Older People with High Support Needs want more Choice and Control in How they Live their Lives

A new paper has been published today (to coincide with International Older Person's Day) by the National Development team for Inclusion (NDTi) to share findings from a two year project which is aiming to increase the voice, choice and control of older people with high support needs. This includes older people living in care homes and those living at home with a lot of support.

Around 1 million older people live in residential care and sheltered / supported housing. Older people want to have a broad range of options for their care and support, yet there seems to be widespread reluctance to develop and adopt new ways of thinking about and working with older people with high support needs. Traditional forms of service provision still dominate. As our society ages, the way we think about ageing, older people and disability needs to change to reflect with this demographic reality and the expressed wishes and desires of older people themselves.

The paper is from a 2 year project taking place in 3 local authorities in the South East Region of England. Local organisations and communities are working together to ensure options and opportunities are developed which support independent living and increase voice, choice and control for older people with high support needs. (See notes to editors for more information on the project and NDTi). The project is supported by ODI as one of the commitments in the Independent Living Strategy, which states:

Older disabled people must have the same options and opportunities for independent living as anyone else and the Strategy contains a number of commitments which will help achieve this goal.

The paper is :

- 'South East Regional Initiative on Increasing the Voice, 

Choice and Control of Older People with High Support Needs - Emerging Lessons'.

It summarises the findings to date from this project and has been written particularly to inform local authorities and partners about the work, to help them to achieve better outcomes for older people as well as best value in the use of public services and resources.

The paper highlights findings and messages about the priorities for ensuring older people can exercise greater choice and control over their support, including where and how they live. It also identifies some of the issues and barriers which get in the way of this happening.

A summary of the paper has been produced as an 'NDTi Insight' - part of a series of 2 page highlights of the most important learning from pieces of work carried out by NDTi.

This is available at the NDTi website on the following links:

www.ndti.org.uk/publications/ndti-insights/ndti-insights.aspx

Alternatively try: http://snipurl.com/181twm

Helen Bowers, Head of the Older People and Ageing Programme at NDTi and author of the paper said:

"The same level of commitment given to transforming health and social care is now required to transform expectations and experiences of older people with high support needs across all public services, including in residential care. Current debate in this area tends to focus on funding pressures and extending traditional services, rather than how we conceptualise, design and deliver support that promotes citizenship and transfers power from professionals and organisations to individuals, their families and friends."

To find out more, contact:- Helen Bowers, Head of Older People & Ageing Programme, National Development Team for Inclusion Magnolia House, 21a Stour Road, Christchurch, BH23 1PL Tel. 01220 471423 helen.bowers at ndti.org.uk
or
Rob Greig, Chief Executive, National Development Team for Inclusion - Head Office, Montreux House, 18a James Street, West Bath, BA1 2BT Tel: 01225 789135 rob.greig at ndti.org.uk

My source:
The Choice Forum

Gardner's 5 Minds for the Future (and the Question)

In order to pursue post graduate study you need a project, which demands a question. Formulating a research question is central. I wonder however whether there remains a bias - hard sciences vs humanities (and triangulation) - towards a class of questions that are closed and so can be answered in X-words : Y-time : with Z-funding? Thereby passing through the necessary academic hoops. Of course I realise that if there are no constraints then chaos would ensue. I just wonder if the journey (creativity, discovery ...) might be lost for the sake of assuring the end product?

My questions (apart from 'beware reflex moves') tend to be framed in broad terms. You could say that as yet I am not disciplined (specific) enough to come up with a question that passes "GO!"

In Howard Gardner's Five Minds for the Future the issue of educational programmes is raised and I read the following:

The second antidote entails the creation of educational programs directed specifically at certain individuals of promise - for example, leaders of tomorrow. Chief executives and general managers are expected to be able to see the big picture - to look beyond their own background and specialization; to understand the various components in their organization or constituency; to think systematically about what is working, what is not working, and how goals can be more effectively achieved. ...

Other individuals - for example, those exhibiting a "searchlight" or "bricoleur" intelligence - might be attracted to such programs as well. They would make use of their enhanced skills even if they do not occupy explicit leadership roles. Perhaps, as educator Vartan Gregorian has suggested, we need a specialization in becoming a generalist. p.75.

Gardner, H. (2008) Five Minds for the Future, Harvard University Press.

History, pocket facts and diffusion

I can't remember exactly which shop it was - Blackwell's at Liverpool University I think - but quite a while ago I picked up a secondhand copy of Roger's Diffusion of Innovations.

I've maintained a link^* to The Diffusion of Innovations Model and Outreach from the National Network of Libraries of Medicine to Native American Communities for many years. So I instantly recognised Roger's book as an important text. I've been reminded to pick this book up soon by a rather musty 'message' postmarked 1828.

In June I was invited to a workshop - 'Funding learning for better health and social care information' which was held at UCLAN (University of Central Lancashire). On a table with various informatics brochures, newsletters and DVDs was one of those small 'pocket facts'; a little multi-folded mini-epic. Of the 22 sides compressed into 6 x 5 cm was one devoted to the history of the university.

There at the top: the start. UCLAN began its life as the:

Institution for the Diffusion of Knowledge
in 1828.

Knowledge, Innovations, Ideas, Concepts
diffusion
- nothing new under the sun.

^* Listed under 'Health & Social Care, Nursing & Related Theory & Practice'.

Cost savings: 4-fold literacy = care literacy

The RCN's campaign I posted yesterday highlights the belief in and potential of nurses to 'think out of the box'.

There are many people, in many walks of life who are currently racking their brains and flipcharts to come up with ideas for cutting costs. In addition to the RCN, the government has its on-line campaign with the 'Spending Challenge'.

As for nurses there is an extra rabbit to pull from the hat: improving patient care.

Media discussion about the cloned beef - food supply story this week brought a point regarding the relative scientific literacy of the general population of USA and UK. This prompted me to consider discipline based literacy, what usually passes for 'basic grounding in ...' or competency. ('Literacy' has already been corrupted, now for another kick.)

For nurses with their subject disciplines, which can be represented in the health career model - what current public sector health (and social) care requires (demands!) is care literacy.

It is the ability of nurses (and other professionals) to be aware of what happens in the two adjoining boxes, or that one remote enclosure that can simultaneously engender and deliver:

• new insights - creativity and innovation;
  
• holistic integrated care;
• care literacy;
• and - cost savings that can still improve patient care.

See also:
http://hodges-model.blogspot.com/search/label/literacy

Frontline First campaign: cost-saving innovations whilst improving patient care

Dear Peter,

Innovations are the key to saving the NHS money. Every day, nursing staff on the frontline are finding new and better ways to deliver patient care.

As one nurse recently wrote to us:

"Without a working knowledge of clinical care provision how can ideas be practical and ensure quality of care is maintained? Nurses are in a prime position to look at care provision to identify better ways of working and therefore identify cost savings without sacrificing patient care and experience."

As part of our Frontline First campaign, the RCN is collecting examples of cost-saving innovations at NHS services across the UK. What nursing solutions have you seen in your workplace that could achieve savings without sacrificing patient care?

http://generalelection.rcn.org.uk/innovation

There are two ways the NHS can find billions of pounds in efficiencies:

discover innovative ways to save money
or
make cuts to staff and services

Every day, UK nurses are helping to devise and implement cost-effective solutions saving their employers money and helping to protect jobs. We've already heard from dozens of nursing staff who told us about innovations in their workplace, from changes to day-to-day practices to
whole new ways of working.

Please take a moment to report any cost-saving innovations you've seen at the workplace:

http://generalelection.rcn.org.uk/innovation

Thanks for speaking up and helping to protect patient care.

Yours sincerely,

Janet Davies
Director of Nursing and Service Delivery

My source:
Subject: Improving patient care
From: "Janet Davies, Royal College of Nursing"
Date: 04 August 2010 16:53:30

From: Harvard Business Review - The Four Phases of Design Thinking

I came across the following post on the Harvard Business Review Blog Network - The Conversation:

10:54 AM Thursday July 29, 2010
by Warren Berger

What can people in business learn from studying the ways successful designers solve problems and innovate? On the most basic level, they can learn to question, care, connect, and commit — four of the most important things successful designers do to achieve significant breakthroughs.

Having studied more than a hundred top designers in various fields over the past couple of years (while doing research for a book), I found that there were a few shared behaviors that seemed to be almost second nature to many designers. And these ingrained habits were intrinsically linked to the designer's ability to bring original ideas into the world as successful innovations. All of which suggests that they merit a closer look.

You can read the whole of Warren's original post, while below I have taken his focus concepts CONNECT, CARE, COMMIT and QUESTION and associated them to the care (knowledge) domains of Hodges' model. Following that there is a rationale. ...

connect	question
care	commit

Connect:Intrapersonal
Placed in the intra-interpersonal domain this is the domain of concepts, thoughts, ideas, creativity and innovation. This is the essence of Warren's reference to 'connect' -

Designers, I discovered, have a knack for synthesizing--for taking existing elements or ideas and mashing them together in fresh new ways.

The INTERPERSONAL links page also highlights other conceptual 'inhabitants' here; in particular knowledge management, the semantic web and psychology. If analysis and reduction is the outcome of the hard sciences, then here as Warren writes is synthesis, integration and invention. We can see how self-belief is critical to many innovators who pursue their dreams regardless of rebuffs by the establishment, to whom - within the health career model - they are also diametrically opposed.

Question:Sciences
The ability to question lie at the heart of human activity, and although thought and mind are represented in the interpersonal domain, questions also exemplify the output of human reasoning powers in the SCIENCES. Evidence based care depends on an ongoing process-ion of questions that drive research. Problem solving with its iterative sequence of assess (question), plan, action, evaluation (question). The health career model reminds us though of the need to consider not only quantity, logic and objective measures, but the role of qualitative research and methods.

Care:Sociology
Seeing Warren's inclusion of 'care' drew me to his post. Here he concludes:

Focus groups and questionnaires don't cut it; designers know that you must care enough to actually be present in people's lives.

Health and (social!) care are social activities. Our students are socialised into the professions and disciplines as they pursue their careers. Our work depends on the effectiveness of human communication and relationships. You can read about 'counselling' and only get so far; ultimately health care is experiential. It is something to be practised.

Commit:POLITICAL
Warren deals with the way designer's view risk and committing early to an idea and the project that might follow. For me 'commit' and being committed has explicit political - power - connotations. So, Warren's reference to commit in the sense of producing a model or prototype and working through problems can be extended. Invention and design may be cognitive pursuits, but they are non-trivial in that they must ultimately and literally be negotiated. Being able to 'commit' needs to be sanctioned. Individuals need to be empowered, or recognise when to either proceed or seek advice and guidance. Furthermore, Warren notes:

The designer's ability to "fail forward" is a particularly valuable quality in times of dynamic change. Today, many companies find themselves operating in a test-and-learn business environment that requires rapid prototyping. (?)

Perhaps the recognition in health policy of the need to balance negative and positive risk taking, self-care and personalised budgets can also be discerned in the above?

Acknowledgement:
Thanks to Warren Berger and HBR

Design an interactive space - 2 meters square - for Expolab project

My source: DESRIST discussion LinkedIn

Hello DESRIST members.

This is about an interactive design project, and the folks at Citilab are very interested in design research. Check it out if you're interested.

Letting you know that Citilab Cornella has an open call for exhibits that explore digital technology for their new project "Expolab". This experiment challenges designers to design 1 or more Expolab cubes with interactives that explore how new digital media and tech affects how we share memories, connect, travel through time and space, work, and experience safety. An opportunity to experiment, and work with the brilliant Expolab team Irene Lapuente, Ramon Sangüesa, and Astrid Lubsen of Citilab.

Start with the cubed 2mx2m space, then modify the space/walls as needed to make it experimental and interactive. Spaces will be equipped with electric and internet connections if needed. Citilab will build 6 of these and put them on display in Barcelona. Expolab cubes can have any number of walls, you can design the whole thing as long as it fits in 2mx2m. The Tech Virtual hosts free 3D prototyping space in Second Life for you to build or document your entry ( http://slurl.com/secondlife/The%20Tech%202/160/211/33 ). If you'd prefer to use your own tools that's fine too, just upload your screenshots after creating a project at:

http://thetechvirtual.org/projects/expolab

Full design brief at http://thetechvirtual.org/projects/expolab/expolab-brief-3.pdf

Looking forward to some new input on this experimental venture! Expolab team comes online for live design reviews Thursdays at 13:00 EST / 10:00 PST / and 18:00 CET (Barcelona). Did I miss anything? Send a note to rketner[at]thetech.org

About Expolab: http://expolab.net/eng/?page_id=5
"Expolab is a new way to understand exhibitions. It is a laboratory devoted to researching and creating new exhibitions in the area of technology, innovation, science and design, which are the main focus of work at Citilab. Expolab raises the possibility of creating exhibitions with strong citizen participation and contribution from the very beginning of an exhibition, and not just using the audience as providers of feedback once the exhibitions is one. This represents a new challenge within the world of museums and exhibitions.

Additional links:

5th DESRIST Conference Design Science Research http://desrist2010.iwi.unisg.ch/

Sciences knowledge domain: Virtual Reality, Visualization resources
(suggestions, reports of broken links appreciated):
http://www.p-jones.demon.co.uk/linksTwo.htm

Global Pulse 2010 March 29th - 31st #gp2010

I have just registered for:


From March 29^th through March 31^st you will have the chance to participate in something truly exciting. Inspired by President Obama’s “New Beginnings” speech to Cairo University, the U.S. Government is hosting Global Pulse 2010, an innovative, online brainstorming discussion.

During this unique event, individuals throughout the world will have a chance to participate in and influence a global conversation centered on 10 hot-button social issues facing the global community within the fields of science and technology, entrepreneurship, and human development.

MARK YOUR CALENDARS!

GANM's - Dr. Patricia Abbott will be a featured expert during the event. She will host a discussion on E-Health from 11:00am-noon (eastern time) on March 30, 2010.

Why is Global Pulse 2010 important?

Global Pulse 2010 will offer a unique way for community members to connect and engage, build new relationships and share their ideas on how we can strengthen our global partnerships to better address our shared global challenges.

Global Pulse 2010 is an open forum that will highlight ten broad topics:

• Empowering Women and Girls
• Enabling Essential Education
• Building Stronger Partnerships
• Exercising Political and Civil Rights
• Inspiring a New Generation
• Promoting Global Health
• Advancing Entrepreneurship, Trade & Economic Opportunity
• Fostering Science, Technology & Innovation
• Supporting a Sustainable Planet
• Pursuing Grand Challenges

How to Register for Global Pulse 2010?

To register please visit:https://www.collaborationjam.com/minijam3/globalpulse2010/registration/
For more information, please visit us at www.GlobalPulse2010.gov

You may also join us on Facebook, Twitter, Orkut, and LinkedIn to stay up to date on key Global Pulse 2010 activities. Stay tuned for more information on Global Pulse 2010!

PLEASE NOTE: We want to hear from your network. If you know of others who would be interested in participating in this event, please feel free to forward this email. As there are a limited number of virtual seats in Global Pulse 2010, we ask that these individuals complete and submit this brief form available at www.GlobalPulse2010.gov/registration Pending the number of available seats, slotted individuals will be notified so that they may then formally register to participate in Global Pulse 2010.

My source:
GANM (Global Alliance for Nursing and Midwifery)

New education bodies created to promote innovation in the NHS

Health Innovation and Education Clusters (HIECs)

New bodies that combine the expertise of industry, health and education have been formed to promote innovation in the NHS, Health Minister Ann Keen announced today.

Health Innovation and Education Clusters (HIECs) are cross sector partnerships between NHS organisations, the Higher Education sector and blue chip companies such as BMW, GlaxoSmithKline and BT.

Through joint working HIECs will provide professional education and training and promote innovation in healthcare by speeding up the adoption of research. They will also provide professional education and training.

Over £11 million will be given to the 17 successful applicants that were chosen by an Independent Award Panel Chaired by Sir Alan Langlands, Chief Executive of the Higher Education Funding Council for England.

Health Minister Ann Keen said:

“HIECs are special partnerships that draw on the wealth of skills and experience of their members to improve the development of high quality care and services by quickly bringing the benefits of research and innovation directly to patients.

“These projects will attract and encourage the best talent who can recognise and rapidly adopt new and innovative healthcare and treatment.”

Independent Award Channel Chairman, Sir Alan Langlands, said:

“The standard of applications has been really high and we have been impressed by the high profile names that want to be involved in improving NHS care.

”HIECs will drive up quality standards in education and training and ensure fast adoption of innovation for the benefit of local people.

“The flexibility of the HIEC model means that the vision of each one is appropriate and specific to its local area.”

The HIEC concept was originally developed by a group of leaders from the NHS and university sector during the NHS Next Stage Review as one of the ways to deliver high quality healthcare.

Ends

For the full press release click here.
(Includes details of the HIECs per Strategic Health Authorities)

My source: NHS-HE-FORUM at JISCMAIL.AC.UK

Conceptual spaces and innovative environments

Continuing to read Scott Berkun's the myths of innovation there is a really useful reference and illustrative source for Hodges' model.

The reference I must chase is - according to Berkun on page 90 - Alex F. Osborn's excellent book Applied Imagination. It is Osborn who apparently coined brainstorming and the management and creative industry of which Hodges' model is a (small) part. There's much more here as the original brief on how to - has been corrupted, consequently failed in application and lost its potential.

Later in the text Scott highlights the importance of environment and management's contribution to creating and protecting innovative assets (teams), that may not be valued in the rest of the organization. Berkun quotes Tom Kelly (IDEO) who notes that:

Innovation flourishes in greenhouses. What do I mean by a greenhouse? A place where the elements are just right to foster the growth of good ideas. Where's the heat, light, moisture, and plenty of nurturing. The greenhouse we're talking about, of course, is the workplace, the way spaces take shape in offices and teams work together. p.103.

Guess what - does this h2cm translation make sense to you....?

Light	Heat
Moisture	Nurturing

'Light'? Well I know there's E=mc² but here it's about purpose, leadership, spirit and belief.
'Heat'? This is the current physical element, technical white heat, global heat and need.
'Nurturing'? Great managers nurture and create the political space for innovation.
'Moisture'? Well this is to be found in the sociological domain: think about it....! ;-)

I never thought of Hodges' model as a greenhouse, but then it is far more than a brainstorming plug-in. Maybe it can act as a catalyst for change for you?

h2cmng at yahoo.co.uk

Ref. Osborn, Alex (1953). Applied Imagination: Principles and Procedures of Creative Problem Solving. New York, New York: Charles Scribner's Sons. ISBN 978-0023895203.

Ack: Scott Berkun.

Innovation and the 'middle' in NHS computing

Let's start with a quote:

Information systems are no longer associated mainly with data processing; they are increasingly seen as a management tool and an aid to action. This means that the costs of failure are much greater, and these costs are incurred when expensive systems are not used or are inadequately used. Surveys have shown that in as many as half of systems there are large gaps between users' expectations and the system's performance.

When do you think the above was written?

Here's the reference:

Mumford Enid (1991) Need for relevance in management information systems: what the NHS can learn from industry. BMJ. June 29; 302(6792): 1587–1590

1991: quite sobering really.

Previous - part-time - work reviewing data standards proposals focuses the mind in terms of the role of standards in interoperability, service impact and other essential assessment qualities. As the NHS has sought to implement standards as with the National Programme for IT you are also aware of the clamour for creativity and innovation. Innovation is there in the title of agencies.

I have long pondered about the extent to which - like Nature and vacuums - standards abhor innovation and creativity. How much is the 'standard' about doing things by the 'book' ... page 57 : para.3 ...

My eye caught the viewpoint piece in this week's Computing -

If you approach the world positively, a downturn is a good time for innovation. The shortage of people and money can create the pressure that leads to creativity. There are three areas where action will help organisations succeed in exploiting IT to enable business innovation:

Kick out Prince2

What more is there to say about innovation and Prince2? The focus of the Prince2 project management methodology – on organisation and control, and defining what to deliver before you have begun – is death to innovation. It is a bad solution trying to solve the wrong problem. It takes the IT profession in the wrong direction if we want to contribute to business innovation. It has to go. The agile development movement provides much stronger foundations for succeeding with projects that result in business innovation.

Ashurst, Colin, Viewpoint: How to use IT to enable innovation, Computing, 5 November, 2009.

Of course there IS a world of difference between information standards and project management standards, but there is no escape from the need for (effective) management of transition and change WITH business continuity. Within that management - engagement approach (as per agile) -

+++++++ socio-technical +++++++

- perspectives, as highlighted by Mumford (and others) all those years ago must have a place.

Additional links:

Computing, Letter of the week, UK is cursed with an anti-innovation culture, 5 November

BCS Sociotechnical Specialist Group

eHealthNews NHS Bury Primary Care Trust Goes Live with iSOFT Lorenzo RC 1.9

KT-EQUAL event Ageing Research 17 September

I was really pleased to be able to attend this event last Thursday (do check the site as there is an ongoing programme of workshops):

Making the most of the potential of Assistive Technology

This workshop organised in conjunction with BIAS (Brunel Institute for Ageing Studies) will provide a round-up of recent developments in AT and the underlying research aimed at enhancing independence in the home, improving safety and security, extending the use of the car, managing continence, maintaining the body and stimulating the brain.

 

Hosted by: Brunel Institute for Ageing Studies
Sponsored by: BIAS and KT-EQUAL

10:20 Welcome and Introduction, The world of  BIB and older people, Chair for the morning, Professor Emeritus Heinz Wolff, Founding Director, Brunel Institute for Bioengineering (BIB), Brunel University 
10:30 New Service Quality to Support Self-Care, Keren Down MBE, Director of FAST
10:55  Tackling Ageing Continence, Felicity Jowitt, Brunel Institute for Bioengineering
11:20 Refreshments
11:40 From chairs to stairs, Dr Ruth Mayagoitia, Applied Medical Research Group, King's College London,
12:05 "The Companion" - Independence, choice and self-sufficiency, Edward Varney, Brunel Institute for Bioengineering
12:30 Discussion
12:45 Lunch
13:45 Introduction to the afternoon, The world of BIAS and older people, Chair for the afternoon, Professor Mary Gilhooly, Professor of Gerontology, School of Health Sciences and Social Care, Brunel University 
13:50 KT-EQUAL: its mission for older people, Professor Peter Lansley, Director KT-EQUAL, University of Reading
14:00 Older drivers & older IT users: designing new technology, Suzette Keith, Middlesex University
14:25 Safety and Security in Later Life, Professor Rachel McCrindle, KT-EQUAL Consortium, University of Reading
14:50 Tea
15:10 Nourishing the body and saving the soul, Dr Arlene Astell, St Andrews University
15.35 Technology for people with dementia, Eleanor van den Heuvel, Brunel Institute for Bioengineering
16:00 Discussion
16:30 End

As noted above Prof. Heinz Wolff duly and delightfully introduced proceedings and chaired the morning. As a community mental health nurse for older adults and informatics / ICT enthusiast the day certainly proved worthwhile for me. Here are some reflections on two sessions:

While clinical and information standards have and remain a preoccupation for me, Keren Downs' session raised the chicken and the egg problem of standards and quality in the development of self-care and assistive technologies. Keren's presentation highlighted the stasis in design in the older adults sector and the question of how to energise future vision and models for innovation. There was reference to Shaping the future of care together and Common Core Principals to Support Self Care 2008, Department of Health.

Funding inevitably featured - the green paper listing three options:

Partnership - government pays for between a quarter and a third of care costs ...
Insurance - government pays for between a quarter and a third of care costs ...
Comprehensive - everyone pays into a state insurance scheme, whether or not they need care, and everyone gets free care when they need it.

The next slide reminded me of the tilting, table fitted geriatric chairs of old as Keren Downes highlighted the relative stasis in design and need for change for this population group.

While form follows function - can it also stifle innovation? When you consider change in materials, people's homes, care environments, attitudes ... there must be opportunities for innovation?

I also recalled similarities between this market of assistive technology and that of benefits realization within nursing (health) informatics. Especially as barriers were considered such as:

• poor design (usability)
• information provision
• workforce competency
• procurement
• (To which I would add 'value added services' - maintenance, life-cycle management.)

As the speaker and work of FASTUK made clear, older adults represent a growing and emerging market, for whom standards and design will be critical if self-care and assisted living are to be fully realised *.

The final slide listed some reports and a web link as follows:

FAST reports: www.fastuk.org

• Assistive Technology supporting self care, July 2006
• Assistive Technology –Workforce Development, June 2007
• Annual Report to Parliament on Research and Development in Assistive Technology, July 2009

Felicity Jowitt in another session:

TACT3: Tackling Ageing Continence through Tools, Theory and Technology

- provided a concise non-medicalized definition:

Urinary Incontinence 'is a condition in which involuntary urine loss 
is a social or hygienic problem and is objectively demonstrable'.

International Continence Society definition of incontinence

The talk included explanations of the problems and how they arise, prevalence, management, available AT options and the anatomically - stigma driven challenges that male and female continence presents. To close new assistive devices were discussed. The creation and production of discrete, well-designed person- (in a social context) friendly aides, special pads and devices to detect the odour that signifies the need to change a continence pad before the human nose is alerted.

The sessions featured a Q&A session and amongst the many questions raised, I wondered about the ideal of continence aids that also help nurses and carers maintain high quality standards of care and professional values. ... Perhaps from the late 1970s I have antiquated notions of basic nursing care? It is shocking to hear stories of people being told to "do it anyway - you've got a pad on!". Does it not occur to these people that if the person is asking they obviously have insight and are distressed by their urgent situation. As to people who are confused and asking as a result of agitation - the mind boggles and the heart aches at the standards of care evident in such an attitude.

So, this was a really thought provoking and - despite the subjects - enjoyable event and I have only of course scratched the surface.

The majority of presentation (including those above) are available on the download page.

A related reference I am following up:

Duarte, L.R., Marquié, L., Marquié, J-C. et al. (2009) Analyzing feature distinctiveness in the processing of living and non-living concepts in Alzheimer’s disease, Brain and Cognition, Volume 71, Issue 2, November 2009, Pages 108-11.

I will do a h2cm matrix on continence in the future.

* You can almost hear the critical exclamation of a future aged '60s generation - "No way dude I'm not using that!". Perhaps by then we will have the means to ensure they retain the faculties to pass a critique.

Mind the glass! Socio-technical engineering and vision

Amid the efforts to increase the ease with which technology integrates into our lives is the realization that some areas are more challenging than others. Education and health care spring to mind. In both of these fields if you are something of an expert in ICT and a subject domain expert then you can potentially pull off something of a coup. Being able to sit on the fence and appreciate two critical dimensions of an ensuing discussion about a clinical or learning system (perhaps even both) you can climb down off said fence and make a real difference.

From experience as a nurse, though it is (always) wise for any one practising as an informatics 'clinician' to constantly look over their shoulder. This domain is one that could be rationalised, automated, by-passed especially when we contrast new and emerging informatics roles across health disciplines with generic trends in health records EHR and PHR?

In the forthcoming generations of health record systems, informatics specialist will need to make their technical knowledge more accessible in their role as:

key contributors to -
SOCIO-TECHNICAL
- balance and patient (public and carer) engagement.

As community and personalised models of care influence the development of PHR, then hospital based EHR will themselves be forced to become transparent. There is also the matter of how the service integration agenda will influence how systems are described and 'sold' as a product and (essential) benefit. As the majority of readers will recognize at the end of the day - it's about the information - knowledge: not the technology.

Perhaps on reflection this is the key to new or existing informatics roles:

- we are engaged in "engineering transparency" ....

Inspired by a discussion on the LinkedIn HIMSS list.

ERCIM News 77 - special theme "Future Internet Technology"

The latest edition of ERCIM News has just been published at: http://ercim-news.ercim.org/

Special Theme: "Future Internet Technology"

The Internet is undoubtedly permeating and transforming all aspects of our economies and societies. It is a remarkable catalyst for creativity, collaboration and innovation and more broadly, for the development of our economies and societies. A few examples: in 1998, Google indexed 26 million web-pages, today it indexes 1 trillion; Within only five years, Facebook and MySpace have attracted each more than 100 million users world wide; user-generated content such as YouTube produced more than 73 billion streams in 2008; with around four billion mobile users world wide, the Internet is becoming more and more mobile and capable to support a range of new applications and services that were not foreseen in its original design. Read more...


My source: ERCIM - the European Research Consortium for Informatics and Mathematics - mailing list.

ERCIM News: special theme - "Safety-Critical Software"

ERCIM News no. 75 has just been published:

Special Theme: "Safety-Critical Software"
Featuring a keynote by Gérard Berry, Chief Scientist, Esterel Technologies; Member of the ERCIM Advisory Board; Member Académie des sciences, Académie des technologies, and Academia Europaea.

Next issue: January 2009 - Special Theme: "Sensor Web"
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Source: Peter Kunz; ercim.org

Additional links:
International Science Grid This Week
THE GOOD, THE BAD AND THE CHALLENGING: The user and the future of information and communication technologies. A transdisciplinary conference organised by COST Action 298 "Participation in the Broadband Society"