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?

The alchemy of terminology, symbols, and signs ...

Or, 'What is a nurse doing … in a chemistry class?' [Ack. See Estrada]

In reading, I was reminded that chemistry adopted mathematical symbols for its own use. Not only that, but as a core science (with physics and biology, emerging from natural philosophy) there is a historical development from the time of alchemy:

Please see (with a graphical abstract):

C.Wentrup, The Transition from Alchemical to Modern Chemical Symbolism: from Bergman and Guiton de Morveau to Hassenfratz and Adet, Higgins, Richter, Dalton, and Berzelius. ChemPlusChem. 2024, 89, e202400033. https://doi.org/10.1002/cplu.202400033

This journey matters today as the use of symbols, in mathematics or other fields can be a barrier to learning and hence personal and disciplinary progress:

Ollie Hunter. Lost in translation: Demystify scientific symbolic language to help your chemistry students overcome any potential learning barriers. Royal Society of Chemistry, 23 May 2022.

As acknowledged many times, it is easy to take a word, or concept from one discipline and 'fit' it to - or in another. Or is it? Estrada concludes:

“The complexities of modern science and modern society have created a need for scientific generalists, for men trained in many fields of science.” This is a paradigm of science in the XXI century, where the advent of such fields like the study of complex systems requires multidisciplinary approaches. But the previous phrase was not written in the XXI century. It is the starting sentence in The education of a scientific generalist” published in Science in 1949 (Bode et al. 1949).' p.161. 

'Mathematics has been defined as the science of patterns. Thus, mathematicians search for “numerical patterns, patterns of shape, patterns of motion, patterns of behavior, voting patterns in a population, patterns of repeating chance events, and so on” (Byers 2010). Once a pattern is identified either in chemistry or in mathematics, the researcher can proceed to the clarification of the systematic rule which is behind that pattern. This is evident in the analogy used here between code-breaking and structure elucidation. This attachment to patterns makes both chemists and mathematicians very prone to the use of pictures. An organic chemist hardly can say anything about the chemical reactivity (or any physical or chemical property) of a molecule from its exact quantum-mechanical Hamiltonian. However, she will construct a complete narrative about the physical and chemical properties of a molecular structure drawn in a piece of paper, even if such a molecule is completely imagined. The power of pictures in mathematics is discussed in the book Mathematics and the Unexpected by Ivar Ekeland (1990) where its value is recognized as fundamental in the early stages of the development of mathematical ideas. This also introduces a very important analogy among chemists and mathematicians. Namely, that they use a proper language in their respective fields. While physicists use the mathematical language in their investigations, chemists use the sophisticated language of chemical formulas and specific symbols to represent charges, rearrangements, partial equilibria, etc. These “invented” languages mainly appear only in Chemistry and in Mathematics, making them unique intellectual activities.' p.162.

With thanks to the author, Ernesto Estrada IFISC for additional thoughts and insights:

Estrada, E. What is a mathematician doing…in a chemistry class?. Found Chem 26, 141–166 (2024). https://doi.org/10.1007/s10698-023-09497-4

HIFA Discussion: Alcohol Use Disorders - Language 'being drunk'

----- Forwarded message -----
From: Peter Jones, UK <hifa AT hifaforums.org>
To: HIFA - Healthcare Information For All <hifa AT hifaforums.org>
Sent: Sunday, 25 February 2024 at 06:35:47 GMT
Subject: [hifa] Alcohol Use Disorders (86)

This morning on Times Radio UK, Hugo Rifkind 1000-1300 from 10.58:30 UTC:

 https://www.thetimes.co.uk/radio/show/20240224-26978/2024-02-24 

- there was mention of research in Germany on language, finding that there are over 540 words for 'drunkenness' being drunk. Apparently, the key is adding -ed to many words.

https://www.research-in-germany.org/idw-news/en_US/2024/2/2024-02-19__I_m_gonna_get_totally_and_utterly_X-ed.__OR__Can_you_really_use_any_English_word_to_mean__drunk__

This stood out for me as Hodges' model can potentially encompass the full corpus of a language, with the various contexts in which language is applied/used.

Significant of course informationally, in evidence-based practice, and research, were 'definition of terms' are (usually?) essential.

Also reminded of national variation in clinical/medical terminology. Scottish slang for injection includes 'jag'.

For health communication and HIFA, clearly language is fundamental and presents a real 'can of worms' (sorry!) in sense-making, creating 'noise' in the communication channels.

Should health services/systems effect a (gradual) change (shift) of emphasis to education and prevention - with the requisite policy support (utopic?) then this will need to be addressed.

In checking this news, it appears Germany has a more acute problem with alcohol. Can anyone 'local' - please shed any light on this?

I will post again about the HIFA discussion with a week ... left and highlight the above.

Many thanks

Peter Jones
Community Mental Health Nurse and Researcher
CMHT, Prescott House, Salford NW England, UK (Mon-Tues)
Blogging at "Welcome to the QUAD"
http://hodges-model.blogspot.com/
http://twitter.com/h2cm

h2cmuk AT yahoo.co.uk

Evidence-based care: The original Gordian Knot

or - Choose your audience carefully.

Within health and social care (and other - safety-critical - academic and professional fields) evidence-based care is pivotal as proof of safety, reproducibility, effectiveness, efficacy, professionalism, and benefits for the subjects of care and public. How best then to prove the scope, scale, relevance and safety of Hodges' model? How to demonstrate in theory and practice the utility and increasing relevance of Hodges' model? There are times I have to temper my belief, passion and enthusiasm for h2cm; am I too ardent, and at risk of coming across as preaching? There is a further tension. The one that is constant: language.

As a nurse, attention to language and terminology is vital to effective communication, establishing and sustaining rapport and empathy. This concern applies across situations, contexts and encounters; with patients, patient and carer (family), and colleagues. We are encouraged to avoid jargon, abbreviations  and technical terms. I use Hodges' model implicitly (aide-mémoire, assess, plan, evaluation, prioritise) and explicitly - sharing the model on some occasions but not all.

In the role of researcher / author, the audience, especially - editors, reviewers, and readers have expectations in how concepts, ideas, theories are expressed and explained. To a degree, the very title of a publication, preempts the language to follow. As I present, or write, sources must be declared and  referenced. Again, resort to jargon is discouraged. Clarity and brevity are strengths. And yet how likely is it that at least 1/3 reviewers will demand more technical rigour and explanation? If terms are used from other disciplines, the expectation follows that their cross-disciplinary application is explained and argued for, and meanings differentiated.

With potential theoretical underpinnings for Hodges' model to be found in Gärdenfors's Conceptual Spaces, and Meyer & Lands's Threshold Concepts and others (nursing and healthcare no-less); John D. Cook provides additional pause for thought - as I look even further afield:

"When I was in college, I sat in on a communication workshop for Latin American preachers. ...

Another lesson from that workshop, the one I want to focus on here, is that you don’t always need to convey how you arrived at an idea. Specifically, the leader of the workshop said that if you discover something interesting from reading the New Testament in Greek, you can usually present your point persuasively using the text in your audience’s language without appealing to Greek. This isn’t always possible—you may need to explore the meaning of a Greek word or two—but you can use Greek for your personal study without necessarily sharing it publicly. The point isn’t to hide anything, only to consider your audience. In a room full of Greek scholars, bring out the Greek.

This story came up in a recent conversation with Brent Yorgey about category theory. You might discover something via category theory but then share it without discussing category theory. If your audience is well velrsed in category theory, then go ahead and bring out your categories. But otherwise your audience might be bored or intimidated, as many people would be listening to an argument based on the finer points of Koine Greek grammar. ...

Some things may sound profound when expressed in esoteric language, such as category theory or Koine Greek, that don’t seem so profound in more down-to-earth language. Expressing yourself in a different language helps filter out pedantry from useful ideas. (On the other hand, some things that looked like pure pedantry have turned out to be very useful. Some hairs are worth splitting.) 

Sometimes you have to introduce a new terms because there isn’t a colloquial counterpart." ...

 Category theory and Koine Greek: John D. Cook. 

Category theory and Koine Greek: John D. Cook. 
https://www.johndcook.com/blog/2016/06/27/category-theory-and-homiletics/

See also: Applied category theory: John D. Cook

https://www.johndcook.com/blog/applied-category-theory/

Recognition of Nursing's contribution to life quality of patients

"Maria Isabel Razquin, Director of the University where all the pre and post registration nursing education is undertaken and the medical staff trained, gave a key note speech. ... She spoke of the conceptual discipline in nursing, and of how the market economy was affecting health services. This theme was extended into world health information and the storage of data; the development of nursing informatics and how nursing practice should lead to validating and developing minimum datasets using an understandable language. She then alluded to NANDA and the 4 thesaurus' which holds medical and nursing terms that can be cross referenced with new information and knowledge. All the terms we commonly use in the UK were mentioned: multi-disciplinary, updated, accurate, efficient and research and knowledge based.

She went on to say that it has been difficult to quantify the life quality of a patient; it has been tried and it has failed, not showing the significance of nursing. Conceptualisation is a foundation for nursing and it was suggested it could be used with research, with the scientific focus and practical sources being the future body of knowledge. Nurses, she said, should have a clear identity of the care given in multidisciplinary teams, while combining facts and data with nurse training, recognised nursing disciplines and leaders of research would enable competence in complicated fields. Skilful and relevant collection of data, she concluded, would facilitate education and change management training for encompassing computerising with conceptualisation." p.19. 

Sampson, H.E. (2000). International Symposium of Nursing Diagnosis - Pamplona, Spain - May 2000. ITIN, British Computer Society, Nursing Specialist Group. Volume 12: Issue 3. Sept. 2000. pp.19-21. ISSN 0956-5159.

NANDA - https://nanda.org/

ITIN - Information Technology in Nursing

An 'updated' title(?):

"Recognition of Nursing's contribution to Sustain and Enhance the People's Life Chances."

Concept analysis - Rodgers

"The method of concept analysis has not been well understood in nursing. Most significant is the observation that nurse scholars who describe or employ the method have rarely explored the philosophical foundations and implications of conducting an analysis of a concept. As a result, it is not clear precisely how the method functions or how analysis of a concept actually contributes to further intellectual progression. While the availability of a clear conceptual definition has much appeal, the actual value of a such a definition cannot be taken as self-evident." Rodgers (1989). p.330-331.

"The method entails an initial phase, a core analysis phase, and a further analysis phase (Tofthagen & Fagerström, 2010), which according to Rodgers (2000, p. 85) includes the following overlapping activities:

1. Identifying the name and concept of interest and associated expressions.
2. Identifying and selecting the appropriate setting.
3. Collecting the data to identify:
    a. The attributes of the concept.
    b. The contextual basis of the concept.
4. Analyzing the data.
5. If appropriate, identifying an exemplar of the concept.
6. Identifying hypotheses and implications for the further development of the concept."
Näsman, Nyqvist, & Nygård (2022). p.3104.

Rodgers, B.L., Concepts, analysis and the development of nursing knowledge: the evolutionary cycle. J. Adv. Nurs. 1989:14,4,330-335.

Näsman, M., Nyqvist, F. & Nygård, M. Disentangling the Concept of Well-Being in Very Old Age Using Rodgers’ Evolutionary Concept Analysis. J Happiness Stud 23, 3101–3126 (2022). https://doi.org/10.1007/s10902-022-00496-4

NANDA International's First Webinar

On Thursday a webinar - NANDA-I's first - provided an update on Nursing Diagnoses:

 

It wasn't just what is new and revised in the diagnoses that was of interest, but the explanation and discussion of the Level of Evidence criteria. Resources, challenges, ways to get involved, and future directions were also described. The levels of evidence criteria for diagnoses submission stood out, reinforcing how 'concepts' remain key to this work and application.

In the Q&A I asked about NANDA-I (and other classification schemes) contributing to the metrics for the Sustainable Development Goals (and not just 'health' SDG-3) and Social Determinants of Health. Since the 1990s nursing informaticians saw terminology systems and technology having a role in making nursing visible. This is crucial at the global* level of SDGs, SDoH and challenges that are not 'on the horizon', but are a present and real danger: climate change, conflict, pandemics, and mass migration. Despite such uncertainties, I found the event very encouraging.

 *local, and glocal too.

TABLE OF CONTENTS:

Part 1 The NANDA International Terminology: General Information

1 What's New in the NANDA-I 2021-2023 Edition
2 International Considerations on the Use of the NANDA-I Nursing Diagnoses

Part 2 Recommendations for Research to Improve the Terminology
3 Future Improvement of the NANDA-I Terminology
4 Revised Level of Evidence Criteria for Diagnosis Submission

Part 3 The Use of NANDA International Nursing Diagnoses
5 Nursing Diagnosis Basics
6 Nursing Diagnosis: An International Terminology
7 Clinical Reasoning: From Assessment to Diagnosis
8 Clinical Application: Data Analysis to Determine Appropriate Nursing Diagnosis
9 Introduction to the NANDA International Taxonomy of Nursing Diagnoses
10 Specifications and Definitions Within the NANDA International Taxonomy of Nursing Diagnoses
11 Glossary of Terms

Part 4 The NANDA International Nursing Diagnoses
Domain 1. Health promotion
Domain 2. Nutrition
Domain 3. Elimination and exchange
Domain 4. Activity/rest
Domain 5. Perception/cognition
Domain 6. Self-perception
Domain 7. Role relationship
Domain 8. Sexuality
Domain 9. Coping/stress tolerance
Domain 10. Life principles
Domain 11. Safety/protection
Domain 12. Comfort
Domain 13. Growth/development

Paper: Florence Nightingale and J.S. Mill Debate Women's Rights

EVELYN L. PUGH

"In Florence Nightingale's correspondence a series of letters to and from
J.S. Mill treat a different subject than her usual correspondence with
government officials, health and sanitation reformers, and hospital
administrators in many parts of the world. Although it was never her
intention when she initiated the exchange of letters, she and Mill quickly
became involved in a controversy concerning the role of women.

Interwoven with some religious and philosophical matters, the
Nightingale-Mill correspondence which falls into two periods, 1860 and
1867, is essentially a debate on women's rights. One debate concerns
terminology and hinges on the entire validity of the question of publicity
for the women's movement, then in its infancy, as well as the opening of
the medical profession to women. The other focuses on differing percep-
tions of the role of women in political action. The exchange never became
public during the lifetime of the participants, emerging with little notice
only in the twentieth century with the complete publication of their
correspondence in the journal Hospitals in 1936.¹"

  Self - INDIVIDUAL - Person

|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

Community - Group - Population

thought belief logic, philosophy, ethics 'duty' dichotomy of thought	action active-passive medicine scientific progress 'professions' theory of feminism
social and economic history social progress role expectations publicity public awareness	politics nascent political movement women's rights law 'duty'

 

¹"Florence Nightingale as a Leader in the Religious and Civic thought of her Times,"
Hospitals, X (July, 1936), 78-84. There are a total often letters, five from each, in the correspon-
dence. Three of Mill's letters to Nightingale, with some omissions and two of them identified
only as "To a Correspondent," were published in Hugh S. R. Elliot, Letters of John Stuart Mill,
(London, 1910). Some of her letters to him with portions of his replies were published in Sir
Edward Cook's official biography, Life of Florence Nightingale, (London, 1913). (The edition of
Cook used in this essay is the 1914 printing).

Pugh, E. L. (1982). Florence Nightingale and J.S. Mill Debate Women’s Rights. Journal of British Studies, 21(2), 118–138. http://www.jstor.org/stable/175536

 

5th Workshop on Visualization for the Digital Humanities

We are happy to announce that the 5th edition of VIS4DH — the Workshop on Visualization for the Digital Humanities — will take place on Sunday, October 25, 2020 in Salt Lake City, Utah, as part of the IEEE VIS2020 conference.

For 4 years now, the VIS4DH workshop has brought together researchers and practitioners from the fields of visualization and the humanities to discuss new research directions at the intersection of visualization and (digital) humanities research. The general aim is to foster productive collaborations that mutually advances all fields involved. Papers and invited talks from previous years can be found here.

Re-Thinking
Re-Defining
Re-Imagining Data

This year, we invite a dialogue on the topic and terminology around “data”, a contested term within and between a range of disciplines. There are varying perspectives on the meaning and use of data that impact how we engage and debate it. “Data” seems core to visualization! Or is it? We invite both theoretical and applied works at the intersection of visualization and (digital) humanities around these and other questions related to the workshop theme.

You can contribute and showcase your work through our paper track (just like in previous years) and/or through our provocations track (new for VIS4DH 2020!) – the official calls for papers and provocations can be found on the Call for Submissions page.

Check back here or follow us on Twitter for the latest updates.

Consultation on the proposed withdrawal of the SNOMED CT national care planning content

In addition to responding myself, I notice on the actual consultation page on 'Citizen Space' there is an option to share this consultation.

Dear Peter,

You are registered for the care planning content via the HSCIC Technology Reference data Update Distribution website.

The national Care Planning Content is designed for use to support care planning functionality across health and social care. This functionality crosses many professions/sectors which may have differing descriptions for a care plan in the traditional health record (e.g. treatment plans, birthing plans, support plans, intervention plans or care order sets). The content can support the interoperation of care plans across boundaries and paper based care plans based on the pack have also been used successfully to gain greater familiarity with structured terminology (SNOMED CT).

More details at: ...

The absence of a declared owner or sponsor for this product means that we are proposing to withdraw it and are keen to hear views and understand the impact of not maintaining this content and its associated services.

We have a number of questions to determine how information Standards could best support the development of a standard for care planning, the consultation can be found at: ...

- and we would value and encourage your feedback on this proposal.

If you have any questions regarding the above you can contact us by sending an e-mail to information.standards AT hscic.gov.uk. This is the preferred form of communication.
...

Regards
The TRUD support team
Health and Social Care Information Centre

Patient? Client? Consumer? Some thoughts....

Below is an edited version of a response to an item posted on LinkedIn Working Nurses, the issue raised by Genevieve M. Clavreul, RN, Ph.D. is as follows:

One day I came across “The Martha Stewart Show” as it aired a segment dedicated to nurses and Nurses Week. It began with a brief discussion of the history of nursing over the past century or so, and I recognized many of the instruments from my youth and my early career in nursing. But what caught my fancy was how the nursing school representative, a nurse herself, continually referred to the patient as the “client,” and how she seemed to struggle while using the term, as if it was a foreign concept.

The replies thus far have already addressed this question and and its ramifications very well, reflecting the scope of experience and expertise of many working nurses. We have this issue in the UK - NHS also, indeed it is no doubt a global matter.

Mental health has 'client' and 'service user'. Health care IS a business, but a business that must be allied with professionalism. I know that goes without saying, but please bear with me. Use of 'patient' seems to denote dependency and not partnership and collaboration. Being a 'patient' you are compliant with your treatment, rather than concordant with insight into your care plan and the pros and cons of medication (intervention or non-intervention).

As nurses though we have a duty of care. Each nurse represents the profession and the terms we use reflect the values we hold in theory, practice and management (the business again).

On one level perhaps the multiplicity of terms reflects upon the complexity of health and social care and the many contexts 'nursing' takes place. The emphasis on 'recovery models', self-care, the expert patient, relapse prevention, well-being is a sign of the demographic trends and the rise of social media and e-health.

I understand that patiency is a key concept and question in formulating models of nursing: When does a patient become a patient and when does that period end? It is not wholly fashionable for nurses to act as advocates and yet I would argue that being in a 'business' nurses can / should / must advocate not just for the patient but for the health of the general population. Nurses should also look over their shoulder (that's business politics) and take cognizance of the first rule of first-aid. In this case you cannot be an advocate for personal, family, local, regional, national and global health if you become the casualty. By implication the profession - nursing - suffers too.

Will we reach a point were access to and the salience of 'patiency' as a - human currency - has to be enshrined in human rights? What title do we grant to our seniors in whatever environment: their home of twenty years, their hospital bed, their Room 123 of The Nursing Home?

In any business the ethos and strategy for success should be to make the 'business' transparent. I'm in London at the moment at an IT event. One presentation focussed upon the 'user experience' - UX. Customer service in health is essential [ CX - CareX ! ], but this should not be a 'business' add-on. This is crucial to all caring professions. Rather than be thrown from side-to-side by the science OR art of health and its client OR patient equivalent we can embrace the dialogue and make a positive difference as we do so.

The astute student / learner will ask the person concerned how they wish to be addressed. As future nurses and nurse leaders in the 21st century they might also consider those populations around the world who would very much like to hear the utterance of 'patient': not in reference to themselves, but their infants and children ...

compose, direct, conduct and 'dilute to taste' outcomes

In Drupal musings 12 I mentioned that the classification of nursing practice is not necessarily at the forefront of nursing's mind set against the turbulence and rush of clinical areas.* This is especially so at the moment as nurses on wards, clinics and community try to identify savings.

I am interested in classification in part as this is a raison d'être for the health career model; on a mental (cognitive) level, in practice and potentially in virtual representations of health care activities. For learners it is an extra to hold the bicycle saddle for those first turns of the pedals. Additionally, for those who have completed many rides and races (lifelong learners) they can reflect on how they got there, and plan for the next round.

As a conceptual framework then h2cm is, like classification, in the background. The model can help to compose, direct and conduct (c-d-c) nursing (health and social) care. Classification matters to ALL nurses because we need to know not only the c-d-c of nursing but the outcomes too.

If all the above is in the background, then together with classification the health career model can help differentiate nursing as a discipline and make nursing visible. We can only take heed of the adage "divide and conquer" by being able to differentiate nursing from other disciplinary contributions. Then perhaps we can truly identify and so define the facets of integrated, interprofessional and multidisciplinary care that must also be person-centred. As nurses and the team respond to the individual's trauma (assault, illness, chronic disease ...), they can also assure their combined values, which must be defined and articulated if there is to be a unified philosophy.

If the respective professions have not noticed (I am sure they have) 'professionalism' is itself under assault in terms of unique knowledge and skills, respect, power and status. To a degree this a good thing. It is also called 'progress': countering restrictive practices, improving service access and challenging institutionalised and state paternalism. Professionalism is accorded for reasons of accountability, education, responsibility, integrity and advocacy. Amid the public (mental) health disaster that we face - the professions - are needed more than ever and if the assault is taken too far ... ?

* Should you know of examples where classification IS at the forefront of nursing practice please let me know - h2cmng @ yahoo.co.uk.

Drupal musings 12: Semantic Web, ICNP, Case studies and Care domains

Drupalcon 2010 Copenhagen is over for me. It's been a really useful week: awesome indeed. My head is dizzy with all the options, sources and resources to consider. I will contact the London Drupalcon group for 2011 with some suggestions regards beginners, networking and outreach.

Ever since setting off on the Drupal road, the semantic web has been a constant item of street furniture. In Szeged '08, Paris last year and this past week in Copenhagen the semantic web, RDF and terminologies have had a pivotal presence. I did not attend all the rdf / SW sessions but Wednesday's Semantic Terminologies was sit on the floor popular (even though at that point the program hit a bottleneck from 6 to 3 streams). Whatever the cause - I was there, late and my pivot ached (no padding!).

As a Drupal 7 prelude I'm creating a Drupal 6 site, a basic homepage for someone. The content for the latter is fixed - sorted. Apart from the pages for the archive, the new h2cm content involves me figuring out how to combine:

1. the health career model;
2. nursing - in theory and practice;
3. external sources and resources;
4. and Drupal.

Johannes Wehner's terminology session above did not emphasize RDF, but highlighted Open Linked Data by means of Open Calais as a tool to extend existing content. I've downloaded the Drupal OC module and obtained a key.

As for the list: #1 The health career model is straight forward really. Four care domains - get on with it! From there though it is quite a reach to encompass #2 & #3. My options appear to be:

• free tagging, auto tagging - let the users of the site decide;
• pre-define a data set, a terminology (classification) for the health career model;
• use an existing nursing classification / terminology scheme - perhaps a subset.

Before I decide I need to be aware of what is available. I e-mailed Derek Hoy in Scotland - contact for the International Classification for Nursing Practice® [ICNP]. This is another thing I pick up, put down. ... Now thanks to Derek I'm sorted now with ICNP downloaded (and I will need a module to import .csv files). There are videos on the ICNP website.

I have followed the development of nursing terminologies for quite some time. The most striking thing to me is how removed they are from the day-to-night life on wards and other care encounter situations. With mental health as a Cinderella in terms of the politics and recognition of nursing service provision I am in effect professionally twice removed. For the vast majority of nurses on the ground and from where I work in community mental health the ICNP, SNOMED CT, Omaha and other schemes are rather esoteric things. They are there in the background, part of management and reporting 'function'. This is not to say that the above initiatives have few followers, or lacks experts in this field. Make no mistake nursing has its own geeks, nursing classification its experts!

The scope of ICNP makes it a great candidate (from the website) -

Diagnosis/outcome

Interventions

Individual 7 axes

1. focus
2. action
3. client
4. judgement
5. location
6. means
7. time

Plus:

• it's International;
• it's by nurses, for nurses;
• it has momentum (political and financial support);
• So it is credible, and research based.

Despite this, I must take a critical look at what is available for my needs and time available. All the above provide way too much for a first bash - prototype, proof of concept. I have the luxury of not worrying about safety. My project does not constitute an electronic health record or other variant. Yes, I want to prove the health career model and to this end I must also find or create several nursing case studies to interrogate within Drupal and h2cm.

Perhaps as things improve economically, nursing classification will be revived and will allowed the time to fully mature? I recall in 2006 plans to explore mental health within SNOMED which unfortunately did not materialise. So, when I say mature, I mean like cheese in the holistic senses of the ingredients: nursing care concepts across contexts that also incorporate self-care, recovery, demographic trends ...; and the process across communities of practice (integrated care) through to academic and management applications - research / reporting.

In March 2010 plans were announced of plans to harmonize the efforts of the ICNP and SNOMED CT nursing.

So, with a possible jumpstart - a sprint for my site this autumn in Manchester, UK and work afoot to make nursing classification matter on the 'ground' there is more to follow on several fronts. ... I remember a presentation Derek did in the 1990s about classification and making nursing visible - let's do it!

contact: h2cmng @ yahoo.co.uk

ERCIM News #71 Technology-Enhanced Learning (TEL)

Amongst a packed issue on Technology-Enhanced Learning (TEL), the latest edition of ERCIM news mentions how computer aided learning has become TEL.

If you are researching this field, or would like a heads-up on EU activity in e-learning this is a great resource. My interest is three-fold:

1. investigating CAL in the early years;
2. recognising h2cm's potential in curriculum development
3. and of course the possibility of producing TEL resources in the future.

The next ERCIM issue for January 2008 is on The Future Web, you can subscribe online.

Must check on the equivalent sources for the Americas, Africa, Middle East, Asia, Australia - New Zealand - Oceania...?

Bye for now - back to cooking, ironing AND writing ;-)
h2cmng AT yahoo.co.uk