Hodges' Model: Welcome to the QUAD: March 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

Saturday, March 30, 2013

Individual - Group: Axes & Histories

What are the dimensions of the axes that make up the structure of Hodges' model?

Can the individual see the group - the global population - beyond the fresh air in their pocket?

In not seeing the individual, as the global corpus shouts about: "choice", "economic growth", "freedom", "human rights", "democracy", "justice" ... do they see the big picture amid the political smog, the corporate dust storm?

One form human society has so far not generally taken is global. There is still virtually no shared consciousness globally of common struggles or common achievements. Enormous groups - the poor in the Global South for instance - have no sense of forming a single community; in an earlier age, the experience of being subjected to European colonial force failed to create a common anti-colonial front. Even today's most urgent global issues tend to be tackled regionally or nationally: the history of global warming or organised crime is a history of multiple actors, as often as not talking at cross-purposes. p.8.

Prof. Mark Mazower, All together now, FT Weekend, March 9 - 10, 2013, p. 8. Reviewing The Undivided Past: History Beyond Our Differences, by David Cannadine, Allen Lane.  

Sunday, March 24, 2013

Society (global trends?) that diminishes the greatest gifts

Last December 15th -16th Harry Eyres' column The Slow Lane in the FT Weekend (p.24) pointed me to the New Economic Forum's pamphlet entitled The New Materialism. Mr Eyres wrote about the The most precious gifts and the fact that things do not last like they used to. Quality lies in things that last, things that are worth repairing and repairable.

The piece prompted me to think back about some of the children's toys. Very gratefully received as gifts, guilt sprung when more of an impulse (impelled) buy: what about the amount of plastic, the oil, the probable lack of longevity in use, the longevity in decay and the some-other-where of waste and disposal?

Recall then the joys of the wooden train set, with non-toxic paint... The toy flung aside as the cardboard box is tossed, turned and crawled into and puzzled about. The reflection took me around a few towns too, the pound shops. It's good when you really can afford to make a choice about what you buy, about quality. The hammer, clearly not ready for hand: unbalanced once home. I'm not saying all 'cheap' screwdrivers are the same, but the slightest amount of torque and the handle is undone. Probably the one cheap find and sometimes free are the watchmaker's screwdriver sets. Eye-saving when the screw on the side of my glasses comes loose and the lens falls out on something soft thus far.

All the mass production and lack of love and care invested in making things - the loss of true craft, as Mr Eyres points out, makes me wonder whether this also pollutes the way we value our health.

Like so much advertising - conditioning - we recognize the true significance of what is happening only when forced to and we ourselves suffer a failure and 'break' in some way, to some degree.

This issue is provoking various responses. An example being Beck's Song Reader, an album released solely as sheet music.

Saturday, March 23, 2013

Inaugural issue open-access journal: Global Health - Science and Practice

Dear HIFA members,

The inaugural issue of the open-access journal Global Health: Science and Practice, is now available here:

Below are extracts from the editorials:
'USAID and the Schools of Public Health at JHU and GWU welcome you to the inaugural issue of GHSP­an open-access, peer-reviewed journal for the global health community, particularly program implementers, to contribute to and benefit from a dialogue based on science and practical programmatic experience...'
'We foresee that public health practitioners, university colleagues, donors, and other development partners will be able to contribute to and benefit from a dialogue based on science and experience of what works for field programs.... GHSP will take a multidisciplinary approach to the science and practice of global health... We look forward to your engagement and feedback.'
Ariel Pablos-Méndez, Michael Klag, Lynn Goldman
Glob Health Sci Pract 2013;1(1):1-2
'Formal research definitely helps. But it is not enough. We also need programmatic know-how, including experience-based knowledge and 'lessons learned.'.
James D Shelton, Ronald J Waldman
Glob Health Sci Pract 2013;1(1):3-4

Best wishes,

My source: HIFA2015

Friday, March 22, 2013

BBC Horizon II: Processes - step this way ... safely

Following the BBC TV Horizon programme last night "How to Avoid Mistakes in Surgery" I came across the following list concerned with processes:

Sequential steps. Where one step follows another.

Alternative steps. Where conditional logic specifies which of several paths should be traversed.

Iterative steps. Where a single step is repeated multiple times.

Composite steps. Where steps are nested within other steps.

Optional steps. Where any one of a set of steps may be traversed, depending on the results of a boolean operation.

Checklist. Where all of a number of steps must be traversed, but in any order. p.126.
The list is related to software development and manufacturing as per the reference source below. Within informatics and project management I've noticed and written here about the emphasis placed on processes. Process, process and yet more - in one form or other. As A&E doctor Kevin Fong revealed people can get lost in a process (intubation), especially experts within organisational hierarchies - complex teams in urgent circumstances. In information system projects the need for a socio-technical perspective is essential, and is synonymous with due consideration of human factors. Processes are an essential ingredient to understanding the world and there's a huge literature on events, co-ordination, timing, logistics, value ... but as the Horizon programme pointed out there's also a need for reflection, stepping back, taking in or trying to grasp the big picture. Maintaining situation awareness is vital to assure safety and as the program showed in a crisis hindsight makes a blind spot visible. This is why process is one of four P's in Hodges model (the others - purpose, practice and policy). Processes count, but they are only part of the bigger picture.

The steps above are intended for software developers, but the descriptions throw up some points when subject to a more literal - human - interpretation (which might be a problem?).

The 'alternative' steps: could that mean skipping one in turn as in 'alternate'?

And crucially for the checklist are there any risks associated with its being completed in any order?

There is a world of difference between programming methods and logic on the one hand; and human language and dialogue on the other.

Fayad, M.E., Johnson, R.E. Domain-Specific Application Frameworks: Frameworks Experience by Industry.

Thursday, March 21, 2013

"How to Avoid Mistakes in Surgery" BBC TV Horizon 21/03/2013 2100 UT

On 03/18/13 9:45 AM, Martin Bromiley wrote:
About two years ago I approached Dr Kevin Fong with an idea for a BBC scientific programme, and at last it’s happened. Since September I’ve been working with Kevin and the BBC Horizon team to pull together a programme about human factors in healthcare. It looks at how learning about the human in the system and the system itself can bring about enormous improvements in safety and outcomes that technology and medical science can only aspire to.

Kevin and the Horizon team have produced something inspirational yet scientific, and - just as importantly - is by a clinician, for clinicians. It's written in a way that will appeal to both those in healthcare and the public. It uses a tragic death to highlight human factors that all of us are prone to, and looks at how we can learn from others both in and outside healthcare to make a real difference in the future.

Although the BBC Management chose a surgery based title for the programme to gain mass public appeal the lessons of this programme are for everyone in healthcare.

It would wonderful if you could pass on details of the programme to anyone you know who works in healthcare. My goal is that by the end of this week, every one of the 1 million or so people who work in healthcare in the UK will be able to watch it (whether on Thursday or on iPlayer). BBC 2 Thursday 21 March 2100 UK


Martin Bromiley

My source: Joy Whitlock via LinkedIn

Saturday, March 16, 2013

Piloting (online) health literacy - 'easy as she goes?'

On Thursday afternoon I introduced Hodges' model to six student nurses. In wrapping up the session I suggested the students look up 'health literacy' indicating how Hodges' model can incorporate reflections on the many literacies essential for life (and death) in the 21st century. For one student this small kernel of news was unfortunately too late, a piece of work having just been handed in.

Great to see the following item in this week's HSJ - Health literacy training on offer for 100,000:

The NHS Commissioning Board will work with a charity to offer 100,000 people access to training in online health literacy over the next year, it has announced.
The board’s national director for patients and information Tim Kelsey said on Thursday it had made the agreement with UK Online Centres, an organisation which specialises in tackling digital exclusion.
The work comes in the run up to the board’s deadline of 2015 for patients to have access to their GP health records. ...
Health literacy training on offer for 100,000, Health Service Journal. 14 March 2013, p.10.
In terms of health literacy as a whole this is one aspect, but as the previous post point out we need to consider human factors. Innovation  also involves physical and cognitive access, relationships, referral, the interplay and dependencies between existing literacies (poor functional literacy and yet high health literacy?), differentiating between literacies, motivations and to what extent can participants themselves be mobilised as a force for change beyond 100,000 ...?

The Telehealth supplement in the same issue of HSJ notes that small companies struggle when they are offered yet more pilot projects with 30 patients.

100,000 - well that should be a good shot in the arm.

Trueland, J. (2013) The six billion dollar question, Telehealth supplement. HSJ, 14 March, 8-9.

Friday, March 15, 2013

The Breakthrough Prize in Life Sciences & the scope of innovation

A prize that furthers progress in the life sciences is to be welcomed and the winners certainly lauded. Logic would dictate that The Life Sciences Breakthrough Prize and the funding behind it targets the hard sciences: biology, physics and chemistry and the vast and growing number of associated specialist disciplines.

'Life', however, as in living is more than a binary operation - as the FT Weekend editorial notes:

Those eureka ideas

... It would be good to see more daring choices in the future: those outside the well-trodden circuit of university departments and research institutions in the industrialised world.
Breakthroughs in life science go beyond the laboratory to interactions with patients, doctors, public health officials, drug companies and regulators. They should also tap into advances in information technology. ...
(Financial Times - FT Weekend, page 10, 9th - 10th March 2013)

Tuesday, March 12, 2013

Community Informatics and Improving Health: New Special Issue

The Journal of Community Informatics has just published its latest issue at
 http://www.ci-journal.net/index.php/ciej. We invite you to review the Table of Contents here and then visit our web site to review articles and items of interest.
Thanks for the continuing interest in our work,
Michael Gurstein, Ph.D.
Editor in Chief: Journal of Community Informatics, Vancouver CANADA Phone 604-602-0624 gurstein at gmail.com
The Journal of Community Informatics
Special Issue: Community Informatics for Improving Health Table of Contents
Overview of ICTs and Health
                Lareen Ann Newman
Editorial: Community Informatics for Improving Health
                Michael Gurstein
Developing decentralised health information systems in developing countries –cases from Sierra Leone and Kenya
                Edem Kwame Kossi,       Johan Ivar Sæbø,             Jørn Braa,            Mohamed Mumeneeh
Jalloh,   Ayub Manya
Improving community health equity: the potential role for mHealth in Papua New Guinea
                Belinda Jane Loring
Capturing Qualitative Spatial Data to Understand Social Epidemiology in Public Health
                William R Buckingham
Narrating Aboriginality On-Line: Digital Storytelling, Identity and Healing
                Naomi Adelson,                Michelle Olding
Decreasing Health Disparities through Technology: Building a Community Health Website
                Olga Idriss Davis,              Kristen Bean,     Dominica McBride
Bridging the Digital Divide: A Bilingual Interactive Health Kiosk for Communities Affected by Health Disparities
                Kristen Bean,     Olga Davis,          Hector Valdez
‘MYBus’: Young People's Mobile Health, Wellbeing and Digital Inclusion
                Bjorn Nansen,   Kabita Chakraborty,        Lisa Gibbs,           Colin MacDougall,           Frank Vetere
Concussion Information on the Move: The Role of Mobile Technology in Concussion Management
                Osman Hassan Ahmed, Andy J Pulman
With a little help from my friends: experiences of building a virtual community for children with cancer
                Paula Hicks,        Jane B. Grimson,              Owen P. Smith
Impact of Internet on delivery of critical cardiac health care  :
                Sudeepa - Banerjee
A review on mHealth research in developing countries
                Wallace Chigona,              Mphatso Nyemba,          Andile Metfula
Socio-technical approach to community health: designing and developing a mobile care data application for home-based healthcare, in South Africa
                Retha de la Harpe,           Hugo Lotriet,      Dalenca Pottas, Mikko Korpela
Perceived Benefits Of Remote Data Capturing In Community Home-Based Care:
The Caregivers’ Perspective
                Nobubele Angel Shozi,  Dalenca Pottas, Nicky Mostert-Phipps
Health Impact Assessment of a UK Digital Health Service
                Sue Heather Wright,       Irfan Ghani,        John Kemm,       Jayne Parry
Points of View
W(h)ither Community: Locating participatory approaches to ICT-enabled health and development
                Ian Pringle
The Journal of Community Informatics http://www.ci-journal.net

Sunday, March 10, 2013

Space to reflect

2013 could be quite a year for comets, at least in the northern hemisphere.

As we reflect in our studies and at work it is vital to take a breathe and reflect when we can on things otherwordly - Comet PanSTARRS:

Weather permitting after work  I will visit Parbold Hill to get a good view of the western horizon.

I've tried on two evenings - 12th - 13th - to spot PanSTARRS without success. There's still time as it moves north. The new moon was quite a sight last evening. Through the binoculars a jet very low down looked like a rocket - the shuttle taking off. Between the low clouds I watched the sun set: cue reflection

APOD archive southern appearance: comets Lemmon & PanSTARRS

Image source: NASA.

Friday, March 08, 2013

International Women’s Day 2013 (three items)

I received three emails concerning IWD which I have reduced and edited here:

KIVA - every day we at Kiva hear stuff like this:
70% of the world's poorest people are women.
Two-thirds of illiterate adults are women.
• HIV is still the leading cause of illness for women in many places.
Kiva loans help thousands of powerful, inspiring women start businesses, educate their children, and realize their dreams.
You can tip the balance!

Want to make a difference? Send a Free Trial to your friends and family so they can empower a woman on Kiva too. Just send them to kiva.org/women


Miss Representation.org - Cause and Effect: Why We Need to Tell Herstory


Join Wiley in celebrating International Women’s Day on March 8th 2013! This free compendium of thought-provoking research from Wiley's leading publications celebrates women’s accomplishments, past and present, and examines the barriers that continue to obstruct equality of the sexes.

We hope that you enjoy reading this research and wish you a happy International Women’s Day!