Hodges' Model: Welcome to the QUAD: 2014

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Sunday, December 28, 2014

When someone mentions health AND arts I reach for my "holistic (carry) case"

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group
my well-being
prescribing


social prescribing


economics


Use the arts to boost the nation’s health:
http://www.theguardian.com/commentisfree/2014/dec/28/arts-boost-nations-health-nhs-funding-arts-council
With the NHS under ever greater strain, the Arts Council and health authorities are collaborating on schemes around the country ...
Peter Bazalgette
The Observer,

Arts Council - ILFA and the holistic case for art and culture
https://www.artscouncil.org.uk/about-ilfa/ilfa-and-holistic-case-art-and-culture

Create: A journal of perspectives on the value of art and culture
https://www.artscouncil.org.uk/create/create-issue-1


Monday, December 22, 2014

simplicity - complexity and Content Types



Without activating any content related modules Drupal 8 beta 4 is pretty stark. That's not a criticism. There are just two content types listed: article and basic page as per the screen dump below. The fact is Drupal is providing an easel and that's exactly what you need even before we get to the palette and canvas. As for other content types, there is a Book, Comment and Forum in core as additional options a checkbox away. There are many other contributed content types that could be added depending on your purpose.

Drupal 8 add content: Article and Basic Page
That's the challenge; using existing resources, stretching them as far as possible. In a book like Drupal for Education and E-Learning you can see even without dedicated learning resources, even with generic content types it is possible to create complex learning environments. Add this to experience of  distance learning - e-learning in the raw - that includes library access, databases, reading, discussion, peer review ... (and for our cohort another residential) and there's plenty to learn from.

In reality content is brittle, usually you can't just stretch it. Imagination and control in the form of flow and rules can work wonders. What is glued together - can be broken apart. It's educational chemistry: learning.

Reuse when possible. Be, active-reactive: responsive.

Is this a desktop I see before me, or is it a smartphone? 

So the screen image above is quite an invitation. I'm sure I've posted about his before: what else should be listed?

Tuesday, December 16, 2014

Axis of rotation: reflected images & imagination

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

imagine a mirror here
self image: REFLECTION

place a mirror here
REFLECTION: body image

what about here ...


and here?



Sunday, December 14, 2014

two cultures? mental health care_physical care : health care_social care : Hodges' model axes


http://www.proguide.it/index.php/2011/02/23/valscura-sassongher/?lang=en
Val Scura

 
C P Snow The Two Cultures
http://www.newstatesman.com/cultural-capital/2013/01/c-p-snow-two-cultures

My source:
Robbins, T. (2014) On the straight and narrow, FT Weekend, Travel, 6-7 December. p.8.

Val Scura - image source:
http://www.proguide.it/index.php/2011/02/23/valscura-sassongher/?lang=en
©Francesco Tremolada

Tuesday, December 09, 2014

"You're a nurse? How much do you know?"

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

Yes, I am a nurse - thanks for asking.
So come on - how much do you know?
Actually, I know very little.
Eh?
Why is that?
Surely you have to be quite knowledgeable,
all the lectures, the training on wards, clinics, out in the community, staying updated too?

ethics, giving bad news, communication, self-awareness, empathy and rapport, recovery model, education... anatomy & physiology, healing, homeostasis, medicines, basic life support, drug side effects, risk of falls, observations, infection control...
cultural competence, team work, respect and dignity, the 6Cs, carer education, handling conflict, family therapy...policy, records, scope of practice, continuing education, professional development, confidentiality...

Surely, this little snip points to a packed 'curriculum'?

So it does, but as a nurse you can't make too many assumptions?

Well, yes I suppose so; no-one should pre-judge but you'll have to explain?

[ Now, why am I so pleased you said that...? :-) ]
Well a nurse has to be dispassionate in order to be compassionate.

So... as a nurse you contradict yourself?

No, not exactly. I suppose, given your opening gambit, we have to be neutral, neither hot, nor cold. That way we are sensitive to difference and spotting change. If we think someone is cold, or has a fever then we measure - we find out we check their temperature. So of course some things we can learn based on fact-finding.

Inevitably, assumptions are made as there's a job to do, but it's important not to prejudge. There's a big difference between assumptions, judgements, stereotypes, biases, hypotheses, and the like.

So a nurse can be tepid all the time? Where's the warmth in that, eh?

Good point, but you know what we're about here.
There's general warmth, friendliness, being approachable, civil, being professional.
Then there's warmth as an ingredient in those critical instances.

So, it's a case of yes and no. At first you've to be open-minded. Take the conceptual  framework Hodges' model. Initially it is all structure, but this structure provides four empty care domains - five when wrapped by the spiritual. This can act as a great aide-mémoire.

With a referral you make use of any information that is provided because that's very important too. The information that is received initially is hopefully sufficient to indicate the nature of the problem in broad terms. It may be more specific pointing to an existing diagnosis, a relapse, or multiple diagnoses.
Yes I see. Hodges' model is the blank sheet and as such it is open, non-judgmental.

Yes, but there are also indicators that point to risk, physical - falls for example, plus psychological and mental health aspects like risk of self-harm, harm to others and possibly self neglect. These are the things that must also to be assessed and as such ruled-out.

SELF -
SELF -
HARM
NEGLECT
HARM TO OTHERS
HARM BY OTHERS - ABUSE
VULNERABLE ADULTS
ABILITY TO GIVE CONSENT,
MENTAL CAPACITY

So when does that 'open-mindedness', or 'neutrality' become closed?

As we learn about someone, we build up a picture that kind-of notion, once known some things are closed as they don't tend to change.
They're concluded?

Yes, but one of the reasons that nursing is such an ace job - and yes I know why your grimacing - but it IS!

Anyway, that first day can be a lesson in dynamics. If not the first day it will soon follow!

So, you have to use many different sources and kinds of knowledge.

Yes, that's right and the best knowledge of all is...?

Well, I guess learning for ourselves is the best, most permanent way.

You have it there. It's a really exciting time for nursing, health and social care. Although they go on about technology and clearly technology has a major role to play. 'IT' is playing a major role and if you listen carefully you can hear the robots...

There is much more to do on that 'humanistic' side.

The open-mindedness, openness and acceptance is a baton that we must pass back to the patient. Self-care, when possible, health literacy skills and competence are crucial now.

It's not just the days that are different either. The people we encounter, the patients, the clients - call them what you will, they are all pearls. Aggregated, yes sure, you see so many oysters; but open and face-to-face as a nurse each one shines, unique and peerless with individuality.

OK. Thanks - that's cool indeed!

Acknowledgement - Stu Young, Royal College of Nursing Students

Thursday, December 04, 2014

Report: Personalised Health and Care 2020 [II] - National Information Board

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

"All patient and care records digital,
real time and interoperable by 2020."
"Clinicians in primary, urgent
and emergency care, and other key transitions
of care contexts will be operating without paper records by 2018."
"Patients have access to their hospital,
community, mental health and social care services records by 2018."

"By April 2016, commissioners and providers
must publish "road maps" showing how they
will develop interoperable digital records
and services by 2020."
 


Report: Personalised Health and Care 2020. National Information Board. November 2014.

Source:
Illman, J. (2014) National tech blueprint sets greater role for regulators - Personalised Health and Care 2020: selected recommendations, Health Service Journal, 21 November. 124: 6424; p.13.


Tuesday, December 02, 2014

Saturday, November 29, 2014

Reflexive strategy realised in policy: from hokey cokey to hocus pocus

Strategy is usually about the longer term, as such it needs to be reviewed, but it is hardly a matter of reflex. Crisis management within a strategy should be an operational contingency, the implementation of contingency plans.

As posted several years ago, I've been fascinated by the need for vulnerable people to 'beware of reflex moves'. The example I have comes across repeatedly is due to the people community mental health services encounter. Older adults who are newly bereaved (and suddenly become vulnerable) and for whom it is (also) suddenly judged by well-meaning family members that they should move their home to be nearer the family. This decision is often made quickly, when the grieving if it is ongoing, has only just started and decision-making is impaired to say the least.

It is a bit of stretch, but we can relate this to health, social care and policy. Let's see ...

As an evidence-based activity health care is far removed from "hokey cokey". To be precise its Levenshtein distance (or edit distance) is 8 :-)

Unfortunately, a recent HSJ/Serco Commission on Hospital Care for Frail Older People concluded that health and social care integrated care is a "myth" in terms of being the "silver bullet" for the NHS's financial difficulties (Barnes, 2014).

I'd been wondering about the problems that have been solved and those still ongoing since I began my nursing career in the late 70s. You could call the latter personal legacy career issues. The commission's report describes the current flagship project the better care fund, as having been planned in a "hokey cokey" fashion.

Of course, integration is as many-splendored in its transformational promise, as it is many tentacled in its complexity. What is being integrated? To what extent does this include disciplines, finances (budgets), philosophy, location, record systems, management, policy, accounting, reporting and accountability ...? How do we measure and recognise success?

On a positive side the Levenshtein distance for "hocus pocus" from "health care" is 10, so that maybe reassuring?

The worry is that there is form elsewhere, also highlighted in HSJ (Illman, 2014).

The 3 Million Lives telehealth programme has been scrapped. If it is a measure at the time of this post, the last tweet was 18 March 2013.

Given the major upheaval that the NHS has been through this is hardly the ideal environment for policy making that must engage staff and the public.

Engagement - crucial!

Barnes, S. (2014) Landmark report criticises integration policy. Health Service Journal, 21 November, 124: 6424; pp. 4-5.
Illman, J. (2014) NHS England outlines telehealth successor, Health Service Journal, 26 September, 124: 6416; p.13.


Friday, November 28, 2014

Papers 2 study: The longitudinal effect of concept map teaching on critical thinking of nursing students

Lee, Weillie; Chiang, Chi-Hua; Liao, I-Chen; Lee, Mei-Li; Chen, Shiah-Lian; Liang, Tienli (2013) The longitudinal effect of concept map teaching on critical thinking of nursing students. Nurse Education Today, Vol.33(10), pp.1219-1223.

From the summary (with my emphasis):

... The intervention of concept map teaching was given at the second semester in the Medical–Surgical Nursing course. The results of the findings revealed student started with a mean critical thinking score of 41.32 and decreased at a rate of 0.42 over time, although not significant. After controlling for individual characteristics, the final model revealed that the experimental group gained a higher critical thinking score across time than the control group. The best predictive variables of initial status in critical thinking were without clinical experience and a higher pre-test score. The growth in critical thinking was predicted best by a lower pre-test score, and lower scores on surface approach and organized study. Our study suggested that concept map is a useful teaching strategy to enhance student critical thinking.

Thursday, November 27, 2014

Threshold Concepts - one of '10 trends set to shake up education'

Professor Ray Land emailed the Threshold Concepts community following up on the conference held in July 2014. I can't believe that very soon another month and the 2016 conference in Nova Scotia will be 'next year', but there we go...

Prof. Land updated us on a prospective book, and when available I will post news of the book and the next conference here.

While I am sure Threshold Concepts are (very) applicable to Hodges' model and my research interests, I am not trying to contribute to the planned text. I'm busy enough with the third graduate study module. Reading, discussion, a 4k word draft essay, two peer student reviews...

Prof Land also highlighted the following, which he's happy for me to share with you [I've added the image]:

... We were pleased to see that Thresholds were identified as one of '10 trends set to shake up education' as reported in The Times Higher magazine last week.


http://www.open.ac.uk/iet/main/files/iet-web/file/ecms/web-content/Innovating_Pedagogy_2014.pdf
Innovating Pedagogy 2014 - Report
The report, produced by the Open University and called 'Innovating Pedagogy 2014', is free to download here:

https://iet.open.ac.uk/file/innovating-pedagogy-2014.pdf

Kind regards and hope that all is well where you are.

More shortly

Ray
____________________________________________________
Professor Ray Land
Director, Centre for Academic Practice (CAP)
& Professor of Higher Education,
School of Education, Durham University,
Leazes Road, Durham DH1 1TA
United Kingdom

Monday, November 24, 2014

Big Hero 6 - clip (Healthcare is never 'Frozen')

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group











My source:
Educate the Young - Disney and Pixar Understand Patient-Centered Care

House of Care model

... the House of Care model - a coordinated, patient centred system, in which patients and carers work with healthcare staff, supported by organisations, to optimise their care. HSJ (2014)

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

Patients

Healthcare staff

Carers


Organisations


NHS England: House of care -
http://www.england.nhs.uk/house-of-care/

King's Fund: House of care -
http://www.kingsfund.org.uk/publications/delivering-better-services-people-long-term-conditions


My source: 
Trueland, J. (2014) How to tackle the workforce planning issue, Health Service Journal. 124, 6418: pp.16-21.

Sunday, November 23, 2014

Antipsychotics & Dementia: Managing medications (across Hodges' model)

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group
person-centered care, communication

diagnosis
medication management
assessment - review
premature deaths, stroke
side-effects
observation
Anti-psychotics:
Traditional - 1st generation
Atypical - 2nd generation
de-prescribing
pain, analgesia, 
research
anti-depressant
cholinesterase inhibitors
titration
trial reduction
avoid benzodiazepines if possible
Team working, collaborative care, family
nursing homes
challenging behaviours -
shouting, aggression, psychosis, agitation
Behavioural and psychological symptoms of dementia (BPSD)
psychosocial interventions, reassuring staff, knowledge and skills
Policy, Reports, Governance, Audit, Consent, Capacity, Consultation, Multi-disciplinary approach, institutions, choice

My source: AlzheimersAustralia via twitter
https://www.dementia.org.au/

Monday, November 17, 2014

Response to: Pros and cons of pulling behavioral and social data into EHRs [Government Health IT]

Mike Miliard Editor of Healthcare IT News posted an item:

Pros and cons of pulling behavioral and social data into EHRs

To put my reply in context here is the start of Mike's post:
Should more types of health data figure into electronic health records?

On the one hand, the Institute of Medicine put out a call for doing just that on the grounds that behavioral and social data can benefit population health practices to ultimately improve the care of individual patients. For physicians who already complain that EHRs are burdensome and distract from care delivery, on the other hand, the idea of making electronic records more complex, perhaps even cluttered, will inevitably be unwelcome news. ...

Talk about a work in progress? How long does it take to get this right? Of course health and social care data is always ongoing, as governments change, policy, medicine, local government, social care, technology and society too.

As Mike notes for many physicians the EHR is already burdensome. My context is quite different being nursing, mental health, and crisis-oriented in the community. I've defined small research-based datasets in the past and it is a fascinating pursuit. Trying to have the data defined and reporting ready before the 'door opens'. Doing this retrospectively is no fun at all.

At work when I visit someone in a residential care or nursing home, do I record this as 'home', or 'community' in the absence of the aforementioned categories? Is this ageism?

Is there a digital dividend to come to the physician's aid? Surely increasingly the physical measurements and observations in medicine, surgical... can be automatically captured, disseminated and presented accordingly? Surely, it is possible today to bring in other data as the context changes? If we can autofill on words, we should be able to auto-fill the dataset as context shifts? There are many algorithms out there already 'alive and countin-the-clickin'  in the milliseconds.

It seems Mr Miliard is writing about one way to define 'integrated care'?

It isn't just 'public health' though;
it must combine, be inclusive of - 'public mental health'.

The focus of the article is the Institute of Medicine's report:

Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2

Mike lists eight domains from the report and these are mapped to Hodges' model below:

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group
educational attainment, stress, depression
physical activity, stress

social isolation, intimate partner violence (for women of reproductive age)

financial resource strain,
neighborhood median household income

I've included stress twice as there are at least two forms: anxiety - internal; and environmental - external.

Sunday, November 16, 2014

Woman says goodbye to beloved horse from hospital bed hours before she dies

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

Sheila Marsh is reunited with her horse Bronwen one last time.
Photograph: Andrew Foster/Twitter






The Guardian:
Woman says goodbye to beloved horse from hospital bed hours before she dies:
http://www.theguardian.com/uk-news/2014/nov/07/sheila-marsh-horse-reunion-goodbye-hours-before-she-dies

Image source:
http://www.theguardian.com/uk-news/2014/nov/07/sheila-marsh-horse-reunion-goodbye-hours-before-she-dies

Saturday, November 15, 2014

Report: Personalised Health and Care 2020 - National Information Board

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

self-help, self-care, person-centredness, personalised care

task-centredness, administration, time, processes, events, data capture

"Patients told to go online in
radical NHS reform"


"Government withholds
35m nursing technology fund"



Report: Personalised Health and Care 2020. National Information Board. November 2014.
https://www.gov.uk/government/publications/personalised-health-and-care-2020

Sources:

The Times, Patients told to go online in radical NHS reform. 13 November 2014. London. p.1.

The Nursing Times, Government withholds 35m nursing technology fund. 12 November 2014. p.2.

Thursday, November 06, 2014

'Voronoi treemap' by Michael Balzer, (2005)


http://www.brainpickings.org/2014/07/17/the-book-of-trees-manuel-lima/
'Voronoi treemap' by Michael Balzer, (2005)


Images courtesy of Princeton Architectural Press via Brain Pickings

The Book of Trees - on a table in Waterstones, Manchester this evening.

Monday, November 03, 2014

Learning model for International Health - progress since 2005?

In the third module of my technology enhanced learning studies I have been reading:

Henry, B., & Ueda, R. (2005). Learning model and curriculum designs for international health in nursing. Japan Journal of Nursing Science, 2(1), 17-24.

The aim of the paper is:

Nursing’s domain of inquiry for international health is unclear. A learning model to frame this specialty is unavailable. The goal of this analysis was to open debate worldwide on the nature of concepts, relationships, and analytic constructs that can serve as a foundational blueprint for international nursing curriculums. The aim was to define and operationalize international health in nursing by constructing a learning model.
The results included the identification of five main concepts:

 environment, demography, culture, technology, and research.

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

environment, technology, demographics
culture

Using Hodges' model above I have mapped these concepts to the model's domains. The influence of context looms large of course, so we can also for example consider the sociological aspects of the environment and the politics of the environment which is currently newsworthy on a global scale.

I've placed the concepts in the primary domain. We can extend them in many ways. Diagonally, technology can be extended to what is (should be?) socio-technical. Usability brings in the interpersonal domain and subjective experience. Funding and access politicizes many concepts and no-less here.

I'm being deliberately contrary with research. Usually I'd split research between the sciences and sociology. My doing so equates to the dated, but still significant distinction between quantitative and qualitative forms of research respectively. Basically this means that using Hodges' model we can replace the humanistic (subjective) and mechanistic (objective) labels above with 'research'.

We can take 'environment' and be person centered looking at the individual experience. We can do the same but for a group, or population.

As I investigate culture, nursing, Hodges' model and educational technology I do wonder what progress has been made since 2005: where these concepts sit within the care domains (and why), and what about the gaps? Back to the literature...!

Sunday, November 02, 2014

Sohei Nishino - Dioramas: Tokyo, Kyoto, Osaka, Hiroshima, Shanghai, London ... Jerusalem

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group
Jerusalem © Sohei Nishino

Jerusalem 2012-13
Nishino's maps aren't supposed to be geographically accurate. "It is simply the town seen through the eyes of a single individual," he says, "a trace of the way I walked through it." He uses a film camera and develops the images himself before painstakingly cutting and assembling them into a collage.

The Sunday Times, Magazine, p.50-51. 19 October 2014.

[politics of (some) places] pj



Michael Hoppen Gallery (30 October - January 7):
http://www.michaelhoppengallery.com/

My source: Scenes from the cutting room floor, 19 October 2014, Spectrum, The Sunday Times, 49-52.
Image - Jerusalem, source:
http://www.michaelhoppengallery.com/artist,show,3,161,485,2753,0,0,0,0,michael_hoppen_contemporary.htmlJerusalem

Saturday, November 01, 2014

Ebola: impact across the care domains

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

grief, mental trauma, stress

ChildFund International opens first Interim Care Center for children orphaned by Ebola:
https://www.childfund.org/ChildFund-International-opens-first-Interim-Care-Center/
Dear Friends,
Ebola is  frightening.  Most information from TV, Facebook, and from our governments is poor. We want to change this by providing to you the best possible scientific information  about Ebola from leading scientists from Nigeria, Africa, the Library of Alexandria and experts world wide.

We have created a cutting edge lecture on Ebola for you to teach your students, share with your faculty and distribute to your friends. The Lecture has been translated by 20 scientific experts  into  Arabic, Chinese, English, Farsi, French, Hebrew, Japanese, Malay, Pashtu, Russian, Spanish and Urdu. It present the best possible scientific knowledge about this disease.

http://www.pitt.edu/~super1/lecture/lec52511/index.htm

...
We provide this to you as a “gift that is meant to be given”. Please share this with your students and faculty, and post the lecture on Facebook, tell others about  it through Twitter, etc.  The Library of Alexandria Lecture is free, developed by the global scientific community. Include links to this from Universities, Libraries, schools media, etc.

Let us continue to learn and share the scientific facts about Ebola.

Drs. Elegba, Kana, Bello-Manga and Adiri
Faculty of Medicine
Kaduna State University, Nigeria
Ismail Serageldin, Ph.D., Director Library of Alexandria
Ronald LaPorte, Ph.D. Director Emeritus WHO Collaborating Centre, Pittsburgh
Al Jazeera America
The biggest concern of the Ebola outbreak is POLITICAL*, not medical:
http://america.aljazeera.com/opinions/2014/8/ebola-virus-liberiasierraleonepolitics.html


Additional links:

Understanding the Ebola Virus and How You Can Avoid It:
https://alison.com/course/understanding-the-ebola-virus-history-treatment-and-prevention-revised

The Economist: Ebola and big data - Waiting on hold:
http://www.economist.com/news/science-and-technology/21627557-mobile-phone-records-would-help-combat-ebola-epidemic-getting-look

Ebola Resources:
http://ebolaresources.org/

Ebola Deeply:
http://www.eboladeeply.org/

Ebola, David Quammen, Bodley Head:
https://www.davidquammen.com/

Sources:
HIFA2015
https://sci-techuniverse.blogspot.com/2013/01/terrifying-facts-about-ebola.html
*my emphasis

Friday, October 31, 2014

Metamorphosis (Ste p e-learning [curve?] )

I'm walking over ground of a gradually steepening pitch. At a certain point, I pause and start using my hands; the real mountain begins. I am climbing. Do I, as soon as my back slopes forward, return to the state of the quadruped? Almost: my body transforms; feet become hands and my two manual grips secure balance. Homo erectus, the standing man, of recent date, reverts back to the one from whom he is descended: the archaic quadrumane. This thunderbolt recollection became so black, in me, that I no longer fear to speak of the beast; I remember who we were (p.3).
Michel Serres (1999) Variations on the Body, Univocal.

Saturday, October 25, 2014

EAST-WEST: meetings of minds, bodies and souls

south
INTERPERSONAL : SCIENCES
? WEST ------------------------------------------- EAST ?
SOCIOLOGY : POLITICAL
north
"The Philosopher" by Ludwig Deutsch (1905) from the collection of Shafik Gabr.

East West Dialogue:
http://eastwestdialogue.org/

Image source and title link:
NY Times Robin Pogrebin November 29, 2012
Seeing Orientalist Art as an Aid to East-West Dialogue
http://artsbeat.blogs.nytimes.com/2012/11/29/seeing-orientalist-art-as-an-aid-to-east-west-dialogue/?_php=true&_type=blogs&_r=0

My source:
Financial Times 23 November 2013, p.6 

Wednesday, October 22, 2014

HUMANISTIC-MECHANISTIC: How far can dichotomy travel?

International Space Station STS-127 Wikimedia


Where are the Voyagers Now?

Image source:
http://upload.wikimedia.org/wikipedia/commons/e/ed/ISS_%26_Endeavour_Shadow_STS-127_2.jpg

Wednesday, October 15, 2014

Glen Campbell - I'm Not Gonna Miss You

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group




Music video by Glen Campbell performing I'm Not Gonna Miss You. (C) 2014 Big Machine Records, LLC.

Glen Campbell and Jimmy Webb have produced some truly age-defining music. A memory I hope to cherish all my days of these tunes was September 17 1979 flying Wardair from Manchester to Calgary. We chased the sun all the way over Iceland, Greenland ... with Glen singing along. A magical experience and holiday.

Thanks Mr Campbell!

May the nursing care you now receive be as person-centered as your music is to me and countless other people; and may high quality care be available to all who need it.

Thanks to Randy Roberson for this news.

Tuesday, October 14, 2014

c/o [hifa2015] Stop the .health!

Hi everyone,

Some of you may know about the research I and colleagues around the world have been pursuing on the new health-related domains published in the Lancet, JMIR, Globalization and Health, and featured by news outlets such as NPR, Kaiser Health News, the CBC, and others.  Right now we have the unique opportunity to make an impact by demanding that that public health interests are a priority in the future of the Internet.

Background
Currently, about a dozen health-related generic top level domains (gTLDs) are being added to the Internet.  They include domains such as .healthcare, .med, .doctor, .clinic and MOST IMPORTANTLY a new .health.  Unfortunately, ICANN is now in the process of awarding this hugely important domain space that could shape the very future of health information online to a company that has no interest nor expertise in public health.  Basically, ICANN has ignored key stakeholders including the World Health Organization, World Medical Association, Save the Children, IMIA, France, Mali, and others who have expressed great concern about ICANN’s treatment of the .health.  This recently ended in a secret and private settlement to award the .health that was scheduled to go to a public bidding process.

This decision is important as it will impact global public health and the health of individual consumers.  As people increasingly use the Internet for health information and use that information to make crucial treatment decisions, the quality and trustworthiness of health information online has never been more important.  A .health that was properly governed, had sufficient participation from the medical and public health community, and that was structured as a global public good for the broader community, could have been a game changer for ensuing the reliability of health information online and improving health outcomes.  This has not happened, as ICANN has focused on economic and commercial interests over public health.

What you can do
We are now engaged in a last ditch push to make a real difference here and we have an opportunity to do so.  Right now ICANN is having their annual meeting in Los Angeles. After discussions with friends at WHO, other academics, and even those sympathetic to our cause within ICANN, we’ve learned that only the broader public health and medical community can make a difference.  For this reason, I am hoping you will join our coalition in letting ICANN know that the concerns of the public health community for the .health need to be addressed immediately.

You can make a difference by directly engaging in ICANN’s policy processes via an online public forum this THURSDAY, OCTOBER 16 - 14:00-17:00PM PDT.  Participation is easy and will not take much of your time:

All you have to do is visit the following URL (http://la51.icann.org/en/schedule/thu-public-forum), and then click the “Virtual Meeting Room Stream Live” link, click the option to participate as a guest, and you will be entered into an adobe connect chat room where you can participate and voice your concerns.  Some of the concerns that could be addressed are:

- why has ICANN ignored calls by the WHO, World Medical Association, France, Mali, and others about the .health
- why did ICANN award the .health with no transparency through a secret settlement?
- why has ICANN not responded to multiple letters sent to their board about the .health asking for a moratorium/suspension of the process?
- why does ICANN treat other domains such as .wtf, .sucks, with better safeguards than the .health?
- why has ICANN not listened to the public health community about the .health and other health-related domains?
- health is such an important issue, shouldn’t we have a place on the Internet where we can trust our health information?

I will be personally attending the ICANN meeting in LA and meeting with certain key ICANN officials to try to make an impact.  Please join us so that we can ensure the .health is a place to improve your health, not harm it.

If you have any questions feel free to contact me at anytime attmackey AT ucsd.edu.  Only with your help can we hope to make a difference.

Thanks!

References and Sources

Published articles:

  • Mackey TK, Liang BA, Kohler J, Attaran A. The Fight over dot-health: Ensuring the Future of Health Information Online.<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62215-1/fulltext?rss=yes> The Lancet. 2013; 382:1404.
  • Mackey TK, Liang BA, Kohler JC, Attaran A. Health Domains for Sale: The Need for Global Health Internet Governance<http://www.jmir.org/2014/3/e62/. J Med Internet Res. 2014;16(3):e62.
  • Mackey TK, Eysenbach G, Liang BA, Kohler JC, Geissbuhler A, Attaran A. A Call for a Moratorium on the .health Generic Top-Level Domain: Preventing the Commercialization and Exclusive Control of Online Health Information<http://www.globalizationandhealth.com/content/10/1/62. Global Health: 2014; 10:62.
News articles:
  • National Public Radio: (http://www.npr.org/blogs/health/2014/09/26/351416992/will-dot-health-make-it-more-likely-that-youll-get-scammed)
  • Canadian Broadcasting Corporation (http://www.cbc.ca/news/health/health-websites-could-be-overrun-by-commercial-interests-experts-fear-1.2779128)
  • TechDirt (https://www.techdirt.com/articles/20140926/08041428649/health-experts-issue-call-to-prevent-icanns-commercialization-new-health-domain-leading-to-exclusive-control-online-health.shtml)
  • Medical News Today (http://www.medicalnewstoday.com/releases/283165.php)
  • Kaiser Health News (http://www.kaiserhealthnews.org/Daily-Reports/2014/September/29/health-IT.aspx)
  • Medpage (http://www.medpagetoday.com/PracticeManagement/InformationTechnology/44766)

My source: HIFA: Healthcare Information For All: www.hifa2015.org

Friday, October 10, 2014

WMHD II c/o LSE: Investing in crisis care for people with schizophrenia makes moral and economic sense

“When someone has a mental health crisis, it is distressing and frightening for them as well as the people around them. Urgent and compassionate care in a safe place is essential – a police cell should never need to be used because mental health services are not available. For me, crisis care is the most stark example of the lack of equality between mental and physical health.” 
(The Rt Hon Norman Lamb MP, Care and Support Minister)
There is a strong moral and economic case for investing in innovative approaches that support people with schizophrenia to live independently in the community. Crisis resolution and home treatment teams and crisis houses can help reduce the need for expensive hospital admissions with some studies suggesting that the costs of care can be reduced by up to 30% through these service models. There is a clear potential for Clinical Commissioning Groups to make better use of their resources by investing in home treatment teams and crisis houses as approaches to crisis resolution.
My source: The London School of Economics and Political Science, Health and Social Care blog email

Hodges' model in recovery ...
Jones P. (2014) Using a conceptual framework to explore the dimensions of recovery and their relationship to service user choice and self-determination. International Journal of Person Centered Medicine. Vol 3, No 4, (2013) pp.305-311.

World Mental Health Day 2014: or...

https://www.time-to-change.org.uk/sites/default/files/WMHD%202014%20EVENTS%20POSTER%20FINAL.pdf
https://www.time-to-change.org.uk/WMHD



http://www.mentalhealth.org.uk/our-work/world-mental-health-day/world-mental-health-day-2014/

or - World Parity of Esteem Day 2014?

Thursday, October 09, 2014

Privacy: Open Data, Individual and Group

The vertical axis of Hodges' model is the individual - group, or self through to collective. Health and social care constantly negotiates this from the ideals and delivery of person-centred care to public mental health. So often for health professionals the emphasis is on the individual, the person's care needs, their strengths, their rights, outcomes and feedback on care received. The same individual focus is also ascribed to records and information. Protection of data, maintaining confidentiality is an essential duty of health care  professionals.  

Earlier this year the government's care.data scheme was placed on hold. 'Open' is the way of the world: open access, open source, open data and open government. Increasingly the group as an entity needs to considered in what may be a new way, as Floridi writes:

The idea that groups may have a right to privacy is not new, and it is open to debate, but it has not yet received all the attention it deserves, although it is becoming increasingly important.
 ...
Open data is more likely to treat types (of customers, users, citizens, demographics population, etc.) rather than tokens (you, Alice, me), and hence groups rather than individuals. But re-identifiable groups are ipso facto targetable groups.It is therefore a very dangerous fallacy to think that, if we protect personal data that identify individuals, the protection of the groups will take care of itself. p.23.

Luciano Floridi. Group Privacy. The Philosophers' Magazine. Issue 65, 2nd Quarter 2014. pp. 22-23.


http://grantabooks.com/The-Private-Life

Here is a related book (on my list) a BMJ award winner:

The Private Life, Josh Cohen:
https://granta.com/products/the-private-life/

The war over private life spreads inexorably. Some seek to expose, invade and steal it, others to protect, conceal and withhold it. Either way, the assumption is that privacy is a possession to be won or lost.

But what if what we call private life is the one element in us that we can't possess? Could it be that we're so intent on taking hold of the privacy of others, or keeping hold of our own only because we're powerless to do either? ...




Wednesday, October 01, 2014

Bits of information a-cross the centuries - Bad Tidings & The Love Letter

As noted previously on W2tQ the significance of information practically and as a concept is very obvious in health and social care. Not just the debate about assuring privacy and confidentiality of clinical records and professional disclosure, but the meaning of information to an individual. This is assuming that the person concerned has the mental capacity to recognise what a particular circumstance, event, item of news means; and not just this morning, but tomorrow...

A diagnosis, lab result, a date for this procedure or that operation all can be a major source of anxiety and stress.

This week's visit to Amsterdam also included a visit to the Stedelijk Museum, where I saw Jobstijding (Bad Tidings), 1932 / Carel Willink (1900-1983). On Saturday I marvelled at Vermeer's The Love Letter and many other great works at the Rijksmuseum. ...

Through art and these works in particular we can contrast the social impact of information, of news - its meaning past and present with our ongoing preoccupation with binary representation and the information age.

Snail mail may be less common and yet the impact of decisions, news, life events ... remains.

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

https://www.rijksmuseum.nl/en/collection/SK-A-1595
Vermeer - The Love Letter
1 0
0 1
http://www.stedelijk.nl/en/artwork/3872-de-jobstijding
Carel Willink - Jobstijding (Bad Tidings)

0 1
1 0

Image sources:
The Love Letter, Vermeer
http://www.sai.msu.su/wm/paint/auth/vermeer/vermeer.love-letter.jpg

Jobstijding (Bad Tidings), 1932, Carel Willink (1900-1983) Stedelijk Museum, Amsterdam, The Netherlands

http://www.pinterest.com/pin/567383253025365412/

Sunday, September 28, 2014

ERCIM News No. 99 Special theme: "Software Quality"

Dear ERCIM News Reader,

ERCIM News No. 99 has just been published at
http://ercim-news.ercim.eu/en99

http://ercim-news.ercim.eu/en99Special Theme: "Software Quality"
http://ercim-news.ercim.eu/en99/special/

And on the occasion of ERCIM’s 25th anniversary, we published a selection of articles on the future challenges of ICST:
http://ercim-news.ercim.eu/en99/challenges-for-icst

Keynote by Willem Jonker, CEO EIT ICT Labs: "The Future of ICT: Blended Life"
http://ercim-news.ercim.eu/en99/keynote/the-future-of-ict-blended-life



This issue is also available for download as:
pdf:  http://ercim-news.ercim.eu/images/stories/EN99/EN99-web.pdf
epub: http://ercim-news.ercim.eu/images/stories/EN99/EN99.epub

Next issue: No. 100, January 2015 - Special Theme: "Scientific Data Sharing"

Thank you for your interest in ERCIM News.
Feel free to forward this message to others who might be interested.

Best regards,
Peter Kunz
ERCIM News central editor

Saturday, September 27, 2014

Rijksmuseum Amsterdam - health in art : art in health

I arrived in Amsterdam last night and spent today, 8 hours in the Rijksmuseum. It is an amazing experience, even to just scratch the surface. Early on it was not busy! Entering the building, is as publicised, to discover a remarkable series of spaces.

There are so many highlights of a rewarding day. One must be within the final hour 1610 finding one of Van Gogh's self portraits. Van Gogh finds himself placed in the interpersonal domain not just by virtue of this self portrait, but his struggle with mental health and  hospitalisations.

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group
http://www.vangoghmuseum.nl/en





The Anemic Woman
Samuel Dirksz van Hoogstraten [Public domain], via Wikimedia Commons
There were many other (ill-)health related examples (and many that are also bright and humorous).

The sick child. The Sick Woman....

When initially viewing Visiting the Sick you have some searching to do. The sick individual themselves and the doctor are rather lost in the background. The painting stresses the sociological, domestic aspects of health past and present.

In Visiting the Sick and The Anemic Woman we get a view of the way outside (possibly of spiritual significance?) and another room through doorways. From TV, reading and my visit today, this is a common device within Dutch genre painting. If we have a diagnosis now in the 21st century, we still need to look through the windows and doors that relate to the individual and their social situation. In the age of the interface and partitions we still need to negotiate themDoorways, windows and portals as changes in knowledge content, can in the form of care domains illuminate the boundary of what is objective and subjective. This is central in health and social care.


Van Gogh self portrait source:
http://historiek.net/chinezen-zeer-geinteresseerd-in-van-gogh/13217/#.VCb5mRbivTo

The Anemic Woman image source:
http://commons.wikimedia.org/wiki/File:Samuel_van_Hoogstraten_-_The_Anaemic_Lady_-_WGA11719.jpg

Thursday, September 25, 2014

1 in 3 will be older adults by 2025 in Japan

In June Dr Mayumi Hayashi described Japan's vision of 'total care' for its older population in HSJ. The article that prompts this post follows another with lessons for England.

Referring to a "2025 vision" this forward thinking has its roots in established systems of healthcare set up in 1961 and social care established in 2000 (p.25).

Care integration is not new as a fundamental issue in health and social care. It is for me a career legacy issue. As a student nurse it was discussed and debated, closely allied with multidisciplinary and holistic (joined up physical and mental health) care. Even now 37 years later it will drive many arguments and policy deliberations in the run up to the next election here.

Many nations are faced with stark demographics. As the population ages and works its way through wooden blocks, Rubik cubes, it is the population pyramid that takes on increasing significance.


Dr Hayashi lists the need for inclusion, integration and continuation of four components that are essential to the realisation of this vision:
  • maximising the integration of healthcare and social care;
  • promoting policies for prevention and outreach together with safeguarding;
  • embedding supported living programmes and dementia friendly community initiatives; and
  • addressing “late life specific” housing needs.
I have mapped these to Hodges' model below:

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group
embedding supported living programmes and dementia friendly community initiatives integration of health and social care
"late life specific" housing needs
(integration of health and social care)
promoting policies for prevention and outreach, together with safeguarding


It becomes clear to see in Japan, China and other nations how telecare and smart homes have a role to play. Getting the basics of integrated care resolved firstly is the prerequisite whatever the culture.

Where achieved the integration of health and social care can act as a diagonal brace as it straddles two care domains. Perhaps the model also reflects the ongoing challenges of parity in esteem in mental health care and physical care; and the funding ambiguity for people living with dementia as opposed to other medical conditions?

In January 2014 the FT Weekend magazine also featured an article on ageing in Japan.

Hayashi, M. (2014) Japan's vision of a 'total care' future looks bright, Health Service Journal, 124, 6404, 25-27. 

FT magazine cover image:
https://www.facebook.com/financialtimes/photos/a.10150157857040750.297340.8860325749/10152119294570750/?type=1

Tuesday, September 23, 2014

Agnostic qualities in Hodges' model

In the previous post I highlighted "Holistic approaches to learning are agnostic as to method." 

I added that there would be more to follow as Hodges' model can be viewed as agnostic on several levels. The following is taken from a paper on Hodges' model and its application in forensic nursing:

Hodges’ model claims to be person-centred and situated (Jones, 2008). What exactly does this mean for forensic nursing? The utility of Hodges’ model lies in it being agnostic. By ‘agnostic’ this means that the model is not dependent upon, dedicated to, sanctioned by, or owned by any particular discipline (even nursing). It was not designed with a particular media, clinical setting, situation or organization in mind. It is true, however, that the model was formulated within academia and health and social care, being taught and applied by community mental health nurses, learning disability and health visiting students. Apart from the history and universality of the model’s cruciform structure and its inherent 2 x 2 matrix form [often referred to as a Johari window (Luft and Ingham, 1955)], the model is also culturally neutral. This is an essential requirement to reflect and enact nursing values and codes of conduct (Nursing and Midwifery Council, 2008).
Doyle, M., Jones, P. (2013). Hodges’ Health Career Model and its role and potential application in forensic mental health nursing. Journal of Psychiatric and Mental Health Nursing. 20, 7, 631-640.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2012.01961.x/abstract

Saturday, September 20, 2014

Book: Teaching Crowds - Learning and Social Media

This book is available as an open access pdf. Here is an extract from chapter 2 on Social Learning Theories.

Holistic approaches to learning are agnostic as to method. Drawing from connectivist and older models, they valorize diversity and the socially distributed cognition afforded by the read-write Web and other publishing models, accepting that every learning experience is unique, and every learner’s needs are different. Connectivist approaches, for all their extensive reliance on networks of people engaging socially, are at heart focused on the individual—specifically, the individual’s learning. Holistic models embrace the fact that it is sometimes more important that a group learns, rather than an individual, especially in collectivist cultures (Potgieter et al., 2006). Holistic models recognize that, sometimes, guidance is what is most needed, that people can learn without direct engagement with others and, even that transmittive instructionist models of teaching have a place. p.61.
In the next post I will explain the emphasis placed in the quote.


Jon Dron and Terry Anderson (2014) Teaching Crowds: Learning and Social Media, AU Press.

My source:
ITFORUM mailing list 
http://listserv.lt.unt.edu/mailman/listinfo/

Friday, September 19, 2014

Self-determination: individual - group (high-low) resolution

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group


Flag of Scotland (Union Jack colours and proportion).png
Border
Binary Decision
magnanimity

Flag of the United Kingdom

Image sources:
"Flag of Scotland (Union Jack colours and proportion)" via Wikimedia Commons.
https://commons.wikimedia.org/wiki/File:Flag_of_the_United_Kingdom.svg

Wednesday, September 17, 2014

The Lyon Declaration on Access to Information and Development

Dear all,

The Lyon Declaration on Access to Information and Development 
http://www.lyondeclaration.org/ was successfully launched at the World Library and Information Congress 2014 in Lyon. Since then, over 280 organisations from across the library and development community have signed the document and called upon United Nations Member States to incorporate access to information in the new post-2015 development framework. The Declaration has now been translated into 13 languages.

Following the release of the Open Working Group Outcome Document in July, IFLA is now waiting to see what UN Secretary General Ban Ki-Moon will present to the UN General Assembly later this year in New York. The Secretary General is currently overseeing preparation of a ‘synthesis report’ that will bring together the outputs of various processes on the post-2015 development agenda and help UN Member States find a way forward in negotiations over the next twelve months. The synthesis report is expected to be released at the end of October/early November.

What are the next steps?

Once the synthesis report is issued it is crucial that policymakers in the capitals of UN Member States get to hear what libraries want to see in the new framework. As outlined in the Lyon Declaration, IFLA wants the United Nations to acknowledge that access to information, and the skills to use it effectively, are required for sustainable development, and to make sure that the framework’s goals, targets and means of implementation reflects this.

Your voice will be needed for us to achieve this goal.

IFLA is currently preparing an advocacy toolkit which will help library representatives to approach decision-makers in order to talk to them about the importance of access to information in development. IFLA wants to help its members and partners to take the opportunity to position themselves inside development debates in their home countries, so that their governments recognise the value libraries bring to development. Ultimately, libraries can benefit from being included in the national plans that will implement the new development agenda from January 1st, 2016.

The advocacy toolkit will be available in early October 2014.

What can you do to help?

  • You can sign the Lyon Declaration and add your voice to the call at the United Nations.
  • You can translate the Lyon Declaration into your language and share it with colleagues in your own country.
  • You can encourage others in the library and development sectors to sign the Lyon Declaration.
  • You can organise meetings with policy makers in your country and use the toolkit provided by IFLA in order to make the library voice heard on a national level.
  • You can promote the principles of the Lyon Declaration throughout your network and ensure that the message gets spread as widely as possible.
The Lyon Declaration is available at http://www.lyondeclaration.org/

...

Background

The Lyon Declaration on Access to Information and Development calls upon United Nations Member States to make an international commitment through the post-2015 development agenda to ensure that everyone has access to, and is able to understand, use and share the information that is necessary to promote sustainable development and democratic societies. It was prepared by IFLA and a number of strategic partners in the library and development communities.

Please also see the webversion.

Julia Brungs
Policy and Projects Officer
International Federation of Library Associations and Institutions (IFLA)
P.O. Box 95312
2509 CH The Hague
Netherlands

My source: HIFA2015