Hodges' Model: Welcome to the QUAD: October 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

Sunday, October 30, 2016

Book: The Moral Economy - Individual - Group

humanistic -------------------------------------------  mechanistic

My source: Financial Times
Cover image: Amazon

Saturday, October 29, 2016

George Monbiot & Ewan McLennan - Breaking the Spell of Loneliness

humanistic -------------------------------------------  mechanistic

My source: BBC 2 or C4?

Friday, October 28, 2016

Loneliness: across the Domains c/o BMJ

humanistic -------------------------------------------  mechanistic



mental health

feelings  identity  meaning

motivation - behaviour


physical health, coronary heart disease , stroke


longitudinal observational studies


systematic review


social network

 family - relationships - befriending

social isolation

quality of life

family - community cohesion

social enterprise



social care provision

day centers

mobility - transport


public - funding - private


Valtorta, N.K., Kanaan, M., Gilbody, S., et al. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studiesHeart. Published Online First: [April 18, 2016]. doi:10.1136/heartjnl-2015-308790

My original source:
Smyth, C. Warning: loneliness as bad for your health as tobacco & Scourge of Loneliness. The Times, 20 April 2016, p.4 and 20.

Thursday, October 20, 2016

Reflection is holistic...

humanistic -------------------------------------------  mechanistic
"Reflection is holistic - it considers the whole, 

where aspects within the experience 
can only be viewed 
within the context of the whole, 

 they exist in dialectical tension, 

and cannot be reduced into parts or stages."

Johns, C. (1997). Becoming an effective practitioner through guided reflection (PhD Thesis). Open University, p.47.

Wednesday, October 19, 2016

Report: "Health as the pulse of the new urban agenda"

The following report published by WHO continues the themes of the previous post...

"New models of cooperation and cross-sector collaboration are needed to identify synergies across these sectors, and generate actions that result in overall gains to society, with health, environmental and economic co-benefits." p.19.

From the Executive summary:
How can policies and decisions at the city level expand opportunity for and protect the health of the 54% of humanity now living in cities? This document outlines some opportunities and basic strategies, while answering the following critical questions:  
1. Why is urban development important to health and vice versa?
2. What are examples of successful urban policies and strategies that deliver environmental, economic, social and health benefits?
3. How can decision-makers apply a “health lens” to urban planning, governance and finance, and avail themselves of tools to improve health, reduce social inequalities and ensure wider access to services and opportunity?
4. What role can the health sector play in advancing healthy, sustainable urban planning?

Editors (and image)World Health Organization
Publication dateOctober 2016
ISBN978 92 4 151144 5 

A Breath of Fresh Air - published

Report: A Breath of Fresh Air 

humanistic -------------------------------  mechanistic
Mental Pollution
advertising truth-values

mental health

anxiety  depression  fear

psychological effects of 
noise, vibration, foul air

awareness understanding

Vulnerable individuals:

Older Adult
Person with Chronic Health Problems

Air Pollution
Definition - Measurement - Monitoring
Image: http://www.cleantheair.org/air-quality-information/particulate-matter
Transport & Fuels: Diesel, Coal
Power Stations Coal Powered

Vulnerable Population Density


Public Health Information Giving

Public amenities

Quality of Life

Housing - Parks

Health Professionals Intervention


Policy  Standards  Law  Accountability

Retain Standards from EU regulations

Clean Air Zones          Clean Energy Providers

NHS Carbon Emissions

Accessibility Transport Modalities


Monday, October 17, 2016

Global Health report “Triple Impact- how developing nursing will improve health, promote gender equality and support economic growth"

Dear Colleagues

Many thanks to all of you who contributed to the compilation of the All Party Parliamentary Group for Global Health report “ Triple Impact- how developing nursing will improve health, promote gender equality and support economic growth.’

A review group of APPG members has undertaken a major review of the development of nursing globally over the last few months, holding a number of witness sessions, collecting evidence and debating our findings with the RCN, ICN and others. The report “Triple Impact – how developing nursing will improve health, promote gender equality and support economic growth” launched on the 17th October 2016 sets out a radical agenda and argues that the UK should play a major role in developing nursing globally.
Many thanks again for your time and support.

Best Wishes

Emily McMullen
Coordinator & Researcher to Lord Crisp | All Party Parliamentary Group on Global Health
Office of Lord Crisp | Fielden House | 13 Little College St | London, SW1P 3SH
Email: info AT appg-globalhealth.org.uk
Website: http://www.appg-globalhealth.org.uk

[Ms McMullen's original email edited adding text from report source]

Friday, October 14, 2016

Amazing open access Townsend Archive - Poverty in the UK materials

The Townsend archive provides open access to a range of original documents underlying the 1967/68 Poverty in the UK survey led by Peter Townsend. This survey pioneered the application of relative deprivation in measuring poverty.

The archive includes over 2500 digitised questionnaires from the survey. On these questionnaires you will find hand-written notes made, at the time of the interview, by the survey field workers. They provide telling details of the living standards and attitudes of that time. They are searchable by region, interviewer and survey booklet number.

The archive also covers a range of other papers associated with the administration and conception of the survey and notes and drafts of Townsend’s book. You can also download Townsend’s ‘Poverty in the United Kingdom’ book.

You will also find video interviews with researchers, fieldworkers and colleagues involved in, or associated with, the Poverty in the UK survey. David Donnison, Hilary Land, Adrian Sinfield, John Veit-Wilson and others reflect back on this landmark project. These interviews provide unparalleled insights into survey and research methods then and now, the relationship between social policy research and policy making across the last 45 years, and the impact, or otherwise, of research on tackling poverty.

To take a look at this fascinating resource visit: http://poverty.ac.uk/townsend-archive

Original source includes SOCIAL-POLICY AT JISCMAIL.AC.UK

Tuesday, October 11, 2016

Diagnosing Corruption in Healthcare - new Transparency International publication

Dear All,

Corruption has become prevalent in healthcare to the point that it is normalised. From the politician to the patient, individuals routinely place their own private interests above public health goals and patient health outcomes. That was the conclusion from speaking to thirty public health experts and anti-corruption specialists across the globe, as part of our most recent research project.

Our earlier research had shown that those working in the healthcare sector have a low understanding of corruption. Previous attempts at providing an overview of the types of corruption in the sector, while providing an excellent resource for those dedicated to the subject, had been complex and lacked comprehensiveness. Our new publication Diagnosing Corruption in Healthcare [http://www.transparency.org.uk/publications/diagnosing-corruption-in-healthcare/], which we launched at the opening session of the World Health Summit yesterday, aims to bring all the relevant information into one space. We have produced a "map" of corruption in healthcare that contains 37 types of corruption that are clustered into eight areas in health systems.

On our new website ti-health.org you can explore the map fully. Take a look at the explanations of each type of corruption, understand better how they occur in practice by examining some case studies, and if you still want to learn more there are links to other resources on the web.

Please also note that we will be publishing an eight-episode podcast series. Each episode will cover one of the eight corruption categories identified in our research. The first episode will be published this Wednesday, providing an introduction to corruption in healthcare and exploring how corruption can occur in the high-level governance of a health system.

We hope that those working in the healthcare sector, from doctors and nurses to company compliance officers and directors, will be able to use this "map" to better understand the corruption risks in the work. We also hope this map will prompt policy makers, in the public health and anti-corruption fields, to tackle this formidable challenge that endangers health outcomes around the world.

Best wishes,


Sophie Peresson
Pharmaceuticals & Healthcare Programme
Transparency International UK

Be GREEN, keep it on the SCREEN
Healthcare. Environment. Media. Education. Business. #TransparencyMatters to us all. Tell us your story here .

HIFA profile: Sophie Peresson is Director of the Pharmaceutical & Healthcare Programme, Transparency International, UK. Email address: sophie.peresson AT transparency.org.uk

My source: HIFA: Healthcare Information For All: www.hifa.org

Monday, October 10, 2016

World Mental Health Day - Weeks, Months, Years (and Tears: or trying to find them)

Prompted by World Mental Health Day posted below are some thoughts related to each of the domains of Hodges' model in respect of mental health and health and social care in general.

humanistic -------------------------------  mechanistic

Reflection is an important human ability. It can be variously described as - reasoning, problem solving, introspection ... but an ability of self-reflect and critique our circumstances in a balanced, mature, objective way is an important skill that should ideally be shaped like so many others in childhood. Education and health literacy matters.

Evidence for reflection and reflective practice for nurses and other health professionals remains rather sparse and contested. There can be ethical challenges and assessment and measurement of reflection and reflective practice is problematic.

Hodges' model can support individual reflection providing a framework to facilitate person centred, integrated and holistic care. Globally there is no generic conceptual framework. Here is a candidate!

The parity of esteem debate that is so often heard in the political domain, becomes a stark fact of life to the individual in their physical and mental health. The two must be integrated.

Policy makers look to the SCIENCES domain to find the technical and analytical tools to study demographic trends and produce national statistics. 

Health providers are increasingly having to deliver services for individuals and programmes for population health. Data and Big Data all contribute through national governments to regional centers and the WHO.

Far from the binary logic of maths and the technical wonders it gives rise to, here in the SOCIOLOGICAL domain the YES or NO to having next of kin, partner, family and friends is pivotal from a mental health perspective. 

There is an irony that the size and stability of someone's social network is an indicator of their staying well; while social media can act as a force for good, or a negative force aimed at those vulnerable to bullying and abuse.

Effective communication is situated and ultimately determined by context: personal, local, glocal and global.

In this domain, whichever corner you turn to, it is politicised: be it funding for services; the word 'recovery'; the very existence and acknowledgement of mental health allied to human rights and service provision; employment and welfare; policy for access, diversity, equity, gender, equality.... mental health is manifest with political dimensions.

How are the needs of specific groups met, children, youths, women, men...?

Mental health law is crucial for personal and public safety. How this is conducted and governed is a measure of a modern state and please note the distance from the INTRA- INTERPERSONAL domain at upper left.

Thanks to @MHChat and community for reminder #WorldMentalHealthDay #WMHD16

Sunday, October 09, 2016

Queen of Katwe: Searching for a chess board

humanistic -------------------------------  mechanistic

(Robinson Crusoe & Friday)


Group Psychology

Behavioural Economics

Queen of Katwe

My source:
Gilbey, R. (2016) Leading the race for the Oscars, Culture, The Sunday Times, pp. 6-7.


Saturday, October 08, 2016

Heterodoxy in Economics and Healthcare

I may as well face it: I am tarred with the same brush that paints psychiatry, hospital and community mental health services these days (and nights). Sometimes the media, with due cause I sadly add, dispenses with the brush: the paint comes by the bucket full and is hurled.

As a product of the Victorian asylum system I am bound to be tainted. This seems to be the case when seeking feedback on Hodges' model from activists for anti-psychiatry, patient activism, engagement, self-care, carers rights and recovery. There are those who feel even the latter is a political foil that stabs at the heart and mind of those in desperate need of mental health care. The situation is exacerbated even further, such is the politicisation of healthcare and mental health in-particular since austerity cast its shadow on funding.

In seeking comment on Hodges' model this is very much about pros and cons. Hodges' model being from the 1980's is an historical artifact, but I beg to differ as to its relevance. To that audience Hodges' model is probably the antithesis of "Love at First Sight". Like the psychiatric system and the legal powers it can exercise, the model says;

"Look I can help you. Let me show you how much I care.
Don't worry. We can make sense of this.
I'll just put you and everything not just in one box but several" 

If that is the reaction then the possibilities: creative, innovative, reflective, person centred... of then blurring and erasing these lines, divisions and gathering the whole person and their situation is lost.

So, if the new wave thinking in mental health provision eschews the paraphernalia of models and framework then what is the alternative?

The question is important, vital even when we look at the mental health nursing curriculum. Curricula are never fixed in the sense that the new emerges from the old. How radical is this change?

The above reflections are prompted by an excellent piece in the FT Weekend (1-2 October) by David Pilling on the teaching of economics. I recalled a few years ago the rumpus on campus reported across the media.

Individuals and families do seek explanations, both of what ails them, their treatment and the plan of care whether enacted as self-care - a care partnership - or emergency care in the first (and vital) instance. Pilling writes about the how economics is taught, the call for broader curricula (which is underway) and the role for heterodoxy.

So I've a few questions: Where is the heterodoxy in healthcare (beyond alternative medicine/homeopathy)? Is there really no need of a generic conceptual framework in healthcare?

If the new Econocracy needs a framework then students across disciplines may also find some value in Hodges' model...

Given the cross-disciplinary pressures on healthcare systems the world-over there really is a need rethink healthcare as well as economics. Arguing in response about the economic benefits of technology is indicated and well-justified, but it is not e-nough.

HUMANISTIC-------------------------------  mechanistic
"The students gathered
in response to an email ...



Individual Psychology

(Robinson Crusoe)

(email...) It asked whether the economics
they were learning, dominated by
mathematical formula and abstract
models, was relevant to the real world."
"How far can economics be called
a real science?"

"Earle complains that the repeated
use of such formulaic models presents
a "closed system", immune to
external interrogation. "You are taught
a narrow way of thinking 
about the economy as this 
set of rules and laws 
not to be questioned and
 not to be engaged 
with," he says. ..."

(Robinson Crusoe & Friday)

Group Psychology

Behavioural Economics

He would like, he says,
to "put politics, and
philosophy and, well,
ethics back into economics
by teaching it as a "contested",
cross-disciplinary subject..."

"Post-Crash Economics 
has folded into
Rethinking Economics"

Post-Crash Economics Society

My source:
Pilling D. (2016). Crash and learn, Life & Arts, FT Weekend, 1-2 October, p.1-2.

Tuesday, October 04, 2016

The New Script of Nursing : El Nuevo Guión de Enfermería

Dear Colleagues and Members of the Global Alliance for Nursing & Midwifery (GANM),

All of us know that our profession is undergoing an extraordinary transformation and that nursing will never look the same. While we know this, there is a profound need to educate the general public about the broader scope of our work and expanding opportunities.

As the breadth and impact of our work increases, so does the need to recruit and retain nurses—crucial elements during a nursing shortage throughout the world. Together, we are writing the new script of nursing,” and we have create​d a video that reveals the intensity and magnitude of our profession that is much more than what meets the eye – researcher, clinician, change agent, inventor.

We purposely did not brand this video as our own because the advancement of the profession and the healthcare needs of the patients we serve are more important than any of our individual or organizational needs. By not branding, the message will go farther and have greater impact.

I encourage you to use it as your own and help spread the word of the new script of nursing. Like many of you, we can’t support a national campaign, but together we can perhaps start the process of educating the public and moving nursing toward a realistic, contemporary image.

Share it on social media, send it to your colleagues to push out, and join us in saying “#WeGotThis.”

Patricia Davidson
Dean, Johns Hopkins School of Nursing


Estimados/as Colegas y Miembros de la Alianza Global de Enfermería y Partería (GANM),

Todos nosotros sabemos que nuestra profesión está experimentando una transformación extraordinaria y que la profesión de enfermería nunca mas tendrá el mismo aspecto. Si bien sabemos esto, existe una profunda necesidad de educar al público sobre el amplio alcance de nuestro trabajo y oportunidades de expansión. 

A medida que la amplitud y el impacto de nuestros trabajo aumenta, también lo hace la necesidad de reclutar y retener enfermeros y enfermeras -- elementos cruciales durante una escasez de enfermeras/os en todo el mundo. Juntos, estamos escribiendo el "nuevo guión de la profesión de enfermería," y hemos creado un video que revela la intensidad y la magnitud de nuestra profesión que es mucho más de lo que parece a simple vista - investigador/a, clínico/a, agente de cambio, inventor/a.

Fue a propósito que no etiquetamos este vídeo como nuestra propia producción debido a que el avance de la profesión y las necesidades de salud de los pacientes que atendemos son más importantes que cualquiera de nuestras necesidades organizacionales o individuales. Al no etiquetar este video, el mensaje va a ir más lejos y tendrá un mayor impacto.

Los animo a usarlo como su propio mensaje para asi ayudar a difundir la palabra sobre el nuevo guión de la profesión de enfermería. Como muchos de ustedes, no podemos apoyar una campaña nacional o mundial pero juntos podemos quizás iniciar el proceso de educar al público y avanzar la imagen de enfermería hacia una mas realista y contemporánea. 

Compártanlo en las redes sociales, envíenlo a sus colegas, y se únanse a nosotros en decir "#WeGotThis."

Patricia Davidson
Decana, Escuela de Enfermería Johns Hopkins 

The GANM is part of the Johns Hopkins University School of Nursing PAHO/WHO Collaborating Center.

The thoughts, opinions and views that are posted on the GANM do not reflect those of either Johns Hopkins University or WHO.

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