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What is the main argument, narrative and effect of this text?

margauxf

The authors review literature on the datafication of health, which they identify as the way through which health has been quantified on a number of different scales and registers. They focus primarily on the datafication of health in clinical health care and self-care practices, rather than medical research and public health infrastructures. From this literature, they identify three key themes: datafied power (the ways through which data permeates and exerts power over forms of life), living with data (focused on datafication as an intimate form of surveillance, and a technology of the self), and data-human mediations (which emphasizes the nonhuman elements mediating datafication dynamics and experiences—such as algorithms, data infrastructure and data itself).

 

In examining literature on datafied power, the authors acknowledge a lack of scholarship on understanding data and datafication in terms agency, rather than simply power and domination. For instance, data is sometimes mobilized in “creative and even pioneering ways (Rapp 2016)” (265).

 

They describe literature on “living with data” as increasingly focus examining the social, narrative, and affective dimensions of data practices and experiences (e.g. work on the “Quantified Self,” a group seeking self-knowledge through numbers – a form of relationality that might be described as datasociality). Some scholars have argued that data can render “‘feelings and problems more tangible and comparable” (Sharon & Zandbergen 2016, p. 11)” (267). Some have also acknowledged as well a “curious resonance between the vision of empowered, resisting individuals that many ethnographers of self-tracking celebrate, and the rhetoric of consumer empowerment found in discourses of digital health (Schull 2017, Sharon 2017)” (267).

 

The literature on data-human mediations emphasizes the agency, liveliness and/or performativity of nonhuman elements—essentially, how they structure and shape the possibilities for action. For instance: “as social expectations of normality and health become embedded in tracking devices’ target numbers, presentation of scores, and gamified incentives (Depper & Howe 2017, Whitson 2013), a “numerical ontology” comes to suffuse everyday practices and “the ways in which people relate to their own bodies” (Oxlund 2012, p. 53; see also Jethani 2015, p. 40)” (269). Perspectives and action can be enabled or disabled by wide variety of factors: the design and performativity of data technology software (user interface, operational and analytical algorithms), hardware (devices, sensors), data itself (as illustrated in different ways), and data infrastructures (labs, data centers, serve and cloud storage, and networks that organize how data is stored and circulated). An analytically constructive focus in this literature has emerged by applying the concept of “assemblage” as a way of tracing how data moves: “where it flows, where it finds impasses, how algorithms act on it along the way” (270).

 

Lastly, the authors identify scholarship on “data activism” as an emerging focus on exploring how data technology capacities might be employed to promote social justice, collective action, and political participation, as well as to challenged dominant norms and ideologies: “Individual self-tracking data, for instance, can have social and political potential when it is pooled to identify health inequalities, collective environmental exposure, or disparities in quality of life (Gabrys 2014).” (271)

 

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Sara.Till

This organization seeks to provide emergency medical services to community members of Bed-Stuy, an area seeing disproportionate levels of physical violence and trauma. Before BSVAC the average ambulatory response time to the city was approximately 30 minutes, gravely eating into the "Golden hour" trauma patients are allowed. In light of this, two EMS workers chose to start a volunteer EMS agency to provide emergency care to the city, expose community members to careers in EMS, and teach BLS skills to residents. 

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Sara.Till

The founding members were Bed-Stuy residents Captain James "Rocky" Robinson and Specialist Joe Perez. Since then, membership has extended to other EMS personnel, the majority of whom are also Bed-Stuy residents. This is also the first multi-cultural ambulatory agency and seeks to provide meaningful careers to Bed-Stuy residents

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Sara.Till

The agency itself is an illustration of emergency response; before BSVAC ambulance response time averaged around thirty minutes-- a far cry from the standard eight minutes aimed for by ambulatory agencies around the Capital region. The original goal of BSVAC was to cut down these times, thereby increasing patient outcomes and creating a sense of safety in a community rippling with gang and drug violence. In addition to this initial goal, BSVAC also reaches out to the surrounding community, teaching CPR, first-aid, and BLS to Bed-Stuy residents. This aids in emergency response, as CPR and first-aid measures can be delivered quickly to a patient even before the ambulance arrives. 

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Sara.Till

The organization of the group came from within the areas riddled with violence. As their commander is quoted in an article about the 27th anniversary, "People in the 'hood' had no chance. We had to wait for someone who did not look like us to come and save our lives." Commander Robinson is credited with starting the organization in an attempt to decrease wait times for emergency services in Bed-Stuy. Additionally, he and other ambulatory members regularly run EMT courses, aimed at pulling youth away from drug and gang related activities, providing them with an education and a future career. The agency, in many ways, has helped save multiple community members from a short and terrible life marked by violence.

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Sara.Till

As I mentioned in earlier answers, at the peak of the crack-cocaine epidemic, BSVAC was founded (1988). It took outside EMS agencies an average of 30 minutes to reach patients with Bed-Stuy, a time that is far too costly for major trauma patients. This causes the current Commander (formerly referred to as Captain) "Rocky" Robinson to begin a volunteer EMS agency within the city itself. Placing the agency in the city decreased response time significantly, with BSVAC now averaging a response time of less than 4 minutes. 

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Sara.Till

Currently, BSVAC survives on state and community funding. However, as recently as 2014 the agency was being funded by the Commander's pension and funds from re-mortgaging his home. At present time, BSVAC has also received a check from Councilman Cornegy for their timely, professional response to violent crimes involving police officers and for general service to the community. As it stands, BSVAC runs on a budget of approximately 250,000 per year, mostly through donations and legislative grants. 

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Sara.Till

This group has yet to produce a published report; however, they openly provide data about their response time-- which averages less than 4 minutes. This is a significant decrease from outside ambulatory agencies. Additionally, state statistics can be extrapolated to the group, such as noting that the vast majority of homicides still occur with Bed-Stuy, leading to their approximately 100 calls per month. 

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Sara.Till

At this time, the group does not appear to have drawn any significant research nor produced any. I would be intrigued to see if medical personnel (such as emergency medicine residents doing their research fellowships) would have any interest in the group, their call volume, and patient outcomes.

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Sara.Till

As an ambulatory agency, BSVAC obviously utilizes the typical EMS technologies, such as oxygen, BVM, ambulance, pulse oximetry, ect. However, it should be noted at the time of publication (2014), an article by the New York Times describing BSVAC's economic struggles, only 1 of the 6 functional rigs could be used due to lack of funding. At the time of the article, this rig had broken down-- and only through the volunteer maintenance by an EMT student's father had it been returned to commission. This leads me to believe that well BSVAC has all the available technologies, these may be dated or somewhat worn in nature.