Ambivalence in digital health: co-designing an mHealth platform for HIV care

In reaction to polarised views on the benefits or drawbacks of digital health, the notion of ‘ambivalence’ has recently been proposed as a means to grasp the nuances and complexities at play when digital technologies are embedded within practices of care. This article responds to this proposal by demonstrating how ambivalence can work as a reflexive approach to evaluate the potential implications of digital health. We first outline current theoretical advances in sociology and organisation science and define ambivalence as a relational and multidimensional concept that can increase reflexivity within innovation processes. We then introduce our empirical case and highlight how we engaged with the HIV community to facilitate a co-design space where 97 patients (across five European clinical sites: Antwerp, Barcelona, Brighton, Lisbon, Zagreb) were encouraged to lay out their approaches, imaginations and anticipations towards a prospective mHealth platform for HIV care. Our analysis shows how patients navigated ambivalence within three dimensions of digital health: quantification, connectivity and instantaneity. We provide examples of how potential tensions arising through remote access to quantified data, new connections with care providers or instant health alerts were distinctly approached alongside embodied conditions (e.g. undetectable viral load) and embedded socio-material environments (such as stigma or unemployment). We conclude that ambivalence can counterbalance fatalistic and optimistic accounts of technology and can support social scientists in taking-up their critical role within the configuration of digital health interventions

Images of the Toronto Provincial Asylum, 1846-1890

Built in 1850, the Toronto Provincial Asylum was once the largest mental hospitals in Canada. The main building was demolished in 1975, and the property is now home to the Queen Street branch of the Centre for Addiction and Mental Health. Although there are remnants of the nineteenth-century institution, including most of the perimeter wall, the only lasting visual reminder of the property as a whole is a small group of images. By the last quarter of the nineteenth century, perhaps in order to ease public concern over the increasingly custodial function of the institution, Victorian media sources repeatedly presented an unchanging or immutable depiction of the Toronto Asylum. Drawing upon the architectural concept drawings of the 1840s, which contained an ideal vision for the building, pictures from the 1870s, 80s and 90s depict the asylum as the new, clean, and proud-looking structure it was when it opened. Arguably, these images are what the Victorian public wanted to see: they preserved the early-century optimism that such institutions would yield high cure rates and they supported the view that the care of the mentally ill belonged in the hands of the medical profession.Construit en 1850, l’asile provincial de Toronto a jadis été le plus grand hopital psychiatrique du Canada. L’édifice principal a été démoli en 1975, et le terrain de la rue Queen accueille maintenant un Centre de toxicomanie et de santé mentale. Bien qu’il y ait toujours des vestiges de l’institution du 19e siècle, incluant la majeure partie du mur d’enceinte, le seul rappel visuel persistant de la propriété dans son ensemble est un nombre restreint d’images artistiques. Dans le dernier quart du 19e siècle, probablement dans le but d’apaiser les préoccupations du public à propos de la fonction de plus en plus ‘incarcérative’ de l’institution, les sources médiatiques victoriennes présentent à répétition une description immuable de l’asile de Toronto. S’appuyant sur les plans architecturaux conceptuels des années 1840, les images des années 1870, 80 et 90 dépeignent un asile neuf, propre et ayant aussi fière allure qu’au moment de son ouverture. Sans doutes, ces images constituent ce que le public victorien souhaite voir : elles préservent l’optimisme du début du siècle posant un taux élevé de guérison pour ces institutions, et elles supportent l’idée que le soin des malades mentaux doit être aux mains de la profession médicale

Henryk Szlajfer, Paweł Ceranka (red.), My Naród... 90 lat stosunków dyplomatycznych między Polską a USA, Warszawa 2009, ss. 98

Krzysztof Flis - Białystok719920

In the balance: report of a research study exploring information for weight management

This paper uses findings from a research study called Net.Weight to examine the concepts of interaction, information quality and Internet-based information from the perspective of people engaged in managing their weight. The Net.Weight study was a two-year project funded by the British government 19s Department of Health and located in the city of Brighton and Hove. It examined the potential for increased, innovative and effective uses of information and communication technologies (ICTs) to support the self management of weight. The study had several inter-related research strands and the findings discussed in the paper emerged primarily from participatory learning workshops and evaluative interviews. The paper demonstrates that the interaction between people is an important aspect of the information process, which is often neglected in the literature. It suggests that exploring the user-user dimension might add to the understanding of information effectiveness. It also suggests that an approach to information and health literacy which includes a social as well as an individual perspective is necessary. On quality assessment, it supports findings from other studies that organisational authority is a key measure of reliability for lay users and that quality assessment tools have a limited role in the assessment process. The Net.Weight participants embraced the Internet as a medium for weight management information only when it added value to their existing information and weight management practices and when it could be integrated into their everyday lives

Information to fight the flab: findings from the Net.Weight study

The purpose of the paper is to examine information use and information literacy in the context of weight management. It reports on a two-year study funded by the Department of Health known informally as the Net.Weight Study. Net.Weight examined the potential for increased, innovative and effective uses of information and communication technologies (ICTs) to support the self management of weight. The research was conducted in the city of Brighton & Hove by an inter-disciplinary team from the University of Brighton. The paper gives a brief overview of the various methods used in the study as a whole but discusses one strand, the user survey, in more detail. The survey gathered data on people’s information and ICT use around weight management. The design of the survey questionnaire required the adaptation of existing literacy assessment instruments and this process is described in this paper. The findings show that people use a wide range of information sources for information and support around weight management. The most useful sources are slimming groups, food packaging, friends and family, magazines, TV and health books, thus representing a variety of media, formal and informal, and including human sources. The internet was reported to be a useful source for around half the survey respondents and is most often used for information about diet and exercise. A majority of respondents described themselves as active information seekers and confident about their information skills. They are less confident about internet information than information generally and even less confident about using the internet to support weight management activities. The concept of literacies, particularly around information and health, provide a framework for examining the Net.Weight findings. The findings are discussed in terms of their implications for health information policy and for those interested in applying information literacy theory to health. The role of healthcare practitioners in weight management information is addressed, as is the need for targeted rather than generic health information. It is suggested that the work done in the education sector to increase awareness of information literacy and improve skills could provide a useful model of good practice in a health context. However, the evidence provided by the Net.Weight study suggests that for such an approach to be relevant it needs to reflect the complexity of health information processes in everyday lives

Die Palikot-Bewegung

Die Palikot-Bewegung (Ruch Palikota) hat in den Parlamentswahlen 2011 einen überraschenden Wahlerfolg erzielt und ist drittstärkste Kraft im Sejm. Entstanden war sie erst im Sommer 2010, als es zum Bruch von Janusz Palikot mit seiner damaligen Partei PO gekommen war, in der er intern sowie gegenüber anderen Parteien streitbare Positionen verfochten hatte. Die starke Seite der Palikot-Bewegung ist ihr Talent, die Sehnsucht nach einem modernen und effektiven Staat anzusprechen, und ihre Fähigkeit, sich an die Erwartungen des Infotainment anzupassen. Sie hätte die Chance, die Radikalisierung von PiS , die Ermüdung der Regierungspartei PO und die Führungsschwäche in der SLD für sich zu nutzen. Doch stehen die mangelnde Glaubwürdigkeit des Parteichefs und anderer Politiker, unklare politische Botschaften und die Unterordnung der Parteistrategie unter taktische Erwägungen ihren Ambitionen entgegen, eine dauerhaft prägende Kraft auf der politischen Bühne zu werden