Hodges' Model: Welcome to the QUAD: November 2012

- 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

Thursday, November 29, 2012

(Extreme) sensitivity to initial conditions: Employment - Sickness

There was an item today on BBC Radio 4's You and Yours on the government's Fit for Work tests.

The new fitness for work assessments have been under review. The discussion featured Professor Malcolm Harrington and his final report on the Work Capability Assessment Review and highlighted the humanistic and mechanistic dimensions of this very complex issue (see also the back-to-work programme). Points raised include:

  • the impact of certain medications and treatments on an individual's ability to partake in an interview;
  • the meaningfulness of an appeals process that once won, then sees subsequent recalls;
  • 4/10 appeals are won;
  • the need to balance decision making and the computer based process, with the former utilising documentary evidence;
  • people with mental health and cognitive problems may be less able to advocate for themselves.
What troubled me is (the admittedly) single example were a client attending a review was advised not to bring documentary evidence. What this does is to effectively switch OFF three of four care domains: SOCIAL, INTERPERSONAL and (remarkably) the SCIENTIFIC.

What are the purposes to which clinical assessments, tests, reviews can be put? Why do clinicians and the social care team create records?

Relying primarily upon, or being driven by a computer based algorithm makes this a POLITICAL 'exercise'.

As such it will be seen SPIRITUALLY as cold and uncaring.
POLITICAL neglect reinforcing similar neglect and disinterest in the CITIZENRY.

Wednesday, November 28, 2012

RFID Tags Track Possible Outbreak Pathways in the Hospital

There is no substitute for providing evidence that confirms many common-sense assumptions about what happens in the clinical environment that is the ward - in this case paediatrics.

See the links below for details and explanation.

My source: John Matson. Graphic Science. Scientific American, November 2012, page 76.
See also the original PLoS ONE paper.

Sunday, November 25, 2012

CASA - Centre for Advanced Spatial Analysis: Working Papers

Date: Sat, 24 Nov 2012 10:24:30 +0000
From: Willard McCarty
Subject: CASA Working Papers

Many here will find something of interest, I suspect, in the Working Papers series of the Bartlett Centre for Advanced Spatial Analysis, University College London,


In particular my eye was caught by Martin Dodge and Rob Kitchin, "The ethics of forgetting in an age of pervasive computing", CASA Working Paper 92.

Undoubtedly those with GIS-related concerns will find much more than that.
Willard McCarty, FRAI / Professor of Humanities Computing & Director of the Doctoral Programme, Department of Digital Humanities, King's College London; Professor, School of Computing, Engineering and Mathematics, University of Western Sydney; Editor, Interdisciplinary Science Reviews
(www.isr-journal.org); Editor, Humanist
(www.digitalhumanities.org/humanist/); www.mccarty.org.uk/

My source:  Humanist Discussion Group, Vol. 26, No. 520. www.dhhumanist.org/
With CASA logo added here. 

Wednesday, November 21, 2012

Spaces that Speak*: Theatrum Mundi / The Global Street

Even as I search for extraterrestrials we are creatures of space.

The Agora in
400 BCE
Womb, swaddling clothes, crib, play pen, 'home', garden, neighbourhood, community, village, town, city...

Here on W2tQ cognitive and conceptual space is the focus. Hodges' model provides a space for individual or group reflection. In addition to providing a conceptual space the model can represent our physical spaces, our social spaces - incorporating the various means of denoting relationships be that social network, family - genogram, or community group.

As a unit of 'civilization' there should be civic spaces in villages, towns and cities.  This is frequently not a 'civil' space as might be envisaged in the political sense. In contemplating the health of the individual we must also see the group, the citizens and ultimately the global community. If in future individual's must assume greater responsibility for their health, through which space will that responsibility be communicated? Will the channel of choice be the 2nd, or 3rd household TV, the PC-laptop screen; smart phone or merely the Parliamentary debate?

Where is 'public space', where can women and children meet in safety, where can free speech be voiced, be heard? If the presence and stability of public space is not an indicator of 'public health' what is it? What is the impact of policy? When cars are removed from an inner town and the area pedestrianised does a public space follow - the people as they walk by(e)? Can philosophy break out of the public houses and into other public spaces?

The following initiative is centered upon only three cities Frankfurt, London and New York, but will hopefully provide some insights:

Theatrum Mundi / The Global Street 
- is a new urban forum. It seeks to understand what brings life to a city, particularly in its public places and asks how these might be better designed. It brings architects and town planners together with performing and visual artists to reimagine the public spaces of twenty-first century cities.
*and listen.

My source: Heathcote, E., Design. A breath of fresh air for public spaces. FT Weekend 27-28 October 2012. 4-5.

Former link image source: http://mkatz.web.wesleyan.edu/grk201/GRK201.Agora.400.html

Sunday, November 18, 2012

International Antibiotics Awareness Day

Dear HIFA2015 and CHILD2015 colleagues,

Today is International Antibiotics Awareness Day. The message below is forwarded from the forum of the International Federation of Medical Students Associations (IFMSA), which is a longstanding official HIFA Supporting Organisation.

"Inappropriate use of antibiotics has become a serious threat to public health globally". It is a major cause of needless death and suffering today, and threatens death and suffering on an unimaginable scale in the future. A major contributing factor is lack of access to relibable, unbiased information for prescribers and consumers. Information is either absent, or is restricted to biased marketing materials from big pharma.

I have invited Students Targeting Antibiotics Resistance Today (START) and IFMSA members worldwide to join us to promote a future where every prescriber and user has access to reliable, independent information on medicines, including and especially antibiotics.

A suggested starting point would be to make independent, reliable publications such as the British National Formulary freely available to all on the internet.

Best wishes,

Today, Nov 18th  is International Antibiotics Awareness day.

What is the problem? Antibiotic resistance is now an everyday problem in hospitals across the globe. The selection and spread of resistant bacteria in hospitals is a major patient safety issue. Infections with antibiotic resistant bacteria increase morbidity and mortality, as well as the length of stay in hospitals. Inappropriate use of antibiotics may increasingly cause patients to become colonised or infected with resistant bacteria. There are few new antibiotics in the development pipeline. As resistance in bacteria grows it will become more difficult to treat infection and this affects patient care

Why do we need an  Antibiotic Awareness Day? The inappropriate use of antibiotics has become a serious threat to public health globally, Taking antibiotics for the wrong reasons or incorrectly causes bacteria to develop resistance against antibiotic treatments with a risk of rendering antibiotics ineffective in the future.

What is the aim of Antibiotic Awareness Day? The aim of European Antibiotic Awareness Day is to emphasis the importance of taking antibiotics responsibly by putting an end to unnecessary use of antibiotics and encouraging people to follow their doctor’s instructions on how to take antibiotics in the appropriate way. The purpose of the day is to build on and reinforce the success of national campaigns on responsible use of antibiotics

Why is responsible use of antibiotics important? Keeping antibiotics effective is everyone’s responsibility. Responsible use of antibiotics can help reverse the growing trend of antimicrobial resistance and keep antibiotics effective for the use of future generations. On this basis, it is appropriate to inform the public, health professionals and carers of the sick, elderly and children about when and how to take antibiotics responsibly.

How can I get involved? Here are several ideas on how to help support this initiative: Spread the word Talk about the International  Antibiotic Awareness Day and its significance with your friends, family, colleagues and your Patients Make use of the materials by advertising the International Antibiotic Awareness Day in newsletters, on websites, in the media and on the Internet, by inserting a link on your website, in your e-mail signature or in your blog. Organise and participate in activities.


On behalf of Students Targeting Antibiotics Resistance Today (START) Team
Cecilia Kallberg, Jannie Dressler, Oluwasaanu Bunmi Michael.

My source: HIFA2015

Saturday, November 17, 2012

The Bigger Picture - Hockney: Hodges' model 4 dynamic perspectives

In the decades to follow the patient, the carer, the health and social care professional must all be dynamic. All must be capable of movement - that is taking in several perspectives. As always composition is vital. So is choreography. As Hockney indicates the picture comprises both ordinary perspective and reverse perspective.

If static, found only for a moment: an assessment, plan, evaluation. A snapshot. Then moving a-gain.

Ever seeking the dynamic.
Acknowledgement: David Hockney

My source:
'The mass media has lost its perspective'.
David Hockney, The Financial Times, Page 11, October 27-28, 2012 

Image source:

Additional post:

Friday, November 16, 2012

Conceptual Reflections on Schizophrenia - Hodges' model

A decade ago I was studying the Psychosocial Interventions for Psychosis (COPE) pathway part-time at Manchester University. The student body was interprofessinal made up of nurses, psychologists, occupational therapists, nurses and if memory serves me right people from the voluntary (third) sector. What I learned then left me wondering where I had been all those years since qualifying (lost in IT....).

There are many universities now delivering this curriculum, presenting the very latest research. The lecturers are frequently the researchers themselves, working in ongoing multicenter trials studying  various aspects of the treatment and care management of psychosis.

This is why it is very alarming to hear of the lack of progress not just within in-patient care as per the findings of the Schizophrenia Commission, but the delivery of care for these individuals and their families across the health and social care system. Of course, as a former student and holder of a PG(Dip.) I am not at present practising these skills formally.

In the h2cm table that follows I have highlighted some of the main concepts across the care domains of Hodges' model:


beliefs, perception, attention, anxiety, stress, vulnerability, pleasure, feedback, motivation, mood, therapies, therapeutic relationship, communication, assets, cognitive triad, perception, delusions, hallucinations, positive and negative symptoms, person-centered care, existing coping strategies, mental health assessment, literacies (3Rs, emotional, health), salience, attention, attribution, meaning, creativityphysical health, weight, fitness, side effects, medication, atypical antipsychotics, evidence,
genetics, research, diagnosis, (cognitive) information processing, dual diagnosis, risk, models of care, recovery, hierarchy of clinical evidence, care processes - assessment, care planning, access to interventions, audio recording of sessions, protocols, DSM IV
clinical supervision, social attitudes - family, friends, community, stigma, myth, media, carers, familes, social relationships, network, self help groups, survivors,
activities, daily routine, 'value' of a diagnosis - pros & cons (discuss), community centers, clinical supervision, positive risk management, employment, social history of mental health, social psychiatry, stories,education - schools & community,
'community care', housing
mental health history, institutional vs. community care, mental health law, autonomy, consent, capacity, best interests, equity
mental health services, early intervention, access, POLICY, anti-psychiatry, equity, governance, data gathering, statistics, reporting, outcomes, services,
secure provision, early intervention, crisis intervention, DSM V, commissioning,
funding for mental health, education and training, sickness - welfare benefits - 'incapacity' review 'return to work'

The relative position of concepts above does not indicate priority.

Wednesday, November 14, 2012

Associate Professor Fran Biley - Bournemouth University

It is with great sadness that this week I learned of the passing of Fran Biley. In 2003 I contacted Fran having heard he had worked up in Lancashire in the early 80s as a charge nurse on a then new elderly mentally ill unit. I could not resist the possibility that here was someone who perhaps knew of Hodges' model or had used it.

There were no major leads, but Fran always encouraged me in my preoccupation with Hodges' model. I did not have a sense that I was just being indulged, or that Fran was purely exercising good manners which I'm sure he had in abundance. Fran also provided support indirectly and so I will miss both his positive words and observations.

There may be some communications on the old PC to recover, as I've enjoyed following Fran's contributions over the years. The brilliant video on students and nursing theory which I posted here on W2tQ in 2010 and Fran's posts to various lists over the years, including:

From: Francis Biley at BOURNEMOUTH.AC.UK;
Sent: Thursday, 29 November, 2007 11:58:15 AM

Didn't Liam mention nursing in the original post somewhere? What about Peplau, Orlando, and Travelbee and perhaps a host of others who produced buckets full of evidence of whatever flavour you'd like to choose; and Barker as well of course, not added here as an afterthought, more as emphasis.

And as for contemporary, Orlando's book was published in ?61, and Travelbee died in 73 (I think??)....and we all (should) know Peplau's history (perhaps...)...and FNs Notes on Nursing is still on and off my book shelf like a yoyo.

Or is it that we've been influenced by psychologists, psychiatrists, sociologists and etc to such an extent that these people (and nursing per se) have clearly disappeared from the horizon, or where never there in the first place?

I will keep going Fran! Many thanks.

Tuesday, November 13, 2012

Second Latin American and Caribbean Global Health Conference “Transcending borders for health equity” Santiago, Chile January 9-11, 2013

From PAHO (Ana Luisa!)

Santiago, Chile January 9-11, 2013 - http://www.congresosaludglobal.uchile.cl/

Abstracts should be submitted through the Conference website and received before November 26, 2012 at 12:00pm (Chilean time)


The Latin American Alliance for Global Health (ALASAG)
The School of Public Health “Dr. Salvador Allende G.” of the University of Chile
The Latin American Association of Schools of Public Health (ALAESP)

The objective is to share knowledge and strengthen partnerships for education, research and advocacy in Global Health in Latin America and The Caribbean. The conference also seeks to contribute a Latin American outlook to the most pressing issues in the global health and development agenda, such as the impact of the economic crisis, social movements and conflicts and the Millennium Development Goals (MDGs).

The Conference is intended as a forum for discussion and proposal for progress toward achieving greater equity and social justice within and among all countries.

The program is organized under the following thematic areas:

• Migration, violence and population displacements
• Education and Human Resource Development in Global Health
• Health law and human rights
• Nutrition and food security
• Challenges of social movements and social media networks
• Development cooperation and global health, peace, and diplomacy
• Universal coverage and social protection
• Research, innovation and implementation in global health
• Working towards the post Millennium Development Sustainable Goals
• The economic crisis and its impact on public health
• Climate Change, Challenges and Opportunities for Global Health


The following speakers have confirmed their attendance
- Sr. Ricardo Lagos Escobar, former President of Chile and Commissioner of the WHO Social Determinants of Health Commission,
- Dr. Jaime Mañalich, Minister of Health, Chile,
- Dr. Ginés Gonzalez, President Emeritus ISalud University, Buenos Aires, Argentina Ambassador to Chile and ex- Minister of Health, Argentina,
- A representative of Dr. Mirta Roses, Regional Director of the Pan American Health Organization (PAHO / WHO),
- Sir Michael Marmot, UCL International Institute for Society and Health;
- Prof. Ronald Labonte, University of Ottawa,
- Dr. Paulo Buss, Fiocruz Foundation,
- Dr. Anvar Velji, Consortium of Universities for Global Health (GHEC-CUGH),
- Prof. Oscar Cabrera, O'Neill Institute for National and Global Health Law at Georgetown University,
- Dr. Pierre Beukens, Tulane University School of Public Health and Tropical Medicine and CUGH,
- Dr. Haile Debas, University of California San Francisco, and CUGH,
- Dr. Wolfgang Munar-Angulo, Gates Foundation,
- Dr. Roger Glass, Fogarty International Center,
- Dr. Jeannette Vega, Rockefeller Foundation,
- Dr. Ilona Kickbusch, The Graduate Institute, Switzerland.


Many individuals and organizations in Chile, Latin America, the Caribbean, North America and Europe have contributed significant resources to ensure that this second Conference is as successful as the first one. The School of Public Health at the University of Chile, as host of the event, has generously contributed its own resources and from other Chilean funding sources to ensure the success of the Congress. The members of ALASAG in 10 LAC nations are working to promote the conference in their own countries. At the time of this announcement, the following organizations have agreed to partner with ALASAG and the University of Chile to co-sponsor the conference: the Ministry of Health of the Chilean Government, the Pan American Health Organization, Consortium of Universities for Global Health, Columbia University Global Center in Latin America (Santiago), the Fogarty International Center, the O´Neill Institute for National and Global Health Law, Georgetown University, Canadian Society for International Health, Chilean Occupational Health Safety Association (ACHS), Aguas Andinas Corporation, Clínica Las Condes and Pfizer Chile, S.A.

Giorgio Solimano Cantuarias President 2nd Latinamerican and Carribean Global Health Conference
School of Public Health Universidad de Chile
V. Nelly Salgado de Snyder Technical Secretariat Alianza Latinoamericana de Salud Global (ALASAG)
National Institute of Public Health Cuernavaca, México


Transcendiendo fronteras para la equidad en salud
Santiago de Chile 9-11 de enero, 2013

Instituciones convocantes:

La Alianza Latinoamericana de Salud Global (ALASAG),

La Escuela de Salud Pública “Dr. Salvador Allende G.” de la Universidad de Chile

Website: http://www.congresosaludglobal.uchile.cl/


Compartir conocimientos y fortalecer alianzas para la educación, investigación y abogacía a favor de la Salud Global en la Región de América Latina y El Caribe.
Aportar la mirada latinoamericana a los temas más candentes de la agenda mundial sobre salud y desarrollo, tales como el impacto de la crisis económica, los movimientos y conflictos sociales y los Objetivos de Desarrollo del Milenio (ODM).
Establecer un Foro de discusión y propuesta para avanzar hacia el logro de mayores niveles de equidad y justicia social dentro y entre todos los países del mundo.

Resúmenes deberan ser enviados a través de la página web del Congreso hasta el día 26 DE NOVIEMBRE A LAS 12:00h

Ejes de trabajo:

- Migración, violencia y desplazamientos poblacionales
- Colaboración internacional para el manejo integral de desastres y epidemias
- Desafíos de los movimientos y las redes sociales
- Mecanismos de cooperación y diplomacia para la salud global
- Cobertura universal y protección social
- Investigación, innovación e implementación en salud global
- Hacia los nuevos Objetivos de Desarrollo del Milenio
- Crisis económica y su impacto en la salud pública
- Cambio climático, desafíos y oportunidades para la Salud Global
- Cooperación para el desarrollo y diplomacia en Salud Global

Giorgio Solimano Cantuarias -Presidente 2º Congreso Latinoamericano y del Caribe sobre Salud Global
Escuela de Salud Pública Universidad de Chile
V. Nelly Salgado de Snyder - Secretaría Técnica Alianza Latinoamericana de Salud Global (ALASAG)
Instituto Nacional de Salud Pública - Cuernavaca, México

Please visit the GANM webpage at: http://knowledge-gateway.org/ganm/

My source: GANM c/o Patricia Abbott.

Saturday, November 10, 2012

Two recent references informing my studies: Concept maps & Threshold concepts in mental health

These two references inform my study of Hodges' model:

Zubrinic, K., Kalpic, D., Milicevic, M. (2012). The automatic creation of concept maps from documents written using morphologically rich languages. Expert Systems with Applications. 39. 12709–12718.

Stacey, G., Stickley, T. (2012). Recovery as a threshold concept in mental health nurse education. Nurse Education Today. 32, 534–539.

I will post again soon with some thoughts on the above. If you can suggest other recent resources please get in touch.

And on a personal note ALL THE BEST TO DAN, KAREN & little ANNA too. 10.11.12 a day to remember.

Saturday, November 03, 2012

'Semantic Reefs' - All at Sea, on Land and in Mind

In reviewing some literature recently I came across the phrase 'semantic reef'. In forwarding a copy of the paper Dr Trina Myers described the semantic reef as: an architecture created to automatically infer phenomenon or alerts about coral reefs using Semantic technologies (aka. Linked Data).

The coinage of semantic reef in the paper by Myers and Atkinson really captured my imagination. While the semantic web is of interest to me and the environment is the oxygen to the human ecosystem, to our very existence and well-being; Myers and Atkinson's semantic reef is very specific:

The Semantic Reef Knowledge Representation system is an eco-informatics application designed to assist in the integration of remotely sensed data streams and historic data sets supporting flexible hypothesis design and knowledge extraction. The system is an ontology-based architecture built to allow researchers to combine disjoint data sets into a single Knowledge Base for modelling the impact of climate change on coral reef ecosystems. p.16.
I've written previously of the conceptual role that the axes of Hodges' model can play. How they act as a distinct, idealised boundary between the disciplines. Most evident is the MECHANISTIC-HUMANISTIC divide between the hard sciences and the humanities. Academics, researchers, health practitioners can become trapped in a disciplinary silo. Reefs are often a Great Barrier. Mariners have to find navigable waters to find a way through. Safe passage is recorded.

The last thing anyone wants is a shipwreck; whether in the ecosphere, designing software or health care.
Maybe this is another (long-winded-yes) way of recognising the collapse of holistic bandwidth at the point of a medical emergency, a crisis. The situation IS a shipwreck. A disaster of a very personal kind. What lies beyond the information required in that specific instant, what lies outside that atoll is suddenly not important.

More positively though a reef also represents an opportunity. It is a sign, a measure of global health. As such it IS a community. It is community. Harmony. Balance. It is the community around which others revolve. And we need to recognise; nOt that, but this and nOw. ...:

Trina Myers, Ian Atkinson (2013). Eco-informatics modelling via semantic inference. Information Systems. 38, 1, March 2013, 16–32.

Thanks to Dr Trina Myers.

Image sources:
Australian National Maritime Museum