Health care and handedness

The word legerdomain featured on Wordsmith's Word.A.Day as listed below:

PRONUNCIATION:
(lej-uhr-duh-MAYN)

MEANING:
noun:
1. Sleight of hand.
2. A display of skill.

ETYMOLOGY:
From French leger de main (light of hand), from leger (light) + de (of) + main (hand). Ultimately the from Indo-European root man- (hand) that's also the source of manage, maintain, maneuver, manufacture, manuscript, and command.

It is a shame and a matter debated at large that specialists - whether medical or of other disciplines - are not held in the high esteem that they once were. And yet when you come across a leader and specialist in their field the way they deploy their knowledge, insight and skills remains something to greatly admire and respect. I mean knowledge and experience that transcends sole reliance on interpersonal skills and blinding people with jargon and 'science'. Such are the outcomes of what the specialist brings to the (operating?) table, that it may even seem like a sleight of hand. Not in the sense that it is a trick, but there is an effortless transparency to not only what they achieve, but how they make people - their patients, clients feel. Not just feel, but how these people react and may find themselves.

If there is a sleight of hand it is in how while a specialist, they can and do cross boundaries. They see and can count the important numbers (evidence) in their discipline, but they know (from some no doubt hard-won lessons) that frequently some of the numbers in the very sequence they need lie outside their comfort zone.

RIGHT-handed (mechanistic)

or

(humanistic) LEFT-handed

- they know there is a

middle

and they cross it, without anyone noticing.

Combining h2cm, Informing Science and informatics on the Rainbow Bridge

As a boy one of my favourite superheroes and subjects of myth was Thor and his retinue - Loki, Odin, The Rainbow Bridge. These remain tantalizing escapes for young minds should a corner shop sell comics.

As I mentioned previously in posting about the informing science journal, a paper currently in preparation makes use of holistic bridges and I have had in mind Thor and his ilk and Rainbow Bridge between worlds. In Hodges' conceptual framework the domains of knowledge that make up the model could almost be disparate worlds. This disciplinary repulsion presents several challenges at a time when disciplinary in-fusion is needed (demanded by our problems):

Integration of health and social care in the form of:

• physical - emotional health;
• applied socio-technical informatics
• personalised and service centred care

Academic cross-disciplinary working, e.g. informatics -

• clinical
• urban
• e-governance

Last summer I posted a suitably colourful mix of holistic bridges that included the image below. These hyphenated cross-disciplines conjoin the four care or knowledge domains of Hodges' model.

My interest in ICT began with the ZX81 in 1981 and ever since I've been intrigued as to how we can integrate the above. Why does this matter? It matters not just because of the complexity of the problems we face in in our work and home lives. The real challenge lies in communication.

To take one problem the application of ICT in health care. Here the technical world, the mechanistic butts up against - clashes with - the humanistic. The paper published in spring focused upon socio-technical structure in nursing informatics.
Structure whether virtual, conceptual framework, mythical rainbow is one thing; but what purposes can arise from structure?

In highlighting communication (critical in health care) our purpose is -

using information technology to help convey
the meaning of information in order to inform.

The two axes (or hammers?) in Hodges' model are:

HUMANISTIC - MECHANISTIC [H-M]
and
INDIVIDUAL - GROUP [i-g]

These axes provide the bridge to link informing science and Hodges' model. In the act of communicating, imparting information we may be concerned with the concept of information from its mathematical formulation, the channel, noise through to the semantics and meaning from a sociocultural perspective. This seems to match with the (horizontal) axis [H-M], while the task of informing is concerned with the agents that is the (vertical) axis [i-g].

So what is the relevance of Thor? Well that role of engaging clients (patients, carers, managers, service users....) in communication sees a group communicate with an individual and vice-versa. The processes involved are not necessarily discrete as might be captured 'on paper'. The axes of Hodges' model labelled 'information' and 'informing' become blurred.

We are constantly reminded of the multi-contextual nature of health care. Now, I don't know if care is suddenly more complex on a Thursday, I just figure that when Thor starts to swing his hammer there is suddenly not one axis, but a great many. We are not just aware of multiple contexts we are forced to consider the multi-dimensional too.

Additional links:

Informing Science Journal

Thor image and interesting discussion:
http://afewshotstoshaman.blogspot.com/search?q=thor

Thor - movie 2011?

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 ....

One mind, many minds - ONE PLANET. One need, many needs - ONE PLANET: what price stability?

Hodges' model
a gyro for the
Mind and Planet

One mind or many more than ever we need to think OUT of the box and IN it.

Additional links:

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'...

Gyroscopes.org
The Incredible Genius Of Eric Laithwaite

Images - source: Photobucket

Thanks to David McKendrick for the inspiration.

Transdisciplinary Research: Supplement in American Journal of Preventive Medicine

Sometimes being turned on by conceptual frameworks, transdisciplinary studies, paradigms and other esoteric sounding - blue skies stuff, you wonder if you are being just a tad grandiose. Your lip gets bitten especially when you are not being paid to think and write in this way and your doing so has major repercussions for the people in (and out) of your life. ...

Transdisciplinary research studies is far from new (have a scroll through Links I 2nd row - 'Theology / Inter - Transdisciplinary Studies'), but it is still very reassuring for me to see transdisciplinarity feature in a supplement of the latest American Journal of Preventive Medicine:

Thomas Kuhn wrote is his classic book, The Structure of Scientific Revolutions, that paradigm shifts occur in science when the old ways of making sense of the world are no longer useful or appropriate. The need for a transdisciplinary approach to the study of health and disease is critically needed because the traditional silo approach to these issues clearly is not adequate to the challenges we face. As has been noted, we are not able to identify many disease risk factors; even when we do successfully identify risk factors, it is difficult for people to change their behavior to change their risk profile; and even if people do change their behavior, new people continually take their place because we have failed to identify many of the fundamental societal forces that cause the problem in first place. A new paradigm is needed.
Syme, S.L. (2008).

Other papers in the supplement include:

• Enhancing Transdisciplinary Research Through Collaborative Leadership
• Evaluation of Interdisciplinary and Transdisciplinary Research: A Literature Review
• The Social Determinants of Cancer: A Challenge for Transdisciplinary Science
• Challenges for Multilevel Health Disparities Research in a Transdisciplinary Environment
• The Role of Transdisciplinary Collaboration in Translating and Disseminating Health Research: Lessons Learned and Exemplars of Success

If you come across other transdisc resources please let me know through the main site.

Syme, S.L. (2008). The Science of Team Science: Assessing the Value of Transdisciplinary Research, American Journal of Preventive Medicine, Volume 35, Issue 2, Supplement 1, August, Pages S94-S95. (two pages 18 refs).