c/o Jayne Wilton: Reflex-ive :: Reflection - Breathe : DO - REPEAT - WHILE

INDIVIDUAL

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    INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

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GROUP

'Many of us will have experienced playing with the interaction of our breath on shiny surfaces such as windows and mirrors, allowing us temporary fields of condensation in which to doodle thoughts or messages. In emergency situations a mirror or shiny surface is held in front of the mouth of a subject to confirm whether or not they are breathing. The Breathe series makes use of these dynamics. The breath of a series of  individuals was captured on a shiny copper surface and then etched to create a negative of the breath where it sat on the copper plate. The result is a series of evocative landscapes. This work employs and yet subverts traditional printing processes. The inscription of spent breath onto precious metal immortalises a discharge and presents an alternative to portraiture.' Jayne

Reflection - Reflexive   Resuscitation    mirror

Wilton - is a visual artist who explores the breath as a unit of exchange between people and their environments. Her practice uses darkroom processes with drawing, photography, video and sound to capture the usually invisible trace of breath as it moves across a surface. www.jaynewilton.com

My source and thanks to Jayne Wilton: 

Jayne Wilton. Breathe, Artist's Statement. Resurgence & Ecologist, July/August2023: 339: p.47 & (p.49 image).

Previously: 'breathing' : 'reflex' : 'reflection' : 'art'

The Economist: a Nurse, an Obituary - Lini RIP

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

Lini Many Keralans work in the Gulf. More lucrative than staying at home. Dream of Gulf as a magical place. Proud pictures taken outside the house. Study Motivation Ambition Love

Lini - died of the Nipah Virus (fatal in 70% of cases) May 21st 2018, aged 28 Night shift Patient admitted: Mohamed Sadiq from Changaroth Panchayat Fever, breathing difficulty Fluids, paracetamol, change of clothes, sit with all night long The patient died after a few days  Travel by bus to work from Chempanoda, slow but beautiful journey across rivers, areca-nut and rubber trees, past wooded hills. The Western Ghats tower to the east, catch the evening sun. Bats - infected water, or the mangoes nearby. Lini was studying to improve her knowledge ...

Puthussery (family) Lini --------Sajeesh | | --------------- |                    | Rithul (5 yrs)       Sidharth (2 yrs) Sajeesh, away 5 yrs Bahrain working as an accountant Daily phone calls, returned a few times a year Able to afford 1 storey brick house Social media - rumours Origin of infection?

to be eligible for a permanent government nursing job. On contract to Perambra Taluk hospital Upgraded from a community health centre 10 yrs ago Still short of doctors and specialists Difficult cases still go to Kozhikode 50km away Lini worked as a daily-wage nurse - flexible hours. Place not quite paradise as farmers at times gathered to protest when their land was misclassified as protected forest and claims to ownership were rebuffed. Husband tried to get a family visa, but Lini wanted a nursing job in Gulf first. (She loved her work too much)

Obituary, Lini Puthussery, The Economist, June 2nd, 2018, 427, 9094, p.86.

Hubris syndrome: Daedalus Project [Psycho-Political]

INDIVIDUAL

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 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

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GROUP

Hubris Syndrome "Democratic politicians as diverse as Woodrow Wilson, Franklin D. Roosevelt, Churchill, Kennedy, Johnson, Nixon, Pompidou, Mitterrand, Blair, George W. Bush, Chirac, and Sharon all lied about their health. ...

... Between 1906 and 2008 seven Presidents are judged to have been mentally ill while in office: Theodore Roosevelt (bipolar disorder), Taft (breathing-related sleep disorder), Wilson (major depressive disorder), Coolidge (major depressive disorder), Hoover (major depressive disorder), Johnson (bipolar disorder), and Nixon (alcohol abuse). Many despots-such as Hitler, Stalin, Saddam Hussein, Pol Pot, Idi Amin, and Robert Mugabe-have been branded by the press and public opinion as suffering mental illnesses. Lord Owen argues neither Hitler nor Stalin were mad in any sense the medical profession recognizes (whereas Mussolini and Mao had depression, possibly bipolar disorder)."

'Faith' in leadership? 'Choice'?

In Sickness and in Power by Owen David

I remember Lord Owen's book being published, over a decade ago and heard radio interviews at the time (BBC Radio 4, Start the Week?). Not sure why I didn't pick this up as the disciplinary bridges are stark and clear (now!): PSYCHO-POLITICAL and GEO-PSYCHIATRIC. The importance of the issues the Daedalus Project addresses, now within Maudsley Philosophy Group is not just suddenly 'self' evident*, but is of importance for the world's population- impacting upon global safety and security.

Even since Lord Owen's book the rise of AI adds complexity (as ever).

 *irony intended.

Text: https://www.goodreads.com/book/show/3205306-in-sickness-and-in-power

Owen, D. (2009) In Sickness and in Power: Illnesses in Heads of Government during the Last 100 Years, London: Methuen Ltd.  ISBN: 978-0-413-77689-1

Plus via twitter: 

Thanks!

This is great talk from David Owen on Hubris syndrome we organised at @The_BNPA meeting a few years backhttps://t.co/73qGD42oQY

— Tim Nicholson (@Tim_R_Nicholson) March 6, 2022

Exoplanets, exobiology, exocortex, exocare ...?

http://www.guardian.co.uk/books/booksblog/2008/may/14/godvsatanindeepspace

Exoplanets

planets outside the solar system

An exoplanet (or extrasolar planet) is a planet orbiting a star different from the Sun (the "exo" prefix means "outside" in Greek). Up until now, one has found mainly gas giant planets, which are easier to detect than telluric planets. However, due to the increasing sensitivity of the detection methods, one already begins to observe the first planets of sizes comparable to the Earth.

Source: http://media4.obspm.fr/exoplanets/pages_definition/questce.html

Exobiology

The term exobiology ... covers the search for life beyond Earth, and the effects of extraterrestrial environments on living things.
Source: http://en.wikipedia.org/wiki/Astrobiology

Exocortex

-noun
An artificial external information processor that augments the brain's high-level cognition. Julia used her exocortex to access the memory of her tenth birthday.
Source: Fleming, N. The next wave. New Scientist, 14 May 2011. 210, 2812, p.33.

Exobuilding

ExoBuilding explores the novel design space that emerges when an individual‟s physiological data and the fabric of building architecture are linked. In its current form ExoBuilding is a tent - like structure that externalises a person's physiological data in an immersive and visceral way. This is achieved by mapping abdominal breathing to its shape and size, displaying heart beat through sound and light effects and mapping electro dermal activity to a projection on the tent fabric.
Source: http://www.cs.nott.ac.uk/~hms/pdfs/SchnadelbachEtAl_ExoBuilding_CameraReady_AuthorVersion.pdf

(8 April 2013 #DTMD13)

Exoskeleton

http://www.infoniac.com/hi-tech/top-10-robotic-exoskeletons.html

n.
ex·o·skel·e·ton ( k s -sk l -tn). n. A hard outer structure, such as the shell of an insect or crustacean, that provides protection or support for an organism.

Source: http://www.thefreedictionary.com/exoskeleton

exoskeleton: A medical device that allows individuals with severe spinal cord injury to walk and enhances rehabilitation for stroke victims.
Source: http://tagdef.com/exoskeleton

Exocare: Depends on your perspective - context / situation sensitive

Care exercised by a planet, or that planet's representation (on Earth the UN) towards life on other worlds, includes ethics, protocols and first contact.
See also: https://www.seti.org/seti-institute/project/details/seti-and-policy

Care not delivered by statutory health services. Care delivered by the individual also described as self-care.

Care directed at specific celestial objects, often as a result of long held ethnocultural beliefs and customs, the moon for example.

Care that extends 'human ecosystems' to what is external to the physical self, to encompass Gaia - the Earth and biosphere. Love directed not at a single person, or thing but the sense of what is whole.

Also refers to the use of a conceptual framework to frame reflections on health and social care - individually, socially or globally. Provides a means to integrate concepts of care according to the situation and salience incorporating the individual-group (population); the local, global and glocal.

Health & Care results in mountains of data: c/o Burke & Cao 2024

"When medical schools train medical students, they teach them to treat patients as collections of various data points. They are laboratory tests and results, each measured to a standard number of significant figures. Notes students write hack down the richness of patients' identities and experiences: unemployment increases suicide risk while having a religion diminishes it. Each positive result that an interview or physical exam reveals adds another data point to the growing mountain, while a negative result erases a branch of possibilities in a treatment algorithm. It is a familiar process for every doctor, almost second nature, and yet it creates a chasm between patients and providers. Learning about a patient and their life becomes a process of deleting what's seen as irrelevant, and a patient's humanity gets lost in the chaos of data. ..."

"How would Nan Shepherd treat a mountain without her vision being mangled by medical training? She would probe it, palpate its surface, and listen to it rather than trying to comprehend it by reading reams of surveyor data. She would build a portrait of it in her mind beyond solely that which was intended to slot into the criteria of the IC-10. Perhaps she'd write a sensuous physical exam: ..."  

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

"CONSTITUTIONAL: a granite mountain range, millions of years old, overall stable and solid, teeming with living, breathing organisms CARDIOVASCULAR: its rivers are patent, low and high turbulence at turns, its veins crisscross the surface RESPIRATORY: the wind carves through it in mighty exhales MUSCULOSKELETAL: its stone carries a range of lives, and the wind, the snow, the sun slowly bend the range of its form GI/GU: it slowly digests, grows, evacuates, and seethes as its wastes give rise to new life NEUROLOGICAL: the mountain is awake but dreaming with you"

The Living Mountain

Burke, R., Cao, E. To Care for a Mountain - What medical practitioners can learn from Nan Shepherd. Oxford Review of Books, Summer 2024, Volume 8, Issue 2. p.14. In association with Stanford. Ack. length of quotations in relation to length of author's article.

Nan Shepherd 1893 - 1981:  Scottish Poetry Library 2024.
https://www.scottishpoetrylibrary.org.uk/poet/nan-shepherd/

Cover image: Allen and Unwin

The poetry of presence c/o Kenner's 'Mechanic Muse'

'... Eliot's poetry responds to yet another of the new century's pervasive experiences, that of being talked to by people we cannot see. This happens whenever we pick up a telephone, a thing we do so many times a day we quite overlook the strangeness of what lappens next. A character in The Cocktail Party remarks that you can't tell the truth on the telephone, meaning probably that you lose three quarters of your communicative power when you cannot be seen and your breathing body is absent, and you must fabricate mere semantic sequences. Your words are only a fraction of what you say, and the telephone throws you back on nothing but words. It is in Sweeney Agonistes, the play that gives the telephone bell a wholly metrical speaking part, that we hear the famous phrase, "I gotta use words vhen I talk to you."
    When the phone rings in that play - 

    Ting a ling ling 

    Ting a ling ling

Dusty snatches it up and says,

Hello Hello are you there?' 

Kenner, H. (1987) The Mechanic Muse, Oxford: OUP. pp.34-35.

c/o Intima 'Reflect on the World' . . .

CARE/of Intima:

REFLECT ON THE WORLD WITH US EVERY FRIDAY AT NOON.

No pressure, but we want to remind you that every Friday, around noon EST, we post a Crossroads blog—a short reflection that contributors from our current issue do on something from our archives. Think of “Friday at noon” as a blip in your busy life where you take time to yourself to reflect on our small part of the universe. Pause and spend 5 minutes reading one each Friday — it’s the equivalent of a deep-breathing exercise, a short yoga stretch, a tiny palate cleanser of lemon sorbet between the complex courses served up to us every day, or a moment stolen between patients or in a waiting room when you step out of your routine. Read the titles of recent ones below, then go and read a few. If you like what you read, set up a reminder alert.

◇

INDIVIDUAL

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    INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

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GROUP

My source: Intima (and image) - mail list.

See also: 'reflect' : 'crossroads'

Drupal musings 8: Styling the archive

I've been editing the basic html pages (as mentioned before on W2tQ) these include:

• Brian Hodges' introduction with a content listing and the scope of the model to help bridge theory and practice.
• My introduction to the model based on an interview with Brian conducted 28th May 1998 in Manchester, England.

I've been here before and lost the thread, working within Drupal. This time though editing the pages in Textmate, things are taking shape. Three headings, three fonts (currently) Georgia, Droid Serif, Tangerine; styled lists and striped tables. It might be basic, but there is a style sheet that is almost breathing as it INFLATES : deflates, the result of various experiments. The fonts look good except for the FOUT 'flash of unstyled text'. As the previous link shows there are some fixes for that - which I hope will follow in due course. That would be a distraction at this point though as there is much to focus upon. Although the archive will have a style of its own, other parts of the site must reflect its content. That said, there still needs to be some stylistic coherence. ...

Written in Padstow, Quayside Cottage listening to a children's show on the bandstand.

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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    INTERPERSONAL    :     SCIENCES               

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/

Cognitive Therapy & Community MH Nurses - anyone for tennis?

Last week there was quite an announcement about psychological therapies - specifically cognitive behavioural therapy, with a £170 million boost to help treat the millions of people affected by anxiety and depression. Stuck with their condition many are also stuck on waiting lists.

On the media the inevitable debate followed about research, the evidence base and the possibility that perhaps nurses could undertake some of this work. You guessed it - the 'but' followed in the form of 'training'. True, training will be needed, as the conveyor belt that is the workforce takes on-board the new kids in town and seeks to squeeze the best out of its more senior clinicians. With mention of training though someone had better watch that £170 million, to ensure it really does deliver quality therapy with the required supervision. There's also an invitation here for the various schools of therapy to take up arms - and this could be a further distraction.

A stock-take of EXISTING skills would be in order. Many people have already been trained in CBT as part of a skills set to deliver psychosocial intervention. Personnel information systems that are breathing (alive!) are critical, since there are many nurses (one hand raised here) and other disciplines who have the skills to maximise the effectiveness of that investment. Polish those rusty skills and there's a regular Genie there. So where are they?

Well many are playing tennis and it sure is not pretty...

If you listen carefully you can hear the grunts; the thud-after-thud as the players seek the sweet-spot. Any applause was lost a long time ago. You see, primary and secondary care are locked in a tie-break. Primary care refer; secondary care continue to hone their return of service, trying to spot the attempted ace down the centre. Screening tools are perfected, referral thresholds revised - the net gets dizzy; meanwhile, who is doing the therapy, the carer support, the public mental health education? Of course, this word therapy also comes with economic and status baggage.

You have to feel sorry for both these players and their coaches, now they can't just run to return the ball, the rules say that between shots they have to include a gymnastic element too.

Wimbledon 2008 should be fascinating: there's bound to be a break soon - I bet your demographic dollar$

Image source http://www.tennisserver.com/set/set_03_09.html

h2cm: fixed or primary concepts the push and pull of nursing

When commentators, students and others write of the primary or core concepts of nursing what does this mean in terms of Hodges' model [h2cm]?

For quite some time I have been describing Hodges' model as a cognitive - conceptual space. This suggests that there are fixed concepts within the care domains. Yes, they may vary according to the context and over time, but if concepts were arrows and our aim is true then h2cm would provide the ideal target. It on this care matrix that we really could take aim and nail the kernels of knowledge that make up our care activities.

Is it a mistake to venture that for people to talk of basic nursing care, essential care needs, that there must be some fixed ideal out there; an ideal that nurses, society and policy makers can hang discussion and debate upon? And let's face it there is much to debate - mental health stigma, obesity, nutritionism, heart disease, dementia, unplanned pregnancies, funding, access, poverty. ...

Medical sociology has done and continues to do society at large a great service. It forces practitioners to look over their shoulder and take in the social and cultural forces that influence health. As a question for further deliberation within medical / clinical sociology we might ask: How are the concepts in Hodges' model fixed? There are several possible answers:

1. Someone determines that concepts a, b, c, d are in care domains 1, 2, 3, 4. The question of whether Hodges' model (or any other conceptual resource) is classed as evidence based depends on how that determination is made.

2. Alternately, the structure of the model provided by the axes, could act as a skeleton. This might serve as a boot strap breathing life into the empty spaces created by this structure. The first instances of concepts might then arise like some sort of quantum event - self, other, temperature, time, height, mood. ...

3. As (medical) sociology, philosophy and psychology continue to reveal, we also need to accept of course that society, culture and language are all inextricably linked and they pre-empt that empty space, predetermining what will be written (thought and reflected) there.

4. This external influence is a must if those working in the health and social care professions are to communicate with those 'outside' (public involvement can only run so far?). It is not so much a case of common ground, as common space and the freedom and opposition that this affords. this is essential for communication amid what is variously called - multidisciplinary working and integrated care. Here there must be a degree of latitude between different disciplines' usages of terms. This must provide common understanding or some close approximation and yet still be safe.

So rather than empty space the care domains are really full of care concepts all waiting on tenterhooks, to see whether they will get to aggrandise and become 'complex care needs'. Will the assessor / care evaluator pick them - from what is initially a virtual crowd? Go on make their day: care-fully!

Fundamentals of Care - mapped to Hodges' model

I came across a paper on 'fundamental care':

Jackson, Debra & Kozlowska, Olga. (2018). Fundamental care - the quest for evidence. Journal of Clinical Nursing. 27. 10.1111/jocn.14382. 

The definition Prof. Jackson subsequently pointed to is as follows:

"Fundamental care involves actions on the part of the nurse that respect and focus on a person’s essential needs to ensure their physical and psychosocial wellbeing. These needs are met by developing a positive and trusting relationship with the person being cared for as well as their family/carers."

I've taken the fundamentals of care from the International Learning Collaborative and mapped them to Hodges' model. The psychosocial list has been divided across the two applicable domains - you'll see what I've done.

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

PSYCHOsocial fundamentals of care Communication (verbal and non-verbal) Privacy Education and information Emotional wellbeing Choice Having values and beliefs considered and respected

Physical fundamentals of care Personal cleansing (including oral/mouth care) and dressing Toileting needs Eating and drinking Rest and sleep Mobility Comfort (pain management, breathing easily, temperature control) Safety (risk assessment & management, infection prevention, minimising complications) Medication management

PsychoSOCIAL fundamentals of care Being involved and informed Dignity Respect Education and information Having values and beliefs considered and respected Social engagement, company and support Feeling able to express opinions and needs without care being compromised Having interests and priorities considered and accommodated (where possible) Relational fundamentals of care Active listening Empathy Engaging with patients Compassion Being present and with patients Supporting and involving families and carers Helping patients to cope Working with patients to set, achieve and evaluate progression of goals Helping patients to stay calm

As this domain seems to be 'empty', I  will add some thoughts in the POLITICAL domain...  You can imagine a series of layers here.  As per the physical fundamentals above include - safety and homeostasis would be uppermost. Difficulties in the above instantly raise alarm bells and the old chestnut construct of dependency.  The lack of specifics on mental health suggests something that is incomplete and appears to assume a certain degree of functioning? The psychosocial actions invariably overlap and with the relational. We are hopefully socialised into dignity, respect, compassion, empathy and related attributes. What impacts  on a person's privacy, dignity may vary from person to person to some extent. This however introduces the humanistic care of engaging with people, their carers and the need to be person-centred. On privacy ... and preserving the integrity of an individual (and their 'group'), there are of course (duty of care and) professional standards (in this domain) that help guide our advocacy and accountability. Clearly, there is much to do..

Previous posts on 'fundamental-ism'

Thunderstorm Asthma in Hodges' model

individual

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INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group-population

anxiety - impact on respiration previous individual experience personal health literacy: "What I need to do when X,Y,Z advanced care plan: staying well, preventive measures (see below)	Breathing, Asthma Climate, Thunderstorms Pollen (rupturing?) 8,500 Hospital Treatment 1,900 Emergency calls in 5 hours Intensive Care at least 8 Deaths Protocols - metrics
Family, carer, community support Social media, warnings Provenance of information provided - community trust.	Health Services Emergency response / resources Disaster Management / Review

Melbourne thunderstorm asthma death toll rises to eight, The Guardian, 29 November 2016.

My source:
Davey, M. (2016). Deadly asthma thunderstorm kills four and leaves Melbourne reeling; &
Sample, I. (2016). Analysis, Doctors agree on why, but are less sure how. The Guardian, 25 November. p.3.

 

Update in italics - June 18th 2022, plus:

Bellomo, R., Gigliotti, P., Treloar, A., Holmes, P., Suphioglu, C., Singh, M.B. and Knox, R.B. (1992) Two consecutive thunderstorm associated epidemics of asthma in the city of Melbourne. The possible role of rye-grass pollen. Med. J. Aust. 156, 834-837.

Suphioglu, C., Singh, M.B., Taylor, P., Bellomo, R., Holmes, P., Puy, R. and Knox, R.B. (1992) Mechanism of grass-pollen-induced asthma. Lancet 339, 569-572. 

Knox, R. B. (1993) Grass pollen, thunderstorms and asthma. Clin. Exp. Allergy. 23, 354–359.

Ong, E.K., Singh, M.B. & Knox, R.B. Aeroallergens of plant origin: Molecular basis and aerobiological significance. Aerobiologia 11, 219–229 (1995). https://doi.org/10.1007/BF02447202

Nasser, S.M., Pulimood, T.B. Allergens and thunderstorm asthma. Curr Allergy Asthma Rep 9, 384 (2009). https://doi.org/10.1007/s11882-009-0056-8

E Andrew, Z Nehme, S Bernard, M J Abramson, E Newbigin, B Piper, J Dunlop, P Holman, and K Smith. Stormy weather: a retrospective analysis of demand for emergency medical services during epidemic thunderstorm asthma. BMJ, 359, 2017.

Rabiee, S., Mousavi, H. & Khafaie, M.A. Thunderstorm asthma outbreak, a rare phenomenon in southwest Iran: patients’ perspectives. Environ Sci Pollut Res 25, 36158–36162 (2018).
https://doi.org/10.1007/s11356-018-3478-9

Kevat A. Thunderstorm asthma: looking back and looking forward. J Asthma Allergy. 2020;13:293.

Luschkova, D., Traidl-Hoffmann, C. & Ludwig, A. Climate change and allergies. Allergo J Int 31, 114–120 (2022). https://doi.org/10.1007/s40629-022-00212-x

 

https://asthma.org.au/blog/tips-to-prepare-for-a-thunderstorm-asthma-event/


 

Drupalcon London - Day 2 Tues. Dries's keynote & HTML5

The first day of Drupalcon London 'proper' is done and there is still so much to take in (but I am staying in the kitchen!). Dries' keynote reflected the current state of Drupal in contrast to the previous European gatherings which have really focussed on the next version. Last year that was only five months away. Dries did attend to Drupal 8, but maybe two years or so till release is a helpful breathing space.

In Drupal 8 attention is being given to specific scorecards and other strategies to manage core (gates) to assure quality and co-ordination. I'm pleased to see HTML5/CSS3 up there as a priority. Last week in .net magazine I read an article (p.104-108) by Jen Simmons on HTML5 in Drupal and some of the challenges in fully updating a Drupal 7 site to this latest standard.

There were many other great sessions. Already I've strayed from 'my' schedule posted previously. After speaking to people I must check Display Suite, and Entities - the latter which I attended. While there is still lots happening re. job and 'home' after four (European) Drupalcons it's high time for me to find some cheap yet cheerful hosting to experiment more meaningfully. I've a (very) basic Drupal 7 brochure and enquiry site, trying to finish and host that will finally bring HD to this experience for me. Anyway must go - another keynote 0900...

Silent - Spring, Summer Autumn Winter ...

individual
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 INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

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group

	The Sea Around Us Under the Sea-Wind
	The Edge of The Sea

"The oceans are the living heart and lungs of our planet. They produce most of the oxygen in our atmosphere, and through their circulating currents they control climate. Without healthy oceans, we land-dwelling, air-breathing mid-sized primates will die.

The republication of the marine biologist Rachel Carson's first three books ... marks a new, widespread recognition of these facts."

Margaret Atwood, Did we think the sea was too big to fail? Review, The Daily Telegraph, 29 May, 2021. pp.6-7.