NIH: Suggest social justice items for Electronic Health Records

My source: Spirit of 1848 list [The collaborative tool is very interesting]
Let's make suggestions for inclusion of social justice factors in Electronic Health Records by participating in the NIH activity described below.

Dear colleague,

Your input is requested to help make recommendations for a standardized set of patient-reported variables to be collected in primary care and public health electronic health records (EHRs), which will lead to unprecedented data harmonization and opportunities for health research. In order to participate in this process:

• Please visit the website for the collaborative tool: www.gem-beta.org
• Click on the blue button at the top titled "EHR Campaign." Or alternatively, click on the News tab and then the associated EHR campaign title.
• Read the summary statements written by the expert panels
• Enter your comments on the recommended measures, and if needed, suggest alternative measures (see attachment for detailed instructions).
• Forward this request to your colleagues who may be interested in this initiative

Comments will be accepted through April 4, 2011.

Background about this Collaborative Effort

Several institutes within the National Institutes of Health in collaboration with the Society of Behavioral Medicine are coordinating an effort to identify a core set of brief, practical measures to recommend for use in adult primary care and public health electronic health records (EHRs), and we are inviting you and all members of your affiliated organizations to join this collaborative effort.

The HITECH Act and the Patient Protection and Affordable Care Act place new emphasis on the widespread and meaningful use of electronic health records (EHRs). This is an important advance, with one significant exception: Currently EHRs fail to capture data reflecting crucial health behaviors and psychosocial issues. Such patient-reported variables are both health outcomes themselves, and major determinants of other health outcomes.

To address the critical need for patient-reported data, we are organizing an effort to evaluate and recommend actionable, patient-reported measures of health behaviors and psychosocial factors for use in electronic health records (EHRs) within adult primary care and public health settings. In order to facilitate broad participation in the development of standard measures we are using a three-phase process of consensus building.

In the first phase panels of subject matter experts were convened for each of 13 behavioral domains to review available measures and to recommend up to 4 reliable, practical measures for each domain that would be appropriate to utilize in primary care and public health settings and to be reported in EHRs.

*Your input is being requested for the second and third phases of the project.*

For the second phase we are using the NCIs Grid-Enabled Measures (GEM) Database to gather feedback from all stakeholders. In order to participate in this process, please visit the GEM website, www.gem-beta.org, and click on the blue button at the top titled "EHR Campaign." Or alternatively, click on the News tab and the associated header for the EHR campaign. Begin by reading the summary statements written by the expert panels, view the recommended measures, enter your comments on the recommended measures, and if needed, suggest alternative measures. Comments will be accepted through April 4, 2011.

The third phase will be a workshop/town hall meeting on May 2, 2011 at the NIH bringing together scientists, practitioners, policy makers, and patient/consumer representatives to review the results of this campaign and make recommendations on standard consensus measures for behavioral health and health behavior screening in primary care and public health settings. We encourage everyone interested in this effort to participate, and more information about this meeting will be forthcoming. Immediately following this workshop there will be a closed session meeting of key stakeholders to make final recommendations based on feedback obtained from the GEM tool and the open meeting.

Workshop participants will receive a summary of the meeting as well as information on final recommendations. Subsequent to the meeting, organizers and key stakeholders will discuss strategies to build support and implement plans to advance the adoption and incorporation of a core set of patient-reported behavioral and psychosocial measures in primary care and public health EHRs.

We truly thank you for your participation in this project to standardize the collection of behavioral data in EHRs because it will enable the collaborative group to put forth the best possible recommendations and ultimately improve patient outcomes.

Sincerely,

The EHR Measures Meeting Planning Committee
Maureen P Boyle, Ph.D.
AAAS Science and Technology Policy Fellow
Office of Behavioral and Social Sciences Research
Office of the Director, NIH
31 Center Drive, Building 31, Room B1-C19; MSC 2027
Bethesda, MD 20892-2027

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.

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

compose, direct, conduct and 'dilute to taste' outcomes

In Drupal musings 12 I mentioned that the classification of nursing practice is not necessarily at the forefront of nursing's mind set against the turbulence and rush of clinical areas.* This is especially so at the moment as nurses on wards, clinics and community try to identify savings.

I am interested in classification in part as this is the raison d'être for the health career model; on a mental (cognitive) level, in practice and potentially in virtual representations of health care activities. For learners it is an extra to hold the bicycle saddle for those first turns of the pedals. Additionally, for those who have completed many rides and races (lifelong learners) they can reflect on how they got there, and plan for the next round.

As a conceptual framework then h2cm is, like classification, in the background. The model can help to compose, direct and conduct (c-d-c) nursing (health and social) care. Classification matters to ALL nurses because we need to know not only the c-d-c of nursing but the outcomes too.

If all the above is in the background, then together with classification the health career model can help differentiate nursing as a discipline and make nursing visible. We can only take heed of the adage "divide and conquer" by being able to differentiate nursing from other disciplinary contributions. Then perhaps we can truly identify and so define the facets of integrated, interprofessional and multidisciplinary care that must also be person-centred. As nurses and the team respond to the individual's trauma (assault, illness, chronic disease ...), they can also assure their combined values, which must be defined and articulated if there is to be a unified philosophy.

If the respective professions have not noticed (I am sure they have) 'professionalism' is itself under assault in terms of unique knowledge and skills, respect, power and status. To a degree this a good thing. It is also called 'progress': countering restrictive practices, improving service access and challenging institutionalised and state paternalism. Professionalism is accorded for reasons of accountability, education, responsibility, integrity and advocacy. Amid the public (mental) health disaster that we face - the professions - are needed more than ever and if the assault is taken too far ... ?

* Should you know of examples where classification IS at the forefront of nursing practice please let me know - h2cmng @ yahoo.co.uk.

Holistic bandwidth (and the dangers) of political care

The attack on MP Stephen Timms here in the UK highlights not only the ongoing importance of personal safety for public service personnel, but how much politicians value their constituency work. It is no accident that these sessions are called "surgeries".

The politician meets not just a citizen, but a political obligation and duty to care. In the media reports it was interesting to hear of how much satisfaction MPs get from their constituency work. Listening to the reporting and debate prompted me to realise that although politicians vary in how well they engage and empathise with their constituents the problems they are asked to deal with covers a broad holistic spectrum. Consider this listing written by Tony Wright MP:

• The education system
• The transport system
• The social services
• Health services
• Housing
• The environment
• Government bodies
• The justice system
• Immigration and asylum
• Finances and employment
• Trade unions
• The media

I am a community nurse five days a week.

Our MPs are community politicians one day a week with 'Constituency Friday'.

So to The Rt Hon. Stephen Timms (and his staff) I wish you a speedy recovery and congratulations on the extent of you and your peer's constituency work.

Holistic in a word and deed.

Congratulations also to the Green Party on the success of their leader Caroline Lucas MP.

The Health Career Model: POLITICAL domain resources

Health, social care and personal map making

There have been two series running on BBC 4 in the UK over recent months and currently with a cartographic and historical focus:

see - The Beauty of Maps

This Vermeer - The Art of Painting - was featured in one programme and reveals the power and status of maps as Wikipedia also explains.

It is natural to see the health career model as a map, but this map is not just the preserve of the wealthy. Hodges' model can be used universally by all - a common framework.


Use of the term map and its synonyms is in turn common in medicine in many forms:

The map of medicine
Anatomical charts
WHO Global Health Atlas
The Malaria Atlas Project (MAP)
Globalis
HealthMap

The above sites reveal how maps, charts and atlases relate the individual, geography and health.

In addition to its geographic connotation projection also has a psychological meaning. Hodges' model provides a substrate* on which to project personalised, national and global health.

An individual; a people; a nation: for each a journey .... and for each a map ....

Image source:
http://en.wikipedia.org/wiki/The_Art_of_Painting_%28Vermeer%29

* You have to love that floor ;-)

Injustice: Why social inequality persists by Daniel Dorling

I first came across the work of (Prof.) Danny Dorling in the 1990's in connection with workshops on visualization in the social sciences and Geographic Information Systems (GIS). The other week I read a feature on his (very timely) book in the Society section of The Guardian (O'Hara, 2010).

You do wonder exactly where we are in policy terms given the interval since the Black Report. Dorling's book then sounds like a must-read, with the information posted below from the publishers.


In addition in Waterstones at the weekend I found The Spirit Level, available on their 3 for 2 offer. The links also posted below with an insightful 2009 review of The Spirit Level by Daniel Ben-Ami on sp!ked; plus a related LGC & HSJ event:

Implementing the Recommendations of the Marmot Review:
Reducing Health Inequalities

Injustice: Why social inequality persists

About This Book

Few would dispute that we live in an unequal and unjust world, but what causes this inequality to persist? Leading social commentator and academic Danny Dorling claims in this timely book that, as the five social evils identified by Beveridge are gradually being eradicated, they are being replaced by five new tenets of injustice, viz:

• elitism is efficient;
• exclusion is necessary;
• prejudice is natural;
• greed is good; and
• despair is inevitable.

In an informal yet authoritative style, Dorling examines who is most harmed by these injustices and why, and what happens to those who most benefit. Hard-hitting and uncompromising in its call to action, this is essential reading for everyone concerned with social justice.

"His attack on elitism and despair is impressive, his factual evidence undeniable." Rt Hon David Blunkett MP

Additional resources for Injustice: http://www.policypress.co.uk/injustice_appendix.asp

Dorling, D., Orford, S. and Harris, R. (1998) Visualization in the Social Sciences, A Report for the ESRC/JISC Advisory Group on Computer Graphics, AGOCG Technical Report No 41 (ISSN 1356-9066). Report as a PDF

O'Hara, M. (2010). Why Britain's battle to bring down social inequality has failed, p.1 of the SocietyGuardian section of the Guardian on Wednesday 21 April 2010.

The Spirit Level: book

The Equality Trust, established by the authors.

Distorting the spirit of equality, sp!ked review of books.

How can maps provide motivation?

"The class of maps that go beyond navigation to consolidate thought and convey a message belong to the broader class of infographics that aggregate words and numbers in a visual medium. While charts and graphs are often used to show progress to a goal, nothing personalizes the objective like measuring status, and revealing shortcomings, on a map."

-- Matt Ball, editor, the Americas / Asia Pacific


My source: V1 Newsletter Volume 4 / Issue 13/ March 30, 2010

http://twitter.com/spatialsustain

Health & holistic care in the 21st and 22nd Century

With the technical means at our disposal it is relatively easy to provide information to the masses. Facebook, Google and advertisers are increasingly better versed to target information not just our way, but your way.

Health education and preventive medicine programs depend on the dissemination of health and well-being information, that in turn also relies on access to an expanding digital infrastructure. Equality of access to information communications technologies is now the province of human rights and not just manifestos whether ambitious or binned.

There is much talk of trying to categorise the stage (and hence maturity) of our civilization: hence we talk about being in the information age.

In health care terms this is clearly the case. The provision of information is a key operation and goal of the UN and WHO as per the Millennium Development Goals. Amid the MDG and multiple other related initiatives we need to take care that the habits of many thousands of years do not dilute our efforts.

There is a danger that just as we have broadcast seeds to grow crops,
we will repeat the exercise with technology's reach and
so many seeds will fall on stony ground and
so not take root and
grow.

As people working in the development field know only too well, initiatives like Health Information for All by 2015 and national efforts are not just about the provision of information. In some respects that is not as big a problem as it once was (though is still presents a huge challenge) with community, urban and developmental informatics. Mobile phones and various technologies can get information to people. Increasingly though the problem is one of sufficient or extended literacy. This extends the conventional educational literacy and notion of the 3R's - Reading, wRiting and aRithmetic.

What knowledge do I need about my health and that of the 'other' gender and ethnic groups with whom I share this 'home'. What knowledge do I need in order to live long and then be able to prosper and do so sustainably?

Allied with the problem of literacy is seeking the attention of individuals. This perhaps is why infant, primary and secondary schooling are so important - learning to attend is the most important lesson of all. Especially as health and well-being messages must compete in the multi-spectral communications channels polluted with so much dross.

The MDG make clear the above requirement in Goal 2: Achieve universal primary education:

2.1. Net enrollment and retention in primary education
2.2. Proportion of pupils starting Grade 1 who also reach the last grade of primary education
2.3. Literacy rate of 15-24 year old #

With the requisite baseline - personalised literacies and the information that HIFA2015 and others can provide then individuals can achieve a level of health and well-being knowledge commensurate with living (and dying well) in the 21st century:

and 2nd-by-2nd the

growing proportion of the global population that will know the
22nd century. ...

# Thanks to Remi Akinmade and HIFA-2015 list
http://mdgs.un.org/unsd/mdg/Host.aspx?Content=Indicators/OfficialList.htm

Literacy on W2tQ
http://hodges-model.blogspot.com/search/label/literacy

Midwifery Materials for Haiti - in French/Creole - NEEDED

My source as posted to the GANM and on HIFA 2015 lists:

I am writing the (GANM) community to ask for assistance in gathering online midwifery and nursing materials - in the French or Creole language, for Haiti.

The National Nurse School University and Faculty of Medicine in Haiti has collapsed and they have lost most of their training materials. Dr. Larouche was killed in that collapse - he was teaching an OB course to the midwifery class at the time. I do not know the fate of the nursing/midwifery students, but one can imagine that the outcome is probably not a good one. Dr. Larouche was filling the void left by the untimely death of Madame G.Francoeur last year (she died in an auto accident).

Midwifery in Haiti was just recovering after the sadness of the loss of Mme Francoeur - and the earthquake has now destroyed most everything that they had.

Agnes Jacobs, UNFPA survived and has been emailing from Haiti. She and her colleagues are working to pick up the pieces and try to reconstruct materials for training midwives and nurses in life saving skills.

I am writing to members of the GANM asking for support in finding DIGITAL materials that we can provide to Agnes for the time being. It is VERY hard to get shipments of books and things to Haiti right now, but in the future, I suspect that Agnes will be able to use books, and guides, and computers to rebuild midwifery in Haiti. So eventually we will ask for books and things, but right now it is very hard to get these types of things to her. I know she is not alone, I know that COHI, PAHO, and many others are on the ground. I think the GANM can work with all these others to help in whatever way we can.

Johns Hopkins is sending a team to Haiti, including Dr. Beth Sloand who has been travelling to Haiti with students for over a decade. Beth does not have room to take printed materials, but she can maybe take a packed hard drive or CDs/DVDs that we load with teaching materials. Agnes does have a computer and internet (sporadically) - so I have been discussing with her the potential of sending digital materials which she can start to use right away until printed materials can be provided.

She welcomes health materials in French and or Creole primarily. They should be materials that can *instantly be used to teach midwives and community health workers* - so scientific articles that require interpretation and reconstruction into teaching materials are not what I am asking for at the moment. Right now there are no resources to turn scientific literature into teaching materials. Do you have teaching materials that you would be willing to share?

I would like to ask that people send either direct links to online resources that we can copy down to a CD or send useful teaching materials that we can put on a CD.

Please email them to the GANM or to me (pabbott2 @ son.jhmi.edu)

Regine Marton wrote already directing us to look at Hesperian and the WHO Reproductive Library (in French). We have the Hesperian material now. The WHO library is helpful.

If you have any quality materials for training of midwives that you would like to donate or direct us to find, please let us know. Please send scientifically sound materials - the last thing that Haiti needs are questionable methods or what we call in the US "hocus-pocus" (unproven claims or "magic").

I hope this makes sense and that the GANM community will come together to help Haiti in a “different” way. I think what we are doing is unique – while of course there are huge needs for emergency care and the like we are looking one step ahead to helping Haiti rebuild its educational infrastructure.

Best Regards,
Patti Abbott
GANM Moderator and "Electronic Midwife"

memo FROM: Classroom health TO: Global health - PSHE education and model standards

Health care and educational professionals learn and adopt the key tools of the trade whilst training. Although for several decades experiential learning has also gained recognition and weight, it is the learning of theory and relation to practice in basic training that shapes the future career. We can describe this as formative professional education. We then hope that this learning and the tools in use are then updated according to research, evidence and best practice. There is much navel gazing at present as to how to measure, nurture, instill and strengthen the character trait of compassion. This applies not only to children, but within nursing.

This issue highlights of course what students bring with them to the lecture theatre, clinical arena and what they take from there to carry them through their professional career. My ideal would be that students have already learned and used Hodges' model as 14-16 year old's, as they negotiate their personal, social, health and economic (PSHE) education.

While Hodges' model is a world away from a de jure standard
- that is, defined and enforced by the ISO -
it might just :) become a de facto standard,
because of its widespread adoption in and beyond the classroom.

There is a great opportunity here for Hodges' model in the UK as PSHE education becomes compulsory in 2011. Perhaps you can help in or beyond the UK?

Reference:
Mooney, H. (2009). Can you measure compassion?, Nursing Times, 21 April 2009.

Blog post inspired by adamatronics groups.drupal.org Drupal in Education: Joint effort on a D6 SCORM API

tags: 'preventive medicine' + 'preventive medical sociology'?

NIGH message for GANM network - We Need Your Help with the UN General Assembly

Please assist if you can....

Dear GANM Colleagues,

The Nightingale Initiative for Global Health (NIGH) (www.nightingaledeclaration.net) team invites you to join with us to ask the 2009 UN General Assembly to consider the UN Resolution proposal (see below) as they will be voting until the end of December 2009.

Currently the NIGH team is working in and around the United Nations in New York City — to propose a UN Resolution (below) recognizing the work of global nursing.

Please write to your country's UN Ambassador in New York City.

To find your country's UN Ambassador:

1.) A list of permanent representatives and observers to the UN in New York will be emailed right behind this message.

[Heads of Permanent Missons to the UN in New York - 146.3 KB, application/pdf ]

2.) to find the mailing address and a link to your country's web page (where you can find their email address) for your country's representative - go to:
http://www.un.org/en/members/index.shtml

Address the following message to your UN Ambassador. Finding the email address may take a little more effort, but it is quicker. We hope you will take the extra effort to let your representative know how important this issue is.

If you want to add a personal note to this example message please feel free:

≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈
re: Resolution to Acknowledge Campaign for 2010 to Support UN MDGs

(Enter the name of your UN Ambassador and country)

Permanent Mission to the United Nations

EXCELLENCY,

We ask you please to consider, now, initiating or supporting a Resolution for this 2009 General Assembly:

1/. The General Assembly, in recognition of the devotion and dedication of the world’s nurses and midwives and their care and concern for the health and well-being of the “peoples of the United Nations,” hereby acknowledges, with gratitude, their celebration of the “2010 International Year of the Nurse,” the Centennial of Florence Nightingale, through their campaign to raise global public awareness and support for the eight Millennium Development Goals (MDGs).

2/. The Assembly recognizes, in particular, their vital contribution to reducing child mortality and improving maternal health — as specified in MDGs 4 and 5 — and expresses appreciation for their overall commitment to the achievement of these United Nations’ objectives.

Sincerely yours,

Phalakshi Manjrekar, MScN, RN, India
Barbara Dossey, PhD, RN, AHN-BC, FAAN, USA
Dionne Sinclair, MSN, RN, Jamaica
Cynda H. Rushton, PhD, RN, FAAN, USA
Deva-Marie Beck, PhD, RN, Canada

Co-Directors, Nightingale Initiative for Global Health (NIGH) on behalf of 20,000 nurses from 110 nations who have signed the ”Nightingale Declaration for a Healthy World.” See: http://www.NightingaleDeclaration.net

≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈ end of message~~~~~~~~~

”Global Public Health“ has been a key focus of the United Nations, until December 31, 2009, and then the UN focus moves to “Gender Equality” for 2010. We believe that it is, therefore, urgent that we get this Resolution into the UN General Assembly agenda for adoption before the end of 2009.

We have contacted Ambassadors from all 192 Member States, asking them to support this proposal. As well, we have sent them the attached press release, which we will also be forwarding on to all 200+ media representatives and media agencies accredited at the UN.

The NIGH team thank you for your consideration of our request. Please circulate this request to other colleagues.

Additional links: 2010 International Year of the Nurse (IYNurse)

GANM (Global Alliance for Nursing and Midwifery)

Drugs, Policy and spent Energy

The ongoing controversy here in the UK over drugs policy amid the sacking of Prof. David Nutt - chairman of the Advisory Council on the Misuse of Drugs and since Friday the resignation of other members highlights the tension between the SCIENCES and POLITICS.

As a father, mental health nurse (and light imbiber of real ale and wine) all I know is that the government has been lobbied for decades by concerned groups over the risks of excessive alcohol consumption. With changes in alcohol licensing opening hours and pricing/tax it seems the government has the local town centres and community legislation it deserves.

Given the current spat you might think that within Hodges' model the SCIENCES and POLITICAL domains would be diametrically opposed? But no! There they are bosom buddies on the mechanistic side of the model.

Although the clue is in the title - advisory - as to the extent to which the government is bound to follow advice, the government's policy, advisory groups and policy should be in accord as far as the media and public are concerned.

Otherwise what price for evidence-based politics?

For individuals and communities alike we need order between the SCIENCES and POLITICS otherwise chaos reigns. Order does not just fall out of the tree. The issues here include at risk youngster's for whom exposure to cannabis might precipitate a psychotic episode; the granularity of a classification of drugs for legal purposes and that for clinical and social care. The debate is complex and takes work and energy on many levels. There are many dimensions to appreciate in this situation:


While very unfortunate, this is timely as I read Ben Goldacre's Bad Science.

You do have to worry about the position of
common sense.

There are other sources of heat already on the boil with many spillages to follow. These will arise from the friction of SCIENCE, climate change and policy. Ah bliss to live in interesting times. ...

Web can help elderly surfers slow dementia: The Sunday Times

From The Sunday Times
October 18, 2009
Web can help elderly surfers slow dementia

Ivy Bean

(Photo by Bob Collier)

Ivy Bean, who is 104 years old, is the UK's oldest Tweeter (IvyBean104) on the social networking site, Twitter.
Jonathan Leake, Science Editor

GOOGLING is good for grandparents. Internet use can boost the brain activity of the elderly, potentially slowing or even reversing the age-related declines that can end in dementia, researchers have found. Using brain scans, they found the internet stimulated the mind more strongly than reading, and the effects continued long after an internet session had ended.

“We found that for older people with minimal experience, performing internet searches for even a relatively short period of time can change brain activity patterns and enhance function,” said Gary Small, professor of neuroscience and human behaviour at University of California, Los Angeles (UCLA). In the research, Small and his colleagues worked with 24 men and women aged between 55 and 78. Half of them had used the internet a lot; the others had little experience.

At the start of the research, they were asked to conduct a series of internet searches while their brains were scanned using a technique known as functional magnetic resonance imaging (fMRI). This measures changes in blood flow around the brain to work out which parts are the most and least active. After the initial scan, participants went home and used the internet to carry out specified tasks for an hour a day at least seven times over the following fortnight. Then they had a second brain scan, again while searching the internet.

Small and his colleagues found the impacts began immediately, with the first scan demonstrating brain activity in regions controlling language, reading, memory and vision. By the time of the second scan, however, the activated areas had spread to include the frontal gyrus and inferior frontal gyrus, areas known to be important in working memory and decision-making. The researchers suggest internet searching stimulates brain cells and pathways, making them more active.

“Searching online may be a simple form of brain exercise that might be employed to enhance cognition in older adults,” said Teena Moody, a UCLA researcher who co-wrote the report with Small. Moody believes internet searching challenges the brain more than reading because people need to perform several tasks at once. These include holding important information in their own memory while simultaneously assessing the information on screen and extracting the parts they want from graphics and words.

The research will be presented tomorrow at the annual meeting of the Society for Neuroscience in Chicago, where the impacts of ageing on the brain are a big theme. It has long been known that as people age, their brain functions and abilities also change. In many respects these changes are beneficial — verbal and social skills tend to improve until at least late middle age, for example. In other areas there can be declines. One of the best known is mathematics, as shown by the number of mathematicians and physicists who do their best work early and then struggle to match their youthful performances.

It is only in recent years, however, that researchers have been able to use technologies such as fMRI to observe the brain in action and measure the changes that come with age. What they have found is that as people age, their brains undergo structural and functional changes, often including atrophy, reductions in cell activity and increases in deposits of insoluble protein. All of these can reduce cognitive function.

In Britain, for example, around 700,000 people suffer from dementia, a condition in which so much of the brain has died that function is severely impaired.

Small and Moody’s argument is that brains are similar to muscles, in that the more they are exercised, the healthier they become. So, activities such as internet use, reading and socialising can slow or reverse normal age-related declines. Small said: “Our most striking finding was that internet searching appears to engage a greater extent of neural circuitry that is not activated during reading.” Other neuroscientists support the idea of exercising the brain but question the benefit of spending too much time on the internet.

http://www.timesonline.co.uk/tol/life_and_style/health/article6879663.ece

My source: CI list thanks to Michael Gurstein (with additional editing and links)

World Mental Health 'Day' - what about the night shift?

For convenience sake our lives usually follow the sun's traverse. The majority of events associated with World Mental Health Day will take place during office hours and early evening.


I am looking forward to a local event in Leyland, Lancashire on Monday, which includes speed dating. This will provide that 10-15 minute opportunity to share and obtain information about other services and people involved in local mental health care. The agenda looks excellent and includes the active participation of carers and service users.

So, what of World Mental Health 'Day'?

Mental health - like all health and social care is a 24 hour affair. How often do we forget this? Of all the care (knowledge) domains I write about here, mental health remains the 'silent one'. If you have had worries, anxiety and much more besides you know full well there are actually 24 hours in a day and the silence is not because 'mental health' sleeps. So 'Day' is quite apposite in shedding light on what remains a poorly understood and  stigmatised aspect of health care and our lives. 

Comprising all four declared domains and uncertainty - the spiritual domain is not referred to in Hodges' model explicitly and yet in our day-to-day existence spiritual matters figure in lives just begun, journeys ongoing and lives at an end and people remembered. Whether we practice a religion, follow a belief there is no escape from news that relates to religion. Strange then: not listed in Hodges' model and yet more evident and prevalent than mental health it seems. In my career I have noticed how religion and mental health can be very uncomfortable companions for some individuals. One exacerbating or being the cause of problems in the other. By the same, or maybe a different token, religion is also a great source of comfort, solace, affirmation, peace and reconciliation for many and a crucial resource through the many people who work under the auspices of the World's religions.

I have tried to catch this 'relationship' in my categorization of links in the INTER - INTRAPERSONAL domain which includes:

Psychology, Mental Health, Therapies, with Philosophy, Ethics, Ideas, Context, Creativity, Theology and Inter-Transdisciplinary resources.

So wherever you are, I hope you find peace especially through this day and night, whether or however you illuminate your mind, heart and soul.

Image source: http://www.daily-tangents.com/ImageCat/ErthMoon/
and NHS various.

Hodges model: indicative concepts in Substance Misuse Care

Hodges' model
in substance misuse services

psychological dependence vulnerable individuals, education, risk, assessment, review, motivation to change, harm reduction,  motivational interviewing, appreciative inquiry, life skills, education, advice, feedback withdrawal, aggression, hallucinations, change, drug use history, measures, care pathways, contract, rapport, empathy	substance profiles, abuse, signs physical dependence, health status, pregnancy, research methods, evidence, diagnosis, co-diagnosis, staff awareness, statistics,  scientific advice, dissemination models: stepped care, training, forensic science - mental health, classification, interventions, physical access, stepped care models
dependents, family, social network social attitudes, vulnerable communities, community projects, self-help, e.g. A.A., socio-economic depreviation, systemic - family, group therapies Advertising, housing, casual drug use, work, employment, benefit incentives, re-integration, inclusion, community, neighbourhood policing, drug culture, media	supply, cost of drugs - alcohol health & social care policy, service interfaces, statistics Drugs strategy, funding, X-agency working, funding, GP contract, commissioning, "client contract-plans", National Treatment Agency, NICE, Home Office, legislation, crime, offending, re-hab. / specialist teams / treatment facilities, Government data, community prescribing, employers

Additional links:

Hodges' model: QUADS 'A4 page' with indicative generic content for the four care domains

The SOCIOLOGICAL links page includes Seven Ages, Public, Patients, & Carers...
The INTRAPERSONAL links page - Mental Health, Psychology, Therapies...
The POLITICAL links page - Economics, Policy, Citizenry...
The SCIENCES links page - Research, Drug resources, Anatomy & Physiology...

Informing Science (with Thor to follow) ...

The problem with the web is you search, find and save stuff and then it virtually disappears on hard drives and folders only to somehow bubble-up back to life hopefully at a time of need. So with the Informing Science Journal.

I know the details are only a click away, but here they are:

The academically peer refereed journal Informing Science endeavors to provide an understanding of the complexities in informing clientele. Fields from information systems, library science, journalism in all its forms to education all contribute to this science. These fields, which developed independently and have been researched in separate disciplines, are evolving to form a new transdiscipline, Informing Science.

Informing Science publishes articles that provide insights into the nature, function and design of systems that inform clients. Authors may use epistemologies from engineering, computer science, education, psychology, business, anthropology, and such. The ideal paper will serve to inform fellow researchers, perhaps from other fields, of contributions to this area.

Ever since reviewing Gary Hall's "Digitize This Book!" the future of academic publishing, the university as an institution and scholarly disciplines has been on my mind. I did have another book on my wish list that predicted I believe the death of the university if things do not change. This is lost somewhere... I am really pleased to rediscover this journal, its contents and look forward to reading more and possibly contributing once existing projects are completed...

In the substance misuse paper draft, in addition to the usual key concepts I am wondering about the use of holistic bridges and so...

More to follow soon on the aims of the Informing Science Journal with reference to Thor, bridges and what informing science means for Hodges' model ....

Well-being, Teddy Bears and the NYC Fresh Air Half-Marathon

These days 'well-being' crops up everywhere it seems. Literally in the crops and technology used to grow our food, in response to the rise of obesity and its personal and social impact. Diabetes, bullying, the need for exercise, personal space and quality time the well-being list and its associations is as long as the number of journals and magazine issues and covers it features in.

For Hodges' model though where can well-being be found?

I believe there is a risk that 'well-being', whilst it undoubtedly has a role to play in health and social care, education, media, policy (oh and lifestyle), runs the risk of diluting the critical health messages. Not in the sense of not dealing with critical health problems but not as bad as putting your health at risk. If you do not do X, or Y and put your well-being at risk this is not as bad as putting your health at risk...? Do people really make the right connection? One response to my initial question is as follows:

Emotional Well-being	Physical Well-being
Social Well-being	Political Well-being

Since well-being is a rather nebulous concept the risk is that -

'Well-being' may become* a sort of Teddy Bear comforter.

Well-being is very helpful in opening doors to walk-in centres, well man and women clinics and in damaging the stigma that surrounds mental health. For me though well-being is not to be found in the h2cm matrix, Well-being is the totality. It is how well we are in all the care domains. How well are they integrated? Well-being brings a whole new meaning to global health. Collectively this also includes that spiritual yearning found within humanity. Miss one domain out and like a pack of cards... ...

So next time you drag Teddy up the stairs easy
as you go....

Speaking of well-being: running while you can - is a great mantra because the ability to run is a great gift for those of us who can; whether 100s of meters or marathons. Here is news of what looks a truly great event across the Pond:



Hi again Peter

I sent you an email last week and didn't hear back so I thought I would try again. The Fresh Air Fund is still looking for runners and sponsors to join our Fresh Air Fund-Racers team for the NYC Half-Marathon on August 16th. It would be a huge help if you could post a mention of this exciting news on Hodges Model: Welcome to the QUAD. This is a great way to participate in NYC's premier summer road race while helping Fresh Air Fund children. Please feel free to use anything from our site here:

http://freshair.org/racers

Last summer's NYC Half-Marathon was a huge success and the Fresh Air Fund-Racers raised more than $125,000. We are also still in need of Friendly Town hosts for next month. Host families open their hearts and home to a NYC child who would not otherwise have the opportunity to escape the hot, crowded city streets. Please let me know if you are able to post or have any questions, and if you could send me the link that would be fantastic.

Thank you so much, (A pleasure Sara - all the best for next month!)

Sara
-----
Sara Wilson,
The Fresh Air Fund
sara@freshair.org
www.freshair.org

Additional links:

Runners Web: Run for Charity

NHS Health and Well-being: Boorman Review

Work and Well-being

* may already be...?

Guidance: Breakthrough to real change in local healthcare - a guide for applications to create Health Innovation and Education Clusters (HIECs)

6 May 2009: The Department of Health is investing £10 million in the introduction of Health Innovation and Education Clusters (HIECs) across England. HIECs will be partnerships between NHS, higher education, industry and other public and private sector organisations. They will support the spread and adoption of innovation locally and strengthen professional education and training.

This guide describes the vision for HIECs, the role of HIECs in education and training, how HIECs will support innovation and the application process. This starts a period of informal dialogue with strategic health authorities (SHAs) and prospective HIEC partners, leading to expressions of interest in early September 2009 and a final announcement on the first wave of HIECs in December 2009. SHAs are co-ordinating applications and, as part of the process, they are arranging regional stakeholder events.

Contact details for the SHA in your area are included.

Published by Department of Health, UK

Review: Tackling Health Inequalities - ten years on

A review (Published: 7 May 2009) of developments in tackling health inequalities in England over the last ten years.

This report reviews developments in health inequalities over the last 10 years across government - from the publication of the Acheson report on health inequalities in November 1998 to the announcement of the post-2010 strategic review of health inequalities in November 2008. It covers developments across government on the wider social determinants of health, and the role of the NHS. It provides an assessment of developments against the Acheson report, reviews a range of key data sets covering social, economic, health and environmental indicators, and considers lessons learned and challenges for the future.

Published by Department of Health, UK

c/o Alex Scott-Samuel The Spirit of 1848 list