- 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

Thursday, May 26, 2011

Musings... the elusive transdisciplinary particle(s!)

At any moment there are concepts and phrases that creep into the everyday and academic vernacular, even when their precise meaning is not clearly defined or understood. Such terms may be used interchangeably, as if one means the same as another. Two examples are multidisciplinary and interdisciplinary, followed by intradisciplinary (perhaps not as common) and transdisciplinary. We are already familiar with multidisciplinary; in the form of the team and the record, but what of these other terms?

These musings are not an attempt to define them (the above title would differ). Reading 'transdisciplinary' et al. it may seem like they should be restricted to the keyword list of an academic paper; or found in the very title of a journal as can be readily found. My fascination lies in them all, but for me it's Transdisciplinarity that invites the high-five.

I came across what sounds a marvellous course of study in Zurich - the Master of Arts in Transdisciplinary Studies. Zurich is not alone in offering such programmes. Reading their course introduction on the above link you will see the instant appeal as a champion for #h2cm.

These terms are of relevance here – due to another: complexity. In truth every age has its complexities. In this age and here on W2tQ the complexity stands out as we mix health, education and information technology. It is often suggested that the World's problems are such that they demand transdisciplinary solutions. Success in assuring a sustainable food supply, climate change, energy production, and our general well-being ... depends on the researchers in one field being aware of, testing and utilising ideas, materials, methods and methodologies from what are usually totally disparate disciplines – fields of enquiry. Making these connections calls for opportunities to take time out, network, engage in (variously mediated) dialogue, and funding to fuel insight, innovation and creativity. (Sometimes, disciplines need their heads banging together). Although seemingly denoting a broad scope, the term is often used in specific problematic areas of research including sustainability, transport, energy, waste management. ...

In health and social care Hodges' model figures here because in effect the model declares that it wants its cake and will eat it. By this I mean that to the model the disciplines are distinct and need to be treated as such; but also that the disciplines with their history, epistemological qualities, theories and practices, and respective research agendas need to step outside their box. They need to traverse the conceptual space represented within the model – and be prepared to travel back and forth outside the comfort zone.

In struggling to resolve the 'transdisciplinary' perhaps there are devices up to the task and fit for purpose; that is if we care to look, feel, smell, taste and listen hard enough?
Can we find evidence for this trend towards transdisciplinarity?

What about evidence in the movement and advocates for interprofessional education? Some disciplines are churlish, reluctant bed-fellows, eschewing the opportunities offered. Others embrace interprofessional learning. As per the Web they readily, even if unconsciously, adopt the mash-up mentality and attitude. They may preserve their status and integrity with a hybrid approach; keeping discipline centred training (essential for continuing professional development) but also taking advantage of what interprofessonal education and training might offer. As health services standardise on assessment and outcome measures then this approach, this trend toward the transdisciplinary seems common sense in terms of efficiency.

If in a health context you feel that transdisciplinary is a step too far, then please recall* those recurring health conundrums that constantly exercise theory, practice and management. You know the line-up:
  • multidisciplinary care
  • health care records
  • person-centered care
  • health care vs. education...
Solutions that are not derived on a transdisciplinary basis may well work; but not as well as they might. It may be that appeal to the transdisciplinary is merely blue sky thinking. It has its place on the leading edge of scientific and technical innovation but not here. Given the challenges outlined previously it appears health and the idealism of staff need an injection of idealism. Could it be that transdisciplinary approaches can form the basis for a new idealism? To complete this interprofessional educational point, perhaps this means of educational engagement can potentiate future transdisciplinary initiatives? Not directly on the level of ward, community team, clinic but tackling those so called bigger picture themes like health education, health promotion, service access.

A further give-away trail that might provide evidence of the elusive transdisciplinary particle is the curriculum? While some institutions may find their compromise (because this is a problem) informatics is struggling to retain or even find a place on the nursing curriculum. The curriculum is full. It is packed. If nothing else this highlights the complexity alluded to earlier. Like the increased embedded functionality our electronic devices provide both within the circuit boards and when in our hands, clinical informatics needs to be embedded in the respective curricula. What does this say of education, of the curriculum? Perhaps the reason why transdisciplinarity seems ephemeral and quixotic is that our transdisciplinary efforts are tantamount to a collective (group) mindfulness. First steps and collisions are never easy. ...

Additional links:

Transdiscipline - TheATLAS
Journal of Transdisciplinary Federation of Science and Technology

Image source - Drakenstein Palliative Hospice

* The above musings and the others on #W2tQ are from a longer text in draft. PJ

Wednesday, May 25, 2011

RCN Dementia project: survey on the experience of care in general hospitals

Dear Sir/ Madam

The Royal College of Nursing is currently leading a project to help improve the care of people with dementia in general hospital settings. The project is being supported by the Department of Health and is being undertaken jointly with other professional bodies and voluntary sector organisations.

Are you someone living with dementia, or a family member/friend?

Do you have direct experience of care in a hospital setting?

If so, we would like to hear your views about what works, what makes it difficult and what really makes a difference. The responses you provide will help in developing practical resources & guidelines and help influence the way dementia care is delivered in these settings.

For your chance to win £100 of John Lewis vouchers and to help us learn more about your experience of care in hospital, please take a few moments to complete the survey which can be accessed online by clicking on the following link: http://www.employmentresearch.co.uk/dementia_carers.htm


Alternatively, we can send you a paper copy in the post along with a pre-paid envelope. Please contact Nikki Mills as above.

We are keen to get as many responses as possible so please do feel free to circulate this information as widely as possible. We are also attaching a flyer to promote the survey so if you are member of a group or organisation where you can display this, we would be most grateful.

The closing date for the survey will be Thursday 16th June 2011

If you need any further information about the project then please contact Nikki Mills (as above) or Rachel Thompson (Dementia Project Lead) using the contact details below.

Thank you for your support.

Best wishes

Rachel Thompson
Dementia Project Lead
Royal College of Nursing
Nursing Department
Royal College of Nursing
20 Cavendish Square
London W1G 0RN

My source: RCN, Robert Clarkson LCNFT, Nursing Liaison PDG LCNFT.

Saturday, May 21, 2011

The Difference that Makes a Difference: an interdisciplinary workshop on information and technology

Location: The Open University, Milton Keynes, UK

Dates: 7-9 September 2011

Few people would argue that the development of information technologies has had a profound impact on modern society. Information is communicated, stored and manipulated using digital computers, the Internet, and fixed and mobile telephony, resulting in a deep and extensive impact upon all aspects of our lives. While talk of information is routine and unproblematic for engineers and technologists, it has been recognised since the early days of digital technologies that there is an uneasy relationship between the engineer’s concept of ‘information’ and wider uses of the word (cf. Roszak, 1986).

It is nevertheless appreciated that information, whatever is meant by this concept, is important – indeed it is foundational – to a quite remarkably diverse range of disciplines. Information is emerging not only as the new language of science - from quantum information to the genetic code - but as a key commodity of business, a major concern of the state, the front line for crime and crime prevention, the primary arena of technological development, an increasing concern of philosophy, and even a focus for conceptual art. Indeed, it is difficult to identify any field of life in the developed world that can not now be seen to some degree to have a significant information aspect, and to a greater or lesser extent this has all emerged because of developments in information technology.

The idea of information as a distinct concept, applicable across a wide range of disciplines, is growing in prominence. It has been especially emphasised within the natural sciences (von Baeyer, 2003; Vedral, 2010; Davies and Gregersen, 2010) and philosophy (Floridi, 2010). Much of this work takes information theory as developed by technologists, beginning with Shannon (1948), as its starting point, but draws little on contemporary work of technologists. At the same time, a different strand of work has arisen, drawing its inspiration from the growing influence of the Internet, and largely conducted by technologists (e.g. Weinberger, 2007; Brown and Duguid, 2000). This research in turn has little connection with the work in natural sciences and philosophy.

As we move further into the ‘information age’, we need to make the bridge between information of the information technologist and understanding of information in other disciplines. As researchers and practitioners in diverse fields grapple with an understanding of information – what it is, how it can be modelled and tools for coping with it – now more than ever is the time to share insights and bring some clarity and coherence to these differing perspectives.

We have begun some of that work, largely with colleagues around the Open University, resulting in a recent edited book (Ramage and Chapman, 2011). However, these discussions need to go much wider and deeper. We therefore propose to hold an international workshop to bring engineers and technologists together with scientists, philosophers, social scientists and artists – leading thinkers from all and any discipline that uses the language of information – to talk and listen, and to share their insights with us all.

There have been and continue to be many conferences, symposia and workshops addressing the technology, the applications and the consequences of information technology, but it is rare to find opportunities to address the understanding of the nature of information itself.

The need for work addressed more specifically at understanding the nature of information is exemplified by a problem expressed by Terrence Deacon (2010):
For more than half a century we have known how to measure the information-conveying capacity of any given communication medium, yet we cannot give an account of how this relates to the content that this signal may or may not represent. These are serious shortcomings that impede progress in a broad range of endeavors, from the study of basic biological processes to the analysis of global economics.

This workshop seeks to bring together those working with information in a wide range of disciplines - engineers and technologists together with scientists, philosophers, social scientists and artists - to discuss and expand our collective understanding of what we mean by information in our different disciplines. We are not seeking to combine these different understandings, but to share them and to explore commonalities.

The title of the workshop is based on a celebrated definition of information by Gregory Bateson (1972, pp.457-9), who wrote:
A difference is a very peculiar and obscure concept. It is certainly not a thing or an event. This piece of paper is different from the wood of this lectern. There are many differences between them – of color, texture, shape, etc. But if we start to ask about the localization of those differences, we get into trouble. Obviously the difference between the paper and the wood is not in the paper; it is obviously not in the wood; it is obviously not in the space between them, and it is obviously not in the time between them. (Difference which occurs across time is what we call “change”.) ...

Kant, in the Critique of Judgment – if I understand him correctly – asserts that the most elementary aesthetic act is the selection of a fact. He argues that in a piece of chalk there are an infinite number of potential facts. ... I suggest that Kant’s statement can be modified to say that there is an infinite number of differences around and within the piece of chalk. There are differences between the chalk and the rest of the universe, between the chalk and the sun or the moon. And within the piece of chalk, there is for every molecule an infinite number of differences between its location and the locations in which it might have been. Of this infinitude, we select a very limited number, which become information. In fact, what we mean by information – the elementary unit of information – is a difference which makes a difference.
The workshop will consist of four main sessions, each with keynote speakers and a number of presentations from others. Our goal is for maximum participation. If you are interested in the role and nature of information, we invite you to join us in Milton Keynes in September.

Magnus Ramage and David Chapman
Thanks to David for my being able to post these details here. I have registered and if time permits will submit an abstract. I'm really looking forward to this workshop. pj

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

'information' on W2tQ

Saturday, May 14, 2011

1st National Health Literacy Research Conference - NW England

As noted at the start of the month the health care domains model will be presented in the form of a poster at the following event on the 10th June. There are still a few places left!

1-day Conference at Chancellors Hotel and Conference Centre (Manchester)

Friday 10th June 2011

Join us for our first national Health Literacy Research Conference. Health literacy is:

the cognitive and social skills which determine the motivation and ability 
of individuals to gain access to, understand, and use information 
in ways which promote and maintain good health’.

The conference will include 2 plenary sessions with international health literacy keynote speakers and a panel discussion.

More details are available from the website www.healthliteracy.org.uk
or Lucy McDonald - Email: mcdonall at lsbu.ac.uk

C4 News researching anti-psychotic drugs in people with learning disabilities, inc. children and young people

Channel 4 News is researching the use of anti-psychotic drugs to control challenging or difficult behaviour in people with learning disabilities, including children and young people.

If this is an issue which affects you (or those you care for) or if you would like to share your views or experiences, in confidence, then please do get in touch with Philip Carter on -

... email at pc at pacarter.com

(Dementia is also an issue for people living with learning disabilities and their families. PJ)

My source: The Choice Forum - by the Foundation for People with Learning Disabilities


Monday, May 09, 2011

'Gaps' a poem by Philip Holmes - Journal of Humanistic Mathematics


Philip Holmes
pholmes at math.princeton.edu 

Take a line and take away
the middle third, and then
the middle thirds of two thirds
left behind, and middle thirds
of those four ninths remaining.
Go on and on: what’s left at last
is utterly disjoint – beginnings,
ends – each point divided from
the next, but oh! so close,
infinitely numerous
as what you started with
and carefully have pried apart.
Will there be time to measure up
this dust of unremembering?

* *

Take a line and take away the middle third,
and then the middle thirds of two thirds
left behind, and middle thirds of those four
ninths that still remain. Reiterate:
what’s left at last is utterly disjoint –
beginnings, ends and more – each point
divided from the next and yet uncountable
and numerous as what you had before.
Take a life and take the most part out,
for so it happens; only the best-rehearsed
of memories remain: a voice transformed
among the absences, a face, a hand.
You brought me here, but there was more:
dust that blows away, gaps that captivate.

Journal of Humanistic Mathematics Vol 1, No 1, January 2011.
Editors: Mark Huber, Claremont McKenna College; Gizem Karaali, Pomona College

Used with permission of Philip Holmes and JoHM with thanks.

Friday, May 06, 2011

h2cm: where does 'programming' begin and end?

On first impressions Hodges' model is a table. Its structure shouts "table!"
It is a table around which we can gather. It is political: a tabular rasa.

Since 1987 I've been fascinated by the potential that this basic construct, call it the 2 x 2 starter kit for holistic care has to conceptualise (as someone at the HEA Critical Reflection SIG meeting noted), represent, and explain nursing, health, social care and umpteen other situations.

It has great potential because of what we might do with the contents of the table.

This two x two table instructs.
It makes demands: "Initialise Me" with at least four care concepts.
It has critical reflective potential.
Nursing care problems, relapse prevention plans, strengths and steps to recovery can suddenly take on another dynamic form. The extent to which this transforms is still in human* hands (and minds!) but I am sure this informational potential and purpose is there; especially reading Fowler (2010):
This use of tables as source code is unusual, but it's an application that could be used more often. People like specifying things in tabular form, whether it's examples for test data or more general processing rules such as a Decision Table (495). Many domain experts are very comfortable with editing tables in spreadsheets, which can then be processed into source code. p.156. Fowler (2010) Chapter 10 A Zoo of DSLs.
You can see why nursing - health and social care are so complex:

- staff are busily 'programming' in at least two or three domains and constantly pressured to theorise and practice safely and effectively in four (*five when we include the spiritual).

Fowler, M. (2010) Domain Specific Languages: Addison-Wesley Signature Series, Addison-Wesley Professional.