Hodges' Model: Welcome to the QUAD: March 2018

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 ...

Friday, March 30, 2018

When a Double-Page Spread is not Enough ...

individual
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INTERPERSONAL : SCIENCES
humanistic ---------------- the HEALTH RECORD --------------- mechanistic
SOCIOLOGY : POLITICAL
|
group

VA ".. how important is the notion of the book or the page to your research and outcomes?"

AGV "They are fundamental to my research.


I explore the double-page spread as a material support and a discursive space for visual ideas within an exhibition context. ...




The double-page spread is for me an extended space, a place to develop a site-specific practice.


... My intention is to generate meaning through symbolic signification, enhancing its material qualities through mirroring, folds, reflections and echoes."



Source: In Conversation, PRINTMAKING TODAY, Spring 2018, Cello Press Ltd. Volume 27, No. 1 Issue 105, p.4. Victoria Ahrens talks to Altea Grau Vidal about her PhD research and the format of the double-page spread as an opening for all her work.

Tuesday, March 27, 2018

Citizenry: In Hodges' model

individual
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INTERPERSONAL : SCIENCES
humanistic ---------------- HUMAN NEEDS --------------- mechanistic
SOCIOLOGY : POLITICAL
|
group

Philosopher
My identity

'Nowhere'?


Public, Family, Community


Citizens, Nation State, Welfare

Political identity


BBC Radio 4 The Public Philosopher: Citizens of Nowhere?

Sunday, March 25, 2018

Somewhere in Between: c/o Wellcome Collection

individual
& INBETWEEN
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INTERPERSONAL : SCIENCES
humanistic & INBETWEEN ---------------------- mechanistic & INBETWEEN
SOCIOLOGY : POLITICAL
|
group
& INBETWEEN 
thoughts

feelings





wellbeing

Somewhere in Between c/o Wellcome Collection
Somewhere in Between


society
collaboration scientists & artists

art as:
genetic engineering;
HIV medicine;
 free diving;
mirror-touch synaesthenia.




My source: Moulton, N. (2018) We are all scientists now, FT Weekend, Life&Arts, 3-4 March. p.4.

Tuesday, March 20, 2018

Steve Coleman And Five Elements, Functional Arrhythmias


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


Steve Coleman And Five Elements, Functional Arrhythmias






Monday, March 19, 2018

Individual choice & life chances c/o Mark Power

individual
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INTERPERSONAL : SCIENCES
humanistic --------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
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group
Harlan, Kentucky, December 2015 (c) Mark Power

PRACTICE

POLICY

Photo and source with thanks: Harlan, Kentucky, December 2015 @copy Mark Power

My source: Requiem for a dream, David Chandler, 2018 FT Magazine, March 3-4.

Friday, March 16, 2018

UKSS 2018 – Can systemic thinking help shape health services?

Looking forward to a 20 minute presentation I have just sorted accommodation for this conference in June. I am still wondering about train or car, preferring the former if possible for the c.240 mile trip to Portsmouth. With an interest in ecology I welcome the opportunity to be involved in an event connected with Schumacher College. I have long wondered about Dartington. Now that would be an excellent way to study and learn about Hodges' model and 'holistic bandwidth'...

News of this conference I posted on 2 January 2018 but as I add the news to the sidebar - here are some details once again and the necessary links...

UKSS Conference 25th June 2018

Can systemic thinking help shape health services?

A UK Systems Society conference in association with SPMC and the Schumacher institute; supported by the World Organisation of Systems and Cybernetics and the Associazione Italiana per la Ricerca sui Sistemi

Speaker: Alex Whitfield, CEO Hampshire Hospitals NHS Trust

Provision of health service is facing major challenges in every country. Life expectancy has increased, people are active for longer, and citizens expect first class healthcare and for “repairs” to be done quickly to restore them to their full capacity. Some expectations are fantasy but others are justifiable, yet every day we hear or read about outcomes that give cause for concern. In the UK we recognise that the NHS cannot continue in its present form. But the NHS is close to the heart of our citizens making major reforms difficult because of the intense passion that any discussion generates. But the NHS as a ‘system’ is more than 3/4 of a century old. The way that illness and old age are viewed now is different to that when the health service was created. This conference will provide a platform for ideas that might contribute to a way forward.

We would be delighted to see and hear from you at this conference.

Wednesday, March 14, 2018

PROCESS and tick the boxes DO

For four decades at least and much longer (70 years?) within many health services there has been a preoccupation with process. Patients and carers may then perceive such services and how services are delivered as machine-like. As a whole the experience then constitutes an actual output - an outcome of clinics, appointments, waiting lists, tests and treatments. This is very unfortunate amid ongoing claims for services that are person-centred, individualised, patient oriented and even patient-first.

The patient is left to feel like a diagnosis, or even worse a problem in search of a diagnosis; tossed from one clinical encounter to another. In-between all this activity there are hopefully some compassionate brush strokes that soften the picture and patient experience. If not people notice the impact on values and quality of care ...


Whenever I see the word 'holistic' I wonder if it really is holistic? Yes, you can be holistic by ticking all the boxes, but nursing involves much more.

individual
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INTERPERSONAL : SCIENCES
humanistic --------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
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'Process' has been delivered at the door of nursing by management and the appeal to theory to inform practice. Nursing itself produced the 'nursing process'.

The nursing process through the stages of assess, plan, implement and evaluate prompted the argument that nurses were processing patients. To nurses of a certain age the nursing kardex, the record filled in every shift mirrored the nursing process. In a way recourse to process is not a problem, it is inevitable. It is to be expected. As we deal with space, time, risks and decisions ... we have to make judgements that are invariably process bound.

The four P's can help to 'balance the books' ...

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

PURPOSE

PROCESS

PRACTICE

POLICY


We need to remind ourselves of the four P's as they affect us individually and as organisations and collaborative agencies.


PURPOSE

PROCESS
PRACTICE

PURPOSEPROCESS
PRACTICEPOLICY


Perhaps, patient engagement can be defined as when the tick-boxing is obvious but it is also taking account of the 4Ps (and in a way beyond tokenism). For example, patients, carers and the public involved in policy review? The patient is then more realistically involved in the activity. Anything else, really is a tick-box exercise.

Progress has been made (at least in the four decades of my purview). Government policy is in continuous development but there remains - as ever - much to do. Especially in spanning the various distances that apply from policy, experience, care to be delivered and how; from the individual to the health services and health system as a whole.

('P'rogress! Mm... Is there another way to measure progress?) ;-) 

Tuesday, March 13, 2018

The fake news game (four forms of resistance?)*

individual
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INTERPERSONAL : SCIENCES
humanistic --------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
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group
psychological well-being
vaccination against
misinformation
trust

"... research has shown that exposing people to propaganda tactics can psychologically immunise them against a growing epidemic of misinformation said to be sweeping across social media and online news outlets."

inoculation: resistance 

TRUE vs FALSE
 epidemiology of news 
 broadcast dynamics
assertions - claims

gamification: 
instructional, educational, app design

inoculation: resistance



stories ..... rumors
virality

role: fake news producers

social media:
‘echo chambers’ and ‘filter bubbles’

inoculation: resistance

Fakenewsgame.org

POLITICAL polarisation

inoculation: resistance

Jon Roozenbeek & Sander van der Linden (2018) The fake news game: actively inoculating against the risk of misinformation, Journal of Risk Research, DOI: 10.1080/13669877.2018.1443491

My source:
Honestly, fake news is now an online game, The Daily Telegraph, 20 February 2018. p.8.

*perhaps even five?

Monday, March 12, 2018

The spread of true and false news online c/o Vosoughi et al.

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

trust

"Falsehood also diffused faster than the truth. The degree of novelty and the emotional reactions of recipients may be responsible for the differences observed."



TRUE vs FALSE
 epidemiology of news 
 broadcast dynamics
assertions - claims

"To understand how false news spreads, Vosoughi et al. used a data set of rumor cascades on Twitter from 2006 to 2017. About 126,000 rumors were spread by ∼3 million people. False news reached more people than the truth; the top 1% of false news cascades diffused to between 1000 and 100,000 people, whereas the truth rarely diffused to more than 1000 people."


social well-being

stories ..... rumors
virality

social media
social networks
social bots

"We define news as any story or claim with an assertion in it and a rumor as the social phenomena of a news story or claim spreading or diffusing through the Twitter network. That is, rumors are inherently social and involve the sharing of claims between people. News, on the other hand, is an assertion with claims, whether it is shared or not."



POLITICAL polarisation

political and economic well-being

'news' = institutional source?

"Defining what is true and false has become a common political strategy, replacing debates based on a mutually agreed on set of facts. Our economies are not immune to the spread of falsity either. False rumors have affected stock prices and the motivation for large-scale investments, for example, wiping out $130 billion in stock value after a false tweet claimed that Barack Obama was injured in an explosion (7). Indeed, our responses to everything from natural disasters (8, 9) to terrorist attacks (10) have been disrupted by the spread of false news online."


Soroush Vosoughi, Deb Roy, Sinan Aral, The spread of true and false news online. Science 09 Mar 2018: Vol. 359, Issue 6380, pp. 1146-1151. DOI: 10.1126/science.aap9559

Saturday, March 10, 2018

Book Review: [ii] An introduction to Health Research Methods

An introduction to Health Research Methods Where were we from Part [i]? For the book contents listing look no further. The publisher's site also provides sample pages.

For part ii we are up to chapter 14. Correlation studies, also known as aggregate or ecological studies had me scurrying to the index. While such studies usually rely on secondary analyses I thought about the power of social media to disrupt such distinctions. 'Social media' is there p.165 and this would be primary 'live' (the idea of a feed sounds 'live', but then web crawling can be quite retrospective) or secondary and might deserve a chapter of its own in. Despite such queries figures proceed to inform the analysis of correlation pp.97-100.

At step 3 we are still under a third way through  the text, excluding the glossary and index. Chapter 15 explains research timelines and protocols. While trying to formulate my own research question, I created a research plan and Gantt chart (figs 15-1 & 15-2). This prompts me to revisit the exercise as an independent scholar with the decade long aspiration to create a new website. The treatment here is aimed, of course, at research teams with responsibilities and a principal investigator. Figure 16-1 on sample populations and how they are derived I sometimes share with students on placement as I encourage them to be researchers. They should always be asking questions, as students, at their job interview and a new post provides an ideal opportunity to hear problems, issues, uncertainties. Many managers miss this - a fresh pair of eyes.

Vulnerable populations deserve and are given specific mention. Chapters 17 and 18 covers primary research concepts, such as, sample size, power estimation, reliability and validity. The systematic approach throughout the book is evident here. My initial note about lack of whitespace sees Jacobsen advocating for whitespace in questionnaire design. This advice flows into surveys, interviews and other assessments. The research essential of Boolean search is described with the process of a systematic search strategy, also allied with Forest and Funnel plots. Do take time with chapter 25 on writing research grants, even if you are an individual. It is obvious, but your financial situation can greatly affect your staying power in a programme of study that incorporates research, or is research led. Personal circumstances can change.

In step 4 if research has its quarry face, then we meet it here in (what can be) the hard-grind of data management (chapter 26) code books, data entry, data cleaning and data coding. The maths is invariably explicit in chapters 28 and 29 on descriptive statistics, regression analysis. Here the figures and text really do go hand-in-hand. If baby should never be in the corner Step 5 reminds us that research should never just be stuck on the shelf. In reporting findings you will find posters, conferences, presentations and writing papers, citing sources, and seeing an article through submission, revision to publication. A chapter deals with success - or how to keep going which brings readers to end with a glossary that is not cross referenced but the index is thorough.

This is very good introduction and the title really reflects the aim and content. This is an excellent primer that you can return to after the paint is well dry. It will be a pleasure to pass this book on to a nurse working in research - clinical trials. As is often the case there is an online access code to additional course materials. I have not broken the seal but may add further comments if they follow. There are always other things that might be included. As research stresses literature is there a way to include literacy, to wrest health literacy from the fog of the research question? Visual methods are increasingly used and the comic format used for educational, and even presentation of theses and dissertations. Genomics and the advent of (medically) personalised care may demand additional knowledge for researchers of all levels.

The other thought I alluded to in part [i] does not affect my recommendation for this book; but it concerns the primary, secondary and tertiary forms of research, literacy and access to information. Yes, these have an established place in the research process and lexicon (inclusion/exclusion criteria, informed consent...) with a history to reinforce this foundation. But is there a problem as this research is supporting health systems that really must change. Does something further in research need to change? Where and how could we incorporate the quaternary view? Never mind a chapter: could that have a step all its own?

Part [i]

With thanks to Emma Phillips, Marketing Manager: Academic Class Learning.

Friday, March 09, 2018

Book Review: An introduction to Health Research Methods [i]

An introduction to Health Research Methods
For this review, the preface says it all in the purpose of this book as a: "necessary foundation for meaningful improvements in clinical and public health practice." From an outcomes based view, to the research process itself the book is organised through five - very recognisable - steps:
  1. The Research Question 5-43
  2. Study approaches 35-100
  3. Study design and data collection 101-211
  4. Analysis 213-271
  5. Dissemination 273-345
I have included the page numbers across the steps to give you an idea of the weighting. The text cuts across the various methods, disciplines and credentials of the researcher.

If you are looking for whitespace this book is not for you. As a result though this adds of course to value-for-money. As evidence of packing-it-in the publishers have packed the pages, which for a research book is welcome. The execution while dense with ink on the page, is well delivered in presentation. The font is large, clear, distinct and readable. The adopted format is established very quickly. The first paragraph refers to a figure which is also on the first page. Figures are used to good effect throughout the book, shaded tones not colour.

As per the steps outlined above, two structures to help formulate a general research topic and question are described Exposure, Disease, Population [EPD] and PICOT. Mental health represented here encouraged my reading early on. Literature is also explored, the process of reviewing and systematic revires and meta-analysis in chapters 3 & 22.

With so much research being conducted the matter of originality and gaps in the literature are included. Figure 3-1 provides useful "Ideas for new studies" p.18, the issue of gaps also earns a figure of its own. Chapter 4 quite rightly brought pangs of guilt here dealing with "Focusing the research question" - primary (new data), secondary (existing data), tertiary (review and synthesize the literature). I have struggled to finalise a goal and set specific objectives. This did give me something to ponder upon which I will save for the end.

Each chapter begins with a pithy sentence of advice. Some chapters are very short, e.g. chapters 5 and 6 but this is justified and not suggestive of a need for an alternative structure. Step 2 signifies the arrival at more technical content; time frames, population selection, case definitions, cohort studies, cross sectional surveys, case control studies - with odds rations. This is all framed in accord with the introductory theme. Even an introductory book cannot avoid maths and Jacobsen deploys the figures to very good effect, for example Incidence in figure 11-5. Chapter 12 may be less heavy on the maths but it is a vocabulary expander for the uninitiated in research, as figure illuminate random control trial approaches, randomization efficacy, numbers needed..., flows of participants and screening a diagnostic test results (positives and negatives). The author's picking out Qualitative Research - Chapter 13 gave me hope for Hodges' model which can readily differentiate between quant and qual. And yes, brainstorming and mapping are mentioned at the start of the book.

TO BE CONTINUED...

Thursday, March 08, 2018

Drupalcamp London: And all that jazz

Drupalcamp London was a bootcamp literally in light of the weather. This affected the schedule a bit but it was well worth attending.

The first session on my list was not the intended module development but:

Flexible content editing with paragraphs and Drupal 8 - with Baddý Sonja Breidert who stepped in at short notice. We were encouraged to look at Open Doors as an example of Paragraphs being deployed. The fact that there were 25 types of paragraphs prompts the thought - not so much how many would I would need but the users? Apparently, paragraphs are not that user friendly to edit. Navigation was indicated 'Manage Display' - 'Preview' - 'Paragraph'. The 'environment indicator' flagged whether the site in use was live or dev: a reminder. A future tip included not using entities, but media for anything reusable. Reusable paragraphs were applied to banner and images, using simple entities. There were some special functions (and specific modules) in the table of contents, entity embed, entity browser, insert view and add map.

In considering when to use paragraphs this connects with choosing content types - another key question for me. There was a lot more in what was a 'changed session'. I'll check the slides / videos were available and for those below. The three keynotes were excellent too:

Let’s take the best route - Exploring Drupal 8 Routing System

Drupal in the era of microservices

"Hi user, I am Drupal. How can I help you?"

Accelerating Drupal projects with Thunder: a case study

In 'Make your site findable' dutchyoda Dick Rensema pulled me up short. So, I will check out the metatags module and use this from the outset. As for being findable - it's also best to have separate text and images not have both within a WYSIWYG editor. Another point is to 'make it long'. That sits well for the archive pages for Hodges' model.

Lunchtime on Sunday was preceded with gambry on Plugin API, a key idea being:

ENTITY - Same model different data
PLUGIN - Same "thing" type different ways

This was a captivating, dense, rich session and one to revisit.

Finally, the 0930 start in London helped as I'd been up late. Ronnie Scott's is an amazing experience, the second house from 1030 doors open through to 0300: I left at 3 thanks also to Resolution 88.




Wednesday, March 07, 2018

Forensic Architecture (Care Forensics?)

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




forensic
adjective: forensic
  1. 1.
    relating to or denoting the application of scientific methods and techniques to the investigation of crime.
    "forensic evidence"
  2. 2.
    relating to courts of law.
noun
plural noun: forensics; noun: forensic
1.
scientific tests or techniques used in connection with the detection of crime.


See also:
ICA London, 7 March - 6 May, Counter Investigations: Forensic Architecture.

My source:
Rowan Moore, Forensic Architecture: detail behind the devilry. The Observer Sun 25 Feb 2018

Tuesday, March 06, 2018

Four forms of Recovery? Hodges' model and the Political Domain

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

Recovery?

Recovery?
Recovery Space - Report



Five forms in fact including the spiritual...

See also:
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.

Monday, March 05, 2018

c/o BMJ: Rediscovering humanitarianism in the wake of the aid agencies scandal

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

PURPOSE
individual values, ethics...

whistle blower
courage

Psychology of:
bystander as co-worker?

(Good work and the greater good
 excuses
the misdeeds of an individual*)

empowerment vs. exploitation

define: "humanitarian"

natural disasters

"Hollywood to Rochdale"

scale of organisations:
larger = lower costs

monitoring challenge for large organisations in chaotic settings (for all orgs.)
PROCESS


PRACTICE

HUMAN WELFARE

vulnerable persons

Public interest
Private vs. Public

community trust

"football club"

(inveiglement)

Charities (raising money)
Corporations (making money)
POLICIES
Donors
competition
"reputation management"
organisations
organisational governance & values
Leadership
*individuals in positions of power over others
Human Rights

Safeguarding
International Summit
Regulation - not just a ▢ here?



BMJ: Rediscovering humanitarianism in the wake of the aid agencies scandal

My source: HIFA - David Southall of MCAI

Q. What is the first rule of first aid?

Mental Health & Debt

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

Mental health problem

 1 in 4


10p coin N - NHS



Debt

Mental Health and Debt 2017 report

Friday, March 02, 2018

Just - "one quarter in four years"

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





"Number of nurses and health visitors fell by 0.2%

Shortage of 40,000 nurses

The total number of managers rose to 32,000 ... a rise of almost one quarter in four years

7% rise in number (over one year)




of senior managers on NHS payroll

Sharpest rise among managers was in those whose pay normally starts at £65,000 a year."


Source: Donnelly, L. (2018) NHS bureaucrats on the rise as nursing numbers fall, The Daily Telegraph, 1 March, p.2.