Ruby Holistic I

Using BBC BASIC many years ago as I recall I used an array to capture user input and then save this data to files.

I've just written a very simplistic Ruby program, not very Rubyesque in its code style to capture some data and store this in an array. There are many options here and not limited to:

• declaring an array from the outset;
• using a hash;
• using MySQL.

At present it's just about getting used to the Ruby syntax. I have yet to write a class and methods of my own and resort to file handling. Looking forward to doing so. Not far into the Ruby on Rails book it was getting very interesting so I need to pick that up again too...!

Also need to get back to Drupal and the new versions of Brian's notes and my introduction to the model and website. How many themes and modules are Drupal 6 compatible now? It's the NW England Drupal user group meeting again on the 20th in Manchester.

CARE = Plastic + Paper + Packages

The commodification of health seems to be a new phenomena and yet of course the search for 'cures' and 'spells' to ease this universal aspect of human existence has been with us for millennia. Now though the world of pyramid selling has ramped things up. The world at large has stepped on the gas. Plastic may well rule as the means to pay for the COS-plas-ME-tic surgery and presents a public face to the digital world of bits and bytes.

Now as we've seen the superstores and global IT players are getting in on the act (is that an unfortunate turn of phrase?) with Tesco, Google and Microsoft on board the bus with their respective partners. Health tourism clearly extends the notion of 'package holiday' AND 'care package'.

So - 'global health' anyone?

There must be a risk that the real messages of global health will get lost in the fog of contrails and business transactions.

In the meantime the heady interplay of plastic and paper and getting the biometrics to fit just right - points to the need for vigilance. As this blog and website makes clear I'm an ICT champion. I'm also a community mental health nurse. This means with fellow champions that two perspectives need to taken into account and monitored for risks and opportunities. I just wonder whether the move from paper to paperless records opens the door to the dilution of high standards of care?

Look at it this way: there we are in our care sectors with our care packages. In health we are trying to get leaner, stripping out redundant processes, delays, duplication, trying to magnify real purposes and strengths. As for the superstores well they (and we!) still need to get to grips with packaging. I hope this does not just prove to be a straight swap - variously labelled -

'FRAGILE'
'THIS WAY UP'

Fragile tape: image source http://adifferentvoice.wordpress.com/2007/09/18/labels/

Hodges' domains and the 'audience'

In Tuesday's post on the NHS health library services four key purposes cited in the report were listed:

1. Clinical decision making by patients, their carers as appropriate, and health professional
2. Commissioning decision and health policy making
3. Research
4. Lifelong learning by health professionals.

It is encouraging to see that my assumptions about the scope of Hodges' model can be identified elsewhere. This is clearly the case with the four key purposes above and the four introductory pages  to Hodges' model - listed as follows:

library purpose -|- h2cm audience -|- h2cm knowledge (care) DOMAIN

patients, carers (person-centred) -|- Individuals -|- INTRAPERSONAL
commissioning ... policy making -|- Policy makers, Managers -|- POLITICAL
research -|- Students, Researchers, Lifelong learners -|- SCIENCES
health profs as lifelong learners -|- Society, Public, Learning culture# -|- SOCIOLOGY

# The SOCIO- in socio-technical

Personal Health Records: Microsoft, Google & NHS HealthSpace...

This post follows from an item by Neil Versel at Digital HealthCare & Productivity on Google CEO Discusses Google Health.

This sentence makes interesting reading:

Schmidt said Google can change that by delivering a product that is not “too vertical” or “too specialized” like so many of the PHRs out there.

Wherever you find Google discussed, Microsoft are also in the mix, so there's an invite to open the HealthVault (see: https://www.microsoft.com/en-gb/industry/health?rtc=1). There are many more PHR players as Versel's article highlights.

All of which begs the question how long has the NHS's HealthSpace been around for - quite a while by my reckoning.

While on things personal and public - the journal Health Expectations - promotes critical thinking and informed debate about all aspects of public participation in health care and health policy.

Book: Social Information Technology: Connecting Society and Cultural Issues

Social Information Technology:
Connecting Society and Cultural Issues

Edited By:
Terry Kidd, Univ. of Texas Health Science Center, USA;
Irene Chen , Univ. of Houston Downtown, USA

Description:

An interdisciplinary field, technology and culture, or social informatics, is part of a larger body of socio-economic, socio-psychological, and cultural research that examines the ways in which technology and groups within society are shaped by social forces within organizations, politics, economics, and culture. Given the popularity and increased usage of technology, it is imperative that educators, trainers, consultants, administrators, researchers, and professors monitor the current trends and issues relating to social side of technology in order to meet the needs and challenges of tomorrow.

Social Information Technology: Connecting Society and Cultural Issues provides educators, trainers, consultants, administrators, researchers, and professors with a fundamental research source for definitions, antecedents, and consequences of social informatics and the cultural aspect of technology. This groundbreaking research work also addresses the major cultural/societal issues in social informatics technology and society such as the Digital Divide, the government and technology law, information security and privacy, cyber ethics, technology ethics, and the future of social informatics and technology, as well as concepts from technology in developing countries.

Jones, P. (2008) Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons, IN Kidd, T., Chen, I. (Eds.) Social Information Technology Connecting Society and Cultural Issues, Idea Group Publishing, Inc. Chap. 7, pp. 96-109.

h2cm: Google search results meta tags

A visitor to the website today ("hello Miami") arrived c/o Google. While I contemplate the task of content revision, one thing that seems to work are the meta tags on all the pages. I'm sure more data could be added, but it is good to see that Google is picking out and listing individual pages:


As you may have noticed, I've finally taken the advertising plunge. In the side bar 'Support W2tQ' there are three book links thanks to Packt Publishing. There isn't going to be a radical change in the overall 'tone' of this blog and site, but if there are any would-be advertisers reading this - please consider joining what will ultimately be a select band. It would be nice to have some funds to offset future costs after the past decade and to help towards covering a further conference venture. Funds would also help towards some specific training in Drupal, Ruby...
Enjoy the arc that is mid-week.

Report of a Nat. Review of NHS Health Library Services in England: From Knowledge to Health in the 21st Century

This Review has highlighted the centrality of library, knowledge and information services within the NHS and describes four key purposes for library and knowledge service:

1. Clinical decision making by patients, their carers as appropriate, and health professional
2. Commissioning decision and health policy making
3. Research
4. Lifelong learning by health professionals.

The Report makes detailed recommendations to strengthen library/knowledge services so that they are fit for purpose for the future, and as efficient and effective as possible in making a positive impact on the health of patients and the population. A number of technical issues and implications are raised.

My source: NHS-HE-FORUM

DSL examples - thrills and spills: "Data lend me your ear!"

The final chapters of Olsen's book Design Patterns in Ruby made my lips dry. I hadn't checked ahead, but Olsen mentions mid-text what's to follow. In getting there and reading about the Interpreter pattern and DSLs, I do hope this does not prove a one-off date. Olsen's book IS brilliant (and besides Ruby looks so dynamic across the dance floor), but the examples used were tinged with anti-climax and prompted a reality check.

Olsen's examples DO illustrate the principles, like most things worthwhile they need deliberate reading, but they DO deliver. So what's up? Well, the examples presented are taken from the world of IT (file backup). Yes, I know... well what do you expect! I had hoped for a DSL from a less technical domain; something left-of-centre, something that traverses the HUMANISTIC - MECHANISTIC divide. This is where the definitions of domain, DSL and the craft of caring and programming can (possibly) provide some useful insights.

For decades the literature and projects have focussed upon nursing languages. Communication relies on language of course. Even the absence of messages - verbal, non-verbal or other - tells us something. In health and other professions great emphasis is placed upon communication skills. We have to listen actively. How we listen - the constraints, what we deem as significant, and what is subsequently recorded and retained defines our care domains.

The domains that are the subject of DSL are specific, which explains how they can be implemented in some 50-70 lines of code (this also says something about Ruby). In contrast, within Hodges' model those four domains may as well be galactic quadrants they are so broad. Regardless of this (non-trivial) issue, standing at the nexus of h2cm the question needs to be asked (and is constantly being asked by health & informatics communities):

How good a listener can the MECHANISTIC ear be?

Person-centred care: "Right! Down! Down! Riiggghhht again! Spot On!"

-|- Person-centred care is one of the Grails of health and social care. It is up there with holistic care, which it precedes since holistic care needs a subject (discuss?).

In terms of Hodges' model the 'person' (for me) is to the upper-left-of-centre. Why there? Well, you really understand why when helping people cope through dementia.

It is no surprise that the development of person centred care and personhood have been especially concentrated and emphasised in the care of people living with dementia.

They need to be and constantly refreshed too - everyone forgets - some of us more than others.

Physically of course 'person' translates to the upper-right quadrant. So there you have it - in the INDIVIDUAL-group axis the classic dichotomy-debate: MIND-BODY.

I have no argument with the need for person-centred care, but faced with a Grail and the bright light that can encompass it, safety and respect dictates we step back. From a distance we can then see that person-centred care is only part of a much bigger picture.

At the end of the day (and night!) we need to be centred full-stop.

If not then saying the words that count such as dignity, respect, choice, privacy will echo in the intra-INTERPERSONAL domain and make everyone feel good in the SOCIOLOGICAL domain. All very worthy but possibly without making an impact where it counts - in the POLITICAL domain.

By placing the person at the centre of Hodges' model ALL the
domains are ready to hand and mind.

Upon common ground: programming languages, therapies and care models ('space')

Perhaps programming languages, psychological interventions and models of care are closer than we think?

"It is worth remembering that a new programming language is sometimes viewed as a panacea, especially by its adherents. But no one language will supplant all the others; no one tool is unarguably the best for every task. There are many different problem domains in the world and many possible constraints on problems within those domains."

Fulton, Hal (2007) The Ruby Way (2nd Ed.), Chapter 1: Ruby in Review, Addison-Wesley, p.1

Fulton includes some great quotes - this from the Introduction:

The way that can be named is not the true Way.

- Lao Tse, Tao Te Ching

Lao Tse also wrote on 'space'.