Hodges' Model: Welcome to the QUAD: 2013

- 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, December 26, 2013

To-do list and challenges ... 2014

...in no particular order of priority or level of challenge presented...

Graduate study - distance learning, assignments, supervision, residential week
Research question
Role of simulations - games?

E-mail address (beyond yahoo and demon)

Video and Audio skills
 Drupal 8 (stable Windows install - Linux)
the Drupal stack (still)
Abandon/transition from this blogging platform to other

Complete and format recovery, recovery model and Hodges' model paper for submission to journal
Prioritise and relate conference attendance and presentations/workshops to post-grad studies
Complete remaining three books for review

focus, focus, focus...

Happy holidays a Healthy and Prosperous New Year to All!

Monday, December 23, 2013

SCNTST - Self Therapy

Self Therapy

"... Self Therapy 
is designed for the headphones
 not the dance floor, ..."

Hunter-Tilney, L., Life&Arts, FT Weekend November 16-17 2013, p.19.

group - population

Image source: http://renownedforsound.com/index.php/album-review-scntst-self-therapy/

Sunday, December 22, 2013

mEDucator 3.0 | Open Linked Education - Melina+ (Drupal)


Checking through links yesterday I came across the mEDucator initiative and Melina+ [no longer available] which is part and noticed it is built using Drupal.

There is a thread on Drupal.org on science applications:


I posted in 2009 about the Science Collaboration Framework - SCF (for creating biomedical resources).

The link to SCF no longer works; there is an archive of this and other work that was part of Harvard's Initiative in Innovative Computing (IIC).

So it's important to consider these initiatives at least in terms of their longevity, their scale and number of participants, as examples of funded research and as Drupal projects.

Wednesday, December 18, 2013

Papers, *actual* post-grad studies and a visit to Brian Hodges

Early last month I posted about planned trips to Sheffield and Lancaster Universities.

On the 4th I visited Paula Procter at Sheffield Hallam University, spending two hours there. Paula and I have known each other through informatics conferences since the late 1980s or early 90s and the British Computer Society Nursing Specialist Group. (Sadly this group and its publications are not as active as they used to be.) I really appreciate Paula's time and her key conclusion that rather than thinking about Hodges' model I need to apply my knowledge and experience with the model and DO something with it. In doing something with the model in a certain community - most likely residential care and nursing homes - I would also have a potential community of users for the new website. This was quite something to hear as I'm at that stage of my career when, shall we say - other possibilities beckon.

In the afternoon I travelled the short distance to meet Brian Hodges at his home. It was great to meet with Brian again and his wife. It was a lovely sunny afternoon as per the welcome and some cake! We reflected on the respective changes over the past five years and current events. Hot-off-the-press of course was my sharing the discussion with Paula and the planned visit to Lancaster University.

We agreed to meet again and not leave it so long next time. Brian has a desire to write again and and a prospective topic in dependence - independence. I hope this is something Brian can do and forward a photo for the (still) promised site. Brian now has copies of the most recent papers and the latest draft on recovery in mental health and the model.

On the Wednesday, after work I drove to Lancaster to discuss their PhD E-Research and Technology Enhanced Learning (thesis and coursework) distance learning.

At the start of last week a reserve place - for January 2015 became an offer of a place next month.

So, as of next month I will make a start. There is a residential week to look forward to at the end of March. Three second hand books from the reading list are ordered. There is a recommended video link too that invites repeat viewing, Etienne Wenger on Communities of Practice:


- and in the Nursing Informatics book I'm reading for review, on page 189 box 11.1 is on the same topic and referenced source Wenger, E..

I predicted quite some time ago about the post count decreasing here ... now I have an excuse and I plan on this including Drupal.

Tuesday, December 17, 2013

Cognitive Informatics and other forms?

Over the past couple of months I've posted on topics that include an example of Hodges' model related to the post's particular theme. In McGonigle and Mastrian's Nursing Informatics and the Foundation of Knowledge, Second Edition (2012) on page 63 the editors cite Wang (2003):

Cognitive informatics attempts to solve problems in two connected areas in a bidirectional and multidisciplinary approach. In one direction, CI uses informatics and computing techniques to investigate cognitive science problems, such as memory, learning and reasoning; in the other direction, CI uses cognitive theories to investigate problems in informatics, computing and software engineering (p.120). 

I will leave it to you to consider the INTRA-INTERPERSONAL and SCIENCES domains, and not (just) how Wang's cognitive informatics 'fits' within Hodges' model, but what of the many other informatics fields. Here they seem like stepping stones, but taken together where do they lead to, from, ... about ...?

Wang, Y. (2003), Cognitive Informatics: A New Transdisciplinary Research Field, Brain and Mind: A Transdisciplinary Journal of Neuroscience and Neurophilosophy, Vol.4, No.2. pp.115-127.  

Saturday, December 14, 2013

H2cm - Beauchamp and Childress (1994) four principles of healthcare ethics

I'm clearing the decks of books at the moment, one of which is McGonigle and Mastrian's Nursing Informatics and the Foundation of Knowledge, Second Edition (2012). I notice a 3rd edition is in preparation.

A review will follow, but in chapter 5 on Ethical Applications of Informatics on page 73 (pb.) the four principles healthcare ethics of Beauchamp and Childress (1994) are mentioned in a very concise, informative discussion.

Although the exercise that follows involves 'putting concepts in boxes', doing so helps us to see beyond the boxes, to see the links between.

Although harm takes several forms it is physical harm (for nonmaleficence) that is most commonly thought of. This is the ethics concerning an individual so why have I placed beneficence in the sociology domain? Justice should be straight forward, but only if reinforced by law, and then only if that law is exercised. Autonomy should be straight forward. I must have the mental capacity, the insight to have choices. In the eyes of others these choices may be rationale or irrational. Although justice is place in the political (group / population) domain, rights are ascribed to individuals. This is useful property of Hodges' model the way that the individual and their mental life are diametrically placed (opposed?) and linked. It is others who are having determine the ethics of a given case, evaluating what is in the person's best interests; also having to take into account any advanced directives, or living wills.

What do you think? If you have some comments, can improve this or feel there is a correspondence here please let me know.


autonomy nonmaleficence
group - population

  • Respect for autonomy - the patient has the right to refuse or choose their treatment. (Voluntas aegroti suprema lex.)
  • Beneficence - a practitioner should act in the best interest of the patient. (Salus aegroti suprema lex.)
  • Non-maleficence - "first, do no harm" (primum non nocere).
  • Justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality).
Above text:

Thursday, December 12, 2013

Critical Thinking - Gaining knowledge: Beginners + Experts = audience?

Clearing through books last month with several bound for the charity shops I came across Critical Thinking in Nursing: An Interactive Approach, by Rubenfeld & Sheffer, with the following table (p.30):

Ways of:

Gaining Knowledge Assigned readings and asking authoritiesMultiple written and verbal sources, and experience
Thinking DualisticRelativistic
Using rules Context freeSituation dependent
Looking at situations NarrowBroad

The table is not remarkable in its theme, but it is a useful prompt for Hodges' model and future studies. The concepts listed might help illustrate how Hodges' model can support learning. In addition to having an individual focus the model can consider any situation, hence the claim that the model is 'situated'. As stated previously person centeredness is not a given. It does not follow, nor is it achieved just because 'person centered' features several times in care philosophies and policies. The person must be put at the center of the model and then each of the domains considered together with the spiritual dimensions.

I'm also reading a nursing informatics book (posts and review to follow) that discusses casuistic ethics, that is case-based reasoning. While the utility of casuistry is debated in nursing, the need to consider the individual is always paramount. A prime example of the focus on the individual is the programme Inside the Ethics Committee on BBC Radio 4. Central to ethics are the frequent dilemmas that arise in health and social care, the difficult moral choices and dichotomies that must be faced. The model can be used in a context free way, that is considering rules in general; and also employed in specific contexts, such as a best interest meeting for a person recently moved into a residential care facility and distressed by the experience.

There are many dichotomies that can be identified in the basic model, and to a certain extent they reflect the dualistic thinking of the beginner as they build an understanding of particular fields of health care. As learners progress they integrate the concepts they encounter and are then able to associate these and relate them to prior learning, the current case and generate hypotheses that may also be predictive. Hodges’ model can frame and help represent student encounters be they narrow or broadening (recognising patterns). Gaining knowledge may need particular attention by the student (mentor and lecturer) in terms of the student's strategies for creating and protecting opportunities as a beginner and competent practitioner.

As a sign-off mentor I’ve become acutely aware – as required - of a learner’s level of skills and knowledge. What is their level of competence? What is their level of situational awareness? How are they progressing through their learning according to previous mentors and their own goals, learning objectives and evaluation? The concept of emotional intelligence is not new and still has the attention of researchers. Perhaps this could also inform questions for research into Hodges’ model as students elaborate their initial representations of nursing care, skills and knowledge through their course and ongoing as experts. Is emotional intelligence central to compassion in nursing? Encompassing all of these ‘ways’ in the table is reflection. This is not just for reflective practice but an ability to critique one's own practice and that of others.

The table is also helpful at this time considering future content and content types and the potential audience of a new website. The challenge is to emulate the table above in the way it reduces, simplifies very complex educational matters. Yesterday afternoon I was able to attend a very helpful two hour research clinic in Lancaster, following this I must (still) reduce the above questions and also recognise my own biases.

Rubenfeld & Sheffer (1994) Critical Thinking in Nursing: An Interactive Approach. 1st Edition, Lippincott Williams and Wilkins.

Sunday, December 08, 2013

Join the Revolution: For the Lady in the Corner (c/o ST4Health)


personal experience
one disease -
malaria, smallpox, leprosy, TB,

 emergency treatment, hospitals,
systems, capacity
society, community, village

gender, interactions,
humanitarian works,

policy, organisations,
population health improvement, global health, poverty,
economics, outcomes

group - population

My source:  HIFA2015 list

Saturday, December 07, 2013

Reading and writing the minutia of locked doors and windows (still a draught)

Couples, married or not, partners are the cards that frequently, if not by definition, lean on each other beyond the pale, to the n-th degree. Witness so many lessons of what love really is.

They bend and flex. Tested by history, timelines entwined, ties-that-bind, trying to persist in the hear and how.

Their psychological union is challenged as memories become eroded and physically frailty takes hold. Usually; mostly, on the one.

Eventually things, established relationships break and one or the other - should we say: finds themselves in - residential care.

Courtship enables us to become socialised to and with each other and respective families and in some instances other cultures and beliefs.

In this crucial transition sometimes there is learning through experience as respite care is sought.

In other cases health services wonder how this relationship has survived for so long. A crisis is a precipice for change. A chaotic invitation. Radical.

A sudden shift from what was home to a new world of corridors, r, ro, roo, room, rooms; my room? New noises and smells and altered routines and jumbled faces, touches, days and nights

The dolls of childhood are left behind, but may be picked up again literally as an emotional comforter. If not this then perhaps a ‘paper clad dol’ that is bound to be - ‘deprivation of liberty’.

In this new home, this person walks the corridor and inspects the minutia of the doors and windows. Staff pass by(e) waving by their walk - "so-busy-look-no-hands" while trying to be butterflies.

Butterflies that cannot say which way is ‘out’.

They are they. Difficult to follow with eye, head and a hand to catch. The individual recognises the whole of the comings and goings, the main thoroughfare. The strategic point, the nexus of comings and goings.

Something's not right though! I need to be somewhere else.

Sadly (or Usually), there is no going back.

Is there a pattern to this confused-coming-to-terms-with?

From asking repeatedly about being elsewhere, especially with the setting of the sun is there a shift in attempted reasoning? So correct, so responsible all those decades ago. Perhaps even months ago...

If no one will listen to me then perhaps if I have my wife/husband with me then they will see the importance of my cause, my mission.

See look - I have my wife, husband, partner with me now: we really need to go!

Can the residential care home support this person? Can they meet their care needs? They say they are ‘struggling’. Will they need to move – again?

How do they work through this transition? What do we know of how individuals negotiate this transition in their lives? How can we try to understand?

How do they make sense of what has happened, and where they now find themselves? Will their level of distress, agitation gradually extinguish as with their efforts to leave?

As they look to the windows, seek to traverse the doorway, cross the foreign threshold and venture to that somewhere that is not here, we know one thing.

Person centredness lies in the minutia of the life once lived through those locked doors and windows.

We can ‘open’ the doors and windows by travelling with them, together, sharing that journey, the sense of those times and upon returning help them adjust to this new listen and how. Clearly, deprivation of liberty is not a punishment here, yet it demands compensation by provision of high quality personalised care.

Wednesday, December 04, 2013

The EQUATOR Network: Support for “Declaration of transparency”


Following publication in the BMJ, in October 2013, of a proposed declaration of transparency a number of journals have now expressed their support for the transparency declaration and now ask lead authors to sign a declaration affirming that:
"this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained".

The following journals have now expressed their support:

BMJ Open
BJOG: An International Journal of Obstetrics and Gynaecology
Canadian Journal of Anesthesia
NIHR Journals Library

Reference: Altman DG, Moher D. Declaration of transparency for each research article. BMJ 2013;347:f4796 [free full text].

My source: equator network - newsletter December 2013

Saturday, November 30, 2013

The Resurgence of - Soul Soil Society - in h2cm

On my travels into Manchester for Drupal NW and other monthly meetings I sometimes have time to call at the Cornerhouse (now HOME. It's an independent cinema and visual arts venue. The shop is open until about 7pm and amongst many interesting publications I discovered Resurgence which is now Resurgence & ECOLOGIST. It is a great read - as per its banner - on the environment, activism, social justice, arts and ethical living. The great read lies not just in the content, but the fact that it challenges your way of life.

The welcome in the latest issue Nov/Dec 2013 by Satish Kumar the editor-in-chief includes mention of two books, one by Satish Kumar himself: Soul Soil Society.

As technology races ahead and governments chase economic growth through capitalist-based socio-economic systems what stands out is the failure of political systems to keep up.

The question is not how soil is created through a natural process that takes time and is itself a vital variable in a complex ecosystem. The question is how hard can we push soil?

What are the global effects of giant excavators that can move mountains, cut swathes of tarmac through rain forests? What is the natural value of soil, of land for individual farmers against synthetic fertilisers, genetically modified seed, land grabs ...? Why do we call the rainforests - rainforests#? The impacts are local, global and glocal as this issue of Resurgence and others highlights.

Below I've transposed the book's title on to Hodges' model:





What is missing?
group - population

# See also: PHYSICS & THE RAINFOREST, Peter Bunyard, pp.12-14.

Additional book:
Jonathon Porritt, The World We Made

Thursday, November 28, 2013

The Health Foundation launch new Person-Centred Care resource centre

Dear CHAIN member,

We would like to draw your attention to the following new resources.  
Please pass on as appropriate.  Thank you.

The Health Foundation has launched their new person-centred care resource centre:



The resource centre is designed to help healthcare professionals implement a more person-centred healthcare service, where people are supported to more effectively manage and make informed decisions about  their own health and care. Initially focusing on shared decision making and self-management support.

Wendy Zhou
CHAIN Manager

CHAIN - Contact, Help, Advice and Information Network  
– is an online international network for people working in health and social care.  
For more information on CHAIN and joining the network please visit website: 

Wednesday, November 27, 2013

Playing and working with words and music - étude : ctude


An étude (/ ˈeɪtjuːd /; French pronunciation: ​[eˈtyd], a French word meaning study) is an instrumental musical composition, usually short, of considerable difficulty, and designed to provide practice material for perfecting a particular musical skill.

Source: http://en.wikipedia.org/wiki/%C3%89tude


A ctude is a care assessment and evaluation instrument, a composition that is usually short, in summary form comprised of key concepts, and yet capable of representing the complexity of health and social care contexts. The ctude is designed to provide practice material for developing expertise in care assessment, holistic and integrated care that is also person-centred. Coined from étude (/ ˈeɪtjuːd /; French pronunciation: ​[eˈtyd], a French word meaning study) it is a study in care and can be a snapshot, or a dynamic series.

Tuesday, November 26, 2013

Winter Exhibition at Wellcome Trust: Foreign Bodies, Common Ground


Art in Global Health: Reflections

http://www.wellcome.ac.uk/News/2013/WTP054754.htmThe exhibition brings together artworks including painting, photography, sculpture, film and performance, made during residencies at medical research centres funded by the Wellcome Trust in Kenya, Malawi, South Africa, Thailand, Vietnam and the UK.

The contributing artists were given a simple and wide-ranging brief: to find out about research being undertaken and produce work responding to their investigations. The result is a series of varied, moving and humorous works, recording journeys taken within the complex realm that lies between scientific processes and local communities, often on the frontlines of communicable diseases.
"Health issues are usually addressed by women
because of their standing in society.
The question is: how do we bring the
into the picture?"
Elson Kambalu
About Art in Global Health

‘Global health’ is a phrase we hear more and more frequently. As it attracts more attention it attracts more investment and more research. But what does it mean? ...
group - population

‘Foreign Bodies, Common Ground’ at Wellcome Collection
[See Internet Archive]

My source: FT Weekend Magazine

Wednesday, November 20, 2013

Consultation on the proposed withdrawal of the SNOMED CT national care planning content

In addition to responding myself, I notice on the actual consultation page on 'Citizen Space' there is an option to share this consultation.

Dear Peter,

You are registered for the care planning content via the HSCIC Technology Reference data Update Distribution website.

The national Care Planning Content is designed for use to support care planning functionality across health and social care. This functionality crosses many professions/sectors which may have differing descriptions for a care plan in the traditional health record (e.g. treatment plans, birthing plans, support plans, intervention plans or care order sets). The content can support the interoperation of care plans across boundaries and paper based care plans based on the pack have also been used successfully to gain greater familiarity with structured terminology (SNOMED CT).

More details at: ...

The absence of a declared owner or sponsor for this product means that we are proposing to withdraw it and are keen to hear views and understand the impact of not maintaining this content and its associated services.

We have a number of questions to determine how information Standards could best support the development of a standard for care planning, the consultation can be found at: ...

- and we would value and encourage your feedback on this proposal.

If you have any questions regarding the above you can contact us by sending an e-mail to information.standards AT hscic.gov.uk. This is the preferred form of communication.

The TRUD support team
Health and Social Care Information Centre

Tuesday, November 19, 2013

Immortality, the matrix and Hodges' model

The 5th care - knowledge - domain is the Spiritual


floating off as souls
not dying

coming back to life
living on through legacy

group - population

My source: FT Weekend March 31 - April 1 2012, Memento mori, Book review by Julian Baggani of Stephen Cave's Immortality: The Quest to Live Forever and How It Drives Civilization.

Sunday, November 17, 2013

[hifa2015] How can we stop ICANN decision that could profoundly damage global health?

Dear HIFA colleagues,

A few weeks ago I posted the Lancet article below, which highlights the threat of a commercial sale of the new top-level domain ".health".

The authors point out that ICANN (Internet Corporation for Assigned Names and Numbers), which controls all internet naming, could be about to make a decision to sell ".health" to the highest commercial bidder. The decision is imminent. I have indeed heard that an ICANN meeting that will include discussion of ".health" is being held over the *next few days*.

As the authors of the Lancet article point out, sale of ".health" to a commercial enterprise "could have a profound effect on health information access and quality for generations to come". This is something that should concern all of us, everywhere.

ICANN hosts a wiki which apparently can only be edited by them and which briefly describes the issue in rather difficult-to-follow language, without actually explaining the nature of the objections that have been raised by leading health organisations, including WHO, and by national governments:

These objections may be found elsewhere by googling. Essentially, there is a *great* deal of concern among health agencies worldwide, and a small handful of governments, of the public health consequences of commercialising ".health". In particular, there will be little if any assurance that the content of websites carrying the ".health" domain name will contain reliable health information. There is a serious risk that misinformation and/or commercially biased information could be propagated using the ".health" suffix. It is likely that many citizens worldwide will see the ".health" suffix as an indication that the information is primarily intended for their health, whereas the reality would be that much of the information would inevitably be wholly unreliable, and driven by commercial (or even ideological) motives.

I was especially concerned to read the latest news on this wiki, which read as follows: "The IO [Independent Objector - see below] lost its objection to Afilias' applicant for .health in a ICC determination by 3 panelists made on 6 November 2013. The determination was the first Limited Public Interest Objection to be decided, as well as the first objection filed by the IO to be decided. [19]

I am not entirely clear how the proceedings work, but the wiki tells us that "[ICANN's Independent Objector] is an appointed authority on international law whose role is to object to strings on the grounds of Community harm and Limited Public Interest were detailed in the applicant guidebook. His objections are official objections and are funded by ICANN, though his office is otherwise independent. Reasons for the specific case against .health were not initially given, but, in the case of Limited Public Interest, "the applied-for gTLD string must be contrary to generally accepted legal norms of morality and public order that are recognized under fundamental principles of international law. The expert panel appointed by the ICC will base its decision on the existence of such a contradiction." The applied for string must threaten an incitement to violence of lawless action, discrimination, child pornography, or "be contrary to specific principles of international law as reflected in relevant international instruments of law.""

This reference to "violence of lawless action, discrimination, child pornography..." is bizarre and I cannot claim to understand how this is relevant. What is at issue here is the availability of reliable versus unreliable healthcare information. I hope that others on HIFA may be able to enlighten us further.

Regrettably, there has been an almost total absence of advocacy and awareness-raising about the issue, apart from The Lancet article. Other than the authors of the Lancet article, there is no advocacy leadership of which I am aware. This is the kind of issue that needs a prominent global health leader to speak out. I do not know whether Margaret Chan, Director-General of WHO, is free to speak out on this, but I feel that we need a strong statement from someone at the highest level.

In the meantime, what can we (HIFA members) do to stop ICANN making - or at least deferring - a decision that could profoundly damage global health?

Best wishes,
HIFA profile: Neil Pakenham-Walsh is the coordinator of the HIFA2015 campaign and co-director of the Global Healthcare Information Network. ...
[ As mentioned above Neil also posted the Lancet article - I have just copied the link below ]

Below is the citation and extracts of a new article in The Lancet. The full text is freely available here:

Ensuring the future of health information online
Tim K Mackey, Bryan A Liang, Amir Attaran, Jillian C Kohler
The Lancet, Volume 382, Issue 9902, Page 1404, 26 October 2013
doi:10.1016/S0140-6736(13)62215-1Cite or Link Using DOI

Saturday, November 16, 2013

Call for papers: Social Robots: Form, Content, Critique - International Journal of Social Robotics

Dear Humanists,

With the usual apologies for duplications and request for cross-posting to suitable lists and potentially interested colleagues - on behalf of my co-editors:

Call for Papers: Social Robots: Form, Content, Critique
special issue of The International Journal of Social Robotics

Co-editors: Michaela Pfadenhauer (Karlsruhe University / Karlsruhe Institute of Technology), Satomi Sugiyama (Franklin College, Switzerland), Charles Ess (University of Oslo).

We invite papers from scholars and researchers across the disciplines (including philosophy, robot ethics, artificial intelligence, cognitive science, media/sociology, information science, art history) that examine and explore social robots through three distinct but inextricably interwoven frameworks:

  • Form/appearance (e.g., human/animal likeness in appearance; everyday media forms and robotic functions; cultural attitudes toward robot forms, etc.)
  • Content/AI/applications (e.g., implications of artificial intelligence in everyday human experiences such as memories, relationships, and conceptions of the self and self-understanding;  applications that shape human-robot interactions; applications of mobile media and their implications in human's robotic experiences, etc.)
  • Critical issues that undergird the above, including; ethics, intimacy, emotions, authenticity, etc.

Paper submission deadline: 1 January 2014
Notification to authors: 1 March 2014
Submission of authors' revised papers: 1 May 2014
Final acceptance: 1 June 2014
(accepted papers will be immediately published at the IJSR webpage with a Digital Object Identifier for citation purposes)
Publication: August, 2014

The call is an outcome of the COST Strategic Workshop on Social Robotic and Sustainability that took place in Brussels, Belgium, on 10-13 June 2013.

Authors are required to register on the website and to follow the Journal's Instructions for Authors' as provided there.

Many thanks in advance,

- Charles Ess
Professor in Media Studies
Department of Media and Communication
Director, Centre for Research on Media Innovations

University of Oslo
P.O. Box 1093 Blindern
Oslo Norway
email: charles.ess AT media.uio.no

My source: http://digitalhumanities.org/humanist

Wednesday, November 13, 2013

Held in equal esteem: Physical health and Mental health

As a mental health nurse you are familiar with concept of ‘esteem’. Self-esteem is central within assessments of clients, central to all care workers as safe and effective practitioners; and self esteem tests carers in those people for whom their condition means self-esteem is something attributed by proxy.

I noticed just recently use of the term esteem applied to the disparity between physical health and mental health. The two upper-most domains in Hodges' model (interpersonal and sciences) draw attention to the historical duality of mind and body. To integrate the two means acknowledging differences and this is acute in terms of finance, research and treatment plus many other measures.

The limitations of my emphasis in a series of previous posts on holism, holistic care, holistic approaches become apparent as long as the political domain is not addressed. You can be as holistic as you like, identifying, processing and integrating the full remit of health care concepts relevant in a case. If esteem is not achieved then the benefits of being holistic must be severely damaged. They may even be considered futile politically (speaking - just a whisper)?

Through the links below this post demonstrates that esteem is stirring in the political, policy and legislative domain and is being addressed, even if a solution will not arrive overnight.

My original sources: New Scientist, the HSJ and BBC.

Nick Craddock (2013) Opinion: Where's our Higgs? New Scientist, 27 April, 2914; pp.30-31.
Psychiatry needs the star quality of physics to help recruit top academics and fight the scourge of mental illness - this opinion piece concludes:

So, in 2013, psychiatry has powerful scientific tools and a developing narrative that already points to strong theoretical bases. Yet, in the UK research into mental illness is stalled at around 5 per cent of the annual medical research budget, and the picture is similar in other rich countries. That will have to change – and governments and funders are starting to see this. The door is open: all that is needed is for more of the best to come in and find out just how hot psychiatry really is.

‘Esteem gap’ between mental and physical health remains
10 October, 2013 | By Alastair McLellan
The government knows the challenges the facing mental health sector, but without radical solutions the goal of treating mental and physical health service users on an equal footing seems as far away as ever.

Debate on 10 October: Parity of Esteem for Mental and Physical Health - Lords Library Note

Lords debate – Parliament TV:

Royal College of Psychiatrists: OP88. Whole-person Care: from rhetoric to reality (Achieving parity between mental and physical health)

Tuesday, November 12, 2013

TO: EU -omics research community; if you are seeking a holistic approach for personalised medicine...

The relevance of Hodges' model as a resource in 21st century health care and research can be found within personalised medicine.

This is in addition to the need to assure holistic bandwidth within existing health care delivery, when it is person centered care that is the concern. Personalised medicine brings with it further challenges as it emphasizes the scientific, the inevitable reductionist work can potentially increase the distance between the humanistic and the mechanistic. The working document from the European Commission -

Brussels, 25.10.2013 SWD(2013) 436 final COMMISSION STAFF WORKING DOCUMENT. Use of '-omics' technologies in the development of personalised medicine

on page 7 we read:

The figure is instructive as it shows that a holistic approach is needed to fully appreciate the challenges and opportunities presented by personalised medicine. 
'Holistic' is a much maligned word, with its fuzzy, new age connotations. Especially when the word count = '1'. Another related document also picks up the holistic call:
IMI2 will deliver tools, methods and prevention and treatment options (directly or indirectly) that will progress the vision of personalised medicine and prevention. Through providing the framework required to support collaboration between scientists, regulators, HTAs, patients and healthcare providers, IMI2 will ensure that research is translated into implementable solutions to current healthcare challenges. Solutions that are not purely focussed on the development of new medicines, but that provide a holistic personalised healthcare package as well as maintain people healthy and productive through out their lifetime. Reclassification of diseases based on their root cause and not symptoms will help addressing unmet needs even in areas where a range of options exist but patients do not respond, because their symptoms are misleading therapy choices.
[ IMI - Innovative Medicines Initiative ]

Outline Strategic Research Agenda for a biomedical research public private partnership under Horizon 2020: (draft) The right prevention and treatment for the right patient at the right time. 08 July 2013. (pdf link removed file not readable)

On page 10:
A sustainable healthcare system is a holistic one in which the patients are responsible for their wellness and quality of life; physicians, therapists, nutritionists, community carers, and all other actors in the value chain are motivated to this goal; delivery of care takes into account patient beliefs, values and both rational and irrational behaviors; the care is affordable to both public and private payers and promotes health; sustainable businesses can thrive; and the education, prevention and management of chronic conditions are aligned to achieve this goal.
The focus of these documents is -omics and the development of new medicines. By its very nature this research, data and knowledge lies deep within many sciences: new sciences no less. This recognition of the need for holistic approaches and perspectives is still very encouraging. As the first document on personalised medicine notes, future treatments must be from "bench to bedside". We can equate this as "mechanistic to humanistic", but only as long as the patient in that bed is a person and not just viewed as a diagnosis with an associated -omic profile.

Have a look also at the figure on page 7, the medical innovation cycle. As discussed previously on W2tQ patient safety needs situated awareness and holistic perspectives.

My original (and seemingly incomplete) source:
http://www.researchresearch.com/index.php?option=com_news&template=rr_2col&view=article&articleId=1339313 [no longer available]

Saturday, November 09, 2013

(other) for-getting(s)

HUMANISTIC -------------------- MECHANISTIC


the premiers
 the presidents
 forgot not so much themselves,
but the peoples, the respective histories
 they represented and carried,
 the weight of history - the threats,
the acts of terror. there they were:
two psyches - one hand shake.
 the wait of history
re-purposed, refactored, re-minded

the young girl was late for her interview,
she didn't notice
 the metal bench, the glass door,
 she ran through them
and took flight...

the marriage guidance counsellors were totally perplexed
as couples seemingly ripped up their years-long, decade-long
 there were no scraps to be waved either and pointed
the room for an argument
the dialogue and the future
was suddenly bright
a weapon of mass construction

within all governments long term planning 10, 20, 30... years took hold - the effects, no! the impacts: were local, global and glocal and this was just the beginning... tax was paid by all, whether individual or corporate entity, the only loops were off-world...

group - population

Thursday, November 07, 2013

Calling all healthcare radicals!

Rocking the boat and staying in it: how to succeed as a radical in healthcare

Corporate Rebels United is a global movement of “corporate rebels” across multiple industries and sectors. Many healthcare rebels/radicals are part of this. This is the manifesto of Corporate Rebels United which perfectly captures the mission of organisational radicals in healthcare to deliver the new truth of healthcare transformation.

Through Hodges' model I am an advocate for 'radical history', nursing care lessons from the past can (must!) inform future health and social care.

Monday, November 04, 2013

FGM: 66,000+1 'cultural sensitivity, political correctness', or +0 real action ?

HUMANistic -------- RIGHTS

context: eradicating female genital mutilation


psychological effects ...

physical effects ...
socialisation into ...?
intergenerational practices
social change
need for 'cultural sensitivity'
need for ACTION
group - population

Additional links:

BBC News: Health professionals must screen for genital mutilation

Image: Daughters of Eve

The Guardian: Report calls for female genital mutilation to be treated as child abuse

Symposium: Zero Tolerance: Eradicating Female Genital Mutilation
A Public Policy Exchange Symposium 13 November 2013 - Public Policy Exchange
It has been estimated that over 20,000 girls under the age of 15 are at risk of FGM in the UK each year, and that 66,000 women in the UK are living with the consequences of FGM. More than 1,700 victims were referred to specialist clinics in the last two years, with at least 70 women and girls as young as 7 seeking treatment every month. FGM has been a criminal offence in Britain since 1985; however, there has not been a single prosecution to date. Furthermore, since 2003, it has been illegal to aid or participate in arranging FGM to be performed on another person inside or outside Britain.

Sunday, November 03, 2013

Graduate Study in Philosophy/Ethics of Information at the University of Oxford

From: Luciano Floridi - lfloridi at gmail.com

Please circulate

If you are interested in pursuing interdisciplinary graduate study at the University of Oxford in philosophy and/or ethics of information in connection with digital technologies, the Oxford Internet Institute offers:

1. The eleven-month residential MSc in Social Science of the Internet.
Students from a wide variety of backgrounds can combine their interests in philosophical/ethical issues with Internet-related courses in law, policy and other social sciences.
  2. This is for students wishing to undertake groundbreaking, detailed research.
Students are encouraged to ask original, concrete questions and to adopt incisive methodologies for exploring them, in order to help to shape the development of digital realities.
  3. The Summer Doctoral Programme.
This provides top doctoral students from around the world with the opportunity to work for a few intensive weeks with leading figures in Internet/digital research.
For more information, please check: http://www.oii.ox.ac.uk/graduatestudy/

For an initial expression of interest, please send a short CV (max 1500 words) and a short outline of research interests or project (max 1500 words) to:

Mrs. Penny Driscoll, BA (Hons), MA
PA to Prof Luciano Floridi
Professor of Philosophy and Ethics of Information
Oxford Internet Institute, University of Oxford
1 St Giles, Oxford, OX1 3JS

Saturday, November 02, 2013

Papers, possible post-grad studies, conferences and a visit to Brian Hodges

This coming Monday and Wednesday I'm investigating post graduate study options with visits to Sheffield and Lancaster Universities.

Heading to Sheffield on Monday I'm also looking forward to catching up with Brian Hodges the creator of Hodges' model in the 1980s. It has been a long time since Brian and I met. I'll see if there is anything I can feedback here.

There is one conference abstract submitted for a presentation next year and another abstract almost completed. This for a workshop which I'm structuring such that it might also inform possible future studies. With these two abstracts for UK based events, I'm also looking at conferences abroad in the latter half of 2014 and 2015. So if anyone has any suggestions please let me know.

The paper on recovery in mental health and Hodges' model is not too far from a complete first draft. It runs to 5,000 words now. I had a great start with the help of two people. Twitter can be a great help in garnering assistance and with a quick response.

There is some feedback and contacts to follow up on the service-user research side (see references below). One research project to cite is True Colours an online self-management system. The advice over the past few weeks is also quite illuminating in evidencing Hodges' model. Another draft paper on case formulation, diagrams and h2cm is well advanced, but on hold at present.

Rose, D., Sweeney, A., Leese, M., Clement, S, Burns, T, Catty, J & Wykes, T. (2009) Developing a user-generated measure of continuity of care: Brief report. Acta Psychiatrica Scandinavica.: 119: 320–324.

Rose, D. Fleischmann, P and Wykes, P. (2008) What are mental health service users’ priorities for research in the UK? Journal of Mental Health, 17 (3): 520-530.

Friday, November 01, 2013

A book chapter: Spatial semantics - definitions...

This book would appear to be an essential reference in respect of h2cm, the following is from chapter 13:

Spatial semantics is the study of the meaning of spatial language, but what is to be regarded as ‘spatial language’? A moment’s reflection suffices to show that the answer to this question is anything but trivial, since SPACE is not a self-contained ‘semantic field’, but rather constitutes an important part of the background for all conceptualization and meaning (Kant [1787] 1964). Furthermore, the term ‘space’ has been used all too often in an extended, metaphorical sense in Cognitive Linguistics and Cognitive Science, e.g., ‘Space Grammar’ (Langacker 1982), ‘Mental Spaces’ (Fauconnier 1985), ‘Conceptual Spaces’ (Gärdenfors 2000). Hence, an unrestricted interpretation of the term ‘space’ might lead us to think that ‘all semantics is spatial semantics’, a conclusion that not even cognitive linguists would find too attractive. Therefore, the scope of spatial semantics needs to be restricted, and this can and has been done in at least three different ways: by form class, by semantic category, and by communicative function. The three definitions based on these restrictions do not coincide, however, and each leaves something to be desired.

Jordan Zlatev (2007) Spatial Semantics, Chapter 13. In. Hubert Cuyckens and Dirk Geeraerts (eds.) Handbook in Cognitive Linguistics. Oxford, Oxford University Press.

Wednesday, October 30, 2013

TEDMED Great Challenges Google+ Hangout: Unraveling Dementia 31st Oct

Unraveling Dementia: The Race to Find Answers

Thursday, October 31st, 2PM EDT

Recent advances in research are describing more of what we need to know to prevent or treat Alzheimer's and dementia. Projects like the BRAIN Initiativedescribed at TEDMED 2013 by Dr. Rafael Yuste, and new medication discoveries, drive our opportunities to best understand dementia and imagine a future without it. Join our online conversation to talk about the latest breakthroughs in dementia, including research that has identified early lifestyle changes you can make to reduce your risk. 

Tuesday, October 29, 2013

Student engagement survey UK pilot – Year 2: HEA

Forwarded from the HEA

The National Survey of Student Engagement (NSSE) was designed to measure students’ participation in activities and practices that are known to relate to improvements in learning. It asks about the amount and quality of effort that students invest in their studies, as well as the extent to which their courses and institutions are supportive and encouraging. It was developed and first used in North America in 2000, and has now been adapted and implemented in Australia, New Zealand, South Africa and Ireland.

In early 2013, nine UK institutions piloted a range of survey questions derived from NSSE. The questions were focused on four key areas:

  • Critical thinking. Four questions asked students about the emphasis their coursework placed on a range of mental activities such as evaluating and applying information.
  • Course challenge. Three questions focused on how their courses have encouraged them to work hard.
  • Collaborative learning. Three questions asked students how often they had interacted with other students in a range of ways.
  • Academic integration. Five questions explored students’ interaction with academic staff, participation in class and discussions with others outside class.

8500 students responded, and the report of the first year of the pilot will be published on 6 November 2013 and will be available at ... The report contains analysis of the results, as well as findings from interviews with students about the questions used.

In order to allow more institutions to take part in this project, and to collect more data for research purposes, the project will run again in spring/summer 2014.

Participation in this project allows institutions to ask students about the extent to which they are investing effort in their studies, to identify areas where more encouragement and opportunities to engage may be required. Institutions will be able to benchmark their own results against the aggregate UK results, both at institutional and subject level, to better understand their students’ engagement.

For full information on the pilot and how to be involved, along with all related documentation please see our website at ...

Kind Regards

Dr Celia R Brigg
Academic Lead (Business Development)
The Higher Education Academy, Innovation Way, York Science Park, Heslington, York, YO10 5BR

Friday, October 25, 2013

Arts: "Reflection on a sofa" Hodges' model as a 'memory palace' I

Prior to the New Dynamics in Ageing Showcase this Monday (a great event) I travelled down to London on Sunday morning. I wasn't 100% that morning, nothing specific.

I arrived at noon dropped the bags at the B&B and then took the nine stops from Kings Cross to South Kensington. A few minutes walk brought me to the Victoria and Albert Museum. I was early to collect my timed ticket for the Sky Arts Ignition: Memory Palace exhibition.

After queuing for ten minutes (we Brits eh!) at the proper sign to be told I just had to approach the entrance at the allotted time. I went to check the cafe. This was very nice, on the pricey side and rather busy. It's not easy to find a seat, do self-service and be secure. Anyway it was time for a walk, find somewhere else. Before doing so I went to shop and bought the exhibition book, not a huge tome and quite interesting.

Not far away around the corner I found the Brompton cafe. There were seats here. I ordered a cappucinno. There was a large communal table so I sat there. I was ok for about twenty minutes and then came over all hot and increasingly dizzy. I realised I had to move and quickly so took my jumper off and walked around to the right where there was a bookshop.

It was empty and there was sofa with 'LOVE' emblazoned on it - three times - if I registered this correctly. I could hear the cafe and just see one table through the passage way. At that moment I'd had enough of the individual-group axis and the humanistic-mechanistic took over as I went semi-horizontal.

After a couple of minutes I recovered myself and was able to get up - yes the gyro functions - and carry on my way. I am really grateful for that little space and rest. I was still determined to visit the exhibition and attend the showcase. This was fortunate timing with Sunday the 20th the last day of the exhibition and I wanted to keep it that way.

In the post-apocalyptic world of British author Hari Kunzru’s specially commissioned 10,000 word novella, London has been ravaged by a magnetic storm; all memory, art, writing, and recording has been banned. As one man attempts to remember, alone in his cell, the narrative unfolds.
Zoe Pilger, The Independent - Art review.
“misremembered” ambulance by London-based illustration collective Le Gun
“Once there were great palaces called Hospitals.” In contrast to a dystopian future when the NHS and indeed all medical knowledge has been erased, the idea of basic public services appears miraculous. “It was a time of great wonder,” he writes, referring to the present. This fragment of text is accompanied by a fabulous sculpture of a “misremembered” ambulance by London-based illustration collective Le Gun. A ghoulish figure brandishes a whip and pulls a cart filled with potions that promise ad-hoc, alchemical healing.
Zoe Pilger, The Independent - Art review and image
See page 18-19 of Kunzru’s book.
I started in a memory palace, a book shop. I left to visit another, carrying my own memory palace in my mind.

Hodges' model is a memory palace, vacant, awaiting occupancy by patient, client, or carer. The model acts as a great prompt past, future and the here and now.

Wednesday, October 16, 2013

Blog Action Day 2013: Human Rights - Health and Disability

HUMANistic -------- RIGHTS

Reflecting on Human Rights with Hodges' model
Educating health professionals about disability: A review of interventions
Tom Shakespeare and Ira Kleine suggest health professionals need a better understanding of the health needs and human rights of disabled people. Read the first comprehensive review of educational interventions. (HEA)
Physical (and cognitive) access to info:

Governments are legally obliged to ensure adequate access to health information
The Lancet Global Health, Volume 1, Issue 3, Pages e129 - e130, September 2013
-ismsDear All, I would like to congratulate the initiative HIFA-Watch about access to health information as universal human right and use this opportunity to share with you an excellent illustration, presentation by video on the Declaration of Human Right, source of inspiration for all. http://www.youtube.com/watch?v=O9chQdZw7Bc
And I use also this opportunity to share with you the Medicus Mundis International discussion paper published today which compares key elements of the concept of Universal Health Coverage as promoted by the World Health Organization
With my warmest regards.
World Health Organization, Knowledge Management and Sharing
group - population

Additional links:
Law in Action BBC Radio 4 (see - Interview with Attorney General Dominic Grieve 15 Oct 2013 download available for 28 days)

Health and Human Rights: journal


Tuesday, October 15, 2013

ERCIM News No. 95 Special theme: "Image Understanding"

Dear ERCIM News Reader,

ERCIM News No. 95 has just been published at

Special Theme: "Image Understanding"
Guest editors: Michal Haindl, Institute of Information Theory and Automation, Academy of Sciences of the Czech Republic, and Josef Kittler, University of Surrey, UK

Keynote: "Image Understanding – An EU Perspective"
by Libor Král, Head of Unit A2 – Robotics in Directorate General Communication Networks, Content & Technology, European Commission

This issue for download
: http://ercim-news.ercim.eu/images/stories/EN95/EN95-web.pdf
epub: http://ercim-news.ercim.eu/images/stories/EN95/EN95.epub

Next issue: No. 96, January 2014 - Special Theme: "Linked Open Data"
(see Call at http://ercim-news.ercim.eu/call)

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

Best regards,
Peter Kunz
ERCIM News central editor

ERCIM "Alain Bensoussan" Fellowship Programme
ERCIM offers fellowships for PhD holders from all over the world. The next round is open!
Next deadline 31 October 2013

Monday, October 14, 2013

Health, Art and The Reith Lectures 2013 (and the search for the perpetual umbilicus)

This week sees the start of The Reith Lectures on BBC Radio 4 by Grayson Perry.

The question is: who decides on what makes art good?

Perry writes in the Financial Times Weekend:

Clement Greenberg, a famous art critic in the 1950s, said that art will always be tied to money by an umbilical cord of gold, either state money or market money. I'm pragmatic about it: one of my favourite quotes is you'll never have a good art career unless your work fits into the elevator of a New York apartment block.
Once born into the world, the umbilical cord that transfers and imbues life and sustenance no longer matters physically. It is the social ties that bind, according to the lyrics and life experience.

In health and social care we need to find a perpetual umbilical cord that makes well-being and health not just something to take for granted. Not some thing that is only noticed when the piece of art won't fit into the elevator any longer.

This is the challenge in health care. A challenge that will see art movements and markets come and go. The solutions will rely on science, technology and art.

@science @technology @art 
each brings its own engineering.

We need tools that facilitate self-care when needed. Cognitive engineering that people can call upon by virtue of the combined literacies they possess. Self-care that is delayed due to self-knowledge.

Cognitive tools people can take anywhere; from elevators in New York and doors to apartments, yurts in Mongolia, the multitude of tents in Jordan to the terraced houses near Wigan Pier ...

Financial Times, Grayson Perry’s Reith Lectures: Who decides what makes art good? October 11, 2013 7:16 pm

Friday, October 11, 2013

Recent Advances in Research on Housing Transitions and the Life Course - a one-day symposium

Meeting of the Royal Statistical Society Social Statistics section.
DATE: Tuesday 10 December 2013
TIME: 10am-5pm (followed by a drinks reception)
LOCATION: Royal Statistical Society, 12 Errol Street, London EC1Y 8LX

We are pleased to announce a one-day symposium on recent developments in research on housing transitions through the life course.  The event will feature presentations from leading international demographers, geographers and economists on different aspects of housing careers. Topics include:

  • the interrelationship between housing and fertility: childbearing patterns by housing conditions and housing changes after the birth of a child
  • wage, employment and house-price effects on migration
  • intergenerational transmission of home ownership and neighbourhood poverty
  • residential mobility, neighbourhood poverty dynamics and neighbourhood choice among families
The symposium is sponsored by the ESRC-funded project “Interrelationships between housing transitions and fertility” (see http://www.bristol.ac.uk/cmm/research/housing for further details). 

William A.V. Clark (University of California, Los Angeles) Clara Mulder (University of Groningen), Heather Joshi (Institute of Education) Hill Kulu (University of Liverpool) David Manley (University of Bristol) Birgitta Rabe (University of Essex) Elizabeth Washbrook (University of Bristol)

A programme and abstracts are at http://www.bristol.ac.uk/cmm/research/housing/symposium/index.html

REGISTRATION AND QUERIES: All are welcome and attendance is free.  Refreshments will be provided, including lunch and a drinks reception.  However, advance registration is essential.  Please complete the online registration form at ... to reserve your place.

[ I mentioned to the organisers about the ongoing transitions I have posted about before; that of older adults moving house (home) often in response to a bereavement to be nearer other family members. This is not the symposium's focus, but remains a question in terms of the potential impact on the individuals concerned and health and social services. pj ]

Tuesday, October 08, 2013

Zero, One, Fifteen, (Thirty, Sixty...?)

care-S S-cares
context: UK news media 15 minute carer visits to elderly clients

Reflecting on Social Care with Hodges' model
The one, self, me, a person. Carers: ethics (and common sense? when is 15 minutes of 'fame' enough?), demonstration of rapport, empathy, dignity, loneliness, independence. Carer stress. Job satisfaction. Staff knowledge and skills. Observation. Mental state. Mood. Choices - personal preferences. Personal - carer's values. Cognition - Re-cognition. Case review. Individualized care? Expressed concerns (wither...?) theory: task vs. person-centered care
mechanistic aspects of care, travel, geography, arrival, tasks, plan, recording, constraints - esp. time, practical problems encountered. Number of carers involved. Safety. Protective clothing. Seasonal factors. Evidence base? Best practice? Relapse rates? Telecare role? Physical mobility - movement. Systems, processes, logistics and scheduling. Degrees of freedom - flexibility. Data, information, datasets. Admissions - depth of data?
practice: task vs. person-centered care
Caring relationship building, trust - very personal - intimate care, subjective: time with someone I like / don't like? Relatives experience. Social care infrastructure - community centers. Ability to go out shopping with a carer. Media: BBC 2 Newsnight 7/10/13; The Times; C4 News. Social contact. Social mores (time?)
Policy, professionalism, recording, outcome measures. Agreement - care plan. Care reviews. Ban on 15 minute visits? Management. Standards. Supervision. Zero hour contracts. Pay and conditions. Staff turnover. Vulnerable adults. Personal development, training. Risk of organization's reputations being damaged. Corporate responsibility, values. 'Value for money'. New commissioning systems. Advocacy (position significant). Whistleblowing. 'Francis effect' increase in nursing posts. HSJ, 25 Oct 2013, p.6. 'Funded establishment'.

group - population

Discount the contract, you can then 'discount' the individual worker and the client.
Care Relationship = Care Transaction

Wikipedia: "15 minutes of fame"

Saturday, October 05, 2013

and a 1 [ Empirical - Tabula Rasa ] 2, 3, 4...

Hodges' model: another blank slate
2 a blank slate...
1 Empirical - Tabula Rasa (4th album)

4 and here?

3 as dictated here
group - population

Wikipedia: Tabula rasa

Image: Israbox