Hodges' Model: Welcome to the QUAD

- provides a space devoted to the conceptual framework known as Hodges' model. Read about this tool that can help integrate HEALTH, SOCIAL CARE, INFORMATICS and EDUCATION. The model can facilitate PERSON-CENTREDNESS, CURRICULUM DEVELOPMENT, HOLISTIC CARE and REFLECTION. Follow the development of a new website using Drupal (it might happen one day!!). See our bibliography, posts since 2006 and if interested please get in touch [@h2cm OR h2cmng AT yahoo.co.uk]. Welcome.

Tuesday, July 25, 2017

Advertising: The air that we breathe; or don't?

humanistic --------------------------------------- mechanistic

Mental Pollution

Unbranded Advertising

Unbranded advertising of prescription medicines to the public by pharmaceutical companies (Protocol) 

Health - Literacy?

Digital Ad# Fraud
False / Fake Ads

Hodges' model makes explicit the divide between the public and the public's understanding of science.

Consider here the increased noise in advertising channels since the millennium as the media multiply, in addition to false advertising the rise of fake ads. Fake ads for jobs, drugs, goods and a littering of click-bait. Contactless plastic that touches the deepest oceans. Consumerism has become post-truth as any sense of 'standards' are undermined on several fronts.

The overlaps and increased complexity then become apparent.

# 'information'?

n.b. If I recall the source for the paper I will add it here!

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Monday, July 24, 2017

TOILET: Ek Prem Katha

When a love story = Hygiene and Safety

humanistic --------------------------------------- mechanistic

belief hygiene

personal hygiene

political hygiene

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Sunday, July 23, 2017

"Get in that corner! Now!"

"Which one?"

"Don't you be so hard-faced with me.

humanistic --------------------------------------- mechanistic
anxiety                                fear

guilt                                  hate
here - out of sight    out of reach - over here

this corner: out of earshot         that corner
shame                              ridicule

embarassment                     alienation
bullying - abuse                     punishment

injustice                           deportation

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Saturday, July 22, 2017

The harmony of opposites: to relativize the continuous / discontinuous dualism by Michel Lussault

"If we accept a somewhat schematic presentation, we can estimate that the modern Western knowledge system has been deployed on the basis of opposition couples conceived as expressing unquestionable dualities. These couples organized thought, all its activities, under all its regimes including the knowledge of expertise and the knowledge of common sense, and they constituted a kind of cognitive dogmatics; That is to say, they made it possible to define the very relevance of the problems that could be posed. From these dualities, and for a long time from these dualities alone, it has been permitted and legitimate to pose a number of social, political and cultural problems and then to find ways of solving these problems. In view of our integration into the cultural space of the modern West, we all know and experience the prevalence of these antagonistic duos which have structured the thought and continue, albeit in a somewhat more discreet way, -tender." *
Google translation French to English from:

LUSSAULT, Michel. L’harmonie des contraires : pour relativiser le dualisme continu/discontinu In: Continu et discontinu dans l’espace géographique [online]. Tours: Presses universitaires François-Rabelais, 2008 (generated 22 July 2017). Available on the Internet: <http://books.openedition.org/pufr/2398>. ISBN: 9782869063198. DOI: 10.4000/books.pufr.2398.

"On peut estimer, si l’on accepte une présentation un peu schématique, que le système de connaissance moderne occidental s’est déployé à partir du fondement constitué par des couples d’opposition conçus comme exprimant des dualités incontestables. Ces couples ont organisé la pensée, toutes ses activités, sous tous ses régimes y compris les savoirs d’expertise et les savoirs du sens commun, et ils ont constitué une sorte de dogmatique cognitive ; c’est-à-dire qu’ils ont permis de définir la pertinence même des problèmes qui pouvaient être posés. À partir de ces dualités, et pendant longtemps de ces dualités seulement, il a été autorisé et légitime de poser un certain nombre de problèmes sociaux, politiques, culturels et de trouver ensuite des modes de résolution de ces problèmes. Nous connaissons et éprouvons tous encore, compte tenu de notre insertion dans l’espace culturel de l’Occident moderne, la prégnance de ces duos antagonistes qui ont structuré la pensée et continuent, fût-ce de façon un peu plus discrète, de la sous-tendre."
* sous-tendre - 'to underlie it'?

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Bliss + Symbols = Language for Care?

As I have written before on W2tQ the initial attraction of Hodges' model was its relation to brainstorming, mind-mapping, diagrams and the possibility of iconic languages. In addition, in the 1980s graphical user interfaces GUIs were introduced on microcomputers and PCs. There followed a rapidly expanding literature on icons, visual languages and interfaces. I had also heard of a Charles Bliss [ Charles K. Bliss (1897-1985) ] and Bliss Symbolics. So, to brainstorming ... we can add ideographs and pictographs.

This past week BBC Radio 4 explored the life and work of Charles Bliss and the application of Bliss in literacy, care and special needs education. The programme presented by Michael Symmons Roberts is available for 4 weeks. For its 30 minutes length the programme introduces Bliss himself, his life, aims, the challenges he and his wife faced and the ongoing legacy of his work. It could be argued - and has been - that this is a step backwards to hieroglyphs; but the programme is broader in its reference to 'care'...

humanistic --------------------------------------- mechanistic


Wikipedia - Portal:Constructed languages

BBC Radio 4
The Symbols of Bliss

Ideal of
Universal - International

In the 1990s I received some copies of a journal devoted to 'Unish' a constructed language. The link to unish.net does not seem to work, but the Wikipedia site below includes some details.

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Friday, July 21, 2017

New paper for h2cm bibliography "Better palliative care for people with a dementia..."

There is a new paper I have been able to add to the bibliography in the side bar. Here is the abstract and reference with a link. I will post about this again next month, teasing out points relevant to what is a very important combination of care needs and Hodges' model.

Better palliative care for people with a dementia: summary of interdisciplinary workshop highlighting current gaps and recommendations for future research
Dementia is the most common neurological disorder worldwide and is a life-limiting condition, but very often is not recognised as such. People with dementia, and their carers, have been shown to have palliative care needs equal in extent to those of cancer patients. However, many people with advanced dementia are not routinely being assessed to determine their palliative care needs, and it is not clear why this is so.

Main body
An interdisciplinary workshop on “Palliative Care in Neurodegeneration, with a focus on Dementia”, was held in Cork, Ireland, in May 2016. The key aim of this workshop was to discuss the evidence base for palliative care for people with dementia, to identify ‘gaps’ for clinical research, and to make recommendations for interdisciplinary research practice. To lead the discussion throughout the day a multidisciplinary panel of expert speakers were brought together, including both researchers and clinicians from across Ireland and the UK. Targeted invitations were sent to attendees ensuring all key stakeholders were present to contribute to discussions. In total, 49 experts representing 17 different academic and practice settings, attended.

Key topics for discussion were pre-selected based on previously identified research priorities (e.g. James Lind Alliance) and stakeholder input. Key discussion topics included: i. Advance Care Planning for people with Dementia; ii. Personhood in End-of-life Dementia care; iii. Topics in the care of advanced dementia at home. These topics were used as a starting point, and the ethos of the workshop was that the attendees could stimulate discussion and debate in any relevant area, not just the key topics, summarised under iv. Other priorities.

The care experienced by people with dementia and their families has the potential to be improved; palliative care frameworks may have much to offer in this endeavour. However, a solid evidence base is required to translate palliative care into practice in the context of dementia. This paper presents suggested research priorities as a starting point to build this evidence base. An interdisciplinary approach to research and priority setting is essential to develop actionable knowledge in this area.

Dementia Neurodegenerative diseases Interdisciplinary research Research priorities Advance care planning Personhood Care at home

Fox, S., FitzGerald, C., Harrison Dening, K., Irving, K., Kernohan, W.G., Treloar, A., Oliver, D., Guerin, S., Timmons, S., (2017). Better palliative care for people with a dementia: summary of interdisciplinary workshop highlighting current gaps and recommendations for future research. BMC Palliative Care 17, 9. doi:10.1186/s12904-017-0221-0 

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Thursday, July 20, 2017

Special Issue of Learning Health Systems: “Patient Empowerment and the Learning Health System”

New research available now!

Learning Health Systems
Learning Health Systems

Don’t miss the new Special Issue of 
Learning Health Systems

Guest Edited by Joshua C. Rubin

Patient Empowerment and the Learning Health System explores the influence of patient engagement on the development of a Learning Health System.

Learning Health Systems is a peer-reviewed, open access journal dedicated to the science, engineering and design of continuous improvement of health and health care. All articles in the new Special Issue are accessible free of charge.

Inside the New Issue

Patient Empowerment and the Learning Health System
Joshua C. Rubin

Building a learning health community: By the people, for the people
Sally Okun and Kim Goodwin

Advancing the science of patient input throughout the regulatory decision-making process
Million Tegenge et al.

Diverging views on health information exchange organizations
Mari F. Greenberger et al.

Patient-centered drug development and the Learning Health System 
Laura S. Crawford et al.

Developing a framework for integrating health equity into the learning health system
Danielle Brooks et al.

My source: 
A request from -
Kathleen Young
Editorial Assistant, Learning Health Systems
Room 210 Victor Vaughan
1111 East Catherine Street
Ann Arbor, MI 48109

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Wednesday, July 19, 2017

(This...) Peter Jones: At last I'm making an academic impact!

(Northern) Summer Silly Season starts here...?

----- Forwarded Message -----
From: Academia.edu
To: h2cmng@yahoo.co.uk
Sent: Wednesday, 19 July 2017, 3:43
Subject: 697 people recently read a paper you are mentioned in

Dear Peter Jones,

697 people recently read one of the papers that mentions the name "Peter Jones".

A total of 709 papers on Academia mention your name.

Clicking through the link provided (the underline is mine):

709 papers mention the name "Peter Jones"
Receive real time notifications whenever a new paper mentions you and see every paper that mentions your name.


Vain and the constant grandstander that I am, I did not explore further.

There's a big difference between 'me' as an individual and the name "Peter Jones". While naming conventions vary across the world and according to customs and cultures I have a given name and a family name. Jones, like Smith is a pretty big family.

This 'Peter Jones' does not own a helicopter and with it many millions. [Although while 'rich' in many respects - a pay rise is greatly needed for the NHS.] Neither, have I provided the voice for 'The Book' in the TV version of Hitchhiker's Guide to the Universe.

You would think that Academia.edu would recognise the principles at work here. 'Scraping' the web is one thing, this is another...

humanistic --------------------------------------- mechanistic

Dragon's Den + Helicopter



Political news silly season -
is during the 'summer'
or all year long...?

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Tuesday, July 18, 2017

Relativistic - Thinking checks and balances [V]

Effective nurses aspire to be time travellers.

Why should flash traders have all the adventure?

They also need to think relatively and be relativistic thinkers, the latter as described by Johnson (1994). If this sounds like faster than light travel in a sense it is, or at least it should seem like. Meeting the patient as they or someone reaches for the phone to seek help: is obviously taking the anticipation of care needs to the relativistic extreme - so what is this about?

This page at JHU "Perry’s Scheme – Understanding the Intellectual Development of College-Age Students" lists how Perry's formulation is reduced from nine to four levels of development:
  1. Dualism – knowledge is received, not questioned; students feel there is a correct answer to be learned.
  2. Multiplicity – there may be more than one solution to a problem, or there may be no solution; students recognize that their opinions matter.
  3. Relativism – knowledge is seen as contextual; students evaluate viewpoints based on source and evidence, and even experts are subject to scrutiny.
  4. Commitment within relativism – integration of knowledge from other sources with personal experience and reflection; students make commitment to values that matter to them and learn to take responsibility for committed beliefs. There is recognition that the acquisition of knowledge is ongoing activity.
Previous posts from January 2016 - with links supplied below - have reflected on dualistic and multiplistic thinking. I'm still exploring how work in educational psychology might inform my own. Picking up this thread again how does Hodges' model engender and contribute to relativistic thinking? Relativistic thinking as relates to Hodges' model is about a journey and not just one as item #3 above suggests. The student's journey may fly-by in time, but it is long and quite dense. Learners must negotiate lectures, self-study, simulation, patient, carers and public encounters, learning journals, clinical placements, assessed work and assessments, student-mentor sessions and all that the curriculum entails. Within the student's career there are innumerable situations and contexts if we cared to count them.

Responding to #3 Hodges' model can encourage immersion in a given context that presents a learning opportunity. They can also evaluate the situation as the care domains provide an epistemological platform from which to take in viewpoints and in the care domains scrutinize the knowledge that is shared and found through study. This includes the knowledge of experts. Whatever the care domain as a platform and viewport the student finds themselves in they should find a tendency to anticipate the other vistas nearby. Not only that but cognitively if not literally the patient and family when relevant can be with them. For person-centred care isn't just a matter of what is relativistic, but quantum too. 'Where' the patient is: so we are too.

Johnson, D.D. (1994). Dualistic, Multiplistic, and Relativistic Thinking as it Relates to a Psychology Major. Honors Theses. Paper 202.

See also:
William Perry's Scheme of Intellectual and Ethical Development
A journey along the 9 "Perry" positions (as modified by Belenky et al. 1986) by William J. Rapaport

Thinking checks and balances [I]

Dualistic- thinking checks and balances [II]

Dualistic- thinking checks and balances [III] (or: The-hyphen)

Multiplistic - Thinking checks and balances [IV]

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Sunday, July 16, 2017

How Do I Give Bad News? c/o HospiceFoundation.ie

humanistic -------------------------------------------  mechanistic

Level of knowledge and understanding

empathy and rapport
Losses ... many forms ...
shattered hopes, dreams, aspirations

patient's reaction -
anger, anxiety, blame, shock,
helplessness, misinterpretation

Acknowledge reaction
diffusing anger...
Respect denial of bad news

awareness - understanding


It is good to use non-verbal cues to
 convey warmth, sympathy, 
encouragement or reassurance 
to the patient. p.10.

Bad news = information that
affects the individual's
identity - very existence - 
Correct patient and family

Plans to give - convey bad news -
Multidisciplinary Team informed

Bad news = information that affects the individual's future

When to inform?
As soon as information is known.

Ensure environment - time protected, no interruptions, mobile phones ...
At bedside, curtains closed, eye-level, volume of voice, deafness?

Proceed at person's pace
Give information in chunks

Be prepared to 'fire warning shot' -
'telegraph' what may follow

Diagnosis FUTURE prognosis
Time and 'space' often need to be
created and then protected (respected)
or that of a loved one.

shock of others -
family and risk of being overheard
awareness - understanding

social support strengths

Shared resilience with acceptance

A standard to use:
If the person was my relative would I
 have been happy with how the
 news was given? p.6.

How Do I Give Bad News?


Sick child? p.16.

Sudden death? p.20.

Age of consent - 16 years old - 18?

Right to:
  • accurate and true information
  • receive or not receive information
  • decide how much information
  • decide who should be present at consultations
  • decide who should be informed about their diagnosis and what information they should receive
Under no circumstances should you hand over personal belongings in a plastic bag. p.23.


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Saturday, July 15, 2017

c/o Marschalek (2017) Public Engagement in Responsible Research and Innovation

This blog often features EU research initiatives and conferences and a European project (2014-2016) to build a Responsible Research and Innovation (RRI) Toolkit also has a conference series and various publications. Marschalek's dissertation is a invaluable resource on RRI, drawing on the need for reflection, reflexivity, critical thinking and highlighting many models within sciences and participative methods. Reading the following you will hopefully glean the basis for my interest in the document and what might follow the project overall.

1.2 The Relevance of (Self-)Reflection and Reflexivity  
Scientists are not typically asked to anticipate future societal effects of their work. ...  
... But reflections, particularly on non-intended effects, are rarely undertaken. Reflection is not (yet) viewed as an integral part of scientific work. Many other more important issues need to be addressed within a scientific career. ...  
... Studies like this and others have revealed that researchers are rarely encouraged to self-reflect. ... 
... What is needed is to »step into the helicopter« (Schuurbiers, 2011, p. 784) to look at one’s own work from a distance. A look from the outside and feedback also help reflection. »Researchers are not accustomed to viewing their decisions from a normative perspective or discussing the normative aspects of decisions explicitly. ... 
... Unfortunately, not many reflection tools are available as yet. Quality standards and codes of conduct should »stimulate the reflection of the relation between one’s own values and that of external parties« (Asveld, Ganzevles & Osseweijer, 2015, p. 585) and there are self-reflection initiatives to motivate individuals to reflect on the impact of their work, e.g. a »Hippocratic Oath for individual scientists« (Sutcliffe, 2011), but even fewer ask organisations for self-reflection. Marschalek (2017) pp.15-16.

Marschalek, Ilse. (2017). Public Engagement in Responsible Research and Innovation.
A Critical Reflection from the Practitioner’s Point of View. University of Vienna, Vienna.

My source and with thanks:
International Science Shop Contact Point
Norbert Steinhaus
Wissenschaftsladen Bonn - Bonn Science Shop
Reuterstr. 157 - 53113 Bonn – Germany

skype: wilabonn
Twitter: @ScienceShops
facebook: www.facebook.com/livingknowledge

Living Knowledge: Building partnerships for public access to research

Responsible Research & Innovation: RRI Tools
Twitter: @RRITools

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Wednesday, July 12, 2017

WHO news update: Framework on integrated people-centred health services

Dear colleagues,

On behalf of the WHO integrated people-centred health services team, I am pleased to share with you a few news items summarizing our recent work. Please note that all news can be found on our IPCHS webpage.

Innovations from BRICS countries on people-centred health reforms at 70th World Health Assembly


WHO launches Global Service Delivery Network for universal health coverage


New WHO video: What is people-centred care?

We would also like to highlight this recent meeting organized by the WHO European Centre for Primary Health Care in Almaty, Kazakhstan.

New WHO advisory group launched in Almaty to shape the future of primary health care


A WHO inter-regional hospitals meeting on "Transforming hospitals for universal health coverage" also took place alongside these meetings, and a news item will soon be published to our website - please keep your eyes out for it!

We hope that this update will help contribute to your work in advancing our collective IPCHS agenda, and encourage you to please help share these items with your respective networks as you see fit.

Many thanks again for your ongoing commitment and support to the WHO Framework on integrated people-centred health services. We look forward to continuing our collaborations with you in the coming months!

With warm regards,

Stephanie (on behalf of the IPCHS team)
Stephanie Ngo
Services Organization and Clinical Interventions Unit
Service Delivery and Safety Department
World Health Organization | Geneva, Switzerland
Email: ngost AT who.int | Twitter: @stephaniengo

n.b. I have embedded the video not just the link in the above copy from the HIFA maillist. pj

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Tuesday, July 11, 2017

Book: The Vital Question

humanistic --------------------------------------- mechanistic
"We are nothing special. Bacteria such as E coli can divide every 20 minutes. To fuel its growth E coli consumes about 50 billion ATPs per cell division, some 50-100 times each cell's mass. That's about four times our rate of ATP synthesis. Convert these numbers into power measured in watts and they are just as incredible. We use about 2 milliwatts of energy per gram - or some 130 watts for an average person weighing 65kg, a bit more than a standard 100 watt light bulb. That may not sound like a lot, but per gram it is a factor of 10,000 more than the sun (only a tiny fraction of which, at any moment, is undergoing nuclear fusion). Life is not much like a candle; more a rocket launcher." p. 64.

Lane, N. (2015) The Vital Question: why is life the way it is? London: Profile Books. p.64 (Paperback)

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Monday, July 10, 2017

A person-centered sepia tinted reflection

humanistic --------------------------------------- mechanistic



While the history of my 
career now has a:

sepia tint


- I believe my enthusiasm and passion are still alive and kicking.

After all - that's quite something to wake up to on workdays, 
and quite a thing that helps to close your eyes at the end of day.

When I started my career forty years ago next month the 'I' in patients was well and truly lost. That 'I' wasn't even well in truth, as it was completely submerged in the asylum system that was Winwick Hospital. As a new nursing assistant, then student nurse and deputy charge nurse change had to follow and quick.

Change did follow, patients having a choice over what to drink tea or coffee and is that milk - sugar? Previously it was all a done deal in one giant pot. I never intended to be a tailor but there I was at 18 assessing gents for trousers from the store room. Personalised clothes eventually followed and a shop too.

In the draft paper on Hodges' model and Threshold Concepts I have noted that while laudable and vital as an objective of high quality care, person centred care presents learners with troublesome knowledge. This is because so much of what happens to patients... service users, clients, carers and family members is inherently service centred. It has to be to a degree and reconciling the how and why work is organised as it is, while delivering person centredness and person centred care remains a challenge today: and tomorrow too! ;-)

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Saturday, July 08, 2017


Following on from - Money and Mental Health [i] Impact of Mass Unemployment Events (MUEs)

I have been familiar with the relationship between mental health and finance since student days in the late 1970s. Debt was and remains a profound and common problem. This can exacerbate existing mental health problems or it be the trigger - the straw that breaks the camel's back. From the report:

One in four people with a mental health problem is also in problem debt, and half of people in financial difficulties have a mental health problem (p. 13).
Finance still has this impact whether it is a lack of basic financial skills (literacy), life chances and opportunity or attributed to bad luck. Speaking of 'luck': I have frequently felt angry and frustrated with government policy. It is common sense and statistically inevitable that within the population there will be people who are vulnerable to addiction of many sorts. Why make it easier for those who are vulnerable to potentially loose everything? Not only that but money impacts all those in vulnerable groups, not just people in work. When we talk of health inequality what is the biggest factor? I've come across instances of elderly people receiving scam mail and not just the 'odd' post. While within Hodges' model below I have family as a resource, sadly this can also be part of a problem.

'Productivity' looms large in the report and draws a rueful smile here. In the NHS productivity and its increase is a constant requirement. In the general economy UK productivity is low and seemingly stuck. Successive governments have failed and now with Brexit productivity is still on life-support.

In the report 'financial fragility' is a very useful construct (as with circumstantial, rather than careless overspending). The public sector is also highlighted in this regard:
Forecasts suggest that 5.4 million public sector workers, one in six of the UK workforce, will be worse off in 2020 than they were in 2010 (p.16).
Before you view the report itself and the small conceptual sampling in Hodges' model, the report refers to the hidden epidemic that this report seeks to highlight and represent. This government and successive, nationally and globally need to get to grips - somehow - with the hidden economy - parts of which are blatantly obvious in the subterfuge around tax avoidance. This is another relationship that operates upon us all - employed, unemployed, young and aged - and which Hodges' model can also help illuminate.

Evans, K., Holkar, M., Murray, N. (2017) OVERSTRETCHED,OVERDRAWN, UNDERSERVED: financial difficulty and mental health at work, The Money and Mental Health Policy Institute, May 2017.

What follows is drawn from the report above - with a couple of additions:

humanistic ----------------------------------------- mechanistic
group - population
(including nursing)


hidden epidemic

... over two thirds (67%) of employees who are struggling financially report at least one sign of poor mental health that could affect their

ability to function at work
loss of sleep,
poor concentration,
reduced motivation,

Increased risk taking
(impact - occupation...?)

Guilt/shame Anxiety Low self-esteem Anger Frustration Fear Low mood Self-harm Suicidal ideation Insomnia Panic attacks Depression, Lethargy/apathy Substance misuse

[... starts here!]

Physical effects of anxiety, stress, alcohol, smoking (increase, relapse), other
substance misuse

physical fragility
(lack of resilience)

Nearly half (45%) of all working days
lost to ill health were a result of stress
in 2015/16 – adding up to
11.7 million days
across the economy.

work access to:
  "on-site exercise facilities, healthy
 food and rest spaces"

hidden morbidity

Influence of individual mental health on colleagues,
team morale
and cohesiveness

fear of bailiffs
- seen by others at my door

pressure on relationships

conflict at work

family breakdown

shame, guilt, stigma

social support,
friends, family, colleagues


"Money and Mental Health will set out the case for employers to provide practical support to employees experiencing financial difficulty, and how this could boost the mental health, wellbeing and resilience of their workforce."

"financial fragility"

Creditor action

poor performance, punctuality, reliability
disciplinary action

services - counselling / advice

Individual's awareness of Rights

the hidden economy

Thanks and Acknowledgement to The Money and Mental Health Policy Institute

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Friday, July 07, 2017

Draft: Table 3 What about this one - should it stay or...?

 Table 3 Features of Hodges' model related to Threshold Concepts [TCs]

This is, I think, a more obvious element of a paper on Hodges' model and threshold concepts than Table 2 which has now been removed from the draft. Despite the inclination to relate the main features of one to the other at 5449 words it looks like this table will also be dropped. I'm not working to a word limit for a given journal, but 5-6000 words including references seems a more disciplined figure at this stage.

While I've just explained a rationale for it, the purpose of table 3 does not seem very clear within the paper. At 90 words the table is hardly lengthy, but it is the main text and ideas it relates too. Without fooling myself, I'm sure the draft is now much improved continuing to sort the wheat from the chaff as it were. Now I've placed the emphasis on explaining the example 'Deprivation of Liberty'. There is an interloper in the table: can you spot it?

Yes, that's it - Compound TCs [CTCs]. In this I'm questioning whether there are hybrid conceptual structures in Hodges' model? I'm proposing that 'Deprivation of Liberty' (must) be considered as a compound TC, for reasons (care requirements actually) of integrated, person-centered and holistic care. I also intend to argue that these are legacy issues (based on a 40 year career - practitioner research?) in terms of quality of care and quality of teaching / learning which also call for measurement. In addition to CTCs, I also see Hodges' model as a means to precontextualisation.

So, Table 3 thanks for hanging out with me: you will be revisited at some point, but for now it looks like your rows and columns are numbered!

Once again if needed this invaluable introduction and bibliography on threshold concepts may help with the meaning of the threshold concepts features.

Hodges' model FeatureTC Features and additional points
Care Domains
Liminality, Transformative, Troublesome, Irreversible, Integrative, Bounded, Discursive, Reconstititive
Disciplinary and contextual way-finding and sign-posting
Health Career
Transformative, Reconstititive, Irreversible
H-M axis
Integrative, Reconstititive, subjective-objective, qualitative-quantitative
Personal, Collective, 4Ps purposes, processes, policies, practises, 
Effectiveness, Efficiency
I-G axisIntegrative, Reconstititive,
Personal, Collective, 4Ps purposes, processes, policies, practises
Equity, Efficacy, Equality
Hodges' model – as a whole
Holistic, Person and Student-centredness, Troublesome
Idealisation, being person-centred, precontextualisation
Compound TCs
Troublesome, Integrative, Discursive, Reconstititive, Liminality
Situated learning, Person centredness, Reflection on experiences

See also - Draft: Table 2 ... 

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Thursday, July 06, 2017

Money and Mental Health [i] Impact of Mass Unemployment Events (MUEs)

This post was prompted by an infographic on twitter and an associated report that includes the infographics:

Davies AR, Homolova L, Grey C, Bellis MA (2017). Mass Unemployment Events (MUEs) – Prevention and Response from a Public Health Perspective. Public Health Wales, Cardiff ISBN 978-1-910768-42-6.

The report is very interesting, not just in it demonstrating the conceptual scope and application of Hodges' model, but in the real-world examples of people who have experienced this socioeconomic phenomena which impacts so heavily on the individual, spouses (partners) and communities. In addition the research is global across countries and industries. It is sobering to reflect also on the dynamic that is the workforce. Paradoxically, at present UK employment is at a high:

"The employment rate (the proportion of people aged from 16 to 64 who were in work) was 74.8%, the joint highest since comparable records began in 1971." (ONS June 2017).
The report does not mention the 'gig economy', but the rise of 'zero hours' a feature of the new economy is found on page 48. With demographers, forward thinking policy makers and media seers predicting the future of work as the robots not only find their feet, but walk, run and jump - you wonder where we are headed. Children will need to be educated in such a way that they are prepared to retrain, possibly several times in their working lives. Other avenues to ease the human pain are a basic universal income, and a reduced working week. You do wonder if another hidden and subtle MUE is underway? It is not so much massive, as yet, but it is happening in not so slow - slow motion ...?

What follows is drawn from section 4.

humanistic ----------------------------------------- mechanistic
group - population

Effect on mental health and well-being

loss of self-esteem, increased stress,
anxiety, changes to perceived control,
shame and loss of status, withdrawal
experiencing a grieving process

insomnia, depression, self-harm,
attempted and completed suicide


financial strain

 Effect on pre-existing poor health behaviours - 

helplessness, hopelessness

loss of individual and collective* identity

physical health

reduced freedom from disability


reduced life expectancy

stroke, myocardial infarction
weight gain
relapse to smoking ... again

- such as, increased alcohol consumption, tobacco smoking, illegal and prescription drug misuse, and being overweight

"job for life"
hidden morbidity
spousal mental health

reduced household income

change in family dynamics


increased conflict and domestic violence, increased unplanned pregnancy, and reduced infant growth - child educational attainment

Community impact: loss of cohesion and identity*

the already unemployed

social inequalities

women seeking community mental health support as their (male) partners will not seek help

having to work away from home

intergenerational impact

culture of worklessness, unemployability

"job for life of a family"

hidden unemployed

accumulation of debt

jobs offered not local

labour market

housing market - affordability
commuting costs

reliance on food banks

 increased expenditure on antidepressants 
and related drugs

financial hardship

increased hospitalisation, out-patient attendance

Community impact: labour market and economy

Loss of industries
youth move away - 

no workers for new initiatives/industries

loss to local economy of MUE

reliance on welfare benefits

A future post will conduct a similar treatment of a publication by The Money and Mental Health Policy Institute.

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Wednesday, July 05, 2017

ERCIM News No. 110 Special Theme "Blockchain Engineering"

Dear ERCIM News Reader,

ERCIM News 110
ERCIM News No. 110 has just been published at https://ercim-news.ercim.eu/

In this issue: 

Special Theme "Blockchain Engineering" coordinated by the guest editors Elli Andoulaki (IBM Research – Zurich), Matthias Jarke (RWTH Aachen University & Fraunhofer FIT) and Jean-Jacques Quisquater (Université catholique de Louvain, Belgium, and research affiliate at MIT).

A public sector section includes - "How Distributed Ledgers Can Transform Healthcare Applications".

This issue is also available for download in 
pdf and ePUB

Thank you for your interest in ERCIM News. Feel free to forward this message to others who might be interested.

Next issues: 
No. 111, October  2017 - Special Theme: "Digital Humanities" (see call for contributions)
No. 112, January 2018 - Special Theme: "Quantum Computing"

Best regards,
Peter Kunz
ERCIM News editor in chief

ERCIM "Alain Bensoussan" Fellowship Programme
Postdoc fellowships available at leading European research institutions. 
Simple application procedure. 
Next application deadline: 30 September 2017 

HORIZON 2020 Project Management 
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Your institution interested in joining ERCIM?
See http://www.ercim.eu/download/ERCIM-flyer-web.pdf

is published quarterly by ERCIM, the European Research Consortium for Informatics and Mathematics.
The printed edition will reach about 6000 readers.
This email alert reaches more than 7800 subscribers.

ERCIM - the European Research Consortium for Informatics and Mathematics - aims to foster collaborative work within the European research community and to increase co-operation with European industry. Leading European research institutes are members of ERCIM. ERCIM is the European host of W3C.

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Peter Kunz
ERCIM www.ercim.eu

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Tuesday, July 04, 2017

Volte-Face - Reflection

humanistic ----------------------------------------- mechanistic
group - population

My source: Moody, O. (2017) Facial prejudice: we are all guilty of it, Saturday Review, The Times, 10 June, p.14.

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Monday, July 03, 2017

Machine, Platform - You and Me

humanistic ----------------------------------------- mechanistic
group - population
What does this mean for you and me?

Book: Machine Platform Crowd


n.b. A platform is a 'machine'. A crowd divorced of humanity can also 'be' a machine. ...

My source: Various

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