'Safe space' - which one?

 Individual
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     INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

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GROUP

psychological safety

physical safety

social safety

"NHS staff will be able to speak out about mistakes without fear of reprisal for the first time, thanks to a new investigation unit with "safe space" powers. The Health Services Safety Investigations Body (HSSIB), which was launched last week, has been granted a remit that in effect means any testimony or evidence given to it by doctors, nurses and other staff medical staff will not be handed over to another agency - such as the police, a coroner or the General Medical Council - unless the High Court rules that it must."

Lintern, S. 'Safe space' unit to protect NHS staff reporting medical errors, The Sunday Times, 22nd October 2023, p.11.

BGS Report "Smarter data, better care: Empowering care homes to use data to transform quality of care"

 

"The British Geriatrics Society (BGS) hosted an event in London in September 2023 on ideas and practice around a minimum dataset for care homes. This report, which is based on presentations at the event and the debate that followed, makes 12 recommendations for the effective implementation and delivery of a national minimum dataset that we believe policy-makers and regulators should consider."

Below, I have related the report's 12 recommendations to Hodges' model:

 Individual
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     INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

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GROUP

my quality of life my quality of care care home residents research - how new Artificial Intelligence can be harnessed safely and ethically to extract optimum value^^ out of linked social care data

my quality of life my quality of care integration - a harmonised set of quality of life and quality of care indicators not just a process* (data gathering/entry) by care sector on behalf of others high-level of interoperability

resident's families (advocate) needs that cannot be met at home ^Government recognition of contribution of social care sector to society linking of information sources, preserving privacy but improving public's understanding of how such data can be used (benefits) combine learning from the DACHA study, evidence of the analytic power of data instruments like interRAI, and the lived experience of those working in our care sector

care home managers & frontline staff shared decision-making - commissioners, regulators and providers sector-wide conversation around the data that does and does not need to be known by different stakeholders Investment in a data-informed system for health care and social care - greater equity between the two^ sustained - longer term approach - reduce the data burden Government funding of dedicated in-home data coordinators - cost recognised from outset

4Ps in Hodges' model -

INTRA- INTERPERSONAL - purpose
SCIENCES - process
SOCIOLOGY - practice
POLITICAL - policy

^^Where does 'optimum value' lie in Hodges' model?
How are these reconciled?

Transforming the quality of care in care homes through better use of data.  https://www.bgs.org.uk/policy-and-media/transforming-the-quality-of-care-in-care-homes-through-better-use-of-data 

Mathematical 'objects' c/o TPM

INDIVIDUAL

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

SOCIOLOGY  :   POLITICAL 

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GROUP

"Fine's position is called 'procedural postulationism'. When we postulate, when we do a certain sort of reflection on mathematical objects, our acts in a sense bring those objects into existence. But what's going on is not quite like an author imagining a character. It's more like intellectually bumping into something, where the bumping and the something result in a new grip on mathematical objects. But he suggests that the objects, once we have them, in a  sense have always been there. I ask him how he makes sense of the idea." p.23.

"The right picture isn't one in which we just create the objects the way you might create a statue, bring into existence something that didn't exist before. What you're doing when you postulate is extending the domain of quantification, you're extending the objects about which you're talking. It's not that you're bringing them into existence. You're targeting the domain of quantification, a domain of discourse which hadn't been previously targeted. These objects are themselves mathematical objects that don't exist in time, in fact, if they exist they necessarily exist. So it's not that they previously didn't exist, it's just that you now managed to target a new domain of eternal, necessary existence." p.23.

"Logical and philosophical investigations into parts and wholes have been dominated by a certain tradition that goes under the name 'mereology'. ... I hold the view according to which there are many different ways in which parts can form wholes, and many of those ways are not mere sums. I think it's unfortunate for philosophy that philosophers focus so much on mereology as traditionally conceived."

"But how can a thing be more than the sum of its parts? Where does the more come from? Fine explains, 'If you take a tower of blocks that a child might make, that's composed of the blocks, but it's not a mere sum of the blocks. The blocks have to be in a certain order, one has to be on top of the other. I'm inclined to think of that tower as the blocks in a certain arrangement. So when you think of it in that way it's not a mere sum of the blocks. If you want to actually understand mereological structure as it's presented to us, it's very rare that we're going to be talking about mere sums. We're going to be talking about objects structured in a certain way to constitute a whole.'" p.25.

Garvey, J., with Fine, K. The silence of the lambdas, The Philosopher's Magazine, 4th Quarter 2011. 55: pp.19-27.

https://as.nyu.edu/faculty/kit-fine.html

South Sudan Medical Journal - November 2023 Gender-Based Violence

Dear reader,

Our November issue on gender-based violence (GBV) is online here. See details below; we thank the many people who contributed to this important topic.
 
Please share this issue with your colleagues and promote it through your social platforms.

For example: “The South Sudan Medical Journal’s November issue tackles gender-based violence @SSMedJournal #SouthSudan #SSOT” or retweet from @SSMedJournal
 

EDITORIAL

• Ending GBV in South Sudan Anne Pita Lomole

RESEARCH ARTICLES

• Maternal socio-economic and neonatal medical characteristics associated with survival of preterm neonates in Torit State Hospital, South Sudan: a descriptive cross-sectional study Beatrice Doki, Pontius Bayo and Ronald Jada
• Factors associated with maternal deaths in Bongor Provincial Hospital, Chad Gabkika Bray Madoué, Allarehene Noudjalbaye, Saleh Abdelsalam, Kainba Passoret, and Diguisna Kadam

FOCUS ON GENDER-BASED VIOLENCE

• Gender-Based Violence: How South Sudan is fighting back Nyakomi Adwok
• Clinical management of rape survivors Koma Akim
• One Stop Centre for the survivors of sexual and gender-based violence at Juba Teaching Hospital Busiri Julius Korsuk
• SSMJ talks to Data Gordon about Men4Women Ann Burgess and Data Gordon
• Ask the GBV experts Koma Akim and Nyakomi Adwok
• The reality of GBV: The story of a South Sudanese girl child in Kenya Nyajuok Tongyik
• 16 Days of Activism Against GBV Rita Martin Lopidia  
• Resources on gender-based violence/violence against women and girls related to South Sudan
• GBV Educational/Training Resources

SHORT COMMUNICATIONS

• Applications for postgraduate Training Gordon Memorial College Trust Fund (GMCTF)
• Letter to the Editor
• Obituary: Dr Bashir Aggrey Abbas Meseka 
• Obituary: Dr Peter Lado Aggrey Jaden

FRONT AND BACK COVERS IMAGES: From Tales of Lala, No to GBV (Credit: Crown the Woman, South Sudan)
 
Our articles are listed by African Journals Online (AJOL) and the Directory of Open Access Journals (DOAJ) as well as being on our website. SSMJ is included in the EBSCO scientific research collection.

The SSMJ team
Email: southsudanmedicaljournal AT gmail.com
Website: http://www.southsudanmedicaljournal.com
Follow us on Twitter/X @SSMedJournal and our Facebook Group

Hodges' model - as 'a' philosophy c/o TPM

As much as I might like, or aspire to write, this is not a treatise on Hodges' model as a philosophy. Anyway: why limit ourselves to one 'philosophy', when several might apply, or at least be found?

Other TPM articles within the 50 new ideas issue point to Hodges' model (of course 😉).

Philosophy itself may benefit. Philosophy is "the love of wisdom". While there are dangers in siloed kowledge and the thought that put it there, what is classed as wise across the domains of Hodges' model in a given context? Contexts change, but how can philosophical reasoning help us 'keep our options open'? Or is the situation and context 'closed'? 

Again much as I might like, in response to Benatar's Forsaking wisdom (pp.23-24) I'm not trying to clever - even my sense of humour does not extend that far. We do want to apply Hodges' model  practically. Maybe disciplines exist in a perennial state of self-doubt? Peter Boghossian discusses Philosophy that matters (pp.29-30). Nursing is no exception being challenged still regards its professional and academic identity. In mental health nursing there are concerns about the field as a specialty being genericised. The nursing discipline for which identity and meaning is key finds its own identity challenged. Helen De Cruz writes of The Philosopher's rut (pp.41-42). A contributing factor is the tendency in philosophical debates to be dominated by two-well-outlined opposing positions. This framing can stifle exploration, and yet in Hodges' model with oppositions built-in the model as a whole provides conceptual escape; a series of conceptual spaces to explore. 

Hodges' model can help postpone what De Cruz refers to as cognitive closure, another reason for the philosopher's rut. We tend, psychologically to draw quick conclusions such that we are averse to ambiguity. This may be innate to a degree, as seen in 'black and white' thinking. Ironically, for me with Hodges' model is the counterposition of reflection as navel-gazing, resulting in too many options, and no decision at all.  

With the self, I, individual appearing to take a prime position in Hodges' model, Michael Cholbi reminds us of the philosophical significance and history of self-knowledge (pp.35-36). Student nurses need to acquire sufficient substantial self-knowledge to be safe, effective, competent, satisfied and lifelong learning practitioners. In another issue 98 4th Quarter 2022, Jonathan Matheson asks Why Think for Yourself (pp. 26-32), is there a rationale in intellectual autonomy and love of truth? You can exercise your intellectual autonomy and make it collaborative, by deciding on the port of entry to Hodges' model. This is a determinant in terms of the context, the situation that prompts you reach for the model in the first place. 

me - you INDIVIDUAL - the few
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     INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

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others - GROUP - many

inherent philosophy in Hodges' model the mind - my mind Personal identity epistemology ontology - being - identity my - beliefs - (yours) abstraction logic - mathematics concept of opposition^ opposition of concepts^ representation of -isms ethics - moral reasoning values - value unconditional positive regard	physicality - materialism the brain - my brain - body Organic identity implicit binary structure superimposed relations vectors coding and classification language corpora reality as orientation: (e.g., what three things do we need to know?) personalised medicine ('up here') professional scope - curricula silos of knowledge scientific method/methodologies
language - semantics - meaning dialectics 'other minds' practical reasoning applied philosophy individual-collective debate: utilitarian principles social philosophy socialisation of learners (professions) conformance - group think	health in politics politics in health human rights the unborn - future humans protected human characteristics diametrical oppositions in Hodges' model (e.g., 1. my mental state - mental health law; 2. public understanding - of science; 3. my freedom - the law. 4. culture - (techno-culture!) - science...) power - freedom political philosophy

In John Corvino's Applied philosophy out of the closet (pp.39-40), I'm not sure if it was Martha Nussbaum who stressed the need for philosophy to be practical. Is this the same as applied? I note her work on capabilities. Hodges' model seeks to reduce the gap between the learning involved in (between - hence bridging) theory and practice - to achieve competencies. For the future of (Brian) Hodges' model this matters, as I understand that efforts are ongoing to apply category theory to the social sciences. It is a pragmatic conceptual structure. To return to identity, A M Ferner tackles (literally?) Organic identity (pp.49-50); while Kerrie Grain takes on what is next-door in Hodges' model - Personal identity (pp. 51-52). As I continue to sort papers, journals and books there is more to follow. 

The Philosopher's Magazine, "50 New Ideas", 1st Quarter 2016. Issue 72. pp.20-120.

TPM #72 cover image: https://ericthomasweber.org/correcting-political-correctness/

^Ack.

Needham, R. (1987). Counterpoints. Berkeley: University of California Press.

(Looking f/w - I think - to chapters 7-8. With specific post(s) to follow.)

Your story about the use of the Resilient Health Systems evidence collection

Championing evidence-based humanitarian action

Evidence Aid aims to save lives and livelihoods in disasters by providing decision-makers with the best available evidence and by championing its use.

On Wednesday, 22 November 2023 at 10:12:26 GMT, Claire Allen, UK <callen AT evidenceaid.org> wrote:

Kind request - Do you have 5-10 minutes to complete our survey about the Resilient Health Systems evidence collection

https://evidenceaid.org/evidence/resilient-health-systems
Your insights and opinions are incredibly valuable to us.

The form will be available until Monday 27 November 2023, but in the meantime, if you have any issues, please do not hesitate to contact - 

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As always, we value your insight and opinions, all of which are essential to the functioning of Evidence Aid.

Claire Allen, Operations Manager Evidence Aid: Championing evidence-based humanitarian action. Please note that my regular working days are Monday, Tuesday and Thursday. Please do not expect a response outside of those days.

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HIFA profile (and my source): Claire Allen is Operations Manager at Evidence Aid, UK. Professional interests: Evidence Aid (www.evidenceaid.org) provides evidence for people in disaster preparedness and response to make better decisions. Areas of interest = humanitarian crises, natural disasters and major healthcare emergencies (disaster = when a country is unable to cope with the disaster/crisis or emergency). She is a member of the HIFA Working Group on Access to Health Research. http://www.hifa.org/working-groups/access-health-research Email: callen AT evidenceaid.org

Attending: Active listening c/o Baggini & TPM

Reading through more past issues of The Philosopher's Magazine, I came across Baggini's short contribution of Attending one of "50 New Ideas".

That Hodges' model has a role in attention must follow from its main purpose as an aide-mémoire. To 'know', to recognise that your memory has been jogged is surely to attend.

I realise that Hodges' model represents a philosophical smörgåsbord, rather like the 50 ideas in this issue.^

Baggini draws on a film for inspiration on empathy, feelings for other, humanity and moral philosophy. For Hodges' model our context can encompass media, but the focus remains empathy, ability to relate in the clinical, social care context. Attention and interpersonal skills come the fore here.

If you are not hungry, the model (smörgåsbord) can be considered as empty. This is a precondition for 'attending' - having unconditional positive regard. Apart from information that relates to the patient's, student's, and your safety the domains of Hodges' model are vacant spaces. How they are populated depends on how we attend. There are important lessons for students here. The first is their phone. Its being on their person, may impact their ability to attend to the other (person). The window to outside isn't a screen either.

 Individual
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     INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

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GROUP

previous experience cognitive furniture - elephants in the room (for all?) attend/attending attention active listening authenticity observation empathy - rapport therapeutic relationship unconditional +ve regard I see, I hear you ...	physical space physical environment measurements furniture - layout position / posture observation

Attending needs to be active listening. This includes all the senses, although sniffing the air is probably  best avoided - body odour may announce itself. Attention, then is synonymous with observation and in this context must span an individual's physical and their psychological presentation. You may draw social, political and spiritual assumptions, it is human to do so. Intuition has a role in healthcare but initial conclusions must be recognised as potentially premature and be verified. 

To initiate, be-in, partake-in such situations is to attend to the verbal, and non-communication; the data you already have and information communicated, including in a referral. Is this confirmed, challenged, what is your opinion? What about your colleagues? Most importantly, what does the person (patient, client... say)? What is unspoken? Do you understand? Did you seek clarification? 'Where' have you been / not been in Hodges' model? What picture is emerging at this stage?

It is gratifying that this is the first of the 50 'new' (2016) ideas in TPM #72. 

More to follow - drawing on TPM and (I think, Hodges' model as a 'philosophy? Surely not!)

Baggini, J., Attending, The Philosopher's Magazine, 1st Quarter 2016. Issue 72. pp.21-22.

TPM #72 cover image: https://ericthomasweber.org/correcting-political-correctness/

Book review iii. General Psychotherapy: Principles and Common Theoretical Aspects - Rediscovering Humanity

   General Psychotherapy

In chapter 3 neurophysiological development is explored and epigenetic influences (3.2). For a decade or so I've highlighted to students the need for them to be aware of 'omics' which will clearly impact their future careers and subsequent learning. This is detailed also outlining limbic development, through to cognitive-linguistic functioning; and not just learning but forgetting. It is easy to take the self for granted, but here is a description of a self in formation, the neocortex, imagination and role of the pineal gland. Biological radiation of living beings (there is a error in the heading I believe*) is fascinating for reasons already acknowledged. Then it is as if time begins and psychological development can begin (life chances permitting). From the author's practice two cycles are illustrated - growth and transformation drawing on Gestalt thought and all referenced. 

Ever since reading on Goethe's part-whole thought I've been aware of mereology. Chapter 3 also examines intrapsychic and social space in respect of part-whole relationships. I'm continuing this journey so it helpful to find the distinction here also.

"According to the resonance principle, identification with key partial aspects can very quickly lead to an unresolved, formative core conflict. In an individual setting, empty chairs or symbolic locations may serve as backdrops for projection. Distance, posture and line of vision are highly relevant in this regard. In a group setting, forms of constellation work with representatives may be more helpful." p.155.

The book's philosophical content is well realised, fused with history and the development of psychology and neurosciences. Plato's cave is explained and related to tabula rasa: the blank slate (3.6.3). I feel I'm in Plato's cave in trying to look at Hodges' model as a mathematical object. There is encouragement too in Hartmann-Kottek identifying the role of blank slate. Hodges' model is also about forgetting, unconditional positive regard hence a blank slate. Chapter 3 concentrates on approaches to explain our development and personality, quantum-theoretic, Far-Eastern traditions, and Western working towards how we achieve coherence as an integral individual, building and relying on inner and external social and interpersonal resources (Fig. 3.4: Tower of consciousness. p.212.). Energy a key in this part of the book, is summarised in a further figure on background dimensions - combining two-axes of Whole-Parts and Space-time - Spaces of possibilities (p.222).

Chapter 4 is a welcome discussion of systems, interspaces, self, communication again through a cultural lens. Chapter 5 would benefit all healthcare students - an understanding of health and illness. While not tackled here - how we integrate and simultaneously address both requirements in service delivery is the challenge of 21st Century health provision? This is higher level from the outset: Attempts at Classification (5.1). While a  traditional book, reading had an immersive feel for me (with many posts on W2tQ): Diagnostic tools, 2-sided understanding of health and illness, the diagnostic, therapeutic (always kept in sight) reversal of symptoms, fields of tension and resources at various stages of development.

For readers looking for actual therapies, chapter 6 is the practical center of the text. The current state of psychotherapy is likened to the blind people trying to find an elephant in the dark. 'Many paths' in a subtitle is welcome, almost suggesting there is scope for all approaches and perhaps they can meet 'somewhere'? Motivations and politicisation aside, the variety of psychotherapeutic are indeed a treasure. They are listed, comprehensively as far as I can see, including many new to me. They are further sub-divided and considered: clusters through time, behavioural, then considered as per depth and effect levels, verbal - non-verbal, emotions, breathing and meditation, variations in consciousness. 

I've considered blind-spots before and highlight Hodges' model as having a role in situational awareness - hence safety and care assurance. Hartmann-Kottek remains grounded in how blind-spots can affect therapists and patients - individually and in alliances. The therapeutic relationship, transference and countertransference are emphasised once again. Compassion too - as part of a credible relationship - with selective authenticity. Technical points are raised too, the use of counterpart in Gestalt therapy. Some 40 pages of chapter 6 are very practical, with exercises and examples of conversations between patient and therapist to illustrate specific approaches and situations. This is far from a specific therapy manual but there is this quality to the content.

 

 'I' - 'Individual' 'SELF' 'Patient' 'Client'

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

SOCIOLOGY  :   POLITICAL 

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dyad / couple  family  GROUP community population

psycho- symbolic personal meaning emotion lived experience emotional distance	-somatic

*Living near Manchester in NW England, the city's symbol is a bee (industry..). It appears in the text that 'Being' has become 'Beeing' in some instances - so an extra homely feel here.

Many thanks to Prof. Hartmann-Kottek and Springer for the review copy.

One more post to follow.

Hartmann-Kottek, L. (2022). General Psychotherapy, Principles and Common Theoretical Aspects - Rediscovering Humanity. Springer. https://doi.org/10.1007/978-3-030-87466-7

Empty chair image:
https://www.mentalhelp.net/blogs/gestalt-therapy-the-empty-chair-technique/