World Patient Safety Day 2026

World Patient Safety Day calls for global solidarity and concerted action by all countries and international partners to improve patient safety.

The Day brings together patients, families, caregivers, communities, health workers, health care leaders and policy-makers to show their commitment to patient safety.

The resolution WHA 72.6 ‘Global action on patient safety’ recognizes patient safety as a global health priority and endorses the establishment of World Patient Safety Day to be observed annually on 17 September. ...

Source:  https://www.who.int/campaigns/world-patient-safety-day

iii Book: 'Complexity in Health Care - A Paradigm Shift for Clinical Practice'

In reading this book and others on W2tQ, I must make the following points:

  * my need to remember the purely USA context (I have never worked there);
  * my healthcare, nursing, informatics experience is NHS-based;
  * this review (and others) is motivated by the project here - Hodges' model;
  * as a result, I will be quoting heavily, there is much to bring to your attention.

As noted in post (i) there is much to whet the appetite, a paradigm shift, 'comprehensive, collaborative, and integrated care' (p.11) certainly have become popular topics in the medical literature. Not only that but 'interpersonal and intersubjective treatment models' too (p.12).

The role of 'Case Managers' is highlighted, plus the Case Management Society of America, which is committed to:

•  Improved Consumer Health Outcomes
•  Professional Diversity, Equity, and Inclusion
•  Cultural Competency and Humility
•  Advocacy for the Health Consumer
•  Integrity and Ethical Principles
•  Promoting Health Equity
•  Educating Case Managers Across the Care Continuum
•  Evidence-based Quality Care
•  Holistic, Compassionate Care
•  Fostering Communication and Collaboration
•  Advancing Research, Innovation, and Use of Technology
•  Fiscal Accountability [ https://cmsa.org/about/ ]

Whether the USA influences global trends in the structure and form of healthcare is another post, but there is a UK Case Management Society too: https://www.cmsuk.org. I can see a fit here [UK] with the development in recent decades on social prescribing. A different role, of course but part of a complex jig-saw.

As expected definitions are provided: 

'Roger Kathol has eloquently defined "health complexity" as "the interference with the achievement of expected or desired health and cost outcomes, due to the interaction of biological, psychological, social and health systems factors when patients are exposed to standard care delivered by their doctors" [1].' p.10. 

Roger G. Kathol, Rachel L. Andrew, Michelle Squire, Peter J. Dehnel (2018) The Integrated Case Management Manual: Value-Based Assistance to Complex Medical and Behavioral Health Patients. 2nd ed. Basel: Springer.

I can see where this definition comes from, but for me, it does not sit right. The problem when there is 'interference' is the assignment of responsibility and consequence that blame can follow. We've seen this, and in mental health too), with the recover model^. Some of the terms here may be completely innocuous politically speaking (which is the author's intent of course), but they can also be 'weighted'. Hence they can become concrete terms of judgement. Think about it: achievement, expected, desired, cost (and) outcomes, standard care, delivered (by doctors)? Or, am I over-thinking again.

In the margin I pencilled/drew:

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

Standard -	care
Other -	factors

As ever, the individual patient is our focus. The individual is supported (literally) by the social and political (infra-)structures that act as a scaffold, safety-net for most.

Time flies, I can't believe it was 2007 I posted 

Plush HQ foyer, shame about the mannequins!

I had this notion of life-size cardboard cutouts representing the average people who use a given health service provider (local, or not so local these days?). The data will be there in statistical annual reports. I'd noticed the displays - analogue and digital that greeted visitors at a local NHS Trust HQ. This would be the book's 'routine patients' who receive standard care. 

Chapter 3 introduces 'variables' which again is brief, but imporant as variables recur throughout the book. The 'Clinical Field' is first outlined, as in:

• Sources of clinically relevant factors;
• Dynamic factors;
• and: Variables representing contributions from practitioner(s).

Abstract variables are differentiated from those that are concrete. It's reassuring to read there is no true simplicity within the clinical field, and the author's goal is to 'unpack complexity so it remains as true to life as possible, not just manageable conceptually.' p.18.

Frankel et al. are primed to go beyond this. Maths, as in statistical procedures are one tool. Chapter 4 adds to this with a theoretical model to guide clinical understanding of patients with biopsychosocial complexities, the foundations of our paradigm shift. p.23.

If you have an understanding of Hodges' model you can picture my response to this. But, staying grounded, the whole book and paradigm shift represents a form of scientific "emergence". It is frustrating that literature searches fail to pick out Hodges' model. 

Frustrating too as reading of "awe", also on page 23, I have experienced this many times (over say 1977 - 2019 ...). So, I held on to my dummy (pacifier!?) and read on ...  

Chapter 4 Technical Considerations is one the longest and contributes all of Part III. Here you can read about science, measurement, statistics, empirical, operational definitions, intelligence, reliability. I often see a chapter, book section as a useful primer for students and the same applies here; with inter-judge realiability, validity, control, null hypothesis, statistical methods and much more. Reference to mathematics (axiomatic too) had me hoping for more. I picked out Structural Equation Modelling:

 'We would also like to suggest that following the steps involved in "structural equation modeling" (path analysis) is a good way of conceptualizing and reasoning about complex clinical variables altogether. For example, constructing a clinical model informally (intuitively, loosely from data) and thinking about (diagramming) how the variables involved may moderate and mediate each other can be a useful activity for clarifying the nature and requirements of a complicated clinica1 situation. 
 

 In simplest terms, an independent variable is the causal or influential variable that impacts and effects the dependent variable. A moderating variable is a dichotomy, and refers to two comparison groups (e.g., male/female; passed/fail; religious/nonreligious; tall/short; high versus low socioeconomic status) that display significantly different degrees of magnitude on a correlated relationship. For example, the relationship between a specific treatment for a medical disorder and treatment outcomes may be moderated by socioeconomic differences. The treatment outcome relationship may be stronger and more positive for individuals with elevated socioeconomic standing who therefore have better support systems and access to medical professionals, and fewer economic stressors.' p.36.

I think from this the authors might be sympathetic to giving 'life' to the POLITICAL domain and Hodges' model; after all it lives in people's daily experience - acknowledged or not. The book's structure works thus far: Chapter 5 Nature-Nurture (n.b. no escape!)  and the Epigenome. The structure - flow - works, as at just over four pages, it begs further reading (beyond the listed references). I still have my copy of:

Fritjof Capra and Pier Luigi Luisi (2014) The Systems View of Life - A Unifying Vision. Cambridge: Cambridge University Press.

 

With the epigenome being added to the 'patient complexity equation' in chapter 5, I wondered whether this was predictable, a promise, or a tease?

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

nature?	NATURE?
NURTURE?	nurture?

 

Previously: 'complex' : 'nature' : 'mental health' : 'person(-centred)'

More to follow ...

^Jones P. (2014) Using a conceptual framework to explore the dimensions of recovery and their relationship to service user choice and self-determination. International Journal of Person Centered Medicine. Vol 3, No 4, (2013) pp.305-311. 

Steven A. Frankel, Steven D. Thurber, James A. Bourgeois (2023) Complexity in Health Care: A Paradigm Shift for Clinical Practice. Cham. Switzerland: Springer. ISBN: 978303114948.

ii Book: 'Complexity in Health Care - A Paradigm Shift for Clinical Practice'

I didn't have time to finish reading Frankel et al. before WCCS26. This book has an index which was very useful, to efficiently check certain points. It is amazing the number of books without an index.

Chapter 1 is 'Guiding Principles' and links really well with the index. At two pages it is brief and yet also constitutes Part 1. 

Part II The Clinical Situation, continues an introductory thread. Chapter 2 The “Clinical Situation”: An Introduction to Its Structure and Complexity is what attracted me to the book. At five pages, there was more in this vein. I looked ahead and found that the chapters all seemed short. Checking the book's web page, 50 chapters in 270 pages, so just over 5 pages and well referenced too.

Initially, you might feel short-changed, of course, I didn't with a review copy. But don't worry. You are in patient- person-centred hands here. Sometimes content matters. The three authors work and are researchers in psychiatry. For me, the guiding principles and part II provide a handshake with the index. The person here then, is given a literary hug. Immediately, there is a link between the variables of care and the structure of a case (or caseness). 

'But importantly that "structure" is dynamic changing over time. We classify variables as "clinical" as they are brought into play for the purpose of treatment, i.e., the goal of healing.

The clinician is not just challenged to unravel this complicated situation but also to represent the patient accurately, including his or her "human" elements as represented by temperament and personal attitudes. What are the patient's essential needs. tolerances, preferences? Yet, there is even more to know about each patient. Does she have children? What is her financial status, her ethnicity? What are her attitudes about medical professionals. Does she believe in medicine, or even in science?

Beware! None of these factors are dispensable when trying to understand a patient. Just try to leave out a few and you are left with a gutted rendering of that person, not a living human being.' p.7. 

(and continued in fragmented form below ...)

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

'The result even when this level of detail, is available may still be an anemic version of the patient.    Traditionally a medical patient is subjected to an extensive workup that includes a mental status examination, in addition to a detailed past and present history, ...	... and an extensive "review of (organ) systems.
Now add the multiplicity of problems, psychiatric and systemic medical, from which the patient suffers. ...	Multiplicity may include systemic medical, psychiatric, social, financial, and lack of access to health providers.' p.7.

'From this description it seems logical that complex patients presenting with mixed medical-psychiatric disorders be managed with an ongoing collaborative approach delivered by a multispecialty team. Included may be a primary care physician, psychiatrist, and/or psychotherapists. One or more of the collaborating professionals may be a nurse practitioner and/or a physician's assistant.' p.7

I will return to the 'logical' in the final quoted paragraph above. The author's declare their intent from the outset, and by the literature-to-date they achieve this (may I please add? 'in spades!').

 

Over the years and as raised on W2tQ, several colleagues and contacts have asked "Where is the book on Hodges' model?" Not to sound weird, but this book asks that same question through some challenges to the usual 'medical' text. There are several lessons to take away here, even if only to keep a dream alive. While the physical size of a textbook, its practical appeal and stance makes it appear as something to pop in your top shirt/jacket pocket. A pocket guide: quite an impression just 10-20 pages in, and in this digital age.

 

As you would expect from mental health practitioners - psychiatrists - psychotherapists, interpersonal, subjective-objective and intersubjective factors are integral to how complexity is defined and measured. In Chapter 2, pp.11-12 there is mention and reference to the Value-Based Integrated Case Management Complexity Assessment Grid:

Specker, S., Andrew, R., Drexler, E., Koithan, E., Thurber, S., & Frankel, S. (2026). Development of the Self-Administered Health Complexity Screening Instrument. Professional case management, 31(2), 81–89. https://doi.org/10.1097/NCM.0000000000000845

I will check this instrument as I complete this review. As noted on April 9th this book was published in 2023, so I remain grateful to Daniela and colleagues at SpringerNature for the review copy (which also enjoyed WCCS!).

Previously: 'complex' : 'holistic bandwidth' : 'mental health' : 'person(-centred)'

More to follow ...

Steven A. Frankel, Steven D. Thurber, James A. Bourgeois (2023) Complexity in Health Care: A Paradigm Shift for Clinical Practice. Cham. Switzerland: Springer. ISBN: 978303114948.

NANDA-I Newsletter - theme of clinical reasoning

'This month at NANDA-I, we have been exploring the theme of clinical reasoning.

Clinical reasoning is at the heart of nursing; it’s how nurses make sense of complex patient information and choose the best path forward. While many nurses think of diagnosis as the centerpiece, it’s really the thinking that leads up to it, gathering cues, interpreting what matters most, and then safely determining goals and actions, that makes all the difference in outcomes. Strong reasoning helps nurses notice subtle changes and act with confidence.

As healthcare grows more complex, understanding how nurses think, not just what tools they use, helps elevate care for every patient. We’ll be sharing insights throughout the year to help you stay connected to nursing knowledge and its impact on care delivery and education.'

 

Teaching Tip: Clinical Reasoning in Practice

Start With Assessment to Improve Reasoning

When nurses work with standardized languages and clinical judgment tools, it’s tempting to dive right into diagnosis. But the most accurate and useful nursing judgments always come from strong, systematic assessment first. Quality assessment supports better interpretation of patient needs and more precise identification of nursing responses. Quick Tip: Use a flexible assessment framework, whether it’s a conceptual model or a tool like functional health patterns, to make sure you’re capturing the data that matters most first. When you build a solid foundation with assessment, everything that follows (including diagnostic thinking) becomes clearer and more grounded.

 

My source: 'Friends of NANDA®-I Newsletter' subscription (with my emphasis).

See also:
https://nanda.org/2025/12/nanda-360-for-educators-and-researchers-strengthening-nursing-knowledge-through-diagnosis-centered-reasoning/

Assessment, plus planning, implementation - action, evaluation (plus, formulation).

Functional and cognitive [Health, Illness, Climate, Poverty, Political, Security, Prevention, Self-care, ...] patterns.

'... make sure you’re capturing the data that matters most first' - Situated, Context, Salience.

For a competent practitioner an assessment can also be 'therapeutic' for the patient.

Previously: 'classification' : 'diagnosis' : 'NANDA' : 'ICD'

ii On Sociology & Becoming a Nurse

Two final observations re.

Maclean, Una. (1974) Nursing in contemporary society. London: Routledge & Kegan Paul.
https://wellcomecollection.org/works/qhqc24fv

Firstly, there is a question for new student nurses:

'In the case of nursing, the Royal College of Nursing laid down the course of training and the final tests whilst the General Nursing Council held the solemn register to which aspiring professionals were ultimately to be admitted, and  the aim of these two powerful proponents of the nurse's unique role was to limit he epithet 'nurse' to those who had successfully navigated the straight and narrow path to registration.' p.67.

Q. Above, Maclean refers to a solemn register. What do you believe may have shaped the author's writing at that time in 1974? Is the nurse register, towards which you now aspire still 'solemn'? 2000 words.

There has been much debate of late regards the title 'Nurse'. 'Doctor' also.

Secondly, Maclean was prescient in acknowledging the 'Patient's right to information'. pp.119-120.

Jayasinghe (2025) 'People‑centred care: a systems view of a new paradigm'

C/o HIFA

Dear friends,

It is my pleasure to share the link to my article "People-centred care: a systems view of a new paradigm". It is published online in Discover Health Systems and Open Access. Please see full-text access to your paper by using the following link:

https://rdcu.be/ejNUq

Kind regards Saroj

ABSTRACT People-Centred Care (PCC) is an emergent property in an “open” system. Policies aiming at promoting PCC can be categorized under four nested levels: Micro-level; Meso-level; Macro-level; and Mega-level and used to draw systems diagrams. We develop a single composite diagram which demonstrates interactions and feedback, within and across subsystems, resembling panarchy.

Jayasinghe, S. People-centred care: a systems view of a new paradigm. Discov Health Systems 4, 43 (2025). https://doi.org/10.1007/s44250-025-00215-9.

Saroj Jayasinghe MBBS (Col), MD (Col), MRCP (UK), MD (Bristol), PhD (Col), FRCP (Lond), FCCP, FNASSL Fellow of the International Science Council, Emeritus Professor, University of Colombo, Former Head, Department of Medical Humanities, University of Colombo, Sri Lanka Consultant Physician sarojoffice AT yahoo.com, saroj AT clinmed.cmb.ac.lk

Professor Jayasinghe's paper provides several informative figures on centredness, scale and levels, micro-mega; and affords a way to use Hodges' model to help define person, patient, people and service-centred care. These definitions could be developed, refined and validated using a relational formulation.

Individual

|

      INTERPERSONAL    :     SCIENCES               

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

 SOCIOLOGY  :    POLITICAL 

|

Group

PERSON-  PATIENT-CENTRED psycho-

PERSON- PATIENT-CENTRED location bio-

social PEOPLE-CENTRED 'Health systems and services designed ‘for and with people’ are captured by the concept of People-Centred Care (PCC) defined as an approach “to care that consciously adopts individuals’, carers’, families’, and communities’ perspectives as participants in, and beneficiaries of, trusted health systems that are organised around the comprehensive needs of people rather than individual disease, and respects social preferences.' Duong, et al. (2024).

political policy - engagement - design SERVICE-CENTRED panarchy 'Let us together forge a new way of knowing and practicing health care in the post-Sustainable Development Goal era, using people-centred care as our guide to achieve Universal Health Coverage.' Duong, et al. (2024).

Duong DB, Holt B, Munoz C, Pollack TM. For and with people: announcing the Lancet Global Health Commission on people-centred carefor universal health coverage and a call for commissioner nominations. Lancet Glob Health. 2024:S2214-109X(24)00216-X.
https://doi.org/10.1016/S2214-109X(24)00216-X.

Previously: 'design' : 'patient' : 'person' : 'system' : 'people'

Webinar: 11 December - Universal Health Coverage (UHC) Day 2024

"The UHC Compass and Social Participation:

empowering patient organisations to hold governments

 accountable for universal health coverage"

Register for the UHC Compass launch!

To mark Universal Health Coverage (UHC) Day 2024, IAPO will officially launch the UHC Compass at an exciting webinar titled "The UHC Compass and Social Participation: empowering patient organisations to hold governments accountable for universal health coverage" on 11 December 2024, from 11:30 to 13:00 GMT via Zoom.

The webinar will be conducted in English with simultaneous interpretation into Spanish.

Panellists include:

• Dani Mothci – International Alliance of Patients’ Organizations (IAPO) 
• Dr Pamela Cipriano – UHC2030 & International Council of Nurses
• Lara Brearley – Special Programme on Primary Health Care Universal Health Coverage - Life Course, World Health Organization
• Dumiso Gatsha – Success Capital NGO & Civil Society Engagement Mechanism for UHC2030 (CSEM)
• Nicola Bedlington – Global Patient Think Tank & Millwater Partners
• Smitha Sadasivan – Global Patient Think Tank, Inclusive Health Policy, Disability Rights India Foundation & CSEM 
• Paul Mendoza – Psoriasis Philippines and Psoriasis Asia Pacific & IAPO

The UHC Compass is a dynamic tool created by patients for patients, empowering local leaders and communities to advance universal health coverage (UHC). In the context of the World Health Assembly resolution on social participation and UHC Day 2024, this session will explore how the Compass can serve as a tool to hold governments accountable for investing in UHC.

Co-created by the Global Patient Think Tank (GPTT), a diverse group amplifying the patient voice in the UHC movement, the Compass is proudly hosted by IAPO. Our mission is to ensure this resource reaches and benefits our global network of patient organisations.

Join us to discover how the UHC Compass can help make UHC a reality for everyone!

Learn more & register [https://www.iapo.org.uk/node/15686] Share https://iapo.cmail19.com/t/d-fb-sfiudt-iuqjytrli-o/ Tweet https://iapo.cmail19.com/t/d-tw-sfiudt-iuqjytrli-b/ Share [https://iapo.cmail19.com/t/d-li-sfiudt-iuqjytrli-h/]

[http://www.iapo.org.uk]

The International Alliance of Patients’ Organizations is registered in England and Wales as charity no.1155577 and company limited by guarantee no.08495711.

Registered office: Hounslow House, 7 Bath Road, Hounslow TW3 3EB, UK.

It is also the IAPO's 25th Anniversary.
More details at:

https://www.iapo.org.uk/node/15687

I will post again in the New Year.

My source: HIFA

Previously: compass : UHC : patients

Identity: Self, person, client, patient ... player

INDIVIDUAL
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 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

Identity morphism

My source: Twitter - X

https://x.com/Ravens/status/1751712286769660409?s=20

Plus:

https://www.cbssports.com/nfl/news/lamar-jackson-makes-unreal-catch-of-his-own-pass-in-chiefs-ravens-afc-title-game-leaving-tony-romo-amazed/
 

Image:

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

'Mechanical medicine' is a thing ...

Planet Medicine

"Mechanical Medicine: Ancient surgery, poultices; some herbal medicine and bodywork; all Western technological medicine. 

Since healing occurs in the physical world, all medicines must have some substance, if only the substance from which a potency is derived or the bodies of the participants. The acupuncture needles are not pure energy, and the herbs of the Ayurvedic or Basque doctor grow from real soil; even the mind has the external properties of the brain. The San Pedro cactus of Peru which, according to Eduardo Calderon, transfers its light and vibration to the patient and locks with his aura to drive all physical and mental aspects of alienation to the surface, originates in the physical properties of the desert." p.374.

Grossinger, R. (1982) Planet Medicine - from stone age shamanism to post-industrial healing, London: Shambala Publications Inc.

Book cover: Ebay.

Nursing care of the patient - 1976 and Earth Day . . .

Moidel, H.C., Giblin, E.C., Wagner, B.M. (Eds) (1976) Nursing care of the patient with medical-surgical disorders. New York: McGraw-Hill,  ISBN 10: 0070426554 / ISBN 13: 9780070426559

"The process of nursing assessment is a deliberate and systematic analysis of the patient and his environment with the purpose of gathering data about the patient's health-illness status and resources. A systematic and recorded assessment also provides (1) a baseline measure for identifying change over a period of time; (2) a foundation for the nursing-care plan, giving direction to nursing interventions; (3) a means for evaluating the effectiveness of nursing care." p.8.

"The nurse's major tools for obtaining data regarding a patient's health-illness status and resources include communication (with the patient, his family, health team, and nursing-team members), direct observation and examination (through the use of all sensory channels and technological adjuncts), consultation, and review of the literature. The use of these tools, which is amplified in chap. 7, should be in accordance with some organized, systematic, valid, and reliable framework." p.9.

The need for systematic and deliberative approach remains, despite the passing decades. Whatever 'system' is adopted it needs, as per 1-3 to be dynamic, act as a substrate; that is also neutral - non-prescriptive (apart from); facilitating the flow of assessment, planning, interventions and evaluations, and what used to measure effectiveness, outcomes, quality and safety. As an American text, chapter 7 is also concerned with 'nursing diagnosis' and Orem is referenced.

Nursing care of the patient
with medical-surgical disorders

 

Nursing Management

"Nursing management is based upon and follows assessment. It is the process of determining and initiating goal-directed nursing action in relation to the patient problems diagnosed during assessment. Without assessment, nursing management becomes mechanical, dependent on physician's orders, and detached from the ultimate goal of wholeness for the patient." p.9.

We still need balance in humanistic-mechanistic care delivery. Paying attention and due regard to the interpersonal detail and needs, while also seeing the whole.

"Delong studied the impact of preoperative information on recovery from surgery. In general, individuals who were given specific detailed information regarding the surgery and postoperative care had a less complicated recovery and were discharged earlier than those who received general nonspecific information. When coping styles were considered, it was found that those who exhibited flexible patterns of coping with general stress in their lives recovered well regardless of the type of information they received. Copers, who were defined as individuals who seek out information regarding potential threat, recovered better if they were given specific information before surgery. Avoiders typically showed slow, complicated recoveries, regardless of specific or nonspecific information; however, those who received specific information had more postoperative complications than those who heard only the general information." pp.38-39.

Now in healthcare, we are concerned with Health Information for All, and Health Literacy. I wonder what the informational nuances are in 2023 bio-psycho-socio-politically: and of course spiritually?

"All the disease and illness concepts cited above have reshaped society's thinking and practices about health, maintenance of health, and treatment of disease when it appears. But each emphasizes specific aspects of the totality of interwoven dynamics that constitute disease and illness, leaving us with cumbersome vocabularies and classifications that are partial and imprecise. Theoreticians, endowed as they are with a sense of order and logic, will most assuredly seek to bring the various viewpoints together into new conceptual frameworks." p.51.

Now our 'new' conceptual frameworks must incorporate nursing, patient-nurse relationship, the 'team', society, research and evidence-based care, policy - local, national, and global, plus technical and climate change all amid the politics of health and the informational milieu - or melee?

Also of note (Chap. 1):

Section headings: Care as a Nursing Function, with Cure, and Coordination as Nursing Functions.

Ecologic Orientation, Part 2.

Individual differences in patterns of anxiety arousal, stress-relevant information and recovery from surgery. Delong, R. D., University of California, Los Angeles ProQuest Dissertations Publishing, 1970. 7116307. https://www.proquest.com/openview/0d64def524b9e5845b7e168aa4cc5876

<>

As I continue to sort through 'old' books and papers, on Earth Day we are (duty) bound to reflect on the future. As my grandson was on the post-school play ground this week, I noticed the infants and those at risk of walking into the merry-go-round. I wondered whether in their senior years, will the ice be returning, the sea-levels stabilise, and will the CO² in the atmosphere be reducing? 

What of - Nursing care in 2076? We need a conceptual framework that can project the care of the past and now, into the future. For those who are not yet here.

Previously:

'Planetary Health'

Gaia

'climate change', 'ecology' . . .

"163 Days"

 INDIVIDUAL

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 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

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GROUP

	163 Days - Hannah Hodgson
Poetry in [not in] motion

“Hannah Hodgson takes us to the paradoxical heart of poetry itself: to be held inside a pain both intensified and soothed by the sheer brilliant presence of the poet’s mind.” – Caroline Bird

Hannah Hodgon is an award-winning poet and a palliative care patient. In her compelling debut collection 163 Days, she uses a panoply of medical, legal, and personal vocabularies to explore what illness, death and dying does to a person as both patient and witness.  

163 Days is the length of Hannah’s longest period of hospitalisation to date. In this long poem, she probes various truths, personal and medical; truths which clash like a tray of dropped instruments in a silent operating theatre.

The speaker is a teenager on the cusp of adulthood. Doctors struggle to diagnose her complex conditions. Through daily, diary-like poems we see the children’s ward through Hannah’s eyes. It is decked out in primary colours. Volunteer clowns visit. At seventeen she is ‘too old’ to be here, ‘too young’ to move to the adult ward.

The mundanity of hospital life is marbled by a changing landscape of mood, hope and loss. Her symptoms are painful. She has numerous tests and procedures to keep her alive long enough to figure out what’s wrong. A gap yawns between the person she is, and the person in her medical notes.

In ‘Aftercare’, Hannah navigates the worlds of both nightclubs and hospice care as she embarks on a new version of her life as a disabled adult. 163 Days is an important collection, in which Hodgson’s true voice takes poetry into difficult places.

Listen to the BBC radio play adaptation of 163 Days on the New Creatives website here.

163 Days by Hannah Hodgson, Seren Books ISBN-13: 9781781726471
Publication Date: Monday, March 28, 2022

My source:
Hannah's book in Kirkby Lonsdale, The Book Lounge 17th February 2023.

STEM Women: Dame Clare Marx [RIP]

Pablo Picasso. Science and Charity. Barcelona, [March-April of] 1897. Oil on canvas 197 x 249.5 cm.
Museu Picasso, Barcelona. Donation Pablo Picasso, 1970. MPB 110.046. Museu Picasso, Barcelona.
Fotografía, Miquel Coll © Sucesión Pablo Picasso, VEGAP, Madrid 2020

 INDIVIDUAL
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 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

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GROUP

Clare  intelligence ...	physical contact, touch ... good surgical hands ...
Marx ... ability to talk to patients	Dame

Dame Clare Marx "First woman to be elected president of the Royal College of Surgeons who sought to root out sexism and expand surgical training ... A charismatic colleague taught her the three qualities of a successful surgeon: intelligence, good surgical hands and an ability to talk to patients."

"Marx said Picasso's Science and Charity emphasises
'the importance of physical contact' between doctor and patient."

Register, Obituaries, The Times, November 30, 2022, p.53.

See also: 'Arts'

Mechanisms, Individuals and Collective

Last week I joined a webinar:

 

https://www.biokoinos.org/events

BioKoinos Research Seminar

Saúl Pérez González & Elena Rocca - 

Evidence-based and patient-centred clinical practice. The bridging role of evidence of mechanism.

  

I have mapped some of the concepts to Hodges' model. A link to the paper is included below. The session was very helpful, especially with ongoing developments in genomics and personalised medicine.

 

INDIVIDUAL

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 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

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GROUP

patient-centred evidence safety of a certain intervention for a particular patient safety efficacy	individual - epidemiology - population patient-centred evidence safety of a certain intervention for a particular patient biology pathophysiological mechanism prediction ... confirming and disconfirming - depending on whether or not it supports that certain epidemiological results apply to the single patient.
evidence safety efficacy	evidence safety efficacy

Pérez-González, S., & Rocca, E. (2022). Evidence of Biological Mechanisms and Health Predictions: An Insight into Clinical Reasoning. Perspectives in Biology and Medicine 65(1), 89-105.  

http://philsci-archive.pitt.edu/20364/1/Postprint%20Evidence%20of%20biological%20mechanisms%20and%20health%20predictions.pdf