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social, health, political imagery through the lens of G J Huba PhD © 2012-2021

Posts from the Psychology Category

I guess it’s just me … I search Google for sites with “psychology mind maps” and I get lotsa pages returned. Of course very FEW of these pages let you know where the ideas, recommendations, and organization comes from. That makes me pretty pissed off.

I have a simple rule for evaluating psycho-pop, psycho-babble, psycho-art, and psycho-schmaltz: if the author (artist, developer) cannot prove to me that the information came from a credible source and is being communicated by a credible source, I assume it is psycho-fantasy and just walk (actually run) away.

Here’s a few things to ask about before you go ahead and change your job, spouse, running shoes, or haircut because somebody gives you some magic MBTI letters, a number on a test published in a self-magazine, or advice that must be right because it appears in a pretty mind map.

I love great psychology content conveyed in an easy to understand manner. I hope I produce some. Most do not produce anything except profits. Know what you are buying (and staking your life on) when you get information from a book, TV, the Internet, text, or a graphic.

Please click on the diagram to zoom in.

Don't Believe a Psychology (Self Help) Mind Map Unless it Tells You

Irv Oii is known to many international news organizations and researchers as a star data journalist. Being a home worker (although home may be the UK, Ohio, the Middle East, Central Africa, Hong Kong, or Antartica) and a fairly reclusive person, nobody seems to have met Irv. Some speculate that he might be a Jewish Asian-American. Others believe Irv is short for Irvelina, a Russian immigrant physician who went to Ohio (or was it Ojai, California) when the Soviet science programs collapsed and turned into the lower funded Russian collaborative efforts with the EU and USA. The collapse of the Soviet Union resulted in the closing of her laboratory in Minsk. Some even think Irv Oii is an acronym.

Irv is thus an enigma and no pictures of her/him seem to exist. An artist’s conception (mine) based on the writings and consultations of Irv Oii on healthcare breakthroughs is shown below. My belief is that a portrait of Irv should hang over the desk of every data journalist and researcher.

Please click the image to zoom.

Irv Oii

Please click on the graphics to zoom.

it's program evaluation,  not research, dummy

 

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evaluationmap

researchmap

Note: November 2015

I started writing about the importance of the content in the mind map — facts and important information well researched — back in November 2012. For the next few weeks I am intending to repost some of these posts with my updated thoughts about Mind Mapping 3.0 and what I would now call Mind Mapping 4.0. I will introduce Mind Mapping 4.0 after reviewing some of my views about Mind Mapping 3.0.]

It’s fine to put your own notes or feelings or ideas into a mind map that will be for your use or one which will be clearly labelled as you opinion. But, if you want to put ideas into general circulation as “facts,” you need to have done your homework and tie the information in the maps to established research, clinical findings, and expert opinion (and document whose expert opinion it is, whether that of someone else or yourself). Mind Mapping 3.0 was the introduction of high-quality data into this useful method of thinking.

George Huba

I would categorize the pioneering efforts of Tony Buzan and others to introduce and popularize the method of mind mapping as Mind Mapping 1.0 and the parameterizations and resulting computer programs by ThinkBuzan, Topicscape, Mindjet, and others as Mind Mapping 2.0.

[As I saw it in 2012 and continue to view it in 2015] Mind Mapping 3.0 is the integration of computer-assisted mind mapping methods, artistic sensibility to enhance visualization, AND MOST IMPORTANTLY, substantive, creative, well-documented valid and reliable content of great importance.

Click on the figure to expand.

Mind Mapping 3.0

There are a number of things that can be done to cut the cost of healthcare while, at the same time, freeing doctors and others to do their jobs better. These improvements cost almost nothing to implement [if all of the constituencies and politicians do not compete to be King Kong].

Visiting legislator who stumbled across this web page? Here’s your chance to act like a grown-up and represent the people of the world, not drug companies nor major research universities nor individual “researcher” egos and retirement funds.

Click on images to expand.[almost free] strategies to improve healthcare

Cartoon Rabbit - Giving A Thumbs Up

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Click on the images to zoom.

The fictional detectives would have been great program evaluators. All looked at all types of data. Miss Marple was a model of pleasantry who could work her way into an organization or group and see it as it was without changing anything by observing. Holmes and Watson — whether in the original books and movies, the Ironman version of the movies, their current BBC incarnation in 21st Century London, or their CBS incarnation in 21st Century Manhattan with Dr John Watson now Dr Joan Watson (for the better) — use Holmes’ razor sharp mind and Watson’s intuitiveness and questioning. Sam Spade, wise cracks, an iron fist, and underlying sensitivity.

Program evaluation is not about conducting research, randomly assigning participants to conditions, or using quasi-experimental designs. Program evaluation is about understanding why programs produce certain outcomes, intended or not, positive or not, unique or not. To truly understand a program quantitative and qualitative data needs to be collected with great attention to the sensibilities, needs, risks, and potential confidentiality breaches of data of program participants, program staff, program administration, funders, and other stakeholders.

I love program evaluation. Every program is unique and at the same time representative of certain classes of human service organizations.

Be a detective. Look carefully and understand the beauty of a well-running program and how to help staff improve a program that is not working as well as it could.

evaluation detective work

A Life in Hats

Click on the image to enlarge it.

Symbols bring back a lot of memories. 1951 and being born (literally) in that tiny corner of the Bronx where Yankee Stadium faced the Polo Grounds (home of the New York, now San Francisco, Giants). My Dad told a story of studying for his college classes while caring for me as an infant and listening to the sounds coming from the two ball parks on the same summer evening. 1957 was the start of a life and elementary school in Massachusetts where my grandfather was the world’s longest suffering Boston Red Sox fan. In 1968 I left high school after 11th grade without graduating with the intention of being a physicist, discovered psychology soon thereafter, and graduated from Fordham College in 1972. In 1976 I left Yale after completing my PhD program. The Yale hat is the most important one of my life. 77 saw me at the University of Minnesota freezing my butt off and the next year I was in Los Angeles at UCLA warming it up. In 1980 I received my psychologist license and then went through the 1980s and 1990s as a committed, harried, stressed out Los Angeleno. In 1988 I started my own company and promptly appointed myself president. The 2000s were a time for becoming a committed North Carolinian, relaxing, and learning to say y’all. 9/11, of course, was the day most Americans started rethinking many issues in their lives.

The important part of this timeline is that these simple symbols mean a lot to ME and each evokes hundreds of direct memories and thousands of extended associations.

There is a lot to be said about trying techniques like this timeline to bring back cherished memories that you haven’t thought about in a while. Maybe the right symbols for you are concerts or movies or births or vacations or stages in the lives of your family members. Consider using symbols; a lot of our memories are encoded around images and not around words.

The University of Minnesota hat evokes some really funny stories like buying an ice cream cone in 20 degree weather (probably in October or April) from an outside vendor and walking down the street not having to worry about drips. Or playing marathon games of pinball or the first video games (pong, pacman) with a fellow assistant professor. That California Angels hat makes me think of standing in line from 2am on to purchase tickets for the American League (baseball) championships and then two or threes weeks later standing in line all night to get opening Saturday tickets for the Empire Strikes Back and becoming one of the first to know Darth Vader was Luke Skywalker’s father. Little things, big things, all stringing together in my memory from various symbols.

You might want to try this yourself. Works for me; may work for you too.

Aside 1: My grandfather had Alzheimer’s disease. Any time you put a Red Sox symbol in front of him you heard about Ted Williams, and the damn NY Yankees, and the Green Monster, and the times he took me to minor league baseball games as a kid, and how good (really bad) I was at baseball, etc. My baseball memories of him are those of the years before the dementia when he multi-tasked (in the 1960s) by having TWO different baseball games going on the radio at once (cacophony in that house) and a baseball game on TV. At times he was reading the then new magazine Sports Illustrated at the same time or the local sports section. If you asked him what had happened recently in any of the three games, he would tell you the last 10 plays or so or what Carl Yastremski had done in his at bats that day. And yes, he took me to at least 50 minor league (AA; Springfield Giants) baseball games every spring and summer. And I’m pretty sure he purchased a hot dog and popcorn for me at every game where we always sat in the same seats behind home plate.

Aside 2: If you look around my office or other living space, you will see that it is filled with small symbols that evoke memories (in my case baseball hats, pens, coffee mugs from meetings and vacations and schools, old office equipment in a big stack). If you look around most homes, you will see something parallel to my office. Why did you think we all patronize the souvenir shops at the national parks and airports and sports stadiums and try to keep our kids out but only half-heartedly? Symbols to organize and elicit memories.

The Program Evaluator's Tool Kit

Measure, Find Relationships, Communicate

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Ask the Big Questions and Study How the Answers Relate to One Anotherimage

Decode Events and Naturally Occurring Data

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Examine in Detail

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Listen
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Find Patterns
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This analysis, that analysis, yesterday’s analysis, tomorrow’s analysis, Uncle Izzy’s analysis … is there anything that is a not a form of analysis? Create your own bullshit anagram and bullshit detector. And then see how well it applies various politicians, political claims, the cable news stations, and others. You’re on your way to become a walking, human bullshit analyzer.

So without much further ado, a new form of analysis. And a make your own anagram template.

bullshit analysis

The Old …

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The Current …

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And the Ideal

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  • Click on images to zoom.
  • Note that both the placement of the circles AND the front to back placement are significant and intentional.

This is the first of a series of posts I am making about program-organizational (and individual) evaluation. Much of what I will discuss is not in the mainstream of traditional program evaluation methodology.

My approach is different. It works.

In this first section the point is — obviously — that evaluation is iterative and nonlinear. This led to my first model that EVALUATION IS DETECTIVE WORK several decades ago. [Perhaps that explains my current obsession with all versions of Sherlock Holmes, whether in the original, present London, present New York, or by Iron Man.] At any rate, it seems ELEMENTARY to me that instead of thinking of program evaluation as a linear research experiment with a fixed design (a metaphor that works at best imperfectly), it is more important to treat evaluation as detective work where good rules of evidence must be followed and the evaluator is at fault if all outcomes are not found.

My initial development of the Detective Model in 1992 came from my observation that in much traditional program evaluation the evaluator applies a flawed “research” experimental model and the insensitivity of this approach means that a program looks worse than it is because the evaluation methodology is in error. Who pays for this problem? The program, of course, since the evaluator walks away saying that the “program sucks” and not that the evaluator screwed up. In the Detective Model, applied iteratively and nonlinearly, the evaluator and the program are partners, and it is clear what the responsibilities and level of success each has.

Seems ELEMENTARY to me.

As usual click on the image to zoom.

Evaluation is an Iterative, Non-linear Process

Look around at the restaurant or on the subway or on airplanes or at bicycle riders (yup, see it a lot around here) or at store workers or person in the car next to you at the red light or in television shows and at businesspeople, teens, tweens, older adults, hospital patients, hospital doctors,  athletes, the disabled, those wearing the most trendy clothes and those dressed in all black with black hats/scarves. Data is streaming into all of their lives: email, texts, videos, music, e-magazines and e-newspapers, web sites world wide, Twitter, Facebook, Instagram, and the local restaurant’s menu. Netflix, iTunes, Amazon Prime, your bank, your doctor, your pharmacy, your local fast food purveyor, extra news and feeds from the sporting event you are attending, the latest Kardashian kamikazi komedy.

The video game is the work of the Devil.

With the exception of an increasingly small percentage of individuals with unlimited data because they were early adopters and have not changed their cellular plans, most of us are paying by the gigabyte. Those with free plans are throttled so that they really cannot use an unlimited amount of data for a fixed price so the fixed prices will go away soon.

Drop data prices, streaming will expand exponentially, the phone companies will make even more money, you will never see your friends in the flesh anymore, family dinners as we knew them in 1960 or even 1980 will be dead and replaced by family members sitting at the same table eating junk food and each watching their own data stream, and no one will want to go to the movie theater or red box anymore. Even the Columbian cocaine lords may go out of business.

Data overload will lead to data addiction and probably result in humanity evolving into the Borg Collective.

Borg

We need to make some changes before Skynet and the Terminators become inevitable.

skynet


terminators

I think the human race has no more than 30 years to evolve before the bytes take over. It will make the “War on Drugs” seem like the good old days and war with the Cylons inevitable. If you thought Big Pharma was going to control your life by promising the end to pain and disease, think again. Big Wireless will be even more insidious and the way Big Pharma has increased healthcare costs significantly will turn out to have been smaller than wireless when the historians look back in 100 years. Wireless data streaming is already starting to become the crack of the next decades.

Turn the Devil’s toys off when you: go home, go to dinner, watch TV, are in a meeting, are in a class, are in a place of religious observances, go on vacation, go to bed, take a shower, go into the bathroom (yup, your screaming boss may be in a toilet stall at DFW or ORD), or go to a friend’s home. Get out of the habit of pulling your cell phone out to take a picture of your family and then checking your email or Twitter account while you are at it. And stop modeling the “cellular data comes before everything else” lifestyle to your kids.

Even Spock turned the data stream off sometimes. Do so and “Live Long and Prosper.”

Content is Queen. The ultimate point of any mind map is to use and present information clearly in a way that communicates conclusions  that are valid, reliable, and important.

Some examples. Are all of those mind maps floating around showing psychological variables and purporting to illustrate major findings and theories actually using valid information? (Guessing what all people feel like or how they learn and thinking it must be valid since, after all, you are a human, is probably not an indication that you are using highly valid data.) What is the expertise of the individuals who generated the information portrayed in the mind map? Was the information based on empirical studies, well-established theory, the musings of a pop psychology writer, what your Mom taught you, what your best friend thinks, what you saw in a movie? Did you (as a student or casual reader) just read a popular psychology book and accept what that person wrote on how you can be more rich, famous, happy, socially connected, sexy,and thin?

Much attention in mind mapping goes into the “artistic presentation” aspects of the maps, the colors, the rules, the images. And yes, prettier, neater, more original, and more creative maps are probably better received than those that use none of the great tools of visual thinking. But the reality is that the clothing does not make the person nor does the artistry of the map make the content more valid or reliable or important.

The first mind map below shows some of my thoughts and suggestions about how mind maps should be reviewed by experts in the content areas being addressed if the map will be used for purposes other than personal learning or process documentation or as art. That is, if the point of the map is to present facts, then the purported facts really need to be checked by someone who is an expert in the content area. In most cases, I have no problem with authors being responsible for their own work so long as they clearly state their own expertise levels and where the data for the mind maps originated. I have a big problem with someone who is not a trained mental health professional telling the world how to diagnose depression or ADHD. If the author of the map is not an acknowledged expert presenting her or his own work, then the source and limits of the information in the mind map need to be stated, and in some cases, independently evaluated.

Evaluating Mind Maps with Expert Content

The second mind map is actually just the first one produced in iMindMap exported into the alternative computer program MindNode Pro. Is the first map prettier than the second? Sure seems so to me. Is the first map more valid? No. It contains identical information. Does the first map communicate better than the second? Sure seems so to me.

Keep in mind that the goal of most mind mapping is to present valid, reliable, and important information in way that is easily understood, easily remembered, and easily communicated. Using this criterion the first map is probably significantly better.

iMindMap5 Map

The third mind map is identical in content to the two maps just considered but was generated using default options in the program XMIND. The style of the mind map is similar to that of another program (Mindjet AKA MindManager), and is that many argue is the best for presenting information to those in business.

XM Evaluating Mind Maps with %22Expert Content%22

Hopefully by the time you read this, you will have looked carefully at the actual content of the mind map in one or more of the variations. Content is Queen; it is all about the ideas. In the process of mapping, we need to incorporate references to the source of the information displayed. Pretty is good and memorable, but is not more important than the information presented. Content is Queen, although she does look better in a nice dress or business suit.

Keyword Boardtopics and sub-topics: evaluating mind maps with “expert content” criteria information accurate source stated authoritative recognized cited by others opinion? state adult learning multi-channel non-hierarchical non-linear iterative approximations successive small steps link existing knowledge experience emotions cultural memory consensus neuroscience “catchy” style serious disease disaster war human toll horror funny often many topics “lighter” facts graphic usually images fonts colors this opinion mine g j huba phd @drhubaevaluator © 2012 all rights reserved based professional judgment experience 15 years healthcare professionals researchers physicians nurses psychologists social workers others administrators no science citations but read dr seuss really early lexical mind mapper organic style tony buzan thinking flexible suggestions discussion @biggerplate quick notes iteration 1 imindmap mac written on limited to content purportedly expert reproducible empirical “textbook” peer review? content content content content most important meaningful valid reliable educational goals objectives audience mind maps uniqueness used color fonts non-linearity “artistic” memorable by established experts content visual thinkers other concerns mission critical data good empirical public never present as perfect examples medical safety criminal justice financial mental health reproducibility mind map logic data logic education logic expert knowledge conclusions

This figure shows my current core set of apps. I use these about 90% of the time when I am on the iPhone (in addition to the built-in apps). This set of apps permits you to do some pretty advanced calculations, manage tasks, write longish memos, clean up your pictures, use social media, show movies, take notes, and store web pages for later reading.

Who woulda thought in 1967 that tricorders would exist during the lifetimes of my high school friends and I; cell phones did not become available for another 20 years, and the original scientific calculator was released about 1974.

Now half of the adults around me in a college town look like Spock staring into his beloved tricorder (about 8 times the size of an iPhone). A lot of them seem to have about the same degree of social intelligence as Spock as they stare at the machines in restaurants with their friends.

Without further ado, a look at what is on my iPhone.

iphone 5 apps daily core set

Keyword Board

iphone 5 apps: daily core set photography perfectly clear media amazon instant video youtube netflix mind mapping imindmap social media tweetbot pinterest tweetings word press blog task management due clear magazine zite pocket © 2013 g j huba other scan myscript calculator calcbot wolfram alpha notes draft skitch fastfinga3 evernote ia writer day one

BIG Data is coming (or has already come) to healthcare. [It is supposed to usher in new eras of research, economic responsibility, quality and access to healthcare, and better patient outcomes, but that is a subject for another post because it is putting the carriage before the horse to discuss it here.]

What is a data scientist? A new form of bug, a content expert who also knows data issues, an active researcher, someone trained in data analysis and statistics, someone who is acutely aware of relevant laws and ethical concerns in mining health data, a blind empiricist?

This is a tough one because it also touches on how many $$$$$ (€€€€€. ¥¥¥¥¥ , £££££, ﷼﷼﷼﷼﷼, ₩₩₩₩₩, ₱₱₱₱₱) individuals and corporations can make off the carcass of a dying healthcare system.

Never one to back away from a big issue and in search of those who value good healthcare for all over the almighty $ € ¥ £ ₨ ﷼ ₩ ₱, here are some of my thoughts on this issue.

Click image to zoom.

who is a health data scientist

Content knowledge by a well-trained, ethical individual who respects privacy concerns is Queen. Now and forever.

Keyword Board

topics and subtopics: who is a “health” data scientist? trained in healthcare? methodology research databases management information systems psychology? psychometrics other public health? epidemiology other medicine? nursing? social work? education? biostatistics? medical informatics? applied mathematics? engineering? theoretical mathematics? theoretical-academic statistics? information technology? computer science? other? conclusions must know content 70% methods 30% must honor ethics 100% laws practice privacy criminal civil federal state other greatest concerns correctness of results conclusions ethical standards meaningfulness validity reliability privacy utility expert in content field data analysis data systems ethics and privacy other member? association with ethics standards licensed? physician nurse psychologist social worker other regulated? federal hipaa state other insured? professional liability errors and omissions continuing education requirements? ethics renewal of licensure regulatory standards insurer commonsense laws go away if not well trained content field data analysis not statistics committed clean data meaningfulness subject privacy peer review openness ethics ethics ethics are arrogant narrow-minded purely commercial primarily motivated $$$$$ blind number cruncher atheoretical © 2013 g j huba

The USA has no highly visible, charismatic, scientifically-medically experienced, brilliant, and creative leader-spokesperson for federal healthcare programs. IMHO, the last one we had was C. Everett Koop in the 1980s.

Since being such a leader should be a Cabinet-level position, the best-qualified leader would get the same salary as an out-of-work former governor or political operative in the Senior Executive Service (about $200,000).

I favor a “healthcare czar” position to which the directors of various health-related US federal agencies report.

The effects of having a great leader with oversight on most major US healthcare initiatives would be huge. A positive thinking, creative individual should be able to get $100s of millions (or billions) out of the healthcare system while increasing quality. Instead of squeezing physicians on Medicare reimbursements we need someone who can squeeze the bureaucracy to lift money-wasting and unnecessary health regulations, squeeze the health insurance and big pharma industries to get-real about their profits, and energize the general public to personally address such preventable diseases as those related to obesity, alcoholism, tobacco use, and unwanted pregnancies. Such an individual could get cooperation from the press to research and write stories about positive system change.

Such a change costs only the small expenses of a search committee compromised of prominent health stakeholder groups, and the commitment of the President to health- and socialcare.

There are 100s of great medical-science leaders in the USA who can do a fantastic job of getting healthcare coordinated and understood by the public. Koop was a conservative, traditionally religious, Republican who took on the religious right over his medical conclusions that the reality of good medical practice in the USA had to get over homophobia and hatred of the homeless drug abusers in order to dampen the effects of the HIV epidemic. He also took on the major of lobbies of the tobacco industry in stating clearly that tobacco was addictive and responsible for millions of deaths. Koop’s politics were almost opposite to mine but the actions he concluded were necessary were the same as I would have taken from my liberal vantage points.  Just as a conservative Republican can do an excellent job of guiding the healthcare system if she or he is a committed medical-scientist, so too can a liberal Democratic medical-scientist do a similarly excellent job.

Go ahead dismiss this idea. Then go back to reading my posts on your big Cinema Monitor from the company who had a charismatic leader and type your responses on a keyboard from the same company.

You want a great US national healthcare system that is efficient, treats patients and healthcare providers fairly, and stresses prevention and patient-centered care? Get a great leader. This individual will cost only about $200,000 per year and some ego stroking by POTUS and the Press. Let the unemployed former governors go find out what it is like to live on unemployment benefits and use Medicaid.

WTF hasn’t the search committee already started to form?

Seven Reasons Some  Healthcare-Socialcare Systems  Achieve Better Outcomes

obamacare_t

Trying to find as many typos and logical inconsistencies on my blog as possible. Darn things seem to breed like cockroaches.

And now a cockroach story … not too ugh …

Got start in psych research in an animal learning lab studying single ganglion learning in cockroaches. Important because of technology 40 years ago and simplicity of cockroach. Got cockroaches across street at the Bronx Zoo (they lived in the warm, food rich animal houses of the time). I see a natural progression in my career from studying the “psychological” processes of cockroaches to writing about Congress.

Fractal2

 

Update Jan 2 2013: I think I might study snakes next.

MindMapp is a brilliant new iPad app for mind mapping posted on the app store in mid-December. You can see my review of the app there. Break-through: this is an amazing app that changes the game, at least on the iPad (and hopefully iPhone).

To say that I highly recommend MindMapp is an understatement. Students and everyone who takes notes should have this app.

A map created in MindMapp about MindMapp. This was my first “real” map, and I know that I will get faster and better at this fairly rapidly. It took about 30 minutes to work through the instructions in the included self instruction module, practice, and then to draw the map.

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Here is a little cost comparison I made last year (numbers were current in 2011). This is definitely a case where a mind map can communicate better than a government spread sheet in Courier typeface.

Click image to zoom.

Save $1,410,000 tomahawk

We have the technology to mine archival text and numeric databases and present the results visually in ways more people can interpret and use.

Collectively the world has spent billions (perhaps trillions) of dollars on basic medical and scientific research in the past decade.

Enough with a small review of a few studies known to a scientific author.

Show me the results.

A proposed paradigm …

Paradigm for  Scientific Literature  Reviews and  Meta-Analyses

Click on the image to zoom.

A lot of folks think that if addicts or the mentally ill are offered a free drug abuse or alcoholism treatment episode and then start using drugs or alcohol again that “you had your chance” and “we won’t pay for another try.”

I do not believe that. I studied very effective drug abuse and alcoholism and mental illness programs for three decades and repeatedly found that many people needed as many as a dozen different treatment episodes over many years to finally “get over” the problem. This is true for many clients and it is true for the very best treatment programs in the US. A lifetime of learning to become dependent on drug or a lifetime of feeling helpless and isolated is not going to be solved in 28 days in a hospital-based program or in 90 days in a residential drug abuse treatment program. Yes, it does happen for a few. Most need to try at least a few more times before the treatment works. That is the way it is.

Heck, I’d still be trying after 17 failures to give a person who was willing to try to turn their life around another chance. People are worth that.

Here are some of the chances we need to provide to everyone as many times as needed.

18th Chance

expand 2

Added March 3, 2013

18j 18i 18h 18g 18f 18e 18d 18c 18a

For two years I have argued that mind maps can be (are) good ways to summarize complicated research into easily-understood theoretical models. The mind map below has gone through a few iterations since 2010. This is my version of November 25 2012. All pictures are of the same map.


 

In November 2011, I first distributed a framework for getting rid of HIV/AIDS once and for all. Yes, it will be expensive. Yes, it will take international cooperation. Yes countries, agencies, and individuals have to stop behaving like spoiled children. Yes, it can be done. My ideas are shown below in a slight update made in July 2012.

In the current healthcare system, the people who most need help are the least likely to get it.

Think they need an annual physical, some vaccinations, antibiotics when they get an infection, a scolding when they get too fat, and a lecture when they smoke?  Think again.

How do you deal with an individual who comes into an emergency room (or in the era of Obamacare, the office of a primary health provider) and is “sick.” Is it because they are homeless or abusing drugs or never had regular healthcare before or struggle with a psychiatric diagnosis perhaps developed as a survivor of rape, incest, or alcoholic parents?

Who do you think is in the current publicly-supported healthcare system of last resort? If that panhandler at the stop sign comes to see a doctor, the patient will typically be hungry, a chain smoker, unable to tell a coherent story or provide a medical history, and prepared to blame a doctor for not being able to fix all of the problems the person has encountered through life. Can you separate a life of living on the street while using drugs and eating fast food with lots of fat and cholesterol from what is found in a simple annual blood panel? Can you tell the medical patient to start eating in a healthy way (when the patient is homeless, has no job, has no money for Whole Foods Market)? Can you expect these patients to adhere to a doctor recommended treatment-intervention which might include lots of pills for an unhealthy lifestyle or because of HIV/AIDS?

High need patient-clients in the healthcare system have many needs and difficulties. Fix one and you see three more problems.

We need a system that can deal with patients-clients that have many of the problems shown in the mind map below. Concurrently. Simultaneously.

or alternately (same model, different way of viewing it) …

PS. I know that effective and cost-effective healthcare/socialcare agencies can be built because the US government has created dozens, if not hundreds, of these programs as “demonstrations” that the concept works. The program is then funded for about five years at a “fair” level and after five years receives no further federal funding (the program is then supposed to have a rich aunt or a “corporate” fund raising department). We KNOW that comprehensive service systems can be built, be effective, use resources appropriately and frugally.

It just takes a village.

Oprah, where are you?

One of the things that has frustrated me in the past six months is that as I look back over 60 years, I would like to be able to organize much of the information I accumulated in mind maps into something that looks like a time line. I did learn a while ago about the absolutely fantastic time line mind maps developed by Hans Buskes (@hansbuskes on Twitter; http://mastermindmaps.wordpress.com/) and  Philippe Packu (@IPhilVeryGood on Twitter; http://www.drawmeanidea.com/). These guys have some incredible examples. Far beyond my artistic ability.

So I kept using regular mind maps with a first branch being a year or range of years. The example below shows my reactions to the presidencies of the individuals who served as POTUS during my lifetime. But, notice a little trick I introduced. Instead of the year branch coming directly out of the central idea, I have a “blank” or filler branch and then the time period branch comes out of that. No big deal. Just like a regular mind map with a little piece of formatting.

What I discovered is that my adding the extra (padded) branches in the mind maps like those above, it then takes just about 10 minutes (I need more practice) to go from the mind map above to the one below.

All you have to do is turn off the automatic routine for changing the positions of the branches and drag them around a little. You get the the nice straight line by pinning each of the extra padded branches along a straight line and then letting little time-cluster mind maps grow at the various temporal nodes. Takes almost no time. (Ok, so I did stop and do a little font and picture formatting but it is no big deal). All of these good things happen because the program I used (iMindMap) has a feature that permits you to pin some or all of the branches into specific places. In this case you just have to pin the one padded branch for each of the time nodes.

Want a 3D timeline? Hit the button in iMindMap and you can have one like that below. Note that you also can treat the timeline as a “regular” iMindMap in terms of changing fonts, colors, styles, and adding clip art and images. Kind of cool. I was heavily influenced by the work of Hans and Philippe: this is my attempt to simplify it.

Want a timeline presentation? Yup. There’s a button for that too.

I spent 35 years studying more than a thousand health and social care systems designed to serve the most underserved, disenfranchised, and poor members of our society. These programs were located in 38 states and most major cities of the United States. I think we know what makes a service system successful. Here are my conclusions. And most of these changes are not necessarily expensive to make.