Distinction: Phenomenal - Psychological and Scientific interpretations

"In order to separate different uses of quality dimensions it is important to introduce a distinction between a phenomenal (or psychological) and a scientific interpretation. The phenomenal interpretation concerns the cognitive structures (perceptions, memories, etc.) of humans or other organisms. The scientific interpretation, on the other hand, treats dimensions as a part of a scientific theory." Gärdenfors (2004).

SELF - individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - POPULATION

Phenomenal (or psychological)	Scientific

Gärdenfors, P. (2014) Conceptual Spaces as a Framework for Knowledge Representation, Mind and Matter, Vol. 2(2), p. 14. 

Planetary Health (i) (and the need for a global conceptual framework)

(with thanks to Global Health Now)

In a pointed challenge, Lancet editor-in-chief Richard Horton warned Consortium of Universities for Global Health conference attendees Saturday that an exclusive focus on improving health will fail.

Horton argued instead for planetary health.

“We have to cross outside of health and think about the relationship between health and other dimensions being defined as sustainability,”

Horton said, in a keynote address at the annual CUGH conference, which opened Saturday in San Francisco and attracted more than 1,800 attendees from around the world.

Citing the work of a Lancet Commission that published a 2014 manifesto, Horton argued that the global health community and others need to embrace planetary health. “Our vision is for a planet that nourishes and sustains the diversity of life with which we coexist and on which we depend,” Horton and others wrote in the manifesto.

Brian W. Simpson, Global Health NOW

Full text:

http://www.globalhealthnow.org/news/horton-to-cugh-planetary-health-is-the-solution
[ See below: PJ ]

Best wishes, Neil

Let's build a future where people are no longer dying for lack of healthcare knowledge - Join HIFA: www.hifa2015.org


https://www.globalhealthnow.org/2016-04/horton-cugh-planetary-health-solution

Previously on W2tQ:

One mind, many minds - ONE PLANET. One need, many needs - ONE PLANET: what price stability?

Exoplanets, exobiology, exocortex, exocare ...?

Notes (ii) from Paipa Conference: Q & A

Blog Action Day: h2cm around the water whole

TED: Nic Marks - The Happy Planet Index

Time, History, Technology, Institutions, Transparency and Reflective Practice

Despite the passing of time

refactored as
institutional history
 and
 technical solutions,

reflective practice

and
transparency

in care
remain aspirational.

Image: Sculpture at Prague Congress Center

h2cm and clinical equipoise

The past few weeks reading the Journal of Evaluation in Clinical Practice - I've encountered the concept of equipoise: specifically the clinical form.

The Health Career - Care Domains - Model is all about 'poise'.

The model's care domains provides the perfect workout.

Medicine, health and social care constantly exercises us. We are, whether or not we recognize it, on a balance board. In fact if you consider that image and then factor in the complexity of health care today you realise just how much stuff (technology), how many people (subjects, agents) need to be on that same board. Who does the board belong to though? Well of course it's -

Jo Public's (... and often off-balance, strengths depleted, sick (and tired), relapse prone...)

The April 2010 issue of the above journal is a fascinating read. I noticed today that some of our placement students were not aware of the recent and current position regarding health policy: that is the 'long view' of decades such as: Health of the Nation, the National Service Frameworks, Darzi ... They need to address that and I'm sure they will.

This journal issue prompts me to consider evidence based medicine anew, especially:

• Its history spanning 20 years.
• Its occupying the SCIENCES domain, with its weight threatening to overbalance all (you could say it's a significant singularity).
• The realization that the Emperor is short on clothes.
• Given the above it can mature. Bogdan-Lovis and Holmes-Rovner (2010)

Back to that board: and stepping onto the health care domains - all four of them so spread your feet - you can see instantly (feel that feedback) how EBM, shared decision making and (person) patient-centered care are all related. As Bogdan-Lovis and Holmes-Rovner (2010) highlight:

Equipoise is the heart of the shared decision making movement, and it embodies the problems for which patient decision aids are most often developed to explain the risks and benefits of competing alternatives. p.377.

h2cm is well suited to this task on so many levels.

The past week or two I've also noticed several mentions of the need to nudge people - here and there - both in the media and in Bogdan-Lovis and Holmes-Rovner's paper and references.

More to follow - and as you step-off take care ....

Wilson, K. (2010) Evidence-based medicine. The good the bad and the ugly. A clinician's perspective. Journal of Evaluation in Clinical Practice, 16, 398-400.

Bogdan-Lovis, E., Holmes-Rovner, M. (2010) Prudent evidence-fettered shared decision making. Journal of Evaluation in Clinical Practice, 16, 376-381.

And for the week ahead:

One mind, many minds - ONE PLANET. One need, many needs - ONE PLANET: what price stability?

http://hodges-model.blogspot.com/2009/02/one-mind-many-minds-one-planet-one-need.html

Care design: c/o DDC Copenhagen

On Monday afternoon I explored the city of Copenhagen walking to several sites - the Tivoli Gardens, the Tycho Brahe Planetarium and other parts of this lovely city. I ended up spending a couple of hours at the Danish Design Center.

Like my occasional visits to London's museums, the DDC although very small provided a couple of pearls. One display across a wall upstairs outlined the main forms of design theory and practice:

• The USER as designer
• TECHNOLOGY in the design process
• New MATERIALS and smart design
• NATURE
• SOCIAL design and CARE design
• GREEN design
• ART design
• EMOTIONAL design
• REPLACEMENT due to changing fashions (built in obsolescence!)
• SERVICE and CONCEPT design

The following text was displayed to describe SOCIAL design and CARE design:

The population pyramid has changed shape. The working-age group is shrinking compared to the group of people of retirement age. In addition, there is the large segment of the so-called weak - particularly in the 3rd world. Thus, social design and care design will be big and important design areas in the future, because the solutions will seek to strengthen the health care sector and improve conditions in the 3rd world and for underpriviledged people in general. Parameters such as increased dependency, quality of life and dignity are crucial elements in solutions relating to social design and care design. DDC display; August 23 2010.

Many themes come together here. Some are represented in the tags below. Care design is much more than what we might consider as 'standard design' aspects, such as; user interface [UI] and user experience [UX]. Care design is even more dependent upon user engagement.

There is another dependency that as yet has a '?' in the data entry box.

Care design needs coherent forms of personal, social and civic responsibility. These are yet to emerge as think tanks, governments and health experts seek (urgent) solutions.

In comparison to the above the 200 character limit on labels (tags) on Blogger presents a very small challenge. I can well imagine the outline of a book on 'care design': the result would be a big tome; but this would not just be (PJ inspired) hyperbole. Care design is not new, but the DDC text above must accentuate the individual, and not just care design at the public and private sector hospital level. Care design in an individual context is mission critical. Heady content - for books, websites and policies - as befits our times.

Thank you DDC, Copenhagen: wonderful indeed...

Currencies and travel in health and social care

Before the advent of the euro, holidays in Europe were that bit more exotic. Having to buy and adjust to another currency - and not just one - was part of the novelty and fascination of travel.

Health and social care have their own currencies (and yes, read that as there being integration here too!). Most of the currencies are national given the efforts to standardise, with examples such as, length of stay, referral to treatment and more recently in residential care and elsewhere continuing care and its occasionally truculent neighbour 1-to-1. Unfortunately, like land masses, these currencies can also suffer from continental drift.

Dissemination (use in the wild) lack of review and ongoing attention to standards, benchmarks and definitions can see a currency drift in its application and subsequent reporting (affecting perceived utility, value and impact). The value of a currency can be diminished over time as it no longer acts as a unit of difference.

So enjoy your travels, but beware the risks while you vive la difference, especially in your work!

Image source: http://www.artlebedev.com/mandership/77/

Basic Nursing Care @ the X-roads?

Basic nursing care:

It sounds straight forward enough doesn't it?

And yet according to news today here in the UK (The Independent) some nurses it seems fail to deliver safe, effective and efficient care of the required standard. This sorry news was reported by The Patients Association. The cases cited are upsetting and represent the care and behaviour of a minority of nurses, although there was a debate as to the 'true' numbers the report findings may represent.

The worrying point here though is this highlights not just a lack of basic nursing skills and knowledge, but a blatant disregard for the needs of vulnerable individuals and a sense of humanity. Even with NVQ's in the UK and equivalent programmes elsewhere when it comes to high standards of care we can take nothing for granted.

A commentator on the radio asked if the nursing profession is at a crossroads?

It is.

This crossroads is also a target that nursing must hit -
not most of the time -
but every time and for every person.

In truth of course, all professionals should constantly find themselves at the crossroads.

So, where next for nursing and who has the map?

Original image source:
http://www.thesignlady.net/signs/images/warningsigns/W2-118X18CrossRoad.jpg

Clickstream Data Yields High-Resolution Maps of Science - PLoS ONE

Johan Bollen, Herbert Van de Sompel, Aric Hagberg, Luis Bettencourt, Ryan Chute, Marko A. Rodriguez, Lyudmila Balakireva

Abstract: Background

Intricate maps of science have been created from citation data to visualize the structure of scientific activity. However, most scientific publications are now accessed online. Scholarly web portals record detailed log data at a scale that exceeds the number of all existing citations combined. Such log data is recorded immediately upon publication and keeps track of the sequences of user requests (clickstreams) that are issued by a variety of users across many different domains. Given these advantages of log datasets over citation data, we investigate whether they can produce high-resolution, more current maps of science.










Read more...

Citation: Bollen J, Van de Sompel H, Hagberg A, Bettencourt L, Chute R, et al. (2009) Clickstream Data Yields High-Resolution Maps of Science. PLoS ONE 4(3): e4803. doi:10.1371/journal.pone.0004803

Editor: Alan Ruttenberg, Science Commons, United States of America

Received: June 25, 2008; Accepted: February 6, 2009; Published: March 11, 2009

Additional link:

Arthur M. Sackler Colloquium on "Mapping Knowledge Domains"

My source: Humanist list

1st Contact: ET and care on the front line

ET as in 'extraterrestrial' may seem remote from nursing and health care, but where there's a will....

Health and social care appears to become ever more specialised with each turn of the policy machine. People's lives are experienced as being ever more complex. Health care is filled with uncertainty and the public present with multi-diagnostic, person-centred, choice bearing, (usually) recovery directed problems, needs and strengths.

Pity then the care workers on the front line, at the point of 1st contact. Like the baseball catcher it helps if they can field the knowledge and skills required to cover physical, mental health and possibly learning disabled clients. You have to hope that coaches recognise that Hodges' model can help the team be aware and fully prepared to cope with 1st contact supporting and facilitating what follows. So, how does your team get to grips with complex care?

Additional links:

Baileff, A. (2004) Developing high quality first contact nursing in Southampton NHS Walk-in Centres. At, Innovations in Partnership, Practice and Education, 3rd Annual Scholarship Conference, Portsmouth UK, 2 Jul 2004. Southampton, UK, University of Southampton. http://eprints.soton.ac.uk/9197/

Declaration of Principles Concerning Activities Following the Detection of Extraterrestrial Intelligence http://www.setileague.org/general/protocol.htm

Image and source: Louisville Slugger OXFB Omaha Pro Series 13 Inch First Base Baseball Mitt from
Formerly - anaconda sports

Identification and Hodges' model

In health and social care the importance of correctly identifying people in your care is drummed into you from the outset. Even before staff are on the payroll or in the lecture theatre everyone knows that common sense shouts "pay attention!"

Drug administration and various other clinical interventions are safety critical:

Right patient - Wrong drug
Wrong patient - Right drug

If in additional to acute clinical scenarios we add information giving and 'social care' then once again identity is key:

Right person(s) - Wrong information
Wrong person(s) - Right information

Information unsurprisingly lies at the
heart of identification
and consequently
safety.

There are four key identifiers that we rely on and they map to Hodges' model beautifully - use them wisely....

GIVEN personal, first name	DATE OF BIRTH
FAMILY NAME	NHS number

Four key identifiers

That other 2nd-hand book - 'Conceptual Spaces'

In February I posted about a day in Sedbergh the book town with marvellous weather for the time of year.

In addition to the The Big Book of Concepts book, I bought a copy of Peter Gärdenfors' Conceptual Spaces. Oh, to be able to take a measured and systematic approach to this....!

I'm only just up to chapter 3 and it's a fascinating book. The ideas make this a key reference for anyone studying Hodges' model (and much more besides).

The preface sums up much about some of the problems researching* Hodges' model:

"... I will satisfy no one. Philosophers will complain that my arguments are weak; psychologists will point to a wealth of evidence about concept formation that I have not accounted for; linguists will indict me for glossing over the intricacies of language in my analysis of semantics; and computer scientists will ridicule me for not developing algorithms for the various processes that I describe."

The subtitle - The Geometry of Thought - says it all. There are so many key concepts here. I'm looking forward to chasing the references cited and other works. I don't vandalise books usually, but hey it's summer almost and the highlighter is doing its thing. The questions run thick and fast....

• Is Hodges' model one conceptual space or four...?
• What quality dimensions can I identify?
• What quality dimensions could a h2cm community identify?
• What existing multidimensional scaling work exists in health and social care?
• ....?

More to follow...

*or at least trying to research...