Biomedical terminologies are focused on what is general, Electronic Health Records (EHRs) on what is particular, and it is commonly assumed that the step from the one to the other is unproblematic. We argue that this is not so, and that, if the EHR of the future is to fulfill its promise, then the foundations of both EHR architectures and biomedical terminologies need to be reconceived. We accordingly describe a new framework for the treatment of both generals and particulars in (...) biomedical information systems that is designed: 1) to provide new opportunities for the sharing and management of data within and between healthcare institutions, 2) to facilitate interoperability among different terminology and record systems, and thereby 3) to allow new kinds of reasoning with biomedical data. (shrink)

The goal of referent tracking is to create an ever-growing pool of data relating to the entities existing in concrete spatiotemporal reality. In the context of Electronic Healthcare Records (EHRs) the relevant concrete entities are not only particular patients but also their parts, diseases, therapies, lesions, and so forth, insofar as these are salient to diagnosis and treatment. Within a referent tracking system, all such entities are referred to directly and explicitly, something which cannot be achieved when familiar concept-based systems (...) are used in what is called “clinical coding”. In this paper we describe the components of a referent tracking system in an informal way and we outline the procedures that would have to be followed by healthcare personnel in using such a system. We argue that the referent tracking paradigm can be introduced with only minor – though nevertheless ontologically important – technical changes to existing EHR infrastructures, but that it will require a radically different mindset on the part of those involved in clinical coding and terminology development from that which has prevailed hitherto. (shrink)

The social science approach to risk has matured over the past two decades, with distinct paradigms developing in disciplines such as anthropology, economics, geography, psychology, and sociology. Social Theories of Risk traces the intellectual origins and histories of twelve of the established and emerging paradigms from the perspective of their principal proponents. Each contributor examines the underlying assumptions of his or her paradigm, the foundational issue it seeks to address, and likely future directions of research. Taken together, these essays illustrate (...) that the principal achievement of social sciences has been to broaden the debate about risk beyond the narrow, technical considerations of engineers and the physical and life sciences. The authors conclude that expert knowledge is not value-free, that public perceptions of and attitudes toward risks vary according to a wide range of social, psychological, and cultural variables, and that public opposition to particular risks cannot be assuaged by technical fixes. The essays reveal the circuitous paths that lead people to the study of risk, highlight how these paths have crossed and discuss some of the seminal influences on individuals and the field in general. Social Theories of Risk presents a broad, retrospective view of the state of the theory in the social sciences, written by many who have been on the cutting edge of risk research since its early days. The book includes both established and novel perspectives that address the theoretical foundations of the field and reflect what we know about risk as a psychological, social, and cultural phenomenon. The collection of papers not only informs us of the tributary ideas that spawned the social studies of risk, but also how the field has matured. The biographical flavor of the essays provides fascinating reading for established members of the field, and a valuable entree for newcomers. It is an ideal college text for courses in the history of science, environmental policy, and science, technology, and society, as well as the burgeoning array of more specialized courses in risk assessment and management. (shrink)

A systematic overview of modern metaphysics, A Survey of Metaphysics covers all of the most important topics in the field. It adopts the fairly traditional conception of metaphysics as a subject that deals with the deepest questions that can be raised concerning the fundamental structure of reality as a whole. The book is divided into six main sections that address the following themes: identity and change, necessity and essence, causation, agency and events, space and time, and universals and particulars. It (...) focuses on contemporary views and issues throughout, rather than on the history of metaphysics. (shrink)