Shifting contours of boundaries: an exploration of inter-agency integration between hospital and community interprofessional diabetes programs
Bibliographic record
Abstract
This article reports on research into the relationships that emerged between hospital-based and community-based interprofessional diabetes programs involved in inter-agency care. Using constructivist grounded theory methodology we interviewed a purposive theoretical sample of 21 clinicians and administrators from both types of programs. Emergent themes were identified through a process of constant comparative analysis. Initial boundaries were constructed based on contrasts in beliefs, practices and expertise. In response to bureaucratic and social pressures, boundaries were redefined in a way that created role uncertainty and disempowered community programs, ultimately preventing collaboration. We illustrate the dynamic and multi-dimensional nature of social and symbolic boundaries in inter-agency diabetes care and the tacit ways in which hospitals can maintain a power position at the expense of other actors in the field. As efforts continue in Canada and elsewhere to move knowledge and resources into community sectors, we highlight the importance of hospitals seeing beyond their own interests and adopting more altruistic models of inter-agency integration.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.030 | 0.038 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.022 | 0.043 |
| Scholarly communication | 0.019 | 0.017 |
| Open science | 0.004 | 0.025 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".