Hodges' Model: Welcome to the QUAD: January 2018

- 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

Wednesday, January 31, 2018

Care with a Smile: For a Smile in Care Homes

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

Self-esteem, self-image

anxiety, worry, depression

Able to express needs
Ability to ask, remind, argue - self-advocate
Challenging behaviours,
agitation, aggression

Irritability, poor sleep

reduced attention and concentration

Observation of staff - pain?

Loss of dentures, memory

Changes in gums, gum disease, weight loss
cleaning teeth, false dentures, fit, marking dentures, care plans
Access to toothbrush, toothpaste, mouth wash, Oral hygiene
Sugar – sweets (one of few pleasures?)

Risk of thrush and other infections (cardiac?)

Mobility of the resident
Appearance and sense of well-being

Pain of toothache, analgesia – tiredness
Avoiding eating and drinking properly

Access to dental surgery

Changes with speech

Equipment challenges of remote care, technology changes
Mobile clinics

Responding to expressed distress -
whether explicit or implicit
(listening - caring)

Avoiding other people.

Having friends and family to advocate for dental care

Impatience with others, argumentative,

Family expectations

Commissioning of dental care in the residential / nursing home sectors
Local authorities, Health, CQC
Asessment - Evaluation
Referral process
Staff  awareness and knowledge

The nursing home make the referral?
The family must make the referral?
National standards
Domiciliary visits paid in advance.

Dental service packs packs circulated to residential and nursing homes across a Region.
Global access to Dental care?

Monday, January 29, 2018

Saturday, January 27, 2018

Planning tool for Early Onset Dementia - Mapped to Hodges' model

 This post is prompted by a tweet:

humanistic --------------------------------------- mechanistic
Self-knowledge of symptoms -
Learn about my condition
Learn and stimulate the brain
Use lists, what I am doing, what interests me
music, places, work-experiences ...
Consider interventions, record in my biography
Feel safe, confront fears and anxieties
What does 'well-being' look like for me
Positive thoughts, dreams, aspirations
Use Mental Capacity for Future Planning
- and signs
 Seek environments that support me;
avoid those that drain or inhibit me

Use technology to create biography
(Research into diagnostic journey)

Take control - strategies on nutrition and health
Share biography with loved ones, friends.
Tell them how they can help -

 Ensure (assure) future needs are/will
be met as I would like them

(Hey!) I can still contribute to society so ..

- consider getting help e.g. Dementia Advisors
(Guidelines for health services, esp. primary care, GP, family physicians)
Mental Capacity Act, Power of Attorney,
Advanced Decision Making
Yes: to occupation, earning or volunteering

Apologies in advance, as the formatting may be disrupted on some devices so two lines may not scan across the care domains as intended.

As you can see this brief 'sketch' of #StillMyLife shows that the emphasis of this planning tool is well-placed. This also highlights what I have referred to as 'holistic bandwidth'. There are many claims regarding the centredness of various things, for example; student education and learning, health and nursing care, government and the way business is conducted. In this instance, the question of what is the conceptual, disciplinary and professional extent of a tool, approach, theory or practice. Is its claimed philosophical, ethical, social or other objective fully deserved? Is it person-centred, or task centred? Does it deal with the political dimensions of significance to an individual with a disabling health condition as it claims?

n.b. Note the boxes and the absence of ticks.

Thursday, January 25, 2018

Conference: The Foundations of Conceptual Engineering

A conference on The Foundations of Conceptual Engineering at NYU, on Sept 14 and 15, 2018. To attend, please register by following this link no later than August 31, 2018.

One dimension of cognitive success is getting it right, i.e gaining knowledge of facts. Another dimension of cognitive success is using the right concept, i.e. framing a topic in the right way. This view, if correct, tasks inquirers with critically examining the concepts they are using and perhaps replacing those concepts with new and better ones. This task is often known as “conceptual engineering”.

The idea that conceptual engineering is an important task for inquirers in and outside philosophy has recently gained traction. Some philosophers think conceptual engineering is an important task for inquirers to pursue.  The conference is focused on foundational issues in connection with conceptual engineering. Topics to be addressed include the following:
  • What are the semantic mechanisms that underlie conceptual engineering?
  • What are concepts, and which role (if any) do they play in conceptual engineering?
  • How can a theory of conceptual engineering be integrated with large-scale semantic theories? 
  • Which precise changes does a language undergo when its speakers engineer concepts?
  • Is conceptual engineering something that speakers can ever purposefully bring about?
  • What is the relation between changing concepts and changing reality? 
The planned conference will focus especially on the semantic foundations of conceptual engineering and push towards a better understanding of the process.

The conference is organized collaboratively by members of NYU (Vera Flocke and David Chalmers) and members of the research project ConceptLab, located at the University of Oslo (Herman Cappelen and Andrew Peet).



If this conference needs a workshop, a workbench, or conceptual engineering facility they might care to look at Hodges' model. Whether for conceptual brainstorming, requirements, prototyping, refactoring, combination ... Hodges' model can have a role. Some musings in this vein follow...

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

One dimension of cognitive success is getting it right,
i.e gaining knowledge of facts.
Another dimension of cognitive success is using the right concept,
 i.e. framing a topic in the right way.
Acceptable to the patient (or advocate) and ethical?
Achieving concordance - agreed 
relevant to the context, issue, problem?
Logical consistency, coherence and permanence?
Holistic bandwidth is tested - semantic scope?
Conceptual Engineering instantiated in software, argumentation? AI? Conceptual Spaces?
Topic is person-centred 
(patient, student, carer...)
Testing: Concepts with positive :: negative are switched - re-framed? 
Other dichotomies? Conceptual slide-rule?
Known 'semantic drift' in vocabulary - concepts: disuse, archaic, new, re-purposed?
Assessment is comprehensive?
Knowledge of 'conceptual engineering' 
how to - rules, laws (mechanisms)?
Concepts were measurable (as were previously defined) quantifiable?
Flagged interdisciplinary use of concept? Transdisciplinary?
Visual tools - representation, diagrams?
Reversible quality: 'engineering' disassembly?
Conceptual dependency on threshold(s)?
Engineering concepts: 
tolerance, project, professionalism, failure, risk, benefits, techne?
'Conceptual engineering' defined units & standards: word, words ... corpora?
Research methodologies, methods?
Available social sources were utilised, or at least pursued?
Narrative derived from concepts references life history (story)?
Tested and accepted by peers - multidisciplinary team?
Quality criteria were met
Cultural, ethnic due regard  met

concepts used were appropriate
 to outcome(s)?
'Space' for uncertainty, constraints, unwise decisions?
Policy influence on language, examples found in health and social care 2008-2018 austerity?
Accords with and assures the Sustainability Development Goals?
'Macro conceptual engineering' - 
Level of required change in health systems: 
new & existing

Tuesday, January 23, 2018

Public Service(s) Ethos ii (notes)

Behind the post from 19 January 2018 are the 4Ps which can be related to Hodges' model.

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


Were possible the patient should have a purpose in relation to their condition, care, and recovery as far as possible. (How do we define proactive, preventive care...?) The nurse and colleagues will similarly be purposed to deliver person-centred care. The organisation can make a difference here - to individual practitioners, translating the organisational ethos through leadership to ensure individual's can be creative, safe, effective, innovate and find their role and purpose rewarding and (constantly) refreshing. Ethos here should align with personal ethics and values. Fire may be a mechanistic phenomena, but burnout here is best avoided.

process -

In the past and today nursing has been and is defined and described in task-oriented terms. Hodges' model acknowledges this by differentiating between the activities that nurses carry out some are mechanistic and others are humanistic. Through a combination of  interventions nurses help patients regain their independence as far as possible. 
Outsourcing and project management are also tied to process-laden perspectives, models and schema.
practice -
Students are socialised into practice (yes, I had a bath).  Our practice is contextual, that is, it is situated. Interaction and the time nurses spend with patients and often carers places an emphasis on the exercise and maintained competence of interpersonal skills. Empathy, rapport, dignity and respect, universal positive regard ... they are exercised and practised here. If this is the domain were therapuetic relationships are forged, this is also the domain where contact-time counts. Count the beans as we may, the qualitiative relationships in the time spent between nurse-patient; lecturer-student; mentor-student; leader-team contact are definitive for the public and practitioner. Enjoy this, as the robot help is enabled with an ethos of its own?

The initial post was prompted by POLITICS.  Many nurses try to be apolitical, necessarily so at work. In a way, as you can see the HUMANISTIC-MECHANISTIC axis provides a dodge. The humanistic placement of practice in Hodges' model can account for the public service ethos of "Don't Panic Carry On". Although many try to circumvent the politics of healthcare, there is no escape from the effects of policy on the service. The UK and USA remain ideologically divergent in healthcare (and geologically) but the debate is now heard everywhere and when. It is infraglobal. It is heard everywhere and when. In the political domain there are obvious sensitivities associated with our use of maps and our place upon them. Addressing the ethos of healthcare at an individual and population level now calls for maps of a unique kind.

Sunday, January 21, 2018

Finding voice: Harmonious and Discordant Care

  Life stories: 

Where exactly and when do life chances and health career pivot?

for hard-up singers and musicians in 1899, 
calling it his favourite of all his works." p.2

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

"You are born an artist
or you are not
and you stay an artist even if
your voice
is no longer a wonder" p.2

"unpleasant smells of urine" and
"17-hour gaps"
between dinner and breakfast

"Almost half of Britain's 410,000 residents receive some level of local authority support ..."

"Guests are free to come and go
as they please and though Mandelli
 doesn't go out to dinner any more,
she still goes to La Scala,
often to rehearsals." p.2

"Around one-third of the UK's
bed capacity is at risk of closing
within the next 5 years, ..."

"The rise of the minimum wage
has also put pressure on an industry
where labour accounts for 70 per cent of costs, while Brexit has increased reliance
on more expensive agency staff."


Plimmer, G. (2017) Frailty of Four Seasons shows risk to residents, FT Weekend, 16-17 December. p.18.

Roberts, H. (2018) At Home: Harmony in Verdi's care home, House&Home, FT Weekend, 6-7 January. p.2.

Friday, January 19, 2018

Public Service(s) Ethos

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



Corbyn, J. "... public services ethos ..." heard this week on the news, 17 January, 2017.

Monday, January 15, 2018

Representation of the People

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


of the 



An act to unite 

"The Representation of the People Act 1918 meant that a greater number and a broader mix of voices could now be heard at the polls. 100 years later, we mark the centenary of this historic Act with this UK 50p coin range. "

2018 ...
Representation of the People's 
health and social care...?

My source and image: The Royal Mint

Saturday, January 13, 2018

Person-centred care [PCC]: is it really happening? c/o National Voices


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

what’s important to the individual,
is co-ordinated around their needs
and involves them in decisions.

"To be person-centred, that care needs to work together to wrap around all the needs of the individual in a holistic way. Sadly, our report found that neither the NHS nor adult social care can demonstrate co-ordination of care, despite ‘integrated care’ being a key goal of all national and local leaders over the past five to 10 years.
The way health and care services work must change to reflect the needs of the population. It would be a start to recognise that co-ordination of care is an important factor, and that we need to be measuring whether it is happening."
(many) Definitions = 5 key indicators of pcc: 
good information,
good communication,
involvement in decisions, 
care co-ordination
 and care planning.

Service user reported data from 19 nat. surveys
NHS:  in primary care, only 39% of patients said their GP was ‘very good’ at involving them in decisions. What’s more, personalised care planning doesn’t really happen. Only 3% of GP patients with one or more long-term conditions reported having a written care plan, suggesting that opportunities to deliver personalised care in the NHS are being missed.

"Personalisation of care is more advanced in adult social care than in the NHS, with 89% of adult social care users reporting that the care and support they received helped them to have control over their daily life.

Similarly, 63% of people using a social care personal budget said that this had improved their ability to make everyday decisions.
Participation and control of decisions is well-established in adult social care, with just over 90% of those using community adult social care saying they were involved in decisions about their care and support needs."

(See original post - report for important additions)

 20+ years policy
Care Act 2014

National Voices
coalition of health and care charities  report
‘Person-centred care in 2017'

No National data on this...

"It is clear from our report that a strategic overhaul of how care is measured is needed. Rather than single-service, single-setting, activity measures, more credence needs to be given to the experiences of the people who rely on services. Only then can we help local systems succeed in offering personalised, integrated and holistic care.
Whilst there have been some advances in the delivery of person-centred care, there is still a long way to go before the policy rhetoric matches the reality experienced by people."

Tuesday, January 09, 2018

ERCIM News No. 112 Special Theme "Quantum Computation and Information"


Dear ERCIM News Reader,

ERCIM News No. 112 has just been published at https://ercim-news.ercim.eu/

The Special Theme "Quantum Computing" was coordinated by the guest editors:

Jop Briët (CWI) and Simon Perdrix (CNRS, LORIA)

This issue is also available for download in pdf and ePUB

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

Next issue:
No. 113, January 2018
    - Special Theme: "Smart Farming
    - Section Research and Society: "Research Evaluation"

My source: Peter Kunz  peter.kunz AT ercim.eu

Monday, January 08, 2018

Scratching the surface: Optimization algorithms

... In healthcare ..? 
Well - yes,
we've definitely scratched the surface,
but not a sufficient number of surfaces,
and not necessarily the right ones 
in the right order...

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


My source:

Sunday, January 07, 2018

Know: A Journal on the Formation of Knowledge

The news below (which I have edited slightly) is from a longer message by Willard McCarty and alerted me to a new journal, the strapline speaks volumes here -

Reflections on Disciplinary Knowledge

It is not open access but the contents are listed:

Date: Fri, 29 Dec 2017 11:08:41 +0000
From: Willard McCarty willard.mccarty AT mccarty.org.uk
Subject: Interdisciplinarity and Collaboration

In the leading article of the first issue of Know: A Journal on the Formation of Knowledge
(http://www.journals.uchicago.edu/toc/know/current), Simon Goldhill surveys major problems requiring an interdisciplinary approach then observes that:
When expertise is so hard to attain and fields are developing so rapidly, there are inevitably only a few people who are in themselves genuinely interdisciplinary in the sense of having mastered two or more disciplines in a creatively combinatory fashion. Rather, what most of the major problems I have mentioned do need is collaborative responses. The question of interdisciplinarity, thus, is most insistently a question of how to collaborate.
... Willard also draws attention to the editor's introduction to the first issue.
Humanist Discussion Group, Vol. 31, No. 493.
Department of Digital Humanities, King's College London

Friday, January 05, 2018

Book: Ants Among Elephants: An Untouchable Family and the Making of Modern India

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


Ants Among Elephants

Thursday, January 04, 2018

Hodges' model DoB = early 1980s. So it's obsolescent?

No Way!
The model is more relevant than ever...

humanistic --------------------------------------- mechanistic
The 'discerning' customer

chuck, drop, dump, bin. throw, fling, tip
[left] 20% ink?
How many ink cartridges do you need?
How many blades...?

The discerning market?

"In passing the "Hamon Law," as it's known, in 2014, France became the first country in the world to open the door to sanctions for the widespread manufacturing practice of "planned obsolescence" - creating products pre-designed for failure at some point so that consumers will be enticed to replace them.
Specifically, the legislation outlaws "the use of techniques whereby the person responsible for placing a product on the market deliberately aims to reduce its lifetime in order to increase the replacement rate." David Schrieberg

Forbes.com David Schrieberg - Landmark French Lawsuit Attacks Epson, HP, Canon And Brother For 'Planned Obsolescence'

Halte à l’Obsolescence Programmée (HOP)

My source: Sage, A. French have last word on printers, The Times, September 20, 2017, p.40-41.

Wednesday, January 03, 2018

Modelling Scale: Self, Families, Communities, Organisations - a Planet's Health...

Dear HIFA colleagues,

I would like to wish you all a happy new year and to share with you a powerful quote on the front cover of the current print issue of The Lancet:

"Achieving planetary health will require a renaissance in how we define our place in the world. A new narrative will reject the one streaming into our homes — that happiness comes from relentlessly acquiring more things — and embrace what we know: that what truly makes us happy is time spent with those we love, connection to place and community, feeling connected to something greater than ourselves, taking care of each other."
The quote is from a lecture by Samuel Myers, Planetary Health Alliance at Harvard University, USA. The citation is below and the full text is freely available here:

CITATION: Planetary health: protecting human health on a rapidly changing planet
Dr Samuel S Myers
Volume 390, No. 10114, p2860–2868, 23 December 2017
DOI: http://dx.doi.org/10.1016/S0140-6736(17)32846-5

Best wishes, Neil

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA: www.hifa.org


My additions:

I am always fascinated by the need for such expansive perspectives, the need to simultaneously factor in scale; how for example, do we warn future generations of environmental hazards?

Such questions are also crucial to "how we define our place in the world"?

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

The Far Future - BBC Radio 4

The Long Now

Political planning
NHS workforce planning
NHS preparedness for (a?) the (this?) Winter

Source: HIFA Dr Neil Pakenham-Walsh with thanks.