When Health Care is Displaced by State Interests: Building Dialogue Through Shared Findings

Civic Utilisation based on meta-ethnography willingness of government to open data Modeling of Influential factors

[Purpose/Significance]Government open data has been in China for 10 years, however, the actual use of it has been criticised. This study analyses citizens' willingness to use government open data from their perspectives and constructs a model, aiming to promote in-depth research on citizens' use of government open data. [Methodology/Process] Meta-ethnographic qualitative research method was adopted to synthesise and integrate the 25 original studies. [Results/Conclusions] The study finally constructed a model of factors influencing citizens' willingness to use government open data, and identified four dimensions: "citizen", "platform", "government" and "environment". The four dimensions of "citizen", "platform", "government" and "environment" were identified, of which "citizen" involves "intrinsic motivation", "behavioural attitude", "information attitude" and "information security". The four dimensions of "Citizen" include "Intrinsic Motivation", "Behavioural Attitude", "Information Literacy", and "Demographic Characteristics", while the four dimensions of "Platform" include "Data Quality", "Information Literacy", and "Demographic Characteristics". platform" involves the sub-dimensions of "data quality" and "platform quality", "government" involves the sub-dimensions of "organisational conditions" and "policies and regulations", and "government" involves the sub-dimensions of "organisational conditions" and "policies and regulations". government" involves two sub-dimensions, "organisational conditions" and "policies and regulations", and "environment" involves two sub-dimensions, "social environment" and "type of context", with each sub-dimension having a different impact on the use of open government data by citizens. The different factors under each sub-dimension have different degrees of influence on citizens' use of open government data. Finally, suggestions are made to enhance citizens' willingness to use open government data.

Construction of influencing factors model for public information avoidance behavior in major infectious disease outbreaks based on meta-ethnography

Objective

Major infectious disease outbreaks are highly susceptible to diffuse outbreaks due to their sudden and more widespread nature. Compared to previous outbreaks such as the Spanish flu and SARS in China, COVID-19 has greatly affected the health of citizens and the economic development of countries worldwide, and is representative of major infectious disease outbreaks in many ways. Information avoidance, a common information behaviour during major infectious disease outbreaks, can alleviate the stress caused by information overload as a strategy to reduce negative emotions and maintain optimism. However, it can also bias risk perceptions and avoid content of greater value. Therefore, a deeper understanding of public information behaviour, particularly how and why relevant information is circumvented, places a demand on researchers.

Methods

A meta-ethnographic qualitative research methodology was used, and the seven steps of the methodology were strictly followed, including identifying integration themes, defining the connotations of integration themes, reading original studies, identifying relationships between studies, inter-translation between studies, synthetic translation, and presenting integration results. 26 original studies were integrated in a unified research framework, with a macro perspective that integrates consistent as well as complex and even contradictory findings and identifies dominant factors.

Conclusions

Identify demographic factors, information literacy, risk perception, cognitive structure, information quality, information sources, external characteristics of information, and environmental characteristics sub-dimensions around the dimensions of 'individual', 'information' and 'environment'. The study also explored the factors under each sub-dimension. The study finally identified three dimensions, nine sub-dimensions and 26 factors, and obtained a more complete theoretical framework to construct a "model of factors influencing public information avoidance behaviour in major infectious disease epidemics", with a view to providing a theoretical basis and practical reference for relevant departments in guiding public information behaviour and health practices in major infectious disease epidemics.

Legislatively Excluded, Medically Uninsured and Structurally Violated: The Social Organization of HIV Healthcare for African, Caribbean and Black Immigrants with Precarious Immigration Status in Toronto, Canada

African, Caribbean and Black immigrants face persistent legislative barriers to accessing healthcare services in Canada. This Institutional Ethnography examines how structural violence and exclusionary legislative frameworks restrict the right to HIV healthcare access for many Black immigrants. We conducted semi-structured interviews with Black immigrants living with HIV (n = 20) and healthcare workers in Toronto, Canada (n = 15), and analyzed relevant policy texts. Findings revealed that exclusionary immigration and healthcare legislation shaping and regulating immigrants' right to health restricted access to public resources, including health insurance and HIV healthcare and related services, subjecting Black immigrants with precarious status to structural violence. Healthcare providers and administrative staff worked as healthcare gatekeepers. These barriers undermine public health efforts of advancing health equity and ending HIV "while leaving no one behind." We urge continued policy reforms in Canada's immigration and healthcare systems regarding HIV care access for Canada's precarious status immigrants.

"We can't just have a casual conversation": An institutional ethnography-informed study of work in labour and birth

Labour and delivery units often become contested workplaces with tensions between obstetrics, nursing, and midwifery practices. These tensions can impede communication and raise concerns about provider wellness and patient safety. Remedying such tensions requires inquiry into the drivers of recurrent problems in interprofessional practice. We engaged in change-oriented inquiry informed by institutional ethnography (IE) within an academic hospital in Toronto, Canada (2017-2019). Clinicians identified critical incident analysis reports used to document recurrent issues for transfers of care (TOC) and consultations between professionals. We then mapped the everyday/everynight work of midwives, nurses, and obstetricians by observing (75 h) and interviewing them (n = 15). We also traced work processes to local (forms and hospital policies) and external (national policies and evidence-based guidelines) texts. Our IE-informed analysis made visible the otherwise hidden links between the everyday work of practitioners and its social organization. Three intrapartum work processes involving midwives consulting with obstetricians were identified: induction of labour with TOC back to midwife once labour was "active", consultation without TOC, and TOC for various indications. Three points of disjuncture complicated these processes: (i) a local "3 consult rule", linked to medico-legal governance and remuneration structures; (ii) subjective interpretations of the "4-cm dilation rule", a policy meant to standardize practice; and (iii) regulations delaying the timing of consultations. The Electronic Fetal Monitoring system served as a powerful text, materializing issues of professional scope and autonomy for midwives, and medicolegal accountability for obstetricians. Our study extends extant evidence that medicine-driven governance of midwifery practices can perpetuate interprofessional challenges. While practitioners spoke of the three disjunctures as 'laws', most also viewed them as ostensibly modifiable. Interprofessional tensions may be addressed by considering how social organization, materialized in texts detailing medico-legal liability and remuneration, can constrain possible practices through regulatory protocols, local ruling policies, and cultural expectations (e.g., documentation practices).