What sort of field is 'nursing'? (i)

. . . It is NOT 'relaxed'.

My copy of Harris (2015) is secondhand, £8.50 from 'Green Ink' in Hay-on-Wye last November. 

Apparently, the (professional - high-level) study of mathematics is a relaxed field. McCleary reviews the book and the good, truth, and beauty of mathematics; 'relaxed field' relates to the latter:

Mathematics without Apologies:
Portrait of a Problematic Vocation

"That leaves beauty, the deepest source for Hardy, and the most challenging motivation for mathematical activity. Challenging because it calls into question how external support of mathematics is justified. Hardy tells us that “a mathematician, like a painter or poet, is a maker of patterns.” Throwing mathematicians in with the painters and poets leads to justification of mathematics as an art. Harris situates his discussion of beauty in the notion of play. Play needs to take place in a “relaxed field,” a notion introduced by ethologist Gordon Burghardt to describe animal behavior when not preoccupied with food, mating, territory, or predators—'the opposite of stress.'"

John McCleary, Book Review, NOTICES OF THE AMS VOLUME 65, NUMBER 10 pp.1280-1283. https://www.ams.org/journals/notices/201810/rnoti-p1280.pdf 

Talk of absolutes is common in mathematics. There is absolutely no mathematician involved in the writing of this post and others. That said, I have been privileged to work in a 'relaxed' manner.* When I trained mental health and then general nursing, we were part of the 'numbers' on the duty-rota. Your presence was not just a matter of learning, there were concrete things - tasks - to do. Completing the Community Psychiatric Nursing Certificate course 1987-8, involved a secondment to another community team (thank you Bolton!). My caseload was left to the support of colleagues, so I could concentrate on the course. A course in which Brian Hodges (not Wilfred Hodges - the  logician) taught his eponymous model. Post-Project 2000 with nurse education an undergraduate pursuit, students were designated supernumerary. Student nurse finances are precarious, worthy of a post in itself. 

If relaxed and stress are opposites, nurses would seek to be 'relaxed'** suffice to have the time and resources to deliver care safely, professionally and to a high standard. Adequate time + resources also brings a dividend: person-centredness, health promotion and education, preventing relapse. As it stands, however, for nurses be they students or qualified, nursing is far from relaxed.

tbc... ii

Harris, M. (2015) Mathematics without Apologies: Portrait of a Problematic Vocation. Princeton University Press.

*But without the charisma Harris describes.

**The notion of slack resource could be applied, space for creativity and innovation in assessment, planning, interventions (case formulation) and evaluation.

See also: 'Four Fields'

Humanistic motivations for study - c/o Harris et al.

 "Asking '[I]n what sense . . . can mathematics be considered a democratic regime . . .' open to all, Pimm and Sinclair quote (Supergiant) Henri Poincaré to the effect that 'only mathematicians are privy to the aesthetic sensibilities that enable' the decision of 'what is worth studying.' The article, published in a journal for educators, is motivated by the 'view that mathematics can do something for me in a humanistic sense that repays the the careful attention and deep engagement it may require; one that may expose students to a fundamental sense and experience of equality . . . and provide them with another sense of human commonality.'" p.33.  

Harris, M. (2015) Mathematics without Apologies: Portrait of a Problematic Vocation. Princeton University Press.

Hodges' model - Axes - Structure :: Domains - Content

Seventy-sixth World Health Assembly

WHO Note for Media, 26 May 2023

Read online:

https://www.who.int/news/item/26-05-2023-seventy-sixth-world-health-assembly---daily-update--26-may-2023

Text of note follows and a Comment from me below.

Gearing up for a historic UN High-Level Meeting on Universal Health Coverage

Member States expressed alarm that millions of people cannot access life-saving and health-enhancing interventions. Out-of-pocket spending on health catastrophically affects over 1 billion people, pushing hundreds of millions of people into extreme poverty. The situation has worsened due to the COVID-19 pandemic.

In response, Member States agreed a resolution supporting preparations for the United Nations High-Level Meeting (HLM) on Universal Health Coverage (UHC) in September 2023. UHC means that all people have access to the full range of quality health services they need without financial hardship.

c/o World Health Assembly - media

In a transformative policy shift, Member States across high-, middle- and low-income countries expressed strong commitment to reorient their health systems based on primary health care (PHC) as a foundation for achieving health for all and reaching the furthest left behind first. About 90% of UHC interventions can be delivered using a PHC approach; from health promotion to prevention, treatment, rehabilitation and palliative care, potentially saving 60 million lives by 2030.

The Member States emphasized the importance of demonstrating the highest-level political commitment at the HLM in September with the aim of achieving resulting in a concise, action-oriented declaration for UHC.

[...]

COMMENT (NPW): I would add that quality of care is just as important as access and affordability. As we have discussed on HIFA, a 2018 Lancet paper estimated that 5-8 million deaths are caused by poor quality care every year (as we pointed out at the time, the true figure is probably much higher higher because it did not include care in the home or community before reaching a health facility). The Lancet paper did not estimate the number of deaths due to poor-quality primary versus secondary care. Quality of care is fundamentally dependent on the timely application of reliable healthcare information, and most deaths are probably (arguably, as we do not know the numbers) avoidable through the timely application of reliable healthcare information, even with minimal physical resources.

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil AT hifa.org

HIFA - my source.

c/o HSE.ie - Model of Care for People with Mental Disorder and Co-existing Substance Use Disorder (Dual Diagnosis)

"The definition of Dual Diagnosis for this Model of Care is: ‘the co-morbid disorders due to substance use and/or addictive behaviours along with the presence of mental disorder(s)’. The disorders of substance use include disorders of alcohol use." p.10.

Model of Care for People with Mental Disorder and
Co-existing Substance Use Disorder (Dual Diagnosis)

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mental disorder addictive behaviour - inc. gambling and gaming disorder lived experience recovery (here?) [cognitive access: orientation, insight, literacy, communication ..] training patient and	Demographics: Adult Dual Diagnosis team cover population of 300,000 Adolescent Dual Diagnosis teams 10 to 17 years lived experience data gathering p a th w  a ys [ physical access: place, time] e-health, therapeutic modules reablement, recovery (here?)
public involvement Carers Social Inclusion Social capital lived experience Vulnerable women, communities, homeless, ethnic minorities, refugees, recovery (here?) rehabilitation	Dual Diagnosis Service funding [ planned - in-patient beds ] TRAINING Service users lived experience interdepartmental discussion re. service provision for prison population probation services asylum seekers, immigrants Key Performance Indicators recovery (here?)

FOR: Economic, Educational, Environmental, Social, Political DETERMINANTS . .

READ: Cognitive, Physical, Social and Political ACCESS

My source: https://twitter.com/h2cm/status/1661299925391384576?s=20

A model insufficiency to realise Health for All - La santé pour tous

The Bio-Psycho-Social model is insufficient to realise -

Health for All - La santé pour tous

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psycho-	bio-
social

In a time of physical, emotional, mental . . . pollution, the 'wrapper' is non-disposable:
the human SPIRIT that also sees and acts to achieve Planetary Health.

Previous posts: 'stamps'

Book: "Blue Machine"

How the Ocean Shapes Our World

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	Blue Machine

 

Czerski, H. (2023). Blue Machine. How the Ocean Shapes Our World. London: Penguin. Retrieved May 22, 2023, from https://www.penguin.co.uk/books/441190/blue-machine-by-czerski-helen/9781911709107

My source:
Whipple, T. (2023) The big blue machine: why the oceans rule the world, Saturday Review, The Times, 20 May. pp.16-17.

See also c/o APOD:

Astronomy Picture of the Day

"How much empathy should doctors have?" c/o BBC Radio 4 'All In The Mind'

In ongoing reading and writing, I'm developing examples of care situations and contexts that extend across the domains of Hodges' model, candidates include:

1. Eating Disorder
2. Sense-Making in light of information disorder
3. Public Understanding of Science
4. Empathy and Rapport in healthcare disciplines

#4 has loomed large for quite a while. The contrast between being humanistic and mechanistic: warmth, engaged, attending, person-centred  and subjective; set apart from being objective, logical, cold, precise, mechanical, efficient, and accurate. These terms and more also indicate the scope (vertical and horizontal) of Hodges' model. In my nurse training, I remember that first intramuscular injection, and how my mentor - supervisor explained how, as a prescribed treatment - remember the patient needs it. The 'political' dimensions of this - informed consent, capacity, personal - professional ethics, mental health, and mental health act, add obvious complexity and critique to this example. 

 

In #4 I've the more general medical example of the surgeon and empathy. Then, this past week 'All In the Mind' devoted an informative feature on the topic (available for 12 months):

"A good bedside manner is a wanted quality in healthcare professionals. But as is performing procedures that can be painful or uncomfortable. As medical students train to become doctors, they can experience changes in their levels of empathy; the ability to resonate with how others feel. Learning long lists of diagnoses and pathologies, the human body starts to resemble more of a machine. But how detrimental is this? Claudia Hammond asks Jeremy Howick, director of the Stoneygate Centre for empathic healthcare at the University of Leicester, who is training healthcare professionals to express more patient empathy to improve health outcomes and reduce burnout. Lasana Harris, professor of social neuroscience at UCL, describes how too much empathy might be a cause of burnout, and medics should toggle empathy on and off depending on context. Medical students from the University of Bristol express how they feel empathy should come into their future roles. "

'Welcome to the QUAD' includes many previous posts on empathy, rapport.

Below, I have mapped key concepts and programme content to Hodges' model:

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Empathy (regulation) and Rapport Therapeutic alliance Risk of burnout Emotional curiosity	Research - BioMedical Model [machine] First injection - 'invasive' procedure . . . Doing Surgery - cutting a person Body posture - Sitting down with person - patient
Social Neuroscience Language, presence Pre-op contact with nurses Restore 'humanity' Reassure	Lived experience - Staying in hospital a night. 'Being a patient?' Accountability - Responsibility Time and Resources to do the job. [PJ]

AI Anxiety and the Public Letter in Hodges' model

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'doomerism' fear, belief, rationality artificial intelligence AI anxiety reflection, critical thinking	echo extinction biological intelligence pace of change past Speed NOW Time future
public public understanding of science 'public letter' collective fear - history life: family, work, leisure ..	policy governance motivation: public good, marketing, business, profit, power, control . . .

My source:

"Something strange has appeared in our sky. Let’s get a sense of what this alien is before we blow it out of the sky. Maybe it’s beautiful!"
https://t.co/UKwZCkjYrN

No apocalypse for now! An excellent, balanced piece on AI anxiety from @StephenMarche @guardian

Let's think more… pic.twitter.com/iJvPlzzK1q

— AI (@DeepLearn007) May 15, 2023

Share your thoughts: Health Research & Community/Public Engagement

Dear HIFA Community,

As part of a multi-country scoping study commissioned by Wellcome Trust 

https://www.linkedin.com/company/wellcome-trust/

Pivot Collective: https://www.linkedin.com/company/pivotcollective/

- is conducting a rapid survey to better understand community/public engagement and knowledge exchange in health research.

*The Ask:* Provide your insights, thoughts and perspectives - click the survey here: 

https://lnkd.in/dgR6Wak3

This should take 15-30 minutes to complete, and data will be anonymised.

Please complete the survey by Wednesday 17 May 2023.

Thank you!

As background, this survey is part of a larger project that aims to identify more effective routes for communities to be involved in research, with *an ultimate goal of understanding how communities can play a genuinely meaningful, inclusive, and reciprocal role in the research ecosystem.

The project is led by Pivot Collective: https://www.linkedin.com/company/pivotcollective/ in partnership with - 

Eh!woza: https://www.linkedin.com/company/eh-woza
citiesRISE: https://www.linkedin.com/company/cities-rise
Restless Development: https://www.linkedin.com/company/restless-development
Vocal, Praxis, and Fiocruz.

If you'd like to learn more, please don't hesitate to reach out.
We are grateful for your time and insights, and would love to talk.

Best wishes,
Claire B. Cole

Co Director Pivot Collective Consulting +1 917.523.6523
claire AT pivotcollective.org
pivotcollective.org
27 Palmer Road, Muizenberg, 7945 

https://www.facebook.com/PivotCollective/
https://www.linkedin.com/company/30643635
https://www.instagram.com/pivot_collective/

HIFA profile: Claire Cole is Co-Director and Senior Technical Advisor at Pivot Collective USA. Research interests: Participatory and applied research; Sexual and reproductive health and rights; Adolescent health and development; HIV and AIDS; Marginalized and underserved populations; Adaptive management and adaptive implementation; Responsive health systems; Resilience; Implementation science.

My source:
You are receiving this message because you are a member of the community -
HIFA - Healthcare Information For All.

"Imagine dumping nearly 400,000 paper documents -

- into a dead drop
located discretely on the hard shoulder of a road."

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"Third is the rise of new actors, 'super-empowered' individuals, capable of intervening in historical developments at a systemic level."	"First is a change in the materiality of communication. Communication becomes more extensive, more recorded and the records become more mobile."
"Finally, fourth is a structural transformation of the public sphere (through media consolidation at one pole, and the explosion of non-institutional publishers at the other), to an extent that rivals the one described by Habermas with the rise of mass media at the turn of the 20th century." p.31.	"Second is a crisis of institutions, particularly in western democracies, where moralistic rhetoric and the ugliness of daily practice are further diverging at the very moment when institutional personnel are being encouraged to think for themselves."

Image: Amazon

"In the wake of Wikileaks' recent headline-busting exposés, a very different news and informational landscape is emerging. Whilst acknowledgeing the structural leakiness of networked organisations. Felix Stadler finds deep-rooted reasons for the crisis of information security and the new distribution of investigative journalism." p.31.

Source: Stalder, F. (2011) Double Negative Feedback: CONTAIN THIS! LEAKS, WHISTLE-BLOWERS AND THE NETWORKED NEWS ECOLOGY. MUTE. Spring/Summer, Vol. 3, #1, pp.30-37.





https://www.metamute.org/editorial/magazine/mute-vol.-3-no.-1-double-negative-feedback

7th International Conference for Systems and Complexity Sciences for Health

 

Health systems around the world are reaching a tipping point – the rising need for health care of an aging population, emerging problems like Ebola and persistent problems like malaria and tuberculosis, and the recent Covid pandemic all highlight the limitations of our healthcare systems and their prevailing models of organization. While there is increasing awareness of the risks to our health systems there is little evidence of starting the necessary widespread engagement with all stakeholders to deal with this ‘wicked problem’.

The status quo in a nutshell – the hospital-centric focus with its emphasis on curing diseases has resulted on the one hand in its financial unsustainability, and on the other in patients’ distrust in being able to receive the right care at the right point in time that meets their needs. The focus on disease management of the common chronic disease spectrum provides a never-ending business opportunity driven by ongoing investigations and interventions of questionable benefits. There are no funds left to address the ’causes of the causes’, and to invest in improving the social determinants of health like secure work and employment, safe housing and urban communities, health foods and community gardens, and education and learning support. These activities are essential to reduce the stress mediated psychoneuroimmunological drivers that cause and perpetuate disease.

Continued . . .

Safety first: Hard hats must be worn^

- this is a construction site.


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This may be another distraction? Before I examine and explain Hodges' model as a generic conceptual framework, model of care, (implicit theory?) . . . I need to explain, provide an account for the model's construction.

Image: 

https://www.safetysign.com/products/5467/danger-hard-hats-must-be-worn-sign

^Safety boots, high viz vests ...

"There are no tools stored in this van overnight"

. . . but there is a tool
with great potential
available here 24/7/365 . . .


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Identity morphism

Images: 

 

https://krossovochkin.com/posts/2020_04_26_category_theory/

 

https://cdn.shopify.com/s/files/1/0044/4701/0919/products/no-tools-stored-in-this-vehicle-overnight-sign-646188.png?v=1680276776