DSA & Q-Lab: 'In an Age of Answers, Questions Matter More Than Ever'

This afternoon I joined an online webinar organised by THE DIGITAL STATECRAFT ACADEMY:

'Gaining understanding by structuring inquiry: 
probing data with one right question after another is almost here'

The art, science, and practice of governing well in the algorithmic age

The Digital Statecraft Academy (DSA) is a global hub for cultivating visionary public leaders ready to navigate the complexities of data, AI, and digital governance. Backed by world-leading academic and policy institutions, DSA equips today’s leaders with the tools, knowledge, connections, and foresight to govern ethically, strategically, and resiliently in a rapidly evolving digital world.

 

There is a manifesto to read and endorse: and Ten Principles of Digital Statecraft

 

Also highlighted was Q-Lab 

About Q-Lab

Questions shape what becomes visible, what is investigated, what is funded, and ultimately what societies come to know. They are fundamental not only to scientific inquiry but to a wide range of sectors and practices—from education and journalism to policymaking, medicine, law, and business, among others.

Despite this foundational role, questions are seldom treated as objects of systematic study. Established fields examine intelligence, knowledge production, and decision-making, yet few, if any, take questions themselves as their subject.

How should we define a good question? Which questions are most likely to serve as stepping stones toward breakthrough insights? Who determines which questions matter most? In short, what do we actually know about questions?

Questions Lab (Q-Lab) is the first multidisciplinary initiative dedicated to establishing questions as a field of study and practice, understanding how questions emerge, how they evolve, which questions make the greatest impact, and how they shape the trajectory of knowledge across disciplines and generations, in order to help individuals and institutions navigate complexity, deliberate more thoughtfully, and set better priorities.

I look forward to more events in future.

 

Previously: Questions in eclipse : 'question'

Student engagement survey UK pilot – Year 2: HEA

Forwarded from the HEA

The National Survey of Student Engagement (NSSE) was designed to measure students’ participation in activities and practices that are known to relate to improvements in learning. It asks about the amount and quality of effort that students invest in their studies, as well as the extent to which their courses and institutions are supportive and encouraging. It was developed and first used in North America in 2000, and has now been adapted and implemented in Australia, New Zealand, South Africa and Ireland.

In early 2013, nine UK institutions piloted a range of survey questions derived from NSSE. The questions were focused on four key areas:

• Critical thinking. Four questions asked students about the emphasis their coursework placed on a range of mental activities such as evaluating and applying information.

• Course challenge. Three questions focused on how their courses have encouraged them to work hard.

• Collaborative learning. Three questions asked students how often they had interacted with other students in a range of ways.

• Academic integration. Five questions explored students’ interaction with academic staff, participation in class and discussions with others outside class.

8500 students responded, and the report of the first year of the pilot will be published on 6 November 2013 and will be available at ... The report contains analysis of the results, as well as findings from interviews with students about the questions used.

In order to allow more institutions to take part in this project, and to collect more data for research purposes, the project will run again in spring/summer 2014.

Participation in this project allows institutions to ask students about the extent to which they are investing effort in their studies, to identify areas where more encouragement and opportunities to engage may be required. Institutions will be able to benchmark their own results against the aggregate UK results, both at institutional and subject level, to better understand their students’ engagement.

For full information on the pilot and how to be involved, along with all related documentation please see our website at ...

Kind Regards

Celia

Dr Celia R Brigg

Academic Lead (Business Development)

The Higher Education Academy, Innovation Way, York Science Park, Heslington, York, YO10 5BR

Into the looking glass: A collective self-assessment of health literacy

Dear friend ....

I am hoping to take a quick snapshot of health literacy around the world - and I need your help to accomplish this task.

Below is a link to 10 short and easy-to-answer questions - a very short survey - on SurveyMonkey. Responding shouldn't take more than a few minutes of your time but in the aggregate I believe will produce an actionable and meaningful understanding.

These questions are intended for people/organizations actively working on health literacy issues in communities or clinics or hospitals or states and nations and/or actively conducting health literacy research with people in any context.

I will be in your debt if you could help me by doing just two things that should not take up your time.
1. Respond to the questions - anonymously - yourself.
2. Share this email and the link with your entire network of health literacy professionals.

Here is the link:
https://www.surveymonkey.com/r/VXPZJPL

If you have any questions or concerns about this effort, please contact me directly.

Best wishes as always,
Andrew Pleasant, Ph.D.

HIFA profile: Andrew Pleasant is Director of Health Literacy and Research at Canyon Ranch Institute, United States. Professional interests: Health literacy, Prevention of disease, Integrative medicine, Health system reform. andrew AT canyonranchinstitute.org

My source: HIFA.

[ Completed. PJ ]

NW England: UCLAN - Postgraduate Student Conference 2015 Designing and Delivering Research to Inform Clinical Practice

School of Health

Monday 26th January 2015 

9am to 4pm Adelphi Conference Room

A series of short talks to stimulate and inform those contemplating, planning and undertaking research

Supporting UCLan’s postgraduate students

8.30 Registration. 9.00 Start.  

9.00 – Welcome by Professor Tim Thornton, Professor of Philosophy and Mental Health. Why do we need different research methods?  Chair: Professor Caroline Watkins, UCLan School of Health Director of Research.  

9.20 – Dr Louise Connell, NIHR Career Development Research Fellow. Developing a health research career.  

9.40 – 10.20 Session 1 - Systematically reviewing the evidence.  
• Dr Stephanie Jones, Senior Research Fellow & Colette Miller, Research Assistant. Searching the literature to explore what impact training health professionals has on patient outcome. 
• Dr Gill Thomson, Senior Research Fellow Maternal and Infant Nutrition and Nurture Unit (MAINN). Metasynthesis – why and how we do it. 

10.20 - 10.30 Questions 

BREAK – 10.30– 11.00 (30 minutes tea/coffee/networking) 

11.00 – 12.00 Session 2 - Clinical Trials and complex interventions. 
• Dr Chris Sutton, Principal Lecturer and Associate Director Lancashire Clinical Trials Unit. The role of feasibility trials in the development and evaluation of complex interventions. 
• Dr Michael Leathley, Post Doctoral Research Fellow/Principal Lecturer (Research). Health economics in feasibility trials. 
• Dr Lois Thomas, Reader in Health Services Research. What do process evaluations contribute to trials of complex interventions?  An example from the ICONS: Identifying Continence OptioNs after Stroke Trial.  

12.00– 12.20 Questions  

LUNCH 12.20 until 13.20 networking. Sandwich lunch provided  

13.20 Chair: TBC  13.20 – 14.20 Session 3 - Implementation science and service user involvement. 
• Dr Rob Monks, Senior Lecturer and John Billington. Experienced-based co-design. 
• Dr Mick McKeown, Principal Lecturer, Centre for Mental Health and Wellbeing. & Fiona Jones, Community Futures.  Activism, action and alliances: meaningful involvement in research.  

14.20 – 15.00 Session 4 Qualitative research to answer health and social care questions. 
• Dr Janine Arnott, Research Fellow, Children’s, Families and Transitions. Data collection from children. 
• Prof Soo Downe, How qualitative research can influence national and global policy in maternal and child health.  

15.00 – 15.20 Questions  

15.20 – Dr Alexis Holden, Head of UCLan Funding Development and Support. ‘UCLan Research and Innovation Office (RIO) – How can we help you?’  

15.40 – Final session - TBC.  

16.00 CLOSE

...

Adelphi Building, Preston (Adelphi Conference Room, UCLan's Adelphi Building, Adelphi Street, Preston, PR1 7AY

[ I only learned of this event yesterday afternoon and have managed to secure leave and a place - there are a few more left. ]

Questions in eclipse

 Last Friday 9th I had a Zoom chat for 30 mins, regards Hodges' model with faculty in the USA.

We touched upon:

• background to Hodges' model
• courses taught across the water and interests
• overlaps, inc. person-centered care - socio-technical
• informatics & literacies
• maths/logic

As an outcome it was suggested I forward some questions I'm currently of Hodges' model. Questions that for me, are challenging, put me in the dark, and may not even be valid?

Going through my draft notes I picked out 20, beginning with the working title:

Hodges’ Model as a mathematical object and relational ontology:
category theory or category mistake?

1. Can it be argued there is what amounts to a care locus - that can 'locate' person-centredness?
   
   
2. Can the model's domains be seen as functions?
   
   
3. Are the domains placeholders?
   
   
4. Is there a case to test, and if logical implement co-domains (e.g. parity of esteem)?
   
   
5. Are there other 'structures' in Hodges' model,  for example L-shaped forms, that is relations that involve three domains and (seemingly) omit one?
   
   
6. Are there practical - case studies - that can be associated with such structures?
   
   
7. Can Hodges' model be considered as a single conceptual space (Gärdenfors), or a series of four? (blog posts)
   
   
8. Can Hodges' model be used to identify and apply threshold concepts (Meyer & Land)? (blog posts)
   
   
9. Can we argue that the structure of Hodges’ model as defined by the axes extent, provides and invites inverse relations?
   
   
10. Is Hodges' model as a structure only (a template) equivalent to an empty set (empty set as an initial object)?
11. Is this a mathematical analogue (being neutral) to a practitioner's unconditional positive regard?
    
    
12. Taking its axes and four (care/knowledge) domains can Hodges' model be reduced to a graph?
    
    
13. If Hodges' model acknowledges/incorporates Cartesian duality, are there Cartesian products?
    
    
14. In these Cartesian products are critical operations, e.g. relating to psychotropics - physical health; eating disorder - physical/mental health; complex emotional needs - policy (evidence-based care)?
    
    
15. If the model is inverted, mirrored ... what follows: is the structure - function - consistency retained?

    
    
16. Is Hodges' model 'closed' in comparison with Buzan's (open?) approach to mind-mapping?
    
    
17. There is an 'equation of time': is there an 'equation of care'?
    
    
18. Thought experiments: (semantic distance... cognitive linguistics)
    
    

    Which concept (INTERPERSONAL :: SCIENCES) is closer to the ‘INDIVIDUAL’ axes; which is closest to the ‘GROUP’ (SOCIOLOGY :: POLITICAL)?

    
    

    Which concept (SOCIOLOGY :: INTERPERSONAL) is closer to the HUMANISTIC axes; which is closest to the MECHANISTIC (SCIENCES :: POLITICAL)?

    
    
19. Role of 'types' in Hodges' model - that is, patient / model as a whole as objects (with identity)?
    
    
20. What significance can be gleaned given commonality between several mathematical terms, e.g. group, object, (co-)domain and Hodges' model?

I can no doubt structure - group these questions, and I've not picked out many concerned with Hodges' model as a set, or, as yet, those venturing into category theory. I am wondering, what the commutative law might tell us about holistic, integrated care, and parity of esteem when applied through Hodges' model? Also refining 3-4 case examples to explore and illustrate the same?

While it is maths that prompts this diversion, perhaps ultimately health care disciplines can determine its own formal approach that can produce its own context-sensitive rules, that straddle mathematics/logic and the humanities?

In initial emails, I'd noted the forthcoming eclipse across the USA. Checking, my interlocutor is just N of the path of totality (I wish!) for April's total eclipse. I'm enjoying the darkness here too.

https://science.nasa.gov/eclipses/future-eclipses/eclipse-2024/where-when/

#TotalEclipse2024 #SolarEclipse2024

"Perceptions of Nursing and of a Midwestern Associate Degree Nursing Program" study by Shannon Frodge

In August I posted the news and success of Shannon Frodge's Master's study in which Hodges' model was used as a theoretical framework.

I've copied the abstract, Shannon's reference to Hodges' model and her research questions below. There are some 55 pages, 9,700 words in total, if you want to the read the discussion and conclusion well according to Shannon the text is available on ProQuest.

Every so often I'll bring up the matter of nurse, health and social care recruitment on W2TQ: it really is going to be critical. I do not work in HR - recruitment, but being interested in public (mental) health I am very conscious of demographic trends and be(d)sides standards of care matter too...

Thanks Shannon for the copy, your specific focus on this issue and for recognising and using Hodges' model. I know evidence is important in terms of the tools we use, but you've demonstrated that tools can have a legitimate entry point in their adoption and application. You've posed many questions and presented new angles with recommendations too.

Abstract

The current nursing shortage is complicated by the fact not enough students choose nursing to offset the number of nurses who are nearing retirement. This is distressing to the profession, and is of particular interest to nursing schools. This quantitative, descriptive correlational study examined the perceptions of 99 students in grades sixth through twelfth in a public Midwestern school system regarding nursing as a career choice, 41 current students in the local community college’s nursing program, and recruiting methods that would or did most influence them. The framework for the study is Brian Hodge's Health Career Model. Students were surveyed using a Likert-scale tool with demographics and comments. Descriptive statistics included frequency tables, cross tabulations, chi squared, and confidence intervals. Comments were grouped for qualitative phenomenologic purposes. Findings indicated statistically significant differences in perceptions of students based on sex and grade which could be used to enhance recruitment efforts.

Research Questions

Specific research questions pertaining to this study are:

1. Are middle and high school students in a Midwestern community considering nursing as a career choice?
a. If so, what are the reasons?
b. If not, what are the reasons?
c. What recruitment strategies would most influence these students to decide on nursing as a career choice?
d. What recruitment strategies would most influence these students to seek their education at the Midwestern community college ADN program?

2. Of currently enrolled students in a Midwestern community college ADN program:
a. What recruitment strategies most influenced these students to decide on nursing as a career choice?
b. What recruitment strategies most influenced these students to seek their education at the Midwestern community college ADN program?

Theoretical Framework

The framework for this study is Brian Hodges’ Health Career Model (Hodges, 1997). This model looks at the nurse as an individual whose practice depends on his/her education and past experiences (Hodges, 1997). The model is composed of two intersecting lines that look at the nurse’s attributes both individually and in group settings, and his/her ability to perform job duties both interpersonal and mechanical (Hodges, 1997). Within the four quadrants then, Hodges identifies four major areas of knowledge necessary to practice nursing (Hodges, 1997).

This particular framework lends itself to this study as it looks at traits of individuals who are nurses and helps to explain how their background and knowledge influence the care they give. Hodges writes “the health career is influenced by personal factors of the individual of physical or psychological origin and factors relating to the social world and the policies that govern daily life” (Hodges, pp 1, 1997). Because some of these attributes or interest in these knowledge areas must be present in order for an individual to choose nursing, the model is appropriate to the study.

IO Magazine #41 Being = Space x Action

"The Parmenides poem in fact opens a rather impressively large range of philosophical issues which remain unresolved to this day: the questions of the unity of knowledge, the unity of being, the unity of knowledge and being, the nature of proof, the nature of thought itself, the nature of justice, the relations between thought, proof, knowledge and justice, the possibility of rational cosmology and the relationships between logic and cosmology, the existence and nature of abstract entities, the privileged status of philosophical knowledge - all these questions became explicitly formulatable questions immediately following the production of Parmenides poem, none of them are definitely resolved today, and the future of science, culture and the human spirit all depend to a far from trivial degree on how these questions come to be reflected upon." pp.3-4.

IO Magazine. Reveal Digital, 01-01-1988
Contributed by: Charles Stein; Don Byrd; A.S. Yessenin-Volpin; Christer Hennix; Henry Flynt; Henry Flynt; George Quasha; Charles Stein; Christer Hennix; Luitzen Egbertus Jan Brouwer; L.E.J. Brouwer; L.E.J. Brouwer; Charles Stein. Stable URL: https://www.jstor.org/stable/community.28038534

The poem: http://philoctetes.free.fr/parmenidesunicode.htm

Sun Microsystems blog: Pretty good example* of a Strategic (Design) Brief

The Sun Microsystems site includes a blog (Martin Hardee) with an article entitled as above that poses eight questions. These questions can greatly inform the process of creating a strategic brief (which is also provided for download). Although the item is from 2005 and the context differs - contrast a corporate website design and a future website for Hodges' model - there is value for me in answering the questions. So here goes... starting with the opening paragraph from the original blog post then the questions in bold, interspersed with my responses:

As I've mentioned in previous postings, the most important single step you can take in designing anything for the web is to create a strategic brief. This should be done early in the discovery phase of any design project. The reason it's so important is that it will make you focus and it will provide a guide map for whoever is creating and implementing your design. To write a strategic brief, you'll need to know a lot of important but oft-ignored basics such as:

A) Why are you embarking on this design (or new web site, or whatever), anyway?

The existing website was created in 1997 using Hot Metal Pro and written in HTML. The site was built as a personal and spare time project around the original course notes of Brian Hodges. These were in the form of Word files produced with secretarial support as part of a Post Graduate Certificate of Eduction project. As a result the current website has developed in a rather ad-hoc manner, with the addition of pages on informatics and information. The home page was re-designed in 2005 using Fireworks (Adobe) reflecting the model for which it is 'home'. At no point thus far has the website provided a community for users of Hodges' model. The site is currently static, without a database to support dynamic content development and a community of users.

Use of Drupal will provide a (truly) dynamic lever by potentiating the following:

1. sheer unadulterated enthusiasm and fun (lifelong learning - literacy skills);
2. a more professional footing (hosting...);
3. international customisation (multiple languages);
4. ultimately address several audiences (health, education, informatics and public);
5. find out what would-be users of the model want;
6. create some consistent styling;
7. provide an archive;
8. building on the foundation provided by the website and this blog W2tQ;
9. provide a foundation for future research (by producing my 1st Drupal site - a beta);
10. (As already noted I have wondered about linking this project to a research course, but at the moment I ask myself what's the point...?)

B) What are your business objectives and how would you measure success?
There are no 'business objectives' as such, but if this blog and a future site can generate some revenue to support purchase of hardware, (some) software and services then "that's about time". General objectives are to generate critical thinking and decisions on:

• content types to support the use of Hodges' model;
• phased development;
• interface design - use of Ajax, jQuery.

Ultimate (reach for the stars...) objectives:

• to invite users to contribute to the model's development;
• reopen the question of visualization in the social sciences;
• to learn of other conceptual frameworks that might also support 'global health for all';
• to produce a virtual learning environment that conjoins health, informatics and education;
• to influence nursing curricula development;
• to create a self-sustaining global community of users
• to cover some costs and let go. ....

C) Who are your various audiences or customer segments and what are their objectives (often different from your business objectives, btw)

+ students (health and social care); students (generic - PSHE);
+ all qualified care professionals
+ lecturers

The objectives here are diverse, but include completion of learning and course tasks, including essays and case studies, tools to support and demonstrate reflection and holistic / integrated care in theory and practice. Lesson plans and means of assessment are also essential, to what extent can students and professionals - indeed all users of a conceptual framework demonstrate - competency? This has to be through specific assignments and marked assessment which could include:

1. essay;
2. case study;
3. oral presentations, audio, video podcasts;
4. quizzes, e.g., multiple choice;
5. and possibly specific 'roles' through the Drupal site.

The politics of the educational establishment include that tools should be evidenced, safe, fit for purpose. There may also be a requirement to dovetail with use of dedicated learning management systems and standards such as SCORM. As such a new site should seek to incorporate such standards - through Drupal - in so far as they do not affect innovation and projecting the model into the future.

+ patients and carers

Patients and carers would often benefit from a means to facilitate dialogue with their keyworkers and the associated health and social care team. Hodges' model can help provide a schema, portal and media form for such dialogues. This dialogue can potentially act as:

• an aide-mémoire for the patient during a Consultant appointment (maximising the time available for both parties);
• a means for educational engagement (medication concordance, relapse prevention....).

+ policy makers and care commissioners
+ managers

These stakeholders are concerned with metrics, outcomes, quality and evidence.

+ information and communication technology staff

In addition to project management tools ICT staff would benefit from tools that support socio-technical perspectives.

For all the would-be users of Hodges' model the critical question is evidence. The new site should provide a foundation for research in Hodges' model and other conceptual frameworks.


D) What's the scope: How much are you going to tackle at once?

By using a content management system Drupal provides a means to be more productive (once sufficiently skilled!) in terms of addressing the objectives and scope delineated above.

This is the key question!

I need to acknowledge advice already provided from friends at the Drupal NW England group and Ruby community. Basically - do what you need to to get a site out of the door. What I must identify is the baseline functionality and design that will provide the foundation for a site. The baseline must include:

• roles and access rules;
• at least one specific content type (whether existing or new) for Hodges' model;
• RDF;
• accessibility.

E) What sort of constraints do you have in terms of product, business process, technology, or budget?

Hodges' model is nebulous and grand in its potential scope so it is vital that constraints are imposed on the project. A new PC and software will prove a great advantage leaving behind a trusted 7 year old machine. There is a no dedicated budget for the project.

The biggest constraint is time. This is non trivial and has already impacted this blog in that the comments are disabled. Early on the comments facility invited spam.

F) What existing projects and groups does this project need to coordinate with in order to avoid a train wreck?

None. The only legacy commitment are to move the existing pages to an archive that is readily accessible and signposted.

There are however two considerations:

1. Since first identifying Drupal as the platform to adopt, it was at version 4.7. It is now on the brink of version 7.0. This dynamic development environment presents challenges of its own.

2. As already highlighted if the new site is to reach the educational community it will be necessary to take heed of existing Drupal modules and resources, e.g. the DrupalEd distribution, The Scientific Collaboration Framework and assess their suitability - 'off the shelf'.


G) What kind of market and "voice of customer" research (including site metrics) do you already have?

In ten years with the existing site evidence shows that people do not have time to 'get in touch'; more needs to be offered. The existing website is 'failing' in terms of:

• as stated its dated design;
• site metrics - hits;
• publishing standards (academic, relevance, timeliness and currency, referencing, styling, semantic markup);
• and user engagement.

Despite the non-trivial constraint of time and website 'stasis' this blog is an emerging as a potential channel of engagement. The clustermaps and recently added 'flags of the world' demonstrate the global appeal of the content here and hopefully the model. Since there is little time for analysis of Google analytics data, the new site will utilise core statistic functionality and contributed modules as available (and proven).


H) What are the roles on the project? For instance, if you're engaging a design vendor what are they delivering vs. what are you delivering to the final mix?

As per the existing site and given budget constraints (i.e. there is none) there are no 'roles' on the project. All are up for grabs and presently rest with me. Hence the appeal of a content management system (Drupal) to ease the design and development burden.

Additional links:

Sun Microsystems blog post:
http://blogs.sun.com/MartinHardee/entry/pretty_good_example_of_a

Drupal
* The good example here is the title of the Sun Microsystems article and not necessarily my answers to the questions.

Image sources:
Drupal Groups
Chess piece:
http://www.mindful-leadership.com/Strategy%20Facilitation.htm

HIFA Discussion: Alcohol Use Disorders - Drink Aware and Change

Dear HIFA colleagues,

I would like to invite you to retweet the following that I have just sent on our X/Twitter account:

"Pls RT: I just took the DrinkAware test as if I drank 3 pints a day (well over the recommended limit). The result was "Great news! You are at lower risk of alcohol-related problems". We invite others to check. Thx NPW https://www.drinkaware.co.uk/tools/drinking-check#/ "

You can see the tweet and retweet here: https://twitter.com/hifa_org/status/1762399130154885617

We are unsure why the test - which is taken by 900 people every day - is providing such misinformation.

DrinkAware is funded by the alcohol industry.

Thank you for your help to publicise this issue.

Best wishes, Neil

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil AT hifa.org

To which I replied:

RT'd as requested.. 

Reply from twitter ... 

This evergreen article was written 10 years ago
"Be aware of @Drinkaware "https://t.co/UGcVFb5gFB via @peter_g_miller et al

— Ash Paul (@pash22) February 27, 2024

McCambridge J, Kypri K, Miller P, Hawkins B, Hastings G. Be aware of Drinkaware. Addiction. 2014 Apr;109(4):519-24. doi: 10.1111/add.12356. Epub 2013 Oct 28. PMID: 24164565; PMCID: PMC3992896.

UPDATE 10th March

Dear HIFA colleagues,

Further to our discussions on HIFA, in the past week DrinkAware HAS CHANGED THEIR ADVICE to people who drink 42 units per week (3X the recommended maximum). Questions remain about how many people were misled by previous advice, whether that advice was deliberate, and whether WHO's AUDIT test (currently used as the basis for the DrinkAware test) should continue to be used by anyone as an unsupervised self-evaluation tool.

BACKGROUND On 22 February 2024 I reported on HIFA an apparent problem with DrinkAware, the UK's largest alcohol charity, funded by the alcohol industry. https://www.hifa.org/dgroups-rss/alcohol-use-disorders-79-role-alcohol-industry-10-alcohol-industry-and-misinformation

I took their Drinking Check. I posed as a man who drinks 42 units per week (3X the recommended maximum) and DrinkAware told me: "Great news! You are at lower risk of alcohol-related problems. This means you are at lower risk of serious diseases such as stroke, heart and liver disease, and seven types of cancer and may already be noticing the benefits of lower risk drinking such as deeper sleep, more energy and brighter moods."

There was no advice to reduce my consumption.

This test was repeated by other HIFA members in subsequent days, with the same results.

On 4 March 2024 we reported our findings to the World Health Organization.

CHANGE IN ADVICE Today, 10 March 2024, I took the test again. As before I posed as a man who drinks 42 units per week. This time I got a different result:

"You are on the right track. You are at lower risk of alcohol-related problems... To keep your health risks low, the UK Chief Medical Officers advice is to drink no more than 14 units a week. If you are regularly drinking above 14 units per week there are tips and advice below about how to cut down."

INTERPRETATION Prior to 4 March 2024, DrinkAware was encouraging many heavy drinkers (up to 42 units per week) to continue drinking as they are.

DrinkAware claims that its Drinking Check tool was used by 250,991 people in 2021, so it appears that potentially tens or even hundreds of thousands of people drinking 14-42 units per week may have been misinformed.

At some point between 4 March and 9 March, Drinkaware changed their Drinking Check tool so that heavy drinkers (up to 42 units per week) are now advised to cut down.

SHOULD WHO's AUDIT TEST BE USED AS AN UNSUPERVISED SELF-EVALUATION TOOL?

Previous messages on HIFA have suggested that AUDIT should only be used as a clinical tool by health professionals, and not as an unsupervised self-evaluation tool. WHO's AUDIT manual notes: 'Care must be taken to tell patients why questions about alcohol use are being asked and to provide information they need to make appropriate responses. A decision must be made whether to administer the AUDIT orally or as a written, self-report questionnaire.' https://iris.who.int/bitstream/handle/10665/67205/WHO_MSD_MSB_01.6a-eng.pdf

NEXT STEPS

How many people were misled by previous advice, was that advice deliberate, and should WHO's AUDIT test (currently used as the basis for the DrinkAware test) continue to be made available as an unsupervised self-evaluation tool?

I invite HIFA members to suggest next steps. Are you a health journalist (or do you know a health journalist) who might be interested to look into this in more depth? Please pass this on and/or contact me: neil@hifa.org

Meanwhile I shall report this new finding to WHO.

I look forward to your comments and suggestions: hifa AT hifaforums.org

Best wishes, Neil

Finally ...

Dear HIFA colleagues,

We now enter our 6th and final week of the deep-dive into Alcohol Use Disorders, where I invite you to reflect on what has been discussed so far (and what has not been discussed). In your view, what is the key learning in relation to the 5 questions we have explored:

1. Do people understand the health, socio-economic and environmental harms of alcohol? What matters to them? How can they be better informed? How to reduce stigma? 2. Do health workers have adequate knowledge to prevent and manage alcohol use disorders among their patients? What matters to them? How can they be better informed? 3. What is the role of the alcohol industry? What can be done to address misinformation from the alcohol industry? 4. Do public health professionals and policymakers have adequate knowledge to prevent and treat alcohol use disorders in their country? What are current national policies and what more can be done to fully implement those policies? 5. How can we define and measure alcohol use disorders?

To help with this, I have prepared a full compilation of our discussion so far (205 pages):

https://www.hifa.org/sites/default/files/publications_pdf/Alcohol_Use_Disorders_Compilation2.pdf

I shall now work on an edited version (selected text organised under subheadings for each of the 5 questions and for other topics) and will get this to you asap.

Many thanks, Neil

Call for Papers: Bioethics and Philosophical Health - JECP

Submission Deadline: Thursday, 31 December 2026

Contemporary bioethics has developed sophisticated tools for ethical decision-making. Yet it often operates within assumptions that reduce life to physiological viability. Ethical questions are frequently treated as matters of procedure and consent. Meanwhile, patients and clinicians face questions that exceed these frameworks. What makes a life worth living? How does illness disrupt or reveal meaning? What forms of care support not just survival but existential coherence? These questions call for a deeper engagement between bioethics and the philosophy of existence.

Despite growing interest in person-centred care, conceptual tools for clinical evaluation remain limited. Frameworks for assessing philosophical sense-making and existential orientation are underdeveloped. The Philosophical Health perspective addresses this gap by going beyond physical and psychological health. It asks how we cultivate meaningful lives through bodily experience, self-understanding, relational belonging, engagement with possibility, purposeful action, and philosophical reflection. The concept draws on the ancient tradition of bios philosophikos. It proposes that healthcare should attend not only to pathology but to the philosophical dimensions of human existence.

This special issue creates space for exploring how philosophical health can deepen bioethical inquiry as an embodied ethics of the good life. It challenges reductive assumptions and fosters practices that support purpose and meaning in lives, even when disrupted by health challenges. We welcome transdisciplinary contributions from philosophers, bioethicists, clinicians, medical humanists, and social scientists. Topics include how philosophical frameworks enrich clinical practice, how healthcare shapes existential experience, how the 4E cognitive approach may inform bioethical theory, and how dialogical methodologies can be integrated into institutional contexts. The issue aims to rediscover bioethics as a genuinely philosophical and existential enterprise, that is as bios ethikos.

Topics of interest for this call for papers include but are not restricted to:

• Philosophical frameworks for enriching or transforming bioethical practice and clinical evaluation;
• Philosophical dimensions of clinical encounters: embodiment, selfhood, temporality, and meaning-making;
• Critiques of the reduction of ethical deliberation to procedure, regulation, or risk management;
• How healthcare practices shape or constrain the philosophical dimensions of human existence;
• The 4E cognitive approach (embodied, extended, enactive, embedded) applied to bioethical theory and practice;
• Integration of philosophical inquiry and dialogical methods into clinical or institutional contexts;
• Empirical and conceptual engagement with the Philosophical Health methodology, including SMILE_PH;
• Cross-cultural and planetary perspectives on philosophical health and the good life;
• Methodological innovations in clinical philosophy, philosophical counselling, and reflective practice.

More details here: https://onlinelibrary.wiley.com/page/journal/13652753/call-for-papers/si-2026-000772

_______

Dr Luis de Miranda

Associate Professor (Docent) in Bioethics, Uppsala University

Marie Skłodowska-Curie Fellow, Turku Institute for Advanced Studies
Associated Researcher, Centre for Research Ethics and Bioethics,

Department of Public Health and Caring Sciences, Uppsala University

https://www.luisdemiranda.com/

My source: Philos-L "The Liverpool List" is run by the Department of Philosophy, University of Liverpool https://www.liverpool.ac.uk/philosophy/philos-l/ Messages to the list are archived at http://listserv.liv.ac.uk/archives/philos-l.html. Follow the list on Twitter @PhilosL. Follow the Department of Philosophy @LiverpoolPhilos

Networked Learning Conference 2016 leads to Barcelona which means...?

After the ICIC 2016 in Barcelona this past week I'm still reflecting on Lancaster and the Network Learning Conference. It has been a busy month. I'll write about Barcelona (again) soon, but with the ICIC presentation done (thanks to all 30+ who attended the session and engaged afterwards) I can catch up a little. Despite the stress this implies this is all positive as the challenge lies in the opportunities and tensions between nursing-healthcare, education and technology.

In Lancaster, Fran Tracy (Liverpool John Moores University) and Jesper Jensen (University of Southern Denmark) held a symposium - Designs for learning with the Semantic Web. Three papers were presented followed by discussion on:

1) the emergent nature of semantic web technologies, 2) how participatory research practices like DBR are affected during the development of semantic web technologies and 3) how both of these concepts may find a new place as we move forward into increasingly complex and changeable educational environments.

By means of introduction there were several useful pointers and reminders, including Stahl with a definition of emergence and a definition of design based learning (and DB Research). It was the combination of semantic web, DBR and networked learning which made this an immediate must-go-to session for me. My research proposal is seeking to combine these aspects plus situated learning.

I probably won't be following DBR by-the-letter(s) as defined by some advocates. My application will to some extent be emergent. There will, as I envisage it, be several invitations for users to contribute to DBR but being asynchronous this needs to be factored in. All learners - users could contribute to successive iterations, but this is unlikely and once the numbers get beyond 10-15 it would become complex and difficult to make a sense of. Poll-based reconciliation might work? As per #2 above my plan would be that a number of subjects (web users) would provide views on their experience with the model and the future site. So it is DBR on a scale that befits a small-scale evaluation study. Tracey also mentioned Wang and Hannafin (2005) and their definition of DBR:

a systematic but flexible methodology aimed to improve educational practices through iterative analysis, design, development, and implementation, based on collaboration among researchers and practitioners in real-world settings, and leading to contextually-sensitive design principles and theories. (p. 7)

The context sensitive is were I see a role for situated learning. There are a couple of hierarchies that result. Situated learning brings in the community (- of practice), but Hodges' is firstly about the student, the care situation and their learning with the model, reflection and developing reflective practice. There are few examples of technology mediated group reflection, but the technical challenges of the group form make the individual starting point more realistic?

Simonson also cites the above and notes how DBR is pragmatic. My approach is pragmatic (that's why it's taking so long).

In Hodges' model I've written before how the interpersonal care domain, combines the INTRA (an individual's metacognition - their thinking about thinking) and the INTERpersonal (how they relate to the other). The NL conference and this past week at #ICIC2016 have helped me realise that this project may also possess this property*. As an intraproject and interproject (?) subjects (students) may engage at any of the following levels:

• Not engage in design questions at all / Read the intro materials on Hodges' model
• Read the intro materials / use the site for their case study purposes

Drupal can (I believe and have seen demonstrated) provide a great deal of web analytics from logs and reports. There is the prospect of taking this further using web analytics to inform the specific site locations subjects have visited. (For Hodges' model visual tracking would be an excellent measure but that is beyond me). There is a potential escalator of sorts here:

• Use the site for their case study purposes / comment on the usability of h2cm and the site
• Comment on the usability of h2cm and the site / See their web analytics data and my conclusions about this 
• See their web analytics data and my (other student's!) conclusions about this / Use their experience, knowledge and this feedback to respond to design questions

These design questions would then socio-technically span their nursing care learning and TEL. The project as a whole represents at its core the intra, its about the student's reflection and being reflexive. It could be that the project can progress to group and community. As posted previously I have highlighted the functionality of Drupal with respect to the semantic web. I mentioned Drupal in the discussion. The conceptual (and semantic) dimension that can be found within Hodges' model, the curriculum, the learner's vocabulary and development might facilitate that transition from individual to group? Since 2008 I've followed the development of RDF, semantic web in Drupal and the longevity of contributed modules and Drupal projects that have used them. Framing these observations with an emergent lens is fascinating in terms of the challenges, opportunities and tensions in nurse education, TEL and furthering Hodges' model.

I added the asterisk above as what follows from that point seems a long winded description of what is basically an experiment, with the attendant risks... I need to forget about the INTER and concentrate on the INTRA and yet both clamour for attention. Whatever follows must deliver something tangible for subjects^# to mitigate the risk and translate experiment into (some resemblance of) workflow? It can't be quod cum fit, however long 'after' may be...

(The terms intra-project and inter-project are not novel, see for example: http://eprints.qut.edu.au/31946/ )

The symposium paper

Simonson, M. (2006). DESIGN-BASED RESEARCH Applications for Distance Education. The Quarterly Review of Distance Education, 7(1), pp. vii–viii.

Wang, F. & Hannafin, M. (2005). Design-based research and technology-enhanced learning environments. Educational Technology Research and Development, 53(4), 5-23.

# students, subjects, users - all these terms may be applicable.

Planetary Health (ii) (and the need for a global conceptual framework)

I have 5,000 words drafted on Hodges' model and threshold concepts, for which I've yet to find a home. Staying with the previous post's theme of planetary health the paper includes the following: 

A decade ago Groffman, et al., (2006) stated that ecological thresholds can be 'troublesome' in being important but in having no practical application. Threshold concepts are not, however alone; there are also threshold questions (Halldén and Lundholm, 2009). The answers to these questions are critical to global sustainability and planetary boundaries (thresholds) - an ongoing research effort (Rockström et al., 2009).

Groffman, P., Baron, J., Blett, T., et al. (2006). Ecological Thresholds: The Key to Successful Environmental Management or an Important Concept with No Practical Application? Ecosystems, 9(1), 1-13.

Halldén, O. & Lundholm C. (2009). 25-30 August. Conceptual Change and the Complexity of Learning. Threshold Questions, Meaning making and Contextuality. Paper presented at the 13th conference European Association for Research on Learning and Instruction, Amsterdam, Holland.

Rockström, J., W. Steffen, K. Noone, Å. et al. (2009). Planetary boundaries: exploring the safe operating space for humanity. Ecology and Society. 14(2): 32. [online] URL: http://www.ecologyandsociety.org/vol14/iss2/art32/

See also:

Jones, P. (2008). Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons, IN Kidd, T., Chen, I. (Eds.) Social Information Technology Connecting Society and Cultural Issues, Idea Group Publishing, Inc. Chap. 7, pp. 96-109.

WHO Guidance Global Discussion Forum 26 July - 6th August, 2010

Announcement:

Please pass this invitation onto to your networks and colleagues and encourage them to join this virtual discussion forum.

The World Health Organization (WHO) and the WHO Guidance forum invite you to join the

WHO would like you to join a 2 week virtual discussion forum designed to provide an opportunity for people to share their ideas, experience and opinions about the type of evidence-based guidance WHO should produce to support the reduction of maternal and perinatal mortality and morbidity. We want to make this guidance more accessible and focused on addressing technical and health systems challenges and meeting the information needs of people working in this field.

Your contribution to this discussion will help us to identify priority policy or practice issues in which it would be helpful to have either a policy brief, guideline or other type of resource materials produced.

REGISTER NOW! http://my.ibpinitiative.org/whoguidance

During this two-week forum you will receive one-two emails per day: one email to introduce the day’s questions, and one daily digest of the contributions. Five questions will be addressed, and each discussed over two consecutive days. All contributions received will be acknowledged.

Once you have registered you can participate in the forum simply by responding to the daily e-mails or sending a message to:

whoguidance at my.ibpinitiative.org

For any questions on this Virtual Global Discussion Forum please contact the forum facilitator: Cordelia Coltart at: coltartc at who.int

Many thanks and we look forward to hearing your views during this exciting venture.

Cordelia Coltart
Intern WHO
MBBS MPH MRCP BSc DTM&H
Reproductive Health and Research
E-mail: coltartc at who.int

World Health Organization
20, avenue Appia
CH-1211 Geneva 27
visit WHO at: www.who.int
My source:
Sandra Land, GANM (Global Alliance for Nursing and Midwifery) ganm at ibp.wa-research.ch

Reflection, Revalidation, RCN Congress and Research

Thinking Out Loud: Journal 'Regulars'

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

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

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

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

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

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

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

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

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

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

Be Well :: Be Safe All

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

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

TC2020: 8th Biennial Threshold Concepts Conference 2020

Bentham House, University College London

London, UK, July 8-10, 2020

After almost two decades of research on threshold concepts that stemmed from Meyer and Land’s seminal publication in 2003 it is time to reflect and take stock. As an idea it has generated significant interest and has become a world-wide phenomenon that has captured the interest of researchers and practitioners across the globe.

The promise it offers as a lens to consider curriculum design, approaches  to pedagogy and a way of reimagining learners has already had significant impact  as the Flanagan website attests… But its full potential remains as yet unrealised. Is it time for an honest appraisal of where we are and where we want to go? If we want to continue to develop the ideas then we need to ask ourselves some potentially troublesome questions:

• Has threshold concepts become synonymous with learner difficulty?
• Have we become entrenched in a slavish adoption of the framework? Or do we apply the framework too loosely?
• How do we avoid thresholds becoming seen as a panacea that can explain all learner difficulty?

In considering these and other questions the conference offers an opportunity to reflect on the achievements thus far and encourages us to consider where we think work in the area needs to go next. There will never be a single solution to support all learners master the same threshold but an awareness of threshold concepts and their associated complexities allows us to become more informed practitioners.

Conference Sub-themes

• Disciplinary retrospectives: transforming the disciplines;
• Practice based thresholds: embedding thresholds within professional practices;
• Liminality: knock knock knocking on transformation’s door;
• Thresholds and curriculum design: new horizons;
• Troublesome not tricky: not all that challenges is a threshold;
• Avoiding swampy ground: acknowledging the pitfalls and planning for the future.

Submission Guidelines

We are inviting the following submissions:

• Full paper: 20 minutes presentation, 10 minutes Q&A (max 300 word submission);
• Lightning Talk: 5 minutes presentation, grouped questions (max 150 word submission);
• Roundtable: 1 or 2 to lead a discussion, perhaps outlining a planned project or exploring an interdisciplinary collaboration (max 300 word submission).

The deadline for submissions is 6pm GMT 16 December (was originally end of Friday 6th December) 2019.

Conference sub-themes

• Disciplinary retrospectives: transforming the disciplines;
• Practice based thresholds: embedding thresholds within professional practices;
• Liminality: knock knock knocking on transformation’s door;
• Thresholds and curriculum design: new horizons;
• Troublesome not tricky: not all that challenges is a threshold;
• Avoiding swampy ground: acknowledging the pitfalls and planning for the future.

Organising Committee

• Jason Davies (UCL)
• Julie Rattray (Durham)
• Anne Tierney (Heriot-Watt)
• Susannah McGowan (Georgetown, USA)
• Abel Nyamapfene (UCL)
• Elia Gironacci (Warwick)

See also:

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

DSA Webinar: Gaining understanding by structuring inquiry: probing data with one right question after another

Dear colleagues,

 

You are warmly invited to an online webinar hosted by The Digital Statecraft Academy (DSA), which may be of interest to those working with data and evidence in social policy.

 

DSA Webinar: Gaining understanding by structuring inquiry:
probing data with one right question after another

 

Date: Thursday 8 October 2026

Time: 15:00 BST / 16:00 CEST

Register: https://events.teams.microsoft.com/event/c6b38f8d-8f6c-4324-8c98-a73eeb36af86@f8ff7417-c954-4bf8-ba5a-1c103f38279d

 

Good analysis on clean data can still give a poor answer if the question behind it is wrong. This session looks at how we move from questions to evidence, in two steps.

 

Dr Stefaan Verhulst (Co-Founder, The GovLab at New York University and The Data Tank; Co-Editor-in-Chief, Data & Policy) will look at where questions come from, which questions get asked, and how governance priorities and political context shape them long before anyone opens a dataset.

 

Professor David Hand (Emeritus Professor of Mathematics, Imperial College London) will look at the next step: turning a real-world question into a statistical one that data can answer, and how this step can go wrong.

 

The session will be chaired by Dr Zeynep Engin, Co-Founder and Director of The Digital Statecraft Academy.

 

The discussion draws on Professor Hand's new book, What is the Question? Deciding What You Really Want to Know (2026)

 

The webinar is open to all. Register via this form. Please feel free to share this invitation with colleagues who may be interested.

 

Best wishes,

The Digital Statecraft Academy

 

My source: JISC SocioTech list - https://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=SOCIOTECH