Post-Brexit: out of the ashes, a Kingdom of Londinium?

badge - county of londonPost-Brexit, could London become a separate kingdom within the United Kingdom?

londiniumThe UK and its federated daughter states – former colonies such as Australia and Canada – may not be much different. Canada is a collection of independent provinces, each with its own powers, conjoined as a federation for shared purpose.

The UK is a united kingdom of different kingdoms.

With mechanisms, for centuries, to add or remove territories, change the laws, and change common custom.

Could some of the United Kingdom’s constituent kingdoms stay in the EU, and some parts leave, without damage to the unified UK?

Could the capital of England move back to Winchester? or go Birmingham? or to England’s geographic centre? Even as the Parliament of Great Britain and office of Prime Minister continues in London?

Precedents: coats-of-arms-image

 


Images:

Coat of Arms of the London County Council: By Notscott ((Source: R. Crosley, London’s Coats of Arms (1928)) [Public domain], via Wikimedia Commons: https://commons.wikimedia.org/wiki/File%3ACountyLondon.svg
Seal of the Brussels Capital-Region: By SVG by SiBr4 [Public domain], via Wikimedia Commons: https://commons.wikimedia.org/wiki/File%3AFlag_of_the_Brussels-Capital_Region.svg
Seal of the District of Columbia: By District of Columbia – http://www.vectorslike.com/, Public Domain, https://commons.wikimedia.org/w/index.php?curid=32918640
Coat of Arms of Berlin: Ottfried Neubecker (1908–1992), [Public domain] via Wikimedia Commons: https://commons.wikimedia.org/wiki/File:Coat_of_arms_of_Berlin.svg
Coat of Arms of Lübeck: By SVG by David Liuzzo [Public domain], via Wikimedia Commons: https://commons.wikimedia.org/wiki/File%3AWappen_L%C3%BCbeck_(Alt).svg

Astronaut Double Amputeans and Paraplegians?

It’s all about perspective.

And tenacity.

And determination.

And character.

tom-reaching-for-lab-umbilicals-sts098-330-0071After NASA Astronaut Scott Kelly and Russian cosmonaut Mikhail Kornienko of Roscosmos got home from a year in space this past spring, the US Congress began examining whether to provide lifetime health benefits to astronauts. Many are ex-military and get benefits that way. NASA will monitor recipients for long-duration mission health planning.
 
At industrial design school, one of my human factors projects was a spider-like astrogeology exoskeleton, designed so geologists could move along a cliff face looking at strata. And the thinking fed into iteration #1 of my design thesis: one of the first social web wearables; a performance tool for whitewater slalom athletes. But a bigger aspect of the thinking keeps coming back to me: A question that might help address the dilemma of bone loss. A question that keeps coming back after doing WarriorHealth CombatCare and finding out about the fine work done at Walter Reed National Military Medical Center in Bethseda, MD.

USMC Cororal Todd LoveIs a veteran with paraplegia or no legs the natural spacecraft driver?

Since bone density loss is a key barrier to long-term low gravity living…aren’t technically-trained veteran paraplegians and double amputees great candidates for the astronaut corps? Does a fighter pilot have the discipline, skill and temperament to be a launch driver? Does an armored division tanker have the skills to be an in-flight systems specialist?

Does USMC Corporal Todd Love (an incredibly inspirational guy! seen here) really need legs to operate in micro-gravity, when he might only need wheels on the ground? (As you can see, he does not need legs whatsoever).

I ask you…

Constellation_spacesuitConstellation_spacesuit-paraplegian2

Could this approach create uplifting new opportunities to serve and thrive in a way that makes the unavoidable SCI injury extraordinarily valuable?

Aren’t two-legged people naturally less abled in the spaceflight environment?

Who is the more-natural space-athlete?

Who is the more-natural astronaut?

David Huer


Numbers

US veterans with Spinal Cord Injury (SCI) as of 2008: 26,000 veterans
http://www.military.com/benefits/veterans-health-care/veterans-with-spinal-cord-injury-disorders.html

US citizens with SCI: 240,000 and 337,000 people
New injuries per year, as of 2015: 12,500 people
http://www.sci-info-pages.com/facts.html

Latest EVA suit made by Oceaneering Inc. (Houston, TX):
http://www.nasa.gov/pdf/246726main_ConstellationSpaceSuitSystemBriefing.pdf

Interesting aspects of design/safety aspects
* Effect to bone mass/density and to body functions
* Pant legs + boots: removedaperture and material needs cut by ~40%, with 5 apertures (head, left & right arm, left & right leg) reduced to 3.
* Electronic components & new designs for torso & new “thighboots”
* “Thighboots” reduce the dangers of entanglement & provide push-off tasking as needed
* External prosthetics designed to attach to thighboots

Healthcare research outcome:
Could NASA, the VA and DoD assess impact on SCI to help society groundside?


Images:

US Astronaut Tom Jones (STS-129): https://skywalking1.files.wordpress.com/2009/11/tom-reaching-for-lab-umbilicals-sts098-330-0071.jpg

USMC Corporal Todd Love and Team X-T.R.E.M.E. competing in The Spartan Race, Leesburg, VA, 2012: http://www.dailymail.co.uk/news/article-2195897/Triple-amputee-veteran-completes-grueling-10-5-mile-endurance-race-called-The-Beast-hours-honor-fallen-U-S-soldiers.html

Constellation EVA Spacesuit: NASA http://www.nasa.gov/pdf/246726main_ConstellationSpaceSuitSystemBriefing.pdf
(Image modified with removal of lower extremities in image)

The Flu, Transmitted Infection Vectors & Healthcare Labour

800px-Students_assisting_surgeryCould in-house Facility Epidemiology manage healthcare $compensation costs?
David Huer, Vancouver, Canada.

 

 

In Health Care as in all public safety and assurance occupations, it is vital to protect the trained caregiver from inadvertent harm because that person’s loss damages society’s ability to serve everyone.

vector-path-01

I’ve been at home with flu for a week. Friends from the States came to visit throughout the Lower Mainland and up the coast, then we had a visit. Shortly thereafter, I got walloped. And then, whilst talking to them on the phone later, learned that a group of students, coughing and sniffly, came onto their connecting flight. And learned from my family physician that flu symptoms do not show for 12 hours after exposure. Making us suspect they might be the source vector.

Periodically, I volunteer business services to health clinics, and it was in thinking about that, and the vectoring of this flu, that I’ve been wondering:

Could we recognize a role for Transmitted Infection Vector (TIV) in $compensation rates at a healthcare facility?

Could we alter our definition of effectiveness in patient-centred care, to one where Health Worker salary $compensation is weighted to account for exposure to Patient Transmitted Infection (PTI). Recognizing the likelihood that the worker could become a Transmitted Infection Vector (TIV)?

  • Identifying different risks of exposure of different classes of health worker?
  • Recognizing that different classes have different risk to become TI Vector transmitters?
  • Could this become the means to improve $compensation package effectiveness?
huer-tiv-proximity-risk-chart-01b

TIV Proximity Risk

 


 WHERE TO START

Dartmouth’s Chris Trimble neatly summarizes healthcare innovation pathways at the Dec 2015 article here: http://www.kevinmd.com/blog/2015/12/innovation-health-care-delivery-can-boiled-4-ideas.html

  1. Standardize and delegate
  2. Coordinate
  3. Prevent
  4. Improve treatment decisions

All 4 paths influence this idea, and gathering the data set is enormously challenging if collected with traditional paper and interviews. But, local WiFi/GPS (Smartphone, Geo-fenced In-House Smartphones, Active ID cards) and machine-learning – accessed through programs like Samsung’s Enterprise Alliance Program – offer a nearly automated data-gathering method, that could make this an effective, scalable process and tool for private, public, and mixed-model social enterprise health facilities.

vector-modeling-02b

Building the Combined Model (Actuarial Model + Epidemiological Model) from source data

PHASE O1

  1. Determine Facility Factors
  2. Determine Human Factors
  3. Determine Budget Factors.
vector-modeling-01b

Building the Actuarial Model from source data

PHASE O2

  1. Build and test the Actuarial Model

PHASE 03

  1. Gather “employee path-taking data” to develop epidemiological data for analysis of likely TIV source-paths and source-points.
  2. Develop Epidemiological Model

SUMMARY PHASE

  1. Combine Actuarial and Epidemiological Models
  2. Negotiate $Compensation Packages

Example:

Using the University of New Mexico’s Dental Clinic and Surgery Center.

Rough calculations look interesting:
(see supplementary calculations below coloured hospital maps)
tiv-calc-model-03c

In a traditional payout, the RN Administrator might have highest pay, derived from:

  • Years of Service
  • Seniority
  • Assumed accumulated technical expertise
  • Assumed accumulated humane-contact expertise
  • Terms of a Collective Agreement

In this model, the RN Surgery Nurse is deemed to be likely to face higher risk of becoming a TI Vector. Therefore, to protect the continuing presence of this person as a public resource, s/he is:

  • Deemed to require higher compensation for the risk.
  • Able to choose career paths using the Risk/Compensation ratio [ R/C ].
  • Able to pre-select or accept shift assignments shifts using R/C Ratio guidelines.

 

nmex-overlay-01b

nmex-overlay-02b


The implications are interesting:

  • Health workers of all types (nurses, physicians, security guards, waste cleaning workers, nurse practitioners, administrative staff, mechanical engineers, etc.) experience different levels of stress – and each person’s ability to manage their exhaustion, to obtain compensation, can be hugely challenging. As are suicide and trauma experienced from patient violence and administrative overload. Could TIV-adjusted $compensation packages bring about a new harmoniousness of purpose among health facility staff?
  • Could WiFi/GPS/Machine-learning be used to calculate a fluctuating Premium that adjusts to the ability of RNs carrying out their duties?
  • Could a higher status Surgeon Emeritus (SE) get lower compensation relative to an Active Surgeon (AS) when the SE faces lower daily risk? 
  • Could $Premium compensation go up during a full moon or after a sports match? Will workers choose to pick that busy shift knowing the R/C compensation rate?
  • Would unexpected source-points and source paths be discovered? For example, the handling path for medical waste held as evidence by a police constable?

 

tiv-calc-model-01

 

 

tiv-calc-model-02


Image:

Students assisting surgery in an affiliated hospital of Hebei North University. https://commons.wikimedia.org/wiki/File:Students_assisting_surgery.JPG, Author: CMSRC, 1 April 2008, 21:27:07, Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0).