Exploring the process of care for people who inject drugs in hospital settings
Bibliographic record
Abstract
In recent years, hospitals have experienced alarming increases in admissions of people who inject drugs (PWID), which present unique challenges to the care process. Untangling the complexity of care can be difficult due to interactions that occur between human and non-human elements including hospital systems, policy, technology, time, and space. The purpose of this study was to explore relations between social and material elements within the acute care environment, to better understand how care is enacted and to identify novel approaches for improvement. Data collection and analysis utilized a practice-based approach informed by constructivist grounded theory and sociomaterial perspectives, which emphasized relationships between human and non-human elements. Data included observational field notes, interviews, and artifacts from 154 hours spent on acute medicine units of two hospitals in an urban setting in Ontario, Canada. Findings revealed that differing expectations, strained conversations, and various policies assembled to produce misalignments in care. Such misalignments included mistrust, suboptimal pain and withdrawal management, and frequent patient absences and/or discharge against medical advice. Care misaligned in ways that reflected both social and material elements, demonstrating a need for hospital staff and systems to challenge existing care models built around individual control and abstinence-informed practices.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".