anything. But video of the audience shows them registering surprise, looking around, and then dismissing the observation.

On an internal scale, I think human vision and perception play many such tricks on people where pre-perceptual processes form an impression, sort of try it on for size, decide it doesn't fit, and then discard it. The behavior can be seen in functional MRI clinical images of the brain, but the person involved claims nothing ever happened in the first place.

The photon example runs into another phenomenon of look-ahead, or feed-forward (instead of feed-back.) When intelligent, observing, thinking agents are involved, to look at the mathematics, systems respond not only to the past but to the future. We all know that people respond to expectations of the future, which really, really messes up measuring the direction of causality. The scientific tools and statistics we use assumes causality goes forward in time, and causality that appears to go the other direction jams the equipment.

A simple example mentioned above would me observational measurements of the suburbs, where anyone can easily see that the process of putting garbage cans out next to the curb causes garbage trucks to arrive.

(photo by abbamouse on flickr )






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Thursday, November 23, 2006

When nothing is something


When complex adapative systems are involved, very often nothing is something and something is nothing. This makes it hard to get the correct model engaged to use to interpret the data.

A nice, clean example of the first principle, where "nothing" is "something" is a very common regulatory feedback loop often known as a "clamp." Probably the most common examples of these are thermostats and automobile speed "cruise control." The system is engineered on purpose to observe the world, to see a difference between some observable property of the world and some goal, and to take the appropriate action to bring the world's property back into line with the goal that is currently set. No big deal.

However, when the regulatory feedback clamp is the hidden model, it may be much harder to detect and realize what you are looking at. A good example might be, say, a tobacco control ad campaign. Say you measure the historical prevalence of smoking in some area, then intervene with a big educational ad campaign, then measure the final prevalence of smoking, and there is no change. The question is, "Did the ad campaign work?"

One possible underlying model is that no one watched the ads, and so it flopped for that reason. Another possible underlying model is that many people watched the ads and started to change their behavior, which was instantly picked up by the tobacco companies, which responded by seriously ramping up their ads until smoking returned to the level the industry wanted for that area. And, for every dollar spent in the tobacco control ad, the industry had to spend $1,000 to counter the effect. So, now, again the question is, "Did the ad campaign work?"

This is a case where "nothing is something." Because of the intervening active external systems effect, the impact of the intervention netted out to zero, as measured by one particular outcome variable. So, if you assume an underlying linear regression model where
prevalence = some constant plus some factor times your ad campaign dollars, you will measure zero effect for the coefficient factor. If you're sloppy, you would say that the ad had no effect on prevalence. If you're careful, you'd say that you cannot demonstrate any statistically valid impact on prevalence. These conclusions are correct, but misleading, as your ad campaign was very effective, but wasn't the only thing going on.

( Image is from "deadgirl1121" at flickr )



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Flu - weekly influenza in USA



Current influenza activity (flu) reported each week by the Centers for Disease Control (CDC) in Atlanta.

This is normal flu, not "avian flu".

It's interesting that the start this year seems to be in the area devastated a year ago by hurricane Katrina.

Last year, the flu started later, and the Southeast US was just about the last area to get flu.

This could be a real effect due to both the higher stress and lower employment and fresh food sources among the population and the continued damage to the public health infrastructure.

So, does crime pay?


Does crime pay? Can you get away with murder?

These are important and unsettled question in public health, government, public policy, social and economic development, religious studies, banking, personal ethics, and corporate ethics.

Furthermore, these are questions that should be amenable to systematic study and evidence gathering by scientific researchers.

One thing is certainly clear, regarding this type of crime or terrorism in general - it's probably way more cost-effective to stop the behavior before it begins than try to intercept it mid-stream. Once criminals take power, it's hard to unseat them from the outside. And, so far as the rule of thumb is correct that "power corrupts and absolute power corrupts absolutely," this is a closed reinforcing feedback loop, where power leads to corruption that, in the short run, leads to more wealth and more power, etc.

For all their downsides, people who believe firmly in a Final Judgment by God and in the idea of hell and eternal damnation are probably less likely to commit crimes or fall into corrupt practices than those who don't believe there is accountability because they haven't seen it yet.

Again, we have multiple systems thinking concepts intertwined in this discussion. The big ones off the top of my head are:

Is there a negative (discouraging or punishing) feedback loop in society that is not obvious to casual inspection? (in this life, not in the next one, as that one is hard to observe directly.)

If there is such a loop, with "lags" and "amplification", so that it arrives finally "with a vengeance", who ends up in the line of fire? The person? The person and family? Anyone in the vicinity? The corporation? The neighborhood? The culture? The whole country? The whole planet and all Homo sapiens? The whole galaxy?

If there is such an echoing loop of any type, can we say anything more about the behavior? Is there rapid gain from a crime, followed by it slowly eroding? Is there rapid gain, followed by an oscillating instability that decays over time? Is there rapid gain, followed by rapid loss and an escalating oscillilation that results in destruction? What? Or is the response of the world purely random and what we see is what we get? Is there gain in this life, but then payment for bad karma in multiple successive lives?

If there is a downside, what is the mechansm of "enforcement" or delivery? Do crimes against people or humanity result in some internal change ("guilt"?) that drags people down? Or some external change ("loss of trust") that drags people down physiologically? Or some external change (loss of social capital and direct investment) that slowly sinks the whole environment?
Or what? Are socially destructive people, like pathogens that destroy our own bodies, somehow flagged ("opsonized") somehow for later neutralization and removal by some other agents, besides the local "justice system", effectively a social immune system?

As with evaluation of any action, the value of the result is probably context dependent and almost certainly boundary dependent and scale-dependent. Viewed locally, at short range, one answer may be obvious. Viewed at mid range, other answers may be obvious. Viewed at very long range, yet different answers may be obtained by competent observers and researchers.
This effect needs to be accounted for in evaluating observations.

So, a king could take some action against a neighboring country that, in the short run, appeared to gain territory or wealth, but in reality turned all the other previously neutral countries against that king, so that, long term, the king's reign was cut short. A tactical victory, but a strategic catastrophe.

Every military strategist knows that it is possible to win a battle but lose the war. In fact, it's possible to win every battle and still lose the war. I used to teach the board game "Go" at Cornell, and MBA's would consistently lose that way - they would focus on short term material gain, ignoring entirely long-range positional loss, and then, after winning a series of battles (by their flawed accounting system), they would suddenly realize that they had lost the entire game. No wonder this game was a required skill of all Japanese Samurai soldiers.

So, are kings, corrupt politicians, organized crime bosses "winning" or "losing"? That's an interesting question that can be studied. I'm not sure it has been.

And, even if it is 100% certain that some behaviors lead to a short-term benefit but a long-term disaster, people go ahead and do them. Smoking is a prime example.

What's the answer? Various people have various opinions. This is a very hard question to answer scientifically with existing concepts and measurement tools. Many CEO's or their large stockholders and investment companies would love to know the answer to this question, but haven't yet turned to "public health" as the researchers to go find out the answer for them.

Ineresting question, though.

(Image by Darco TT )

Social intelligence

When we're looking at the tools science, religion, and business use to look at the world, we have two important properties of human beings that need to be kept in mind.

One is that the shape of a "human being" physiologically is increasingly unclear, but appears to extend somewhat outside their skin.

The other is that the shape of "human consciousness" also extends outside one mind.

What does this mean and why is it relevant?

First, what has been described as one of the "most robust" findings in public health epidemiology is that the physical health of "a person" is highly dependent upon that how that "person" is related to, interconnected with, and interacting with the larger group of "people" around them, and vice versa.

This relationship is very strong, and breaking social ties and connections between "a person" and "other people" can have demonstrable damaging or even fatal effects on that "person."

I use the term "person" in quotes because, from a mathematical systems point of view, if we trace out the physiological and psychological regulatory control loops, they clearly extend outside the skin and include "other people."
This is a very intimate relationship. It is stronger than an "environmental factor", such as the temperature or noise-level. It can be a "phase-lock loop" where internal systems are actually entrained and mathematically "become one" with another "person."

Daniel Goleman, in his recent New York Time's bestselling book Social Intelligence pictured above, describes the new classes of neurons that have been discovered in the brain that facilitate this process, including the "spindle cell" and "mirror neurons".

Where Goleman doesn't go, but I will and have in prior posts, is to look at the multiperson unit from a computer science and information processing viewpoint.

In radio and optical astronomy, a new and very powerful technique is "aperture synthesis", where many small telescopes are mathematically fused together so that, even though they look separate to the eye, they are acting in a very deep sense as "one". The result is twofold - first, the collecting area is vastly increased, so that more signal is available. Second, and more subtle, the resolution of the whole unit is improved, because it depends inversely on the largest diameter of the whole unit, even if there are gaps in the middle.

This unity is very deep, and we don't really have good words to describe it. Mathematically, the many remain separate and yet have become one. (e pluribus unum.)

The unity may not be directly perceived, but the change in output of the combined unit is dramatically different.

Similar phenomena have been observed, now repeatedly, and documented in collections of people that for brief periods of time exceed even slime mold in their power to come together intellectually and emotionally and form a team that is orders of magnitude beyond the normal "committee" that results in putting people in a group.

Professor Kim Cameron at the Ross School of Business nd the center for Positive Organizational Scholarship at the University of Michigan study these extremely high performance teams, and how to achieve this result for business purposes, to solve problems and boost the bottom line. This is real stuff, not some fantasy dream. It really works and has a huge dollar impact.

So, when we start to think about how it is that scientists, or religious people, or business men think and perceive the world, we need to realize that our legacy concepts of what a person is, and what a collaboration are, need some polishing.

In a very real, measurable sense, there is a "public" that has a health, which interacts with but is different from the "individuals" that make up that public. Even our counting "one, two, three" is a billiard-ball technology in a quantum-mechanic wave-type world, and doesn't really work very well. We don't yet know "how many am I?" This reflects work at MIT's Artificial Intelligence lab by Marvin Minsky, as in The Society of Mind, which questioned how many of us are inside one mind anyway.

This is a core issue in the generalized systems theory, or life-sciences, or business - the theory and technology and principles of multicellular operation that actually works well and is "healthy".

Psychiatric care for our children - faith or evidence?



On the subject of evidence-based science and medicine, here's a brief excerpt from an article in today's New York Times. Maybe one thing this suggests is that the question should not be an axis of "science versus religion" but a triangle of "science, religion, and business" in terms of what it is that determines our public policy and national behaviors.

Proof is Scant on Psychiatric Drug Mix for Young
New York Times (online)
November 23, 2006

There is little doubt that some psychiatric medicines, taken by themselves, work well in children. For example, dozens of studies have shown that stimulants improve attentiveness. A handful of other psychiatric drugs have proven effective against childhood obsessive compulsive disorder, among other problems.

But a growing number of children and teenagers in the United States are taking not just a single drug for discrete psychiatric difficulties but combinations of powerful and even life-threatening medications to treat a dizzying array of problems.

Last year in the United States, about 1.6 million children and teenagers — 280,000 of them under age 10 — were given at least two psychiatric drugs in combination, according to an analysis performed by Medco Health Solutions at the request of The New York Times. More than 500,000 were prescribed at least three psychiatric drugs. More than 160,000 got at least four medications together, the analysis found.

Many psychiatrists and parents believe that such drug combinations, often referred to as drug cocktails, help. But there is virtually no scientific evidence to justify this multiplication of pills, researchers say. A few studies have shown that a combination of two drugs can be helpful in adult patients, but the evidence in children is scant. And there is no evidence at all — “zero,” “zip,” “nil,” experts said — that combining three or more drugs is appropriate or even effective in children or adults.

“There are not any good scientific data to support the widespread use of these medicines in children, particularly in young children where the scientific data are even more scarce,” said Dr. Thomas R. Insel, director of the National Institute of Mental Health.



(photo by wendilinxx on flickr )

Faith and evidence-based reasoning


One dimension of the public debate between science and religion is resolved as "faith" versus "evidence."

Yes, I'd agree that where you have tried and true calibrated observational tools, then viewing reality directly should trump legacy impressions or old mental models of what's out there right now. Things change.

The problem with operationalizing that is that we don't generally have calibrated vision. In fact, the observational powers and perception of any one human working alone are generally dismal,
easily fooled, context-sensitive, path-sensitive, and not reproducible.

We are quite biased about seeing personal flaws, so move the discussion outside. Would you trust a person I selected at random from around you to have perfect judgment and perception of the world and to always make good calls about what's going on and what to do Probably not.

Even if you are an academic or scientist or doctor. Maybe, especially if you are a professional, you are able to see flaws easily in others regarding their observational powers, judgment, and freedom from bias favoring mental models clung to despite evidence to the contrary.

And, the field of "science" as a whole, while quick to note reasoning flaws in those outside the field, can be slow to equally weight centuries of evidence that the scientific method is no guarantee of freedom from bias. Stephen Jay Gould documented this very well in The Mismeasure of Man. New data that contradicted existing and beloved mental models have always been rejected more than appropriate, even by scientists, often especially by the best scientists. Thomas Kuhn writes well on the problems of changing the paradigm in The Structure of Scientific Revolutions.

Yes, "science" rejected Bohr's quantum mechanics, Einstein's "theory of relativity", plate tectonics, Barbara McClintock's "jumping genes", etc. Scientists clung to with a religious fervor the idea that DNA and the human genome had 100% of the information in it needed to create an organism, and none of it was "epigenetic", and none of it was, gasp, changeable in real-time by the environment in a heritable way.

And, my favorite - at the current time, "systems thinking" and the need to include closed feedback loops in models of reality is clearly becoming more and more important, but requires letting go of the misperceived "scientific method" restriction that anything important can be isolated from reality and studied under controlled conditions, and described quantitatively. Unfortunately, that removed economics, business, psychology, love, war, sociology, and most of the rest of human activity from the sphere of "science" which, fascinatingly, did not perceive this as a testament to the weakness of its methods, but saw it as a statement of the worthlessness of the problem domains for study. They were, sniff, "soft" sciences, not really the kind one would invite to a garden party.

So, there's the problem. Our individual perceptual system, even among very well trained scientists, remains flawed and biased. And, our perception of the quality of our own personal perception seems curiously exempt from the flaws that everyone else around us seems to have.

So, we don't perceive the world well, and, worse, we don't perceive that we don't perceive well.
The observational equipment humans are born with is blind to its own blind spots.

Thus, grudgingly, we are forced to use statistical methods to try to overcome our own skepticism or gullibility and avoid errors in seeing things that aren't there, or not seeing things that are there. We are forced to submit our beloved ideas to the cold or acidic waters of peer review, where many of them are shown to have flaws we didn't realize.

The blindness problem and lack of humility are true for those in management and leadership positions as well, and the lack of contact with reality are most easily perceived from either below (the staff) or outside (stockholders), but often almost invisible from within, where shared delusions take on the power of reality.

Thus, it becomes critical for safe and sane operations that there be pathways for the staff to point out problems with leadership's mental models and perceptions of the world. These are not always accepted gracefully. Yet, even the US Army Leadership Field Manual, and all the teachings of High Reliability Organizations, stress the need to build a "safety culture" where individuals can question and challenge the prevailing wisdom.

So, finally, swing this back around to questions of faith. If even people who are way above us in IQ and who have ten years more education than us are subject to having their best judgment proven wrong, what level of humility should we have about our own?

If our eyes very often deceive us and our very perceptions betray us, does it make sense to go with personally perceived reality or with a larger, more slowly moving flywheel of socially hard-won and peer-reviewed reality?

So, while, yes, we need to have a culture that allows respectful questions to be raised and taken seriously, and that needs to accept that things change over time, we also need to recognize that any single random observation we have that contradicts that social wisdom is more likely wrong than a brilliant insight.

Regardless of level of experience and education, these factors are at play, and it is a good rule of thumb to have many counselors from many diverse backgrounds vet our observations and point out to us, in as civil and loving a way as possible, where we, uh, are wrong.

In the meantime, whether science or religion, "faith" in the generally accepted corpus of knowledge is the flywheel we have to go on day by day. In either field, that mental model of the world has to be updated if there is consistent, persistent evidence that there is now a mismatch between the model and the reality. The process works better if those with old views and those with new views are respectful of the need for dynamic stability and the ongoing conversation to continue.

What has always proven to be wrong, historically, is to say "Ah, we've removed the last bug, and the system is now perfect." The reality is, very little of what we hold dear seems to survive 100 years intact.

The unbiased forecast, therefore, has to be that most of what we currently believe to be true is equally distorted.

Also, if genes or religious beliefs are preserved over hundreds or thousands of years, they must serve some very important purpose, because preservation is an expensive process. While the value may not be obvious in a quick glance or in a short-run accounting, we should be respectful of the assumption that there is some value, some kernel of truth, something underlying that selection by survival, that would be good to understand, tease out, and hear.