Hodges' Model: Welcome to the QUAD: May 2019

- 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

Thursday, May 30, 2019

[4-5 page...?] Book: "Homage to Humanity"

SELF - individual
humanistic ----------------------------------------------- mechanistic

You speak ...
I do not understand...
But that is a wonder...
I do see you...
 and the great happening
of the place and way you live ...
And, now I understand...


Homage to Humanity by Jimmy Nelson


My source: LUXX, The Times, p.39; book cover Blackwell's

Sunday, May 26, 2019

'Muchness' - Enabling nurses to be more person-centred within their workplace culture: participatory research

Friday, May 24, 2019

Dear McKinsey and Company, Re. "The era of exponential improvement in healthcare?"

Re. Your article:

The era of exponential improvement in healthcare?

(By Shubham Singhal and Stephanie Carlto)
Technology-driven innovation holds the potential to improve our understanding of patients, enable the delivery of more convenient, individualized care—and create $345 billion to $420 billion in value by 2025.

Healthcare advances have delivered great benefits to society, bringing material improvements in average life spans and quality of life.1 Yet these improvements have come at a cost—an ever-expanding portion of the US GDP is being consumed by healthcare expenses.2 Could technology, enabling delivery of healthcare advances while improving affordability, be part of the solution? We have reviewed the evidence, done the math, and identified technology-enabled use cases that could create between $350 billion and $410 billion in annual value by 2025 (out of the $5.34 trillion in healthcare spending projected for that year3 ).
Read more ...

But how would we recognise the era of exponential improvement in healthcare?

SELF - individual
humanistic ----------------------------------------------- mechanistic
The exponential benefits realised 'elsewhere' in global, local and glocal health and healthcare systems finally sees the achievement of parity of esteem with mental health not only fully funded, but designated as the key that must be turned 4 happiness. Despite the diametrical opposition of this domain to the political domain, there is a breakthrough in policy makers and the body politic prioritising "The Long Now"
"Predictions of an exponential increase in people living with dementia in the coming 30 years require evidence-based strategies for advancing dementia care and maximizing independent living. However, the evidence required to inform priorities for enabling improvements in dementia care is rarely presented in a way that stimulates and sustains political interests."  Martin, O’Connor, & Jackson (2018).

Community-based healthcare becomes
 the norm and the educational,
preventive and sustainable ethos for
health and healthcare systems
is adopted globally.
Look at the readiness and response-to potential epidemic crises, plus
 interventions in population health. 
Exponential benefits are accrued.
Evidence - look at the number of
 (new) hospital beds.
The community IS the market.

Exponential growth in global
healthcare funding, health information
for all, access to universal health care.
 Social Determinants of Health not
just a vision: but enacted and ongoing
Evidence - climate change slowing,
air quality improving -
the 21st Century truly begins ...

Martin, A., O’Connor, S., & Jackson, C. (2018). A scoping review of gaps and priorities in dementia care in Europe. Dementia. https://doi.org/10.1177/1471301218816250

My source:
email - McKinsey Insights

Thursday, May 23, 2019

New Special Issue from Global Public Health

From: Global Public Health
Sent: Monday, May 20, 2019 10:41 AM
Subject: New Special Issue from Global Public Health

Please join Global Public Health in celebrating the launch of our newest special issue:

This special issue considers the legacy of the Latin American Social Medicine and Collective Health (LASM-CH) movements and other key approaches—including human rights activism and popular opposition to neoliberal governance—that have each distinguished struggles for collective health in Latin America during the 20th and now into the 21st century.

At a time when global health worldwide has been pushed to adopt increasingly conservative agendas in the wake of global financial crisis, the rise of radical-right populist politics, and the rupture of liberal democratic regimes, attention to legacies of Latin America’s epistemological innovations and social movement action are especially warranted. Examining the nexus of activism, policy, and health equity, the collection advances understanding of health politics in the region and the lessons they offer.

This special issue includes four Free Access articles. We invite you to share the links to these articles (see below) and details about the special issue across your networks.

Richard Parker, Editor in Chief

Featuring 4 Free Access Papers

Social inequities and contemporary struggles for collective health in Latin America
Emily E. Vasquez, Amaya Perez-Brumer, and Richard G. Parker

Social Medicine and International Expert Networks in Latin America, 1930-1945
Eric Carter

Latin American social medicine across borders: South–South cooperation and the making of health solidarity
Anne-Emanuelle Birn & Carles Muntaner

Revisiting the social determinants of health agenda from the global South
Elis Borde & Mario Hernández

My source:
Spirit of 1848 Listserve. WWW.SPIRITOF1848.ORG

Sunday, May 19, 2019

Self-care - Care of other (Mother Earth)

'Maze Maker' by Michael Ayrton

1965, pencil and watercolour on paper 34.9 x25.4 cm

Negotiating the Healthcare Maze

SELF - individual
humanistic ----------------------------------------------- mechanistic

*Tate Etc. issue 44: Autumn 2018, p.84.

Image: Christie's

*Thanks to Tate Liverpool's Cafe for art magazines for reading...

Thursday, May 16, 2019

Kenyan-Korean ‘Solar Cow’ project wins CES Innovation Award c/o Africa Times

SELF - individual
humanistic ----------------------------------------------- mechanistic

Child's education

Child attends school OR work?

Access to power
Light, Phones

Social utility of electricity
Parental - family decision making: social 'nudge' ...
'Solar Cow' Project: Africa Times
Communities .. 

Parental power

School attendance

Collective financial motivation


Industry - Civil Partnership

 .. em-powered

Tuesday, May 14, 2019

Southern Sudan Medical Journal: May 2019 issue on Primary Health Care

Dear SSMJ Reader,
The special May 2019 issue on Primary Health Care is now online here and includes items on support for PHC in refugee camps, approaches and strategies for PHC, charging for health care, literacy and health, community screening for diabetic retinopathy, vaccination coverage and CHWs treating malnutrition.  See details below.

Send us your feedback, your manuscripts (which we can help you prepare), encourage colleagues to join the mailing list here, follow us on twitter: @SSMedJournal and our Facebook Group, and find previous SSMJ articles at African Journals Online (AJOL) and the Directory of Open Access Journals (DOAJ).
The SSMJ Editorial team
admin AT southernsudanmedicaljournal.com.

In the May 2019 issue:

  • Forty years of primary health care programming and its future in South Sudan Dr Ayat Jervase 
  • Using livelihoods to support primary health care for South Sudanese refugees in Kiryandongo, Uganda Dominic Odwa Atari and Kevin McKague 
  • Integrated Primary Health Care (iPHC) for developing countries: a practical approach in South Sudan Victor Vuni Joseph and Eluzai Hakim 
  • Addressing high vaccination coverage in primary health care setting: challenges and best practices Bobby Paul and Indranil Saha 
  • Preventing blindness from diabetic retinopathy through community screening Wani G Mena 
  • UK-South Sudan Alliance: a strategy for increasing capacity and access to primary care and public health Rich Bregazzi 
  • What is the best way for healthcare systems to charge sick patients? Alfred Lumala, Lucien Wasingya-Kasereka, Martin Opio, Jenard Ntacyo, Samuel Mugisha, John Kellett 
  • How can we bridge the gap between literacy and health in South Sudan? China Mayol Kuot 
  • The Evidence for Contraceptive Options and HIV Outcomes (ECHO)
  • Performance of low-literate community health workers treating severe acute malnutrition in South Sudan Elburg Van Boetzelaer, Annie Zhou, Casie Tesfai, and Naoko Kozuki 
  • Martha Primary Health Care Centre: how resilience and international collaboration is transforming a community Poppy Spens 
  • Point Of Care Ultrasound (POCUS) is saving lives Achai Bulabek 
  • Juba College of Nursing and Midwifery milestones in 2018 Anna Modong Alex 
  • Obituary: Dr Joy Theophilus and Dr Emmanuel Kenyi
  • What South Sudan must do to reduce high maternal and infant deaths? Janet Mugo and Munawwar Said 
  • The Ten Steps to Successful Breastfeeding WHO
We thank all the authors, reviewers and editors who helped to produce this special issue.

Sunday, May 12, 2019

Forgotten in a Crisis: Addressing dementia in humanitarian response

SELF - individual
humanistic ----------------------------------------------- mechanistic

Difficulty in Understanding

Natural Disasters
War Crimes
Refugee Crises

Difficulty in being Understood

Forgotten in a Crisis: Report

ADI, GADAA and Alzheimer's Pakistan launch report on Dementia in Humanitarian Settings

My source: Several - inc Channel 4 News 12 May 2019.

Thursday, May 09, 2019

8 Dimensions of Wellness: c/o SAMHSA

The following image the 8 dimensions of wellness was gleaned from the tweet also copied below (media removed). To illustrate the potential scope and application of Hodges' model I have mapped these dimensions to Hodges' model:

8 dimensions of wellness SAMHSA

SELF - individual
humanistic ----------------------------------------------- mechanistic








I would place 'Spiritual' outside of the model. This is not an afterthought. The dimensions that are placed within a care (knowledge) domain, this is not to say that there is no overlap. There very clearly is.

As for the 'spiritual' it is outside the 'concrete' structure of the model for the following reasons:

Being outside the basic form of Hodges' model speaks to the universal, subjective-objective, existential, timeless and ethereal qualities that are allied with the 'spiritual'.

SCIENCES: Can the spiritual be proven by science? How often do we experience the spiritual in nature? (I don't know about you but put under the stars and I become a philosopher.) Is the Earth 'alive' in a sense, as in Gaia? Do we imbue Nature with its real value? Being outdoors, in the green literally is currently being emphasised as essential for our mental health.

SOCIAL: Our respective upbringing, culture and social background greatly influences how we individually make sense of the 'spiritual'. Religious beliefs and practices are central to social activities, communities and ethnic groups. As an example of the aforementioned overlap, our social attitudes to ourselves, others with different beliefs are shaped by our social environment.

Central to Hodges' model are the life experiences - within which you will find the health career* - that are shaped by this domain.
INTRA- INTERPERSONAL: What we believe and our motivations are grounded in a person's intellect and emotional state. In this sense an individual can be vulnerable, but an individual's receptiveness to belief and learning can also provide opportunity for recovery as in SAMHSA's

POLITICAL: Whether or not they cite religious doctrine, there are many speeches by true, as in, inspirational, peace-loving, humanistic, environmental rights-led leaders that are experienced in a spiritual manner. It is in this domain that power is exercised and with this the right and freedom to find and practice individual spiritual meaning.
A final thought regards the Spiritual and Hodges' model is that the above also represents the many uncertainties, the incredible mystery and gift of life.

*Hodges' Health Career - Care Domains - Model

My source with thanks:

Wednesday, May 08, 2019

AffecTech Workshop: Lancaster Tuesday May 14th 2019, 9-1pm

Presented by Lancaster University

Help shape the future of innovative technologies for mental health

We hope you will join us as a guest of Lancaster University, for a special workshop and networking opportunity exploring interactive mental health technologies being developed here in Lancaster. This is a first of a kind opportunity for professionals and public to engage with new prototypes being developed as part of the AffecTech network – a major international research project developing personal technologies for affective health.

Where: Reading and Writing Room, Storey Arts Centre, in Lancaster City Centre
(Next to Lancaster Railway Station)

When: Tuesday May 14th 2019, 9.00 am to 13.30 pm

Why: Learn about personal technologies for affective health, and help shape a major initiative dedicated to delivering self-help technologies to help sufferers of affective health conditions such as depression, anxiety and bipolar disorder.

More information and registration (free). 

[Hope to see you there!]

Tuesday, May 07, 2019

The Fourth Quadrant - Johnson (2010)

For anyone who has read Steven Johnson's Where Good Ideas Come From, you might appreciate that for me it was a case of take-two from the previous post 'The adjacent possible'. How could I not include the chapter "The Fourth Quadrant" especially as the book's 'Conclusion'?

If title was one take, the other was "Oh! How does this relate to h2cm?" After reading and reflecting things fell into place. Johnson wants to represent the history of innovation (no less) using roughly two hundred of the most important innovations and scientific breakthroughs from the past six hundred years, starting with Gutenberg's press, Einstein's theory of relativity, the invention of air conditioning through to the birth of world wide web (pp.218-219).

There are three figures in the chapter spanning 1400-1600; 1600-1800; 1800-present. Johnson's diagram for 1800-present (p.229) is in-part 'mapped' to Hodges' model below.

A few insights into my reasoning. In the Interpersonal domain I am emphasising an individual's primary (and original) motivation for their work and what follows. In the sciences - here PROCESSES are central. As with all models this is an idealisation, so there is a lot of overlap.

humanistic / non-market ------------------------------- mechanistic / market

3. Non-Market/Individual

Not devised for fiscal gain, individually devised .. amateur scientist, or hobbyist.

Spectroscope           Hormones
Bunsen Burner             E - mc2
Rechargable Battery      Special Relativity
Nitroglycerine        Earth's Core
Cell Nucleus          World Wide Web
Stethescope         CT Scan

1. Market/Individual

Devised for fiscal gain, individually devised i.e. Air Conditioner

Mason Jar
Tesla Coil
Gatling Gun
Vulcanized Rubber

Programmable Computer

4. Non-Market/Network

Not devised for fiscal gain, collectively devised.
Open source envirnoment or academia.

Braille      Periodic Table     RNA Splicing
Chloroform        EKG    Aspirin
Cell Division    Global Warming
Benzene Structure        Continental Drift
Hereditary       Superconductors

2. Market/Network

Devised for fiscal gain, collectively devised, multiple firms interact

Airplane    Lightbulb    Steel   Automobile
Induction Motor      Radio 

Contact Lenses    Welding Machine
Moving Assembly Line   Motion Picture Camera
Locomotive     Vacuum Cleaner
Electric Motor     Washing machine
Refrigerator      Vacuum Tube
Telegraph      Helicopter

Johnson, Steven (2010) Where Good Ideas Come From, London: Allen Lane.

Monday, May 06, 2019

The adjacent possible

"The adjacent possible is a kind of shadow future, hovering on the edges of the present state of things, a map of all the ways in which the present can reinvent itself." p.31.

SELF - individual
humanistic ----------------------------------------------- mechanistic

"The strange and beautiful truth about the adjacent possible is that its boundaries grow as you explore those boundaries. Each new combination ushers new combinations into the adjacent possible. Think of it as a house that magically expands with each door you open. You begin in a room with four doors, each leading to a new room that you haven't visited yet. Those four rooms are the adjacent possible. But once you open one of those doors and stroll into that room, three new doors appear, each leading to a brand-new room that you couldn't have reached from your original starting point. Keep opening the doors and eventually you'll have built a palace." p.31.

Johnson, Steven (2010) Where Good Ideas Come From, London: Allen Lane.

Sunday, May 05, 2019

Innovations: From Myths To Reality (Revisiting - Berkun, 2007)

Even though Brexit may have normalised hoarding, temporarily(?) at an economic level, I've been sorting some books to 'go' because of  'new' arrivals. Here then are some further reflections on Hodges' model as an innovation in response to Scott Berkun's 2007 title. As you can see there are many overlaps between Berkun's myths of innovation, which in the book are each given a chapter:

Myth #1: The Myth of the Epiphany

The creation of Hodges' model by Brian Hodges in the mid-1980s might be likened to an epiphany of sorts. I didn't ask that particular question when we met in 1998. It was however, more accurately a solution to the forthcoming challenge of Project 2000 and the revolution in the nurse education from schools of nursing to university based, undergraduate courses of study.

This educational, theory and practice-based focus is evident in the four purposes for the model's creation:
  1. Person-centred - holistic care;
  2. To bridge the theory - practice gap;
  3. To facilitate reflection and reflective practice;
  4. To support curriculum development.
If we are talking 'myths' too, how many of these issues were at the model's creation in the mid-1980s what we would term legacy issues now?

Myth #2: We Understand the History of Innovation

If the rise of ideas and the existence of 'fads' suggests that innovations wax and wane - falling out of fashion then - yes. There is a history. I'm assuming that the emphasis on models and theory development in nursing is past its 'golden age'? Whether we understand innovation in the healthcare, medicine, nursing, other disciplines is another question; especially socio-technically. I will return to this at #4.

Myth #3: There is a Method For Innovation

In healthcare there is a method: it is, the method (and methodology of) research that provides evidence for practice and hopefully policy.

(There's brainstorming too of course - for which h2cm is the gift.)

Myth #4: People Love New Ideas

New starters and students in many lines of work are usually made aware of their potential and status (wanted or not) as 'change agents'. Student nurses should be torch-bearers of new ideas that are evidence-based. Whatever our age as lifelong learners we should always be open to new ideas, especially with the advantages that experience brings to the work and testbench of ideas. Constructive criticism should help - by definition - to construct.

So often though, there is marked resistance to ideas whatever 'age' they are. The ongoing mantras are "We've always done it this way!"; or "This is quicker! Tried and tested!" ...

For the past decade (at least) the UK economy has been plagued by a productivity crunch. This is also affecting health care. Myths 1-4 can also be considered under the heading of 'progress'. How much do we understand 'progress'? An examination must reveal productivity and innovation as fundamental elements.

Myth #5: The Lone Inventor

As I may have mentioned before when we were taught Hodges' model (1987-1988 Manchester Polytechnical College - MMU) as students and informed that we must apply h2cm in a marked case study/assignment there were some mutterings. Students often contribute to the development and testing of countless theories and models.

Brian did not publish much on the model beyond a book chapter. In this sense there is a lone inventor and a lone champion drawing an immense number of additional sources (here since 2006 for example).

Myth #6: Good Ideas Are Hard to Find

Ideas are not hard to find. For Hodges' model this is quite ironic. Ironic because, of course, the model provides a net to help 'capture' not just good ideas - but a brainstorm full of them.

There's something even more important though:

Hodges' model can help us find ideas not as 'good' or 'bad' in the first instance, but to test the ideas across contexts to see how an idea might perform. Only then is an idea 'good' and suitable for purpose (see #9).

Myth #7: Your Boss Knows More About Innovation Than You

The defences of ritualised practice and accepted (ideas) practice are well established ...
  • Not invented here!
  • Not created - owned by me!
  • Who is Hodges?
Social media constantly espouses on 'true' leadership and how power is exercised and distributed (if at all), but for many leaders power is a factor and the pedigree of the ideas and strategies that are deployed is a political football.

Myth #8: The Best Ideas Win

The videotape recording standards is a regular lesson here. The best ideas often do not win.

Sometimes building something is not enough ... or is it?

Whatever the 'truth' here - I still believe there is a great resource in this model.

Is h2cm a compound instrument?
Is h2cm an implicit holistic theory?
Is h2cm a series of conceptual spaces?
Is h2cm all of these ... ?

I also believe the challenge of individual and population health has a long-tail as a legacy problem.

Whether h2cm 'wins' or not - its relevance for the problems and solutions of the 21st and 22nd centuries grows each day ...

Myth #9: Problems and Solutions

Management and organisational gurus often extol the virtue of 360 degree vision. Hodges' model can encourage this as there are several dimensions and dichotomies 'embedded' within. Of particular note in myth 9 is objective versus subjective qualities - and what counts as good or bad (to follow).

A key in healthcare is that 'the' problem is not ours.

It is 'ours' - if factors impose upon clinical decision making are a distraction 
- such as economics.

Identifying what the problem is - requires that we validate and integrate several sources of information: the referrer, the person - patient/client with the problem and what can be observed and investigated.

In healthcare again there is a need for co-production and Hodges' model can play a role in this. Sometimes the 'solution' may not be what is expected when a patient's choices are taken into account.  Hodges' model can work to the patient's strengths and the situation. The model can be used explicitly or implicitly to help assure the working out of the problems and the solution. A by-product of this is that we are prompted in consequence to ask questions and act on an individual's health and other literacies. What becomes evident given the challenges of productivity, demographics, public engagement is a gap in our understanding were co-production is concerned.

Myth #10: Innovation is Always Good

Berkun highlights how some innovations are not always good. H2cm may be challenging in terms of fears of 'runaway' reflection or navel-gazing. Could h2cm lend itself to a mechanistic response to problems. Is that a robot I can hear?

Could h2cm be a gift to those who wish to deskill the health and social workforce?

From models of care and theories of nursing to checklist A, B, C & D?

Use of the model on paper is one thing, but what of e-based forms of application? How can we assure accessibility to the model? Can we make an e-reflective workbench a reality for our students?

As noted in #9 the need for research to innovate in co-production, collaborative, person-centred care within developed and developing health care systems remains marked.

Scott Berkun (2007) The Myths of Innovation, CA: O'Reilly.

Friday, May 03, 2019

12th Networked Learning Conference 2020 18-20th May - Denmark

18-20th May, 2020 in Kolding, Denmark

A research-based conference on networked learning in higher education, lifelong learning & professional development

The 2020 conference is the twelfth international networked learning conference.

Since 1998 the biennial Networked Learning Conference has been an opportunity to participate in a forum for the critical examination and analysis of research in networked learning – particularly in Higher Education and lifelong learning. Networked learning has become a broader area of inquiry over the years bringing together research in education and organisations spanning formal and informal learning settings. It is a conference that has been particularly concerned with critical perspectives, theory, pedagogical values, analysis, practice based research and designs for learning. The focus of the conference has been research and practice that addresses relational and interactional aspects of learning and development with an emphasis on dialogical learning, collaborative and cooperative learning and learning in social networks.

The conference will be held at on the 18th, 19th and 20th May, 2020, at University of Southern Denmark in Kolding, and the local organisers are all from the University of Southern Denmark.


[ I greatly enjoyed attending in 2016 at Lancaster, UK. ]