Hodges' Model: Welcome to the QUAD: January 2008

- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Wednesday, January 30, 2008

Test page - CSS for the old content (and new)

The work to re-style - OK actually 'style' - the existing site content is ongoing.

There are two drop capital formats at present, still experimenting. The first gets upset in Netscape (although I gather NS is no longer supported beyond this or next month). There is much still to do -

  • Styles for TABLES
  • Quotes, cite and abbreviations
  • More work on the heading tags
  • Lists - ordered and unordered (I've used an image for a bullet)
    • hierarchy (as here)
  • I'd like to use a typewriter style font for the references.
  • (?Drupal)
    • Paging and navigation of the same
    • Accessibility
    • Printing
I wondered that although Brian's original notes and my original introduction are to be 'archived', whether I could punctuate the text with an 'update box' feature? The user would have a choice whether to omit this when printed or displayed.

The style sheet used above is a bit of a monster, as it includes all the elements for the Drupal theme. Constantly navigating this is helping with the wider aspects of styling to follow.

You may notice on the links pages, e.g.: SCIENCES I've deleted the existing column headings and added the 'th' tag to the main table. So, at present the column headers don't look very pretty. In truth they never have really. They will be much better.

I've been fairly pleased with much of my early HTML work, I can't believe that I never made proper use of the heading and so many other tags. In Dan Cederholm's book the advice is to sort the STRUCTURE first then the STYLING. Pretty sound me thinks - I better get on with both...

Tuesday, January 29, 2008

Halos, clouds and living ontologies

Simon TemplarIt would be nice to be blessed with a halo, but I guess I'd rather be elliptically challenged than possessed of a slipped disc.

Halo-less, succor is found imagining the concept cloud that follows me around. Of course we all have one:

A dynamic cognitive-virtual creation that would be a wonder of the universe if it could be seen. Maybe this is why the WWW is such a marvel?

Life is a comic book really, we just don't see the thought bubbles. ...

As of Jan 2008 - this blog's side bar has a sandpit listing tools in which I would love to fully immerse myself. One of these is Protégé. Like so many pieces of this (my) care informatics jig-saw, this - the keystone? - is yet to be picked up.

It is heavy, a specialist tool; built for knowledge engineering not for care engineers.

After decades of excellent work by researchers in expert systems and decision support systems... knowledge management tools like Protégé are making knowledge engineering much more accessible. Web 2 (and Web 3...) is using the semantic web as a foundation and the term semantic web seems to capture the concept cloud (that might be) instantiated in Hodges' model.

I know the links pages may seem a links-fest or even a links-farm, but in LINKS I intra-INTERpersonal the presence of knowledge management is neither incidental or accidental. Conceptual tools and Protégé in particular might provide a means to help thread together:

  • caring and learning: the 4Ps and care participants
  • informatics
  • records
  • Hodges' model

When I set about creating the website in 1997 this is what I had in - and out of - mind. Already familiar with Buzan's mind-mapping, Hodges' model was and remains a living ontology. A tool to capture and freeze concepts and reasoning at selected critical intervals. This living dynamic vision was just what I needed, to blow the dust off Brian's model, sat there languishing on the shelf. Better a living ontology than a model sleeping in the recessed cloisters of the more mature student's memory. As far as Protégé is concerned though, I've yet to fully raise my right foot, never mind complete the first step (and listen into the literature) perhaps I may never.

Maybe for living ontologies this is where communities come in - so please look after your halo!

Image source: http://www.simon-templar.de/

Sunday, January 27, 2008

Reflections on Drupal Denver theme

Customising Drupal themes is a central skill in the Drupal and other communities. The number of contributed and updated themes are a great testimony to the specific expertise people develop. In tackling a project Drupal developers put a team together across the spectrum of required skills and this includes someone proficient with themes.

I want the new site to look different and reflect the unique structure and content of Hodges' model, but I don't want to spend all my time grinding a mirror for the telescope. I want to be out there observing - even if that's just with binoculars and the naked eye.

I've found the Denver theme quite appealing in its simplicity and functionality:

If you click&check the above image in detail you'll see I need to sort the banner (transparent?) another image would be preferred. There are several menus too: the tabs, left and right side bars plus breadcrumb trails. I've finally defined a new site within Dreamweaver [MX], so I can also focus on the style sheet(s).

Wouldn't you know it - I just checked and Denver isn't currently listed as a Drupal 6 theme. Forever a realist - this is always going to be an issue so ....

Records 2: Flying the standard

'Records I' was posted last September, time to revisit this theme...

If I am a real champion of Hodges' model, convinced of the value and care-worthiness of this 21st century conceptual framework then why have I not been an agent of change@work?

Surely, I would not have stopped short of stepping on toes, or letting a lack of evidence get in the way of advocating the model as a solution to real problems? So why haven't I been the standard bearer where it really matters - on the shop floor? Excuses are many and include:

  • the personal - part-time nature of my combined nursing-informatics interest;
  • following local policy Care Programme Approach [CPA];
  • professional accountability - risk assessment and management and working as a CPA lead;
  • watching with interest as the Single Assessment Process joined the fray;
  • and even more recently the Common Assessment Framework;
  • plus, and this may be a cop out - I like people to decide/discover things for themselves.
Having been away from the clinical practice from Nov 2004 to last summer I was informed as to how much things had changed. After a short period of time I realised on the contrary how little things had changed.

We are still completing paper documentation designed for risk assessment, service engagement and case management of younger adults. Sometimes this focus and attention is justified with older adults, but this is rarely the case. Case files end up with pages of redundant white-space, white noise that slows what we might call conventional information retrieval.

It has been recognised for a long time that IT systems are key to unlocking multidisciplinary working and joining the dots of policy across health, social care and associated care sectors. The outcome of the CPA review is due later this month, it will be very interesting to see the direction this takes and what hooks there are for Hodges' model. The hooks I can see and well and truly intend to snag my lip upon here include:
  • "paperless working";
  • self-assessment;
  • e-working at the point of care;
  • collaborative working and treatment with education interventions;
  • individual budgets and new commissioning models;
  • social inclusion, social enterprise;
  • social capital and employment.
Ultimately, I do believe Hodges' model will find its niche - why? Clearly, the 4P's with records and policy in particular are becoming ever more complex. At times like this a tool to -

simplify and summarise : engage and educate

- must have a place in our curricula, paper and e-record systems, client's and carer's hands and our cognitive tool sets.

Ack: links Care Services Improvement Partnership.

Saturday, January 26, 2008

Drupal 5.2 - 5.6 - 6.0 (and back again...)

I still haven't upgraded Drupal to version 5.6 and so I thought - well let's see what going to 6.0 entails? Next step: download release candidate 2.

Reading the instructions - after backing up the database and files, I put the current 'site' off line, disabled all the modules, set the theme to a core offering and ran through the remaining steps. The Drupe 6 install screen is slick and shows quite a few changes that I look f/w to completing one day.

This time though - trying (foolishly) to upgrade I did not get very far.

Selecting 'English' as the install language then running update.php, the SQL complained and suffered one of those last-line kind of fatal errors.

I may have left one module - 'localisation' enabled and this amongst other things tripped me up.

Anyway, I managed to get back to my original 5.2 and learned quite a few things along the way.

Now at least I feel able to take a copy of what I have to the Drupal NW England user group in Manchester next month (Feb 20th) or whenever. The Drupal directories are a lot clearer in my head now, I even feel like going for a multi-site set up...?

I know this is dreary and at this rate there will be more 'Drupal' tags here at W2tQ than 'Hodges Model'; but as was mentioned at the start it's steep over here and well worth the time spent reading and planning. Another question is what will the database look like? Hence the possible benefits of a multi site set-up?

I've been clearing the existing website directory of redundant clutter, on my PC and at Demon. Reading my pages now, there is not an awful lot to archive. I'll start putting together the style sheets:
  • archive pages (existing content)
  • book pages (new)
  • links pages (existing - unsure about the future)
  • front page template?
The theme will be a contributed effort for now as I'd like to focus on the content and overall structure at this stage. I'll post a few more screen shot examples over the weekend.

(Need to photograph a jacket for that Apollo, Africa and E.T + a favourite book - post)

Monday, January 21, 2008

Free book, part-time enthusiasts and the damage done!

Using Dreamweaver I've been correcting more of the missing 'top of page' links. I'm still using 'top' as the name which is a no-no according to one book. Validating the HTML and all the 'font' tags showed up. What a mess!

Many people still include these tags in their web sites. My pages also include reference to a CSS-style file; so the 'font' tags really are superfluous. Some are there purely to add colour, but I want to strip the pages down, then assess the content:

  • Keep and revise/update
  • Keep but archive
  • Delete (quick!)
I've ordered jQuery in Action and had some good news regards another forthcoming book title next month:

Care of the good people at PACKT Publishing I'm in line for a free pre-order copy of David Mercer's new book:
Building powerful and robust websites with Drupal 6

In return I have to complete a review, which I'll post here and on Amazon. I'm really looking forward to this title and doing a review from the perspective of a Drupal beginner and with the new website for Hodges' model in mind.

Sunday, January 20, 2008

Missing the sun....

Rivington - July 2007

Peter Jones Copyright Photo
Really miss you Mr Sunshine
at least you are on your way back again
with your showers
just one or two -
in toe.

Photo copyright Peter Jones

The symbol '+'

Apart from a multitude of symbolic meanings the figure below also provides the structural foundation for Hodges' model and as symbols.com notes:
Cross from symbols.com

The cross with arms of equal length is an extremely old ideogram used in most cultures. It is also one of the basic gestalts in Western ideography (as opposed to the basic elements, which are derived entities). The cross is found in every part of the world, in prehistoric caves and engraved on rocks.
In my interview with Brian Hodges' over 10 years ago in May 1997, Brian provided an account for how he arrived at this structure (summarised below). As mentioned elsewhere on this blog, the website, symbols.com and other sources - the cross, or 2x2 matrix is a common device to explain and structure. The four elements, the four humours (or humors) yellow bile, black bile, phlegm and blood, the seasons; there are so many things that can be characterised in this way.

With '+' as a starting point for me to reflect on Hodges' model I see each line as an individual. This agent or subject could include patient (person) and health care worker; lecturer and student and many other examples.

The act of cros-sing, the intersection of the axes represents two human beings being in a situation.

Space and time brings people together:

and also forces us apart - physically and temporally.

Adding an arrow to one end of these axes creates the dynamic of communication.

The angular distance in the alignment of those arrows offers hope -
  • in our common humanity we are never in 180 degree opposition;
and yet acknowledges:
  • the isolation of the individual -
  • and the challenge.
The work that must done. Hence the primacy of communication skills and values; in order to bridge individual being, ti:me and space.

Perspective is helpful here as an extension:

While we may get close to another person, through relationships that entwine the lines - be they spun by professional obligations, friendship, family ties, or intimate sexual relationships - the two lines are always distinct: part of an elaborated knot.

Is it just the special ties that must forever seek to be one+

The best way to explain h2cm is to review the questions Brian Hodges originally posed.

To begin, who are the recipients of care? Well, first and foremost individuals of all ages, races and creed, but also groups of people, families, communities and populations. Then Hodges asked: what types of activities - tasks, duties, and treatments - do nurses carry out? They must always act professionally, but frequently according to strict rules and policies, their actions often dictated by specific treatments including drugs, investigations, and minor surgery. Nurses do many things by routine according to precise procedures, rather like the stereotypical matron with machine-like efficiency? If these actions are classed as mechanistic, they contrast with times when healthcare workers give of themselves to reassure, comfort, develop rapport and engage therapeutically.

This is opposite to mechanistic tasks and is described as humanistic; what the public usually think of as the caring nurse. In use this framework prompts the user to consider four major subject headings or care domains of knowledge. Namely, what knowledge is needed to care for individuals - groups and undertake humanistic - mechanistic activities? Through these questions Hodges’ derived the model axial structure.

Saturday, January 19, 2008

Nursing process: a lesson for interface developers

Back in the 1980s when the nursing process first appeared in the UK, amongst the pioneering early adopters there were nurses who were also worried. Would the nursing process with its mechanistic connotations lead to the person, the patient - literally being processed? There is a lesson here for nursing (health and social care) IT systems / interface developers ...

They really are star performers you know, regular high-wire runners. They have to make things simple, safe, efficient, fit for purpose and yet also deal with complexity as they juggle multiple contexts and second guess the psychological state of not just one user (crucial as that is), but several groups (disciplines, beginner-specialists, user roles and security...).

In Tidwell's Designing Interfaces the first chapter is more a psychology primer than pure IT text. The first pattern is safe exploration (and there's much more too).

This week someone e-mailed me and stated that the website and links (in particular) are 'daunting'. While for me the website and links pages have been an emergent pursuit, for 1st-xth time visitors .... well; I have to agree.

Thinking beyond a new site for an archive and book project - this is the trick, I suppose. How do you make a site or information system inviting and put the user at ease? How do you hide complexity until it is appropriate to do the non-trivial things? In order to capture data quickly and efficiently at the point of care how can those static check boxes and drop-down lists duck and weave the user's perception that:

1. They as a professional are being de-skilled;
2. or that the patient (person!) is indeed being 'processed'?

That's not just one tightrope, but several ...

Holistic care striking a balance: Dance halls and the steps we take

I was reminded recently of these research related terms:


Of or relating to the study or discovery of general scientific laws.


Concerned with establishing the uniqueness of a phenomenon:
an individual, a place, or a region, for example.

These words struck me due to the way that Hodges' model can encompass them courtesy of the INDIVIDUAL-GROUP and HUMANISTIC-MECHANISTIC axes.

You know those arcade and now home based interactive dance games where the player dances on a pad?: well if Hodges' model is a dance hall and the concepts we use (the semantic web) comprise the dance steps; then if we focus on one side only (self?) we would essentially be standing on one foot - dancing with one half of our body or may be even a quarter.

Come on.
Yes of course - "at your own risk".
Stand up, move the chair out of the way and do your groove thing!

Try it!

Do you feel a bit silly?

OK, OK, it's no use,


I confess!

While I try to be holistic, that's how I dance...

Image source adapted from:

Answers.com - definitions

Friday, January 18, 2008

New International SocioTech and Knowledge Development Journal in 2009

Here is news of a new journal for 2009:

----- Original Message ----
From: Elayne Coakes
Sent: Sunday, 2 December, 2007 3:36:06 PM

I am very pleased to announce that a new quarterly journal from IGI global called "International Journal of Sociotechnology and Knowledge Development” will be launched with its inaugural issue on Jan 09. The OVERALL MISSION of this journal is to provide both a practical and comprehensive forum for exchanging research ideas and down-to-earth practices which bridge the social and technical gap within organisations and society at large. It will encourage interdisciplinary texts that discuss current practices as well as demonstrating how the advances of - and changes within - technology affect the growth of society (and vice versa). The aim of the journal is to bring together the expertise of people who have worked practically in a changing society across the world for people in the field of organisational development and technology studies including information systems development and implementation. The journal will attempt:

  • To support sociotechnical philosophies for organizational change and development;
  • To provide an interdisciplinary outlet for information systems and organisational development papers;
  • To provide an outlet for qualitative and reflective papers.
To accomplish this goal, the journal encourages:
  • The exploration of social and technical artefacts as they apply to change and development;
  • Qualitative analyses of change and technical practices;
  • Interdisciplinary approaches;
  • Articles which tie into, or disagree with, themes from prior issues.
The journal wishes to publish papers that offer a detailed analysis and discussion on sociotechnical philosophy and practices which underpin successful organizational change thus building a more promising future for today’s societies and organisations.

Enquiries can in the first instance be sent to the Editor-In-Chief for consideration. Dr Elayne Coakes: coakese AT westminster.ac.uk

Thursday, January 17, 2008

Socio-technical paper, Drupal, and 'title' attribute

The final draft of the socio-technical chapter proposal has been sent to the editors 7K words, 30 refs and 7 figures.

I'd like to think the paper is a bit unique, as there can't be many that combine: a model of nursing, '-', horse and litter, N-S and E-W, PRINCE2, ITIL, the 4Ps. the moon and the lunar terminator (bit of a fixation that actually) and myth.

Regards the submitted copy there's some positive news with interest in a revised version specifically targeted at nurses. The submitted copy originally had 8 figures, one was culled for space. That missing illustration could provide the basis for another (shorter) paper. Before that though, there may be a rude lesson to follow as to why there are no other papers with this particular mix of content.... Well, here's one very interesting reference I missed...

e-Social Science Conference, October 7-9, 2007, Ann Arbor, MI
A socio-technical framework for cyberinfrastructure design
Ann Zimmerman

Before being hit by the flu I had started to create a form and template in Drupal. I need to have a 'look' (that's 3-4 sessions worth) at the Content Construction Kit and Views too. Must also update my version of Drupal, I meant to do that when the room swooned.

I couldn't make the Drupal meeting last night (double booked!), but I had a great evening talking shop over a meal with a work colleague and two of our former work mates. Cheers - Kath, Lesley and Andy. We are hoping to repeat this sometime soon with a bigger table: COMPANY! better than a course of antidepressants.

In my absence I was able to post a question about the possibility of formal Drupal training either down south or here in the NW. If we can get sufficient numbers, 1-2 days training would be invaluable. It's looking good as others are up for this too. I'll be there for the usual meeting on 20th Feb - can't wait - (but I will --- birthday before then).

For ages I've wanted to feature more details about the conference links. Finally catching the CSS bus, I've started to add the 'title' attribute to the links. Eventually, a tooltip will display the dates and country. This will help me enormously in editing. Apart from conferences - NO MORE LINKS - other than updating/deleting. There are so many things I've spotted on the existing site: 'top of page' links that don't work; Dreamweaver functions I have not made use of.

That's the problem of being self-taught, and I'm determined not to waste time in learning Drupal. While I'm conducting this code/style 'review' the wheat and chaff in present and future content is becoming apparent.

Last, but not least: All the best to the The University of Toronto's International Health Program and the Annual Health and Human Rights Conference for 2008 which begins tomorrow (and 2009....).

To follow: Apollo, Africa and E.T..

Saturday, January 12, 2008

CSS, Case study layout?, jQuery - book

The directory for Hodges' model on my PC is full of erm* - essential files, plus quite a few that never saw service beyond the first writing. A timely find with spring not too far away!

Working on another iteration of the Q&A page, I came across a trial layout from one of my brief and sporadic forays into CSS.

The idea was to feature a case study with accompanying reference to h2cm. I'm glad I left that file sitting there, because now the idea of creating a community of h2cm users would fit in with this. It's a layout that begs for a database to populate it.

There are of course some critical data governance issues to investigate too!

Playing with this old page you realise the universality of context. Database or not, in the interview dialogue I've a health care worker (hcw) and client. Reading Dan Cederholm's Web Standards Solutions I've used label harnessing contextual CSS to highlight (colour) the speakers.

The CSS on the links pages (and in general) is a real mess and worth exploring; then I'll look at the h2cm content within Drupal. I never realised there were so many other tags associated with tables.

If this running around pages past and present seems a little haphazard, well one thing I'm trying to figure out is dividing the main (theme) style master.css and what would be custom.css ...? As I've started to use example pages there are a lot of CSS stuff and jQuery functions I don't need:

$(document).ready(function() {
$("#orderedlist dd:eq(1)").hover(function() {
Book cover source Amazon.
I'm deleting the redundant code and it is working, learning 'bit-by-bit'.

There's no escape though, I'm in the market for another book - jQuery, plus there's another title due next month.

A good time to opt for an electronic copy.

*Some thing's going on here - three times I typed 'rem' - happy productive memories....

In brief: flu! Drupal, H-M axis question & jQuery

I hope this post finds everyone very well? Health wise here the holiday season was cast in a flu-ridden appearance. I did reflect on things for two days: looking down the toilet - balance gone, double vision and 'tiredness'. I'm usually fortunate and dodge the viral bullets. The flu started just after last month's Drupal meeting in Manchester. I was putting lessons learned into effect and had created my own template file when the room started to spin. Anyway enough of that - I hope...

Since falling about the day after, I have not Druped at all. I have managed to read up on CSS and think about Pippa's question on the humanistic - mechanistic axis. In the end I combined the two, namely using some CSS and jQuery, the javascript library used in Drupal. The result is a draft version of seven questions and styling, which a click will reveal and hide. It works (but is it accessible and should I be using a definition list?)!

I'd like to post the questions here with the javascript, but don't want to get side-tracked. I believe that adding the javascript code as a blog widget will see it added to the template. Compared with a great many blogs the template here is unremarkable, so tackling Pippa's question in this way will pay major dividends (he said) in styling the revised h2cm content for the new Drupal site.

Sunday, January 06, 2008

DOE’s SciDAC Visualization and Analytics Center for Enabling Technologies -

Even though the datasets involved are way beyond my day-to-day (clinical) work in mental health and an understanding of the techniques involved, I'm a sucker for the images and knowledge that scientific visualization opens up.

At Cyberinfrastructure Technology Watch the article -

DOE’s SciDAC Visualization and Analytics Center for Enabling Technologies - Strategy for Petascale Visual Data Analysis Success

- includes on page 2 discussion of survival of the data tsunami and refers to following figure:

For quite a while I've been thinking about individual health and social care and the point at which things become complex. You come to realise the role scalability plays in these things. And when you do - complexity is never far away. Just how far away are these esoteric datasets?

At VACET the body behind this work it speaks volumes that 'visualization' is not alone. It's not just about (and never was I'm sure!) pretty pictures: ANALYSIS figures large too (great to see enabling in there too!).

Health Affairs blog - MENTAL HEALTH PARITY: researchers stress importance of out-of-network benefits

There is an interesting insight into US mental health provision/funding and what can be hidden factors posted by Chris Fleming at the Health Affairs Blog.

Friday, January 04, 2008

Social Care in the UK BBC Radio 4 - starting Monday

On Monday BBC Radio 4 will begin a special month-long feature on the future of social care.

Two programmes Women's Hour and You and Yours will take what sounds a very in-depth and challenging look at current plus future social care provision and the issues that concern us all. Podcasts will be available.

They are very keen to hear of people's experiences as a carer or people receiving care:

Have you been affected by cuts in care provision?
Have you had to arrange care; what has the experience been like?
Do you have examples of best practice?
Tell us your experiences.

There are also recent reports to listen to:

  • Reform of social care funding
    • The half a billion pound scheme to help people arrange and organise their own social care.
  • Provision is shrinking
    • Councils cutting back on care.
  • The unseen workforce
    • Unpaid carers could save the government £87 billion a year.
  • Transition Care
    • Who pays for a disabled child’s care after 18?
  • The future of social care
    • You and Yours special
Bye for now...

Thursday, January 03, 2008

h2cm: what's in a name? enquiry to Barbara Rylko-Bauer

In October 2006 I exchanged e-mails with Barbara Rylko-Bauer who is Adjunct Associate Professor at Michigan State University; a medical anthropologist interested in health disparities, violence, human rights, and applied anthropology. Back then Barbara had questioned the use of the term 'career' in the title of Hodges' model.
Now with the website - purposes/audiences/content/strategy - review in mind I contacted her again - our correspondence edited for space and context is copied below.

On the website and W2tQ there is a post that references Hughes and the life chances meaning of career. I think Barbara's points about a subtitle, heuristics, synthesis, the knowledge (care) domain labels, e.g. sociology, h2cm as a pathway and other thoughts must certainly influence future developments: see what you think: ...

From: Barbara Rylko-Bauer
Sent: Thursday, 27 December, 2007 11:37:54 PM
Subject: Re: Hodges model (Serres-Hodges paper and PiH)

... I went back and looked at Hodges' model to refresh my memory...and I think that what struck me most was that it serves as both a conceptual tool that encourages a more holistic way of thinking about health and health care, and a heuristic tool that provides links to many different sources, some obviously about health, others less so but still relevant.

So, I'd first ask if there is a way of conveying that across in the title. You might need a subtitle: A tool for holistic approaches to health and health care.

I'd also suggest that your domains could be expanded to reflect better the broad spans of information they cover: so social or social/cultural (rather than sociology) and political-economic rather than just political. Just a thought.

As for the title, in skimming your explanations of "career" I think that a phrase that conveys the broadness of this concept, that it is all-encompassing rather than focusing on "career" in the conventional sense (although clearly the model evolved out of thinking about training of nurses). For example: human-health career and care domains -- one could use "patient" and yet, health and health care goes well beyond concerns of humans who happen to be patients.

Don't know if this helps....but it's nice to reconnect with you.

Thanks and best wishes,

On Fri, 28 Dec 2007 01:00:30 +0000 (GMT) Peter Jones writes:

Goodness - I had one good idea today and that was to e-mail you! That's really useful, thanks so much.

Would you mind if I share your thoughts in a blog post and if so could you please provide a some details of your background? You've certainly given me something to think about.

All the best Barbara for the new year and many thanks again.


From: Barbara Rylko-Bauer
Sent: Tuesday, 1 January, 2008 2:33:45 PM
Subject: Re: Hodges model (Serres-Hodges paper)

Dear Peter:

Happy New Year!

Tx for sending me your chapter.... I was not able to open it but did skim what you attached in the e-mail, and it reinforces my sense that you should try and find a way of presenting the model as a tool for both finding and for synthesizing information on health and health care. I don't think that this is clear just from looking at the title of the model as it now stands or from the way it is imaged. It's really a pathway more than a model...does that make sense?

Go ahead and post my comments. I would prefer that my email address not get posted, just because I'm already swamped and would hate to get emails from people that I could not properly respond to (seems rude).

Good luck with this!

Best wishes,

If you also have any thoughts on this please get in touch....

Tuesday, January 01, 2008

Annual Health and Human Rights Conference 2008

Ordinarily I would not list an event that is less than 3 weeks away, BUT this conference is different:

1. the focus is HEALTH & HUMAN RIGHTS
2. the theme is urban and rural localities

3. the event is annual (so I just re-position the current listing to 2009).
4. I was asked to add a link despite the timing.
5. and besides their brochure is entitled 'Bridging the Gap'.

When I extended the initial two links pages the POLITICAL domain link categories emerged very quickly.

Health AND human rights are inseparable, if education for all is to follow.

If HEALTH is missing then HUMAN RIGHTS are eclipsed.

Unlike an eclipse though this is not just the conjunction of coincidences. It highlights fundamental dependencies.

This conference is an ideal place to learn about them and whether this year or next - make a real difference.

Happy New Year + enquiry: Occupational Health and Hodges' model

Whether the 1st of January is with you or yet to arrive as I post this I would like to wish you a very happy and peaceful New Year.

I've received an enquiry from Pippa Crouch copied below - a great start to 2008.

There's another post to follow today on University of Toronto's Health and Human Rights Conference later this month and WorldCOMP'08. In the meantime....

Pippa: I'd be very pleased to help you. If you've some specific questions about the HUMANISTIC-MECHANISTIC dimensions in the OH context ask away and I'll try to answer them. Once your study is sorted we can move on from there. (I have a graphic template for an A3 poster - used in 2005 - I can share with you.... If your OH contacts/Univ. would like me to link to the conference let me know.) Thanks for your interest and the insights/references below, really enjoyed reading it.

Sent: Saturday, 29 December, 2007 7:27:12 PM
Subject: thank you - OH and Hodges' model

Just wanted to say a quick thank you for your web site.

I am writing a paper for my Occupational Health degree and have to apply a model. As it stands there are no models specific to OH which are of any use. They are either theoretical or 'amended' from traditional nursing.

I stumbled across your website and thought I would give the career model a paragraph or two, but have become completely converted and will now be using it as the model on which to base my critical incident.

After spending weeks shifting through all the dross that apparently is supposed to make our lives as nurses easier, it is nice to finally find a model that I can actually use in practice. I will (after submission of course) be posting the link on our University website.

Many thanks

Pippa Crouch (convertee)

Date: Sat, 29 Dec 2007 21:56:11 +0000
Subject: Re: OH and Hodges' model
Hello Pippa

Thanks so much for your message - a real fillip with the start of a new year beckoning.

I'm really pleased to hear that the model is useful. As you may be finding the model will grow with you as you learn and encounter new OH and other experiences.

If you have any queries get in touch and let me know how you get along. I'd be delighted to provide some feedback on your study. If you wish and would like to provide a little background about yourself, such as where you are studying and practising I would very much like to post your message on the blog?

As you have noticed on the blog one of the ideas for the new site is an open source book that people can contribute to. A contribution on OH would be a great idea. If you are already published or would like to try I'd be delighted for us to knock some ideas around regards the possibility of collaborating. (Maybe other OH practitioners will get in touch and provide assistance and opportunities?) Your studies are the priority at present of course.

Any way all the best with your studies and for the new year holiday.


Sent: Monday, 31 December, 2007 7:56:31 PM
Subject: RE: OH and Hodges' model
Hey Peter

Please feel free to publish any of my emails on the blog.

As you know now, my name is Pippa Crouch and I'm an OH nurse advisor at East Grinstead Hospital. I'm fairly new to OH, but I have a sound background in oncology and A&E. I have recently experienced a very steep learning curve from spending two years as a practice nurse in OH to becoming an OH nurse advisor virtually overnight. Couple that with now running my own department for a small NHS trust (of around 1000 employees), this transition has been alarming to say the least!

I suppose what I have found the hardest is the ethical position that being an OH nurse puts you in. You are still the patient's advocate, but you have a wider responsibility to the employer and community as a whole. This I suppose is what part 3 of the register prepares you for.

I have never been pro models and usually I think they are a waste of time and energy. Nursing is an instinct; if you are unable to talk to patient’s and decipher their needs then you are in the wrong profession.

That said, whilst looking back on my nursing career, there is a distinct basis from which the questioning occurs, whilst in oncology there was Orem's self care model in the background and A&E - a very loose base of Roper, Tierney and Logan.

I suppose why I am struggling now is because there is no universal model for OH. Wright (1990) likened OH nursing to a building with fours pillars from which to distribute the weight equally. Each pillar is a simile for practice, education, research and management and each has to be equal else the building will fall.

Adisesh (2003) designed the OH Paradigm which incorporates how work can enhance health giving it a more balanced view as opposed to always causing detrimental effects.

In OH there are many models, yet there does not appear to be a universally accepted model to date. This presumably is due to the diversity and ambiguity of the OH role. Alston (1990) devised the Hanassari model which has allowed OHNs to reflect on their role, yet there is little indication that it has actually been applied in practice (McBain, 2006; Chang, 1994).

When I started my role, I found myself suddenly expected to be able to take patient histories and identify needs. I relied heavily on my experience in A&E for this, what I wanted was a model and an assessment tool that was actually applicable to the working environment.

I stumbled across Hodges' model purely by chance and at first gave it little thought. Then lying in bed that night I began to see how all the pieces fitted together. I realised how I could use my A&E assessment tool but take it further and how to use it as a health promotion tool as well. If I am honest then I am only learning the basics of it at present but feel it will grow with me and I can tailor it to my needs.

The only area I feel I would like more guidance is the humanistic to mechanistic section. I lack some clarity and was hoping you could offer some help?

To be honest I doubt I will be able to attend (2 very small children..), but I have been asked to write something for the OH review. I am thinking that with your guidance I may be able to use the HC model for it? I have been approached by the University to present a poster at this year’s OH conference.

Let me know what you think, and please feel free to edit any of this for the blog.

Wishing you all a happy New Year.


Adisesh, A. (2003). Occupational Health Practice. In Snashall D, Patel D (eds) ABC of Occupational and Environmental Medicine. London, BMJ Publishing.
Alston, R. (1990). 'A critical examination of roles and attitudes of occupational health nurses, their relationship with safety personnel and managers and implications for education and training initiatives'. MA Thesis. Thames Polytechnic, London.
Chang, P-J. (1994). 'Factors Influencing Occupational Health Nursing Practice'. A two-part PhD thesis. Kings College London, University of London.
Hodges, B. (1997). Hodges' Health Career Model http://www.p-jones.demon.co.uk/hcm.htm (Accessed online 29/12/07 Online: 1998-2015).
Wright, S.G. (1990). Building and Using a Model for Nursing 2nd edition, Edward Arnold, UK.