Hodges' Model: Welcome to the QUAD: February 2016

- 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

Monday, February 29, 2016

Rare Disease Day, 29 February 2016

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What does 'rare' mean here, ...

... here

and here?

Sunday, February 28, 2016

HSJ Mental health: A sign of the time(s)?

I'm a subscriber to HSJ and greatly enjoy reading it, even if this includes catching up.

The January 13th issue was headlined "2016: THE YEAR OF OPPORTUNITY?"

The editorial/leader A year of opportunities with many unanswered questions (pp. 3-4) spanned more than the usual single page and commented upon:

  • funding efficiency
  • services transformation
  • technology
  • commissioning
  • health and social care integration
  • primary care
  • hospitals
  • mental health
  • workforce
  • regulation
  • and leadership
Mental health has been much in the news of late with the promise of funding. HSJ noted:
"For mental health, the question is a simple one. Will the sector see the increased funding long promised?" p.4.
Leadership, regulation, workforce, health and social care integration, commissioning ... can all be related to mental health, but with February's news I wonder if mental health can be revisited as a piece of horizon scanning as per the sub-heading? Otherwise, before February is out - is this a case of "job done"?

There are roughly 60 sentences in the piece as a whole. Some of the sentences are quite long in contrast to the above.

Mental health 1 : 4 and yet here equivalent to 2 minutes - less in reality?
The mental health question may be simple, but the way it influences all the many unanswered questions including public - mental - health is obviously complex.
As a nurse manager I recall it being difficult to please everyone all of the time. Editors are similarly challenged, but mental health IS worthy of integration and journalistic recognition.

McLellan, A. (2016) A year of opportunities with many unanswered questions, Health Service Journal. 13 January 2016. 125: 6472, pp.3-4.

Clock image c/o http://www.oliverboorman.biz/projects/tools/clocks.php

Friday, February 26, 2016

Open Data as Open Educational Resources: 4th March 1400-1700 UCL

Next Thursday evening I'm heading to London for Drupalcamp Saturday and Sunday. On the Friday afternoon I'm attending:

Open Data can be understood as “universally participatory data”, which is openly shared by government agencies, NGOs, academic institutions or international organisations.
Open Data can be used in Higher Education using real life scenarios, bringing together students, academics and researchers working towards overcoming local and global real problems.
In this way students can develop transversal, research and citizenship skills, by working with the same raw materials researchers and policy makers use, contributing with the society in new and yet-unimagined ways.
 The event will be featuring
  • Santiago Martín: University College London
  • Mor Rubistein: Open Knowledge International
  • Leo Havemann: Birkbeck, University of London
  • Dr Carla Bonina: University of Surrey  
  • William Hammonds: Universites UK
  • Dr Fabrizio Scrollini: Latin American Open Data Initiative
  • Dr Tim Coughlan: Open University  
Medawar G01 Lankester Lecture Theatre: UCL, Gower Street, London, United Kingdom -

Thursday, February 25, 2016

Individual transport across the care domains


"Mind the Gap!"

"Where's the Ramp?"

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Unfortunately I'm a bit late to help publicise the -

Mental Health and Transport Summit

which was featured on BBC Radio 4 You and Yours today (from 22:25 mins)
Presenter: "What is the mental health equivalent of a ramp?"

See also - Cosmobilities

Image sources:
Wheelchair ramp image c/o https://pixabay.com/

Tuesday, February 23, 2016

The Alphabet of Illiteracy - #ProjectLiteracy

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Project literacy [this one closed, but the need ongoing ...]

Monday, February 22, 2016

Phi and the cruellest cut

"The measure of how a system integrates information is called phi.

One way of calculating phi involves dividing a system into two and calculating how dependent each part is on the other. One cut would be the "cruellest", creating two parts that are the least dependent on each other. If the parts of the cruellest cut are completely independent, then phi is zero, and the system is not conscious." p.10

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an Integrated Information Theory

Ananthaswamy, A. (2016) The 1-second test of consciousness, New Scientist, 20 February, 229: 3061, p.10.


Sunday, February 21, 2016

Domain-specific vignette development in polyarthitis: Arends, et al. (2015)

This paper by Arends et al. (2015) sheds further light on the use of vignettes and the difficulties (for me) in categorising care phenomena. There is a great deal of overlap in the three domains that the authors apply to patients with arthritis. Their domain-specific focus is also of interest.

Independent functioning extends across the interpersonal and sciences domains of Hodges' model as mental functioning and physical. Sports, holidays, hobbies and other activities while usually social in nature can be solitary pursuits. In this example even if the context is social as per the domain, it is the impact upon the individual that the researcher's note:

"Changes in life domains caused by a chronic disease can have psychological and social consequences for patients and can affect their identity"... (p.1896)
In the quote below, copied across the domains of Hodges' model, volunteering is political in nature, but the reward in this instance - voluntary work in a nursing home - could be intrapersonal, derived from the interaction with and making a difference to the residents, staff and visitors.

So, it is vital to capture - or freeze the context in some way, vignettes it appears are one way to achieve this.

"The 11 vignettes all have a main character that is diagnosed with RA. In each situation, the impact of the disease on daily life is described as the main character always encounters a limitation or difficulty. The stories are set in three different domains:
the social domain,
the leisure activities domain,
and the independent functioning domain...
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In the independent ...

psyche        identity 

functioning domain, the topics are gardening, household tasks, and running errands.

Topics of the vignettes in the social domain are activities with partner, children, family, and friends. In the leisure activities domain, the topics are sports, holidays, hobby,

and volunteering." (p.1900)

Arends, R., Bode, Y., Taal, C., & Laar, E. (2015). Exploring preferences for domain-specific goal management in patients with polyarthritis: What to do when an important goal becomes threatened? Rheumatology International, 35(11), 1895-1907. DOI: 10.1007/s00296-015-3336-8 

Thursday, February 18, 2016

Spring Night and Willow, 1917/after 1920 Astrup

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Painting Norway: Dulwich Picture Gallery.

My source and image:
Campbell-Johnson, C. (2016). He's Nordic - but nice, The Times, February 5th, p.12.

Wednesday, February 17, 2016

Petition to get Mental Health Education on the curriculum c/o Change.org

Laura Darrall London, United Kingdom

"Last year I had what society refers to as a mental breakdown and after coming out the other side I knew I needed to give something back. I started the #itaffectsme campaign to encourage people who have suffered or who know someone who has suffered to post selfies on social media - to help prove that the one in four people who suffer from mental health issues really are everywhere. 
#itaffectsme wants to see Mental Health Education put on the National Curriculum. To arm our children with knowledge, understanding and compassion. 1 in 4 people suffer with mental illness and 50% of those are established by age 14. We teach our children symptoms of chlamydia and gonorrhoea so why not depression, OCD and anxiety?" 

Note: I have copied this petition as Hodges' model could definitely be used in schools, colleges to frame and support Personal Social Health Economic Education

Tuesday, February 16, 2016

Mental Health [TaskForce Strategy]: an ongoing tale of quarters

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Mental health

1 in 4
people experience problems each year

15-20 years 
shorter life expectancy 
for those with severe problems

75% receive no help

£105bn cost to economy 

£9.2bn spent by NHS a year

Mental Health


'Task' - 'Force'



Statistics source:
NHS England: Mental Health Taskforce


BBC #inthemind

Monday, February 15, 2016

[Business] Domains of extraordinary Disruption ?

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Creative: In this case the organisation itself is the disruptor. For instance, when new start-ups disrupt established players.

Transformational: These disruptions are planned and internal. An example would be a company turnaround.

Reputational: These disruptions are unplanned and internal. Examples include fraud cases, misconduct, management conflict and product safety problems.

Hostile: These disruptions come from an external source. Examples include cyberattacks, activist investors and hostile bids.

"Large disruptions can move from one category to another. Each type of disruption will require a different style of leadership."

Source: Boards in Challenging Times: Extraordinary Disruptions.

My source:
Chynoweth, C. Crisis? No, it's an opportunity, Business, Sunday Times, 7 February 2016, p.12.

Sunday, February 14, 2016

Paper - The effectiveness of internet-based e-learning on clinician behavior and patient outcomes: a systematic review

As I work on my research proposal this paper (in press) is a very useful and timely reference...

Abstract - Background

The contemporary health workforce has a professional responsibility to maintain competency in practice. However, some difficulties exist with access to ongoing professional development opportunities, particularly for staff in rural and remote areas and those not enrolled in a formal program of study. E-learning is at the nexus of overcoming these challenges. The benefits of e-learning have been reported in terms of increased accessibility to education, improved self-efficacy, knowledge generation, cost effectiveness, learner flexibility and interactivity. What is less clear, is whether improved self-efficacy or knowledge gained through e-learning influences healthcare professional behaviour or skill development, whether these changes are sustained, and whether these changes improve patient outcomes.

Sinclair et al. refer to:

"One suitable framework that is congruent with e-learning research is Kirkpatrick’s four levels of evaluation." (p.53).

I have taken the rest of the paragraph and mapped the stated levels to Hodges' model:

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Level two pertains to learning and the evaluation of knowledge.

Kirkpatrick’s model is hierarchically based with level one relating to student reaction and how well the learner is satisfied with the education program. 

Level three expands on this and considers whether the education has influenced behavior. In the context of this review, behavior change is any practice that is intrinsically linked with the outcomes of the e-learning program undertaken.

Finally, level four evaluates the impact on outcomes such as cost benefit or quality improvements. 

The author's continue: "The majority of e-learning research has focused on participant experience and knowledge acquisition, outcomes that correspond with the first two levels of Kirkpatrick’s model. To date, few studies have examined the effectiveness of internet-based e-learning programs on HCP [health care profession] behavior, which aligns with Level 3 of Kirkpatrick’s model (p.54)."

Peter M. Sinclair, Ashly Kable, Tracy Levett-Jones, Debbie Booth, The effectiveness of internet-based e-learning on clinician behavior and patient outcomes: a systematic review, International Journal of Nursing Studies, Available online 4 February 2016, ISSN 0020-7489, http://dx.doi.org/10.1016/j.ijnurstu.2016.01.011
Keywords: e-learning; Systematic Review; Education; Information Communication Technology; Health Care Professional

Friday, February 12, 2016

2nd Workshop: Conceptual Spaces at Work - 25-27 August 2016, Sweden

The workshop focuses on concepts and their applications using the theory of Conceptual Spaces (CS), as introduced by Peter Gärdenfors (2000).

Applications of Conceptual Spaces
It provides a geometric model for the representation of human conceptual knowledge that bridges the symbolic and the sub-conceptual levels of representation. The model has already proven to have a broad range of applicability, not only within cognitive science but also across a number of disciplines related to concepts and representation. 

A sample of this work is collected in Zenker & Gärdenfors (2015), based on papers presented in Conceptual Spaces at Work 2012 at Lund University.


(I hope to attend.)

Sunday, February 07, 2016

Hodges' model - Integrating the five vignettes?

Some reading while working on my research proposal:

Vignette methodologies for studying clinicians’ decision-making: Validity, utility, and application in ICD-11 field studies


Vignette-based methodologies are frequently used to examine judgments and decision-making processes, including clinical judgments made by health professionals. Concerns are sometimes raised that vignettes do not accurately reflect “real world” phenomena, and that this affects the validity of results and conclusions of these studies. This article provides an overview of the defining features, design variations, strengths, and weaknesses of vignette studies as a way of examining how health professionals form clinical judgments (e.g., assigning diagnoses, selecting treatments). As a “hybrid” of traditional survey and experimental methods, vignette studies can offer aspects of both the high internal validity of experiments and the high external validity of survey research in order to disentangle multiple predictors of clinician behavior. When vignette studies are well designed to test specific questions about judgments and decision-making, they can be highly generalizable to “real life” behavior, while overcoming the ethical, practical, and scientific limitations associated with alternative methods (e.g., observation, self-report, standardized patients, archival analysis). We conclude with methodological recommendations and a description of how vignette methodologies are being used to investigate clinicians’ diagnostic decisions in case-controlled field studies for the ICD-11 classification of mental and behavioural disorders, and how these studies illustrate the preceding concepts and recommendations.

Evans, Roberts, Keeley, Blossom, Amaro, Garcia, . . . Reed. (2015). Vignette methodologies for studying clinicians’ decision-making: Validity, utility, and application in ICD-11 field studies. International Journal of Clinical and Health Psychology, 15(2), 160-170. DOI: 10.1016/j.ijchp.2014.12.001 


Vignette studies use short descriptions of situations or persons (vignettes) that are usually shown to respondents within surveys in order to elicit their judgments about these scenarios. By systematically varying the levels of theoretically important vignette characteristics a large population of different vignettes is typically available – too large to be presented to each respondent. Therefore, each respondent gets only a subset of vignettes. These subsets may either be randomly selected in following the tradition of the factorial survey or systematically selected according to an experimental design. We show that these strategies in selecting vignette sets have strong implications for the analysis and interpretation of vignette data. Random selection strategies result in a random confounding of effects and heavily rely on the assumption of no interaction effects. In contrast, experimental strategies systematically confound interaction effects with main or set effects, thereby preserving a meaningful interpretation of main and important interaction effects. Using a pilot study on attitudes toward immigrants we demonstrate the implementation and analysis of a confounded factorial design.

Atzmüller, C., & Steiner, P. (2010). Experimental Vignette Studies in Survey Research. Methodology: European Journal of Research Methods for the Behavioral and Social Sciences, 6(3), 128-138. DOI: 10.1027/1614-2241/a000014 

Friday, February 05, 2016

New Zika Fact Sheet in English & Spanish - c/o [hipnet]

The Zika virus, a mosquito-borne disease, has reached epidemic proportions in Brazil and is moving north through Central America and the Caribbean. Several cases have been reported in the US and the World Health Organization estimates Zika will appear in nearly every country in our hemisphere, except the cooler areas of Canada and Chile.

To help people cope with this disease, Hesperian has rapidly developed emergency information on Zika, its symptoms, and how to take personal and community-wide precautions to limit its spread. Now available in English and Spanish, we are working on translations in Portuguese and Haitian Kreyol to ensure this health information reaches the people who need it most.

I hope you find this online, printable resource helpful. Please share it widely with your networks:

English http://en.hesperian.org/hhg/Zika#
Spanish http://es.hesperian.org/hhg/Zika

Rachel Grinstein​
Rachel Grinstein
Development and Marketing Associate
Hesperian Health Guides

Check out our two new titles:

HIPNet is a practitioner support network. We encourage cooperation and collaboration among members to eliminate duplication of materials, and promote dialogue and use of health information. Join HIPNet at http://knowledge-gateway.org/hipnet

Thursday, February 04, 2016

"Values in Advanced Directives" mapped to Hodges' model

Hechter, et al. (1999) consider values in respect of advanced directives and medical treatment. The authors discuss an old debate in social science that still divides objectivists and subjectivists. Below, with my emphasis the four designated values are mapped to Hodge' model:

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(ii) self-concept values involving feelings of dignity, self-control, and/or physical capacity (designated as function);

(i) hedonic values about pain, aversive physical states, chances for recovery to some minimally satisfactory level, and so forth (designated hereafter as pain);

(iii) allocentric values referring to concerns with creating an emotional burden for family and/or loved ones (designated as burden)

(iv) financial considerations (designated as cost) (p.409). 

Since 1999 and considering the above I have added the following additions to reflect elements of change and a more generic view:

identity, self-expression (of needs), consistency in expressed wishes, intentionality, mood, alternative-adaptive forms of communication, time - active listening

distance, logistics (family, friends), what telecare might offer in terms of communication, evidence-based interventions, measures, assessment

independent advocacy, standards of social care, 'appropriate' placement for ongoing care, social - life history;

legislation - mental capacity, advocacy, evidence-based care - policy, pension, safeguarding;

While the focus of Hechter, et al. is specific these values also apply in a more generic sense. As students and lifelong learners engage with patients, carers and public they must learn to have due regard for the totality of values that might be encountered.

Hechter, M., Ranger-Moore, J., Jasso, G., & Horne, C. (1999). Do Values Matter? An Analysis of Advance Directives for Medical Treatment. European Sociological Review, 15(4), 405-430. 

Tuesday, February 02, 2016

LE t's GO

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Elahe Izadi (2016) The disabled Lego figures that have sparked actual tears of joy. Independent.

Photo source [mirrored]: 

Lego: "If you build it, they will come"

Will they - really? I wonder and hope so...

Still much building to do ...

Monday, February 01, 2016

Definition of a conceptual framework, Antonenko (2015)

"Definition of a conceptual framework  
Anecdotal evidence obtained from numerous discussions with students, colleagues, and the few research design books that address the issue of conceptual frameworks (e.g., Ravitch and Riggan 2012) indicates that the construct conceptual framework is viewed from at least three perspectives. The first, and most superficial, view defines conceptual framework as a visual representation of the structure of the study and its alignment with the relevant theoretical foundations. According to this view, conceptual framework is a figure, typically presented as a concept map, that summarizes all key information presented in the literature review of the study" (p.55).
At first it is confusing when within academic writing you have to present your theoretical - conceptual framework. In Hodges' model I already have one. Antonenko is very informative but I don't believe that this first definition is necessarily that superficial. It depends on the context and purpose. There is something in instrumental value that seems closely allied with the visual form and the paper provides an example.

If as Antonenko suggests there is a conceptual framework presented in the literature review, perhaps Hodges' model as a conceptual framework that can integrate discussion and the conclusion(s)? From the paper there are other points of note - even in the sub-headings alone, for example:

Conceptual framework is more than a literature review
The connective function of conceptual frameworks

Discipline is essential to prevent any risk of superficiality, or navel-gazing and Antonenko lists many strategies, including:
Avoiding getting stuck in a ‘‘no-risk’’ zone (Miles and Huberman 1994, p. 22), a situation where all concepts in the framework are abstract and interconnected. Informed commitments must be made regarding what the researcher finds as most relevant and important pieces of the conceptual framework. The entire point of building a conceptual framework is to be explicit and selective about the focus of the study (p.66).

Antonenko, P. D. (2015). The instrumental value of conceptual frameworks in educational technology research. Educational Technology Research and Development. 63(1), 53–71. http://doi.org/10.1007/s11423-014-9363-4

My source and with many thanks:
Technology Enhanced Learning studies, Module 6. Lancaster Univ.