Hodges' Model: Welcome to the QUAD: November 2011

- 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

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

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

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 .... 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,
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

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?

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.

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.

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.

Sunday, November 06, 2011

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.