Oct 27

An exploratory study into HNC patients’ perceptions of their appearance

Posted on by

Every now and again we are fortunate enough to have an opportunity to under take a piece of research in an area that we are passionate about. For a number of years, I’ve been interested in how the treatment of head and neck cancer (HNC) affects a patient’s perceptions about their appearance. As part of my recent MSc in Health Psychology with the University of West of England, I was required to undertake a small research project and decided to scope an exploratory study into this topic. My supervisor Dr Tim Moss suggested that I include an investigation of the concept of ‘positivity’ (also refered to as posttraumatic growth).  The project has now been completed and written up.  Below is a copy of the abstract and if you are interested a PDF will be available in the near future.

The extent of Patients’ Positivity, Appearance Adjustment and Quality of Life following treatment for Head and Neck Cancer: An exploratory study

Background: Facial disfigurement is considered to be one of the most distressing aspects of head and neck cancer (HNC) and its treatment, but it has been the focus of little systematic study.  However there is a growing body of literature supporting the suggestion that such a stressful event may be a catalyst for positive psychosocial changes.  To date there are no existing studies looking at the relationship between quality of life (QoL), sense of appearance and positivity in this patient group.

Aim: To investigate how HNC affect patients’ QoL, sense of appearance and positivity.

Method: A Questionnaire battery containing the Medical Outcomes Short Form 12 (SF-12), Derriford Appearance Scale (DAS24) and Silver Lining Questionnaire (SLQ) was sent to 1,571 patients treated by the Maxillofacial Department in 2009.  The same measures with the inclusion of the University of Washington QoL Questionnaire (UoW), were posted to 299 HNC patients.  The study compares the Maxillofacial patients and HNC patients with reference data and explores associations with clinical factors.

Results: Reasons for non-completion of the questionnaires was given by a 118 patients.  Two hundred and thirty nine (15%) of the Maxillofacial patients and one hundred and thirty two (44%) of the HNC patients returned questionnaires.

The HNC patients had reported less distress and dysfunction related to appearance than age and gender matched norms.  They had similar QoL to other reported HNC patients, but worse than an age matched norm group.  Tumour stage was the only demographic to reveal a difference in relation to appearance.  The HNC patients also reported having a greater sense of positivity than the maxillofacial group and a similar level to previous data collected on lung cancer patients.

The complexity of the patient cohort has introduced many confounding variables, and the number of completed questionnaires was insufficient to identify the significance factors related to the data obtained on the measures.  Although there are indications that age and cancer staging may be particularly important.

Conclusions: The data collected in this study suggests that appearance issues are of less concern to HNC patients than the general population, and that they appear to be more positive, but further research is needed to investigate individual differences allowing for all the confounding variables.  Allowing for the lack of significant findings, we posit some hypotheses that would merit further investigation.  We also suggests that a follow up study, using the same validated questionnaires, over an extended patient group and longitudinally, may be able to identify significant co-variables. This may in turn inform the provision of support and information for patients to aid them in their difficult time.

Oct 17

Empire of the Skies

Posted on by

(Disclosure: I was invited by Andrew Kelly to attend this talk & receive a complementary copy of James’ book and encouraged to blog about it afterwards, I did so I am.)

James Hamilton-Paterson’s new book “Empire of the Skies” has the official sub-title “When Britain’s Aircraft Ruled the World“, but from the interview with Andrew Kelly (Director, Festival of Ideas) it could more accurately be sub-titled “Decline and Delinquency of a National Industry“. Coming to Bristol during celebrations of 100 years of aviation engineering & innovation (BAC100) was thus akin to walking into the lion’s den and giving the lion a slap round the head with a fresh sirloin steak.

In fairness to James, his book begins at the end of the Second World War and focuses mainly on the military jet story. For the most part it is a boys-own style recounting of the early years in jet aircraft development. James’ own fondness and passion for that era is evident throughout and where he dips into melancholy it is for opportunities missed and advantages squandered.

Right at the start of the interview James made the point that, post-war, there were some 23 companies making aircraft from original R&D to production, and a further 9 engine manufactures. The almost mythical status of the RAF and associated planes, meant that politically the companies that built them “couldn’t be allowed to fail”, and where else have we heard that recently?

The following Q&A was predictably robust in defence of the aerospace sector, though too many rambling commentaries without discernible questions left little time or opportunity for a real Question Time cross examination.

From all the post-war jets, four are put forward as ‘great’; the Canberra (in service from 1951 and operational with the Indian Air Force until 2007); the Hunter in the same year (although only from the Mk6 onwards) and still operational with the Lebanese Air Force; the  Vulcan (1952), for which James describes Operation Skyshield in 1961 to test NORAD’s new DEW (Distant Early Warning) radar system where these remarkable aircraft effortlessly breached the US line and landed in New York State, less than 20min flying time from New York City; and the Harrier (1967) which was only the second post-war jet (after the Canberra) to be bought by US, and the last wholly British designed & manufactured military jet. This is also the de-facto end of the story for the book. English Electric Canberra at the 1951 Farnborough Air Show

If I have a criticism of the book it’s that there’s no grand narrative. There’s not enough depth and analysis in this book to genuinely think of it as a dissection of the post-war aerospace industrial decline. Although James apportions blame roughly equally between incompetent management at the companies and dithering short-termism in Government, he doesn’t go into the wider industrial-political story that might have explained why this happened. Its not really the story of Bill Waterson, though he is often the human face to the story. Other characters, such as Flight Lieutenant Al Pollock ‘buzzing’ the Houses of Parliament & flying his Hunter at full tilt through Tower Bridge on 4 April 1968 in protest at the lack of celebration for the 50th Anniversary of the RAF (for which he was discharged without a Court-Martial), are dropping in as vignettes but it’s not really a story of the decline of the RAF either.

The book, much like James during the interview, is at its best when recounting the undeniable bravery and honest patriotism of the people involved in pushing the technological limits of aviation long before the science was understood.

I did learn one cool fact, in 1971 we launched the satellite Prospero on a Black Arrow rocket (another wholly British undertaking) to test solar cells and detect micrometeorites, it’s still up there and probably will be for another 100 years.

Sep 16

How do you ‘lean’ a business?

Posted on by

In these straightened times, its a great opportunity to review your business processes & establish the foundations for the future.

Never let a crisis go to waste. Rahm Emmanuel (via WSJ)

Lean means taking a fundamental look at your business & driving out waste. Some of these wastes will be obvious (work in progress, re-work, multiple sign off sheets, etc) some of the waste may be harder to identify. There are experts in “Lean” & 6 Sigma Black-Belts, these may work for you, but I would suggest that you begin with a strategic review of your purpose, then consider some systems process modelling that will show how well, or otherwise, you are working towards those strategic proposes. From there you can assign costs and added value to activities to help with cast flow forecasting.

Strategic Purpose

You need to have one.

I was lucky to spend some time with Michael Corbett (Product Box, @productbox) a couple of weeks ago using a fairly new method called the “Business Model Canvass“. We spent a couple of minutes talking about the canvass but it’s such a simple, visual method that we quickly started drawing ideas on the sheet and making connections. It was quite fun to be the ‘client’ and not to have to think too hard about the model but just concentrate on the process.

We looked at a business I was involved with and used the Canvass to work up a representation of the business model. The visual approach quickly distilled the Strategic Purpose (which I can waffle on about for ages) and encapsulated a clear  Value Proposition. The business was a good test of the canvass as it’s not a simple model of taking orders, fulfilling orders, rinse & repeat.

We spent quite a bit of time discussing the stakeholders (or customer segments), activities and relationships. This actually identified a critical Value Proposition that I was completely unaware of. It had certainly not been articulated before.

We also worked out most of the rest of the business model, though without much detail. By lunch time we’d 75% of the business model captured, though not in a form that you could have presented to a third party. However, in a dozen or so post-it notes we’d encapsulated most of a traditional business plan and produced a couple of very clear value propositions that, together with the key partners & customer segments, represented a pretty good Strategic Purpose.

Fleshing out the sketch

Michael then pulled out his trump card – he’d set up a Google Site specifically designed to capture the output from our Business Canvas session. This contained all our notes, diagrams, together with a whole load of background info on the canvass, process, and associated references. Basically, all the information necessary to take the insights gained from the business canvas exercise and turn them into an action plan.

Michael explained that, given that it contains all this information in one place, and that it relates to a new product (or service) that he calls it a ProductBox™. Normally we’d have been working on the Canvass as team of business owners / founders / exec’s prior to launching a new product or service, and the ProductBox is designed to keep that team-work going on line. I just happened to be working with Michael on my own.

After our meeting I logged in to my new ProductBox and took a look at the draft diagrams & notes. Because we’d spent the time drafting the original using paper and pens, it was very easy to start using the on-line diagrams. The associated notes helped to expand the short notes with more detail.

After a couple more hours I’d got quite a detailed business model described. I’d also explored some of the panes in the canvas in more detail and put in some background information and explanatory notes on how things related to each other. One of the drawbacks with simple visual representations is that you often lose critical details, having the Product Box with all the notes kept all those notes together with the canvass. Although I was working on this alone (with Michael keeping an eye on me) the package is a wiki so naturally collaborative if you’re in company with others.

After a couple of sessions I had sufficient detail that I would naturally start using something like IDEF0 to detail the business processes needed to make the canvass work. One feature of IDEF that I really like is the concept of layering processes through parent-child relationships, while the Canvass doesn’t force on you, I can see it being a great complement to other approaches (and the wiki design of the ProductBox would help here also).

The end result (even after a couple of sessions) was sufficiently detailed that I could use the canvas as a map of the business model to describe to others. It’s also a live document that can continue to grow as more contributions are posted.

Michael and I discussed the use of the canvass. I think it’s strength is as a planning tool that very quickly and visually allows people to discuss their business model (without lots of MBA mumbo-jumbo). At first I was a little frustrated at the lack of detail, but I’ve come round to appreciate the simplicity of the presentation framework. There’s a lot more detail under the surface and the Product Box that Michael set up allows for almost infinite details if that’s what floats your boat.

Should you Canvass your business?

What I liked was the holistic view of the business model, and the expressed statement about Value Proposition. Anyone thinking of pitching their business should take a look at this approach, and have a chat with Michael.

Thanks to Michael for his comments on an earlier draft of this post and for introducing me to the Business Canvass and ProductBox.

Aug 06

Management vs Money – which is more important?

Posted on by
Montmartre

John Althouse Cohen, 2005

This is an age old problem for the company starting out (or indeed growing rapidly). Obviously a complete lack of top-notch people or abject poverty are both unlikely to lead to success.

But where should your focus be?

This recent piece from Startup Professionals Musing comes down pretty firmly on the people side of the argument. Even with all the caveats about being a US review of investing, the broad findings are valid here in the UK as anywhere else.

With that in mind what can you do?

Well you should get out and meet people that will either be those high quality people, or know them and can introduce you. Make yourself known to the local University incubator teams, go along to your local Open Coffee such as <shameless self-promotion>Open Coffee Bristol</ss-p>, try searching Google for <your town> entrepreneur / startup / etc.

Or go to one of the events specifically put on to help bring growing companies together with exactly the right kind of people to help the do even better.

One such event is the Angel News ‘Pitching for Management not Money’. <Disclosure; I promised Modwenna I’d help promote the event but there’s no financial return to me, and the tickets for this first event are free anyway!> The first of these events outside London (in partnership with Intramezzo and Boulevard) is taking place on Monday 28 Sept at the Smith & Williamson offices in Bristol. Sponsorship from Burges Salmon and Business Link means the tickets for both businesses and prospective executives are free.

If you’re not already registered with Angel News there are a couple of links below to sign up for this event, hope to see you there.
http://www.designcity.co.uk/invites/p4mnm_280910_comp_bris.html
http://www.designcity.co.uk/invites/p4mnm_280910_aud_bris.html

Jun 06

Improv concerts & what social media can learn from them

Posted on by

Yesterday evening I attended the live premier of a BBC Concert Orchestra & Festival of Nature commissioned concert. (Disclosure: Science City Bristol are sponsoring the Science Cafes @ Festival of Nature, but I’ve not been involved in this concert, other than attending.)

The performance was in two halves; a short sequence of clips from the BBC Natural History Unit with the orchestra playing live, short chat with Q&A and then a repeat performance. Why two performances, and what’s it got to do with social media?

Well, the orchestra wasn’t the full BBC Concert Orchestra, 5 members of the orchestra and a composer were joined by 24 young people from schools across Bristol. They met for the first time on Tues, worked for 3.5 days and gave the performance on the Friday. They hadn’t seen the film clips beforehand, and they hadn’t played as an orchestra before. They also didn’t have any written musical score at the performance; it was all played from memory and partly improvised. And it sounded fantastic, both times!

December 28, 2009 by manning999

The key came during the Q&A. When they first watched the film and asked the young people about the music to go with it, there were lots of suggestions about a cymbal crash here, some flute there, and so on. Lots of focus on the individual instruments and notes, but no ‘bigger picture’. The first thing the composer and the BBC Concert Orchestra’s Learning Team did was to re-view the films and talk about that bigger picture, the emotions they evoked or wanted to bring out, the sense of majesty (Humpback Whales) or playfulness (Giant Otters).

Once they had those broad messages and the overall framework of the pieces, then they began to experiment with chord sequences and harmonies. By all accounts it was a very egalitarian approach with ideas being voted on, and continuous refinement selecting or disposing of small parts that worked or didn’t.

In the final performance, most of the music was played from memory, but there were still flashes of inspiration by individual orchestra members, and because they’d gone through that development process and the ground rules were clearly laid out, those individual flourishes could be included without grandstanding or throwing everyone else into confusion. They were all listening intently to each other throughout the performance, as well as having great fun.

You can see the whole thing (well a recording of the concert mixed with the films) on the BBC Big Screen in Millennium Square as part of the Festival of Nature (12-13 June 2010).

Business as music

The parallels with some types of business are quite striking. They had a CEO that was clearly in control, and he empowered this team to do what they do best. They worked on a shared vision and understanding of the broad task at hand, and willingly contributed ideas to other sections if it made the overall performance better. In the actual performance they were working to agreed boundaries but within those boundaries there was freedom to do what was best at that particular instant in time.

Social media as music

Too often people talk about social media in the same way as the young people first approached the films. We could use twitter to send out little updates, and that would link to our Facebook page, and we can pull in our blog rss, and mash up with a Google map, and…

Twitter is not a Strategy

There needs to be a bigger picture. Even if all you’re doing it trying out these tools to see how they work for you or your business, you need to have some thought as the purpose. You also have to have some thought as to the socially acceptable way of doing things. The musical rules that the BBC used were a based on a heptatonic scale, rather than the pentatonic scale. Neither is right or wrong, but you can’t do both at once (at not without calling it ‘experimental’). :)

There’s nothing wrong with breaking a few rules, that’s almost the definition of being a stand-out excellent entrepreneur / artist / individual. But you really need to know which rules you’re breaking and to what purpose.

Of course, with social media the rules aren’t quite the same as in other forms of social interaction, and as new tools come along they can mutate. Fortunately one of the rules that has completely reversed is lurking, allowing you to observe behaviour before you dive in.

Once you have that bigger purpose, knowing what the rules of participation are, then you can choose which tools / instruments will deliver the required performance.

Plans are worthless. Planning is essential. – Winston Churchill, Dwight D. Eisenhower, & many others

And of course things won’t go according to plan, but that’s where having the clear shared sense of purpose means that people can act without having to fight through layers of bureaucracy. And they can act honestly as human beings rather than PR spin-doctors or script-reading robots.

What’s your social media strategy? Listen, plan, listen, act, repeat; or deliver a stream of ‘messages’ across all channels in a blitzkrieg approach?