Accounts of big data practices often assume that they target individuals. Personalization, with all the risks of discrimination and bias it entails, has been the critical focus in accounts of ...consumption, government, social media, and health. This paper argues that personalization through models using large-scale data is part of a more expansive change in probabilization that, in principle, is not reducible to individual or ‘personal’ attributes and actions. It describes the ‘personalization’ of an online grocery shopping recommender system to list a small number of grocery items of personal relevance for each of the millions of online grocery shoppers at a major UK supermarket chain. Drawing on a theory of probability proposed by the philosopher of science Karl Popper and anthropological work on shopping, it suggests that the attempt to generate personalized predictions necessarily incorporates impersonal relations to others and things. Using a mixture of discourse analysis and code-based reconstruction of key elements of the recommender system, it suggests that personalization is one facet of an open-ended weave of propensities associated with people and things in contemporary big data configurations. The paper explores how, in the context of recommender systems, the constitutive incompleteness of shopping lists, their propensity to expand or change, might be more important than their capacity to be personalized.
This commentary addresses the critically important role of health workers in their countries' more immediate responses to COVID-19 outbreaks and provides policy recommendations for more sustainable ...health workforces. Paradoxically, pandemic response plans in country after country, often fail to explicitly address health workforce requirements and considerations. We recommend that policy and decision-makers at the facility, regional and country-levels need to: integrate explicit health workforce requirements in pandemic response plans, appropriate to its differentiated levels of care, for the short, medium and longer term; ensure safe working conditions with personal protective equipment (PPE) for all deployed health workers including sufficient training to ensure high hygienic and safety standards; recognise the importance of protecting and promoting the psychological health and safety of all health professionals, with a special focus on workers at the point of care; take an explicit gender and social equity lens, when addressing physical and psychological health and safety, recognising that the health workforce is largely made up of women, and that limited resources lead to priority setting and unequitable access to protection; take a whole of the health workforce approach-using the full skill sets of all health workers-across public health and clinical care roles-including those along the training and retirement pipeline-and ensure adequate supervisory structures and operating procedures are in place to ensure inclusive care of high quality; react with solidarity to support regions and countries requiring more surge capacity, especially those with weak health systems and more severe HRH shortages; and acknowledge the need for transparent, flexible and situational leadership styles building on a different set of management skills.
Retail, media, finance, science, industry, security and government increasingly depend on predictions produced through techniques such as machine learning. How is it that machine learning can promise ...to predict with great specificity what differences matter or what people want in many different settings? We need, I suggest, an account of its generalization if we are to understand the contemporary production of prediction. This article maps the principal forms of material action, narrative and problematization that run across algorithmic modelling techniques such as logistic regression, decision trees and Naive Bayes classifiers. It highlights several interlinked modes of generalization that engender increasingly vast data infrastructures and platforms, and intensified mathematical and statistical treatments of differences. Such an account also points to some key sites of instability or problematization inherent to the process of generalization. If movement through data is becoming a principal intersection of power relations, economic value and valid knowledge, an account of the production of prediction might also help us begin to ask how its generalization potentially gives rise to new forms of agency, experience or individuations.
As population health needs become more complex, addressing those needs increasingly requires the knowledge, skills, and judgment of multiple types of human resources for health (HRH) working ...interdependently. A growing emphasis on team-delivered health care is evident in several jurisdictions, including those in Canada. However, the most commonly used HRH planning models across Canada and other countries lack the capacity to plan for more than one type of HRH in an integrated manner. The purpose of this paper is to present a dynamic, multi-professional, needs-based simulation model to inform HRH planning and demonstrate the importance of two of its parameters-division of work and clinical focus-which have received comparatively little attention in HRH research to date.
The model estimates HRH requirements by combining features of two previously published needs-based approaches to HRH planning-a dynamic approach designed to plan for a single type of HRH at a time and a multi-professional approach designed to compare HRH supply with requirements at a single point in time. The supplies of different types of HRH are estimated using a stock-and-flow approach.
The model makes explicit two planning parameters-the division of work across different types of HRH, and the degree of clinical focus among individual types of HRH-which have previously received little attention in the HRH literature. Examples of the impacts of these parameters on HRH planning scenarios are provided to illustrate how failure to account for them may over- or under-estimate the size of any gaps between the supply of and requirements for HRH.
This paper presents a dynamic, multi-professional, needs-based simulation model which can be used to inform HRH planning in different contexts. To facilitate its application by readers, this includes the definition of each parameter and specification of the mathematical relationships between them.
Previously, we have demonstrated a high incidence and prevalence of Crohn's disease (CD) and ulcerative colitis (UC) in the Canadian province of Manitoba. However, the epidemiology of inflammatory ...bowel disease (IBD) in other regions of Canada has not been defined. The aim of this study was to estimate the incidence and prevalence of CD and UC in diverse regions of Canada and the overall burden of IBD in Canada.
We applied a common case identification algorithm, previously validated in Manitoba to the provincial health databases in British Columbia (BC), Alberta (AB), Saskatchewan (SK), Manitoba (MB), and Nova Scotia (NS) to determine the age-adjusted incidence rates per 100,000 person-years for 1998-2000 and prevalence per 100,000 for mid 2000 and to estimate the IBD burden in Canada. Poisson regression was used to assess differences in incidence rates and prevalence by gender, age, and province.
The incidence rate for CD ranged from 8.8 (BC) to 20.2 (NS), and for UC ranged from 9.9 (BC) to 19.5 (NS). The prevalence of CD was approximately 15- to 20-fold higher than the incidence rate, ranging from 161 (BC) to 319 (NS). This was similar for the prevalence of UC, which ranged from 162 (BC) to 249 (MB). Adjusting for age and province, the female:male ratio for incidence ratio was 1.31 (p < 0.0001) for CD and 1.02 (n.s.) for UC and was mostly stable across the five provinces.
Approximately 0.5% of the Canadian population has IBD. Canada has the highest incidence and prevalence of CD yet reported.
Accounts of social network platforms have often stressed their programmability. The economic, social and technical fabric of social media has been directly associated with the code that modulates ...their connectivity and constructs opaque forms of property and capitalisation. The programmability of contemporary platforms is shifting in significant respects. By describing some recent shifts in programming practice at Facebook, the paper explores how predictive and machine learning approaches arise from a constitutive opacity present in all platform ensembles. It suggests that the growth in predictive programmability can be understood in terms of an increasingly experimental interplay between processes of platformisation and infrastructuralisation. Understanding these changes in programmability might be useful in analysing the relations between large information-communication ensembles and contemporary forms of life. It conceptualises, in particular, opacity as a constitutive problem for platforms rather than a proprietary limitation.
How can one ‘see’ the operationalization of contemporary visual culture, given the imperceptibility and apparent automation of so many processes and dimensions of visuality? Seeing – as a position ...from a singular mode of observation – has become problematic since many visual elements, techniques, and forms of observing are highly distributed through data practices of collection, analysis and prediction. Such practices are subtended by visual cultural techniques that are grounded in the development of image collections, image formatting and hardware design. In this article, we analyze recent transformations in forms of prediction and data analytics associated with spectacular performances of computation. We analyze how transformations in the collection and accumulation of images as ensembles by platforms have a qualitative and material effect on the emergent sociotechnicality of platform ‘life’ and ‘perception’. Reconstructing the visual transformations that allow artificial intelligence assemblages to operate allows some sense of their heteronomous materiality and contingency.
ObjectivesThe Choice and Partnership Approach (CAPA) was developed to create an accessible, child-centred and family-centred model of child and adolescent mental health service delivery that is ...adaptable to different settings. We sought to describe the state of evidence regarding the extent, outcomes and contextual considerations of CAPA implementation in community mental health services.DesignScoping review.Data sourcesPublished and grey literature were searched using MEDLINE, Embase, CINAHL, PsycINFO, Scopus and Google to 13 and 20 July 2022, respectively.Eligibility criteriaWe included reports focused on the implementation, outcomes (clinical, programme or system) or a discussion of contextual factors that may impact CAPA implementation in either child and adolescent or adult mental health services.Data extraction and synthesisData were extracted using a codebook that reflected the five domains of the Consolidated Framework for Implementation Research (CFIR) and reviewed for agreement and accuracy. Data were synthesised according to the five CFIR domains.ResultsForty-eight reports describing 36 unique evaluations were included. Evaluations were observational in nature; 10 employed pre–post designs. CAPA implementation, regardless of setting, was largely motivated by long wait times. Characteristics of individuals (eg, staff buy-in or skills) were not reported. Processes of implementation included facilitative leadership, data-informed planning and monitoring and CAPA training. Fidelity to CAPA was infrequently measured (n=9/36) despite available tools. Health system outcomes were most frequently reported (n=28/36); few evaluations (n=7/36) reported clinical outcomes, with only three reporting pre/post CAPA changes.ConclusionsGaps in evidence preclude a systematic review and meta-analysis of CAPA implementation. Measurement of clinical outcomes represents an area for significant improvement in evaluation. Consistent measurement of model fidelity is essential for ensuring the accuracy of outcomes attributed to its implementation. An understanding of the change processes necessary to support implementation would be strengthened by more comprehensive consideration of contextual factors.
Urban planners are increasingly working with ideas around datafied cities, such as platform urbanism, to understand urban life and changes with technology. This article seeks to assist urban planners ...in these efforts by analysing and mapping the qualities of platform urbanism. Drawing on a dataset of approximately 100 examples that detail urban data practices, we trace some of the current tendencies that are shaping the nature and dynamics of platform urbanism. While we identify no unifying narrative or overarching pattern to our data, we interpret this as supporting Barns’ (2019) notion of a pivot towards platforms. We argue this through exploring the interoperability between data sources and domains (vertical and horizontal integration), identifying elements of how platforms intermediate urban life through their growth in different sectors and the use of geolocation, and note the different artefacts that contribute to platform urbanism. We also note a concerning dynamic where city administration becomes ‘locked in’ to specific corporate products and interests, and thereby ‘locked out’ from alternatives. We discuss this in the context of social inclusion and what this means for urban planners, including the fragility of corporate platforms and what platforms urbanism means for social relationships in the city.
Introduction
Improving healthcare for people with multiple chronic or ongoing conditions is receiving increased attention, particularly due to the growing number of people experiencing multimorbidity ...(MM) and concerns about the sustainability of the healthcare system. Primary care has been promoted as an important resource for supporting people with MM to live well with their conditions and to prevent unnecessary use of health care services. However, traditional primary care has been criticized for not centring the needs and preferences of people with MM themselves. Our aim was to conduct a review that centred on the perspective of people with MM in multiple ways, including having patient partners co‐lead the design, conduct and reporting of findings, and focusing on literature that reported the perspective of people with MM, irrespective of it being experimental or nonexperimental.
Methods
We searched for published literature in CINAHL with Full Text (EBSCOhost) and MEDLINE All (Ovid). Findings from experimental and nonexperimental studies were integrated into collaboration with patient partners.
Results
Twenty‐nine articles were included in the review. Findings are described in five categories: (1) Care that is tailored to my unique situation; (2) meaningful inclusion in the team; (3) a healthcare team that is ready and able to address my complex needs; (4) supportive relationships and (5) access when and where I need it.
Conclusion
This review supports a reorientation of primary care systems to better reflect the experiences and perspectives of people with MM. This can be accomplished by involving patient partners in the design and evaluation of primary care services and incentivizing collaboration among health and social supports and services for people with MM.
Patient or Public Contribution
Patient partners were involved in the design and conduct of this review, and in the preparation of the manuscript. Their involvement is further elucidated in the manuscript text.
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