Equipment that can be sterilized has been forced out of the market by these disposable things. It is far easier to push disposable product on medical providers and encourage rent-seeking and subscriptions to such things.
It’s exactly the same way with contact lenses. When I was in college in the ’90s, I could get a pair of permanent contact lenses. They would cost a few hundred bucks, but they would last me several years if the prescription didn’t change. They were the same as glasses. You would clean them everyday and disinfect them, and they would serve quite well permanently.
But the contact lens industry decided that wasn’t good enough, and decided that they could sell subscription services for contact lenses that you would need to discard every night.
And those daily wear contact lenses, the disposable kind, basically forced out of the market the permanent ones and now the optometrist regards me as a Martian when I request permanent lenses instead.
You completely ignored human error aspect. Before the blood donation centers used one time use equipment, donors were getting infected with something nasty every now and then. You can sure as hell expect people to commonly forget to properly sanitize those syringes.
Sterilization is* the most strictly controlled process in any hospital. Nobody can just "forget" to sterilize or pick up a used syringe thinking it's sterile.
* Or at least it should be. It seems that Pakistan is different.
> Sterilization is* the most strictly controlled process in any hospital.
As aviation has shown—where human error has been studied for decades—reducing mistakes is difficult and expensive because it requires multiple layers of quality assurance. In countries where labor is costly, especially in healthcare, it has got to actually be cheaper to use single-use equipment, with the added benefit of reducing the risk of infection through that route to zero.
There is also the reality that a sealed package is more of a guarantee of sterility than something that should be autoclaved. Even in the US there have been cases of nasties being passed by inadequate cleaning.
And we had a big scandal locally. Were they doing a shoddy job of colonoscopies? Probably. But genetics left no doubt that they were using one needle per jab, but one syringe per patient. And drawing up from multi-use vials. Stick the hep C patient, in pulling back a bit ends up in the syringe. Discard needle, syringe is still infected. New needle, old syringe, draw from the vial again, vial is now infected.
There is a secured room here where I've been assigned a PIN, but the room's door is unlocked between 6am-6pm. Nevertheless, I always enter my PIN on the pad, or at least try to recall it clearly. Because if you're in the habit of pulling that door open during the day, 8 months later will come a time it is locked, and you won't remember your PIN because you've never ever used it.
The same goes for sterilizing such things in a medical setting. I think HCPs are very accustomed to the disposable and pre-sterilized supplies that they don't even consider an item's sterile status or the need to sterilize it after use. So this is the pitfall that comes with all the disposable stuff: that routine sterilization is forgotten as a skill or as a necessity.
You can still get rigid gas-permeable lenses that last basically forever, I wear them every day. You have to take them out at night and clean them, but you only buy them once (unless you damage or lose them, or your prescription changes).
I share your hate of rent-seeking and subscription culture, but tbf disposable contact lenses are legitimately a nicer product to use. I've done it both ways.
If you can't trust them to follow the very easy directions of "throw away the single use syringe", how likely is it that they are going to follow the much more complicated process of properly sanitizing the glass syringe?
We sterilize plenty of other common tools like scalpels so that doesn't seem like a valid reason. Obviously the disposable design is not even an adequate solution to the risk of cross contamination. I would imagine if it were a real concern you could easily add something like a color changing strip that would indicate whether the needle has been autoclaved since its last use without rendering it useless.
They can "survive" autoclave cycles that render other pathogens dead/inactive, but there do exist autoclave cycles that seem to pretty reliably inactivate prions.
And consequently the company needs to continue building its own adapters and SDKs to use existing commercial and open-source solutions (e.g. in data and observability), because Clojure and Datomic are almost never supported out of the box by any tools. That's a cost added that may not always be justified, because anything related to Clojure and/or Datomic is going to require bespoke integrations.
Not to mention that hiring is a problem because the Clojure market is relatively small. But that's not the reason the language never caught on. Perhaps only a reason companies rarely choose it.
As I tried to explain above, Clojure is made for a specific set of problems. Your problem seems to be interop with the SDK of the month and hiring. My problem is mutable state. It's logical that we'd choose different solutions.
A pure Clojure stack is extremely rare in most organizations. And integrating data from microservices with data lakes and observability platforms is not "SDKs of the month" but a normal business concern.
What I am trying to say is that immutable state may be one aspect of something much larger that did not factor into Nubank's original decision to use Clojure for microservices. It may have clear benefits there (and in your case - I don't deny that), but downstream you pay for that rarity by having to build every integration yourself.
If you go to duckduckgo.com/settings you can generate a URL with all of your saved settings. Loading it will configure all the settings it includes in your browser's local data. Blocked sites are included, I just checked.
Meta-critique: I abhor "highlights" or summaries like this:
> We identify key issues causing digital transformation failure.
> Our findings explain how researchers and practitioners should identify certain pitfalls leading to digital transformation failure.
And what were those issues and findings?
Don't give me a summary of the summary. That's what LLMs are for!
Unfortunately, the abstract is equally unenlightening:
> Our findings indicate a widespread tendency to categorise the DT ecosystem using terms like ‘technology’, ‘information system’, and ‘management’, among others. However, this approach neglects an in-depth examination of the specific and novel aspects of DT that have contributed to its failures.
Without wasting more of my time reading such a badly written research paper, I have no idea what they are trying to say in the abstract, which doesn't bode well for the rest.
For the same reason that anyone's reasoning process and answers to random exam questions are never used as textbooks: if the reasoning is not guaranteed to be right, why would you want to make that training material?
We can empirically figure out how often the reasoning model is correct. With a 95% empirical accuracy, it should still help the model directionally. No training data set needs to be 100% accurate. No?
Why optimize for efficiency though? Why not human flourishing or planetary health, whichever way you wish to define that?
Efficiency sounds to me like an absolutely awful way to run any society as it's what turns individuals into disposable cogs of a machine that needs to be operated smoothly because, well, no obvious reason other than a fetish to see the machine run smoothly, no matter the human cost.
Until you manage to eliminate or at least limit competition between groups, efficiency is a very important metric to optimize for lest you get out-competed by others, at the very least reducing the effect of your group, if not resulting in it shrinking or disappearing.
I agree it's not perfect, but I think you are over-dramatizing.
My gut says that planetary healthy would be wildly improved if we worked to build a more efficient society. Having meaning & caring about being a well running world would hopefully give us some grounds to flourish on, pride and effort and will to drive us towards something meaningful, beyond the grab-as-much-money-as-you-can state of things today. A collective future worth caring about.
The article talks about building a social world for people deliberately. It seems like they had some care, wanted to try to improve the social lives of people too. If anything I think the Technocracy people understood somewhat better that these decisions about how we treat people are not instanteous questions: maybe we get more social productivity out of some by treating them like crap & working them to collapse, but then we have decades of them being a social and perhaps economic drain on all society. That short term exploitation is what capital does to people today already! But no scientist worth a salt is going to create such imbalanced wasteful systems!
Efficiency can mean a lot of different things. It depends on what you are trying to make efficient, doesn't it? An efficient society, in my view, would be focused on happiness indexes, on gini coefficients. It would be trying to make our footprint more modest, try to make goods repairiable & sustainable long term. Modern eco-concern today has a lot of overlap with many of the basics here.
I'm speculating a lot. But if you don't want to nibble at this food for thought what other morsels are worth trying? This very much is a case where, again, I find the anti-willpower striking and concerning, the leaping into the negative. Over something strange and weird and a bit fanciful and naive. But at least they were working for something to believe in. At least they had a will to better, one that seems fundamentally resoundingly kind of true, kind of needed: a view that is long term, that focuses on building a maintainable long term running order, that doesn't consume until exhaustion.
I'd characterize it as cybernetic, as observant to & attending to inputs and outputs of systems. And interested in improving the results, by observing how these systems function.
Your characterization feels like one of those seeing-only-evil's that I characterize as an anti-willpower.
So the overwhelming majority are OK with missing out on top talent.
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