Hodges' Model: Welcome to the QUAD: January 2015

- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Saturday, January 31, 2015

Nursing Rubens








Rubens Tour - themes







Health as Art and Science?

"The triumph of Ruben's nudes is his magnificent evocation of the texture of human skin, represented in such a way it feels almost palpable. We see blood coursing through the veins of voluptuous flesh. The delicate mother-of-pearl complexions of the female bodies radiate with light. ..." 
(Lust, Royal Academy of Arts, Gallery Guide)

B(e) nurse

Tuesday, January 20, 2015

Do you have a spirit level? Yes, try this one...

When an individual becomes a group -

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


Half Global 


Wealth: Having it all and wanting more
Ack. Thanks to Archbishop Sentamu & Channel 4 News for reminding me of The Spirit Level book.

Monday, January 19, 2015

Dream Away

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

Sunday, January 18, 2015

Book Review: Illness


As mentioned on W2tQ before this book has been feigning illness for over a year, sitting static on the bookshelf. Brushing it off has brought great reward that was quickly delivered as the book is just 160 pages plus references and index. My review copy is the revised edition from 2013.

The book is well structured with five chapters, that tread a consistent path through what is a very objective-subjective landscape. The author's aim and orientation is clear from the beginning. Each chapter provides a phenomenological account of how illness affects the life of individual. The shadow that is death is also an important thread throughout the book, culminating in the final chapter. Havi Carel describes the book as neither a personal story nor a purely philosophical reflection on illness. It is both, we are told (p.15).

 The introduction lays out the disciplinary, experiential and perspectival divide that the book seeks to address, broadly normativist and naturalistic approaches to health and illness [presented using h2cm]. I say consistent above as you can see the personal story and philosophical aspects, but amid this 'illness' Lymphangioleiomyomatosis (LAM) a balanced gait between the personal account and philosophical dimensions is maintained. According to the text and Foundation: LAM is a progressive lung disease that usually strikes women during their childbearing years. The introduction and chapter 1 provides the narrative to the discovery of having LAM. This demonstrates the rather frequently haphazard, deferred, denial-oriented way in which people seek medical help. Given the apparent severity of the symptoms you might expect that help was sought sooner. I thought that was a male phenomena? This is one of several 'what ifs'... Havi expresses later.

Others reviews (yes I read one) remark on Carel's candidness and honesty. The book is courageous too, engaging the reader as an interviwer-interviewee; some questions are answered in the next paragraph, others left for the reader. Yet privacy, dignity and self-respect of the author foremost and people (family, friends, professionals) involved is preserved.

The philosophical discussion is not very technical, accessible it draws upon ancient Greek philosophers, notably Epicurus and the phenomenological school of Heidegger, Merleau-Ponty. Further reading is listed and related to the book's themes. Critics of the book as Mikey Burley describes, see too many emotion-laden autobiographical anecdotes. The appeal for me of this book and the achievement of the author is to stress how the humanistic is still so frequently lost. The mechanistic stamps on communication, compassion, effective and person-centred care. Recourse to anecdotes is inevitable if we are to integrate an individual's experience and what the sciences can offer. Not just knowledge in all its forms, but seeking 'truth' - or its best approximation. Is the battle the individual Vs. the disciplines? Psychology is well established as a discipline and yet its early beginnings in Wundtian introspection were found wanting. We are still seeking balance.

The book is neither a treatise nor a tractatus, but it does seek to gain traction on meaning within health theory, practice. This is not armchair philosophy, it is everyday philosophy as might now be found in some pubs (public houses), it is trying to move towards philosophical therapy. Havi Carel addresses the way that health is taken for granted: we notice when there is a problem, functionality is curtailed. Contemplation of decline, mortality and death is not for the everyday, it is for the aged, Havi's students: Havi and many others who are touched by illness.

The body and mind feature large as would be expected, embodiment and agency. "We are our bodies; consciousness is not separate from the body" (p.16). What stands out for me is Havi Carel's call for a deeper conceptual shift since physiological accounts are insufficient to represent the personhood of illness. Actually, I know we keep saying 'deeper' but taken literally that might be reduction's way. The dichotomies here: objective-subjective, physical-mental health, internal-external (p.70), social model-medical model, self-other, health-disease and others ... seem to demand conceptual outreach. 'Meta' is everywhere these days, is this the case as Carel writes, with habit or pre-reflective: something for me to explore (p.27)?

Carel states what we know, but needs to be flagged. What does a walking stick represent, a zimmer frame, a wheelchair? In the same way that time can be compressed and extended so too can distance: it is not objective (p.16). As a former cross country runner that lesson was learnt quite a while ago, running diagonally across a ploughed field on a hill in February: oxygen debt. Once paid I recovered, but with a diagnosis like LAM and other rare diseases. I realise another definition of the individual-group axes within Hodges' model: a small group can become and act as one through activism.

Havi writes of mentally recording things, to remember abilities that will be lost, as adaptation and adjustment blur past and present. Experience of nursing people with dementia has prompted me to try to do this. Carel's hiking, swimming desire to push the envelope is universal. I can still remember the path running through Crompton's Woods, the trees, the turns the ups and downs. Reading Illness I recalled my brother vaulting over the back fence, we would land already halfway down the embankment the dust caught in the summer sun. We flew then. The woods for decades now a housing estate. Remember.

While reading was there was a coincidence in the media, the news of disease, cancer, life choices and bad luck (p.37). I suppose it is down to luck who deals with us a patient-client. I've always viewed an accepting, positive, open and caring attitude as fundamental for health and social care practitioners. Carel encounters care professionals who should be doing other things. Chapter two 'The social world of illness' begins with a single word: empathy. Regardless of ongoing austerity - Carel's story begins in 2004-2006 - empathy is the emotion in shortest supply. This really hurts. I am still trying to find a name for the professional who fails to be human, preoccupied with the mechanics of illness (p.47).

We have digital humanities and as noted in W2tQ medical sociology boasts an established literature. The medical humanities and philosophy of medicine are seeing to extend our understanding of health and illness (p.51). I am encouraged in the need for holistic views and approaches, conceptual and cultural frameworks (p.53). The counterpoint to unprofessional, negligent, disrespectful professionals is the need to learn to be rude, in order to cope generally (p.55). Some sentences are definitive. On well-being: "Well-being is the invisible context enabling us to pursue possibilities and engage in projects" (p.64). If I ever write another paper on information I will reference page 70, as I continue to reflect. Is technology, data - big and small and the quantified self the whole answer to healthcare's challenges?

Page 80 invites a philosophical discussion on personal identity, dementia and existence, to which we could also add sense-making and grief. The impact of illness is well made, as is the explanatory power of Heidegger. There is a mental exercise - imagining health within illness. I can extend this:
  • Apply the concept of health to the domains of Hodges' model?
  • Apply the concept of illness to the domains of Hodges' model?
  • Apply the concept of health within illness to the domains of Hodges' model?
Page 81's focus on being, ability and dichotomies is very supportive of my studies. I'm not sure if the irony in mention of Stephen Hawking and a contracted horizon is intentional, but it made me smile. Page 87 reminded me of my hackneyed thoughts about cogeography - a cognitive geography of concepts for healthcare (and more); something beyond a classification system or nomenclature. An architecture that encompasses the dichotomies, disciplines and experiences mentioned above and in the book. Page 90's note of the apparent deficit perspective of medicine towards the lived body, might also emphasize the assumption of deficit in knowledge and the rise of the expert patient, student-centered learning also.

I have many more notes from chapters 4-5 and at least one more blog post to follow. Other questions arose from chapter 5. Will people be referred to mental health services in future because they are deemed suicidal as they decline their personalised genomic treatment (Kim Stanley Robinson's, Red Mars)? Chapter 5 Living in the Present had me thinking about Plato's Philosopher Kings (p.148). At the end of the day we must rule ourselves even in the darkest of circumstances, but this takes wisdom and philosophy. This is a much needed book and I have only scratched the surface. I will let you learn of the book's full title and the significance of the same. A great read, despite the subject.

BURLEY, M. (2011), EMOTION AND ANECDOTE IN PHILOSOPHICAL ARGUMENT: THE CASE OF HAVI CAREL'S ILLNESS. Metaphilosophy, 42: 33–48. doi:10.1111/j.1467-9973.2010.01675.x

Many thanks to Katharine Green, Editorial Assistant, Acumen Publishing for my copy.

Additional link:
BBC Radio 4: In Our Time, Phenomenology 

Friday, January 16, 2015

Social Care is dry in January

I bought The Times today and on the front page is the news from University of Oxford:

Dehydration ‘common’ among patients admitted from care homes:

When nursing and residential homes are struggling to manage an individual's care and look to refer to mental health services (usually) they know they need to asked the 'question'. This is about physical health: does the resident have an infection, are they eating and crucially drinking, are they in pain, constipated. ...

Although the headline augers badly and points to an ongoing (politically) 'inflammatory' problem within the sector, there is a great deal of compassion out there.

A resident's marked emotional distress and torment can upon investigation become a matter of how to also manage the staff's distress as they try to meet the individual's care needs. The latter does not help the former and amongst other things points to an educational need. This is especially so, if residents are to be able to continue to 'age' in their new 'home' with the additional complex needs that might follow.

Fluid balance used to be an element of basic nursing care.

Now of course - social care is not nursing care.
It is not always 'basic' either.

Thursday, January 15, 2015

Architecture and Design: 4 beds in 4 domains

'Privileged' is definitely the wrong word. Perhaps it is the advantage of experience and the passing of almost four decades and more....

Times have changed since arriving at Winwick Hospital on a bike as a student nurse for an early shift at 0655. I would  leave my bike just down a small corridor to the right of the main entrance. I don't think I locked it. Then depending on the ward allocation I walked through the red carpeted front of the hospital to the increasingly rough and seemingly lost corridors beyond.

Hospitals have changed markedly. Winwick and other asylums have gone - thank goodness.

Cockroaches, leaking roofs, two-storey blocks where when necessary the patients would carry the meals up the stairs. A charge nurse set about ensuring that the patient's were provided with proper safety equipment if there were no lifts. The dormitories were large: 40+ bedded and more. There were lockers of some description I think, but personalised clothing was still to follow in 1977.

Despite the emphasis on community care, a project that in reality is still a work in process, the need for hospital beds remains. I have worked to keep people out of hospital, to help provide crisis support at home. When beds are needed the experience for members of the public and their families is radically different today. As taxpayers we recognise the need for efficiency in design, procurement, commissioning and managing new buildings. So it is within the NHS. Visiting new modern facilities, and this includes private nursing homes, you really appreciate the benefits good design can bring for patients-residents, staff, students and visitors.

humanistic ------------------------------------------- mechanistic
My space
Private space - observations permitting/negotiated
Space to wander
Space for wheelchairs

Why is Joe staying in bed?
Why is Mary not going in the lounge?
4 Bed Multi Bed Bay c/o ProCure21+

Public space
Quiet spaces (who says?)
Dining areas
Activities room
Noise levels
Meeting rooms
Interview rooms

Public Engagement
Project Management
Value for Money

Image source: http://www.procure21plus.nhs.uk/standardshare/

Tuesday, January 13, 2015

Peter's penchant for boxes...?

Although the number of posts using Hodges' model may suggest I'm obsessed with putting things in boxes and I am extolling you to do the same, please note; this is not the case [well not entirely ;-) ].

The model recognises the common need to make sense of things, hence our tendency to dichotomise, categorise, to seek meaning and order. The model makes explicit 'four basic boxes', but then invites us to transcend them by testing each one, subjecting the four domains to reflection. Five domains, taking in the spiritual also.

Given a situation, a context, a patient, or carer, or student ... we can ask what are the facts, what are the issues and how are they linked? Mentally we can consider what important concepts are missing?

It is not for me to provide all these concepts. I may|should|must also listen, observe and liaise in order to identify them. The solution is about teamwork, partnership and collaboration.

Yes, the 'boxes' really are there. The disciplinary divides do still exist. In h2cm they are integral to the structure of the model. But as we progress in applying the model we seek to blur, if not erase the boundaries. To achieve holistic and integrated care we need to collapse the boxes. It seems something more than interdisciplinary and interprofessional is needed to connect and integrate what are frequently neglected knowledge (care) domains and content.

I should be able to explain some of this in my review of Prof. Carel's book 'Illness'.

Monday, January 12, 2015

Reading 'Illness'

Over the UK holiday period in-between searching the literature (pre-reading list) for the next module I've been catching up with very overdue book reviews.

Havi Carel's book Illness (2013) [2nd edition] was received December 2013 and is thankfully short and very readable. The review's still to follow as I am just halfway through, but there is a point in the preface (xvi) that cascades down each side of Hodges' model as Prof. Carel identifies two approaches to how illness is approached:

humanistic ------------------------------------------- mechanistic
sees disease as a value-laden term.

sees disease as a value-free concept, as biological dysfunction.


stigma, communication, friends, compasssion...


matters of fact, procedure, targets...

What is clear already from the text is that it is probably more accurate to say that the normativist approach springs from within the sociological domain. Our attitudes to disability and illness are informed by our upbringing, family, friends, education - our formative experience. Then we are socialised into our respective health and social care roles.

Prof. Carel makes clear (up to page 72 at least) the impact (see the domains above!) of an illness upon the individual that can then be compounded by others and by the health care systems that should holistically care before it treats or palliates.

More to follow...

Many thanks to Katharine Green, Editorial Assistant, Acumen Publishing for my copy.

Sunday, January 11, 2015

Self Orbits CERN: BBC Radio 4 [Looking forward to March]

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

 BBC Radio 4: "Self Orbits CERN": 
Will Self goes on a 50-kilometre walking tour of the Large Hadron 
Collider at Cern, just outside Geneva.

Looking forward to March....

Image source:

Saturday, January 10, 2015

The Difference That Makes a Difference 2015 (DTMD 2015) Information and values: ethics, spirituality and religion

Dear colleague,

The Difference That Makes a Difference 2015 (DTMD 2015) is the third in a series of biennial workshop on the nature of information. The theme of this event is Information and values: ethics, spirituality and religion. It forms part of a larger summit on information organised by the International Society for Information Studies, held on the 3rd-7th June at the Vienna University of Technology, Austria. DTMD 2015 is organised by The Open University, UK.

This workshop starts from the premise that information and values coexist in a relationship of tension, and that they engage in a dialectical process in certain key areas of human society. Within these areas, information and values co-construct a synthesis which includes but transcends both aspects. This synthesis is particularly expressed in the fields of ethics, spirituality and religion.

Particular inspirations for this workshop include the work by West Churchman on The Systems Approach and its Enemies, which argued for a dialectical relationship between the rationalist ‘hard’ systems approach and perspectives such as morality, politics, religion and aesthetics which are apparently opposed to it. Ethics and religion have also been long-standing interests in various areas of cybernetics, which is the starting point for this exploration of information, and were central concerns in the later work of Norbert Wiener, Heinz von Foerster and Gregory Bateson. In this sense the workshop is continuing an ongoing stream of work.

As well as leading to new insights into ethics, spirituality and religion, this work also acts as a further lens through which to explore the nature of information. The language of information is increasingly used in many different disciplines, and comparing the usage in different fields contributes to a better understanding of information in its own right. The areas of spirituality, ethics and religion are somewhat less examined in the context of information than many other disciplines, and so this workshop will continue the ongoing process of exploring multi-disciplinary aspects of information.

This workshop follows two international workshops held in Milton Keynes, UK, in 2011 and 2013, both entitled The Difference that Makes a Difference. These workshops explored the nature of information in a range of disciplines (including physics, biology, sociology, computing, systems thinking, philosophy, geography and art, among others). Proceedings of both workshops can be found at http://www.dtmd.org.uk/.

Key questions which the workshop will address include:

  • Can newly-emerging insights into the nature of information inform ethics, spirituality and religion? And does our understanding of ethics, information and religion contribute to a new understanding of the nature of information?
  • If information is the new language of science as Von Baeyer suggests, can it also be a new language of ethics, spirituality and religion?
  • If we are re-ontologising the world as an infosphere, does that make information ethics the new universal macroethic, as Luciano Floridi suggests?
  • Is the language of information effective in talking about spirituality?
  • Can we interpret the theologies, mythologies and praxis of religion using the language of information? How do religions use information and informational concepts? Conversely, what might it mean to think about information as theological or mythological?
  • Can a theory of information provide a weltanschauung to replace or supplement religion as the motivation for ethics, spirituality and community, and if so, is such a replacement necessary and / or desirable?
The workshop organisers welcome submissions which address themselves to the above and related questions through the medium of art as well as traditional academic formats – DTMD 2013 had a major focus around the interplay between art and information, and we hope to continue this in the current workshop.

Submission deadline (extended abstracts of 750-2000 words): 27 February 2015
Notification of acceptance: 20 March 2015

Workshop organisers (all at The Open University, Milton Keynes, UK):

David Chapman, Magnus Ramage, Chris Bissell and Mustafa Ali (Department of Computing and Communications)
Derek Jones (Department of Engineering and Innovation)
Graham Harvey and Paul-Francois Tremlett (Department of Religious Studies)

Online version of call for papers: http://summit.is4is.org/calls/call-for-papers/the-difference-that-makes-a-difference-2015

Hope to see you in Vienna in June!


Friday, January 09, 2015


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

Image source:


NW England: UCLAN - Postgraduate Student Conference 2015 Designing and Delivering Research to Inform Clinical Practice

School of Health
Monday 26th January 2015 
9am to 4pm Adelphi Conference Room

A series of short talks to stimulate and inform those contemplating, planning and undertaking research

Supporting UCLan’s postgraduate students

8.30 Registration. 9.00 Start.  

9.00 – Welcome by Professor Tim Thornton, Professor of Philosophy and Mental Health. Why do we need different research methods?  Chair: Professor Caroline Watkins, UCLan School of Health Director of Research.  

9.20 – Dr Louise Connell, NIHR Career Development Research Fellow. Developing a health research career.  

9.40 – 10.20 Session 1 - Systematically reviewing the evidence.  
• Dr Stephanie Jones, Senior Research Fellow & Colette Miller, Research Assistant. Searching the literature to explore what impact training health professionals has on patient outcome. 
• Dr Gill Thomson, Senior Research Fellow Maternal and Infant Nutrition and Nurture Unit (MAINN). Metasynthesis – why and how we do it. 

10.20 - 10.30 Questions 

BREAK – 10.30– 11.00 (30 minutes tea/coffee/networking) 

11.00 – 12.00 Session 2 - Clinical Trials and complex interventions. 
• Dr Chris Sutton, Principal Lecturer and Associate Director Lancashire Clinical Trials Unit. The role of feasibility trials in the development and evaluation of complex interventions. 
• Dr Michael Leathley, Post Doctoral Research Fellow/Principal Lecturer (Research). Health economics in feasibility trials. 
• Dr Lois Thomas, Reader in Health Services Research. What do process evaluations contribute to trials of complex interventions?  An example from the ICONS: Identifying Continence OptioNs after Stroke Trial.  

12.00– 12.20 Questions  

LUNCH 12.20 until 13.20 networking. Sandwich lunch provided  

13.20 Chair: TBC  13.20 – 14.20 Session 3 - Implementation science and service user involvement. 
• Dr Rob Monks, Senior Lecturer and John Billington. Experienced-based co-design. 
• Dr Mick McKeown, Principal Lecturer, Centre for Mental Health and Wellbeing. & Fiona Jones, Community Futures.  Activism, action and alliances: meaningful involvement in research.  

14.20 – 15.00 Session 4 Qualitative research to answer health and social care questions. 
• Dr Janine Arnott, Research Fellow, Children’s, Families and Transitions. Data collection from children. 
• Prof Soo Downe, How qualitative research can influence national and global policy in maternal and child health.  

15.00 – 15.20 Questions  

15.20 – Dr Alexis Holden, Head of UCLan Funding Development and Support. ‘UCLan Research and Innovation Office (RIO) – How can we help you?’  

15.40 – Final session - TBC.  

16.00 CLOSE


Adelphi Building, Preston (Adelphi Conference Room, UCLan's Adelphi Building, Adelphi Street, Preston, PR1 7AY

[ I only learned of this event yesterday afternoon and have managed to secure leave and a place - there are a few more left. ]

Thursday, January 08, 2015

ERCIM News No. 100 Special theme: "Scientific Data Sharing and Reuse"

Dear ERCIM News Reader,

ERCIM News No. 100 has just been published at http://ercim-news.ercim.eu/en100
Join us in celebrating the 100th issue and post a message at http://ercim-news.ercim.eu/guestbook

Special Theme: "Scientific Data Sharing and Reuse"

Keynote by Carlos Morais, European Commission: "e-Infrastructures Enabling Trust in the Era of Data-Intensive Science"

This issue is also available for download in:
pdf:  http://ercim-news.ercim.eu/images/stories/EN100/EN100-web.pdf
epub: http://ercim-news.ercim.eu/images/stories/EN100/EN100.epub

Next issue: No. 101, April 2015 - Special Theme: "The Internet of Things & the Web of Things"
(see Call for articles at http://ercim-news.ercim.eu/call)

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

Tuesday, January 06, 2015

Calling Dewey and the care domains

In Education for work: background to policy and curriculum Corson (1991) considers the workplace, workers, satisfaction and the constraints that operate there. From almost a century ago Dewey is cited and resonates with nursing and Hodges' model:

The result was a redesign of workplaces to lessen the constraints and to satisfy worker's desires from achievement, recognition and interest: to offer them meaningful work. For Dewey work of this kind plays a critical role in self-fulfillment and in continuing education: it becomes a vocation or a calling:
A calling is of necessity also an organizing principle for information and ideas; for knowledge and intellectual growth. It provides an axis which runs through an immense diversity of detail; it causes different experiences, facts, items of information to fall into order with another (Dewey, 1916, p.362). p.173.

Corson, D. (1991) Introduction: Studies in Work Across the Curriculum, In. CORSON, D. (ed.) Education for work: background to policy and curriculum.Clevedon: Multilingual Matters Ltd. p.173.

Dewey, J. (1916) Democracy and Education. Macmillan: New York.

Monday, January 05, 2015

Book review: Quinn's Principles and Practice of Nurse Education [ 6th Edition ]

I owned the 3rd edition of this book and approached the publisher for a copy of the most recent, which is gratefully received. This review is quite delayed in fact, I've a few other reviews to get on with too.

From the outset while a book on nurse education, the text serves general students and practitioners in education in parts one and two. I completed my PG Cert almost twenty years ago and this book would be an asset to current students (see the content listing for parts 1-2 below). There are many technical concepts within what is a comprehensive text; for example, there are 54 index entries related to 'assessment'.

Much of the book's value is accentuated for readers here in the UK. Here is an established and high quality textbook that provides a UK perspective. As a 7th edition the references for each chapter are expansive taking in key historical sources and more recent publications. There are many illustrations in the form of flowcharts and figures. Following each chapters references, suggested further reading is provided. Review exercises at the end of chapters serve the added purpose of sign-posting content. The information architecture and design of the book makes for a logical, clear and readable experience. Even if the content were lacking, which it is not, the book is fairly substantial at 550 pages. The book is well produced, the paper quality (lending to the weight) and the binding works! Yes, the binding serves to secure the pages and works well when the book is opened flat. This is an obvious requirement and yet so frequently it is a struggle.

As to specifics: Parts 1 and 2 are a welcome refresh. The discussion on thinking and critical thinking are sufficiently detailed and of special interest (pp.58-66) to me. Intuition receives a 'nod' with a dedicated paragraph on p.66, sufficient no doubt to give our students a troubling 'prod' in their future and ongoing careers? I wonder if pages 51-59 might benefit from review and more references, acknowledging what is a well-executed historical account within part 1? An educational challenge I am pondering at present is that of values within nursing. How can we teach these (including the 6Cs)? Amongst what is new to the book is that it meets NMC standards. It would be easy to produce a list of omissions, but I would expect to see abuse, safeguarding, whistleblowing, and vulnerability in this book. How students encounter these concepts and subsequently learn about such sensitive topics must be critical to their insight (life experience to date), self-awareness and skills development. Reflection is very well represented throughout the parts of the book which encourages my efforts with Hodges' model.

I mentioned the book's relevance to current PG Cert Education students and must add that I have referenced the text in a paper for my current studies in technology enhanced learning. On this front the publishers clearly recognise the extended potential of additional e-learning services through CourseMate. An Instant Access Card accompanies the book. Part 4 extends this relevance to continuing professional development and lifelong learning. Chapter 11 is very helpful for its practical dimension, describing placement learning, link lecturers, mentoring and the challenge of the failing student. Sometimes ESOL - English for Speakers of Other Languages is a factor and 'language' could be noted more specifically. This is not a matter for student selection but should be ongoing and would also be addressed within the public (equality and diversity pp.129-134). In mental health I am acutely aware of the importance of communication skills. This comprehensive treatment includes supervision, sign-off mentoring, practice educators plus triennial review.

If I have a bad habit it's looking through the index of a book and asking: What might I expect to see here? The bad aspect is it's tantamount to reviewing by exclusion. And I'm already guilty too. The book fulfills its purpose and does not need to reflect the whole nursing curriculum. But... I would have hoped to see 'open source', Massive Open Online Courses (MOOCS), the role of mobile e-learning, learning management systems - Blackboard is mentioned but not Moodle. Perhaps there are commercial considerations at work? 'Threshold levels' are mentioned but not 'threshold concepts'. This is understandable as we are only just on the cusp of a special interest group in health and social care (more on that to follow I hope). For those like myself who are on the service-practice side chapter 8 is insightful, on marking and providing student feedback beyond the student-mentor relationship. There is constructive support and encouragement for new lecturers and advice on quality and evaluation in higher education.

A year ago I reviewed an even larger textbook on Nursing Informatics, and in truth informatics still has a long way go to prove itself to most of the nurses I meet and work with. I keep doing the sales pitch and this includes acknowledging the student's awareness of coding and classification, or  pointing them (usually 1st and 2nd years) to this knowledge. Health Informatics is represented in the text and the glossary (pp.539-541). In terms of professional accountability it is vital that as nurses we are aware of what happens to the data we help to create. Students are also the researchers of tomorrow and as such they need to be aware of diagnostic schemas and ongoing issues in this area. It is true that this is the curriculum and yet the authors do right by including classification in the context of the library, and coding as in the types of fractures (figure 3.6, p.77); some mention of coding and classification within nursing and healthcare surely seems justified?

Nursing has struggled to make itself visible - for the right reasons for many years. As we look to our students to resolve this are they to rely upon some form of reverse-magic* alone? Despite this proverbial bee, I can highly recommend this book - it is a great resource.
1 Introduction: Nurse Education in the university and the clinical setting
2 Adult learning theory
3 Perspectives on teaching and learning
4 Curriculum theory and practice
5 Planning for teaching
6 Teaching strategies
7 Assessment of learning
8 Student feedback / feed-forward
9 Teaching study skills
10 Evaluation

*It is of course customary to marvel at the visible becoming invisible.

HUGHES, S.J. & QUINN, F.M. (2013) Quinn's principles and practice of nurse education. 6th Edition. Andover, Hampshire: Cengage Learning.

I would like to extend my thanks to Mr Matthew Keown at Cengage for my copy of this book.

Sunday, January 04, 2015

Reflecting on Nortin Hadler's "Missing the Forest For the Granularity"

I read Nortin Hadler's Missing the Forest For the Granularity (July, 2014) on The Health Care Blog with great interest. The article draws attention yet again to the risks and preoccupation with processes and systems. This provides me with another opportunity to highlight the 4P's within Hodges' model: Process, Policy, Practice and Purpose and add some of the points that Dr Hadler addresses.

The 4Ps by themselves might have meaning but they can't do work. For that we need a context and several perspectives. As Dr Hadler points out big data intrudes on the clinical encounter determining not just what is collected, but how it is captured and structured.

There are frequently two datasets at the practitioner level: one is administrative and managerial in form and purpose; the other is clinical - patient, person centered. Effective communication already presents a challenge. On top of that then how relevant are the IT systems. The holy grail of IT systems still seems to be benefits for clinicians and patients - the public. Until then will the IT continue to push the patient-clinical relationship as if it is some wobbly toy? You bet it will!

Where exactly should the “Physician’s Dashboard” reside? Is it a case of "the ayes have it" but only on the right?

Nortin also refers to the United States postponing ICD-10. From Wigan Pier I clearly do not understand the issue, but this seems from here more like a very prolonged delay. A delay that perhaps says more; not just about the healthcare 'system(s)', but the many interfaces to be found there.

Many thanks to Dr - Prof. Hadler for his article:

humanistic ------------------------------------------- mechanistic
“cognitive” specialists, the care of the patient revolves around the “granularity” of the narrative.
individual attention and focus
ability to share purposes
 Using individual differences and idiosyncrasies

patients as widgets (here)?
Can you see the dashboard here?
 data gathering
big data, ICD-10
Electronic Medical Record -
 templates and “smart sets”

Patient - BIG DATA - Doctor
 empathy 'NOISE' empathy
life-course (“social”) epidemiology
Europe, health care systems, United States, health economists, hospital administrators, patients as “units of care”, physicians as “providers”, clinical demand = “throughput.”
common denominators

Saturday, January 03, 2015

Emphasising 'naivety' and collections of things: The Serving Library

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


by Anthony Huberman

1. A total absence of information about a given subject usually solicits no curiosity: without an awareness of its existence, we can’t possibly care about it.


7. Eventually, we have a dictionary definition.

See the pdf below and the title link for many other items within this journal:

My source: Visit to The Serving Library exhibition at Tate Liverpool

Image source: Goodreads.com

Friday, January 02, 2015

The mining of meaning: copper - in and out of the ground

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

West O'okiep Mine, Okiep (1862 to the early 1970s)
284,000 tonnes of copper extracted

$ £ ...

Image source and with thanks to Dillon Marsh

My original source: New Scientist 6 Sept 2014 pp. 24-25.

Thursday, January 01, 2015

The mining of meaning - across the domains and years

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

In September 2014 I visited Amsterdam to attend Drupalcon and arriving early spent a day at the Stedelijk Museum. Exhibitions included a project within On The Move by Witho Worms and Hans Gremmen
Witho Worms (Amersfoort, NL, 1959) is a photographer who lives and works in Amsterdam. Hans Gremmen (Langenboom, NL, 1976) is a graphic designer who works and lives in Amsterdam.  - See more at: http://www.stedelijk.nl/en/exhibitions/on-the-move/witho-worms-and-hans-gremmen#sthash.2lKS8S6r.dpuf
Witho Worms (Amersfoort, NL, 1959) is a photographer who lives and works in Amsterdam. Hans Gremmen (Langenboom, NL, 1976) is a graphic designer who works and lives in Amsterdam.  - See more at: http://www.stedelijk.nl/en/exhibitions/on-the-move/witho-worms-and-hans-gremmen#sthash.2lKS8S6r.dpuf

Around Wigan there were many spoil or slag heaps from the coal industry that once thrived across Lancashire. There is a leisure area known as The Three Sisters reclaimed land from the mining industry. Slag heaps can have a very physical presence over towns and villages.

For some communities these man-made mountains hold memories of a hard family life, of many loves and joys and disaster.

The exhibition of photographs and their book revealed how the coal mining spoil heaps are universal. They look the same and represent the same toil and graft. Whatever the country - risk is risk : dust is dust. In these modern pyramids we see mining as a global phenomenon not just coal and a happenstance of geology and local history. The process of production of the book's prints is fascinating too, saying far more than the images alone as with the socio-politics of this industry.
Stedelijk Museum
Stedelijk Museum
Stedelijk Museum
Stedelijk Museum

Cette Montagne, C’est Moi / This Mountain That’s Me (2006-2011)

and Happy New Year to all!