South Sudan Medical Journal - August 2026

Dear Reader,

The August 2026 issue is online here; we thank all the copyeditors and reviewers who helped prepare these papers. If you are submitting a manuscript, remember to read our Author’s Guidelines first.

We are looking for volunteers to join the Editorial team. Email us if you have time and editing skills.

Editorial

Can the Ebola Zaire vaccine stop Bundigunyo virus? Edward Kenyi

RESEARCH ARTICLES
Assessment of airborne fungi in the emergency and traumatology departments of University Hospital Centre, Sidi Bel-Abbes, Algeria Derouicha Matmour, Samia Merad, Yassine Merad, Achwak Bendouida, Zoubir Belmokhtar, Zakaria Merad, Mohamed Amine Boumelik, Benali Beghdadli, Othmane Ghomari 

Maternal and nutritional factors associated with early childhood development in rural Indonesia Hadi Ashar, Mohammad Zen Rahfiludin, Sri Achadi Nugraheni, Dwi Hapsari Tjandrarini

Observed outcomes and costs of laparoscopic versus open cholecystectomy in Juba, South Sudan Mayen Achiek, Jingo Faride, Mohamed Ibrahim, Abraham Mafair Kezekia, Chep C. Chep, Garang D. Nyuol, Ajak M. Dhel, George Lefteri

Stakeholders’ perspectives on determinants of health financing in South Sudan: a qualitative assessment Jonathan Majok, Gabriel Loi, Solomon Dut, Aluel Ayom, Thiey Kuethpiny, David Ngor, Sarah Nyannyot

Predictors of unsuccessful treatment outcomes among adults with pulmonary tuberculosis in a resource-limited setting Tri Agus Yuarsa, Malehah Mohd Noh, Richard Avoi, Meryl Grace Lansing, Putra Agina Widyaswara Suwaryo 

Assessment of the understanding of evidence-based medicine among undergraduate medical students in Gadarif University, Sudan Khalid Mohammed Ali, Ozaz Yagoub, Inshirah Mustafa, Tarig Fadelelmoula
 
Environmental health risks associated with open dumping practices in Central Kalimantan, Indonesia: an observational study Nawan, Septi Handayani 

Assessing the quality of health facilities providing antenatal care services in Bor, South Sudan John Thon Pandak Kuot, Shalini Ninan Cherian

Prostate cancer awareness and factors influencing screening among men at St. Francis Referral Hospital, Tanzania Theresia A. Karuhanga, Zeinabu Awardh Sharif, Antony Magoda, Philbert Madoshi 

CASE REPORTS 
Long-standing aspirated foreign body in a child complicated by pneumothorax and empyema Gawar Gel, Juma Deng, Justin Rubena

Clinical rabies in an HIV-positive pregnant mother with surviving newborn Ayol Mac Ayol

BACKCOVER: WHO: Guidelines for the management of pregnant and breastfeeding women in the context of Ebola virus disease

FRONT COVER IMAGE: The grown fungal colonies on SDA media collected from different types of samples. (Article on page 149)

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South Sudan Medical Journal
Health and Social Sciences Research Institute, Juba
South Sudan
Copyright (C) 2026 South Sudan Medical Journal All rights reserved.

NHS Corridor Care – Urgent and Emergency Care Daily Situation Reports

If politicians & policymakers regularly 'walked'
 all the corridors of Hodges' model -
 they would see the false economy 
of their combined incremental works.

Incremental? Yes, in first being a 'temporary measure', then having a deleterious impact as the duration per patient and number of patients on corridors increased.

Now to the situation when the standard of care is unsafe, sub-standard, and denigrates the NHS as a social institution.

The fact of insufficient beds and its effect on care (pathways) and patient (and family) experiences severely affects staff morale, as they recognise subtle abuse, a precursor to structural and attitudinal changes that foster, encourage and establish institutionalised harm.

Staff also realise that they risk being de-skilled, 're-educated' -
becoming less compassionate ... (a 'lesser Nurse') as corridor care 
and its consequences are normalised.

Ignoring demographic trends and without an alternative concerted 
preventive/health education and health promoting plan, this is the result 
of the health and social care funding and policy
of successive governments, enacted by NHS management.

NHS England: Corridor Care – Urgent and Emergency Care Daily Situation Reports
https://www.england.nhs.uk/statistics/statistical-work-areas/corridor-care-urgent-and-emergency-care-daily-situation-reports/

Martha's mum, dad, guardian ...

Hayward, E. Parents really do know when
their child is sick, The Times,
30 May 2025, p.1.

The previous post highlighted the fact that while practice (and theory) based upon research finding that are 'evidence-based' and scientifically rigorous are a 'gold standard; there are other means by which knowledge is obtained. Cultures, often have systems to transfer knowledge - that which matters to the society, even if is not written in the conventional meaning of the term.

Intution is another source, and within social groups can be a powerful spur to action, and help seeking. This is demonstrated regularly in the knowledge that a parent, or guardian has about what is the normal presentation for a child in their care. 

In the UK Martha's Rule is being tested in NHS hospitals. It is encouraging then to hear and read news of a study in Australia (so in combination a 'multicenter' effort?).

Mills, E., Lin, P., Asghari-Jafarabadi, M., West, A., & Craig, S. (n.d.). Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: A prospective cohort study. The Lancet Child & Adolescent Health. https://doi.org/10.1016/S2352-4642(25)00098-7

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

"Not herself ..." Martha	"Not well" Martha
Mills parents, guardians, friends & family	Martha's Rule*

Hayward, E. Parents really know when their child is sick, The Times, 30 May 2025, p.1.

*Under test in the UK.

Previously: 'intuition'

RCN Congress iii 2025 - Accountability for patients in ambulances

The resolution (with a reading list) on Accountability for patients in ambulances

- drew attention to language once again (yes, well there's a truism: what do you expect!). This time highlighting how corridor care is now variegated. In addition, politically you can circumvent addressing an issue, by referring to 'never events', and 'zero tolerance' as we read:

'This agenda item addresses the urgent issue of accountability, for both registered nurses and the organisations they work for, when patients are cared for in ambulances waiting to access emergency departments.

The resolution comes at a time when, across all four countries, there are unprecedented ambulance handover delays with patients left in vehicles which are neither appropriately staffed nor resourced outside overwhelmed emergency departments. Despite the prolific nature of this practice, there is no clear guidance on accountability. Who is responsible for the care and safety of those patients - the ambulance service, the hospital, the emergency department, or the individual registered nurse providing care?

These delays accessing care and the lack of guidance on who is accountable for the waiting patients, compromises the ability of health care staff to provide good quality care and risks patient safety. It also exposes registered nurses and other health care professionals to professionally, ethically and legally ambiguous situations. It could also contribute to the crisis in nursing wellbeing, raising issues such as moral distress and professional, emotional and physical burnout. It may, therefore, also impact the already perilous recruitment and retention.'

Student nurses, paramedics ... please take note: There is a paper to be written on Hodges' model and the gaps we encounter in health and social care. For Brian Hodges this started with the theory-practice gap; one of four original stimuli for the creation of the model. 

As the idealised standards, quality and safety of care being delivered are surrendered; this gap stands out as the virtual keystone.

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

individual - PURPOSES patient safety - distress nurse wellbeing emotional burnout moral distress personal ethics individual responsibilities	procedure delivered care - observation mattress, trolley .. ambulance design instrumentation, noise time - duration logistics - PROCESSES - handover physical resources - beds
communities of PRACTICE team working - coherence team experience - students THE DAMAGE - that is 'BOOK-PASSING' The public's - carer's experience (wither friends and family)	law - guidance - ambiguity POLICY professional accountability risk management organisational responsibility workforce recruitment & retention

Previously: 'RCN' : 'gap' : 'accountability' : 4Ps

When a bomb goes off, ...^

INDIVIDUAL

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INTERPERSONAL : SCIENCES              

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

SOCIOLOGY : POLITICAL   

|

GROUP

	.. whatever's     around .. "WHEN A BOMB GOES OFF, .. gets      weaponised"
	donate.redcross.org.uk msf.org.uk ideals.org.uk map.org.uk uk-med.org

Rosanna Dodds, Operation Gaza, HTSI, FTWeekend, December 9th, 2024. p.37-38.

Victoria Rose, Plastic Surgeon: https://www.youtube.com/watch?v=AzZjmG791Dk

^anywhere ...

Invitation to participate in research: Supporting midwives to provide emergency maternal & neonatal care in rural communities with limited resources

The challenges of providing quality midwifery care in rural and remote communities are significant, particularly in low and lower-middle-income countries. I am excited to invite midwives, midwifery educators, health service managers and Ministry of Health personnel from the focus countries listed below to participate in a PhD research study. Our research team aims to identify ways to better support midwives providing emergency maternal & neonatal care in rural communities with limited resources. Insights gained from these different perspectives will help us provide evidence for policy, education and practice.

Please consider participating in the study and/or sharing the link with your colleagues.

To participate in our online surveys, please use the following links:

Midwife/nurse-midwife survey: https://lnkd.in/eD4YSQnn

Educator/Manager/Ministry of Health survey: https://lnkd.in/gphj-i4D

If you would like more information, or if you are interested in participating in an online in-depth interview to discuss these issues, please email: Kristen.Graham AT anu.edu.au

Further information is also available at https://nceph.anu.edu.au/research/projects/strengthening-primary-care-midwives-preparedness-readiness-emergency-maternal

Focus countries: Sub-Sahara Africa: Burundi, Eswatini, Eritrea, Ethiopia, Gambia, Ghana, Kenya, Lesotho, Liberia, Malawi, Nigeria, Rwanda, Sierra Leone, South Sudan, Sudan, Tanzania, Uganda, Zambia, Zimbabwe, South & SE Asia: India, Pakistan, Philippines, Pacific: Kiribati, Papua New Guinea, Samoa, Solomon Islands, Tuvalu and Vanuatu

This study has ANU ethics approval (Protocol 2022/492)

Thank you Kristen

Kristen Graham PhD candidate

National Centre for Epidemiology & Population Health ANU College of Health and Medicine The Australian National University Canberra ACT 2600

HIFA profile (and my source): Kristen Graham is a PhD Candidate at the Australian National University, Australia. Professional interests: Sexual, reproductive, maternal, newborn, child and adolescent health; Midwifery; Workforce capacity building in rural and remote low resource settings. kristen.graham AT anu.edu.au

#iwd2023 #internationalwomensday
Ack. All midwives. PJ

WHO and Religions for Peace global conference on strengthening national responses to health emergencies

WHO and Religions for Peace global conference

Hosted by the World Health Organization in collaboration with Religions for Peace and the EPI-WIN Faith Communities of Practice this global conference looks at ‘Strengthening national responses to health emergencies: WHO, Religious Leaders, Faith-based Organizations, Faith Communities and National Governments’.   

 Throughout history religious leaders, faith-based organizations, and faith communities at all levels, have played a key role in health emergency preparedness and response, and in many places, in ongoing health service delivery.   

The COVID-19 pandemic has magnified the important role faith partners, as trusted community leaders, play in mobilizing community led action to protect, care for and advocate for marginalized or vulnerable people; sharing critical, accurate and tailored health information; and providing spiritual care, guidance, and support during times of crisis and uncertainty.   

Together WHO and faith partners work with and in support of national governments to achieve joint health goals, mitigate the negative effects of health emergencies and ultimately help to bring them to an end.  

This conference delves into good practice examples, which cover diverse themes, regions, and faiths, and represent a valuable resource for the current and future health emergencies.   

The sessions of the conference will feature innovative responses in the areas of (i) Spiritual care during times of crisis, (ii) Country collaboration between WHO, faith partners and national governments, (iii) Trust and health histories, and (iv) Communication and advocacy for vaccine equity, access, and uptake.  

More details ... 

My source: 

https://twitter.com/nurse_yogini/status/1450740628879458306?s=20

High Intensity Networks - serenity integrated mentoring SIM model of care

individual
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 INTERPERSONAL : SCIENCES 

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

SOCIOLOGY : POLITICAL

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 group

'Serenity' a humanising term? TRAUMA informed? Expressing distress Poor coping skills Suicidal ideation, Plans, Intent Self-harm Personal Responsibility -  Serenity Practitioner values? Therapeutic modality Access to Therapy - DBT ...? Active research in this field - Parity? Chaotic presentation [Define] High Intensity: Needs highly personalised care 'person-centred care' 'This' is why I became a MH Nurse: Values

High Intensity Network# and “serenity integrated mentoring” (SIM) model of “care” Nursing theory: 'patiency' Integrated Recovery Programme - IRP [Define] High Intensity: Attempted suicide, Frequency, Nos. of services, Nos. of A&E attendances, Dual, n-diagnosis, Data Evidence-base Independent review Mare Serenitatis: Peace on the Moon? Resource allocation: Framing the problem* 'Clinically'

Language & Terminology 'High Intensity' Education of students: 'committed' - 'completed'? Care in the Community (Social) Serenity Social Justice Community - MH Nursing - of Practice Therapeutic relationships Historical artefact: The therapeutic alliance

Policing, Law & Enforcement “high intensity users” (HIUs) of emergency services Mental Health [Police officers] Teams Criminalisation Decriminalisation of Suicide 1961 (Organisational) Serenity? High Intensity (Service-centred) Cost, Time, Personnel, Services involved Commissioning, Policy Outcomes - Cost Savings? NMC MH Nursing Standards MH Nursing Curricula

^#Website not provided: "Service Temporarily Unavailable" 

*There is a 'problem' here. Is the main symptom and sign however, evidence of an ongoing lack of parity of esteem?

My source: Twitter - various

 

ERCIM News No. 124 Special Theme: "PANDEMIC - Modelling & Simulation"

Dear ERCIM News reader,

ERCIM NEWS

ERCIM News No. 124 has just been published at https://ercim-news.ercim.eu/ The Special Theme of this issue focuses on research surrounding the current epidemic emergency. The contributions address actions to understand and counteract the spread of the virus. This special theme has been coordinated by our guest editors Salvatore Rinzivillo (ISTI-CNR), Joakim Sundnes (SIMULA) and Karin Rainer (AGES).

In the section "Research and Society" some of our institutes describe how they are meeting the challenges of COVID-19.

Thank you for your interest in ERCIM News. Feel free to forward this message to anyone who might be interested.

Next issue:
No. 125,  April 2021
Special Theme: "Brain-Inspired Computing"

Announcements in this issue:

---

Call for Proposals: Dagstuhl Seminars and Perspectives Workshops
Schloss Dagstuhl – Leibniz-Zentrum für Informatik is accepting proposals for scientific seminars/workshops in all areas of computer science, in particular also in connection with other fields. https://www.dagstuhl.de/dsproposal

---

SAFECOMP 2021
York, UK, 7-10 September 2021
Call for Papers and Workshop Proposals

---

The GATEKEEPER 1st Open Call
600,000€ available for AI and Big Data Applications, tools or components

---

-- 
Peter Kunz                      	
ERCIM Office

Person-Centredness and Safety: 25st / 350lb / 159kg

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group - population

	https://www.bariquins.com/ ... doors and doorways, entrances, exits, passages, chairs, stretchers, hoists ... moving - handling ...

My source:
Twitter:
https://twitter.com/Bariquins

Eco-Visionaries: Confronting a planet in a state of emergency c/o Royal Academy

Discover how architects, artists and designers are responding today to some of the most urgent ecological issues of our times.

"From climate change to species extinction and resource depletion, the damaging effects of modern life are more tangible than ever. Eco-Visionaries examines humankind’s impact on the planet and presents innovative approaches that reframe our relationship with nature. Through film, installation, architectural models and photography, the works in this exhibition interrogate how architecture, art and design are reacting to a rapidly changing world, beyond mainstream notions of sustainability.

In the 1950s, scientists started raising serious concerns about the damaging effects of modern life on the environment. Since then, architects, designers and artists have joined the urgent effort to draw attention to the planet’s fragile and endangered ecosystem."

Royal Academy - source and continued ...

Planning to visit the exhibition and related event in February.


Previously posted:
Thursday, October 15, 2009

Blog Action Day: Imagine a generation taking nothing for granted from the start

What's in a Name?

  Or, The First Rule of First Aid* ... #SafeStaffing

Health care is often described as complex ...

there are tools to help simplify, conjoin 

and help care navigation and learning ...

Despite this and even if people are listening

politics, politicians and policy makers seem determined to turn health care into a maze ...

INDIVIDUAL

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INTER-PERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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GROUP

*Protect yourself first.	"WAITING ROOM" "WAIT HERE"

RCN Safe Staffing Campaign:
https://www.rcn.org.uk/employment-and-pay/safe-staffing

patient safety learning hub:
https://www.pslhub.org/

'Named Nurse' 25 years ago.
Mitchell G, Strain J. The role of the named nurse in long-term settings. Nurs Older People. 2015 Apr;27(3):26-9. doi: 10.7748/nop.27.3.26.e679. Review. PubMed PMID: 25809049.

My source (and image):
https://twitter.com/helenh49/status/1210956380636663813

Forgotten in a Crisis: Addressing dementia in humanitarian response

SELF - individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group - POPULATION

Difficulty in Understanding	Natural Disasters Conflict War Crimes Refugee Crises
Difficulty in being Understood	Forgotten in a Crisis: Report

ADI, GADAA and Alzheimer's Pakistan launch report on Dementia in Humanitarian Settings

My source: Several - inc Channel 4 News 12 May 2019.

BREXIT: On the Border

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group - population

	Medicines, Medical products Time - Logistics
	"Border Delivery Group" import - export checks BREXIT DEAL :: NO DEAL REFERENDUM #2 ELECTION (crunch) Commons Vote (deferred)  ?

Source: Hughes, L. (2018) NHS faces risk of reduced drug access for six months, FT Weekend, 8-9 December, p.2.

Would you like to help design a new risk assessment tool?

On Tuesday, 19 June 2018, 19:06:42 GMT+1, Charlotte Christiane Hammer, UK wrote:

We are looking for experts in the fields of health protection and humanitarian aid who are interested in helping us with the content validation for a new risk assessment tool for communicable diseases in humanitarian emergencies. The validation will be in the form of a short interview (between 20 and 35 minutes) via Skype during which you will have the opportunity to examine the tool and comment on it. If you are interested or know anyone who might be interested, please send us an email and we will give you further details regarding the project and the consent procedure. Your help is greatly appreciated. Please also forward this email to any colleagues who might be interested.

Kind regards,

Charlotte Hammer

Charlotte Christiane Hammer, MA, MPH

PhD Candidate

Health Protection Research Unit in Emergency Preparedness and Response

University of East Anglia
c.hammer AT uea.ac.uk

Related post - Dec 2017  
My source:

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

HIFA Voices database: www.hifavoices.org

Three Billboards (Some of us are more Alone than others...)

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

"500,000 dead in Syria"	"And still no action?"
"How come, Security Council?"

care - Medical and Humanitarian Organizations use Three Billboards to Call on UN to Stop Violence in Syria

Thunderstorm Asthma in Hodges' model

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group-population

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/


 

Ponencia "La revolución de la emoción" | The Revolution of Emotion & Hodges' model

Below I have mapped some of the concepts discussed in the video to Hodges' model plus the 4Ps.

individual

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INTERPERSONAL : SCIENCES

HUMANISTIC-------------------------------  mechanistic

SOCIOLOGY : POLITICAL

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group-population

emotion  uncertainty  identity individual skills (inner tech) emotional intelligence fear-----terror sadness    stress    anxiety loneliness person centered communication     love PURPOSE "HUMAN	disease technology      devices experience - expertise life  death 'an object' - 'meat' anonomised - aggregated waiting rooms working / caring space PROCESS - PROCEDURE(S) TECHNOLOGY"
love relationships    goodbyes 'life' : the way you/we live patient-family people centered stories - narrative PRACTICE	professionals rules permissions 'restricted' spaces accessibility service centered power Hierarchy (obstructive) 'distance' (protective) POLICY

what3words = addressing the globe : Hodges' model = mapping the world of care

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

think feeling happy	soma tech pressure
gender celebration peers	Bureacracy Hegemony Subsidiarity

What3words.com

My source: 

Hurley, J. (2016) It pays to know exactly where you are going. The Times, 27 April, p.49.

Enviropyrexia

individual
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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL
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group

	India: Temperatures are so high some roads have started to melt
	Plans for COP21 in Paris - December 2015 PKO - 'pyrexia of known origin'

My source and image: India’s heat wave kills hundreds and melts roads