Hodges' Model: Welcome to the QUAD: July 2010

- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Friday, July 30, 2010

New challenging behaviour charter launched

I noticed the item below (with links and images added here) on the Foundation for People with Learning Disabilities Forum. It makes a very important point:

"The label 'challenging behaviour', has become misused over time."
My worry is that this finding is not just relevant to individuals with learning disability and their families, but other groups.

People with dementia, especially in the latter stages can present with behaviour that is increasingly described as 'challenging'. Care facilities are being commissioned and designed with the requisite care, staffing and environment to provide care for people in an effort to provide the highest quality and standard of nursing care.

To some extent these are distinct groups with specific needs. So the use of 'challenging' in one context obviously has a different currency and meaning in another. Whilst the practise and care environments may be separate, is there no place where cross-over may occur? I remember a local RCN meeting presentation that highlighted the demographic trend of dementia within the learning disability population.

To start a painting we often start with a wash:
efficiency - puts a broad brush in the hand.

As we aspire to provide person-centred care
what type of brush do you hold?

We paint with the words we use - take care.

The Challenging Behaviour - National Strategy Group has launched a charter to promote the human rights of individuals with learning disabilities who are perceived as challenging.

Up to 27,000 people with learning disabilities in the UK may have been given a label of challenging behavior, resulting in this group of people being - stigmatised and socially excluded denied the right to ordinary lives in the community, to education, recreation and employment placed in institutional settings a long way from home and families.

The label challenging behaviour, has become misused over time. Rather than being used as a term to encourage carers and professionals to understand the underlying reasons for a person's behaviour, 'challenging behaviour' has been used as a diagnostic label, viewed as being intrinsic to the person.

The Challenging Behaviour - National Strategy Group want people (and organisations) to sign up to the charter to register their support for the principles it contains and to commit to action to improve the lives of children and adults who are labelled as challenging. We need as many people as possible to support us, so please ask your friends and family to sign up too.

To read the charter, including an easy read version visit:



What is the Challenging Behaviour - National Strategy Group?

The Challenging Behaviour - National Strategy Group (CB-NSG) was launched on November 7th 2008. The CB-NSG is a key national group to address the needs of children, young people and adults with learning disabilities whose behaviour is perceived as challenging.

Members of the CB-NSG include family carers, representatives from the Department of Health, Royal College of Psychiatrists, British Psychological Society, Royal College of GP's, NHS Trusts, researchers, service providers and a range of practitioners, regulators, commissioners and third sector representatives. The group is action and outcome focused and comes together twice a year to monitor progress, share best practice and develop coordinated action plans.

What is challenging behaviour?
"Behaviour can be described as challenging when it is of such an intensity, frequency, or duration as to threaten the quality of life and/or the physical safety of the individual or others and it is likely to lead to responses that are restrictive, aversive or result in exclusion." (Challenging behaviour - a unified approach; RCPsych, BPS, RCSLT, 2007)
Challenging behaviour is things like hitting your own head against a wall, pulling curtains down or pulling someone's hair. Often people do this because they cannot communicate with words and they have little or no choice and control over what is happening to them. How do I find out more?

To find out more about the Challenging Behaviour National Strategy Group, please refer to 'All change' the Summer issue of 'Challenge' today. This issue focuses on the work of the National Strategy Group and includes articles from Dr Roger Banks (Consultant in the Psychiatry of Learning Disabilities), Jackie Edwards (Family carer) and Bob Tindall (United Response).

'Challenge' is the newsletter of the Challenging Behaviour Foundation and is available free of charge by emailing: info at thecbf.org.uk or downloading from www.challengingbehaviour.org.uk

Helen Marron
The Challenging Behaviour Foundation
Email: info at thecbf.org.uk

Wednesday, July 28, 2010

Drupal musings 9: Copenhagen next month & the archive

With less than a month to go now until Drupalcon 2010 in Europe - Copenhagen; it's time to look at the program and the tracks available.

Already, the session choice is dizzying. In the mix is -

  • Designing UI with Seven, Mark Boulton
  • Semantic Taxonomies, Johannes Wehner
  • Add a mobile version to your Drupal site, Martin Jørge
  • Imaginary users can save your Drupal site, J-P Stace
  • Writing Better CSS for Drupal, Maarten Verbaarscho
It will be worthwhile considering previous events and sessions attended and building on the content there. I must also check on the education app related sessions, birds of a feather.

I showed someone the styled archive pages - apparently they look old - good to hear! ;-)

Monday, July 26, 2010

Animated Minds - teaching resource

Animated Minds is a series of short animated documentaries which use real testimony from people who have experienced different forms of mental distress. A single aim underpins all the films: to help dispel myths and misconceptions about ‘mental illness' by giving a voice to those who experience these various difficulties first hand.


My source - post by:
Jill Anderson: j.anderson at lancaster.ac.uk
Mental Health in Higher Education jiscmail list

Sunday, July 25, 2010

Book: "Outcome Measurement in Mental Health" Cambridge University Press

Outcome Measurement in Mental Health
Theory and Practice
Edited by Tom Trauer
Published June 2010

In order to operate in an evidence-based fashion, mental health services rely on accurate, relevant, and systematic information. One important type of information is the nature of the problems experienced by recipients of mental health care, and how these problems change over the course of time. Outcome measurement involves the systematic, repeated assessment of aspects of health and illness, either by service providers, service recipients, or both. From outcome measurement clinicians and service recipients achieve a common language whereby they can plan treatment and track progress, team leaders and managers secure a basis to compare their services with others and to promote quality, while policy makers and funders derive evidence of effectiveness. This book will be an essential and practical resource for all members of the mental health clinical team as well as those responsible for establishing or managing services, and directing policy.

• Presents a global perspective on outcome measurement enabling readers to compare and contrast practices around the world
• Enables readers to identify the specific challenges presented in different groups and settings, the instruments to use, and how to use the results
• Emphasizes the relevance and use of outcome data to clinicians, to help them improve their effectiveness


Preface; 1. Introduction Tom Trauer; Part I. Outcome Measurement Around the World: 2. Mental health outcome measurement in Australia Jane Pirkis and Tom Callaly; 3. Outcome measures in New Zealand Graham Mellsop and Mark Smith; 4. Outcome measurement in England Mike Slade; 5. Outcome measurement in Ohio and the United States James Healy and Dee Roth; 6. The outcome questionnaire system: a practical application for mental health care settings Michael J. Lambert; 7. Outcome measurement in Italy Mirella Ruggeri; 8. Outcome measurement in Germany Sylke Andreas, Thomas Becker, Holger Schulz and Bernd Puschner; 9. Outcome measurement in mental health services in Norway Torleif Ruud; 10. Outcome measurement in Canada: one province's experience with implementation in community mental health David Smith; Part II. Outcome Measurement in Specific Groups and Settings: 11. Routine outcome measurement in child and adolescent mental health Peter Brann; 12. Outcome measurement in adult mental health services Tom Trauer; 13. Outcome measurement in older persons Rod McKay and Regina McDonald; 14. Outcome measurement with indigenous consumers Tricia Nagel and Tom Trauer; 15. Routine measurement of outcomes by Australian private hospital-based psychiatric services Allen Morris-Yates and Andrew Page; 16. Mental health outcome measurement in Non-Governmental Organizations (NGOs) Glen Tobias; 17. Outcome measurement in drug and alcohol services Maree Teesson and Mark Deady; Part III. Current Issues in Outcome Measurement: 18. Outcome measurement - applications and utility Tom Trauer; 19. Stakeholder perspectives in outcome measurement Tom Trauer; 20. Assessment of change in outcome measurement Tom Trauer; 21. Routine outcome measurement: perspectives on skills and training Tom Trauer and Tim Coombs; 22. A review of instruments in outcome measurement Tom Trauer; 23. Some economic and policy considerations for outcome measurement Rowena Jacobs; 24. Future directions Tom Trauer; Index.

My source:

UK Routine Clinical Outcomes Network Forum

Saturday, July 24, 2010

WHO Guidance Global Discussion Forum 26 July - 6th August, 2010


Please pass this invitation onto to your networks and colleagues and encourage them to join this virtual discussion forum.

The World Health Organization (WHO) and the WHO Guidance forum invite you to join the

WHO would like you to join a 2 week virtual discussion forum designed to provide an opportunity for people to share their ideas, experience and opinions about the type of evidence-based guidance WHO should produce to support the reduction of maternal and perinatal mortality and morbidity. We want to make this guidance more accessible and focused on addressing technical and health systems challenges and meeting the information needs of people working in this field.

Your contribution to this discussion will help us to identify priority policy or practice issues in which it would be helpful to have either a policy brief, guideline or other type of resource materials produced.

REGISTER NOW! http://my.ibpinitiative.org/whoguidance

During this two-week forum you will receive one-two emails per day: one email to introduce the day’s questions, and one daily digest of the contributions. Five questions will be addressed, and each discussed over two consecutive days. All contributions received will be acknowledged.

Once you have registered you can participate in the forum simply by responding to the daily e-mails or sending a message to:

whoguidance at my.ibpinitiative.org

For any questions on this Virtual Global Discussion Forum please contact the forum facilitator: Cordelia Coltart at: coltartc at who.int

Many thanks and we look forward to hearing your views during this exciting venture.

Cordelia Coltart
Intern WHO
Reproductive Health and Research
E-mail: coltartc at who.int

World Health Organization
20, avenue Appia
CH-1211 Geneva 27
visit WHO at: www.who.int

My source:
Sandra Land, GANM (Global Alliance for Nursing and Midwifery) ganm at ibp.wa-research.ch

Thursday, July 22, 2010

Drupal musings 8: Styling the archive

I've been editing the basic html pages (as mentioned before on W2tQ) these include:

  • Brian Hodges' introduction with a content listing and the scope of the model to help bridge theory and practice.
  • My introduction to the model based on an interview with Brian conducted 28th May 1998 in Manchester, England.
I've been here before and lost the thread, working within Drupal. This time though editing the pages in Textmate, things are taking shape. Three headings, three fonts (currently) Georgia, Droid Serif, Tangerine; styled lists and striped tables. It might be basic, but there is a style sheet that is almost breathing as it INFLATES : deflates, the result of various experiments. The fonts look good except for the FOUT 'flash of unstyled text'. As the previous link shows there are some fixes for that - which I hope will follow in due course. That would be a distraction at this point though as there is much to focus upon. Although the archive will have a style of its own, other parts of the site must reflect its content. That said, there still needs to be some stylistic coherence. ...

Written in Padstow, Quayside Cottage listening to a children's show on the bandstand.

Tuesday, July 20, 2010

The art and science of Serresian spin

To Michel Serres:
- the middle is a point of reflection, a point at which questions - the question - must be asked. In fulfilling the purposes of the health career model:

  • bridging the theory - practice gap;
  • facilitating holistic practice;
  • supporting (personal and group) reflection;
  • enabling curriculum development;
- the model's four domains are constantly (re-)visited in turn. Motion is constant. Conception - birth provides that initial impetus. Health status. Life - momentum. Centered on the person the movement is usually self-correcting, seeking balance. Health care. Questions and answers whether whole or in part follow, leaving a trail of care delivered and care planned. A record.

There is definite synergy between our use of the health career model, the dynamic quality and quantity of health and social care and Serres' description of the spinning top:
"The behaviour of the cone or the top is worth analysing. Throw this toy and describe, as Plato did, what happens. It is in movement, this is certain, yet it is stable. It even rests on its point or its pole, the more so as its movement is rapid. All children know this. But its rest is still more paradoxical. The top may move about, by translation, without ever losing its stability. To repeat, it can do so as long as it turns very quickly.

Even better, its axis may lean, take on an inclination, without putting the movement of the whole in too much danger. It may again rock, by nutation, oscillating around a mean location. This very ancient and quite childish machine is marvellously instructive.

First of all, it combines and the movements known and thinkable at the time: rotation, translation, fall, leaning and swaying. An integral model, additive, overcharged, yet simple. Second, and above all, it conjoins in a simple one-off experiment phenomena judged or presumed to be contradictory. It is in movement and rest, it turns and yet does not move, it rocks and is stable. The simplicity of a complexity, first and foremost, an additive machine; a synthesis of contradictions, beyond anything else. Now it may serve as a little model of the world, for a naive simple and local orrery. It quivers, at rest, it moves forward, turning, like the heavens, like the stars." p.28-29.

Michel Serres, (2000) The Birth of Physics, Return of the Model, Turba, Turbo. Clinamen Press.

Image source: https://www.cbsnews.com/news/spinvox-or-someone-like-it-keeps-spinning/

Monday, July 12, 2010

ERCIM News No. 82 Special theme "Computational Biology"

Dear ERCIM News Reader

ERCIM News No. 82 has just been published at http://ercim-news.ercim.eu/

Special Theme: "Computational Biology"

- coordinated by: Gunnar Klau, CWI, The Netherlands and Jacques Nicolas, INRIA, France

- featuring a keynote by Dirk J. Evers, Director, Computational Biology, Illumina, Inc.

Next issue: October 2010 - Special Theme: "Cloud Computing Platforms, Software, and Applications"

(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
ERCIM News central editor

Of specific interest to me pages 59-60:

Graph Transformation for Consolidation of Creativity Sessions Results
by Peter Dolog

Saturday, July 10, 2010

Drupal musings 7: HTML5, CSS3 ... & Mr Hodges meets Drupal

At Manchester airport in May I noticed Web Design Essentials (WDE). Reasons of cost £14.99 and weight meant it was put back on the news stand. The content was excellent! Back in the UK a week later, no sign of it in the supermarket. I found a copy this week at WH Smiths and made the 'investment' - a belated holiday treat.

This is gold mine of nuggets on HTML5, design - wireframes, user experience (UX), fonts and typography:


- personas, CSS3, jQuery and much more. Now I think about it UX has been around for quite a while, it's a sure sign of how web design has matured such that practitioners can and must focus on the experience. There's another blog post there contrasting UX in web design with UX in health services. Reading about the use of personas in design and planning for a site might also deserve a specific post. As WDE indicates there are companies dedicated to UX. I do not have that luxury and yet I do have to define my initial target audience and their anticipated experience.

The web design related listing I maintain at LINKS I (Intrapersonal) are being updated as a result of the leads in WDE.

Through the scheduling and poll services of Doodle (thanks Chris) and with the Drupal NW England list I'm checking on which day in the autumn - November - is best for a group of volunteers to help jump start the new site. Everything is sorted now for Drupalcon next month.

Friday, July 09, 2010

HIV/AIDS and Rights - Social Networking - The Vienna World AIDS Conference

To: Members of The CI Community Interested in HIV/AIDS and Communication
From: Warren Feek

Peter - Please Join: "HIV/AIDS Future Strategy" network at
http://groups.comminit.com/node/306528 - if you have not done so already.

Many best wishes.

I am writing in advance of the Vienna World AIDS Conference (July 18-23 2010) - an event summarised on The CI website - http://www.comminit.com/en/node/310758/347 - with an invitation to participate in dialogue on the themes of this important conference...whether you will be in Vienna or not!

The CI's Development Network Group called "HIV/AIDS Strategy: Future Directions" - http://groups.comminit.com/node/306528 - is the hub for our communication and media focused networking pertaining to the conference. This group presently has 489 members. This is complemented by the relevant HIV/AIDS Rights Knowledge within the HIV/AIDS theme site at ...

If you are not already one of them, please join the conversation! You can register here - http://groups.comminit.com/user/register - or, if already registered, join the group by going here - http://groups.comminit.com/node/306528 - and clicking on the red words "Request membership".

Thanks - it will be excellent to have you engaged.

To view communication- and media-related events happening at the Conference, please visit the HIV/AIDS Strategy: Future Directions Group's July calendar: ...

Click on each event's name to read a description of what will be happening, where, and when. (Please note also the hyperlinked word "more"...click there to see the entire list of C4D-related events taking place each day). And please do add your own event description: Once logged in, just click on "Submit an Event" in the box on the right-hand side of the screen.

You can learn, for example, about:

* "Is AIDS Activism Dead?" (Monday July 19 2010, from 11:00-12:30, in Global Village Session Room 1)

* "Distance Based Learning Technologies: E-Health and Social Media for Clinical HIV" (Monday July 19 2010, from 14:30-18:00, in Mini Room 8)

* "'I Want My Rights Now" - A Toolkit for Young People to Advocate Successfully" (Monday July 19 2010, from 11:00-12:30, in Mini Room 3)

* and many more...

Thursday, July 08, 2010

Born HIV Free campaign announces 11 million views for "Baby in the Sky" creative film

Dear Writer and Blogger,

In our series of news related to the 6-month Born HIV Free campaign, we are delighted to send you a press release focussing on the specially created film "Baby in the Sky" created by Les Bonzoms for this campaign.

The film has attracted a great deal of attention through YouTube and other broadcasts, helping to make people aware about the campaign.

Thanks as ever for your support,

Ogilvy Public Relations Worldwide France, Paris

“Baby in the sky”: a stunning new film made by Les Bonzoms specially for the Born HIV Free campaign attracts more than 11 million viewers on dedicated YouTube channel

Geneva, 6 July 2010 – The YouTube channel dedicated to The Global Fund’s Born HIV Free campaign which was launched seven weeks ago, has already been seen by more than 11 million viewers. The channel features an exceptional animation film called “Baby in the Sky”, created by the design team Les Bonzoms and with music of Amy Winehouse. Euronews, the international news channel, joins the campaign by also featuring the video until October.

“The purpose of the Born HIV Free campaign is to encourage millions of people to support The Global Fund so we can finally put an end to the tragedy of 430,000 babies being born HIV-positive every year, when we have the means and the expertise to prevent this.” says Carla Bruni-Sarkozy, Global Ambassador for the protection of mothers and children against AIDS. Hopefully this beautiful film will reach a wide audience because of its creative ingenuity, and inspire millions of people to support The Global Fund so we can finally put an end to this terrible injustice.”

“Baby in the Sky” is a highly creative and imaginative animated film that conveys the beauty of life ahead for an unborn child. The film artistically portrays an imaginary journey in a world full of adventurous landscapes and fantastic creatures. It ends with a call from Carla Bruni-Sarkozy for an HIV-free generation in which she says “Life is a beautiful journey. Don’t let AIDS kill it.”
The film owes its powerful soundtrack to multi-award winning and singer/songwriter artist Amy Winehouse, who offered the pro-bono use of her “Back to Black” song for the film.
“It was a question of finding a true resonance with the images in the film created by Bonzoms”, says musician / producer Julien Civange, who conceived the Born HIV Free campaign, about the use of Winehouse’s music. “We wanted to find a piece that was modern but also well known, something that carried the same sensibility as the film. The magic came with the soundtrack by Amy Winehouse, an artist that Carla considers one of the greatest and most talented of her generation and who was generous enough to participate in the campaign.”
The animation can be viewed on the Born HIV Free YouTube channel and will also be distributed through various social and mass media platforms during the course of the campaign.

Since June 20, Euronews, the international news channel, has been broadcasting “Baby in the Sky” on its network in 155 countries. The film is shown in 90-second slots an average of three times a day for the first month and then once a day thereafter. Broadcasting of the film will continue until 5 October 2010.

"All of us at Euronews are very proud to be associated with this initiative, which is supported by an incredible positive animated film" said Philippe Cayla, Chairman of the Executive Board of Euronews. "We are glad to open Euronews' influential and far-reaching network to such professionals and experts fighting to eradicate HIV transmission during pregnancy. We are mobilized to make a success of this campaign and we strongly believe that Euronews' viewers will be deeply moved and will want to participate in the Born HIV Free campaign," Mr Cayla added.
CNBC has also been broadcasting the video on its network in Europe, Middle East and Africa since the launch of the campaign.

Speaking about the distinctive nature of the “Baby in the Sky” project, Jack-Antoine Charlot, a designer from Les Bonzoms said: “It was necessary to stop playing with the notion of guilt as an incentive for people to act and instead to reinforce a sense of wanting to share and take part in something. In the case of mother-to-child HIV transmission, the medications already exist to stop it. The problem is one of mobilization.”

After the film, viewers are invited to show their support by signing their name on the campaign’s “virtual wall of support”, on the www.bornhivfree.org website. The campaign asks people - by the simple act of clicking a button - to register their support for the work of The Global Fund and for the elimination of mother to child transmission of HIV by 2015.
Watch the videos on: www.youtube.com/bornhivfree

Tuesday, July 06, 2010

Editorial JRN. Coalition in leadership: Politics - the big picture and the big game

In the Journal of Research in Nursing, Veronica Bishop's editorial -

Coalition in leadership.
Politics - the big picture and the big game

- explores the state of the body politic in nursing. Bishop's focus is research, but the implications extend beyond the UK, to nursing globally. The body is indeed immersed in politics, but it seems the feet are dry and there is no one at home.

Considering that The Politics of Nursing by Jane Salvage was published c. 1991 political maturity is long overdue?

While the sexual politics of nursing have been campaigned for in the nursing media and vigilance is needed, it seems that a political birth for nursing needs to be induced. There is a political mentality there, there has to be. The future is too challenging, too fraught, too close to be mollified by appeals of "Anything for an easy life (and death)!."

Bishop begins with a quote:

The very essence of leadership is that you have to have a vision. It’s got to be a vision you articulate clearly and forcefully on every occasion. You can’t blow an uncertain trumpet.
Theodore Hesburgh (1917–(2015))
If you are familiar with Hodges' model then you know what is coming. ... In quantitative (and qualitative) terms 25% of our deliberations using Hodges' model can be POLITICAL. This is not just the political dimensions of the patient, carer and the health and social care enterprise. The model includes the practitioner, but back to Bishop:
Having ‘power’ is a concept that sits uncomfortably with many nurses – it does not fit with the ideal of caring and many clinical nurses are quite open in their lack of regard for those in management, seeing them as power-seekers rather than power-movers. Clearly nurse leaders have in many cases failed to take their clinical colleagues with them in the drive to put nursing where it belongs, at the decision-making point that drives the agenda for health services, a point borne out by Stanley (2009).
How ironic that 'comfort' itself has been the subject of concept analysis and theorising in the nursing literature. If student nurses are exposed to the POLITICAL from the outset of their careers, then surely at the very least they will be more comfortable dealing with the guises and disguises of power?

Bishop refers to leadership and ownership and the two are frequently conjoined. The question of politics in nursing - in thought, practice, management and policy (research!) - makes me wonder ownership of what?

If the political domain is so frequently a vacant lot as far as nurses are concerned, then perhaps when we do put in an appearance we are not taken seriously. It really is a case of: what are you doing here?! As Bishop points out through -
Nurses are scientific. When they want to get to the core of a problem they always try to drill down. Yet politics are about the big picture. Nurses are agriculturalists in that they grow and nurture things but politicians are hunters – they’re always after the big game. It’s these kinds of differences nurses need to start to understand. (Cumberlege, 2007).
Nurses are there in the POLITICAL domain: they are constantly trying to complete the big picture.
... we were considering the best way for her [Baroness Cumberlege] to approach an interview the following day, and eventually, after we had viewed the uppermost issue of the day from every angle she said ‘Oh, nursing is so big!’. How right she was – there is hardly any aspect of life that it does not overlap or impinge on, so considering the big picture is a mammoth task! And again, she was right, we need leaders who have clarity and energy, and can cut through the detail and focus on the professional entity.
Yes, the big 'P'-icture is a mammoth task, hence the need to uncover, compose and frame it early. POLITICS is not just a matter of whistle blowing, industrial relations, policy, the system, us-and-them, banner headlines. ...

Politics is much more and crucial to research as Bishop attests. So, if our students do not reflect upon and articulate the politics of health: ill-health, well-being, equality and inequality, wealth and poverty ... then that professional entity will be a political ghost. A ghost playing a little game in an alien and alienating domain.

Veronica Bishop (2010) Coalition in leadership. Politics - the big picture and the big game, Journal of Research in Nursing; 15; 291.
DOI: 10.1177/1744987110374692

Sunday, July 04, 2010

The cost of anholistic care

Being 'holistic' in care delivery can seem anachronistic, paying homage to new age thinking and practices. Paradoxically, being holistic in nursing can also mimic an admin exercise that amounts to ticking the boxes. So for Hodges' model - have you visited all the care domains?

  • POLITICAL care ✓
  • PHYSICAL care ✓
  • SOCIAL care ✓
Advanced discharge planning is many things:
  • idealised care;
  • standardised care;
  • evidence of policy, targets;
  • sign posting for the care pathway;
  • an essential care aspiration that emphasizes the individual's strengths and resources.
As Wimbledon once again reaches its climax we observe that a fast serve needs to be prepared for a fast return of serve.

Last month 23 June, 2010 The Guardian, Society Guardian featured The high cost of return:
Hospitals could lose up to £1.5bn of NHS funding a year because of the government's decision to penalise those where patients return within 30 days of being treated. That is the conclusion of research conducted by health analysts Dr Foster into the potential impact of the tough new policy. It warns that NHS trusts face large potential losses, the biggest could reach £28.7m, as a result of the new approach. In all, 146 acute, specialist and mental health trusts could lose out. Denis Campbell, p.3.
Apparently -
Andrew Lansley wants to force the NHS to provide better care in hospitals and mental health establishments, to keep treating patients there until they are fit to leave and to work more closely with community-based healthcare professionals, such as GPs and district nurses, to ensure sick people receive more help with their convalescence after discharge and so are less likely to return to hospital. "Making hospitals responsible for a patient's ongoing care after discharge will create more joined-up working between hospitals and community services and may be supported by the developments in re-ablement and post-discharge support," he says.
I hope in reading the above you have a sense of my frustration in that the health career model can encourage and support timely reflection that can help achieve holistic, integrated - coherent care.

If the model was shared
- a common resource -
across disciplines and available to patients and carers
then the potential benefits (and savings?) are even greater.

Saturday, July 03, 2010

CfP IEEE IC Special Issue: Web Technology and Architecture for Personal Health Records

IEEE Internet Computing: special issue planned for 2011

Guest Editors:
Chimezie Thomas-Ogbuji [cut at case.edu], Karthik Gomadam [karthik at knoesis.org], and Charles Petrie [petrie at stanford.edu]

Final submissions due 1 November 2010
Please email the guest editors a brief description of the article you plan to submit by 15 October 2010.

The healthcare industry is well positioned to take advantage of contemporary Web-based architecture to address the technological challenges of personal health record (PHR) systems, many of which require simultaneous advances in engineering, informatics, and network-based applications. Of particular interest are the PHR systems that capture healthcare data entered by individuals.

This special issue seeks original articles describing development, relevant trends, and challenges in incorporating contemporary Web-based technology for the primary functions of PHR systems. The main functional categories of interest are information collection, sharing, exchange, and management.

Appropriate topics of interest include:

  • Web-based, structured data collection in PHR systems;
  • implementations of access-control policies and healthcare data sharing;
  • distributed, identity-based authentication methods;
  • digital signature and encryption techniques;
  • Web portal architecture’s general components and capabilities as the basis for a PHR system;
  • architectural paradigms regarding connectivity to other healthcare information producers and consumers;
  • data models for PHR systems;
  • distributed data subscription and publishing protocols;
  • successful Web-based applications for chronic disease and medication management;
  • health applications for PHR systems on mobile devices;
  • privacy and security issues;
  • HIPAA and its implications for adopting cloud computing for PHR applications; and
  • semantics for PHR interoperability and applications


Friday, July 02, 2010

Drupal musings 6: Content types - Reflection!

Does anyone have any experience in using established models of reflection in:

  • education (nursing, public health, information technology)
  • practice
  • therapy
  • supervision
  • carer support
  • eHealth
  • ... ?
If so please get in touch [h2cmng at yahoo.co.uk].

In its initial downloaded state Drupal has two content types:

  1. story
  2. and page.
The option then is to use these which would be rather limiting. Add to these two by enabling other core modules. Drupal administrators can extend the core functionality by adding other modules which provide new content types.

You can also roll your own. A key content type for the new site is one that uses the health career model to facilitate - reflection - one of the original purposes for the model.

This also provides an opportunity to adopt a model of reflection that is itself supported by research. This may be Gibbs:
  • Stage 1: Description of the event
  • Stage 2: Feelings and Thoughts (Self awareness)
  • Stage 3: Evaluation
  • Stage 4: Analysis
  • Stage 5: Conclusion (Synthesis)
  • Stage 6: Action Plan
John's Model of Structured Reflection
  • Aesthetics – the art of what we do, our own experiences
  • Personal – self awareness
  • Ethics – moral knowledge
  • Empirics – scientific
  • with its Cue Questions
Smyth’s Framework for Reflection on Action
  • Activity
  • Inform (Analysis)
  • Confront (Self awareness)
  • Reconstruct (Evaluation and Synthesis)
There are many others. ...

Once the hedgehog-headlights glare has passed, this is going to be a really interesting project. There must be a way to link one (or more) of the above with each of h2cm's care (knowledge) domains. There must be a way to create a first version that can be extended and support other content types. The possibilities are really exciting - hence the glare (reflected of course!).

Thursday, July 01, 2010

earth, wind, fire, water AND the birth of physics

To begin - the health career model is concerned with space, structures and knowledge (care domains) built around two axes, plus the 'subjects' and 'activities' of health.

How we define and (so) divide space and accord that space salience amid changing contexts is critical to theory, practice and management and the models we subsequently derive:

... The dichotomy does not cut, it defines, it surrounds the closure of a limit, it delineates a boundary. Within the space thus enclosed like meets like. Or rather, conversely, the specific convergance [convenance] or identity, the assembly of the analogous, delimits zones in the disorder which are distinguished from each other. The earth is separated from the waters, air divides from fire. ... p.28.

Michel Serres, (2000) The Birth of Physics, Return of the Model, Turba, Turbo. Clinamen Press.