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right. Thank you, William. hello! Everybody here and there, wherever you are, and whenever you are it's probably early for early morning for some of you. I hope you can hear me. Let me just briefly introduce myself first before kicking off with my presentation. So Paulo Cree Lari, from the University of Toulouse in France.

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I'm a researcher and lecturer in sociology, and I teach sociology of organizations, sociology, of public policy, and many other things as we used to in France, and I've been doing research for the past 20 years now about sociology of risk

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initially related to base station transmitters for mobile phones, and then later on until today about industrial risk.

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So title, my presentation breeds industrial risk prevention between a lot of technocracy and a little democracy. And I'm trying to answer here to some of the questions that have been raised by Patrick Brown and Evelyn, by Andro in that call for abstracts.

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basically. Who defines defines harm and who defines risk and what comes out of it. And I have a case study about one specific risk, industrial risks in my specific country, Italy. With some elements to answer the questions that I have been embraced. So I would

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you start by saying that risk definitions are important? The definition of risk is important due to many reasons. Most importantly, risk includes on certain knowledge, as Beck said, wrote in 1,986

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reminded also by Yen's and the relationship between brisk and uncertainty on a session on Monday. afternoon This is true in risk policy making, and in brisk related mobilization. So, for example, if you list, if you if you look to public policy frames

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about risk or frames of collective actions. about risk, either from a Ryan and Shawn Perspective or Ben, for there's no perspective. You can see that

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the sense that actors link to one definition or more definitions is important, and this counterbalance a naturalistic point of view that would assume that public policy and mobilisation are

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undertaken because of intrinsic ontological properties of substances or activities. And this is not all true, I think, and so the construction of the meaning and of definitions, and on frames of risk are important, especially because a risk includes naming a problem in order to solve it.

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includes selecting, categorizing, prioritizing, etc. And this has some important consequences later on, because upon these definitions you have inclusion of some actors and exclusion of some other actors, you have the inclusion of the legitimate expertise.

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And the exclusion of non-legitimate expertise. You have Resources that are allocated! That are attributed to some actors and not to others, and ultimately you have degrees of technocracy and democracy, or a combination of both of them.

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So I would talk here about industrial risk prevention, or there are many risk many definitions of risk. On Monday we have seen many just as well. I'm talking about one specific risk which is related to major accidents due to chemical substances or industrial activities.

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This is an acute event, like a leak or an explosion, or a fire that can trigger massive negative consequences for entire population. So this kind of risk I'm talking about is different from chronic environmental pollution on one side, and it's different from a nuclear, a major accidents. They have a totally different regulation, totally different citizens mobilizing and getting.

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etc. So I'm talking specifically about industrial risk prevention related to chemical major accidents.

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those kinds of risks. This kind of risk is collective, which means not individual. It is imposed. It's not undertaken on a personal voluntary basis like I don't know. Paragliding, parachuting, bungee, jumping, and whatever so on and so forth, and has a high magnitude, possibly meaning that it has a very high stakes.

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and possibly can affect large population, like in Bhopal or in Sabo, or in Toulouse explosion in 2,001, and so on and so forth. My case study is about Italy. In the Veneto region there is a petrochemical plants in the municipality of Venice, which is called Porto Margara, that I studied

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in intensively for periods of time, from 2,009 until 2,018. And I'm talking precisely here about the public policy which is called Se image, which is the acronym roughly in itana for integrated system, for environmental environmental monitoring and crisis management. And basically the question I raise is, how do actors and groups define industrial risk.

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and with what outcomes. And I think the big question underlying this is

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is technocracy

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persistent in industrial risk management? Yes or no. And if yes, why

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so? This image is a new technological device and an innovative service to the population was back then, and is now an innovative service and a technological device

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to the population. It performs 3 tax tasks at the time. Data collection, data analysis, emergency management. Those tasks are usually separated in risk, prevention and management. They are performed simultaneously here. And that's why this image is unique, not only in Italy, but also in Europe. So we have data collection, meaning that there are some laser beams

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outside the parameter of the plants of Porto Magara that breed and quantify pollutants in the air, live 24 h a day every single day of the year, and then data are conveyed

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erez agmoni to a specific room where there are people analyzing data, and in the case of a leak, or an explosion, or thresholds of emissions that are overcome by substances. The emergency management is triggered, so there is the fire brigade, the Civil protection sirens, and whatever 150

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the tools are for emergency management. This service has been designed in 2,001 tested 5 years later, operational from 2,007 and still operating today. It is a result of a partnership between the public and the private sector.

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Erez Agmoni. On one side we have the regional agency of Veneto for environmental protection, and on the other side, in the partnership, we have the plans of the Porto Margara area. So public sector, private sector doing a partnership together, it is worth noting that partnerships in general, in brisk management or industrial risk management are quite common, but this has one particular feature, 101.

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The our path, the regional agency, is the controller meaning, it has judicial power, and does inspection on site. So it's quite a sort of environmental police that have many powers to enforce regulation. And on the other side, in the partnership there are the controlled.

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which means that there are the chemical plants that are inspected. And this is a tricky part, because, generally speaking, regulation gives roles to everyone. It's a formal regulated by law relationship. And here they go beyond this, and they have a collaboration which is totally informal between the controller and the controlled.

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So how do experts from both sides? Public sector and private sector define risk? Well, they define risk in terms of technical

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aspects. Okay? So they have a very specific language, domino effects, flammability, probability, explosibility. and whatever is related technically and from a regulatory standpoint, to industrial risk, and it define as such industrial risk, and over time

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they go from mistrust to building trust. So remember, they are from a public perspective and from a private perspective. So at the beginning they see each other with mistrust, and then they build trust, and they build a trading zone, as Galaxon would put it, sharing a common language.

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Of course this is a metaphor. There is no specific place like zone physically determined, but it's like a zone where they can exchange competence, information, communication, ideas about industrial risk. And so they manage to link 2 separate ecologists.

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as Abbot would say, and the hinge common to the separate ecologies would be industrial risk.

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They build a monopoly of knowledge in confined spaces with low social noise. They have meetings, they meet, they call each other, they talk to one another. But this is confined space in rooms secluded from public scrutiny with low social noise, which means that media don't cover what's going on, and the citizens are not invited.

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and they are not aware of what's going on behind closed doors. And this leads to a certain degree to agnatology, not because there is an action because there is one. It's a public policy, not because there is ignorance. There is another knowledge involved, but because there is invisibility. So Emmanuela Ree says Agnatology is made up by

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3 eyes invisibility in action, ignorance. We have knowledge here we have action, but we do have invisibility because nobody says what's going on?

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 citizens have an alternative definition of risk.

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Citizens who live close Near the plants in the Margara community have a different definition of industrial risk which is less technical. they don't talk about domino effects. It's more general, related to limited substances. For example, Foss Gene. What if for gene on site is going to explode. What kind of impact do we have on our population and on the population of Venice, which is right there?

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And, for example, they draw maps

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of the impact of an explosion of the tank of for gene or other substances to the city of Venice, with radiuses that show the very big impact outside the perimeter of the industrial area that can affect the population cause many people many people's death, etc.

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 so they have. Citizens have that I interviewed. I have a so, a different definition of risk of industrial risk. They are excluded basically because their expertise has no pedigree means meaning that they are not legitimate.

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Just the experts from the plants and from the regional agency have a legitimacy in their expertise. Citizens are not really legitimate, so to speak, and they self-exclude, meaning that they do not go to some meetings organized by the municipality because they don't want to. So there is a bias of exclusion, but also of self-exclusion, and there is limited knowledge of normative

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aspects on their sides. So what do people do with their expertise and knowledge and risk definition? Well, in this case.

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the public and a private sector define risk in terms of technical aspects, and they do something symmet. In this case there is an alternative definition where citizens define, brisk in different way, which is not technical in kind, and they ask for a referendum to the municipality of Venice, for the decades at the localization of phosphine to other places.

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But the municipality of Venice does not have.

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Competence for this matter, which is exclusively a state matter.

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So conclusion? Risk definitions are important, but Structural constraints should not be neglected. For example, paradoxically, Italy.

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Which a new The disaster of 7, or in 1,976, has no mandatory public arenas of discussion, so there is no meeting that is mandatory by the law to include citizens in discussion, forumed round tables about industrial risk. Contrary, for example, to what happens in France, where there are many such inclusive arenas.

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my case study also shows that risk can be depoliticized by experts who talk about technical problems. But it can still be political in the sense that citizens are excluded. And to me this is not at all technical. This is very political decision, risk, prevention policy can be efficient, but lacking legitimacy.

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I do not know if we should be worried. I think we should, but I want to hear from you. If you look at the Weber's legitimacy and efficacy

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terms about organizations, I asked myself. This is something that is efficient over time, preventive and risk, but it lacks legitimacy. So if I go back for 1 min to the question, is technocracy persistent in industrial risk? The answer would be, Yes.

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why? 3, answers number one, because there are technocrats, public sector and private sector experts basically rule by virtue of their expert knowledge number one number 2, technocracy is persistent because there are no arenas of participation that are mandatory. And so this excludes citizens from participation and number 3

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Citizens themselves themselves. Ask for, ask for something that cannot be given to them. The referendum on a local basis cannot be held simply because the municipality is the wrong target. So I hope to have answered to some questions. Now I will listen to yours. Thank you very much indeed.

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Thank you very much for giving me the time.

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and our next presenter is remote. So let's see if we can.

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So let's move on to the next presenter.

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 let's see. Okay.

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it should be.

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Oh, sorry.

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I'll go to zoom.

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Okay. Close this.

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Sorry.

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Oh, he attacked in the bottom. There. Okay.

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not good with Mac windows.

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What am I not doing?

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See?

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Okay.

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yes.

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Evelyne Baillergeau: I don't know.

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Evelyne Baillergeau: Hello! Can you hear me?

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Evelyne Baillergeau: Can you hear me in the room?

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Evelyne Baillergeau: Okay, good. Shall I start now? I don't hear anything from the room.

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Evelyne Baillergeau: Can you give? Just give me a sign.

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Evelyne Baillergeau: William.

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Evelyne Baillergeau: Can you see my slides?

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That's your end of

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trying to?

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Can you hear us, Evelyn? Yes, I can hear you. Good. How about you? Can you hear me? Yes. Can we turn the bottom up?

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Was

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Mom. How about this?

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 It's not the

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Evelyne Baillergeau: oh, it is a hundred. Okay, how about now? Can you hear us now? Yes, I can hear you all right. We just your voice is a little bit soft. But maybe maybe

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Evelyne Baillergeau: people closer to it.

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and also. can we move this out of the way?

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We do that?

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Yes, sorry. We want to see it

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this one. that one?

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No, this one

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there. Okay, all right. Sorry for the The wait next speaker is Evelyn. Allied ballet Baligo. I hope I pronounce this correctly. Alar joke. Okay. And I gaily gave healthc. And they're both from the University of Amsterdam, and their title of your talk is participatory participatory health, promotion and advance form

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of democratized prevention as a question.

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and whenever you're ready, Evelyn, you can start and I will keep time. But I have to come back to the mic to warn you if you over.

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but I'm sure you can do that yourself as well.

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Evelyne Baillergeau: Yes. thank you very much.

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Evelyne Baillergeau:  Okay. Can you see? You see my my screen now?

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Evelyne Baillergeau: Yes.

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Evelyne Baillergeau: I hope so. So. Let's get started.

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Evelyne Baillergeau: I assume you hear me? Well, I can't see anything from the room, so please let me know if if there is anything unclear or if you can hear me. Well.

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Evelyne Baillergeau: so I'm thank you very much, William. I'm Ivan by Ashle, from from University of Amsterdam, and my go to, and is also from the University of Amsterdam. I'm also co-organizer of this session, and I'm really delighted to have this nice session to

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Evelyne Baillergeau: that happened. so I'm a sociologist and also a criminologist. So I'm interested in different kinds of of risk and in undesired events involved in prevention.

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Evelyne Baillergeau: But today I'm focusing on a head promotion and and

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Evelyne Baillergeau: The the starting point of this talk is to consider prevention policy areas where the causation of the undesired events which are to be prevented is uncertain, ambiguous, or

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Evelyne Baillergeau: and clear. and

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Evelyne Baillergeau: and in the last years.  and

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Evelyne Baillergeau: yeah. So well, we are, wondering

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Evelyne Baillergeau: how risk and harm are defined in prevention

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Evelyne Baillergeau: and also wandering by home.

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Evelyne Baillergeau: and today. I'm focusing on health promotion.

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Evelyne Baillergeau: which is usually informed by academic knowledge, but increasingly subjected to

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Evelyne Baillergeau: engagement in information and intervention.

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Evelyne Baillergeau: Increasingly in the last few years representative of target population have been engaged in, have promotion.

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Evelyne Baillergeau: leading not only the academic knowledge which is usually informing, have promotion.

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Evelyne Baillergeau: but also other forms of knowledge to be considered in health, promotion

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Evelyne Baillergeau: in particular.

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Evelyne Baillergeau: experiential knowledge of targeted population

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Evelyne Baillergeau: and through engagement intervention. I'm thinking of Patsy Battery.

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Evelyne Baillergeau: has promotion

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Evelyne Baillergeau: and wandering because, are these different kinds of knowledge considered? The how democratic is democratized as promotion.

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Evelyne Baillergeau:  we can wonder about that, because

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Evelyne Baillergeau: well, academic experts and policymakers are more likely to hold the capacity to influence the course of event in public policy than other citizens who.

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Evelyne Baillergeau: and actually little is known about the outputs of engagement intervention.

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Evelyne Baillergeau: In have promotion, and this is why, here.

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Evelyne Baillergeau: and wondering how we can contribute to this.

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Evelyne Baillergeau: I will draw on a case. Study of participatory has promotion.

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Evelyne Baillergeau: Actually an empirical case, engaging older, adolescent in childhood obesity prevention in Europe in 5 European countries.

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Evelyne Baillergeau: And I will present this later data later. And also I'm using

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Evelyne Baillergeau: and building on phenomenology and governmentality theory to propose a framework

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Evelyne Baillergeau: and for the study of democratization, of public health promotion.

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Evelyne Baillergeau: And I'm curious to know to hear from you all as if it could. This framework can be useful as well.

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Evelyne Baillergeau: So first I'm going to present a little bit of my theoretical framework.

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Evelyne Baillergeau: and and So I'm starting from a phenomenological take on knowledge, considering knowledge in the broad sense of it.

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Evelyne Baillergeau: So, considering

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Evelyne Baillergeau: knowledge that has been formally validated as academic through publications in Academy journals. but also other forms of everyday knowledge or common sense. Knowledge has Alfred Shoots and Berger and Luckman will name it.

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Evelyne Baillergeau: and I'm interested in questioning the the the processes. that conduce knowledge to be validated

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Evelyne Baillergeau: formally, but also informally, and

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Evelyne Baillergeau: I'm also, besides phenomenology, I'm also considering governmentalitieship theory and building on the governmentalities a governmentalist

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Evelyne Baillergeau: efforts to understand the existing regimes of power.

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Evelyne Baillergeau: and when it's applied to the study of prevention

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Evelyne Baillergeau: in particular, O'malley, show that risk is not only technically neutral and rather a government of technology building on the

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Evelyne Baillergeau: policy.

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Evelyne Baillergeau: a political selection of some forms of knowledge, of risk excluding others. As Paulo also mentioned.

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Evelyne Baillergeau:  however, Building on government ite especially Patomani's research. Governmentality is also well suited to a discussion of circumstances in which the perpetuation of domination.

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Evelyne Baillergeau: of knowledge they mean it. Domination may be avoided in prevention and building. On this framework, we

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Evelyne Baillergeau: 3 graded framework of advanced democratization.

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Evelyne Baillergeau:  in this framework. I'm taking Democrats democratization to be a graded process through which our differential are reduced. That's my understanding of

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Evelyne Baillergeau: democratization. And so the first grade. This is the baseline.

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Evelyne Baillergeau: In this is a common target in participatory as promotion. That target pro and population is invited to explore their exponential knowledge and to suggest citizen-friendly response

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Evelyne Baillergeau: to some and desirable events that were identified by others.

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Evelyne Baillergeau: This is the baseline. and

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Evelyne Baillergeau: so the focus there is very much on risk management

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Evelyne Baillergeau: beyond that wine, and also O'malley prompted us to imagine a second grade in the

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Evelyne Baillergeau: democratized

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Evelyne Baillergeau: prevention, in which the target population is not only invited

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Evelyne Baillergeau: to contribute to add to expert knowledge

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Evelyne Baillergeau: in risk management, but also to contribute about

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Evelyne Baillergeau: how risks are defined.

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Evelyne Baillergeau: and

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Evelyne Baillergeau: and this is the second great prevention.

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Evelyne Baillergeau: democratization. And the third grade.

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Evelyne Baillergeau: we can imagine. Actually, this is

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Evelyne Baillergeau: our view that we can imagine beyond the second grade. A third grade once second grade is done

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Evelyne Baillergeau: there. maybe

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Evelyne Baillergeau: different ways in the way. There are differences in the ways. Risk are defined as

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Evelyne Baillergeau: so there may be a third great democratization in which all fake stakeholders negotiate their respective understandings of and desired events and risks towards common ground.

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Evelyne Baillergeau: so that's the the framework. And now I'm going to show how this our empirical data collected from the co-create projects

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Evelyne Baillergeau: a feature against this framework. So for this, the co-create project in this project. it's focused on

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Evelyne Baillergeau: childhood obesity and

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Evelyne Baillergeau: and and

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Evelyne Baillergeau: in this. In this project the undesired events at stake are a wide range of non

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Evelyne Baillergeau: communicable disease, including type, 2 diabetes.

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Evelyne Baillergeau: hypertension and coronary, her disease and several cancer of which overweight and obesity and atolicence are assessed as increasing the risk.

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Evelyne Baillergeau: This is the starting point of the project so strongly building on academic knowledge of childhood obesity

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Evelyne Baillergeau: also stressing that childhood obesity is a systemic issue to be addressed along a systems approach.

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Evelyne Baillergeau: however, in co-create, which is a participant. He has pre had promotion, inviting adolescents to reflect on their experiences of childhood obesity. and or and how their environment can be

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Evelyne Baillergeau:  and there was a strong participatory components with cycles of learning which are shown now on the pictures and cycle of of of of of learning in which young people are invited to generate policy ideas based on their own

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Evelyne Baillergeau: comprehension of the issue of childhood obesity, and not being necessarily themselves obese, or at risk of obesity. But

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Evelyne Baillergeau: young people, adolescent, reflecting on their own environment, and how their environment can be of a personic in some way. yeah.

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Evelyne Baillergeau: So through different circles of learning. young people who are generating policy ids, refining these policies and finalizing them

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Evelyne Baillergeau: to learning from other forms of knowledge, and also researching their environment.

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Evelyne Baillergeau: if you, I can be interested, I can show you more about this. But just to move on very quickly, based on the observation of these projects, and the ecographic data collected in 15 groups, involving in total almost 2

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Evelyne Baillergeau: 200 adolescents. In 5 European countries, we found that a variety of knowledge form were involved in the preparation of their policy, ideas, academic knowledge, scientific knowledge of childhood, obesity which they learned through the process. The participatory process lasted the whole year

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Evelyne Baillergeau: and a whole school year.

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Evelyne Baillergeau: and also experiential knowledge of how their environment may be conducive to childhood obesity explored

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Evelyne Baillergeau:  through their participatory activities, but also other forms of knowledge. Policy, knowledge, clinical knowledge of experts involved in the process when they fancied, when young people fancied, including some experts, like psychologists, nutritionist and and so on. 100 and

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Evelyne Baillergeau: also peer knowledge, social media knowledge where use and participatory action, knowledge for knowledge which we to to mention the outputs of their own research.

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Evelyne Baillergeau:  and through the process. Looking at how knowledge of childhood obesity were involved in the process. We noticed that

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Evelyne Baillergeau: and different forms of knowledge were involved in validation processes.

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Evelyne Baillergeau: And and  we noted that in some groups

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Evelyne Baillergeau: the exploration of their own perspective and other forms of of knowledge.

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Evelyne Baillergeau: to consider

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Evelyne Baillergeau: there

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Evelyne Baillergeau: Other dimension of childhood obesity.

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Evelyne Baillergeau:  and

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Evelyne Baillergeau: different from the academic systemic understanding

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Evelyne Baillergeau: of

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Evelyne Baillergeau:  They started

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Evelyne Baillergeau: with

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Evelyne Baillergeau:  and there

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Evelyne Baillergeau: was an invitation to contribute to policy ideas.

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Evelyne Baillergeau: which was very widely

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Evelyne Baillergeau: embraced

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Evelyne Baillergeau: by the young people.

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Evelyne Baillergeau:  Throughout the meetings we noticed that in some cases the second. a great of democratization, were reached.

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Evelyne Baillergeau: When young people brought up some polemical dimension of childhood obesity.

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Evelyne Baillergeau: prevention

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Evelyne Baillergeau: When they were exploring their own perception, and in particular, that childhood obesity seem to be a label that may work as a risk factor used. For another Under undesirable and designed event, which is stigma

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Evelyne Baillergeau: obesity, elected stigma which was not involved, and was conflicting in some ways with a child obesity prevention in certain ways.

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Evelyne Baillergeau: and also The second one was that the prevention is meant to influence others by needs of policy, thereby also challenging individual agency

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Evelyne Baillergeau: and

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Evelyne Baillergeau: through the

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Evelyne Baillergeau: and

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Evelyne Baillergeau: and and also in some in one group. we noted that.

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Evelyne Baillergeau: The dialogue between different forms of of of knowledge in particular. these conflicting views on childhood obesity came into attention With

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Evelyne Baillergeau: the systemic systems based and the stunning of childhood obesity came into tension. In some group we noted that there was some negotiation

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Evelyne Baillergeau: involved, and and between different stakeholders, and in this particular case we can speak about third grade de most democratization. So to wrap up

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Evelyne Baillergeau: yes, indeed, participatory have promotion can in some cases feature as advanced.

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Evelyne Baillergeau: an advanced democratized

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Evelyne Baillergeau: prevention, but only under certain circumstances which need to be carefully observed and questioned.

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Evelyne Baillergeau: case by case. Thank you.

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Okay. So now let's see.

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Thank you. And we will go on to the next speaker. So let's see, just minimize. I guess we

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okay.

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the

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all right.

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I think. Browse rose. I think so. Yeah, I'm not sure.

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 like the magic trick. Okay? all right. So our next speaker is living living in the focal, and co-author is Lorenzo Dodi. for the from the University of Milano. The co-author and title is risk, uncertainty and health emergencies. What can qualitative social social research do?

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Thank you.

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thanks a lot for

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your organization of this meeting, and I would like to tell you first of all, that this presentation is mainly based on a Phd. Research carried out by a Lorenzo Dodi under my supervision.

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And Lorenzo is not here can't be here, and she can't present her line. So this is why I present these research alone.

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and I would like also. to add that. this Ph. D. Is a quite peculiar ph. The a so-called executive Ph. D. That means that There is a Phd. Scholar

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who is a scholar while being an employee at an enterprise or a public administration.

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And so in this case, the point of view of the researcher Lorenzo Doddy is also a point of view of an actor of a professional. This is the peculiar and the crucial

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aspect of the research.

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so

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and I don't know how to go ahead.

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Well.

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maybe yes.

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Sorry.

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Can you show me what to do? No, it doesn't work. We have to stop sharing.

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because this is the sharing mode

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that

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okay, great. Thank you.

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So what is the scheme? More or less? The scheme? Of the research and of the presentation? As for the theoretical framework, We deal with the radical uncertainty, not uncertainty, but radical uncertainty.

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And so we refer to the debate about the radical uncertainty that permits our contemporary word.

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and in a way

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calls for new approaches to emergencies

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not based only on the prevention, not based only on the possibility of a calculating risk.

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 we refer, in particular to the health care, emergency and the pandemic emergency. Of course

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I will refer to the debate on differences among prevention, precaution, and preparedness approach.

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Preparedness as being proposed in the international debate. This concept has been debated in the international literature by Andrew Laikov.

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and, as we know, preparedness refer to a threat to a danger

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that is not predictable. And so what we can do is to mitigate, just mitigate.

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and the disruptive effects of emergency, of a disaster, of a crisis, and so on.

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 Of course, the pandemic is only the last one, let me say, of a complex of events?

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That question, that question, the established approaches of risk, management, disaster, management, and so on.

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What is the empirical field of the presentation of the research. The empirical field is a local elf authority. Parma, in Parma, in a city in the northern Italy, in the region in the northern region of Italy, Emia, Romania, and we will see that there are a free empirical levels of observation implied by the research.

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and, as I said before, is quite is very important to stress this kind of in-between level of observation regard in particular the role of Lorenz Adori. And so the double level of reflection that is analytical, one that is an analytical one and a practical one.

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And the main purpose of the research

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is to to try to use. ethnographical analysis, ethnographical research.

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 there is of course, and emitted in order to understand social organization processes.

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Of dealing with emergency, but at the same time, also as a tool practical tool, in order to deal with the same processes and practices.

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I can go very quickly for the theoretical framework. Of course, the territory of our framework addresses on Greek society debate. And on safety and risk management approach

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And on organization like tonography. And I, I would say that the Mayor reference is the This focus on radical uncertainty and preparedness, and so the shift from prevention to, as I said before, to precisional approach and the preparedness approach.

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the analytical framework! The starting point is that the pandemic and the need to be prepared to be prepared. You know this. I forgot to tell you that the research has been carried out during 2 years, and that are the 2 years of the pandemic, the peak of the pandemic.

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and the the local authority, of course, has been Totally Obliged to deal with this emergency! And so the pandemic and the need to be prepared. In a way, stress some fields of tension in more established risk management approaches

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the urgent time to open to new logics, new logics, different, in a way from a clinical probabilistic technique.

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the unit, the the main unity. But it's not the only unit of observation is this a risk management unit that belongs to the local alpha authority?

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And so the idea is to try to incorporate to the ethnographic methodology into organisational disk management technique not only to analyze but also

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to use.

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this is a methodologist technique.

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this refers to a previous experimentation, that is, that has been in the same local authority 3 years ago regarding dark distribution points of drugs.

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and in a way the approach is a participatory ethnography through which the research try to involve different subjects from the empirical fields

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who act themselves as a a kind of iconographers.

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Okay?

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what about clinical risk management? The clinical risk management is a a set of technique of approaches.

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that try to deal with the so-called and adverse event that are unexpected, unexpected events that happen. That can cause can cause damages to people, and In a way they are undesirable events.

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clinical risk management in this case is the main tool of the safety management.

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Elcar. You need the operating in at the level of a local F authority. this unit, has to identify risks to measure them and evaluate them, and the consequences of adverse events and elaborating strategies for managing them.

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we can also tell that on the background of these issues implied by risk management, alcohol, risk management in time of pandemic there is a more general

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shipped, maybe, or a perspective that is very well

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synthetised by the one approach. That is the idea that emergencies, extraordinary events, such as pandemics, global warming, etc., need different approaches, need specific approaches, and in particular systemic approaches

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as the one else approach that is based on the idea of the interaction and the interdependence among human beings and the environment well-being.

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the calculation. Electronography is a very well known approach. I would like just to add that in this way it is very important to stress the reflective mode of organizational photography, because

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as I said before, professional are para ethnographers, so they are in a way used to reflect on their practices, on their organizational context, on the mistakes they do, and so on. So the

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these reflective aspects of it is very important as well as it is very important. The attention that organisation, lithography, in general pay to different elements of organisations, such as

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an object, interaction, narrative, languages, symbol, and so on.

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The research has been carried out, as I said before, in more or less. 2 years. The first objective is to check the effectiveness or castinational photography as a methodology to support healthcare organization

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in regarding risk management, and the second objective that is intertwined with the the first one is to investigate the discrimination practices and strategies.

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And at the 3 levels. And you can see a scheme of the research and the of the 3 levels. So the research there is a macro level that regards

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in particular a crisis unit activated at the territorial level.

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And there is a Meso level that concerns in particular

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a so-called house house

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and in particular processes of access, and the reception of services that are that are used there, and the micro level that regards

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in particular, the Ker safety network of the local alpha authority and the research on the whole, mixes free methodologies, different methodologies, documentation, analysis, conversation, analysis, participant observation, and the use of this reporting.

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skid the parting skit that we will see very quickly.

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 so this is the question. This is the starting question.

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and does a condition of a photography bring about change? And the answer is more or less yes, because

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organizational photography engaged professional in a cultural change in their approach, to risk management and to mistake how to deal with the mistakes, etc.

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We can have just a glimpse of some of the

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tools

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and the moments of the organizational ethnography use in in the research.

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This is the skid for reporting a

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an adverse event.

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and it is being organised in a tonograph in an organizational ethnography course, in order to.

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in order to show and to learn with the the professional how to see how to see mistakes, how to report mistakes out to see other events. I want to report them.

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And a it also a in a it's it's been organized.

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As for the Ltos, pinned or moltenator in this case, as I said before.

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the focus was on the services on the accessibility of services in particular regarding the meeting point between users and the professionals.

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volunteers and the security security employees.

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And as for the crisis unit that the focus was on sharing information. That has been

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a lot of work on the report in the conversation. In this case

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the focus was on sharing information communication in both the direction, top down the bottom.

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and in order to understand and to stress and to deal with the different definition of the situation, the different situation of the emergencies and the different situation about what to do in order to deal with the emergency.

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so

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Some concluded remarks.

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we can say that the pandemic implies also implies new challenges

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and kind on a certainty, and in a way push organization to be more flexible and responsive, to adopt a new kind, new tools of action.

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and as for risk management, clinical risk management

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is usually to adopt new tools, transit disciplinary tools, not only clinical tools, so managerial tools, but also in this way ethnographical tools for understanding, analyzing phenomena and methodologies which are particularly complex.

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regard health care. Professional in this case is very clear. The possibility is. It is just a possibility, of course, but in a way this possibility became a reality or a reality. To require new knowledge, new knowledge to prepare to prepare for emergency.

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And from this point of view organisation. Letography is for sure methodology that can a large large.

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and the kind of actors, of competencies, of skills

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and the ways of dealing of emergencies, thanks to its transferability to situate the learning processes.

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but organizational litography in a way, may also, potentially, of course. In this case Open up to a greater involvement of citizens and communities. This is quite clear in the case of the as I quoted before.

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thank you.

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Was there some?

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So we came rushing on.

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If you lose the people on online, or I think you you you you stop sharing. Oh, yeah.

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okay, so right now.

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 so then, it's okay like that. Yeah, like this. And she was having droll to advance the slide. So that's why.

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Ok? Well, we'll move on to the next presenter, and that's Terry Manca from the University of Alberta

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and the long title. They weren't really sure what to do with pregnant clients, qualitative. And so investigation of discourses about disease risks and uncertainty about vaccination.

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Hi thanks for joining today. I hope I can advance slides. But we'll find out. Maybe I can't.

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okay, I can. And now it's advancing many. All right, I'm Tara. I'm now with Athabasca University. I started there after submitting my abstract for the conference.

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and I'm going to talk about pregnant people's experiences and perspectives of vaccination and pregnancy during the first 10 months of vaccine roll out in Canada for the COVID-19 vaccine.

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The study is also about other vaccines. I'm focusing on COVID-19, partly just for time purposes and on pregnant persons, perspectives also for time purposes. I've also interviewed health care providers.

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Finally, it's beginning to become noticeable, and I think it is shaping how I interpret the data and write. I am currently a pregnant person

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interpreting this data and doing this, finishing up the study.

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So I think that affects things as well. I've

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in the 2 postdocs I did before starting at Athabaska University. Both were focused on vaccination and pregnancy. So if you have questions

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beyond this study, I might no answers, even some that aren't that sociological. So start by acknowledging my funding, so I have the 2 post doctoral grants and some funding that also helps me get here.

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So just to start pregnant people and their fetuses are at increased risk epidemiologically, how they define risk

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of severe disease from COVID-19 and other respiratory infections. In Canada there are 3 vaccines that are routinely recommended in every pregnancy.

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So that's the inactivated influenza vaccine, which is first recommended in 2,007,

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and

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Ted up for protection against infant whipping cough and COVID-19, which was first recommended in mid 2021.

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There are other vaccines that might be recommended if you're traveling and we're expecting an Rsv vaccine to be approved for use in pregnancy in the next couple year or 2.

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With these recommendations, there's a lot of recommendations for pregnant people to limit what goes into their bodies as a lot of sociologists have analyzed.

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so. But just for an example, when I was talking to my doctor about what to do if I accidentally need a strawberry which I'm allergic to, they basically said, don't eat a strawberry. There's not a lot of evidence about anti-estamine use when you Google it. Some things say that there is evidence of but anti-estamine use, but it's this big

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01:04:52.010 --> 01:05:03.950
weighing the risks of taking in this pharmaceutical versus an uncontrolled allergic reaction was basically what they were telling me, just to avoid having the allergic reaction as a precaution

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01:05:04.270 --> 01:05:16.879
 with vaccination and pregnancy at the time of roll out for pregnant individuals. Most vaccines, clinical trials have excluded pregnant and breastfeeding people.

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and that creates gaps in data that are needed to make decisions about vulnerabilities. and it's the result of people often being labeled vulnerable and incapable of consent to participate in clinical trials

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because they're consenting for 2 bodies.

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or just

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generally being considered too vulnerable

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to participate in general with that. A lot of pregnant people and people who can become pregnant are actually among nurses, health care providers and others who are highly exposed to these diseases in the event of something like COVID-19.

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And

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so without evidence, there are often gaps and recommendations. There can be barriers to accessing vaccines.

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or there can be no data to inform decisions with COVID-19, there was actually more countries permitting vaccination early in rollout than there have been with some other health emergencies, such as Ebola and Zika

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But, as you can see on this map from comment, the COVID-19 maternal immunization tracker. dated May ninth, 2,021 policies varied from recommending, permitting, permitting, with qualifications, which is where Canada sat, not recommending, with some exceptions, not recommending or just not stating, a position statement at all for breastfeeding and

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pregnant people.

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You have to also remember that each of these countries, not quite each. But many of these countries had different vaccines.

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So that's also a factor, whether there is a predicted or theoretical risk at all with the ones with Mrna vaccines available in Canada and the United States, and a lot of countries

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01:06:57.920 --> 01:07:03.660
as well as the viral vector vaccines before all the blood clot. Things started happening.

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There was no theoretical risk for use in pregnancy.

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and there is. There are guidelines for including pregnant people in clinical trials. So that's something I should add to. They were available before the pandemic. It could have been done. It is expensive, it is challenging. There are many things to monitor between the timing of

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vaccination, timing of pregnancy

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and all these different things. But it is possible with COVID-19. This is actually better than what you'd see with some of the

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cases with things like Ebola, where it had in some countries a 90% death rate. If you got Ebola in pregnancy, and they still wouldn't want to offer the vaccine.

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So anxiety and fear, as I mentioned yesterday, are arguably among the emotions that characterize the first couple years of the pandemic, especially prior to vaccine rollout.

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Similarly, Mary Douglas highlighted risk and anxiety of common feelings directed towards ambiguous and transitional states which include pregnancy.

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So bodies change rapidly throughout pregnancy.

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They're transitioning from becoming from one to becoming 2, or sometimes more bodies.

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And in this respect I think the state of being under an unvaccinated can also be considered somewhat ambiguous, especially with asymptomatic spread of COVID-19

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People would be kind of perceived as being between health and illness in some ways, if they weren't

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vaccinated where you your potential risk to others, just for that status. With this pregnant people are heavily self-regulated and externally regulated to protect themselves, and especially their fetus, from disease, and simultaneously from exposure to pharmaceuticals. So these were

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pretty challenging for some people to navigate.

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So with this study, as interested in looking at the work involved in making decisions about vaccination and pregnancy and the risk assessment in varying dynamic context of pregnancy and the pandemic and the status of evidence about vaccination.

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01:09:09.410 --> 01:09:16.950
I have kind of 3 pieces of data with this. The interviews with prenatal care. Providers and interviews with

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01:09:16.960 --> 01:09:36.069
pregnant participants overlap quite a bit. 4 of the pregnant participants were also prenatal care providers. They are included today, and I have also been doing a discourse analysis of available information which have so far published about the discrepancies in Public Health discourses for COVID-19. Specifically

382
01:09:37.350 --> 01:09:42.700
so with the sample I'm talking about today. There were 31 participants. I interviewed them

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01:09:43.100 --> 01:09:57.149
over the course of a year, so quite a long span. Most participants completed 2 interviews. The first was about their views on pregnancy, on vaccination in pregnancy, and the second was collecting their responses to available information about vaccination.

384
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And I've been analyzing data using a discourse analysis approach in Max Qda.

385
01:10:04.580 --> 01:10:12.219
sorry participants. Although this might look like there is some diversity.

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01:10:12.460 --> 01:10:26.920
largely, I would say, participants identified with privileged positions. A lot of them were gaining access somewhat early to vaccines as a health care workers, or they were informed about vaccination, as people who worked in fields related to health.

387
01:10:27.090 --> 01:10:37.129
Although there was one participant with a grade 8 education level, there were only a couple that were below a university degree of some kind. There were some pursuing a postdoc.

388
01:10:37.400 --> 01:10:49.109
and many, as I mentioned, working in areas related to health, including 2 midwives and 2 nurses who discuss and recommend vaccination with clients as part of their practice.

389
01:10:52.350 --> 01:11:00.130
So in terms of findings, most participants wanted to receive all vaccines available in pregnancy. Not all. There were some that didn't

390
01:11:00.220 --> 01:11:05.690
want specific vaccines, and some that didn't want COVID-19 vaccines.

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01:11:05.830 --> 01:11:14.070
However, they demonstrated considerably less uncertainty in making decisions about influenza and Teddat vaccines in comparison to COVID-19.

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01:11:14.120 --> 01:11:18.720
So even the ones who didn't want an influenza vaccine, they were more confident in that decision. A lot of the time

393
01:11:19.090 --> 01:11:29.530
and when reflecting on COVID-19 vaccines, participants were grappling with multiple ambiguous and dynamic contexts of the pandemic pregnancy and available evidence.

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I just tried to highlight some of these where they felt an urgency for protection from COVID-19. But they were also aware that there wasn't a lot of evidence about vaccination and pregnancy. They wanted to time vaccination in certain trimesters, or after certain obstetrical appointments.

395
01:11:46.330 --> 01:11:51.150
but and that was as a way to try to balance some of their safety concerns about the vaccine.

396
01:11:51.360 --> 01:12:02.920
and there were a lot of feelings of individual responsibility, because this decision in Canada was often left to the individual, and their health, sometimes their health care provider, but sometimes they didn't feel very supported.

397
01:12:03.260 --> 01:12:09.589
And then with that they were navigating a lot of contradictory information and recommendations.

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01:12:14.130 --> 01:12:24.439
So participants spoke to the risks of not being backed of their potentially not being there for their families and shared knowledge that their babies would not be okay if they became severely ill from COVID-19.

399
01:12:24.500 --> 01:12:38.659
So this is a little bit different from that adversarial relationship which also came up where it's assumed that the maternal body and fetus are kind of don't necessarily need the same thing, or you can just suffer through it. And that's what's best for your fetus.

400
01:12:38.890 --> 01:12:58.039
 So Shanaya, who is prioritized for COVID-19. Vaccination is an indigenous person, as someone with health conditions and as an addictions counselor working with populations that were considered vulnerable explain that she needed to get vaccinated as soon as possible, because for her COVID-19 was pretty much a death sentence.

401
01:12:58.870 --> 01:13:02.610
that part wasn't supposed to be animated. But you can't see it, anyway.

402
01:13:02.830 --> 01:13:15.490
With this some participants also experienced barriers to access, especially if they were trying to get vaccinated between January and February 2021,

403
01:13:15.940 --> 01:13:17.240
so

404
01:13:17.470 --> 01:13:20.569
as health care providers.

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01:13:20.690 --> 01:13:25.860
they could encounter others who were worried about whether or not they were actually eligible for the vaccine.

406
01:13:25.930 --> 01:13:31.420
Zoe, who was prioritized as a nurse, explained. They weren't really sure what to do with pregnant clients.

407
01:13:31.440 --> 01:13:45.399
and they advised me to talk to my health care provider. She had to reach out, and it took 2 and a half months for Zoe to access the vaccine after she was initially offered in January 2,021. So it's more than enough time to contract Covid and get really sick.

408
01:13:45.590 --> 01:13:52.679
It also meant that she wasn't able to likely, wasn't able to receive the second dose of her vaccine during pregnancy.

409
01:13:52.750 --> 01:14:01.350
and more evidence had emerged prior to her delivery dates that it's possible to pass antibodies from the vaccine onto the fetus

410
01:14:01.470 --> 01:14:13.149
to help protect them in the first 6 months after birth. So, just because Canada expanded the time range between the first and second dose to make vaccines more available. That would have affected that.

411
01:14:13.790 --> 01:14:26.110
And these barriers are likely the results of gaps in evidence. Before mid 21, when the first manuscript, from a large observational study of pregnant Americans was published in the New England Journal of Medicine.

412
01:14:26.420 --> 01:14:36.540
and other participants noted this publications that really speaks to the privileged position where they're watching the evidence. They're aware of the science that's actually emerging as they go.

413
01:14:38.950 --> 01:14:55.860
Participants were also worried about timing, as I mentioned, so they wanted. They were really grappling with how to best protect themselves, especially in early pregnancy, which was perceived as a more ambiguous state they saw. The pregnancy is very vulnerable. It is the time period in which most miscarriages occur.

414
01:14:56.040 --> 01:15:11.399
so they considered COVID-19 disease outbreaks also in relation to, or they consider vaccination in relation to, disease, outbreaks in their region and changing public health measures, provinces, lifting mass mandates, and different things like that.

415
01:15:11.600 --> 01:15:14.030
and they wanted more data to emerge

416
01:15:14.930 --> 01:15:29.630
 as well as they wanted their fetus to develop more towards becoming a completely separate body from their own. So in the second or third trimester, or in a couple of cases, when the but when the fetus became an infant, and they were actually breastfeeding, they were.

417
01:15:29.900 --> 01:15:33.980
or hoping to breastfeed. They were more optimistic about getting vaccinated then.

418
01:15:34.240 --> 01:15:47.169
So Karis, who was in advance life support Paramedic, explained that she was concerned about fever in the first trimester, and decided to wait until the second trimester to minimize the risks of vaccine-related fever, which is a known side effect.

419
01:15:47.360 --> 01:15:52.450
and to maximize her chances of passing antibodies onto her baby

420
01:15:54.410 --> 01:16:08.070
timing was really crucial. So in another example, June mentioned in an interview that she may hesitate on COVID-19 vaccination because because it was new. So during the first interview she was a little bit hesitant.

421
01:16:08.150 --> 01:16:12.789
but by the second interview she wanted the vaccine, and

422
01:16:12.950 --> 01:16:15.589
by the time she knew she was eligible.

423
01:16:15.750 --> 01:16:26.229
and she felt ready to receive the vaccine, it was so close to her due date, and she just didn't want to deal with side effects while going into labor. So she actually decided to wait until after pregnancy. For that reason.

424
01:16:26.450 --> 01:16:36.850
So June's concerns were around preparation for labor, and entering as strong as possible into childbirth. and she discussed her concerns with her midwife, and felt supported in that decision.

425
01:16:38.990 --> 01:16:43.749
Most participants were very concerned about the risks of COVID-19 and pregnancy.

426
01:16:43.810 --> 01:16:54.590
Serena explained that reading about the risks of getting sicker from COVID-19 in pregnancy and hospitalizations were about 5 to 10 times. As likely if you were pregnant than if you weren't pregnant

427
01:16:54.870 --> 01:17:07.209
and the uncertainty surrounding COVID-19 vaccines. But it's not been tested in pregnancy. It really was manifesting in her being afraid of getting Covid, and also being afraid of getting this untested vaccine.

428
01:17:07.320 --> 01:17:15.810
So in this she's really speaking to feeling alone, and she delayed that vaccination initially, and then did get vaccinated in late June.

429
01:17:18.290 --> 01:17:32.229
So, without clear guidance, participants felt individually responsible to find information and make decisions about vaccination and pregnancy. Some found the information challenging to find, especially through website-based content and Google searches which brought up

430
01:17:32.280 --> 01:17:42.400
a of misinformation. And these are participants who are very well educated on how to find information for the most part. and, as Kendra explained.

431
01:17:42.640 --> 01:17:55.870
credible information from organizations like the Cdc. And health, Canada should be able to be easy to find without going crazy. Googling and Kendra had received all 3 recommended vaccines in pregnancy.

432
01:17:56.030 --> 01:18:08.349
yet she was uncomfortable with her COVID-19 decision, and she was left even after getting the vaccine, wondering did I make the right choice for my baby? And how will that affect her? She's really thinking long term. And what

433
01:18:08.600 --> 01:18:12.460
isn't just those uncertainties that aren't really known.

434
01:18:12.710 --> 01:18:24.010
So she really also felt that her choice was constrained by a need for extra protection, both of as a pregnant person and as someone with Spina, Bifida, and epilepsy. So there's other health conditions affecting those 2.

435
01:18:25.420 --> 01:18:32.700
So just to conclude, participants navigated competing risks and uncertainties within the unique context

436
01:18:32.710 --> 01:18:45.370
of their pregnant bodies progressing towards becoming 2, and in one case 3 changing public health measures, outbreaks of COVID-19 variance. The Delta variant was really deadly in pregnancy

437
01:18:45.460 --> 01:18:47.370
and outbreaks.

438
01:18:47.830 --> 01:18:54.800
and the outbreaks that characterize the pandemic as well as yeah. Lifting health measures

439
01:18:55.070 --> 01:19:03.959
and participants were very attentive to rapidly emerging evidence and inconsistent information about the safety and effectiveness of vaccination and pregnancy

440
01:19:04.150 --> 01:19:11.319
which was only emerging because pregnant people had willingly taken the vaccine despite gaps in evidence.

441
01:19:11.520 --> 01:19:14.790
So thank you, I'll stop there. And

442
01:19:26.380 --> 01:19:31.929
all right. So we managed to through the presentations without which?

443
01:19:32.190 --> 01:19:37.339
So we have about 20.

444
01:19:37.500 --> 01:19:40.260
So I think we have enough time, for

445
01:19:40.710 --> 01:19:50.970
I think I'm supposed to stand here. So if you don't see me we have enough time for questions from the audience, so I'd like to open it up straight away for anyone who would like to ask the question

446
01:19:51.290 --> 01:19:56.040
to any of the presenters, or even to all of them at the same time. But

447
01:19:56.500 --> 01:19:57.210
so

448
01:19:57.890 --> 01:19:59.320
go ahead. Yes.

449
01:19:59.380 --> 01:20:05.980
Well, I don't. If you speak loudly, I think we can hear you.

450
01:20:06.120 --> 01:20:12.530
You're supposed to go to the microphone. Okay

451
01:20:13.020 --> 01:20:15.100
for

452
01:20:15.190 --> 01:20:17.570
Maybe it's a better if I ask

453
01:20:19.660 --> 01:20:23.680
other people, and I

454
01:20:23.900 --> 01:20:24.580
the

455
01:20:24.790 --> 01:20:30.960
I have 3 questions, one for one question, for

456
01:20:31.430 --> 01:20:34.839
paper, because

457
01:20:35.110 --> 01:20:44.999
It seems to me that there are a different connection points not so explicit, but at the and connection point.

458
01:20:45.210 --> 01:21:06.000
And so the the first question is for Professor Kibel Looney. Sorry. Sorry. Sorry. Your first name. because you referred before to the the politician applications

459
01:21:06.160 --> 01:21:19.310
of the kind of risk management you observe. And I'm very interested in this because it's in a way crucial from my point of view, a crucial issue.

460
01:21:19.310 --> 01:21:41.639
And so the question is, in which sense the politician, do you refer to political arena, to official institutional, political arena, and to policy making processes. Or do you refer another sphere of

461
01:21:41.720 --> 01:21:59.339
the politicisation of repolitisation? Dynamics, because it is very close to what we are reserving on this period, on preparedness as a technique or a kind of re-politicide issue.

462
01:21:59.850 --> 01:22:20.280
The second question that is quite connected is for Evelyn, because Evelyn said that the First Level, the third degree of democratization implies negotiating processes.

463
01:22:20.280 --> 01:22:35.960
And so the question is a very simple question, what kind of negotiating space or processes. That is a kind of a public space.

464
01:22:36.030 --> 01:23:04.950
a kind of deliberative processes, is it's I. I'm very interested to understand more this because, I'm quite close to the debate on deliberative processes. from the perspective on the capability approach. And so the possibility of questioning values and the norms and the pre-ans. So assumption all of public choices. I'm very interested in this.

465
01:23:04.980 --> 01:23:28.029
And the third question is, for I'm I'm bad memory. Sorry for? I I also not so. But yeah, for you. Because you said before, if I understood well, that is that there is an individual work

466
01:23:28.040 --> 01:23:30.450
in order to feel the gap.

467
01:23:30.800 --> 01:23:35.479
It's an individual responsibility. It's individual work to feel.

468
01:23:35.520 --> 01:24:04.179
And I was wondering if in your research, you focus on the relationship between this, this individual responsibility, because it is a kind of hypothesis and the relationship between citizens and expertise or knowledge scientific knowledge.

469
01:24:04.180 --> 01:24:15.530
it is a trust or mistrust regarding technical expertise, clinical expertise, and official knowledge about this.

470
01:24:19.270 --> 01:24:24.469
Yes, so we would like to respond, would you like to?

471
01:24:26.480 --> 01:24:53.179
So I would like to respond to Lavinia, to the depoliticization that I mentioned or there. Sorry about this, do not know what I did. Well, there's a vast debate on technicalization and depoliticization. Okay, so there are many ways to convey ideas about this. What is specifically meant, for example, in some French literature about deep politicization is that you take an issue

472
01:24:53.350 --> 01:25:01.509
away from the public debate, you depoliticize it, and then you dress the problem in terms of

473
01:25:01.570 --> 01:25:06.540
risk management technicalities and so on and so forth.

474
01:25:06.570 --> 01:25:18.250
So there are 2 aspects, depoliticization and technicalization. I was referring especially for my presentation to technicalization. But I should also mention that this image

475
01:25:18.510 --> 01:25:33.820
I was talking about. This device cost 4 million euros that were paid by the region of Veneto, by taxpayers of the region, and there was a debate, and everybody could see in principle where the money went.

476
01:25:33.820 --> 01:25:59.240
But after this the experts from the regional agency for environmental protection of vanity hid basically the direction they were going, and withdrew this from the public debate. And so something that was a public issue financed a public policy finance by the regional venture

477
01:25:59.240 --> 01:26:27.269
was taken away from the citizens and dressed as like you don't understand. You wouldn't understand, any way, it's a paternalistic view that I have seen in many other situations, in risk management in Italy, for example, mobile phones. And this tells us something about democracy, and that was my point. So I'm not sure I answer to your question, but that would be an answer. Okay, thank you.

478
01:26:28.180 --> 01:26:39.850
Evelyn, are you? Do you hear us. Okay. Would you like to reply to the question? Sure, thank you very much, Slovenia, for your for your question. I'm I'm

479
01:26:39.920 --> 01:26:52.450
Evelyne Baillergeau: So that was about the the negotiation involved in the third grade. democratization. And actually

480
01:26:52.470 --> 01:26:59.280
Evelyne Baillergeau: I'm happy to tell a little bit more about about it. the negotiation.

481
01:26:59.630 --> 01:27:07.410
Evelyne Baillergeau: Well, well, quite a funny has party battery projects.

482
01:27:07.540 --> 01:27:26.880
Evelyne Baillergeau: Well, it happens, indeed, that experiential knowledge of target population are explored, and then there are some new knowledge involved, possibly involved in in prevention due to this exploration

483
01:27:26.940 --> 01:27:29.869
Evelyne Baillergeau: of the

484
01:27:30.160 --> 01:27:41.929
Evelyne Baillergeau: experiential knowledge of target population. But it's very, very common that once this expansion knowledge is explored.

485
01:27:41.940 --> 01:27:47.460
Evelyne Baillergeau: then, how is it involved? in

486
01:27:47.630 --> 01:27:57.760
Evelyne Baillergeau: prevention. It's doesn't rely on docket population, but on experts, scientists

487
01:27:57.970 --> 01:28:17.459
Evelyne Baillergeau:  analyzing, interpreting, interpreting this experiential knowledge and turning into their way their ways into the the policy ideas

488
01:28:17.550 --> 01:28:22.719
Evelyne Baillergeau:  gear that at prevention

489
01:28:23.660 --> 01:28:32.160
Evelyne Baillergeau: and and until and and this can be Well, this is

490
01:28:32.520 --> 01:28:47.700
Evelyne Baillergeau: of course, in in some way reproducing experts led prevention and negotiation, as we understand it in this

491
01:28:47.890 --> 01:28:51.000
Evelyne Baillergeau: model is

492
01:28:51.880 --> 01:28:56.689
Evelyne Baillergeau: and based on the commitment

493
01:28:57.210 --> 01:29:08.289
Evelyne Baillergeau: of different actors in different stakeholders in the This decision

494
01:29:08.490 --> 01:29:11.530
Evelyne Baillergeau: of how to consider

495
01:29:11.550 --> 01:29:15.660
Evelyne Baillergeau: how to involve different forms of knowledge, of risk.

496
01:29:15.730 --> 01:29:24.170
Evelyne Baillergeau: into a policy. And in the case of

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01:29:24.200 --> 01:29:48.940
Evelyne Baillergeau: party battery, I I would say, What kind of negotiation? Well, this can be understood in different ways. In the case of participatory health promotion that we involved in our case, it was in the in the case we could observe, it was adolescent, involved in the participatory action. Research

498
01:29:49.070 --> 01:29:57.070
Evelyne Baillergeau: together with the facilitators. And and

499
01:29:57.390 --> 01:30:17.590
Evelyne Baillergeau: But I would say other kinds of negotiations could be could be involved in in other cases. And so well, that's a start of an answer at the time. I'm

500
01:30:17.710 --> 01:30:21.850
Evelyne Baillergeau: I think

501
01:30:22.400 --> 01:30:25.470
Evelyne Baillergeau: other forms of negotiation could also be

502
01:30:25.590 --> 01:30:33.990
Evelyne Baillergeau: involved. But I'm curious to know what you think as well, Lavinia, on those issues based on your own research

503
01:30:34.970 --> 01:30:36.889
Evelyne Baillergeau: for that of Lorenzo.

504
01:30:36.910 --> 01:30:44.820
Okay? But maybe we could. Also, we can ask a monster

505
01:30:44.970 --> 01:30:46.259
mixing up your name there.

506
01:30:46.390 --> 01:30:49.289
Yeah, no worries.

507
01:30:49.660 --> 01:30:56.049
It's always called. I was always called Monk when I was on a running team with 3 other tears.

508
01:30:56.330 --> 01:31:06.140
 in terms of individual responsibility to fill the gaps in evidence, I would say absolutely, that's happening. There is a responsibilities.

509
01:31:06.270 --> 01:31:15.430
I'm not sure. I think it might be different across different populations. If we're looking at other populations that aren't really included in clinical trials. If you're immunocompromised.

510
01:31:15.610 --> 01:31:32.820
pediatric populations at first were not allowed access. They actually included elderly populations in COVID-19 vaccine trials, which is different. But with pregnancy and breastfeeding is a lot different, because a lot of that responsibilities is about the being you're creating

511
01:31:33.000 --> 01:31:40.809
and not just about protecting yourself. So women and people who can become pregnant are often

512
01:31:40.950 --> 01:31:55.719
really encouraged to self-responsibleize and inform every decision they make with extensive evidence and research, and all the intensive mothering and parenting things come in really early that way in terms of risk management.

513
01:31:56.030 --> 01:32:02.740
and sometimes even before pregnancy, as I know. Sarah Moore wrote about an article and risk rituals.

514
01:32:03.010 --> 01:32:14.169
with vaccination, with COVID-19. I would say that the evidence often wasn't there when I did the discourse analysis, part of the

515
01:32:14.260 --> 01:32:28.510
Public health documents. There was a Territory saying that some populations can't be vaccinated yet, and included pregnant people. The government of Quebec's website included pregnant people among populations that couldn't get vaccinated yet. So it's this tension where

516
01:32:28.580 --> 01:32:32.930
trying to seek out expert opinion where some provinces are saying, this is probably the safest option.

517
01:32:33.050 --> 01:32:53.670
and others are saying you probably can't get it at all is really hard for people, and Canada's unique there, and that we have different vaccine programs in each province. which I know is not common across the world, but it made things really inconsistent, and I suspect they I don't necessarily assume they were consistent.

518
01:32:53.910 --> 01:33:02.279
Worldwide. I know Australia and New Zealand had a program where they harmonized some of the communication, and that might have manifested a bit differently

519
01:33:02.340 --> 01:33:15.469
in expectations to incorporate that expert recommendations and guidance where it really came up for the expectation to follow expert guidance was with influenza and T. Dot vaccination.

520
01:33:15.850 --> 01:33:22.189
because there is evidence. So the health care providers, I think, would often just expect people to listen.

521
01:33:22.250 --> 01:33:32.280
The information's worded. If you look at the public health documents in ways that are around, just expecting people to listen and not really acknowledging it, as much of a decision

522
01:33:33.650 --> 01:33:35.190
that answers the question.

523
01:33:38.670 --> 01:34:02.739
other questions. I I had a question actually to Paulo. So maybe I can ask that. I the the scheme that you outline. Seems like one that would be fairly amenable to corruption. You have to. You have the the all 3 of these levels. of that, you know, collecting the data and then also analyzing it and

524
01:34:02.780 --> 01:34:24.519
and then implementing some risk management. So I I wondered if you had come across evidence that there is at least discussion or a recognition that you know this is obviously likely to. I mean the the case. I'm thinking of it. Now, just cases in Japan where

525
01:34:24.520 --> 01:34:43.949
the nuclear regulation was left up to the companies. And then we we know what happened in 2,011, and as the result, there is now a nuclear regulatory commission in Japan that was set up afterwards because of that problem. So I wondered if you know corruption has come up in any of your discussions, or even if there's evidence of that.

526
01:34:44.010 --> 01:34:44.710
there you go.

527
01:34:48.540 --> 01:35:10.030
Thank you, William, from for the question. I have no evidence of corruption, if there was one, I'm not aware, and I don't think many people could go into it because they would probably be hidden somewhere. I've just mentioned in this because I asked men times to interview engineers from the plants.

528
01:35:10.030 --> 01:35:34.369
and they didn't bother to answer me not to answer no, but not to answer at all. So I just had the representative of the associations that gather the chemical plans of the site we had a Very, who had a very polished, gentle, but communicational form of expressing things. So everything's fantastic. We do many brilliant things, and so on, and so forth.

529
01:35:34.580 --> 01:35:41.430
 As a sociologist from outside the perimeter of the plants, I would say that my

530
01:35:41.610 --> 01:35:53.990
task as a researcher was not really to investigate corruption, but to point to specific fields.

531
01:35:53.990 --> 01:36:17.789
Where there is a collusion, I do not know if it makes sense which stays in law, which is not really people taking money or advantages directly, but they build something because they belong to structures that want to go in a particular direction. And so I think this is more the case. So I don't think there were

532
01:36:17.790 --> 01:36:29.619
bribes or whatever. But there were just people agreeing on some principles, because it was really convenient for each organization to do so, and

533
01:36:29.629 --> 01:36:48.470
I do not know if it is corruption, collusion, or participation or collaboration, or whatever it makes sense that it is something that is beyond. just a simple partnership. And this leads to me to another thing.

534
01:36:48.500 --> 01:37:08.830
It is very important in brisk regulation, to be sure of the people involved, because I think, in many cases, and I'm told in the United States. Sometimes the regulated party regulates, so to speak, and that what I would like to go into deeply in a following

535
01:37:08.889 --> 01:37:13.439
forthcoming forthcoming paper about this issue. Thank you very much.

536
01:37:16.040 --> 01:37:38.629
I don't give the Lavinia a chance to reply to Evelyn, either. But oh, okay, okay, yes. We do have time for One or 2 more questions, maybe, Jen. So we'd like to.

537
01:37:42.730 --> 01:37:43.420
So

538
01:37:47.469 --> 01:38:01.380
I wonder about that idea of politicalization? Yeah. So I think when about the risk governance framework. So Allah Ortinran, who would make a very strong case that it depends on the risk

539
01:38:01.389 --> 01:38:13.379
how you involve the public, and I've understood you more or less in the way that you probably should always somehow involve the public. But that would mean an

540
01:38:13.379 --> 01:38:36.150
over burden of of societies, because it's just too many. You cannot for everything engage them. Then one of the strategies might be a kind of a mighty power accounting framework for what could go in that direction. So I was wondering whether your politicalization idea might be a bit too strong. But

541
01:38:36.150 --> 01:39:00.740
because because, yeah, in risk management, you would say, you cannot regulate everything. In some cases it's The politicalization or engaging the public wouldn't make sense. It's just so primitive a technical problem. And so I would be interested where you would then say, there's a limit or so. But at the same time there might be good argument that a kind of regulation is necessary.

542
01:39:00.740 --> 01:39:06.219
prevent corruption, or have a kind of control.

543
01:39:06.770 --> 01:39:14.129
Yeah, there was also one question I had for you about the

544
01:39:14.480 --> 01:39:25.160
 you, you you finalized your your your talk about pregnancy, that the The tendency to

545
01:39:25.330 --> 01:39:37.510
put the responsibility to the individual would be a result of lacking a knowledge or uncertainty or so. And I think in health context, you probably almost

546
01:39:37.510 --> 01:39:58.919
always as a responsibilities of the patient. So I'm wondering whether that is really a good argument, or whether there is something else going on, or a common way it just when it is, or uncertainty, becomes bigger or smaller. But but it might not be the main main reason, really what? Why, that's happening.

547
01:39:59.330 --> 01:40:18.589
So so I was wondering. But that's a good argument to to conclude your yeah, at the end, whether it's really the the uncertainty as such, or whether it's just a protective response from the organization. But what obvious happens?

548
01:40:19.060 --> 01:40:21.279
Yeah, from the decision making.

549
01:40:31.570 --> 01:40:43.019
Yeah, I think there is always a responsibleization. I agree with that. I think there's also tension with the gaps in evidence. And who's responsible?

550
01:40:43.080 --> 01:40:51.639
It's an impossible responsibility in a lot of ways right? Because how do you make an informed decision when all of the evidence says there is no information.

551
01:40:51.740 --> 01:41:05.409
It's also a deferral of responsibility as I've written in other papers. or argued in other papers from drug regulators and vaccine developers, manufacturers onto

552
01:41:05.480 --> 01:41:16.109
individuals where we've even seen it in product monograph statements where they'll say, you know, we don't have any evidence on this in the product label the package that comes out when you open the vaccine.

553
01:41:16.170 --> 01:41:25.769
But the Advisory Committee recommends it in pregnancy. So that's their responsibility. It's not ours kind of thing.

554
01:41:26.220 --> 01:41:28.500
So it's deferr's happening. And I'm still

555
01:41:28.620 --> 01:41:33.260
hashing out what exactly. The main argument from this piece should be

556
01:41:36.940 --> 01:41:38.500
21.

557
01:41:42.040 --> 01:41:48.110
Thank you for your question. I would say the following thing.

558
01:41:48.970 --> 01:42:13.040
Mine was a provocative statement, saying that there is a deep politicization that conducts to technicalization and back to re-politicization again, I think what I was trying to say is that when you withdraw a thing from the political sphere, and then you dress it in a technical way. Sometimes you are repoliticizing it in the sense that

559
01:42:13.140 --> 01:42:39.229
excluding citizens from any participatory process to me sounds like politics. Okay? So that's what the point. We should notice also that in industrial risks there is dram 3 cavaso directives from the European Union, 1,982, 1,998 and more recently, that say basically

560
01:42:39.270 --> 01:42:44.640
empower citizens and communicate better with citizens.

561
01:42:44.840 --> 01:43:12.299
And my take here is that in Italy they know this, and they tried to adapt locally in the international laws something that restricts this possibility for the citizens. In France there are hundreds of arenas round tables, including citizens. It's probably not democratic need neither, as they say in France, which means that

562
01:43:12.300 --> 01:43:37.409
erez agmoni not so many people go there. There are industrial people that are conducting the exchange. There are many people from the administration of the State, so it's not really democrat, but at least it is more democratic than in Italy. And I agree with you. You cannot really include hundreds of people in the regulation of chemicals. It's very technical. One

563
01:43:37.410 --> 01:43:48.040
experts have to do this, but at least I think that you should, because the directive of Cavzo and the European Union tell you so. Include

564
01:43:48.040 --> 01:44:14.770
some forms of participation that go beyond the Emitter receiver communication model. And that's what's happening in Italy, and I think they should shift to a polyphonic way of communication with people with a dialogue, and not just a unilateral way of communicating. We know you. Don't we tell you what it is, and you have to receive our message. One.

565
01:44:15.300 --> 01:44:17.889
So that would be my answer. Thank you

566
01:44:19.960 --> 01:44:45.799
very. I think we've reached the end of time. It's past 1220. So I I think I'm going to take the prerogative and finish the session. I would like to thank. I didn't get a chance at the beginning to thank the co-organizers. Evelyn, who is up there on screen, and also Patrick Brown, and I want to thank the audience for coming and joining, and especially also to the presenters for excellent set of papers. So thank you very much.