Glossaries - calques, standards and what is, or can be canonical?

Post Marrakech and WCCS26 I'm still contemplating on matters 'complex' and 'complexity', across complex systems and complex care. We humans (and this one in-particular) have a penchant for compunding complexity, adding complications. Our languages are a case in point. 

As the conference demonstrated mathematical is central to the discovery of chaotic and complex systems. Maths itself preempted the discovery of the Lorenz System, and the Mandelbrot Set.

Efforts to look at Hodges' model mathematically has resulted in a small draft comparative glossary (4-5 terms). In addition to the history of chemistry and its adaptation of mathematical symbols, I soon came across complex numbers, complex dynamics, complex mathematics (don't worry I know my limits). But, symplectic geometry! What is that?

Apparently, 'The term "symplectic" is a calque of "complex" introduced by Hermann Weyl in 1939.'
(https://en.wikipedia.org/wiki/Symplectic).

So, over decades of ward meetings, reviews, care plans it was symplectic patients, symplectic care and situations all the time? Where am I heading with this? Probably nowhere in particular. There's still the risk of a meeting c/o gravity with the floor. I've been fascinated with the way words such as design and architecture are conjoined and added to things that do not qualify, at least from the purists perspective. This is joy of languages, they change constantly. 

Familiar with 'standard' in the clinical and informatics sense; 'canonical (form)' has come up within maths. It occurs in health too:

Graham, M., Winter, A. K., Ferrari, M., Grenfell, B., Moss, W. J., Azman, A. S., Metcalf, C. J. E., & Lessler, J. (2019). Measles and the canonical path to elimination. Science, 364(6440), 584–587. https://www.jstor.org/stable/26649426 

Sepehri, A. (2015). A Critique of Grossman’s Canonical Model of Health Capital. International Journal of Health Services, 45(4), 762–778. http://www.jstor.org/stable/45140527

Lee, H.-S., Paik, M. C., & Lee, J. H. (2009). Estimating a Multivariate Familial Correlation Using Joint Models for Canonical Correlations: Application to Memory Score Analysis from Familial Hispanic Alzheimer’s Disease Study. Biometrics, 65(2), 463–469. http://www.jstor.org/stable/25502307 

Voit, E. O. (2000). Canonical Modeling: Review of Concepts with Emphasis on Environmental Health. Environmental Health Perspectives, 108, 895–909. https://doi.org/10.2307/3454323 

 

Goddu, A. (1985). The Effect of Canonical Prohibitions on the Faculty of Medicine at the University of Paris in the Middle Ages. Medizinhistorisches Journal, 20(4), 342–362. http://www.jstor.org/stable/25803849

 In drawing up a glossary, and starting with a blank sheet (that is not Hodges' model) this is all worth consideration. Could Hodges' model find a place as a canonical form - even clinically?

Is it? Can it be? An elevator pitch!

How many times have people asked me?

"If you were to explain Hodges' model as an elevator pitch what would you say?"

So, what would it be?

I wrote this on twitter and think it's a step in the right direction - domains: 

There is -

              *Person, self, individual ..

*Other(s), collective, pop.. 

      (a) person has MIND & BODY (for now!) 

(a) person is supported by ALL Others 

We call this Humanity

For the majority all bridges *cognitively* accessible:

  https://hodges-model.blogspot.com 

n.b. Politicians, policy makers

Rediscovering nursing ...? [ concepts-maths i/iii ]

   Individuals

 

'In the Introduction to his landmark book, Individuals Peter Strawson talked of the “massive central core” of human thinking that has no history … categories and concepts which, in their most fundamental character, change not at all”.'

'Strawson’s central core revolved around the need for us to identify persistent objects in a unified framework of space and time. He was not troubled that with the arrival of special and general relativity our concepts of space and time had changed, nor that our concept of middle-sized dry goods had changed to accommodate what we suppose to be their constitution by quantum particles.'

Blackburn, S. Rediscovering the Past, The Philosopher's Magazine, 1st Quarter 2018. 80: 72-73. 
https://archive.philosophersmag.com/rediscovering-the-past/

Strawson, P.F. (1964). Individuals (1st ed.). Routledge. https://doi.org/10.4324/9780203221303

https://www.taylorfrancis.com/books/mono/10.4324/9780203221303/individuals-strawson

See also:

How 'divine' is the language of care?

Care concept engineering - anyone? [ concepts-maths ii/iii ]

So, I can proceed, fall flat on my face - [ concepts-maths iii/iii ]

"Integrated - care": What's in a word, or two?

This blog post was sat in 'drafts' since 28/01/2007 (yes, I know what that suggests). It concerns an issue, or more properly a theoretical and experiential aspiration in health AND social care that should in truth have provoked many papers for Hodges' model by now.

In the almost 18 years since, I wonder about the total number of papers devoted to this subject, the service's delivery, policy, outcomes, reviews and reports on integrated care? In nursing theory, philosophy and the start of many 'learned papers', it is customary to begin with a definition of terms. What happens when we divide 'integrated care' and first treat integrated and care separately? Does this aid our understanding? Do we divide and conquer? Is there a difference in results? Conceptual analysis would see us do both, and conduct a literature search.

In practice, (and clinical - especially) we often use words in rather lackadaisical way. Not surprising really, after all we've got a job to do! When pronouncements are made regards health and social policy I hear it as good intentions. I also reach for my soap box. It is often hyperbole, rhetoric. The same applies to the related idea and ideal(?) of holistic care, and person-centredness. I'm biased, of course, but I believe that Hodges' model can help to scope, and define these idealised features of health and social care (and education). As noted, people don't have the luxury of time to stop and deliberate on the precise meaning of the language they routinely use. As noted, at the end of the day - if it gets the job done then that's sound.

In a poll of words that are both much used and the meaning taken for granted integrated must be near the top for several reasons:

• its seniority: it has been around for decades.
• its scope across sectors and day-to-day life.
• our dependence on its fulfillment.

N-Gram suggests some possible insights into integrated and related forms of care:

https://books.google.com/ngrams/graph?content=integrated+care,holistic+care,person-centered+care&year_start=1800&year_end=2022&corpus=en&smoothing=3 

[Trying to embed, results in 1/3 white space at the bottom?]

It seems that integrated care [IC] has been a standing agenda item in health and social care media, education, the workforce, conference, exhibition and policy for several decades. Perhaps, things have calmed somewhat? So either IC is either very important, complex, a hard thing in practice or maybe it's all of these and more besides? IC is a undeniably a compound concept. Is this a cop-out though? You declare something 'compound' then sit back - job-done? I've suggested the same of threshold concepts in health (and probably other contexts?). Time will tell. In the meantime I have reflected on 'integrated care' across the domains of Hodges' model:

self

|

INTERPERSONAL : SCIENCES              

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

SOCIOLOGY : POLITICAL   

|

other

INTEGRATION OF: PRACTITIONER; Team; service; org... Philosophy* assessments threshold for acceptance into service (referral criteria) patient experience & engagement health education / literacies programmes spiritual research involvement	INTEGRATION OF: health record (e- or paper) location - team base care disciplines geographical area referral sources assessments - tools/scales data and statistics research involvement
INTEGRATION OF: HEALTH & SOCIAL CARE public engagement hospital  carer (parent/guardian) experience community services social care - NHS family experience public engagement in research Patient / Public Community Advocacy Treat demand :: Support prevention	INTEGRATION OF: funding leadership / management accountability - complaints (not the same thing!) outcome measures ILLNESS - PREVENTION / education self-care <> planetary care -  Sustainability assisted dying! palliative care! Public - Private - Voluntary Sectors Provider :: Purchaser [Systems] All-Party Parliamentary Groups^

*ethics, values.

^One aspect of so-called 'joined-up government'.

WHO online survey on maternal well-being framework - ENG, FR and SPA translations available

 ------- ENGLISH ------

Dear colleague,

You are invited to participate in the development of the World Health Organization (WHO) maternal well-being framework through an online survey. 

This consultation is one step in a broader process led by the WHO Department of Maternal, Newborn, Child and Adolescent Health and Ageing (MCA) towards creating a comprehensive framework that supports maternal well-being across diverse environments and cultures. Based on the results of a scoping review of the literature and an expert consultation held in May 2023, a preliminary framework has been developed including a definition, domains and subdomains. WHO/MCA is now organizing multiple consultations which objectives are listed below. 

What is the purpose of the survey?

• Ensure comprehensive coverage of all critical elements of the framework and identify potential gaps in the definition, domains and framework of maternal well-being.
• Evaluate the framework’s applicability across various settings and cultures.
• Foster collective agreement and consensus among key stakeholders.

Who can take part to this survey?

Any individual or organization who has interest in maternal health and well-being. This includes, but is not limited to:

• Representatives of women's groups
• Health workers (midwives, OBGYN, nurses, neonatal nurses, paediatricians, psychiatrists, psychologists, community health workers...)
• Experts in human and sexual and reproductive rights, public health, health promotion, gender, mental health, economics, humanitarian, etc.
• Academics and researchers 
• Government organizations
• National civil society organizations / NGOs
• International agencies / UN agencies
• Private sector

How to participate in this survey?

Please click on the following link: Survey Link

We expect this survey will not take longer than 15 minutes to complete. It is available in English. 

The survey will be open until 17 August 2024. 

We would be grateful for your response to this survey and your kind help in circulating to your colleagues and networks.

Please reach out to Justine Le Lez - lejus AT who.int with any further questions. 

Best regards,

On the behalf of the Department of Maternal, Newborn, Child and Adolescent Health and Ageing (WHO/MCA)

------- FRENCH / FRANCAIS ------

 

Bonjour,

Vous êtes invité·e à participer à l'élaboration du cadre conceptuel du bien-être maternel de l'Organisation mondiale de la santé (OMS). 

Cette enquête est une étape d'un processus plus large dirigé par le Département de la santé maternelle, néonatale, infantile et de l'adolescent et du vieillissement (MCA) de l'OMS, visant à créer un cadre conceptuel exhaustif soutenant le bien-être maternel dans divers environnements et cultures.

Sur la base des résultats d’une revue de la littérature et d’une consultation d’experts tenue en mai 2023, un cadre conceptuel préliminaire a été élaboré, comprenant une définition, des domaines et sous-domaines. L’OMS/MCA organise actuellement plusieurs consultations, dont les objectifs sont énumérés ci-dessous.

Quel est l’objectif de l’enquête ? 

• Assurer une couverture exhaustive et identifier d'éventuelles lacunes dans le cadre actuellement proposé.
• Évaluer l'applicabilité universelle et l'adaptation du cadre conceptuel à divers contextes et cultures.
• Favoriser un consensus collectif afin que le cadre conceptuel reflète reflètent une large gamme de perspectives et d'idées

Qui peut participer à cette enquête ? 

Toute personne ou organisation intéressée par la santé maternelle et le bien-être. Cela inclut, sans s’y limiter :

• Des représentants de groupes de femmes

• Des professionnels de santé (sages-femmes, gynécologues-obstétriciens, infirmières, infirmières puéricultrices, pédiatres, psychiatres, psychologues, agents de santé communautaires…)

• Des experts en droits humains, droits sexuels et reproductifs, santé publique, promotion de la santé, genre, santé mentale, économie, santé humanitaire, etc.
• Des universitaires et chercheurs
• Des organismes gouvernementaux
• Des organisations nationales de la société civile / des ONG
• Des agences internationales / agences des Nations unies
• Le secteur privé

Comment participer à cette enquête ? 

Veuillez cliquer sur le lien suivant : Lien vers l’enquête

Nous estimons que cette enquête ne prendra pas plus de 15 minutes à compléter.  

L’enquête sera ouverte jusqu’au 25 août 2024.

Nous vous serions reconnaissants de bien vouloir y répondre et de la diffuser auprès de vos collègues et réseaux.

Pour toute question, n'hésitez pas à contacter Justine Le Lez.

 

Cordialement,

Au nom du Département de la santé maternelle, néonatale, infantile et des adolescents et du vieillissement (OMS/MCA)

 

------- SPANISH / ESPANOL -----

Está invitado a participar en la elaboración del marco conceptual del bienestar materno de la Organización Mundial de la Salud (OMS). 

Se le invita a participar en el desarrollo del marco de bienestar materno de la Organización Mundial de la Salud (OMS). Esta encuesta es un paso en un proceso más amplio liderado por el Departamento de Salud Materna, del Recién Nacido, del Niño, del Adolescente y del Envejecimiento (MCA) de la OMS hacia la creación de un marco integral que apoye el bienestar materno en diversos entornos y culturas.

Con base en los resultados de una revisión de la literatura y una consulta de expertos realizada en 2023, se ha desarrollado un marco preliminar que incluye una definición, dominios y subdominios del bienestar materno.  La OMS/MCA está organizando actualmente varias consultas, cuyos objetivos se enumeran a continuación. 

 

¿Cuál es el objetivo de la encuesta? 

· Garantizar una cobertura exhaustiva e identificar posibles brechas en el marco propuesto actualmente. 

· Evaluar la aplicabilidad universal y la adaptación del marco conceptual a diversos contextos y culturas. 

· Fomentar un acuerdo colectivo para que el marco conceptual refleje una amplia gama de perspectivas e conocimientos. 

¿Quién puede participar en esta encuesta? 

 

Cualquier persona u organización interesada en la salud materna y el bienestar. Esto incluye, sin limitarse a: 

·  Representantes de grupos de mujeres

· Profesionales de la salud: matronas (parteras profesionales/obstetras/obstetricias/comadronas), ginecólogos-obstetras, enfermeras, enfermeras pediátricas, pediatras, psiquiatras, psicólogos, agentes de salud comunitarios…

· Expertos en derechos humanos, derechos sexuales y reproductivos, salud pública, promoción de la salud, género, salud mental, economía, salud humanitaria, etc.

· Académicos e investigadores

· Organismos gubernamentales

· Organizaciones nacionales de la sociedad civil / ONGs

· Agencias internacionales / agencias de las Naciones Unidas

·  El sector privado

¿Cómo participar en esta encuesta?

 Por favor, haga clic en el siguiente enlace: enlace a la encuesta

Estimamos que esta encuesta no tomará más de 15 minutos para completar. 

La encuesta estará abierta hasta el 25 de agosto de 2024.

Le agradeceríamos que respondiera y difundiera la encuesta entre sus colegas y redes.

Para cualquier pregunta, no dude en ponerse en contacto con Justine Le Lez.

 

Atentamente, 

En nombre del Departamento de Salud Materna, Neonatal, Infantil y del Adolescente y del Envejecimiento (OMS/MCA)

Nursing observations: the need for Political inoculation in "Intro 101"

"Hockey's (1989b) typology of nursing activities as consisting of autonomous, derived and delegated elements suggests we should focus on the interventions which are initiated as well as undertaken by nurses. This is the core of nurses' work. It is what nurses do which is not done by other people. Nursing has always found it difficult to describe this core. Goddard's (Nuffield Provincial Hospitals Trust 1954) choice of the term 'basic' to describe this element of nursing work has had a disastrous influence not only on nurses' perceptions of the value of their work but also on the way in which nursing is regarded by other professional groups. It has been suggested that the term was used as a shorthand for 'fundamental' or 'essential' and that is has been systematically misinterpreted over the last three decades* by those who wish to use it to justify the horizontal division of nursing labour. Goddard demonstrated that basic nursing was undertaken by the least qualified and the lowest skilled. This observation might have sparked off a revolution in the delivery of nursing care but instead it has been and is used to justify the continued employment of unskilled labour in direct patient care." p.128.

*My emphasis: "... over the last three decades .." hence, since the early 1960s.

INDIVIDUAL

|

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

"The struggle between the twin poles of professionalism and bureaucracy is mirrored in that between the holistic, therapeutic approach in nursing, and that which is reductionist and functional (e.g. the task-centred approach to care). To work successfully in such a climate demands considerable skills of nurses, for they must seek to change the nature of the organisation, or at least to neutralise its effects so that they can concentrate on therapeutic practice. Amongst these skills must be those of change agency." p.107.

"Much of health care and particularly nursing is still organised along hierarchical and bureaucratic lines. To work professionally in such a system may in some way be seen as a contradiction in terms. The nurse may seek to exercise professional autonomy and make decisions about patient care (and indeed the organisation may seem to be encouraging him or her, at least superficially, to do so). Yet at the same time the nurse receives conflicting signals as others endeavour to exercise control over nursing practice such as doctors, senior nurses, finance directors, supplies officers and so on." p.107.

In this book's final chapter: Paterson and Zderad's five Phases of Phenomenological Nursology.^

INDIVIDUAL

|

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

1. Preparation for the nurse knower coming to know. (Hodges' model as a template - 'clean slate' also facilitating unconditional positive regard - openness to a new encounter - whether the first or subsequent.) 2. Nurse knowing the other intuitively. (Intuition still has a role. A message: speak to a colleague - seek supervision!)

3. Nurse knowing the other scientifically. (Reductionism is needed yet balanced with the humanistic esp. as the march (float ...) of the robots/AI follows apace.)

4. Nurse complementarily synthesising known others. 

(This is a purpose for Hodges' model, supporting the user to identify salient concepts and the relationships between them and their quality; then to reflect, think critically and move towards formulation.)

5. Succession within the nurse from the many to the paradoxical one. 

Nursing as Therapy

  (Tied to #4 above, but can emphasize health education, health literacy, co-production and co-creation with the patient - client. A collapse - in the synthesis with simultaneity of the individual and collective. Arriving at a conclusion and for the future of Hodges' model in theory and practice: an abstraction.)

Paterson J.G., Zderad L.T. (1976). Humanistic nursing. New York: John Wiley. 

The conceptual scope of Hodges' model is demonstrated in how it can encompass other (all?) models of care and frameworks, including humanistic nursing.

McMahon, R. and Pearson, A. (1991) Nursing as Therapy. London: Chapman & Hall.
^Chapter 8 - Breaking the mould: a humanistic approach to nursing practice. pp.170-191.

Bought secondhand, 'Nursing as Therapy' caught my attention as I have read and wondered about 'assessment as therapy' across disciplines.

Safety first: Hard hats must be worn^

- this is a construction site.


INDIVIDUAL
|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

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 ...