Mathehu's Weblog

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Combating professional isolation: Connecting professionals via social and technological networks

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One of David’s tweets pointed me to this blog by  George Siemens. He discussed the use of social and technological networks in education.  Reading his analysis, I realised that the very same principles are at work when trying to connect professionals with the aim of keeping them informed of new developments and learning from each others setbacks and successes.  

Paraphrasing George it is fair to say that online networking opportunities have transformed personal and professional lives. They nothing short of revolutionsed the way we learn, communicate, and interact with others. While some sectors have embraced these new opportunities, there are still many areas and professionals who either have yet been exposed to such networks or who have not had opportunities to make use of them in their line of work.  

Mirroring education in schools and Universities, their professional development events tend to still follow the traditional expert-centred template. Seminars, workshops or conferences are structured via a speaker system in which participation in one form or another is either encouraged or not. Either way, they remain a rather closed and localised way of learning and engaging.  

While face-to-face interaction and human contact are key factors in learning and (personal as well as professional) development, every internet user has access to experts and scholars irrespective of their geographical location or difference in time zones. To quote George Siemens, professionals (like or as students),  

“are not confined to interacting with only the ideas of a researcher or theorist. Instead, a student can interact directly with researchers through Twitter, blogs, Facebook, and listservs. The largely unitary voice of the traditional teacher [or any expert, speaker, etc.] is fragmented by the limitless conversation opportunities available in networks.”  

Using such networks allows for the ultimate tailoring of each person’s personal or professional development. While they allow for a bespoke approach for each individual user, they need to be set up, maintained and guided by someone with a fairly good understanding of the respective area of interest (i.e. the teacher in the education context).  

George suggested seven roles a teacher plays in a networked learning environment. Once more, I will stick closely to his portrayal of these roles, while applying them to the context of connecting professionals.  

These are the roles he suggested:  

1. Amplifying
2. Curating
3. Wayfinding and socially-driven sensemaking
4. Aggregating
5. Filtering
6. Modelling
7. Persistent presence


Getting professionals engaged in any undertaking has more changes of success if information is accessible with a minimum of effort required to retrieve and forward it. Twitter, Buzz and similar services provide a means of doing just that. Each tweet has a maximum of 140 characters (roughly three lines), forcing the creater to convey information  in a concise manner. Within seconds a piece of information can be evaluated for its relevance. Usually, the tweet is accompanied by a shortened URL, which makes more comprehensive information accessible with only one extra click.  

Amplification comes in by retrieving this information and then re-tweeting it, thus making it available to others linked to the person sending the tweet. Information can be tweeted and then re-tweeted by the host of a network or by anybody else aligned to the network.  


The term curator is derived from the Latin words curare and cura, whose meanings include attending to, taking care of, or taking responsibilty for. Once more I quote George Siemens directly to convey the relevance of this concept to teaching (as well as connecting professionals):  

“An expert (the curator) exists in the artifacts displayed, resources reviewed in class, concepts being discussed. But she’s behind the scenes providing interpretation, direction, provocation, and yes, even guiding. A curatorial teacher acknowledges the autonomy of learners, yet understands the frustration of exploring unknown territories without a map. A curator is an expert learner. Instead of dispensing knowledge, he creates spaces in which knowledge can be created, explored, and connected…The curator, in a learning context, arranges key elements of a subject in such a manner that learners will ‘bump into’ them…As [professional] learners grow their own networks of understanding, frequent encounters with conceptual artifacts shared by the teacher [network host or other members] will begin to resonate.”   

Wayfinding and socially-driven sensemaking

When learning a new skill or engaging with a  new medium or area of interest the amount of learning required often appears daunting. However, with each step the terrain ahead becomes more familiar, even though the odd dead-end or detour will be encountered. Professional networks, through their structure and member input, provide valuable sign-posting in initial familiarisation as well as the development of subsequent expertise in a given field. Networks facilitate this process by filtering information and by emphasising salient information.  


In the days before the emergence of tools like Google Reader or other aggregation services, interested individuals had to visit  a number of different hompages by organisations, journals, blogs, etc. to remain informed of new developments. Services like Google Reader offer and individualised one-stop platform for this purpose. Rather than visiting different websites, these websites are linked to Google Reader. As a result, one visit to the Reader contains all the new information available on the linked websites.  

A professional network has the potential to function in a very similar way. Within this network, relevant sources of information can be linked, displayed, discussed, and amplified.  


The above roles and functions of professional networks also help to somewhat safeguard its members from the danger of being inundated by information. In the same way as they collate relevant information, members’ also contribute to determining the boundaries of interest.  


In the same fashion as a network’s membership collectively determines the boundaries of interest, the collective but also individual members function as role models in various ways. George Siemens alludes to the idea of apprenticeship learning and the process of becoming in this respect. I think he was referring to Deleuze and his concept of apprenticeship.  

A couple of years ago, a colleague and I published a paper applying Deleuzian ideas to Action Research. Some of these application also hold true for professional networks. In the following excerpt I simply replaced any reference to Action Research with professional networks.  

Deleuze’s notion of an ‘apprenticeship to signs’ carries within it interrelated elements of meaning.   

Signs’ refer to the elements of the unfolding of events, both virtual and actual, with which the participants   

engage as part of their learning in a social or technological network. Learning is essentially concerned with signs.   

Signs are the object of a temporal apprenticeship, not of an abstract knowledge.  To learn is first of all to consider  

a substance, an object, a being as if it emitted signs to be deciphered, interpreted (Deleuze, 2000, p.4, emphasis in the original).  


The concept of ‘apprenticeship’ in this context does not mean ‘novice’ or ‘beginner’ in the conventional sense (although it may include that).   

As Deleuze in the quote above indicates, it refers to the educative aspect of being part of a network of professionals.   

An apprenticeship to signs embraces a necessary participative engagement with the substance of the network rather than   

‘bystander’ or ‘objective observer’ status.  Thus, as regards learning, it is not “do as I say”, but rather “do with me” (Deleuze, 1994, p.23).   

This relates to the minoritorian aspect of becoming the ‘friend’ of the problems discussed in the network through direct engagement.   

‘One becomes a carpenter only by becoming sensitive to the signs of wood, a physician by becoming sensitive to the signs of disease’ (Deleuze, 2000, p.4).   

Of course, direct engagement refers not only to participate but also to the overall management of a network.”  

The apprenticeship idea, particularly the modeling involved in learning, also plays a key role in Bandura’s social learning theory or in Roger’s innovation diffusion theory. Social or technological networks provide ample learning to learn from other participants in many different ways, either as active participant or passive recipient of the information and ideas addressed.  

Persistent presence

Well run and managed networks also provide a consistent presence for participants around the clock and without holiday or weekend brakes. As such, they provide information and access to other participants at any time. This constant availability provides flexibility but also reassurance as information is available as needed.  


Social and technological netrworks based on or guided by these characteristics should make it possible for almost all professionals to avoid professional isolation and stay up-to-date on professional matters and beyond. The challenge is to construct networks, which are attractive, useful, manageable and sustainable.




August 22, 2010 Posted by | Behaviour modification | Leave a comment

Tackling health inequality and mental wellbeing in the community: Reflection on a project evaluation

The first impression I had when starting an evaluation of a project tackling health inequalities and mental wellbeing in a defined community was that the key terms are vague and – at least on first impression- not well defined. Hence, first challenge for the evaluation.

The project builds on changes to existing service delivery within the area, particularly on improved partnership working. Here is the second (and related) challenge, what does partnership working mean?

A look through the baseline data and relevant community surveys showed another interesting picture. 80% of the project area was classified as very deprived in Council and Government reports. However, survey findings indicate high satisfaction with most features of the area. The main problems appear to be drug use and prostitution but these were mentioned as problems by less than a third of the surveyed people. Also, some wellbeing scores (using WemWbs) were higher in this area than in one of the regions most affluent areas. Serendipitously, just this week a paper was published looking income and happiness in a global survey.

The authors write that  the level of income was a predictor of life evaluation but not so much of positive and negative feelings. These feelings were strongly related to the fulfillment of psychological needs, including learning, autonomy, using one’s skills, respect, and the ability to count on others in an emergency. They conclude that a person’s economic status and psycho-social evaluation predict different types of well-being. Interesting.

July 27, 2010 Posted by | Uncategorized | Leave a comment

Partnership working in health care – Ontological and epistemological perspectives

Partnership working: What is it and how do we know it when we see it?

The following is a summary and reflection on Janette Pow’s PhD Thesis entitled “Assessing partnership working: Evidence from the National Sexual Health Demonstration Project“.  I had the honour of being one of her supervisors and I am now able to reap the harvest from her excellent work. All the substantial information provided is taken out of her thesis, which is an excellent read!! My only contributions are the odd comments and bridges.

Reference: Pow, J. (2010). Assessing partnership working: Evidence from the National Sexual Health Demonstration Project. Unpublished thesis: Napier University.

Partnership working has been a buzz word within health care and beyond for quite a while. Yet, defining partnership working is a “terminological quagmire” (Lloyd, et al 2001). Terms such as collaboration, cooperation, coordination, coalition, network, alliance and partnership are often used interchangeably within the same literature (Huxham 1996, Percy-Smith 2005 and Sloper 2004).  Indeed, the Audit Commission (2004) argued that “the term partnership is increasingly losing credibility, as it has become a catch all for a wide range of concepts, and a panacea for a multitude of ills”.

Thankfully, various systems to identify and evaluate partnership working have been developed. Overall, partnership working is likely also to involve a combination of social, political, environmental and health care factors (Baron-Epel et al 2003).  Various ways to characterise partnerships in more detail have also been suggested. For example, the Audit Commission (1998) differentiates between formal and informal partnerships, whereas Lasker et al (2003) distinguish between strategic and operational partnerships.

Wildridge (2004)  is one of many authors who provided  assistance in navigating this quagmire by identifying several commonalities between the different conceptualisations of partnerships.

Commonalities between the different conceptualisations of partnerships (Wildridge, 2004)

  • Between organizations, groups, agencies, individuals, disciplines

  • Common aim or aims, vision, goals, mission or interests

  • Joint rights, resources and responsibilities

  • New structure(s) and processes

  • Autonomous, independent

  • Improve and enhance access to services for users and carer’s

  • Equality

  • Trust

Ling (2002), on the other hand, provided an  illuminating perspective on variations in partnership characteristica.

Varying characteristics in partnership working (Ling, 2002)

Partnership Members

Links between partners

Scale and Boundaries

Organizational context of partnership


High or low trust


‘Fit’ with existing institutional architecture

Parts of organizations

Equal or hierarchical

Numbers of partners

Maturity of relationships

Whole organizations

Focused or broad sweep

Boundaries (where they are drawn)

Legitimate or illegitimate


Co-evolution, coupling and convergence

Boundaries (tight or loose)

Resource dependency



Boundaries (own or mandate)

Impact/steerage capacity


Continue reading

July 20, 2010 Posted by | Uncategorized | 1 Comment

Protected: Is the hegemony of medicine a burden for health care provision?

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June 2, 2010 Posted by | Uncategorized | Enter your password to view comments.

Taking Moodle into Prison Dentistry

It’s official, I’ll start a new job in August looking into oral health promotion in Scottish prisons. Here are my first thoughts ab0ut how to approach that.

Dentists working in prisons tend to work in professional isolation. They are usually the only dentist in a prison and work without the support of dental hygienists or therapists. In addition to dental and oral health challenges they are also working in an environment, which is, at times, challenging their interpersonal and stress management skills.

Dentistry in prison is also rarely a funding priority, which results in under-staffing, long waiting times, logistic difficulties in moving prisoners from their cells to the prison surgery, difficulties sourcing necessary equipment and materials in a timely fashion, etc.

While the funding shortage is not likely to change, there are some apparently cost-neutral strategies to at least address professional isolation, professional development as well as sharing of good practice and challenges.

Moodle is an open source, virtual learning environment, which is free to use. It has been traditionally adopted in schools or Universities but is now used by almost 50,000 organisations across the globe. This widespread uptake is a testimony of its flexibility, free service, interactivity and a host of other features, which are either part and parcel of the package or can easily be linked to wherever they are in the web. As a result, it lends itself well as a platform to support collaboration and networking among groups like prison dentists as well as between dentists and other professions (health and otherwise).

I’ll be keeping a close eye on David’s blog to inform my thinking and approach on this matter.

Let’s assume that offering a Moodle platform to prison dentists is a good idea.  First of all, prison dentists would have to be part of this right from the start. They would need to inform the content of the Moodle platform, the tools utilised, the appearance, and the level of interactivity.

What arguments are there to convince them of the benefits of participating in such an endeavour? How could these arguments be presented so that they convince dentists and potential funders?

Let’s use David’s ideas for the first time and explore the concept of distributive or distributed leadership. Distributed leadership was described “as a shared process of enhancing the collective and individual capacity of people to accomplish their work roles effectively” (Yukl, 1999, p. 292). Exploring the idea of distributed leadership makes intuitive sense from a number of perspectives.

  • Prison dentists are highly qualified professionals used to working in isolation. Each one is an expert in their field, potentially providing gold standard care, which could inform service delivery in general. Often they also work in private practice where they have leadership roles in their business.
  • There is usually one dentist per prison. Each prison will provide an idiosyncratic context for the dentist’s work. Consequently, each prison dentist needs to consider his environment but may be able to benefit from other perspectives in the aim of improving practice generally as well as in each prison context.
  • Health care provision in prisons falls under the responsibility of various leaders, including health professionals, prison authorities, and governance institutions. A distributed leadership perspective would allow for the various roles and remits to be integrated.
  • The skills required to provide gold standard oral health care within the constraints and unique challenges of the prison system are likely to exceed the skills set of any one person.

On the other hand, it may be a stretch to call individual dentists’ practice shared leadership. Maybe, this should rather be viewed as a network or a potential partnership. Let’s have a look at partnership working within the health context. Following this, I’ll delve into Social Network Analysis.


Yukl, G. (1999). An evaluation of conceptual weaknesses in transformational and charismatic leadership theories. Leadership Quarterly, 10(2), p. 285-305.

May 13, 2010 Posted by | Dental care research | 3 Comments

Biophilia – A synopsis of the concept as presented in Erich Fromm’s ‘The Heart of Man’

I found a first edition of this book online for a good price and bought it. That was a couple of years ago. I finally managed to read it and it was an interesting journey back in time, both in zeitgeist (written and published during and shortly after the Pig’s Bay crisis and the threat of nuclear war) and psychodynamic theory.

Fromm is searching for the essence of mankind, the characteristic that defines humans. His take on this is that the basic position of man is to stand apart from nature due to his ability to be aware of himself and his consequential ability to be reflexive. These abilities separate man from nature and make him stand alone. Fromm refers to this separation as a contradiction inherent in human existence” (Fromm, 1964, p. 116). This contradiction is evident in two ways.

1) Albeit being an animal, man’s survival instincts are incomplete or not sufficient to survive anymore (they have become blunt). Man relies on speech and tools to survive and that makes him special among all other living beings (although this might not be quite true anymore today, as we discovered some animals using tools and know more about their communication strategies).

2) We are aware of ourselves and of the fact that we are mortal. In this sense, we transcend nature because we are aware of life itself (the animal is not, which makes it a part of nature).

His quest about how we deal with this contradiction in our existence leads him to the question of whether our action are based on free will or whether they are determined by nature and/or nurture. He brings this conflict and contradiction to the point as follows:

“Man is confronted with the frightening conflict of being a prisoner of nature, yet being free in his thoughts; being part of nature, and yet to be as it were a freak of nature; being neither here nor there. Human self-awareness has made man a stranger in the world, separate, lonely, and frightened” (Fromm, 1964, p. 117).

As a result, we strive towards overcoming our sense of separateness and to become one again with nature. Our attempts at achieving a sense of belonging, we either regress or progress. Regression leads us back to nature (i.e. Rousseau, becoming childlike or childish, the womb), to animal life (rule of strength, violence, etc.) and to our ancestors (religions, laws, etc.). Progression means to develop to become fully human and to regain the lost harmony with nature and to lose the terror of separateness.

Fromm explores humans’ ‘Genius for Good and Evil’ and our regressive and progressive paths by investigating the dimensions of narcissism (benign-malignant), necrophilia-biophilia and incestuous ties (absent – incestuous symbiosis). In their malignant or destructive expressions, he calls these three concepts the syndrome of decay. This syndrome encompasses all tendencies directed against life and finds its expression in necrophilia, narcissism, and incest. I have always been particularly interested in his concept of biophilia. Hence, I summarised the key aspects of biophilia, as well as its opposite necrophila, below.

Necrophilia or the love of the dead shows itself in sexual perversion or the ‘morbid desire to be in the presence of a dead body’ (Fromm, 1964, p. 39). However, it is more than that. A person with necrophilous tendencies is drawn to everything that is dead or not alive, including corpses, decay, feces, dirt. They prefer to talk about sickness, funerals, death, destruction, the past; they are ‘cold, distant, devotees of law and order’ (p. 40) and like the use of force. Necrophiles like everything that does not grow but which is mechanical. ‘The necrophilous person is driven by the desire to transform the organic into the inorganic, to approach life mechanially, as if all living persons were things. All living processes, feelings, and thoughts are transformed into things’ (p.41). He continues to provide example in a similar vein but I think the picture he draws is emerging.

The opposite to necrophilia is biophilia, the love of life, the attraction to everything that lives and grows. Preserving life and preventing death is one form of biophilia. Biophilous tendencies can be much more varied and tend to integrate and unite, to fuse with different and opposite entities (this starts on a molecular level but also includes sexual union). This productive orientation expresses itself in curiosity, preference of the new over the old and a functional rather than mechanical approach to life. For biophilia to emerge or be sustained, certain societal conditions need to be in place. Chief among them are the absence of injustice and the presence of freedom to create and innovate.

Interestingly, Fromm also had something to say about knowledge management: ‘Briefly then, intellectualization, quantification, abstractification, bureaucratization, and reification – the very characteristics of modern industrial society, when applied to people rather than to things, are not the principles of life but those of mechanics. People living in such systems become indifferent to life and even attracted to death‘ (Fromm, 1964, p. 59).

The concept of biophilia encompasses people searching for self-awareness, aspirations, and growth. Given the current emphasis on mindfulness in psychological therapies and beyond, it was interesting to rediscover that in the 60s, when this book was published, From was already repeatedly referring to Buddhism and the eightfold path leading to awareness to the good in man by discovering him/herself. Moreover, Fromm’s approach fits with the psychological, health, and economic theories for which I have the greatest affinity: Frankl’s Logotherapy and Existential Analysis, Antonovsky’s Salutogenesis and Amartya Sen’s Capability Approach.

May 8, 2010 Posted by | Behaviour modification, mindfulness | 3 Comments

Cognition Accelerated by Just 4 x 20 Minutes Meditation

I came across this blog and it was another piece of evidence about the benefits of mindfulness mediation.

Cognition Accelerated by Just 4 x 20 Minutes Meditation.

May 2, 2010 Posted by | mindfulness | Leave a comment

A selection of psychological theories on motivation

Below is a quick overview of the main motivation theories used in psychology, education, economics, and public health. I took most of the information off the net and provided links to informative, yet brief, sites.

Content theories of motivation

Content theories explore the forces or building blocks driving peoples actions.

The main content theories of motivation are:

–     Maslow’s Hierarchy of Needs

–     ERG

–     Herzberg’s Two Factor theory

Maslow’s Hierarchy of Needs

Maslow’s Hierarchy of Needs model has definitely become part of common knowledge. A short but educational summary of the main tenets of this theory can be found at

ERG Theory

Clayten Alderfer modified Maslow’s Hierarchy of Need by summarizing the levels of need into three basic categories: existence needs, relatedness needs, growth needs (ERG). More about ERG and the differences to Maslow’s model can be found in a short and concise overview at .

Herzberg’s Two-factor Theory

Herzberg’s theory takes a different perspective on what motivates (satisfies) or de-motivates (dissatisfies) us. In a nutshell, Herzberg’s theory did not define satisfaction and dissatisfaction as being at opposite ends of the same continuum. The opposite of satisfaction is not dissatisfaction, but no satisfaction. The opposite of dissatisfaction is not satisfaction, but no dissatisfaction.

The following figures provide schematic overviews of the traditional view of viewing satisfaction and dissatisfaction on two ends of the same scale. Herzberg, as discussed above, saw different factors leading to satisfaction and dissatisfaction.

For more information, including critical views of the theory’s validity, see one of the links below:

Here is a link to Herzberg’s book in which he outlines his two-factor theory: Motivation to Work

Process theories of motivation

Process theories explore the cognitive processes determining people’s actions.

The major process theories are

–     Equity theory

–     Expectancy theory

–     Goal-setting theory

Equity theory

According to equity theory the perception of unfairness in a social or organisational setting leads to tension, which in turn motivates the individual to act to resolve that unfairness.
For more information, see

Expectancy theory

F = ∑(V x I x E)

Expectancy theory argues that the strengths or ‘force’ of an individual’s motivation for behaviour change is expressed as the product of the valence of the outcome from that behaviour, the expectancy that effort will lead to good performance, and the instrumentality of good performance in leading to valued outcomes.

For more information, see

Goal-setting theory

Goal setting is both a process theory of motivation and a motivational technique, based on the argument that work performance can be explained with reference to characteristics of the objectives being pursued, such as goal difficulty, goal specificity and knowledge of results.

For more information, see

April 15, 2010 Posted by | Uncategorized | 1 Comment

Evaluability assessment

Here is a manuscript I started to write a couple of years back. I never finished it to a standard that made me consider submitting it to a journal. However, it should contain enough information to provide an overview of the nature and benefits of evaluability assessments.

Evaluability assessment

April 15, 2010 Posted by | Uncategorized | Leave a comment


As a first and quick response to David’s blog, I uploaded a Powerpoint presentation on Salutogenesis. This should provide a rough overview of this inspiring perspective on health promotion

April 15, 2010 Posted by | Uncategorized | 1 Comment