Living and Loving Dangerously

individual

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INTERPERSONAL : SCIENCES             

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

SOCIOLOGY : POLITICAL   

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group

identity - choices   Memory - Cognition DEMENTIA - Early onset Inability to consent   inhibition-disinhibition  mental capacity	My liberty, my choices "What! I'm married to you? Oh!" Treatment - medication  'Secure (safe)' environment 'Holistic assessment'?
Marital/Initimate Relationships Social (our) identity Existing relational behaviours Interrelational needs Interpersonal grief Social identity/expectations Yes, but we're married ... had 40 years together ... Family bias, prejudices.. A 'new' step-parent ... Access to support:  relational - mutual vulnerability	Informed consent Assumed consent Rape, Sexual abuse, crime Capacity to give consent Consistency in decisions Lasting power of attorney - finance; health External safeguards Human rights Access to supervision - clinical & management

Prompts:

Previously post: Living and Caring Dangerously

Danny Leigh. Critic's choice - Films on release: Queen at Sea. Life&Arts, FTWeekend, 19/20 September, 2026, p.18.

https://depijp.rialtofilm.nl/en/films/queen-at-sea

So many difficult conversations. All on their own unique continuum in terms of sense-making for all concerned. 

A 'new' diagnosis at age 60; versus one at 44. Families seeking to control disclosure of the diagnosis from the patient. Clinical and family debate about this.

Finding a person locked-in the house, while their partner 'nips' to the shops. A person having their freedom to go out, on their regular walk  -despite acknowledged risks. (When they are known by people on their route - community care in action. Receiving a call from a neighbour; or the neighbour who knows where you park and can intercept you, on arrival or departure to express concerns. Or, even as you venture out for a walk with their neighbour of many a year. Categorise them as you will: [nosey, caring, concerned, public spirited, neighbourly, or (healthily) curious]?

Other discussions of grief at the loss of a person they have loved - in every way. A grief that presents new dark dimensions to what has gone before. Complicated by a state of early onset of memory loss. An ongoing disintegration of personhood and identity. An inability to consistently express thoughts, wishes, and choices. An inability to give informed consent. A loss taunted by retained physical desirability. What does love, sex, compassion mean now? What is the sum now, of love expressed over 'x' years? Hearts hollowed out, of what can be so important to a couple. Not vital to all. But for others, a source of conjoined affirmation, joy, warmth, companionship, a celebration of life and being human.

How to share that grief even amid close friends and family, who cannot cope themselves and withdraw? What of the preparedness of professions to manage such situations? What structures are in-place for team meetings, clinical supervision and inclusion in training, especially safeguarding?

From the bibliography (lower sidebar):

Hodges, B.E. (1989) The Health Career Model, IN, Hinchcliffe, S.M. (et al.) 1989 Nursing Practice and Health Care, 1st Edition only, London, Edward Arnold.

Adams, T. (1987) Dementia is a family affair. Community Outlook, Feb, 7-8.

Merritt MK, Procter N. Conceptualising the functional role of mental health consultation-liaison nurse in multi-morbidity, using Peplau's nursing theory. Contemp Nurse. 2010 Feb-Mar;34(2):158-66. doi: 10.5172/conu.2010.34.2.158. PMID: 20509800.

Murphy, K., Welford C. (2012) Agenda for the future: enhancing autonomy for older people in residential care.International Journal of Older People Nursing. 7, 75–80.

Kernohan, W. G., & Jones, P. (2023). Hodges’ Health Care Model as a Framework for Quality. Paper presented at Interprofessional work: developing oral care and the health workforce for the future, Brescia, Italy.
https://pure.ulster.ac.uk/en/publications/hodges-health-care-model-as-a-framework-for-quality

Jones, P. (2025). A Conceptual Mapping Exercise of Deprivation of Liberty Safeguards in Residential & Community Care Using Hodges' Model and Threshold Concepts. Journal of Evaluation in Clinical Practice, 31: e70085. https://doi.org/10.1111/jep.70085

Jones, P. (2025), A Generic Model and Conceptual Framework to Prime Curiosity Across Health and Social Care Disciplines to Facilitate Lifelong Learning. Journal of Evaluation in Clinical Practice, 31: e70252. https://doi.org/10.1111/jep.70252

Previously: 'capacity' : 'consent' : 'law' : 'safeguarding'

'Shattered' by Hanif Kureishi

Cathleen Schine, Ungovernable, Capricious Life, The New York Review of Books, April 10, 2025, Volume LXXII, Number 6, pp.15-16.

Shattered by Hanif Kureishi. Ecco, 328 pp., $28.00

'Shattered' c/o Penguin  

'Hanif Kureishi, the English playwright, screenwriter, and novelist, posted these words on his Substack in January 2023: 

  On Boxing Day, in Rome, after taking a comfortable walk to the Piazza del Popolo, followed by a stroll through the Villa Borghese, and then back to the apartment, I had a fall.

I had been following Kureishi's Substack for a while out of admiration, curiosity, and loyalty-though Id met him only once, briefly. His dispatches were warm and entertaining, often about the writer's life. But this one was shocking: 

   I cannot move my arms and legs. I cannot scratch my nose, make a phone call or feed myself. As you can imagine, this is both humiliating, degrading and a burden for others. 

According to his hospital report, his fall resulted in neck hyperextension and immediate tetraplegia. An MRI scan showed a severe stenosis of the vertebral canal with signs of spinal cord injury from c3 to C5. It was unclear, he said, whether he would be able to walk again "or whether I'll ever be able to hold a pen." He was speaking these words through Isabella, who was slowly typing them into her iPad.' p.15.

individual

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INTERPERSONAL : SCIENCES             

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

SOCIOLOGY : POLITICAL   

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group

shattered	SHATTERED
SHATTERED	shattered

'A hospital is the place from which modesty and dignity disappear, desert you, seemingly forever, as soon as you cross the threshold. Kureishi, a reliably sexy, unrestricted writer, presents the physical deterioration and indignities he undergoes with his usual wit. The sense of vulnerability is crushing, but it is also one of the characteristics Kureishi reveals about himself that makes him so likable here, and the writing so intimate. The tone is remarkable: even the self-pity has no self-pity. One way he achieves this is by sprinkling punch lines throughout:

I woke up and started to cry. When you cry you must wipe away your tears, which is something I'm unable to do. So my eyes filled with bitter salty water and I got into a panic and thought I might lose my eyesight along with everything else. Finally, a kind nurse came into my room and downed me with a good dose of Lorazepam, then she touched me on my cheek and said, "It's not so bad, at least you're not in a coma."' pp.15-16.

Paper: What factors influence evidence use in policy? An updated systematic map

 Abstract  [ REVIEW | Article in Press ]

In 2014, a large systematic map found that relational factors were amongst the most frequently reported facilitators of evidence use in policy. Since then, there has been a growth in evidence-use initiatives and research, many of which have attempted to address relational factors. In this timely updated map, we describe the current state of research about which factors influence evidence use in policy. A search strategy combining ‘evidence’, ‘barriers and facilitators’ and ‘policy/policymakers’ was used to identify studies across 15 electronic databases between 2012 and 2022. Studies were screened for those that include empirical data about evidence use in policy. Data extraction enabled descriptive analyses characterising studies in terms of focus, topic area, setting, and types of factors influencing use. Two thousand, one hundred and ninety-nine studies were included, a 20-fold increase over 10 years. The most commonly reported factors influencing use were the relevance of evidence, and then organisational (resources, skills, personnel and managerial support). A large number of studies reported on evidence-use interventions (n = 877) of which 379 were evaluations. Findings may indicate a shift towards relational and systemic thinking about evidence use. There appears to be a growing recognition of the resourcing, work, time, and workforce required to embed evidence use within and between organisations. With this huge growth in the literature, particularly in new evidence use interventions being tested across policy sectors, continued review and mobilisation is necessary to effectively inform the design and implementation of evidence use interventions and research.

Oliver, K., Malin, J., Akerlof, K.L. et al. What factors influence evidence use in policy? An updated systematic map. Humanities and Social Sciences Communications. (2026). 
https://doi.org/10.1057/s41599-026-08391-6

Not a citation for Hodges' model, but I am grateful to Prof. Oliver and co-authors for being able to assist with data extraction using EPPI-Reviewer Screening Wizard. The preceding patience and guidance to complete the coding tasks was also invaluable in being transferable. I learned a great deal and it has been perversely reassuring (disheartening!) to see that the path to final publication is also 'circuitous' for academics.^  An additional lesson is building on existing work and publication (Oliver, 2014) to revisit a method and research question. (Updates to follow).

Previously: 'map' : 'systematic' : 'policy'

^A conclusion, much shared I believe: academic publishing is systematically dysfunctional.

Climate and the Feeling of [Momentarily] Drier Feet: Australia-Tuvalu Falepili Union Treaty

As is oft the case, I recovered a newspaper cutting (or ripping) that made my feet feel drier, for several moments at any rate ...

Reading this really gave me a lift, given the ongoing state of world events then and now:

Australia-Tuvalu Falepili Union treaty

The Australia-Tuvalu Falepili Union treaty was signed on 9 November 2023 and entered into force on 28 August 2024.

As part of the Falepili Union treaty, Australia has:

• recognised for the first time in a legally binding treaty, Tuvalu's continuing statehood and sovereignty, notwithstanding the impact of climate-change related sea-level rise
• committed to assist Tuvalu in response to a major natural disaster, health pandemic or military aggression
• created a special visa pathway to support mobility with dignity, which will enable citizens of Tuvalu to come to Australia to live, work and study.

There are also obligations under the Treaty to ensure Australian interests are protected and to facilitate the smooth operation of the migration pathway and increased security cooperation:

• Tuvalu is obliged to ensure its immigration, passport, citizenship and border controls are robust and meet international standards for integrity and security
• Tuvalu will mutually agree with Australia any partnership, arrangement or engagement with any other State or entity on security and defence-related matters in Tuvalu.

Continued ...

My source: Nic Fildes, Migration: Australia offers Tuvalu residents visa to escape climate change. FTWeekend, 11-12 November 2023, p.4.

Disciplines in Disarray - Scope of Practice, Disciplinary boundaries

To be in a state of disarray, is to be disarmed, without access to resources, or at least having an impaired ability to organise strategically for reasons of defence, disputation or argument. Constructive debate will be hard to achieve and so the confusion continues.

Prior to 2013 ideas for a paper with a would-be co-author began. Early that year there were 5000 words. There's probably mention of (another!) project on these pages – somewhere/when? The focus was using Hodges' model to explore 'scope of practice' in nursing. As the conceptual gift that keeps giving, Hodges' model can encompass all health disciplines, curricula, and professions, informal caring and social care too.

This post is prompt-ed (human ‘intelligence’ needs a nudge too) by ‘discussion’ on what was twitter, and currently on ‘X’. So in turn I can reflect on how relevant this paper would be today.

I still have that draft of over 5000 words. It is now woefully out-of-date. Out-of-date? Well the available job postings across the health and care sectors, have always changed. If you scan the paper copies of  Nursing Times, Nursing Standard, Nursing Mirror (anyone?) and the BMJ, The Lancet, Health Service Journal over three-four decades the evidence is clear. Then try the e-media, (and with it AI!)?

Now, for several years the impacts of  policy and change in advanced nursing practice, plus associate roles, that have also been applied in medical training and education are coming home to roost. Depending on your corner, and position in the debate there's a position called 'Noctor' (Vaughan and Kar, 2026).

I find it regrettable that consultants and 'senior' nurses have taken corners, as policy results in grossly negative examples with potentially safety consequences. There has always been a 'distance' to be bridged between health disciplines. In the past any sense of competition was usually, and so constructively patient-centred - grounded in the delivery and quality of care. The contest was tempered through mutual respect and dignity, and recognition of respective roles, knowledge, abilities and contribution to what is (and remains?) the multidisciplinary team?

Now with technology and AI in the mix, maintaining goodwill, common-sense and keeping the patient, public and future generations in sight will need a degree of diplomacy as yet not called-upon.

This made me think of the unions in the 1970s and more recent examples of work-to-rule. 

As health professionals argue between themselves, what is the cost of distraction?

Yes, that paper using Hodges' model on 'scope of practice (and theory!)' would be timely now.
In fact, it is urgently needed.

Vaughan L, Kar P. Vexatious complaints are being weaponised to discourage debate BMJ 2026; 394 :e100697 doi:10.1136/bmj-2026-100697 

Previously: 'scope' : 'publications'

Sometimes it can take an old model ...

 

'Sometimes it can take an old model, 
to build a new one, 
that makes the existing model obsolete.'

To borrow from Buckminster Fuller.                         

 
Resurgence & Ecologist, Sept/Oct 2020, Issue 322, p.33.

Health Literacy UK (HLUK) Conference 4 March 2027 in Manchester

Communicating and delivering health
and care that people can understand and use

Manchester 2027 – Where Health Literacy Takes Centre Stage

Join Health Literacy UK on 4 March 2027 for an exciting national conference bringing together passionate voices from across healthcare, public health, academia, local government and the voluntary sector. Expect inspiring keynote speakers, practical learning, fresh ideas and powerful conversations focused on making health information and services accessible to all. Whether you’re new to health literacy or leading change in your organisation, this is an event you won’t want to miss.

Hear from leading experts, discover practical approaches to improving health literacy, and connect with colleagues who are committed to reducing health inequalities and creating more inclusive health and care services.

Health Literacy UK (HLUK) invites researchers, practitioners, policymakers, educators, community organisations and students to submit abstracts for presentation at our national conference on 4 March 2027 in Manchester. 

Please see HLUK where additional details are provided and will follow:

https://healthliteracy.org.uk/hluk-conference-4th-march-2027/

n.b. I hope to see you there!

Call for Abstracts: Land Use for Net Zero Hub Early Career Conference

Dear colleagues,

 

We are pleased to open the call for abstracts for the Land Use for Net Zero Hub Early Career Conference, which will be held on 7 September (1:00–6:00 pm) at the James Hutton Institute in Aberdeen, ahead of the LUNZ consortium meeting (8–10 September). The call for abstracts will close on 12 June 2026.

 

The conference theme is: “Future Careers at the Science–Policy Interface: Exploring Opportunities and Challenges in LUNZ.”

 

We aim to bring together early career researchers and practitioners from LUNZ Hub and LUNZ Research, as well as other early career groups interested in the conference themes, to network, share work, and discuss careers at the science–policy interface.

 

We welcome abstracts for poster and oral presentations within the following themes. Submissions can include works in progress and unpublished research, as we aim to stimulate open dialogue, feedback, and learning. We also encourage contributions from partners beyond academia. The format of the day will be shaped by the level of interest across these topics:

 

• Transdisciplinary collaboration across sectors and knowledge systems
• Science communication and knowledge impact
• Modelling and evidence for land use change
• Integrating people, place, and nature in Net Zero transitions
• Just transitions and community resilience
• Community-based research in academia and policy

 

Please complete the following form to submit your abstract: https://docs.google.com/forms/d/e/1FAIpQLSeOzhkowu0NdM3YlQz-XEIovSB3805zX5LTT4Fm7FzBPq3f7Q/viewform?usp=header

 

Once we have received and reviewed abstracts, we will open up registration to presenters and the wider community.

 

If you are interested in helping with the organisation of the conference at an early stage, we would be very happy to hear from you—please get in touch.

 

We look forward to your participation.

 

Best regards,

LUNZ Early Career Board

https://lunzhub.com/get-involved/early-careers-board/

 

Anita Lazurko (she/her)

Senior Transdisciplinary Scientist

Biodiversity and Land Use

--------------------------------

My source: At 'Ecologies of Care':

Henrike (Kika) Neuhaus

Pronouns: she/her, they/them

Post-doctoral Research Fellow in Anthropology and Art

Livelihoods and Institutions Department

Natural Resources Institute

University of Greenwich 

ORCID: https://orcid.org/0009-0002-1245-5881

#RCN26 RCN Congress - Nurse Education

If you think hard-enough all the debates at RCN Congress connect to 'education', but two are laser-focussed:

Protecting nurse education

Resolution submitted by the Education Forum
That this meeting of RCN Congress asks RCN Council to lobby UK governments to protect nurse education from university sector economic pressures.

Quality of clinical placements

Matter for discussion submitted by the Students Committee
That this meeting of RCN Congress discusses ways in which the quality of clinical placements can be ensured and consistent across all 4 countries.

For more senior colleagues, you may momentarily think back - all rose-tinted - to the pre-undergraduate Schools of Nursing, but you also realise change was needed and inevitable. A new millennium was fast approaching.

Now, however it seems within the university ecosystem, nursing is a threatened subject and discipline. Nurse education is exposed and itself vulnerable. In the 21st century fitness-stakes - finance wins:

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

mental fitness	physical fitness
SOCIAL VALUE  & VALUES	FINANCIAL FITNESS

 

At RCN Congress, the status of nursing as a profession in the USA, was raised. Looking online, I found the following at the U.S. Department of Education: Myth vs. Fact: The Definition of Professional Degrees.

In January 2025 I posted about the situation at Cardiff University. At Congress the matter of the quality of clinical placements, became a resolution. The protection of nurse education provoked an impassioned and emotional debate. Student nurses seeing what is happening to nurse faculty. Nurse faculty seeing the years of experience 'walk' be-pushed out through the door. It seems there is no collective noun for a group, or collection of redundancies. Mass comes to mind, especially in this instance. A 'rash' seems appropriate. But, the condition is more serious and bears further investigation:

As a Google search demonstrates - https://share.google/SViFPWuJovKWhErEE

IT doesn't stop there ...

How many of us (nurses, and other 'professionals') are seeing job offers(?) such as:

Remote
Contract

$35/hr - $80/hr (this is lower than others ...)

About the job

Nursing Informatics Specialist (AI Training)

About The Role

Your clinical knowledge is more valuable than you think — beyond the bedside. We're looking for experienced nursing professionals to help train and evaluate AI systems built for healthcare. As a Nursing Informatics Specialist at Alignerr, you'll apply your frontline expertise to ensure AI understands real-world clinical workflows, EHR systems, and nursing documentation the way actual nurses do.

This is a unique opportunity to work at the intersection of nursing practice and cutting-edge AI — on your own schedule, from anywhere.

• Organization: ---------
• Type: Hourly Contract
• Location: Remote
• Commitment: 10–40 hours/week
  
  

What You'll Do

• Evaluate AI-generated clinical content for accuracy, safety, and alignment with real nursing workflows
• Review and annotate EHR documentation scenarios, flagging errors or gaps in clinical reasoning
• Translate nursing practice knowledge into structured feedback that improves AI model outputs
• Assess how well AI systems reflect clinical informatics best practices across areas like documentation, data integrity, and care coordination
• Provide expert insight on health IT tools, including EHR platforms such as Epic or Cerner
• Work independently and asynchronously on task-based assignments
  
  

Who You Are

• Registered Nurse (RN) or equivalent clinical background with hands-on experience in a healthcare setting
• Familiar with EHR systems and clinical documentation workflows
• Able to analyze clinical scenarios and communicate clear, structured feedback
• Detail-oriented with strong written communication skills
• Self-motivated and comfortable working independently in a remote environment
• No prior AI experience required — your clinical expertise is what matters
  
  

Nice to Have

• Experience in clinical informatics, health IT, or nursing informatics roles
• Familiarity with data annotation, quality review, or evaluation processes
• Background in quality improvement, patient safety, or clinical education
• Exposure to health data standards (e.g., HL7, FHIR, SNOMED)
  
  

Why Join Us

• Work on cutting-edge AI projects with leading research labs and AI teams
• Fully remote and flexible — set your own hours and work at your own pace
• Freelance perks: autonomy, variety, and global collaboration
• Apply your nursing expertise in a completely new and impactful way
• Contribute to AI that could meaningfully improve how healthcare technology serves patients and clinicians
• Potential for ongoing work and contract extension

You might think (no pun intended!): 

'Well this all about informatics. Don't worry - it will all work out fine!'

But, please notice, the clinical and nursing requirement:

"Registered Nurse (RN) or equivalent clinical background with hands-on experience in a healthcare setting."

Not exactly, Hodges' model is it? Even if specific to this role, what does it say:

• about :: the title of 'Registered Nurse'
• about :: Nurses and Nursing as a Profession
• and :: to search engines and agentic AI?

So be aware, and concerned (worried even!) for nursing and nurse education ... 
for the humanity of healthcare:

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

de-humanisation	BIG TECH
"Where has everyone gone?" Social values Social justice What about research, debate, evidence..?	Nursing Faculty Universities as Institutions that reflect Society Why is there an echo in here? It's been hollowed out.

P.S. I am not a technophobe. Previously: 'AI' : 'SOCIO-technical'