Hodges' Model: Welcome to the QUAD: On Care, Papers, Distance, Pressure, Academia and Falls

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Saturday, September 13, 2025

On Care, Papers, Distance, Pressure, Academia and Falls

In my student nursing days late 1970s there was a big-stick of motivation. It wasn't management, and yet it was. There was a stigma attached to a patient developing a pressure sore - decubitus ulcers. The NHS then had many psychogeriatric wards, but that care is now with nursing homes. Despite the best efforts some patients did, especially on the mental health infirmary, which was staffed by 'general'  trained nurses too. Using aseptic technique wounds had to be packed (stage 3-4?). Some of the treatments, were not exactly 'evidence-based'. There is a historical account of previous treatments provided on 'Asylum Years'.

In the 1990s I was working on a 'book' about health, nursing and informatics (it was simpler then?). Submitting the project as a book proposal, a letter from one publisher reads: 'thanks but no thanks'. Although unsuccessful, that exercise accounts for the range of interests I still maintain today, and the scope of posts here on W2tQ. Continuing to clear and sort notes, one is for the 'book':

Abbott, P., & Payne, G. (Eds.). (1990). New Directions in the Sociology of Health (1st ed.). Routledge. https://doi.org/10.4324/9781351141727

From the above book, I've a page of notes headed "For chapter 2" drawing on a brilliant chapter 4:

Distance Decay and Information Deprivation: Health Implications for People in Rural Isolation

By George G. Giarchi

Abstract

Deprivation is frequently associated with the lives of inner city dwellers in old densely packed terraced housing, or with the residents in high-rise city slums and concrete council houses. In substantive socio-economic terms the deprivation of both the urban and the rural setting are the effects of the same structural dysfunctions, as aptly demonstrated by Townsend's 1968 classic study of poverty. On the basis of empirical studies rural deprivation affects the standards of health of many people in the countrysides of the UK particularly the most vulnerable dependent populations, such as younger children and older adults at the lower end of the social scale. The houses which are 'unfit' are damp, poorly lit, badly ventilated or lack healthy sanitation: clothes are rotten with mildew. Leschinsky's nationwide survey of rural health services indicates that centralization of health provision is a major reason for health disparities in rural areas.


I looked up the author, guessing that they were possibly still in academia, emeritus, or more likely (then, a decade or more in their career) retired by now. The search did not take long, but filled me with sadness and anger:

'A coroner has said there were "missed opportunities" to prevent the death of a hospital patient who died after developing a bedsore.

George Giacinto Giarchi, 86, died in November 2017 at Plymouth's Mount Gould Hospital after being treated for weeks at Derriford Hospital after a fall.

At Plymouth Crown Court coroner Ian Arrow said Mr Giarchi died of multi-organ failure from the pressure ulcer.

His family urged ministers to ensure hospitals had adequate staffing levels.

The former Plymouth University professor was admitted to Derriford Hospital after falling and fracturing his arm at home on 25 September 2017.

He was later transferred to Mount Gould where the lesion was first noticed.'

Pressure ulcers, known as bed sores, are injuries caused by pressure on the skin often seen in bedridden patients.'

https://www.bbc.co.uk/news/uk-england-devon-48798285

 Thank you and bless you Prof. George G. Giarchi RIP.

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 https://www.academia.edu/3794699/Reflecting_on_the_glocal_through_the_conceptual_framework_of_Hodges_s_model