Dementia care: communication in nursing homes

In nursing home liaison the importance of communication quickly asserts itself (as it does throughout health and social care). As an organisation effective communication is evident (or should be) at all levels:

• Corporate: across the 'group'
• Management: within the home
• Clinical: continuity of care between shifts, days - nights
• Care staff and residents - especially those with challenging behaviour
• The care home (staff), relatives and community

This week and as also recognised for colleagues in the future, my role will focus on education. In particular reviewing the background, theory and practice of communication with people who are more severely disabled by this condition. I've sixteen slides as a guide, a lesson plan but I will be using a flipchart (arriving early to scribble away) with the intent to engage the audience. Given my pre-occupation with information I want to mix and match as follows:

1. Use information as a central concept, not technically but personally as per self-awareness, knowledge and orientation, person-centred care.
2. Have people contemplate communication in a practical sense.
3. Finally, obviously ensure that what is discussed and shared is directly related to their work, the care needs and challenges of the residents (and families?).

On the information front I'm sure I can employ the conventional and simplified communication model:

SENDER - channel - RECEIVER

This may appear mechanistic but it's an effective way to highlight the real difference that Health Care Support Workers - and indeed family and friends can make to resident's lives. Referring to this model I can demonstrate the very upsetting inequalities that are often found here. The audience can contrast themselves as SENDER and RECEIVER with each other and in care scenarios.

We will identify and acknowledge the deficits that people living with dementia must contend with and endure. This is to review previous learning and ensure staff fully appreciate the care situation. More positively the session will stress the role of staff as builders and agents of personalised care with a great contribution to make.

1. They can consider (critically) the care environment - yes the 'home' - as the source of potential noise. 
2. When there is an imbalance in the capabilities, comprehension and meaning between SENDER and RECEIVER skilled, insightful, and patient staff can compensate, addressing the person's unique needs.

If there are matters that cannot be resolved then these 'risks to person-centred care' should be carried forward to management: a prescription that must be repeated as necessary. With the purported high rate of staff turnover in homes (is that a myth - what are the figures really?) they should be able to leverage these FFIs - frequent first impressions - from new staff, before they are also part of the furniture.

Allied with this is a request for support in person-centred care. For me these two go together and it's good that this 2nd session follows tomorrow. This is an opportunity to introduce the Health Care Domains Model and build upon the points raised and factor in the questions and issues raised by the staff.

Critically across all these layers of comms is: Leadership. A key part of that of course is recognising training needs and pursuing change.

Proximity: Relationships, Records, e-Health - Person-centredness near and far

When data protection and confidentiality is debated "the need to know" is often wheeled out as a rationale for access to personal identifiable data.

See the following:
NHS Confidentiality Consultation - FIPR Response (esp. #18).
DoH, Confidentiality, UK

In addition, if I need to access the record of patient held at hospital 'x' from hospital 'y' what is the health care relationship that prompts and justifies this need?

At present visiting nursing and care homes, you go knowing that data capture and recording (care assessment) is a fundamental requirement. Having a secure laptop for community has long been promised. While tech solutions are available and implemented elsewhere, my lack of such technology prompts me to imagine a future visit. ...

Pulling up at the nursing home I walk up the drive, ring the bell. While I wait the new tablet device in its bag has already introduced itself to the home. As I am allowed in - my identity assured - the tablet continues its dialogue, it:

1. Downloads and updates existing active client data.
2. Downloads additional data as per the agreed dataset on the new referral.
3. Checks on items 1-2 with a review of recent prescribing for key psychotropic medicines.
4. It checks the most recent NICE, Cochrane evidence and reconciling the local care knowledge. (This may seem excessive at present, but come personalised medicine this will be crucial).
5. Will check on most recent clinical reviews and due dates.
6. The h2cm template is there ;-) ready to present the care domain summary for the general physician ... and possibly (roles?) the next care professional to visit this home and this resident.

The significance of relationships is usually denoted by distance. Personal space is rather obviously spatial. This is how we recognise (well one of the ways!) the meaning and significance of an intimate relationship. In care situations with individuals who are confused and potentially aggressive we are conscious of the need to have due regard and respect for that person's personal space. Spaces and boundaries have to be negotiated in a variety of ways and means. 

Health information technology has already made effective use of role-based access to systems. If we take person-centred care to the nth degree, proximity can also count as it does in mobile health (m-health). Whilst to effect a role is to be in a certain location and context (sat at the office PC in the hospital) roles are organisationally and politically defined. Proximity is also contextual and situated in other ways, my proximity to:

• the nursing home;
• the individual's room;
• the individual themselves.
• (and their relatives)

While telecare / informatics can deliver a dividend in remote care, it is essential that it can also demonstrably support person-centred care. The best way (clinically assured) to do that for many activities is person-to-person contact. Just because one-side of the relationship may not recall the encounter as little as five minutes after, does not mean that there is no value in sustaining the ring of the bell, the exchange of s-miles, the record that results and other background conversations.

Image source:
Gestalt - proximity
http://graphicdesign.spokanefalls.edu/tutorials/process/gestaltprinciples/gestaltprinc.htm

Healthy Sleeping Tips With Consumption Foods

What you eat during the night turned out to be a big enough impact on the quality of sleep. You actually can easily get better rest by simply making some changes and added some specific foods that help you sleep.

One thing to remember, you do not need to eat these foods right before bed. Because, this will only make you wake up due to increased blood flow to the digestive system.

Eat these foods an hour or two before you go to bed. This will provide an opportunity for the digestive process so that the effect or efficacy of this food will taste. Here are five types of foods that help you sleep better:

1. Cottage cheese

This type of cheese is the most perfect source of protein for you before bed. This cheese contains casein protein which is absorbed slowly by the body. Casein will distribute amino acids into muscle tissue for several hours after consumption.

In addition, the cheese helps you sleep well because it contains amino acid tryptophan, which is naturally going body converts into two types of hormones that help you sleep, ie melatonin and serotonin.

2. "Oatmeal"

Although most people think of oatmeal is the menu for breakfast, these foods are also useful at night. Because the carbohydrates in oatmeal trigger the release of serotonin in the body. Serotonin is a hormone that makes us comfortable, reduce stress, and makes the mind is more calm.

Because oatmeal is digested more slowly, the selection of food is certainly very appropriate. You do not have to worry about waking at night due to your blood sugar levels soar.

Add apples on the menu with a little cinnamon oatmeal. You can also serve it with skim milk.

3. Peanuts or peanut butter

Other foods that you need to consider to improve the quality of sleep is nuts or natural peanut butter. Nuts are a natural source of niacin, nutrients can also help pelapasan serotonin in the body. Both of these foods do contain fat and calories are slightly higher. Therefore, you must wisely manage the portions. By take it in moderation, both types of these foods can help you find success in diabetes management.

To get the best results, serve peanut butter with whole wheat bread.

4. Warm milk

Drink this one is already legendary in helping you to sleep faster. The reason behind the benefits is the content of tryptophan. For most people, presenting it in the form of hot drink will make the mind more calm and relaxed.

In addition, milk also contains calcium which will help the brain regulate the production of the hormone melatonin, a naturally functioning regulate your sleep cycle every day.

Add honey if you prefer the natural sweetness and that too will add carbohydrates to help release serotonin.

5. Wine

Well, the last meal you need to consider in improving sleep is the wine. This fruit is the only one that contains the hormone melatonin. Therefore, by adding fruit regularly in your fine dining menu, the body attempts to form a sleep-wake cycles in nature will be helpful. As a result, you will be able to sleep more quickly and soundly every night.

How to serve it, you can mix the pieces of grapes in a bowl of yogurt. This menu will be a perfect snack before bed.

The Benefits Beer For Health

Beer is the third most popular beverage in the world after water and tea. This drink is also known to be the oldest drinks and had made long before recorded history. Although beer can be intoxicating but have touted the health benefits.

In the Western countries is a true beer drinker. It was almost no activity that does not involve beer, ranging from watching the football, play cards, get together, get together at the bar, barbecue party, and other special events.

In general, the beer is made from a mixture of water, rice or wheat grains, fruit and yeast. Brewing beer-making process is called. The process begins by soaking wheat seeds to germinate (malted) and then heated to produce the sugars and flavor. Some brewers sometimes use rice or corn and using the extra fruit, herbs and spices to produce a unique flavor.

The next process is to mix the seed sprouts, grains that are not heated in water. The resulting sugars and starch solution and then poured and difermensikan to produce beer. Clarity of the color of beer depends on the level of roasting. The color of dark beer that comes from wheat that baked until slightly darker.

Alcohol content in beer is not so much compared to other liquor, like vodka or whiskey. Alcohol in beer varies between less than 3 percent to 40 percent (by volume) depending on the type and manufacturing techniques.

Make healthy

Although classified as liquor, but various studies show beer, like wine, if consumed in moderate doses can be healthy for the body. Basic ingredients of beer making is a source of carbohydrates, B vitamins and potassium.

"The scientific evidence says alcohol, whatever kind can increase levels of good cholesterol and reduce heart attack risk by 30 percent," said Eric Rimm, ScD, a researcher from Harvard University.

He also said alcohol can improve insulin sensitivity and reduce the risk of diabetes. Because beer also contain high enough fluids, beer consumption also reduces the risk of kidney stones. In small doses of alcohol also can make blood circulation more smoothly.

Even so need to be considered a healthy dose of beer, ie no more than two doses. The recommended dose is 12 ounces (equivalent to 1.5 cups) of beer each day.

"Excessive consumption may eliminate health benefits of beer and increase the risk of liver disease, cancer, cirrhosis, alcoholism and obesity," says Rimm, committee members Dieteray Guidelines 2010.

He also suggested that beer is not consumed by high-calorie foods, including small meals (snacks) that are usually available when watching sporting events or chatting casually.

1st Int. Congress of Nursing Models and Theories: Colombia 24th-25th Feb. 2011

I am delighted to report the news that the

Health Care Domains Model

will feature at this International conference.

In November I received an invitation to be one of the main speakers from the Grupo Gics Investigacion Team; and so next month I will be heading south to Paipa, Boyacá, Colombia.

This prospect would not be possible without the support of the conference organisers - GICS and Prof. Wilson Canon Montanez, Nursing Faculty of the University of Santander UDES (Bucaramanga-Colombia) and my employer Lancashire Care NHS Foundation Trust.

Recently a group of Nursing Faculties of three major Universities in Colombia (Universidad de Santander UDES, Universidad Pedagogica y Tecnologica de Colombia UPTC y Universidad de los Llanos UNILLANOS) have come together to organize the First International Congress of Nursing Models and Theories.

This congress will be held in the city of Paipa-Colombia 24 and 25 of February, 2011:
http://www.uptc.edu.co/eventos/cong_enfermeria/index.html

I very much look forward to this trip for several reasons:

• New people to meet and things to learn.
• This invitation literally puts h2cm on the map (so I must deliver)!
• It is marvellous to see faculty and nurses in Colombia re-invigorating thought about models of nursing.
• I have never travelled this far south - how will Orion look?

This will be a great adventure, but before then - where's my checklist: presentation(s), jab, tabs, passport...

Nursing: magnetic Force 5

Back in 2009 I came across a post - Nurse magnets crucial for recruitment and retention about the 14 Forces of Magnetism:

In 1983, the American Academy of Nursing conducted a survey of 163 hospitals to learn why some hospitals attracted and retained well-qualified nurses who were devoted to quality patient care.

The 14 Forces are listed and described by the ANCC. The forces themselves include:

• Force 1 Quality of Nursing Leadership
• Force 2 Organizational Structure
• Force 3 Management Style
• Force 4 Personnel Policies and Programs
• Force 5 Professional Models of Care
• Force 6 Quality of Care
• Force 7 Quality Improvement
• Force 8 Consultation and Resources
• Force 9 Autonomy
• Force 10 Community and the Hospital
• Force 11 Nurses as Teachers
• Force 12 Image of Nursing
• Force 13 Interdisciplinary Relationships
• Force 14 Professional Development

The professional, organizational, and political (policy) emphasis of the 14 forces is obvious and becomes clear when each is weighed in terms of where it sits within the domains of h2cm.

Try it as an exercise. ...

Recruitment is ALL about magnetism.

If you are unsure, ask a magnet about the meaning of retention.

Demographics are already applying pressure upon these forces of magnetism. Not just when referred to explicitly in the USA within organizational media; but globally. Demographics is another magnet - it approaches with increasing force.

From here in the UK (and readers elsewhere) we have to exercise care when models are mentioned. While the theorists and philosopher's of nursing nail their definitions to the mast (h2cm?) there remains a models muddle, not just in the variety of models of care, but in the levels at which they operate. This is not a criticism, it's an observation - consider Force 5:

Force 5: Professional Models of Care
There are models of care that give nurses the responsibility and authority for the provision of direct patient care. Nurses are accountable for their own practice as well as the coordination of care. The models of care (i.e., primary nursing, case management, family-centered, district, and holistic) provide for the continuity of care across the continuum. The models take into consideration patients’ unique needs and provide skilled nurses and adequate resources to accomplish desired outcomes.

In the US in particular 'models of care' (moc) often refer to finance and accountability of costs (the market process), in the UK moc might refer to commissioning. In Force 5 the addition of 'Professional' (as the original author's no doubt recognized) is crucial. If you repeat the above exercise, plotting Force 5 on the Health Care Domains Model then you see how Force 5 works for nursing and remains to this day a great achievement as a yardstick for quality, assurance and retentive power.

In the almost 30 years since the research on the 14 Forces, I do wonder though if there is a need to imbue the following with magnetic properties:

• person-centred care;
• self-care;
• carers and public engagement;
• prevention;
• public (mental) health
• and informatics?

Yes, many of the above can be assumed to lie within the existing Forces 1-14. Health and social care are not static. Nursing has much to contend with from the level of the individual practitioner through to the group within an organization. The 14 Forces of Magnetism are well established in the USA and deservedly so, they clearly deliver.

In the political and economical heat of an economic recession, however; magnets may reach their particular^* Curie point. Then they cease to work.

The constant bangs and knocks of change, the incessant hammering of party politics and the 'market' on the door of "high quality nursing care" can also take its toll on magnetism.

Nursing needs to take care.

Related post on Healthcare IT News:

Top 10 trends for 2011 include IT, new care models

*OK it should be constant, but like our patients these magnets are not all the same - they have varying levels of vulnerability.

To follow some definitions from an olde book ...

Personal realities and in the media

Ordinarily I would be completely lost in tonight's Horizon - What Is Reality? at 9pm BBC2. I will be watching, but I won't be as lost as I have been.

Today I took a big step forward - sorting 'issues' that will allow me to purchase a new home. I ('we') also resolved the post-marital issue of pensions. This has proved a major reality re-orientation factor since July 2008. There is the old house to sell, but nonetheless real progress.

I am really looking forward to the NW England Drupal meet in Manchester on Friday. That's another reality to immerse oneself in - especially Drupal 7!

ERCIM News #84 - Intelligent and Cognitive Systems

Dear ERCIM News Reader,

ERCIM News No. 84 has just been published at http://ercim-news.ercim.eu/

Special Theme:
"Intelligent and Cognitive Systems"
- coordinated by: Rüdiger Dillmann and Tamim Asfour, Institute for Anthropomatics, Institute of Technology Karlsruhe, and Antonis Argyros, FORTH-ICS

- featuring the keynote "Cognitive Systems and Robotics" in the ICT Programme of the European Commission, by Hans-Georg Stork, European Commission, Information Society and Media Directorate General, Unit E5 “Cognitive Systems,Interaction, Robotics.

Includes on p.20
Long-term Evaluation of a Mobile Remote Presence Robot for the Elderly
by Amedeo Cesta, Gabriella Cortellessa, Lorenza Tiberio

Next issue: April 2011 - Special Theme: "Unconventional Computing Paradigms"

Thank you for your interest in ERCIM News.

Feel free to forward this message to others who might be interested.
Best regards,
Peter Kunz
ERCIM News central editor

Help wanted: Broken links (and help upstairs)

Periodically on W2tQ I highlight the four care domain links pages, e.g.:

http://hodges-model.blogspot.com/2009/06/heroes-wanted-to-slay-monster-or-just.html
http://hodges-model.blogspot.com/2010/02/topicscape-care-domain-links-in-3d-for.html

Simon Phillips emailed me, copied below: (edited removing the actual broken links)
------------------
Peter,

I am writing to notify you of a small issue that I have just found on one of the pages of p-jones.demon.co.uk

http://www.p-jones.demon.co.uk/links.htm

There seems to be a number of broken links on this page. These are the links that I found were not working:

• Nat. MH Info Center Substance Abuse and MH Services Admin. (SAMHSA)
• Systematic Reviews: Centre for Reviews and Dissemination
• Advancing literacy: A review of LIFE 2006–2009 UNESCO
• Wearable Computer Lab
• Keldy Forest

Obviously it is not a particularly great user experience when the links of a website don’t work, which is why I thought I would bring this to your attention. I trust you will be able to fix this issue soon.

Thanks for taking the time to read this email and for creating such a useful website.

Kind regards
Simon Phillips
-----------------

Simon runs a website about stair lifts, which provides information on choosing a stair lift and a comparison table of UK stair lift manufacturers.

In response I've corrected the links. I do check them with some automated tools, but as mentioned since 1998... they have become something of a monster. Considering the total number the vast majority are valid.

Before you all dash to check and get in touch :-) which would be greatly appreciated, please note that I can't necessarily respond to all such contacts in this way - but I can see what I can do ...

Many Thanks Simon!

Spinal Cord Injuries-Treatments-Causes-Pain Relief- Cures

What is Spinal Cord Injury?

The spinal cord is the gateway for all nerve paths; Spinal cord injury (pinched nerves, collapsed vertebrae, herniated discs) is one of the most shocking catastrophic injuries that one can suffer. The location of the injury and the severity of the damage determine the complications involved and the dysfunction. Medical science is discovering that the sooner the spinal cord injury is addressed and treatment begins, there is a direct correlation to recovery of the affected areas.

Most common causes of spinal cord injuries include:

Sport-related injuries, violent assaults, Automobile accidents, Slips, trips, and falls.

Some signs that a person has potentially been badly hurt include:

Paralysis, Loss of reflex, Loss of sensation, Sensitivity to touch, Pain.

Spinal Cord Injuries Treatments Cures:

There is no cure for the spinal cord damage so far. However, after the injury has occurred, treatment will determine the outcome. Therefore, make sure that affected people are taken to special spinal injury hospitals for specialist care. This is really vital to treat all other injuries that might have occurred to other organs. Sometimes, people who are injured might have a short life span due to side conditions caused by the injury.

W2tQ: Wacky races - global health care and stereotypes

Since adding the clustermaps and flag counter I've been following the 'trends' of number of visitors. I'd hoped in summer 2009 I might in 6 months reach 500 daily readers of the feed for W2tQ. That total still eludes me. The flag counter is ongoing and 'scientific methods' aside it is interesting to reflect on progress there.

When I first thought of this post it was to be read to the tune and commentary of 'It's the Wacky Races!' This is not to cock a snoop at the participants, but the tongue-in-cheek nature of this post.

There are no surprises in the clear leader with the US way out in front. In terms of the target audience - everyone is very welcome as the message of this blog: is global. Within the flag counter there are some surprises. This may suggest the universality of English on the web and also the increasing effectiveness of translation tools. Or, people can see - and read - that there is a health, education and informatics currency in h2cm.

Here are the flag counter images from December 2009 (left) and January 2011 (right). In both the US, GB, Canada are out in front. India is right there as Germany puts on the gas. Despite being stuck in the sub 450 range with feedburner, it's great to see the global progress that W2tQ is making. I'm not sure what happened to the 'EU', it was there initially with '15'. It looks like they've punctured or something?

I wonder if to some extent there is the same stereotyping at work within the global health community as between the health and social care disciplines? Not just within some nations - but within local 'multidisciplinary teams'? How aware are we of what other disciplines do? How do they complement our role? How can we increase our combined impact?

Many of the developing countries are now represented as visitors to W2tQ. How well, from Lancashire, UK can I understand their daily ride? What problems are faced by health care workers in this range of nations? What resources do they have to call on - within and without their communities.

I hope this blog* can act as a springboard - not to a race, but to community building and collaboration. We all have much to learn from each other on our respective journeys. As you lean out of your car(e) window, I wonder what you see?

*Or more accurately the Drupal powered site that must follow!

Healthy tips how to hypertension cope with garlic

Efficacy of garlic in preventing various diseases has long been a concern to scientists. Besides as anticancer, garlic was also able to cope with hypertension.

Doctors in Austria recommends garlic in addition to medical drugs for patients with hypertension. They have performed experiments on 50 patients with hypertension to consume garlic supplements, but also keep taking the medicine.

The patients who received four capsules of garlic extract per day have lower blood pressure compared with patients receiving placebo pills (pills with no active ingredient).

Previously, research has also shown that garlic extract effectively lower cholesterol and high blood pressure in hypertension patients are not handled.

"Garlic supplements have long been associated with decreased levels of blood pressure. In this study we tried to see the benefits of garlic extract as an adjunctive therapy in addition to hypertension drugs from doctors," Karin Ried said, garlic researchers.

Nevertheless, the researchers explained that garlic supplements can be consumed only after getting a doctor's advice since garlic can thin the blood and cause interactions with some medical drugs.

Health Alternative: 11 Benefits of Tamarind for Health

Tamarind or Java acid which is known as a spice in the kitchen, turned out to have many benefits for treatment. Pain and rancid odor at the time of menstruation, sore throat or diphtheria, dry cough, ulcers, low blood, thrush, vaginal discharge, and measles are some diseases that can be treatment by tamarind.

This alternative plant from Africa, usually planted as a tree, can reach a height of 25 meters. Leaves finned equally and yellowish flowers. Rod-shaped fruit and seeds with a length of 3.5 to 20 cm and 2.5 cm thick. Soft leather outer shell of brown and flesh fruit taste sour.

The color of tamarind fruit is white and after dark greenish to brown. Fruit flesh is usually used to preserve food, make the syrup, or clean metal goods whose color changed to black. The old flesh is sometimes processed (cooked) for durability.

Due to a blackish color, commonly called kawak acid. Flesh contains a variety of acids, such as tatrat, malate, citrate, succinate, acetate. The tamarind acid is believed to facilitate bowel movement and blood circulation. The leaves contain flavonoids which are anti-inflammatory and pain relief.

According to experts from the Indonesian medicinal plants, leaves of tamarind tree is believed to reduce the heat in and also increase appetite. Also, because it contains tatrat acid, tamarind is believed to be a laxative for those who have difficult bowel movements.

Because it is a gel to absorb liquid, tamarind can also be used to destroy fat. Tamarind can be made as hot drinks. As a variation, tamarind can also be combined with other traditional medicines like ginger, pace, or the other alternative traditional. What is important, see the needs and dosis.

Sour fruit flesh is usually made of jelly, syrup, or candied. Heavy wood core made into fine wood carvings and used as material. Seeds baked or fried, so it can be eaten. The fruit is included in the list of traditional medicines that have been legalized.

And here are the 11 benefits of tamarind for our health:

1. Tamarind concoction. Tamarind Blain kawak (meat cooked fruit acid that has been processed and it is black rather than brown) of five grams, spinach leaves with thorns and leaves kale each 10 grams, a little salt.

The leaves of spinach and kale finely ground, mixed with acid and given a little salt. Stick to the boil until the entire surface is covered with all. When it is dry, replace it again with the new. In this way, in a short time will be ripe and burst ulcer.

2. For sprue. One cup of washed leaves of young tamarind, a piece of thinly sliced turmeric five centimeters. Boil four cups of water until only half. So it was a bit tasty, add the palm sugar when boiling. Filter. Drink every morning and evening. Repeat for several days.

3. Dysmenorrhea. A handful of leaves young acid mixed with two fingers of turmeric and a half cups cooking water, then finely ground. Collision plus enough water then filtered and drunk. b. Acid kawak half thumb, 10 pieces of ginger, palm sugar to taste. The third material was boiled with a glass of water, allow it to be half. Drink every morning, do a row during the week before the coming months.

4. Prevention of high cholesterol. Take 150-200 grams of tamarind leaves, finely crushed. Give a glass (220 ml) hot boiled water. Then strain and drink until gone. Do it three times a day.

5. Lowering infant fever. Kawak acid and turmeric each one's thumb, young leaves of jasmine five pieces, two stalks scallions. After being washed, crushed all ingredients until smooth. Stick it on the crown of the baby.

6. Fever after childbirth. Acid kawak one finger, palm sugar to taste. Acid and palm sugar brewed with hot water in the glass. After a warm drink. Drinking two glasses each one until a few days.

7. Hemorrhoid. Acid kawak one gram, and Meniran leaves nasty shard of each six grams, three grams of ginger. Once cleaned, boiled with a liter of water, allow it to be half. After a cold, drink three times a day.

8. Low blood. Acid kawak five grams, 250 grams spinach, 10 grams palm sugar, red onion 50 grams, 15 grams of chili pepper, salt seven grams. Spinach boiled, not too ripe. All other ingredients pounded together into sauce. Brown rice, spinach, and sauce is used as a lunch meal. Do it every day as a side dish.

9. Diphtheria. Tamarind, radishes, red onion, kencur each of five grams, 10 grams of papaya leaves. Acid addition, all materials were given water and then squeezed ground water. Add acid. Brewed with hot water. Stir until evenly distributed. While still warm, use it to gargle. Do it three times a day.

10. Dysentery. Acid kawak five grams, turmeric and ginger each 10 grams, a tablespoon of pure honey. Kawak acid, turmeric, and ginger pounded together, put one cup of hot water, wring it out, then strain. Pour the honey into the juice and stir well. Taken all at once in the morning.

11. Eczema. Tamarind handful, tubers temu lawak one fruit, one piece of palm sugar. Bulbs ginger pounded, mixed with acid and sugar. Boil in two cups of water until the remaining half. Drink once a day. Do it every other day.

2011... looking ahead: Line of sight - Lines of insight

LINE OF SIGHT:

LINES OF INSIGHT:

Fractal Drum

Image sources:

Wilkinson, F.J., Monkhouse, H. R. (1967). Maps and Diagrams; Their Compilation and Construction [Paperback], Methuen & Co Ltd. Intervisibility, Line of sight. p. 125 [scanned].
(Book purchased in Mevagissey, Cornwall, Hurley Books July 2010)

Fractal drum. Lines of INsight: http://classes.yale.edu/fractals/panorama/ManuFractals/FractalDrums/FractalDrums.html

Health and social care - listen!

Palmar Hyperhidrosis- Treatments, Cures, Botox

Sweating of hands is called Palmar Hyperhidrosis. whereby sweat is excessively secreted out of one’s hands. Other forms of Hyperhidrosis include planter (feet) and facial (face), axillary Hyperhidrosis (underarm). A person suffering from Hyperhidrosis may experience excessive sweating in more than one area of the body.


Signs of Palmar Hyperhidrosis Symptoms:

You experience your hands feeling clammy and perspire more than normal. Sometimes, it results to dripping sweat and it's very irritating when you have to shake somebody's hand.The temperature of your palms compared to your other body parts is outstandingly higher.Your skin seems to peel when you excessively sweat. It's different from scaling but it's more close to exfoliating.
After the excessive sweating of palms, extreme dryness of palms is noticed.

Palmar Hyperhidrosis Treatments Cures:

Yoga, Meditation, weight loss may be used to control.
Iontophoresis is another treatment for Palmar Hyperhidrosis. This technique uses exchange of electrical ions between the skin and a tray of water with electrical current. Ion exchange process causes the skin in your hands and feet to thicken slightly. This process actually helps to block the sweat glands. You will have to immerse your hands and feet in a water tray with electrical charge for this treatment. This treatment has been fairly successful and not costly.
Botox helps reduce or even stop sweaty palms, But the key drawback is that Botox is not a cure, rather more a continuous maintenance procedure with diminishing returns.

ETS or endoscopic thoracic Sympathectomy is a surgical procedure whereby related localized nerves and sweat glands are clipped or burnt to stop sweating. This procedure directly addresses your sweaty palms issue and does stop the sweaty hands sweating. However, the cost of such a surgery could set you back by a good few thousand dollars. Research proves that 100 percent of ETS patients develop compensatory sweating on their underarms, torso, feet and parts of the face. If ETS is meant for eradication of embarrassing sweaty moments, imagine the new frustrations you could face with compensatory sweating.

2010-2011 posts, papers, studies and Drupal

Happy New Year everyone!

2010 saw 211 posts, 183 in 2009. As ever a mix of original material concerning h2cm, conferences and call for papers. Fingers x'd 2011 should run to approx 150 posts as I focus on work, studies and Drupal. The good thing for me is that all three of these can run along together and I intend to forge a union if at all possible.

At work my full-time role is clinical - nursing; Nursing Home Liaison. Increasingly we are finding what nurses on the ground have recognized for a long time. With this job comes an educational role, despite efforts to upscale the skills and knowledge of the residential care / nursing home sectors. H2cm is a gift in these quarters, in prompting and facilitating reflection, holistic and person-centred care.

Studies: On this front I'm trying to identify a research question from a bewildering mix of possibilities. Previously I've referred to the relevance and my interest in conceptual spaces:

Hodges' model: Background - Foreground and the Space Between

The socio-tech and conceptual space papers

Next paper? Conceptual Spaces and Hodges' model

Nursing theory - conceptual spaces: Where's my T-shirt?

Gardenfors' book - a quote and can that be, surely not ...h2cm?

That other 2nd-hand book - 'Conceptual Spaces'

This is definitely a worthwhile focus. I'm making enquiries to try to find a mentor. Strange, or maybe not actually, that I am a nurse mentor and sign-off mentor too and here I am coughing and spluttering in need of a mentor myself to help sort the wheat from the chaff. The 10K words on conceptual spaces is now 13K.

Today is a good day for throwing numbers about, but being short of time I hate wasting it. So I've been revisiting the papers situation. ...

The co-authored h2cm and forensic nursing paper is completed with two revisions, but still needs a home.

I missed an opportunity with the h2cm and substance misuse paper. Trying to complete it in the summer of 2009 before my eye surgery I did not stick to the brief. I'm hoping a new co-author can take the 5K words and help re-frame the content from a practice and service perspective. It really is refreshing to work with other people. I look forward to providing an update here later in the Winter - Spring.

Since this summer and the posts (one and two) about the Journal of Evaluation in Clinical Practice I've drafted a piece on h2cm and medical progress taking an informational perspective. I'm not sure if this will pass muster, but this 5K did not take too long and I enjoyed the process.

As to Drupal - I've hit the wall that has "styling" written all over it. It seems if you start with a basic theme like Zen you are rewarded with an easy to negotiate palette, that is - you do it yourself. With more complete themes you need to read and orientate yourself with somebody else's handiwork. This is the next job and then move to Drupal 7 - released on the 5th.

In October I received an invitation to present at an international nursing conference. I've submitted a presentation and have offered to do a workshop too. This was accepted. It all depends on travel and confirmation of arrangements so we will have to see. If they just wanted support with links they only needed to ask.

More to follow on all the above and wherever you are

may I wish you a very happy, healthy, 

peaceful and prosperous 2011!

To follow: Line of sight, lines of insight ...