Patient navigation model - Paper: mapped to h2cm

On twitter I learned of an EU project @CANCERLESS_EU and an initial paper:

 Exploring the application of the navigation model with people experiencing homelessness: a scoping review, Journal of Social Distress and Homelessness, DOI: 10.1080/10530789.2021.2021363

Phrases like 'navigation', 'architecture', 'maps' are a trigger so after some tweets, I was kindly directed to the above paper.

Here, I'm mapping patient navigation and related concepts I have added, to Hodges' model.

"Patient navigation is a community-based and person-centered intervention, whereby a named worker – the navigator – supports and guides individuals to overcome the barriers they face in accessing healthcare services and works to facilitate timely and appropriate access to care for the individual as well as their relatives, and caregivers, when needed (Freeman, 2012; Wang et al., 2015)."

 INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

psycho- depression, anxiety, distress, trauma (psyche) serious mental health substance misuse dual diagnosis vulnerability isolated difficult to engage, missing appointments, no designated point of access - Address Personally reliant on welfare/benefits for finance - phone contact sporadic. providing emotional support, phone, transport Hit by energy costs/rent (pre-payment) if finding a place. hopelessness, lack of trust - let down many times? Stigmatized attitudes towards treatment? tailored health education asocial (due to lived experience, trauma..?)

-geography low-income areas, or areas with a high proportion of ethnic minorities or migrants USA - other nations - terminology? method: scoping review, literature search, inc. exc criteria interventions tailored to age and gender respiratory conditions, trauma (physical) excess winter mortality "homeless population having an average age at death of just 47, 30 years lower than that for the general population" exposure to activities known to increase risk of cancer HIV patients data - inc. no-show rates in-person / phone Timeliness of screening, intervention

Navigators - lay persons, or clinical professionals Lived experience, "near peer" family Training for Navigators organizing and attending appointments and facilitating self-care/self-management clinical and community settings, parks, pavements, and homeless encampments, home visits, walking and support groups *risk of stigmatization and experienced discrimination navigation less successful with certain groups?

Underserved, marginalized people Homelessness High-risk of poor health-related outcomes reported barriers access to appropriate healthcare for this population are also often compounded by lack of insurance, legal problems*... ...the PN model has been associated with a reduction in hospital costs, and even in some cases, increased revenue histories of offending and/or care women in rural areas non-specific vulnerable populations reduce incarceration, vocational and volunteering activities, access to housing

Christina Carmichael, Lee Smith, Edelweiss Aldasoro, Alejandro Gil Salmerón, Tamara Alhambra-Borrás, Ascensión Doñate-Martínez, Radhika Seiler-Ramadas & Igor Grabovac (2022) Exploring the application of the navigation model with people experiencing homelessness: a scoping review, Journal of Social Distress and Homelessness, DOI: 10.1080/10530789.2021.2021363

Persistent or Global navigation: Hodges' model

Interfaces are hardly novel these days, even our acknowledging them is a moot point. An interface that is effective will be transparent to the 'user' who is able to get on with the task, the process that is their purpose. For web design, medical devices and

There are many posts on 'interfaces' here on 'Welcome to the QUAD' from 2007 to 2020:

Hodges model: What is it? [2] It’s an interface... 

(Contrast this view, perhaps, with recent posts on Hodges' model as a matrix.)

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

- and the tag 'interfaces' (59).

 

Hodges' model remains an interface to me.

 

The homepage for the website 1998-2015 presents Hodges' model - as the interface - to the user (visitor).

In revisiting (before it visits the charity shop) Steve Krug's Don't Make Me Think (2006) reference to persistent navigation or global navigation (p.62) reinforces the fact that humanity needs an interface for health and care. Two qualities that such an interface needs include:

1. Persistence in being Cognitive (isn't everything?) but in the sense here of being simple and so ready-to-mind.
2. Being Global as in Global Health, plus Universal Health Coverage, generic, applicable to all persons, contexts and situations.
   

iii Picking up sticks: when axes matter

It is one thing for us to break the stick, but quite another from a concept's perspective. They are accustomed to the dynamics at work, when as search terms they are exploded, or not. And, not just any concept but one that can be unique. Consider the concept, and how or where it finds itself [ in Hodges' or another model ]? Let us use the intra-INTERPERSONAL domain, as an example, and ask:

1. Is 'mood' fixed by the I-axis alone?
2. Does the humanistic axis have a role in where in the doomain the user of Hodges' model places 'mood'?
3. Acknowledging person-centredness, if the patient/client had a view, to what extent would this agree (with annonymity assured) with the professional's judgement, or a relatives / guardian?
4. What is as a result, 'mood' has become 'very low mood'? (To continue in this vein , invites complication, but we will continue.)
5. Introducing the 'Other' whatever their role and relationship, pushes us to the humanistic, but whether this is achieved in a person-centred manner (triage excluded) is a matter of opinion and judgement (evaluation).

If mood is fixed by the I-axis then if we determine the issue is 'low mood' are we introducing a combined quantitative and qualitative dimension, a continuum, at the selected point in the interpersonal domain? Writing previously about threshold concepts, I wondered, and proposed compound threshold concepts. There is a progression from the patient's subjective self-assessment, to in all likelihood of an objective measure being introduced, so spanning two domains. Definition of 'compound' aside; there is a compound structure at work.

What points 1-5 above reveal is triangulation. When it is argued that Hodges' model facilitates navigation as per my presentation on 21st April, this is a strategy from mixed-methods research in practice. Many years ago, Hodges' model was described as a 'cognitive periplus', reflecting the way ancient mariners initially charted the coastlines creating the first map, as per their culture and dispora. In the west more recently the value of social approaches and activities, especially in mental health. Care navigation is a role. Literally sign-posting to individually suited (which must be stressed) activities, resources, and agencies. So, in Hodges' model what are our three triangulation points? They are:

1. Axial;
2. Intra- InterDomain; 
3. Person-centred. 

Perhaps, we can describe 1-2 as conceptual anchors at least when dealing with a concept, while #3 is more about approach, values and philosophy. So, there is something of a 'cheat' going on, because each one is compound:

1. Axial: The axial is comprised of four points. The axes create a Cartesian plane (figure). And, as far as a patient is concerned, they mark off a point on the respective Individual and Humanistic-Sciences parts of the axes. This form of triangulation point can claim a general conceptual precision (language) in the applied terminal labels; but what happens in-between can be patently fuzzy. A mix of what may be objective and subjective.

2. Intra- Interdomain: This may be the most imprecise triangulation point. It appears the axes of Hodges' model are composite (figure). They have two-sides as a boundary. To be pedantic, in our example, one plays to the interpersonal domain, the other the sciences.

[The relationship between the axis and the domains in Hodges' model, is far from unique; but I wonder if there is something else here?]

2. Person-Centred: There is a paradoxical nature to person-centred(ness). It is also nebulous in nature, and yet in care it is definitive in practice (safety, purposes, values, professionalism, competency, ...).  It forms locus which can also be classed as a traingulation point, at the centre of the model. This is the point around which Hodges' model is built. This captures the individual's (life, care) context and situation, all influenced by their life chances as consequent health - and other - careers. Salience and our attention^ is key. Is it possible to frame our purpose(s)?

^A focus for [N] autumn.

Marrakech, Le Jardin Secret. 24th April. 1000-1830.

2013 Year of Piri Reis & Navigating the world of nursing care - in Jordan

The conference in Jordan is over it has been an intense and excellent two days, with a free day tomorrow. It has been a brilliant opportunity to share and learn not just about nursing, but travel, culture and some of the people that make up the global nursing community.

I am truly grateful to the Jordanian Nursing Council for accepting my abstract. The welcome and hospitality has been truly amazing.

In the flight magazine on the way here there was an article about Piri Reis, which reminded me of Paul Cunliffe's book about Pytheas.

From the UNESCO website:

The United Nations Educational, Scientific and Cultural Organization (UNESCO) has agreed to declare 2013 the year of Piri Reis on the occasion of the 500th anniversary of a map he drew up that included seven continents, reported the Anatolia news agency. 

“This map marks a significant event in the history of the country and has enabled its collective knowledge to be transmitted through generations. As a rare world map from the 15th and 16th centuries, Piri Reis World Map is an invaluable piece of the world's documentary heritage as it provides insight on the history of its time. It is therefore part of the Memory of the World and should be made better known,” stated UNESCO.

The world-renowned Ottoman captain and cartographer Reis is best known for world maps and charts collected in his “Kitab-ı Bahriye” (Book of Navigation).

Source: http://www.todayszaman.com/newsDetail_getNewsById.action?newsId=294065

Source: http://en.wikipedia.org/wiki/Piri_Reis_map

I have written before about Hodges' model as a map -

a cognitive periplus 

- for navigation through the complex world(s) of health and social care.

Would a new mariner take to the sea without a clear sky, a compass, map, or satnav? What then of our students?


Additional link: Please see the entry for Iran -

http://www.unesco.org/new/en/unesco/events/prizes-and-celebrations/celebrations/anniversaries-celebrated-by-member-states/2013/

Book review "Clinical Intuition in Psychotherapy: The Neurobiology of Embodied Response"

Clinical intuition is something that in formal learning terms is intangible, but in practice is earned and relied upon as a gift of experience. When I first received this book from the author Terry Marks-Tarlow, leafing through I thought the emphasis was on the neurobiology presaging a rather technical read. The references to brain structures, neocortex, brain waves ... seemed to suggest a reductive approach, remote from my conception of intuition in clinical practice. I need not have worried, the initial discussion on the brain and evolutionary development is not just a foundation for what follows but as the title suggests underpins and integrates the whole text. Despite the title and as the foreward advises you do not have to be a psychotherapist to read and appreciate this book. The stall is set from the outset in the introduction which explains that chapter one defines clinical intuition:

Clinical intuition is defined from a neurobiological perspective as a right-brain, fully embodied mode of perceiving, relating, and responding to the ongoing flows and changing dynamics of psychotherapy. (p.3)

The introductory material here is essential foundation reading for people starting a career in psychology and mental health related disciplines. The evolutionary development of the brain from reptile through to the mammalian brain is invaluable. Tying this to specific brain functions and circuits - care, fear, panic, play, lust, rage and seeking - helps integrate brain anatomy, perception, emotion, and behaviour. The advances in neurobiology to follow will no doubt demand that we all extend our understanding of this interdisciplinary fusion.

Clinical Intuition in Psychothreapy

The book itself (hardback edition) is very well produced, the type face easy to read and the book well structured and with a well balanced mix of illustrations and photographs. The reference listing at the end runs over thirteen pages and is well grounded historically and in having regard to ongoing research. The index is comprehensive (fourteen pages) and a resource itself providing a look-up approach. The book's use of case studies, thirteen in total informs the text and provides some continuity through the book. Dialogue between therapist and client is easy to follow and illustrations are provided with ample explanation in situ. The references also utilize web-based resources.

I recall intuition coming up as a thread on several occasions on the psychiatric-nursing list especially between 1998 and 2004. Intuition is a central quality for all personnel working in health and social care. We must also recognise intuition as a human trait as when non-health professionals exercise the judgement that: "Wait a minute, we need a clinical opinion here." Self-care is also discussed. I had a Pythonesque moment - "Is this the right room for an argument?" - considering psychotherapy as a therapeutic modality within therapies as a whole. Here in the UK (and no doubt elsewhere) self, brief and solution based therapies rule economically. Even though the shortage of psychological intervention is recognised in the UK through IAPT improving access to psychological therapies, we need to ask: how does psychotherapy fare in the current (austerity) climate? To what extent can clinicians exercise intuition? Therapy relies on caseness, relationships and narrative, but to what extent can these be acknowledged and delivered within the economical time frames that frequently operate? 

Although there's no specific chapter on training for clinical intuition, Marks-Tarlow provides a list of how researchers have characterized clinical intuition (more recently in the 1980-1990s); five characteristics are proposed:

• Sudden recognition;
• Immediate knowledge;
• Emergent awareness;
• Non-verbal insight; and 
• Holistic integrative sensibilities. (pp.42-43).

 Of the first two sudden recognition and immediate knowledge, I thought of the intuitive sense that is applied upon receiving a referral. That is the assumptions (not always helpful) that arise from the information provided (and missing) and where this leads you? But of course, is this clinical intuition? Intuition as the author makes clear (p.3 and) throughout the book is in psychotherapy. Intuition here (and for me) depends on interpersonal - therapeutic - interaction. What precedes is something else (data integration, hypothesizing, reasoning...?). I can however still see explanatory avenues in the above that can help us travel from the conceptual (reduced) to a holistic whole. I did wonder about the role of intuition in suicidal ideation and risk management, but this is also a question of referral criteria and caseness.

I would very much like to write myself about information and complexity and these themes recur in the text, especially the latter. Several 'spaces' are discussed too: social, physical and spatial schemas. The work of Buzsáki on the hippocampus, navigation and maps - landmark navigation - is fascinating in chapter 7 Navigating the Seas. I have likened Hodges' model to a cognitive periplus - an ancient maritime map. Over the next few months I'll post some quotes from the book.

This is an excellent book that I heartily recommend. The discussion of what is implicit in the brain and so in therapy, what is embodied and wisdom in mentoring invites re-reading. Finally but vitally there is much humour and humanity here too.

Many thanks to Terry Marks-Tarlow for the review copy.

So, Hodges' model is all about Vision ...?

... It depends how you define 'vision'
and even then,
Hodges' model is about so much more ...

Inclusion, Holistic bandwidth, Holistic care ...

This is what we should all aspire to
especially as children -
to realise our person-al potential.


INDIVIDUAL

|

INTRA- INTER-PERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

GROUP

Dreams Empathy Rapport Attending Listening INSIGHT Knowledge / Learning Communication / Liaison Palliative Medicine Holistic Care DeafBlind Alexandra Elaine	Senses Sight- VISION 0% - 5% Touch Negotiation / Navigation Physical Physical examination Vital signs Observation Surgery  Patient assessment Total:  DeafBlind?
Adams Negotiation - Acceptance "A DeafBlind Doctor?"  Patient Reactions Colleagues - Reactions ‘A doctor said, what are you doing with a patient’s cane?’ DeafBlind	Negotiation Human Rights Law Employment Law Equality, Equity Governance Political Accessibility 'Tick Boxes' Activism: TEDMED DeafBlind

Sources:
BBC and Andrew Gregory, Healing touch of the deaf and blind doctor-to-be, The Sunday Times, September 29, 2019, p.3.


This post is a reminder for me about the accessibility of this blog...

Health literacy conference - definitions & Hodges' model

Well yesterday was a very useful and enjoyable day both in learning about health literacy [HL] and trying to get the message out there about the potential of Hodges' model.

The keynotes a.m. and p.m. were all very informative the speakers leaders in this field - inc.

Prof. Don Nutbeam who talked about definitions of health literacy:

• functional literacy
• communicative and interactive literacy
• critical literacy

One of many take home points being that a person can have high health literacy, but low general literacy. The other and new literacies that I have illustrated on W2tQ and on my poster were mentioned. Prof. Nutbeam's description of health literacy in absolute and relative terms brought out the meerkat in me (well, ok I sat up - I didn't stand on my chair and look all around). As is often the case it's something we kind of know, but without the eloquence that specialism, expert thought and structure brings.

The absolute form of health literacy is applicable in clinical care - conceptualised as RISK;
while the relative form of health literacy has greater application in public health as an ASSET.

Clearly, Hodges' model can be related to Prof. Nutbeam's work both in theory and practice especially with the communicative / interactive and critical forms. Perhaps the health care domains model could also form part of an assessment to measure functional literacy; one that is hybridized across the literacies, e.g. SCIENCES care domain = drug dose / admin calculation or nutrition task?

From the outset the need to conceptualize health literacy was noted. This had me scribbling away - conceptual navigation - conceptual envisioning ....

My poster did erm... stand out next to the A0 - A1 and greater efforts. I'll investigate the possibility of future support if needed from a local university to produce something - A1 would be brilliant. At the end of the day in the panel discussion I was able to highlight Hodges' model and I am grateful to the people who approached me afterwards and look f/w to hearing from them.  In turn I will try to effect some connections on behalf of others - my local council and children's services.

The other sessions were brief at 15 mins, but nonetheless demonstrated the vibrancy and creative potential of health literacy. I'll post more on HL - other sessions, references, call for papers, news of other events, 2012 and the significance of HL to Hodges' model and my interest in informatics.

Before I close - the lack of anyone present with central policy gravitas was raised in questions and the previous support of DoH was stressed by a delegate in response. As I understand DoH also originally contributed to the funding of the HL initiative and steering group.

I wonder if some health literacy practitioners could make an impression on policy makers through the acknowledged need to get people back to work? If so, they could help carry the HL flag for the rest of the community; and should they need a design for that flag.... ;-)

Call for Maps: Mapping Science Exhibit, 7th Iteration on "Science Maps as Visual Interfaces to Digital Libraries" (2011)

Background and Goals

The Places & Spaces: Mapping Science exhibit was created to inspire cross-disciplinary discussion on how to best track and communicate human activity and scientific progress on a global scale. It has two components: (1) physical exhibits enable the close inspection of high quality reproductions of maps for display at conferences and education centers and (2) the online counterpart (http://scimaps.org) provides links to a selected series of maps and their makers along with detailed explanations of how these maps work.

Places & Spaces is a 10-year effort. Each year, 10 new maps are added, which will result in 100 maps total in 2014. Each iteration of the exhibit attempts to learn from the best examples of visualization design. To accomplish this goal, each iteration compares and contrasts four existing maps with six new maps of science. Themes for the different iterations/years are:

  * 1st Iteration (2005): The Power of Maps
  * 2nd Iteration (2006): The Power of Reference Systems
  * 3rd Iteration (2007): The Power of Forecasts
  * 4th Iteration (2008): Science Maps for Economic Decision Makers
  * 5th Iteration (2009): Science Maps for Science Policy Makers
  * 6th Iteration (2010): Science Maps for Scholars
  * 7th Iteration (2011): Science Maps as Visual Interfaces to Digital Libraries
  * 8th Iteration (2012): Science Maps for Kids
  * 9th Iteration (2013): Science Maps for Daily Science Forecasts
  * 10th Iteration (2014): Telling Lies With Science Maps

Places & Spaces was first shown at the Annual Meeting of the Association of American Geographers in April 2005. Since then, the physical exhibit has been displayed at more than 175 venues in over 15 countries, including eleven in Europe, plus Japan, China, Brazil, Canada, and the United States. A schedule of all display locations can be found at http://scimaps.org/exhibitions

Submission Details

The 7th iteration of the Mapping Science exhibit is devoted to science maps that serve as visual interfaces to digital libraries. These maps might communicate the

  * quality and coverage of data sets,
  * the structure (ontology, taxonomy, classification hierarchy) of data sets,
  * (semantic) linkages between data sets,
  * the evolution of a data set, or
  * access and usage patterns of data sets.

They are intended to support the navigation, management, and utilization of mankind’s scholarly knowledge and to make it more readily available to researchers, educators, industry, policy makers and/or the general public.

We invite maps that show a visual rendering of a dataset together with a legend, textual description, and acknowledgements as required to interpret the map. Science map dimensions can be abstract, geographical, or feature-based, but are typically richer than simple x, y plots. Scientific knowledge can be used to generate a reference system over which other data, e.g., funding opportunities or job openings, are overlaid or be projected onto another reference system, e.g., a map of the world, but must be prominently featured.


Each initial entry must be submitted by Jan 30th, 2011 and needs to include:

  * Low resolution version of map
  * Title of work
  * Author(s) name, email address, affiliation, mailing address
  * Copyright holder (if different from authors)
  * Description of work: Scholarly needs addressed, data used, data analysis, visualization techniques applied, and main insights gained (100-300 words)
  * References to publications in which the map appeared
  * Links to related projects/works

Entries should be submitted via email to the curators of the exhibit: Katy Börne (katy at indiana.edu) and the exhibit designer Michael J. Stamper (mstamper at indiana.edu) using the email subject header “Mapping Science Entry”.

Please feel free to send any questions you might have regarding the judging process to Katy Börner (katy at indiana.edu). Please keep subject header (as used here).

This call - with additional details -  is also available at http://scimaps.org/call

Book: [ii] 'The Systems View of Life - A Unifying Vision'

The introduction highlights the oscillation through history between reductivism, holistic and integrative perspectives; the relationship between theology and the claims for and crystallisation of knowledge and the sciences. The development of cybernetics and systems theory in the 1950s and 1960s does not have it all its own way: 

'The eclipse of systems thinking from pure science had become so complete that it was not considered a viable alternative. In fact, systems theory began to be seen as an intellectual failure in several critical essays. One reason for this harsh assessment was that Ludwig von Bertalanffy (1968) had announced in a rather grandiose manner that his goal was to develop general systems theory into "'a mathematical discipline, in itself purely formal but applicable to the various empirical sciences.'' He could never achieve this ambitious goal because in his time no mathematical techniques were available to deal with the enormous complexity of living systems.' p.11.

(With Zeeman's book on Catastrophe Theory on-loan at present the above is helpful.)

I've picked up a book of Arne Naess's, put it down again: or did I buy 'The Ecology of Wisdom'? I can't check at present (the books I've left are all boxed / created), but Naess sets the scene for the mechanistic worldview.

'Care flows naturally if the 'self" is widened and deepened so that protection of free Nature is felt and conceived as protection of ourselves. .. Just as we need no morals to make us breathe... [so] if your "self" in the wide sense embraces another being, you need no moral exhortation to show care.. . You care for yourself without feeling any moral pressure to do it. (quoted by Fox, 1990, p. 217)

'What this implies, according to the eco-philosopher Warwick Fox (1990), is that the connection between an ecological perception of the world and corresponding behavior is not a logical but a psychological connection. Logic does not lead us from the fact that we are an integral part of the web of life to certain norms of how we should live.' p.14.

Science fiction gives you an appreciate of 'deep', even if not initially the philosophical connotations. Deep space, A.C. Clarke's Deep Range, and more recently deep time brought me to consider deep care on the old website and here on W2tQ with Hodges' model a means of navigation. Naess refers to shallow and deep ecology. Now we also have deepfakes, although the climate change deniers may struggle to believe their deepfake - that is: reality.  Although the book was published pre-sustainable development goals, sustainable development is discussed in detail. For me, the climate change and the SDGs demand we consider ecology, ecosystems, life, and the Earth across the domains of Hodges' model and the spiritual explored in chapter 13.

 

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

	shallow | DEEP

A table on page 13 contrasts several opposites across thinking and values:

As usual, I can't shift beyond the book's introduction, but these points for me underscore the value of the book and Hodges' model. Throughout the blog and papers various dichotomies, polarities, oppositions arise. The structure of Hodges' model lends itself to this, and consequently finding the middle. All the above can be reflected upon in relation to Hodges' model, and also searched.

Chapter 1 explains how the discoveries of Galileo, Descartes, Bacon, Newton and Darwin contributed to the world and life - in biology being viewed mechanistically. The focus of the book is 'Western' and the developed nations; as the main contributor to the current state of the planet. The Cartesian divide - mind & matter/body distinction (p.24) is implicit within Hodges' model:

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

res cogitans	res extensa

Newton's work is described and the limitations of Newtonian physics - the social sciences presented a challenge(!). Thermodynamics is introduced helpful for subsequent chapters.

For general science students the book provides a historical primer, and even an introduction to the philosophy of science. Chapter 2 is short but conjoins cells, molecules, genes (Mendel, Watson & Crick; Franklin & Wilkins, and others), and mechanistic medicine. 

'This will not change until medical science relates its study of the biological aspects of illness to the general physical and psychological condition of the human organism and its environment, The conceptual problem at the center of contemporary healthcare is the confusion between disease processes and disease origins. Instead of asking why an illness occurs and trying to remove the conditions that led to it, medical researchers try to understand the mechanisms through which the disease operates, so that they can then interfere with them. These mechanisms, rather than the true origins, are seen as the causes of disease in current medical thinking. In the process of reducing illness to disease, the attention of Physicians has moved away from the patient as a whole person.' p.43.

Thinking about this in basic instrumentalist terms the reliance on optics, the craft of telescopes and microscopes to discover the very large (our Milky Way as 'a' galaxy) and the invisible - germs, bacteria must have been a profound factor.

If you are selecting subjects for age 16 exams, do not underestimate the value of SOCIO-ECONOMIC history. It has helped me as a community mental health nurse. Especially in light of austerity (UK), the cost of living and energy crisis and the 'housing disaster' (book 2024 with) posts to follow. Chapter 3 uses b&w illustrations of key figures, such as, Locke, Adams, and Marx. I remember in the media, economics education being questioned. That is part 1: concise (p.59!) and yet still relevant today.

Many thanks again to CUP for the pb copy.

Fritjof Capra and Pier Luigi Luisi (2014) The Systems View of Life - A Unifying Vision. Cambridge: Cambridge University Press.

https://www.cambridge.org/gb/universitypress/subjects/life-sciences/genomics-bioinformatics-and-systems-biology/systems-view-life-unifying-vision?format=HB&isbn=9781107011366

Drupalcamp London: And all that jazz

Drupalcamp London was a bootcamp literally in light of the weather. This affected the schedule a bit but it was well worth attending.

The first session on my list was not the intended module development but:

Flexible content editing with paragraphs and Drupal 8 - with Baddý Sonja Breidert who stepped in at short notice. We were encouraged to look at Open Doors as an example of Paragraphs being deployed. The fact that there were 25 types of paragraphs prompts the thought - not so much how many would I would need but the users? Apparently, paragraphs are not that user friendly to edit. Navigation was indicated 'Manage Display' - 'Preview' - 'Paragraph'. The 'environment indicator' flagged whether the site in use was live or dev: a reminder. A future tip included not using entities, but media for anything reusable. Reusable paragraphs were applied to banner and images, using simple entities. There were some special functions (and specific modules) in the table of contents, entity embed, entity browser, insert view and add map.

In considering when to use paragraphs this connects with choosing content types - another key question for me. There was a lot more in what was a 'changed session'. I'll check the slides / videos were available and for those below. The three keynotes were excellent too:

Let’s take the best route - Exploring Drupal 8 Routing System

Drupal in the era of microservices

"Hi user, I am Drupal. How can I help you?"

Accelerating Drupal projects with Thunder: a case study

In 'Make your site findable' dutchyoda Dick Rensema pulled me up short. So, I will check out the metatags module and use this from the outset. As for being findable - it's also best to have separate text and images not have both within a WYSIWYG editor. Another point is to 'make it long'. That sits well for the archive pages for Hodges' model.

Lunchtime on Sunday was preceded with gambry on Plugin API, a key idea being:

ENTITY - Same model different data
PLUGIN - Same "thing" type different ways

This was a captivating, dense, rich session and one to revisit.

Finally, the 0930 start in London helped as I'd been up late. Ronnie Scott's is an amazing experience, the second house from 1030 doors open through to 0300: I left at 3 thanks also to Resolution 88.

MAACAL: Statues Also Breathe

Catharsis Arts Foundation in collaboration with Obafemi-Awolowo University and 108 students, 2022

This exhibition presents a collaboration between Obafemi-Awolowo University, 108 students from all across Nigeria, and the families of the Chibok girls who were kidnapped by Boko Haram in 2014. 

Inspired by the iconic terracotta heads of Ife, it was initiated by artists Prune Nourry and Ade Bantu and seeks to raise awareness on the plight of the missing girls, and to highlight the diversity of Nigerian culture. . . .

On Thursday I visited MAACAL - Museum of African Contemporary Art Al Maaden, an art gallery  I first read about in FTWeekend Life&Arts, not long after first visiting Marrakech in 2023.

The main exhibit presents itself straight away after entering:

Statues Also Breathe, exhibition view, Art Twenty One, Lagos, Nigeria
 ©Dohdohndawa Photography/DDD Studios

A short but touching film in the gallery bears testimony to the fact many 'school girls' are still absent. Repetition is standard method in design. In today's manufactured world you might think what is so special about this? Until you are there physically, and walk through them. You see each one, a who: unique, an individual, a person taken away from where they belong.

As a white man from NW England, there was a moment when I realised: I was on the same continent where this had happened and is ongoing. Searching Youtube reveals other related videos concerning the exhibitions. It's strange watching them again as a check on their availability. A short video of an event to launch three new installations earlier this year is worth watching. Unfortunately, my phone failed until I got back to Marrakech, so I've no photos. I've three works in mind though.

I walked there, and back after trying to sort a taxi with a lovely couple from Germany and their son. Some taxis are limited to carry three persons. This is what arrived. The sun, even behind clouds that day, and flights taking off from the airport helped my sense of direction. The girls, seeking an education, did not have these means of navigation.

The garden at MAACAL was small but lovely. I hope to return one day, and well before then . . .

Test page - CSS for the old content (and new)

The work to re-style - OK actually 'style' - the existing site content is ongoing.

There are two drop capital formats at present, still experimenting. The first gets upset in Netscape (although I gather NS is no longer supported beyond this or next month). There is much still to do -

• Styles for TABLES
• Quotes, cite and abbreviations
• More work on the heading tags
• Lists - ordered and unordered (I've used an image for a bullet)
• hierarchy (as here)
• I'd like to use a typewriter style font for the references.
• (?Drupal)
• Paging and navigation of the same
• Accessibility
• Printing

I wondered that although Brian's original notes and my original introduction are to be 'archived', whether I could punctuate the text with an 'update box' feature? The user would have a choice whether to omit this when printed or displayed.

The style sheet used above is a bit of a monster, as it includes all the elements for the Drupal theme. Constantly navigating this is helping with the wider aspects of styling to follow.

You may notice on the links pages, e.g.: SCIENCES I've deleted the existing column headings and added the 'th' tag to the main table. So, at present the column headers don't look very pretty. In truth they never have really. They will be much better.

I've been fairly pleased with much of my early HTML work, I can't believe that I never made proper use of the heading and so many other tags. In Dan Cederholm's book the advice is to sort the STRUCTURE first then the STYLING. Pretty sound me thinks - I better get on with both...

'Life's compass' ...

'... I have been thinking a lot about the responsibilities of leadership. How do people in positions of power reach decisions and do they fully consider the consequences of these decisions? In questioning how someone chooses to lead, I'm also asking how that individual navigates the possible courses of action, and what kind of compass is being used to guide them. It has made me think about how any of us choose to navigate our way through life and where we look for a sense of direction. I wonder what we might change about the choices we make if we were more reflective about what serves as a compass in our lives.'

'"The Invention of the Compass" is attributed to an anonymous painter of the late 16th century, although there exists a roughly contemporaneous plate of the same title, and of an almost identical image, engraved by the Dutch artist Jan Collaert the Elder. In the original painting an old man with a long white beard, and dressed in a voluminous red and brown cloak, sits behind a large table in the centre of a room. As well as a canopied bed and another desk spread with books and scientific instruments, there is a model, or vision perhaps, of a carrack sailing ship hanging from the ceiling. There is also a large round compass device that sits heavy on the floor on the left foreground of the canvas. ...'

'It is as if this painting (Caravaggio) intended to serve as a compass, helping to move our steps and actions in the direction of caring for others. This is a powerful idea, and it suggests that all images contain that potential to influence how we live. Where we choose to direct and keep our gaze to some extent can determine how we permit our lives to be guided, if not in a physical sense then toward a value system that can end up having an impact on the way we engage with the wider world.' (My emphasis)

Ack. Enuma Okoro, Life's compass, The art of life, Life&Arts, FTWeekend, 1-2 February 2025. p.2. (Still need to subscribe, marvellous reading!)

Caravaggio, The Seven Works of Mercy

The Invention of the Compass

INDIVIDUAL

|

      INTERPERSONAL    :     SCIENCES               

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

 SOCIOLOGY  :    POLITICAL 

|

GROUP

moral compass personal values my choices	maps - compass position - navigation direction - distance degrees of freedom
the public the public good group think	leadership power political freedom

Enuma Okoro, Life's compass, The art of life, Life&Arts, FTWeekend, 1-2 February 2025. p.2.

Images: 

New Inventions of Modern Times [Nova Reperta], The Invention of the Compass, plate 2
https://collectionapi.metmuseum.org/api/collection/v1/iiif/659663/1403273/main-image

By Caravaggio - Unknown source, Public Domain, https://commons.wikimedia.org/w/index.php?curid=10286196

Previously:

'compass' :: 'map'

Two one-day events in September: BCS SPECIALIST GROUP ON AI

BCS SPECIALIST GROUP ON ARTIFICIAL INTELLIGENCE (BCS-SGAI)

 

There are two one-day SGAI events arranged for September, both at the British Computer Society London office (near Moorgate underground station).

 

Trustworthiness and Safety in Generative AI - Friday September 11th 2026

https://www.bcs-sgai.org/genai2026/

 

Real AI 2026 - Friday September 25th 2026

https://www.bcs-sgai.org/realai2026/

 

There are online registration forms available from the event websites.

 

Trustworthiness and Safety in Generative AI - Friday September 11th 2026

Despite impressive breakthroughs in capabilities across text, vision, audio, and multimodal reasoning, current generative models remain prone to unpredictable failures and exhibit unresolved challenges in alignment, grounding, and robustness techniques, including hallucinations, instability under distribution shift, hidden internal representations, and limited theoretical understanding of how large‑scale models encode and propagate knowledge. This colloquium aims to create a forum for discussing cutting edge advances and emerging challenges in the trustworthiness and safety of generative AI.

 

The talks will include:

• Beyond the Pixel: Trustworthy and Safe Generative AI for Medical Image Quality Transfer
• Spoofing Deep Leakage Attacks in Federated Learning
• Can We Trust the Voice on the Line? Robust Audio Deepfake Detection from Real-World Calls to the First “Hi”
• The Scenic Route to Deception: Dark Patterns and Explainability Pitfalls in Conversational Navigation
• Differential Adjusted Parity for Learning Fair Representations
• Decision-theoretic uncertainty quantification in generative deep learning
• Zero Trust Architectures for Secure Multi-Agent AI Systems: From Identity to Collaboration Integrity

Registration fee: £50 (plus VAT) for BCS and SGAI members and £90 (plus VAT) for others. This includes attendance at the event, lunch and refreshments.

Students and unwaged: £35 (plus VAT).  Group discounts are also available.

 

Real AI 2026 - Friday September 25th 2026

This event is aimed less at deep AI specialists and more at those who may be interested in understanding what AI can offer, and what it is doing right now. The event will feature talks from leading exponents and case studies outlining practical applications of AI from a wide range of application domains. Plenty of time has been allowed in the programme for discussion.

 

The talks will include:

• Evolving the SDLC: Our Journey Towards Agentic Software Engineering
• Robotics in the Age of AI: Adoption, Illusion and Direction of Travel
• Is Judgement Uniquely Human?
• Agent Trust and Coordination in Autonomous Multi-Agent Cyber Defence Systems
• Agentic AI: The Good, the Bad, and the Ugly – Three Real-World Use Cases

Registration fee: £90 (plus VAT) for BCS and SGAI members and £110 (plus VAT) for others. This includes attendance at the event, lunch and refreshments.

Students and unwaged: £50 (plus VAT).  Group discounts are also available.

 

Max Bramer, Chair, BCS-SGAI 

bcs-sgai.org

[And my source.]

After'math' II of... The Difference that Makes a Difference

Continuing in the vein of challenging and stimulating ....

It seems there are several people attributed with the saying "the map is not the territory". The debate around maps and territories came up in discussion and is frequently raised on psychology and therapy discussion lists. At DTMD I referred to h2cm as a cognitive periplus, which I came across in Cunliffe's book The Voyages of Pytheas. Basically, ancient mariners would draw a map, a periplus of the coastlines for navigation and an outline of land masses. During the meeting I came to equate the basic features on the coast as data; buildings or smoke as information; and the conclusions derived as knowledge. Whether to proceed inland well, that is about pioneering, courage and wisdom.

A challenge comes with the DTMD talk of information theories. The DTMD workshop was promoted as a forum to discuss and expand our collective understanding of what we mean by information in our different disciplines.

What would an information theory based on the knowledge domains look like? Given the presence of the SCIENCES domain then the mathematical and logic-based theories are already determined for us, are the specific information theories and models that relate to the physicality, the entropic journey of the body? What information theories can we identify for the other domains:

• INTRA-INTERPERSONAL?
• SOCIAL?
• POLITICAL?
• and the spiritual, unknown?

If we categorised the 25 info theories listed by Paolo Rocchi in his session how might they be distributed across the h2cm domains?

Here is part of the listing c/o Prof. Rocchi and with many thanks:

• The statistical theory of information by Shannon (1949);
• The algorithmic theory of information by Solomonoff, Kolmogorov (1965), and Chaitin (1977);
• The economic theory of information by Marschak (1971);
• The living system information theory by Miller (1978);
• The autopoietic theory of information by Maturana, Varela (1980);
• The biological information theory by Jablonka (2002);
• The cybernetic information theory by Nauta jr. (1970);
• The dynamic theory of information by Chernavsky (1990);
• The fisherian theory of information by Fisher (1950);
• The general information theory by Klir (1991);
• The general theory of information by Burgin (2009). ...

What is the result? What criteria determines the final domain 'home'? On what basis can we differentiate such theories - quantitatively and qualitatively? As noted at DTMD where are the family resemblances? Perhaps they can be found within the care domains:

Sciences - inclusion of a mathematical - logical underpinning (There be equations in the hold!)?
Social - reference to social and family networks without explicit recourse to mathematics? The use of psycho-social concepts?
Interpersonal - reductionist-wholist rendering that incorporates perception, individual information processing? What can be drawn from the latest research in anxiety and psychoses for example? Is it appropriate to wonder if ontological* approaches have anything to offer?
Political - Theories that cover economics and also explain power relations, decision making, and choice for example? 

Even though when we see / read the word 'unified' you tread carefully, Hodges' model ultimately presupposes a unified view. Recall again the DTMD2011 challenge:

to discuss and expand our collective understanding of what we mean by information in our different disciplines.

So the purpose here on W2tQ and through h2cm is to focus on all the domains simultaneously; at least when information in the context of health is our concern. As I mentioned in my presentation, there are clear exceptions in emergency and crisis situations. Then 'holism' is suspended. Information (re)sources, selection, analysis, synthesis and salience are focussed; specialised individual, team and organisational memory are brought into play with varying degrees of technology in support. The second-by-second, minute-by-minute demand for data, information and knowledge increases, its longevity in terms of significance may decrease, replaced by updated values by turn until 'stability' is restored: by human effort or nature.

To be sustainable (applicable, creditable, relevant ...) for me a unified theory of (health) information must span situations such as the emergency and all the h2cm domains and care contexts. Now that is a challenge!

*What would it mean to create four ontologies that could be merged together?

Navigating Health and Social Care: We are on a mission - aren't we ...?*

"Before the introduction of instrument navigation, an aircraft pilot had to give up his mission whenever weather conditions worsened to a degree where visual orientation did not allow for secure landing at his destination airfield. This is situation of today's surgery." p.43.

Adams L, Krybus W, Meyer-Ebrecht D, Rüger D, Gilsbach JM, Mösges R, Schlöndorff G (1990)
Computer assisted surgery. IEEE Computer Graphics and Applications. 10:43–51.

*All together.

What's in a Name?

  Or, The First Rule of First Aid* ... #SafeStaffing

Health care is often described as complex ...

there are tools to help simplify, conjoin 

and help care navigation and learning ...

Despite this and even if people are listening

politics, politicians and policy makers seem determined to turn health care into a maze ...

INDIVIDUAL

|

INTER-PERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

GROUP

*Protect yourself first.	"WAITING ROOM" "WAIT HERE"

RCN Safe Staffing Campaign:
https://www.rcn.org.uk/employment-and-pay/safe-staffing

patient safety learning hub:
https://www.pslhub.org/

'Named Nurse' 25 years ago.
Mitchell G, Strain J. The role of the named nurse in long-term settings. Nurs Older People. 2015 Apr;27(3):26-9. doi: 10.7748/nop.27.3.26.e679. Review. PubMed PMID: 25809049.

My source (and image):
https://twitter.com/helenh49/status/1210956380636663813