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The authors developed and validated an algorithm using health administrative data to identify patients who are attached or uncertainly attached to a primary care provider (PCP) using patient responses to a survey conducted in Ontario, Canada.

The authors conducted a validation study using as a reference standard respondents to a community-based survey who indicated they did or did not have a PCP. The authors developed and tested health administrative algorithms against this reference standard. The authors calculated the sensitivity, specificity positive predictive value (PPV) and negative predictive value (NPV) on the final patient attachment algorithm. The authors then applied the attachment algorithm to the 2017 Ontario population.

The patient attachment algorithm had an excellent sensitivity (90.5%) and PPV (96.8%), though modest specificity (46.1%) and a low NPV (21.3%). This means that the algorithm assigned survey respondents as being attached to a PCP and when in fact they said they had a PCP, yet a significant proportion of those found to be uncertainly attached had indicated they did have a PCP. In 2017, most people in Ontario, Canada (85.4%) were attached to a PCP but 14.6% were uncertainly attached.

Administrative data for nurse practitioner's encounters and other interprofessional care providers are not currently available. The authors also cannot separately identify primary care visits conducted in walk in clinics using our health administrative data. Finally, the definition of hospital-based healthcare use did not include outpatient specialty care.

Uncertain attachment to a primary health care provider is a recurrent problem that results in inequitable access in health services delivery. Providing annual reports on uncertainly attached patients can help evaluate primary care system changes developed to improve access. This algorithm can be used by health care planners and policy makers to examine the geographic variability and time trends of the uncertainly attached population to inform the development of programs to improve primary care access.

As primary care is an essential component of a person's medical home, identifying regions or high need populations that have higher levels of uncertainly attached patients will help target programs to support their primary care access and needs. Furthermore, this approach will be useful in future research to determine the health impacts of uncertain attachment to primary care, especially in view of a growing body of the literature highlighting the importance of primary care continuity.

This patient attachment algorithm is the first to use existing health administrative data validated with responses from a patient survey. Using patient surveys alone to assess attachment levels is expensive and time consuming to complete. They can also be subject to poor response rates and recall bias. Utilizing existing health administrative data provides more accurate, timely estimates of patient attachment for everyone in the population.

This paper analyzes how information systems (IS) can serve as tools of neo-colonial control in offshore outsourcing of research and development work. It draws on critical work examining business and knowledge process outsourcing.

The paper reports an empirical study of how laboratory information management systems (LIMS) shape offshore outsourcing practices involving Western client firms and Indian contract research organizations (CROs) in the pharmaceutical industry. The study adopted a multi-actor perspective, involving interviews with representatives of Western clients, Indian CROs, system validation auditors, and software vendors. The analysis was iterative and interpretative, guided by postcolonial sensitivity to themes of power and control.

The study found that LIMS act as tools of neo-colonial control at three levels. As Western clients specify particular brands of LIMS, they create a hierarchy among local CROs and impact the development of the local LIMS industry. At inter-organizational level, LIMS shape relationships by allowing remote, real-time and retrospective surveillance of CROs’ work. At individual level, the ability of LIMS to support micro-modularizing of research leads to routinization of scientific discovery, negatively impacting scientists’ work satisfaction.

By examining multiple actors’ perceptions of IS, this paper looks beyond the rhetoric of system efficiency characteristic of most international business research. As it explores dynamics of power and control surrounding IS, it also questions the proposition that outsourcing of high-end work will move emerging economies upstream in the value chain.

Preservice teacher (PST) professional development programs are crucial for cultivating high-quality STEAM teachers of the future, significantly impacting the quality of regional STEAM education. The Guangdong-Hong Kong-Macao Greater Bay Area, as a region of cross-border cooperation, integrates the resources and advantages of Guangdong, Hong Kong, and Macao, possessing rich cultural heritage and innovative capabilities. Transdisciplinary Education for Cultural Inheritance (C-STEAM) is an effective approach to promoting educational collaboration within the Greater Bay Area, facilitating the integration of both technological and humanities education. This study aims to develop a Technology-Enabled University-School-Enterprise (T-USE) collaborative education model and implement it in the Greater Bay Area, to explore its role as a support mechanism in professional development and its impact on C-STEAM PSTs' professional capital.

Adopting a qualitative methodology, the study interviewed PSTs who participated in a C-STEAM teacher education course under the T-USE model. Thematic coding is used to analyze their knowledge acquisition, interaction benefits with community members, and autonomous thinking and decision-making in theoretical learning and teaching practice.

The findings show that the T-USE model significantly enhanced the PSTs' human capital, including teaching beliefs, knowledge, and skills. In terms of social capital, PSTs benefited from collaboration with PST groups, university teaching teams, in-service teachers, and enterprises, though challenges such as varying levels of expertise among in-service teachers and occasional technical instability emerged. For decisional capital, the T-USE model provided opportunities for autonomous thinking and promoted teaching judgment skills through real teaching challenges and scenarios. Reflective practice activities also supported PSTs' professional growth.

This study reveals the effectiveness and internal mechanism of the T-USE model in C-STEAM PST training, offering significant theoretical and practical references for future PST education.