Showing posts with label ethics. Show all posts
Showing posts with label ethics. Show all posts

Thursday, February 3, 2011

KT-EQUAL future events - Ageing Research and Design 4 Health Conf.

Dear colleague,

KT-EQUAL is planning lots of interesting events in the next few months focused on aspects of ageing research.

Below are a few upcoming events that may be of interest to you, more information can always be found on our website.

Upcoming workshops include topics such as -
  • digital inclusion
  • ethical dilemmas
  • and creative societies.
A flyer is available with more information about these exciting free events.

The I'dgo consortium has also confirmed the full programme for their seminar on An international perspective on the Built Environment for an Ageing Population: Issues in maintaining access to outdoor places on the 16th February 2011.

Another upcoming conference which is still accepting papers* is the Design for Health Conference in Sheffield Hallam University on the 13th-15th July 2011
http://www.design4health.org.uk/

We look forward to seeing you at some of our events in the future.

Best Wishes

Helen Haigh
KT-EQUAL Co-ordinator
University of Sheffield

PJ adds: *Kirsty Christer at SHU contacted me re. D4H to advise that submissions are open until 7th Feb.

Thursday, December 23, 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).

Friday, December 3, 2010

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

Tuesday, November 9, 2010

Grand Challenges for Global Health: 15th - access to clean, clear, knowledge

Dear HIFA2015 colleagues,

The news item below is forwarded from the Global Health Council, which reports the mHealth Summit taking place this week in washington DC. It is especially good to see that Bill Gates is giving a keynote address. This suggests that the Gates Foundation may be poised to address the 15th Grand Challenge for Global Health, as proposed by international health leaders in The Lancet:
"The Gates Foundation identified fourteen challenges [Grand Challenges for Global Health] but a fifteenth challenge stares us plainly in the face: The 15th challenge is to ensure that everyone in the world can have access to clean, clear, knowledge - a basic human right, and a public health need as important as access to clean, clear, water, and much more easily achievable."
Tikki Pang (WHO), Muir Gray (NHS, UK), and Tim Evans (WHO): 'A 15th grand challenge for global public health.' The Lancet 2006; 367:284-286.
http://www.thelancet.com/journals/lancet/article/PIIS0140673606680501/fulltext

When HIFA2015 was in planning back in 2006, the lead author of the above paper, Dr Tikki Pang (Director of Research policy and Cooperation at WHO) said: 'HIFA2015 is an ambitious goal but it can be achieved if all stakeholders work together'. Bill and Melinda Gates are critical stakeholders. I look forward to see Bill Gates' presentation. Will the Gates Foundation take up the 15th Challenge? Will the Gates Foundation prioritise the challenge of health information for all by 2015?

Bill Gates keynote yesterday is not yet available on the web, but it will be soon at: http://mhealthsummit.org/conference/live-webcast

I hope that Bill Gates will use this opportunity to articulate a clear and specific vision from the Gates Foundation: a vision of a world where people are no longer dying for lack of access to appropriate, reliable healthcare information. With their support, there is no doubt this vision can and will be realised.

With best wishes,
Neil

HIFA2015 profile: Neil Pakenham-Walsh is the coordinator of the HIFA2015 campaign and co-director of the Global Healthcare Information Network. He started his career as a hospital doctor in the UK, and has clinical experience in rural Ecuador and Peru.  For the last 20 years he has been committed to improving the availability of healthcare information for health workers in developing countries. He has worked with the World Health Organization, the Wellcome Trust, Medicine Digest and INASP (International Network for the Availability of Scientific Publications). www.hifa2015.org  neil.pakenham-walsh AT ghi-net.org

My source:  www.hifa2015.org

Sunday, May 23, 2010

63rd World Health Assembly unanimously adopts the WHO global Code of practice on the international recruitment of health personnel

Dear HIFA2015 colleagues,

Please find below a press release from the Global Health Workforce Alliance. In the words of Dr Mubashar Sheikh, GHWA Executive Director: "The world is now a significant step closer to ensuring health workers are available and accessible to all".

WHO/Jess HoffmanPRESS RELEASE: 'Sixty-third World Health Assembly unanimously adopts the WHO global Code of practice on the international recruitment of health personnel. Alliance members and partners applaud Member States. The Alliance 21/05/2010.

[Photo: WHO/Jess Hoffman. Dr Pierre François Unger, State Councillor of the Canton of Geneva, addresses delegates at the opening of the Sixty-third World Health Assembly.]

'Geneva, 21 May 2010 - In a historic move today, the Sixty-third World Health Assembly unanimously passed a resolution to adopt the voluntary WHO global Code of practice on the international recruitment of health personnel. With this step, the world's nations acknowledge the global dimension and complexities of the health workforce crisis and the interconnected nature of both the problems and the solutions.

'With this resolution, Member States commit themselves to the voluntary principles and practices for the ethical international recruitment of health personnel taking into account the responsibilities and rights of source and destination countries, other stakeholders, and those of the migrant health personnel themselves. The Code provides ethical principles applicable to the international recruitment of health personnel in a manner that strengthen the health systems of developing countries.

'A drafting committee was established on the first day of the Assembly and after three days of negotiations, stayed up till 4:30 am on Thursday, 20 May 2010 to seek consensus on a draft resolution that retained the principles and spirit of the Code while also representing a way forward for all countries.

'The draft was unanimously accepted at the tenth session of Committee A late evening on 20 May 2010 and brought long awaited joy and celebration to the many organizations and individuals, campaigners and professionals, institutions and Member States who had been working tirelessly since the last three years to see a meaningful and equitable resolution on the Code be adopted at the World Health Assembly.

'"The process was not always easy, but there was commitment from all Member States to see a resolution adopted. This helped to keep the process moving and the results are there to see" says Alliance Board member, Bjarne Garden, Assistant Director, Global Health and AIDS Department, NORAD, a member of the Norwegian delegation.

'"This brings to fruition the pioneering work seeded by the Alliance three years ago with the creation of the Health Worker Migration Initiative bringing together the Health Worker Migration Global Policy Advisory Council and WHO led team of technical experts. It is the result of the work of multiple stakeholders who have effectively rallied around together. The world is now a significant step closer to ensuring health workers are available and accessible to all", says Dr Mubashar Sheikh, Executive Director, Global Health Workforce Alliance.

'World Health Organization (WHO) has played a key role in coordinating the process. "The Code sets out a roadmap for implementation. Within 2 years WHO will provide guidance to countries on monitoring implementation of the Code, and then report to the Assembly on the progress against implementation. The Code is voluntary, but progress on implementation will be monitored and reviewed" explained Dr Manuel Dayrit, Director, WHO department of Human Resources for Health.

'Health personnel migration has been a clearly identified priority for the Alliance since its inception. During the First Global Forum on Human Resources for Health in March 2008, the Alliance endorsed the Kampala Declaration and Agenda for Global Action, which sparked broad interest in the creation of the Code.

'Progress on the code has been achieved as a result of consultations and discussions, particularly at all six WHO Regional Committees and national consultations, involving participation by a wide range of stakeholder groups. The UN ECOSOC meeting and the G8 Summit in July 2009, and the UN General Assembly in December 2009 had strongly supported and encouraged WHO to move forward in finalizing the draft code of practice. The 126th Session of the WHO Executive Board, January 2010, had discussed a revised draft of the Code and recommended that it be submitted to the 63rd World Health Assembly.

'At this momentous milestone, the Alliance and WHO call upon Member States and all its partners to reinforce its spirit of working together as they now gear up to implementing the code. The Alliance remains committed to facilitating the process and supporting sharing of information among Member States and all stakeholders.'

The Draft Resolution, dated 20 May 2010, is available here:
http://www.who.int/workforcealliance/knowledge/themes/migration/wha_A63_A_Confpaper_11.pdf

Key elements of the draft code (as described in The Lancet, 15 May) are:
  • Establishment of voluntary global standards for ethical international recruitment of health personnel, balancing rights and obligations of source states, destination states, and health personnel.
  • Promotion of coordination of national policies and international cooperation among states and their partners in health professions and civil society.
  • Recommendation that states strive to meet their domestic needs for health services with their own human resources through planning, education, and training for health workforce.
  • Recommendation that states ensure that international migration should have net positive effect on developing countries through technical assistance, support for health personnel training and retention, twinning of health facilities, and specialised technology and skills transfers.
  • Recommendation that states establish voluntary financial mechanisms to support efforts of developing countries to strengthen health systems.
  • Recommendation that states protect rights of migrant health workers through fair labour practices. In all terms of employment and conditions of work, migrant health personnel should enjoy same legal rights and responsibilities as domestically trained health workforce, without discrimination.
  • Recognition that health personnel have ethical responsibilities to cooperate with local authorities in interests of patients, health systems, and society.
  • Recommendation for national data collection and information exchange on health personnel migration, including establishment of national centre for information exchange, expansion and coordination of national research, and periodic reporting to WHO.
  • Promotion of compliance through periodic state reporting to WHA of measures taken to implement the code; and recommendation that WHA periodically reviews the code's implementation with input from non-governmental sources.
Allyn L Taylor & Lawrence O Gostin. International recruitment of health personnel. The Lancet, 375(9727)1673-1675, 15 May 2010
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2960596-X/fulltext?_eventId=login&&version=printerFriendly
(free access after free registration)


My source: HIFA2015 with photo addition

Friday, February 19, 2010

'Problem patients?' 2 - Appease me do (not)

Many of the aspirations of nursing are just that - aspirational.

Appeasement and other similar 'power' associated concepts helps explain some of the appeal of Hodges' model - with its inclusion of a POLITICAL care domain. The needs of the ONE (interpersonal care domain) are diagonally opposed by the needs of the MANY (political care domain).

Just because I may approach someone (*evidently*) abusing medication / alcohol, over-eating, risk taking ... does not mean I am prepared to continue to nurse them and hence support them in that behaviour. Attempts to engage can be made and (must be) documented, as subsequent referrals and care will build on those care encounters. There is a marked difference between those individuals above who are often socially excluded, risk takers and people who are preoccupied with their health and mental health state. (Are such people stuck in the 'sick role?) Such patients may well seek new drugs and then instantly question the medication they are taking, never satisfied, they may query their care record and care while in hospital by virtue of their personality and anxieties.

I can reject negative behaviours and attitudes, but not the person. As a member of the health care team I can explain clear terms for future engagement should the patient wish. At the end of the day we constantly review: do they have mental capacity and to what extent does their behaviour present a risk to themselves, or others...? There is also a role for specific care management to be effected, to screen and prevent people reaching emergency services when this is repeated and unnecessary. The combination of some conditions such as long term respiratory problems and anxiety can create acute management problems, both for the individuals concerned, their family carers and care providers.

People do have choices to make, and so must take responsibility for how they exercise those choices.

Crucially this also needs to be explained to referrers - e.g. general practitioners / family physicians. For effective care management the inclusion of paramedic, crisis, social and intermediate care services in care management communication and coordination is also essential.

So, there is absolutely no need for a "current model of appeasement based care".

(This is a wind-up - surely? If not I am available for career advice.)

Yours truly and the patient's (even if it hurts),

Peter Jones

'Problem patients?' 1

Nurse Philosophy list

Wednesday, February 17, 2010

'Problem patients?' 1 - Wimps and space to care

I responded to a mail list discussion around 'problem patients' which began with the following main points:
  • a relatively new nurse
  • surprise that a significant minority of (my) patients are pathological wimps;
  • even prior to seeing them they can often easily be spotted by examining their medical records;
  • for example, I frequently notice that wimps have an obscene (and often downright odd) amount of special meal requests;
  • current nursing philosophy encourages nurses to be endlessly supportive of wimps. i.e. to follow the often demonstrably wrong idea that "the patient is always right.";
  • IMO nurses who claim they benefit such patients using the current model of appeasement based care are co-dependent personality types who enjoy feeling needed more than they enjoy actually helping people.
My first response is copied below with some additional points a further post will follow:

Patients are always a challenge in that they come in lots of 'varieties'. This is why we recognise the need for individualised, person-centred care. One variety is physical trauma laden to which the full-complement of the multidisciplinary team must respond. These patients and *their* crises bring out the best in us in terms of the skills and knowledge, team work they force us to exercise.

Among the plethora of other varieties there are those who are viewed as 'problems'. Like the Pepsi ad of decades ago they are variously and pejoratively described as -

multiattendin, attentionseekin, patiencesappin, bedblockin,
buzzabuzz-buzzin, heartsinkin, timewastin,
symptomfindin, carenumbin

....
patients!

If I receive referral information or heads up information on diagnosis of a 'tci' (to come in) that suggests the above is on the way, has arrived or worse "is on your caseload" - what do I do?
  • Brace myself for impact?
  • Go off sick (suffering loss of job satisfaction)?
  • Become purely task or disease focussed, give up on effecting +ve change and improved outcome?
  • Share collective anecdotes in the office - staff changing as a way to cope, de-stress, inject some humour?
OR do I -
  • Avoid labelling them, or use these labels in a re-constructive way?
  • Ask why are they 'who' they are?
  • Gaze into their 'life history' and help them learn from it?
  • Refuse to make gross assumptions, even based on previous experience with client - patient?
  • Look at the individual wholistically - socially, educationally, behaviourally?
  • Believe you can still make a difference (be the fly-half you can be and play ball)?
  • Side step being tripped by foibles, behaviours and blatant displays of -ve obstructive ...... attitude that offend 'me'?
  • Enter their space and do my utmost to find room for manoeuvre (this is the hardest test)?
  • Speak to my manager(s) very tersely about protecting 'me' as a scarce resource and shout "OK where the hell is the gate keeper!"
  • Or, as a nurse do you boldly go and seek out new strengths and new opportunities in the same way that Kirk, McCoy, Spock et al. (2264) go and seek New Life, New Civilizations...?
You may have an impossible lock to pick (in its most severe form this has become known as 'personality disorder'), but the nursing challenge is there in all its personal and professional glory. Address this personal - under-the-skin - slant - seek supervision. Be aware of the pit that some people fall into. The trap for some people with life chances they may have completely:

missed, never had, were stolen, denied,
took for granted, spurned,
totally - wasted.

Around the pit is the zone of judgement, but beware it is a singularity (no perspective) and very slippery.
  • Otherwise go do your job: Nurse.
Nurse Philosophy list

Reference:

Kirk, McCoy, Spock et al. (2264) The Caring Imperative, To Boldly Go..., Four Quadrant Galactic Care Journal, Integrated Galactic Care Publishing Inc. itess-cube: 1701u-care4mesafelyandnicely

Monday, February 1, 2010

Sir Terry Pratchett: 34th Richard Dimbleby Lecture - Shaking Hands with Death

Terry Pratchett The Guardian

I watched Sir Terry Pratchett's Richard Dimbleby Lecture (I am not yet sure if this will be available on iPlayer?). The issues are already well recognised, much debated and provide a constant tap on the shoulder for us all:

Although the poll numbers are small
there is a definite shift afoot.

From the BBC:

One of the world's most popular authors gives the 34th Richard Dimbleby Lecture from the Royal College of Physicians in London.

Sir Terry Pratchett announced in 2007 that he had been diagnosed with a rare form of early-onset Alzheimer's disease. In his keynote lecture, Shaking Hands with Death, he explores how modern society, confronted with an increasingly older population, many of whom will suffer from incurable illnesses, needs to redefine how it deals with death.

The acclaimed creator of the bestselling Discworld series, he is the first novelist to give the Richard Dimbleby Lecture. His books have sold more than 65 million copies and have been translated into 37 languages.

<->

I realised in listening to Sir Terry that although I usually apply socio-technical in an informatics context, the term is of course equally applicable to the debate surrounding assisted suicide, or assisted death as Sir Terry prefers to call it. The quality of (our social) life is lost in the beep, buzz, hum and scan of hyper-technical health care.

It is as if the technology of health care is producing relativistic effects. Instead of the travellers being explorers heading for stars at near the speed of light; they are travellers cast adrift within a long term chronic disease that cuts them off from time, place, person, those they love and - for Sir Terry - choice. ...

This debate will run on ...

Photo source: The Guardian

Thursday, August 27, 2009

Basic Nursing Care @ the X-roads?

Basic nursing care:

It sounds straight forward enough doesn't it?

And yet according to news today here in the UK (The Independent) some nurses it seems fail to deliver safe, effective and efficient care of the required standard. This sorry news was reported by The Patients Association. The cases cited are upsetting and represent the care and behaviour of a minority of nurses, although there was a debate as to the 'true' numbers the report findings may represent.

The worrying point here though is this highlights not just a lack of basic nursing skills and knowledge, but a blatant disregard for the needs of vulnerable individuals and a sense of humanity. Even with NVQ's in the UK and equivalent programmes elsewhere when it comes to high standards of care we can take nothing for granted.

A commentator on the radio asked if the nursing profession is at a crossroads?
It is.
This crossroads is also a target that nursing must hit -
not most of the time -
but every time and for every person.


In truth of course, all professionals should constantly find themselves at the crossroads.

So, where next for nursing and who has the map?

Original image source:
http://www.thesignlady.net/signs/images/warningsigns/W2-118X18CrossRoad.jpg

Saturday, January 31, 2009

(Confidential) Letter to self - and you, and you, and you... ?

Hi PJ,

I'm wondering if you can help with something that's been troubling me a bit...?

You know that as a nurse (and future patient!) confidentiality (which increasingly relies on the security of ICT systems) is of course vital to your profession and professionalism both in theory and practice. Quite rightly take this for granted and you could be in serious trouble, with your job in jeopardy.

I’ve been wondering about the way that Jo-public views their personal health information and clinical record and how these views have evolved over the past decade and how they will change in the next 5, 10 .... years? A change that will have major implications for definitions and the meanings of record, access, sharing, personalised, and professional. This is also one of those slippery slopes; since it will be very difficult to get that emerging genie back in the bottle. The clinical record even with new consent models will increasingly make it a currency for exchange within a *wider* community given the rise of electronic and personal health records, Health 2.0, 3.0…. By 'community' I mean one not just restricted to health and social care organizations, but one that could be much more extensive.

There are a lot of tools out there in the public domain that enable the creation of new portals, services to which other agencies can add value. This is not a problem: 'value-added services' is one definition of progress.

The problem is the pace of change and the extent.


Health has always been commodified. Recently on the news I heard that a kidney is probably worth 1.5 million dollars.

Perhaps for the ‘professions’ given the sanctity of clinical records this is the
ultimate trip?

Any thoughts or directions to references…?

Many thanks and best regards,

'Your other half'
P.S. People had better be careful when they mix personalised and professional - that's quite a potent concoction. I wonder if you can sell it?

<->

Additional links / reading:

Nursing & Midwifery Council - Standards

Viewpoint Paper

A Research Agenda for Personal Health Records (PHRs)
David C. Kaelber, Ashish K. Jha, Douglas Johnston, Blackford Middleton and David W. Bates
Journal of the American Medical Informatics Association, Volume 15, Issue 6, November-December 2008, Pages 729-736.

Abstract:

Patients, policymakers, providers, payers, employers, and others have increasing interest in using personal health records (PHRs) to improve healthcare costs, quality, and efficiency. While organizations now invest millions of dollars in PHRs, the best PHR architectures, value propositions, and descriptions are not universally agreed upon. Despite widespread interest and activity, little PHR research has been done to date, and targeted research investment in PHRs appears inadequate. The authors reviewed the existing PHR specific literature (100 articles) and divided the articles into seven categories, of which four in particular— evaluation of PHR functions, adoption and attitudes of healthcare providers and patients towards PHRs, PHR related privacy and security, and PHR architecture—present important research opportunities. We also briefly discuss other research related to PHRs, PHR research funding sources, and PHR business models. We believe that additional PHR research can increase the likelihood that future PHR system deployments will beneficially impact healthcare costs, quality, and efficiency.


From the above:

Markle Foundation http://www.markle.org

Robert Wood Johnson Foundation http://www.rwjf.org


Considering something ‘ELSE’: Ethical, legal and socio-economic factors in medical imaging and medical informatics
Penny Duquenoy, Carlisle George, Anthony Solomonides
Computer Methods and Programs in Biomedicine, Volume 92, Issue 3, December 2008, Pages 227-237.

Abstract:
The focus on the use of existing and new technologies to facilitate advances in medical imaging and medical informatics (MIMI) is often directed to the technical capabilities and possibilities that these technologies bring. The technologies, though, in acting as a mediating agent alter the dynamics and context of information delivery in subtle ways. While these changes bring benefits in more efficient information transfer and offer the potential of better healthcare, they also disrupt traditional processes and practices which have been formulated for a different setting. The governance processes that underpin core ethical principles, such as patient confidentiality and informed consent, may no longer be appropriate in a new technological context. Therefore, in addition to discussing new methodologies, techniques and applications, there is need for a discussion of ethical, legal and socio-economic (ELSE) issues surrounding the use and application of technologies in MIMI. Consideration of these issues is especially important for the area of medical informatics which after all exists to support patients, healthcare practitioners and inform science. This paper brings to light some important ethical, legal and socio-economic issues related to MIMI with the aim of furthering an interdisciplinary approach to the increasing use of Information and Communication Technologies (ICT) in healthcare.

Situation-Based Access Control: Privacy management via modeling of patient data access scenarios
Mor Peleg, Dizza Beimel, Dov Dori, Yaron Denekamp
Journal of Biomedical Informatics, Volume 41, Issue 6, December 2008, Pages 1028-1040.

Abstract:
Access control is a central problem in privacy management. A common practice in controlling access to sensitive data, such as electronic health records (EHRs), is Role-Based Access Control (RBAC). RBAC is limited as it does not account for the circumstances under which access to sensitive data is requested. Following a qualitative study that elicited access scenarios, we used Object-Process Methodology to structure the scenarios and conceive a Situation-Based Access Control (SitBAC) model. SitBAC is a conceptual model, which defines scenarios where patient’s data access is permitted or denied. The main concept underlying this model is the Situation Schema, which is a pattern consisting of the entities Data-Requestor, Patient, EHR, Access Task, Legal-Authorization, and Response, along with their properties and relations. The various data access scenarios are expressed via Situation Instances. While we focus on the medical domain, the model is generic and can be adapted to other domains.


Patient Information Advisory Group - PIAG: http://www.advisorybodies.doh.gov.uk/piag/

Picker Inst. http://www.pickereurope.org/

Tuesday, January 27, 2009

Book review: Gary Hall's "Digitize This Book!" (DTB)

Book cover imageFollowing reviews of two IT books Gary Hall's "DIGITIZE THIS BOOK!: The Politics of New Media, or Why We Need Open Access Now" (DTB) has proved a change and a challenge. While I am familiar with new media - growing up with it as a webmaster and blogger, (as a community mental health nurse) I am not exactly well read in this subject; hence my inability to summarise and the length of this review. I have read Lessig's The Future of Ideas and related texts which prompted my requesting the book from the publisher. In this review I make several references to Hodges model. I make no apologies for the same as this is my nascent open access project of the past decade and experiences there have informed this review.

There is an irony here in that Hall for me is acting as an introductory reader; in the introduction Hall bemoans the state of academic publishing, amid the internal market, increased student numbers, students as customers (where have I heard that before?), the rise of corporatization in academic publishing with its emphasis on introductory texts and regurgitated works.

The effects of change over the past few decades means short term employment for many staff, changes in disciplinary emphasis, the concentration of research. As a result Hall states there is a lack of original and challenging ideas and thinking, fewer avenues for researchers starting out on their careers. The advent of open access also highlights the cost of books and journals, which in turn affects the range and number of copies acquired by academic libraries for faculty and students.

Hall poses several questions beginning with: what kind of university is desirable, or even possible in the age of digital reproduction? A thorough set of notes permeate the text, with for example, Hall qualifying his use of university, or universities and much more. Hall believes that universities are places worth defending - as places of dissent: an ongoing consequence of the centrality of knowledge, information and communication in political struggle. I have an additional interest in what Hall has to say as (what I believe is) an independent scholar.

Hall's initial question and his own career in the humanities prompts discussion throughout the book on the status of cultural studies. From the factory as the site of struggle, to the university as a key space of conflict around the ownership of knowledge p.5. Hall backs up his concerns with references and figures, (one book across eight campuses) which given the pace of change might well benefit from being in digital form themselves. Flexibility is a much sought quality, and in publishing the ability to publish chapters and full books helps nourish new academic careers, creativity and innovation. Citations and academic tenure go pen-in-hand so this particular market is a delicate one; intellectual impoverishment is a high price to pay.

Papercentric publishing is contrasted by Hall with developments in music publishing, peer-to-peer networks; the impact of Google's Book Search and the fact that a book must be published before it becomes part of Google's project. Hall explains the rise of existing open access archives and limits his book to open access and archives. Hall shakes up the paper format a little by alternating his five chapters with four servings of metadata. These provide keywords, web links, and very helpful bridging discussion.

The open access debate has been ongoing for quite sometime, and not just regarding books and journals but data, especially geographic data - as per The Guardian's 'free our data' campaign. Hall's focus is clear (and repeated) throughout the book with the key questions:
  1. Knowledge and its authority and legitimacy and how it is affected by digitization.
  2. There has been little research on the potential impact of digital reproduction, publication and archiving; either on, or by cultural studies as distinct from digital culture. p.12-13.
For newcomers to cultural studies and new media the book is not exactly light reading, as already suggested above. Hall explores the basis for current and future theory and how the debate rests with recourse to:
  1. The intersection of philosophy and literature, key thinkers Husserl, Levinas, Derrida and the importance of ethics and "other".
  2. Deconstruction and what politics is and is not.
  3. Derrida and the need to think about the university, notably the authority and legitimacy of the contemporary institution.
  4. Analysis of ethics and politics.
Hall points to a crisis of confidence within cultural studies and it is the word within that is significant here. There is cultural studies as a discipline within the university and hegemonic links to social movements, struggles, forces, and scope for radicalism. There's a sense of cultural studies finding a minima, tantamount to a comfort zone where key targets worthy of research - including - cultural studies within the university - are passed over. I also pick up a sense of embarrassment (or at least a negative association), since being political is to be left wing. (I wondered about this when I added an 'Activism' listing to the 'Political' links page on Hodges model - as if activism is tainted.) Hall repeatedly states that the last question in discussions on politics - is politics.

In Metadata I discussion turns to capitalism, including hypercapitalism citing Graham (2002) and how the boundaries between production, consumption and circulation have become dissolved as new media pervades day-to-day existence on conceptual, physical and temporal levels p.21. Amongst several authors Hall relies upon are Poster, Hardt and Negri and their thought on biopolitical production involving ideas, images, affects and relationships with consumers as units of production themselves p.24. A point I must follow up.

The next aspect that Hall addresses I am familiar with at least within health and informatics contexts (including and especially the combined form): this is dichotomy - theory vs. practice. Accounts of digital media are discussed by Hall insofar as 215 pages plus copious notes allows. Included then is the digital dialectic Lunenfeld (2001) real-ideal; body-machine; medium-message; world-screen; the central dialectic being theory and practice. Readers conversant with cultural studies will get much more from Hall as with Lovinck's, practice-driven internet theory and his Dark Fibre (2003). Derrida is referenced unsurprisingly throughout DTB. A recurring theme is the philosopher's focus on the general and the cultural analyst's attending to the particular. Hall states the book is not a "case study". (In light of the issues at hand the question of what constitutes a case study might be an interesting debate?)

So, there are many conundrums here. In many respects cultural media tied so inextricably to technology is dynamic - constantly variable - with its white heat, bleeding and leading edges. ... Strange then, that as Hall observes it seems the use of new media prevents something from really happening in terms of our understanding of theory and practice p.30. Hall returns to his agenda since there are many other forms of engaging in new media; we need to be able to "do" both theory and practice and to what extent Hall asks - can we create a political institution using Homesite, PhotoShop, VBScript and Javascript?

For me there is quite a chasm between open access archive and political institutions - especially the institution as per the university. There is a whole minutia of detail behind Hall's argument here that begs further reading and is ably teased by Hall in the references and metadata sections. I struggle with seeing an open access service or archive as a new institution, but Hall's point (and his referents) is that these OA resources can act as agents of change.

Hall touches on the indications borne from Napster, the change in the CD-music industry and the rise of mp3. Can there be an academic Napster? One key point I learned c/o Gary Hall is the Harnard / Oppenheim pre-print corrigenda strategy, (this must be in Lessig) which enables authors to both publish in the standard (paid for) journals and books, but also post their work without penalty in open access repositories. Whilst reading DTB I contacted a global publisher and without addressing the copyright agreement I enquired about my submitting a published book chapter to an OAA such as Hall and Green's Culture Machine? I am pursuing this, with another chapter to be published this spring: so Hall for me is a mix of theory and practice no less.

For chapter 2 in my notes I read "letting go". For Hall there is a need to move beyond the pre-digital preoccupations and re-evaluate how publishing research is valued and accorded worthiness. Hall describes the change in the notion of 'professional' in media as paper takes on, or tries to synchronize with the web for publishing. How is the production of words changed? The editing process and editorial boards p. 63? What can we learn from Lev Manovich now that the database is the new symbolic form of the computer age? The rise of blogs and their status - influence debated as with wikis, anonymous contributions 'academic blogs'. Again this was of personal relevance as I blog and as the French philosopher Michel Serres has highlighted the Internet will provide opportunities for many outside of conventional 'academia'. Perhaps, I am therefore as an independent scholar - an academic of our times?

The previous stability - as evinced in place and time - in publishing has been thrown into chaos (quite explicitly in that non-linear sense). Hall reveals many examples such as text being replaced by Flash and how computer code has become art. The destabalizing effect of all this is to raise the question of quality control. In order to measure something though language is critical and so the need for a new grammar, a new language is needed. This discussion (p.67) reminded me of Michel Serres use of the Parasite as a trope. An uninvited guest at the table who can nonetheless contribute to positive change. This is new media. There is no escape from the need to 'sort, reject, eject or exclude.' New forms of peer review exist - Psycoloquy (archives on the web) and others are emerging; new approaches have also been tried by long established and venerable paper publications - Nature - no less p.67.

Derrida continues to frame the discussion on authority (Foucault is here too) to the extent that we have always been digital. Judgement and decision making (a binary - dichotomous operation) cannot be evaded in publishing. The problem is the mode of performance from rules, procedures, standards and criteria from the paper world to the digital. Here are two key quotes for me:
It is not a matter of electronic publishing simply being different from paper publishing, in a manner akin to the way that many people have pointed out that to teach online you need to do more than merely put your course materials on the Web, experiment with "course casting" - using webcasting and podcasting to record lectures as audio or video files and then make them available to students to download on to their computers or iPods - or hold seminars in Second Life. page 70.
Digital mode of reproduction raises fundamental questions for what scholarly publishing (and teaching) actually is .... page 7o.
For Hall - academic authority (the power to 'sort, reject, eject or exclude') is already digitized; that is in a sense always already in a similar condition to that which is brought about by digitization.

A seminal influence for Hall (and others judgeing from a brief literature review) is Samuel Weber. Amongst his texts is Institution and Interpretation (1987). If I am reading this correctly Weber's forte is the process and hence permanence of the institution. Institutionalization is taken for granted as something we have to describe, rather than as a process to be understood p.71. Weber is a key source for Hall for re-thinking the university. The institution has differentiated itself from what lies outside p.73. A knowledge of academic speak and the cultural studies dialect in particular helps here. I was looking up some of these terms - a problem (elsewhere) frequently being the consistency in their application. As a would-be pantologist, I appreciated Hall's moving to disciplinarity. A discipline cannot found itself. Enter then the politics of the university, the curriculum, accreditation and the power of university departments. Key to the university is the professionalist paradigm of knowledge - the absolute autonomy of the individual discipline and absolute economy. How does finance, culture and effort equate to paper publishing and e-forms of publishing? p. 78. I have followed the World Social Forum for many years maintaining links to the conferences on the political links resource. Hall purposefully plays on the title with the adage 'Another Cultural Studies is Possible'. P.78

In metadata II 'Print This!' Hall calls upon Benjamin (1973), Readings (1994) and Derrida (1996) since research is needed not only in the process of access, communication, exchanging, classification, storing and retrieving - but change in the very content and nature of that knowledge. Existing disciplines (digital media studies!) fall short. Something else beyond the recognised, legitimate, pre-constructed and disciplinary forms of knowledge is needed. Hall argues (more than once) that new conceptual frameworks are needed. Given that Hodges' model is a conceptual framework, this is a debate I wish I could pick up and wholly pursue.

Chapter 3 takes us to how to build an ethical institution with mention of existing projects: OSI, SHERPA, SPARC, DOAR. Another concept is introduced here 'iterability' - Weber's "it" and Derrida through significance, event, and context. In short, writing is iterable. We must be able to recognise something in order to work with unknowns p.88. There is a quote from Weber (page 93) that prompts me to re-join the library. Misunderstanding, hallucination and illusion are important in the transformation from familiar to unfamiliar p.94. Hall acts as his own critic. He asks - is this a proper analysis? He reflects on whether he really has built an open access archive? In a section entitled 'apprehension and anxiety' we are reminded that apprehend also means 'stop' and the presence of danger - the exception p.98.
For in even asking contributors to identify themselves and their research by title, author, publication date, subject area, abstract, keywords, and so forth we are not being open to the other but are asking them, demanding of them, that they conform to certain pre-established rules, laws, and criteria. page 101.
One of the excuses I have called upon in delaying the creation of a new - more dynamic - website, is that I am not sure about what content types to provide in the first instance and how much information to expect of the ''user' community'. I do realise that without structure there is no order.

In chapter 4 Derridean ethics is referred to but not in the moral philosopher's sense, but:
as an obligation towards the incalculable alterity of the other who renders me responsible and who calls me to question. page 105.
Here, ethics is political and Hall explores three approaches to open access:
  1. The liberal democratizing approach; (CODATA)
  2. The renewed public sphere approach - overcoming passivity;
  3. The gift economy - supplemental or rival to capitalism.
One important concept mentioned by Hall that I know of through Lessig is non-rivalrous. Hall refers to Richard Barbrook and the academic gift economy. These three approaches frame discussion of what it is to be political on the Internet and politicality - the need to remediate politics p.113. Again Hall brings in the fact that critics and researchers of new media are using pre-established frameworks of knowledge and methods of analysis. I must check on the 'transcendental' aspects of this. Once again Hall refers to Derrida in this past - future dichotomised debate; the future being understood in terms of frameworks of the old.

There are some key issues here around socio-techno-politics, in which several commentators feature: Douglas Kellner and Richard Kohn (techno-politics), Dean (2005) and politics as the circulation of content on the Internet and as the activity of officials. The Internet is described as a technical fetish - a screen projector. Much of what is assumed of the Internet as fertile ground for citizenry - a World Parliament - is illusory p.123. Hall asks - how do we frame the debate? Four perspectives are recounted:
  1. Democracy
  2. Dichotomy
  3. Dichotomy (take II)
  4. Digital dialectic
Tactical media looms large, suitably placed in the latter half of the book. Garcia and Lovink provide a seminal definition. Hall is interested in employing new media tactically p.126-127.

I arrived at the operational, tactical and strategic dialogue through information systems and readings in health care management. I have championed Hodges' model as an excellent tool because it can readily frame these and other aspects of the socio-technical debate. The incorporation into the model of a political domain makes it a tool well suited for Hall's purposes too. Once again on p.134 there is a call for conceptual frameworks. Granularity appears to be a difficulty as there is talk of strategy and the tactical, but not operations? For me tactics are intermediate. No doubt I need to read more, but is research not needed on how the miniaturized, technical, personalised, tools that people are adopting, customising, and using are 'operationalised'? How has the mobilization of new media in form and person (individualised, integrated, ubiquitous) affected the operational and hence tactical potential of new media? Amongst these applications and purposes that are deployed onto the market which are 'political' - directly or indirectly?

There is an abundance of theories to follow - the hegemonic and counterhegemonic struggle, neo-Gramscian theory, anti-political moralism (Wendy Brown) plus questions about moralism and what that may say about politics - by way of analytic impotence and political aimlessness p.144. The political terrain is mentioned, comforting as I like to try to think topographically. This part of the political domain is rather uncertain territory - which made Hall's book a challenging and enjoyable read. The rise of New Labour, Conservatism, social democracy, neoliberalism and the Iraq war protest help to reassure, illuminating the landscape. Hall highlights the need to explore politics as official policy and as the communications interactions of the public sphere.

A key argument here is that despite the protests and use of the Internet to mobilise the public, the technology fetish also functions as a means to disavow and conceal this political disempowerment or castration - Dean (2005). So, Internet politics comes out unfavourably when contrasted with other counterhegemonic forms of political struggle p.147. The tussle here is framed as between Dean and Grossberg. A further handhold for me is provided with Dean stressing the importance of context, temporal frames of reference p.148. Hodges' model can function in this way, recording conceptual snapshots across four domains of knowledge that includes the political (and collectively the 'spiritual'). Right on queue the problem of old frameworks of knowledge rears its head yet again. The concept of 'politics' creates a problem, in that there are no true 'exemplars'. One exception is raised: Marc Poster (1997) versus the work of Sherry Turkle 'Life On the Screen' (1996). Poster focuses on the Internet as a form of public sphere of which more is to follow.

Metadata III reminds us that (throughout the book) Hall stresses the need to act tactically. National statistics have been superceded by data that is complex, and yet fluid. The turn to 'power' brings in Foucault and 'heterotopia'; old and new forms of media and the differences and specificity of those new forms. I read DTB through the news of terrorism in Mumbai and became aware of government's ability to control the media - new and old - by essentially 'pulling the plug'. In this respect the Internet is posited as being (positively) 'subversive' bringing about political change and yet it can be subverted itself.

'Reward' is a key external motivator for (the) many and for Hall open access publishing differs from music and copyright in that it can work. The 'market' is different. We are told that the open access movement is neither unified or self-identical. This is a fascinating discussion as there are various performances of digital media and each has a potentiality to transform. Two important concepts lie in the singular and the 'singularity' and evident in the comprehensive index. For me a call to read further and extend. How will a new regime of digital culture emerge? (Is this to say that in being recognizable, it will be predictable; or will it emerge and as it emerges - be revealed?) p.157.

As already noted, Hall views an archive as an institution. On page 160 "an archive is not a neutral institution...". I wonder how the archiving of things 'digital' itself affects digital media? It has been stressed since the late 1970s and earlier that a great deal of digital heritage (yesterdays 'new' media) stands in danger of being lost, often but for the initial work of individuals and now agencies set to preserve the hardware and the media formats they support. The blue-ray discs of today will be the jaded drinks mats of tomorrow, as solid-state and holographic storage media take over.

Hall recounts briefly (but effectively) the history of books and how the early history was plagued with problems, until conventions emerged such as author, mass printing techniques, multiple copy editions, copyright, publishers, proof readers. Eventually books were "fixed". Digital media are still 'suspect' in terms of their authority and legitimacy (WikiPedia is a case in point). What is included? What is excluded? Who decides? I have experienced the politics of WikiPedia myself. What is fascinating for the future and current status of open access is how long it has taken the (until recently) papercentric publishing of medicine and health care to formulate and achieve 'gold' standards in publishing. Here the currency of our time is evidence-based medicine (health, nursing...) and open access aspirations are not lost in this global (health) politico-scientific world. Is there as Hall suggests a green standard of open access self-archiving and a gold standard of open access journal?

Hall seeks clarity in existing definitions of journal and archive, and what are considered the properties of digital archives (positive and negative) p.164. New forms of media are described as 'fragmented'. I'm struck by this thinking of holograms and how when shattered the pieces can still represent the whole. There is undoubtedly much more to follow from this seam of thought and discourse. Hall also writes on how cultural studies prides itself on its interdisciplinary approach and yet (the notion) of interdisciplinarity sustains the identity and limits of disciplines. Ultimately, Hall explains disciplines are more or less violently excluded, paper-world rules are applied and render disciplines (theory and practice) as legitimate or non-legitimate.

Chapter 5: hypercyberdemocracy focuses on Poster's essay 'Cyberdemocracy' with Hall advocating Poster as a means to proceed p.167. Discussion is also informed by reference to technopolitics and the work of Kahn and Kellner; who want to make technopolitics as a major instrument of political action. Garcia and Lovink seek a qualified form of humanism; a useful antidote to both the unopposed rule of money over human beings ... also all forms of technological determinism should be condemned. Technology is designed: it can be criticised, altered, undermined, mutated and, at times ignored p.169. The critical - 'user' perspectives on technology are familiar in the health care setting, with several generations of clinical (nursing) information systems that have now variously evolved into the personal health record and summary care record and seen the creation of a 'common user interface'. Suppliers know now they cannot afford to ignore usability and 'human-factors'.

The next point that spoke for me concerned a shift from emphasis on representation in there own right, and the uses of representations. This made me want to consider the discussion from within cognitive science - a very heavy user of computer based representations. We return to tactics with the question of our use of texts and artefacts as consumers. There is an interesting and illustrative analogy employed to shed light on what the Internet is. We learn that there is no simple distinction between technology and its users. Mention is made of herds, swarms and flocks, but I felt this deserved more detail possibly benefiting from references to the non-linear in cultural studies. Perhaps this is as yet limited? This seems worthy of a further book seeking sources beyond the usual cadre of commentators?

Poster's essay matters for Hall as the Internet raises questions about our traditional notions of 1) Politics; 2) Citizenship; and 3) the Public sphere. Figures on CCTV in the UK loom large here, and how the home - the most private of spaces - is the most connected. The Internet is often thought of as a heterogeneous environment, but for most users it has its mega sites with nether regions that are visited rarely even though (qualitatively) deserving of attention. Habermas writes of the Internet as a political domain p.174. For the unfamiliar, there are other intriguing angles to pursue that include - Stiegler's originary technicity and Derrida's techno-logical condition.

Following several 'World Parliament' and 'global citizenry' websites and mail lists, I identified quite readily with Poster's idea that we need to be open to the possibility of a form of politics that is something other than democracy p.179. This refers back to Hall's choice of subtitle in 'Another University is Possible', a play on the slogan of the World Social Forum. This particular debate is even more relevant as the question now one of 'new' economics not just politics (or in combination their collective governance).

Hall closes with 'hypercyberdemocracy' and states that the search for a politics that is absolutely new is of course a lost cause. Hall demonstrates this through the work of Derrida and Weber. Key though is the need to challenge the old definitions of politics, customarily associated with the state, society, power, the common good. Poster claims that there is no adequate post-modern theory of politics. Is this the case? Hall believes there are theories based on Heideggerian flavoured deconstruction of Phillip Laccouse-Labarthe and Jean-Luc Nancy, Ernst Laclau. Poster's idea of politics is of something raised to a transcendent position, where what it means to be political is already given and agreed upon a priori p.183.

In summary, the Capital vs. the Commons is revisited. The commons is 'abstract labour' as per Paul Virno and Antonio Negri: capitalism is needed to create the commons. Hall lists conditions that allow for the creation of a commons p.192. For Terranova, Barbrook is too optomistic about the hi-tech gift economy; seeing the Internet as both a gift economy and an advanced capitalist economy. As per health and education: how do you measure? Hall reviews the political potential of several thinkers. This for me is complex reading: Does Terranova repeat the dialectic as per Lovink and tactical media? Or does it enable her to think the relation is a more subtle Foucault / Deleuze and Guattari inspired non-dialectic fashion? There are other possible ways forward including Laclau and Mouffe's neo-Gramscian theory of hegemony; the philosophy of Foucault, Deleuze and Guattari or Derrida, or the Italian Autonomist Marxism of Negri, Lazzarato and Virno p.195.

While Hall regards Poster's work as significant and a signpost - in the end (my reading at least) he feels Poster is asking the wrong question. Wrong because of 1) what are identified by Poster as modern understanding of politics; 2) this modern understanding of politics may be what the Internet resists and reinvents; and 3) the wrong question because any such new framework may only be intelligible if a framework is adopted that does not limit the discipline from the outset to modern perspectives of interpretation. I am surprised in reading Hall that there are no more 'recent' commentators directing thought in this field. Can cultural studies be hung by its own petard so to speak? It has the ability (prides itself on its ability) to criticise everything, perhaps this is why there is a crisis regards the politics and for me the temporal metrics - the pace of change. The surprise is acute when you consider the temporal differences that are said muted (the 'Internet Year') to operate in this field, or is this a myth? Perhaps this is yet another variable that must be factored in?

Hall has made me hungry to read more and browse less. I've learned a lot and am still learning. He's forced me to think and re-view and that is a very good thing. I realised some ten years ago that 'democracy' is a very loose term - there are many forms - and with that perhaps a new word is needed? OA may be a key ingredient of a gift economy, but as Hall states it does not follow that OA is democratic always and everywhere. For Hall there is a vacancy that calls for a philosophy of open access. I am not sure of the status and credentials of Harnod, Guedon, Suber and Willinsky et. al., but I would really like to think that there is a role here for independent scholars too?

There is a really strange paradox in the West at present and it concerns our fixation on that point called the individual. Governments and government departments are obsessed with personalisation, the need to engage the citizen by making budgets available to individuals in health, social care and education. Services in the UK have changed greatly in the past twenty years, NHS Direct, mobile phones, the (global) 'Internet population', e-Gov. How does 'politics' keep up and how does cultural studies follow the changes: which 'cohort' are they part of?

Hall asks for a philosophical basis for how cultural studies engages with the university. Quite a different question from those ongoing throughout the book and yet behind them is the question of ethics. Hall insists to the end that the open access archive enables us to conceive of a different future for the university. Hall raises questions about the knowledge economy, new forms of exchange. How (for Negri) can the commons be taken away from exploitation? In economics new ways and means have emerged. I cannot vouch for their distance from 'capitalism', but there are examples such as the Nobel Peace Prize 2006. Alternate economies may indeed be a pre-requisite for what Hall and his peers seek?

In the final metadata IV Hall writes about the singularity of new media, referring to his activity in the field. Checking the index and reading the text the 'singularity' (and singular for that matter) is a pivotal concept that I must investigate. Amid the 'hypered' goings on in technology and this literature there is a need for 'hyperanalysis'. What politics is and what it means to act politically cannot be left completely open and undecided.

For the past 2-3 years I have been creating a new website. I've settled on Drupal as my tool. I'm convinced there is community for Hodges' model out there; there is a rationale for it: and it is global. There is a potential audience of inhabitants, a community of users for this new website. I have to make decisions to get the site out of the door (Tracey Kidder, The Soul of a New Machine). Poster says build the archive. For Hall (and this reader given my position) CSeARCH is the example; an emergent project constantly in the process of becoming.


It really is fascinating to think that with the right content types* AND users I could be helping to create an 'institution' - an archive built in accordance with an open access ethos, its politics AND ethics.

If the length of this review does indeed highlight my inability to be concise, I trust that it also shows how much I enjoyed reading DTB plus the thinking and many threads it stimulated...

215 pages, 53 pages notes, bibliography 20 pages.

*+ themes, modules, styles, code - enthusiasm, energy, engagement ...

Acknowledgement: My thanks to the University of Minnesota Press for the book copy.

My footnotes:

There was an interesting letter in The Guardian 16 October 2008, the week that the research assessment exercise (RAE) results were due to be published. This highlighted the experience of many academics, and the problems faced by some in research posts as to their ability to gain longer term security. Plus the need of established staff to ensure they have their name attached to papers in order to meet their (RAE) tally.

Mandated online RAE CVs linked to university eprint archives: Enhancing UK research impact and assessment Stevan Harnad, Les Carr, Tim Brody and Charles Oppenheim make a compelling case for optimising the UK's pre-eminence in Research Assessment.

Power Struggle: Then in January 6, 2009 Education Guardian highlighted how students are not apathetic, they have found new ways to protest and new targets for their ire p.10. Paul Redmond.

Serres on this blog: http://hodges-model.blogspot.com/search/label/Serres

Source: Michel Serres, The Internet and Learning Opportunities:
Join-Lambert, L., Klein, P., & Serres, M. (1997). Interview. Superhighways for All: Knowledge’s Redemption. Revue Quart Monde. http://www.nettime.org/Lists-Archives/nettime-l-9810/msg00137.html

(I have a paper that combines aspects of Serres and Hodges).

Tracey Caldwell, Open access citation effect illusory: First randomised trial suggests OA boosts readership but not citations, Information World Review, 03 Sep 2008.

Earth image source: http://www.geos.ed.ac.uk/homes/tcrowley

Monday, November 3, 2008

Research Capability Programme NHS UK - consultation

From: The NHS-HE CONNECTIVITY PROJECT Forum - Malcolm Teague
Sent: Thursday, 30 October, 2008 16:42:25
Subject: Research Capability Programme - consultation

Consultation on the wider use of patient information

I attended a briefing event on the Research Capability Programme yesterday in Birmingham which was very informative and excellent progress is being made. It was mentioned that the researchers view was under-represented at the moment in the consultation on the wider use of NHS data eg for clinical research. Researchers currently represent only 2% of the responses. But I have just completed it as an NHS user which was the category that best fitted, so everyone can take part. It also takes you through the scenarios gently step by step. Anyway it would be great if you could encourage as many colleagues to take part as possible at:

http://www.connectingforhealth.nhs.uk/systemsandservices/research/consultation

There were a series of RCP briefing events so some of you may already have attended elsewhere. The presentations are going to be made available so I will endeavour to pass those on in some way later. The NHS-HE Forum got a positive mention from Sir Alex Markham!

Many thanks,

Malcolm

Monday, October 20, 2008

Introducing Visual (Research) Methods: Review Paper

ESRC National Centre for Research Methods Review Paper
Introducing Visual Methods (65 pages)
Jon Prosser, University of Leeds, UK
Andrew Loxley, Trinity College, University of Dublin, Eire
October 2008
National Centre for Research Methods
NCRM Review Papers


Abstract

Over the last two decades there has been a global surge in interest in visual research methods. Word and number-based researchers are coming to realise there is considerable potential for gaining knowledge if image-based methodologies are adopted. This paper provides and overview of approaches and perspectives broken down into five easily digested sections to be consumed wholly or in part: early visual research; researcher created data; respondent created data; research design; and visual ethics. The paper will be of particular interest to qualitative social scientists new to visual methods or those with little experience of their application. A wide range of carefully selected references and resources are included to provide the reader with further in-depth insights.

My source: IVSA Digest - 17 Oct 2008 to 18 Oct 2008 (#2008-153)