74 research outputs found

    Implementing technology in the justice sector: A Canadian perspective.

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    Despite the many technological advances that could benefit the court system, the use of computers and network technology to facilitate court procedures is still in its infancy, and court procedures largely remain attached to paper documents and to the physical presence of the parties at all stages. More and more research is focusing on the use of technology to make the legal system more efficient and to reduce excessive legal costs and delays. The goal of this exploratory research project is to examine the experience of justice sector technology implementation fromthe perspective of individuals involved first-hand in the implementation process. This study will provide insight into the political and cultural factors that support and hinder the implementation of technologies in the justice sector. Unstructured interviews were conducted with individuals involved in the planning and implementation of technological change in Canadian courts in order to gather their perspectives on the change process. These key informants were asked to discuss the process of technological change in their courts, the barriers that they experienced to such technological change, and the factors that promote or support the implementationof technology by courts. A grounded theory approach was used to identifyemergent themes related to these questions. The results provide insight into the factors that promote and impede the implementation of technologies by Canadian courts

    Information Provision for Informed Prenatal Decision Making

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    Abstract: In decision making in maternity care, midwives provide information to support clientcentred decisions. Although midwives are expected to maintain neutrality, a variety of concerns limit nondirectiveness. The impact of these concerns is explored through qualitative analysis of midwife-client interactions. The results provide insight into what counts as “information” in these interactions. Résumé : Lors de la prise de décision dans les soins de maternité, les sages-femmes offrent des informations pour soutenir les décisions de leurs patientes. Bien que l’on suppose que les sages-femmes doivent conserver une certaine neutralité, de nombreuses préoccupations limitent le manque de directives. L’impact de ces préoccupations est exploré à travers une analyse qualitative des interactions entre sages-femmes et patientes. Les résultats présentent un aperçu de ce qui est considéré comme « information » dans ces interactions

    Mobilizing User-Generated Content for Canada’s Digital Content Advantage

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    The goal of the Mobilizing User-Generated Content for Canada’s Digital Content Advantage project is to define User-Generated Content (UGC) in its current state, identify successful models built for UGC, and anticipate barriers and policy infrastructure needed to sustain a model to leverage the further development of UGC to Canada\u27s advantage.This poster session is based on the report, Mobilizing User-Generated Content For Canada’s Digital Advantage (http://ir.lib.uwo.ca/fimspub/21/) and is related to the Brown Bag presentation also presented on March 23, 2011 (http://ir.lib.uwo.ca/fimspres/11/)

    Predicting prostate cancer treatment choices: The role of numeracy, time discounting, and risk attitudes

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    Prostate cancer is the most common cancer among males in the United States and there is lack of consensus as to whether active surveillance (AS) or radical prostatectomy (RP) is the best course of treatment. In this study we examined the role of three overlooked determinants of decision making about prostate cancer treatment in a hypothetical experiment—numeracy, time discounting, and risk taking in 279 men over age 50 without a prior prostate cancer diagnosis. Results showed that AS was the most frequently chosen option. Furthermore, numeracy and time discounting significantly predicted participants’ preference for AS, whereas a propensity to take risks was associated with a preference for RP. Such insights into the factors that affects cancer treatment preferences may improve tailored decision aids and help physicians be better poised to engage in shared decision-making to improve both patient-reported and clinical outcomes

    Digital technology and disease surveillance in the COVID-19 pandemic: A scoping review protocol

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    Introduction Infectious diseases pose a risk to public health, requiring efficient strategies for disease prevention. Digital health surveillance technologies provide new opportunities to enhance disease prevention, detection, tracking, reporting and analysis. However, in addition to concerns regarding the effectiveness of these technologies in meeting public health goals, there are also concerns regarding the ethics, legality, safety and sustainability of digital surveillance technologies. This scoping review examines the literature on digital surveillance for public health purposes during the COVID-19 pandemic to identify health-related applications of digital surveillance technologies, and to highlight discussions of the implications of these technologies. Methods and analysis The scoping review will be guided by the framework proposed by Arksey and O\u27Malley and the guidelines outlined by Colquhoun et al and Levac et al. We will search Medline (Ovid), PsycInfo, PubMed, Scopus, CINAHL (EBSCOhost), ACM Digital Library, Google Scholar and IEEE Explore for relevant studies published between December 2019 and December 2020. The review will also include grey literature. Data will be managed and analysed through an extraction table and thematic analysis. Ethics and dissemination Findings will be disseminated through traditional academic channels, as well as social media channels and research briefs and infographics. We will target our dissemination to provincial and federal public health organisations, as well as technology companies and community-based organisations managing the public response to the COVID-19 pandemic

    Confidentiality, anonymity and amnesty for midwives in distress seeking online support – Ethical?

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    BACKGROUND: Midwife health is intrinsically linked to the quality of safe patient care. To ensure safe patient care, there is a need to deliver emotional support to midwives. One option that midwives may turn to may be a confidential online intervention, instead of localised, face-to-face support. RESEARCH DESIGN: Following the Realist And MEta-narrative Evidence Syntheses: Evolving Standards publication standards, this realist synthesis approach explores the ethical considerations in permitting confidentiality, anonymity and amnesty in online interventions to support midwives in work-related psychological distress. An iterative search methodology was used to select nine papers for review. To assimilate information, papers were examined for ideas relating to ethical dimensions of online interventions to support midwives in work-related psychological distress. This review takes a narrative approach. FINDINGS: Online interventions can support the development of insight, help seeking and open discussion. Additionally, Internet support groups can become morally persuasive in nature. Anonymity and confidentiality are both effective and therapeutic features of online interventions when used in collaboration with effective online moderation. Yet, ethical dilemmas remain where users cannot be identified. DISCUSSION: Confidentiality and anonymity remain key components of successful online interventions. However, sanctioning the corollary component of amnesty may provoke moral discomfort for those seeking immediate accountability. For others, amnesty is seen as essential for open disclosure and help seeking. Ultimately, the needs of midwives must be balanced with the requirement to protect the public and the professional reputation of midwifery. CONCLUSION: In supporting midwives online, the principles of anonymity, confidentiality and amnesty may evoke some resistance on ethical grounds. However, without offering identity protection, it may not be possible to create effective online support services for midwives. The authors of this article argue that the principles of confidentiality, anonymity and amnesty should be upheld in the pursuit of the greatest benefit for the greatest number of people

    Geographical variations in the benefit of applying a prioritization system for cataract surgery in different regions of Spain

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    <p>Abstract</p> <p>Background</p> <p>In Spain, there are substantial variations in the utilization of health resources among regions. Because the need for surgery differs in patients with appropriate surgical indication, introducing a prioritization system might be beneficial. Our objective was to assess geographical variations in the impact of applying a prioritization system in patients on the waiting list for cataract surgery in different regions of Spain by using a discrete-event simulation model.</p> <p>Methods</p> <p>A discrete-event simulation model to evaluate demand and waiting time for cataract surgery was constructed. The model was reproduced and validated in five regions of Spain and was fed administrative data (population census, surgery rates, waiting list information) and data from research studies (incidence of cataract). The benefit of introducing a prioritization system was contrasted with the usual first-in, first-out (FIFO) discipline. The prioritization system included clinical, functional and social criteria. Priority scores ranged between 0 and 100, with greater values indicating higher priority. The measure of results was the waiting time weighted by the priority score of each patient who had passed through the waiting list. Benefit was calculated as the difference in time weighted by priority score between operating according to waiting time or to priority.</p> <p>Results</p> <p>The mean waiting time for patients undergoing surgery according to the FIFO discipline varied from 1.97 months (95% CI 1.85; 2.09) in the Basque Country to 10.02 months (95% CI 9.91; 10.12) in the Canary Islands. When the prioritization system was applied, the mean waiting time was reduced to a minimum of 0.73 months weighted by priority score (95% CI 0.68; 0.78) in the Basque Country and a maximum of 5.63 months (95% CI 5.57; 5.69) in the Canary Islands. The waiting time weighted by priority score saved by the prioritization system varied from 1.12 months (95% CI 1.07; 1.16) in Andalusia to 2.73 months (95% CI 2.67; 2.80) in Aragon.</p> <p>Conclusion</p> <p>The prioritization system reduced the impact of the variations found among the regions studied, thus improving equity. Prioritization allocates the available resources within each region more efficiently and reduces the waiting time of patients with greater need. Prioritization was more beneficial than allocating surgery by waiting time alone.</p

    Access to justice for all: Towards an “expansive vision” of justice and technology.

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    In this paper, the authors examine developments in the Canadian access to justice dialogue from Macdonald’s seminal 2005 analysis to the recent reports of the National Action Committee on Access to Justice in Civil and Family Matters [NAC]. They draw on the NAC’s call for an “expansive vision” of access to justice as the basis for critically evaluating examples of particular technologies used or proposed as responses to the access to justice crisis in Canada. In so doing, they illustrate the importance of conscious consideration of deliverables and beneficiaries in prioritizing technologies for deployment, in determining how the technology ought to be deployed, and in evaluating the potential of a technology to facilitate access to justice. The authors argue that nuanced accounts of the relationships between justice deliverables, technological mechanisms for delivery and intended justice beneficiaries are essential to developing good decision-making mechanisms with respect to access to justice and technology. Dans le présent article, les auteurs examinent l’évolution du dialogue canadien sur l’accès à la justice, depuis l’analyse fondamentale de Macdonald en 2005 jusqu’aux récents rapports du Comité national d’action sur l’accès à la justice en matière civile et familiale (CNA). Ils se fondent sur la « vision élargie » de l’accès à la justice réclamée par le CNA pour évaluer de façon critique les exemples de technologies particulières utilisées ou proposées pour répondre à la crise de l’accès à la justice au Canada. Ce faisant, ils illustrent l’importance d’examiner de façon consciente les livrables et les bénéficiaires pour classer par ordre de priorité les technologies à déployer, pour déterminer comment la technologie devrait être déployée et pour évaluer le potentiel d’une technologie de faciliter l’accès à la justice. Les auteurs soutiennent que des comptes rendus nuancés des rapports entre les livrables en matière de justice, les mécanismes de livraison technologiques et les bénéficiaires prévus sont essentiels pour élaborer de bons mécanismes décisionnels en ce qui concerne l’accès à la justice et la technologie

    Investigation of relative risk estimates from studies of the same population with contrasting response rates and designs

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    Background: There is little empirical evidence regarding the generalisability of relative risk estimates from studies which have relatively low response rates or are of limited representativeness. The aim of this study was to investigate variation in exposure-outcome relationships in studies of the same population with different response rates and designs by comparing estimates from the 45 and Up Study, a population-based cohort study (self-administered postal questionnaire, response rate 18%), and the New South Wales Population Health Survey (PHS) (computer-assisted telephone interview, response rate ~60%). Methods: Logistic regression analysis of questionnaire data from 45 and Up Study participants (n = 101,812) and 2006/ 2007 PHS participants (n = 14,796) was used to calculate prevalence estimates and odds ratios (ORs) for comparable variables, adjusting for age, sex and remoteness. ORs were compared using Wald tests modelling each study separately, with and without sampling weights. Results: Prevalence of some outcomes (smoking, private health insurance, diabetes, hypertension, asthma) varied between the two studies. For highly comparable questionnaire items, exposure-outcome relationship patterns were almost identical between the studies and ORs for eight of the ten relationships examined did not differ significantly. For questionnaire items that were only moderately comparable, the nature of the observed relationships did not differ materially between the two studies, although many ORs differed significantly. Conclusions: These findings show that for a broad range of risk factors, two studies of the same population with varying response rate, sampling frame and mode of questionnaire administration yielded consistent estimates of exposure-outcome relationships. However, ORs varied between the studies where they did not use identical questionnaire items
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