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:

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)

The Cost of Things: The quality of what is fixed and what is marginal

individual
INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

group

	Internet of Things  (IoT) The Zero Marginal Cost Society
IoT is not just an incredible prospect it is an incredible happening. Let us not forget however the Fixed Costs of Social Care

Should some of the costs that assure High Quality be fixed, or remain intangible?

Amortisation

CAPITAL [ take ] II or III ...

Thomas Piketty's economic data 'came out of thin air'

(The Guardian)

French economist's bestselling book on growing inequality in west undermined by 'inexplicable' data, says Financial Times

While they debate the data

the evidence

and how this looks 

from the left:                               :from the right

let's not forget the center and ask

where is the neutral, objective space where values must reside?

global health, development, nursing, health information, education

My original source:

FT Weekend, 24-25 May, 2014.

Update 17 June 2014 c/o Channel 4 News UK:

If you must rumple the care domains - rumple them together

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

group

'A Man’s body and his mind, 
with the utmost reverence to both I speak it, 
are exactly like a jerkin, and a jerkin’s lining; – 

rumple the one	– you rumple the other.’ 1

¹ Sterne L. The Life and Opinions of Tristram Shandy, Gentleman (1761), vol. 3, ch. 4 (eds M New, J New). University of Florida Press, 1978.

Source: Royal College of Psychiatrists (2013) Whole-person care: from rhetoric to reality Achieving parity between mental and physical health. Occasional Paper 88, March 2013. p.2.

Informatics in Primary Care - journal

Informatics in Primary Care Journal

On Wednesday I visited HC2014. Having the week off and with the event literally on the doorstep (London in 2015) it was very convenient.

I'd received an email the evening before on the new informatics federation and heard the official announcement in the opening session. My last HC event was 2005, my first 1986 also in Manchester if I remember correctly.

I posted the federation news this morning. On the BCS stand I picked up a copy of the INFORMATICS IN PRIMARY CARE.

This journal is open access. Despite the title and perhaps illustrative of the dependencies within and need to integrate health (and social care) the journal's coverage is broad and inclusive:

We are interested in how computerised medical records can better record the clinical status of patients and can be used to measure the quality, safety and efficiency of health care professionals and organisations – including primary care, hospital, mental health, and social and community care.  The scope of the journal also includes integrated care and how genetic data might be used to enhance health care.

I will reflect a little more on HC2014 soon.

Health, Art and The Reith Lectures 2013 (and the search for the perpetual umbilicus)

This week sees the start of The Reith Lectures on BBC Radio 4 by Grayson Perry.

The question is: who decides on what makes art good?

Perry writes in the Financial Times Weekend:

Clement Greenberg, a famous art critic in the 1950s, said that art will always be tied to money by an umbilical cord of gold, either state money or market money. I'm pragmatic about it: one of my favourite quotes is you'll never have a good art career unless your work fits into the elevator of a New York apartment block.

Once born into the world, the umbilical cord that transfers and imbues life and sustenance no longer matters physically. It is the social ties that bind, according to the lyrics and life experience.

In health and social care we need to find a perpetual umbilical cord that makes well-being and health not just something to take for granted. Not some thing that is only noticed when the piece of art won't fit into the elevator any longer.

This is the challenge in health care. A challenge that will see art movements and markets come and go. The solutions will rely on science, technology and art.

@science @technology @art 

each brings its own engineering.

We need tools that facilitate self-care when needed. Cognitive engineering that people can call upon by virtue of the combined literacies they possess. Self-care that is delayed due to self-knowledge.

Cognitive tools people can take anywhere; from elevators in New York and doors to apartments, yurts in Mongolia, the multitude of tents in Jordan to the terraced houses near Wigan Pier ...


Financial Times, Grayson Perry’s Reith Lectures: Who decides what makes art good? October 11, 2013 7:16 pm

Surveys, Nursing Education, Drupal and Webform

Just before heading to Drupalcon Prague I learned of a new paper by Gill et al.:

Using a web-based survey tool to undertake a Delphi study: Application for nurse education research

Background: The Internet is increasingly being used as a data collection medium to access research participants. This paper reports on the experience and value of using web-survey software to conduct an eDelphi study to develop Australian critical care course graduate practice standards.
Methods: The eDelphi technique used involved the iterative process of administering three rounds of surveys to a national expert panel. The survey was developed online using SurveyMonkey. Panel members responded to statements using one rating scale for round one and two scales for rounds two and three. Text boxes for panel comments were provided.
Collecting data and providing feedback: For each round, the SurveyMonkey's email tool was used to distribute an individualized email invitation containing the survey web link. The distribution of panel responses, individual responses and a summary of comments were emailed to panel members. Stacked bar charts representing the distribution of responses were generated using the SurveyMonkey software. Panel response rates remained greater than 85% over all rounds.
(in press)

The paper is interesting in combining surveys and an e-variant of the Delphi research method. Conclusions highlight the improved accessibility to experts and how ethics needs to keep pace with technical change and affordances.

Yesterday at Drupalcon there was a presentation on Webform:

Webform 4.0: Surveys in Drupal Improved

I've mocked up a enquiry form using Webform, but this session pointed to how the module can be extended for polls and contact forms. Based on Gill et al. and the eDelphi technique they explain this could be a really powerful combination.


Gill, F.J., et al., Using a web-based survey tool to undertake a Delphi study: Application for nurse education research, Nurse Education Today (2013), http://dx.doi.org/10.1016/j.nedt.2013.02.016

High quality nursing care: Staff numbers + Management + Complexity = Goat (Rabbit or Duck)?

When did someone last get your goat?

For me I owe a vote of thanks to Mr Harry Cayton in the (print) Health Service Journal, 2012

 The wrong answer to the wrong question. 

I know it's hard to believe, but I've been simmering for a year and a half; especially watching, listening and reading about the NHS and the state of nursing in the media.

The subtitle of this short opinion piece (p. 16-17) reads:  

"There is no direct link between staff numbers and care quality, 

so a minimum staff ratio is a fig leaf performance measure." 

Online it is: 15 March 2012 'Mandating staffing levels is not the answer to reducing poor care'
 - so you get the gist...?

As a nurse, the subtitle did its trick, it rubbed against the whole tree of experience, not just a branch or two.

It is a long time since I was a deputy charge nurse on what was then 'psychogeriatrics'. Relatives would arrive on the ward for the first time and start to weep. We had to reassure and demonstrate that we cared not just in words, but actions: nursing care. We got things wrong: teeth, clothing. ... A variety of 'lists' and books signified institutional care. That Victorian institution is no more, this is progress. The change has been amazing. It is also a long time since I was a charge nurse on acute female admission. The thing is numbers always counted. How many times did we, the team, wonder what we could have done with another two, or four hands? Within mental health care risk is a positive and negative companion to all our patient contacts. There may be confusion in numbers, but there is safety too.

You know that numbers do count.

As Mr Cayton points out - poor management is a primary factor in poor care. He quite rightly refers to the complexity that arises. As I have posted here several times, staff attitudes and skills are central to the quality of care that follows. Mr Cayton highlights the same.

If evidence based health care is so powerful why are we still deliberating upon this?

This isn't just complex, it's complex as in complexity science. In the late 70s - 80s and even today there is discussion of dependency and workload measures. There is a real illusion at work.

As a nurse in this context you recognised the limitations of know thyself. You have to know yourself, especially: can I delegate effectively? Am I a manager's manager? How can I balance the office and the ward?

The limitation is: do I know my team? Since the 1980s I wonder how well ward managers know their team. What is the impact of agency workers - nursing and medical? How has this workforce development influenced the work and performance of the FY1s (foundation - first year doctors)?

We ensured we had covered the 'basics' as comprehensively as we could. Everyone was safe, warm, clean, skin clean and intact, dressings completed, fed, watered, given a smile, (if possible) gave a smile and as much reassurance as could be provided. Any care outstanding was reported to the next shift to ensure it was completed as a priority.

Returning to the question of evidence and the illusory, chimeric character of this debate. There is a great post-grad student essay on the relative and normative dimensions of nursing staffing to be written. Health services must wrestle with standards, local responsiveness, person-centredness, outcomes and umpteen other requirements in care delivery. If funding (staffing!) results in nurses having an arm tied behind their back, perhaps mandated staffing levels does the same for managers?

There is undoubtedly much to consider in relation to the equations that abound in staffing numbers and quality of care. As we think of trees of knowledge,  experience and branches, let's remember the leaves; everyone unique.

Update: 24 Aug 2013
News, Health Service Journal, 23 August 2013, Minimum safe staffing work yet to begin, 123, 6364, p.7. 123

"We need tools that are relevant to the care environment; we need leadership locally that has the resources and responsibility to meet the levels the tools are demanding and we need some degree of professional responsibility and decision making at ward level."
(Prof. Jim Buchan)

Additional links:

Policy Unit. Royal College of Nursing (2010) Guidance on safe nurse staffing levels in the UK
http://www.rcn.org.uk/__data/assets/pdf_file/0005/353237/003860.pdf

Safe Staffing Alliance

Kay, J. (2013). Making the case for more nurses, Health Service Journal, 123, 6355, 30-31.

Donnelly L., Mulhern, M., NHS pays £1,600 a day for nurses as agency use soars, The Telegraph, 14 Jul 2012.

http://hodges-model.blogspot.co.uk/2013/03/bbc-horizon-ii-processes-step-this-way.html

26/02/2014:
New [Lancet] study shows degree level nursing education cuts unnecessary hospital deaths
http://www.councilofdeans.org.uk/2014/02/new-study-shows-degree-level-nursing-education-cuts-unnecessary-hospital-deaths/#comment-28

ForAge International Conference, Budapest 30 Sept - 1 Oct 2013

The Future of Learning for Older People in Europe

Learning from Experience    

30 September – 1 October 2013

Budapest, Hungary

http://www.foragenetwork.eu/en/database/item/140-forage-2nd-international-conference/

To coincide with the United Nations International Day of Older People on 1 October, the ForAge Grundtvig Multilateral Network is holding a Pan-European Conference to examine trends and developments in learning in later-life and what can be learned from the experience of European initiatives in this field. The programme includes the following topics:

• The context for later-life learning in 21st Century Europe and the role of ForAge
• Improving the quality of training of those trying to reach potential older learners
• The benefits of later-life learning and the supporting evidence
• Experiences of other European networks as information sources and influencers as well as providing expert opinion about future actions
• Perspectives from international adult education organisations
• Emerging issues and the further development of later-life learning
• Older learners’ perspectives
• Oral and poster presentations of European Projects on later-life learning

Keynote speakers include:

• Hungarian Ministry of Human Resources, Department of Social Affairs 
• Professor Dr László Iván, President of the Hungarian Academy of Elder People
• Dr Alan Tuckett OBE, President of the International Council for Adult Education (ICAE)
• Dr Michael Sommer, Infonet coordinator, Akademie Klausenhof, Germany
• Professor Franz Kolland, University of Vienna, Austria

More details.

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.

ERCIM News No. 93 Special theme: "Mobile Computing"

Dear ERCIM News Reader,

ERCIM News No. 93 has just been published at
http://ercim-news.ercim.eu/en93

Special Theme: "Mobile Computing"
Guest editors: Edgar Weippl (SBA Research, AARIT, Austria) and Pietro Manzoni (Universitat Politècnica de Valéncia, SpaRCIM)
http://ercim-news.ercim.eu/en93/special


Keynote:  "Strategies of the European ICST Public Research Organisations towards Horizon 2020" by Domenico Laforenza
http://ercim-news.ercim.eu/en93/keynote

This issue for download in pdf:
http://ercim-news.ercim.eu/images/stories/EN93/EN93-web.pdf

Next issue: No. 94, July 2013 - Special Theme: "Intelligent Cars"

Thank you for your interest in ERCIM News.
Feel free to forward this message to others who might be interested.

Peter Kunz
ERCIM News central editor

------------------------------------------------------------------------
ERCIM "Alain Bensoussan" Fellowship Programme
ERCIM offers fellowships for PhD holders from all over the world. The next round is open!
Next deadline 30 April 2013
http://fellowship.ercim.eu/

Radical Statistics Group: Journal #107 Health & Wealth

Mis-measurement of health and wealth – Issue 107 (2012)

See also:

Straight Statistics

The UK Statistics Authority

A question. An answer - in response to recent media (HSJ Ack.)

Here are a couple of quotes from HSJ Roundtable meetings:

"What I hear around the country is that we have masses of information but we need to turn that into something that is intelligible and can be used for strategic decision making."...

"We need to look at how information links together to get a holistic picture of the situation." p. 20.

Dr Shahid Ali, (2012) Commissioning Information. Full Measures. HSJ, June 28, 20-23.

 "I don't think we should be integrating systems, we should be integrating around patients."  p. 20.

Dr Shahid Ali, (2012) Integrated Care. Let the Data Flow. HSJ, June 21, 20-25. 

"There's no integrated view of integrated care. The danger is that you have an integrated care system and everyone says, 'I will do one as well', and you end [up] with six of them." p. 22.

Owen Powell, (2012) Integrated Care. Let the Data Flow. HSJ, June 21, 20-25.


A question or two, or three ...

Is there a generic framework that can be shared and utilised across all health and social care?

A free resource that can be deployed in imagination, in solo on paper, in tandem and within a group potentially shaping collaboration, innovation, change and transformation. Applied in the clinical environment, the home, the lecture theater, the sports field...

A tool that can help support reflective practice not only at a strategic level, but the tactical and operational. What is happening on the ground floor? A framework that can help represent not only processes and policy, but practice, individual and group purposes.

Yes, policy maker and CEO meet with your information manager ... and discuss strategy.

But what is data, information, knowledge ....? What is 'health care' for it appears above we do not know?

Is there really no integrated view - even at a basic level that deserves further study?

Yes, health care practitioner meet your patient (client), their carer, your other partners (social enterprise...) and pursue what really counts: the best quality of care you can deliver given several constraints.

What is the outcome to be?

For the majority of the population (those not living with a long term medical condition) the transformation must be self-efficacy:
if 'shift happens' it must be from ill-health to health through education.

One answer:
The health care system cannot do this alone.

New patient chart to save 6,000 lives a year in the UK

The purpose of NEWS - National Early Warning Score is to standardise the assessment of acute-illness severity in the NHS and in doing so: save lives.

For me in the late 70s early 80s there was great emphasis placed on doing the charts, on 'obs' and the art and skill of observation. As a student nurse, you were finally nursing. From my mental health base, I've noticed new students today retain this enthusiasm to do the TPR and BP. To sign-off this essential competency. I mentioned art and skill above to highlight the intuitive side, not to diminish the underlying knowledge. Recognition is essential to prompt action, critical in acute-illness.

I notice some comments in response to NEWS express concern about finding agreements on units and how standards might stifle innovation. Against this though, Nursing Times reported an acute problem with the quality of nursing observation skills in 2009.

It goes without saying that the elements in NEWS are physical: respiratory rate, blood oxygen level, temperature, blood pressure, heart rate and level of consciousness. It will be fascinating to follow the results and not just in England.

In terms of integrated and holistic care - other measures will be needed.

My source: The Independent (27 July 2012).
Laurence, J. (2012, July 27). New patient chart to save 6,000 lives a year in the UK, The Independent. p.12

Your help needed to develop an instrument to measure ‘e-health literacy’

Researchers from the University of Copenhagen, Denmark and Deakin University, Australia are developing an instrument to measure ‘e-health literacy’ in current and future users of healthcare.

To develop this instrument they are undertaking a comprehensive consultation with a wide range of stakeholders. This includes the perspective of users of the healthcare system, as well as the perspective of ‘experts’, i.e. researchers, healthcare professionals, managers and policymakers.

They are looking for help with this task to ensure that the research is comprehensive, asking for your views and observations on what a person needs to be able to do in order to use digital health services (e-health). To do this there is an online survey, which takes about 3 to 5 minutes to complete.

Please complete the survey no later than Wednesday, 1 August 2012. The researchers will collate statements from all respondents over the next month or so. In a second e-mail, they will ask you to group and rank individual statements in terms of importance.

The output will be a comprehensive map of the key elements of e-health literacy. This information will be integrated with data generated from workshops with both health care users and professionals. The final goal is the production of an internationally relevant tool to measure e-health literacy.

If you wish to receive a copy of the results of this research, please indicate this on the last page of the survey.

Please follow this link to the survey:www.survey-xact.dk/LinkCollector?key=DCXCFD3F3N36

My source: Patient Information Forum via twitter

Reflections on: Designing for Self-Care - the home-clinic difference

As much as I might like to I will not be able to attend Copenhagen and the workshop details of which I posted yesterday. Reading the call for papers prompted the following reflections - many of which may not be relevant to the actual workshop content, but hopefully help illustrate Hodges' model:

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

literacy - health literacy, cognitive access, insight, memory, education, communication, attitudes, motivation*, beliefs, BEFORE-AFTER holistic measures, mental health, mood, context, therapeutic modalities, self-recording, person-al purposes - process reconciliation, coding / classification, self data capture, expectations, general health perception, sleep, leisure, independence level (self-efficacy), individual 'clinic' need / attendance, rating of existing clinical relationships, DOO - (presence of) differences of opinion*

physical interface modalities: touch, gesture, eye movement, video interviews; clinical diagnoses (primary), observations, assessment-measures, data capture, medications, lab tests, pain, 'distances' (several not just home-clinic); treatment/drugs - training, mobility (room count, vistas), info prescription, other media - learning materials, self-care tasks (granularity, number, complexity, ...), clinic-al purposes - process reconciliation, evidenced interventions, coding / classification, home adaptations?, experience of telecare? mobile apps? home IT / comms, chronological:pathological age definitions: long term- / chronic

life story, narrative medicine, quality of life, care history - duration / exposure to care systems, domestic relationships, primary care / nursing (multidisciplinary care) relationships, perceived integration of care, social network, access to day care / respite care, definitions - shared vocabulary, self-care folksonomy? (virtual) community creation (outcomes)? affordances, meaning of 'clinic' attendance, 'CKO-X' Carer's Knowledge of

autonomy, power in the home: My space?, service interfaces, available specialist services, responsiveness, support, best interests, privacy, budgets (self), protocol - referrals, political emphasis: physical-mental health? predefined benefits, economic impacts, savings, policy reach, implications for commissioning

As the workshop concerns home - clinic difference and designing for self-care this prompted me to a more detailed consideration of the 'distances' involved. Not just in the physical geographical sense of home-clinic travel (car, walking, public transport, disabled transport) but when last the citizen (patient) visited various locations.

There are many other dimensions of course ... the final context reduces the above to something manageable.

Reflections [II] Conceptual Spaces At Work: Lund University, Sweden, May 2012

[See also Reflections I CSaW2012]

Among many things Dessalles - From Conceptual Spaces to Predicates - told us that meaning is essentially two-fold: analogue and symbolic.

An evocative summary was provided:

(Topo)logical thinking = Conceptual spaces + Contrast

Concepts do not exist as permanent structures.
Predicates are ephemeral.
Questions included: Is there a contrast logic?

You can find Dessalles online and there is a specific book Why We Talk (2007) (some of the chapters look particularly interesting - information).

Also to investigate are there being no locality principle and the danger of holism, and a point about structural matching as part of problems with traditional approaches to meaning that involve interfaces and relationship structures (pardon the ramble - the paper has not appeared yet).

Geuder's Manner Modification and the Representation of Event Concepts found me tweeting - see below. A biomotion demo was tied to the theme emphasizing perceptual cues, manner and meaning.

Off at a tangent the title had me musing on the importance of 'manner modification' in nursing. Sometimes fleetness of attitudinal, objective and emotional foot is needed to deal with a care situation. Tangent aside, there are clearly some serious considerations around health care processes, these are the bread and butter of healthcare records and information systems.

I've just copied my tweets (clinical examples arose in several sessions):

Gardenfors & Warglien ref new paper?* subspaces corres to a division into domains - event concepts

Manner modification eg. "slowly". (Manner central in health nursing) +mention of forgetting + absentmindedness denotes? PTSD?

A representation of a stage structure is needed - further e.g. "carefully" He cleaned the wound...  filled by context (as ever)

Geuder still, now on emotional state predicates - "sadly" Three possible ways to proceed - close now

* The following may be the new paper:

Peter Gärdenfors and Massimo Warglien Using Conceptual Spaces to Model Actions and Events. J of Semantics first published online April 17, 2012 doi:10.1093/jos/ffs007

Reflections [I] Conceptual Spaces At Work: Lund University, Sweden, May 2012

I started writing up and reflecting on my notes while still in Lund on Saturday evening 26th May. As I passed the taxi rank returning to my B&B I knew Eurovision had started: Englebert sang out. It was quite novel to be in Sweden that night.

The conference was excellent.

Lund is a beautiful, friendly city and the weather was amazing.

I am so pleased I made this journey and would like to thank the organisers and sponsors for their work and support. The conference was free to attend, which greatly assisted me. Speakers were in the majority which added to the event's value for me (and the other participants). Some of the presentations included maths and logic, but as I was advised initially I could follow the gist of all the presentations and the details of many.

If you are a nurse, social worker, occupational therapist... and you read through these follow-up posts you may well wonder how is this relevant to healthcare? Well at the moment that is unclear, but I'm sure there is a connection. I'll share some tentative connections here and add some photographs over the next few weeks or so. As I review my scribbled notes I may have made some mistakes, missed out key points and references are still appearing, but here goes ...

The first session on Thursday was by Carita Paradis, who presented White aromas and subtle oak spices: From sensory experiences to language through conceptual spaces. Carita's focus was wine tasting with its four sensory modalities of VISION, SMELL, COLOR, and TASTE and a descriptors list for the properties of wines, such as sharp, soft, lemon and cherry. There is a corpus as the paper explains:

... the source of data used in this investigation is the American wine magazine, the Wine Advocate. The corpus contains 84,864 wine reviews published 1989 – 2006. The total number of words used is 8,332,666 and the number of different words is 46,000 (for more information about the corpus as such and an interactive information visualization (InfoViz) tool to be used to retrieve different kinds of information about the wines reviewed, both linguistic information and metadata, ... p.4.

In addition for both red and white wines there is an aroma wheel. It was helpful in the Q&A at the end to be reminded of the relative dominance of the senses. Questions had me recalling the emotional and reflexive response of disgust and how this is 'hardwired' - the limbic system and connected to other senses. The findings of a lower to higher directionality in modalities - touch through to sound and vision and the use of metaphors and the direction of these: soft light OK but not light softness was fascinating.

So, there are more reasons for a blog post than the four senses referred to by Carita. What descriptors are there for the four care domains (interpersonal, sciences, political and social)? How can they be discovered (or recovered)? Where is the corpus for nursing? Is there a secondary source? Is there a case for a different approach? Are there several in the form of nursing classification and terminology systems?


As to the other sense: I also wondered about the sound of money and advertising (of alcohol), generally more tightly controlled in Sweden as I understand, especially advertising aimed at children.

Carita Paradis & Mats Eeg-Olofsson, Describing sensory experience recontextualization through properties, objects and imagery in discourse, Lund University

h2cm in the presence of -alities

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

morality     personality   mentality   individuality   spirituality intentionality   transcendentality  rationality	dimensionality   causality  functionality logicality   locality   physicality artificiality  materiality  finicality
hospitality   geniality   quality informality     sociability      conjugality practicality  plurality	nationality    feudality  principality   equality  formality  confidentiality brutality  officiality   criminality

Child to adult:

"Yes, but where does reality, aboriginality, universality, proportionality, abnormality, mortality go?"

:Adult to child