Financialising acute kidney injury: from the practices of care to the numbers of improvement.

Although sociological studies of quality and safety have identified competing epistemologies in the attempt to measure and improve care, there are gaps in our understanding of how finance and accounting practices are being used to organise this field. This analysis draws on what others have elsewhere called 'financialisation' in order to explore the quantification of qualitatively complex care practices. We make our argument using ethnographic data of a quality improvement programme for acute kidney injury (AKI) in a publicly funded hospital in England. Our study is thus concerned with tracing the effects of financialisation in the emergence and assembly of AKI as an object of concern within the hospital. We describe three linked mechanisms through which this occurs: (1) representing and intervening in kidney care; (2) making caring practices count and (3) decision-making using kidney numbers. Together these stages transform care practices first into risks and then from risks into costs. We argue that this calculative process reinforces a separation between practice and organisational decision-making made on the basis of numbers. This elevates the status of numbers while diminishing the work of practitioners and managers. We conclude by signalling possible future avenues of research that can take up these processes.

Object-oriented sociology and organizing in the face of emergency: Bruno Latour, Graham Harman and the material turn.

This paper explores the material turn in sociology and the tools it provides for understanding organizational problems highlighted by the Royal Commission into the 2009 'Black Saturday' bushfires during which 173 people died in the Australian State of Victoria. Often inspired by Bruno Latour's material-semiotic sociology of associations, organization scholars employing these tools focus on the messy details of organization otherwise overlooked by approaches assuming a macroscopic frame of analysis. In Latour's approach no object is reducible to something else - such as nature, the social, or atoms - it is instead a stabilized set of relations. A Latourian approach allows us to highlight how the Royal Commission and macroscopic models of organizing do unwitting damage to their objects of inquiry by purifying the 'natural' from the 'social'. Performative elements in their schemas are mistaken for descriptive ones. However, a long standing critique of this approach claims that it becomes its own form of reduction, to nothing but relations. Graham Harman, in his object-oriented philosophy develops this critique by showing that a 'relationist' metaphysics cannot properly accommodate the capacity of 'objects' to cause or mediate surprises. Through our case of the Victorian Bushfires Royal Commission, we argue that a purely relational model of objects loosens a productive tension between the structural and ephemeral that drives sociological analysis. By drawing on elements of Harman's ontology of objects we argue that it is necessary for material-semiotic sociology to retain a central place for the emergence of sociological objects.

From Data to Causes III: Bayesian Priors for General Cross-Lagged Panel Models (GCLM).

This article describes some potential uses of Bayesian estimation for time-series and panel data models by incorporating information from prior probabilities (i.e., priors) in addition to observed data. Drawing on econometrics and other literatures we illustrate the use of informative "shrinkage" or "small variance" priors (including so-called "Minnesota priors") while extending prior work on the general cross-lagged panel model (GCLM). Using a panel dataset of national income and subjective well-being (SWB) we describe three key benefits of these priors. First, they shrink parameter estimates toward zero or toward each other for time-varying parameters, which lends additional support for an income → SWB effect that is not supported with maximum likelihood (ML). This is useful because, second, these priors increase model parsimony and the stability of estimates (keeping them within more reasonable bounds) and thus improve out-of-sample predictions and interpretability, which means estimated effect should also be more trustworthy than under ML. Third, these priors allow estimating otherwise under-identified models under ML, allowing higher-order lagged effects and time-varying parameters that are otherwise impossible to estimate using observed data alone. In conclusion we note some of the responsibilities that come with the use of priors which, departing from typical commentaries on their scientific applications, we describe as involving reflection on how best to apply modeling tools to address matters of worldly concern.

The policy work of piloting: Mobilising and managing conflict and ambiguity in the English NHS.

In spite of their widespread use in policy making in the UK and elsewhere, there is a relatively sparse literature specifically devoted to policy pilots. Recent research on policy piloting has focused on the role of pilots in making policy work in accordance with national agendas. Taking this as a point of departure, the present paper develops the notion of pilots doing policy work. It does this by situating piloting within established theories of policy formulation and implementation, and illustrating using an empirical case. Our case is drawn from a qualitative policy ethnography of a local government pilot programme aiming to extend access to healthcare services. Our case explores the collective entrepreneurship of regional policy makers together with local pilot volunteers. We argue that pilots work to mobilise and manage the ambiguity and conflict associated with particular policy goals, and in their structure and design, shape action towards particular outcomes. We conclude with a discussion of the generative but managed role which piloting affords to local implementers.