In political hands person-centred care is a quantum phenomena (entanglement)

individual
INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

group

Acute mental health needs RISK Self-harm Local care? Empowering the individual? Accessibility Cognitive distance Let therapy commence Continuity (dist-ress) Remote policy touch Organisational (distance) dementia? threshold   ↘	RISK  Self-neglect personal hygiene domestic environment local-regional-national?  metrics: Km or Miles or time? Gallons or Litres? Cost? Illusory savings? threshold ↓
RISK   Harm to others to integrated care  multidisciplinary care      threshold →	Beds

Lintern, S. (2014) Mental health patients sent hundreds of miles for a bed, HSJ, 14 August.

Beds shortage = Gathered Sobs
Mental Health = Lethal Anthem?
Mental health = Lean Halt Them

Bed image:
By kieran jones (http://www.clker.com/clipart-bed-icon.html) [Public domain], via Wikimedia Commons

Excuses found: "premature definition of variables"

Currently reading:

MURPHY E., DINGWALL R., GREATBATCH D., PARKER S., WATSON P. (1999). Qualitative research methods in health technology assessment: a review of the literature. Health Technology Assessment. 2(16), p.84.

http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/0008/64826/FullReport-hta2160.pdf

Marshall (1985) presented the flexibility of qualitative research as one of its strengths. She argued that, in qualitative research, the researcher does not assume that (s)he knows, at the outset, the exact nature of the research question. Rather, qualitative research offers the opportunity of discovery. In fact, researchers vary considerably in the extent to which they formulate the precise nature of the research question in advance of the study. Most seek to avoid what Silverman (1993) referred to as “premature definition of variables”.

<>

Ah, so this is what I've doing!

Yes, but for how long with h2cm, with Drupal...?

1997... 2007...  and counting... :-)

[Itforum] Unique Technology / Assessment Request

The ITForum featured the following post with ongoing discussion and resources related to TEL - technology enhanced learning:

Hello Michael,

When I read your post my thought was that this was a classic example for an adaptive learning module/set of modules. This was a significant concept in the 1970s/1980s when elearning was peaking.

It seems unfortunate that the proliferation of the LMS has all but reduced the learning environment to subject-matter presentation and quizzes.

The recent proclamation of the eLearning Manifesto (http://elearningmanifesto.org) as well as ideas expressed by OULDI (http://www.open.ac.uk/blogs/OULDI/) and my own ideas of Design Alchemy (Sims, 2014) provide alternative ways of thinking about elearning. These may assist in re-thinking strategies to achieve your goals.

Roderick Sims, PhD

design alchemist
 
ITFORUM mailing list
http://listserv.lt.unt.edu/mailman/listinfo/
This is a listserv of the Association for Educational Communications and Technology. The focus of this list is instructional and educational technology topics ranging from technology integration through cognitive systems thinking and beyond.

Thanks to R Sims and Ack. ITForum. I have added the link to Sims, 2014 above.

The original question concerned - core competencies required for nursing programs....

Don't RAID on my Care Domains

individual

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

group

Assessment Person-centred, Holistic, Equality of Esteem in Care, Self-care, Literacies	Rapid Co-ordination, Speed, Synchronization, Length of Stay, Physical access, Systems
Discharge Communities of practice, Resources, After-care, Communications, Education	Interface Policy, Infrastructure, Integration, Choices, Liaison, E-records, Information Sharing

Additional links:

RAPID ASSESSMENT INTERFACE DISCHARGE (RAID) Prof George Tadros

With money in mind: The benefits of liaison psychiatry, MHN

The limitations of the healthcare sector

4

many

decades there 

have been recurring 

issues, austerity measures, 

requirements, policy challenges, 

policy initiatives, gaps between theory 

and practice, a crisis in compassionate care, 

rising waiting times and a plethora of other concerns.

All these then and much more 

affect the

 healthcare

 sector

Clearly, there is no 'magic wand', but there must be a way to address some of the difficulties? 

Within health and social care, locally, nationally and globally we need a tool to help improve interprofessional reflective practice, to support person-centered, holistic care across physical, emotional, social, political and spiritual domains of care. 

The future demands a resource (free, open, easy to learn) that can also facilitate self-care, health literacy and the many carers within families and communities.

 

So, how big is your picture?

Drupal in Education: Richer experiences with Drupal 7 and H5P (HTML5 Package)!

The H5P module is finally available for Drupal 7! Now you can download H5P and H5P content types empowering you to create great rich experiences for your users to enjoy. Content like interactive videos, presentations, drag and drop, fill in the blanks questions and more are available from h5p.org.

We have received many enthusiastic requests for an H5P D7 module and we are proud to present the newly released version. You can find it available on the H5P project page.

You create the content with your web-browser and the content will work just as great on smartphones and tablets, as on you desktop computer.

Below is a summary of the H5P content types that are currently available for Drupal 7 (and all other platforms we support).

Interactive video ( see for additional media: https://groups.drupal.org/node/409763 )
Perhaps the most powerful tool in the H5P toolbox. Upload videos and animations, and make them interactive by adding quizzes, images and text along the way.

Presentation
Create a presentation slideshow with interactions along the way. Add text, images, video and various quiz tasks to your presentation.

Boardgame
A level based board game where the user must complete tasks in various levels to win. Depending on whether the user completes or fails, a video is shown at the end of each level. The game is fully customizable.

Flashcards
An image is displayed and the user has to insert a corresponding text by using the keyboard. The card turns to display the solution. Several cards can be added in a sequence.

Fill in the blanks
Create sentences and leave out words, adjectives, conjugations etc. for the user to complete by typing the missing text on the keyboard.

Question set
Your staple quiz question tool. Add a mix of multiple choice questions, fill in the blanks & drag and drop tasks.

Contact button
A simple widget that allows users of your website to get in touch with you using their preferred channel, such as email, Facebook or Twitter.

For those that are new to H5P, H5P is short for HTML5 Package, and is a simple way to create and share rich and interactive web content. H5P is modular and consists of several content types and applications, perfect for use in e-learning and advertising.

See all the content types in action on H5P.org

With H5P you can:

• Export and import content types and applications between sites, e.g. from a Joomla site to a Drupal site.
• Use existing content types and applications, and build on these to create your own content.
• Create and edit rich web content directly in your browser. No technical skills are needed.
• As a developer, build upon existing content types and applications, or create you own from scratch. Share your work with the rest of the world on the h5p.org!

Source: https://groups.drupal.org/node/409763

Looking forward this next weekend and London for DrupalCamp.

other Drupal posts on W2tQ.

5th Qualitative Research on Mental Health Conference 2014

Practicing mental health: Qualitative approaches to investigating services and interventions
 
Crete, Greece, 2-4 September 2014

The Qualitative Research on Mental Health conference has been established as an international transdisciplinary forum for dedicated qualitative research on a range of topics in the field of mental health, using a variety of methodologies and approaches.

The 1st and 2nd Qualitative Research on Mental Health Conferences were held in Tampere, Finland, in 2006 and 2008, and the 3rd and 4th in Nottingham, U.K., in 2010 and 2012. Previous conferences attracted strong international interest with about 150 participants from a diversity of backgrounds, including service users, health and social care professionals, social scientists and health policy makers, and created a space for lively and enriching discussions. The 5th Qualitative Research on Mental Health Conference is due to take place from the 2nd to the 4th of September near the beautiful city of Chania, in Crete, Greece.

In several qualitative research trends, mental health is approached as a set of practices; these include the professional practices implicated in defining and treating mental distress, the practices through which individuals in distress live with, make sense of and manage their experiences, as well as the wider socio-cultural and institutional practices of understanding and dealing with human suffering. This conference invites qualitative studies, from a variety of disciplines, which describe these practices, their functions and their effects, examine the discourses associated with them, and explore how these practices are viewed and experienced by the parties involved. The conference aims to promote critical engagement with mental health practices through highlighting the personal and socio-cultural processes that underpin them, as well as their intersections with gender, culture and social position.

Submissions for symposia, individual presentations and posters are welcome.

Deadline for submissions 24th January 2014
For further information, please consult the conference website:
http://www.symvoli.gr/conference/qrmh2014/page/main

<>

I will try to submit and attend (being sure to also take snorkel and flippers).

My source and with thanks: http://www.jiscmail.ac.uk/lists/psychiatric-nursing.html

Hodges' model - DSM V: the Politics of (Well-being (Health [Mental Health])) salience, books and domains

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

individual

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) 'salience'  ‘Salience syndrome’ replaces ‘schizophrenia’ in DSM-V and ICD-11: psychiatry’s evidence-based entry into the 21st century? J. Van Os bereavement medical, bio-psycho-social, recovery model self-efficacy self-stigma DSM5 and Ethical Relativism Ultimate terminology:  self, person, patient, service user, client,  Mr, Miss .....	Diagnostic process 'Evidence', objectivity,  repeatability, validity, treatment, drugs Credit Heidi Cartwright, Wellcome Images
The history of DSM: APA : Wikipedia stigma social services social network (size, quality) anti-psychiatry social norms? Media: Books review - essay; Stevenson, T. (2013) Mind field, FT Weekend, May 25-26. p.8.	American Psychiatric Association APA dx revision watch Opinion - commentary: DSM-5: Caught between Mental Illness Stigma and Anti-Psychiatry Prejudice Is Criticism of DSM-5 'Anti-psychiatry'? Goldacre: Bad Pharma .... and much more...!

group - population

Image: http://wellcomeimages.org/

Food Companies: Behind the Brands Scorecard

Jordan JNC Conference: Mental health and stigma, Student nurse's aptitude and the MDGs

There were a great many fascinating talks at the conference in Amman. The following caught my attention:

Dr Heyam Dalky on Perception and Coping with Stigma of Mental Illness: Arab Families' Perspectives

Since I trained in the late 1970s there has been a marked positive change in the social stigma associated with medical and mental health conditions. People are by and large more enlightened regards epilepsy for example. Although perhaps some of the progress can be related to medication, medicine management and community follow-up. Mental health professionals and services are aware of the potential damage that a diagnosis of 'schizophrenia' can inflict on young adults. Despite any sense of progress I might see, there is much still to be done as campaigns such as Time To Change attest.

It was very useful then to revisit the historical development of thought in stigma. Dr Dalky also shared global insights into stigma perception within families by citing research in a range of countries; for example, in Jordan, Morocco, Sweden, Germany, China, Malaysia, and Ethiopia.

Within Hodges' model the individual, as in the self, is given a pivotal and yet mobile place (transferable from the top of the model to the center) this led me to the concept of self-stigma (Corrigan, 2009) as I draft a paper on h2cm, case formulation and diagrams.

In her presentation Dr Dalky notes:

• Link and Phelan (2001) defined stigma as the co-occurrence of the components of: 
• labeling, stereotyping, separation, status loss, and discrimination.
• “self-stigma” or “stigma perception,” is the extent to which individuals believe others stigmatize them because of who they are.

They say travel broadens the mind and listening to this presentation you really see the difficulties, objectives and aspirations that not only practitioners share but families and our clients too.

Heyam F. Dalky, PhD, RN, Jordan University of Science & Technology, Irbid, Jordan
 

Ever since my engineering aptitude was measured in the mid 1970s by predicting the movement of a series of gears I've always held a special place for aptitude and attitude, as reflected here on W2tQ.

Mrs. Maxie Andrade, et al. presentation Aptitude Towards Nursing: Is it Measurable? highlighted a central challenge within nurse education.

Nurse training represents a major personal investment for the student (their family too in many cases), the educational institutions and societies concerned. As a sign-off mentor I assess third year students on their final placement. This is a great responsibility that is usually a privilege, but it can be a frustration at the loss entailed for a failing student.

Mrs Andrade defined aptitude:

Is a condition, a quality or a set of qualities in an individual, which is indicative of the probable extent to which one will be able to acquire under suitable training some knowledge, skill or composite of knowledge, understanding and skill

Ref: Mangal S L. General Psychology. Fifteenth reprint. New Delhi: Sterling Publishers Pvt. Ltd; 2008.

The main questions:

Do nursing students possess the required ability (aptitude) to become an effective nurse?

What abilities do we really expect from nursing students?

The development of a tool to measure aptitude was described, reviewing the literature. Are there any existing tools within nursing? What exactly should a tool measure? Statistics and results were listed. This was a very interesting presentation and of particular interest to me.

Mrs. Maxie Andrade, Asst. Professor, Manipal College of Nursing Manipal, Manipal University


There was also a reminder of the time left to achieve the Millennium Development Goals [MDGs] c/o Prof. Hester C. Klopper's keynote: The nursing education tipping point: Forces of change. 

Less than 1,000 days and that was last month.

One thing I noticed and a sign of the issues in the Eastern Mediterranean is that the JNC conference website has proved unavailable at times. It is accessible as I post this.

Andrade M. Perceptions of health care consumers, deliverers and nurse educators on nurses, nursing practice and nursing education system. Manipal University, Manipal: 2010. (Dissertation work).
Andrade M. Choice of nursing career: Pleasure or pressure. International Journal of Nursing Education. 2012; 4(1); 42-44. 
Corrigan, P.W., Larson, J.E., Rüsch, N. (2009). Self-stigma and the “why try” effect: impact on life goals and evidence-based practices. World Psychiatry. 8(2): 75–81.

Dem@Care Summer School on Ambient Assisted Living

Dem@Care SUMMER SCHOOL ON AMBIENT ASSISTED LIVING (DemAAL 2013)
16-20 September 2013, Chania, Crete, Greece
http://mklab.iti.gr/demaal2013/

We are pleased to announce the 1st Dem@Care summer school on Ambient Assisted Living. The DemAAL summer school is primarily intended for postgraduate (PhD or MSc) students, postdocs and researchers investigating clinical and technical aspects related to Ambient Assisted Living (AAL) technologies for remote health management, ageing well and independent living. Leading researchers from academia and industry will cover theoretical and practical aspects pertinent to pervasive and ubiquitous computing technologies for Ambient Intelligence (AmI) applications, while special focus will be given on the role and opportunities of such technologies for dementia management.

Lecture material will be augmented with hands-on practical sessions. Participants will be provided with electronic versions of all programme lectures and all necessary tools and environments for the hands-on sessions. PC access with all tools pre-installed will be available on site as well. In addition, participants will have the opportunity to present their work and obtain feedback during a dedicated poster session intended to further facilitate interactions and the exchange of ideas.

TOPICS
=======
- Dementia and ICT for staging, enablement, and support
- Wearable and pervasive computing
- Sensor networks
- Sensor correlation and fusion
- Context modelling
- Activity monitoring and recognition
- Semantic Complex Event Processing
- Contextual reasoning in AmI
- Assistive technologies for cognitive support and well-being
- Video & voice-based analytics for symptomatic assessment of dementia

SPEAKERS
==========
- Assoc. Prof. Panagiotis Bamidis (Aristotle University of Thessaloniki, Greece)
- Prof. Jenny Benoit-Pineau (University of Bordeaux 1, France)
- Prof. Claudio Bettini (University of Milan, Italy)
- Dr. Antonis Bikakis (University College London, UK)
- Dr. Francois Bremond (INRIA Sophia Antipolis, France)
- Dr. Ceyhun Burak Akgül (Vistek Isra Vision)
- Prof. Cem Ersoy (Boğaziçi University, Turkey)
- Dr. Kate Irving-Lupton (Dublin City University, Ireland)
- Dr. Laura Klaming (Philips Research, The Netherlands)
- Prof. Chris Nugent (University of Ulster, UK)
- Assoc. Prof. Mounir Mokhtari (CNRS/Institut Mines-Telexom, France)
- Prof. Adrian Paschke (Freie Universität Berlin, Germany)
- Dr. Daniel Rogen (ETH Zürich, Switzerland)
- Prof. Stefan Sävenstedt (Luleå University of Technology, Sweden)
- Prof. Alan Smeaton (Dublin City University, Ireland)
- Dr. Alex Sorin (IBM Research Haifa, Israel)
- Prof. Kåre Synnes (LTU, Sweden)
- Prof. Magda Tsolaki (Aristotle University of Thessaloniki, Greece)

HOW TO APPLY
=============
Please visit and follow the instructions at http://mklab.iti.gr/demaal2013/registration. The deadline for applications is May 30th, 2013.
The summer school fee, including lectures, accommodation, meals and social events is 450 €.

VENUE
=======
The summer school will be held in Chania, Crete, a beautiful land brimming with natural beauty, history, and culture, at the Conference Center of MAICh. For more information about Chania, transportation and accommodation please visit http://mklab.iti.gr/demaal2013/venue.

ORGANISING COMMITTEE
======================
- Ceyhun Burak Akgül (Vistek Isra Vision)
- Stamatia Dasiopoulou (Centre for Research and Technology Hellas)
- Kate Irving (Dublin City University)
- Athina Kokonozi (Centre for Research and Technology Hellas)-
- Yiannis Kompatsiaris (Centre for Research and Technology Hellas)
- Erik Schuijers (Philips Research)

The Bigger Picture - Hockney: Hodges' model 4 dynamic perspectives

In the decades to follow the patient, the carer, the health and social care professional must all be dynamic. All must be capable of movement - that is taking in several perspectives. As always composition is vital. So is choreography. As Hockney indicates the picture comprises both ordinary perspective and reverse perspective.


If static, found only for a moment: an assessment, plan, evaluation. A snapshot. Then moving a-gain.

Ever seeking the dynamic.
 
Acknowledgement: David Hockney


My source:
'The mass media has lost its perspective'.
David Hockney, The Financial Times, Page 11, October 27-28, 2012 

Image source:
http://www.tumblr.com/tagged/a-bigger-picture

Additional post:
http://hodges-model.blogspot.co.uk/2012/01/bigger-picture-david-hockney-ra.html

A World Record for Health Care: The 4 minute reflection

Of all the things that can be done within 4 minutes one of the most significant in the history of sport is undoubtedly who would be the first to run a mile in under four minutes:

In health care four minutes is both an age and an instant in someone's health career.

If we took four minutes to reflect upon a person's care across the care domains what difference might that make?

Just one minute per care domain to help deliver - personalised care, self-care, carer support, integration, health promotion and how to stay well. ...

In healthcare we are constantly seeking GOLD.

Wherever you are have an amazing Olympics!

Visual means: Patient Status at a Glance (PSAG)

A recent HSJ came with a CHKS supported document on Top Hospitals. Page 14 considers Worldwide comparison and learning from others with three items on Patient Status at a Glance (PSAG) Boards; Developing a safety culture; and Reducing readmissions.

All are related (communication, safety, outcomes, multidisciplinary collaboration), but PSAG stands out to me for obvious reasons as it acknowledges the value of visual management, a quick heads-up overview of status. On PSAG four brief sentences note that South Tees Hospital NHS Foundation Trust in the UK has applied experience from Virginia Mason Medical Center in Seattle to develop PSAG in surgery.

Of course this application is focussed, being quite specific in the value of fewer nursing interruptions and a daily update for bed managers. This now contributes to making many wards more productive.

Hodges' model is a 'PSAG' of sorts, but it is more general, global in scope, summative. Perhaps it could act as a precursor to discharge?

Like the astronomer's blink comparator it could provide a before:after visual cue.

So, I wonder if Hodges' model could provide not only Patient Status upon Reflection, but Care Status upon Collective Reflection. This is vital at a time when we also need the patient and carers to be more productive in terms of supporting and sustaining their own care.

Dementia - The size of the challenge

The image and link below is the first of a set on Flickr produced from the Prime Minister's presentation and meeting with the Alzheimer's Society on March 26 2012. A transcript and video are also available:

Transcript - Prime Minister's speech to the Dementia 2012 conference

As the image below suggests there are many stats including the startling variation in services nationwide, for example:

In Belfast diagnosis is at almost 70 per cent.
Here in England we’ve got neighbouring areas with massively different rates…
… in Sheffield 57 per cent; in East Riding – less than 80 miles away – it’s 29 per cent.

Scope, Space, Nursing, Informatics: Fusion II (care)

After Paolo Perrotta (see post January 20, 2012):

and Paolo Perrotta, (2010). Metaprogramming Ruby, The Pragmatic Bookshelf. p.75.


Imagine being a care coordinator making sense and sense making (Dervin, 2005) your way through a new health and social care referral: here is the care program(me) approach. You jump from care problem, to strength, to further assessment question ... until the care domain priority is resolved. A decision point. That's the initial scope (and in an urgent / crisis situation this is resolved in an instant).

The scope is not defined in a single program, but several in parallel. This is why health and social care is often described as complex. You find yourself in a complex. At this decision point you are at the center of a range of local variables.

You can see bindings all over the scope. p.75.

There are assumptions, hypotheses and bits of data yet to be fully apprehended. It's hard but vital to be aware of what is objective and what is subjective. Why?

Raise your head, and you see that you're standing within an object,

[ a very special object ]

with its own methods and instance variables; that's the current object, also known as self. p.75.

To your immediate left and forward there are instance variables: beliefs, choices, motivation, aspirations, memories ... and the unique ability of this self to use its methods to communicate and interact with other selves, the world and future. You notice a problem. Many of the methods you might expect are not intact. There is a problem with the capacity of memory. Where there should be several parameters in sequence: there is. One. This may even then be lacking. Reading and writing is a problem here.

To the right and forward there is a monthly weight chart, a medication administration chart, BP and pulse are also recorded. There is a history of falls, a fractured femur, and bruising. There is a diagnosis - an inguinal hernia. Two postcodes have you momentarily perplexed. Ah, one is static 'home'; the other is current location and that's a close to home telecare mediated match.
 
Turning first to your right and over your shoulder there is an issue with care management and wandering at night: a vulnerability for this person. Another instance variable then flags mental capacity for a that hernia which needs repair. Respite care vouchers have been issued, but the year's allocation remain unused.

Next, turning around to your left there are details of next of kin and the fact that the carer involved is under a great deal of stress.

Further away, you see the tree of constants so clear that you could mark your current position on a map. p.75.

You are in fact encircled by a series of official identifiers. First at 10 o'clock two first names - these are the names that are given. The names for the person, the individual who is the focus of the referral. At two o'clock a key event for this individual their DOB - date of birth. At four o'clock the digits of the NHS number and a local case record number are captured. Completing the "Full name" at 8 o'clock you find a surname, the family name. It's double-barreled too. An explicit effort to preserve and extend family history and lineage.

Squint your eyes, and you can even see a bunch of global variables off in the distance. p.75.

Global variables.

What lies behind them?

It sounds strange to describe the person as an object, even if the context alludes to informatics.
To confirm this object is special. When you think about it though this object, the patient, the person, the individual, this self has a partner: the healthcare professional.

When we say that positive, high quality care values are global that makes sense. They should be: globally. To say they are variable seems to invite poor quality care, slack standards, inequality, inequity. Acknowledging that standards do vary can help ensure vigilance and that high quality care remains the key aspiration for new learners and experts alike. Nursing and other values are then a global variable that need constant attention and governance.