Survival networks: lay expertise and digital knowledge production in the early years of HIV/AIDS

Using Digital Media to Promote Kidney Disease Education

Research and development on the survivability of networks has largely focused on public switched telecommunications networks and high speed data networks with little attention on the survivability of wireless access networks supporting cellular and PCS communications. This paper provides an overview of the survivability issues in PCS networks with emphasis on the unique difficulties presented by user mobility and the wireless channel environment. A multi-layer framework for the study of PCS network survivability is proposed. Metrics for quantifying network survivability are identified at each layer. It is shown that user mobility significantly worsens the network performance after even small failures, as disconnected users move among adjacent cells and attempt to reconnect to the network. Thus survivability strategies must be designed to contend with spatial as well as temporal network behavior. Possible survivability strategies and restoration techniques for each layer in the framework are also discussed.

Poor access to quality health services, especially in urban slums, is a global challenge. Given similar challenges in Nairobi's Kibra informal settlement area, we collaborated with the Langata/Kibra sub-county health management team to conduct a pilot program for improving the quality of child health services delivered by health care providers (HCPs). The pilot introduced a digital mHealth platform to HCPs working in Kibra informal settlement area in Nairobi. This mHealth platform was compliant to WHO's recommended guideline for integrated management of newborn and child illnesses (IMNCI) and was designed to help sick child assessment, diagnosis and management by HCPs. We aimed to determine if using this digital platform, coupled with supportive supervision and community outreach, would lead to improve compliance to the IMNCI guideline for assessment, diagnosis and treatment of sick children. We conducted baseline (February 2019) assessment, trained selected HCPs on the mHealth platform on handheld android tablets, conducted end line (March 2020) and measured any change in HCP's compliance to IMNCI guidelines. Total 89 HCPs were the mHealth platform users during end line assessment. When asked about the choice of antibiotic for treating childhood pneumonia, we found proportion of HCPs who preferred Amoxycillin dispersible tablet, the recommended treatment for childhood pneumonia, increased from 3% at baseline to 38% at end line. Proportion of HCPs who were aware that antibiotics should NOT be used for the management of simple diarrhea increased from 14% (at baseline) to 50% (at end line). At end line, more than 90% HCPs were found compliant in their practice to IMNCI guidelines for sick child assessment, diagnosis and management. These results demonstrate the use of the IMNCI compliant mHealth platforms as a potential important effective way to improve capacity and compliance among HCPs who are serving communities like Kibra informal settlement in Nairobi, Kenya.Key messages• WHO recommended IMNCI compliant mHealth platform enables health care providers to offer quality child health care.• Using mHealth platform to ensure WHO’s IMNCI guideline implementation by health care providers might have potential impact on saving sick children’s lives from preventable deaths.

Self-regulated learning (SRL) is useful for understanding self-directed learning practices. However, SRL behaviours - despite being deemed highly context-dependent - remain mostly unexplored for healthcare workers in low-income countries. This study details how SRL strategies vary and impact on healthcare providers' learning gains when using digital learning platforms. We apply Latent Profile Analysis (LPA) to questionnaire responses from a sample of 264 healthcare providers, arguably the first time LPA has been applied for the context in this subject-domain. We identified four SRL profiles: High, Above-Average with Low Help-Seeking, Average, and Low SRL profiles with significant differences in SRL strategies between the four profiles confirmed by Kruskal-Wallis test and logistic regression. Healthcare providers with more specialised clinical training were most likely to be in the Low SRL profile, but compared to the other profiles, maximised possible learning gains in the fewest learning iterations. From our findings, SRL may not adequately represent the nature of the interaction between these learners and contextual characteristics. Exploring the important role of various external learning regulation behaviours that influence healthcare providers SRL might help address this shortcoming. These findings provide insights into the learner factors to consider when implementing technology-mediated learning in these resource-contexts. They also offer plausible future research directions into how to maximise healthcare providers’ learning gains on digital platforms that is informed by how learners in low-income contexts regulate their self-directed learning.

Allyn Young’s concept of increasing returns, not to be confounded with static, equilibrium constructs of economies of scale and increasing returns to scale, is applied in this article to analyze how and why increasing returns arise in the production (generation) and use (application) of knowledge and of big data, thereby driving economic growth an progress. Knowledge is chosen as our focus because it is ‘our most powerful engine of production’ and big data is included to make the analysis more complete and up-to-date. We analyze four mechanisms or sources of increasing returns in the production of knowledge, and four in the use of knowledge. Turning to big data, increasing returns in the use thereof are examined in two spheres: the dominance resulting from the self-reinforcing functioning of digital platforms and machine learning through gigantic amounts of training data. Concluding remarks concern some key differences between knowledge and big data, some policy implications, and some of the social negative impacts from the ways in which big data is being used.

Digital health apps are becoming increasingly available for people living with diabetes, yet data silos continue to exist. This requires health care providers (HCPs) and patients to use multiple digital platforms to access health data. In this study, we gathered the perspectives of caregivers of children and youths living with type 1 diabetes (T1D) and pediatric diabetes HCPs in the user-centered design of TrustSphere, a secure, single-point-of-access, integrative digital health platform. We distributed web-based surveys to caregivers of children and youths living with T1D and pediatric diabetes HCPs in British Columbia, Canada. Surveys were designed using ordinal scales and had free-text questions. Survey items assessed key challenges, perceptions about digital trust and security, and potential desirable features for a digital diabetes platform. Similar challenges were identified between caregivers of children and youths living with T1D (n=99) and HCPs (n=49), including access to mental health support, integration of diabetes technology and device data, and the ability to collaborate on care plans with their diabetes team. Caregivers and HCPs identified potential features that directly addressed their challenges, such as more accessible diabetes data and diabetes care plans. Caregivers had more trust in sharing their child's data digitally than HCPs. Most caregivers and HCPs stated that an integrative platform for T1D would support collaborative patient care. Caregiver and HCP perspectives gathered in this study will inform the early prototype of an integrative digital health platform. This prototype will be presented and iterated upon through a series of usability testing sessions with caregivers and HCPs to ensure the platform meets end users' needs.

A Collaborative Approach in Prescribing Psychotropics for Persons Experiencing Homelessness.

This discussion of collaborative approaches using traditional and nontraditional providers of women's health care in the Philippines identifies common health problems in the Philippines, discusses solutions and strategies adopted by government and nongovernment providers of women's health care, and details the strategies adopted in the Philippines. The traditional providers are the traditional birth attendants, the folk healers, herbalists, faith healers, and the so-called witches and sorcerers, which are not treated in a derogatory manner in the Philippines. This paper deals only with the traditional birth attendants who are women and whose work deals with women's health concerns. The nontraditional type of health care providers, some of whom are nonprofessionals, include those who have been recruited by government and nongovernment organizations. This paper deals only with the nonprofessional health care providers. 2 major types of health problems in the Philippines are discussed. The first of these is the rapid population growth and its ramifications, including growing demands for food, education employment, health services, and shelter. This further indicates that there will be a larger number of undernourished children, a larger number of poor families and so on. Additionally, there are 295 cases of illness per 1000 persons, of which 68% are acute illness, 27% chronic, and 5% disabilities and accidents. The 2nd type of health problem is only health related, i.e., the inequitable distribution of health resources and health personnel. The recruitment of lay health workers was the solution adopted to ease the inequity in distribution of human health resources. Providers of health care in the Philippines generally are recruited to help solve specific health problems of maternal and child care, including family planning, malnutrition, general morbidity, and dispersal of medicines. In the process they help ease the inequitable distribution of health services. The population problem is being solved by several categories of workers: traditional birth attendants; the full-time outreach worker; and barrio supply point officers.

Digital technologies’ development and their ubiquity has significantly changed the way information is collected and shared. These changes are also observed in the ways that knowledge and information used to design and implement Science, Technology, and Innovation (STI) policies are increasingly made accessible via digital platforms. Lacking, however, are evaluation frameworks to measure the performance and effectiveness of public information systems used for STI policy work. This limits what we know about what aspects work for whom, when, and why. As a response to this gap limiting our collective capacity for improving their utility, this paper presents an assessment framework tool for STI policy-focused digital knowledge platforms. Our proposition is informed by theoretical lessons from the areas of work on Knowledge Infrastructures (KIs) and Next Generation Repositories (NGRs), and practical experiences from policy professionals working in STI policy domains. The tool’s architecture is structured around three interdependent thematic pillars of performance in the production, aggregation, distribution, and maintenance of knowledge in digital information platforms: the communities pillar, the technical systems pillar, and the sustainability pillar. To test the design and utility of our proposed evaluation framework, we applied it on a digital platform of STI policy instruments maintained by the United Nations Educational, Scientific, and Cultural Organization (UNESCO), the Global Observatory for Science, Technology, and Innovation Policy (GO-SPIN) platform. We conclude with reflections on future areas for evaluation framework development.

IntroductionMore than 50% of Swiss adult patients with hypertension do not reach blood pressure targets.1 2 Team-based care can be an effective and safe alternative to clinic-based care for improving...

Allyn Young's concept of increasing returns (not to be confused with static, equilibrium constructs of economies of scale and increasing returns to scale) is applied to analyse how and why increasing returns arise in the production (generation) and use (application) of knowledge and big data, thereby driving economic growth and progress. Knowledge is chosen as our focus because it is said to be our most powerful engine of production, and big data are included to make the analysis more complete and recent. We analyse four mechanisms or sources of increasing returns in the production of knowledge, and four in the use of knowledge. Turning to big data, we analyse increasing returns in the functioning of digital platforms and increasing returns in machine learning from gigantic amounts of training data. Concluding remarks concern some key differences between big data and knowledge, some policy implications, and some of the social negative impacts from the ways in which big data are being used.

Allyn Young’s concept of increasing returns, not to be confounded with static, equilibrium constructs of economies of scale and increasing returns to scale, is applied in this article to analyze how and why increasing returns arise in the production (generation) and use (application) of knowledge and of big data, thereby driving economic growth and progress. Knowledge is chosen as our focus because it is ‘our most powerful engine of production’ and big data is included to make the analysis more complete and up-to-date. We analyze four mechanisms or sources of increasing returns in the production of knowledge, and four in the use of knowledge. Turning to big data, increasing returns in the use thereof are examined in two spheres: the dominance resulting from the selfreinforcing functioning of digital platforms and machine learning through gigantic amounts of training data. Concluding remarks concern some key differences between knowledge and big data, some policy implications, and some of the social negative impacts from the ways in which big data is being used.

Sexual Reproductive Health (SRH) self-care offers a pathway for low income countries to advance towards Universal Health Coverage by empowering individuals, families, and communities to prioritize their SRH needs independently of healthcare providers. Facilitating access to SRH products is crucial for embracing self-care and digital health technologies hold promise for enhancing accessibility. This study explored the role played by rocket health digital platforms in enhancing accessibility to SRH self-care products among youth in Uganda. Employing a cross-sectional design with a mixed-method approach, the study involved key informant interviews with youth who had purchased SRH self-care products from Rocket Health in 2022, as well as key staff at Rocket Health. Quantitative data were extracted from Rocket Health’s Electronic Medical Records covering the period from January 2022 to December 2022.More males (57%) utilized digital platforms for SRH compared to females (43%). The highest utilization was via the E-commerce platform (49%) while the least was via the voice call platforms (4%). A notable portion of youth (30%) still relied on visiting the pharmacy. Contraception products were predominantly consumed through digital platforms (44%), whereas self-testing were less frequently utilized (14%). The study also identified key resources such as the digital infrastructure that maximize the potential of digital health platforms in enhancing SRH self-care. By gaining insights into the digital infrastructure, preferences, barriers, and financial considerations associated with accessing SRH self-care services through digital platforms, targeted interventions such as access to contraceptives, awareness programs, prevention and treatment of Sexual Transmitted Infections can be developed to promote positive SRH outcomes among youth.

Sexual Reproductive Health (SRH) self-care offers a pathway for low income countries to advance towards Universal Health Coverage by empowering individuals, families, and communities to prioritize their SRH needs independently of healthcare providers. Facilitating access to SRH products is crucial for embracing self-care and digital health technologies hold promise for enhancing accessibility. This study explored the role played by rocket health digital platforms in enhancing accessibility to SRH self-care products among youth in Uganda. Employing a cross-sectional design with a mixed-method approach, the study involved key informant interviews with youth who had purchased SRH self-care products from Rocket Health in 2022, as well as key staff at Rocket Health. Quantitative data were extracted from Rocket Health's Electronic Medical Records covering the period from January 2022 to December 2022.More males (57%) utilized digital platforms for SRH compared to females (43%). The highest utilization was via the E-commerce platform (49%) while the least was via the voice call platforms (4%). A notable portion of youth (30%) still relied on visiting the pharmacy. Contraception products were predominantly consumed through digital platforms (44%), whereas self-testing were less frequently utilized (14%). The study also identified key resources such as the digital infrastructure that maximize the potential of digital health platforms in enhancing SRH self-care. By gaining insights into the digital infrastructure, preferences, barriers, and financial considerations associated with accessing SRH self-care services through digital platforms, targeted interventions such as access to contraceptives, awareness programs, prevention and treatment of Sexual Transmitted Infections can be developed to promote positive SRH outcomes among youth.

Have confidence in your competence by keeping current