Call for Papers for Special issue on Linking the Local with the Global within Community Informatics

Please forward as appropriate. Thanks!

Dear all, a special issue of the Journal of Community Informatics (http://ci-journal.net/index.php/ciej) will be devoted to ´Linking the Local with the Global within Community informatics`, guest-edited by Liisa Horelli and Doug Schuler.

The Journal of Community Informatics is a focal point for the communication of research of interest to a global network of academics, community informatics practitioners and national and multi-lateral policy makers. The field of community informatics seeks to explore the potentials of ICTs and their applications for economic, ecological and socio-cultural development efforts at the community level. It seeks to ensure that individuals and communities can take advantage of the opportunities that these technologies can provide.

For this special issue of the Journal, we are inviting submission of original, unpublished articles. We welcome research articles from different disciplines, case studies and notes from the field. All research articles will be double blind peer-reviewed. Insights and analytical perspectives from practitioners and policy makers in the form of notes from the field or case studies are also encouraged. These will not be peer-reviewed.

You can find the full Call for Papers below. Looking forward to hearing from you.
Warm wishes, Liisa and Doug

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Journal of Community Informatics:

Call for Papers for Special issue on Linking the Local with the Global within Community Informatics

Guest editors: Liisa Horelli and Douglas Schuler

The Journal of Community Informatics is a focal point for the communication of research of interest to a global network of academics, Community Informatics practitioners and national and multi-lateral policy makers.
We invite submissions of original, unpublished articles for a forthcoming special edition of the Journal that will focus on Linking the Local with the Global within Community Informatics. We welcome research articles from different disciplines, case studies and notes from the field. All research articles will be double blind peer-reviewed. Insights and analytical perspectives from practitioners and policy makers in the form of notes from the field or case studies are also encouraged. These will not be peer-reviewed.

What is Community Informatics?

Community informatics

...links economic and social development efforts at the community level with emerging opportunities in such areas as electronic commerce, community and civic networks and telecentres, electronic democracy and online-participation, self-help and virtual health communities, advocacy, cultural enhancement, and e-planning among others....is concerned with carving out a sphere and developing strategies for precisely those who are being excluded from this ongoing rush, and enabling these individuals and communities to take advantage of some of the opportunities which the technology is providing. It is also concerned with enhancing civil society and strengthening local communities for self-management and for environmental and economically sustainable development, ensuring that many who might otherwise be excluded are able to take advantage of the enormous opportunities the new technologies are presenting.

- Michael Gurstein in Community Informatics:
Enabling Communities with Information and Communications

Why a special issue on Linking Local with the Global within Community Informatics?

Community informatics (CI) is the study and practice of information and communication systems (especially involving networked digital systems) in the community. Regardless of the agreement on the broad definition, there are inherent tensions within the CI community and with the CI perspective itself. The "simple" idea of community is the source of one tension since there are a multiplicity of definitions and usages of the word "community", many of which are semantically loaded or ambiguous. Is, for example, a "virtual community" a real community?

Another source of tension is between the local and the global, the focus of this special issue. What's local and what's global? What is their significance in terms of our focus on "community"? How do we define the two terms so that they are meaningful and useful to our work? Perhaps these terms distract us from conceptualizing our enterprise in ways that are more useful? What characterizes phenomena or artifacts as belonging to one or the other (and how do they influence each other)? Interestingly, the community of community informatics researchers, practitioners, and activists itself is part of a new hybridity that blurs local and global.

The term glocalization has been coined to focus on the intermixing of local and global influences which are present and active everywhere. Although the phenomenon is not new, it has intensified in recent years due to the Internet, mass communications, mobile telephones, air travel, war, migration, economic interdependence, environmental impacts, and other aspects of 21st century mobilities. But identifying and naming a phenomenon is only the beginning. We must not mistake our use of a new term for understanding. For example, how would glocalization help us understand a network of local communities?

The availability of urban and community ICT could allow people to understand the larger impacts of their everyday decisions. It could also enable people to understand and promote not only the particularities of the local but also commonalities of the global, and to engage with the broader global “sphere”. Consequently, people could become actors who are engaged in the glocal networks of mobile people, goods and information.

However, glocal influence or interaction could be directed from the top-down, laterally, or from the bottom-up. CI implicitly embraces the tension between the local and the global. On some level, global and local pit two types of forces against each other. How does CI consider this clash or intermingling of forces? Does it advocate larger barriers, shelters, or hiding places, from these forces or does it inspire or promote the type of collective intelligence that goes beyond "using ICT?" The recent debate on the CI-research list brought up the idea that CI could be used, in addition to the benefit of communities, to the benefit of global communities. This debate raised arguments that both supported and questioned the claim. On the one hand, there is the risk that glocalisation can dilute (and downgrade) the "community" to some larger (and less individually significant) whole. In that case, it may be important to preserve the 'local' as it maintains the community's domains of control and power over the circumstances that impacts it. It can be reasoned that greater globality essentially removes self-control and self-governance.

On the other hand, glocalisation provides new strategic options for movements who seek resources and support far beyond national boundaries, such as the Chiapas, in Mexico. The global opportunities even begin to play part in the way local activists frame the issues they raise locally. Thus, the "outside world" affects communities, but communities exert forces outwards as well. Local communities can also share experiences and strategies, thus mutually strengthening each other. We need to figure out, how we are going to make the glocal or translocal connections work most effectively. This special issue is intended to help surface the opportunities, challenges, and risks around this theme.

These issues give rise to a large number of research questions. Some of these are listed below but there are many yet to be identified and researched. What processes underlie the forces of globalization? Which are forces of localization? How are people affected by each? How do these forces originate, diffuse, and make their effects felt? Do these forces affect all communities equally or are gender, ethnicity, or other features significant factors? And what should CI researchers / practitioners do in relation to those forces? Is the issue trying to help communities use ICT more effectively, or is it working in a general way to develop communication systems that will help local communities intelligently address the problems that they (and the rest of the world) face? In some situations, for example, this means helping to develop collective problem-solving tools so people can more effectively resist oppression or fight the status quo. Or should their inhabitants be full citizens of the world with the rights and responsibilities that accompany that status? How can we characterize the new diversity of global / local relationships? What patterns exist? In what ways might (hyper?) localism breed parochialism and isolationism? Can we embrace CI without unnecessarily valorizing the local community? What are the opportunities (and what should the limits be) to our research and activism on behalf of and with the local community?

Because CI is a brand new field of research and practice we have the rare opportunity to define our field. Is it useful — or even possible — to conceptualize a social enterprise that is relevant today without explicitly acknowledging climate change, environmental degradation, oppression, poverty, human rights, war and militarism, and other "global" problems that face us all, however indirectly. How should these manifest "global" concerns be factored into our enterprise? And how does the role of information and communication, the foundations of our enterprise, change — if at all — the way we answer these questions? This positioning of our enquiry at such a point should enable a new set of opportunities. CI integrates research and engagement. So its view of localism and globalism needs to be informed through those perspectives.

We invite authors to submit in English both full articles for peer-review, as well as short pieces on specific experiences and/or policy and regulatory issues, to be reviewed by the guest editors.

Please note the deadlines:
Deadline for abstracts: 28 February 2010
Deadline for submissions: 30 May 2010
Publication date is forthcoming

For information about submission requirements, including author guidelines, please visit:
http://www.ci-journal.net/index.php/ciej/about/submissions#onlineSubmissions

For further information, clarifications, comments or suggestions, and to send abstracts of papers for consideration, please contact:

Dr. Liisa Horelli Helsinki University of Technology Centre for Urban and Regional Studies liisa.horelli AT tkk.fi
Douglas Schuler The Public Sphere Project and The Evergreen State College douglas AT publicsphereproject.org

Community Informatics and Improving Health: New Special Issue

Colleagues:

The Journal of Community Informatics has just published its latest issue at

 http://www.ci-journal.net/index.php/ciej. We invite you to review the Table of Contents here and then visit our web site to review articles and items of interest.

Thanks for the continuing interest in our work,

Michael Gurstein, Ph.D.

Editor in Chief: Journal of Community Informatics, Vancouver CANADA Phone 604-602-0624 gurstein at gmail.com

The Journal of Community Informatics

Special Issue: Community Informatics for Improving Health Table of Contents

...

Editorial

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Overview of ICTs and Health

                Lareen Ann Newman

Editorial: Community Informatics for Improving Health

                Michael Gurstein

Articles

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Developing decentralised health information systems in developing countries –cases from Sierra Leone and Kenya

                Edem Kwame Kossi,       Johan Ivar Sæbø,             Jørn Braa,            Mohamed Mumeneeh

Jalloh,   Ayub Manya

Improving community health equity: the potential role for mHealth in Papua New Guinea

                Belinda Jane Loring

Capturing Qualitative Spatial Data to Understand Social Epidemiology in Public Health

                William R Buckingham

Narrating Aboriginality On-Line: Digital Storytelling, Identity and Healing

                Naomi Adelson,                Michelle Olding

Decreasing Health Disparities through Technology: Building a Community Health Website

                Olga Idriss Davis,              Kristen Bean,     Dominica McBride

Bridging the Digital Divide: A Bilingual Interactive Health Kiosk for Communities Affected by Health Disparities

                Kristen Bean,     Olga Davis,          Hector Valdez

‘MYBus’: Young People's Mobile Health, Wellbeing and Digital Inclusion

                Bjorn Nansen,   Kabita Chakraborty,        Lisa Gibbs,           Colin MacDougall,           Frank Vetere

Concussion Information on the Move: The Role of Mobile Technology in Concussion Management

                Osman Hassan Ahmed, Andy J Pulman

With a little help from my friends: experiences of building a virtual community for children with cancer

                Paula Hicks,        Jane B. Grimson,              Owen P. Smith

Impact of Internet on delivery of critical cardiac health care  :

                Sudeepa - Banerjee

A review on mHealth research in developing countries

                Wallace Chigona,              Mphatso Nyemba,          Andile Metfula

Reports

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Socio-technical approach to community health: designing and developing a mobile care data application for home-based healthcare, in South Africa

                Retha de la Harpe,           Hugo Lotriet,      Dalenca Pottas, Mikko Korpela

Perceived Benefits Of Remote Data Capturing In Community Home-Based Care:

The Caregivers’ Perspective

                Nobubele Angel Shozi,  Dalenca Pottas, Nicky Mostert-Phipps

Health Impact Assessment of a UK Digital Health Service

                Sue Heather Wright,       Irfan Ghani,        John Kemm,       Jayne Parry

Points of View

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W(h)ither Community: Locating participatory approaches to ICT-enabled health and development

                Ian Pringle

________________________________________________________________________

The Journal of Community Informatics http://www.ci-journal.net

 

International Workshop on Knowledge Representation for Health Care (KRH4C'13) & Process-oriented Information Systems in Healthcare (ProHealth’13)

Call for Papers

5^th International Workshop on Knowledge Representation for Health Care (KRH4C'13)

+

6^th International Workshop on Process-oriented Information Systems in Healthcare (ProHealth’13)

Organized as One Full Day Workshop

Acronym: KR4HC’13 / ProHealth’13

Murcia, Spain –  June 1^st, 2013

In conjunction with the 14th Conference on
Artificial Intelligence in Medicine (AIME'13)

Web site: ...

Important Dates

Deadline for workshop paper submissions: 8 March 2013
Notification of Acceptance: 9 April 2013
Camera-ready version: 7 May 2013
KR4HC/ProHealth Workshop: 1 June 2013

Workshop Goals

Healthcare organizations are facing the challenge of delivering high quality services to their patients at affordable costs. These challenges become more prominent with the growth in the aging population with chronic diseases and the rise of healthcare costs. High degree of specialization of medical disciplines, huge amounts of medical knowledge and patient data to be consulted in order to provide evidence-based recommendations, and the need for personalized healthcare are prevalent trends in this information-intensive domain. The emerging situation necessitates computer-based support of healthcare process & knowledge management as well as clinical decision-making.

This workshop brings together researchers from two communities who have been addressing these challenges from two different perspectives. The knowledge-representation for healthcare community, which is part of the larger medical informatics community, has been focusing on knowledge representation and reasoning to support knowledge management and clinical decision-making. This community has been developing efficient representations, technologies, and tools for integrating all the important elements that health care providers work with: Electronic Medical Records (EMRs) and healthcare information systems, clinical practice guidelines, and standardized medical vocabularies. The process-oriented information systems in healthcare community, which is part of the larger business process management (BPM) community, has been studying ways to adopt BPM technology in order to provide effective solutions for healthcare process management. BPM technology has been successfully used in other sectors for establishing process-aware enterprise information systems (vs. collections of stand-alone systems for different departments in the organization). Adopting BPM technology in the healthcare sector is starting to address some of the unique characteristics of healthcare processes, including their high degree of flexibility, the integration with EMRs and shared semantics of healthcare domain concepts, and the need for tight cooperation and communication among medical care teams.

This joint workshop brings together two approaches: healthcare process support, as addressed in previous ProHealth workshops, and healthcare knowledge representation as dealt with in previous KR4HC workshops. The workshop shall elaborate both the potential and the limitations of the two approaches for supporting healthcare process & healthcare knowledge management as well as clinical decision-making. It shall further provide a forum wherein challenges, paradigms, and tools for optimized knowledge-based clinical process support can be debated. We want to bring together researchers and practitioners from these different, yet similar fields to improve the understanding of domain specific requirements, methods and theories, tools and techniques, and the gaps between IT support and healthcare processes yet to be closed. This forum also provides an opportunity to explore how the approaches from the two communities could be better integrated.

History of the Joint Workshop 

Providing computer-based support in healthcare is a topic that has been picking up speed for more than two decades. We are witnessing a plethora of different workshops devoted to various topics involving computer applications for healthcare. Our goal has been to try to join forces with other communities in order to learn from each other, advance science, and create a stronger and larger community. In 2012, the two workshops, KR4HC and ProHealth held a joint workshop, which proved to be very successful. This year, we are aiming to continue the collaboration initiative and hold another joint workshop.

The two workshops have quite a long history, as briefly described below.

The first KR4HC workshop, held in conjunction with the 12th Artificial Intelligence in Medicine conference (AIME'09), brought together members of two existing communities: the clinical guidelines and protocols community, who held a line of four workshops (European Workshop on Computerized Guidelines and Protocols (CPG'2000, CPG'2004); AI Techniques in Health Care: Evidence-based Guidelines and Protocols 2006; Computer-based Clinical Guidelines and Protocols 2008) and a related community who held a series of three workshops / special tracks devoted to the formalization, organization, and deployment of procedural knowledge in healthcare (CBMS’07 Special Track on Machine Learning and Management of Health Care Procedural Knowledge 2007; From Medical Knowledge to Global Health Care 2007; Knowledge Management for Health Care Procedures 2008). Since then, two more KR4HC workshops have been held, in conjunction with the ECAI’10 and the AIME’11 conferences.

The first ProHealth workshop took place in the context of the 5th Int’l Conference on Business Process Management (BPM) in 2007. The next three ProHealth Workshops were also held in conjunction with BPM conferences (BPM'08, BPM’09, and BPM’11). The aim of ProHealth has been to bring together researchers from the BPM and the Medical Informatics communities. As the workshop was associated with the BPM conference that had never been attended by researchers from the Medical Informatics community, we had included Medical Informatics researchers as keynote speakers of the workshop, members of the program committee, and to our delight, saw a number of researchers from the Medical Informatics community actively participating in ProHealth workshops. Following the keynote talk given by Manfred Reichert from the BPM community at the Artificial Intelligence in Medicine 2011 (AIME’11) conference, where KR4HC was held, the organizers of ProHealth and KR4HC workshops have shown their interest to hold their workshops in conjunction as part of the BPM'12 conference, which marks a landmark in the collaboration between the two communities. We are continuing the efforts that started four years ago by members of the Software Engineering in Health Care (SEHC) community to strengthen the collaboration between the ProHealth and SEHC communities.

Workshop Theme

Original contributions are sought, regarding the development of theory, techniques, and use cases of Artificial Intelligence and / or process management in the area of healthcare, particularly connected to patient data, clinical guidelines and healthcare processes.

Submitted papers will be evaluated on the basis of significance, originality, technical quality, and exposition. Papers should clearly establish their research contribution and the relation to the goals of the workshop. The scope of the workshop includes, but is not limited to the following areas:

• Process modeling in healthcare
• Computer-interpretable clinical guidelines / protocols and decision support
• Workflow management in healthcare
• Semantic integration of healthcare processes with electronic medical records
• Knowledge representation and ontologies for healthcare processes
• Temporal knowledge representations and exploitation
• Facilitating knowledge-acquisition of healthcare processes
• Visualization, monitoring and mining healthcare processes
• Knowledge extraction from healthcare databases and EPRs
• Knowledge combination, personalization and adaptation of healthcare processes
• Compliance of healthcare processes
• Evaluation of quality and safety of careflow systems
• Managing flexibility and exceptions in healthcare processes
• Process optimization and simulation in healthcare organizations and healthcare networks
• Experiences in deploying knowledge-based tools in healthcare
• Patient empowerment in healthcare
• Linking clinical care and clinical research
• Lifecycle management for healthcare processes
• Context-aware healthcare processes
• Ambient intelligence & smart processes in healthcare
• Mobile process support in healthcare
• Process interoperability & standards in healthcare
• Process-oriented system architectures in healthcare

Format of the Workshop

The 1-day workshop will comprise accepted long and short papers, tool presentations, and 1 keynote. Papers should be submitted in advance and will be reviewed by at least three members of the program committee. An informal proceedings will be available during the workshop. At least one author for each accepted paper should register for the workshop and present the paper. The selected best long (full) papers will be included in the formal proceedings, which are expected to be published as part of the LNAI Springer series, as it was done in all previous editions of the workshop.

Paper Submission

Prospective authors are invited to submit papers for presentation in any of the areas listed above. Only papers in English will be accepted. Three types of submissions are possible: (1) full papers (12 pages long) reporting mature research results, (2) position papers reporting research that may be in preliminary stage not yet been evaluated, and (3) tool reports. Position papers and tool reports should be no longer than 6 pages. Papers must present original research contributions not concurrently submitted elsewhere.
Papers should be submitted in the LNCS format. The title page must contain a short abstract, a classification of the topics covered, preferably using the list of topics above, and an indication of the submission category (regular paper, position paper, or tool report). Papers (in PDF format) should be submitted electronically via the Easychair system ...

Call for Papers: Special issue on Community Informatics for Health - Journal of Community Informatics

Abstract submissions due 14 March 2011

A special issue of the international Journal of Community Informatics (http://ci-journal.net) is going to be devoted to Health. Community Informatics (CI) is the study and the practice of enabling communities with Information and Communications Technologies (ICTs). This special issue will focus on how the social application of ICTs can empower and enable communities towards improving health. The issue is expected to be published in late 2011. The Journal of Community Informatics is a focal point for the communication of research of interest to a global network of academics, community informatics practitioners and national and multi-lateral policy makers.

The field of community informatics seeks to explore the potential of information and communication technologies and their applications for social and economic development efforts at the community level. It particularly seeks to ensure that marginalized individuals and communities can benefit from the opportunities that ICTs can provide. In the area of health, this is all the more important since those with poorer health status and poorer health outcomes are usually those with less (or no) access to ICTs, or are those who have fewer skills to make use of and benefit from ICTs.

For this special issue of the Journal on Health, we are inviting submission of original, unpublished articles. We welcome research articles, along with case studies and notes from the field. All research articles will be double blind peer-reviewed. Insights and analytical perspectives from practitioners and policy makers in the form of notes from the field or case studies are also encouraged - these will not be peer-reviewed.

Please read the full Call for Papers and more specific information on the intended 'flavour' of the issue at: http://www.flinders.edu.au/medicine/sites/southgate/research/projects/digital-tech-health/

Guest editors:

*  Lareen Newman PhD, Southgate Institute for Health Society & Equity, Flinders University - Australia
*  Ali Al Sanousi MD, King Faisal Specialist Hospital & Research Centre, Riyadh - Saudi Arabia

Contact for queries and abstract submissions:  lareen.newman AT flinders.edu.au

IMPORTANT DATES
Deadline for abstracts: 14 March 2011
Notification of successful abstracts:  9 May 2011
Deadline for submission of full papers/articles: 31 August 2011
Estimated publication date: November 2011

----------------------------------------
Dr Lareen Newman, DipEurLangs (Hons), BA (Hons), PhD
Senior Research Fellow
Southgate Institute for Health Society & Equity
Flinders University - Adelaide, South Australia
Personal page: http://www.flinders.edu.au/people/lareen.newman
Program page: http://flinders.edu.au/medicine/sites/southgate/
CRICOS Provider Number: 00114A

Additional link: h2cm in community informatics ....
Jones, P. (2004) The Four Care Domains: Situations Worthy of Research. Conference: Building & Bridging Community Networks: Knowledge, Innovation & Diversity through Communication, Brighton, UK.

c/o HIFA - Publications re. primary health care & community health

Dear [HIFA] friends and colleagues with an interest in primary health care and community health:

Since my last communication with you more than 6 months ago, the entire field of global health has continued to be upended by our US government, with unconscionable effects on millions of people around the world, on advancements in global health research and its ethical foundations, and on the careers of thousands and thousands of people working around the world in the field of global health. As I said before, and I repeat now the obvious, it will take decades to build back what has been destroyed and to regain respect from the rest of the world for the United States and the values that most of us hold dear.

William Foege, eminent global health leader and former Director of the Centers for Disease Control and Prevention wrote this biting editorial <https://www.statnews.com/2025/08/18/rfk-jr-public-health-threats-william-foege-smallpox/> in which he said, among other things, 

"We will live through this drought of values, principles and facts and again apply our talents to improving global health and happiness. Do not back down.”

Atul Gwande, now one of the foremost champions of primary health care and community health of our time (even though he is, like me, an erstwhile surgeon!) and former Director of the USAID Bureau of Global Health during the Biden administration, gave an eloquent presentation of his perspective on the aftermath of the destruction of USAID on 28 April 2025 at the Harvard School of Public Health.

You can watch this here:
<https://www.bing.com/videos/riverview/relatedvideo?q=Atul+Gwande+presentation+at+Harvard+School+of+Public+Health+April+28%2c+2025&mid=26DA144398CF1F613D0A26DA144398CF1F613D0A&FORM=VIRE>.

Here are a few items of possible interest:

The Fourth International Symposium on CHWs will be held virtually next week.

I was most fortunate to be able to attend the second International Conference on Primary Health Care was held in Addis Ababa, Ethiopia, from October 6-10. It was a glorious event, with 750 attendees, mostly from Africa but with strong representation from UNICEF, WHO, Africa CDC, and other international organizations. 

The conference was sponsored by the International Institute for Primary Health Care – Ethiopia. <https://iphce.org/> Directors of PHC from 45 different African countries were present along with at least 50 community health workers from across Africa. There was palpable enthusiasm for the growing momentum for PHC across Africa.

Abhay and Rani Bang are world-renowned champions of community-based primary health care through their work with SEARCH <https://www.searchforhealth.ngo/> (Society for Education, Action, and Research) in Gadchiroli, India, with tribal people. Their seminal publications on the effectiveness of community-based primary health care and community health workers as well as their contributions to India’s national program for reducing neonatal mortality through home-based neonatal care, among others, have gained for them global recognition. Attached is an English translation of an article about their life’s work that was published in April Der Spiegel in the leading German magazine, Der Spiegel.

Nicholas Kristof has continued to share with the world some of the heart wrenching effects of the collapse of the United States Agency for International Development. The New York Times opinion columnist wrote <https://www.nytimes.com/2025/09/20/opinion/trump-usaid-cuts.html> on 20 September 2025 on the human dimension of the shutdown of USAID, citing estimates that 690,000 will die in 2025 and 829,00 will die in 2026 as a result of cutbacks in USAID funding, and 3.1 million children will die during Trump’s second term from these cuts (a PDF is attached if the link doesn’t work for you [mod: HIFA does not carry attachments]).

Two recent publications on novel approaches to reducing child mortality have gained widespread attention.

One study <https://www.nber.org/system/files/working_papers/w34152/w34152.pdf> in Kenya provided a one-time transfer of $1,000 to poor families and observed a decline of nearly half in under-5 mortality as well as in infant mortality. Another study reported that wrapping

A recently reported study <https://pmc.ncbi.nlm.nih.gov/articles/PMC12462887/> from Uganda found that giving mothers fabric treated with permethrin, a long-acting insecticide to protect against mosquito-born illnesses, as a baby wrap dramatically reduced malaria infections in the infants carried in them. There were 66 percent fewer cases among those children compared with babies in the untreated wraps. By the end of the six-month study, only 16 percent of children in the treated wrap group had been sick with malaria, compared with 34 percent in the untreated wrap group, many of whom had multiple malaria episodes.

Now available for purchase on Amazon.com are several important publications related to community-based primary health care and community workers.

Feel free to share this email and these resources with anyone else or with any relevant listserve you may have access to.

You are receiving this email because of your interest in primary health care and community health.

If you know of anyone that you think would like to be included in the listserv, just send me the person’s name and email address.

Warm regards, Henry

Henry B. Perry, MD, PhD, MPH Senior Associate, Health Systems Program Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore, MD, USA 21205 Hperry2 AT jhu.edu

HIFA profile: Henry Perry is a Senior Scientist at the Johns Hopkins Bloomberg School of Public Health, USA. Professional interests: Community health and primary health care. hperry2 AT jhu.edu

Datasets: an organisational province?

For over twenty years I have been fascinated by data visualization and yet this remains by and large the preserve of scientists, with many social scientists still to identify the potential applications and benefits let alone reel them in. It isn't that social science can't call upon large volumes of data it can and does. It is having the appropriate forms of representation and display that are sympathetic to people actually working in those fields dominated by the humanities. This is not the only difficulty...

Recently on a community informatics list someone asked about their particular project that includes social inclusion within a community and the availability and sources of data - especially datasets. The brief dialogue that ensued set me to wonder about some new (for me) and recurring questions in informatics:

• the definition of informatics;
• the interdisciplinary and transdisciplinary boundaries of informatics disciplines;
• how these disciplines relate to each other;
• the range of datasets in terms of formal (statutory) and informal - community driven datasets;
• what names (if any?) do we give to these datasets and how do they relate to each other?

Although the purposes may be informal - the datasets required are usually formal. Local statistics (UK) has an informal air about it, but this is data from the people, collected by the centre, produced by the centre, used by the centre and available (in anonymised form) for everyone. Public health observatories, councils and related agencies are making local data perspectives and resources available as per:

• Health Profiles

As communities seek to engage in the political process they will need access to data (information and knowledge) to effect analysis - synthesis and change. How groups can find or generate this data is a key consideration. This may prompt and is no doubt prompting the creation of mashups, combining what are usually disparate formal data in new ways. Given the 'politics of data' which includes:

• personal sensitivity
• legal aspects and duties
• confidentiality
• security
• anonymisation
• ...

- it is easy to see how dataset players tend to be 'organisations' (I am excluding the emerging 3rd sector players here - but this may be a (big) mistake?). How then can community groups generate data(sets) that can help inform and solve their local problems?

Using the (UK)patient and public involvement (PPI) program as an example, a key part of this important initiative is that statutory health care providers (and commissioners) must ensure there are adequate resources to support PPI in and across the community.

What then of community, urban, mobile health and other forms of informatics? There may be a lot of data washing about in the cyber-community. This may however, be out of reach for those who need the political and evidence-based leverage to be gained from parochial* datasets?

Additional links:

Free Our Data (UK)

W3C SWEO Community Project: Linking Open Data

Acknowledgement: Community Informatics list, Andrew R. Clark, and Brian Beaton (K-net.ca).

*parochial - used in the local sense.

Source: by Peter Jones, Welcome to the QUAD 2009

Human Ecology: Northern England CHE Group - Sedbergh 30 June

As mentioned previously the 2nd Northern England Centre for Human Ecology group meeting was held in Sedbergh last month Saturday 30th 11-3pm.


In addition to hosting the meeting the local organiser(s) also arranges the content for the session - with outside support if necessary. This time Deyna and Criggy took up the baton.

To begin, Criggy shared her work working in rural communities. Referring to my notes many topics were discussed including: community halls as a focus of the community. Raising the profile of sustainable communities, transport in a rural vs urban context and climate change.


Although we were not a legion the diverse experience represented that afternoon showed in knowledge of organisations, e.g. the work of the Commission for Rural Communities and publications - 'What are sustainable rural communities? - 5 Thinkpieces'.

We discussed the car and private transport, the state of public transport, housing, community engagement, belongingness and parish plans. Also in our minds were the extremes of community in terms of age groups, those commuting and second home owners, 'active' and 'passive' community members.

Next: AGENDA 21 and the need to empower civil society locally and globally.

Criggy highlighted and explained the CRC's work on Rural Disadvantage, especially the overlap of:

• Access poverty
• Network poverty
• Financial poverty

The Rural Community Carbon Network and the number of communities that are driving forward with the sustainable agenda not just with words but deeds towards carbon neutrality.

Personalities in this field also featured notably Rob Hopkins. Finally, at least by my notes "Sustainable Communities Plans" were discussed.

Next, Deyna presented her work (I've copied her notes below) on Green Sedbergh covering:

PROJECTS:

Book town and the regeneration after foot-and-mouth
Green Marquee - raising awareness of environmental issues
Green Tourism initiatives - cycle map/local access leaflet / outdoor festival
Peoples Hall - green refurbishment / rebuild
Plastic bag reduction / replacement
Community cinema - social events
Local sustainability - range of shops /local produce
Farmers market
Sedburgh School - local employment
Hydro-electric scheme?
Re-opening of reservior?

ISSUES:

Low wages / High cost of housing / 2nd home syndrome
Rural location / Public transport
2 car families / middle class values
YDNPA national park
Apathy / smugness / commitment

Deyna then sought the groups ASSISTANCE regarding:

Green Parish plan - How? What? Timescale? Cost?
Alternatives to plastic bags?
Implementation incentives - socio-economic?
Balance of individual / community / business needs
Other sustainable / green possibilities

The time really whizzed by, to the extent that my tea went cold (a crime in these circles!) and we only had a break for lunch around 2pm.

The next meeting will be end of Sept-Oct time and may be near Horwich, Bolton. I'll post more details as soon as they are available. Sedbergh is a lovely book town (I bought two second hand) and I really enjoyed meeting CHE students and alumni old and new and as an outsider learning more about human ecology.

Andy also reminded me about the CHE ecopsychology course.

New WHO Quality Toolkit - 'Take ii"

Further to last months post, I've worried at times about the axes of Hodges' model and their status and function. Can I let the axis stand for itself?

INDIVIDUAL

|

|

|

GROUP

Do I expand (explode) the conceptual labels?

self - INDIVIDUAL - person

|

|

|

relationship - family - GROUP - community - population

There seems to be an asymmetry, when you traverse the axis - and its horizontal counterpart; from wherever you start. Perhaps, I worry too much as if the axis was regular then the generic property of the model overall would be diminished. Is this an axis at all?

The website for the Quality Toolkit at: https://qualityhealthservices.who.int/quality-toolkit

- explains the toolkit's scope that includes:

"This new online resource is a user-friendly toolkit to support action on improving the quality of health services at every level of the health system, from national and district to facility and community levels."

I have only scratched the surface here and hope to revisit again - in more detail. Please see below for reflections on the levels by which the toolkit can support action to improve the quality of health services. I have tried to suggest proximity and distance between the SOCIOLOGICAL and POLITICAL (policy). Perhaps, what is a 'clinic' has a name, that it is known by - a key part of the community. The community is closer to the people - to the would-be users of the facility. You can appreciate(?) here the challenge of getting the local community involved in their services. What is 'NATIONAL' should not be remote. Can people compare and contrast with what they are offered? 

 

On the website I note there are video presentations also. The prospect of regular updates for the toolkit is also welcome.

INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

psychological access 'My' clinic Trust, I feel safe) (feeling safe) Tell others - my experience..	physical access clinic (appearance, facilities, safety) controlled environment (cleanliness, sterile.., or more social)
'the centre' COMMUNITY DISTRICT national	facility (policy translation / coherence?) community district NATIONAL

Original source: Jules Storr, Independent Consultant, S3 Global & working with WHO as part of the Quality Toolkit development team - via HIFA

Previously: New WHO Quality Toolkit

'Take II'? Quality means getting it right first time (even as you persist in what you are doing - your aspirations and quality improvement). Vitally, this means you, the team make a positive impression for the person, the individual, client .. carer, group. 

If they need to - they will recognise their own ability, knowledge, follow advice, they will come back, they leave not to return soon as they can now self-care and care for others in their home, community ...

 Please note: This post and that previous is not intended to denote endorsement of Hodges' model.

 

Gateways: International Journal of Community Research and Engagement

Dear Readers,

Gateways: International Journal of Community Research and Engagement is delighted to announce the publication of its latest issue at https://epress.lib.uts.edu.au/journals/index.php/ijcre. We invite you to review the Table of Contents here and then visit our website to review articles and items of interest.

Thanks for the continuing interest in our work,

Margaret Malone
Managing Editor, Gateways
Margaret.Malone AT uts.edu.au

Gateways: International Journal of Community Research and Engagement
Vol 9, No 1 (2016)
Table of Contents
https://epress.lib.uts.edu.au/journals/index.php/ijcre/issue/view/397

Research articles (Refereed)

The journey and destination need to be intentional: Perceptions of success in community-academic research partnerships (1–21)
Robin Lindquist-Grantz, Lisa M Vaughn

Two steps forward, one step back: Achievements and limitations of university-community partnerships in addressing neighbourhood socioeconomic disadvantage (22–40)
Deborah Warr, Richard Williams

Caught up in power: Exploring discursive frictions in community research (41–57)
Cindy Hanson, Adeyemi Ogunade

Supporting communities of practice: A reflection on the benefits and challenges facing communities of practice for research and engagement in nursing (58–73)
Maretha De Waal, Oumiki Khumisi

'Culture' as HIV prevention: Indigenous youth speak up! (74–88)
Ciann Wilson, Vanessa Oliver, Sarah Flicker, Native Youth Sexual Health Network, Tracey Prentice, Randy Jackson, June Larkin, Jean-Paul Restoule, Claudia Mitchell

Engaging youth in post-disaster research: Lessons learned from a creative methods approach (89–112)
Lori Peek, Jennifer Tobin-Gurley, Robin S Cox, Leila Scannell, Sarah Fletcher, Cheryl Heykoop

Impact of international humanitarian service-learning on emerging adult social competence: A mixed-methods evaluation (113–131)
Paul Schvaneveldt, Todd Spencer

Practice-based articles (Non-refereed)

Unusual conversations: A reflection on the mechanics of internationally engaged public scholarship (132–144)
Jonathan Damiani

Fundamental researcher attributes: Reflections on ways to facilitate participation in Community Psychology doctoral dissertation research (145–158)
Renato M Liboro, Robb Travers

Innovating for skills enhancement in agricultural sciences in Africa: The centrality of field attachment programs (159–171)
Anthony Egeru, Paul Nampala, Henry Massa-Makuma, Moses Osiru, Adipala Ekwamu

Mobilizing Minds: Integrated knowledge translation and youth engagement in the development of mental health information resources (172–185)
Christine A Garinger, Kristin A Reynolds, John R Walker, Emma Firsten-Kaufman, Alicia S Raimundo, Pauline C Fogarty, Mark W Leonhart, Mobilizing Minds Research Group
________________________________________________________________________
Paul Ashton, Marilyn Krogh, Margaret Malone, Phil Nyden and Pauline O'Loughlin
Editorial Committee Gateways

My source c/o Margaret Malone via LIVINGKNOWLEDGE-L AT LISTS.UCC.IE

Careif report: The Health Needs of the Indo-Caribbean Community in the United Kingdom

'The Indo-Caribbean community has played a key part in the life of the United Kingdom, but this has not often been recognised. Little is known about this populations’ physical and mental health needs and its experience of health and social services in the UK.

This report, The Health Needs of the Indo-Caribbean Community in the United Kingdom, examines the history of the Indo-Caribbean community in the UK, the prevalence of mental health conditions among the community, barriers to accessing mental health services, and the existing services available.'



Includes:

"The absence of a unique category designating ‘Indo-Caribbean’ as a unique category in the UK Census was identified as a major barrier to obtaining vital epidemiological data on the UK’s Indo-Caribbean population."

Above text:
https://www.careif.org/news-and-events/2025-10-9-careif-report-the-health-needs-of-the-indo-caribbean-community-in-the-united-kingdom

n.b. 
In my community mental health nursing career in Chorley, Preston, and West Lancashire as services were established, the diversity of the local populations was evident, but there was an assumption that many communities were essentially 'closed': one explanation for lack of referrals from specific racialised communities - was that some communities 'looked-after their own'.

Of course this can be racism (acute or subtle), an excuse for inaction, delayed response, lack of action - outreach and translation services. There were marked examples of intervention. I have seen first-hnad interpreting and translation services in action since full-time retirement and the services offered are amazing for the insights and care delivery they can facilitate. Is this why we also need mental health nurses and the team? To translate in challenging circumstances, even by being there, seeking avenues, giving time - especially in instances of psychoses and doing so safely (for all)?

In addition to the main body of Careif's report and its recommendations, it may be helpful to consider the report's key terms relating them to the domains of Hodges' model? I also note reference to the bio-medical model as an explanatory framework. A conference abstract has been submitted today for April 2026, highlighting the need for bio-psycho-socio-political model / framework (Hodges' model - of course?).

See also:

RCN North West Multicultural Group

iv RCGP’s 7th Health and Justice Summit ...

I've been working through notes, photographs and the summit programme hence the flip-flopping between days.

So, back to day one:

Megan Georgiou, Jem Jethwa and Dave Banks, Programme Manager for Royal College of Psychiatrists, Project Officer at Royal College of Psychiatrists and Lead Nurse for the Intensive Support Unit at HMP Durham and Tees, Esk and Wear Valleys NHS Foundation Trust
“Transforming the Care Programme Approach in Prisons”

The Care Programme Approach (CPA) has a history of being poorly implemented within a prison setting. The Quality Network for Prison Mental Health Services and Tees, Esk and Wear Foundation Trust have teamed up to review the process and develop new tools and guidance. The purpose of the workstream is to improve service delivery and patient care. The workshop will summarise the findings from the consultation event and present our work to date.

Late again and frustrated since as a former CPA Lead this subject is close to my heart. It is not a sacred cow, although the learning and values that it helps carry must be carried forward.

I got the immediate impression of a methodology being presented and sure enough we practised too:

Go M.A.D. Thinking ® Results Framework

Part of the approach includes the 10 possibility thinking areas as per the photo.



[There's an additional exercise that reveals the ability of Hodges' model to help prioritise, contextualise (or decontextualise) and assign the 10 areas.]

Dr Alex Acosta-Armas & Ms Sarah Hill, Consultant Forensic Psychiatrist & Service Manager for  North London Forensic Service presented “Forensic Learning Disability Pathways, from prison to the community: Less restrictive practices in secure care and the development of a specialist community forensic LD service”.

Pathways of care for people with learning disabilities, from prison with the establishment of assessment and detection services, followed by secure inpatient care, focussed on introducing less restrictive practice interventions. Development of a community forensic learning disability service aimed to facilitate transition into the community and to support community services.

Brian E Hodges who created Hodges' model was a Learning Disability Nurse and Tutor and designed the model with this population in mind.

I was not ideally placed for photos, but would encourage readers interested in Forensic Learning Disability Pathway to seek out the slides. There was a local history from 1997, improving quality, stating the case for a Community Forensic LD Team, eligibility criteria (referrals), progress since April 2019 and training delivered to date. This was informative relating autistic spectrum disorder, training for staff, assessment within prison and in-patient settings, attention deficit hyperactivity disorder,risk concerns - sexual offending, arson, stalking and FTAC - Fixated Threat Assessment Centres.

Whenever I see a slide, paper ... titled "New Model of care" my heart skips a beat. This model was CHOICES. I will try and obtain more information. 

Robert McEntree - Defining trauma

A workshop was presented by Michelle Osborne & Robert McEntree, Ward Manger & Staff Nurse for Arnold Lodge on “Trauma Informed Care in Forensic Health Care: Male Mental Illness”

How the admission ward of a Medium Secure Forensic Mental Health Unit in Leicester is introducing a framework for Trauma Informed Care.

There is frequent use of 'lenses' as a metaphor and this workshop was helpful as to me it presented 'trauma' as another lens, a potentially constructive metaphor upon an emotional - lived reality (with varying degrees of recall). Robert defined trauma with references and some texts:

The Polyvagal Theory, Stephen W. Porges:
https://www.stephenporges.com/books

The Body Bears The Burden, Robert Scaer:
https://www.routledge.com/The-Body-Bears-the-Burden-Trauma-Dissociation-and-Disease-3rd-Edition/Scaer/p/book/9780415641524

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma Book, Bessel van der Kolk:
https://www.penguin.co.uk/books/259/259420/the-body-keeps-the-score/9780141978611.html

Despite trauma's acuity (obviousness?) the slides were very informative:

What we talk about when we talk about "Trauma"

• Pervasive
• Impactful
• Effects the most vulnerable in society
• Self perpetuating
• Negates potentially supportive relationships

Five core values of Trauma Informed Care and Environments

Safety  Trust  Collaboration  Choice  Empowerment

Barnett Brown, V., Harris, M., and Fallot, R. (2013) Moving toward Trauma-Informed Practice in Addiction Treatment: A Collaborative Model of Agency Assessment, Journal of Psychoactive Drugs, 45:5, 386-393, DOI: 10.1080/02791072.2013.844381

Fallot, R.D. and Harris, M. 2009. Creating Cultures of Trauma-Informed Care: A Self-Assessment and Planning Protocol, Washington, DC: Community Connections. [Google Scholar]

See also:

Becoming Trauma Informed:
https://www.mappingthemaze.org.uk/wp/wp-content/uploads/2017/08/Covington-Trauma-toolkit.pdf

In post iii I made (rather) a lot of 'transitions' and two major examples include veterans returning to civilian life and prisoners on release. The frequency of 'transition' was even raised at the summit. For example, if prisoners are recruited to a health programme and are then released that will be 'lost' so interventions are kept short for that reason. Alternately, reflecting cold reality there is acceptance in being able to re-enrol should someone arrive in custody once again.

Before closing remarks and thanks the summit's sessions ended with news of a transition:

Kate Morrissey, National Programme Manager - Mental Health, Implementation Lead for RECONNECT on:

 “RECONNECT – Care After Custody” 

When I referred to the obviousness of trauma above, of course so often to the observer psychic trauma is not obvious. Is this why transition to stability, coping, staying well, recovery is so hard won? Is this why in housing, welfare and benefits so often the lens cycles through what is 'seen' resulting in doubt, denial and neglect?

These four posts reflect the main sessions and workshops I opted to attend. The summit's focus also included Women in prison, Transgender pathways and Children’s services.

Many thanks to Convenzis and other organisers, sponsors and supporters:
Great values, learning and job.

20th anniversary special issue of The Journal of Community Informatics

Dear CI (Community Informatics) colleagues,

I am thrilled to announce that Peter Johnson and I just published the 20th anniversary special issue of  

The Journal of Community Informatics:

As we explain in our editorial, the first issue of The Journal of Community Informatics was published by Michael Gurstein on October 1, 2004. Since then the journal has continued to remain the open access peer reviewed journal featuring contributions at the intersection of community informatics research, practice, and policy.  We are excited to feature nine essays in this special issue from many of the leaders in our field.

We invite you to read the full special issue in its entirety here:

https://openjournals.uwaterloo.ca/index.php/JoCI/issue/view/661?

Cheers!

Colin

---

Colin Rhinesmith, Ph.D. (he/him)

Founder and Director, Digital Equity Research Center

Metropolitan New York Library Council

https://dercenter.org

------------------------

Listed in the blog's bibliography:

Jones, P. (2012). Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model. The Journal Of Community Informatics. 8(3). Available at: https://openjournals.uwaterloo.ca/index.php/JoCI/article/view/3034

JoCI's special issue: Michael Gurstein: a tribute

Dear CI-ers,

It's been truly inspiring to read all of your comments on the other threads on this listserv. Michael has left an amazing legacy, and in order to keep spreading his knowledge and memory, the Journal of Community Informatics (JoCI) is preparing a special issue in his honor: "Michael Gurstein: a tribute." We will be accepting a variety of different submissions. Please help us spread the CFP (attached and in the following) and please don't hesitate to ask us any questions.

Best,

Eduardo Villanueva-Mansilla, Editor-in-Chief. 

Susan O’Donnell, Brian Beaton, Shaun Pather, David Nemer, Associate Editors.

-----

Michael Gurstein: a tribute

Open call for an extraordinary issue honoring our friend, colleague, and founding editor

The global network of Community Informatics scholars and practitioners would like to celebrate the life and contributions of the founding Editor of this journal, Michael Gurstein, who left us on October 8, 2017. Michael led the Journal for almost 12 years, from idea to inception. As a consequence of his effort, the Journal has become a respected forum for exchanging ideas, experiences and knowledge around the theory and practice of Community Informatics globally.

When he left the Journal’s regular editorial management, Michael became Editor Emeritus and continued to take a strong interest in the sustainability of the Journal. The current editorial team strives to continue the work that Michael defined so eloquently in the past decade. JoCI remains committed to these defining principles, as a Journal that serves to advance both scholarship and practice for all those involved in the many aspects of Community Informatics. This includes, inter-alia, academics, practitioners, decision-makers, activists, at all levels of involvement, and from all over the world. The legacy of JoCI is also Michael’s legacy, and we are proud to be following in his steps.

To express our gratitude for this legacy and as a tribute to his work, the Journal is inviting three types of contributions for this special non-sequential issue:

• Short contributions: These should be approximately 300 words, of a personal nature, remembering Michael, sharing aspects of his life and / or the experience of working with him;
• Longer contributions: These should be approximately 1000 words, and comprise comments on his work. This may include any aspect of his writing on Community Informatics, communities, the Internet and social justice.
• Photographic contributions: These should be accompanied by a short text (max 200 words) and comprise of an album of selected photos featuring Michael and his life and work.

The extraordinary issue is primarily an opportunity to share and reflect on our friend, mentor and colleague. As such the editorial team will review the contributions with minimal assessment and no requirements of specific standards. If you wish to contribute a full-length article, which may also be construed as a tribute to Michael, please submit it to a regular issue to guarantee the normal academic or professional recognition deserved.

Submission process

Please submit your contribution to the Journal following the regular process but selecting “POV-Gurstein issue” as “section” of the Journal (POV = point of view). You must follow the regular submission process of the Journal to facilitate indexing and referencing. The submission may be in a simple format, with just title and author(s), an email address if so willing; and in doc, docx or odt format for text or jpg for photos or mp4 for video. The Journal will convert the written contributions into a PDF file and will publish as the submissions arrive and are approved by the editorial team.

We are planning for the initial publication to be available at the end of October 2017, and will continue accepting contributions at least till March 2018.

If you have any questions or comments, please write to evillan AT gmail.com.

Thanks for your interest in this publication, please share this call widely so that it will reach all Michael’s extensive network of colleagues. 

The Editorial Team, The Journal of Community Informatics

Eduardo Villanueva-Mansilla, Editor-in-Chief.

Susan O’Donnell, Brian Beaton, Shaun Pather, David Nemer, Associate Editors. 

David Nemer, PhD
Assistant Professor

School of Information Science

University of Kentucky

http://dnemer.com

Check out "Favela Digital: The other side of technology" - http://favela-digital.com

Nursing management consultants & being optically challenged

Being somewhat optically challenged at present (need new glasses!) I have nonetheless managed to sort some old papers. I came across a more recent news item from the Nursing Times 8 September, p.3 by Sally Gainsbury. What use is late news?

I raise this now because public sector health finance provides the impetus, so this subject is perpetual motion. It is also reported ongoing by HSJ. I refer to this not to take sides, but to acknowledge that politically there is a need to make decisions and find the required £20bn efficiency savings. The news line reads:

DH told 1,500 district nurses could go with no damage to patient care

The item focuses on a report for the DoH produced by McKinsey management consultants. The government has distanced itself from the reports recommendations, but the need for action remains. The Nursing Times news item includes two clocks (with the total nursing time available depicted as 1 hour) that break down the time spent on patients on general medical wards and community wards. While this is just one aspect of a report of more than 100 pages, the findings are of great interest. ...

GENERAL WARD: 15 mins Physical care; 10 mins Psychosocial care; 35 mins non-patient care.
COMMUNITY NURSES: 17 mins Antenatal activities; 13 mins Postnatal; 27 mins npc; 3 mins other and classes.
I have not worked on a general or mental health ward for a long time, but I was surprised to see the time spent on patient being less on the wards than the community - 25 minutes v. 30 minutes. There are challenges in comparing different clinical areas, but I would have thought travel, administration - including paper and e-record data entry would impinge much more on community. On mental health wards there has been an effort to free nurses to nurse - with protected time? So pause for thought there - but only for a moment....

Thinking about community - providers will no doubt vary in the way (district) nursing teams are organized, the location of their bases and how that impacts average journey times. Districts also vary in the way the population is distributed, especially those neighbourhoods were social and economic deprivation is higher and need may be increased.

This is why access to GIS (geographical information systems) by team managers and members is crucial and should not just be some esoteric academic and intelligence artifact. While we should not under estimate the potential use of GIS to inform inpatient care, it is community services that are best placed to benefit from improved intelligence, planning and decisions.

There is a long thread here and the politicians of all parties know it leads into the forest ....

For example, much can be read in a single word "... McKinsey found that only 15 minutes was on the "physical care" of patients while the remaining 10 minutes went on "psychosocial" care, such as talking to patients." I hope that 'only' does not suggest that talking to patients is 2nd best, even though basic nursing care is the factor in the news regarding public perception of the quality of nursing care. This is a constant problem as we move to outcomes. Are we going to have patients saying - "The physical care was excellent, but I felt like I was in a religious retreat. Nobody hardly spoke, explained anything." Patient education, self care, staying well, the effective use of medication and treatment ... is predicated on psychosocial engagement.

What is also very troubling is that cost savings might mean detrimental changes in the skill-mix; the ratio of qualified to health care assistant staff. Some of the best 'natural' nurses I have worked with and work with today are dedicated HCAs. They have a major role and contribution to make, but if safety gains are to be maintained and improved upon then 'safe' skill-mix is critical.

Given the present demographic, 'nurses' are not new to cuts. In the public sector cuts are part of that perpetual motion I mentioned at the start. What frustrates is working on the holistic care mosaic to produce something that is safe, effective, quality care; then as we come to finally add the threads - clinical supervision, PDP, health IT, outcome measures, public engagement we have to unravel and start again.

Image source used with permission and thanks: D L Ennis. Visual Thoughts http://dlennis.wordpress.com/