Hodges' Model: Welcome to the QUAD: 2012

- 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, December 27, 2012

The Enormous Theorem meets The Enormous Conceptual Framework

with Best Wishes for the Season and 2013...

Hodges' Health Career - Care Domains - Model is not a theory of health and social care.

It can however encompass the conceptual space that comprises not only health and social care, but the lived experience of individuals, and the existence of corporate and political entities (notably policy).

So while mathematicians have The Enormous Theorem, in Hodges' model we can at least reflect on what might be the enormous conceptual framework.

Prize awarded for largest mathematical proof. New Scientist, Sept 10 2011, 211, 2829. p.5.

Saturday, December 22, 2012

KT-EQUAL events: inc. Food and Nutrition in Later Life; Meeting the Needs of People Living with Dementia and their Carers ...

Dear KT-EQUAL supporters,
(Several other posts relating to SPARC and KT-EQUAL have been deleted, this has been retained for personal archive purposes. I learned a lot in attending some events organised under the auspices of this research programme, which stemmed from the IDEAS Factory in 2006.)

Hello. Here's an update about some of our activities and other news that may be of interest to you.

Upcoming events programme
You are warmly invited to join our upcoming events:

Food and Nutrition in Later Life
When:    8 January 2013
Time:     9.30am - 16.15pm
Where:   University of Reading

The day features talks from experts, as well as an interactive "hands-on" showcase.  The event should be informative and fun, and provide an opportunity to meet and network with others who have personal or professional interests in food and nutrition for older people. The programme has been designed to appeal to a wide audience, including older adults, practitioners from health and social care, academic researchers, industry and charities.

Free to attend with lunch and refreshments included.

For further details and to book: ...

Thinking outside the box - meeting the needs of people living with dementia and their carers
When:    24 January 2013
Time:     9.00am - 16.45pm
Where:   The Forum, St James Parade, Bath, BA1 1UG

Dementia is a major challenge facing our health and social services over the next 20 years.  This has now been recognised by the government and significant resources are being directed towards early diagnosis, new treatments and management of people with dementia.

This funding will only be effective if we can develop news ways of supporting and managing people with dementia and there carers.  This will require a multidisciplinary team approach to problem solving and service delivery.  Health and Social Care Practitioners are familiar with the concept of multidisciplinary team working but often lack insights into dynamics of group working. We need to ensure that the interventions are effective and consider outcome measures that are appropriate for a long term neurodegenerative condition that are appropriate for patients and carers.

This event aims:

- to help researchers, health and social care professionals to think differently about meeting the needs of people who are living with dementia
- to consider the range of outcome measures that might be used to assess the benefit of an intervention
- to make researchers aware of the challenges and opportunities of multidisciplinary working
- to inform new researchers of the needs of people with dementia
- to trigger ideas for new research and provide a forum where participants can develop potential proposals

Please note that this event has limited places to ensure that representatives from several disciplines have the opportunity to participate.

Free to attend with lunch and refreshments included.

For further details and to register interest: ...

Design for Living in Later Life
When:    31 January 2013
Time:     10.00am - 16.30pm
Where:   The Open University, Milton Keynes

This event brings together the latest research ideas and developments about creating lifetime environments for people of all ages.

Free to attend with lunch and refreshments included.

For further details and to book: ...
Keeping safe and maintaining independence: older people and sight loss
When:    7 February 2013
Time:     9.30am - 15.45pm
Where:   Weetwood Hall Conference Centre and Hotel, Otley Road, Leeds, LS16 5PS

This workshop event is concerned with sight loss in later life and how we can enable people to live a quality life despite the difficulties that arise from diminished vision.

This event aims to raise awareness of sight loss and its impact and to increase knowledge and understanding of how to support people with sight loss. The programme will showcase new developments in research and practice that have the potential to inform practitioners.

Free to attend with lunch and refreshments included.

For further details and to book: ...
New posts on the KT-EQUAL blog which may be of interest to you:

Housing LIN newsletter – Housing with Care Matters, December 2012

This reflects back on some of the successes the Housing Learning and Improvement Network (LIN) had in 2012, including the recent 2nd annual conference attended by over 300 people.

The conference also saw Norman Lamb, Minister for Care and Support Services, announce an additional £40m in this financial year for Disabled Facilities Grants. Details of this and a number of other recent policy and funding announcements to do with housing, care and support are featured in this end of year newsletter along with information on new learning resources from the Housing LIN, important new publications such as HAPPI2, calls for information, and details of Housing LIN forthcoming regional meetings and events.

New dementia website launched: dementiakt.ca

The Canadian Dementia Knowledge Translation Network (CDKTN) and the National Core for Neuroethics are pleased to announce the launch of the online Dementia Knowledge Translation (KT) Learning Centre. This website is targeted towards new and established dementia researchers engaged in KT.


Invitation to take part in a study

I am sending some details passed onto us by one of our members, based at TRL:

We are currently undertaking a European study regarding older road users and what different countries do about supporting mobility. The aim of our project is to investigate travel patterns and road safety amongst older road users across Europe, see how they are changing and look at what work is being undertaken to support improving mobility. As part of this we are looking to undertake interviews with possible major players as to what they are doing. Would anyone be interested in taking part in a telephone interview with one of our researchers on this topic?

If you are interested please contact Jenny Stannard, Principal Project Manager and Road Risk Consultant.
email: ...


Recent Highlights

A new BBC film highlights the work of our i-design team in Cambridge: how do older people use technology? http://www.bbc.co.uk/news/technology-20664470

Falling off the Bandwagon: Sustaining digital engagement by older people - a series of consultation events have recently been undertaken exploring potential solutions to the challenges faced by older IT users. A major consultation event took place at St Georges House, Windsor focusing on solutions and how to implement them.  http://www.stgeorgeshouse.org/consultations/social-and-ethical-consultations/recent-consultations/

We were delighted that The Princess Royal presented a keynote address at our recent 'Showcase world class occupational therapy research to meet the needs of an ageing population' event. This event took place at the College of Occupational Therapists where The Princess Royal is Patron. It was a unique opportunity to bring together leading experts to discuss ways of meeting the challenges of an ageing population.

I hope that this is helpful. It's been a pleasure to meet with some of you over the course of this year - look forward to further developments in 2013. If you have any queries and or comments/suggestions please do not hesitate to contact me.

As this eventful year draws to a close, we would like to thank you for all your continued support and extend seasons greetings.  All the very best for 2013.

S Bangar
KT-EQUAL Research Co-ordinator
School of Health and Related Research (ScHARR)
University of Sheffield
Regent Court, 30 Regent Street
Sheffield  S1 4DA

Friday, December 21, 2012

International Workshop on Knowledge Representation for Health Care (KRH4C'13) & Process-oriented Information Systems in Healthcare (ProHealth’13)

Call for Papers
5th International Workshop on Knowledge Representation for Health Care (KRH4C'13)
6th International Workshop on Process-oriented Information Systems in Healthcare (ProHealth’13)
Organized as One Full Day Workshop
Acronym: KR4HC’13 / ProHealth’13
Murcia, Spain –  June 1st, 2013
In conjunction with the 14th Conference on
Artificial Intelligence in Medicine (AIME'13)

Web site: ...
Important Dates

Deadline for workshop paper submissions: 8 March 2013
Notification of Acceptance: 9 April 2013
Camera-ready version: 7 May 2013
KR4HC/ProHealth Workshop: 1 June 2013

Workshop Goals

Healthcare organizations are facing the challenge of delivering high quality services to their patients at affordable costs. These challenges become more prominent with the growth in the aging population with chronic diseases and the rise of healthcare costs. High degree of specialization of medical disciplines, huge amounts of medical knowledge and patient data to be consulted in order to provide evidence-based recommendations, and the need for personalized healthcare are prevalent trends in this information-intensive domain. The emerging situation necessitates computer-based support of healthcare process & knowledge management as well as clinical decision-making.

This workshop brings together researchers from two communities who have been addressing these challenges from two different perspectives. The knowledge-representation for healthcare community, which is part of the larger medical informatics community, has been focusing on knowledge representation and reasoning to support knowledge management and clinical decision-making. This community has been developing efficient representations, technologies, and tools for integrating all the important elements that health care providers work with: Electronic Medical Records (EMRs) and healthcare information systems, clinical practice guidelines, and standardized medical vocabularies. The process-oriented information systems in healthcare community, which is part of the larger business process management (BPM) community, has been studying ways to adopt BPM technology in order to provide effective solutions for healthcare process management. BPM technology has been successfully used in other sectors for establishing process-aware enterprise information systems (vs. collections of stand-alone systems for different departments in the organization). Adopting BPM technology in the healthcare sector is starting to address some of the unique characteristics of healthcare processes, including their high degree of flexibility, the integration with EMRs and shared semantics of healthcare domain concepts, and the need for tight cooperation and communication among medical care teams.

This joint workshop brings together two approaches: healthcare process support, as addressed in previous ProHealth workshops, and healthcare knowledge representation as dealt with in previous KR4HC workshops. The workshop shall elaborate both the potential and the limitations of the two approaches for supporting healthcare process & healthcare knowledge management as well as clinical decision-making. It shall further provide a forum wherein challenges, paradigms, and tools for optimized knowledge-based clinical process support can be debated. We want to bring together researchers and practitioners from these different, yet similar fields to improve the understanding of domain specific requirements, methods and theories, tools and techniques, and the gaps between IT support and healthcare processes yet to be closed. This forum also provides an opportunity to explore how the approaches from the two communities could be better integrated.

History of the Joint Workshop 

Providing computer-based support in healthcare is a topic that has been picking up speed for more than two decades. We are witnessing a plethora of different workshops devoted to various topics involving computer applications for healthcare. Our goal has been to try to join forces with other communities in order to learn from each other, advance science, and create a stronger and larger community. In 2012, the two workshops, KR4HC and ProHealth held a joint workshop, which proved to be very successful. This year, we are aiming to continue the collaboration initiative and hold another joint workshop.

The two workshops have quite a long history, as briefly described below.

The first KR4HC workshop, held in conjunction with the 12th Artificial Intelligence in Medicine conference (AIME'09), brought together members of two existing communities: the clinical guidelines and protocols community, who held a line of four workshops (European Workshop on Computerized Guidelines and Protocols (CPG'2000, CPG'2004); AI Techniques in Health Care: Evidence-based Guidelines and Protocols 2006; Computer-based Clinical Guidelines and Protocols 2008) and a related community who held a series of three workshops / special tracks devoted to the formalization, organization, and deployment of procedural knowledge in healthcare (CBMS’07 Special Track on Machine Learning and Management of Health Care Procedural Knowledge 2007; From Medical Knowledge to Global Health Care 2007; Knowledge Management for Health Care Procedures 2008). Since then, two more KR4HC workshops have been held, in conjunction with the ECAI’10 and the AIME’11 conferences.

The first ProHealth workshop took place in the context of the 5th Int’l Conference on Business Process Management (BPM) in 2007. The next three ProHealth Workshops were also held in conjunction with BPM conferences (BPM'08, BPM’09, and BPM’11). The aim of ProHealth has been to bring together researchers from the BPM and the Medical Informatics communities. As the workshop was associated with the BPM conference that had never been attended by researchers from the Medical Informatics community, we had included Medical Informatics researchers as keynote speakers of the workshop, members of the program committee, and to our delight, saw a number of researchers from the Medical Informatics community actively participating in ProHealth workshops. Following the keynote talk given by Manfred Reichert from the BPM community at the Artificial Intelligence in Medicine 2011 (AIME’11) conference, where KR4HC was held, the organizers of ProHealth and KR4HC workshops have shown their interest to hold their workshops in conjunction as part of the BPM'12 conference, which marks a landmark in the collaboration between the two communities. We are continuing the efforts that started four years ago by members of the Software Engineering in Health Care (SEHC) community to strengthen the collaboration between the ProHealth and SEHC communities.

Workshop Theme

Original contributions are sought, regarding the development of theory, techniques, and use cases of Artificial Intelligence and / or process management in the area of healthcare, particularly connected to patient data, clinical guidelines and healthcare processes.

Submitted papers will be evaluated on the basis of significance, originality, technical quality, and exposition. Papers should clearly establish their research contribution and the relation to the goals of the workshop. The scope of the workshop includes, but is not limited to the following areas:

• Process modeling in healthcare
• Computer-interpretable clinical guidelines / protocols and decision support
• Workflow management in healthcare
• Semantic integration of healthcare processes with electronic medical records
• Knowledge representation and ontologies for healthcare processes
• Temporal knowledge representations and exploitation
• Facilitating knowledge-acquisition of healthcare processes
• Visualization, monitoring and mining healthcare processes
• Knowledge extraction from healthcare databases and EPRs
• Knowledge combination, personalization and adaptation of healthcare processes
• Compliance of healthcare processes
• Evaluation of quality and safety of careflow systems
• Managing flexibility and exceptions in healthcare processes
• Process optimization and simulation in healthcare organizations and healthcare networks
• Experiences in deploying knowledge-based tools in healthcare
• Patient empowerment in healthcare
• Linking clinical care and clinical research
• Lifecycle management for healthcare processes
• Context-aware healthcare processes
• Ambient intelligence & smart processes in healthcare
• Mobile process support in healthcare
• Process interoperability & standards in healthcare
• Process-oriented system architectures in healthcare

Format of the Workshop

The 1-day workshop will comprise accepted long and short papers, tool presentations, and 1 keynote. Papers should be submitted in advance and will be reviewed by at least three members of the program committee. An informal proceedings will be available during the workshop. At least one author for each accepted paper should register for the workshop and present the paper. The selected best long (full) papers will be included in the formal proceedings, which are expected to be published as part of the LNAI Springer series, as it was done in all previous editions of the workshop.

Paper Submission
Prospective authors are invited to submit papers for presentation in any of the areas listed above. Only papers in English will be accepted. Three types of submissions are possible: (1) full papers (12 pages long) reporting mature research results, (2) position papers reporting research that may be in preliminary stage not yet been evaluated, and (3) tool reports. Position papers and tool reports should be no longer than 6 pages. Papers must present original research contributions not concurrently submitted elsewhere.
Papers should be submitted in the LNCS format. The title page must contain a short abstract, a classification of the topics covered, preferably using the list of topics above, and an indication of the submission category (regular paper, position paper, or tool report). Papers (in PDF format) should be submitted electronically via the Easychair system ...

Wednesday, December 19, 2012

My coat, Your coat, the Community cloakroom

'Untitled' 2012 (coats, wire, screws), by Jannis Kounellis

"Such wall-mounted three-dimensional pieces seem to me to talk the language of painting rather than sculpture. So does a massive, poignantly flopping black cross created from several navy coats tied together with wire and screws, hung against a wall. Each coat is a human measure, a stand-in for a human presence." p.20.

Wullschlager, J. (2012) Arts: Beauty in a burlap sack, Financial Times, 8-9 December. p. 20.

Bunzl, J. (2001) writes:
"Expressed in terms of a community-building process, we could thus identify the entity of the nation state as representing the equivalent of the individual person: the prime agent through which community or chaos in the world will ultimately be determined." p.20.

Additional link:
Parasol unit (Jannis Kounellis exhibition)

Bunzl, J. (2001) The Simultaneous Policy – An Insider’s Guide to Saving Humanity and the Planet. New European Publications.
Image source:
Wullschlager, J. (2012) Arts: Beauty in a burlap sack, Financial Times, 8-9 December. p. 20.

Sunday, December 16, 2012

Clusters of empathy

There still is a Complexity in Primary Care group but it is now essentially silent. I've met several people through the group over the years.

It might be decades since James Gleick's book Chaos (1987) and yet there is plenty of mileage left in complexity. One of the people I met through the group and hoped to meet in Australia at the ICN Congress is Paul Bennett who informed me of the following paper:

Academic Psychiatry, 33:6, Nov-Dec 2009 p.489
Winseman, J., Malik, A., Morison, J., Balkoski, V. (2009) Students’ Views on Factors Affecting Empathy in Medical Education. Academic Psychiatry. 33:484–491.

In explaining Hodges' model to Paul he was struck by the conceptual clustering in this paper. It isn't that there is a direct match between the paper's figure 2 and the care (knowledge) domains of the model, but multidimensional scaling is a potential tool to explore Hodges' model too.

The influence of political factors in medical education might be another aspect to consider. This is a dimension Hodges' model can encompass.

An acute concern at present in the NHS is the prospect of a seven day service, necessitating changes to the contracts of doctors and other disciplines.

Thanks to:
Paul Bennett, Primary Health Care Education Officer
Broken Hill University Department of Rural Health - Broken Hill
PO Box 457, BROKEN HILL NSW 2880

Wednesday, December 12, 2012

Conferences and studies (what's the date?!)

I don't know about 21.12.12 being a date of note. 12.12.12 has brought another addition to a string of  disappointing conjunctions this past week.

I posted in the summer - here - about the ICN Congress in Melbourne next May. My submission did not make it, being placed on the reserve list. If this journey was going to happen then I would need to make arrangements now. So a desire to visit Australia and share Hodges' model with the ICN community and possibly some academic centers there will have to wait for another time. The original idea of a symposium would have been marvellous, so perhaps there are partnerships still to be forged.

Next up: another possible speaking opportunity for April, admittedly provisional has not been confirmed. Quite a disappointment this as I would have repeated a workshop approach I've used.

And finally ... finding an avenue to study Hodges' model at a postgraduate level (part time PhD) is proving far from straightforward. I knew this would be the case, so I will continue to refine my preparations and make further enquiries and applications.

As this year comes to a close I'm pleased to have done the presentations to date. Great experiences and communities all. I understand that the preoccupations with the Mayan calendar and the end of the World are mistaken. It is the start of a new calendar - a new age. That (always) sounds good to me.

H2CM: the 'title wall'

Museums and other organisations will often use a 'Title Wall' to present an exhibition. I read about this in the current IdN World and as I did thought about the Tate (London and Liverpool) and the visit to the National Gallery last February. The title wall will feature dedicated design, specific use of colour, typography and layout to communicate the promise that is the exhibition inside.

Perhaps Hodges' model is a Title Wall for health and social care?

Immediately, what title are we to use?

To begin with it is "Mrs Moore", until "Jessica - is fine."

The title wall is an invitation for a dialogue with an artist or artists. Hodges' model is an invitation to patient, carer, health professional and student to engage in a care dialogue.

The story still needs to be told whether by an artist or the patient. Listen to the wall. It should say nothing, despite the divide. Self. Other.

Words. Icons. Threaded in time. Often disjoint in mind.

What a job that combines the arts and the sciences - to collaborate in formulating THE BIG PICTURE of a person's health and social care situation.

A museum such as MOMA apparently has an in-house design team.

In-house ... this is our prize.

Can we provide the patient, carer and the general public with the level of health literacy for them to engage in self-care?

Care4grafitti anyone?

Image source: http://www.moma.org/explore/inside_out/tag/ann-temkin

Thursday, December 06, 2012

The Willis Commission on Nursing Education: Recommendations

Here are the recommendations from this commission (the full report is also available):

  • Patient centred care should be at the heart of all pre-registration nursing education and continuing professional development.
  • There were no shortcomings found in nursing education that could be directly responsible for poor standards of care or a decline in care standards.
  • Nurses and their organisations must stand up to be counted on the challenge of poor care and loss of public confidence in order to restore professional pride.
  • Nursing education needs to imbed patient safety and dignity as a top priority.
  • Better evaluation of and research into nursing education programmes is necessary to ensure a programme that is fit for purpose.
  • The future nursing workforce requires nurses to work in a variety of settings.
  • Recruitment campaigns need to widen their diversity in order to encourage the widest, best possible range of applicants.
  • Health care service providers must fully support nursing education.
  • Universities need to recognise nursing as a practice and research discipline.
  • Attention needs to be paid to developing a strategic understanding of the nursing workforce as a whole and as a UK-wide resource.
See also: https://www.hee.nhs.uk/our-work/shape-caring-review
    My source: RCN and others

    Monday, December 03, 2012

    The Difference that Makes a Difference 2013 - Information: Space, Time, and Identity

    You are invited to The Difference that Makes a Difference 2013, An interdisciplinary workshop on Information: Space, Time, and Identity.

    Location: The Open University and the MK Gallery, Milton Keynes , UK
    Dates: 8-10 April 2013
    Website: http://www.dtmd.org.uk

    Deadline for one page abstracts - 3rd January 2013.

    Information has been conceptualised in many different ways in different disciplines, and the DTMD series of workshops is a forum for sharing of those insights . We are keen to involve as many different people, from as many different disciplines, as possible in presenting and participating in the workshop. We invite a wide range of participants to give short (10 minute) presentations on their work as it relates to an understanding of information.

    There will be six sessions:

    Over days 1 and 2 the first four sessions consist of a keynote speaker followed by six or seven short presentations (which will have been selected by referees from submitted abstracts) then a panel discussion.
    1. Information and Space. The relationship between information and space, 'meaning' in our physical environment, and the information landscapes that go beyond physical space.
    2. Information and Time. Both the historic framework of the notion of information, and time as a 'dimension' in information – physics, entropy, information and ‘the arrow of time’.
    3. Information and Identity. Identity (race, gender, nationality, class and sexual orientation, for example) as information and, conversely, information as identity.
    4. What is information? Why are so many disciplines using informational concepts in their narratives? Is a Universal Theory of Information (UTI) possible?
    Sessions 5 and 6 on day 3 draw together the insights from the first two days in two ways. First, through art, when the results of the work of the Workshop artist’s collaboration with delegates is presented and discussed. Second, a final keynote speech from Luciano Floridi, Professor of the Philosophy of Information will lead in to a panel discussion with the keynote speakers from the earlier sessions.

    For more details see the workshop programme: http://www.dtmd.org.uk/programme and the Call for Papers: ....

    Accepted abstracts will be published in a Workshop Digest which will be made available online prior to the event, and, following the workshop, delegates will be invited to submit papers for special issue of Kybernetes, based on papers presented at the workshop.

    We hope to see you in Milton Keynes in April.
    Best wishes,
    Magnus Ramage and David Chapman on behalf of the Programme Committee.
    Dr. David A. Chapman CEng, FIET, FHEA
    Senior Lecturer
    Department of Communication and Systems
    The Open University http://cands.open.ac.uk/
    Intropy blog: http://www.intropy.co.uk/
    ... Twitter @dachapman

    Sunday, December 02, 2012

    FatFonts - fonts with real weight: Giving space and data form

    Links now appear broken ...

    How it works (from fatfonts.org):

    Fatfonts are designed so that the amount of dark pixels in a numeral character is proportional to the number it represents. For example, “2″ has twice the ink than “1″, “8″ has two times the amount of dark ink than “4″ etc. You can see this easily in the set of characters below:

    Source for the above and animated: http://visual.ly/fatfonts-player?view=true

    My source: Jacob Aron, Making numbers punch their weight, New Scientist, 5 May 2012, 214, 2863, p.12.

    Saturday, December 01, 2012

    Thursday, November 29, 2012

    (Extreme) sensitivity to initial conditions: Employment - Sickness

    There was an item today on BBC Radio 4's You and Yours on the government's Fit for Work tests.

    The new fitness for work assessments have been under review. The discussion featured Professor Malcolm Harrington and his final report on the Work Capability Assessment Review and highlighted the humanistic and mechanistic dimensions of this very complex issue (see also the back-to-work programme). Points raised include:

    • the impact of certain medications and treatments on an individual's ability to partake in an interview;
    • the meaningfulness of an appeals process that once won, then sees subsequent recalls;
    • 4/10 appeals are won;
    • the need to balance decision making and the computer based process, with the former utilising documentary evidence;
    • people with mental health and cognitive problems may be less able to advocate for themselves.
    What troubled me is (the admittedly) single example were a client attending a review was advised not to bring documentary evidence. What this does is to effectively switch OFF three of four care domains: SOCIAL, INTERPERSONAL and (remarkably) the SCIENTIFIC.

    What are the purposes to which clinical assessments, tests, reviews can be put? Why do clinicians and the social care team create records?

    Relying primarily upon, or being driven by a computer based algorithm makes this a POLITICAL 'exercise'.

    As such it will be seen SPIRITUALLY as cold and uncaring.
    POLITICAL neglect reinforcing similar neglect and disinterest in the CITIZENRY.

    Wednesday, November 28, 2012

    RFID Tags Track Possible Outbreak Pathways in the Hospital

    There is no substitute for providing evidence that confirms many common-sense assumptions about what happens in the clinical environment that is the ward - in this case paediatrics.

    See the links below for details and explanation.

    My source: John Matson. Graphic Science. Scientific American, November 2012, page 76.
    See also the original PLoS ONE paper.

    Sunday, November 25, 2012

    CASA - Centre for Advanced Spatial Analysis: Working Papers

    Date: Sat, 24 Nov 2012 10:24:30 +0000
    From: Willard McCarty
    Subject: CASA Working Papers

    Many here will find something of interest, I suspect, in the Working Papers series of the Bartlett Centre for Advanced Spatial Analysis, University College London,


    In particular my eye was caught by Martin Dodge and Rob Kitchin, "The ethics of forgetting in an age of pervasive computing", CASA Working Paper 92.

    Undoubtedly those with GIS-related concerns will find much more than that.
    Willard McCarty, FRAI / Professor of Humanities Computing & Director of the Doctoral Programme, Department of Digital Humanities, King's College London; Professor, School of Computing, Engineering and Mathematics, University of Western Sydney; Editor, Interdisciplinary Science Reviews
    (www.isr-journal.org); Editor, Humanist
    (www.digitalhumanities.org/humanist/); www.mccarty.org.uk/

    My source:  Humanist Discussion Group, Vol. 26, No. 520. www.dhhumanist.org/
    With CASA logo added here. 

    Wednesday, November 21, 2012

    Spaces that Speak*: Theatrum Mundi / The Global Street

    Even as I search for extraterrestrials we are creatures of space.

    The Agora in
    400 BCE
    Womb, swaddling clothes, crib, play pen, 'home', garden, neighbourhood, community, village, town, city...

    Here on W2tQ cognitive and conceptual space is the focus. Hodges' model provides a space for individual or group reflection. In addition to providing a conceptual space the model can represent our physical spaces, our social spaces - incorporating the various means of denoting relationships be that social network, family - genogram, or community group.

    As a unit of 'civilization' there should be civic spaces in villages, towns and cities.  This is frequently not a 'civil' space as might be envisaged in the political sense. In contemplating the health of the individual we must also see the group, the citizens and ultimately the global community. If in future individual's must assume greater responsibility for their health, through which space will that responsibility be communicated? Will the channel of choice be the 2nd, or 3rd household TV, the PC-laptop screen; smart phone or merely the Parliamentary debate?

    Where is 'public space', where can women and children meet in safety, where can free speech be voiced, be heard? If the presence and stability of public space is not an indicator of 'public health' what is it? What is the impact of policy? When cars are removed from an inner town and the area pedestrianised does a public space follow - the people as they walk by(e)? Can philosophy break out of the public houses and into other public spaces?

    The following initiative is centered upon only three cities Frankfurt, London and New York, but will hopefully provide some insights:

    Theatrum Mundi / The Global Street 
    - is a new urban forum. It seeks to understand what brings life to a city, particularly in its public places and asks how these might be better designed. It brings architects and town planners together with performing and visual artists to reimagine the public spaces of twenty-first century cities.
    *and listen.

    My source: Heathcote, E., Design. A breath of fresh air for public spaces. FT Weekend 27-28 October 2012. 4-5.

    Former link image source: http://mkatz.web.wesleyan.edu/grk201/GRK201.Agora.400.html

    Sunday, November 18, 2012

    International Antibiotics Awareness Day

    Dear HIFA2015 and CHILD2015 colleagues,

    Today is International Antibiotics Awareness Day. The message below is forwarded from the forum of the International Federation of Medical Students Associations (IFMSA), which is a longstanding official HIFA Supporting Organisation.

    "Inappropriate use of antibiotics has become a serious threat to public health globally". It is a major cause of needless death and suffering today, and threatens death and suffering on an unimaginable scale in the future. A major contributing factor is lack of access to relibable, unbiased information for prescribers and consumers. Information is either absent, or is restricted to biased marketing materials from big pharma.

    I have invited Students Targeting Antibiotics Resistance Today (START) and IFMSA members worldwide to join us to promote a future where every prescriber and user has access to reliable, independent information on medicines, including and especially antibiotics.

    A suggested starting point would be to make independent, reliable publications such as the British National Formulary freely available to all on the internet.

    Best wishes,

    Today, Nov 18th  is International Antibiotics Awareness day.

    What is the problem? Antibiotic resistance is now an everyday problem in hospitals across the globe. The selection and spread of resistant bacteria in hospitals is a major patient safety issue. Infections with antibiotic resistant bacteria increase morbidity and mortality, as well as the length of stay in hospitals. Inappropriate use of antibiotics may increasingly cause patients to become colonised or infected with resistant bacteria. There are few new antibiotics in the development pipeline. As resistance in bacteria grows it will become more difficult to treat infection and this affects patient care

    Why do we need an  Antibiotic Awareness Day? The inappropriate use of antibiotics has become a serious threat to public health globally, Taking antibiotics for the wrong reasons or incorrectly causes bacteria to develop resistance against antibiotic treatments with a risk of rendering antibiotics ineffective in the future.

    What is the aim of Antibiotic Awareness Day? The aim of European Antibiotic Awareness Day is to emphasis the importance of taking antibiotics responsibly by putting an end to unnecessary use of antibiotics and encouraging people to follow their doctor’s instructions on how to take antibiotics in the appropriate way. The purpose of the day is to build on and reinforce the success of national campaigns on responsible use of antibiotics

    Why is responsible use of antibiotics important? Keeping antibiotics effective is everyone’s responsibility. Responsible use of antibiotics can help reverse the growing trend of antimicrobial resistance and keep antibiotics effective for the use of future generations. On this basis, it is appropriate to inform the public, health professionals and carers of the sick, elderly and children about when and how to take antibiotics responsibly.

    How can I get involved? Here are several ideas on how to help support this initiative: Spread the word Talk about the International  Antibiotic Awareness Day and its significance with your friends, family, colleagues and your Patients Make use of the materials by advertising the International Antibiotic Awareness Day in newsletters, on websites, in the media and on the Internet, by inserting a link on your website, in your e-mail signature or in your blog. Organise and participate in activities.


    On behalf of Students Targeting Antibiotics Resistance Today (START) Team
    Cecilia Kallberg, Jannie Dressler, Oluwasaanu Bunmi Michael.

    My source: HIFA2015

    Saturday, November 17, 2012

    The Bigger Picture - Hockney: Hodges' model 4 dynamic perspectives

    In the decades to follow the patient, the carer, the health and social care professional must all be dynamic. All must be capable of movement - that is taking in several perspectives. As always composition is vital. So is choreography. As Hockney indicates the picture comprises both ordinary perspective and reverse perspective.

    If static, found only for a moment: an assessment, plan, evaluation. A snapshot. Then moving a-gain.

    Ever seeking the dynamic.
    Acknowledgement: David Hockney

    My source:
    'The mass media has lost its perspective'.
    David Hockney, The Financial Times, Page 11, October 27-28, 2012 

    Image source:

    Additional post:

    Friday, November 16, 2012

    Conceptual Reflections on Schizophrenia - Hodges' model

    A decade ago I was studying the Psychosocial Interventions for Psychosis (COPE) pathway part-time at Manchester University. The student body was interprofessinal made up of nurses, psychologists, occupational therapists, nurses and if memory serves me right people from the voluntary (third) sector. What I learned then left me wondering where I had been all those years since qualifying (lost in IT....).

    There are many universities now delivering this curriculum, presenting the very latest research. The lecturers are frequently the researchers themselves, working in ongoing multicenter trials studying  various aspects of the treatment and care management of psychosis.

    This is why it is very alarming to hear of the lack of progress not just within in-patient care as per the findings of the Schizophrenia Commission, but the delivery of care for these individuals and their families across the health and social care system. Of course, as a former student and holder of a PG(Dip.) I am not at present practising these skills formally.

    In the h2cm table that follows I have highlighted some of the main concepts across the care domains of Hodges' model:


    beliefs, perception, attention, anxiety, stress, vulnerability, pleasure, feedback, motivation, mood, therapies, therapeutic relationship, communication, assets, cognitive triad, perception, delusions, hallucinations, positive and negative symptoms, person-centered care, existing coping strategies, mental health assessment, literacies (3Rs, emotional, health), salience, attention, attribution, meaning, creativityphysical health, weight, fitness, side effects, medication, atypical antipsychotics, evidence,
    genetics, research, diagnosis, (cognitive) information processing, dual diagnosis, risk, models of care, recovery, hierarchy of clinical evidence, care processes - assessment, care planning, access to interventions, audio recording of sessions, protocols, DSM IV
    clinical supervision, social attitudes - family, friends, community, stigma, myth, media, carers, familes, social relationships, network, self help groups, survivors,
    activities, daily routine, 'value' of a diagnosis - pros & cons (discuss), community centers, clinical supervision, positive risk management, employment, social history of mental health, social psychiatry, stories,education - schools & community,
    'community care', housing
    mental health history, institutional vs. community care, mental health law, autonomy, consent, capacity, best interests, equity
    mental health services, early intervention, access, POLICY, anti-psychiatry, equity, governance, data gathering, statistics, reporting, outcomes, services,
    secure provision, early intervention, crisis intervention, DSM V, commissioning,
    funding for mental health, education and training, sickness - welfare benefits - 'incapacity' review 'return to work'

    The relative position of concepts above does not indicate priority.

    Wednesday, November 14, 2012

    Associate Professor Fran Biley - Bournemouth University

    It is with great sadness that this week I learned of the passing of Fran Biley. In 2003 I contacted Fran having heard he had worked up in Lancashire in the early 80s as a charge nurse on a then new elderly mentally ill unit. I could not resist the possibility that here was someone who perhaps knew of Hodges' model or had used it.

    There were no major leads, but Fran always encouraged me in my preoccupation with Hodges' model. I did not have a sense that I was just being indulged, or that Fran was purely exercising good manners which I'm sure he had in abundance. Fran also provided support indirectly and so I will miss both his positive words and observations.

    There may be some communications on the old PC to recover, as I've enjoyed following Fran's contributions over the years. The brilliant video on students and nursing theory which I posted here on W2tQ in 2010 and Fran's posts to various lists over the years, including:

    From: Francis Biley at BOURNEMOUTH.AC.UK;
    Sent: Thursday, 29 November, 2007 11:58:15 AM
    Subject: [PSYCHIATRIC-NURSING] Evidence

    Didn't Liam mention nursing in the original post somewhere? What about Peplau, Orlando, and Travelbee and perhaps a host of others who produced buckets full of evidence of whatever flavour you'd like to choose; and Barker as well of course, not added here as an afterthought, more as emphasis.

    And as for contemporary, Orlando's book was published in ?61, and Travelbee died in 73 (I think??)....and we all (should) know Peplau's history (perhaps...)...and FNs Notes on Nursing is still on and off my book shelf like a yoyo.

    Or is it that we've been influenced by psychologists, psychiatrists, sociologists and etc to such an extent that these people (and nursing per se) have clearly disappeared from the horizon, or where never there in the first place?

    I will keep going Fran! Many thanks.

    Tuesday, November 13, 2012

    Second Latin American and Caribbean Global Health Conference “Transcending borders for health equity” Santiago, Chile January 9-11, 2013

    From PAHO (Ana Luisa!)

    Santiago, Chile January 9-11, 2013 - http://www.congresosaludglobal.uchile.cl/

    Abstracts should be submitted through the Conference website and received before November 26, 2012 at 12:00pm (Chilean time)


    The Latin American Alliance for Global Health (ALASAG)
    The School of Public Health “Dr. Salvador Allende G.” of the University of Chile
    The Latin American Association of Schools of Public Health (ALAESP)

    The objective is to share knowledge and strengthen partnerships for education, research and advocacy in Global Health in Latin America and The Caribbean. The conference also seeks to contribute a Latin American outlook to the most pressing issues in the global health and development agenda, such as the impact of the economic crisis, social movements and conflicts and the Millennium Development Goals (MDGs).

    The Conference is intended as a forum for discussion and proposal for progress toward achieving greater equity and social justice within and among all countries.

    The program is organized under the following thematic areas:

    • Migration, violence and population displacements
    • Education and Human Resource Development in Global Health
    • Health law and human rights
    • Nutrition and food security
    • Challenges of social movements and social media networks
    • Development cooperation and global health, peace, and diplomacy
    • Universal coverage and social protection
    • Research, innovation and implementation in global health
    • Working towards the post Millennium Development Sustainable Goals
    • The economic crisis and its impact on public health
    • Climate Change, Challenges and Opportunities for Global Health


    The following speakers have confirmed their attendance
    - Sr. Ricardo Lagos Escobar, former President of Chile and Commissioner of the WHO Social Determinants of Health Commission,
    - Dr. Jaime Mañalich, Minister of Health, Chile,
    - Dr. Ginés Gonzalez, President Emeritus ISalud University, Buenos Aires, Argentina Ambassador to Chile and ex- Minister of Health, Argentina,
    - A representative of Dr. Mirta Roses, Regional Director of the Pan American Health Organization (PAHO / WHO),
    - Sir Michael Marmot, UCL International Institute for Society and Health;
    - Prof. Ronald Labonte, University of Ottawa,
    - Dr. Paulo Buss, Fiocruz Foundation,
    - Dr. Anvar Velji, Consortium of Universities for Global Health (GHEC-CUGH),
    - Prof. Oscar Cabrera, O'Neill Institute for National and Global Health Law at Georgetown University,
    - Dr. Pierre Beukens, Tulane University School of Public Health and Tropical Medicine and CUGH,
    - Dr. Haile Debas, University of California San Francisco, and CUGH,
    - Dr. Wolfgang Munar-Angulo, Gates Foundation,
    - Dr. Roger Glass, Fogarty International Center,
    - Dr. Jeannette Vega, Rockefeller Foundation,
    - Dr. Ilona Kickbusch, The Graduate Institute, Switzerland.


    Many individuals and organizations in Chile, Latin America, the Caribbean, North America and Europe have contributed significant resources to ensure that this second Conference is as successful as the first one. The School of Public Health at the University of Chile, as host of the event, has generously contributed its own resources and from other Chilean funding sources to ensure the success of the Congress. The members of ALASAG in 10 LAC nations are working to promote the conference in their own countries. At the time of this announcement, the following organizations have agreed to partner with ALASAG and the University of Chile to co-sponsor the conference: the Ministry of Health of the Chilean Government, the Pan American Health Organization, Consortium of Universities for Global Health, Columbia University Global Center in Latin America (Santiago), the Fogarty International Center, the O´Neill Institute for National and Global Health Law, Georgetown University, Canadian Society for International Health, Chilean Occupational Health Safety Association (ACHS), Aguas Andinas Corporation, Clínica Las Condes and Pfizer Chile, S.A.

    Giorgio Solimano Cantuarias President 2nd Latinamerican and Carribean Global Health Conference
    School of Public Health Universidad de Chile
    V. Nelly Salgado de Snyder Technical Secretariat Alianza Latinoamericana de Salud Global (ALASAG)
    National Institute of Public Health Cuernavaca, México


    Transcendiendo fronteras para la equidad en salud
    Santiago de Chile 9-11 de enero, 2013

    Instituciones convocantes:

    La Alianza Latinoamericana de Salud Global (ALASAG),

    La Escuela de Salud Pública “Dr. Salvador Allende G.” de la Universidad de Chile

    Website: http://www.congresosaludglobal.uchile.cl/


    Compartir conocimientos y fortalecer alianzas para la educación, investigación y abogacía a favor de la Salud Global en la Región de América Latina y El Caribe.
    Aportar la mirada latinoamericana a los temas más candentes de la agenda mundial sobre salud y desarrollo, tales como el impacto de la crisis económica, los movimientos y conflictos sociales y los Objetivos de Desarrollo del Milenio (ODM).
    Establecer un Foro de discusión y propuesta para avanzar hacia el logro de mayores niveles de equidad y justicia social dentro y entre todos los países del mundo.

    Resúmenes deberan ser enviados a través de la página web del Congreso hasta el día 26 DE NOVIEMBRE A LAS 12:00h

    Ejes de trabajo:

    - Migración, violencia y desplazamientos poblacionales
    - Colaboración internacional para el manejo integral de desastres y epidemias
    - Desafíos de los movimientos y las redes sociales
    - Mecanismos de cooperación y diplomacia para la salud global
    - Cobertura universal y protección social
    - Investigación, innovación e implementación en salud global
    - Hacia los nuevos Objetivos de Desarrollo del Milenio
    - Crisis económica y su impacto en la salud pública
    - Cambio climático, desafíos y oportunidades para la Salud Global
    - Cooperación para el desarrollo y diplomacia en Salud Global

    Giorgio Solimano Cantuarias -Presidente 2º Congreso Latinoamericano y del Caribe sobre Salud Global
    Escuela de Salud Pública Universidad de Chile
    V. Nelly Salgado de Snyder - Secretaría Técnica Alianza Latinoamericana de Salud Global (ALASAG)
    Instituto Nacional de Salud Pública - Cuernavaca, México

    Please visit the GANM webpage at: http://knowledge-gateway.org/ganm/

    My source: GANM c/o Patricia Abbott.

    Saturday, November 10, 2012

    Two recent references informing my studies: Concept maps & Threshold concepts in mental health

    These two references inform my study of Hodges' model:

    Zubrinic, K., Kalpic, D., Milicevic, M. (2012). The automatic creation of concept maps from documents written using morphologically rich languages. Expert Systems with Applications. 39. 12709–12718.

    Stacey, G., Stickley, T. (2012). Recovery as a threshold concept in mental health nurse education. Nurse Education Today. 32, 534–539.

    I will post again soon with some thoughts on the above. If you can suggest other recent resources please get in touch.

    And on a personal note ALL THE BEST TO DAN, KAREN & little ANNA too. 10.11.12 a day to remember.

    Saturday, November 03, 2012

    'Semantic Reefs' - All at Sea, on Land and in Mind

    In reviewing some literature recently I came across the phrase 'semantic reef'. In forwarding a copy of the paper Dr Trina Myers described the semantic reef as: an architecture created to automatically infer phenomenon or alerts about coral reefs using Semantic technologies (aka. Linked Data).

    The coinage of semantic reef in the paper by Myers and Atkinson really captured my imagination. While the semantic web is of interest to me and the environment is the oxygen to the human ecosystem, to our very existence and well-being; Myers and Atkinson's semantic reef is very specific:

    The Semantic Reef Knowledge Representation system is an eco-informatics application designed to assist in the integration of remotely sensed data streams and historic data sets supporting flexible hypothesis design and knowledge extraction. The system is an ontology-based architecture built to allow researchers to combine disjoint data sets into a single Knowledge Base for modelling the impact of climate change on coral reef ecosystems. p.16.
    I've written previously of the conceptual role that the axes of Hodges' model can play. How they act as a distinct, idealised boundary between the disciplines. Most evident is the MECHANISTIC-HUMANISTIC divide between the hard sciences and the humanities. Academics, researchers, health practitioners can become trapped in a disciplinary silo. Reefs are often a Great Barrier. Mariners have to find navigable waters to find a way through. Safe passage is recorded.

    The last thing anyone wants is a shipwreck; whether in the ecosphere, designing software or health care.
    Maybe this is another (long-winded-yes) way of recognising the collapse of holistic bandwidth at the point of a medical emergency, a crisis. The situation IS a shipwreck. A disaster of a very personal kind. What lies beyond the information required in that specific instant, what lies outside that atoll is suddenly not important.

    More positively though a reef also represents an opportunity. It is a sign, a measure of global health. As such it IS a community. It is community. Harmony. Balance. It is the community around which others revolve. And we need to recognise; nOt that, but this and nOw. ...:

    Trina Myers, Ian Atkinson (2013). Eco-informatics modelling via semantic inference. Information Systems. 38, 1, March 2013, 16–32.

    Thanks to Dr Trina Myers.

    Image sources:
    Australian National Maritime Museum


    Wednesday, October 31, 2012

    A model, HTML5, games, the normal and the pathological

    In the UK the powers that be finally recognise the need to introduce children to computer programming. Our future economic viability depends on no less. So many children are too locked into playing games to consider how games are created. New developments including the Raspberry Pi should help change this.

    Here's a possible book intro....
    While this book is considered an introduction to building HTML5 care applications with Hodges' model a conceptual framework, it is also intended to be a companion guide to help get you started making, and more importantly, finishing your care applications.
    Now I'm not seriously proposing that a care application could be written in HTML5 (am I?). In trying to encourage a teen game player to try game programming, I came across a sentence in Jesse Freeman's short book Introducing HTML5 Game Development which I've revamped above.

    The book is about Impact (not open source), a javascript framework. Skimming through the text's potential as a present, you appreciate the potential of games and simulations in health care.

    In health care we talk about levels of care. In Impact there is Weltmeister a level editor.

    The reader is also encouraged:
    "Think of the canvas as an image, that we can bitmap data into." p.8.
    There are maps: background and collision. There are Classes, Person is an inevitable example. Admittedly there is also a zombie, but then one of the domains of Hodges' model is frequently described as being populated by zombies (well, look at their movement and the fact that they are non-living).

    There's talk of a GDD - a game design document. There is a need for a high concept, plus an asset pipeline, and if the design includes complex levels the likely need for a background, middle ground and foreground. If Life is about sprites running ragged around levels of game play, Death is in there too.

    Additional link: Normal and Pathological

    Sunday, October 28, 2012

    Open access: everyone has the right to knowledge

    SOURCE: The Conversation

    By Alessandro Demaio, University of Copenhagen; Bertil Dorch, University of Copenhagen, and Fred Hersch, University of Sydney

    This week, we celebrate open access week – an event aimed at bringing attention to this rapidly emerging form of scientific publication and its ethical imperatives.

    Traditionally, knowledge breakthroughs and scientific discoveries are shared through publication in academic journals. Peer-reviewed and highly competitive, careers are made and broken on the number and impact of these publications.

    With the complex, long-standing hierarchy of journal ranking, scientific publishing is big business. From a distance, one might assume that scientific publications aim to maximise the dissemination of ideas, break down barriers to science and make knowledge accessible to the masses – but this is not actually the case.

    The publication process

    When a scientist, whether in the field, the laboratory or the hospital, makes a discovery, she puts her ideas into an academic paper and submits it to a journal. The journal’s editors decide whether it’s relevant to the scope of the publication, and if it is, they (usually) send it on to a small group of the researcher’s peers.

    These are other specialists in the field who will read and give feedback on the paper. If they think the work is worthwhile, and they have no changes to suggest (which is seldom), then the paper will be published in a future issue of that journal.

    At this point, no one has paid for anything. The authors don’t pay to submit the article, the journal doesn’t pay for the scientists’ work and the peer reviewers are voluntary. Even the editors are often unpaid, unless they can integrate this service into their professional work.

    Journals seek remuneration through subscriptions or once-off access fees by the user – often in the order of US$30 per paper. Those of us lucky enough to have an affiliation to a university, or live in Denmark where the government spends many millions on subscriptions for the entire population can access scientific knowledge free of charge.

    Open access

    Open access publication differs in one very important way from “traditional” academic publishing. Instead of the individual paying to access an article, or buying a subscription, researchers pay for the publication of their work, often out of their research funds.

    In the order of US$1,000-$2,500 per publication, this article processing fee is payable when and if the paper is accepted – and it’s routinely waived for researchers from low and middle-income nations.
    This means that while the editorial and peer review process are the same as above, access to the published work is free forever and available openly (hence, open access) online.

    The traditional publishing paradigm can be regressive and exclusive. Think for a moment how it works: I am a researcher, I do research in developing countries. What if I was to go there; take the time, resources, ideas or even blood samples from thousands of local people; take the information back to my university; access all the scientific knowledge I need in order to develop the work; and then publish my findings in journals for which there’s an access fee of one week’s wages for the people involved in my study.

    Sure I might be able to send them a copy, but for the vast majority of people in that community, science remains out of reach. Now, these study participants may also have no internet access for open access sourcing, but many now do and at least the barrier to knowledge is not put up by the scientific community itself.

    Similarly, in high-income nations, it’s still the wealthy, the highly educated or those at higher-education institutions who have greatest access to the vast majority of published science. How is this just?

    And what happens when we add an additional layer of ethical consideration: that these researchers and their work is often is paid for by society, by taxpayers, through public funding. How can we then justify publishing it in academic media inaccessible to the vast majority who paid for it?

    We can’t just blame researchers or the research community for this – and we’re not saying that because we’re researchers. Academic performance and assessment, in the large part, is determined by the amount and impact of one’s publications. The older “traditional” journals have greater histories and so researchers are almost coerced into publishing with these journals.

    Some good news

    The good news is that things are changing. In the first decade of the 21st century, we have seen an explosion in open access publications. During this time, we’ve observed a ten-fold increase in publications (almost 200,000 at 2011) and more than a six-fold increase in the number of open access journals, to almost 5,000.

    Things are clearly moving in the right direction, but this impressive number still accounts for only around 20% of all publishing.

    Simultaneously, global leaders have acknowledged the ethical dilemmas of our current system and backed open access. The European Union, for example, is currently piloting a project to encourage all EU-funded research to place their results in an open-access repository or publish them in open access journals.

    And some nations, including the United Kingdom, Denmark and Australia, are either planning or implementing policies making publication of publicly-funded research in open access journals mandatory.

    The call for change is being echoed by the academic community, which is asking for greater open access and the removal of economic barriers to science.

    Research should be about furthering knowledge for all. And there’s no reason why open access publication shouldn’t be routine.

    There are also strong economic arguments for investing in a knowledge economy. We are confident that with enough support, we will see more nations, companies and organisations mandating open access publication – a move that’s likely to bring social and economic benefits.

    And who knows, maybe we’ll also begin to see the “traditional” academic journals change their business model and one day make knowledge open to all.

    Dr Alessandro Demaio is PhD Fellow in Global Health with the Copenhagen School of Global Health at the University of Copenhagen. In addition, he is a Director of the Global Steering Committee for the Young Professional Chronic Disease Network and NCD Action. For The Conversation, Alessandro expresses his own views only.
    Bertil F. Dorch is currently senior executive adviser to the university librarian at Copenhagen University Library Services (part of The Royal Library, Denmark), and have previously been Head of Center for Research Support Services as well as a research scientist at University of Copenhagen (The Niels Bohr Institute), within the field of astrophysics.
    Fred Hersch does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.

    The Conversation
    This article was originally published at The Conversation. Read the original article.

    Friday, October 26, 2012

    End of Life Care (Pathways), Nursing and Thresholds

    There is a controversy (Telegraph) that has been growing for some time, concerning the Liverpool Care Pathway for end of life care. This is a very demanding and yet rewarding aspect of nursing. I have experience of end of life nursing care in a non-specialist capacity, having worked on wards for older adults and being involved with people who have mental health and life-threatening physical health problems.

    It pains me greatly not just as a scouser that something with 'Liverpool' in it should become a cause of distress, a center for debate and review. Is the pathway green and shady? Is it comprised of stepping stones, with room for two, and with time granted for your next step? Or is there a danger in some instances the path can become tarmac clad, without the succor of a services stop for basic sustenance? Can a pathway become a motorway? What does that sign say? "DON'T HOG THE MIDDLE LANE!"

    What pains me seriously is that what can be a invaluable, evidenced based palliative care resource can be undermined due to the complexity of the generic and palliative care situation.

    If we truly practice person-centered care then there are no care pathways.

    Or, to put it another way: there are as many care pathways as there are patients and carers.

    Whether you believe in social medicine, or private; whether you are laissez-faire, or leave such matters to a higher power there is no escaping the need for organisation - for order.

    The mix and concentration of people, knowledge, resources and time dictates that tasks, roles and processes be delineated and assigned. We need to assure a given level of quality, and to predict things, not everything is as difficult as the weather: or death. Pathways can assist in specific contexts.

    Is there scope for personalisation on a pathway? ...

    Steps and pace can vary and to the left and right of center. There are many pathways though: some valid - evidenced, award winning; while others might be broad, narrow, twisted - to become a disorientating ethical loop...

    Being placed on a pathway denotes a decision point, a threshold. We need to remember in all fields of health and social care practice that there are multiple thresholds to be taken into account, communicated effectively and revisited:


    'me' - existence, resilience, assets,
    personhood, ethics, personal values, mood,
    personalised care, understanding of treatment,
    communication skills, self-expression,
    loss, orientation, observation, distress, psychological assessment, sedation,
    beliefs, choices, :theology
    'me' - existence,
    feeding, nutrition, fluids, 
    evidence base, Liverpool care pathway,
    quality of life measures, referral thresholds, prediction, resilience, reductive - holistic assessment, medication, distance, where: home-hospital-hospice?
    pain management, decision locale,
    specialism, basic nursing care, resilience

    memories, good-byes,
    love, compassion,
    carer under stress, reassurance, counselling skills, meetings with family,
    empathy and rapport, patient and relative engagement, life history,
    relative's recognition that loved one is dying,
    care strategies,  patient experts,
    patient - carer experience,
    communities of PRACTICE

    consent, advocacy, mental capacity, 
    integrated working, effectiveness, independent autonomy, service access, bed availability,
    health & nursing in the media, scope of nursing, scope of medicine, law, medicolegal issues, whistleblowing, complaints, formal review, appeals, organisation, argumentation,
    professionalism, ageism,

    The relative position of concepts above does not indicate priority.

    "The LCP is not the answer to all our needs for care of the dying but is a step in the right direction."
    Marie Curie Palliative Care Institute
    Liverpool Care Pathway for the Dying Patient (LCP)

    Saturday, October 20, 2012

    Slides from IPH Conference Belfast 11 Oct 2012

    Here are the slides from the IPH Open Conference in Belfast. There were several very helpful questions from the floor. With fifteen minutes for the presentation and ten for questions, the 23 slides were ambitious but they were delivered in the allotted time. Many aspects could be developed further and emphasized. In particular the way that public health policy and practice has switched from needs based approaches to assets. This also reflects the trend in self-care and the recovery model in mental health. (I have added needs-assets to one slide.)

    If any public health - public mental health practitioners are interested in exploring the possibilities then please get in touch. After several presentations the issue here is to extend this work so as to be able to test and apply existing and found knowledge to say something new... 

    I greatly appreciate the votes received for the abstract, the organisers for what was a free event to attendees, and the support and hospitality of Prof. Kernohan. 

    Additional link: The Health Well

    Tuesday, October 16, 2012

    Self-care: The Long Answer (Ack. HSJ)

    Here is another item from the HSJ:

    "There is often a Berlin Wall between formal and informal caring environments both in the NHS and in social care," he says [Alex Fox, Shared Lives Plus]. He argues that patient care needs to be de-institutionalised.
    "If we are going to get anything from all the effort and heartache that has gone in to the NHS reforms, CCGs need to take a holistic view of a person, like good GPs do, and understand that a range of factors go in to someone's health and wellbeing and it is finding models that fit personalised and self-care."
    Helen Mooney, (2012). The Long Answer, Health Service Journal supplement (Long term conditions). 28 June. p.1.

    Staying with the vertical axis of Hodges' model there is something beyond the delineation of INDIVIDUAL and GROUP (POPULATION) that this axis performs. It bisects the horizon of external reality that is frequently differentiated into what is HUMANISTIC and what is often described as MECHANISTIC. If not these terms then the humanities and the sciences.

    From a mental health perspective and taking the above reference to 'institution' literally we can reflect upon how the Victorians sought to standardise provision of care for the mentally ill with the asylums. This was a scientific and political solution to an interpersonal and social problem. Institutions continue to be disempowering, in physical and psychological care. In a way this Victorian solution is still ongoing. On the journey from institution, to community, to home, to self... there is still a long way to go.

    The system created to the mechanistic right within the model was custodial. As far as society was concerned the people there were forgotten. A community within a community was re-created. The person, the individual was lost and we are still trying to find them. Progress has been made and can be mapped across Hodges' model. As one example how has the student nurse's learning experience changed over the decades?

    That INDIVIDUAL-GROUP axis, the red line in the figure is the Berlin Wall that we are still trying to tear down.

    There is another view on this which I'll save for the future.