Hodges' Model: Welcome to the QUAD: February 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, February 28, 2018

Book: Poetry Pharmacy

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

Tuesday, February 27, 2018

Yesterday..? Now..? Rare Diseases Day (really*) is Tomorrow


Just imagine - whether thinking about a nursing career, already a student nurse studying and learning how to practice, qualified or returning to nursing ... the range of real differences you - we can make!

*[see also - Yes: Rare Diseases Day was yesterday! oops!! ]

Sunday, February 25, 2018

2nd Planetary Health Annual Meeting in Edinburgh

Since learning about the 2nd Planetary Health Annual Meeting in Edinburgh late last year, I realise I didn't post the news, which is a gift in terms of the purposes of Hodges' model. So, this post celebrates what is a vital subject and call for action and an invite to present a poster. Unfortunately regards the poster, in my haste I did not check the registration terms and the applicable early bird fee of £250 is too much for me personally. If you are a student, or resident citizen of a low and middle income countries opportunity knocks with a welcome reduced early bird registration fee until 9 March.

The planet and planetary health have featured here on W2tQ, on the now defunct website 1998-2015 and in papers, notably:

Jones, P. (2008) Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons, IN Kidd, T., Chen, I. (Eds.) Social Information Technology Connecting Society and Cultural Issues, Idea Group Publishing, Inc. Chap. 7, pp. 96-109.

 Jones, P. (2012). Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model. The Journal Of Community Informatics. 8(3). Retrieved from http://ci-journal.net/index.php/ciej/article/view/876/

Jones P. Exploring the relationship of threshold concepts and Hodges’ model of care from the individual to populations and global health. Rev Cuid. 2017; 8(3): 1697-720. http://dx.doi.org/10.15649/cuidarte.v8i3.464

Another short paper is under review on Hodges' model and the Sustainable Development Goals.

Amid the embarrassment of having to turn the offer down I will follow developments with keen interest and hope that another opportunity may arise.

Saturday, February 24, 2018

Trauma: A definition c/o @fomsf_UWE

Resized image @fomsf_uwe
Trauma "a universal aspect of human experience in which individuals and groups have to undergo or bear certain burdens, troubles and serious wounds to the body and spirit". p.205.

humanistic -- UNIVERSAL HUMAN EXPERIENCE -- mechanistic

burdens troubles

serious wounds

(ethnography, multicultural practice)

 (refugees, mental health providers)

Elzbieta M. Gozdziak (2004) Training Refugee Mental Health Providers: Ethnography as a Bridge to Multicultural Practice. Human Organization: Summer 2004, Vol. 63, No. 2, pp. 203-210.

Friday, February 23, 2018

Depression Worskhop: c/o and with thanks to AffecTech

As posted last September I enjoyed an evening at the launch of AffecTech at Lancaster. This post is prompted by a tweet:

I should add that this post is not intended to represent an endorsement by AffecTech but there is an opportunity to reflect and show how Hodges' model can be used.  I contacted the researchers who - in the spirit just mentioned - kindly forwarded higher resolution images. Of course, not being present at the workshop a lot of information is lost. The reference to art is interesting in itself. It is difficult to capture the context of the whole workshop but - as per the tweet - a short article sets the scene:

AffecTech Design Workshop: Discussion on Cross-disciplinary Methods for Depression Treatment

I have provided two examples of Hodges' model mapping the contents of the workshop. The first,  covers Figure 1: Concept maps of depression causes and symptoms. I don't have a key so there may be the thoughts of several individuals - as per the colours and codes on the flipcharts. Some terms are immediately not only cross-disciplinary but multicontextual in terms of their everyday meaning, for example, darkness, falling, stuck-ness, negative spiral (thoughts, actions), imprisonment mentally, physically, and politically due to dependency, financial constraints.

humanistic --------------------------------------- mechanistic
Unreachable hope                                     Pain
                                          Weight - burdened
       Immobility - motivation
                  DEPRESSION    Anxiety
DESPERATION                                          Stuck
                Darkness    Grief             Falling
      Negative filter         No hope
  Negative spiral                             Lack of
interest and motivation
Internalising rage   Suppressed emotions
Anger Not being listened to                  Darkness
Physical decline Weight


to go

Imprisonment – Social Isolation

No support


Imprisonment – Powerlessness?

Loss of control

Next, I have examined the text immediately following and mapped this [my emphasis] to the model.

humanistic ----------------- THE SYSTEM --------------- mechanistic
Identified, general state of lack of interest as a main symptom of depression (lack of energy, negative spiral), and as one of the obstacles for technology-based treatment of it.

Therapist input: the emotion regulation component of the system should be suggestion-based (promoting novelty in the patient daily routine). system should be able to continuously monitor* (and predict) the user mood

should have an appealing and trust-worthy interface from which it can communicate with the user and modifying his/her immediate context.

If depressed - the agent engages the user in a discussion in which a range of emotion regulation techniques is proposed to him/her.
Includes: (i) modifying environment (light changes, playing music); (ii) recommending activities; (iii) proposing mindfulness exercises; (iv) engaging the user in a discussion; or (v) recommending the user to look for the support of a friend.

Further, at the end of each day the user and the agent discuss progress made over recent days, and define small steps that could be taken in the near future.

Requirement for a pro-active intervention system, and engage the user as soon as (or better just a bit before) a critical situation is detected.

System should: *real time - 'always on'? provide daily feed-back to the user (giving a sense of incrementally overcoming problems).

Low-fidelity prototype of a system that meet these requirements. Composed of two components: (i) wrist-band device worn by the user that monitors the user mood; and (ii) an assistive agent that is responsible for the emotion regulation system component.

Working principle of system - wrist-band devices communicates to the agent when the user is in a depressed mood (- use of biosensors)

Should strive to connect the user with his/her close friends. 

Emotion regulation techniques - (v) recommending the user to look for the support of a friend (see above).

The above is provided as a 'pause for thought'. I'm no expert on NLP, but I am acutely aware of the power of the words we use. And how what is said to patients, carers can be returned as a sizzling hot potato that may reveal: great foresight in what you have missed; a major lack of understanding of a situation and treatment plan; and (then) as follows a need for urgent educational intervention. In applications such as this - care needs to be taken in when and were particular words are used. 'Treatment' is in the title, but can be a loaded term as understood by the patient, client, carer, or user. People will say, "No it isn't - this is a 'balanced' approach." but herein risks lie.

Services should be non-ageist and yet culturally if you survey treatment and related terms - from a decennial perspective I wonder what you would find? I have patients who refer to Dr Google and will challenge and ask about their care and if not satified seek further opinions - a fresh pair of eyes; and others who are quite institutionalized in respect of passively accepting what is 'prescribed'. This may be reflected in the length of their mental 'health career' and their previous mental health history.

Please note the inclusion of THE SYSTEM above in the axes and domains of Hodges' model. This is non-trivial. 

At the end of the day (and the start of the night - for someone with depression?) what is the system? I'm not being awkward, but the 'system' in research can become a lay-by. As a compound term it is shorthand, but obviously we need to focus on the elements, constituents and what glues the system together: coherence. As an example, how often in IT project are 'Requirements' the sought after token that signifies "We are on the right track!"? The focus from the above is laudable being clearly person- patient-centred. Is there more that can be said about the system and requirements in the social and political domains? Is there a way also for the agent to figure higher up the design ecosystem (hierarchy)? This is no doubt were the hard work matters - theory, practice - the thesis!

Given the complexity of the (design, care, technical, global...) problems we face I do believe that Hodges' model may serve a purpose in helping to sustain, or ‘recover’ the context – of a situation. This is the purpose of stories of course. The aim of AffecTech's project here is no less than detecting a critical situation. Perhaps this is the truth of 'integrated health records' from wrist device, to agent, patient's record and health services'? It is brilliant to see such initiatives getting underway they are the future....

 (I may add to this post in coming days - weeks.)

With thanks to Alan Cole and Andrea Patane of AffecTech at Lancaster University.

Thursday, February 22, 2018

Three Billboards (Some of us are more Alone than others...)

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

"500,000 dead in Syria"

 "And still no action?"

"How come, Security Council?"

care - Medical and Humanitarian Organizations use Three Billboards to Call on UN to Stop Violence in Syria

Wednesday, February 21, 2018

Written in the Stars: Is this blog a zibaldone?

"One proof among a thousand of how purely physical systems influence intellectual and metaphysical ones is the system of Copernicus. For the thinker, the Copernican system completely changes the idea of nature and man conceived and thought of as natural in the old, so-called Ptolemaic system. It reveals a plurality of worlds, shows that man is not a unique being, in the same way as the position, movement, destiny of the world is not unique, and opens up an immense field of thoughts about the infinity of creatures that, according to all the laws of analogy, must live on other planets that are entirely analogous to our own, and those planets which, though we cannot see them, may also move around other suns, namely the stars." pp.81-82.
Giacomo Leopardi (1798-1837)
Leopardi, G. (2013) zibaldone: The Notebooks of Leopardi. London: Penguin Group.

Monday, February 19, 2018

The question I have long asked...

What about you?

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


Are We Alone?

Image: http://www.ozmarecords.com/product/voyager-golden-record-3xlp-box-set

Saturday, February 17, 2018

Common Sense..? c/o Shlain

The phrase "common sense" has several meanings. In one, it is the wisdom of all the senses, a holistic and simultaneous grasp of multiple converging determinants. In this meaning, common sense is intuitive and is often the opposite of logic. In another meaning, it is the wisdom of more than one person. It is the result of the give-and-take of face-to-face conversation with another, which allows one to "hear oneself think." In this second meaning, common sense is wisdom generated "in common."
Shlain, L. (1998). The Alphabet Versus the Goddess: The Conflict between Word and Image. London: The Penguin Group, p.315.

Friday, February 16, 2018

Common Sense..? c/o Santayana

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

"Santayana departs from the British school, however, in insisting that a common sense philosophy cannot itself be adequately defended by common sense." p.63.

common sense
common sense

common sense

O'Sullivan, N. (1992) Santayana. St Albans: The Claridge Press.

Tuesday, February 13, 2018

Book: Politics Of The Mind - Marxism and Mental Distress

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




Monday, February 12, 2018

Free online course - Global Health and Disability c/o HIFA

Dear all,

I hope that you are well.

We are super-excited as we are just putting the final touches on our online course on Global Health and Disability. It features key global leaders in disability and many testimonials and videos from people with disabilities from around the world. It argues strongly for the inclusion of people with disabilities in development.

I would be very grateful if you would share the information below with colleagues or others who may be interested in joining the course. It is suited to anyone with an interest in health and disability, from low or high income settings, and should take up about 2-3 hours per week for 3 weeks. The launch is Feb 26. Let me know if you have any questions.

All the best,

Global Health and Disability

Leaving no one behind: disability, health and wellbeing in global development

A 3 week (maximum 4 hours per week) free online course from the International Centre for Evidence in Disability at the London School of Hygiene & Tropical Medicine

Course starts 26th February 2018

For more details, to check out the trailer or to register your free place on the course, click here:


Why join the course:

Around 15% of the world’s population, or 1 billion people, live with some form of disability, with numbers continuing to rise over the coming decades.

People with disabilities are often overlooked in national and international development, and can face widespread barriers in accessing services, including health and rehabilitation services, even though simple initiatives are available to enable access. Our three week course aims to raise awareness about the importance of health and well-being of people with disabilities in the context of the global development agenda: Leaving no one behind.

What topics will you cover?

  • The magnitude of disability and relevance of disability to the global development agenda
  • Defining disability and how it can be understood and measured
  • The challenges to health and wellbeing amongst people with disabilities and why people with disabilities might have poorer health
  • Why people with disabilities may have difficulty in accessing health services
  • Links among longer term health conditions and disability
  • How to improve access to health care and rehabilitation for people with disabilities
  • Community based inclusive development for improving access to health and rehabilitation for people with disabilities
For more details, to check out the trailer or to register your free place on the course, click here

Source: Dorothy Boggs and Hannah Kuper of London School of Hygiene and Tropical Medicine via HIFA.

Saturday, February 10, 2018

Courage: One of the 6Cs - for Individual & Governments? [i]

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

Courage is perhaps one of the more challenging of the 6Cs for learners to grasp and even for experienced staff  to exercise. As a concept a definition is easy to find. Courage is often associated with whistleblowing. Over the decades whistleblowing has proved critical and vexed to both an individual's career and organizations.  Hodges' model encourages us to expand on this ...

The courage of seeking
diagnosis and prognosis
assumptions : misinformation : disinformation
["Dr Google", fake news, drugs online..?]
Disclosure or withholding information

||||||||||||||| LONG GRASS |||||||||||||||
Husbands, wives, partners, sons and daughters with many friends find courage every moment of everyday (and many nights) when caring for someone living with dementia and other chronic illnesses. Practitioners may need courage to challenge promises made by family members that - "A nursing home? Never!" But, is the patient still at the centre of concern in these cases? Care at home at any cost? This can be the 'record' that matters to families.

Governments of all hues and globally are vested with courage, but how they exercise this quality depends vitally on governance. This is same reason, constraint that operates on the individual. "Do I? Don't I?" becomes "Do we? Don't we?" But then that individual practitioner is (must be) supported (governed) by supervision and the deliberations of the multidisciplinary team.
What is the governments' record? Do governments have the courage to address the problems sustainable health and social care presents? Or, do they just kick the  problem...

Courage [ii]: One of the 6Cs - for Individual & Governments?

Thursday, February 08, 2018

Grid Corrections at a Crossroads

or Grid Care Corrections at a Crossroads?


My source:

Monday, February 05, 2018

BBC Radio 4: "The Truth About Hawaii" - AMR

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


Source: BBC Radio 4
Roderick (Paul), Christine (Lizzie) and Jocelyn (Sarah) in 'The Truth About Hawaii'

Sunday, February 04, 2018

Circle of Life - c/o Ben Lockett

Spiritual - Being
humanistic --------------------------------------- mechanistic

Credit: Ben Lockett

Credit and my source:
Ben Lockett/Fortitude Press: The Times, 6 January 2018, p.6. "Circle of life This image of a woman in the Staffordshire moorlands appearing to touch the North Star was created using a technique called star trail photography"

Saturday, February 03, 2018

c/o [hifa] WHO Webinar: Compassion - mapped to Hodges' model

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

sympathy, empathy, compassion
mental states, feelings, emotions
communication (verbal - non-verbal)
experience, sorrow, suffering
personal ethics, learning
reflection, self-compassion
psychometric instruments
mentor, role model
listening, non-judgemental
student idealism
 meditation, contemplation
(drug concordance)

Poor psycho-
methods and methodologies
measure compassion
Technical competence
diagnostic accuracy
studies - literature
(drug compliance)

health & compassion
as a 'science'
social support 

peer support - sharing
reflexive, desire to help
PRACTICE based research
Research on empathy > compassion
role models

better outcomes,
public demand
(for more compassionate)

health workers,
high workload
mission statements
Health Institutions
Regulatory organizations
Medical councils
harassment - poor team functioning

See also and c/o HIFA:
c/o [hifa] WHO Webinar: Compassion – the heart of quality people-centred health services

Friday, February 02, 2018

A Health Self-Portrait...

individual - self - patient - client - carer - person - resident - guest ...
 (you get the picture...?)
humanistic --------------------------------------- mechanistic

How easy is 
it to create 
a portrait of a 
patient's health?
How easy is
 it for a patient
to create a 
health self-portrait?