Hodges' Model: Welcome to the QUAD: November 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, 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.