In this review article, the authors contextualize the contemporary practice of medical tourism in terms of the concept of worldmaking, which was introduced (in this journal) with two articles a year or two ago by Hollinshead. Here, the authors first contextualize medical tourism in terms of "worldmaking" per medium of the observations of the corporeal realms identified by Alexis de Tocqueville almost 200 years ago. In 1835, de Tocqueville wrote with enthusiasm tinged with nostalgic regret about the new world of American democracy that he then saw as the world of the future. A serious rupture in history took place of which he became a most relevant critic. But there have been (according to Mainil, Platenkamp, and Meulemans) many ruptures since then: that is, there have been short periods of "in-between worlds" that became ever more anchored in the timeline of Western history. Today, they argue that tourism as a field of expertise, practice, and knowledge is intertwined with several other networks of expertise. It is responsible (itself) for many small "ruptures" in these modern times. Mass tourism can be seen as such a shift. Sustainable tourism and the attention paid to climate change would be another such shift. And the authors of this review argue that an interesting and deep-seated case in this regard is medical tourism. They argue here that medical tourism has a great deal of worldmaking capacity, especially by means of the Internet and international marketing tools. It arises in the interstices of the interacting networks of a global world. It crosses borders in line with emerging power structures in a global network, but it also meets local resistance or regional obstacles that are related to other networks. In between these worlds of human experience, various interactions of perspectives on the concept of health itself come to the surface. Within the field of medical tourism different stakeholders play a role in a worldmaking process. Our reviewers from the Low Countries thereby argue that medical tourism itself is responsible for a Tocquevillean rupture within and across our global network society. In their view, medical tourism also constitutes a new hybrid-that is, as a hybrid medical paradigm that seems to be appearing within the performative and productive world of tourism.
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In case of a major cyber incident, organizations usually rely on external providers of Cyber Incident Response (CIR) services. CIR consultants operate in a dynamic and constantly changing environment in which they must actively engage in information management and problem solving while adapting to complex circumstances. In this challenging environment CIR consultants need to make critical decisions about what to advise clients that are impacted by a major cyber incident. Despite its relevance, CIR decision making is an understudied topic. The objective of this preliminary investigation is therefore to understand what decision-making strategies experienced CIR consultants use during challenging incidents and to offer suggestions for training and decision-aiding. A general understanding of operational decision making under pressure, uncertainty, and high stakes was established by reviewing the body of knowledge known as Naturalistic Decision Making (NDM). The general conclusion of NDM research is that experts usually make adequate decisions based on (fast) recognition of the situation and applying the most obvious (default) response pattern that has worked in similar situations in the past. In exceptional situations, however, this way of recognition-primed decision-making results in suboptimal decisions as experts are likely to miss conflicting cues once the situation is quickly recognized under pressure. Understanding the default response pattern and the rare occasions in which this response pattern could be ineffective is therefore key for improving and aiding cyber incident response decision making. Therefore, we interviewed six experienced CIR consultants and used the critical decision method (CDM) to learn how they made decisions under challenging conditions. The main conclusion is that the default response pattern for CIR consultants during cyber breaches is to reduce uncertainty as much as possible by gathering and investigating data and thus delay decision making about eradication until the investigation is completed. According to the respondents, this strategy usually works well and provides the most assurance that the threat actor can be completely removed from the network. However, the majority of respondents could recall at least one case in which this strategy (in hindsight) resulted in unnecessary theft of data or damage. Interestingly, this finding is strikingly different from other operational decision-making domains such as the military, police and fire service in which there is a general tendency to act rapidly instead of searching for more information. The main advice is that training and decision aiding of (novice) cyber incident responders should be aimed at the following: (a) make cyber incident responders aware of how recognition-primed decision making works; (b) discuss the default response strategy that typically works well in several scenarios; (c) explain the exception and how the exception can be recognized; (d) provide alternative response strategies that work better in exceptional situations.
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Epistemological relativism in tourism studies has been conceivably paralyzed by the concept of a, or, the "paradigm." In this review article, Platenkamp metaphorically identifies these paradigms with the islands that Odysseus visited (all those centuries ago) during his well-recorded journey to Ithaca. In this context, therefore, Ithaca is changed (by Platenkamp) from being just an idyllic Greek homeland into a contemporary, hybridized world like-in our time-of the multilayered network society in Africa of the capital of Ghana, Kumasi. The basic question for Platenkamp, then, is that of how tourism studies researchers can (or ought?) leave their safe islands (i.e., their paradigms) and organize their own paradigm dialog (after Guba) with others around them on their uncertain and risky voyage to Kumasi. In an attempt to clarify this vital kind of dialog, Platenkamp introduces Said's principles of reception and resistance, but also focuses on the distinction between different modes of "knowledge production" that have been introduced into the social sciences since the 1990s. In this light, to Platenkamp, the uncertainty of this ongoing/unending epistemological quest remains crucial: to him, all (almost all?) believers in a, or any, paradigm within tourism studies are unhealthily "overimmunized" by the tall claims and the perhaps undersuspected strategies of the particular "paradigm" they follow. (Abstract by the Reviews Editor).
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