Harvard Medical School Primary Care Review

"I'm writing to invite you to contribute your
narrative stories of health, community, and equity!"

 

Dear Spirit of 1848:

I hope this email finds you well. I'm a Family Medicine Physician, Instructor at Harvard Medical School, and Editor-in-Chief of the Harvard Medical School Primary Care Review. I'm writing to invite you to contribute your narrative stories of health, community, and equity!

The Harvard Medical School Primary Care Review is an international community-facing publication, and our mission is to “Share stories to amplify the voices of health everywhere.” Publications are approximately 750-1200 words in length, and all references should have hyperlinks (rather than end- or footnotes). The following is a brief set of guidelines for the Review: https://info.primarycare.hms.harvard.edu/review/submission-guidelines. The following Review pieces are nice examples of the type of narrative and community health content we strive for:

• https://info.primarycare.hms.harvard.edu/review/trauma-informed-holistic-health-care
  
• https://info.primarycare.hms.harvard.edu/review/food-access-navajo-nation

Please also share this call with your community partners! We look forward to hearing from you!

Warmly,

Rebekah

-- 

Rebekah Rollston, MD, MPH  (she/her)

Family Medicine Physician, Cambridge Health Alliance

Instructor in Medicine, Harvard Medical School

Editor-in-Chief, Harvard Medical School Primary Care Review

--
Posted from the Spiritof1848 Listserv WWW.SPIRITOF1848.ORG #Spiritof1848

Independent report - Ockenden review into maternity services at Nottingham University Hospitals NHS Trust

FINAL REPORT: 

'This independent review of maternity services at the Nottingham University Hospitals NHS Trust (NUH) considered the quality of care relating to newborn, infant and maternal harm at the trust.

This report covers the findings, conclusions and essential actions of this independent review of maternity services.

Based on a review of over 2,500 family cases that formed part of this investigation, the final report outlines:

• local actions for learning that staff at the trust must do
• system-wide learnings
• immediate and essential actions to improve maternity and neonatal care

The Independent Maternity Review (known as the Ockenden review) was led by Donna Ockenden and involved a multi-professional team of more than 160 reviewers. The review team held individual meetings with over 500 families, and more than 830 current and former staff at NUH engaged with the review.'

https://assets.publishing.service.gov.uk/media/6a3bb59c4c7605ab567238ec/ockenden-report-review-of-maternity-services-nottingham-university-hospitals-nhs-trust-e-lay.pdf

https://www.ockendenmaternityreview.org.uk/

individual

|
INTERPERSONAL : SCIENCES             

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

SOCIOLOGY : POLITICAL   

|

group

listening	Communication Processes  Health Systems
mothers families experience	LISTENING staffing funding

Previously: 'maternity' : 'risk' : 'safety' : 'compassion'

Boyer's model, Hodges' model, scholarship, future website and Drupal

Ack: This blog post draws on a brief but informative two page text by Marta Nibert, Educational Consultant for Occupational Therapy, University of Idaho.

Models abound of course (not only on catwalks where other career choices are displayed), but in nurse education and the sciences. The review of Curriculum Development In Nursing Education reminded me of Boyer's model of scholarship. I have maintained a link to this for many years, the book review prompted me to read more. Boyer is a gift for this scholar of Hodges' model and any others, a gift not just in that off-the-shelf sense, but in a constructive advisory sense.

The table below highlights Boyer's types of scholarship, purposes and measures of performance. The focus of Boyer's model is the quality of professorial activities, in the same way highly skilled and experiences nurses can be removed from the front-line, so to can specialist faculty be distanced from teaching.

Type of Scholarship	Purpose	Measures of Performance
Discovery	Build new knowledge through traditional research.	• Publishing in peer-reviewed forums. • Producing and/or performing creative work within established field. • Creating infrastructure for future studies.
Integration	Interpret the use of knowledge across disciplines.	• Preparing a comprehensive literature review • Writing a textbook for use in multiple disciplines. • Collaborating with colleagues to design and deliver a core course.
Application	Aid society and professions in addressing problems.	• Serving industry or government as an external consultant. • Assuming leadership roles in professional organizations. • Advising student leaders, thereby fostering their professional growth.
Teaching	Study teaching models and practices to achieve optimal learning.	• Advancing learning theory through classroom research. • Developing and testing instructional materials • Mentoring graduate students. • Designing and implementing a program level assessment system.

What I will try to do here is briefly suggest how Boyer can inform consideration of scholarship in Hodges' model and a future website. This is not just a one-way dialogue I believe Hodges' model can also inform Boyer's model. For example according to Nibert, Boyer proposes using 'creativity contracts'. The creative utility of Hodges' model is surely demonstrated in the posts and archive on W2tQ spanning nursing, education and health care? Since the publication of Boyer's paper in 1997 it could be argued there are new forms of scholarship that cast light and shadows on traditional academia and forms of research. More specifically though we can take Boyer's measures of performance and apply them in turn to h2cm. Even though the purposes differ (I am neither quality faculty nor professor) the reflection is helpful:

DISCOVERY

Publishing in peer-reviewed forums.

• There is a limited bibliography listed here on W2tQ.

Producing and/or performing creative work within established field.

• The bibliography and website constitute a mixture of formal and rather ad-hoc creative works in nursing. Much more needs to be done.

Creating infrastructure for future studies.

• As noted in the book review I am fascinated by this word infrastructure. I recognise the need for a 21st century home for Hodges' model; the limitations of a static website and the need to benefit from the stimulus and energy that a community of users would provide. Drupal is the future (for me), a means to provide an infrastructure out of which a community may grow and inform.

INTEGRATION

Preparing a comprehensive literature review.

• Hodges' model deserves a comprehensive literature review, one that spans education, nursing, global health, informatics and cognitive science.

Writing a textbook for use in multiple disciplines.

• 'Book' is an established content type within Drupal and this is a worthy objective, as Hodges' model is the ideal academic Swiss Army knife.

Collaborating with colleagues to design and deliver a core course.

• This is so dependent upon infrastructure and it seems my actively engaging with academics in curricula design and course planning. Drupal is being adopted in education so the scope to engage from an external position is a possibility.

APPLICATION

Serving industry or government as an external consultant.

• Is professorship a pre-requisite for consultancy work? No. Do we just leave this to the professors? No.

Assuming leadership roles in professional organizations.

• Being in the North West of England, a full-time nurse and with many meetings down South this is a barrier to adopting such roles. For the future should there be any opportunities these must be tried - only that way can they be tested.

Advising student leaders, thereby fostering their professional growth.

• As a mentor in clinical practice with the chance to develop local educational links there is scope here; and possibly others?

TEACHING

Advancing learning theory through classroom research.

• As noted above it would be marvellous to be presented with the task of producing lesson plans to encourage research into Hodges' model.

Developing and testing instructional materials.

• As far as the classroom is concerned this is very much a bullet point for the future. Using Drupal however a future site can incorporate some instructional materials.

Mentoring graduate students.

• Ongoing, but would like to engage more in this - and whilst h2cm is on my agenda I do understand models represent a small part of student learning.

Designing and implementing a program level assessment system.

• Another point for a future departure; how do you demonstrate competency in Hodges' model? There are means of assessment, which were applied in the 1980's, case studies, essays and discussion. ...

More to follow...

Additional link:
Instructional Design Review (ID Review) checklist at Schema Performs

Review: A systematic review and mixed- methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm

The systematic review featured here was tweeted:

https://twitter.com/t_hewson/status/1533800510343499779

- and being mixed-methods caught my eye. 

Below, I have mapped some of the concepts, themes and findings of the review to Hodges' model, adding some italicised points of my own.

The relevance of Hodges' model, in carceral, forensic, health and justice contexts is marked. The vertical axis's distinction of individual and group and the need to protect the public from dangerous individuals stands out. As does an individual's physical and mental state to the State - in the political domain. This extends to the Sociological as to the public's expectations over 'law and order' and what - should, must - happen to wrong-doers.

Where the model can help reflection, scoping, critical thinking and problem solving is in the disciplinary bridges it provides between knowledge, or what can be 'silos'; and, the many interfaces that are found within our activities, health, educational or generally. There are several interfaces in this systematic review: Prison staff - prisoner; prisoner - prisoner; prisoner - family; and where the custody function, butts up against that of the health - and how physical and mental health needs are met - or in this environment (literally) negotiated. There is a related finding (page 6):

"In contrast, in one establishment with low rates of self-harm, staff felt that their roles of ‘carer’ and ‘security officer’ were well integrated."

INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

SELF: Prisoner / Prison Officer (and Other roles) Prison staff - perceptions & attitudes self harm (thoughts, motivation) suicide (thoughts, motivation) Staff confidence, skills: Awareness - Prevention Caring - empathy 'manipulative', 'attention seeking' Insufficient training expressed emotion Staff member's wellbeing Capacity to care 'deep acting' emotional intelligence 'hope' QUALITATIVE

SELF: Adult Prisoner, Prison Staff [repetitive] self harm (means, action) suicide (means, action) Carceral environment (PRISON) self-harm - factors Research: Methodology, [Mixed] methods Systematic Review self-report - non-validated questionairres TIME [shift]: 'all the time', 'every time' location, time Staff member's wellbeing Capacity to care 'surface acting' Effect of COVID on self-harm: men/women Assessment tools ACCT - Assessment, Care in Custody and Teamwork processes QUANTITATIVE

Prison - Staff Culture male::female staff -> prisoner -> relatedness Staff - Prisoner interactions in self-harm management Behavioural - learning/copying role - models clarity 'shared/pervasive sense of hope' 'Life skills - literacies' Social determinants of Health (Crime?)

Self-harm: Policy NICE guidelines 'Correction', Young Offender Inst. control–support model demands - resources model Occupational stress Staff Support Training Prison officer training 'Intro 101'?

The comments gleaned from staff are very informative. Also of interest here are ongoing developments in trauma-informed care and this can cover emotional trauma, as in abuse, plus head injury which is a key screening initiative. Achieving parity of esteem across physical and mental health, demands a more delicate balance in health and justice.

'Hope' is a concept subject to much analysis, for example, in the healthcare, sociological and philosophical literature. Incarceration, must bring its own 'trauma', which will vary in its signature across individual, age, first-offence, recidivism, offence, legal processes ... and its impact upon hope. From the challenge of the individual prisoner and their hope, there is the challenge for prison management and policy to instill, facilitate a shared, sense of hope. Amid the news on the state of prisons, there are no doubt examples where this can and is delivered.

Hewson, T., Gutridge, K., Bernard, Z., Kay, K., & Robinson, L. (2022). A systematic review and mixed-methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm. BJPsych Open, 8(4), E102. doi:10.1192/bjo.2022.70

 

Review: iv Fundamentals of Person-Centred Healthcare Practice

Chapter 15 on 'Being sympathetically present' is a timely review of empathy, sympathy and compassion. As students learn and are exposed to experiences in practice and socialised (or not) in how these are practised this is very useful allied with exposure to the 6Cs. Mentioned in post iii: chapter 19 on Person-Centred Rehabilitation would benefit from the addition of reablement and resettlement. Given resort to a single chapter [22] on mental health it is understandable that the extreme form of trauma - physical and psychological experienced (but not necessarily wholly remembered) for people sexually assaulted points to forensic and Criminal Justice Liaison and Diversion Services. The authors here are to be congratulated on a feat of explanatory gymnastics. This just hints at the PSYCHO-dynamic* world that is mental illness, health and well-being (*physical and political).

Perusal of W2tQ reveals how readily Hodges' model can encompass the sciences and the arts (humanities). This is by design (the model's structure). The book stresses art with some (very well-balanced and executed) illustrations and prose. Once again (sorry) though, I thought of veterans, homeless, veterans, prisoners and newly released offenders and their circumstances. Being person-centred is very much attitudinal but this is physical not just cognitive and how we apply knowledge. Where this person is in space that is the centre of gravity. How best to approach, a person living with dementia and impaired senses, a homeless person lying under a bridge - even before we speak. 

 

I'm sure I read 'touch' in here, but it is not indexed. Post-COVID and in nursing as part of person-centredness this is an important part of communications skills, safeguarding and being safe. 

For the newly released prisoner, how prepared are they to be the person they can be, even before we are 'person-centred'?

"For the first time in 25 years the one-off payment given to adult prison leavers in England and Wales is to be raised. The Prison Discharge Grant will increase from £46 to £76, but what difference will that make?"

https://www.bbc.co.uk/sounds/play/m000y5sq

Released On: 24 Jul 2021  Available for over a year

 

The book identifies different interventions and models relevant to the respective practice area, i.e. rehabilitation. Chapter 33 presents a personal challenge in (being a lifelong learner) whether you have a fixed or growth mindset, which of four archetypes of self-awareness applies to you (pp.322-323)? It's worth reading for heutagogy (p.327). I was prompted to consider the ongoing journey here. If anyone would like to test the reflexive credentials of Hodges' model (p.328) please get in touch. Salience is a key concept in Hodges' model. What is important to the patient - person? What is now? Are we only person-centred dealing with conscious persons? Again, perhaps a missed opportunity - care of the unconscious patient? I enjoyed chapter 30 on critical thinking. I was reminded of (verbal) accounts of people applying the Tidal model in forensic care. This proved not exactly straight forward, whereas, once learned Hodges' model can function as an aide-mémoire. If shared then collaboration may be enhanced since as the latter sections of this book show specific concepts need to be identified, articulated, agreed and applied.

The final chapter's title made me laugh a little: A call to action. Sometimes you can't win on the periphery of academia (a privileged position nonetheless?). KISS (Keep it simple stupid) applies to Hodges' model, but whether simple, or deemed complex the model fails to be recognised as a vital tool for all health and social care practitioners. Especially learners taking their seats (in-situ or online) on course 101. I take heart in believing that Hodges' model has a very long tail in relevance and global potential.

Once again model/framework envy creeps in, as I have no evidence (yet). 

Paradoxically (or not) this book will have me try to take note of instances when an interaction calls for a suspension of person-centredness: for me, the patient, client, carer - for us simultaneously.

This is the 'take-away' for me from this book which I also heartily recommend.

I will refer to 'healthful' in another book review.

SPIRITUAL

 

individual - PERSON - patient
|

INTERPERSONAL : SCIENCES

SPIRITUAL  humanistic ---------------------------- mechanistic  SPIRITUAL

SOCIOLOGY : POLITICAL

|

family - group - population

 

SPIRITUAL

Mindset :: Parity - attitude aptitude (My choices*) Hodges' model - disassembly for care	- of esteem :: Touch aptitude attitude Hodges' model assembly of care
Culture Child - Parent - Guardian FAMILY- Social network Be the 'person' the Social Determinants of Health predict/dictate?	prisoner release grants and welfare *(Are you joking - without attending to the politics of health and social care? Diet, green spaces, identity, community (facilities), housing ...)

Many thanks to the publisher Wiley-Blackwell for the review copy.

Review i

Review ii 

Review iii

Fundamentals of Person-Centred Healthcare Practice,  McCormack, B., McCance, T., Bulley, C., Brown, D., McMillan, A, Martin,S. (Eds.). ISBN: 978-1-119-53308-5 February 2021 Wiley-Blackwell.

Global Health Literacy Summit 2020

SAVE THE DATE: 26 - 28 October 2020

Where: Kaohsiung Taiwan

Why: To unite people all over the world, foster knowledge exchange, and promote action to advance health literacy

How:  IHLA Interest Group call for abstracts open now.  General call for abstracts opens soon.

Dear HIFA,

The International Health Literacy Association (IHLA) is a non-profit, member-based organization dedicated to the professional development of its members and the continued growth and development of the health literacy field. IHLA was formed in 2016, incorporated in 2017, launched a website and published its first member newsletter in 2018. IHLA now has more than 1,000 members in 80+ countries. Membership is FREE!

To become a member go to http://www.i-hla.org

In spring 2019, the IHLA Executive Board issued a call for proposals to co-host the first
 IHLA Global Health Literacy Summit 2020
http://www.i-hla.org/summit-2020

After a careful review of five EXCELLENT proposals, E-DA Healthcare Group, I-Shou University in Kaohsiung Taiwan earned the honor to host the meeting. In 10 months, IHLA members from around the world will meet in person, share their work, and learn from others locally and globally.

An immediate way to tailor the association to meet your needs is to join an IHLA Interest Group. Interest groups are run by and for members; they emerge and dissolve as health literacy topics and pursuits become relevant. In this way, IHLA Interest Groups keep the organization enduring and relevant. Interest groups (as described in IHLA's Constitution and Bylaw) have programming rights at the Global Health Literacy Summit and play a vital role in shaping the organization at large.

Here are the next steps for IHLA Interest Groups and the Global Health Literacy Summit 2020.

• Encourage Interest Group members to plan and submit research, practice, policy-oriented panels or workshop proposals for the 2020 Global Health Literacy Summit
• Interest Group Chairs and Co-chairs create a peer review process/subcommittee to screen proposals
• Interest Groups select proposals to forward to the Global Health Literacy Summit 2020 Program Committee by February 27, 2020
• Starting in March, the Summit Program Committee conducts a peer review process and either accepts proposals as submitted, or suggests changes
• The IHLA Program Committee has an open call for other proposals, which may lead to an opportunity to supplement interest group sessions - if needed.

For more information, please view this video:  https://youtu.be/RLKlkGPdhHo

Or contact Interest Group Chairs directly via email:  See list of Interest Groups, Chairs/Co-chairs, and email addresses<http://www.i-hla.org/about/interest-groups/

Also, please see below the Global Health Literacy Summit 2020 Principles of Participation, which apply to all IHLA Interest Groups and Members.

1. Interest group proposals must be peer reviewed by a subcommittee of 2-4 interest group members appointed by interest group chairs.
2. All interest group members should have an opportunity to be considered as a reviewer.
3. Reviewer names must be disclosed to interest group members.
4. Presenters in selected sessions must commit to attend the IHLA Global Health Literacy Summit 2020 prior to submission to the Summit Program Committee.
5. Each interest group is encouraged to use a template developed by the IHLA Summit Program Committee to review submission abstracts.
6. It is unethical to charge or receive money as well as in-kind contributions for abstract submissions and peer review.
7. It is unethical to lobby or influence the members of peer review subcommittees regarding the status of any abstract submission.
8. Research submissions must be original research. In addition, accepted submissions will be retracted if found to be plagiarized.
9. Discrimination is prohibited based on national origin, religion, ethnicity, gender, or any other socio-demographic variable.
10. Interest group sessions are open to all attendees.  As such, interest group sessions should be as welcoming as possible to all IHLA Global Health Literacy Summit 2020 attendees.

Sincerely,

Teresa Wagner  Teresa.wagner AT unthc.edu
Rob Logan  logrob AT gmail.com
Sabrina Kurtz-Rossi  sabrina.kurtz_rossi AT tufts.edu

Review: v "Climate Change and the People's Health"

Climate Change and the People's Health

At just over 30 pages chapter 3 the last is also the shortest, we all hope this does not reflect the length of the future?

Chapter 3. Challenges and Future Prospects

Before beginning to review Chapter 3 I need to revisit the closing sentences of the preceding chapter's conclusion - if you 'get' Hodges' model you will understand why:

"I [Friel] pick up on these ideas of complexity in chapter 3, arguing that how we understand and characterize these phenomena depends on our standpoint and also evolves as knowledge develops and available evidence accumulates. Given those complexities, responding to climate change and health inequity requires the development of policies that transcend doctrinal boundaries and draw on insights from a range of disciplines, including those in the sciences, social sciences, and humanities". p.112.

I hope you can see and will please excuse my reference to Hodges' model, but I've another.

Friel refers to how research is primarily based upon reductive pathologizing and needs to shift [ ;-) ] "towards research that is attentive to, and actively engaged with, policymaking processes". (p.114).

In Hodges' model, the Sciences and Politics are mechanistic, the sciences invariably (with some exceptions) reductive and the 4Ps I have attributed to the model as follows:

1. SCIENCES -PROCESS
2. POLITICAL - POLICY
3. SOCIOLOGY - Practice
4. INTRA- INTERPERSONAL - Purpose

(As in a previous part of this review I have been wondering how policy can (best) permeate the other care (knowledge) domains?)

Being where this review is posted I would be remiss not to state this, picking up on Friel's thought.

OK, let us get back on track. Taking the lead from chapter 2, in Chapter 3 Friel argues the need to take research, advocacy, and policy forward to address environmental degradation, social justice and health equity by breaking down the disciplinary, sectoral and various silos that exist in the many systems that are encountered. Systems research can increase our understanding and the evidence base. Interesting to note also then solutions can be crafted. (p.113). The evidence base on more equal societies is discussed. With the stress on systems research, systems and systems thinking are explained briefly and referenced. As will already be obvious I am all for the plurality of disciplinary approaches that is needed, but as Friel will conclude this, with systems science, and improved understanding of policy processes (hybridised: is this the Green Marshall Plan that is referred to?) to counter the resistance to change that is already being experienced now (p.115).

Perhaps above, I have fallen into Friel's trap. I have been caught out as a model monger (p.115)?

Scale is a concurrent consideration in Hodges' model, as with Friel's account of systems thinking. To macro- meso- and micro-levels let us add nano, there is much still unclear from the presence of plastics and other pollutants in the environment. The arrival of eco-epidemiology is to be applauded (p.116).

Any mention of 'systems' takes me to the Health System Redesign book I reviewed over a year ago on W2tQ. This is a very useful companion to "Climate Change ..." but is not referenced here. Box 3.1 'Systems Approach to Childhood Obesity Prevention' brought home the connection and the visual representation referred to (p.120). I could readily go off again with Friel's section on Politics, Policies, and Processes (p.122). Thank goodness for this - I feel better now - as Friel "shamelessly plugs" personal involvement with a research program at the CRE (p.124). The Centre for Research Excellence in the Social Determinants of Health Equity needs to be, not just on the 'map' (Sciences - located geographically) but affecting policies, practices and purposes (individual and organisational). Friel provides several references - very useful and timely. I will reference this, as I'll explain next time. Again the much needed call for a move from reductionist pathologizing.

Box 3.3 Policy Principles for the World We Want is simplistic (like Hodges' model), but if delivered would be very impactful in terms of the positive change (p.128) that would ensue. Against p.134 my note is "It's a small world!" I'm not sure if this a reference to the Disney song as a perverse consumptagenic global eco-anthem, or to Schumacher? What could be noted (p.134) is the potential role of blockchain in assuring land tenure and ownership. This technology is much vaunted in health, education and the obvious application of economics. In terms of developing nations protection of land rights is critical (even as I write and you read). The chapter closes on policy from "The first 1000 days of Life" to "Health in All Policies" which I reflected upon as "Policies in All the (#h2cm) Domains"? How do we do this? There are avenues as Friel writes of macroeconomics and progressive policy development. There is much on the Social Development Goals and how cities (despite the critique on urbanization) are working together internationally to mitigate climate change effects, even as some governments fail to meet set objectives and global agreements.

The print and layout is excellent, a content listing of sections complements the index (invaluable). The next book I've to review has no index.

Small book, big ideas - correct on both counts and a very informative if rightly troubling read.
One last plea. Do buy this book, but don't leave it on your shelf; read it. There is no excuse, it's small, but your ideas on climate change and the people's health will grow!

I would like to thank OUP

CHAD ZIMMERMAN │ Senior Editor, Medicine and Public Health

Oxford University Press │ 198 Madison Avenue │ New York, NY

and Prof. Nancy Krieger for the review copy and Prof. Sharon Friel for engagement on twitter and RTs.

While I appreciate I make the request to review and this places absolutely no obligation on others, it helps a lot when a publisher / author / conference organiser ... acknowledges the effort - even just a thank you. As ever, the thanks is in the learning gained, not the thanks lost. Many do - lift a hand, nod their head ... of course, making this even more worthwhile here. TY


Chapter 1. Climate Change, Global Justice, and Health Inequities

Chapter 2. It's a Consumptagenic World: Producing Climate Change, Exacerbating Health Inequities


Friel, S. (2019) Climate Change and the People's Health, Oxford University Press, New York

Book review: "After Ethnos" i

A great believer in serendipity, this played a part in my discovering this book. From the FT Weekend's 'How to Spend It' I noticed the book and its cover in 'the aesthete' Anicka Yi (pp.17-18):

 

The best book I've read in the past year is After Ethnos by Tobias Rees. He's mapped out the evolutionary transformation of humans and I think it's an important book for the next stages of our species. p.17.

Looking up the book and the publisher's blurb - a request for a review copy was rewarded.

Two points, first I wondered about the meaning of  'ethnos'. A small word, it seemed to have instant gravitas. It does: being Greek for "a people" (p.1). The quote above does not mention 'anthropology' specifically, but this is very much the book's focus. Once delivered, and making a start I got a taste of what was to follow; and did wonder if I had bitten-off more than I could chew.

 

As a nurse, I thought I'm not an anthropologist, but as a member of humanity we are all in a sense anthropologists. Surely, it isn't a far stretch from 'people skills', social skills, interpersonal skills to anthropology? Perhaps, if you work in mental illness - health this connection, relatedness is accentuated? Anthropology is of course a specialist subject and the book has helped me 'place' it on the book shelf in relation to cultural studies. The view from Wigan Pier does not get you far, even if it has stretched to within 2.5 degrees of the equator and Amman, Jordan. Anthropology is fieldwork as well as a repository for theories.

 

Any qualms were quickly put aside. The book while anthropologically technical and philosophical is an easy read. The main text is 121 pages. So a couple of days and you are after ethnos too. I've still to read the notes as I passed-them-by, recording the numbers of several to look up later.

The project of the book on the DUP site includes:

In After Ethnos Tobias Rees endeavors to decouple anthropology from ethnography—and the human from society and culture—and explores the manifold possibilities of practicing a question-based rather than an answer-based anthropology that emanates from this decoupling. What emerges from Rees's provocations is a new understanding of anthropology as a philosophically and poetically inclined, fieldwork-based investigation of what it could mean to be human when the established concepts of the human on which anthropology has been built increasingly fail us.

There is much to savour here, at least in my reading. Rees refers to:

lines of thinking

lines of escape

lines of research

line of flight

A preoccupation for me is 'line(s) of sight' and insight. Much space is given to differentiating anthropology and ethnology. The role of curiosity (key for Rees) about the human and hence the difference between anthropology that is answer-based to one that is question-based.

 individual 

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

questions	answers
a people	the people

After Ethnos

 

Clearly, the book is a challenge to classical, established, traditional views of  anthropology. What is taught, the curriculum and its future.

Rees seeks to disrupt, derail, depart and break free from what is current thinking, to seek escapes. I like reference to chaos, turbulence; the book is nonprogrammatic and all this without resort to a place at which to arrive.

In chapter 1 the sentence: Classical modern ethnology has come to an end.

 

prompted me - to substitute terms:

Classical and modern nursing (theory and practice?) has come to an end? p.8

Chapter 1 asks: what is anthropology? What is anthropology's job? What's it's domain? The book covers the history of anthropology, ethnology to facilitate a general reader's understanding.

More to follow ... 

 

and thank you to Duke University Press for the review copy.

Book review: "After Ethnos" ii

Book review: "After Ethnos" iii

 

Book review: "After Ethnos" iv

After Ethnos - acknowledgements

Rees, Tobias. After Ethnos, (2018): Durham and London. Duke University Press.

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

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

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

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

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

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

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

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

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

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

 

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

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

Here are the previous posts:

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

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

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

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

'Proof' of the Four Quadrants

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

With many thanks to the publisher for my review copy.

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

Review: i Fundamentals of Person-Centred Healthcare Practice

This book is written for students and as per the title the focus is central to student's learning, knowledge, skills and practice through placement experiences. It needs to be pointed out that there is an underlying framework that the book's chapters refer to, this is the Person-Centered Practice Framework [PCPF]. While the editors have biographies the (non-editing) contributors are listed by affiliation. I would have liked to read a brief professional biography.

I was encouraged, but under no illusions, when I read that the authors: "show how the Framework interconnects with and fits with the approaches, concepts, models or principles relevant to their professions, roles, service users, students, colleagues, service contexts or learning environments." (Foreword). Clearly the PCPF has been fine-tuned and subjected to research nationally and internationally.

The book is thought provoking at the same time as being accessible with bite-sized chapters. I've often wondered about the meanings behind 'careful'. The introduction provides us with 'healthful' which I am still chewing over. I was encouraged too in the introduction as the book clearly needs to define many forms of care (e.g., person-centred, family, relationship) and concepts, such as, person, personhood and person-centred.

The text size, font and layout are modern and accessible. Some of the figures (p.5) while informative take a real effort to read and interpret, given the use of shades of green and grey. Here contrast - black on dark-green - is a problem. Each chapter begins with 'learning outcomes' and there are activities 'Who am I as a person?' in chapter 1. 

As we prepare for COP26 (fingers x'd) chapter 1 differentiates between person and non-persons. Now we see how the future and our ability to practice person-centred care depends on the viability, sustainability and hence protection of the biosphere.

Section 1 and the book as a whole is a marvellous primer for new learners. On pages 8-9 the discussion on 'the reflective person' and Sabat's three forms of self highlights the importance of the context and how person-centredness is situated:

Sabat, S. R. (2002). Surviving Manifestations of Selfhood in Alzheimer’s Disease: A case study. Dementia, 1(1), 25–36. https://doi.org/10.1177/147130120200100101
 

individual
|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

Self 1	Self 2
Self 3	Self 3*?

More to follow(*) with many thanks to the publisher for the review copy.

Review ii 

Review iii

Review iv

Fundamentals of Person-Centred Healthcare Practice,  McCormack, B., McCance, T., Bulley, C., Brown, D., McMillan, A, Martin,S. (Eds.). ISBN: 978-1-119-53308-5 February 2021 Wiley-Blackwell.

Book review: "After Ethnos" iii

After Ethnos

The book has just five chapters. Given that Tobias Rees is trying disrupt, break free, escape to move beyond the established views, theory, practice - fieldwork of anthropology and ethnology critique was bound to follow. The book's response is that each chapter is followed by questions, discussion and responses the author has encountered while formulating the many ideas and arguments in the book. This is very useful structuring device and a lesson in itself (if you can engage with the academic community...).

Not dodging the inevitable questions, chapter one addresses philosophy and history, Durkheim, Mauss and the arrival of humanity, society and history are argued for in a departure for ethnos. I noted an emphasis on contingency, and 'condition of possibility'. There may be a dependency upon - with lower case philosophy and upper-case Philosophy. In 'p'hilosophy I can read a philosophy of care, a personal set of values that must be dynamic (1977 - 2020... !?) and underpins everyday practice.

If chapters four and five warrant re-reading, there are many points on philosophy end of chapter 1 that would bring (more) rewards here. In chapter 2 the history of 'humanity' as a singular collective, the concept arose some 250 years ago in Europe. An interesting conjunction then with 'data' and its impact upon what it is to be human and humanity today and tomorrow...

"Could one interpret this recentness of "the human" as an invitation for research?* ... Could one meticulously map the new, unanticipated venues for being human - for living a life - they are opening up?" p.40.

In the 21st Century we still have need of a periplus.

*Yes!

More to follow ... 

and thank you to Duke University Press for the review copy.

 

Book review: "After Ethnos" i 

Book review: "After Ethnos" ii 

 

Book review: "After Ethnos" iv

 

After Ethnos - acknowledgements 

 

Health Informatics Review Report published

Published yesterday here in the UK by the Department of Health:

The Health Informatics Review Report builds on the Next Stage Review by describing how informatics is supporting the delivery of better, safer care of patients, improving the NHS through better research, planning and management, and empowering patients to make more informed choices about health and care.

A Health Informatics Review Implementation Report will be published in the autumn 2008.

Document purpose: Policy
Gateway Reference: 10104
Title: Health Informatics Review Report
Author: DH
Publication date: 10 July 2008

The Phillips Ives Review

Call to action:  please share widely across your networks.  If you would like our comms pack to promote the review in your organisations in health and social care, please let me know.  

The Phillips Ives Review has launched and will provide evidence and inform strategy; ensuring that nurses and midwives are given access to the knowledge, skills and education required for safe, effective digitally-enabled practice.

We’d like to invite anyone working in nursing or midwifery practice, or interested in this area to share your ideas, case studies and experiences on our engagement platform until 21 August. 

"The Phillips Ives Review was launched virtually on 26 May 2022 by its Chair, Dr Natasha Phillips, Chief Nursing Information Officer (CNIO), NHS England and International Vice-Chair Dr Jeanette Ives Erickson (USA).

This year long in-depth study will identify what is required to enable the meeting of the CNIO NHS England's aims for Nurses & Midwives:

• To ensure nurses and midwives are empowered to practice and lead in a digitally-enabled health and social care system, now and in the future.
  
  
• To ensure nursing and midwifery practice is fully supported by the use of digital technology and data science.

The Review will bring together national and international experts with expertise in nursing and midwifery and beyond, to investigate, critically appraise and make recommendations to ensure the breadth of ambition and scope of future practice of the pre and post registration nursing and midwifery workforce is captured."

My source: FutureNHS - https://future.nhs.uk//home/grouphome

Review: ii Fundamentals of Person-Centred Healthcare Practice

With 30+ pages left I need to remind myself of the book's focus -  the Person-Centered Practice Framework [PCPF]. 

The 'practice' in the title is key too and I am envious of the attention afforded to the PCPF. The book very much seeks to inform student learning and in section 4 on learning and development. The book is very effective in operationalising person-centred care and person-centredness.

I'm constantly fascinated by the way processes arise everywhere. This is inevitable. Time, space, events, the flows of data, information, knowledge and the systems we use are necessarily process-oriented. Who are you at 2pm compared with 8pm - shift patterns permitting?

Purposes are discussed and the 34 chapters cohere very well in style and vocabulary. Perhaps I expect too much. A vocabulary that bridges the process-laden world of the sciences and political machinations with the humanistic - experiential - world of lived experience? I need to accept that 'whole systems' rely on processes that are not just physical, but social, psychological and political. I can't though help but read "Committed to healthfulness as process and outcome" in task-oriented and politicised (outcome) terms (p.15).

In table 2.2 (p.16) on associated concepts a list that includes patient- client- woman- child- family- relationship- centredness, I see this as humanistic and hence as a matter more of purposes and practice than process. A letter explaining 'person-centredness' to an alien visitor the Oscleans, is a welcome creative distraction and reminder for me of SETI@HOME which has stopped distributing work. Here, I read 'service-users' as an unconscious bias towards the dark-side to bring the Force in to the mix. 

On twitter (and here) I've tried to highlight that the BIO-PSYCHO-SOCIAL model is incomplete.

IT IS NO LONGER SUFFICIENT.

Yes: Person-centredness is about an individual's being.

To BE person-centred your stance must include the POLITICAL* (p.19, p.35).

I'm still deliberating on what sort of tool is Hodges' model?

It is far more than a Johari Window (p.36):

https://hodges-model.blogspot.com/search?q=johari

'Situation' litters the text - oh for a situated model: "Look for alternative ways of explaining a situation (i.e. reframing a discussion)" (p.37).

As you can see, this books gets you thinking and reflecting ...

The book's editors and publishers are courageous and true to the format by including weblinks. I will try some of these and report back.

 

self - individual - PERSON - patient client carer
|

INTERPERSONAL : SCIENCES

HUMAN ----------------------------------------------- MACHINE

SOCIOLOGY : POLITICAL

|

family - group - population

patient- client- beliefs wishes identity hope	time place space
woman- child- family- relationship-	policy power £$

More to follow with many thanks to the publisher for the review copy.

Review i

Review iii

Review iv

*Update 6 August: See 'Political Quotient'

Fundamentals of Person-Centred Healthcare Practice,  McCormack, B., McCance, T., Bulley, C., Brown, D., McMillan, A, Martin,S. (Eds.). ISBN: 978-1-119-53308-5 February 2021 Wiley-Blackwell.

 

Book review: "After Ethnos" ii

COVID and the increased frequency with which the 'collective' has entered our discourse resonates for me, as this disrupts, crystallizes the INDIVIDUAL-GROUP axis of Hodges' model. It is clearer now.

There is an important take-away in: "Ethnology emerged as the "science" of the people without history.." p.9. 

There is an elephant in this book. You hear it in the distance, far away - as in anthropologically, ethnographically in fieldwork. When premoderns and moderns are discussed, colonial attitudes and beliefs of peoples far-away.

Good to see Latour p.12 and leaving the index unwrapped there was a surprise to follow. Which came first I wondered, medical sociology or medical anthropology? There are - inner-disciplinary developments. In the late 1980s - early 90s several anthropologists conducted fieldwork in "domains that were formerly believed to be beyond the scope of anthropological expertise, or interest ... medicine, science, and technology." p.11.

After Ethnos

I related readily to Rees's scene-setting and history on the arrival of 'culture' (1770s) and how the human is conceptualized. Yes, in the age of anthropogenic climate change, would you really want to be a cultural anthropologist? p.14.

Time, really is messed up. The developed majority have opted-in to record history in carbon, not just as it has always been. The future is being written now. 

Anyone familiar with Hodges' model will understand my enthusiasm in reading of 'spaces of being', 'disciplinary significance', and the 'house of knowledge' (yes!). The key to the book overall, Rees calls for a philosophically inclined (another line?) anthropology (after ethnos). p.14.

"To be a philosophically inclined anthropologist is to orient oneself in thinking by way of thinking* - in order to find out if, and if, then in what concrete ways venues of thinking/being are coming into existence." p.16 (with ref.)

*meta-cognition?

Rees devotes chapter 3 on fieldwork, the major expeditions that helped shape anthropology and ethnography. In terms of orientation there is a stage even before the journey to the hinterlands. I have interpreted Hodges' model as a conceptual periplus, a map of the coastline of an unknown land, the foundation and (literal) framework of the house of knowledge, be that, a situation, person, family, a discipline, or culture.

Reading, you appreciate the need for anthropology to revise its intellectual toolkit. 

Yes, as an 'open situation' anthropology is situated, but then so is all humanity (and h2cm)?

 individual 

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

person, self, individuated	SCIENCES, TECHNOLOGY, MEDICINE time - distance - place
people, family, other(s), myths, rituals, magic, history(?), society	a philosophically inclined anthropology APPLY HERE!

 

More to follow ... 

and thank you to Duke University Press for the review copy.

Book review: "After Ethnos" i 

Book review: "After Ethnos" iii

 

Book review: "After Ethnos" iv

 

After Ethnos - acknowledgements

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

Business and healthcare share an ongoing fascination with integration. A several decades long preoccupation, I now see as a legacy issue. One, that is set to continue: a clear objective but  tantalizingly always out of reach.

Not that I'm drawn to figures, but there's a double helix (figure 2.4, p.33) to illustrate the distinctions and dependencies that operate between:

INTEGRAL and MODULAR

products

VERTICAL and HORIZONTAL

industry

Pressure to 

DISINTEGRATE - INTEGRATE

Hopefully, you can see what is going on here - the attraction, the fit? Chapter 2 on Form, Method and Mastery presents the foundations of what is to follow, with chapter 3 on the Eight Archetypal Dilemmas. While the context is business the insights here are applicable generally:

Head - Heart*

Inside - Outside

Product - Market

Change - Stability

Content - Process

As in Hodges' model, a situated perspective is called for and in designing 2x2 matrices the author's outline individual and group activities. Their step 3, 'Catalogue' - creating an inventory of interesting and important aspects of the situation is mirrored in Hodges' model - care concepts, patient or carer priorities - and general problem solving. A key difference in the business context is that the quadrants are not pre-defined but must be 'Named'. The critical question, Lowy and Hood write (p.68), is proof: "Are there four real quadrants?"

The Power of the 2 x 2 Matrix

A 'good' book makes / helps you think. In prompting the next blog post this is proof for me of a good book.

More to follow ('care architecture'?) ...

Here are the previous posts:

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

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

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

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

 

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

With many thanks to the publisher for my review copy.

*See also:

https://twitter.com/h2cm/status/1321177843863375883?s=20

Review: iii Fundamentals of Person-Centred Healthcare Practice

 

Previously, I recognised the many links throughout the book and on p.54 there are five relating to professional standards. These reflect the book's international scope and multidisciplinary relevance. Those on page 54 do work and support the text. One of them I was presented not with the expected page and missed the outcome of the 'click'. I wasn't going to re-type but found the page through the site's menu. Some links are long, as I found, whether permalinks [usually shorter] or fallback search text might improve link-longevity I'm not sure.

As a reassurance the contrast issue black-text-on-dark-green is limited to one figure.

The book is well referenced with an additional reading list. I've been made aware through plagiarism detectors (one paper) which - it appears - have 'read' an introductory section to Hodges' model as self-plagiarism. I wondered if in comprising a community of practice the references here maybe somewhat insular. I've no analysis to support this and the same no doubt may apply to other to emergent ideas, including threshold concepts. You have to start somewhere. At fear of contradiction there are many theories called upon and referenced.

Students may find the more attention to the position and specificity of references useful p.75 "we cannot not communicate." How times, chapters (8 - Communicating and Relating Effectively), theory, practice and management are challenged. The art of  'sympathetic presencing' working on the phone triaging acute community mental health referrals, 'Being kind and warm'.

For a text on person-centredness the book is imho mental illness-health light, but then as noted what is the book about? Am I suggesting that such books should attend to disciplinary equality? That said if there is a test for parity of esteem here, what do you conclude from one dedicated chapter? I was surprised, but is there a dilemma here? Beside 'Trust in self and others' I made a note, 'intuition'. Is person-centredness and being person-centred taken for granted within mental health practice? Research suggests not. 

Reading the table of contents you will find:

Chapter 18: Being person-centred in the acute hospital setting
Chapter 19: Person-Centred Rehabilitation
Chapter 20: Being person-centred in community and ambulatory services
Chapter 21: Experiencing person-centredness in long-term care
Chapter 22: Being person-centred in mental health services
Chapter 23: Person-centred support for people with learning disabilities
Chapter 24: Being Person-centred in Maternity Services
Chapter 25: Being person-centred in children’s services
Chapter 26: Being person-centred when working with people living with long-term conditions
Chapter 27: Palliative and end of life care services

I had a sense that the chapters were not sufficiently differentiated despite the titles. This may say more about my reading and the (editor's achieved) coherence of the book overall. Perhaps also for me, person-centredness is realised in-situ with personalised details. Not just vignettes (which are used) but the detailed intra- interpersonal, social, physical, political and spiritual choreography that is person-centred care: whether or not there is engagement (a dance).

Dementia is represented but the context appears to be residential care. You will find challenging / courageous conversations, but not challenging behaviour in situations that test interpersonal skills and person-centredness especially for staff, students, carers and families (dementia in general hospitals - despite numerous initiatives). Trauma has its place in the mental health chapter (and in current literature), but again the challenge of psychoses, anorexia are missed opportunities to reveal the potential and delivery of the Person-Centered Practice Framework.

Since the book's publication with its stress on the welfare and well-being of staff and educators too, the need to make explicit the politics in health is even more extreme. The need to protect the title of 'nurse'; mis-information generally and relating to COVID. Person-centred decision making and shared decision making are described as systems. Perhaps this misses the nuances of a health care professional, the team and family working with a person were they are making an unwise decision (pp.83-92). Another chapter indicates the need and utility of disciplinary bridges:

Chapter 17: Socio-political context in Person-centred Practice

 

individual - PERSON - patient
|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

family - group - population

MIND :: Parity -	- of esteem :: BODY
Culture Child - Parent - Guardian FAMILY SOCIO -	Refugees Homeless title of 'nurse'* mis-information Organisational culture? - POLITICAL

One more to follow with many thanks to the publisher for the review copy.

Review i

Review ii

Review iv

Fundamentals of Person-Centred Healthcare Practice,  McCormack, B., McCance, T., Bulley, C., Brown, D., McMillan, A, Martin,S. (Eds.). ISBN: 978-1-119-53308-5 February 2021 Wiley-Blackwell.

* https://twitter.com/hashtag/ProtectNurse?src=hashtag_click