- provides a space devoted to the conceptual framework known as Hodges' model. Read about this tool that can help integrate HEALTH, SOCIAL CARE, INFORMATICS and EDUCATION. The model can facilitate PERSON-CENTREDNESS, CURRICULUM DEVELOPMENT, HOLISTIC CARE and REFLECTION. Follow the development of a new website using Drupal (it might happen one day!!). See our bibliography, posts since 2006 and if interested please get in touch [@h2cm OR h2cmng AT yahoo.co.uk]. Welcome.

Friday, December 30, 2011

2011 highlights ...

The highlight of the year was the trip to Colombia in February with a presentation, workshop and meeting with quite a few students and their Professor. Lovely people, a warm, very well organised welcome and assistance c/o Luz Stella Saray, Prof. Wilson Canon, Andrea Ramirez and Fred Manrique / UPTC and many others. Colombia is an amazing country even on a brief visit:


It appears the conference link may have changed:

There were two poster presentations: Health Literacy, Manchester in June and the CARDI conference last month in Dublin. The latest poster was a great improvement on June's effort thanks to Prof. Kernohan; and there's a paper to follow.

September brought The Difference that Makes a Difference held at the Open University, Milton Keynes, UK 7-9 Sept 2011. It was a great experience being able to contribute to an event outside of health and social care. Quite a change also to be on the panel and able to respond to a question or two. I find information a fascinating subject. I wish there had been time to respond to the call for papers (and another on health literacy) but there was not enough time. There's more besides posted here on W2tQ, Drupalcon London in August.

I wonder what 2012 will bring...? I've nine days leave left up to the end of March so will be packing the laptop to focus on Drupal up in the Lake District.

Sue and I have tickets for Leonardo at the National Gallery. I can't wait for this after last years visit to The British Museum exhibition Fra Angelico to Leonardo: Italian Renaissance drawings


Next month it looks like I may be moving from Nursing Home Liaison to the Intermediate Support Team.

Thanks for your visit and interest.
Whatever else happens in 2012 I hope the wishes and dreams of individuals and Nations in search of peace and freedom come true. Remember+ChangeHappens2.
Best wishes to all!

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Thursday, December 29, 2011

Interprofessional Collaborative Care Will Be Key to Meeting Tomorrow’s Health Care Needs

Maryjoan Ladden, Ph.D., R.N., F.A.A.N., Robert Wood Johnson Foundation Senior Program Officer

A little over a year ago, the Institute of Medicine’s landmark Future of Nursing: Leading Change, Advancing Health report put forward a series of recommendations for transforming the nation’s health care system. Among them was a call for a system in which “interprofessional collaboration and coordination are the norm.” That’s no simple assignment in a system that often operates in silos, from schooling through practice. But a number of innovators around the nation are already making headway.

Their work is the subject of a new policy brief from the Robert Wood Johnson Foundation, part of its Charting Nursing’s Future (CNF) series. The brief delves into what the IOM recommendation means for health care systems, offers case studies of several collaborative care models already in place, and examines the implications of the recommendation for how we train nurses and other health care professionals.

According to the brief, Implementing the IOM Future of Nursing Report–Part II: The Potential of Interprofessional Collaborative Care to Improve Safety and Quality, the “silo” approach must soon give way if we are to meet coming health care challenges. For example, chronic conditions are increasingly common—not surprising given an aging population. But the health care system is poorly structured to provide the sort of coordinated care and preventive services needed to give these patients quality care while reducing costs. Some health care institutions are gearing up for the challenge.
  • In Boston, where Harvard Vanguard Medical Associates developed its Complex Chronic Care (CCC) program, primary care has become interprofessional, collaborative and noticeably more efficient. Each CCC patient is assigned a nurse practitioner (NP), a registered nurse with advanced education and clinical training. The NP consults with all the patient’s subspecialists and incorporates their guidance in a single plan of care. The NP then manages and coordinates that care, connecting patients to nutritionists, social workers, and other professionals as needed. The model is dynamic, allowing patients to meet more or less frequently with the NPs and their primary care physicians, who remain responsible for the patients’ overall care.
  • In New Jersey, the Camden Coalition of Health Care Providers is “revolutionizing health care delivery for Camden’s costliest patients,” according to the brief. These individuals, sometimes called super utilizers, typically rely on hospital emergency rooms for care. Not surprisingly, such patients account for an outsized share of local hospital costs, often with diagnoses that would have been more properly handled in a primary care setting. The Coalition developed its Care Management Project to reduce these unnecessary emergency room visits by treating patients where they reside, even when that means treating them on the street. A social worker, NP and bilingual medical assistant work as a team to help patients apply for government assistance, find temporary shelter, enroll in medical day programs and coordinate their primary and specialty care.
Training the Next Generation to Collaborate

Of course, the silo effect usually begins in school. In May 2011, six national education associations representing various health care professions formed the Interprofessional Education Collaborative (IPEC) and released a set of core competencies to help professional schools in crafting curricula that will prepare future clinicians to provide more collaborative, team-based care. Such efforts are already under way at a number of institutions.
  • Maine’s University of New England has developed a common undergraduate curriculum for its health professions programs in nursing, dental hygiene, athletic training, applied exercise and science, and health, wellness and occupational studies. The curriculum includes shared learning in basic science prerequisites and four new courses aimed specifically at teaching interprofessional competencies.
  • In Nashville, Vanderbilt University is also pursuing an interprofessional education initiative that unites students from the medical and nursing schools with graduate students pursuing degrees in pharmacy and social work at nearby institutions. Students are assigned to interprofessional working-learning teams at ambulatory care facilities in the area.
  • The Veterans Health Administration (VHA) is piloting an interprofessional initiative, as well, focused on preparing medical residents and nursing graduate students for collaborative practice. As part of the initiative, five VHA facilities have been designated Centers of Excellence and received five-year grants from the U.S. Department of Veterans Affairs. Each VHA Center of Excellence is developing its own approach to preparing health professionals for patient-centered, team-based primary care.
  • In Aurora, Colorado, the University of Colorado built its new Anschutz Medical Campus with the explicit objective of creating an environment that promotes collaboration among its medical, nursing, pharmacy, dentistry and public health students. It features shared auditorium and simulation labs, as well as student lounges and other dedicated spaces in which students from different professions can pursue common interests such as geriatrics in a collaborative fashion.
Such initiatives are clearly the wave of the future, if only because the pressures of caring for a larger, older and sicker population of patients in the years to come will drive efforts to identify efficiencies. In the words of Mary Wakefield, PhD, RN, head of the Health Resources and Services Administration, “As the health care community is looking for new strategies and new ways of organizing to optimize our efforts—teamwork is fundamental to the conversation.”

Sign up to receive future Charting Nursing’s Future policy briefs by email at

My source: Matt Freeman (PRS)

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Wednesday, December 28, 2011

[HIFA2015] Women and Children First

As we draw towards the end of the year, Ros Davies, executive director of
Women and Children First (www.wcf-uk.org) reminds us:

'This Christmas Day, 1000 women will die in childbirth.
1000 women will die this way on Boxing Day too.
In fact 1000 women die every day whilst pregnant or giving birth.

... the vast majority of these deaths could be prevented by the provision of simple information and equipment which many of us take for granted.'

Click here to read online.
My source:
HIFA2015: Healthcare Information For All by 2015: www.hifa2015.org

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Monday, December 26, 2011

Christmas: Buena Vista Social Club & Multidisciplinary, Interdisciplinary, Interprofessional and Transdisciplinary

A welcome gift for Christmas# was Wim Wenders' and Producer Ry Cooder's film - Buena Vista Social Club. The music, story, sound and images are a real treat. Several of the artists are sadly no longer with us, what is clear is the role that music can give to people in their senior years. The companionship and musical narrative that was rekindled in the late 90s is brilliantly captured and just in time: for the rest of us. The way these musicians and the technicians fuse, improvise, learn together, complement and contrast, and inspire each other is brilliant.

Whilst watching and listening I've realised that for the intro to the conceptual space notes I need to grasp details about the cussed customers - multidisciplinary, interdisciplinary, interprofessional and transdisciplinary.

Checking on current and forthcoming books I'm seeking a review copy to inform my musings:

The sequence in the title is not accidental but roughly equates to the descending frequency of use in health and social care. The most common (multidisciplinary) and least (transdisciplinary) are not dissimilar in needing to be defined and explored. Talk of multidisciplinary in theory, practice and management – notably policy – is so frequent that the meaning of the concept is diminished. On the other hand transdisciplinary is so infrequently used that the meaning is blurred. This is compounded by the noisy signature produced by the proximity of interdisciplinary and interprofessional.
This quartet are like musical disciplines and genres that can potentially grate on the ear and yet also make possible some amazing productions. Maybe that process is what goes into World Music? What in turn needs to go into global health?

#Another much appreciated present is the Steve Jobs biog.

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Wednesday, December 21, 2011

Social Impact Bonds (SIBs) in Health

The following text is from the report:

Social Impact Bonds
A new way to invest in better healthcare


This report is about the potential applicability of Social Impact Bonds
(SIBs) in the health field. The SIB is a financial mechanism where 
investor returns are aligned with social outcomes. The SIB is based on a
contract with government in which the government commits to pay for
an improvement in social outcomes for a defined population. Investors
fund a range of preventative interventions with the goal of improving
the contracted outcomes. If and as the outcomes improve, investors
receive payments from government.

To widespread interest, the first SIB was launched in September 2010. 
Its aim is to reduce reoffending among short sentence male prisoners
leaving Peterborough prison.

Social Finance believes that the reach of the Social Impact Bond 
model is wider than Criminal Justice. We asked Professor Paul Corrigan, 
a leading health adviser, to assess the suitability of the SIB model for 
the NHS. This report presents his thoughts. We hope that his report 
provokes a thoughtful debate on how, or alternatively if, financial
mechanisms such as Social Impact Bonds, might fund new 
interventions, improve people’s well-being and ultimately lead to 
a real change in the health system.


Additional link:
Paul Corrigan - blog

My original source: HSJ

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Monday, December 19, 2011

Time Magazine's 2011 'Person of the Year': The Protester

This image released by Time Magazine, Wednesday, Dec. 14, 2011, shows the cover for Time Magazine's 2011 'Person of the Year' issue. The Protester is this year's choice.

Thinking about this recognition of The Protester I believe that -

the Protester is an example of a true holistic practitioner...

How does an individual decide 'enough is enough'? When does the one act on behalf of the many? What happens when a Person clenches their fist, decides to fight for their rights? In a digital world "NO" and denial of individual human rights is not an answer.
When is the individual a mere 'particle'? 

When are they a 'wave'?
The Protester
They reflect - 
but they do not see themselves - 
they see the future for family, friends, nation: and then they act.
When the State clenches its fist what does it strike? 
Who tends to the mental health of the world's leaders?
What price for home, land, human rights, education, health information and justice?

TO: The Editor, Time Magazine
FROM: Welcome to the QUAD

Congratulations on your publication and this annual media event. It is fascinating to note the changing cultural, social and political influences evident in the history of 'Person of the Year', most evident in being originally 'Man of the Year'.

I note you have twice selected former president Ronald Reagan in 1980 and 1983 respectively. The former president disclosed that he was diagnosed in 1994 as having Alzheimer's disease. It is quite a coincidence that in-between Reagan's selection the means to a global memory The Computer was appointed as Machine of the Year in 1982. One thought: how many other individuals listed were, or are affected by the dementias?

I believe at some point in the next five years you could do a great service to the many Persons (younger as well as older adults) and their families who are living with dementia in acknowledging them as PERSON of the year.

To people living with this dreadful condition you can help highlight the importance of health, research, funding, policy, socioeconomic impact and most of all - person-hood where it really does matter.

Thank you for your consideration.

Yours Sincerely,

Peter Jones



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Saturday, December 17, 2011

States of mind and policy [I]: 25% of hospital beds...

The repeated things that some people say, what does that denote?

The repeated things that other people say, what does that demonstrate?

In which care domain does the Person living with dementia reside?
1 : 4 - 25% of occupied beds
[ diagnosis? ]
... and what of their carers... with their expertise?
there is a strategy - yet more hospital champions are needed and training.

My source:
BBC Radio 4 & RCN Students mail list

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Wednesday, December 14, 2011

The International Council of Nurses (ICN) eHealth Bulletin - December Issue

In this Issue:

ICN eHealth SAG Meeting
ICN Accredited Centres News
eHealth Programme Activities
Conference Presentations
eHealth Team Publications
ICN Website
Conference Announcements


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Tuesday, December 13, 2011

Student placements and public engagement - over the years

Mentoring student nurses has always been and remains a non-trivial professional obligation. It is something that I have always enjoyed. I make a point of not wittering on and on about h2cm - well maybe a little :) . To save the student's patience and assure my time it is good to ensure a well-rounded placement.

Over the years I've engaged in community service and research projects so looking to the humanistic domains comes naturally. It's been quite interesting watching the various efforts the health sector has made to engage the public. There's no imperative, but I make a point of highlighting the possible learning to be had in contacting the local public involvement and engagement people. Students have found this to be quite enlightening. Encounters with the Community Health Council [CHC] especially so, although that seems a long time ago now.

The Health Service Journal (still catching up) reminded me of all this in the summer, c/o Calkin & West, 4 August 2011 pp. 4-5. This news item spanned my whole career outlining the history of such bodies:

I even remember the demise of the CHC being reported. Actually no, correct that: I remember the report of the CHC's teeth being taken out before their end. As you look at the timeline represented above it seems to suggest either less stability, or less significance has set in; maybe both. The title of the above piece reads: Plans for engagement are 'insulting'.

Whether or not the CHC ever had sharp canines (with an extra full-moon glisten) and a bite force like a croc is something for the archaeologists to check. One thing for sure, it seems subsequent bodies have no need of dental check-ups, being sans teeth.

Working in the community it was heartening to see the CHC doing its work locally. I also read recently (HSJ I'm sure) how public involvement was finally enshrined in the The National Health Service Act 2006. So you see how progressive the CHC was. It is a great shame this momentum cannot be maintained - for reasons we'll return to in 2012.

For now, as students enter their third year I think it helps to bring life to the POLITICAL care domain. It matters. This ongoing issue is central to health services provision, planning, innovation and the commons ...

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Monday, December 12, 2011

Blogging, social media (sins) and advertising

Every day I receive emails offering guest posts, press releases relating to journal papers, or would I like to conduct interviews with various leaders of their respective fields, people who have also appeared on CNN and other high-end media.

To those who make these requests I have two struggles: firstly the topics whilst frequently concerned with 'health' they are not necessarily suitable for W2tQ; and secondly I do not have time to conduct interviews. This may change, but as things stand not any time soon.

So ... to people who do get in touch - thank you for your interest and recognition of the profile and work here on W2tQ. I greatly appreciate the support of existing paid link partners and seek new partnerships. 

On this topic I posted on the LinkedIn group Social Media Today which I've expanded here, a reply to Courtney Seiter who asked:

What's the worst social media sin?
I'm working on a blog post about ways you can be a "social tool." What's your biggest pet peeve?

It depends on whether you're asking this of corporate users or individuals? As an individual or corporate user assuming that if you build something - they will come - you will have a 'community' is probably the biggest sin.

This is a key concern here. Just because you create a new website that includes what users need - stimulating content (indicative care concepts for care assessment, planning and evaluation...?), content that is relevant and makes users productive does not mean it will work as a community.

Many people in many forums have identified this already. It's important to learn from any existing readers, subscribers, and contacts you have to learn what people, your potential users want. Market research wins! There's no excuse for not being able to do this with the virtual tools available. And as my Drupal friends have stated (and since Szeged 2008) get something out there!

Courtney wonders about how you can be a social tool. Ultimately, it's about being a catalyst, creating a site that connects people (nurses, students) so that a community might emerge. A community that is not 'yours', but a self-sustaining force. (That said, there is always a need for maintenance of online communities - social media.)

My sin is not having an email newsletter, but in defence W2tQ is a newsletter of sorts.

Another consideration is how far do you spread the social media effort? Invites still come in for new social media initiatives, but I make a mental note of the name yet stay focused. My social media  portfolio is full.

More specifically though what is the primary message? An obvious point perhaps; but is it about a product, values. purpose, ideology, change? What are the secondary messages that flow from this? How do these relate to your existing media footprint?

If your business model is distributed public relations are those individual efforts on behalf of clients actually causing damage? Can that affect a company's ranking? Sometimes less is more. ... 

How will you respond when there is a pull on the (fishing) line? How do you measure success? How will you cope if you find you have a catch: a fishing net full? Well you never know. Are you ready to respond?

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Friday, December 09, 2011

Drupalcon London (revisited) Entities & Omega

I mentioned these two Drupalcon 2011 sessions in summer posts and thought they are well worth  revisiting. The first concerns adaptive, responsive design and the Omega theme with Jake Strawn:

Omega keeps cropping up previous Drupalcons, in May at Drupalcamp in Leeds and Wednesday night at NWDUG in Manchester. What is Omega? Here is the intro to this (Drupal) project:
Omega - Responsive HTML5 Base Theme

The Omega Drupal 7 Base Theme is a highly configurable HTML5/960 grid base theme that is 100% configurable. Each zone (group of regions) can be configured for content first layouts (push/pull classes), hidden at any time and each region can be disabled, resized, and placed easily any way you see fit.
The theme appears fairly complex, but there is a lot of effort in developing the theme and tools to support it. Not unique to Omega but there's a way to have some pages with a different format according to context with alternate layout in terms of columns, zones, regions. ... The thought of working with columns seems constraining and yet reading and other sessions on the history of the printed page show how fundamental grids remain to design including the web.

A site that can respond and adapt the viewport to the device it is being viewed on is a must have. Central to design choices, there are fonts too. I notice this past week BBC Radio 4's Book of the Week has featured Just My Type by Simon Garfield and there are still a couple of days to listen to the episodes.

Another topic that keeps coming up is Entities, presented in August by Ronald Ashri:

The video and my notes from Drupalcon London remind me of being really switched on by this module, both in itself and with my requirements in mind.

In addition to the astronomical reference, Eric Evans's book Domain-Driven Design has an excellent figure that helps explain the scope and use of entities. I'll see if I can capture this at some point.

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Wednesday, December 07, 2011

The astrolabe, programming and big pictures

The astrolabe was a
mechanical implementation of
an object-orientation
model of the sky. p.47.

Eric Evans, (2009). Domain-Driven Design: Tackling Complexity in the Heart of Software, Model-Driven Design. Addison-Wesley.

Image source: http://planetariubm.wordpress.com/2011/03/01/femei-celebre-in-istoria-astronomiei-1/

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Saturday, December 03, 2011

Update blog (Feedburner pain), papers, Drupal and future

Up to early summer I had c. 470 subscribers according to the Feedburner counter. The highest this reached was around 482 and for a good while the momentum had been slow, but upward.

Since summer the counter fell back to 150 and more recently 130 and now for two days it is '0'. Apparently the Feedburner service has created problems across the blogosphere. I've decided to take the counter down for the time being.

There are no conference paper or poster presentations pending, but I have a paper to write based on the Dublin CARDI conference poster working with George (Prof. Kernohan). With two other papers being reviewed, this leaves space for Drupal.

I've a hosting account and was about to upload my first Drupal site when domestic matters took a deafening, but final turn. So now back to Drupal and a need to take up a permanent 'residency' there. The NW Drupal user group meeting this coming week always helps.

This domestic resolution also begs reflection on work, 2012 and beyond. It feels strange and exciting to find after a very turbulent three years a new freedom has opened up. This freedom can be taken even further. Let's see ...

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Friday, December 02, 2011

Carer's Rights Day ('Care' a concept going global)

I do wish I had time to update the intro pages which can be accessed on the h2cm homepage. I've assigned the SOCIOLOGY care (knowledge) domains intro to the public and this includes carers.

In Hodges' model the carer is closer to the policy maker than the 'patient', 'client' - person they care for. This does not make protecting carer's rights any easier. This conceptual proximity to the powers-that-be does not reduce the need for an amplified voice. The focus for tomorrow is Money Matters.

The significant realization many years ago was that carer's actually span all ages. What I have learned over the past two years in my role is that even when a family member goes into residential care, the worry, the caring does not stop.

This past July I heard last minute (dinner time) about Disability Awareness Day which was held locally in Warrington, Cheshire. It was a great day and for people in the NW - and beyond - make a date for 2012 15th July.

As to 'care' going global more to follow ...

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Thursday, December 01, 2011

Wooly vests, Engines and Health care: One stroke or two?

The cover of Nursing Times this week declares helpfully and positively that nursing is not broken. Stressed on several fronts clearly, but not broken. The feature explores the contribution that skill mix makes to nursing practice, quality and outcomes.

With the past day of industrial action and the economic climate you hear repeated commentators extolling the need for and benefits of investment in services be that: health and social care, house and road building, high speed rail, green energy, ...

The economy is often described as an engine. The knowledge and skills of the workforce (and students) help fuel prosperity through creativity, innovation and ultimately productivity.

As the looming winter settles in - I start to think about vests. The wooliest I can find.* You wonder to what extent the in-vest-ment in skill mix on the wards and other clinical encounters are oriented  towards tasks, activity and how much that skill mix has the necessary redundancy in place to afford high-quality patient education and person-centered care? You see we need to revest patients and the public at large with the knowledge and self-efficacy to keep well and stay well.

Economies that rely on two cylinder engines are usually considered as a bit behind the times. Noise. Pollution. Waste. How many cylinders do our health care systems run on?

Well, it looks and sounds like one.

One poorly machined cylinder with CURE at one end and PREVENTION at the other. So, the irony. We need a two-cylinder engine not just in health and social care, but people's lives. What a dream machine that would be. Is there a conceptual prototype out there...? You hope that Local Authority changes can refactor the engine, because looking at re-admissions (Milne and Clarke, 1990; Dowler, 2011) a radical redesign is greatly needed.

The truth is that as things stand (and the masses sit) this isn't enough.

(Interesting to note that apparently some 'one-cylinder' designs actually depend on two operations that overlap.)

Milne, R., Clarke, A. (1990) Can readmission rates be used as an outcome indicator? BMJ, 301, 17 NOV. 1139-4.

Dowler, C., (2011) Penalties fail to cut readmission rate, HSJ, 24, 11, 11, 4-5.

*Only kidding.

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Wednesday, November 23, 2011

Job Position: one Research Assistant in Semantic Web and Healthcare areas

This presents a great opportunity:

The Unit for Health Care and Life Sciences (HCLS) at the Digital Enterprise Research Institute (DERI: http://www.deri.ie/) of the National University of Ireland, Galway invites applications for a Research Assistant (RA) position.
Research Assistant (RA) Position: Semantic Web in HealthCare and Life Sciences
DERI – National University of Ireland, Galway
DERI is a leading research institute in semantic technologies that offers a stimulating, dynamic and multi-cultural research environment, excellent ties to research-groups worldwide, close collaboration with industrial partners and up-to-date infrastructure and resources.
The DERI HCLS group (http://hcls.deri.ie/) has a focus on applied research in the use of semantics in solving some key healthcare problems and dealing with: 

  • Interoperability of Electronic Healthcare Records (EHRs).
  • Interoperability of distributed healthcare policies.
  • Infrastructure which will scale to the thousands, and, in some environments millions, of patients who will avail of telehealth in the future.
  • Secure infrastructure which accounts for the ownership of patient data, the privacy and dignity of the patient, and which allows the patient play a part in managing his/her chronic illness.
This will involve research into HCLS ontologies and standards (e.g., HL7, openEHR) within the area of healthcare messaging, patient modelling and distributed personal health records. Research in the DERI HCLS research group is carried out in close collaboration with other collaborating institutions and industrial partners. Candidates should have:
  • A graduate degree in Computer Science/ Software Engineering or related fields.
  • Knowledge of Semantic Web Technologies (RDF, SPARQL, OWL).
  • Knowledge of healthcare standards (e.g., HL7, openEHR) is a plus but not a mandatory requirement.
Successful candidates are expected to have the willingness to combine formal scientific work with hands-on evaluation with healthcare providers.
Please send your application (CV, two letters of reference) in PDF format to the email address below – by Friday, February 3rd, 2012
Ronan Fox/Ratnesh Sahay
Domain for Health Care and Life Sciences
DERI - National University of Ireland, Galway
IDA Business Park,
Lower Dangan,
Galway, Ireland
E-mails: ronan dot fox at deri dot org, ratnesh dot sahay at deri dot org
For more information about Galway, NUIG, and DERI, visit the following websites:

My source: Post by Ratnesh Sahay to several lists.

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Saturday, November 19, 2011

Musings - The Caring Tableau: there's a method in conceptual overloading

[Still trying to figure some things out. ... ]

... Our foundation and scaffold must serve two purposes then. On the one hand it must facilitate conceptual modelling, and on the other hand it must be able to reflect the real world, the real time experiences we encounter.

Our models are built using words, specifically concepts. A minimalistic-holistic approach for the foundation [of h2cm] helps achieve balance, neutrality, agnostic credentials and avoids the additional danger of conceptual overloading.

In computer programming languages conceptual overloading has a specific meaning and application. It refers to the facility of some programming languages – Java for example (Bergel, 2011) – to have methods that have the same name. Methods are re-usable pieces of code that process data in a specific way. In conceptual overloading methods that share a common name are differentiated by different number and types of data specified as parameters. From a minimalist point we can readily expand the model thereby introducing conceptual overloading. The care domains can be viewed as methods, each with their own parameters. In the case of health care the parameters whilst indicated are not fixed. They are instantiated when invoked through a specific context, event or process. This is the challenge facing new recruits as they learn, and the expert as they continue to re-learn, forget, re-learn.

[If we continue the overloading process here, we arrive at the inevitable(?) philosophical junction of truth. In the health career domains model we can look upon the model with its domains as being filled with pebbles. I have frequently described the model as a mental means to turn over the cognitive – conceptual - pebbles and check their relevance. It is as if we have to include all concepts. Then many pebbles are automatically excluded by the very act of the initialization referred to above. This reduction, the emergence of conceptual dimensions is critical, it also reduces conceptual overload. What we have in effect then is a truth table – a care tableau.]

Bergel, A. (2011). Reconciling method overloading and dynamically typed scripting languages. Computer Languages, Systems & Structures. 37, 3, 132-150.

Musings... axes in hand and mind

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Saturday, November 12, 2011

New authoritative overview of Social Computing by Tom Erickson, IBM Research Labs

Dear friends,

I'm happy to announce a new, *completely free*, and authoritative overview of Social Computing, which is highly relevant to anyone designing interactive products. It's written by Tom Erickson - veteran researcher at IBM Research Labs - and includes 9 HD videos filmed in Copenhagen. It also includes commentaries by renowned designers/researchers like Elizabeth Churchill - manager of the Internet Experiences group at Yahoo! - and Andrea Forte from Drexel University.

These materials have taken 10 months to produce and involved 3 editors, 2 peer-reviewers, a camera crew of 2 people, 1 sound technician and 1 video editor. We've decided to continue to create world-class educational materials by elite professors and elite designers and give them to you for free. We would, however, be really grateful if you would share these materials, blog about them, or help us in other ways.

You can watch the videos and read the full overview here:

Have a great day!

Best wishes from Denmark,

Mads Soegaard

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Friday, November 11, 2011

Calling NHS personnel: free Knowledge Management online learning resources developed for and by the NHS

Hello everyone,

I’m writing to you in your capacity as a member of the Knowledge Management group on eSpace. I would like to bring to your attention a series of new, free Knowledge Management online learning resources developed for and by the NHS at: www.ksslibraries.nhs.uk/elearning/km. The resources are jointly developed by the Department of Health Informatics Directorate (DHID) Knowledge Management team and the NHS Library and Knowledge Services at KSS & Deanery, Brighton & Sussex University Hospitals NHS Trust. The resources are designed to help you to:

  • Develop a strategy for knowledge retention and sharing
  • Plan how an individual, team or organisation can learn from the experience of others
  • Capture, share and preserve resources from individuals or teams
  • Record and share learning and experience gained from project or work
  • Understand how knowledge management techniques have helped other organisations
Select the modules that most suit your learning needs. Each module lasts between 15 and 40 minutes.

Visit www.ksslibraries.nhs.uk/elearning/km to get your knowledge management learning started. To find the resource in the NHS eLearning repository, navigate directly to: http://www.elearningrepository.nhs.uk/LOR/search/default.aspx?q=knowledge+management, or go to: http://www.elearningrepository.nhs.ukand browse to KSF -> Information and Knowledge -> IK2 Information collection and analysis, and you will find the resource listed as: Knowledge Management eLearning Resource.

Each module provides a feedback form; let me know if you have thoughts or comments in general about the resource.

Kind regards,
You can access further Knowledge Management resources at:
KM Toolkit: http://nww.connectingforhealth.nhs.uk/km (N3 connection required)
Knowledge Harvesting Toolkit: http://nww.connectingforhealth.nhs.uk/km/resources/assets/knowledgeharv/index_html (N3 connection required)
eSpace: http://www.espace.nhs.uk/
Training materials: http://nww.connectingforhealth.nhs.uk/km/resources/presentations/index_html (N3 connection required)
Quick Reference guides: http://nww.connectingforhealth.nhs.uk/km/resources/postcards/index_html (N3 connection required)
Transition guidance: http://www.connectingforhealth.nhs.uk/systemsandservices/icd/knowledge/transition

Andrew Lambe
Knowledge Management Lead
DH Informatics - Informatics Capability Development
1st Floor, Princes Exchange
Princes Square
Leeds LS1 4HY
e-mail: andrew.lambe AT nhs.net

NHS Connecting for Health supports the NHS in providing better, safer care by delivering computer systems and services which improve the way patient information is stored and accessed.

For NHS CFH Implementation Guidance see

eSpace is a group based online collaboration tool. The service is dedicated to improving healthcare and wellness by promoting the sharing of knowledge, and individuals’ experiences of technology enabled change. eSpace allows you to: network and liaise with colleagues facing similar challenges; share information and learn from the  experiences of others; keep your knowledge of your own professional area current.

My source: eSpace with thanks to Andrew.

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Thursday, November 10, 2011

The Care Campaign

The Care campaign is a joint drive by the Patients Association and Nursing Standard magazine to improve fundamental patient care across the UK.

CARE stands for:

C – communicate with compassion
A – assist with toileting, ensuring dignity
R – relieve pain effectively
E – encourage adequate nutrition

The campaign recognises that everyone who goes into a care setting is entitled to these four fundamental aspects of care – they are a human right.

We hope patients, relatives and nurses will use this Care slogan as a care checklist. Patients and relatives can use it to pinpoint shortcomings in care; nurses can use it to articulate a case to their managers for more support, for example, more staff.

The Care campaign asks all nurses, nursing directors, chief executives and non-executive directors of NHS trusts to sign up to the Care Challenge so that ‘Care’ becomes a universal expectation for patients.

The campaign’s aims are:
  • For nursing staff to adopt the Care Challenge, based on our four-point tool.
  • To highlight obstacles nurses face in delivering the Care Challenge.
  • For organisations to sign up to the Care Challenge.
  • For patients to recognise the Care checklist and to use it to challenge poor care.
  • To support nurses who expose failures to deliver the fundamentals of care.
Contact The Care Campaign: carecampaign AT rcnpublishing.co.uk

Some thoughts:
What is crucial of course is what the above C. A. R. E. depends upon - and this has been considered within the campaign:

C: Attitude, self-awareness, professionalism and training in theory and practice.
A: Time and adequate staff assignment to enable patient - person-centred care not task allocation.
R: Time to observe and interact with patients and relatives - acknowledging patient reports and training in the recognition of pain and management. Pain management should not be incidental - neither should dignity and respect.
E: Too posh to wash - Too senior to help feed a patient, ensure they have a drink?

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Wednesday, November 09, 2011

CARDI conference Dublin 2011: Hodges' model - a poster element

Here is one element of the poster from last week's conference. This part is A3 in size and the linked preview below is to an archived copy on the Internet Archive. I will post the glocal version on W2tQ  in due course. As ever I wish I had more time to devote to producing such work. The symbol common to memory and giant global graph is intended to highlight a person's memory and the distributed 'memory' that is the Web. Such a representation can never capture all the subtleties involved, the overlaps, the contexts and perspectives.

The placement of some concepts is an invitation for reflection. For example, dementia and the use of anti-psychotic drugs also demands consideration of policy, liaison, primary-secondary-residential care interfaces, shared cared protocols, formal reviews, target behaviours, definitions of challenging behaviour, observation skills, clinical records, therapeutic interventions and the care environment ...  Some of the content, such as under Interpersonal Define 'safety', 'health'... seek to stress the same.

Big Society

Many thanks to the CARDI Committee for the opportunity to present, my employer Lancashire Care NHS Foundation Trust for study leave, and Prof. George Kernohan (Ulster.ac.uk) for assistance in supporting my attendance and in the production and printing of the poster. We plan to produce a paper based on the same.

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Monday, November 07, 2011

Bortz's Next Medicine: Defining 'health' and h2cm

On page 137 of Next Medicine, Walter Bortz assembles the Health Equation:

Genes (A) + Extrinsic Agency (B) + Intrinsic Agency (C) + Aging (D) = Health

After providing values for the other elements Bortz notes that:

Intrinsic Agency = Health - 0.45

In other words, such reckoning, though admittedly coarse, means that internal agency accounts for around 55% of the values we need for health, which is similar to the figure obtained by Mike McGinnis of the Institute of Medicine and Bill Foege of the Gates Foundation. (p.137)
'Conceptual frameworks' are referred to frequently in the literature and in a way quite distinct from h2cm. I've just posted about h2cm as a conceptual framework - a potential conceptual space. Bortz stresses the value of having several conceptual frameworks that, for example: enable pursuit of preventive strategies; and the conceptual framework provided by thermodynamics that informs our understanding of life, health and not surprisingly - ageing.

Bortz's conclusion above however also serves to highlight:
  1. The need for a global, generic, universal (data-, information-, knowledge-centric) conceptual framework to pull the elements of this equation together (and much more besides).
  2. This IS essential as those elements include the various disciplines. agents (stakeholders)  involved.
  3. Bortz's conclusion that internal agency accounts for around 55% also acts as a definition of person-centered health care.
From 1 - 3 perhaps h2cm can also serve as an indicator of a (the) prerequisite literacy level that an individual needs to achieve self-efficacy in health terms?

Chapter 10 next and posts on last week's Cardi conference - which was excellent. 

Acknowledgement: I am very grateful to Oxford University Press for the review copy.

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Friday, November 04, 2011

PJ's project [ii]: Hodges' model An aide mémoire, or candidate Gärdenforsian conceptual space? Or would you like a mint?

This 'project' has in reality been ongoing through some thirty years. Although Hodges' model is by its very nature - broad and generic - I'm sure there is a specific research question here. For me this question combines nursing (theory and practice), informatics, health and public engagement. One possible question that h2cm provokes concerns whether the model can be considered a conceptual space?

Over a couple of years I've been adding to some notes which for want of another I've framed under the question above. These notes inevitably languish for a while given a full-time nursing job (plus learning Drupal, this blog, doing posters ...). Picking the text up recently though the intro material seems to have fallen into place. An introduction should cover the recurring issues, challenges - opportunities found in nursing. Although I have the secateurs in hand and the spring is warm, Hodges' model requires that education and cognitive science are also be considered in this way. Anyway, here is the current working outline:

Hodges' model: A mere aide mémoire, or candidate Gärdenforsian conceptual space?


Part 1: Introducing Health & Social Care, Education, Hodges' model

1 Introduction
 1.1 Health and Social Care
 1.2 Recurring Issues in Health and Social Care

2 Education
 2.0 Introduction
 2.1 Education in the 21st Century
 2.2 Issues arising in Education

3 Health Care and Nursing Theory and Hodges' model
 3.0 Introduction
 3.1 Models of Nursing (Care)
 3.2 Hodges' Health Career - Care Domains - Model
 3.3 Information, energy?, records

Part 2: Cognitive Science & Conceptual Spaces

4 Cognitive Science and Computing
 4.0 Introduction
 4.1 Models, contexts, situations, the Project and (Darwinian) Justification
 4.2 Forms of Literacy, Requirements and Socio-Technical Perspectives
 4.3 Computation and Computer Graphics

5 Gardenfors' Conceptual Spaces

 5.0 Introduction

Drawing upon the cognitive science and computing literature the objectives of Gärdenfors’ Conceptual Spaces are made clear from the outset:

‘… is to show that a conceptual mode based on geometrical and topological representations deserves at least as much attention in cognitive science as the symbolic and associationistic approaches’ . p.2.

To what extent is h2cm a geometrical and topological representation? It appears on a simplistic level to qualify as a complex plane (Derbyshire, 2008). In this case, however, the closest we get to imaginary numbers in the negative sense are the null hypotheses of clinical research and reasoning amid uncertainty (REF). Gärdenfors continues:

‘This is a book about the geometry of thought. A theory of conceptual spaces will be developed as a particular framework for representing information on the conceptual level.’ p.2.

Hodges' model provides a framework, but as already noted it is not as yet theory based. It is based on practice, with appeals to experience and the knowledge and skills deployed in the health and social care sector. Could the h2cm framework work with Gärdenfors theory of conceptual spaces and his resulting framework for representing information? When Gärdenfors refers to his book being about the geometry of thought, here I would ask: What have nursing theorists sought? In addition to the stated motivations, surely a geometry of nursing thought? Nursing theorists seek rules and laws for a 'geometry' of care. A geometry of care is no less idealised, no less Platonic in form ultimately reflecting the values of the profession. A geometry of care would clearly be an achievement of harmony in the midst of discord and suffering. Additionally as the nursing discipline appears to some to be compromised in respect of practice, training, attitudes and professionalism.

 5.1 Representation, Explanation and Construction
 5.2 Background on key research methods
 5.3 Gärdenfors conceptual spaces - selected definitions
 5.4 Purposes, Holistic Bandwidth, Safety, Benefits and the Socio-Technical (repetition, move?)

Part 3:

6 Nursing, Care Theory and Care Domains
 6.0 Introduction
 6.1 Indicative literature review
 6.2 H2CM, Research methods and Data, Data, Data, (Data!)

Conceptual Spaces: Process, Practice and Domains - Hodges’ model

Part 4:

Coding and Classification, Ontologies, RDF, Semantic Web
Icons, glyphs, blobs
Patterns, wholes and parts
Users, Purposes and Scope of Application
Drupal and Ruby
Domains and Domain Specific Languages
Closing Discussion

(Back to this post:)
Don't ask why I am doing this. Chaos does reign here - 'Indicative literature review' in the midst...! In my defence these are notes, what's the question? Bits of the text move about, some disappears. Part 4 could become two, or three new parts, but no more than that! To what extent is there a case for M.I.N.T. a Modern Information-oriented Nursing Theory?*

Can you get there from a conceptual framework? When you get on the "conceptual framework" bus, can we simply change the destination to "conceptual space"? Has the academic bus already been and gone, or it drove right past: "Not in Service". Is this too big an ask of a bus? You need a ship to cross an ocean - even one that is illusory.

One thing I am sure of is that the model - #h2cm, this blog #W2tQ, my picking out Drupal, Ruby and the potential of visualization in the social sciences must come together in some way. One can inform the other. There is something really worth doing here. If in the end I don't get to do it well maybe others can finish the piece (the ambiguity here is intentional). Where's that illusory ship....

* M.I.N.T. sounds better than F.I.H.T. - you know cool and refreshing; but I do prefer and we really do need a Future & Information-oriented Health Theory?

Derbyshire, J. (2008). Unknown Quantity, Atlantic Books. p.12.

Gärdenfors, P. (2000). Conceptual Spaces, Cambridge.

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Monday, October 31, 2011

What's the difference between 6 and 7? About 11 years ...

Gradually over the past few months I've checked the care domain links. Deleting those where the domain is now "For Sale", broken, or the content is plain out of date. The final domain was the SCIENCES. It's the largest still and while the links are monsters, it is interesting working through them occasionally.

One change caught my eye last month in the 'Environment, Sustainability, Ecology & EcoSystem Health' listing. I clicked on Six Billion and Beyond and duly found that it has been retired from pbs.org. A few weeks ago I'd shared with students and have included on the CARDI conference poster the fact that today it is believed that the Earth's human population reaches 7 billion.

Looking back Six Billion and Beyond aired in 1999. So in 11-12 years there are an extra billion souls. You have to ask:

  • What will we all drink and eat?
  • Will we all have a (dry) home?
  • Will we all read? (Have access to information and info technology)
  • What will this latest generation believe in?
  • Whose beliefs will they be?
  • Can the 7 Billionth human being of Earth be a true citizen?
  • Before that - for how long will they be allowed to be a child?
  • Will they pray? Who to and why - choice?
  • Will they have to fight (in a uniform)?
  • What will their sense of quality of life be?
  •  Will that 7 Billionth person and their family have access to:
    • health information?
    • basic health care?
    • education?
  • What space is there for their human rights?
  • Can technology finally deliver Socially?
Checking the links this time around proved quite a lesson in global demographics - how long till the next...?

Additional links:

National Geographic Special Series: 7 Billion

The world is home to 7 billion people but how far has it come?
The population milestone is a reminder that there is much work to do on sexual and reproductive health and HIV if we are to meet the millennium development goals by 2015, The Guardian, Monday 31 October.

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Sunday, October 30, 2011

Public health: Whole society, whole government - whole medicine

The Health Service Journal isn't cheap so here every issue as a subscriber is a valuable resource.

In a September issue (1st) there were some really good opinion pieces and articles. One by Graham Burgess (p.17) concerned the coherence of public health. He started with the struggle that has been public health in England for the past 50 years; it has failed to define the problem to be solved.

Things may be set to change with the shift to local government that helps define public health on a social level, not just as a medical preoccupation - a distraction in fact from the disease health service perspective.

The word holistic that we all band-about was brought into stark relief by Mr Burgess as he nailed some w-holistic ecologies in referring to the 'whole of society' and 'whole of government' approaches necessary to build on the finding by the National Audit Office that only 15-20% of the inequalities in mortality rates can be directly influenced by health sector interventions.

There is a need to look further field than the supposed macrocosm that is the NHS: physical health - mental health.

Mental health is a whole world so frequently set apart from 'medicine'. Mental health contains a range of services that all shout: 'I am Cinderella!' So, Mr Burgess both frames the public health line up; and as I see it highlights the holistic scope of what are crucial and still emerging concerns. Still emerging ...? Well in the sense of having new - local authority - legs and thus endowed - how much further can public health run - and what tools are needed?

NAO Department of Health:
Tackling inequalities in life expectancy in areas with the worst health and deprivation

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Saturday, October 29, 2011

Abstract translation (100 words): Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model

I need to produce translations of an abstract into French, Spanish and Russian with a 100 word limit. At present I'm relying on Google translate; any suggestions to improve what follows (the English too!) greatly appreciated. 'Glocal' should prove a bit of a test. (h2cmng at yahoo.co.uk):

Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model

This paper introduces Hodges’s model a conceptual framework as a means to explore the  concept glocal and the more familiar terms local and global. Actual and speculative definitions of glocal are offered. Discussion will also deliberate on the compound meanings of these terms. The model's four knowledge (care) domains facilitate discussion of the physical, social, political and individual dimensions of local, global and glocal. The paper draws upon health, anthropology, history, science, informatics and geopolitics – especially the themes of globalization, literacy,  information technology and communication (voice). The purpose is exploratory with additional resort to philosophical reflection.

Explorar varias dimensiones de locales, globales y glocales utilizando el modelo conceptual genérico Hodges marco de

Este trabajo presenta un nuevo modelo Hodges es un marco conceptual como un medio para explorar el concepto glocal y los términos más familiares locales y globales. Definiciones reales y especulativos de glocal se ofrecen. El debate también se tratará sobre el significado de estos términos compuestos. El modelo de cuatro conocimiento (atención) dominios de facilitar la discusión de las dimensiones físicas, sociales, políticos e individuales de los locales, globales y glocales. El documento se basa en la salud, la antropología, la historia, la ciencia, la informática y la geopolítica - especialmente los temas de la globalización, la alfabetización de tecnología de la información y la comunicación (voz). El objetivo es exploratorio con recurso adicional para la reflexión filosófica.

Exploration des dimensions de plusieurs locaux, mondiaux et glocal utilisant le modèle générique de cadre conceptuel Hodges

Cet article présente le modèle Hodges un cadre conceptuel comme un moyen d'explorer le concept et le glocal termes plus familiers local et mondial. Définitions réelles et spéculative de glocal sont offerts. La discussion portera également délibérer sur les significations composé de ces termes. Les quatre modèle de connaissances (soins) domaines de faciliter la discussion de la physique, les dimensions sociales, politiques et individuels des locaux, mondiaux et glocal. Le document s'appuie sur la santé, anthropologie, histoire, sciences, informatique et de la géopolitique - notamment les thèmes de la mondialisation, de l'alphabétisation technologies de l'information et de communication (voix). Le but est exploratoires avec station supplémentaire à la réflexion philosophique.

Изучение нескольких размеров локальных, глобальных и глокальные использованием модели общих концептуальных рамках Ходжеса

В данной статье рассматривается модель Ходжеса концептуальную основу в качестве средства для изучения концепции и глокальные Наиболее известные термины локальные и глобальные. Фактические и спекулятивных определений глокальные предлагаются. Обсуждения будут также обсуждать соединения смысл этих терминов. Четыре модели знаний (ухода) области содействия обсуждению физических, социальных, политических и индивидуальных размеров локальных, глобальных и глокальные.Статья основана на здоровье, антропологии, истории, науки, информатики и геополитика - особенно темы глобализации, распространения грамотности, информационных и коммуникационных технологий (голос).Цель поисковой дополнительные прибегать к философской рефлексии.


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Friday, October 28, 2011

CARDI conference ageing globally - ageing locally: Poster

The last poster I completed in June for the Health Literacy conference in Manchester was made up of four A4 pages. It was OK, but suffered next to the University produced presentations - maybe it was an imposter. So, I determined that the next would be a more professional A1 - A0 effort.

Thanks to George Kernohan - Prof. of Health Research in the Institute of Nursing Research at University of Ulster - next week's CARDI conference in Dublin will see this realised.

Nine A3 pages were produced in total (too many for insurance). The final 'composition' was not straight forward. George suggested Powerpoint and that clinched it after much aggravation. This will be easier next time! With a week to spare I forwarded the draft to George. As before I've tried to strike a balance between graphics and text. There are three diagrams of the model in total that hopefully capture some of the main conference themes:

Title, author details & acknowledgement
Introduction to Hodges' model with basic model graphic axes and domains
h2cm matrix including the 4P's and Global & Local aspects of ageing
h2cm matrix Glocal and notes, the future and bibliography

The overlap here is quite something: I believe that the 4,400 words on local, global and glocal now has some coherence and merit. The context for that 4K is community informatics. The poster has drawn on that draft and in turn a further paper on this theme but specifically addressing older adults, health care, nursing ... will take things further.

The conference is much more than the posters of course. There are some excellent sessions and speakers too. Apparently the poster has arrived across the Irish Sea and looks OK. The boarding passes are printed - Dublin next stop. I'll also find out what Guinness really tastes like and catch up with James Joyce on Friday.

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Thursday, October 27, 2011

National photography competition KT-EQUAL & Age UK: 'Left to Our Own Devices'

Dear KT EQUAL Supporters,

A national photography competition launched by KT-EQUAL sets out to challenge our preconceptions about how older people interact with technology now and in the future. Entitled 'Left to Our Own Devices', the contest is run in partnership with Age UK.

Entries will be judged not only on their photographic merit but also on how they address issues related to the central theme of older people's interactions with technology -- perhaps by challenging stereotypes, defying expectations or delivering a powerful message.

The most successful images will be selected from across four categories:

• Gadgets and Gizmos
• In the Home
• Out and About
• Open category

All the selected images will be included in a touring exhibition that will visit the Parliament at Westminster and the Assemblies at Cardiff and Stormont, and finishing at the Scottish Parliament next spring.

One image in each category will also receive a cash prize of £250.

The judging panel will consist of:

• Christina McBride, Lecturer in Photography at Glasgow School of Art
• Professor Trevor Cox, a member of the KT-EQUAL consortium
• Phil Rossall, Research Manager (Knowledge Management) at Age UK

Professor Gail Mountain, Director of the KT-EQUAL consortium, said:

"For older people, as for all of us, technology can be exciting and empowering -- but it can also seem baffling or even threatening at times. So we’re challenging British photographers to come up with images that capture different aspects of the complex relationship between people and the devices they create."

Phil Rossall of Age UK said:

"Technology for older people can take many forms. It’s not just computers and smartphones, it’s anything which can make later life more comfortable, more rewarding or less arduous.
"At Age UK, we’re interested in new technology less for its technical merits than for its tangible benefits for quality of life – something we hope this competition will help to promote."

The contest is free to enter at http://lefttoourowndevices.org.uk, where users can also browse other entries and take part in online discussions on the thoughts they provoke.

The closing date for entries is 31 January 2012. Entries are welcome from both amateur and professional photographers. Judging criteria and other rules of entry are listed at http://lefttoourowndevices.org.uk.

Entrants retain copyright over the images they submit, subject to acceptance of standard terms and conditions for entry.


Heather Williams
Project Officer (KT-EQUAL)
Department for Health / Research Development & Collaborations
University of Bath
Email: H.Williams at bath.ac.uk

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Monday, October 24, 2011

h2cm, Bortz's Next Medicine and self-efficacy

Here on W2tQ I've written about the primacy of the individual within the health care domains model. The person, the unique human being is at the center of the nurses' focus and values.

I had a gut instinct with Bortz's book Next Medicine which I am now half-way through. This book is a real gift to me searching for evidence that supports the model's original creation and its purposes. As the book's title attests I'm also seeking evidence that highlights the model's potential today. On page 92-93 Bortz writes:
Self-efficacy. It sounds like an erudite, vacuous, scholarly term of little relevance. But just a moment's reflection leads to the recognition that self-efficacy is the centerpiece, the keystone on which all other body and mind functions depend. Self-efficacy: self-sufficiency, intactness, wholeness, autonomy, independence. These concepts embody the essence of what it means to be fully alive, fully functional.  ...  Self-efficacy, he [Albert Bandura] says, is health. Health is self-efficacy. Rather than being a remote scholarly label, it comes close to being the central axis for health and Next Medicine.
(My emphasis.)
Bortz also highlights Bandura's notion of self-efficacy and self-efficacy prescriptions.

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Saturday, October 22, 2011

Information Prescriptions: Just don't say "job done" or "next!"

The information prescription (IP) is not new. It is what should be a routine intervention that benefits from such initiatives as the specific IP project in 2007, which also produced a final report in 2008.

If people today are expected to self-care, there are recognized problems when they self-information prescribe (or is that paternalism at work?). The provenance of information on the web is a key concern.

In the 1980s and 90s the prescriptions and the management of benzodiazepines in community mental health gradually emerged as a problem. Today (for our children and their children) there's an acute problem with the frequency of antibiotic prescribing. Listen to the informative and sobering BBC Radio 4 programme:

As people are directed to validated and creditable information resources we need to consider the bigger picture that a prescription ('plan') of any sort represents.

A response in the form of a drug/treatment or information prescription does (of course) not mean "job done".

Some follow up may be needed (duh!) as to what has been done with said information. When we speak to people we quickly make global assumptions about their understanding, literacy, motivation and the constraints within which they can operate when outside the clinical encounter. General Practitioners usually have the benefit, and in this context - a great benefit, of having known the patient and the family for many years. Other practitioners may not have that informational reservoir upon which to draw. General practice may itself see changes - pressures on the established patient - family doctor relationship.

The quote below is from the information prescription website:
Information prescriptions contain a series of links or signposts to guide people to sources of information about their health and care – for example information about conditions and treatments, care services, benefits advice and support groups.

Information prescriptions let people know where to get advice, where to get support and where to network with others with a similar condition. They include addresses, telephone numbers and website addresses that people may find helpful, and show where they can go to find out more. They help people to access information when they need it and in the ways that they prefer.
Working in nursing homes I know how demanding and challenging information exchange can be. While the above quote lists suggested content, I've had to signpost in person, once, twice, three times before the time was right for a carer to approach a specific agency for a resource.

Whatever your lingo, personalised information prescriptions are really cool - and hot. We need them.

After all isn't a prescription for drugs just another form of information prescription, molecular, biochemical? One that is also destined to become more personalised and yet on a different informational (genetic) level. More than anything else though we need a public, citizenry who can understand the value, potency of the infoscript in their hand. Is there an antidote for advertising?

 Although the informational exchanges in nursing homes and elsewhere are challenging: we keep trying. To do that the prescriptions should not be used as a means to say "Next!".

Crossroads have historically been meeting places. A space of choices (information) and signposts, make the right choice don't hurry.

Quality outcomes take time, but then I would say that ...

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Saturday, October 15, 2011

The International Health Protection Initiative (IHPI) - Resolution Sign-up

The International Health Protection Initiative believes that health care MUST be protected during armed conflict.

The International Health Protection Initiative (IHPI) is a collective movement of individuals, organisations, institutions and charities (including non-Governmental Organisations-NGOs) who have agreed to help to lobby the United Nations to act to uphold the Geneva Conventions, especially as regards safe-guarding health facilities/equipment/transport, and workers.  The Resolution was agreed following a meeting of the International Child Health Group held in November 2010.
Your support is urgently needed for an international resolution to protect healthcare during armed conflict

The resolution will ultimately be submitted to the United Nations (General Assembly, Security Council, and World Health Organization).

In order to achieve the objectives outlined in the resolution, we need the majority of the world’s healthcare organisations, institutions, NGOs and civil society, especially those in conflict afflicted countries to sign up to this important resolution.

We know that you are aware of the urgent need to protect healthcare during armed conflict, that is, to uphold the Geneva Conventions and we would be most grateful for your support.

Once you have read the resolution we respectfully urge you to sign up to it online, as an individual, or preferably, on behalf of your government, institution, or medical organisation. We also encourage you to state your reasons for supporting this resolution in the appropriate box.

So please Sign up now!

Many thanks for your time and attention and we look forward to working with you to help make this life-saving resolution a reality

The IHPI Team

"War... is when some adults who don't know what good is and what love is, are throwing dangerous war toys which injure innocent people" 
Tamara aged 10 years during the war in Bosnia and Herzegovena.

My source: Prof. David Southall via HIFA2015

My thoughts upon signing up:
This resolution saddens me: that we should need it in the 21st century after millennia of human conflict.

The resolution is an essential course of action that I will help to publicize. Resources by way of legal enforcement, financial and personnel as declared in the resolution to protect basic human rights and health care provision must be assured and enforced globally. As per #5 the trend of pursuing those who commit crimes against humanity should be escalated as the means to record and furnish evidence also increases. This is imperative as a deterrent to those who supposedly 'lead' and those who invariably follow. In this sense 'education for all' is also crucial to help prevent indoctrination - with the additional health dividend that education affords.

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