Hodges' Model: Welcome to the QUAD: October 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, October 31, 2019

Lucian identity ii

HUMANISTIC ----------------------------------------------- MECHANISTIC

Lucian Freud, Interior with Hand Mirror (Self-Portrait), 1967.
Oil on canvas. 25.5 x 17.8 cm. Private collection.
© The Lucian Freud Archive / Bridgeman Images.


See also:

Post: Lucian identity i

Lucian Freud Archive

Royal Academy Lucian Freud: The Self-portraits

My source:
Campbell-Johnston, R. The secrets that still lie in the paint-strewn lair of Lucian Freud, The Times, Saturday Review, October 19 2019, pp.4-5.

Lucian identity i

HUMANISTIC ----------------------------------------------- MECHANISTIC
Lucian Freud, Self Portrait, c.1956 (oil on canvas)


peer (painting)

peer supervision

"... [Lucian Freud's] most precious works are perhaps his unfinished portraits. ... The two painters [Francis Bacon] often used each other as models preferring to depict each other’s psychological states rather than physical. ...

Then there is the unfinished self-portrait from around 1956. (Image #4 in the slideshow) These paintings should be looked at as precious gifts that offer an unprecedented access to Freud’s very personal process. Notice how his loose pencil marks, more like broad guidelines for the final portrait gain volume and become imbued with emotion at the hand of the master. You can see that Freud started each portrait with the most expressive feature of the human face – the eyes, and moved radially outwards from there."
 With my emphasis and image source:
See also:

Lucian Freud Archive

Royal Academy Lucian Freud: The Self-portraits

My source:
Campbell-Johnston, R. The secrets that still lie in the paint-strewn lair of Lucian Freud, The Times, Saturday Review, October 19 2019, pp.4-5.

Wednesday, October 30, 2019

The Rosamund Snow Scholarship for Patient-Led Research

HUMANISTIC ----------------------------------------------- MECHANISTIC
(real) Subjective?


Patient / Carer's experience

(real) Qualitative?
Subjective ------ Research ------ Objective

Disciplinary - Professional
 language and jargon


Qualitative ------ Research ------- Quantitative
Snow, PhD

"The Sociology of health and illness"

Patient-Led Research

Co-Production of Research

'What happens when patients know more than their doctor?'

Medical sociology

Unequal power dynamics
of the
clinical consultation

The politics of self-management

Challenges of advocacy



The Rosamund Snow Scholarship for Patient-Led Research
"Rosamund Snow, who died in February 2017, had type 1 diabetes. After completing a Master’s degree in Social Sciences at King’s College London, she went on to study for a PhD in the patient experience of diabetes. She became a respected academic at the University of Oxford, undertaking research and teaching medical students about the importance of the patient perspective. She believed passionately in patients working alongside clinicians to produce research and teaching that is informed by the (often under-valued) expertise in what it is like to live with an illness. She used her own expertise from experience to question and challenge norms of medical practice, always striving to improve patient care. After her death, Rosamund’s family generously donated funding to Green Templeton College at the University of Oxford, to allow others to be trained to continue the work she started." [ Source: #RSSPLR ]

My source: with thanks @trishagreenhalgh

Tuesday, October 29, 2019

Future - History: Information Systems or Care Records

Brian Warboys Professor of Software Engineering at Manchester University has stated that clinical staff lack the skills to make working information systems should leave it to IT professionals. A consultant physician and cardiologist at Bloomsbury and Islington agreed, the HSJ quote as saying:
"The fault lies not with the IT experts but with ourselves as clinicians. If we do not tell them what we want, how can they come up with the answers? ... There is a case for evaluating every IT solution available now and scrapping some of them". p.8.
Health Service Journal, 101:5259, 4 July, 1991.

'Coroners have warned the NHS on dozens of occasions that its record-keeping is so poor that patient's lives are at risk, an investigation by The Times has found. ...
Coroners have issued 62 warnings since 2013 in which they identified failings in record-keeping that could lead to the deaths of other patients.' ...
 'Simon Eccles, of NHSX, which is responsible for improving digitalisation, said that all of England should be covered by digital records by 2024 so staff could access the information needed to provide patients with the best possible care.'
Greenwood, G. Lost notes and illegible records 'risking lives of NHS patients'. The Times, October 2. 2019. p.16.

Sunday, October 27, 2019

"Broach Schizophrene" by Bryan Charnley

HUMANISTIC ----------------------------------------------- MECHANISTIC

Bryan Charnley (1949 – 1991)

Broach Schizophrene: Oil on Canvas, 1983. In the collection of the Bethlem Museum of the Mind

- on Bethlem Museum of the Mind Blog

Previous post:
Book: The Heartland - Finding and Losing Schizophrenia

My source:
Cathy Rentzenbrink, A battleground inside your head, The Times, Saturday Review. 25 May 2019, p.15.

Friday, October 25, 2019

Liminality in "How ancient rituals help us adapt to the digital age" c/o G. Tett

How ancient rituals help us adapt to the digital age

Ceremonies and symbols matter more than ever in a disorienting world

Context: "This week I made a pilgrimage to the east coast of Scotland to participate in that classic ritual of modern middle-class life: a university graduation".
"However, heritage marketing is not the only factor, given that such rituals also occur in places that do not have 600 years of history behind them. Another way to frame the issue is to ponder a concept first developed by the ethnographer and folklorist Arnold van Gennep, and later elaborated by the anthropologist Victor Turner and the psychologist Carl Jung – “liminality”.

This word comes from the Latin limen – doorway or threshold – and refers to the idea that whenever societies or people make a transition, they typically use rituals and symbols to mark this. 

These usually contain three parts: a ritual to show the end of the old life; a ritual to mark the entry into the new one; and a “liminal” stage between the two, when the transformation occurs. Moreover, in that liminal state the normal rules of life tend to break down. Liminality is the cultural equivalent of the pupation that insects undergo: patterns become untethered and fluid, to be remoulded".

Tett, Gillian. 2019, How ancient rituals help us adapt to the digital age. FT Weekend, Magazine, June 29-30, p.46.

Thursday, October 24, 2019

Birth and Bubbles - Holistic Spaces

HUMANISTIC ----------------------------------------------- MECHANISTIC
health services - organisations

... "To the holistic absorption by the One – upon which the success of so many religions and philosophies was premised for centuries – Sloterdijk opposes the proposition of a dyadic theory of intimacy. This is a distinction between an acute appearance of unity, experienced from a cosmic position of being fully contained inside a whole, and an ontological insistence that this position is itself contingent on a constitutive relationality".

"Sloterdijk dedicates the bulk of Bubbles to birth, providing a detailed discussion of intrauterine dwelling, including the sensory presence of liquids, soft bodies, the early experience of spatial boundaries, fluidal communion in the medium of blood, the constitution of an intimate acoustic bipolar sphere and, above all, cohabitation with the placenta, conceived as primal, anonymous companion. Intrauterine space is approached as the most vivid illustration of the spherological principle according to which coexistence precedes essence. At once enclosed and porous, poetic and connected, intrauterine space is the production of a dense and connected ‘two’: ‘What we call ‘mother and child’ in the abbreviated terms of subject-object language are, in their mode of being, only ever poles of a dynamic in-between’ (Bubbles, p320)". ... p.47.

Duclos, V. (2019). Falling into things: Peter Sloterdijk, ontological anthropology in the monstrous. new formations: a journal of culture/theory/politics 95, 37-53. https://www.muse.jhu.edu/article/715818.

Wednesday, October 23, 2019

Commentary: Global health journals need to address equity, diversity and inclusion c/o BMJ Global Health

HICs: high-income countries
LMICs: low-income and middle-income countries

humanistic ----------------------------------------------- mechanistic
group - population

Individual experience




Task - EDITING - Process


 global south




Community of Practice

Collective Values


LMIC - expertise HIC

Figure 1
Global health editors and editorial board members according to location, gender and group. Group 1 included editors-in-chief, or those in leadership roles; group 2 included senior, deputy or associate editors; and group 3 included editorial board or advisory board members. HICs, high-income countries; LMICs, low-income and middle-income countries.

Nafade V, Sen P, Pai M. Global health journals need to address equity, diversity and inclusion. BMJ Global Health 2019;4:e002018

Tuesday, October 22, 2019

"2020" A Musical (and Global?) Vision c/o Richard Dawson

humanistic ----------------------------------------------- mechanistic
group - population

2020: Richard Dawson
anxiety, mood
mental health

23 June 2016
data = 'evidence'*


Votes %
Leave 17,410,74251.89%
Remain 16,141,241 48.11%
Valid votes 33,551,983 99.92%
Invalid or blank votes 25,359 0.08%
Total votes 33,577,342 100.00%
Registered voters/turnout 46,500,001 72.21%



(Let's call it -) PREPARATION ?

folks- MUSIC -onomy

"permanent sickie"
Civil Service / Servant

In using Hodges' model in clinical, educational and many other contexts (informatics a prime example) I have associated 4P's, one with each care, or knowledge domain of the model:

SCIENCES - process
SOCIOLOGY - practice
POLITICAL - policy


*I've no axe-to-grind, but am all too aware of the primacy of 'data' and evidence.

Wikipedia: Brexit referendum

Monday, October 21, 2019

An update papers, Hodges' model, website...

Here is an update on writing projects ...


A few months ago I decided to cancel the web hosting. The same provider and for the second time. Lack of progress is nothing to do with them. Despite best intentions, the account was essentially redundant, apart from one occasion when I was ready to start transfer of a site including Brian Hodges' lecture notes, as part of what would be an archive. I still have the pages - HTML all ready to 'go' - somewhere... The host company were very good, offering to take me through the process. I will git back on the horse. The journey is still very enjoyable, even if frustrating.

Last weekend at the Northwest (England) Drupal User Group - NWDUG Unconference in Manchester, I gave an eleven slide presentation on the ultimate in vapour ware. Even with no site the day was very useful, the community great. At month end I will be following online DrupalCon Amsterdam. Really disappointed not to be there, but the currency situation nails it, on top of my not having earned the trip.

As posted last Tuesday -

Book: "The Empty Space"

- I've been crossing the Pennines and enjoyed visits to see Mr Hodges at his home. It would be marvellous to get to a point were I can 'demonstrate' some progress on the web front. The Drupal community continue to try to improve the migration and update processes. This can certainly help me. A Drupal developer questioned me a while ago if I'm being too loyal. Is Drupal the right tool? I am considering this ...


As to papers I'm determined to try to clear the desks of draft papers. I'm not duty-bound to write, just learning-bound. In May a journal editor invited me to write about Hodges' model. The brief was more specific, write about the model but not in general terms. I was directed to relate the model to at least two public health themes.*

Trying to put a map on the map is challenging.
Everyone wants data, evidence, findings, method ...

Last month I arrived at a final draft and am now advised to answer my own queries and then submit. So sounds positive thus far. I really will diligently check the submission requirements.

The other paper is a bit of a saga, having started before the Part 1 - MRES studies at Lancaster in 2014. The paper overall concerns Hodges' model, threshold concepts and deprivation of liberty safeguarding. It is now in two-parts, feedback on part one has been favourable but still seeking people with time to read and critique- so hopefully on-track with this too.

*Public mental health is always also implied as far as I am concerned.

Saturday, October 19, 2019

Review: v "Climate Change and the People's Health"

Climate Change and the People's Health
At just over 30 pages chapter 3 the last is also the shortest, we all hope this does not reflect the length of the future?

Chapter 3. Challenges and Future Prospects

Before beginning to review Chapter 3 I need to revisit the closing sentences of the preceding chapter's conclusion - if you 'get' Hodges' model you will understand why:
"I [Friel] pick up on these ideas of complexity in chapter 3, arguing that how we understand and characterize these phenomena depends on our standpoint and also evolves as knowledge develops and available evidence accumulates. Given those complexities, responding to climate change and health inequity requires the development of policies that transcend doctrinal boundaries and draw on insights from a range of disciplines, including those in the sciences, social sciences, and humanities". p.112.
I hope you can see and will please excuse my reference to Hodges' model, but I've another.

Friel refers to how research is primarily based upon reductive pathologizing and needs to shift [ ;-) ] "towards research that is attentive to, and actively engaged with, policymaking processes". (p.114).

In Hodges' model, the Sciences and Politics are mechanistic, the sciences invariably (with some exceptions) reductive and the 4Ps I have attributed to the model as follows:
  3. SOCIOLOGY - Practice
(As in a previous part of this review I have been wondering how policy can (best) permeate the other care (knowledge) domains?)

Being where this review is posted I would be remiss not to state this, picking up on Friel's thought.

OK, let us get back on track. Taking the lead from chapter 2, in Chapter 3 Friel argues the need to take research, advocacy, and policy forward to address environmental degradation, social justice and health equity by breaking down the disciplinary, sectoral and various silos that exist in the many systems that are encountered. Systems research can increase our understanding and the evidence base. Interesting to note also then solutions can be crafted. (p.113). The evidence base on more equal societies is discussed. With the stress on systems research, systems and systems thinking are explained briefly and referenced. As will already be obvious I am all for the plurality of disciplinary approaches that is needed, but as Friel will conclude this, with systems science, and improved understanding of policy processes (hybridised: is this the Green Marshall Plan that is referred to?) to counter the resistance to change that is already being experienced now (p.115).

Perhaps above, I have fallen into Friel's trap. I have been caught out as a model monger (p.115)?

Scale is a concurrent consideration in Hodges' model, as with Friel's account of systems thinking. To macro- meso- and micro-levels let us add nano, there is much still unclear from the presence of plastics and other pollutants in the environment. The arrival of eco-epidemiology is to be applauded (p.116).

Any mention of 'systems' takes me to the Health System Redesign book I reviewed over a year ago on W2tQ. This is a very useful companion to "Climate Change ..." but is not referenced here. Box 3.1 'Systems Approach to Childhood Obesity Prevention' brought home the connection and the visual representation referred to (p.120). I could readily go off again with Friel's section on Politics, Policies, and Processes (p.122). Thank goodness for this - I feel better now - as Friel "shamelessly plugs" personal involvement with a research program at the CRE (p.124). The Centre for Research Excellence in the Social Determinants of Health Equity needs to be, not just on the 'map' (Sciences - located geographically) but affecting policies, practices and purposes (individual and organisational). Friel provides several references - very useful and timely. I will reference this, as I'll explain next time. Again the much needed call for a move from reductionist pathologizing.

Box 3.3 Policy Principles for the World We Want is simplistic (like Hodges' model), but if delivered would be very impactful in terms of the positive change (p.128) that would ensue. Against p.134 my note is "It's a small world!" I'm not sure if this a reference to the Disney song as a perverse consumptagenic global eco-anthem, or to Schumacher? What could be noted (p.134) is the potential role of blockchain in assuring land tenure and ownership. This technology is much vaunted in health, education and the obvious application of economics. In terms of developing nations protection of land rights is critical (even as I write and you read). The chapter closes on policy from "The first 1000 days of Life" to "Health in All Policies" which I reflected upon as "Policies in All the (#h2cm) Domains"? How do we do this? There are avenues as Friel writes of macroeconomics and progressive policy development. There is much on the Social Development Goals and how cities (despite the critique on urbanization) are working together internationally to mitigate climate change effects, even as some governments fail to meet set objectives and global agreements.

The print and layout is excellent, a content listing of sections complements the index (invaluable). The next book I've to review has no index.

Small book, big ideas - correct on both counts and a very informative if rightly troubling read.
One last plea. Do buy this book, but don't leave it on your shelf; read it. There is no excuse, it's small, but your ideas on climate change and the people's health will grow!

I would like to thank OUP

CHAD ZIMMERMAN  Senior Editor, Medicine and Public Health
Oxford University Press │ 198 Madison Avenue │ New York, NY

and Prof. Nancy Krieger for the review copy and Prof. Sharon Friel for engagement on twitter and RTs.

While I appreciate I make the request to review and this places absolutely no obligation on others, it helps a lot when a publisher / author / conference organiser ... acknowledges the effort - even just a thank you. As ever, the thanks is in the learning gained, not the thanks lost. Many do - lift a hand, nod their head ... of course, making this even more worthwhile here. TY

Chapter 1. Climate Change, Global Justice, and Health Inequities

Chapter 2. It's a Consumptagenic World: Producing Climate Change, Exacerbating Health Inequities

Friel, S. (2019) Climate Change and the People's Health, Oxford University Press, New York

Friday, October 18, 2019

Review: iv "Climate Change and the People's Health"

Climate Change and the People's Health
Whatever your educational philosophy when a book offers new concepts that is welcome learning. Learning enhanced when the concept, as is often the case, is a hybrid of terms.

Chapter 2 It's a Consumptagenic World looks at the veritable production of climate change. Our dependence on fossil fuels not just for our transport, but the transport of food and agricultural products is explored. Perhaps there is a political irony in the former slogan of education, education, education amid relentless growth, growth, growth. At least now there is a constant message regards there being "No Planet 'B'".

If chapter 1 considered food security, this chapter attends to the industrial food system. Once again the themes are first introduced and related back. Very interesting here is the rise of urbanisation and the drivers for this. In chapter 1 I noticed the word shift. Nurses are one occupational group that recognise this word only too well. Here though it is the shifts in population that is very worrying. Especially so when many people may be putting themselves in harm's way as chapter 1 described. It is encouraging to see references going back to the 1940s. There is an evidence trail.

Current economic systems seems to reward monopolies and creates externalities (p.60). Unfortunately there is a lack of evidence in the production of pollution if remediation is to be sought. The emission of greenhouse gases where products are produced may be remote from where they are consumed. Friel argues for accountability at the origin of products not where they are consumed. Such externalities are 'out of the box' and need to be put back in the box and properly accounted for - (ecological governance). Often industrial concerns also follow the cheapest ('best value?') labour markets, relocating when needed.

Friel really annoyed me. Yes, in a positive way. Figure 2.2 compares a range of consumer goods and how their cost has changed over time; food, housing, health care, versus technology, media goods for example (p.68). The need for sustainable health care services is a constant topic it seems (Centres of research, journal special issues, conferences, twitter chats...), but when the essentials of living are so expensive does this not undermine and load - displace the disparity - the inequity no-less on to the health sector, its workforce and funding? It is as if the scientific-economic-industrial complex is saying to the health care (and social care) sector "Carry This!". There is no choice. It is a consequence of the society in which the bulk of us live. As Friel writes, processed foods lend themselves to concentrated control of supply chains which can introduce pricing volatility (p.78). The price of good quality nutritional food is a health inequality (p.76); figure 2.3  (p.77) illustrates the system.

While reading I thought of how amid the emotional, social and economic ravages of dementia we talk (well some of us ...) of organisational memory, while having forgotten what 'local' means. The rise of glocalism and the pursuit of growth - at any price it seems - in some quarters even prompts a re-evaluation of philanthropy in the 21st relative to the 19th and 20th? I found myself wondering how we would recognise a shift (the shift) in the market's thinking when watching the business TV channels CNBC, Bloomberg and similar ilk? The consumptagenic system has an effect on organisational memory, it is a behaviour known as perseveration; repetition of the word: profit. For all the thoughts provoked in me, this book is not a capitalism bashing exercise. Far from it, it deals objectively with what remains a sad and dangerous reality.

If it were not for the realist and critical perspectives that must also be present, the efforts of technologists, policy makers and researchers (urban informatics) and others to create Smart cities would seem to guarantee success. The discussion on cities (pp. 93-112), their sustainability, projected populations and the health inequities arising from them is very illuminating. In a teaching situation there is a lot to engage students, not just in the 'city' but in the text overall.

Chapter 1. Climate Change, Global Justice, and Health Inequities

Chapter 3. Challenges and Future Prospects

Friel, S. (2019) Climate Change and the People's Health, Oxford University Press, New York

Thursday, October 17, 2019

Review: iii "Climate Change and the People's Health"

So to the book proper ...

When a book's Forward has 19 references you are primed for many more. The Introduction reinforces this expectation and also defines concepts, specifically health inequality and health inequity. I'm also bound to be drawn-in by a text that:

"... calls for interdisciplinary responses that employ knowledge and analytical tools from across the sciences, social sciences, and even the humanities". p.xxii.
That 'even' is priceless, in terms of the relationship between social sciences and the humanities and the prospective role (that is already being applied?) they will play in solutions, vis-à-vis the communication of climate change and public (mental) health themes using the arts, media, creativity, history and communities.

The Introduction provides a brief primer on global action on the Social Determinants of Health [SDoH] and climate change. A critique of key policies, programmes and reports is provided leading to the arrival of the Sustainable Development Goals. The politics of the above is discussed, with shortcomings and avenues of progress noted. The three chapters to follow are described and as befits a 'small' book we are informed of what the book does not address. The book's focus is climate change. For a text on population growth and transition to alternate energy sources readers should look elsewhere.

Chapter 1. Climate Change, Global Justice, and Health Inequities

The book uses 'Boxes' asides to elaborate on certain points, e.g. Box 1.1 The Earth System. There are tables and figures too. Many make for troubled 'reading' and not for reasons of size or legibility. The text is dense in terms of the information delivered, but that is to be expected. This is serious stuff. "Climate Change - (really) Is a Global Justice Issue" p.16.

While in the open source and open access movements we celebrate the Commons, Friel points to the way that climate change has the characteristics of a "global commons" problem. p.16. Politics permeates the book as noted in post ii.

humanistic ----------------------------------------------- MECHANISTIC
group - population

"Together, the least-developed and developing economies contributed, since the mid-eighteenth century, less than 25% of global cumulative CO2 emissions (Lykkeboe and Johansen, 1975)". p.16.

The problem of having all states adopt the same transformative behaviour is described mechanistically.
There is presently no mechanism. 

Ethics is brought up as it must be in the years, decades to follow. (I was minded to think of Maslow's hierarchy applied to the whole of humanity: now that would be a great levelling. p.20.) Now, there is a new measure beyond the perverse capitalism debate. Why should people be able to live in luxury at the expense of even the basic needs of other peoples being met? Intergenerational inequity has a small section of its own (p.22). Those with the means will be able to move, to mitigate the impacts of climate change. Millions of others are effectively trapped by geography, health inequities and life chances. So many are without political and economic power to make for positive change.

As I was working on a paper on h2cm, SDoH and the SDGs the update on health inequity within and between countries was very welcome (p.24). On "food consumption gaps" I wondered about the plethora of 'gaps' that must exist and (sadly) operate in climate change and people's health (p.28). Globally foodborne disease is not uncommon, but to this degree (p.29)? With an estimated 3,037 deaths annually in the United States. Key health issues are discussed, malnutrition, non-communicable diseases, air pollution - ambient and indoor. A point about Bourdieu (1989) and an individual's life choices, is bound to remind me of 'life chances' within Hodges' model. This is what lies behind the idea of the "Health Career". This is not the professional's career, but the varying status of a person's health and wellbeing through their life (and even before birth and approaching end of life). Friel's discussion of Michael Marmot et al. (1991) and the "Whitehall studies demonstrated that, in addition to maternal security, a  range of psychosocial factors are important for health and are contributors to health inequities, including social support, social capital and social cohesion". p.33.

There are conceptual models for SDoH, the Eco-Social Model of Health, which obviously keeps me turning the pages (p.34).  Friel notes historically how environmental epidemiology has tended towards being reductive and mechanistic in approach, rarely taking onboard the influence of social, economics and political contexts. I scribbled the following as a review quote:
"Appreciation of this global scale and of the range of influences on human health required a significant conceptual as well as a methodological shift". p.35.
New epistemologies are needed: enter eco-epidemiology. Time is a factor in integrating our view of disease and disease prevention. I visualise this as a series of frames for an individual, the same for a community. Many of the figures are Creative Commons Attribution 4.0 license. I have not read the book "The Uninhabitable Earth - Life After Warming, By David Wallace-Wells, but a review declared a depressing quality in the scenarios rendered. I had this in mind noting the statistics and reporting that Friel provides. This is worrying too - future rates of mortality - the overall increase; those attributable to specific effects - diarrhea, childhood undernutrition, heat exposure and more... (p.38). There's a small Box on the Disability-Adjusted Life Year. The effect on sea level rise, food production, heat stress, the movement of disease vectors are the subject of the remainder of chapter 1. This is a sobering read, but necessary. Bizarrely - a contribution to global ecoliteracy: medicine for eco-anxiety?

To be continued ...

Chapter 2. It's a Consumptagenic World: Producing Climate Change, Exacerbating Health Inequities

Chapter 3. Challenges and Future Prospects

Friel, S. (2019) Climate Change and the People's Health, Oxford University Press, New York.

Wednesday, October 16, 2019

Review: ii "Climate Change and the People's Health"

Climate Change and the People's Health
You could read this excellent little book in a couple of hours, but me being me ...

Part of a Series of 'Small Books, Big Ideas' in population health this is an important and timely text of a type that sadly will need to be a constant stream. Constant, not only to keep the message and issue in people's consciousness, but to update the research of a still new interdisciplinary field. Not only that but some sense (measure) of the socio-economic-political state must be realised to identify change (progress). This small book argues for the big change in attitudes, behaviours and systems that must follow.

The book prompts me to imagine the day (whether or not in my future) when the media can report on the gradual reverse of climate change? We have heard of positive changes in the size and behaviour of the Antarctic ozone layer for example; only for progress to be challenged once again. It is not enough to hope for our children, their children ...  and the biosphere of Earth.

The book has just three chapters in 146 pages; 188 pages including the references and index. The 'small' quality relates not only to page number but a hardback size of 18 x 15 cms, such that my copy has been on tour (petrol car and alone) over the summer. A Forward by Nancy Krieger refers to the book series as a whole and points to the political dimensions and how inevitably practitioners must be part of this 'game'. Not just what we oppose but what people stand for. The dynamism in this field is apparent in the reference to expressed opposition alone given rise to despair. This book is very current (2019) but 'eco-anxiety' did not make the index, such is the pace of events (Greta Thunberg). This is not a criticism but speaks of the dynamism and hope that action can (and must) bring as Krieger writes. The fact of this being a political struggle is acknowledged by Friel in the conclusion.

This is not just important but critical. You should never generalise and many nurses (for example) are politically very literate and Active. They seek to protect, sustain and improve the values, the health and health care systems they hold dear. Many other nurses focus on the 'job' of caring. The thought follows that while politics starts in the staff-room and rota; the Politics begins in the ward office and the various meetings and committees. They conclude that they'll leave that to others. For all healthcare workers we can no longer take this stance. Population health demands a population response.

To be continued (of course you don't have to wait to obtain your copy - this is essential reading):

Chapter 1. Climate Change, Global Justice, and Health Inequities

Chapter 2. It's a Consumptagenic World: Producing Climate Change, Exacerbating Health Inequities

Chapter 3. Challenges and Future Prospects

Friel, S. (2019) Climate Change and the People's Health, Oxford University Press, New York

Tuesday, October 15, 2019

Book: "The Empty Space"

The Empty Space, Peter Brook

 In July I caught up with Mr Brian Hodges who created Hodges' model. Having met previously in November 2013 we agreed not to leave it as long next time and so I returned on 7th October.

One question I had was whether in addition to Hughes there were any other influences that led Brian to the model overall?

Brian could not recall a specific reference, but mentioned the theatre being an influence. I, in turn had picked up a second-hand book on one of several recent trips to London, but the title evaded me. Once home I checked and the book is "The Empty Space" by Peter Brook. A Gower Street bargain at £4.99. Brian also checked and emailed to confirm this is the book on his shelf too.

While in London (and elsewhere) I try to visit the theatre and  now look for performances of Ibsen's plays. Whatever I do see, A Doll's House this month, before the performance starts the set design is always intriguing. I've posted on this before, Hodges' model providing a 'stage set', one that should the play require can include the operating theatre.

As a mental health nurse the themes of Ibsen's plays still resonate today. From the performances I have attended the public finds ongoing relevance in: The Master Builder, Ghosts, The Lady from the Sea, Rosmersholm, Hedda Gabler and An Enemy of the People. This is true of the work by others. The drama of life and death that Hodges' model can also stage.

Brian emailed me about a situation that stood out for him in the book, so I will revisit this. What caught my eye is the cover of Brook's book (and yes, the graphic first). Without even opening the book, the 'scene' is (possibly?) set on the book's cover "A Book About the Theatre: Deadly, Holy, Rough, Immediate" ...

humanistic ----------------------------------------------- mechanistic
group - population





Hughes, E. (1958) Men and their work. New York: Free Press. (Hughes was used by Brian to define ‘health career’ the idea of life chances.)

Sunday, October 13, 2019

"All Heart, No Technique"

humanistic ----------------------------------------------- mechanistic
group - population
All heart ...

... No technique
 Hearing World"

sound, volume, voice

Deaf people - Literacy - Statistics


education - system

My source: c/o @READEnglish

Raymond Antrobus


Saturday, October 12, 2019

"Ecoliteracy and the trouble with reading" by Code JM.

Jonathan M. Code (2019) Ecoliteracy and the trouble with reading: ecoliteracy considered in terms of Goethe’s ‘delicate empiricism’ and the potential for reading in the book of nature, Environmental Education Research, DOI: 10.1080/13504622.2018.1558438

"Literacy in the context of health literacy—another type of literacy given distinct status in recent times—is defined as the ability to use information about health in a meaningful way (Velardo 2015)". ...

humanistic ----------------------------------------------- mechanistic
group - population
... "To be health literate is to have access and understanding of the knowledge, motivational factors, and competencies for appraising and applying health information so that decisions and judgements can be made about healthcare, disease prevention and health promotion in everyday life (Sorensen et al. 2012)".

"Perhaps one of the greatest oversights in terms of most ecological, scientific accounts of ecoliteracy is that science has yet to adequately address the mystery of life (a point raised by many authors and succinctly argued by Schumacher (2011)[1977] already several decades ago). This oversight has led to the tendency to approach ‘the book of nature’ in materialistic and mechanistic terms whereas the challenge that emerges through critical considerations raised by Kuhlewind and others is that it is a living book that we—as readers—can potentially participate in if we develop ways of knowing adequate (Schumacher 2011[1977]) to the task".

Wither "The Book of Nature" / "The Book of Science"?

Jonathan gave a presentation at Threshold Concepts Conference in Dundee which I attended. This reminded me of how I have been wanting to re-read Bortoft and related texts, especially Schumacher.

Friday, October 11, 2019

Book: "Poems from the Edge of Extinction"

humanistic ----------------------------------------------- mechanistic
group - population

"One language is falling silent every two weeks. Half of the 7,000 languages spoken in the world today will be lost by the end of this century".

Poems from the Edge of Extinction

Chris McCabe

My source:
Crawford, M. (2019) Poetry, Books, FT Weekend Life&Arts, 21-22 Sepember, p.11.

Wednesday, October 09, 2019

ERCIM News No. 119 Special theme "Smart Things Everywhere"

Dear ERCIM News Reader,

ERCIM News 119
ERCIM News No. 119 has just been published at https://ercim-news.ercim.eu/

Smart applications in several domains, the technological aspects and security and quality issues are the focus of the special theme of this issue.

Guest editors: Margarete Hälker-Küsters (Fraunhofer AISEC) and Erwin Schoitsch (AIT)

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 anyone who might be interested.

Next issue:
No. 120, January 2020
Special Theme: Educational Technology

Peter Kunz
ERCIM Office
2004, Route des Lucioles
(My source)

F-06902 Sophia Antipolis Cedex

join the ERCIM Linkedin Group

The next issue sounds very promising and I look f/w to receiving news of this and possibly reflecting on the content using Hodges' model. The 'Research and Innovation' section is always interesting as in this issue, even while the focus of #119 is as per the title. In addition on page 33:
"Case Case 2 – Smart Health Care: This use case employs the SEMIoTICS technologies to develop an Information and Communication Technology (ICT) solution aimed at sustained independence and preserved quality of life for elders with mild cognitive impairment or mild Alzheimer’s dis-ease, with the overall goal of delaying institutionalisation: supporting both “aging in place” (individuals remain in the home of choice as long as possible) and “community care” (long-term care for people who are mentally ill, elderly, or disabled provided within the community rather than in hospitals or institutions)".

Sunday, October 06, 2019

Libration before Liberation

Last week I visited "The Moon" exhibition at The National Maritime Museum Greenwich. As I videoed the phases of the moon that was on display I recalled how we actually see more than the 50% that is the near-side of the Moon.

humanistic ----------------------------------------------- mechanistic
group - population
Sometimes more (knowledge)
 is revealed than first
 appears ...

Attend to the 'libration of ideas'.

Reflect first ... 

if we shared
a generic means
to share ideas and concepts...?

... then Liberate.

Tuesday, October 01, 2019

AI Governance & (Old) Chestnuts - When Healthcare is a Silo

humanistic ----------------------------------------------- mechanistic
group - population




 artificielle [ ;-) ]

V s
E i
R t
T u
I a
C t
A i
L o

Healthcare and Energy (Sectors)

bias, safety, explainability
unintended consequences

ZERO emissions

"There are areas where we need
to do the research before we know
 what are the right kinds of
 approaches to take".
Sundai Pichai


Blanket vetting or Sector-by-Sector rules?

privacy infringement
Advertising* (cause)

Google AI principles

Bradshaw, T. (2019) Google chief urges regulators not to rush into AI crackdown, FT Weekend, 21-22 September, p. 15.