Reflection, Revalidation, RCN Congress and Research

Thinking Out Loud: Journal 'Regulars'

Like many people I looked forward to experiencing RCN Congress again in June. Now of course Congress itself is a casualty of COVID-19.

Last May as already posted, I picked up several nursing journals too. Having time(!) I've read about reflection, I submitted the required reflective accounts to complete my revalidation last month (so good through to March 31 2023) and I've time to reflect now.

Reading some of the papers and browsing through the journals I notice one has "CPD reflective questions" which are specified for full-length article submissions. Here are some examples from one journal issue:

"If a patient presents with red flag signs of impeding airway obstruction, consider the aspects of the 6Cs in nursing and reflect on the care, compassion, and communication required to the patient and family.
Consider the different dimensions of a person-centred climate of a long-term care setting.
Reflect on the nurse's role in the provision of person-centred care in an older adult residential setting.
How could you make the care of patients in your setting more person-centred?
Reflecting on the case study, what do you consider may help nurses in recognising the condition early and minimise the need for investigations?
Reflect on how the time perspective [can] be an indicator of health and quality of life in people with HIV or another patient group.
Consider how the time perspective can be incorporated into the health care of people with HIV.
Think about how nurses can assess the time perspective in people with HIV."

If you understand Hodges' model then you will appreciate how the model can facilitate reflection on all of the above.

The contents page of many publications usually differentiate between 'features', or 'special focus' and pages listed as 'regulars'.

For quite a while I've not only worked on papers (two advanced drafts at present) but (quietly) wondered about those 'regular' pages and what would it take for journals to adopt Hodges' model as a common resource?

Of course, this begs questions of legitimacy, evidence-base, standards ... and as I have acknowledged Hodges' model is no panacea for a practitioner's or a health system's limitations. Hodges' model itself may constrain the adopted perspectives of readers; as opposed to as I believe, liberating them? If all the posts here were analysed, what is the holistic bandwidth of the content?* If Hodges' model was adopted what trends, if any, would be revealed? If students used Hodges' model to reflect on their own well-being in year 1 - year 3 what would they learn? Are there wells of reflection about which reader's reflections would congregate? Would this in turn be influenced by other recognised biases in publishing and the way the above questions are selected?

It would still be amazing to see Hodges' model as a regular and universal prompt. Even as a research project - the aide-mémoire it is intended to be. The journal would then actively engage with its readership and provide invaluable CPD.

My new folder is already open for the next three years ...

Be Well :: Be Safe All

*I admit that there are topics I have avoided posting, as they are potentially fraught 'politically' or in other respects.

British J. of Nursing, 28,9. 2019 (9 May, Congress Bumper Issue!).

World Health Day

"The pandemic is a portal.
We can walk through it with our dead ideas.
Or we can walk lightly,
ready to imagine another world."
Arundhati Roy

The pandemic represents five portals:

SOCIAL
SPIRITUAL
POLITICAL
INTRA- INTERPERSONAL
SCIENCES

On our respective journeys, 

we can reflect and think critically 

using the disciplinary-bridges provided to us:

socio-political
psycho-social
physico-political
psycho-political
socio-economic

socio-technical

bio-ethical

...

and through 
love, teamwork and perseverance
we see that ...

"Discipline is the bridge between
goals and accomplishment."
Jim Rohn.


individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

https://twitter.com/WHO/status/1247547729879891968?s=20

State of the World’s Nursing Report - 2020

Roy, A. (2020) The pandemic portal, Life&Arts, FT Weekend, 4-5 April, pp.1-2.

Sticking with 'nudge' - behaviour and economics ...

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

psychological realism cognition

neoclassical model "The most well-known critique of behavioural economics comes from a psychologist, Gerd Gigerenzer of the Max Planck Institute for Human Development. Gigerenzer argues that it is pointless to keep adding frills to a mathematical account of human behaviour that, in the end, has nothing to do with real cognitive processes. ... He [Laibson] concedes that Gigerenzer has a point but adds: 'Gerd's models of heuristic decision-making are great in the specific domains for which they are designed but they are not general models of behaviour.'" "There is a tendency to propose some new theory to explain each new fact. The world doesn't need a thousand different theories to explain a thousand different facts. At some point there needs to be a discipline of trying to explain many facts with one theory." [David K Levine, Is Behavioural Economics Doomed?, 2012]

social proof Source: Financial Times

behavioural  economics "The challenge for behavioural economics is to elaborate on the neoclassical model to deliver psychological realism without collapsing into a mess of special cases. Some say that the most successful special case comes from Harvard's David Laibson. It is a mathematical tweak designed to represent the particular brand of short-termism that leads us to sign up for the gym yet somehow never quite get around to exercising. It's called "hyperbolic discounting", a name that refers to a mathematical curve, and which says much about the way behavioural economists represent human psychology."

Harford, T. (2014) Nudge or fudge? Life&Arts, Financial Times, 22-23 March. pp.1-2.

Clearly indoors, clearing papers ...

HelpForce the Domains for Change in Social Care

There are many lessons to be found - and as governments continue to learn - trip over, in the ongoing COVID-19 pandemic.

The government made a call for volunteers:

https://www.england.nhs.uk/2020/03/your-nhs-needs-you-nhs-call-for-volunteer-army/

 and the public has responded with 750,000 respondents:

https://www.goodsamapp.org/NHS

While of little consequence in the larger world, for me this crisis continues to reveal how the axes of Hodges' model encompass far more than their respective labels might indicate.

Taking the vertical axis:  INDIVIDUAL to GROUP (population) nations have had to resort to law to direct, instruct, force their citizens to stay at home.

Health policy, public health and economics specialists have long sought a means to influence people's behaviour. Nudge theory has joined the basic motivators of carrot and stick.

In the UK the call for volunteers has a long history.

Tom Hughes-Hallet, Your NHS Needs You, The Sunday Times, 26 August 2018, p.22.

HelpForce

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

An individual's behaviour ...

... and the impact of the same.

THE BIG SOCIETY

"The Big Society was a political ideology developed in the early 21st century. The idea proposed "integrating the free market with a theory of social solidarity based on hierarchy and voluntarism". Conceptually it "draws on a mix of conservative communitarianism and libertarian paternalism". Its roots "can be traced back to the 1990s, and to early attempts to develop a non-Thatcherite, or post-Thatcherite, brand of UK conservatism" such as David Willetts' Civic Conservatism and the revival of Red Toryism. Some commentators have seen the Big Society as invoking Edmund Burke's idea of civil society, putting it into the sphere of one-nation conservatism.   The term Big Society was originated by Steve Hilton, director of strategy for the Conservative Party, and the idea became particularly associated with the party's leader David Cameron who was a strong advocate for it. The idea formed the flagship policy of the 2010 UK Conservative Party general election manifesto and was part of the subsequent legislative programme of the Conservative–Liberal Democrat coalition agreement. The stated aim was to create a climate that empowered local people and communities, building a "big society" that would take power away from politicians and give it to people." WikiPedia

Clearly, there is a macro form of nudge and hopefully this will result in social care being given the attention (funding) it desperately needs, recognising the value and values inherent in the sector.

Also in the Sunday Times article 'The NHS in numbers':
9m - Increase in UK population of pensioners in next 40 years

1942 - When William Beveridge's blueprint for postwar welfare state was published

10,000 - Volunteers supporting 4,000 staff at Marie Curie cancer care charity.

Tom Hughes-Hallet, Your NHS Needs You, The Sunday Times, 26 August 2018, p.22.


https://en.wikipedia.org/wiki/Big_Society

VerbAtlas 1.0 - Semantic Role Labeling and beyond! c/o Roberto Navigli

VerbAtlas 1.0 - Semantic Role Labeling and beyond!

We are proud to announce that VerbAtlas 1.0 (http://verbatlas.org) is finally available for download at http://verbatlas.org/download. Developed in the Sapienza NLP group (http://nlp.uniroma1.it), the multilingual Natural Language Processing research team at the Sapienza University of Rome, VerbAtlas is a novel large-scale manually-crafted semantic resource for wide-coverage, intelligible and scalable Semantic Role Labeling. The goal of VerbAtlas is to manually cluster WordNet synsets that share similar semantics into sets of semantically-coherent frames. The main features are:

• 466 semantically-coherent frames using 26 cross-frame VerbNet-inspired semantic roles for their argument structure.
• Available both for download and via RESTful API.
• Full coverage of WordNet 3.0 verb synsets (13,000+).
• Complete linkage to BabelNet 4.0, which supports 280+ languages (new version to come later this year!).
• Manual mapping to PropBank of all CoNLL-2009 and CoNLL-2012 dataset occurrences (5000+ mappings).
• Selectional preferences: the superconcept most probably associated with a semantic role in a frame (e.g. food for the patient role of the EAT frame).
• Default/shadow arguments: arguments logically implied or already incorporated into a verb.
• Implicit arguments: arguments that are implicit in the argument structure of a verb.

And much more! Please check out our EMNLP 2019 paper:

A. Di Fabio, S. Conia, R. Navigli “VerbAtlas: a Novel Large-Scale Verbal Semantic Resource and Its Application to Semantic Role Labeling”, EMNLP-IJCNLP 2019, pp. 627-637

and http://verbatlas.org for more details!

A state-of-the-art span-based SRL system which uses VerbAtlas and PropBank jointly is also available from the same website (just type a sentence!).

VerbAtlas is an output of the MOUSSE ERC Consolidator Grant n. 726487 and the ELEXIS project no.731015. Babelscape proudly developed the online interface and API, provides the infrastructure for maintaining the service and works on the improvement of the resource. 

Enjoy!

The Sapienza NLP group

=====================================
Roberto Navigli

Dipartimento di Informatica
Sapienza University of Rome
Viale Regina Elena 295b (building G, second floor)
00161 Roma Italy
Home Page: http://wwwusers.di.uniroma1.it/~navigli

Sapienza NLP Group: http://nlp.uniroma1.it
My Source:
The Semantic-web list @w3.org



What are / should be the current core verbs allocated to each of the care (knowledge) domains of Hodges' model?

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

*personalise	scientify
socialise	politicise

*(intra- inter-)personalise?


From above introduction to VerbAtlas:

"A state-of-the-art span-based SRL system which uses VerbAtlas and PropBank jointly is also available from the same website (just type a sentence!)."

Sentence: "Nurses wear certified personal protective equipment to care for patients with Coronavirus." in VerbAtlas 1.0

See also:

For those working at the intersection between #NLP and #COVID19 here is a possibly interesting venue:

NLP COVID-19 Workshop at ACL 2020 @aclmeeting https://t.co/hLFqljTVJC pic.twitter.com/0bOdcU0qBV

— Emilio Ferrara (@emilio__ferrara) April 4, 2020

Inverse Care Law ... at Social Care's Door

Since 2015 I've had four 'conversations' with the doctors at A&E upon mum's attendance and subsequent admission on a couple of occasions. Initially, I was surprised if not shocked by the speed with which the 'conversation' followed on treatment, the extent of this and the question of resus. The further interactions were still emotionally jarring, even when expected and telegraphed. I also understand: to an extent. Repeated chest infection or urine infection had resulted in confusion, delirium that varied. on one occasion, at the nursing home there was also suddenly talk of a diagnosis of dementia, which prompted social services to wonder, like family and staff, where exactly this diagnosis had come from and investigate. (Another post?)

Mum has been very poorly, most recently in November. What surprised and shocked was the 'conversation' at the end of the bed when I knew mum - with mental capacity at that time was most likely listening. The primacy of person-centredness seemed to be by-passed. I suggested the doctor ask mum since once hydrated she would be fine. There has been a sense of a script being followed with some pressure - urgency behind it, if not a 'prescription'. I empathised with the doctors, often FY1 FY2; such matters are never easy. Now amid COVID-19 there is alarm as social care are challenged with taking on a new role, for which they are ill-equipped. 

In health care you are always conscious of the inverse care law, it seems there is another care law in operation that gives cause to worry for those who cannot advocate for themselves or have no independent advocate. Perhaps there is another inverse law that runs concurrently concerning ethics. Triage, is real. Objectively, as a nurse you think "Am I being selfish?". But, as eldest son - absolutely not. These conversations, and the future aside, the doctors and team as a whole have worked (absolute) wonders for which mum and the family will always be grateful.

Be Well, Be Safe All.

 

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

"There should be no wrong door and every  service should reverse the ...	... Inverse Care Law, which simply states those people in need of health and social care the most  get them the least."
https://www.smithsltd.co.uk/doors/composite	By MrPanyGoff - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19702555

A comment at The King’s Fund, by Lord Victor Adebowale.

Partnership Working, Time to Talk, Drink and Drugs News, October 2018, pp.10-11
https://drinkanddrugsnews.com/wp-content/uploads/2018/10/DDN-October-2018.pdf

If anyone has a photo of a red door at a care or nursing home that I can display above please let me know.

Why 'Integrated Care' remains a Legacy Issue

Define 'integrated care'?

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

Protect myself [You Government] Protect me* The individual need to  'do' something with this model,  not just think about it.  The personal sense (illusion) of doing, with yet another install of Wamp, Drupal ...	Complexity Systems Uncertainty Legacy - issues Evidence-Based Care?
*(I have a duty of care to protect my family and community and not become the next casualty.) Protect my loved ones and community	Evidence-Based Policy? The National Risk Register 2017 Is a tabletop exercise in pandemic  planning and response sufficient? The Political sense of thinking as 'doing'. (This is where the lamp is always on.) Tick here

See also:

'Desk-topping' i [ c/o BBC Radio 4 today 5 Feb. ]

Image source:
https://www.trident-crisis-solutions.co.uk/ (risk register)
https://www.bumc.bu.edu/ (tick box)

Contextual and other forms of Collapse ...

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

"I will get through this."

what is invisible

"Nowadays, digital technology is transforming our lives at an accelerating pace. This sometimes feels wildly liberating. But it is often terrifying too, because cyberspace is so disorientating. More specifically, in the cyberworld there is a constant problem of what anthropologists call "context collapse": it is hard to discern the contours of social interactions because the factors that used to frame our cultural lives are only half-present".

"We will get through this together."

my emphasis


At times such as this - the COVID19 pandemic - we are all trying to maintain the semblance of  "I will get through this." and "We will get through this together"; trying to self-care and in-so-doing care for friends, family, community and the population.

At times when our cultural and personal lives are not even 'half-present', there is an increased need for sense-making, for balance and orientation. While the tool we seek is a vaccine and preparedness for the next one, there are tools to reduce the impact of the several forms of collapse we are presently  experiencing.


Please see also initial post:

https://hodges-model.blogspot.com/2019/10/liminality-in-how-ancient-rituals-help.html

- sourced from and acknowledged Gillian Tett:

Tett, Gillian. 2019, How ancient rituals help us adapt to the digital age. FT Weekend, Magazine, June 29-30, p.46.