Book review: "The Power of the 2 x 2 Matrix" iv

Yes, it is a literal reading but if I didn't 'see' Lowy and Hood's discussion of "The team goes to work" (p.74) with symptoms identification and "Listen, listen, listen" (p.75) I'd miss a trick.

In healthcare the team really matters; in mental health care (especially) it is a professional and therapeutic* ... duty to listen; symptoms are not enough, we must seek signs too; what goes unspoken? A 2x2 matrix once created and agreed can also help identify positive and negative symptoms, in healthcare we differentiate this in several ways. The individual whether psychosis or cancer; and the group (socially and politically) through the impact of constraints and opportunities. There's a 'Health Magazine Marketplace Matrix' (p.76).

Strategy is central with tactical and operational factors in business and commerce and chapter 6 deals with strategic frameworks. The chapter starts: 

"Strategy is the art and science of competing more effectively than one's competitors." (p.91).

Below are two of the matrices described which I've placed within Hodges' model. Nursing is all about seeking, testing, trying, accepting, parking and respecting unexploited opportunities, not only 'in' the intra- interpersonal domain, but the other domains too. I will let you reflect upon the commodification of health and 'end of life'. 

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

Beyond Customer Led Matrix p.96.	Discontinuity and Life Cycle Matrix p.101

The social and political domains are obviously well represented throughout the book: value, customer, prosumer, civics and much more. An example is the Librarian Scenario Matrix which comprises of the dimensions - Locus of Concern  and Social Contract (p.119).

There's mention of architecture in the book which in a business context is understandable. I can not find where I read it but recently the addition of 'architecture' as in 'care architecture' represents a misuse? This is not architecture. This book and Hodges' model makes concepts the bricks, mortar, spans and splines of architecture. 

 

There is much more I could draw out. The Johari Window, individual frameworks - in which the quadrant's significance (size) varies, Myers-Briggs. In addition to a couple of references with the chapters, a notes section provides a full-list. The index is thorough and there are copyright notices for the many tables and figures.

A great book - just lacking one-other model, but I would say that!

Here are the previous posts:

Q. What is Hodges' model? A. It is NOT a 2x2 matrix

Book review: "The Power of the 2 x 2 Matrix" i

 
Book review: "The Power of the 2 x 2 Matrix" ii

Book review: "The Power of the 2 x 2 Matrix" iii

'Proof' of the Four Quadrants

Alex Lowy, Phil Hood (2004) The Power of the 2 x 2 Matrix: Using 2 x 2 Thinking to Solve Business Problems and Make Better Decisions, San Francisco, CA: Jossey-Bass. ISBN: 978-1-118-00879-9

With many thanks to the publisher for my review copy.

 *All effective carers (formal and informal) are 'good listeners' and not just 'good listeners' they respect what is said and if presented with it: a silence.

Book: The Ungrateful Refugee

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

listen to me "Why do we  listen to refugees in one way ...	The Ungrateful Refugee
	... and  Harvard Business School  students in another?" listen to us

"Anyone with a boss knows the basics: lock eyes, shake hands firmly, under-promise, over-deliver, repeat. At HBS, we picked up other ways to affect the need-potential calculus: when pitching something, dismantle scepticism by arguing against yourself. If a narrative lacks complexity, put it into an intellectually satisfying framework. And so on.
The most important signal is this: you don't need them - they need you. Your value lies in the vastness of your potential, walk into every room potential first." p.24.

My source:
Nayeri, D. (2020) How to be believed, FT Weekend, Magazine, 7-8 March, pp.24-27.

Listening and Seeing: The Next Generation

On the latest Sky At Night Sir Patrick Moore brought the most welcome news that Jodrell Bank is not to close due to a recent science funding cock-up. This is a great relief as in addition to seeing - we need to listen too. The Hubble Space Telescope will have its final servicing mission in August.

This will prolong the life of Hubble a true wonder with the images it has sent home to Earth and a fitting last flight for Space Shuttle Atlantis.

As we look forward even further to the Next Generation Telescope now called the James Webb Space Telescope astronomy is not only cool but it's hot and heavy too. Here is a discipline that ensures it samples all the available data streams open to it in order to test, verify, learn and progress. Out on the leading edge of astronomical data windows such as gravity waves, it is a case of discovering just how to listen and see. Diagnostic medicine benefits enormously from existing and new ways to investigate anatomy, physiology and pathological processes.

Astronomers need dishes the size of Jodrell Bank and bigger - such as Arecibo and arrays. People come equipped with telescopes and dishes of their own. As multidisciplinary (multi-eared) research teams develop proposals to take advantage of major initiatives such as the Towards Next-Generation Healthcare programme, let's hope the young stars are able to listen to and connect with the older stars.

(Original links removed.)

In order to listen... 4 holistic care...

As we 'listen' to patients, carers and others in need of care - verbally and non-verbally - we need for safety's sake to be aware of our starting point and where we are heading. Even if only roughly, amid raw emotions, pain, confusion, fear and hope - that next step must be a safe one.

Is there a logic to the steps being taken? There may not be. Sometimes it is listening and being there. There may not be a clear destination, but how will we know when we have arrived at that point in-between? If the way becomes unclear, what signs do we read that might point to the need for an extra hand on the tiller?

Do we have the tools to remain oriented? Is there a compass-4-care? A re-source to map the journey we are both being taken upon?

If listening is but a part of holistic care, is there a tool we can utilise to integrate these many and yet unique journeys?


Source - title:
Alicea-Planas, J. (2015). Listening to the Narratives of Our Patients as Part of Holistic Nursing Care. Journal of Holistic Nursing, Volume XX, Number X, XXXX. doi:10.1177/0898010115591396

Reading and writing the minutia of locked doors and windows (still a draught)

Couples, married or not, partners are the cards that frequently, if not by definition, lean on each other beyond the pale, to the n-th degree. Witness so many lessons of what love really is.

They bend and flex. Tested by history, timelines entwined, ties-that-bind, trying to persist in the hear and how.

Their psychological union is challenged as memories become eroded and physically frailty takes hold. Usually; mostly, on the one.

Eventually things, established relationships break and one or the other - should we say: finds themselves in - residential care.

Courtship enables us to become socialised to and with each other and respective families and in some instances other cultures and beliefs.

In this crucial transition sometimes there is learning through experience as respite care is sought.

In other cases health services wonder how this relationship has survived for so long. A crisis is a precipice for change. A chaotic invitation. Radical.

A sudden shift from what was home to a new world of corridors, r, ro, roo, room, rooms; my room? New noises and smells and altered routines and jumbled faces, touches, days and nights

The dolls of childhood are left behind, but may be picked up again literally as an emotional comforter. If not this then perhaps a ‘paper clad dol’ that is bound to be - ‘deprivation of liberty’.

In this new home, this person walks the corridor and inspects the minutia of the doors and windows. Staff pass by(e) waving by their walk - "so-busy-look-no-hands" while trying to be butterflies.

Butterflies that cannot say which way is ‘out’.

They are they. Difficult to follow with eye, head and a hand to catch. The individual recognises the whole of the comings and goings, the main thoroughfare. The strategic point, the nexus of comings and goings.

Something's not right though! I need to be somewhere else.

Sadly (or Usually), there is no going back.

Is there a pattern to this confused-coming-to-terms-with?

From asking repeatedly about being elsewhere, especially with the setting of the sun is there a shift in attempted reasoning? So correct, so responsible all those decades ago. Perhaps even months ago...

If no one will listen to me then perhaps if I have my wife/husband with me then they will see the importance of my cause, my mission.

See look - I have my wife, husband, partner with me now: we really need to go!

Can the residential care home support this person? Can they meet their care needs? They say they are ‘struggling’. Will they need to move – again?

How do they work through this transition? What do we know of how individuals negotiate this transition in their lives? How can we try to understand?

How do they make sense of what has happened, and where they now find themselves? Will their level of distress, agitation gradually extinguish as with their efforts to leave?

As they look to the windows, seek to traverse the doorway, cross the foreign threshold and venture to that somewhere that is not here, we know one thing.

Person centredness lies in the minutia of the life once lived through those locked doors and windows.

We can ‘open’ the doors and windows by travelling with them, together, sharing that journey, the sense of those times and upon returning help them adjust to this new listen and how. Clearly, deprivation of liberty is not a punishment here, yet it demands compensation by provision of high quality personalised care.

Nursing attitudes [towards patients ( and self { and ? } ) ]

In the past half-year there have been two discussions, that concern the nurse's attitude towards patients.

One was held on the nursing philosophy list in February:

https://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=NURSE-PHILOSOPHY

"The patient is always right"

The other in May was on the mental health in higher education list:

https://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=MHHE

"Insufferable' or 'Suffering' - a response"

Both provoked a similar response and debate. I have just reprised my post in February on the MHHE list and have copied it - with some revision - below:

<->

Patients are always a challenge in that they come in lots of 'varieties'.

This is why we recognise the need for individualised, person-centred care. One variety is trauma laden to which the full-complement of the multidisciplinary team must respond. These patients and *their* crises bring out the best in us in terms of the skills and knowledge, team work they force us to exercise.

Among the plethora of other varieties there are those who are viewed as 'problems'. Like the Pepsi ad of decades ago they are variously and pejoratively described as multiple attending, attention seeking, patience sapping, heart-sinking, time wasting, symptom preoccupied .... patients.

If I receive referral information, or heads up information on diagnosis that suggests the above what do I do?

• Brace myself for impact?
• Become task focused?
• Share collective anecdotes in the staff room as a way to cope, unstress, inject some humour?

OR -

• Avoid labelling them or use these labels in a re-constructive way?
• Refuse to make gross assumptions
• Look at the individual non-judgmentally, holistically, educationally, behaviourally
• Believe I can make a difference (change is always possible [inevitable] )
• Side-step being tripped by foibles, behaviours and blatant displays of -ve obstructive ... attitudes that offend 'me'
• Enter their space and do my utmost to find room for manoeuvre?
• As a nurse do go and seek out strengths and opportunities in the same way that Capt Kirk et al. go and seek New Life, New Civilizations..?

You may have an impossible lock to pick. In its most severe form this is (pejoratively) known as 'personality disorder', but the nursing challenge is there in all its personal and professional glory.

So. Listen.
Attend to this personal
/ under-the-skin \
slant.
Listen and Learn.

Be aware of the pit that continues to trap many people. The life chances - the health career - that they may have missed, took for granted, spurned and much more you (we) will never know about.

Do your job: nurse.

Art and Science of Listening: the conceptual antenna

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

Ability to listen to oneself: self-awareness.	A Fractal Antenna
Active listening.  Attending to other(s), searching for meaning. Supporting self-discovery. Awareness of power, powerlessness, hopelessness, hope.	Governments make promises. Do they ever listen?   Some words are powerful by virtue of their slippery, illusory nature: engagement, Rights, freedom, advocacy, Services.

Ever since hearing of catastrophe theory (New Scientist, Open University) in the 1970s, followed by the emergence of chaos and complexity I've wondered about how chaos and complexity affect each of the care domains.

In health and social care we need a conceptual antenna.

Beyond and combining the four domains there is the additional dialogue, that is Spiritual.

Fractal antenna image source:
http://forum.xda-developers.com/showthread.php?t=1045486&page=3

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

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

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

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

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

How good a listener can the MECHANISTIC ear be?

FROM: Personal Forms, Paper Forms and e-Forms TO: Forms of Transparent and Opaque Support

It is hard to outrun paperwork.

Even though the promise of a great E-scape has been around for so long that the original pronouncement has become an eerie technology-enhanced echo.

Even before we arrive at the paper forms that are the bureaucrat's delight, there is in our mind's eye a personal idealised version.

This is in turn a product of the professional training and experience to which we are subjected. The quality of this personal idealised version is also affected by individual traits (aptitude and attitude) that are further shaped by the situation and the unique individual(s) who becomes the focus of our undivided attention.

This personal form, its gestation and sustenance is important because it affects the other forms:

• paper forms - policy, legacy (we've always done it this way);
• theoretical (academic-the idealised standard) form(s);
• electronic forms:
• the computer based record
• scanned - archived forms (electronic document management systems)
• and other variations (e-mails)

- and how they are received, adopted, owned and used. ....

Very frequently we need to listen. No. I mean really listen. Not just to one person, but two and more people verbally (with yet others non-verbally). People like to play tennis and when they start slugging it out they often seek a referee. There you are, having to 'write' things down, but you are still learning the(ir) rules. And anyway, writing things down on paper or e-form is a distraction for all. This IS NOT a problem (the problem's the grunting you can hear in the background). It is just a natural interface. As with any communication hand-over or transition point we need to take care, to be safe, efficient and effective.

Another personal form has of course arrived in the very humanoid (person-centred!) shape of self-assessment and the personal health record. There are new challenges in how these hybrid, composite record forms are defined, interoperate, cooperate, and how they will be governed and are seen to accrue measurable (holistic) benefits.

If these different forms prove seamless in use and achieve transparency, well that is quite a trick. If alternately the forms are opaque then the misfit will quickly become apparent. So, have you got the forms? Or is that just the way you walk?

Extrasolar planets, x-phi and The Francis report

I'm sure there is a planet out there - extrasolar - with the physical make-up such that be it an incredible water fall, tidal surge, or rolling polished mega-rocks - the noise, could we hear it, would do far more than make your ears bleed.

Today, here in England there is a legal, health and political media event of very serious import. The ruckus in health and political circles might also make for more than bleeding noses and definitely thousands of continuing broken hearts.

The Francis report will be published today. Further insights and findings will be revealed c/o the Public Inquiry with recommendations on the Mid Staffordshire NHS Foundation Trust health care debacle.

In Philosophy Now Jan/Feb 2013 Tibor Fischer's editorial mentions the need for marketing within philosophy and literature, with the suggestion of placing x-phi on a T-shirt.

'X-phi' of course reads as experimental philosophy.

In health care, nursing and social care evidence counts for everything (and for h2cm too). Evidence based practice that is founded upon research is essential. Experiments are needed that can be reproduced, extended, validated. ...

Today is a profoundly sad day for everyone in the NHS, as many commentators have already predicted. The future constantly beckons, but today reflect we must that in the clamour for evidence based care, does this mean we must don T-shirts?:

x-care

Have we forgotten the principles of what it is to care: compassion - our duty of care?

No, but amid the cacophony of technology, technical care, the targets, statistics, budget cuts, the challenges to morale and nursing's values we need to be ever more vigilant.

We must learn how to x-listen and x-shout in the 21st century health care environment(s).

But experiments in how to listen, how to blow a whistle? Surely not.

Well yes: as clearly here basic care systems did not work they failed terribly: individually, organisationally and across the FIVE care domains of h2cm.

ICN Congress in Australia 2013: a symposium - you, me and another nursing colleague?

I posted previously about the aspiration of visiting Australia and presenting at the International Council of Nursing 25th Quadrennial Congress next May.


Instead of opting for a 15 minute concurrent session I am wondering about the possibility of collaborating with two other speakers to prepare a symposium session of 80 minutes. Copied below is a *draft* abstract that could be adapted to include and reflect other speaker’s motivations and interests. The word limit is 250 including title and author details. It would be marvellous not only to present h2cm at the ICN, but sharing the challenge to produce a presentation that is coherent and informs nursing theory and practice today and tomorrow.

The deadline for abstracts is 14th September so if this is going to happen it needs to be very soon; otherwise I will submit an abstract for a 15 minute session.

If you are interested please get in touch. There may be points I have missed, for example I plan on staying for three weeks. If you have a place I can stay with a teaching opportunity I'd be very grateful for your support and the teaching/learning opportunity. Please spread the word...

I know this approach is unorthodox, but this is 2012. If this does not happen next year there may be other opportunities. Thanks for listening...

Draft abstract:

A global health care model for the challenges of twenty-first century care and self-efficacy

You?, me & presenter three?

Nursing is a discipline and profession with global aspirations in terms of supporting health for all. Professional recognition of nursing has in part been gained through the development of nursing theory and models of nursing. This presentation argues the need for a global, generic conceptual framework that has relevance for all nurses and citizens. While there is a marked variation - often for good reason - in nursing curricula having a common framework can provide a foundational standard, a conceptual basis for nursing that can serve as a common currency for dialogue.

Hodges' model, a conceptual framework created in the mid 1980s is the focus. This symposium is presented in three parts. Firstly, the characteristics of the model including its structure, content and original purposes are explained. Secondly, the model is demonstrated by mapping the themes of this congress. This exercise utilises the model’s knowledge domains, namely sciences, sociology, politics, interpersonal and spiritual. Finally, a critique is provided. As I seek to listen to patients, why should you listen? What does a 1980s model of nursing offer to professionals in the 20th century? Where do the values of nursing reside in what is yet another model of care, and how can this model affirm the positive aspects of nursing, global health care, well-being and self efficacy? What directions are there for further research? Additional resources will be signposted.

Image source: http://www.ausbird.com/

Stamping about the world and Hodges' model

I don't know if they say things about stamp collectors but there's one over here. In mitigation I'm of the dormant type, it's more about buying gifts for junior family members. Things to keep if the recipients are minded to. Over the years stamps have taught me a great deal: the rise plateau and fall of an empire; the changing face of Africa and the 'Rest of the World', the politics of the world and the truth and lies behind geographic projections. Like painting, drawing and other possibilities the stamps are there, imprinted on my brain as a possible thing to do.

As a mental health nurse I've come across many people (demographically predictably usually males) who have planned for retirement for quite a while and then when it happens the impact is a psychological sledgehammer. While it's also surprising to learn of the people who do not have any interests, you can also see how trite, inappropriate, insensitive ... the question of "Do you have any hobbies?" can seem.

That's because when you listen and hear:

the harried, hesitant, hopeless bound accounts of not knowing who is looking back in the mirror in a morning. Why am I standing there at all? Walking the dog, whatever the month, you see the crucial umbilicus is failing. The one that connects me simultaneously to myself, others, the world at large and joie de vivre:

then you know.

Then you listen and watch for the positive change working with colleagues. You look for the chinks of light that might show the darkness is perforating and the light shows through. Maybe then there is promise in hobbies and interests of all kinds. Keeping mind, spirit and body active, alive. 

Maybe though - it is just being able to be once again.

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL
|

group

Dr. Arieti, Italy, pinterest.ca	Einstein, stamp, ebay.com
Australia, Community, Stampgallery	UN Stamp: End Violence Against Children unstamps.org

Laws, Rules, Promises & Campaigns

They are not all represented on W2tQ, but many have been posted over the years. Campaigns launched in the aftermath of avoidable deaths within NHS delivered care. The initiatives seek to translate grief into positive affirmative action by making a difference to patient safety, the quality of professional care, policy and funding in some instances. At least drawing attention to the latter.

It is staggering that staff need to be 'reminded' of what should be professional, practice-based, and philosophical (personal - team, ethics and ethos, and values integral to nursing, and healthcare interaction that should be integral and ingrained. 

I thought "What's my motivation?" was a theatrical cliché?

Poppy's Promise is a commitment to making every healthcare experience more compassionate, respectful and person-centred. It supports staff to work in partnership with patients, families and carers, ensuring every voice is heard and every person feels valued.

Oliver's Campaign: The Oliver McGowan Mandatory Training on Learning Disability and Autism is named after Oliver McGowan, whose death shone a light on the need for health and social care staff to have better training. The Health and Care Act 2022 introduced a statutory requirement that CQC-registered providers must ensure their staff receive learning disability and autism training appropriate to their role.  

Jess’s Rule makes sure GPs take a ‘fresh eyes’ approach with patients, making them think again to diagnose and catch serious illnesses earlier. Jess’s Rule – Three Strikes and we Rethink - was launched in England on the 23rd September 2025 by Department of Health and NHS England and in The Isle of Man on the 31st March 2026 by Manx Care. It is endorsed by the Royal College of General Practitioners.

Martha’s Rule helps us notice early signs that someone may be deteriorating and gives you the right to request a rapid review if you’re worried that your or your loved one’s condition is getting worse. This may include a review by the Critical Care Team. Sometimes small changes happen before they show in tests. These can be early warning signs. Martha’s Rule makes sure we listen to concerns and act on them.

Nobody should be separated from the people they love and who care for them. John's Campaign works for the right of people with dementia (and other disabilities or individual needs) to be supported by their family carers — in hospitals, in care homes, and wherever care happens.

Dáithí's Law: Dáithí Mac Gabhann was born in October 2016 with a condition called Hypoplastic Left Heart Syndrome, which basically means that Dáithí was born with half a working heart with the left side not forming correctly in the womb. More information on HLHS can be found here. Dáithí has now been waiting for the gift of a new heart for over 7 years.

Activism is not restricted to patients, parents or guardians but key campaigns have followed through staff efforts:

A message from Kate about the campaign…
“Hello, my name is Dr Kate Granger MBE and I’m the wife of Chris and the co-founder of the #hellomynameis campaign”

⃟ 

The initial website for Hodges' model 1998-2015 and now archived, featured four pages of links to resources associated with the domain they represented. The SOCIOLOGY links included:

Patients, Carers & Self-Care

individual

|
INTERPERSONAL : SCIENCES             

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

SOCIOLOGY : POLITICAL   

|

group

Patient - Nurse ...	Patient - Nurse ...
Guardian - Parent Family Carer	Government Funding Policy makers

In Hodges' model, if neglect, accidents, untoward - serious - never incidents, what is complex, complicated, preventable signify anything; it is the collapse of a situation to the individual-group axis.

For the people involved they will simultaneously hear and feel a catastrophe.

Armed with Hodges' model, plus early insights into informatics, the oscillation between the person on your caseload, and not just beyond the spouse, partner and family but out to the political-zone of aggregation that is your caseload, the local and national population and statistical reports has always been fascinating.

Viewed theoretically, or practically the vertical axis of Hodges' model appears simple, and yet holds great power. A gift of abstraction and dramatic effect - for actor and audience alike. As an 'actor' we can see  our practice and its character humanistic - mechanistic played-out literally through the horizontal axis. Before we act, we can reflect upon the quality and humanity of our care. The audience, peers, families, managers, community, commissioners can also follow the 'narrative', (or lack of it!). Is there a paradox here in these virtual-digital times that the what is really material in care and caring is missing? We must hope the coroner does not need to attend [the play], being able to concentrate on other matters.

Previously: 'compassion' : 'communication' : 'safety' : 'listen' : 'motivation'

'Intellectual brutalisation' and the saving grace and power of poetry

BBC Radio 4 Today: An eminent cardiologist has organised and funded a poetry competition for his medical students to stop them becoming, in his words, intellectually brutalised.
Gabrielle Gascoigne, pictured, is a previous winner.
The BBC’s Jane Dreaper discovers more.

[no longer available] Listen to ‘Poetry competition for 'intellectually brutalised' medics’ on Audioboo

PBS: For these medical students, poetry nurtures the soul

Here's (source: http://www.bbc.co.uk/programmes/b03s6mdp/live ) the full version of Mastectomy - For His Wife, by Gabrielle Ruth Gascoigne:

It will be an honour
to bathe the scars.
Don’t think my tears imply
an ounce of sorrow -
only joy
could fill my eyes.

It will be a pleasure
to hold you close.
Know this – your precious flesh
calls the bluff on gold
and silver -
makes me a king.

It will be a delight
to talk with you
into the night we thought
stolen, clean away -
until day
renews our hope.

It would be too heartless
if all this love,
these sinner’s prayers and more
should fall to nothing
more than rain
on empty streets.

INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual

subjectivity insight, rapport, empathy emotional control, detachment, engagement risk of burnout	objectivity anatomy, physiology          physicality, processes, mechanistic intellectual brutalisation
humanistic communication, relationships (medic) poetry	funding, crowded curricula hidden curriculum

group - population

Let Us Speak With One Voice . . .

INDIVIDUAL
|
INTERPERSONAL    :     SCIENCES              
HUMANISTIC --------------------------------------  MECHANISTIC
SOCIOLOGY :   POLITICAL
|
GROUP

"A singer's voice may be their prize asset,	but its sonic frequency
If the world should blow itself up, the last audible voice would be that of an expert saying it can't be done.* Peter Ustinov (1921 - 2004)	isn't theirs to copyright."

Hunter-Tilney, L. (2023) Can AI make me a star? Life&Arts, FTWeekend, 27-28 May, pp.1-2. 
https://www.ft.com/content/408a8920-cf0c-4f23-925f-8496da15153f 

https://www.ft.com/ludovic-hunter-tilney

Illustration: Raj Dhunna

*How times have changed, and for many 'voice' related quotes.

Listen also: BBC Radio 3 - Artificial intelligence and music

https://www.bbc.co.uk/programmes/m001md3n

Foundations, projects, corners and cornerstones

Ok, so you have a new project - that's great!

Yes, we are going to build something - outstanding!

Sounds marvellous!

We are going to use up-to-the-nanosecond project management tools.

And you're going to do it by the book, charts and real-time tags.

Yes, with a dash of intuition plus - you know - gut instinct!

Well sure, pleased to hear that too.

We will take account of history, learn the lessons -
we've a researcher onboard you know?
Building a world-class team that's all fleet of foot and mind.

We'll tick all the boxes, check all the corners and leave no stone un-turned.

Truly admirable, but how many boxes and corners have you got and how many cornerstones* will you need?

Eh?

Hey listen up. Corners are for losers,

naughty children

and people lost in the dark.

Nobody is going to be stuck standing in the corner on this one!

Oh - right.

Well good luck....

Image sources:
'Cornerstone office': Cornerstone Corp. Center
Dan Flavin: at Artnet.

Inspired by the word 'cornerstone' and Untitled (Corner Piece) 1969 on visit to Tate Liverpool, 25 September 2009 (not the piece illustrated above):

Flavin made a number of works intended to be shown in corners, engaging directly with the architecture of the gallery. His use of commonly available fluorescent tubes enabled him to explore light as a non-physical material, animating gallery walls. The size of the work was determined so that the units could be fastened in the centre only, without having to be anchored to the floor. The artist rejected any symbolic significance of the object, insisting that it was simply a form that made good use of a corner.

Question: How many corners are there in Hodges' model?

*Cornerstones: here referring to stakeholders, sponsors, owners, partners, investors, builders, architects, designers...?

Multiplistic- Thinking checks and balances [IV]

Johnson’s main source Perry (1970) is developmental in tracing a learner's journey from a dualist tendency, through to multiplistic and the third stage which is relativistic thinking. Having related dualistic thinking to Hodges' model, now it is the turn of the multiplistic.

Just as the axes of Hodges' model can be matched to dualistic thinking (followed by the domains), so the model's four care (or knowledge) domains immediately suggest multiple forms of explanation. Reasoning and reaching an understanding about something is what we usually think of as knowledge. The dualistic brought home the actuality of facts. The age of information technology provides a virtual ocean of facts, knowledge, data, information, wisdom. There is the buzz of the advertisers and social media and their influence on what we think and believe. Family, friends, community, culture all have their influence. We recognise the notion of common sense and tacit knowledge. When knowledge is viewed as content (and we avoid the key matter of access) this is a neutral position, but this neutrality changes irrevocably when context is introduced; when questions of ownership, disciplines and the knowledge of individual and community arise. Who knows? How is their knowledge demonstrated? Why should I/we listen to them? Staying with the political domain the further progression to relativistic thinking becomes apparent. There is the view of the doctor, nurse, social worker, allied health professional as an advocate who is not strictly independent and the representative who is.

As the term 'multiplistic' (and pluralistic) suggests the learner develops an appreciation that there is not necessarily a single answer but several. As Johnson (1994) notes, when an answer is provided, even if this is a voice of authority it is not necessarily correct. There is a distinction to be made between there being potentially many answers and many sources for answers.

The same properties attributed to knowledge objective and subjective (dualism in thought and action) also has a bearing here. From: The logic and evidence of a randomised controlled trial; To: the politics of dogma - “Well, this is the way we have always done it!” There are many types and degrees of quality attributed to knowledge. Debate is ongoing about the definition and meaning of bit, data, information, knowledge and wisdom. Is there a hierarchy there? Where would you put dualist and multiplistic thinking in this mix? Is that a valid question? No? Would you reconsider and proffer an answer if (and to follow) the wise amongst us are experts in relativistic thinking?

Bringing multiplistic thinking to a conclusion frequently and routinely demands a consensus being reached and teamwork. Multiplistic thinking and approaches (pluralism) also tends to throw light on constraints that dualistic views might ignore, or by definition have no need to take account of. So dualism can engender bias, even foster blatant prejudice, in comparison to the context of consensual management for example, which is invariably richer, open, continuous and requires self-awareness and awareness of the other. This is not a vote for consensus, to many it is a game and contention often remains.

Decision making as a process and the many ‘logics’ that people try to apply become evident and the varying quality of the same. Communities of practice have their own terminology. As a learner expands their vocabulary and acquires conceptual knowledge they are able to make the transition from novice, beginner ... to proficient learner (Benner, 1984). The aforementioned virtual realm can processes and produces terminologies of its own, so-called folksonomies. This is one of the multiplicities the learner must literally come to terms with. Hodges' model as a conceptual framework and one or more conceptual spaces is ideally suited to support this learning and learning to learn.

Johnson, D.D. (1994). Dualistic, Multiplistic, and Relativistic Thinking as it Relates to a Psychology Major. Honors Theses. Paper 202.
http://opensiuc.lib.siu.edu/uhp_theses/202/

Perry, W. G. (1970). Forms of intellectual and ethical development in the college years. New York: Holt, Rinehart & Winston.

Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park: Addison-Wesley, pp. 13-34.

Thinking checks and balances [I]

Dualistic- thinking checks and balances [II]

Dualistic- thinking checks and balances [III] (or: The-hyphen)

See also:
Jones, P. (1996) Humans, Information, and Science, Journal of Advanced Nursing, 24(3),591-598.

Halos, clouds and living ontologies

It would be nice to be blessed with a halo, but I guess I'd rather be elliptically challenged than possessed of a slipped disc.

Halo-less, succor is found imagining the concept cloud that follows me around. Of course we all have one:

A dynamic cognitive-virtual creation that would be a wonder of the universe if it could be seen. Maybe this is why the WWW is such a marvel?

Life is a comic book really, we just don't see the thought bubbles. ...

As of Jan 2008 - this blog's side bar has a sandpit listing tools in which I would love to fully immerse myself. One of these is Protégé. Like so many pieces of this (my) care informatics jig-saw, this - the keystone? - is yet to be picked up.

It is heavy, a specialist tool; built for knowledge engineering not for care engineers.

After decades of excellent work by researchers in expert systems and decision support systems... knowledge management tools like Protégé are making knowledge engineering much more accessible. Web 2 (and Web 3...) is using the semantic web as a foundation and the term semantic web seems to capture the concept cloud (that might be) instantiated in Hodges' model.

I know the links pages may seem a links-fest or even a links-farm, but in LINKS I intra-INTERpersonal the presence of knowledge management is neither incidental or accidental. Conceptual tools and Protégé in particular might provide a means to help thread together:

• caring and learning: the 4Ps and care participants
• informatics
• records
• Hodges' model

When I set about creating the website in 1997 this is what I had in - and out of - mind. Already familiar with Buzan's mind-mapping, Hodges' model was and remains a living ontology. A tool to capture and freeze concepts and reasoning at selected critical intervals. This living dynamic vision was just what I needed, to blow the dust off Brian's model, sat there languishing on the shelf. Better a living ontology than a model sleeping in the recessed cloisters of the more mature student's memory. As far as Protégé is concerned though, I've yet to fully raise my right foot, never mind complete the first step (and listen into the literature) perhaps I may never.

Maybe for living ontologies this is where communities come in - so please look after your halo!

Image source: http://www.simon-templar.de/

The Difference that Makes a Difference: an interdisciplinary workshop on information and technology

Location: The Open University, Milton Keynes, UK

Dates: 7-9 September 2011

Few people would argue that the development of information technologies has had a profound impact on modern society. Information is communicated, stored and manipulated using digital computers, the Internet, and fixed and mobile telephony, resulting in a deep and extensive impact upon all aspects of our lives. While talk of information is routine and unproblematic for engineers and technologists, it has been recognised since the early days of digital technologies that there is an uneasy relationship between the engineer’s concept of ‘information’ and wider uses of the word (cf. Roszak, 1986).

It is nevertheless appreciated that information, whatever is meant by this concept, is important – indeed it is foundational – to a quite remarkably diverse range of disciplines. Information is emerging not only as the new language of science - from quantum information to the genetic code - but as a key commodity of business, a major concern of the state, the front line for crime and crime prevention, the primary arena of technological development, an increasing concern of philosophy, and even a focus for conceptual art. Indeed, it is difficult to identify any field of life in the developed world that can not now be seen to some degree to have a significant information aspect, and to a greater or lesser extent this has all emerged because of developments in information technology.

The idea of information as a distinct concept, applicable across a wide range of disciplines, is growing in prominence. It has been especially emphasised within the natural sciences (von Baeyer, 2003; Vedral, 2010; Davies and Gregersen, 2010) and philosophy (Floridi, 2010). Much of this work takes information theory as developed by technologists, beginning with Shannon (1948), as its starting point, but draws little on contemporary work of technologists. At the same time, a different strand of work has arisen, drawing its inspiration from the growing influence of the Internet, and largely conducted by technologists (e.g. Weinberger, 2007; Brown and Duguid, 2000). This research in turn has little connection with the work in natural sciences and philosophy.

As we move further into the ‘information age’, we need to make the bridge between information of the information technologist and understanding of information in other disciplines. As researchers and practitioners in diverse fields grapple with an understanding of information – what it is, how it can be modelled and tools for coping with it – now more than ever is the time to share insights and bring some clarity and coherence to these differing perspectives.

We have begun some of that work, largely with colleagues around the Open University, resulting in a recent edited book (Ramage and Chapman, 2011). However, these discussions need to go much wider and deeper. We therefore propose to hold an international workshop to bring engineers and technologists together with scientists, philosophers, social scientists and artists – leading thinkers from all and any discipline that uses the language of information – to talk and listen, and to share their insights with us all.

There have been and continue to be many conferences, symposia and workshops addressing the technology, the applications and the consequences of information technology, but it is rare to find opportunities to address the understanding of the nature of information itself.

The need for work addressed more specifically at understanding the nature of information is exemplified by a problem expressed by Terrence Deacon (2010):

For more than half a century we have known how to measure the information-conveying capacity of any given communication medium, yet we cannot give an account of how this relates to the content that this signal may or may not represent. These are serious shortcomings that impede progress in a broad range of endeavors, from the study of basic biological processes to the analysis of global economics.

This workshop seeks to bring together those working with information in a wide range of disciplines - engineers and technologists together with scientists, philosophers, social scientists and artists - to discuss and expand our collective understanding of what we mean by information in our different disciplines. We are not seeking to combine these different understandings, but to share them and to explore commonalities.

The title of the workshop is based on a celebrated definition of information by Gregory Bateson (1972, pp.457-9), who wrote:

A difference is a very peculiar and obscure concept. It is certainly not a thing or an event. This piece of paper is different from the wood of this lectern. There are many differences between them – of color, texture, shape, etc. But if we start to ask about the localization of those differences, we get into trouble. Obviously the difference between the paper and the wood is not in the paper; it is obviously not in the wood; it is obviously not in the space between them, and it is obviously not in the time between them. (Difference which occurs across time is what we call “change”.) ...

Kant, in the Critique of Judgment – if I understand him correctly – asserts that the most elementary aesthetic act is the selection of a fact. He argues that in a piece of chalk there are an infinite number of potential facts. ... I suggest that Kant’s statement can be modified to say that there is an infinite number of differences around and within the piece of chalk. There are differences between the chalk and the rest of the universe, between the chalk and the sun or the moon. And within the piece of chalk, there is for every molecule an infinite number of differences between its location and the locations in which it might have been. Of this infinitude, we select a very limited number, which become information. In fact, what we mean by information – the elementary unit of information – is a difference which makes a difference.

The workshop will consist of four main sessions, each with keynote speakers and a number of presentations from others. Our goal is for maximum participation. If you are interested in the role and nature of information, we invite you to join us in Milton Keynes in September.

Magnus Ramage and David Chapman

Thanks to David for my being able to post these details here. I have registered and if time permits will submit an abstract. I'm really looking forward to this workshop. pj

Jones, P. (1996) Humans, Information, and Science, Journal of Advanced Nursing, 24(3),591-598.

'information' on W2tQ

Domain walls ...

"A domain wall is a type of topological soliton that occurs whenever a discrete symmetry is spontaneously broken. Domain walls are also sometimes called kinks in analogy with closely related kink solution of the sine-Gordon model or models with polynomial potentials.^[1][2][3] Unstable domain walls can also appear if spontaneously broken discrete symmetry is approximate and there is a false vacuum.

A domain (hyper volume) is extended in three spatial dimensions and one time dimension. A domain wall is the boundary between two neighboring domains. Thus a domain wall is extended in two spatial dimensions and one time dimension.

Important examples are:

• Domain wall (magnetism), an interface separating magnetic domains
• Domain wall (optics), for domain walls in optics
• Domain wall (string theory), a theoretical 2-dimensional singularity."
  
  https://en.wikipedia.org/wiki/Domain_wall
  

 INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

conceptual spaces threshold concepts [#h2cm as] relational ontology	magnetism optics string theory
a space to tell stories of and compare walls seek openings so many spaces of / to welcome	these walls: are they necessary? whose needs do they meet? we know walls listen and talk too who do they protect? who do the respect?

Among the domain walls
are those that bring us together,
those that bring us - 'I' into being,
and yes, those that [try to] take us apart.

Inspiration:
Leslie Rosenberg, THE COSMOS IS MOSTLY MADE OF SOMETHING WE CANNOT SEE, Scientific American, January 2018, Volume 318, Number 1. pp.48-53.

Axioms, Domain Walls, and the Early Universe, P. Sikivie in Physical Review Letters, Volume 48. No. 17, pp.1156-1159; April 26, 1982.