Inner model

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'I beseech you to take interest in these sacred domains so expressively called laboratories. Ask that there be more and that they be adorned for these are the temples of the future, wealth and well-being. It is here that humanity will grow, strengthen and improve. Here, humanity will learn to read progress and individual harmony in the works of nature, while humanity's own works are all too often those of barbarism, fanaticism and destruction.' Louis Pasteur (1822-1895)

Do we need more 'laboratories' in 2017?
Can we produce the researchers and other staff to fill the labs?
What labs should be prioritised?
What progress have we made in integrating knowledge since the time of Pasteur?
Does it matter?
How evidence-based is evidence-based?
Are laboratories more about analysis and hence reduction than synthesis?
Where are the social sciences exactly?

Happy New Year!

The difference that makes...

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So information, while a critical part of learning, is only one among many forces at work.	Information theory portrays information as a change registered  in an otherwise steady state. It's a light flashing out on a dark hillside (to borrow an example from the philosopher Fred Dretske) or the splash of a pebble breaking the calm of a still lake.
In either case, the result, as the anthropologist Gregory Bateson puts it neatly, is ...	"a difference that makes a difference." p.138.

Seely Brown, J., & Duguid, P. (2000). The Social Life of Information. Boston, Massachusetts: Harvard Business School Press, 138.

Book: Cure - A journey into the science of mind over body

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CURE: Book cover

Thunderstorm Asthma in Hodges' model

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anxiety - impact on respiration previous individual experience personal health literacy: "What I need to do when X,Y,Z advanced care plan: staying well, preventive measures (see below)	Breathing, Asthma Climate, Thunderstorms Pollen (rupturing?) 8,500 Hospital Treatment 1,900 Emergency calls in 5 hours Intensive Care at least 8 Deaths Protocols - metrics
Family, carer, community support Social media, warnings Provenance of information provided - community trust.	Health Services Emergency response / resources Disaster Management / Review

Melbourne thunderstorm asthma death toll rises to eight, The Guardian, 29 November 2016.

My source:
Davey, M. (2016). Deadly asthma thunderstorm kills four and leaves Melbourne reeling; &
Sample, I. (2016). Analysis, Doctors agree on why, but are less sure how. The Guardian, 25 November. p.3.

 

Update in italics - June 18th 2022, plus:

Bellomo, R., Gigliotti, P., Treloar, A., Holmes, P., Suphioglu, C., Singh, M.B. and Knox, R.B. (1992) Two consecutive thunderstorm associated epidemics of asthma in the city of Melbourne. The possible role of rye-grass pollen. Med. J. Aust. 156, 834-837.

Suphioglu, C., Singh, M.B., Taylor, P., Bellomo, R., Holmes, P., Puy, R. and Knox, R.B. (1992) Mechanism of grass-pollen-induced asthma. Lancet 339, 569-572. 

Knox, R. B. (1993) Grass pollen, thunderstorms and asthma. Clin. Exp. Allergy. 23, 354–359.

Ong, E.K., Singh, M.B. & Knox, R.B. Aeroallergens of plant origin: Molecular basis and aerobiological significance. Aerobiologia 11, 219–229 (1995). https://doi.org/10.1007/BF02447202

Nasser, S.M., Pulimood, T.B. Allergens and thunderstorm asthma. Curr Allergy Asthma Rep 9, 384 (2009). https://doi.org/10.1007/s11882-009-0056-8

E Andrew, Z Nehme, S Bernard, M J Abramson, E Newbigin, B Piper, J Dunlop, P Holman, and K Smith. Stormy weather: a retrospective analysis of demand for emergency medical services during epidemic thunderstorm asthma. BMJ, 359, 2017.

Rabiee, S., Mousavi, H. & Khafaie, M.A. Thunderstorm asthma outbreak, a rare phenomenon in southwest Iran: patients’ perspectives. Environ Sci Pollut Res 25, 36158–36162 (2018).
https://doi.org/10.1007/s11356-018-3478-9

Kevat A. Thunderstorm asthma: looking back and looking forward. J Asthma Allergy. 2020;13:293.

Luschkova, D., Traidl-Hoffmann, C. & Ludwig, A. Climate change and allergies. Allergo J Int 31, 114–120 (2022). https://doi.org/10.1007/s40629-022-00212-x

 

https://asthma.org.au/blog/tips-to-prepare-for-a-thunderstorm-asthma-event/


 

Time, Space and the Individual (ego)

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Images source:
How we think and speak

My source:
Gattis, M. (Ed.). (2001). Spatial Schemas and Abstract Thought, MIT Press: Cambridge. p.204.

The Space of Origin - Foucault

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"For us, the human body defines, by natural right, the space of origin and of distribution of disease: a space whose lines, volumes, surfaces, and routes are laid down, in accordance with a now familiar geometry, by the anatomical atlas. But this order of the solid, visible body is only one way—in all likelihood neither the first, nor the most fundamental—in which one spatializes disease. There have been, and will be, other distributions of illness. When will we be able to define the structures that determine, in the secret volume of the body, the course of allergic reactions? Has anyone ever drawn up the specific geometry of a virus diffusion in the thin layer of a segment of tissue? Is the law governing the spatialization of these phenomena to be found in a Euclidean anatomy? After all, one only has to remember that the old theory of sympathies spoke a vocabulary of correspondences, vicinities, and homologies, terms for which the perceived space of anatomy hardly offers a coherent lexicon. Every great thought in the field of pathology lays down a configuration for disease whose spatial requisites are not necessarily those of classical geometry." p.3.

"The exact superposition of the ‘body’ of the disease and the body of the sick man is no more than a historical, temporary datum." p.3.

Foucault, Michel (1973). The Birth of the Clinic. New York: Pantheon Books.

From: Individual To: Group and ...

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Ken Price - Pastel (1995)

My source: Wullschlager J. (2016). Critic's Choice, Life & Arts, FT Weekend. 10-11 December, p.16.

HAUSER & WIRTH Ken Price exhibition

Image source:
http://macaulay.cuny.edu/eportfolios/artsandculture_museumsandculture/2013/07/19/ken-price-sculpture-a-retrospective/

BBC Radio 4: "We need to talk ... "

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We  (Well, there's an 'i' in humanity..?)	Need
to Talk	Ab-out

Death

BBC Radio 4: We Need to Talk About Death

100 Years: Nursing, History & Poetry

Book: The Great Convergence ( ...within Hodges' model)

"His [Baldwin's] framework posits three "cascading constraints" that hold back the globalisation of markets, namely the cost of moving goods, ideas and people. Initially, all were bundled together: early societies stayed where they were, passed down information to the next generation and ate what they grew. The first wave of globalisation that created the Great Divergence expanded markets via the falling cost of transporting physical goods, thanks to the steamship and the railway. ..." p.10.

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The cost of moving:  IDEAS	GOODS
PEOPLE	Book: The Great Divergence

Richard Baldwin (2016). The Great Convergence: Information Technology and the New Globalization.  Massachusetts: Harvard University Press.


Beattie, A. (2016). Movement politics. FT Weekend, Life&Arts, Books. November 26-27. p.10.

Book: In Therapy - Intra- Interpersonal

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In Therapy, Susie Orbach

In Therapy, Susie Orbach BBC Radio 4 (My source)

Book review: In Therapy - The Guardian & The Observer

Book cover: Google

Power vectors...?

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	... line management line(s?) of communication special measures legal directions line(s) of command chain of command command hierarchy command line bottom line ...

Hodges' meta-model...?

In combination the empty foreground and background brings us simultaneously to what is 'now': the situation, the context. The personal, social, political and physical are constantly re-presented in the health:ill-health duality. Our focus remains: ill-health. We still lack the depth of vision to resolve this duality. Focus needs structure: only from simplicity may we travel to complexity. 

The need for simplicity, structure, meaning and recording can be found, accomplished and apprehended through the conceptual framework known as Hodges' model. Its cruciform span is coincidental, and yet can be interpreted as four ways. Four ways of looking - seeing, learning and knowing. Five ways and even. As the model and the user reflects the innumerable perspectives that can be found as these conceptual spaces breathe: waxing and waning. Always from that initial state. Emptiness with structure.

Individual Gravitas

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	Trisha Brown: Man Walking Down the Side of a Building (1970)

Trisha Brown: http://www.trishabrowncompany.org/?page=view&nr=1187

My source: The Moderna Museet, Stockholm 24 August 2016.

Image source:
http://alfa-img.com/show/trisha-brown-man-walking-down.html

Cut here and here and...

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	.................. CUT HERE ..................
CUT HERE	and CUT HERE

"Tulip Mazumdar has an uncomfortable encounter with a "cutter" and undergoes a demonstration of what really happens during FGM." BBC Radio 4.

Mazumdar, T. (2016). My quarrel with a proud FGM cutter. BBC.

My source: From Our Own Correspondent, BBC Radio 4. Neither Love Nor Money

Image: https://www.mysoti.com

Too much Information...

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Perception Stimuli Concentration - 'Noise' - Attention Safety - Salience - Space Anxiety - Disposition - Mood Sense-making Models of Communication TOO MUCH - information - TOO LITTLE "How much do you have?"
	Activism Policy Employment Awareness Employer Engagement Equality Inclusion

My source: Post and image c/o BBC Radio 4 - Digital Human

Triangulation: c/o Roger Ballen

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Triangulation: (c) Roger Ballen
	Triangulation: (c) Roger Ballen

© 2016 Roger Ballen

The Theatre of Apparitions

My source and original image (top):
Jackson, K. Snapshots Primitive power in black and white. The New Review, The Observer, 30 October 2016. p.5.

https://www.theguardian.com/artanddesign/gallery/2016/oct/29/through-a-glass-darkly-roger-ballens-theatre-of-apparitions-in-pictures

Dementia & Sleep: What the Papers Say

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Sleep disturbance
Sleep disturbance 2

Just recently I came across a gentleman who in living with dementia and supported by his wife at home has been struggling with his sleep. Waking in the early hours 0330, 0400 in the summer is not too bad accompanied by the dawn chorus, but if it happens most days? And then in Winter: that is another matter.

Also fairly recently there are increasing instances of this man not being sure that the lady-  who is in their / his house and is taking him shopping - is his wife. She looks like my wife...? She knows what to buy and then she pays for the shopping.

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Who are you?	Have the doctor consider  prescribing a sleeping tablet
"Oh OK! Hello Sandra."	Arrange a medical review

This gent is up early anyway as there is a newspaper to collect which involves a walk. The problem is he leaves too early and is then outside waiting. His wife was struggling with all this so we discussed the need for a care review by the community mental health team. A sleep diary was provided to obtain some data upon which to base decisions. While I was in the garden with Mr. my student (thanks Katie) suggested to Mrs Y that this 'imposter' be passed as a friend. This has since proved very effective at reducing anxiety, social tension and distress.

Whilst we constantly strive for truth, honesty and respecting autonomy and dignity, sometimes sadly, 'truth' is compromised. It becomes less clear when it is being cognitively undermined.

We also want to maximise independence and support what are the usual daily activities of living: collecting the newspaper included. Risks were becoming evident however. So, Mrs Y came up with a strategic decision which has seen this gentleman adjust very quickly. Sleeping in until 8 o'clock is quite a surprise for the rest of the family to hear. And for us too. It is as if the (subscription) token for the newspaper was not only sitting waiting in a pocket or wallet. It also had slot in memory, where it had to be kept on constant refresh, whirring away; of such importance that it was proving quite disruptive introducing new risks, disturbing sleep. There are still many other activities and walks to be enjoyed. Nice call Mrs Y:

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	Cancel the newspaper

Reply to: [HIFA] Self-care could cut need for millions of GP visits (4)

The following is a reply to a thread on HIFA - Healthcare Information For All:

Dear Lucie, Thelma and All,

The Austrian economist Joseph Schumpeter (1883-1950) defined a dynamic economy as that which is in equal parts destructive and constructive (Abbott and Ryan, 2000).

As Lucie points out in the NHS we are set-fast in ill-health delivery, curricula and workforce planning. Breaking this demand-supply is to try to stop a runaway process that has spawned many other processes: specialties, disciplines, treatments...

Policy makers repeatedly place the solution in reducing demand by eliminating - providing cures for diseases and through technology.

Innovation through technology is still sold as a (the) solution (2002.. NPfIT - currently NHS Digital). Technology has a role to play. The benefits however must be Socio-Technical.

We can readily see the connection between Schumpeter's definition and our present preoccupation with innovation and technology driven disruption?

Talk abounds of the healthcare system / market / economy being disrupted (as per HIFA and this thread!).

Innovation is often stimulated through seed funding.

In computing a runaway process may need to be 'Killed'. Clearly and despite the resultant irony, we cannot do this to our respective healthcare systems (whatever their constitution and ideology).

We cannot Kill the NHS, private and 3rd sector systems we have at present and have them newly reconfigured on 31 December 2016, 23:59:60 UTC to be primarily:

HEALTH PROMOTING, PREVENTIVE - Self-caring and with a health literate populous

Even with the addition of a leap second; this would be a leap too far.

Change of our health care systems will need to be 'seeded'.

Many small gains can be compounded, the seeds must be broadcast across the domains of Hodges' model:

• INTRA- INTERPERSONAL
• SOCIALLY
• the SCIENCES
• POLITICALLY
• SPIRITUALLY

Abbott, J. & Ryan, T. (2000). The Unfinished Revolution: Learning, Human Behavior, Community, and Political Paradox, Stafford, UK: Network Educational Press. p.162.

Kind regards,

Peter Jones

Looking for a Career in Finance? Why limit yourself...

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Know your patient	Know your patient
Know your patient and carer	Know your clients... and your patient

By knowing them you can help them to know themselves.

From self-knowledge to self-care when possible.

Quantum existence and experience...

"Such a picture of man in the universe is clearly presented in the language of the Wintu Indians of California. Here the primary verbal stem refers to a world, a universe, that neither exists nor does not exist. We might say that it refers to the nature of things, a nature which is not realized because the things themselves do not exist, the situations have not come to be and may never come to be. Only at the instant when man experiences these do they come into existence, into history. The experiential or existential stem of the verb is derivative from this other stem. When man speaks with the aid of this stem, he asserts existence through his own experience of it. And it is only through his doing, through, probably, his decisive act or his act of will, that the world to which the primary stem refers can have concrete existence. This dialogue between the idea of the universe or the potential of the universe, and man's experience, runs through the entire linguistic structure." p.115.

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Lee, D. (1961). Autonomous Motivation. In. Anthropology and education. Series: Martin G. Brumbaugh lectures in education., Series 5. Gruber, Frederick C. (Ed.). Philadelphia: University of Pennsylvania Press. pp. 103-123.

Empty Construction: A prelude to person-centred care

Fight to Power - Flight to Wonder

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Photo sources:

Star Party

Nazeer Al-Khatib
Freelance Photographer‎‏ based in Aleppo

#Syria Fighters from the Free Syrian Army react as they fight against the IS near #Dabiq on October 15 #AFP Photo by @NazeerAlk

My source:

Smith, H.L. (2016). Caliphate crumbles as holy village falls, The Times, 17 October, pp.34-35.

Empty Construction: A prelude to person-centred care

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	Empty Construction

My source: Financial Times
Photo source: http://www.basquecountrymagazine.com/en/street-art

Book: The Moral Economy - Individual - Group

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The Moral Economy

My source: Financial Times
Cover image: Amazon

George Monbiot & Ewan McLennan - Breaking the Spell of Loneliness

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My source: BBC 2 or C4?

Loneliness: across the Domains c/o BMJ

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isolation loneliness mental health feelings  identity  meaning motivation - behaviour SUBJECTIVITY	physical health, coronary heart disease , stroke mortality longitudinal observational studies meta-analysis systematic review OBJECTIVITY
social network  family - relationships - befriending social isolation quality of life family - community cohesion social enterprise SOCIO-	policy social care provision day centers mobility - transport volunteering public - funding - private economic

Valtorta, N.K., Kanaan, M., Gilbody, S., et al. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart. Published Online First: [April 18, 2016]. doi:10.1136/heartjnl-2015-308790

My original source:
Smyth, C. Warning: loneliness as bad for your health as tobacco & Scourge of Loneliness. The Times, 20 April 2016, p.4 and 20.

Hodges' model: The Atlas of Care/Knowledge Domains

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Body Atlas Emotions Mental Health Atlas 2014	Human Cell Atlas Human Protein Atlas
Atlas of Children's Health and the Environment World Atlas of Language Structures	Atlas of Ocean Wealth Atlas of Economic Complexity Atlas of Environmental Migration

Reflection is holistic...

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"Reflection is holistic - it considers the whole,	where aspects within the experience  can only be viewed  within the context of the whole,
they exist in dialectical tension,	and cannot be reduced into parts or stages."

Johns, C. (1997). Becoming an effective practitioner through guided reflection (PhD Thesis). Open University, p.47.

Report: "Health as the pulse of the new urban agenda"

The following report published by WHO continues the themes of the previous post...

"New models of cooperation and cross-sector collaboration are needed to identify synergies across these sectors, and generate actions that result in overall gains to society, with health, environmental and economic co-benefits." p.19.

From the Executive summary:

How can policies and decisions at the city level expand opportunity for and protect the health of the 54% of humanity now living in cities? This document outlines some opportunities and basic strategies, while answering the following critical questions:  

1. Why is urban development important to health and vice versa?
2. What are examples of successful urban policies and strategies that deliver environmental, economic, social and health benefits?
3. How can decision-makers apply a “health lens” to urban planning, governance and finance, and avail themselves of tools to improve health, reduce social inequalities and ensure wider access to services and opportunity?
4. What role can the health sector play in advancing healthy, sustainable urban planning?

Editors (and image): World Health Organization
Publication date: October 2016
Languages: English
ISBN: 978 92 4 151144 5 

A Breath of Fresh Air - published

Report: A Breath of Fresh Air 

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Mental Pollution advertising truth-values ethics mental health anxiety  depression  fear psychological effects of  noise, vibration, foul air awareness understanding education literacy Vulnerable individuals: Child Older Adult Person with Chronic Health Problems	Air Pollution Definition - Measurement - Monitoring particulates Image: http://www.cleantheair.org/air-quality-information/particulate-matter Transport & Fuels: Diesel, Coal Power Stations Coal Powered Vulnerable Population Density Climate
Public Health Information Giving Public amenities Quality of Life Housing - Parks Health Professionals Intervention Socio-	Change[?] Policy  Standards  Law  Accountability Retain Standards from EU regulations Clean Air Zones          Clean Energy Providers NHS Carbon Emissions Accessibility Transport Modalities Economics

Global Health report “Triple Impact- how developing nursing will improve health, promote gender equality and support economic growth"

Dear Colleagues

Many thanks to all of you who contributed to the compilation of the All Party Parliamentary Group for Global Health report “ Triple Impact- how developing nursing will improve health, promote gender equality and support economic growth.’

A review group of APPG members has undertaken a major review of the development of nursing globally over the last few months, holding a number of witness sessions, collecting evidence and debating our findings with the RCN, ICN and others. The report “Triple Impact – how developing nursing will improve health, promote gender equality and support economic growth” launched on the 17th October 2016 sets out a radical agenda and argues that the UK should play a major role in developing nursing globally.

Many thanks again for your time and support.

Best Wishes

Emily
Emily McMullen
Coordinator & Researcher to Lord Crisp | All Party Parliamentary Group on Global Health
Office of Lord Crisp | Fielden House | 13 Little College St | London, SW1P 3SH
Email: info AT appg-globalhealth.org.uk
Website: http://www.appg-globalhealth.org.uk

[Ms McMullen's original email edited adding text from report source]

Amazing open access Townsend Archive - Poverty in the UK materials

The Townsend archive provides open access to a range of original documents underlying the 1967/68 Poverty in the UK survey led by Peter Townsend. This survey pioneered the application of relative deprivation in measuring poverty.

The archive includes over 2500 digitised questionnaires from the survey. On these questionnaires you will find hand-written notes made, at the time of the interview, by the survey field workers. They provide telling details of the living standards and attitudes of that time. They are searchable by region, interviewer and survey booklet number.

The archive also covers a range of other papers associated with the administration and conception of the survey and notes and drafts of Townsend’s book. You can also download Townsend’s ‘Poverty in the United Kingdom’ book.

You will also find video interviews with researchers, fieldworkers and colleagues involved in, or associated with, the Poverty in the UK survey. David Donnison, Hilary Land, Adrian Sinfield, John Veit-Wilson and others reflect back on this landmark project. These interviews provide unparalleled insights into survey and research methods then and now, the relationship between social policy research and policy making across the last 45 years, and the impact, or otherwise, of research on tackling poverty.

To take a look at this fascinating resource visit: http://poverty.ac.uk/townsend-archive

Original source includes SOCIAL-POLICY AT JISCMAIL.AC.UK

Diagnosing Corruption in Healthcare - new Transparency International publication

Dear All,

Corruption has become prevalent in healthcare to the point that it is normalised. From the politician to the patient, individuals routinely place their own private interests above public health goals and patient health outcomes. That was the conclusion from speaking to thirty public health experts and anti-corruption specialists across the globe, as part of our most recent research project.

Our earlier research had shown that those working in the healthcare sector have a low understanding of corruption. Previous attempts at providing an overview of the types of corruption in the sector, while providing an excellent resource for those dedicated to the subject, had been complex and lacked comprehensiveness. Our new publication Diagnosing Corruption in Healthcare [http://www.transparency.org.uk/publications/diagnosing-corruption-in-healthcare/], which we launched at the opening session of the World Health Summit yesterday, aims to bring all the relevant information into one space. We have produced a "map" of corruption in healthcare that contains 37 types of corruption that are clustered into eight areas in health systems.

On our new website ti-health.org you can explore the map fully. Take a look at the explanations of each type of corruption, understand better how they occur in practice by examining some case studies, and if you still want to learn more there are links to other resources on the web.

Please also note that we will be publishing an eight-episode podcast series. Each episode will cover one of the eight corruption categories identified in our research. The first episode will be published this Wednesday, providing an introduction to corruption in healthcare and exploring how corruption can occur in the high-level governance of a health system.

We hope that those working in the healthcare sector, from doctors and nurses to company compliance officers and directors, will be able to use this "map" to better understand the corruption risks in the work. We also hope this map will prompt policy makers, in the public health and anti-corruption fields, to tackle this formidable challenge that endangers health outcomes around the world.

Best wishes,

Sophie

Sophie Peresson
Director
Pharmaceuticals & Healthcare Programme
Transparency International UK

Be GREEN, keep it on the SCREEN
Healthcare. Environment. Media. Education. Business. #TransparencyMatters to us all. Tell us your story here .

HIFA profile: Sophie Peresson is Director of the Pharmaceutical & Healthcare Programme, Transparency International, UK. Email address: sophie.peresson AT transparency.org.uk

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

World Mental Health Day - Weeks, Months, Years (and Tears: or trying to find them)

Prompted by World Mental Health Day posted below are some thoughts related to each of the domains of Hodges' model in respect of mental health and health and social care in general.

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Reflection is an important human ability. It can be variously described as - reasoning, problem solving, introspection ... but an ability of self-reflect and critique our circumstances in a balanced, mature, objective way is an important skill that should ideally be shaped like so many others in childhood. Education and health literacy matters. Evidence for reflection and reflective practice for nurses and other health professionals remains rather sparse and contested. There can be ethical challenges and assessment and measurement of reflection and reflective practice is problematic. Hodges' model can support individual reflection providing a framework to facilitate person centred, integrated and holistic care. Globally there is no generic conceptual framework. Here is a candidate!

The parity of esteem debate that is so often heard in the political domain, becomes a stark fact of life to the individual in their physical and mental health. The two must be integrated. Policy makers look to the SCIENCES domain to find the technical and analytical tools to study demographic trends and produce national statistics.  Health providers are increasingly having to deliver services for individuals and programmes for population health. Data and Big Data all contribute through national governments to regional centers and the WHO.

Far from the binary logic of maths and the technical wonders it gives rise to, here in the SOCIOLOGICAL domain the YES or NO to having next of kin, partner, family and friends is pivotal from a mental health perspective.  There is an irony that the size and stability of someone's social network is an indicator of their staying well; while social media can act as a force for good, or a negative force aimed at those vulnerable to bullying and abuse. Effective communication is situated and ultimately determined by context: personal, local, glocal and global.

In this domain, whichever corner you turn to, it is politicised: be it funding for services; the word 'recovery'; the very existence and acknowledgement of mental health allied to human rights and service provision; employment and welfare; policy for access, diversity, equity, gender, equality.... mental health is manifest with political dimensions. How are the needs of specific groups met, children, youths, women, men...? Mental health law is crucial for personal and public safety. How this is conducted and governed is a measure of a modern state and please note the distance from the INTRA- INTERPERSONAL domain at upper left.

Thanks to @MHChat and community for reminder #WorldMentalHealthDay #WMHD16