Disease surveillance and patient care in remote regions: an exploratory study of collaboration among healthcare professionals in Amazonia

The development and deployment of information technology, particularly mobile tools, to support collaboration between different groups of healthcare professionals has been viewed as a promising way to improve disease surveillance and patient care in remote regions. The effects of global climate change combined with rapid changes to land cover and use in Amazonia are believed to be contributing to the spread of vector-borne emerging and neglected diseases. This makes empowering and providing support for local healthcare providers all the more important. We investigate the use of information technology in this context to support professionals whose activities range from diagnosing diseases and monitoring their spread to developing policies to deal with outbreaks. An analysis of stakeholders, their roles and requirements, is presented which encompasses results of fieldwork and of a process of design and prototyping complemented by questionnaires and targeted interviews. Findings are analysed with respect to the tasks of diagnosis, training of local healthcare professionals, and gathering, sharing and visualisation of data for purposes of epidemiological research and disease surveillance. Methodological issues regarding the elicitation of cooperation and collaboration requirements are discussed and implications are drawn with respect to the use of technology in tackling emerging and neglected diseases

Developing a distributed electronic health-record store for India

The DIGHT project is addressing the problem of building a scalable and highly available information store for the Electronic Health Records (EHRs) of the over one billion citizens of India

Developing a Framework for Stigmergic Human Collaboration with Technology Tools: Cases in Emergency Response

Information and Communications Technologies (ICTs), particularly social media and geographic information systems (GIS), have become a transformational force in emergency response. Social media enables ad hoc collaboration, providing timely, useful information dissemination and sharing, and helping to overcome limitations of time and place. Geographic information systems increase the level of situation awareness, serving geospatial data using interactive maps, animations, and computer generated imagery derived from sophisticated global remote sensing systems. Digital workspaces bring these technologies together and contribute to meeting ad hoc and formal emergency response challenges through their affordances of situation awareness and mass collaboration. Distributed ICTs that enable ad hoc emergency response via digital workspaces have arguably made traditional top-down system deployments less relevant in certain situations, including emergency response (Merrill, 2009; Heylighen, 2007a, b). Heylighen (2014, 2007a, b) theorizes that human cognitive stigmergy explains some self-organizing characteristics of ad hoc systems. Elliott (2007) identifies cognitive stigmergy as a factor in mass collaborations supported by digital workspaces. Stigmergy, a term from biology, refers to the phenomenon of self-organizing systems with agents that coordinate via perceived changes in the environment rather than direct communication. In the present research, ad hoc emergency response is examined through the lens of human cognitive stigmergy. The basic assertion is that ICTs and stigmergy together make possible highly effective ad hoc collaborations in circumstances where more typical collaborative methods break down. The research is organized into three essays: an in-depth analysis of the development and deployment of the Ushahidi emergency response software platform, a comparison of the emergency response ICTs used for emergency response during Hurricanes Katrina and Sandy, and a process model developed from the case studies and relevant academic literature is described

Investigating inclusive risk communication in the context of influenza outbreaks

Outbreaks of novel influenza viruses are continually occurring on many places on our planet, with the ultimate and most extreme consequence being a full-scale pandemic. Modern communication technology is widely used for risk communication regarding recommended change in behavior patterns and other precautions in order to mitigate the transmission. However, the assumption and bias that modern communication technology constitutes the norm causes vulnerable groups to be at possible risk of systematic exclusion to correct and updated information. Through conducting a literature- and case analysis, the aim of this study is to identify insufficient or inadequate risk communication efforts in South Korea and Vietnam during influenza outbreaks, especially with concern of vulnerable groups. Further, to analyze how national influenza preparedness plans observe or ignore these insufficiencies. Results show that vulnerable groups are explicitly recognized in the preparedness plan of Vietnam. However, the South Korean preparedness plan show a more homogenous approach. Both South Korea and Vietnam showed a broad variety of channels used in their risk communication strategies which could be positive in terms of a broad outreach to a heterogenous population, including vulnerable groups. Four key factors that moderate the outcomes of risk communication were identified: Channels, Messages, Transparency and Trust

The Role of Epistemic Communities in the Global Response to Severe Acute Respiratory Syndrome: Implications for Global Health Governance

The aim of this thesis was to understand the role of epistemic communities in the global response to Severe Acute Respiratory Syndrome (SARS), through the theoretical lens of Social Constructivism, in order to explain the extent to which ideational factors and normative power constructed through them contributed to the shaping of Global Health Governance (GHG) surrounding infectious disease outbreaks. The methodology of this thesis combined key informants interviews with archival document‐based research. Archival research consisted of gathering and reviewing government documents, publications of intergovernmental organizations, media reports, press briefings, and policy papers. Discourse analysis was employed to systematically examine the wide range of data gathered. The thesis explored how different discourses have driven the changes in public health reasoning and practice, in the form of prioritisation of certain actions in the global response to SARS at various points in time. In order to show the ideational shifts over time, the SARS story was divided into three key phases in terms of the progress of the outbreak. This thesis finds that the global response to the SARS outbreak over three phases was shaped by contestation among various discourses, which framed the perceived priority issues and policy responses pursued. These ideas did not simply arise as governing norms, but ideational success occurred as a result of collective advancement by actors who were coalesced around particular policy ideas. The thesis provided an account of the interplay between policy ideas and key actors, in the form of epistemic communities, and how epistemic communities served as key sources of advice to policy making during the SARS outbreak. The thesis demonstrates that in many ways, the GHG of SARS mirrored, the GHG of other global health issues in terms of framing of issues and the actors in the formation of and justification for interests in global health. By illustrating the origins and significance of the multiplicity of ideas shaping collective action on SARS, this thesis underscores that governance response in terms of policy outcomes is the product of reconciling health with a plethora of competing priorities, and political economic goals via social construction of reality. The thesis considered the implications of the findings for conceptual understanding of GHG of infectious diseases, and for strengthening policies and practices to address the global infectious disease outbreaks

Grassroots Emergency Health Risk Communication and Transmedia Public Participation: H1N1 Flu, Travelers from Epicenters, and Cyber Vigilantism

Grassroots risk reduction tactics took new forms in the era of social media. Chinese netizens mobilized human flesh searches (HFS), or cyber vigilantism, to reduce the risks posed by international travelers who might import the H1N1 flu virus into China. My study suggests that at the beginning of the H1N1 flu epidemic, rigorous transmedia intervention efforts were made to discipline the early irresponsible overseas Chinese who traveled extensively after arriving in China, but much less attention was paid to risks posed by foreign travelers. The grassroots risk tactics employed emotional appeals, valuative judgment, and moral condemnation to criticize the irresponsible travel of the earliest imported H1N1 flu cases. These transmedia risk tactics got quickly appropriated by regional and national governments to reduce alienation of overseas Chinese and to discipline overseas returnees. Analysis of the HFS episodes reveals the need to create an interface of interaction between authorities and the public for open systems of communication and to consider local public health practices, emotion needs, and values and beliefs when designing health risk communication messages

mHealth: A Mediating Tool for Community Health Workers’ Transformation in Armed Conflict Zones

Communities affected by armed conflict are striving to provide access to effective healthcare services in countries like Nigeria, where there exists a fragile healthcare system with an acute deficit of manpower and resources. This fragility has a negative impact on child health service delivery. mHealth is considered an excellent platform for enhancing/transforming the activities of community health workers (CHWs) in the delivery of effective health services. This paper aims to explore how mHealth implementation mediates and transforms the activities of CHWs in an armed conflict setting using activity theory as a lens. An interpretive research methodology was used, and the method of data collection was done mainly by participatory observations and interviews. The findings show that the introduction of an mHealth tool can transform the activities of CHWs in various ways. The study contributes to information systems research by broadening our understanding of the implementation of mHealth in armed conflict settings

Confronting Chronic Pollution: A Socio-Legal Analysis of Risk and Precaution

The central aim of this article is to demonstrate a socio-legal approach to risk and precaution using the example of chronic pollution. Drawing on ongoing empirical work with the Aamjiwnaang First Nation, which is tucked into Sarnia\u27s Chemical Valley, a secondary aim is to influence and shape how we understand the problem and confront the risks of chronic pollution. This article forwards the argument that the prevailing regulatory approach is incapable of capturing the essence of contemporary pollution harms, because those harms are increasingly linked to continuous, routine, low-dose exposures to contaminants that are within legally sanctioned limits. Community residents and advocates struggling against chronic pollution are increasingly identifying with the environmental justice movement and adopting its strategies of resistance, including its mantra of precaution. These strategies of resistance have the potential to dramatically expose the impotence of the prevailing regulatory approach to chronic pollution