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A strength of Hodges' model is the way that conceptually it automatically encompasses medicine and healthcare whether viewed as scientifically or sociologically.
The obverse and similarly powerful scope of Hodges' model is the relationship and conceptual exchanges to be found between the intra- intrapersonal domain and the political.
One sociological theory of medicine and the doctor-patient relationship by Parsons identifies the sick role. The physician also has a role to play. On my Community Psychiatric Nursing I recall an explanation of the way a health problem can be escalated from initial attempts at self-remedy through to family and friends suggesting "I think you need to go see the Doctor!". Parsons account is described as functionalism. On this account we need permission to be sick and offered respite from our work, family and usual responsibilities.
There is a new report that highlights the ongoing relevance of the sociological domain and medical sociology. Research in the 1950s-1970s is of its time but there are existing lessons to be found. Below I've embedded a presentation from the Academy of Medical Sciences and a related reference. These are placed to show in Hodges' model how the scientific disciplines that include medicine, research and pharmacology are related to society, the public and sociological concepts and research.
The Academy of Medical Sciences has been undertaking a project to examine how the generation, trustworthiness and communication of scientific evidence can be enhanced to strengthen its role in decisions by patients, carers, healthcare professionals and others about the benefits and harms of medicines. The final report has been prepared by an Oversight Group with a diverse range of expertise, chaired by Professor Sir John Tooke FMedSci, and was underpinned by extensive engagement with citizens, patients and healthcare professionals, as well as with other key stakeholders across the biomedical sector. How can we all best use scientific evidence?
"Freidson offers what is perhaps the most telling criticism of Parsons’ model. According to Freidson, Parsons overstates the consensus between the patient and the caregiver. There are often times when the patient disagrees with the physician, conflict ensues, and the patient seeks care elsewhere or does not comply with recommended therapy. In fact, there is a ‘lay referral system’ within the social network of the patient that prefers one caregiver to others for specific social and cultural situations (Freidson 1960)."
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 How can we all best use scientific evidence? |
Recent discussion on a HIFA forum included mention of the Social Determinants of Health SDH and inequality. Revising the draft paper on h2cm and threshold concepts (abstract to follow soon) social determinants arose in references there also (Aronsson, 2016).
I realised that I have not stressed enough how readily (and obviously) Hodges' model facilitates reflection and critical thinking about SDH. Hodges' model can really come into its own in this particular application.
So, just in case I take Hodges' model for granted in its potential utility, below I have drawn on the following figure (the findings within will no doubt vary over time and with further research).
By Jsonin - Created this open source diagram for our research into standard human data elements Previously published: http://determinantsofhealth.org, CC BY 4.0, LinkI have mapped the main percentage items to Hodges' model below. Clearly there is great deal of overlap; what for example, is the effect of the physical environment upon individual behaviours? Medicine and medical care does not just rest upon several sciences, but it is inherently political and about power.
individual behaviour |
7%
physical environment
11%
medical care
21%
genetics and biology
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SOCIAL DETERMINANTS OF HEALTH
23%
social
circumstances | As if we needed to be 'told': This space suggests that there really is still much more to do. To those who would say: "We have done so much!" I would say: "But, we have only scratched the surface of the three 'easiest' care domains." |
One of the joys of working in the community is that while travelling I can often catch the radio. Being on a 10-6 today I was even better placed to listen to 'Start the Week'. Even though there's the web iPlayer ... sometimes maybe it's a case of real time - real thinking...
It is a very engaging conversation that - as I listened - spoke directly to Hodges' model: but I would say that (not sure about the real thinking though..!).
BBC Radio 4 Start the Week (19 June 2017) Health Inequality: TB, Trauma and Technology
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| BBC Radio 4 Start the Week: |
a person A LOVED ONE (timeframe: grief) (timeframe: Why) (timeframe: answers) to questions that should not need be asked (again and again....) 'problem' Fear uncertainty advice flight OR fight values ethics morality PSYCHO- | a house a house . . . a house a house Fire a house fighting Fire a house fighting . . Fire a house fighting Fire a house fighting |||||||||||||||||| strength of towers cladding - facade material science introducing: dead space "probably" 'problem' property: transparency vs opaque (time-frame: risk, evidence) -PHYSICAL |
SOCIO-
a HOME a group of people
family friends
social housing
a community
the most terrible of good-byes
Towers of Strength
SPIRITUAL
(timeframe: social justice)
D.ANGER
'problem'
introducing: a 'new' home
| -POLITICAL property material evidence facade - cladding cost ££ value $$ Health & Safety Law Building regulations (timeframe: Public Inquiry) (timeframe: ACTION) GOV.UK 'problem' 'political correctness'? local-regional-national introducing: another Public Inquiry |
As young children we may encounter 'boxing' quite early on. This first experience, which we may or may not wholly remember is undoubtedly critical to our personality and subsequent psyche. Such early experiences influence our ability to 'look after ourselves', how we deal with bullies, anxiety, the potential for conflict and develop assertiveness skills. When a 'scrap' happens it can be quite sudden, that total impact of everything out of control, sheer danger and literal impacts. The environment might be nursery, playground, cloak room and the presence of peers as onlookers can be another key factor.
In the late 1960s early 70s I found some old boxing gloves under the stairs at my nan's. I had a handful of uncles on mum's side (just two now - Uncles Tom and Ken!) and the gloves had clearly been swung and jabbed down the line. I don't count myself as a fighter, unless someone tries to push their beliefs - without invitation - down my throat. Then it will be more a case of a reflex action. The 'arc' being comprised of vomit. In the school playground I learned to talk my way out of trouble, resorting to humour at times; as you learn to deploy whatever intellect you might have judiciously. Legs are essential to a boxer:
“First your legs go. Then you lose your reflexes. Then you lose your friends”
SELF self-awareness Identity self-belief way-finding dementia - cognitive damage personality change aggression tactics strategy motivation training attitude self-discipline ethics mental health - mental capacity emotions mood Personal safety | boxing technique reflexes speed movement balance punching fitness weight, reach, statistics THE RING stamina nutrition hydration concussion sub-concussive exposure models unconscious knockout Head - Brain injuries physics: force time (duration) momentum technology - sensor equipped gloves Sports Medicine Research Headgear Safety - Evidence Medical risks |
OTHER Ethnographics Coaches <-> Boxers Mentors Support network THE STREET personal history-family History sports history trainer friends club Sporting behaviour family friends
Socio-
| Rules (changes) Conflict Power promotion media finance codification rules Amateur Professional Refereeing Regulating bodies Governance Law Contracts
Economics
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Intra- Interpersonal Skills |
"All the monoliths, though they vary greatly in size, were fashioned to the exact proportions of 1:4:9, the squares of the integers 1, 2, and 3."
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"The rise of capitalism in China resulted in the demise of the "iron rice bowl", under which the state-owned industries provided pensions. Retirees now have to fend largely for themselves or rely on their children, but the collapsing fertility rate has led to the infamous "1-2-4" problem in which a single working-age adult will eventually have to support two parents and four grandparents." p.219.
| "2 for 1 offer" Naylor Report |
Dear PoHG supporter
I've arrived late following up on the sessions from DrupalCon Baltimore in April. As was mentioned at NWDUG last month there are some excellent sessions including this one:
CALL FOR PAPERS
The 7th Workshop on Awareness and Reflection in Technology Enhanced Learning (ARTEL 2017) will be held in the context of the EC-TEL 2017, Tallinn, Estonia: 12 September 2017.
Workshop webpage: http://teleurope.eu/artel17
Twitter hashtag: #artel17
RATIONALE
Awareness and reflection are viewed differently across the disciplines informing Technology-Enhanced Learning (CSCW, psychology, educational sciences, computer science and others). The ARTEL workshop series brings together researchers and professionals from different backgrounds to provide a forum for discussing the multi-faceted area of awareness and reflection. 2017 will be the 7th workshop in the series.
Through the last ARTEL workshops at EC-TEL (2011-2016) the topic has gained maturity and questions addresses are converging towards the usage of awareness and reflection in practice, its implementation in modern organisations, its impact on learners and questions of feasibility and sustainability for awareness and reflection in education and work. To reflect the growing maturity of research in ARTEL over the years in conjunction with the latest trends in TEL, this year’s topic particularly invites contributions that deal with moving from awareness and reflection to action. Changing individual behaviour and collaborative practice is very challenging, and we invite research that particularly deals with technology’s role in helping users take this step.
The workshop will include a paper session, a demo and prototype slam as well as an interactive session. The workshop aims at:
1. Providing a forum for presenting and discussing research on awareness and reflection in TEL.
2. Creating an interactive experience that connects participants’ research, current tools or latest prototypes and models with real end users’ learning experiences and requirements regarding reflection technology.
3. Creating an agenda for future ARTEL research and development.
TOPICS OF INTEREST
Considering the multitude of views on awareness and reflection distributed over a wide range of disciplines the workshop’s general theme is encapsulated in the following questions:
- How can awareness and reflection support learning in different settings (work, education, continuing professional development, lifelong learning, etc)?
- What are the role(s) that technology can play in these contexts?
For ARTEL 2017 we particularly invite contributions that address the theme of moving from awareness and reflection to action. To answer the above and related questions, we are looking for contributions that address the following aspects:
Call For Papers
Topoi: An International Review of Philosophy
Special Issue: “Foundations of Clinical Reasoning: An Epistemological Stance”
Guest Editors:
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| Topoi |
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Being self-aware, reflective and reflexive including aspects of your role that either you don't especially like, or you're just not 'good' at. Recognise when to ask for help, advice, supervision. Anticipating needs. Indicating pros and cons. Keeping up-to-date. *Have the courage to blow that whistle if you must. Communicate to the best of your ability and learn constantly as human nature dictates you must. Look after yourself: if ill Be ill. Take care of your personal ethics and values, don't be bullied into lowering them and running with the crowd. Nurse = Lifelong Learner ... then you will question your own competence. As you strive to be someone else remember you can be yourself. The things you take personally are those you open the door to. Learn from them. Never forget your shield, protect yourself and others in what you disclose about yourself and others. | Being compass-ionate requires 360 degree vision, hearing ... learning and forgetting... Your keen are you? So really observe. Care about time, your management of it as a resource and the time frames of past, now, future, hoped for and imagined. Remember you need to understand information systems, data management in so far as it supports or places at risk the care you deliver and the safety of your patients. If I use IT based media I bear in mind the scope of the platform. Open to innovation: but see the elephant as an elephant. When the robots knock on your door being professional means you won't be in: "Moved On" As you care, draw on learning regards where you stand - you are a guest in someone's home, As your feet are then grounded politically, so too is touch and negotiating personal spaces. |
Learn from others
Expectations Expectations Expectations Manage them in a way such that you do not make promises you can not keep. Be committed to what you do. Learn from your peers, especially for safety's sake, but also form your own opinion. Talk this and work through with colleagues. Not everyone will 'like' you; you in turn may not 'like' people. Working through this (without experiencing abuse) as your role demands is being professional. By all means be a team player, but don't let the games that people play distract you from being professional. Patient-Carer Community Care End of Life Care As you learn from others pay most attention to the lessons in Love as you will witness many. | The trust and respect of others take time to earn, but can be lost in an instant; if you have 'it' use it to foster trust and self-respect in others. You have to remember constantly you are accountable here. Remind yourself of codes of conduct the legal aspects of your role. Know your lines - especially when crossed | STANDARDS. With your ID have your whistle ready*. What you do and who you are is a privilege. Know your scope of practice, but be ready to question it. If you do not the future will. This domain is the most powerful and neglected to the professional nurse. As a professional what are YOU going to DO here? The art of leadership is filled with wonder: at what together you can all achieve. Take stock and ask in Year 1 what are the legacy issues my seniors are wrestling with? In years 10 20 30 40 ... (robotics permitting) repeat and reflect. |
It’s Not a Problem to Solve. It’s a Polarity to Manage. @LexSisney HT @timkastelle https://t.co/sy4qHoxopJ pic.twitter.com/aNKQRP7hRa— Mark Storm (@marksstorm) May 21, 2017
| SELF - SUPPORT |
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SOCIAL - SUPPORT | POLITICAL - SUPPORT |
Thoughts Beliefs Emotions Mood... Motivation, Confidence Memory, Experiences, Trauma, Grief Mental Health - Reasons for Referral Assessment Self-help Self Self-stigma Learned Helplessness
Psychological Theories & Therapies
Sleep Coping Concentration
self-harm risk, specialist services
Surviving OR Thriving?
Vulnerability
Debate: Ethics, Diagnosis, Philosophy of Care
PSYCHO-
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Systematic diagnosis
Evidence-based Care, Treatments
Effective Treatment, Outcomes
Drugs, Side Effects
Local access (200+ miles for a bed?)
Demographics - Research
Data, Information, IT Records Emergency (MH Crises) Services Referrer's Knowledge of Care Pathways Debate: Pathologizing, Big-Pharma Evidence Based measures SOMATIC - BIOLOGICAL |
SOCIAL
Group Therapies Community Family Friends Relationships - Social Network Risk Behaviour Safety
Mental health as a Social Construct
Stigma
Folk theory UNDERSTANDING Specialist
Sociological Theories
prediction uncertainty expectations
Social Norms Conformity
Culture, Ethinicity, Education
Anthropology
Quality of Life
| POLITICAL Power Mental Health Law
Review of Mental Health Act?
WAIT! Government Policy Targets
Gate-keeping
????RING FENCED??? ? Funding of Services ?
?? Parity of Esteem ??
???RING FENCED???
Community Care - Beds - In-patients
Mental Health Services
Primary, Secondary, Tertiary
Mental Health Professionals
Human Resource Planning
Work
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I have posted some items c/o The Communication Initiative Network previously, but that was quite a while ago. Having just contributed to an ongoing discussion I thought it might help me and readers new to COMMINIT to post some background and add to my comment over coming weeks. The topic begins on COMMINIT:
UNICEF, with Rafael Obregon (Chief, Communication for Development, UNICEF New York) leading and The Communication Initiative, through Warren Feek (Executive Director) are holding a series of consultations, to gather views, opinions and ideas on what kind of global mechanism could be helpful for supporting advancements in the scale, sustainability, relevance and influence of programmes, strategies and organisations that develop and implement initiatives rooted in communication and media development, social and behaviour change.
Background
The global development tapestry has seen the growth of a series of such mechanisms seeking to advance particular fields of work. For example, WASH for All; the Global Partnership for Education and, the Global Partnership on Violence Against Children, amongst others.
As we have reviewed these mechanisms it is clear that there are a range of differing goals and roles including:
- Raising technical standards;
- Advocating value and impact;
- Engaging in policy debates and dialogue;
- Coordinating action;
- Accrediting data;
- Expanding funding levels; and,
What kind of mechanism - priority, strategy, structure?
- Acting as a legitimate global point of contact for policymakers, funders and other major global players in development.
The major question for the social and behaviour change, communication and media for development field of work is what kind of mechanism – focus and structure - could help to advance our field of work. Consequently, there will be 3 major themes to the consultation that we will be holding. From your perspective and experience:
- What priority goals and themes would you propose as the focus of such a possible mechanism?
- What strategic approach should such a possible mechanism take to work towards those goals?
- How would you recommend that such a mechanism be structured and organised?
Born in Liverpool. Three children. Community Mental Health Nurse NHS, West Lancashire, Independent Scholar & Researcher Nursing & Technology Enhanced Learning
RMN, RGN, CPN(Cert.), PGCE, BA(Joint Hons.) Computing/Philosophy
PG(Dip.) Collaboration on Psychosocial Education [COPE]
MRes. e-Research and Technology Enhanced Learning
Live and Work in Central & West Lancashire, England - working on achieving a global perspective.
The views expressed on W2tQ are entirely my own, unless stated otherwise. Comments are disabled.
If you would like to get in touch please e-mail me at h2cmng at yahoo.co.uk
This work is licenced under a
Creative Commons Licence.
