Musings... axes in hand and mind

...

Axes in hand and mind
[Accounting for the I-G (individual-group) axis and the need for the H-M axis]

Clearly there is a need for a basic scaffold. One that reflects the real world and the real time to which we are all exposed and are a part; and one that can also represent the model(s) we wish to create - the products of our health care, nursing activities. The scaffold we build must be one on which we can hang concepts and for simplicities sake human (care) concerns. Specifically a conceptual scaffold and a human scaffold. The latter can be represented simply as a continuum from INDIVIDUAL to GROUP, hereafter referred to as I-G.

The other, the conceptual scaffold, calls for what might be termed conceptual inflation. If we imagine the I-G as the vertical challenge (remember the health & safety issue!) and draw with the 'individual' at the top, then there is much we can model based on this basic dichotomy. This is too simple however. We cannot capture the part of the rich tapestry that is life - well-being, health - and death. For this another axis is needed.

(Which begs me to ask myself:

is there a law that suggests that one axis however oriented invites another?)

With this further partition and heralding of a further dichotomy what is lost? What is gained, if anything? In scribing this first line we explicitly separate the 'one' - the self from the other. The addition of another axis is where and how we define a center. With this center and from it we can find the energy to fuel our conceptual inflation. We literally draw out the foundation by considering what these persons do? ...

Conceptual inflation: Four-fold nursing agnostics
...
PJ Dec 2010

Links of interest c/o HIFA2015 list

The following links appeared in recent HIFA2015 Healthcare Information For All posts:

AuthorAID: http://www.authoraid.info/ is a global research community that provides networking, mentoring, resources and training for researchers in developing countries.

IICD - Information and Communication Technologies (ICT) for Development: http://www.iicd.org/

Education for Health: http://www.educationforhealth.net/ an Open Access Journal.

Scientific Eletronic Library Online: Scientific Eletronic Library Online

Welsh Annual Conference 2010: http://www.welshconfed.org/WelshAnnualConference2010.htm

Welsh Information Literacy Framework: http://www.library.wales.org/index.php?id=7498

PLoS journal on Neglected Tropical Diseases: http://www.plosntds.org/home.action

Knowledge 4 Health eToolkits: http://www.k4health.org/toolkits

NCBI.NCI Paper: Poor reporting and inadequate searches were apparent in systematic reviews of adverse effects http://www.ncbi.nlm.nih.gov/pubmed/18394536

Health Speaks: pilots result in 266 new local language health articles http://blog.google.org/2010/12/health-speaks-pilots-result-in-266-new.html

ERMED: Electronic Resources in Medicine Consortium http://www.nmlermed.in/

Global Health and Prevention calendar: http://www.pitt.edu/~super1/lecture/lec40851/index.htm

Musings... building models, health & safety, group and individual

....

Basic foundations and minimal defaults
[Accounting for the I-G (individual-group) axis]

Since nurses and technologists are concerned with communication then the foundation from which they begin to (build and model their) work is of fundamental importance. The foundation needs to be generic in the first instance. Generic in the sense of the commonality that language instills, enables and facilitates within and between communities. Not only that, but if we take the property of 'generic' to its extreme then the foundation must be stripped down to the barest of defaults: there are no 'types'.

To use the safety analogy we need to risk assess the extent of our model building activities.

We can do this by asking: is this a one, or at most two dimensional venture; such that we can rest secure on terra firma? Or are we above 'ground' floor and immediately required to address health and safety legislation?

Since medicine and nursing are concerned with - must be evidence based - there is an immediate  vertical challenge in the hierarchies inherent in the sciences and the structure of knowledge.

Science is not the only influence here. The foundation of what we are modelling and building must reflect the ultimate subjects (the person - patients, carers, communities, whole populations) of our activities. So, the individual (whose very safety is our concern!) must be factored in and with this concept the notion of human rights. While a dialogue of no trivial nature in itself, suffice here to suggest that individual and applied human rights emerges out of and is dependent upon the collective (group). This in turn is a measure of the level of social coherence, coherence through a level of social and political organisation that allows leaders to effect positive change and betterment. The person, the individual is built not upon the shoulders of giants, but ordinary people - our ancestors and peers. ...

Axes in hand and mind
...
PJ Dec 2010

Call for Papers: 1st Int. Workshop on Pervasive Care for People with Dementia and their Carers (PCPDC-2011)

(To the webmasters of http://www.pervasivehealth.org please check the status of your site - 'attack site')

Dublin, Ireland, 23 May 2011

http://trail.ulster.ac.uk/pcpdc/

To be held in conjunction with the 5th International ICST Conference on Pervasive Computing Technologies for Healthcare 2011

The global population of persons aged 60 and over is rising dramatically. Between 2006 and 2050, the number of people aged 60 and over will double from 650 million to 2 billion people representing 22% of humanity. One group of the ageing population that is particularly vulnerable to loss of independence is those affected by dementia. It is estimated that around 820,000 people in the UK have dementia. Recently emerging computing and assistive technology have been used to attempt to improve the quality of life for people with dementia..

The workshop aims to provide a forum for discussion on challenges and opportunities in bringing technology to support people with dementia. The workshop will feature the theme of ‘engaging people with pervasive technology’.

Research topics included in the workshop

This workshop will feature the theme of  ‘engaging people with pervasive technology’ in dementia research. Researchers from academic, healthcare, industrial and third party organisations are invited to contribute. Early researchers and researchers from healthcare are particularly welcome. Research areas include, but are not limited to:

Theme 1 – What are the opportunities of pervasive care technology?

Development of pervasive ICT systems
Human computer interface design
Behaviour monitoring and activity recognition
Knowledge representation and dissemination
Data analysis and interpretation
Sensor design and application

Theme 2 – User engagement

Key issues emerging when working with people who have decreased capacity for consent
Ethical issues for implementation
Methods for engagement
Pitfalls of engaging people with dementia, their carers and intermediate users

Important dates

Submission deadline:          25th February 2011
Notification of acceptance: 25th March 2011
Camera-ready copy due:    4th April 2011
Conference / Workshop:    23rd – 26th / 23rd May 2011

Format

Submitted papers should not be longer than 4 pages in standard IEEE two-column format.

For more detailed formatting instructions please see http://www.pervasivehealth.org/?page_name=author_skit.

Accepted papers will be published online in IEEE Xplore Digital Library (to be confirmed).

Shared Approach: 3 keys (and a certain conceptual framework)

Before we trip into 2011 let's make a quick return to 2008 and the three keys to the Shared Approach in mental health assessment [NIMHE, 2008] which are copied below.

In between each one I have highlighted how the Health Care Domains Model can contribute ...

1) active participation of the service user concerned in a shared understanding with service providers and where appropriate with their carers;

In the end (or at the beginning!) a model of care or assessment tool is only as good as the person using it.

To progress with key #1 there are in fact two locks to open. These are in the form of 'using' and 'user'. H2CM incorporates the individual from the outset. The model encourages consideration of the client's beliefs, preferences, and experiences ... Can the client and carer actually use the model themselves to help understand their needs, their care plan and interventions? Is there a homework exercise there for them?

Do they have capacity to decide? Do they need support - an advocate? How do we ensure the carer is factored into the care equation? Well, in h2cm that's through the social domain.

2) input from different provider perspectives within a multidisciplinary approach, and;

Do you know what "different provider perspectives within a multidisciplinary approach" look like?

Well just envisage that for a few moments. ...

A scary exercise, eh?

In order to take those different perspectives and integrate them a common framework is surely needed?

Artists are lucky they use perspective as an integrative lever on paper, canvas, or whatever medium.

Clients, carers, health and social care professionals need a canvas of their own, BUT one that is sufficiently generic and agnostic to be 'owned' by all. 

3) a person-centred focus that builds on the strengths, resiliencies and aspirations of the individual service user as well as identifying his or her needs and challenges. NIMHE (2008)

H2CM can support and foster person-centred care. The model is situated: there is one (changing) situation with the person at the center. Whatever the context -

strengths, resilience, stresses, vulnerabilities, aspirations, needs, challenges

- the care domains model is fit for purpose. Health and social care is dynamic, in person-centred care that focus needs to change accordingly. Our assessments and evaluations need to resolve the SCIENTIFIC, SOCIOLOGICAL, POLITICAL, INTERPERSONAL and SPIRITUAL dimensions of care while assuring the BIG picture.

Reference:
The National Institute for Mental Health in England (NIMHE) and the Care Services Improvement Partnership. 3 Keys to a shared approach in mental health assessment. London: Department of Health; 2008.
Available from: http://www.3keys.org.uk/downloads/3keys.pdf

Call for Maps: Mapping Science Exhibit, 7th Iteration on "Science Maps as Visual Interfaces to Digital Libraries" (2011)

Background and Goals

The Places & Spaces: Mapping Science exhibit was created to inspire cross-disciplinary discussion on how to best track and communicate human activity and scientific progress on a global scale. It has two components: (1) physical exhibits enable the close inspection of high quality reproductions of maps for display at conferences and education centers and (2) the online counterpart (http://scimaps.org) provides links to a selected series of maps and their makers along with detailed explanations of how these maps work.

Places & Spaces is a 10-year effort. Each year, 10 new maps are added, which will result in 100 maps total in 2014. Each iteration of the exhibit attempts to learn from the best examples of visualization design. To accomplish this goal, each iteration compares and contrasts four existing maps with six new maps of science. Themes for the different iterations/years are:

  * 1st Iteration (2005): The Power of Maps
  * 2nd Iteration (2006): The Power of Reference Systems
  * 3rd Iteration (2007): The Power of Forecasts
  * 4th Iteration (2008): Science Maps for Economic Decision Makers
  * 5th Iteration (2009): Science Maps for Science Policy Makers
  * 6th Iteration (2010): Science Maps for Scholars
  * 7th Iteration (2011): Science Maps as Visual Interfaces to Digital Libraries
  * 8th Iteration (2012): Science Maps for Kids
  * 9th Iteration (2013): Science Maps for Daily Science Forecasts
  * 10th Iteration (2014): Telling Lies With Science Maps

Places & Spaces was first shown at the Annual Meeting of the Association of American Geographers in April 2005. Since then, the physical exhibit has been displayed at more than 175 venues in over 15 countries, including eleven in Europe, plus Japan, China, Brazil, Canada, and the United States. A schedule of all display locations can be found at http://scimaps.org/exhibitions

Submission Details

The 7th iteration of the Mapping Science exhibit is devoted to science maps that serve as visual interfaces to digital libraries. These maps might communicate the

  * quality and coverage of data sets,
  * the structure (ontology, taxonomy, classification hierarchy) of data sets,
  * (semantic) linkages between data sets,
  * the evolution of a data set, or
  * access and usage patterns of data sets.

They are intended to support the navigation, management, and utilization of mankind’s scholarly knowledge and to make it more readily available to researchers, educators, industry, policy makers and/or the general public.

We invite maps that show a visual rendering of a dataset together with a legend, textual description, and acknowledgements as required to interpret the map. Science map dimensions can be abstract, geographical, or feature-based, but are typically richer than simple x, y plots. Scientific knowledge can be used to generate a reference system over which other data, e.g., funding opportunities or job openings, are overlaid or be projected onto another reference system, e.g., a map of the world, but must be prominently featured.
See http://scimaps.org/static/docs/all-maps-1-6.pdf for an overview of the 60 maps already featured in the exhibit.

Each initial entry must be submitted by Jan 30th, 2011 and needs to include:

  * Low resolution version of map
  * Title of work
  * Author(s) name, email address, affiliation, mailing address
  * Copyright holder (if different from authors)
  * Description of work: Scholarly needs addressed, data used, data analysis, visualization techniques applied, and main insights gained (100-300 words)
  * References to publications in which the map appeared
  * Links to related projects/works

Entries should be submitted via email to the curators of the exhibit: Katy Börne (katy at indiana.edu) and the exhibit designer Michael J. Stamper (mstamper at indiana.edu) using the email subject header “Mapping Science Entry”.

Please feel free to send any questions you might have regarding the judging process to Katy Börner (katy at indiana.edu). Please keep subject header (as used here).

This call - with additional details -  is also available at http://scimaps.org/call

Health Tips Facts – Cellulite Definition Symptoms Causes Home Treatments Remedies

Cellulite Definition:-

Body cellulite explains deposits of fats trapped in the pockets of connective tissues that are to be found just under the skin. These are the lumpy substance that looks like cottage cheese and can be found in the buttocks, stomach and thighs. The lumpy substance makes a person appear bulky with creases and layers of fat that is noticeable even from afar.

Cellulite Causes:- 

The most important causes of cellulite are:

Genetics, Hormones, Lack of certain types of exercise, wrong foods. 

These days, Hormonal imbalances are much more common, which is why this problem is so well-known. Overproduction of hormones can cause excess fat storage in the hips, thighs, and butt, also breaks apart collagen fibers.

Cellulite Signs Symptoms:- 

Swelling of the upper and lower eyelid, Orbit becomes swollen and bulges, Eye may appear red, Decrease in the child's ability to move the eyeball.

Cellulite Home Herbal Treatments Cure Care Remedies:- 

Natural treatment goes deep into the skin layers and melts away the fat. Unlike other OTC creams it does not hide the ugly cottage cheese appearance.

It is quite reasonable. It costs you a fraction of the cost involved in surgical methods of removing orange peel effect.

It has no side effects. It can be used in complete privacy of your home.
It does not require any prescription. You just need to order it online and start using it without even telling someone about it.
It has no odor. It can be used any time of the day.

Call for Papers - 2011 CHI Workshop on Bridging Practices, Theories, and Technologies to Support Reminiscence

CALL FOR PAPERS

CHI Workshop on Bridging Practices, Theories, and Technologies to Support Reminiscence 2011
http://www.cs.cornell.edu/~danco/remchiwork/

CHI 2011 Workshop

This one-day workshop explores how HCI-related practice and research can understand and support reminiscence. The workshop has two main goals. First, we hope to bring together academics and practitioners from a variety of backgrounds, disciplines, levels of experience, and approaches to studying and supporting reminiscing. Second, we hope to explore a variety of topics around current and potential uses of technology to support reminiscence, including but not limited to:

- understanding people's current practices around reminiscing;
- exploring empirical studies and theories of memory that might inform technology designs;
- presenting, critiquing, and evaluating existing technologies for reminiscence,
- considering how technology might support new reminiscing practices, and
- supporting social aspects of reminiscence.

We are particularly interested in participants from outside the CHI community to foster new perspectives and collaborations. Our plan is to conduct three short discussion-focused panels organized around participants' interests. Those discussions will ground small groups in articulating interesting directions, studies, designs, and outlines of potential grant and book proposals at the intersection of reminiscing and technology

SUBMISSION

Interested participants should mail position papers of up to 6 pages in .pdf versions of the CHI Extended Abstracts format to danco at cs.cornell.edu by January 14, 2011. Papers should clearly express how the authors' participation will further the goals of the workshop: what do authors offer and hope to gain by participating? They should also clearly, but briefly, present participating authors' backgrounds, in order to support our goals of creating a diverse group of participants.

We will notify accepted participants on or before February 11, 2001. A limited amount of funding will be available, primarily to support attendance for people from other disciplines who are not regular CHI attendees. The workshop will be held on Sunday May 8, 2011 in Vancouver, Canada. Please note that at least one author of an accepted position paper must register for the workshop and for one or more days of the CHI 2011 conference.

IMPORTANT DATES

- Jan 14, 2011: Position papers due
- Feb 11, 2011: Notifications of participation
- Apr 1, 2011: Final versions of position papers (to be shared with other participants)
- May 8, 2011: (Sunday) The workshop! (Here's the list of all workshops.)
- May 9-12 2011: CHI itself

ORGANIZERS

- Dan Cosley, Information Science, Cornell University danco at cs.cornell.edu
- Maurice Mulvenna, School of Computing and Mathematics, University of Ulster md.mulvenna at ulster.ac.uk
- Victoria Schwanda, Information Science, Cornell University vls48 at cornell.edu
- S. Tejaswi Peesapati, Information Science, Cornell University stp53 at cornell.edu

h2cm = Bayesian Quarters?

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

The Bayesian approach allows human insight, subjective though it is, to be combined with statistical information, limited though it may be. It is not surprising that this blurring of the line between the methodologies of the sciences and the humanities has attracted passionate supporters as well as furious enemies on both sides of the cultural divide.

Von Baeyer (2003) p.79.

von Baeyer, H.C. (2003) Information: The New Language of Science, Weidenfeld and Nicolson, London.

Healthy Hair - Hair Care Tips

Every body wants healthy and shinning hair, if your hair is worn long, short or somewhere in between, healthy hair is always in fashion.

* Choose the food that contains green vegetables and sweet fruits. Milk products, coconut and yogurt are also good for your hair.
Cold drinks also can disturb your ingestion and the assimilation of nutrients.
Avoid canned goods. Food with preservative and additional chemical will not give you nutritious benefit for your body.
Spinach, broccoli, and Swiss chard are important resources of vitamin A and C. Your body needs them to produce sebum, a kind of oil that is produced by hair follicle to be natural conditioner for your hair. Egg is one of the best protein resources you can find. It also contains biotin and vitamin B12 that are very essential to be beauty nutrition.
Low fat milk products are essential calcium resources that are useful for hair. These foods also contain casein and whey as two high quality proteins.
Cooking spice like black pepper is also useful for your Black healthy hair. Just add this spice into your soup or other daily cooking.

* Whenever go for sleep with wet hair because wet hair can be easily breakable. Biotin, zinc, magnesium and vitamin B6 are the most important ones to get for ensuring new growth and keeping your existing hairs healthy too.

* Avoid stress because it can have on your hair color seriously in long term. Afford to regulate your time and duty to reduce the pressure. Also, you can do meditation.

* Natural hair treatments such as hair oils, masks and creams that you make yourself are effective treatments for troubled hair.

* Pomegranate is another ingredient commonly found in natural hair care products. Back in ancient Rome and Greece, pomegranate was used as medicine but with its organic acids and tannins, it also adds vitality to hair, especially hair that has been colored.

Dizziness Symptoms- Causes- Home Natural Treatments

What is Dizziness? Definition of Dizziness:

Dizziness is caused when the blood pressure drops suddenly. Research concluded that dizziness caused by low blood pressure but not of high blood pressure.
Signs of Dizziness Symptoms:
Common symptoms of dizziness associated with aging include light headedness, unsteadiness, a spinning sensation, giddiness or wooziness.
Dizziness Signs or any similar factors like it can result to different types of causes, like anemia, migraine, hearing loss, motion sickness or even stroke. Proper analysis and diagnosis of this should be a necessity, since dizziness may be a cause of something else other than what was mentioned.

Dizziness Causes:
Dizziness can be caused of psychological, central or neurological, medical and ontological imbalance. And these imbalance can classified into; sensory disturbances - usually loss or imbalance reception of the senses; central or brain disturbances - these can be a dizziness cause by multiple disruptions of blood flow towards the brain, or any other neurological issue. Dizziness causes a lot of assumption and evaluation. It can be a major or minor issue, a chronic disease or just plainly symptom of hearing imbalance. Most of the dizziness problems as reported are due to hearing problem.

Dizziness Prevention Home Herbal Natural Treatments Remedies Cure Care:

1. Place an Ice Pack on the back of Your Neck - This works probably again due to acupressure points

2. Avoid Stress - Try not to let life get you too stressed out which could lead to anxiety or panic attacks. When a situation happens that causes you stress, stop and take several deep breaths and try to focus on something positive in your life.

3. Massage Area Between Your Eyebrows - This is a known acupressure point that helps to relieve dizziness

4. Drink water as much possible and make it a habit.

5. Inhaling Peppermint or Chamomile Oils.

Recipe for tension: Left-of-center values - Human (lower) Rights

Sometimes the invisible is most visible ...

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

Person visible - invisible in the conceptual frame	Where is your science now?
'Peace' the ultimate meme? Discuss.	"Human (lower) Rights"

Image source: Heiko Junge [20/27] Kansas City Star
http://www.kansascity.com/2010/12/09/2509904/empty-chair-left-for-jailed-chinese.html

Related links:

Recipe: Holistic care - Care pebble turnover*

Recipe II: Holistic care - Care pebble overhere!

Recipe II: Holistic care - Care pebble overhere!

...

WouldBeUser: Well there's no shortage of pebbles, the referrals come thick and fast.

ActualUser: That's why reflecting on that particular pebble is important, turning it - them, their situation over. Asking yourself is there anything I and the team have missed?

WouldBeUser: OK, the beach is still full of them!

ActualUser: Is it the pebble you are trying to see?

WouldBeUser: Ah, of course! Individualised care?

ActualUser: That's right. Nursing, health, social care and in fact good governance everywhere is about seeing the person. Sometimes it isn't easy; but if you pick that person out then you can count the rewards as you would the pebbles on the beach ...

Original image sources - see Recipe I

Recipe: Holistic care - Care pebble turnover*

WouldBeUser: How can you sum up use of the health career - care domains - model?

ActualUser: Well it's a bit like you are picking and throwing some pebbles on the care plan or game board.

WouldBeUser: What - as simple as that!

ActualUser: Yes, but - NEVER underestimate the value of turning each of those pebbles over and reflecting, sharing...

*Also great for a game of nudge - nudge.

Original image sources:

http://imagecache.artistrising.com/artwork/lrg//4/417/7CV9000A.jpg
http://www.crglass.ca/images/dark%20green%20pebbles.jpg
http://www.crglass.ca/images/dark%20blue%20pebbles.jpg
http://www.crglass.ca/images/red%20pebbles.jpg

Winter Skin Care - Routine Protection Home Remedies

Below freezing temperatures and cold winds, face can take quite a beating during the winter season. Covering your face completely is not a simple task.

1. Cold weather can take its toll on your skin, too, especially if you have dry or sensitive skin. The lower temperatures outside, increased windiness and the fact you are turning up the thermostat in your home can all make your skin flaky, blotchy, chapped, dry and itchy.

2. Use of heavier moisturizer on your hands, feet, elbows and knees.

3. Use a mild cleanser as opposed to soap, which can strip your skin of the essential oils it needs.

4. Continue to drink lots of water to provide the necessary hydration to your skin.

5. Use a sunscreen with SPF 15 or better. Although you may not feel it as much, the sun can be just as powerful when reflecting off the snow or while taking a long walk outdoors as it is on a summer day at the beach. A suitable suggestion is to use a moisturizer or foundation with a built-in sunscreen every day.

6. Layer your clothing when going out in cold. Cold weather dries your skin out faster than when it's warm.

7. If your moisturizer doesn't contain sunscreen, apply a sunscreen with an SPF of 15 at minimum. Normally recommended SPF30 or higher but since you are less likely to spend an extended amount of time outdoors, SPF15 is sufficient.

8. Be prepared for extra skin care by carry moisturizing cream with you when you are out.

9. Avoid skin care products that contain ingredients that dry out your skin. Such ingredients to avoid would be fragrance oil, alcohol and other harsh un-natural ingredients.

10. Keep your feet hydrated by slathering on a thick foot cream at night and wearing socks.

11. Wear gloves outdoors to protect your skin from the excessive cold. Apply a bit of hand lotion on your hands before you tuck your hands into gloves or mittens.

Healthy Diet Tips to Improve Immune System

Immune system is the best defense against all types of dreaded ills. So let’s build strong immune system together. Here are some brief but really helpful healthy Immune System Boosters Tips for Healthy Lifestyle.

Maximum Use of Herbs:-
Daily drink a cup or two of ginger tea sweetened with honey especially at winter time.
Use of Echinacea capsules, Garlic is also one of the powerful to boost immunity.

Enough Sleep:-
While we sleep, our body heals and strengthens the immune system. Some important factors like hormone levels, clear thinking and reasoning, weight management, healthy skin, mood improvement and glowing, are totally depend on six to ten hours sleep per night.

Onions:-
In winter, airborne germs can make us ill. So, I do not want to advice about to eat onion but just put whole, raw, unpeeled onions in every room of your house may absorb viruses and bacteria that may help prevent flu and the common cold.

Stress, Anxiety:-
Number of positive thinking people easily available, so just spend some time with them for that every week, consume some time for yourself to do an activity for enjoyment, because anxiety and stress has a way of weakening your immunity.

Exercise:-
Right Exercise especially outside in the fresh air are responsible for circulates the lymph fluids which are important for your immune system.

Antioxidants:-
Fresh fruits and vegetables juice act as vital role of antioxidants are important to strengthen the immune system.

Protein:-
Protein forms from antibiotic and hormone-free beef and poultry are for building blocks of healthy cells resulting in wellness of body, mind and an immune boost.

h2cm and clinical equipoise

The past few weeks reading the Journal of Evaluation in Clinical Practice - I've encountered the concept of equipoise: specifically the clinical form.

The Health Career - Care Domains - Model is all about 'poise'.

The model's care domains provides the perfect workout.

Medicine, health and social care constantly exercises us. We are whether or not we recognize it on a balance board. In fact if you consider that image and then factor in the complexity of health care today you realise just how much stuff (technology), how many people (subjects, agents) need to be on that same board. Who does the board belong to though? Well of course it's -

Jo (off-balance, strengths depleted, sick (and tired), prone to relapse, bank poleaxed...) Public's !

The April 2010 issue of the above journal is a fascinating read. I noticed today that some of our placement students were not aware of the recent and current position regarding health policy: that is the 'long view' of decades such as: Health of the Nation, the National Service Frameworks, Darzi ... They need to address that and I'm sure they will.

This journal issue prompts me to consider evidence based medicine anew, especially:

• How long it's been around - some 20 years.
• Its occupying the SCIENCES domain, with its weight threatening to overbalance all (you could say it's a significant singularity).
• The realization that the Emperor is short on clothes.
• Given the above it can mature. Bogdan-Lovis and Holmes-Rovner (2010)

Back to that board: and stepping onto the health care domains - all four of them so spread your feet - you can see instantly (feel that feedback) how EBM, shared decision making and (person) patient-centered care are all related. As Bogdan-Lovis and Holmes-Rovner (2010) highlight:

Equipoise is the heart of the shared decision making movement, and it embodies the problems for which patient decision aids are most often developed to explain the risks and benefits of competing alternatives. p.377.

h2cm is well suited to this task on so many levels.

The past week or two I've also noticed several mentions of the need to nudge people - here and there - both in the media and in Bogdan-Lovis and Holmes-Rovner's paper and references.

More to follow - and as you step-off take care ....

Wilson, K. (2010) Evidence-based medicine. The good the bad and the ugly. A clinician's perspective. Journal of Evaluation in Clinical Practice, 16, 398-400.
Bogdan-Lovis, E., Holmes-Rovner, M. (2010) Prudent evidence-fettered shared decision making. Journal of Evaluation in Clinical Practice, 16, 376-381.

And for the week ahead:
One mind, many minds - ONE PLANET. One need, many needs - ONE PLANET: what price stability?
http://hodges-model.blogspot.com/2009/02/one-mind-many-minds-one-planet-one-need.html

Body Fat and Disease Risk

If your body weight goes up, not just body fat increases, but also the risk of various diseases. That's because the conditions that can make a person old quickly, such as hypertension, high cholesterol, diabetes, and pain, closely related to the presence of excess fat.

In determining the normal weight, you can use body mass index (BMI), which divides weight by height squared. Value exceeding 25 is considered overweight (overweight) and obese if the value exceeds 30. In addition to calculating BMI, you can also measure the fatness of the abdominal circumference. For women, the maximum is 80 cm and 90 cm for men.

In addition to making the body so it is not agile, piles of fat in the body will invite the arrival of the disease. Similar to other body parts, fat tissue also requires oxygen and nutrients from the blood. With the increased need for oxygen and nutrients, then the amount of blood flow throughout the body would have to increase as well. Thus, increasing the risk of high blood pressure.

Excess fat is also associated with increased LDL cholesterol or bad cholesterol and triglycerides. Over time, these blood fat changes had a role in the formation of fatty deposits (plaques) in arteries. This condition is called atherosclerosis which can make your risk of coronary heart disease and stroke.

Diabetes type 2 is also closely linked to being overweight. Excess fat will directly influence the body's ability to balance blood sugar.

In addition to cardiovascular disease, according to Dr. John Tjandrawinata, SpGK from Boromeus Hospital, Bandung, there are several types of cancer associated with being overweight. "In women, such as breast cancer and uterine cancer. While in obese men, a greater risk of pancreatic cancer and biliary stones," he said.

What should be known is weight loss no matter how small would be useful. If you are obese, then lower the weight as much as 10 percent of it will give a positive effect on health.

Slimming, the traditional safer?

Fats, especially when it comes to accumulate in the body is now the enemy of many people. Therefore, all efforts to remove him popular chosen people, both men and women.

Those who want to lose weight but do not bother to exercise and regulate his diet, usually choosing medicine products, herbs, supplements, or slimming drinks.

Most of these products has not been clinically tested. Therefore dr.Johanes Tjandrawinata, Sp.GK, clinical nutritionist from Melinda Hospital Bandung, advised consumers to be more careful in choosing slimming products.

"Herbal or traditional medicines usually have the effect of increasing the frequency of urination and defecation. Hence the weight will quickly come down," he said at a media event education about anti-obesity drug safety in Jakarta, (1 / 12).

The herbs are often used for slimming are usually made from a plant of Dutch identity, yellow or saffron. Community because many are choosing herbal medicine made from natural ingredients that are safe for consumption.

Besides herbs, other products which have a way of working is similar to the herbal slimming green tea beverages. About this drink, dr.Johanes believes virtually all types of tea are able to reduce body fat.

"Research in Japan shows tea contains ECGC, an antioxidant that can increase metabolism and inhibit the formation of fat cells. Therefore, basically all types of tea can reduce body weight, origin consumed without sugar," he said.

Although most people think herbal and traditional medicines have fewer side effects than chemical drugs, but dr.Johanes said in the long term, traditional medicine can also cause side effects.

"Products that how it works out fluid can interfere with kidney and inhibited blood circulation," he said. He therefore suggested that users of medical herbs in advance to know the materials used clearly and regularly to check kidney.

What needs to be understood, according to him, that weight loss efforts is not a short process but the long term. "It can not be instant. Is not obesity is also a result of a long process?," He said. Enterprises should weight loss is holistic, ranging from setting diet, exercise, behavior modification, and medication, if needed.

Tips for Dealing with Picky Eater Toddlers

Dhea instantly shut his mouth when Lusi (31), his mother, thrust the spoon which contains rice with vegetables spinach. However, 3-year-old girl was happily eating rice with fried sausage after the mother remove vegetables from his plate.

According to Louise, her daughter every day, just want to eat if given a side dish of fried sausages or eggs alone. "He immediately went on hunger strike if given the vegetables. And I had to outsmart so vegetables do not look," said the woman who is a lecturer of this.

Feeding in children under five is often a problem for parents. Many children against their parents when it comes to food and diet. Children who have difficulty eating or just ask the same types of foods such as Dhea is also called the picky eater. The children in this category are quite a lot, almost 50 percent.

Difficulty eating, according to Dr. Aryono Hendarto, Sp.A (K), most often experienced by children at the age of 1-5 years. "At this age children are usually very active and are happy to explore the surroundings. Therefore, no child likes eating activity because it is considered boring," said a doctor who is usually called Ari.

A survey showed that most children are picky eaters only eat mashed foods they like porridge (27.3 percent) and have kesulitah chewing and swallowing (24.1 percent). However, children picky eaters at age 2-3 years, in general, just like a certain food types.

Although the general experience of children under five, Dr. Ari confirmed that difficulty eating is not just a stage of growth. "There are many factors that affect why kids so it's hard to eat, for example because the child had a disease that does not have appetite to eat or because of psychological factors," said a doctor from the Division of Child Nutrition and Metabolic FKUI / RSCM Jakarta.

In seeking the causes of child feeding difficulties, according to Dr. Ari, there are some things parents need to be evaluated, for example, whether the number and amount of food that was given in accordance with the needs of children. "The size of the stomach of each child's different backgrounds, we should not force children to spend an excessive portion," he said in the event parenting workshops on nutrition for children hosted by Abbott Nutrition in Jakarta some time ago.

Parents also need to explore the character of children. For example, if the child including a difficult temperament or whether the parents have created a suitable environment. In addition, parents should also be sensitized on child hunger and satiety. "If just one hour to drink milk, it was clear he was still satisfied when told to eat," he explained.

When children do not eat well, they probably will not get the portion of the nutrients it needs so that it can have an impact on growth. Even so, parents should not give the wrong treatment to the child. "Forcing children to eat will only make things worse," added Dr Tjin Wiguna, Sp.KJ (K), a child psychiatrist.

He explained that, if parents want to develop eating properly, parents should first set an example for his son. "How can kids like vegetables if their parents never ate vegetables or bad comment on vegetables," he said.

Parents are also expected to create a comfortable environment, not in a hurry, and without pressure. "Children are also entitled to make choices like eating anything. Throughout healthy, meet only the demand for children," said Dr. Tjin.

Such as milk supplementation in children difficult to eat, according to Dr. Ari, okay if the child has a growth disorder, such as less weight. "Keep in mind that the supplement is not a substitute for daily meals. Children still need to be taught good eating habits," he said.

To find out the nutritional adequacy diasup children, parents can see from the chart the growth of the child's weight. "If within three months of weight infants do not go up, then indeed he is short of nutrients," he said.

HIV Transmission from Mother to Infants always increase

HIV transmission from mother to infant tends to increase steadily over the increasing number of women with HIV in Indonesia. Although the prevalence data of HIV transmission from mother to baby is still limited, but the trend of transmission will continue to rise because the number of HIV positive pregnant women tend to increase.

Thus disclosed Deputy Assistant Regional Development of the National AIDS Commission Good Rahmat Prabowo in discussion "The Importance of Providing Access to HIV / AIDS Prevention of Mother to Child (Prevention-Mother-To-Child-Transmission/PMTCT-)" which was held in Bandung Frisian Flag Indonesia , on Wednesday (01/12/2010).

Good explains, from about 4.5 million pregnancies in Indonesia every year, an estimated 25 percent raises risk of HIV transmission from mother to baby. Estmasi This can be seen from the HIV screening data obtained from PMTCT services.

"Data in 2008 showed that the number of pregnant women who test for HIV as many as 5167 people, of which 1306 (25%) of them HIV positive," he said.

Good adds, until 2008, has been available PMTCT services to 30 services are integrated in the MCH services (antenatal care). PMTCT programs have also been adopted by several institutions of society, especially for outreach and expand access to PMTCT services.

Increased number of HIV positive pregnant women, continued Good, makes the need for PMTCT services will increase. Based on the results of projections and modeling of the HIV epidemic, the number of positive pregnant women who need PMTCT services will increase from 5730 persons in 2010 to 8170 people in 2014.

On the same occasion, Dr. Reni Ghrahani of Allergy Immunology Division Staff Section of Child Health, Faculty of Medicine, University of Padjadjaran states, prevention becomes very important because every pregnant women with HIV / AIDS to their babies at risk of transmitting 25 to 45 percent. The risk of transmission when the mother has appeared in a state of pregnancy, during childbirth until later when breastfeeding their babies.

"Poor people's knowledge related to transmission and prevention of HIV / AIDS to make Indonesia as the fastest country in the spread of HIV / AIDS in Asia. The worse the condition of the mother, risk of transmission to infants will increase. The process of delivery by Caesarean section and do not give milk to babies from mothers with HIV / AIDS can reduce the risk of transmission to 35 percent, "he said.

Meanwhile, Corporate Communications Manager Frisian Flag Indonesia (FFI) Anton Susanto, confirms it is committed to improving nutrition and public health, especially children.

For this reason, the FFI has commenced involvement in the partnership program to provide access to HIV prevention from mother to child (PMTCT) in Bandung since March 2009. FFI has teamed up with the KPA, Bandung, West Java Commission for Health (KUJBS) and several nongovernmental organizations to help the PMTCT program through the provision of counseling and monitoring support to mothers with HIV / AIDS.

"We are aware that in several countries has shown that preventive action through PMTCT programs can reduce the risk of transmission rates significantly," he said.

For his support of the PMTCT program in Bandung since two years ago, FFI receives award from Bandung City Government. Award presented by Mayor Dada Rosada coincide with World AIDS Day.

Know the Risk of Prostate Cancer Through Finger

There is no simple formula to determine who will have problems in the prostate. Therefore, many doctors recommend that men over the age of 40 years of a medical examination the prostate.

Another way to determine the risk of prostate cancer, at least according to research published in Brisith Journal of Cancer, is to look at differences in finger length. It is said that men who have a longer index finger than ring finger, lower risk for prostate cancer.

Finger length is already formed before the baby is born and is influenced by sex hormones in the womb. The fetus is exposed to the hormone testosterone more less will have size index finger is longer and were protected against prostate cancer later in life.

"The results of this research may someday be used as a screening tool to be combined with other risk factors, such as genetic testing and history in the family," says Professor Ros Eeles, researchers from the University of Warwick and the Institute of Cancer Research, UK.

The study adds evidence of previous studies that mention the link between the influence of hormone balance in the fetus with the disease who may suffer in the future. It is not impossible if the will of the pregnant women can do in ways of prevention of cancer risk in prospective baby.

Even so, the men who have a shorter index finger does not need to worry because prostate cancer is more influenced by the age factor. The older the age of a man, the higher the risk of having prostate problems.

When to Keep Slimming Drugs?

Obesity and all its complications can reduce the quality of life, ranging from limitations of motion, decrease in self-confidence, until the risk of various diseases.

Obesity is a state of excessive accumulation of body fat so that weight well above normal and could endanger health. Body mass index or body mass index (BMI) has been recognized as a method in determining the level of overweight and obesity.

BMI is obtained by dividing weight (kilograms) by square of height (meters). Someone said to overweight if his BMI values over 25 and is obese if his BMI over 30.

The problem of obesity is classified as chronic and difficult to control. "Obesity is a disease with a genetic factor and a major health problem. The increase in body weight after the drug was stopped, also show obesity is a chronic disease, like hypertension," said dr. John Chandrawinata, MND, Sp.GK.

That is why, the management of obesity are also long term. However, during this penananganan identical to the reduction of obesity which is considered torture eat so often fail.

"The condition of obesity is the result of long-term. Therefore, it is also handling the long term," he said at an event about the security of anti-obesity medication that Clinic Nutrition Medical Association held in Jakarta (1 / 12).

Ideally, obesity therapy is done by setting a healthy diet, behavior modification, and exercise to increase energy expenditure.

Assisted drug
Sometimes the patient also needs the help of medical drugs that have proven its safety. The use of obesity drugs for people who already have a certain criteria, such as BMI values over 30 and adapted to the patient's disease history.

However, according dr.Johanes enough patients IMT was not yet 30 but already have prescription weight loss medication. "There are people who are not included obesity, but already experienced in abdominal fat deposition. It is also dangerous," he said.

Weight loss drug circulating in Indonesia are of two types, namely a central work by suppressing appetite and increasing satiety and drugs that work in the gut by inhibiting the absorption of nutrients.

In determining the type of drug to be used, the doctor will see indications and kontraindikasinya. "Drugs actual weight loss, including prescription drugs. Therefore, it can not be careless consumption," said dr.Johanes.

Also of note are patients with drug side effects. Obesity drug that works at the nerve center such as class subutramine now withdrawn permission orbit since proven to cause interference with the heart.

Slimming drug alert

Obesity is a scourge, not only for women but also men. Apart from the obvious appearance, in terms of health has been proven that obesity is detrimental to health. That's why many people do various efforts to reduce excess weight.

In addition to prescription drugs that have been proven medically, commercially available various supplement products, herbal medicine and traditional medicine to reduce excess weight. Although there is no scientific evidence, these products claim to be able to shed fat fast. The extent to which security products?

"Slimming supplements, such as type of fat burner, usually contain caffeine high. In high doses, these supplements can disrupt heart rhythms and cause hypertension," said dr.Johanes Chandrawinata, Sp.GK, from the Association of Physician Nutrition Specialist Clinic Indonesia.

John looking, most outstanding slimming supplement product sold under price expensive but not really effective weight loss. "If it's effective, why are not sold as a prescription drug whose price is definitely more expensive?," He asked.

He urged the public to be careful in choosing slimming products. "Avoid taking drugs, herbs or supplements that have diuretic side effects or increase urination and defecation. The product type that is rapidly losing weight, but drained of body fluids and blood flow to vital organs is interrupted," said a doctor from RS.Boromeus Bandung this.

If used in the long term, these drugs can cause heart and kidney disorders.

Weight loss drug circulating in Indonesia and already approved the current POM is a class of Diethylpropion and Orlistat. Both are clinically proven safe for long-term use.

Previously circulated also anti-obesity drug sibutramine group but since October 2010, POM suspended the marketing authorization of this drug after several international scientific journals publish research results about the side effects of these drugs that can cause strokes and heart problems.

Age and Sex Male Ability Decrease

When you are twenty years of age, you probably never thought about the difficulty to get an erection. But when your age has crept past the number 40, desire and sexual ability you may not be as good as before.

Physical changes and decline in social ability has been mostly due to decreased levels of the hormone testosterone gradually. The decrease of hormones that also affect the energy, strength, muscle and fat mass, bone density and sexual function.

What are the sexual problems faced by middle-aged men?

- In the mid-50s, a man needs physical stimulation and psychological longer to be ready and able to have sex. Even so, in fact strongly influenced men's sexual desire of health and habits than her age. A healthy and fit man normally will remain ready and excited to old age.

- Along with age, a man may take longer to get an erection and maintain it.

- At age 20, your erection occurs in real-time and hard as wood. But now your penis is sometimes weak and limp. The changes were normal. All you need to do to prevent it is to maintain fitness with exercise to keep blood flow smoothly, including to the penis area.

- Sexually transmitted diseases (STDs). Many of us know that the best way to avoid STDs is to remain faithful to one partner. But if you secretly have multiple partners and not using a condom, maybe you will suffer from diseases that are transmitted through sexual intercourse. Some common diseases, genital herpes, syphilis, chlamydia, hepatitis, or HIV.

Bursary applications - 17th Oxford Workshop on Evidence-Based Practice

Dear Colleagues,

The Centre for Evidence-Based Medicine is offering three free bursary places on the -

17th Oxford Workshop on Teaching Evidence-Based Practice.

Applicants will need to cover their travel and accommodation costs.

All applicants should send a covering letter with their application (which can be downloaded at www.cebm.net) detailing their current involvement with Evidence-Based Practice and outlining what they would do with the knowledge gained on the workshop. Applicants should also enclose a current C.V..

All applications should be sent to me at the address at the bottom of this email. Closing date for applications is 31st March 2011.

I should be grateful if you would disseminate this email to any and all interested parties.

The 17th Oxford Workshop on Teaching Evidence-Based Practice will be held 5th - 9th September 2011 at St. Hugh's College, Oxford, UK and is aimed at clinicians and other health care professionals, including those involved in mental health, who already have some knowledge of critical appraisal and experience in the practice of evidence-based health care and who want to explore issues around teaching evidence-based medicine.

There will be two main themes running throughout the workshop:

Teaching will be addressed through the exploration of different educational models for teaching evidence-based practice and identification and discussion of issues of pedagogy, curriculum design development and maintenance. The aim will be to promote the teaching of evidence-based health care at your home institution.

Personal Development will be addressed by offering guidance and help in extending and advancing participants' existing critical appraisal and teaching skills.

All good wishes,

Olive

Olive Goddard
Centre and Editorial Manager
Centre for Evidence-Based Medicine
Department of Primary Health Care
Old Road Campus, Headington
Oxford, OX3 7LF
............................................................
email: olive.goddard AT dphpc.ox.ac.uk
 www.cebmh.com

My source: CEBMH-MEMBERS AT JISCMAIL.AC.UK