A paper by Anzures-Cabrera & Higgins, Graphical displays for meta-analysis: An overview with suggestions for practice

The interesting paper below is currently available online:

Graphical displays for meta-analysis: An overview with suggestions for practice,
Judith Anzures-Cabrera, Julian P. T. Higgins

Keywords: meta-analysis • graphical displays • forest plot • funnel plot • Galbraith plot • L'Abbe plot

Abstract:

Meta-analyses are fundamental tools for collating and synthesizing large amounts of information, and graphical displays have become the principal tool for presenting the results of multiple studies of the same research question. We review standard and proposed graphical displays for presentation of meta-analytic data, and offer our recommendations on how they might be presented to provide the most useful and user-friendly illustrations. We concentrate on graphs that specifically aim to present similar sorts of univariate results from multiple studies. We start with forest plots and funnel plots, and proceed to Galbraith (or radial) plots, L'Abbé (and related) plots, further plots useful for investigating heterogeneity, plots useful for model diagnostics and plots for illustrating likelihoods and Bayesian meta-analyses.

Judith Anzures-Cabrera, Julian P. T. Higgins (2010) Graphical displays for meta-analysis: An overview with suggestions for practice, Research Synthesis Methods, 1, 1, 66-80.
DOI: 10.1002/jrsm.6

<->

I will explore these plot / diagram forms and update the diagrams listing on Links II accordingly. I wonder if this journal (or another?) will re-visit the question of visualization methods in the humanities - social sciences?

Presentation: King's College London 17 May Mental Health SIG

Can you join us at the Higher Education Academy Health Sciences & Practice Subject Centre - Mental Health SIG in London
17th May 1000 - 1600?

I am really looking forward to presenting at the Mental Health Special Interest Group next month. It looks a great prospect as I have an hour on the programme. The draft title does not really represent what I intend, paradoxically I will re-introduce Hodges' model and explain why the model is so relevant in theory and practice.

I will outline my presentation here in a future post and the programme overall. For my sins I am now also a sign-off nursing mentor, so being able to network is another great plus. More to follow ....

Here are some details about the SIG from their website:

Welcome

To date, there has been no UK wide, cross disciplinary special interest group providing a regular opportunity for educators to meet face to face - with a view to exploring common issues and challenges, sharing resources and influencing policy and practice in the field of mental health. Arguably, this has hampered educators’ capacity to shape and respond to new developments.
In February 2005 the ‘Common Ground’ event organised by the Mental Health in Higher Education project in partnership with the Health Sciences and Practice subject centre met to identify key issues facing mental health educators in nursing and the Allied Health Professions. Subsequently, the special interest group has broadened out to encompass all colleagues with an interest in sharing approaches and engaging in debate about educational practice and the implications of policy developments for learning and teaching about mental health.

Who is the Mental Health SIG for?

Anyone involved in higher education with an interest in mental health.
We are keen to bring together people from across all disciplines and perspectives (including lecturers, practice educators and user educators and carers with involvement in education) – those who are mental health specialists and those for whom mental health may be one aspect of a broader subject area.
Health Sciences and Practice Subject Centre
Room: 1.17 Franklin Wilkins Building (1st floor)
Franklin-Wilkins buildings,
King's College London,
150 Stamford Street,
London SE1 9NH

Charity song 'Change for the Better' for World Malaria Day

We [The Butterfly Tree] are launching a charity song, entitled 'Change for the Better' for World Malaria Day, April 25th, to raise funds and global awareness of malaria.

No less that 80% will be used to buy mosquito nets and malaria testing kits.

Your support could save a child's life:

http://www.thebutterflytree.org.uk/pages/2010/africa-malaria-2010/

My source:
LinkedIn Groups, Non Profit Network - MojaLink,
Jane Kaye-Bailey

A call for applications for the 3rd phase of Lifelong Health and Wellbeing (LLHW)

Advanced Notice

A call for applications for the third phase of Lifelong Health and Wellbeing (LLHW) will be announced in early May 2010.

Lifelong Health and Wellbeing is a major cross-council initiative involving AHRC, BBSRC, EPSRC, ESRC and MRC in partnership with the UK health departments. LLHW supports multi-disciplinary research addressing factors across the life course that influence healthy ageing and wellbeing in later life.

The initiative aims to lead to improvements in health and quality of life in later life, inform policy and practice and increase capacity building in ageing related research.

Phase 3 will invite high-quality innovative multidisciplinary applications that focus on major ageing-related challenges faced by the UK in the 21^st century. Proposals will be welcome from multidisciplinary teams in the areas of, but not restricted to the following:

• Mental Health and Wellbeing including quality of life, preserving cognitive function and exploiting mental capital
• Resilience for successful ageing: from cell to society including life course influences, markers for ageing and processes of ageing
• Age-related conditions, including frailty and interventions to promote independence in later life.

Structure of the call
Funds will be available through two modes of support:

LLHW Research Grants - up to £10m will be available for multi-disciplinary research awards from £300k up to £2.5m over three to five years.

LLHW Pilot Studies - a total of £2.5m to fund up to 10 pilot or feasibility studies for a maximum of two years, aimed at informing the development of future cross-disciplinary research proposals.

Selection Criteria
Successful proposals will be of strategic importance, be truly multi-disciplinary, encompassing the remits of more than one Research Council, and have clearly articulated and robust methodology and design.

Further information
Updates and further information about phase 3 can be found on the website:
https://mrc.ukri.org/research/initiatives/lifelong-health-wellbeing/

My source:
Charlotte Jones
NDA Programme Secretary
The University of Sheffield
Department of Sociological Studies
Elmfield, Northumberland Road
Sheffield, S10 2TU, UK

ERCIM News No. 81 Special theme: "Computational Science/Scientific Computing - Simulation & Modelling for Research and Industry"

Dear ERCIM News Reader,
ERCIM News No. 81 has just been published at http://ercim-news.ercim.eu/

Special Theme:
"Computational Science/Scientific Computing -
Simulation & Modelling for Research and Industry
- coordinated by: Ulrich Trottenberg, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Germany, and Han La Poutré, CWI, The Netherlands
- featuring a keynote by Kostas Glinos, European Commission, DG Information Society and Media, Head of GEANT and e- Infrastructure Unit.

Next issue: July 2010
Special Theme: "Computational Biology" (see call for articles)

Thank you for your interest in ERCIM News.
Feel free to forward this message to others who might be interested.

Best regards,
Peter Kunz

<->

[PJ] This issue includes:
p. 44 A Computational Approach to Patient Flow Logistics in Hospitals by Anke Hutzschenreuter, Peter Bosman and Han La Poutré
p.48 Accurate Reconstruction of Single Individual Haplotypes for Personalized Medicine by Filippo Geraci and Marco Pellegrini
p.56 EXTRA Helps SMEs Assess their Knowledge Management Practices by Sanae Saadaoui and Frederic F. Monfils
p.57 The ACM Digital Library at the forefront of Semantic Technology by Stephanie Parker

Happy Birthday: W2tQ is Four! #h2cm #w2tq

Welcome to the QUAD [W2tQ] appeared four years ago today.

It started very slowly with just three posts between April 2006 and August. The annual post totals are:

2010 - 69 (so far)

2009 - 183

2008 - 180

2007 - 138
2006 - 28

Unfortunately, the plan to feature comments (this is supposed to be blog) came unstuck as back in 2006-2008 spam was an acute problem on blogger. The spam situation's much better now, but in re-installing comments the template I've adopted is proving problematic in some cussed ways. I could change the template and try again, but all that takes time ....

Although 'devoted to' Hodges' model (h2cm, the health career model), three broad themes have emerged:

1. nursing, health, global health, public health, policy, politics
2. informatics, technology, sociotechnical, visualization
3. education, nursing education, academia, conferences, curricula

Let's have a look at a selection of tag-label counts:

Hodges model 150, care domains 45, definitions 41, reflection 21

• nursing 80, health 45, global health 54, older people 39, public health 36, policy 93, politics 59
• informatics 213, technology 62, sociotechnical 44, visualization 27
• education 131, nursing education 9, academia 24, conference 61, curricula 18

Surprises (if any) include:

• Drupal 52
• economics 38
• aptitude 4 and attitude 15 (good to see them there, I stress these constantly with students)
• public mental health 38 (Still so much to do!)

I realise informatics is a great personal interest, but not to the extent of 213 posts. Of course, if I am helping to publicise conferences and these are faintly, just a tad bit technical then they are usually tagged informatics too.

• dementia 26 and mental health 45

As I work in mental health and the care of people coping with dementia and their families is an ongoing part of my daily work these tags could figure more. This blog is not solely focussed upon work.

I would like to think that the blog and its posts point to the future also, by way of:

• research 89
• concepts 23 conceptual spaces 21
• references 12
• h2cm community 28, h2cm website 38

It was only last August that I added the bibliography to the blog, and as mentioned there if you can add to the list of publications please get in touch.

So as I close this post, to go light the four ;-) candles on the cake,
may I say a big -

Thank you!

- to all W2tQ's readers and supporters.

Images source:
http://www.beatrixpotteremporium.com/

The post totals and tags above are subject to change as some posts may be deleted, tags merged...

Musings in the nursing domain (specific language)

It is one giant leap from the humanistic world of nursing, health and social care to the m(a-e)chismo of information technology. It is no Earth-bound chasm that greets us in considering the vaguest possibility that nursing could ever be captured, distilled and represented in a domain specific language (DSL). Given the full title of Hodges' model my attraction to DSLs should be obvious, but how realistic is this fascination?

Here are some links to definitions / resources on DSLs:

• Michael Fowler
• DSL Bibliography
• WikiPedia

I am not advocating DSLs as a real time clinical software application, there is neither time here, nor on the wards. Since the sky above is clear blue with not a contrail in sight I am indulging in a little blue sky thinking, a reverie...

Nursing already has its concept analysis, but taken at face value this says nothing about domains as per h2cm (other than the context / application is nursing). To avoid confusion with career in the job-work sense, I have emphasized the notion of domains. By this I mean a partition of specific knowledge about a discipline or subject. This disciplinary focus or subject is often the province of expert practitioners. My forte then in Hodges' model are the INTERPERSONAL and SOCIAL care domains. This is my rationale for the musings here, as all experts were learners once upon a time, and are still as lifelong learners. It is an educational application that I have in mind.

I have come across a paper by Reinhartz-Berger, who describes the movement - Towards automatization of domain modeling. The author refers to domains artifacts and domain analysis:
(I have removed the reference numbers and inserted from prev para*)

A domain in this context [Domain engineering, also known as software product line engineering]* can be defined as a set of applications that use common concepts to describe requirements, problems, capabilities, and solutions. Domain artifacts are built and reused through domain analysis, which identifies the domains and captures their ontology to assist and guide system developers with particular applications in those domains. Despite the rapid growth of technologies and technical solutions, domain analysis models usually remain valid longer than domain designs and implementations, potentially justifying the cost and effort required for their development. Domain analysis artifacts may also serve as the basis for defining Domain-Specific Languages (DSL). Reinhartz-Berger (2010), p.491.

As the previous post - Reading the signs... Idealised Care - amongst several revealed, the domains within the health career model are broad to say the least. So broad that from the INDIVIDUAL-GROUP axis the left-hand margin of the INTRAPERSONAL-SOCIOLOGY^# care domains are but distant horizons (with no curvature in-sight). It's no surprise that I keep wondering about how to get a grasp on that 'space', for reasons of a website, a potential community of explorers, educational objectives and sheer enthusiasm for trying to mix IT up. Reinhartz-Berger continues:

Several domain analysis methods have been proposed over the years. However, they all can be criticized as making the domain engineer alone responsible for developing correct, complete, and consistent domain analysis artifacts. Since domains may cover broad areas and are usually understood only during the development process, creating domain models can be a very demanding task. It requires expertise in the domain, reaching a very high level of abstraction, and providing flexible, yet formal, artifacts. Reinhartz-Berger (2010), p.491.

Also in the literature Chavarriaga and Macías (2009) highlight two approaches that are the focus more generally to help get a grip and the big wide world of knowledge: The Semantic Web and Web 2.0.:

... However, in spite of its semantic power, one of the main underlying problems with this [semantic] paradigm is the explicit representation and visualization of information, mainly focused on ontologies and the complex relationships that these code. This has made the Semantic Web inaccessible and unmanageable by most designers that are not expert on ontological representations and languages, but on domain specific applications and creative design.
On the contrary, the Web 2.0 paradigm provides a rather pragmatic vision. It is based on the use of wikis, folksonomies and protocols like SOAP, mainly intended to the automatic management of services and the collaborative maintenance of (mainly) syntactic knowledge-based information. Moreover, Web 2.0 can be considered an end-user paradigm. ... Chavarriaga and Macías (2009), p.1329.

The Semantic Web, Web 2.0 will (at some point) figure in the new site. A folksonomy can be quite broad by definition, as there is no strict control on the definition of terms. As to DSLs in Hodges' model, there we have four VERY broad domains. Exactly how domain analysis proceeds and what domain artifacts might emerge from this model would no doubt depend on reducing each of the domains, sub-dividing, being more specific.

If nothing else at present the health career model is a hybrid cognitive domain specific language.

References: (my source: Science Direct)

Iris Reinhartz-Berger (2010) Towards automatization of domain modeling, Data & Knowledge Engineering, Volume 69, Issue 5, May 2010, Pages 491-515. doi:10.1016/j.datak.2010.01.002

Enrique Chavarriaga, José A. Macías (2009) A model-driven approach to building modern Semantic Web-Based User Interfaces, Advances in Engineering Software, Volume 40, Issue 12, December 2009, Pages 1329-1334. doi:10.1016/j.advengsoft.2009.01.016

Reading the signs - Idealised Care

With the axes of the health career model labelled and the care domains - that fall between - identified, what can we read into and from the health career - care domains - model?

What basics of care and caring can we find there, what assumptions can we jump upon?

Here is a list ... (which also illustrates how the model grows with the learner) :)

• Health, well-being and social care are not declared in the face of the model, this suggests the model is high-level - generic.
• Health care (here) has at least seven disciplinary degrees of freedom:


• Sciences (biology, physics, chemistry)
• Politics
• Psychology
• Sociology
• Spirituality

• Health and social care theory and practices are reductive.
• Health care involves the traversal of space - distance.
• Health and social care has the potential to be depersonalising and alienating.
• Health and social care is simple and complex.
• The environment is inherent within the model in its varied forms.
• There is a moment of imbalance within the INDIVIDUAL - GROUP.
• Context is essential as a means to situate care (co-ordinate in an 'x','y' sense).
• The means is provided to situate the care context in a person-centred way.
• This model provides a template for personal and group reflection (shallow or deep).
• The model is open in terms of the final content, the content as expressed in care approach, philosophy, discipline, description (concepts, problems, priorities, strengths, a 'mash-up') is not dictated.
• In acknowledging the existence and primacy of the individual (located at the top so - must be important), the model provides a (potential) focus and vehicle for individualised, personalised, person-centred care.
• Whilst individualised care is at the center of care theory, practice and management, it cannot be defined purely by virtue of the INDIVIDUAL-group axis and the claim of an associated INTRA-INTERPERSONAL care domain.
• The individual must also be considered as a POLITICAL entity, a citizen, a legal entity that falls under the auspices of human rights. As such the individual is someone who can (or has previously) expressed their choices, wishes as to their health, care, well-being, best interests.
• Being an INDIVIDUAL within the family of humankind - 1 of some 6.x or > 7 billion - this person is unique and deserving of highest quality care, dignity and respect that should be accorded to all people.
• Health and social care whilst organisationally distinct (POLITICAL - POLICY) are to the INDIVIDUAL and carers (GROUP) concurrent, transparent and ideally integrated activities.
• Physical care (SCIENCES) can be, and is, defined in mechanistic terms; for example, time (objective), events, place, outcomes, observations / data (discrete, quantitative).
• Physical care is hence primarily objective.
• Emotional INTERPERSONAL care can be, and is defined in humanistic terms; for example, time (subjective), communication, responses to events (behaviour), feelings, beliefs, relationships (SOCIAL), expectations, fears, observations / data (subjective, qualitative).
• Physical care, emotional care is often mediated through the SOCIAL domain and the group - the family unit.
• Since this model indicates an initial structure and content the model is of potential use as a reflective resource for novice through to expert.
• The model is generic and as such not limited to health and social care.
• Such is the generic nature of the model it can support all learners in lifelong learning.
• The Spiritual is not there: it is ineffable. It is everywhere, everything, every'I' and everynow.
• Time is inherent in several forms within health and social care.
• The economics of health care is infused to all the domains, notably in the first instance to the SCIENCES and SOCIAL domains.
• The economic effects upon the individual in a humanistic sense, may be remote, but is inverse in terms of its impact.
• The model reinforces dualism: mind - body (but cognitively innoculates also).
• In highlighting boundaries, dichotomy, limits the model can stress the need for integration.
• The model suggests an antipodean fracture in relationships*: the patient and clinician (across physical care and mental health) inhabit the Northern hemisphere; while the carer (public), manager and policy maker the Southern.
• Health and social care is grounded in human communication (and that which is mediated).
• 'Sense making' must be a key issue in health and social care.
• Given the scope of the model, technology must be making a major impact across all fields of health and social care.
• The model can simultaneously represent the SOCIO- and the -TECHNICAL.
• A great many (potentially - all) values and standards are inherent in the model.
• This model can be represented using many media.
• This model is open to the Management Consultant's delicacy alphabet soup, i.e. using letters to represent approaches / methods, e.g. 4P's, 4C's.
• Health and social care can also be described holistically.

*Clearly, given the relationships and issues that arise this bears further examination and discussion.

This list is subject to revision - addition.

Image source:
http://en.wikipedia.org/wiki/File:Antipodes_LAEA.png

Paper: The health career model in forensic nursing

The other week a paper was submitted to a journal on the application of Hodges' model in forensic nursing.

I am really pleased to have worked on this as a co-author and to find the health career model proving its relevance and value in such a challenging care environment.

Basically we divided the work and the paper as follows:

• Introduction to Hodges' model (new material);
• Explanation of why the model is relevant in forensic mental health services;
• Applying key principles of theory and practice of forensic care to each care domain;
• Discussion, recommendations and future directions.

Of course, this is just the 'submission' stage, so I will share news and details here in the near future - for now it's fingers x'd! If you believe the above 'content formula' might be useful to you as a publication template please do get in touch: h2cmng AT yahoo.co.uk

Holistic interferometry

Since Galileo first pointed a telescope at the moon, the instrument has evolved with bigger lenses and mirrors. Despite additional advances in optics, physical constraints eventually prompted development in other directions. Rather than one optical or radio telescope, why not combine the inputs of several, tens, hundreds... ?

The health career model can act as an interferometer
for health across the care spectrum*.

We desperately need holistic interferometry for the personal, social, community (urban, rural and nomadic), national and global health care challenges we face.

* Which includes much of the electromagnetic.

Links:

SETI@home

Seti Inst.

LIGO, the Laser Interferometer Gravitational Wave Observatory

Image source: Seti League
http://www.setileague.org/array2k/array2kb.jpg

Development of a robotic health assistant to the management of malaria among nomads

The following very interesting item was posted on the Healthcare Information For All by 2015 [HIFA2015] list (I have added some formatting and links).

Dear All,

We received a Grand Challenges Exploration grant (a Gates Foundation initiative) for the development of a robotic health assistant to the management of malaria among nomads whose access to health service has always posed a concern. A robotic health assistant was constructed using aluminum casing. The device has three components: an interactive non-replaceable section that processes information and provides output. A replaceable laboratory containing supplies for qualitatively distinguishing between fevers associated with malaria and those that are non-malaria and a second replaceable component, a dispensary containing analgesics, ant malaria [*] and antibiotics for treating different types of fevers. The user communicates with the device using three buttons and receives feedback in Fulfude the nomadic Fulani language. The device interviews the user, processes the user’s responses and gives instructions. The accuracy of the information provided by the patient (user), and the ability of the user to carry out the instructions are critical to illness outcome. The device is solar-powered, is able to repeat previous instructions as many times as the patient desires, and provides referral.

Ten such robotic health assistants (ROBODOCs) were deployed among two main groups of nomads (those with previous experience using communication devices such as handheld mobile phones and those without such experience). The volunteer user was given basic information on the use, the switch-ON button, charging the device, and replacing the components. The user contacts a Field Assistant with hand-held mobile phone who in turn alerts the Research Supervisor whenever a case is managed. The Supervisor holds a phone interview with user and beneficiary patient at the end of the consultation with Robodoc as part of the quality assurance.

Robodoc was withdrawn after three months of deployment. Members of the community, beneficiaries and users were interviewed. Each device was examined for durability in the field. The ten units managed more than 80 cases of fever and appropriately diagnosed and treated 90% of them. Previous experience with using a modern communication device was not an important factor in the use of the Robodoc. The nomads found the device very useful and made suggestions on how it may be used for the management of several other health problems besides fevers.

We are keen to publish the findings from testing the device in a peer-reviewed journal. Does anyone have an idea of any journal that may be interested in this sort of research?

Oladele Akogun

HIFA2015 profile: Oladele Akogun is a professor of public health parasitology at the Federal University of Technology, Yola, Nigeria and Principal Scientist at the Common Heritage Foundation/Nigeria. He has spent over 24 years carrying out research and community service on access of community populations to health care delivery among marginalized populations. He is a pioneer researcher and contributor to the development of the community directed intervention approach to health service delivery now used in onchocerciasis control in Africa. With a Grand Challenges exploration (GCE) grant from The Gates Foundation, he is leading a team to develop a robotic health assistant for the management of malaria among nomads. He sits on two committees of the WHO/African region and on 5 committees at the Federal Ministry of Health, Nigeria. He has worked at various times as consultant to Constella-Futures, Africare and WHO where he worked for a year as Technical Adviser. He has made presentations to the African Regional Ministers forum on Primary Health, the US Congressional subcommittee on international aid and PAHO. He holds a PhD (1991) from the University of Jos and a Master of Public Health (2008) from the University of the Western Cape, South Africa. Some of his views are expressed in http://blog4globalhealth.wordpress.com/bios/akogun1/
akoguno AT yahoo.com

[*Notes from HIFA2015 moderator:
1. I think this should read 'antimalarials'.2. A picture of the device in action is available on the Gates Foundation website at:
http://www.gatesfoundation.org/global-health/Pages/grand-challenges-explorations.aspx
'Oladele Akogun of the Common Heritage Foundation in Nigeria is testing a 'fever kit' for use among nomadic populations. The device is equipped with simple diagnostic tools and prerecorded treatment instructions in the native language to help nomadic caregivers accurately diagnose and treat fevers in a way that reduces mortality and drug resistance.' Thanks, Neil PW]
(In re-posting I have added the image at left.)

International Journal of Integrated Care

Dear IJIC reader,

Recently PUBLISHED in the International Journal of Integrated Care

A Research and Theory paper:

An evaluation of SNOMED CT® in the domain of complex chronic conditions,
by Tara Sampalli, Michael Shepherd, Jack Duffy and Roy Fox

… It is the hypothesis of this work that showing the availability of multidisciplinary concepts for one complex condition can generate a similar expectation of available terms for other chronic conditions …

A policy paper:

Integrating care for people with mental illness: the Care Programme Approach in England and its implications for long-term conditions management,
by Nick Goodwin and Simon Lawton-Smith

… the lesson from the CPA experience suggests that there is potential for better care integration to be had in a strategy based on personalised care planning and investment in care co-ordination for people with chronic and sometimes complex needs …

And a book review:

Managing transition. Support for individuals at key point of change, edited
by Alison Petch and reviewed by AnneLoes van Staa

…This book is unique in its broad focus on different transitions in various contexts, and its exploration of the evidence for support given to people who risk getting ‘lost in transition’. This makes this publication highly interesting to readers of the International Journal of Integrated Care …

...

“All together now: Exploring the Many Faces and Facets of Integrated Care”,
Tampere Finland, June 16-18, 2010.

The INIC Conference 2010 will make an effort to look at and evaluate the challenges and status quo of mutual many-faceted collaboration of integrated care from the point of view of benefits to patients, service users and carers. The annual conferences offer an ideal meeting place for the integrated care community to discuss recent developments and future challenges across systems and continents.

On the website you can find more information on the keynote speakers, the pre-conference and site-visits, the program of the conference and the parallel sessions.

...

Thanks for the continuing interest in our work.

Erika Manten
Managing editor IJIC
ijic at uu.nl
___________________________________________________
Erika Manten - Managing editor International Journal of Integrated Care,
http://www.ijic.org/ - IJIC Editorial office: Igitur, Utrecht Publishing &
Archiving Services, University Library Utrecht, P.O. Box 80124, 3508 TC
Utrecht, The Netherlands.

How can maps provide motivation?

"The class of maps that go beyond navigation to consolidate thought and convey a message belong to the broader class of infographics that aggregate words and numbers in a visual medium. While charts and graphs are often used to show progress to a goal, nothing personalizes the objective like measuring status, and revealing shortcomings, on a map."

-- Matt Ball, editor, the Americas / Asia Pacific


My source: V1 Newsletter Volume 4 / Issue 13/ March 30, 2010

http://twitter.com/spatialsustain

Have workspace, workbench - let chaos ensue

Whether trying to write computer programs, engage in woodwork, artwork or needlecraft the workspace that you need is critical to what follows.

Having a dedicated workspace is the sign of a professional.

If these activities are purely a hobby you may need to create the space on the fly. Getting the easel and paints out, protecting the carpet and then after all those creative juices are spent you have to organise the clean-up.

The Health Career Model can provide a workspace: a dedicated one. So if like many researchers your focus is (global) health, nursing, social care and social policy ... Hodges' model can provide an assurity space. Whatever your approach here is a great way to explore the scope and boundaries of your plans, objectives and final outcomes.

I noticed a letter by Fawcett et al. (2008):

We congratulate Chaffee and McNeill on the publication of their article, “A Model of Nursing as a Complex Adaptive System”.  The development of a new conceptual model of nursing always is a cause for celebration of the advancement of our knowledge. We are, however, concerned that Chaffee and McNeill did not place their conceptual model within the context of or show an evolution from relevant existing nursing conceptual models. We refer readers to Holden’s¹ concept analysis of complex adaptive systems. She explained the relevance to nursing of the concept, complex adaptive systems, by tracing the “rich tradition” of systems thinking in nursing and pointed out that nurse theorists, including Dorothy Johnson, Imogene King, Martha Rogers, and Callista Roy, have developed conceptual models of nursing that reflect systems thinking. Holden concluded, “This rich tradition in nursing that has emphasized connections and interactions within a systems paradigm continues today. Complexity science merely represents the next stage in understanding how systems operate.”¹

Jacqueline Fawcett, RN, PhD, FAAN
Professor, College of Nursing and Health Sciences, University of Massachusetts, Boston.
Jacqueline Fawcett, Elizabeth Ann Manhart Barrett, Barbara W. Wright, Letter to Editor, Nursing Outlook, Volume 56, Issue 2, March-April 2008, 49.

REFERENCE
1. Holden LM. Complex adaptive systems: Concept analysis. J Adv Nurs 2005;52: 651-7. Nurs Outlook 2008;56:49. doi:10.1016/j.outlook.2008.01.003

Whilst explanations of systems have an essential place in understanding nursing, for me the concept of primary interest within (and without) systems is information. This is not just symptomatic of the paradigm of our times, but a fundamental facet of not only engaging leading edge (quantum) sciences, but relating nursing, complexity, systems, art and science to patients, carers, citizenry and global (eco-) health.

If this appears a recipe,
which when executed on the workbench will result in indigestion,
- have faith -
the problems of our times demands a framework with a massive conceptual maw.

So, in turn I would request that future nurse and complex systems researchers look further afield and factor in the need for and use of a high-level global (ethnoculturally agnostic), universal (multidisciplinary, objective, subjective) workspace:

One with sufficient bandwidth.

Having a dedicated workspace that can be shared across disciplines
- that is multidisciplinary -
denotes a mature profession
and a 21st century professional.

Image source: With thanks to Chunx.com 'Chaos Field'

See also:

'assurity space'

Information: See bibliography.

Jones, P. (1996) Humans, Information, and Science, Journal of Advanced Nursing, 24(3), 591-598.
Jones, P. (1996) An overarching theory of health communication? Health Informatics Journal, 2,1,28-34.

2019 Post:
c/o JAN: Formal Concept Analysis ... and an encouraging footnote

CARE: Whether NHS or Social Care ...

C	A
R	E

Whether -
NHS or Social Care^*
what
C.A.R.E.
is crying out for is a
universal, shared, holistic and wholly integral conceptual framework.
Then and only then will the currencies^# of care be
transferable, translatable and transforming!

* Private, 3rd sector, religious order, or social enterprise ...
# Currencies does not just refer to finance.

Launch of the National Care Service in England

Source: Department of Health, 30/03/2010

In the biggest change to the welfare state since the creation of the NHS, everyone who needs care when they are old or disabled will get it for free, Health Secretary Andy Burnham announced today as he launched the National Care Service in England.

The National Care Service will be based on a principle of shared social insurance and will be funded by contributions from everyone in a fair way. The National Care Service will ensure people get high quality care when they need it and it will give peace of mind that savings and homes will be protected from the expensive care costs that arise from serious long term conditions, such as Alzheimer’s or recovering from a stroke.

Andy Burnham said:

“Today we are launching a National Care Service that is fair for all, ending the cruel care lottery we have today. Like the NHS, everyone will contribute and everyone will get their care for free when they need it. This is the biggest change to the welfare state since 1948 and, like the NHS, it’s going to take time to build.

“The National Care Service will mean that people will be treated with dignity and respect, people will have control and choice over their care and they will be helped to stay in their homes for as long as possible. People who have to live in residential care will, from 2014, get their care for free after two years and there will be more help to pay the residential costs.

“We’re not replacing the millions of carers or families who look after each other. They are the underlying principle of the National Care Service and we will better support them.

“We’ve already laid strong foundations through reforms over the past few years. But, with an ever growing older population – there will be 1.7 million more people needing care in the next 20 years – we must radically overhaul the way care is paid for and provided.

“I feel very strongly that this is a responsibility we must all help to shoulder. And it’s clear from what we have heard from the thousands of people who have given us their opinions on this over the past twelve months, that people agree. That’s why we know that the fairest way to help everyone who is affected by a serious disease, illness or disability is for us all to pay into a system so we get free care when we need it.”

The cost of care is currently a cruel lottery. No one has any way of knowing how much care and support they may need in the future. A 65-year-old can expect to need care costing on average £30,000 during retirement. However, some people, for example people with severe dementia, could end up needing care costing as much as £200,000.

The National Care Service will put an end to this unfair system. It will be built on strong foundations of recent reforms and will overhaul the way care and support is paid for and provided. It cannot be built overnight and will be phased in three stages:

Stage One
• Build on the best of the current system through reforms that are already underway and deliver the Personal Care at Home Bill.

Stage Two
• From 2014 extend the coverage of free care so that people will receive free care if they need to stay in residential care for more than two years.
• Set up a commission to support consensus and advise the Government on the fairest and most sustainable way that people can make their contribution to a care system which is free when they need it.
• Set up a National Care Service Leadership Group of expert stakeholders who will advise Government on the implementation of the National Care Service, focussing on the systems and business processes that need to be put in place to make the National Care Service a reality.
• Introduce a National Care Service Bill to set the legal foundations of the National Care Service.
• Enshrine in law for the first time nationally consistent eligibility criteria for social care helping to remove the postcode lottery of care that exists now
• Push forward with the prevention agenda and continue the drive towards personal budgets so that by 2012 everyone who would benefit from a personal budget will have one.
• Ensure accurate, relevant and accessible information about what people are entitled to, how the assessment process works and how to access care services is provided to everyone.
• We want to improve the gateway for accessing social care and disability benefits to make simpler and easier for people.
• Introduce a quality framework including a body to drive up quality in social care.

Stage Three
• The introduction of a comprehensive National Care Service that is free when they need it for all adults with an eligible care need, funded by contributions.
Following the biggest ever consultation on care and support that saw over 68,000 members of the public, carers and representative organisations have their say, it is clear that people believe it is right that everyone should contribute to a care system that is free when people need it– similar to the NHS. However, the necessary consensus on how people should pay into such a system has not yet been reached. A National Care Service Commission, will therefore be established to advise Ministers on the fairest and most sustainable way for people to do so.

Care Services Minister Phil Hope said:

“We must find a fair way of funding the National Care Service. The stakes are very high. That’s why we must have a clear consensus. We are setting up a commission to tell us what would be a fair way for everyone to pay into this new system.

“Everyone will pay into it in a fair way and in return everyone will then have peace of mind that their savings and homes will be protected from high care costs. The whole of society will benefit and the National Care Service will support individuals and families for generations to come.”

The National Care Service will have six founding principles. It will:

1. Be universal – supporting all adults with care and support needs within a framework of national entitlements.
2. Be free at the point of use – based on need, rather than the ability to pay.
3. Work in partnership – with all the different organisations and people who support individuals with care and support needs day-to-day.
4. Ensure choice and control – treating everyone with respect and dignity, ,putting people in charge of their lives.
5. Support family, carers and community life – recognising the vital contribution families, carers and communities play in enabling people to realise their potential.
6. Be accessible – easy to understand, helping people make the right choices.

Contacts: Department for Health Email: NDS.DH at coi.gsi.gov.uk

Additional links:

DoH: 30 March 2010, The White Paper, Building a National Care Service

The Big Care Debate

MCQ (answer) on clinical coding and classification

The answer to the multiple choice question is item 4:

- a product of the 18th century driven by death?

François Bossier de Lacroix (1706-1777*), better known as Sauvages, is credited with the first attempt to classify diseases systematically.

Sauvages' comprehensive treatise was published under the title Nosologia methodica.

A contemporary of Sauvages was the great methodologist Linnaeus (1707-1778), one of whose treatises was entitled Genera morborum.

Beginning of the 19th century, the classification of disease in most general use was one by William Cullen (1710-1790), of Edinburgh, published in 1785 under the title Synopsis nosologiae methodicae.

My source:
http://www.who.int/classifications/icd/en/HistoryOfICD.pdf

* I note sources that record Sauvage's year of death as 1767.
http://www.persee.fr/web/revues/home/prescript/article/rhs_0048-7996_1969_num_22_4_2601