Showing posts with label change. Show all posts
Showing posts with label change. Show all posts

Friday, 19 September 2014

Wednesday, 3 September 2014

Five Domains - Five Gyres

There are five domains in Hodges' model that can help us assess, plan and formulate health and social care, support reflection upon interventions and evaluate progress over time. An aide-memoire indeed!
individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group



Brain Plasticity


 
Plastic Brain

With five domains to support short and longer-term memory do we really need to force the oceans to remember when we fail to care...?

Thursday, 28 August 2014

Compare and contrast potential - Energy for Change Index and Hodges' model

The biopsychosocial model is quite all encompassing used as it is to help explain and represent pain, explain human development and balance the physical excesses of psychiatry.

For all its scope the biopsychosocial model is two domains short of Hodges' model.

Hodges' model is dated though, a child of the mid-1980s. The biopsychosocial model predates Hodges' and as models of nursing have fallen out of favour in terms of the attention they receive the biopsychosocial is subjected to critique as per:
Ghaemi, S.N. (2009). The rise and fall of the biopsychosocial model. Br J Psychiatry.195(1):3–4.

Hatala, A.R. (2012). The status of the “biopsychosocial” model in health psychology: Towards an integrated approach and a critique of cultural conceptions. Open Journal of Medical Psychology, 1, 51-62. doi: 10.4236/ojmp.2021.14009
A cursory check reveals a diverse and current literature on the biopsychosocial model. If this is positive for the general role of 'models' in health and social care education and learning then there is another encouraging source in the five energies for change with its five domains, as per the figure:
http://www.changemodel.nhs.uk/pg/cv_blog/content/view/74232/network?cview=62406
The five energy domains
  • Spiritual
  • Social
  • Physical
  • Psychological
  • Intellectual
There is clearly great similarity with Hodges' model although in h2cm the spiritual combines all the four domains of which the political also replaces the intellectual. I would equate the intellectual with the psychological, accepting of course the existence of individual and group psychologies. Being intellectual and becoming intellectual to the extent of an individual realising their potential has long been recognised as a political matter and consequence (Freire). As such the Political domain within Hodges' model is central to its relevance within the field of engagement and innovation and beyond.

Whilst the energy for change domains have a specific derivation and (instrumental) purpose I would suggest that a possible strength for Hodges' might lie in the notion (which it is) that there is an underlying conceptual structure from which the domains arise. This structure might support the model's application in time, as well as assuring its longevity and the stamina of its champion.


My prompt: Land, M., et al. (2014) Pedal to the metal to improve the NHS. HSJ, 124, 6389, 26-27.

Image: (please see title and image link)

Saturday, 21 June 2014

disABLED: What's behind a symbol?

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

NY State

Well done NY excellent MOVE!
(and hope to visit next year)

My source: James Moore, Clash of Symbols, The Independent 20 June 2014, p.35.
 
Image source from upper right:
http://in-abled.com/blog/2014/04/would-martin-luther-king-jr-care-about-disabilities/
http://en.wikipedia.org/wiki/Disability

Wednesday, 4 June 2014

Would you let a robot take your blood?

A Robot With A Hypodermic Needle 

Written by Lucy Black
27 July 2013

Would you let a robot take your blood? The answer to this question illuminates our real relationship to machines that aspire to rise above the robot vac. Is there another sort of uncanny valley?

Veebot is a very clever use of some basic image processing plus some very accurate positioning mechanisms. It first locates a good vein using infrared. Once it has a target it switches to ultrasound to make sure that there is enough blood flow to make it worth inserting the needle.

More...




My source:
International Society for Presence Research: June
http://ispr.info/


individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group
trust, confidence, anxiety, expectations, 'needles' - phobia, previous experiences, model of the 'other', intelligence, physical tests to differentiate mental health problems, subjective feelings - 'creepiness'
human
pa
safety, measurement, imaging, mechanics, technology, electromagnetic spectrum, infra red, ultrasound, motion, accuracy, research, trials, evidence, logic, blood sample,  appearance, (surgical robots R-here)
factors
in             RFT - 'right first time'
public awareness, interaction, relationships, community of practice - acceptance, publicity, media, dissemination
investment, policy, certification, law, standards, testing, supervision, labour relations

Tuesday, 3 June 2014

L-earning a Living with McLuhan

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

In 1964, Marshall McLuhan predicted that the future of work would involve -


 "learning a living"... .


production


communities of practice
earning a living



Source:
Parchoma, G. (2006). A proposed e-learning policy field for the Academy. International Journal of Teaching and Learning in Higher Education, 18(3), 230-40. (p.232).
Reading for module 2.

Sunday, 25 May 2014

Contextual annealing: Research rolling - hotter, colder, hotter

In conducting research you focus on the question, then the method follows. You may have to go back to the question (in truth) as the methods available to you present their own opportunities and constraints.

Over the past two months this has been a questionnaire within residential care facilities.

Sometimes a confounding factor is to how to describe the study. It's a bit like the figure-ground illusion. One minute you are thinking of the individual, the care worker; the next moment the organisation.

Perspectives shift all the time. This is one of the roles of Hodges' model. The ability to switch from individual to group (population) and various other perspectives and contexts.

I’ve an image of an iceberg. At any one time the questionnaire study’s above the water, the institutional case study under: but then it rolls.


Saturday, 12 April 2014

Making learning visible dodging bullet points

Since January and the start of the course in Technology Enhanced Education there's been - and still is - a lot of reading to do. I've gained new and renewed insights into possible research methods and I'll share some of this in the next few weeks. The figure below is from:

Hay, D., Kinchin, I., Lygo‐Baker, S., 2008. Making learning visible: the role of concept mapping in higher education. Studies in Higher Education. 33, 295–311. doi:10.1080/03075070802049251

Figure 4 from Hay.
Over the years I've noticed and been rewarded when after a session on the care domains model some audience members have commented that the exercise made them think. There's nothing special in that of course, simple maths makes me think. Perhaps, people felt relief for a change from the passive absorption of facts, images, acting as static targets for a slew of bullet points. What comes across though is that there was some effort involved. In the figure above we can imagine the energy needed to not only create new and maintain existing concepts, but reject others. This might also constitute one front of the theory - practice gap?

This in a way reflects my thinking that although we refer to person-centred care in theory, practice and policy, this does not automatically follow. Person-centredness should take effort, work and energy. If that is the case, it also needs time.

Saturday, 8 March 2014

International Women's Day 2014 “Equality for women is progress for all” He for She

8 March is International Women’s Day, #IWD2014! 

This year, the theme is “Equality for women is progress for all”.

http://www.unwomen.org/en/news/in-focus/international-womens-day#webcast


In order to achieve gender equality, we have to change what it means to be a man. For International
Women’s Day [@UN Women] highlights in its #HeforShe initiative men leaders who stand up for gender equality.
“Women’s empowerment works for men, too. Where men and women have equal rights and opportunities, societies prosper. I am a He for She.”
-Ban Ki-moon, UN Secretary-General. 

See what other prominent men from around the world have to say:
http://owl.li/ucuvz #IWD2014

Friday, 7 March 2014

Living with Practical Realities, 1978: Courtesy the Artist © Stephen Willats

Within Intermediate Support, Older Adults we are short-staffed at present. I was asked to work this Saturday - tomorrow - but was able to take Wednesday off. This helpfully coincided with a half-day event in Liverpool - Developing (research) proposals for Research for Patient Benefit (RfPB).

In the afternoon I took two hours (with reading to do also) at the Tate, this included:

Keywords: Art, Culture and Society in 1980s Britain

The exhibition included the three photographs displayed below by Stephen Willats. They are usually presented side-by-side. Since the 1970s and 80s the photographs made me wonder about social policy, social care, change and progress.

I was also prompted to recall a visit to a pensioner's club with my nan (maternal grandmother as we called her) in Liverpool in 1969-70.
[Clicking on the photos provides a more legible copy, or see collection link below ].

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

?




group - population

Image source:
Stephen Willats
Living with Practical Realities, 1978
Photographs
Letraset, gouache and ink on card
3 panels, each 109 x 76 cm

Collection: Tate London

Courtesy the Artist
© Stephen Willats

Thursday, 7 November 2013

Calling all healthcare radicals!

Rocking the boat and staying in it: how to succeed as a radical in healthcare

 
 
Corporate Rebels United is a global movement of “corporate rebels” across multiple industries and sectors. Many healthcare rebels/radicals are part of this. This is the manifesto of Corporate Rebels United which perfectly captures the mission of organisational radicals in healthcare to deliver the new truth of healthcare transformation.

Through Hodges' model I am an advocate for 'radical history', nursing care lessons from the past can (must!) inform future health and social care.
 

Sunday, 27 October 2013

Positioning Nursing in a Digital World. RCN eHealth Survey 2012 Report


Abstract:

Commissioned by the RCN, this eHealth survey explores the knowledge and experiences of nursing staff in relation to current eHealth developments, together with their attitudes to new and emerging uses of technology in health and social care. The aims of the 2012 survey were to identify the readiness of nursing staff to participate in eHealth, to understand the barriers that prevent nursing staff from benefiting from information and communications technology, and to ascertain what progress has been made since the previous RCN eHealth survey in 2010. 

Image source: http://www.gerrybolger.com/wp-content/uploads/2013/07/image1.jpg

Thursday, 10 October 2013

Recent Advances in Research on Housing Transitions and the Life Course - a one-day symposium

Meeting of the Royal Statistical Society Social Statistics section.
DATE: Tuesday 10 December 2013
TIME: 10am-5pm (followed by a drinks reception)
LOCATION: Royal Statistical Society, 12 Errol Street, London EC1Y 8LX

We are pleased to announce a one-day symposium on recent developments in research on housing transitions through the life course.  The event will feature presentations from leading international demographers, geographers and economists on different aspects of housing careers. Topics include:

  • the interrelationship between housing and fertility: childbearing patterns by housing conditions and housing changes after the birth of a child
  • wage, employment and house-price effects on migration
  • intergenerational transmission of home ownership and neighbourhood poverty
  • residential mobility, neighbourhood poverty dynamics and neighbourhood choice among families
The symposium is sponsored by the ESRC-funded project “Interrelationships between housing transitions and fertility” (see http://www.bristol.ac.uk/cmm/research/housing for further details). 

SPEAKERS:
William A.V. Clark (University of California, Los Angeles) Clara Mulder (University of Groningen), Heather Joshi (Institute of Education) Hill Kulu (University of Liverpool) David Manley (University of Bristol) Birgitta Rabe (University of Essex) Elizabeth Washbrook (University of Bristol)

A programme and abstracts are at http://www.bristol.ac.uk/cmm/research/housing/symposium/index.html

REGISTRATION AND QUERIES: All are welcome and attendance is free.  Refreshments will be provided, including lunch and a drinks reception.  However, advance registration is essential.  Please complete the online registration form at http://www.cmm.bris.ac.uk/clients/booking/91/ to reserve your place.


[ I mentioned to the organisers about the ongoing transitions I have posted about before; that of older adults moving house (home) often in response to a bereavement to be nearer other family members. This is not the symposium's focus, but remains a question in terms of the potential impact on the individuals concerned and health and social services. pj ]

Saturday, 24 August 2013

50 years "I have a dream..."

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

individual
"I have a dream!"Do things and science and technology have to dictate humanity's dreams?
We have a dream...A man had a dream...
group - population

Sunday, 7 July 2013

Part II: Pensioners, 'Health students' and Children

For decades the reactive health care system has been founded, loved and sustained through the primary care - secondary care hospital system, together with its complex range of referral systems and processes.

Now demographic trends and economic pressures have seen the emergence and ongoing development of the virtual hospital. Call centers and teams that deliver nursing and medical care in the home to prevent admission and facilitating early discharge are still basically reactive.

What is needed is a cognitive hospital.

A form of hospital that acknowledges the health care system but can finally progress the preventive agenda on an individual, educational basis, fostering self-efficacy, health literacy and if necessary self-care.

Tuesday, 30 April 2013

Jordan: hospital, hospitality and the global research nurses network

The Jordan conference and experience prompted me to reflect upon 'hospitality' and 'hospital'. Also hospital as a physical environment and the way this contrasts with community care; and those without access to either.

At the research workshop on Monday with Nicola McHugh Project Coordinator for the Global Research Nurses' network, we were asked to consider and record how our respective job had changed. I jotted down the following also expanded here:

Winwick Hospital - Institutional care.
Issued with a (grey) suit and waistcoat.
White coats. Union lapel badges.
Witnessed (not overnight and still ongoing ...?) the transition to community care.
Development of primary care mental health.
The emergence of information technology.
From frontplate - nursing process and models, theories of nursing.
Nurses as advocates - now the addition of independent advocates.
Revisions to the Mental Health Act.
Changes in organizational hierarchies.
Changes in nurse education.
The increase in significance of the POLITICAL care domain:
informed consent, mental capacity, public engagement, litigation.
The cycle of re-organisations - NHS and Social Services.
Community Mental Health Nurses as therapists to assessors.
The development of the care programme approach (CPA).
The reduction in the number of injections / use of electroconvulsive therapy.
New drugs, evidence, specialist teams.
From in-house system to Körner to National Programme for IT to ..........
Less stigma for some conditions: epilepsy, psychosis but much remains
Diseases - Recovery - Self-care

Here are hospital and hospitality:

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

individual

During the Middle Ages hospitals served different functions to modern institutions, being almshouses for the poor, hostels for pilgrims, or hospital schools. The word hospital comes from the Latin hospes, signifying a stranger or foreigner, hence a guest. Another noun derived from this, hospitium came to signify hospitality, that is the relation between guest and shelterer, hospitality, friendliness, hospitable reception. 
The word hospitality derives from the Latin hospes, meaning 'host', 'guest', or 'stranger'. Hospes is formed from hostis, which means 'stranger' or 'enemy' (the latter being where terms like 'hostile' derive).
group - population

Sources:
http://en.wikipedia.org/wiki/Hospitality
https://en.wikipedia.org/wiki/Hospital

Monday, 15 April 2013

HSJ: The NHS and fundamental change ...

 ... governments typically try to will the end but not the means: they try to shift the habits of the NHS while protecting buildings and people; or in Lord Darzi's pithy phrase, they change "the anatomy of the NHS rather than its physiology". p.16.

Finding the pith in Hodges' model (and the problem of refactoring - where would you like to start?):

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

individual
PURPOSE
cognitive geography
(the 'physiology' of mindsets)
Anatomy & Physiology
PROCESS 
structure, buildings,geography
time, events, space
 (habituated - )
PRACTICE
(collective purposes)
team integration

the NHS (organisation)
POLICY
workforce, funding 
local, regional, national, global
group - population

Seddon, N. (2013) Opinion: Learning from international innovators, HSJ, 12 April. 123: 6346; 16-17.

Monday, 8 April 2013

Exoplanets, exobiology, exocortex, exocare ...?

http://www.guardian.co.uk/books/booksblog/2008/may/14/godvsatanindeepspace
Exoplanets

planets outside the solar system
An exoplanet (or extrasolar planet) is a planet orbiting a star different from the Sun (the "exo" prefix means "outside" in Greek). Up until now, one has found mainly gas giant planets, which are easier to detect than telluric planets. However, due to the increasing sensitivity of the detection methods, one already begins to observe the first planets of sizes comparable to the Earth.
Source: http://media4.obspm.fr/exoplanets/pages_definition/questce.html

Exobiology
The term exobiology ... covers the search for life beyond Earth, and the effects of extraterrestrial environments on living things.
Source: http://en.wikipedia.org/wiki/Astrobiology

Exocortex
-noun
An artificial external information processor that augments the brain's high-level cognition. Julia used her exocortex to access the memory of her tenth birthday.
Source: Fleming, N. The next wave. New Scientist, 14 May 2011. 210, 2812, p.33.

Exobuilding
ExoBuilding explores the novel design space that emerges when an individual‟s physiological data and the fabric of building architecture are linked. In its current form ExoBuilding is a tent - like structure that externalises a person's physiological data in an immersive and visceral way. This is achieved by mapping abdominal breathing to its shape and size, displaying heart beat through sound and light effects and mapping electro dermal activity to a projection on the tent fabric.
Source: http://www.cs.nott.ac.uk/~hms/pdfs/SchnadelbachEtAl_ExoBuilding_CameraReady_AuthorVersion.pdf
(8 April 2013 #DTMD13)

Exoskeleton

http://www.infoniac.com/hi-tech/top-10-robotic-exoskeletons.html
n.
ex·o·skel·e·ton ( k s -sk l -tn). n. A hard outer structure, such as the shell of an insect or crustacean, that provides protection or support for an organism.
Source: http://www.thefreedictionary.com/exoskeleton
exoskeleton: A medical device that allows individuals with severe spinal cord injury to walk and enhances rehabilitation for stroke victims.
Source: http://tagdef.com/exoskeleton


Exocare: Depends on your perspective - context / situation sensitive

Care exercised by a planet, or that planet's representation (on Earth the UN) towards life on other worlds, includes ethics, protocols and first contact.
See also: http://www.seti.org/post-detection.html

Care not delivered by statutory health services. Care delivered by the individual also described as self-care.

Care directed at specific celestial objects, often as a result of long held ethnocultural beliefs and customs, the moon for example.

Care that extends 'human ecosystems' to what is external to the physical self, to encompass Gaia - the Earth and biosphere. Love directed not at a single person, or thing but the sense of what is whole.

Also refers to the use of a conceptual framework to frame reflections on health and social care - individually, socially or globally. Provides a means to integrate concepts of care according to the situation and salience incorporating the individual-group (population); the local, global and glocal.


Thursday, 28 February 2013

Scaling Up mHealth: Where Is the Evidence? PLoS Med essay (c/o HIFA2015)

Dear HIFA members,

An essay in the open-access journal PLoS Medicine discusses the evidence base for mHealth and makes recommendations for scale-up. Below is the citation, summary points, selected extracts and recommendations for scale-up. The full text is available here:
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001382

Best wishes,
Neil Pakenham-Walsh
HIFA moderator
[ HIFA2015: Healthcare Information For All by 2015 ]

CITATION: Tomlinson M, Rotheram-Borus MJ, Swartz L, Tsai AC (2013) Scaling Up mHealth: Where Is the Evidence? PLoS Med 10(2): e1001382. doi:10.1371/journal.pmed.1001382

SUMMARY POINTS
- Despite hundreds of mHealth pilot studies, there has been insufficient programmatic evidence to inform implementation and scale-up of mHealth.
- We discuss what constitutes appropriate research evidence to inform scale up.
- Potential innovative research designs such as multi-factorial strategies, randomized controlled trials, and data farming may provide this evidence base.
- We make a number of recommendations about evidence, interoperability, and the role of governments, private enterprise, and researchers in relation to the scale up of mHealth.

SELECTED EXTRACTS:
'A recent World Bank report tracked more than 500 mHealth studies, and many donor agencies are lining up to support the 'scaling up' of mHealth interventions [7]. Yet, after completion of these 500 pilot studies, we know almost nothing about the likely uptake, best strategies for engagement, efficacy, or effectiveness of these initiatives...  mHealth is in a period very similar to the early days of the Internet: not creating robust, interoperable platforms will ensure failure for mHealth initiatives to be scaled to improve health outcomes for at least the next decade.'

RECOMMENDATIONS FOR SCALE UP OF MHEALTH
- Existing standards for research should be reconsidered in order to provide guidance as to when scale up is appropriate.
- mHealth interventions should be guided by a plausible theory of behaviour change and should use more than one technique depending on the targeted behaviour [38].
- We need to establish an open mHealth architecture based on a robust platform with standards for app development which would facilitate scalable and sustainable health information systems.
- Implementation strategies such as factorial designs that are able to test the multiple features of interventions must be explored, in order to provide the necessary evidence base.
- Scale-up of mHealth in LAMICs should be preceded by efficacy and effectiveness trials so that they are founded on an appropriate evidence base.
Governments, funders, and industry must cooperate in order to set standards to create a self-governing commercially viable ecosystem for innovation.