Expert Yet Vulnerable: Understanding the Needs of Transit Dependent Riders to Inform Policy and Design

Transportation is a crucial resource that links people to jobs, social networks, community and services. The transit dependent -- those who do not own private vehicles -- occupy a unique position. They are expert in their knowledge of public transportation while vulnerable to the failures and limitations of transit. This paper presents the results of a study that is aimed at understanding the lived experience of transit dependent riders. Using a framework of structuration theory as an analytic lens, we provide a thematic analysis of qualitative data including interviews with socially connected groups of people and video diaries. The results demonstrate the expertise that transit dependent riders have about transit and its policies and how they deploy that expertise in productive and cunning ways to make the system work for them. The analysis of this data resulted in three categories of agency to consider when designing for vulnerable populations: resourcefulness, reciprocity and powerlessness. The paper concludes by advocating for a human-centered approach to designing systems in community informatics and offers a set of guiding questions for designers of information and communication technologies (ICTs) to consider, especially with regards to vulnerable populations

Expert yet vulnerable: Understanding the needs of transit dependent riders to inform policy and design

Transportation is a crucial resource that links people to jobs, social networks, community and services. The transit dependent -- those who do not own private vehicles -- occupy a unique position. They are expert in their knowledge of public transportation while vulnerable to the failures and limitations of transit. This paper presents the results of a study that is aimed at understanding the lived experience of transit dependent riders. Using a framework of structuration theory as an analytic lens, we provide a thematic analysis of qualitative data including interviews with socially connected groups of people and video diaries. The results demonstrate the expertise that transit dependent riders have about transit and its policies and how they deploy that expertise in productive and cunning ways to make the system work for them. The analysis of this data resulted in three categories of agency to consider when designing for vulnerable populations: resourcefulness, reciprocity and powerlessness. The paper concludes by advocating for a human-centered approach to designing systems in community informatics and offers a set of guiding questions for designers of information and communication technologies (ICTs) to consider, especially with regards to vulnerable populations

Transport analysis in an uncertain world

This short article reflects upon the task of informing policymaking and investment decisions in times of deep uncertainty, in the face of problems that are more 'wicked' than 'tame' and in the context of ever present biases

Adapting the Posterior Probability of Diagnosis Index to Enhance Evidence-Based Screening: An Application to ADHD in Primary Care

This study adapts the Posterior Probability of Diagnosis (PPOD) Index for use with screening data. The original PPOD Index, designed for use in the context of comprehensive diagnostic assessments, is overconfident when applied to screening data. To correct for this overconfidence, we describe a simple method for adjusting the PPOD Index to improve its calibration when used for screening. Specifically, we compare the adjusted PPOD Index to the original index and Naïve Bayes probability estimates on two dimensions of accuracy, discrimination and calibration, using a clinical sample of children and adolescents (N = 321) whose caregivers completed the Vanderbilt Assessment Scale to screen for Attention-Deficit/Hyperactivity Disorder (ADHD) and who subsequently completed a comprehensive diagnostic assessment. Results indicated that the adjusted PPOD Index, original PPOD Index, and Naïve Bayes probability estimates are comparable using traditional measures of accuracy (sensitivity, specificity, AUC) but the adjusted PPOD Index showed superior calibration. We discuss the importance of calibration for screening and diagnostic support tools when applied to individual patients

Global Governance Behind Closed Doors : The IMF Boardroom, the Enhanced Structural Adjustment Facility, and the Intersection of Material Power and Norm Change in Global Politics

Up on the 12th floor of its 19th Street Headquarters, the IMF Board sits in active session for an average of 7 hours per week. Although key matters of policy are decided on in the venue, the rules governing Boardroom interactions remain opaque, resting on an uneasy combination of consensual decision-making and weighted voting. Through a detailed analysis of IMF Board discussions surrounding the Enhanced Structural Adjustment Facility (ESAF), this article sheds light on the mechanics of power in this often overlooked venue of global economic governance. By exploring the key issues of default liability and loan conditionality, I demonstrate that whilst the Boardroom is a more active site of contestation than has hitherto been recognized, material power is a prime determinant of both Executive Directors’ preferences and outcomes reached from discussions. And as the decisions reached form the backbone of the ‘instruction sheet’ used by Fund staff to guide their everyday operational decisions, these outcomes—and the processes through which they were reached—were factors of primary importance in stabilizing the operational norms at the heart of a controversial phase in the contemporary history of IMF concessional lending

Care team and practice-level implementation strategies to optimize pediatric collaborative care: Study protocol for a cluster-randomized hybrid type III trial

BACKGROUND: Implementation facilitation is an effective strategy to support the implementation of evidence-based practices (EBPs), but our understanding of multilevel strategies and the mechanisms of change within the black box of implementation facilitation is limited. This implementation trial seeks to disentangle and evaluate the effects of facilitation strategies that separately target the care team and leadership levels on implementation of a collaborative care model in pediatric primary care. Strategies targeting the provider care team (TEAM) should engage team-level mechanisms, and strategies targeting leaders (LEAD) should engage organizational mechanisms. METHODS: We will conduct a hybrid type 3 effectiveness-implementation trial in a 2 × 2 factorial design to evaluate the main and interactive effects of TEAM and LEAD and test for mediation and moderation of effects. Twenty-four pediatric primary care practices will receive standard REP training to implement Doctor-Office Collaborative Care (DOCC) and then be randomized to (1) Standard REP only, (2) TEAM, (3) LEAD, or (4) TEAM + LEAD. Implementation outcomes are DOCC service delivery and change in practice-level care management competencies. Clinical outcomes are child symptom severity and quality of life. DISCUSSION: This statewide trial is one of the first to test the unique and synergistic effects of implementation strategies targeting care teams and practice leadership. It will advance our knowledge of effective care team and practice-level implementation strategies and mechanisms of change. Findings will support efforts to improve common child behavioral health conditions by optimizing scale-up and sustainment of CCMs in a pediatric patient-centered medical home. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04946253 . Registered June 30, 2021

Automated analysis of vessel morphometry in retinal images from a Danish high street optician setting.

PURPOSE: To evaluate the test performance of the QUARTZ (QUantitative Analysis of Retinal vessel Topology and siZe) software in detecting retinal features from retinal images captured by health care professionals in a Danish high street optician chain, compared with test performance from other large population studies (i.e., UK Biobank) where retinal images were captured by non-experts. METHOD: The dataset FOREVERP (Finding Ophthalmic Risk and Evaluating the Value of Eye exams and their predictive Reliability, Pilot) contains retinal images obtained from a Danish high street optician chain. The QUARTZ algorithm utilizes both image processing and machine learning methods to determine retinal image quality, vessel segmentation, vessel width, vessel classification (arterioles or venules), and optic disc localization. Outcomes were evaluated by metrics including sensitivity, specificity, and accuracy and compared to human expert ground truths. RESULTS: QUARTZ's performance was evaluated on a subset of 3,682 images from the FOREVERP database. 80.55% of the FOREVERP images were labelled as being of adequate quality compared to 71.53% of UK Biobank images, with a vessel segmentation sensitivity of 74.64% and specificity of 98.41% (FOREVERP) compared with a sensitivity of 69.12% and specificity of 98.88% (UK Biobank). The mean (± standard deviation) vessel width of the ground truth was 16.21 (4.73) pixels compared to that predicted by QUARTZ of 17.01 (4.49) pixels, resulting in a difference of -0.8 (1.96) pixels. The differences were stable across a range of vessels. The detection rate for optic disc localisation was similar for the two datasets. CONCLUSION: QUARTZ showed high performance when evaluated on the FOREVERP dataset, and demonstrated robustness across datasets, providing validity to direct comparisons and pooling of retinal feature measures across data sources

Not what you expected: Implementing design thinking as a leadership practice

Changing user needs have created new opportunities for libraries, requiring evolving leadership practices that support innovation and rapid change. Design thinking can provide leaders with a concrete process to move toward action. The authors – one an executive administrator at a large, multi-branch public library, the other an academic librarian who leads a small team – share how design thinking has positively influenced their leadership practices. The benefits of implementing this flexible process have included improved user experience, more creative solutions, wise investments, staff empowerment, increased transparency and trust, and employee learning and development. Both leaders experienced these benefits even though they are in different positions on their hierarchical organization charts. The authors propose that implementing design thinking as a leadership practice has a place in the evolving role of libraries and can shift organizational cultures to become more user-centered and embrace innovation. In addition to these benefits, the chapter discusses specific project examples, challenges, and tips for library leaders to successfully implement the process. Design thinking is translatable across library types and throughout private industry. Discussing design thinking as a leadership practice can benefit the profession and communities by giving leaders a common language to use when learning from and sharing with each other in conversations about innovation