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Time to write

Fig.1 H809 EMA Mindmap (for fellow H809 / MA ODErs I’ve added a PDF version in the TMA Forum) Created using Simpleminds.

  • H809 – Practice-based research in e-learning
  • MA ODE – Masters in Open and Distance Education
  • TMA – Tutor Marked Assignment
  • PDF – PDF

Yonks ago I realised for me the best time to study was v.early in the morning. 4.00 am to breakfast isn’t unusual, 5.00 am is more typical. All it costs is an early night. This is easy too – no television. Its move from the shed to the dump is imminent.

A week ahead of schedule I find I have an EMA to complete – this’ll give me a three hour, exam like run of it. Even the dog knows not to bother me.

For those on the same path the mindmap of my H809 EMA is above.

Ask if you’re interested in a legible PDF version.

This gorse bush off density has patterns within it that I can decipher. The net result ought to come out somewhere around the 4,000 word mark too. This approach could not be more different to my earliest TMAs and EMAs three years ago – they were too often the product of what I call ‘jazz writing’ (this kind of thing), just tapping away to see where it takes you. This process used to start on scrolls of backing wallpaper taped to my bedroom wall. Now it goes onto a whiteboard first.

As always this blog is an e-portfolio: most notes, moments in student forums and references are in here.

I recommend using a blog platform in this way. You can default to ‘private’, or share with the OU community … or ‘anyone in the world’. One simple addition to this would be a ‘share with your module cohort’.

By now I have clicked through some 165 posts taggeed H809 and can refer to H809ema for those picked out for it.

One split occured – I very much wanted to explore the use of augmented reality in museum visits, but found instead a combination of necessity and logic taking me back to the H809 TMA 01 and a substantial reversioning of it. Quite coincidentally this proposed research on adherence to preventer drugs amongst moderate to severe asthmatics had me taking a very close interest on a rare visit to a hospital outpatient’s. Nasal endoscopy must look like a circus trick to the casual observer as the consultant carefully ‘lances’ my skull through the nose with a slender and flexible rod on which there is a tiny camera and light. ‘Yes, I can see the damage from surgery’ he declares (this was 33 years ago), ‘but no signs of cancer’.

There’s a relief.

An unexplained nose bleed lasting the best part of 10 weeks was put down to my good-boy adherence to a steroid nasal spray that had damaged the soft tissue. And the medical profession wonder why drug adherence can be so low? 20% to 60% 33 years on and courtesy of the OU Library I found a wholly convincing diagnosis – allergic rhinitis. The ‘paper’ runs to over 80 pages excluding references and has some 20 contributors (Bousquet, 2008). I’ll so miss access to the online library as most papers appear to cost around the £9 to download. This desire to remain attached by a digital umbilical chord to such a resource is one reason I wish to pursue yet more postgraduate studying and potentially even an academic career. I get extraordinary satisfaction browsing ‘stuff’ to feed my curiosity.

When I stop diddling around here I’ll pick off this mindmap in a strick clockwise direction from around 1 O’Clock.

Simpleminds is great as a free App. It’s taken me a couple of years to get round to paying £6 for a version that can be exported into a word file though I rather enjoy the slower, more considered ‘cut and paste’ which adds another opportunity to reflect, expand or ditch an idea.

REFERENCE

Bousquet, J, Khaltaev, N, Cruz, A, Denburg, J, Fokkens, W, Togias, A, Zuberbier, T, Baena-Cagnani, C, Canonica, G, Van Weel, C, Agache, I, Aït-Khaled, N, Bachert, C, Blaiss, M, Bonini, S, Boulet, L, Bousquet, P, Camargos, P, Carlsen, K, & Chen, Y (2008) ‘Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update (in collaboration with the World Health Organization, GA2LEN’, Allergy, 63, pp. 8-160, Academic Search Complete, EBSCOhost, viewed 19 June 2013.

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We’re no longer trying to sell magic potions out the back of a tub-trap

Photo

Fig.1. We’re no longer trying to sell magic potions out the back of a tub-trap. 

Still playing catch-up after the Tutor Marked Assignment (TMA)

Through week six writing and most activities (a few hours left to wrap)

I’m on my seventh Open University Postgraduate module – six on e-learning, one from the MBA programme.

I’m familiar with week 7 as we begin week 8.

I’ll catch up over the weekend.

Perhaps.

If it rains a good deal and my son’s football is off (again). This will come back to haunt me – with all the bad weather they are moving to two matches a week. The Daddy Taxi might be busy.

For H809 conjured up the ‘Perfect Storm of Online Research’

  • Young people, including minors
  • Online – gamified if not virtual worlds, with social aspects (whether wanted or not)
  • Medical – not a medical market research but ostensibly an ‘intervention’ of sorts that would require expertise, training and sign off for everyone involved.
  • Global – what isn’t if it is accessible online?

The good news?

  • They haven’t found life on Mars yet so I can keep it contained to Earth.

My plan

  • Set further parameters.

I’m looking at use of e-learning to improve uptake of preventer medication by young people with severe moderate asthma (i.e. they are supposed to take a daily preventer inhaler, like me, I do – they don’t).

I may ‘contain’ the research to a group where in some cases a step has already been taken to ameliorate the situation – swimming. I’ll talk to the ASA (hypothetical) and have participants as UK swimmers with asthma

This on ethics and permissions relating to research will be of value. 

University of Oxford Research Integrity

By entering medical research I have entered a minefield!

There are pages of protocols and procedures, training and checks with personnel and so on from the universities, the NHS and UK Government legislation.

Photo

Fig.2 A foothill just turned into climbing Olympus Mons, the 21000m largest mountain on Mars.

A picnic just turned into a medieval banquet for Henry VIII and all his six wives … (I’m off to walk the dog).

If I’m burying my head in sand then it is the red sand of Mars.  In any case, why climb Olympus Mons when I can land on it in a Twitter / PayPal sponsored Mars Rocket.

In truth I am reassured by the scope and comprehensive nature of the guidelines, protocols and legislation.

The wonders of the OU Library

I will never tire from serving my curiosity when I entre the OU Online Library. I am often lost for weeks at a time, dipping into everything that catches my eye, reading some of if all the way through, following up further leads, then further leads until I find I’ve either circumnavigated the globe, dropped back a century or more or am spinning circles in a slow, spiraling descent through a single authors previous thinking.

I don’t need a ball of thread to help me find my way out and there’s no Minotaur to slay at the centre.

All I hate is a underpowered laptop and a rubbish internet connection.

Currently my interest is reseach on compliance, noncompliance, adherence and coherence in use of asthma drugs. I should know, I am one. My compliance is excellent. One asthma attack in my teens and I do everything to the letter. I fail to understand how and why 30% of people with my condition end up hospitalised or dead. The reading is extraordinarily diverse, bringing it down to the person, their identity with the condition and unwillingness to take a couple of puffs on an inhaler morning and night – when surely they are in and out of the bathroom anyway?

If you know any asthmatics like this please put them in touch or send them to my blog where I will add notes.

 

How to improve asthma patient outcomes using spaced education

Cover of "Living with Asthma"

Cover of Living with Asthma

There had been no plans to make this content public, but I thought I’d share it because of my interesting realisation that the Zemanta search tool may be  a reasonably valid way to winkle out papers relevant to a topic of interest. Out of habit it now I offer link to further content that on first appearances seems to  offer similar or contrasting views. Before I look at the selection that was offered to me, and the 7 from the 16 or so I was offered I am going to go through conventional route using the Open University Online Library and see what I may find that to any large extent differs.

I am not a physician or Medical Docotor, though I am asthmatic and have been in, on and off a variety of inhalers and sometimes oral steroids for some thirty years.

Preventer – Inhaled Steroid – two puffs twice a day. Used with a spacer to reduce chances of thrush.

Reliever – as needed, which is generally never, with rare need if I develop a chest infection, in which case I may end up on antibiotics anyway.

Oral Steroids – Very rarely, usually related to a chest infection. Once every five years?

Nebulizer – Never. Unlike my late father and one (or two) relations who take the view that they only need the preventer when they are wheezy … and end up hospitalised when they have an asthma attack and in the case of my father on steroids for so long that he became diabetic.

Preventative measures – know your triggers, avoid them, keep fit and attend an annual Asthma Clinic. I have to be cautious with house dust allergy and its partner in crime – damp. The odd list of triggers includes, at times, bleach, cumin seeds, one of the Lucozade sports drinks (odd that, coming from GSK who also produce asthma drugs). Possibly white flour. Yeast causes other problems too. We have a dog, but I’m not comfortable for long in a house with soft furnishings where there are cats. Get the bedroom windows open as often as possible. Use a specialist vacuum cleaner on the mattress, pillows and duvet. No carpets. No curtain. Leather sofa preferred.

Fig. 1. Twenty years ago I found myself producing, directing and writing a two information videos for a major pharmaceutical company – ‘Living with Asthma’ and ‘the Cost of Asthma’.

These had a shelf life of some ten to fifteen years, eventually to be replaced by DVD and online interactive equivalents. We did a combination of narrative drama reconstruction – a thread from a TV soap  in which a protagonist has an asthma attack, interviews with patients and experts (doctors and pharma) and narration with 3D animations and charts.

The purpose of this exercise is to:

  • Justify and explain the question for a piece of empirical research.
  • Offer FIVE pieces that  support then set you research on its way.
Though an academic exercise I’m going to treat this as something that could find funding, and that I could carry out.
What is the proposed research about? Asthma patient ignorance of best practice in relation to taking their prescribe drugs – why they are taking the drugs, how they work, when they should take them, how and how often …
What is it trying to find out or achieve? Improve patient care i.e. compliance (UK) – so taking their medicine correctly. This is important where the condition is chronic and the symptoms aren’t continuous. People tend to lapse taking the preventative drugs … it takes several days on onset of symptoms for these to kick in.
How will it go about doing that? A randomised controlled trial in which all asthmatics are invited to sign up to receive information over a period of x months, reminders about asthma and their drug taking regime.
What will we learn from it and why was it worth learning? That a significant percentage of asthmatics who have been prescribed an inhaled steroid (preventer medicine) to take twice daily are failing to do so, simply because they don’t see the need to do so unless they are feeling wheezy (a misconception, it should be taken regardless) or they allow their inhalers to run on empty for some time before being aware of this.That a significant percentage of asthmatics, probably largely the same group as above, misuse their reliever inhaler a) taking it too often b) not correctly inhaling so that drug ends up lining their mouth rather than entering their lungs.Taking the right dosage of inhaled steroid, as prescribed, in the correct manner, is likely to reduce need for the reliever inhaler to nil and will result in less long term damage being done to the lining of the lungs.It will improve patient outcomes, reduce the use of inhibitors and reduce hospital visits or overnights where a person has suffered an avoidable asthma attack.

 

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