Book: Knowledge and Action (open access)

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KNOWLEDGE	ACTION

Knowledge and Action

There are of course many types of knowledge. There must be if our muscles can also be said to have a 'memory'. Here I am referring to the cognitive phenomena of an individual's possession of knowledge and how this is elicited, assessed and expressed clinically, educationally and in our day-to-day experiencesl. Clearly knowledge is, or should be translated into practice with evidence in the actions that follow.

This new, open access book on "Knowledge and Action" is a valuable and timely arrival. Timely as chapter 12 - Semantic Knowledge, Domains of Meaning and Conceptual Spaces is by Prof. Peter Gärdenfors. It is already a year since the last Conceptual Spaces Workshop in Sweden.

There are also two chapters related to healthcare.

Part of the utility of Hodges' model lies in how it can encompass knowledge (in all its forms), action AND space, the latter is also a key focus of the text. In addition I often added the concepts of subjectivity and objectivity to posts. The quote below from the book which I am citing at length to retain the meaning is also interesting as it could apply to Hodges' model as a whole. Hodges' model is multicontextual and situated. In addition:

We might also say that healthcare is invariably intersubjective; into which the evidence-based ethos would have us inject the largest dose possible of objectivity through scientific and/or political means(?).

Please see the specific chapter for the references in what follows:

Current theories of practice constitute an effort to reformulate the Aristotelian conception of phronesis, which implies that practice is seen as the basis and purpose of theoretical knowledge (Flyvbjerg, 2001). That conception also implies an escape from the dualism of the subjective and objective (Bernstein, 1971; Stern, 2003, p. 185). Schatzki is seen as one of the leading thinkers in this approach, and he bases his practice theory on a new societal social ontology in which the dualism of ontological individualism and holism is overcome (Schatzki, 2006). He calls his new ontology site ontology, defining site as a type of context in which human coexistence takes place and which also includes the social entities themselves. Social events can thus be understood only through an analysis of this site. The close relationship between this concept of site and the geographic concept of place^# (Tuan, 2001) is evident:  

    Practice theory places practices at the center of the socio-human sciences instead of traditional structures, systems, events, actions. None of the practices can be reduced to a sum of its elements, which are of a complex character: they are mental and material, factual and relational, human and material, individual and supra-individual, etc. This conception also overcomes the dualism action/structure, … Each practice then operates in a typical regime, according to particular scenarios, it has its inherent normativity, etc. (Višňovský, 2009, p.391).

As an open access text this is valuable source, which I will revisit again soon.

Huib Ernste (2017) Rationality and Discursive Articulation in Place-Making. Chapter 3. In Knowledge and Action. editors: Peter Meusburger, Benno Werlen, Laura Suarsana. Vol 9. Online: Springer (Open) International Publishing.

^# I have wondered about this combination of cognition and geography -
https://hodges-model.blogspot.co.uk/search/label/cogneography
There is existing work on 'psychogeography' post to follow.

My source for this book with thanks: Library | Lancaster University

A primitive Pythagorean triple

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	Today's date is a primitive Pythagorean triple. pic.twitter.com/2j0BAwUtkS — Algebra Fact (@AlgebraFact) August 15, 2017

Happy 40th to me #NHS!

Fences too far? Prevention, Health Education and Promotion

On my community visits I see many horses out in the fields. There are 'horses' in information systems too:

What are "horses"?

“As an intentional nod to Clever Hans, a 'horse' is just a system that is not actually addressing the problem it appears to be solving.” (Sturm, 2014).

In healthcare we keep talking about the need for more emphasis on prevention, health education and promotion. So much of what we do is not futile, despite the growing^* debate on euthanasia, but as a 'system' that incorporates and enacts prevention, health education and health promoting principles (and literacies) we continue to fail. In short, the healthcare system is a horse as defined by Sturm.

I'm certain - even without evidence (intuition influenced by the quality^# media?) that public health AND public mental health have been going backwards. Or if you like, the politicians keep talking the talk but this is limited to the political domain (or paddock)? So many promises in the form of committees, consultations, green, white papers that could be betting slips. In fact the government seems to favour those betting slips or the associated behaviours that produce tax revenue as opposed to the 25 year cross-party plan that would really herald change. This level of change will take longer and would be realised in younger people. Perhaps there are signs of change as many young adults eschew drugs and alcohol (UK)..?

There are two ways in which Hodges' model is a horse; or not:

1. Firstly, there is (still) no information system based on Hodges' model that might appear to be solving a problem.
2. Secondly, Hodges' model has not really had the opportunity to address the health and social care problem. As such it cannot be judged in such equestrian terms.

In the meantime the horses remain in their respective paddocks. Some are racing about, others jumping, a group do dressage, while increasing others are out to pasture - they graze and neigh-say (everything is fine DO carry on)!

^*Whatever one's respective views this debate will grow - a consequence of demographics driven through the heart of the political divide.
^#A sticky wicket then?

B. L. Sturm, “A simple method to determine if a music information retrieval system is a 'horse',” IEEE Trans. Multimedia 16(6):1636–1644, 2014. Winner of the 2017 IEEE Transactions on Multimedia Prize Paper Award.

My source: B. L. Sturm email to: http://digitalhumanities.org/humanist

HORSE2017

On “Horses” in Applied Machine Learning

Research workshop, QMUL, London

Wednesday 20 September 2017, approx. 9h30-17h 

Location: Arts One Lecture Theatre, QMUL, London E1 4NS

http://c4dm.eecs.qmul.ac.uk/horse2017/

Planetarium, Mercury

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My source: The Times, June 9 2017, p.13.

Book: A Mind at Play

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A MIND AT PLAY	A MIND AT PLAY

I still have a collection of articles on information and information theory saved from old magazines, such as, PC World, Practical Computing, PC Magazine (British), PCW and Byte. I've some specific books too that might form a collection of sorts, once they gathered together and sorted. Maths helps, but you don't need a high level of math ability to grasp the basics. It is a fascinating field and now with quantum computing, AI ... the future isn't just beckoning we're caught in its tenacious gravity field - especially as we get older!

I still have the aspiration to write a follow-up to the paper below, combining information, health and complexity. Meanwhile this book looks good summer reading...

Jones, P. (1996) Humans, Information, and Science, Journal of Advanced Nursing, 24(3),591-598.


Image: Simon and Schuster = A Mind at Play

An Inconvenient Sequel: Truth To Power

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c/o BBC Radio 4 & Facts4Life - Balance Ball

The following is taken from the transcript of the BBC Radio 4 programme "Inside Health" which I heard today and an image from the resources of Facts4Life which featured as an item.

I have always wondered what is the youngest age at which Hodges' model might be taught. I have noted before how the model can be used implicitly - guiding the professional - or explicitly with the patient or group having insight into the model. The approach of Facts4Life is well worth publicising in the ability and intelligence that children can and should be credited with ...

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... We might have somebody else who’s representing emotions, you say oh I’m feeling a bit sad and grumpy, so their hand might come off.  As each hand comes off whilst the body or the ball wobbles it doesn’t actually fall but as more and more compromises are made, there’s more and more problems to encounter, then it could get to the point where they drop the ball altogether.  And that could be oh perhaps we need a bit of help here, what could we do to help get this body back in balance. ... Green

Around year three we’ll say okay homeostasis we can explain it by using a balance ball.  So a balance ball like a yoga ball.  And the ball represents the body and then we talk to the children about how an illness might look. ... Green  Traditionally there’s been a lot of focus around very black and white concepts that you have good drugs and bad drugs.  Adults tend to make things black and white because they think that’s simplifying things and actually children are really good at grappling with big ideas. Green

Facts4Life

Do you think historically that we have been too black and white then, that we’ve sort of had health in one pocket and illness in another and never the twain shall meet? Porter I do, as a profession yes and as a society there is at the moment an easy contract between the population, as it were, and the health professionals and the contract is that whatever’s wrong with people we will deliver a solution. Toft

I also note on Facts4Life's website, the audiences they are appealing to. I see Hodges' model as being applicable to:

Students - Learners (the research community)
Carers - members of the public
Teachers - Lecturers
Policy makers and Managers

So, if you need a conceptual balance ball: here + catch!

@Facts4Life
Inside Health - BBC Radio 4

How do you define person-centredness? Editorial c/o Dewing & McCormack

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Individual values, choices and preferences* What matters to the patient. person-centredness = hard to define? compassion (the 6Cs) PERSON-	"We believe that a focus on person-centredness provides an opportunity for nursing to rise above particular theoretical 'fan clubs' and work within a coherent set of principles that are multivariate, context nonspecific and trans-specialist." Dewing & McCormack (2017). measures?
measures? A certain type (quality) of nurse-patient relationship Community of Practice Culture - isolating?	-CENTREDNESS *You can - as a nurse - ask the questions about the above, but how you advocate, realise this in nursing is very complex and challenging. policy Services (workplace)? Organisational memory=Organisational respect?

"An example is needed and will be provided next. The intention is to demonstrate the potential utility of Hodges' model to conjoin ipseity, that is; the self, individual identity and personhood with the group and population. Further studies will seek to establish how Hodges’ model can be used in case formulation not just at an individual level – were social factors inform assessments and evaluations – but in community and global health development. Hodges’ model is further suited to this task as the model supports precontextualisation by helping us to anticipate the future and recontextualization in seeking to make sense of the past. Overarching this temporal dimension is the fact that Hodges’ model by being so general and independent of any particular discipline the model is transtheoretical. There is no single theory that can explain, predict or account for the validity of Hodges’ model."
[Draft notes for an editorial that might follow? PJ ]

As the editorial describes, amid women-centred, child-centred and family centred care in Hodges' model we can place whatever the situation, or context demands at the center of Hodges' model and thereby at the focus of our care deliberations whether reflective, theoretical or practice based.

My source:

Tell me, how do you define person-centredness? https://t.co/T9fh7h3cpY @ProfBrendan @JanDewing @jclinnursing @OxINMAHR @ppr

— Prof Debra Jackson (@debraejackson) August 4, 2017

http://onlinelibrary.wiley.com/doi/10.1111/jocn.13681/epdf

Dewing, J. and McCormack, B. (2017), Editorial: Tell me, how do you define person-centredness?. J Clin Nurs, 26: 2509–2510. doi:10.1111/jocn.13681

Nurses ... console, console, yes; but don't become one ...

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subjective	console noun ​ a surface on which you find the controls for a piece of electrical equipment or a machine: a gaming console
console verb ​ to make someone who is sad or disappointed feel better by giving them comfort or sympathy: He tried to console her, but she kept saying it was all her own fault. I tried to console her with a box of chocolates. I was consoling Liz on having broken up with her boyfriend.	objective [ political objectives? ]

My source:
Whiston Hospital: Accident & Emergency & Resus, Laminated FLACC.
Face, Legs, Activity, Cry and Consolability scale for assessing pain in infants and children

See also:
Crellin D.J., Harrison, D., Santamaria, N, & Babl, F.E. (2015). Systematic review of the Face, Legs, Activity, Cry and Consolability scale for assessing pain in infants and children: is it reliable, valid, and feasible for use? Pain. Nov;156(11):2132-51. doi: 10.1097/j.pain.0000000000000305.

Dictionary entries:
http://dictionary.cambridge.org/dictionary/english/console

Thought, Formulation, Thresholds and Coherence

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"The paradigms that guide our clinical thinking are necessary. They afford us, at a minimum, the comfort (and the benefits) of being in error, rather than thrashing about in confusion. And .... they provide us with the necessary consistency, coherence and vision. ...."  (Dumont, 1993, p. 203)	Dumont: "All that is visible must grow beyond itself, and extend into the realm of the invisible." TRON
Or: "All that is invisible must grow beyond itself, and extend into the realm of the visible."

Dumont, F. (1993). Inferential heuristics in clinical problem formulation: Selective review of their strengths and weaknesses. Professional Psychology: Research and Practice, 24, 196–205.

Dumont is cited in:

Vertue, F., & Haig, B. (2008). An abductive perspective on clinical reasoning and case formulation. Journal of Clinical Psychology, 64(9), 1046-68.

Student? Leaving school or college soon?

How will you apply yourself?

What about a career in which you can truly apply your skills, knowledge and self?

What about...

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applied psychology	applied human biology
applied sociology (working with people)	applied politics

...applied nursing?

As you align your career with a patient's health career you can make a real difference.

There is a bonus too: you can also help transform nursing and other health disciplines to prevent the patient exercising their health career and were needed staying as well as they possibly can.

Yes, given the public (mental) health situation there's a lot of irony in that, but it is ironic in being of  extreme importance in the 21st Century as new entrants, like you, join higher education and the workforce to begin - exercise ;-) your career. Amid demographic change, increased use of technology, genetics, robotics and other challenges nursing must adapt, innovate, improve the quality of care and the public's safety. A career full of challenges - there must be some longevity in that too!

Health careers - nursing NHS

Hughes, E. (1958) Men and their work. New York: Free Press. (Hughes was used by Brian Hodges to define ‘health career’ the idea of life chances.)

No Body... No Mind...

Hodges' model: an open conceptual space for the naive beginner and expert alike...

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NO BODY...!?	NO MIND...!?

"I also find it helpful to be both expert and naive. Following Shunryu Suzuki’s saying, “in the beginner’s mind there are many possibilities; in the expert’s mind there are few,” I find it helpful to approach each client with an attitude of “we don’t really know anything about this, let’s explore it together.” On the other hand, clients expect (and have a right to expect) some level of expertise and the fact as clinicians is we do have a body of knowledge which is valuable. By being both “expert and naive,” simultaneously teacher and student, we can model a kind of being-with-a-problem, which is most paradoxical but most essential: I (and you) are both healthy and ill, distressed and just fine." p.23.

Rosenbaum, R., & Shahar, Golan. (2012). Thoughts on Mrs. T: No Body, No Mind. Journal of Psychotherapy Integration, 22(1), 19-26.

Invitation to join HIFA - Healthcare Information For All

Dear Welcome to the QUAD reader

I would like to invite you to join HIFA. HIFA (Healthcare Information For All) is a growing global health movement working in collaboration with WHO Geneva and supported by around 300 health and development organisations. HIFA has more than 16,000 members (health workers, librarians, publishers, researchers, policymakers and others) committed to the progressive realisation of a world where every person has access to the information they need to protect their own health and the health of others. We have about 5000 members in Africa, 5000 in Europe, and 6000 in the rest of the world, across 177 countries. We interact on five forums in three languages (English, French, and Portuguese). HIFA members have experience and knowledge which they can use to bring clarity to challenging questions around global health issues in general and healthcare information issues in particular. Our website is www.hifa.org and membership is free! Join here: www.hifa.org/joinhifa

Many thanks,
Peter Jones

If you use Facebook or Twitter, please spread the word. The HIFA Twitter handle is @hifa_org (with thanks to our HIFA twitter coordinator Jules Storr) and the HIFA Facebook page is https://www.facebook.com/HIFAdotORG/ (with thanks to HIFA Facebook coordinator Tara Ballav Adhikari)

You can also point people to our latest HIFA Annual Review:
http://www.hifa.org/sites/default/files/other_publications_uploads/HIFA_Annual_Review_2016.pdf

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA: www.hifa.org

My source: Neil Pakenham-Walsh - coordinator of HIFA

Advertising: The air that we breathe; or don't?

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Mental Pollution Adbusters	Unbranded Advertising Unbranded advertising of prescription medicines to the public by pharmaceutical companies (Protocol)
Health - Literacy?	Digital Ad# Fraud False / Fake Ads

Hodges' model makes explicit the divide between the public and the public's understanding of science.

Consider here the increased noise in advertising channels since the millennium as the media multiply, in addition to false advertising the rise of fake ads. Fake ads for jobs, drugs, goods and a littering of click-bait. Contactless plastic that touches the deepest oceans. Consumerism has become post-truth as any sense of 'standards' are undermined on several fronts.

The overlaps and increased complexity then become apparent.

^# 'information'?

n.b. If I recall the source for the paper I will add it here!

TOILET: Ek Prem Katha

When a love story = Hygiene and Safety

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belief hygiene	personal hygiene = public health & safety
	political hygiene

"Get in that corner! Now!"

"Which one?"

"Don't you be so hard-faced with me.
Go!"

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anxiety fear guilt hate	here - out of sight out of reach - over here this corner: out of earshot that corner
shame ridicule embarassment  alienation	bullying - abuse punishment injustice deportation

The harmony of opposites: to relativize the continuous / discontinuous dualism by Michel Lussault

"If we accept a somewhat schematic presentation, we can estimate that the modern Western knowledge system has been deployed on the basis of opposition couples conceived as expressing unquestionable dualities. These couples organized thought, all its activities, under all its regimes including the knowledge of expertise and the knowledge of common sense, and they constituted a kind of cognitive dogmatics; That is to say, they made it possible to define the very relevance of the problems that could be posed. From these dualities, and for a long time from these dualities alone, it has been permitted and legitimate to pose a number of social, political and cultural problems and then to find ways of solving these problems. In view of our integration into the cultural space of the modern West, we all know and experience the prevalence of these antagonistic duos which have structured the thought and continue, albeit in a somewhat more discreet way, -tender." *

Google translation French to English from:

LUSSAULT, Michel. L’harmonie des contraires : pour relativiser le dualisme continu/discontinu In: Continu et discontinu dans l’espace géographique [online]. Tours: Presses universitaires François-Rabelais, 2008 (generated 22 July 2017). Available on the Internet: <http://books.openedition.org/pufr/2398>. ISBN: 9782869063198. DOI: 10.4000/books.pufr.2398.

Original:

"On peut estimer, si l’on accepte une présentation un peu schématique, que le système de connaissance moderne occidental s’est déployé à partir du fondement constitué par des couples d’opposition conçus comme exprimant des dualités incontestables. Ces couples ont organisé la pensée, toutes ses activités, sous tous ses régimes y compris les savoirs d’expertise et les savoirs du sens commun, et ils ont constitué une sorte de dogmatique cognitive ; c’est-à-dire qu’ils ont permis de définir la pertinence même des problèmes qui pouvaient être posés. À partir de ces dualités, et pendant longtemps de ces dualités seulement, il a été autorisé et légitime de poser un certain nombre de problèmes sociaux, politiques, culturels et de trouver ensuite des modes de résolution de ces problèmes. Nous connaissons et éprouvons tous encore, compte tenu de notre insertion dans l’espace culturel de l’Occident moderne, la prégnance de ces duos antagonistes qui ont structuré la pensée et continuent, fût-ce de façon un peu plus discrète, de la sous-tendre."

* sous-tendre - 'to underlie it'?

Bliss + Symbols = Language for Care?

As I have written before on W2tQ the initial attraction of Hodges' model was its relation to brainstorming, mind-mapping, diagrams and the possibility of iconic languages. In addition, in the 1980s graphical user interfaces GUIs were introduced on microcomputers and PCs. There followed a rapidly expanding literature on icons, visual languages and interfaces. I had also heard of a Charles Bliss [ Charles K. Bliss (1897-1985) ] and Bliss Symbolics. So, to brainstorming ... we can add ideographs and pictographs.

This past week BBC Radio 4 explored the life and work of Charles Bliss and the application of Bliss in literacy, care and special needs education. The programme presented by Michael Symmons Roberts is available for 4 weeks. For its 30 minutes length the programme introduces Bliss himself, his life, aims, the challenges he and his wife faced and the ongoing legacy of his work. It could be argued - and has been - that this is a step backwards to hieroglyphs; but the programme is broader in its reference to 'care'...

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'bliss'	Wikipedia - Portal:Constructed languages
BBC Radio 4 The Symbols of Bliss	Ideal of Universal - International Languages

In the 1990s I received some copies of a journal devoted to 'Unish' a constructed language. The link to unish.net does not seem to work, but the Wikipedia site below includes some details.

New paper for h2cm bibliography "Better palliative care for people with a dementia..."

There is a new paper I have been able to add to the bibliography in the side bar. Here is the abstract and reference with a link. I will post about this again next month, teasing out points relevant to what is a very important combination of care needs and Hodges' model.

Better palliative care for people with a dementia: summary of interdisciplinary workshop highlighting current gaps and recommendations for future research

Abstract

Background
Dementia is the most common neurological disorder worldwide and is a life-limiting condition, but very often is not recognised as such. People with dementia, and their carers, have been shown to have palliative care needs equal in extent to those of cancer patients. However, many people with advanced dementia are not routinely being assessed to determine their palliative care needs, and it is not clear why this is so.

Main body
An interdisciplinary workshop on “Palliative Care in Neurodegeneration, with a focus on Dementia”, was held in Cork, Ireland, in May 2016. The key aim of this workshop was to discuss the evidence base for palliative care for people with dementia, to identify ‘gaps’ for clinical research, and to make recommendations for interdisciplinary research practice. To lead the discussion throughout the day a multidisciplinary panel of expert speakers were brought together, including both researchers and clinicians from across Ireland and the UK. Targeted invitations were sent to attendees ensuring all key stakeholders were present to contribute to discussions. In total, 49 experts representing 17 different academic and practice settings, attended.

Key topics for discussion were pre-selected based on previously identified research priorities (e.g. James Lind Alliance) and stakeholder input. Key discussion topics included: i. Advance Care Planning for people with Dementia; ii. Personhood in End-of-life Dementia care; iii. Topics in the care of advanced dementia at home. These topics were used as a starting point, and the ethos of the workshop was that the attendees could stimulate discussion and debate in any relevant area, not just the key topics, summarised under iv. Other priorities.

Conclusions
The care experienced by people with dementia and their families has the potential to be improved; palliative care frameworks may have much to offer in this endeavour. However, a solid evidence base is required to translate palliative care into practice in the context of dementia. This paper presents suggested research priorities as a starting point to build this evidence base. An interdisciplinary approach to research and priority setting is essential to develop actionable knowledge in this area.

Keywords
Dementia Neurodegenerative diseases Interdisciplinary research Research priorities Advance care planning Personhood Care at home

Fox, S., FitzGerald, C., Harrison Dening, K., Irving, K., Kernohan, W.G., Treloar, A., Oliver, D., Guerin, S., Timmons, S., (2017). Better palliative care for people with a dementia: summary of interdisciplinary workshop highlighting current gaps and recommendations for future research. BMC Palliative Care 17, 9. doi:10.1186/s12904-017-0221-0 

Special Issue of Learning Health Systems: “Patient Empowerment and the Learning Health System”

New research available now!

Learning Health Systems

Learning Health Systems

Don’t miss the new Special Issue of  Learning Health Systems Guest Edited by Joshua C. Rubin

“Patient Empowerment and the Learning Health System” explores the influence of patient engagement on the development of a Learning Health System. Learning Health Systems is a peer-reviewed, open access journal dedicated to the science, engineering and design of continuous improvement of health and health care. All articles in the new Special Issue are accessible free of charge.

Inside the New Issue

Patient Empowerment and the Learning Health System
Joshua C. Rubin

Building a learning health community: By the people, for the people
Sally Okun and Kim Goodwin

Advancing the science of patient input throughout the regulatory decision-making process
Million Tegenge et al.

Diverging views on health information exchange organizations
Mari F. Greenberger et al.

Patient-centered drug development and the Learning Health System 
Laura S. Crawford et al.

Developing a framework for integrating health equity into the learning health system
Danielle Brooks et al.

My source: 
A request from -

Kathleen Young

Editorial Assistant, Learning Health Systems

Room 210 Victor Vaughan

1111 East Catherine Street

Ann Arbor, MI 48109

(This...) Peter Jones: At last I'm making an academic impact!

(Northern) Summer Silly Season starts here...?

----- Forwarded Message -----
From: Academia.edu
To: h2cmng@yahoo.co.uk
Sent: Wednesday, 19 July 2017, 3:43
Subject: 697 people recently read a paper you are mentioned in

Dear Peter Jones,

697 people recently read one of the papers that mentions the name "Peter Jones".

A total of 709 papers on Academia mention your name.


Clicking through the link provided (the underline is mine):

MENTIONS

709 papers mention the name "Peter Jones"

Receive real time notifications whenever a new paper mentions you and see every paper that mentions your name.

<>

Vain and the constant grandstander that I am, I did not explore further.

There's a big difference between 'me' as an individual and the name "Peter Jones". While naming conventions vary across the world and according to customs and cultures I have a given name and a family name. Jones, like Smith is a pretty big family.

This 'Peter Jones' does not own a helicopter and with it many millions. [Although while 'rich' in many respects - a pay rise is greatly needed for the NHS.] Neither, have I provided the voice for 'The Book' in the TV version of Hitchhiker's Guide to the Universe.

You would think that Academia.edu would recognise the principles at work here. 'Scraping' the web is one thing, this is another...

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Peter	Dragon's Den + Helicopter THE BOOK
Jones	Political news silly season - is during the 'summer' or all year long...?

Relativistic - Thinking checks and balances [V]

Effective nurses aspire to be time travellers.

Why should flash traders have all the adventure?

They also need to think relatively and be relativistic thinkers, the latter as described by Johnson (1994). If this sounds like faster than light travel in a sense it is, or at least it should seem like. Meeting the patient as they or someone reaches for the phone to seek help: is obviously taking the anticipation of care needs to the relativistic extreme - so what is this about?

This page at JHU "Perry’s Scheme – Understanding the Intellectual Development of College-Age Students" lists how Perry's formulation is reduced from nine to four levels of development:

1. Dualism – knowledge is received, not questioned; students feel there is a correct answer to be learned.
2. Multiplicity – there may be more than one solution to a problem, or there may be no solution; students recognize that their opinions matter.
3. Relativism – knowledge is seen as contextual; students evaluate viewpoints based on source and evidence, and even experts are subject to scrutiny.
4. Commitment within relativism – integration of knowledge from other sources with personal experience and reflection; students make commitment to values that matter to them and learn to take responsibility for committed beliefs. There is recognition that the acquisition of knowledge is ongoing activity.

Previous posts from January 2016 - with links supplied below - have reflected on dualistic and multiplistic thinking. I'm still exploring how work in educational psychology might inform my own. Picking up this thread again how does Hodges' model engender and contribute to relativistic thinking? Relativistic thinking as relates to Hodges' model is about a journey and not just one as item #3 above suggests. The student's journey may fly-by in time, but it is long and quite dense. Learners must negotiate lectures, self-study, simulation, patient, carers and public encounters, learning journals, clinical placements, assessed work and assessments, student-mentor sessions and all that the curriculum entails. Within the student's career there are innumerable situations and contexts if we cared to count them.

Responding to #3 Hodges' model can encourage immersion in a given context that presents a learning opportunity. They can also evaluate the situation as the care domains provide an epistemological platform from which to take in viewpoints and in the care domains scrutinize the knowledge that is shared and found through study. This includes the knowledge of experts. Whatever the care domain as a platform and viewport the student finds themselves in they should find a tendency to anticipate the other vistas nearby. Not only that but cognitively if not literally the patient and family when relevant can be with them. For person-centred care isn't just a matter of what is relativistic, but quantum too. 'Where' the patient is: so we are too.

Johnson, D.D. (1994). Dualistic, Multiplistic, and Relativistic Thinking as it Relates to a Psychology Major. Honors Theses. Paper 202.
http://opensiuc.lib.siu.edu/uhp_theses/202/

See also:
William Perry's Scheme of Intellectual and Ethical Development
A journey along the 9 "Perry" positions (as modified by Belenky et al. 1986) by William J. Rapaport

Thinking checks and balances [I]

Dualistic- thinking checks and balances [II]

Dualistic- thinking checks and balances [III] (or: The-hyphen)

Multiplistic - Thinking checks and balances [IV]

How Do I Give Bad News? c/o HospiceFoundation.ie

individual

|

INTERPERSONAL : SCIENCES

humanistic -------------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

|

group-population

Level of knowledge and understanding empathy and rapport self-care Losses ... many forms ... shattered hopes, dreams, aspirations patient's reaction - anger, anxiety, blame, shock, helplessness, misinterpretation Acknowledge reaction diffusing anger... Respect denial of bad news awareness - understanding vulnerability It is good to use non-verbal cues to  convey warmth, sympathy,  encouragement or reassurance  to the patient. p.10. Bad news = information that affects the individual's identity - very existence -

Correct patient and family Plans to give - convey bad news - Multidisciplinary Team informed Records Telephone Bad news = information that affects the individual's future When to inform? As soon as information is known. Ensure environment - time protected, no interruptions, mobile phones ... At bedside, curtains closed, eye-level, volume of voice, deafness? Proceed at person's pace Give information in chunks Be prepared to 'fire warning shot' - 'telegraph' what may follow Diagnosis FUTURE prognosis Time and 'space' often need to be created and then protected (respected)

or that of a loved one. shock of others - family and risk of being overheard awareness - understanding social support strengths Shared resilience with acceptance A standard to use: If the person was my relative would I  have been happy with how the  news was given? p.6. How Do I Give Bad News? CULTURE & LANGUAGE INTERPRETER SERVICES

Sick child? p.16. Sudden death? p.20. Age of consent - 16 years old - 18? Right to: accurate and true information receive or not receive information decide how much information decide who should be present at consultations decide who should be informed about their diagnosis and what information they should receive Under no circumstances should you hand over personal belongings in a plastic bag. p.23.

Source:
http://hospicefoundation.ie
http://hospicefoundation.ie/wp-content/uploads/2013/04/How-Do-I-Break-Bad-News.pdf

c/o Marschalek (2017) Public Engagement in Responsible Research and Innovation

This blog often features EU research initiatives and conferences and a European project (2014-2016) to build a Responsible Research and Innovation (RRI) Toolkit also has a conference series and various publications. Marschalek's dissertation is a invaluable resource on RRI, drawing on the need for reflection, reflexivity, critical thinking and highlighting many models within sciences and participative methods. Reading the following you will hopefully glean the basis for my interest in the document and what might follow the project overall.

1.2 The Relevance of (Self-)Reflection and Reflexivity  

Scientists are not typically asked to anticipate future societal effects of their work. ...  

... But reflections, particularly on non-intended effects, are rarely undertaken. Reflection is not (yet) viewed as an integral part of scientific work. Many other more important issues need to be addressed within a scientific career. ...  

... Studies like this and others have revealed that researchers are rarely encouraged to self-reflect. ... 

... What is needed is to »step into the helicopter« (Schuurbiers, 2011, p. 784) to look at one’s own work from a distance. A look from the outside and feedback also help reflection. »Researchers are not accustomed to viewing their decisions from a normative perspective or discussing the normative aspects of decisions explicitly. ... 

... Unfortunately, not many reflection tools are available as yet. Quality standards and codes of conduct should »stimulate the reflection of the relation between one’s own values and that of external parties« (Asveld, Ganzevles & Osseweijer, 2015, p. 585) and there are self-reflection initiatives to motivate individuals to reflect on the impact of their work, e.g. a »Hippocratic Oath for individual scientists« (Sutcliffe, 2011), but even fewer ask organisations for self-reflection. Marschalek (2017) pp.15-16.

Marschalek, Ilse. (2017). Public Engagement in Responsible Research and Innovation.
A Critical Reflection from the Practitioner’s Point of View. University of Vienna, Vienna.
https://www.zsi.at/object/publication/4498/attach/Marschalek_Public_Engagement_in_RRI.pdf


My source and with thanks:
International Science Shop Contact Point
Norbert Steinhaus
Wissenschaftsladen Bonn - Bonn Science Shop
Reuterstr. 157 - 53113 Bonn – Germany

skype: wilabonn
Twitter: @ScienceShops
facebook: www.facebook.com/livingknowledge

Living Knowledge: Building partnerships for public access to research
www.livingknowledge.org

Responsible Research & Innovation: RRI Tools
www.rri-tools.eu
www.facebook.com/RRI.Tools.Project
Twitter: @RRITools