9,381 research outputs found

    Implementing Health Impact Assessment as a Required Component of Government Policymaking: A Multi-Level Exploration of the Determinants of Healthy Public Policy

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    It is widely understood that the public policies of ‘non-health’ government sectors have greater impacts on population health than those of the traditional healthcare realm. Health Impact Assessment (HIA) is a decision support tool that identifies and promotes the health benefits of policies while also mitigating their unintended negative consequences. Despite numerous calls to do so, the Ontario government has yet to implement HIA as a required component of policy development. This dissertation therefore sought to identify the contexts and factors that may both enable and impede HIA use at the sub-national (i.e., provincial, territorial, or state) government level. The three integrated articles of this dissertation provide insights into specific aspects of the policy process as they relate to HIA. Chapter one details a case study of purposive information-seeking among public servants within Ontario’s Ministry of Education (MOE). Situated within Ontario’s Ministry of Health (MOH), chapter two presents a case study of policy collaboration between health and ‘non-health’ ministries. Finally, chapter three details a framework analysis of the political factors supporting health impact tool use in two sub-national jurisdictions – namely, Québec and South Australia. MOE respondents (N=9) identified four components of policymaking ‘due diligence’, including evidence retrieval, consultation and collaboration, referencing, and risk analysis. As prospective HIA users, they also confirmed that information is not routinely sought to mitigate the potential negative health impacts of education-based policies. MOH respondents (N=8) identified the bureaucratic hierarchy as the brokering mechanism for inter-ministerial policy development. As prospective HIA stewards, they also confirmed that the ministry does not proactively flag the potential negative health impacts of non-health sector policies. Finally, ‘lessons learned’ from case articles specific to Québec (n=12) and South Australia (n=17) identified the political factors supporting tool use at different stages of the policy cycle, including agenda setting (‘policy elites’ and ‘political culture’), implementation (‘jurisdiction’), and sustained implementation (‘institutional power’). This work provides important insights into ‘real life’ policymaking. By highlighting existing facilitators of and barriers to HIA use, the findings offer a useful starting point from which proponents may tailor context-specific strategies to sustainably implement HIA at the sub-national government level

    Organizations decentered: data objects, technology and knowledge

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    Data are no longer simply a component of administrative and managerial work but a pervasive resource and medium through which organizations come to know and act upon the contingencies they confront. We theorize how the ongoing technological developments reinforce the traditional functions of data as instruments of management and control but also reframe and extend their role. By rendering data as technical entities, digital technologies transform the process of knowing and the knowledge functions data fulfil in socioeconomic life. These functions are most of the times mediated by putting together disperse and steadily updatable data in more stable entities we refer to as data objects. Users, customers, products, and physical machines rendered as data objects become the technical and cognitive means through which organizational knowledge, patterns, and practices develop. Such conditions loosen the dependence of data from domain knowledge, reorder the relative significance of internal versus external references in organizations, and contribute to a paradigmatic contemporary development that we identify with the decentering of organizations of which digital platforms are an important specimen

    How to Be a God

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    When it comes to questions concerning the nature of Reality, Philosophers and Theologians have the answers. Philosophers have the answers that can’t be proven right. Theologians have the answers that can’t be proven wrong. Today’s designers of Massively-Multiplayer Online Role-Playing Games create realities for a living. They can’t spend centuries mulling over the issues: they have to face them head-on. Their practical experiences can indicate which theoretical proposals actually work in practice. That’s today’s designers. Tomorrow’s will have a whole new set of questions to answer. The designers of virtual worlds are the literal gods of those realities. Suppose Artificial Intelligence comes through and allows us to create non-player characters as smart as us. What are our responsibilities as gods? How should we, as gods, conduct ourselves? How should we be gods

    Language-Based Causal Representation Learning

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    Consider the finite state graph that results from a simple, discrete, dynamical system in which an agent moves in a rectangular grid picking up and dropping packages. Can the state variables of the problem, namely, the agent location and the package locations, be recovered from the structure of the state graph alone without having access to information about the objects, the structure of the states, or any background knowledge? We show that this is possible provided that the dynamics is learned over a suitable domain-independent first-order causal language that makes room for objects and relations that are not assumed to be known. The preference for the most compact representation in the language that is compatible with the data provides a strong and meaningful learning bias that makes this possible. The language of structured causal models (SCMs) is the standard language for representing (static) causal models but in dynamic worlds populated by objects, first-order causal languages such as those used in "classical AI planning" are required. While "classical AI" requires handcrafted representations, similar representations can be learned from unstructured data over the same languages. Indeed, it is the languages and the preference for compact representations in those languages that provide structure to the world, uncovering objects, relations, and causes

    Songs without borders: complex interpretative song worlds and the audiences that inhabit them

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    The genre of music commonly referred to as art song often elicits emotionally charged responses in accounts of audience experiences. However, scholarship has largely neglected the object of inquiry where these responses and experiences materialise: the live art song event. The principal research task in this study is to investigate audience experience of live art song events in the UK. The audiences and events at the centre of this inquiry coalesce around the work of the art song promoter Oxford Lieder. Using a mixed method approach (questionnaire, diary methods and guided interviews), statistical and thematic analysis, and Interpretative Phenomenological Analysis, is applied to a dataset that utilises 82 individual participants’ experiences of live art song events, including regular attendees and those experiencing live art song for the first time. To frame the findings of this inquiry, this study establishes the concept of complex interpretative song worlds: defined as a collection of interactions that audience members draw upon to construct their experience of live art song events, through a dynamic and multi-faceted interplay with the system of possibilities afforded by live art song environments. In this study, complex interpretative song world theorising takes place across three levels of audiencing: (1) Interactions with the live art song domain (the norms, behaviours, and conventions of live art song environments) are gathered under three themes. Collecting activity sees a desire for participants to scrutinise song objects, embrace familiar artists and repertoire, and adopt a connoisseur-like approach to knowledge acquisition. Connecting activity reveals a prized sense of close psycho-social resonance, which takes place between songs, performers, spaces and everyday experiences. Venerating activity foregrounds a view of songs as inviolable objects, where perceived changes to songs are deemed heretical by some, examined through the (re)introduction of sung English translations into the live art song corpus. (2) Interactions with live art song objects (the lexical and musical features that make up songs) reveal the ways audience members process words and music, and prioritise either, or both features during live art song events. The presentation of these materials in ways that blur senses (sights and sounds), and time (before, during, and after performances), are shown to be as additive to audience member conceptualisations of the nature of lexical-musical relationships as they are disruptive. (3) Interactions with live art song actors (performers, producers, and audiences) reveal processes of role formation at work, where vocal acts, non-vocal acts, and fixed and non-fixed traits complicate the way audience members derive impressions of performers. Art song’s hybridity as a genre, which is not a dramatic form, yet ‘not not’ a dramatic form, reveals the imbricated way audience members construct identities of performers: as professional musicians; as human beings; and as inhabitants of roles defined textually through a song’s poetic content. This interdisciplinary study draws predominantly on three overlapping areas of scholarship, and makes new contributions to knowledge in all three. For musicology, this inquiry develops deeper understandings of live art song objects to complement the hegemony of hermeneutic, musico-analytical and historiographical research that typifies much of the existing art song literature. For audience studies, these findings provide new audiencing insights, by examining an art form not yet analysed by empirical audience research methods, and one that simultaneously combines both words and music as a mode of expression. For translation theory, this inquiry responds to calls within the existing literature for more research to understand the reception of translation in music. This study also generates dividends outside of the academy, providing new insights for performers and promoters of art song to inform approaches to programming, presentation, production, marketing and audience development

    Towards the development of care management in community care for elderly people in Korea

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    This study is concerned with the feasibility of several forms of care management in the development of community care for elderly people in Korea. Chapter one introduces the background of community care in Korea in the light of demographic, socio-economic, and political realities. This chapter reviews the changing Korean society as a barometer to understand the scope, size, and speed of social needs, especially community care for elderly people, over the last few decades. Chapter two explores various definitions, concepts, and theories of community, community care, and care management by building upon trends previously established in the research. This helps to identify the different models of care management and the pre-conditions necessary for the application of different models in Korea. Chapter three explores what factors have affected the development of community care, and what community dare has achieved for elderly people in the UK. Especially, care management in community care for elderly people in the UK is examined in detail. Chapter four details the findings of field research on community care for elderly people in Korea. This covers the needs of elderly people and their carers, and the social worker's tasks and available resources. The potential for the use of care management based on the findings of field research is assessed. Chapter five investigates whether the UK models of care management are suitable for Korean society, which interventions are useful for developing care management, and the strategies, and principles involved

    B/order work: recomposing relations in the seamful carescapes of health and social care integration in Scotland

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    As people, ageing and living with disabilities, struggle with how care is enacted through their lives, integrated care has gained policy purchase in many places, especially in the United Kingdom. Accordingly, there have been various (re)forms of care configurations instigated, in particular, promoting partnership and service redesign. Despite integrations apparent popularity, its contribution to improved service delivery and outcomes for people has been questioned, exposing ongoing uncertainties about what it entails and its associated benefits. Nonetheless, over decades, a remarkably consistent approach to integrated care has advanced collaboration as a solution. Equally, any (re)configurations emerge through wider infrastructures of care, in what might be regarded as dis-integrated care, as complex carescapes attempt to hold and aporias remain. In 2014, the Scottish Public Bodies (Joint Working) (Scotland) Act mandated Health and Social Care Integration (HSCI), as a means to mend fraying carescapes; a flagship policy epitomising public service reform in Scotland, in which normative aspirations of collaboration are central. What then are the accomplishments of this ambitious legislation? From the vantage point of 2021, HSCI has been assessed as slow and insubstantial, but this is not the complete picture. Narratives about failing to meet expectations obscure more complicated histories of cooperation and discord, successes and failures, and unintended consequences. Yet given collaborative ubiquity, if partnerships are contested how then are they practiced? To answer this question, I embarked on an interorganisational ethnography of the enactment of a Health and Social Care Partnership (HSCP), which went ‘live’ on April 1st, 2016; in a place I call ‘Kintra’. I interrogate what happened when several managers (from the NHS and Council) endeavoured to implement HSCI according to the precepts of the Act; working to both (re)configure and hold things together behind care frontiers; away from the bodywork of direct care, immersed in everyday arrangements in the spaces of governance and operations. I chart their efforts to comply with regulations, plan, and build governance apparatuses through documents. I explore through coalescent objects how distributed forms of governance, entwined in policy implementation, were subsequently both sustained, and challenged. I observed for seven months actors struggling to (re)configure care services embedded in a collaborative approach, as well as establish the legitimacy of the HSCP; exemplified through the fabrication of what was understood as a 'must-do' commissioning plan. In tracing documents, I show the ways in which HSCI was simultaneously materialised and constituted through documentation. I reveal how, in the mundane mattering of document manufacturing, possibilities for (re)forming the carescape emerged. By delving into inconspicuous, ‘seamful’ b/order work that both sustained distinctions between the NHS and Council and enabled b/order crossings, I expose how actors were knotted, and how this shaped efforts to recompose the contours of the carescape. While ‘Kintra’s story might be familiar, situated in concerns that may resonate across Scotland; I reveal how collaboration-as-practice is tangled in differing organisational practices, emerging from quotidian intra-actions in meeting rooms, offices, car parks and kitchenettes. I deploy a posthuman practice stance to show not only the way in which public administration ‘does’ care, but it’s world-making through a sociomaterial politics of anticipation. I was told legislation was the only way to make HSCI in ‘Kintra’ happen, nevertheless, there was resistance to limit the breadth and depth of integrating. Consequently, I show how the (re)organising of b/orders was an always-ongoing act of maintenance and repair of a (dis)integrating carescape; as I learnt at the end of my fieldwork, ‘it’s ‘Kintra, ‘it’s aye been!
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