Hodges' Model: Welcome to the QUAD

- provides a space devoted to the conceptual framework known as Hodges' model. Read about this tool that can help integrate HEALTH, SOCIAL CARE, INFORMATICS and EDUCATION. The model can facilitate PERSON-CENTREDNESS, CURRICULUM DEVELOPMENT, HOLISTIC CARE and REFLECTION. Follow the development of a new website using Drupal (it might happen one day!!). See our bibliography, posts since 2006 and if interested please get in touch [@h2cm OR h2cmng AT yahoo.co.uk]. Welcome.

Saturday, June 24, 2017

Evidence for simplicity, genericity, openness and holistic competence

N-th mover to Integrated, Person-Centered and Holistic Care

walk the talk, sour grapes, or holistic humbug?

Although, sadly (and all down to me) I stepped off the PhD programme with an MRes, the intention was not to bring my journey with Hodges' model to a close. The joke of course with this model is that you are always presented with a crossroads. As I've written previously (even in draft!) this model is a baton to pass on to others. If the workforce of the 1970s to date evaluates its contribution to health care change and progress, then while the achievements speak for themselves, the challenges* that remain still shout out:
  1. parity of esteem 
  2. integrated - co-ordinated and collaborative care
This week I received an email, purely as a list member I must add:
NHS Innovation Accelerator 
Applications for the 2017 NHS Innovation Accelerator (NIA) are now open. For 2017, the NIA is seeking local, national and international innovations that address the following NHS priorities:

·         Mental Health
·         Urgent and Emergency Care
·         Primary Care
Applications will remain open until midnight on Wednesday 26 July 2017. 
For more details please see: http://nhsaccelerator.com/apply/ 
Of course immediately I thought about Hodges' model, given that from the information provided mental health is a priority and a top priority for citizens. Plus, the things that can make a difference to problems:
  • Suicide and relapse prevention
  • Access and availability with a focus on perinatal, children and young people, dementia and psychological therapies
  • Early identification and intervention to minimise the impact on a person’s life, the likelihood of escalation and, in some cases, the chances of survival
  • Care closer to home including self-care and access to services at home, in a primary or community setting
  • Holistic care of both mental and physical health needs including prevention, screening and treatment for those at greatest risk of poor physical health   
"There are many innovations available to improve mental health services, however they are not always used..."

There are however a series of requirements, which present a stumbling block as high impact evidence is lacking.

The purpose of NHS Innovation Accelerator lies in the name. The target is established initiatives and projects that would benefit the NHS and others from a boost of further momentum and leadership support including funding and mentoring. Hodges' model is far from this, but the call is interesting nonetheless.

Reading the details I can argue, for example, that Hodges' model is immediately applicable across the life-span. The model is already designed, but in use the model could be said to meet the requirement of being co-designed with people (including carers, where appropriate). I have used the model with patients and carers (young and adult) who have lived experience of mental illness. With some consideration of the patient, carer, as I have stressed here before on W2tQ the model is accessible to a diverse population. Critically, the delivery of the most significant benefit in terms of outcomes and cost savings needs proof.

It seems that many of the world's problems could be ameliorated through education. This has been evidenced for decades and yet globally there are those who politicise their respective educational system, or even worse deny sections of a society access to education.

In healthcare how can we demonstrate the effectiveness of what is basically a back-of-an-envelope tool? While not a solution Hodges' model helps us to resolve the constituents of healthcare demand and supply, to critically analyse and synthesize - what is going on? I'm sure Hodges' model is just one of many local 'innovations' (in this case created in NW England) that are not evidenced and are therefore missed. Why is this? It may be that the model needs to be re-discovered since being invented somewhere else, by somebody else makes it a non-starter. Similarly, reading the information 'model of care' always grabs my attention:

Your innovation can be a device, digital app or platform, 
a service, process, pathway or model of care

But as is often the case, this is framed in service commissioning, funding, delivery and yes patient outcomes terms. Devices, apps, platforms and services can be specified to a high degree. This is essential to success in research (as is dissemination). Aims and objectives can then be clearly defined, outcomes can be recognised and measured. Processes and pathways are perhaps more fuzzy? These are all important tools, aspects and contexts in health care.

My frustration is that this and similar research formulations seem to exclude tools and resources that are by their nature intentionally simple, holistic, generic and cognitive-reflective. The "model of care" is broken. A whole systems approach# is needed that incorporates education and with it prevention and staying well; plus caring for those affected by illness and disease. We have to honour the legacy problems that the political, education and health systems have 'delivered'. Even if not broken the model of care is missing its twin, the model of life-style choices'.

I still believe there is a model - a conceptual framework - that must precede the (politicised?) model of care, if health and social care are to be truly transformed. Without this, well yes the NHS can accelerate, staff have demonstrated this repeatedly while negotiating all sorts of obstacles. The line of travel will however be circular; circular, but without the discoveries and change gifted to the particle physicists.

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population

education

mental health

cognitive access

benefits - outcomes

subjective

Evidence

process

primary care, accident and emergency

physical access

objective
qualitative

home

social care

co-design

public engagement


quantitative

strategy

'model of care'

education system

citizens

cost savings

My source: 
Irina Johnston
CHAIN Administrative Assistant

If you wish to publicise information on the CHAIN Network please email your request to: enquiries AT chain-network.org.uk

CHAIN - Contact, Help, Advice and Information Network – is an online international network for people working in health and social care. For more information on CHAIN and joining the network please visit website: www.chain-network.org.uk

*
  1. parity of esteem (a very broad interpretation - the comparison and contrasts between mental health and physical care on several levels - demand, supply, funding, research, integration, staffing, policy, outcomes, evidence-base, social determinants...)
  2. integrated - co-ordinated and collaborative care (this is not one thing, but several. These terms are sometimes used interchangeably. Care that is truly integrated will also be co-ordinated and collaborative.
This is not recourse to jargon, Hodges' model implies several systems from the outset.

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Thursday, June 22, 2017

There's finding home and then there's Finding Home...

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population

Home
is
where
the
heart
is

Finding home

HOME




powerless power powerful


My source: Bloomberg

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Wednesday, June 21, 2017

Report: How can we all best use scientific evidence? (Lessons from Medical Sociology)

A strength of Hodges' model is the way that conceptually it automatically encompasses medicine and healthcare whether viewed as scientifically or sociologically.

The obverse and similarly powerful scope of Hodges' model is the relationship and conceptual exchanges to be found between the intra- intrapersonal domain and the political.

One sociological theory of medicine and the doctor-patient relationship by Parsons identifies the sick role. The physician also has a role to play. On my Community Psychiatric Nursing I recall an explanation of the way a health problem can be escalated from initial attempts at self-remedy through to family and friends suggesting "I think you need to go see the Doctor!". Parsons account is described as functionalism. On this account we need permission to be sick and offered respite from our work, family and usual responsibilities.

There is a new report that highlights the ongoing relevance of the sociological domain and medical sociology. Research in the 1950s-1970s is of its time but there are existing lessons to be found.  Below I've embedded a presentation from the Academy of Medical Sciences and a related reference. These are placed to show in Hodges' model how the scientific disciplines that include medicine, research and pharmacology are related to society, the public and sociological concepts and research.

The Academy of Medical Sciences has been undertaking a project to examine how the generation, trustworthiness and communication of scientific evidence can be enhanced to strengthen its role in decisions by patients, carers, healthcare professionals and others about the benefits and harms of medicines. The final report has been prepared by an Oversight Group with a diverse range of expertise, chaired by Professor Sir John Tooke FMedSci, and was underpinned by extensive engagement with citizens, patients and healthcare professionals, as well as with other key stakeholders across the biomedical sector. How can we all best use scientific evidence?
individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population




"Freidson offers what is perhaps the most telling criticism of Parsons’ model. According to Freidson, Parsons overstates the consensus between the patient and the caregiver. There are often times when the patient disagrees with the physician, conflict ensues, and the patient seeks care elsewhere or does not comply with recommended therapy. In fact, there is a ‘lay referral system’ within the social network of the patient that prefers one caregiver to others for specific social and cultural situations (Freidson 1960)."


How can we all best use scientific evidence?




My source: BBC Radio 4 Today 20 June 2017.

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Tuesday, June 20, 2017

Pointing to the gap: Social Determinants of Health in Hodges' model

Recent discussion on a HIFA forum included mention of the Social Determinants of Health SDH and inequality. Revising the draft paper on h2cm and threshold concepts (abstract to follow soon) social determinants arose in references there also (Aronsson, 2016).

I realised that I have not stressed enough how readily (and obviously) Hodges' model facilitates reflection and critical thinking about SDH. Hodges' model can really come into its own in this particular application.

So, just in case I take Hodges' model for granted in its potential utility, below I have drawn on the following figure (the findings within will no doubt vary over time and with further research).

By Jsonin - Created this open source diagram for our research into standard human data elements Previously published: http://determinantsofhealth.org, CC BY 4.0, Link
I have mapped the main percentage items to Hodges' model below. Clearly there is great deal of overlap; what for example, is the effect of the physical environment upon individual behaviours? Medicine and medical care does not just rest upon several sciences, but it is inherently political and about power.

Throughout my career and many others I am sure, there is an accompanying gap. It follows us around from the initial educational encounters through to our very latest mandatory training and CPD exercises. Whilst educational in being the theory-practice gap, applying SDH to Hodges' model reveals a much greater gap that politically is still being fought over...

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population
38%
individual behaviour


7% 
physical environment
11%
medical care
21% 
genetics and biology

SOCIAL DETERMINANTS OF HEALTH

23%
social
circumstances



As if we needed to be 'told':

This space suggests that there really is 
still much more to do.

To those who would say: 
"We have done so much!" 
I would say: 
"But, we have only 
scratched the surface of 
the three 'easiest' care domains."



The 38% attributed to an individual's behaviour is a further source of evidence for Hodges' model as a resource for education and personal change.

Aronsson, J. (2016). Transformative sustainability learning within the undergraduate nursing curriculum. Community Practitioner, 89(1), 20-21.

WHO: SDH

CDC: SDH

Wikipedia: Social determinants of health


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Monday, June 19, 2017

Health Inequality: TB, Trauma and Technology - c/o BBC Radio 4

One of the joys of working in the community is that while travelling I can often catch the radio. Being on a 10-6 today I was even better placed to listen to 'Start the Week'. Even though there's the web iPlayer ... sometimes maybe it's a case of real time - real thinking...

It is a very engaging conversation that - as I listened - spoke directly to Hodges' model: but I would say that (not sure about the real thinking though..!).

BBC Radio 4 Start the Week (19 June 2017) Health Inequality: TB, Trauma and Technology


BBC Radio 4 Start the Week:

In reference to a book there is mention of organisational justice, which I will add to the post on the Grenfell Tower disaster.

I've a related post to follow after midnight UK on social determinants of health. Thank you for your ongoing interest.

Additional tags:
#psychiatry #information #basic needs #shelter #authority #uncertainty #friends #community #location #crisis #war #globalhealth #book #resilience #care #stigma #neglect #institution #community #technology #outcomes #research #services #internet

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Saturday, June 17, 2017

The Compartmentalisation of Grief and Tragedy: RIP

INDIVIDUAL
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
POPULATION



a person

A LOVED ONE

(timeframe: grief)

(timeframe: Why)

(timeframe: answers)
to questions that should not need be asked 
(again and again....)

'problem'

Fear

uncertainty

advice

flight OR fight

values

ethics

morality

PSYCHO-

a house
a house
.
.
.
a house
a house
Fire a house fighting
Fire a house fighting
.
.
Fire a house fighting
Fire a house fighting
||||||||||||||||||

strength of towers
cladding - facade

material science

introducing: dead space

"probably"
'problem'

property: transparency vs opaque

(time-frame: risk, evidence)

-PHYSICAL
SOCIO-

a HOME

a group of people

family friends

social housing

a community

the most terrible of good-byes

Towers of Strength

SPIRITUAL

(timeframe: social justice)

D.ANGER

'problem'

introducing: a 'new' home

-POLITICAL

property

material evidence

facade - cladding

cost
££ value $$

Health & Safety Law

Building regulations

(timeframe: Public Inquiry)
(timeframe: ACTION)

GOV.UK

'problem'

'political correctness'?

local-regional-national

introducing: another Public Inquiry


Some reflections on the tragic event at Grenfell Tower, London, UK.

Personal note: In posting this, of course, I do not wish to trivialise the enormity of what has happened, the point is that even in disasters - across the world, tools are needed to reflect, think critically, to support learning in order to ultimately assure a safer future for all...


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Wednesday, June 14, 2017

Museum of the Moon

INDIVIDUAL
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
POPULATION



Source: The Times, June 14, 2017. p.40.

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Tuesday, June 13, 2017

Boxing 'II'

As young children we may encounter 'boxing' quite early on. This first experience, which we may or may not wholly remember is undoubtedly critical to our personality and subsequent psyche. Such early experiences influence our ability to 'look after ourselves', how we deal with bullies, anxiety, the potential for conflict and develop assertiveness skills. When a 'scrap' happens it can be quite sudden, that total impact of everything out of control, sheer danger and literal impacts. The environment might be nursery, playground, cloak room and the presence of peers as onlookers can be another key factor.

In the late 1960s early 70s I found some old boxing gloves under the stairs at my nan's. I had a handful of uncles on mum's side (just two now - Uncles Tom and Ken!) and the gloves had clearly been swung and jabbed down the line. I don't count myself as a fighter, unless someone tries to push their beliefs - without invitation - down my throat. Then it will be more a case of a reflex action. The 'arc' being comprised of vomit. In the school playground I learned to talk my way out of trouble, resorting to humour at times; as you learn to deploy whatever intellect you might have judiciously. Legs are essential to a boxer:

“First your legs go. Then you lose your reflexes. Then you lose your friends”
Willie Pep

My legs helped me a time or two.

Not too many years ago, so a new generation is in the frame and a nephew had boxing gloves of his very own. He trained with a local club and had some fights. I didn't go watching, but didn't make too big a big fuss either. He doesn't box now as it happens; he's married with family and busy earning a living. Over four decades I've cared for several gentleman, former boxers who developed dementia. Hence, my lack of enthusiasm. (Although the selective literature listed below does not reflect it, women's boxing is of course also well established.) The extent to which boxing caused their dementia is not the point here. It's trying to acknowledge the ongoing debate: the risks, the history (Ancient Greece 688BC), the discipline, sense of belonging and self-respect it can instill. Of course a great many sports can do this. Of course, I listened very attentively as one gent could still relate how perhaps he had been 'used' in terms of the fights and purses back in the 50s-60s. Vulnerable adults of today and yesteryear. Today American Football is concerned about head injuries, in football heading the ball repeatedly is in the news. Technology should be able to reduce the risks even more and protect individuals from injury that is obvious and more insidious in nature.

Some of these points I've considered in Hodges' model as follows:

individual
|
INTERPERSONAL : SCIENCES
humanistic ---------------------------------------  mechanistic
SOCIOLOGY : POLITICAL
|
group

SELF

self-awareness
Identity
self-belief

way-finding

dementia - cognitive damage

personality change

aggression

tactics  strategy

motivation training attitude

self-discipline

ethics

mental health - mental capacity
emotions

mood

Personal safety

boxing technique

reflexes speed movement balance

punching fitness

weight, reach, statistics

THE RING

stamina nutrition hydration

concussion
sub-concussive

exposure models

unconscious knockout

Head - Brain injuries

physics: force time (duration) momentum

technology - sensor equipped gloves

Sports Medicine Research
Headgear
Safety - Evidence

Medical risks

OTHER

Ethnographics
Coaches <-> Boxers
Mentors

Support network

THE STREET

personal history-family
History
sports history

trainer friends club

Sporting behaviour

family friends
Socio-
Rules (changes)

Conflict Power

promotion media finance

codification rules

Amateur Professional

Refereeing

Regulating bodies

Governance

Law

Contracts

Economics


Selective reading:

Sacha, J. (2017). Fighting Feelings. Sociological Perspectives, 60(1), 77-94.

Erlanger, D. (2015). Exposure to sub-concussive head injury in boxing and other sports. Brain Injury, 29(2), 171-4.

Falvey, &., & Mccrory, P. (2015). Because not all blows to the head are the same. British Journal of Sports Medicine, 49(17), 1091.

Mcintosh, A., & Patton, D. (2015). Boxing headguard performance in punch machine tests. British Journal of Sports Medicine, British Journal of Sports Medicine, 14 July 2015.

http://www.welshboxers.com/quotes/

See related post 2016: 'Boxing' I


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Thursday, June 08, 2017

The Care Domains: Where numbers count...

INDIVIDUAL
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
POPULATION
1:1
Intra- Interpersonal Skills


"All the monoliths, though they vary greatly in size, were fashioned to the exact proportions of 1:4:9, the squares of the integers 1, 2, and 3."


"The rise of capitalism in China resulted in the demise of the "iron rice bowl", under which the state-owned industries provided pensions. Retirees now have to fend largely for themselves or rely on their children, but the collapsing fertility rate has led to the infamous "1-2-4" problem in which a single working-age adult will eventually have to support two parents and four grandparents." p.219.

"2 for 1 offer"
Naylor Report


So let's listen to the wisdom of the four elders...

Sources:
2001: A Space Odyssey Wiki

Ford. M. (2015) Rise of the Robots: Technology and the Threat of a Jobless Future, London: Oneworld Publications. p.219.

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Sunday, June 04, 2017

A UK Charter for Health

Dear PoHG supporter

A UK Charter for Health

During this election campaign the NHS and its financial cost are quite rightly of enormous significance. People clearly care about the principles on which the NHS is founded – fairness, equity and public provision. It’s time to broaden the debate and apply those principles to the wider social and economic causes of ill health.

Now we have a tool with which you can work to get health equity onto the political agenda during this final week of the election campaign. We are attaching the UK Charter for Health, developed by PoHG, The Equality Trust and Birmingham City University over the last twelve months. Please use it to ask your local candidates to support the goals of this charter and compare their party's manifesto proposals to the policy suggestions in Figure 1.

It is only by shifting policy upstream towards prevention of illness and promotion of health that the financial cost of treatment through the NHS will be brought under control.

But don’t stop when the election is over! Please promote the charter amongst your networks and colleagues – put it up in your workplace, talk about it with your friends and fellow workers, press your local health authorities and councils to adopt it. For our part PoHG will continue to refine, develop and promote the charter nationally.

With best wishes

Sue Laughlin and Alex Scott-Samuel
(Co-chairs of PoHG)

Politics of Health Group Mail List Messages
Visit the PoHG website for lots of interesting links and publications: http://www.pohg.org.uk/
Visit PoHG on Facebook: https://www.facebook.com/282761111845400
Follow us on Twitter: @pohguk
You can subscribe to / unsubscribe from the PoHG mail list here: http://www.jiscmail.ac.uk/POHG

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Saturday, June 03, 2017

Here - in a corner of a living room ...

Here


INDIVIDUAL
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
POPULATION


Richard McGuire

Main image: Garner, D. While Stuck in a Corner, an Artist Bends Time. ‘Here,' Richard McGuire’s New Graphic Novel Books of The Times. New York Times, Dec. 23, 2014.

My source: Sunyer, J. As time goes by. FT Weekend, Life&Arts. 13-14 December 2014, p.12.

Book cover source: Amazon

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Friday, June 02, 2017

Thursday, June 01, 2017

7th Workshop on Awareness and Reflection in Technology Enhanced Learning (ARTEL 2017)

CALL FOR PAPERS

The 7th Workshop on Awareness and Reflection in Technology Enhanced Learning (ARTEL 2017) will be held in the context of the EC-TEL 2017, Tallinn, Estonia: 12 September 2017.

Workshop webpage: http://teleurope.eu/artel17
Twitter hashtag: #artel17

RATIONALE

Awareness and reflection are viewed differently across the disciplines informing Technology-Enhanced Learning (CSCW, psychology, educational sciences, computer science and others). The ARTEL workshop series brings together researchers and professionals from different backgrounds to provide a forum for discussing the multi-faceted area of awareness and reflection. 2017 will be the 7th workshop in the series.

Through the last ARTEL workshops at EC-TEL (2011-2016) the topic has gained maturity and questions addresses are converging towards the usage of awareness and reflection in practice, its implementation in modern organisations, its impact on learners and questions of feasibility and sustainability for awareness and reflection in education and work. To reflect the growing maturity of research in ARTEL over the years in conjunction with the latest trends in TEL, this year’s topic particularly invites contributions that deal with moving from awareness and reflection to action. Changing individual behaviour and collaborative practice is very challenging, and we invite research that particularly deals with technology’s role in helping users take this step.

The workshop will include a paper session, a demo and prototype slam as well as an interactive session. The workshop aims at:

1. Providing a forum for presenting and discussing research on awareness and reflection in TEL.
2. Creating an interactive experience that connects participants’ research, current tools or latest prototypes and models with real end users’ learning experiences and requirements regarding reflection technology.
3. Creating an agenda for future ARTEL research and development.

TOPICS OF INTEREST

Considering the multitude of views on awareness and reflection distributed over a wide range of disciplines the workshop’s general theme is encapsulated in the following questions:

- How can awareness and reflection support learning in different settings (work, education, continuing professional development, lifelong learning, etc)?
- What are the role(s) that technology can play in these contexts?

For ARTEL 2017 we particularly invite contributions that address the theme of moving from awareness and reflection to action. To answer the above and related questions, we are looking for contributions that address the following aspects:

  • Theoretical discussion of awareness and reflection in TEL and related concepts (e.g., collaborative learning, creativity techniques, experiential learning, etc.) 
  • Methodologies to identify, study and analyse awareness and reflection in the context of (technology-enhanced) learning (quantitative and qualitative methods, learning analytics, visualisations etc.) 
  • Empirical studies about technology support for awareness and reflection 
  • Technology (design, application, evaluation) supporting awareness and reflection 
  • Designing awareness and reflection in TEL applications and processes 
  • Using awareness and reflection support to enhance the learning experience 
  • Awareness of social context, knowledge, artefacts and processes 
  • Awareness and reflection in specific contexts, such as higher education, work-integrated learning, learning networks, etc. 
  • Challenges and solution ideas to help users move from awareness and reflection to action, i.e. to changing individual behaviour and collaborative practice 
SUBMISSION

- Full papers: Description of novel theoretical, empirical or development work on awareness and reflection in TEL, including a substantial contribution to the field (up to 15 pages).
- Work in progress: Ongoing research and current approaches on investigating the field, with initial insights for the community (up to 7 pages).
- Demos: Prototypes, design studies and tools for the support of awareness and reflection in TEL, which can be demoed and discussed (up to 3 pages).

All contributions will be peer reviewed by at least two members of the programme committee evaluating their originality, significance, and rigour. The papers will be published in the CEUR workshop proceedings (http://ceur-ws.org). Submissions should use the Springer LNCS template (http://www.springer.com/computer/lncs?SGWID=0-164-6-793341-0).

Please submit your paper via EasyChair: https://easychair.org/conferences/?conf=artel2017

IMPORTANT DATES

22.06.2017 Submission Deadline
15.07.2017 Notification of Acceptance
30.08.2017 Camera-Ready Papers
12.09.2017 Workshop
31.10.2017 Publication of Workshop Proceedings

ORGANISERS

Milos Kravcik, DFKI, Germany
Alexander Mikroyannidis, The Open University, United Kingdom
Viktoria Pammer, Graz University of Technology and Know-Center, Austria
Michael Prilla, Clausthal University of Technology, Germany


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Tuesday, May 30, 2017

Topoi: Call For Papers Special Issue - “Foundations of Clinical Reasoning: An Epistemological Stance”

Call For Papers

Topoi: An International Review of Philosophy

Special Issue: “Foundations of Clinical Reasoning: An Epistemological Stance”

Guest Editors:

Topoi
Mattia Andreoletti (Campus IFOM-IEO, Milan)
Paola Berchialla (University of Turin)
Giovanni Boniolo (University of Ferrara)
Daniele Chiffi (Tallinn University of Technology)

Overview:
Among the most discussed epistemological issues in clinical reasoning is the problem of the external validity. Considered as one of the most urgent, this problem arises from the fact that the results of the Randomized Controlled Trials (RCTs) are seldom applied to the whole reference population, which is identified with people needing a medical treatment.

Once verified that the results of an RCT are valid, we still have to explain how to apply these results to patients who did not take part in the experiment. As a matter of fact, several individuals who present particular features are excluded from the groups of patients selected for the experiment. Therefore, how can we justify the belief that a certain treatment has the same effect when applied to a different setting? Without a reasonable answer to this latter question, RCTs would prove less helpful, as they would only show the results related to a particular situation, without any guarantee that the same results could apply to other contexts. The possible advantages of a Bayesian perspective on RCTs will be explored. Finally, even if a way to apply population-based knowledge to a specific case is acknowledged, in order to choose a suitable treatment for a patient, diagnostic and prognostic judgements are traditionally essential. Both diagnosis and prognosis always occur behind a veil of uncertainty, nonetheless they seem to convey different forms of uncertainty. The concept of diagnosis is, in fact, usually affected by the inductive risk of error, while prognosis seems more likely to be associated with fundamental uncertainty towards a future condition, which may be difficult to probabilistically compute.

Possible Topics include (but are not limited to):

- Logic and Epistemology of Clinical Reasoning
- External validity of RCTs
- Bayesian Forms of Clinical Reasoning
- Diagnosis and inductive risk of error
- Prognosis and severe uncertainty

Invited Contributors:

Ileana Baldi (University of Padua)
Margherita Benzi (University of Eastern Piedmont)
Pierdaniele Giaretta (University of Padua)
Sydney Katherine Green (University of Antwerp)
François Pellet (University of Münster)
Ahti-Veikko Pietarinen (Tallinn University of Technology)
Federica Russo (University of Amsterdam)
Donald Stanley (Maine Medical Center, Portland Maine)

Submission guidelines:
Contributions must be original and not submitted elsewhere. Papers must be in English and should not exceed 8,000 words (references and footnotes included). Each submission should also include a separate title page containing contact details, a brief abstract and a list of keywords for indexing purposes. All papers will be subject to double-blind peer-review, following international standard practices.

Manuscripts should be submitted exclusively through the Online Manuscript Submission System (Editorial Manager), accessible at http://www.editorialmanager.com/topo/. Please save your manuscript in one of the formats supported by the system (e.g., Word, WordPerfect, RTF, TXT, LATEX2e, TEX, Postscript, etc.), which does NOT include PDF.
Make sure to select the appropriate article type for your submission by selecting: S.I. Foundations clinical reasoning (Andreoletti/Berchialla/Boniolo/Chiffi) as the appropriate tab from the scroll-down menu.

Deadline for submissions: August 31, 2017

For any further information please contact:
Mattia Andreoletti (mattia.andreoletti@ieo.eu); Paola Berchialla  (paola.berchialla@unito.it)
Giovanni Boniolo (giovanni.boniolo@unife.it); Daniele Chiffi (chiffidaniele@gmail.com)
--
Daniele Chiffi, MA, MSc, PhD
Tallinn University of Technology
Ragnar Nurkse Department of Innovation and Governance
Akadeemia tee 3, 12618 Tallinn, Estonia


My source:
Mail list of International Philosophy of Nursing Society (IPONS)


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Monday, May 29, 2017

Conceptual Blending - Glocalisation

glocalize

MEANING:
verb tr.: To make a product or service available widely, but adapted for local markets.

ETYMOLOGY:
A blend of global and localize. Earliest documented use: 1989.

USAGE:
“Communications have also been glocalized. Facebook, the global power on the rise, is an expression of this.”
Uri Savir; Glocalization; Jerusalem Post (Israel); Feb 24, 2012.

Source:
A.Word.A.Day
with Anu Garg

This week’s theme
Portmanteau (blend words) 

I've been subscribed to A.Word.A.Day for many years and could not resist posting this word based on the current week's theme and musings...
  • Conceptual blending
  • Blended learning
  • Blended family
Self care + Health care (the multidisciplinary team) + Social care (family/friends as carers) + State care = Blended care


Jones, P. (2012). Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model. The Journal Of Community Informatics. 8(3). Retrieved from http://ci-journal.net/index.php/ciej/article/view/876/

Jones P. (2014). Using a conceptual framework to explore the dimensions of recovery and their relationship to service user choice and self-determination. International Journal of Person Centered Medicine. Vol 3, No 4, (2013) pp.305-311.


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Thursday, May 25, 2017

"Impenetrable Room" 2016 Iván Navarro

We are One


INDIVIDUAL
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
POPULATION







My source: FT Weekend, Collecting, 1-2 April 2017, p.15.

Image source: http://www.papermag.com/12-must-see-art-shows-opening-this-weekend-2065294511.html


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Wednesday, May 24, 2017

What does professionalism mean to me? #IND2017 (dnf: draft never finished)

Something along, within and across these lines...


INDIVIDUAL
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
POPULATION

Being self-aware, reflective and
reflexive including aspects of your
role that either you don't especially
like, or you're just not 'good' at.
Recognise when to ask
for help, advice, supervision.
Anticipating needs.
Indicating pros and cons.
Keeping up-to-date.
*Have the courage to blow
that whistle if you must.
Communicate to the best of your
ability and learn constantly as human
nature dictates you must.
Look after yourself: if ill Be ill.
Take care
of your personal ethics and values,
don't be bullied into lowering them
and running with the crowd.
Nurse = Lifelong Learner
... then you will question your own competence.
As you strive to be someone else remember you can be yourself.
The things you take personally are those you open the door to. Learn from them.
Never forget your shield,
protect yourself and others in
what you disclose about
yourself and others.



Being compass-ionate requires

360 degree

vision, hearing ...
learning and forgetting...

Your keen are you?
So really observe.

Care about time,
your management of it as a resource
and the time frames of
past, now, future, hoped for and imagined.
Remember you need to understand information systems, data management in so far as it supports or places at risk the care you deliver and the safety of your patients.
If I use IT based media I bear in mind the scope of the platform.
Open to innovation:
but see the elephant as an elephant.

When the robots knock on your door being professional means you won't be in: "Moved On"

As you care, draw on learning
regards where you stand -
 you are a guest in someone's home,
As your feet are then grounded politically,
so too is touch and
negotiating personal spaces.
 Learn from others 
Expectations Expectations Expectations
Manage them in a way such that you do not make promises you can not keep.
Be committed to what you do.
Learn from your peers, especially for safety's sake, but also form your own opinion.
Talk this and work through with colleagues.
Not everyone will 'like' you; you in turn may not 'like' people. Working through this (without experiencing abuse) as your role demands is being professional.
By all means be a team player, but don't let the games that people play distract you from being professional.

Patient-Carer
Community Care
End of Life Care
 As you learn from others 
pay most attention to the lessons 
in Love as you will witness many. 

The trust and respect of others take time to earn,
but can be lost in an instant;
if you have 'it' use it to foster trust and self-respect in others.
You have to remember constantly
you are accountable here.
Remind yourself of codes of conduct the legal aspects of your role.
Know your lines -
especially when crossed | STANDARDS.
With your ID have your whistle ready*.
What you do and who you are is a privilege.
Know your scope of practice, but be ready to question it. If you do not the future will.
This domain is the most powerful and neglected to the professional nurse. As a professional what are YOU going to DO here?
The art of leadership is filled with wonder: at what together you can all achieve.
Take stock and ask in Year 1 what are the
legacy issues my seniors are wrestling with?
In years 10 20 30 40 ...
(robotics permitting) repeat and reflect.


... because, being professional means learning and unlearning when the lines are there for a purpose and when they need to be shifted, lifted or plain erased ...


Previous post c/o NMC

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Monday, May 22, 2017

Monday, May 15, 2017

SUPPORT: Global Health - Health Support - Support Change

INDIVIDUAL
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
POPULATION
SELF - SUPPORT


SOCIAL - SUPPORT

POLITICAL - SUPPORT


My source: Halcyon Gallery

Artist: Lorenzo Quinn https://twitter.com/artistlorenzo/status/863282451212374017

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Friday, May 12, 2017

What does professionalism mean to you? c/o NMC - #IND2017


Dear Peter

We are writing today to wish you a happy International Nurses’ Day – a chance to celebrate the exceptional professional contributions of nurses across the world.
 
The professionalism of nurses and midwives has always been essential to good care. We all know professionalism when we see it – but there’s never been a single definition for what it means in nursing and midwifery.
 
So we wanted to use the opportunity of International Nurses’ Day to tell you about a new tool we have developed, Enabling professionalism in nursing and midwifery practice, which defines professionalism in nursing and midwifery for the first time.
 
We hope it will help you to explain and strengthen your own professional contribution as a nurse or midwife, as well as being a tool you can use to reflect on your practice when you revalidate.
 
We have each shared what professionalism means to us, and we would love to hear your stories too. Share your views on what professionalism means to you through this form or through the NMC’s Twitter account @NMCnews using #professionalism.
 
Best wishes, and happy International Nurses’ Day.
 
Jane Cummings, Chief Nursing Officer, England
Charlotte McArdle, Chief Nursing Officer, Northern Ireland 
Fiona McQueen, Chief Nursing Officer, Scotland
Jackie Smith, Chief Executive and Registrar, Nursing and Midwifery Council
Jean White, Chief Nursing Officer, Wales

----------------------------------------------------------------------------------------------------------------
I will investigate this tool and reflect - post about it in the near future as appropriate.
To nurses and carers the world over Very Best Wishes for #IND2017.
Please look after yourselves too!!*

*The 1st rule of 1st aid.

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Thursday, May 11, 2017

Mental Health Awareness (Second) ... (Hour) (Day) Week (Month) (Year) (Life) (History)

INDIVIDUAL
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
POPULATION

Thoughts Beliefs Emotions Mood...
Motivation, Confidence
Memory, Experiences, Trauma, Grief

Mental Health - Reasons for Referral

Assessment

Self-help     Self      Self-stigma

Learned Helplessness

Psychological Theories & Therapies

Sleep  Coping  Concentration

self-harm risk, specialist services

Surviving OR Thriving?
Vulnerability

Debate: Ethics, Diagnosis, Philosophy of Care

PSYCHO-
Systematic diagnosis

Evidence-based Care, Treatments

Effective Treatment, Outcomes

Drugs, Side Effects

Local access (200+ miles for a bed?)

Demographics - Research

Data, Information, IT Records

Emergency (MH Crises) Services

Referrer's Knowledge of Care Pathways

Debate: Pathologizing,
Big-Pharma

Evidence Based measures


SOMATIC - BIOLOGICAL
SOCIAL

Group Therapies

Community Family Friends

Relationships - Social Network

Risk  Behaviour  Safety

Mental health as a Social Construct

Stigma

Folk theory UNDERSTANDING Specialist

Sociological Theories
prediction uncertainty expectations

Social Norms      Conformity

Culture, Ethinicity, Education

Anthropology

Quality of Life
POLITICAL

Power         Mental Health Law

Review of Mental Health Act?

WAIT! Government Policy Targets

Gate-keeping
????RING FENCED???
 ? Funding of Services ?
??  Parity of Esteem  ??
???RING FENCED???

 Community Care - Beds - In-patients

Mental Health Services

Primary, Secondary, Tertiary

Mental Health Professionals

Human Resource Planning

Work

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