Hodges' Model: Welcome to the QUAD: October 2014

- 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

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

? WEST ------------------------------------------- EAST ?
"The Philosopher" by Ludwig Deutsch (1905) from the collection of Shafik Gabr.

East West Dialogue:

Image source and title link:
NY Times Robin Pogrebin November 29, 2012
Seeing Orientalist Art as an Aid to East-West Dialogue

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:

Wednesday, October 15, 2014

Glen Campbell - I'm Not Gonna Miss You

humanistic ------------------------------------------- mechanistic

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.

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.


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...



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.


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

The Private Life, Josh Cohen:

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.

humanistic ------------------------------------------- mechanistic

Vermeer - The Love Letter
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Carel Willink - Jobstijding (Bad Tidings)

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Image sources:
The Love Letter, Vermeer

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