Hodges' Model: Welcome to the QUAD: 2026

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 ...

Thursday, July 02, 2026

LAST CALL 2nd AIxIA Summer School on Artificial Intelligence for Healthcare!

[apologies for multiple postings]

A few last spots are still available for the school, taking place in Trento, Italy, on 13-17 July 2026.

The school is open to anyone interested in AI for Healthcare: Master and PhD students, researchers, clinicians, physicians, data scientists, AI engineers, and professionals working at the intersection of AI and healthcare.

Master and PhD students benefit from a reduced fee: 470 EUR.
The regular fee is 495 EUR.

This year’s edition will focus on:

  • Medical Imaging
  • Smart Hospitals
  • Patient Trajectories
- with attention to concrete healthcare problems and to different AI research perspectives, including generative AI and neuro-symbolic AI.

More information:
https://lnkd.in/dEBmQ8Rr

Registration:
https://lnkd.in/dggvaMSP

Please share with anyone who may be interested!

#AI #DigitalHealth #Healthcare #ArtificialIntelligence #GenerativeAI #NeuroSymbolicAI #MedicalImaging #SmartHospitals #PatientTrajectories #AIxIA

My source: francesco.calimeri, unical.it

Wednesday, July 01, 2026

Tricotyledons, systems and social problems

'If scientists and engineers are to be able to attack social problems with the same validity and effectiveness with which physical problems have been attacked, then a much more sophisticated and rigorous system design methodology is needed.

Such methodology, called the tricotyledon theory of system design, has been developed as a synthesis of: empirical and speculative approaches to system design [2], the methodology of operations research [10], classical optimization techniques [18], results in specialized branches of mathematical system theory [1,4,6,7], and the constructs of general mathematical system theory [12,13,14].

Experimental applications of the tricotyledon theory of system design to several problems in widely differing contexts [3,4,8,9,16,17] indicate that the methodology holds great promise for validity and effectiveness in attacking any large-scale, complex, man/machine system design problem with precision and rigor. There are no theoretical limitations (such as differentiability, linearity, finiteness, or discreteness) for the problems that can be attacked within the tricotyledon theory of system design.

In this short abstract the theory is only described in terms of set and system theoretic concepts as presented in Reference [12), [13], or [14]; no exploitation of the theory, either theoretical or practical is attempted here.' ..' p.224-225.

'The task of defining a large-scale, complex, man/machine system design problem P=(S,T,α,β,γ,D) often requires an interdisciplinary team in practice. An interdisciplinary team requires, in turn, that the above definitions be translated into non-mathematical methodology. This has been done in Reference [15].' p.229.
15. Wymore, A.W., Systems Engineering Methodology for Interdisciplinary Teams, unpublished manuscript. (Another loss?)


Wymore, A.W. (1975) The Tricotyledon Theory of  System Design. In. Category Theory Applied to Computation and Control: Proceedings of the First International Symposium, San Francisco, February 25-26, 1974 (Lecture Notes in Computer Science, 25) by E.G. Manes (Editor).

See also: 

https://en.wikipedia.org/wiki/A._Wayne_Wymore

http://sysengr.engr.arizona.edu/wymore/bookreview.html 

https://lockywolf.wordpress.com/2019/02/16/a-mathematical-theory-of-systems-engineering-the-elements-by-a-wayne-wymore/ 

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Tuesday, June 30, 2026

'Oh Thomasina!' Such a drama in a diagram

Arcadia

Last evening I really enjoyed a performance of Tom Stoppard's Arcadia at the Duke of York's, or soon to be - The Tom Stoppard Theatre:

Act I, Scene 2  

'Septimus ... You should no more grieve for the rest than for a buckle lost from your first shoe, or for your lesson book which will be lost when you are old. We shed as we pick up, like travellers who must carry everything in their arms, and what we let fall will be picked up by those behind. The procession is very long and life is very short. We die on the march. But there is nothing outside the march so nothing can be lost to it. The missing plays of Sophocles will turn up piece by piece, or be written again in another language. Ancient cures for diseases will reveal themselves once more. Mathematical discoveries glimpsed and lost to view will have their time again. You do not suppose, my lady, that if all of Archimedes had been hiding in the great library of Alexandria, we would be at a loss for a corkscrew? ...'^ p.20.

 Act II, Scene 3

'Lady Croom We are intruding here - this will not do, Mr Hodge. Evidently, nothing is being learned. (To Noakes) Come along, sir! 

Thomasina Mr Noakes - bad news from Paris! 

Noakes Is it the Emperor Napoleon? 

Thomasina No. (She tears the page off her drawing block, with her "diagram" on it) It concerns your heat engine. Improve it as you will, you can never get out of it what you put in. It repays eleven pence in the shilling at most. The penny is for this author's thoughts. 

She gives the diagram to Septimus who looks at it.' p.74
...
Now Septimus retrieves his book from Thomasina. He turns the pages, and also continues to study Thomasina's diagram. ... 

Septimus Why does it mean Mr Noakes's engine pays eleven pence in the shilling? Where does he say it? 

Thomasina Nowhere. I noticed it by the way. I cannot remember now. 

Septimus Nor is he interested by determinism -------

Thomasina Oh... yes. Newton's equations go forwards and backwards, they do not care which way. But the heat equation cares very much, it goes only one way. That is the reason Mr Noakes's engine cannot give the power to drive Mr Noakes's engine. 

Septimus Everybody knows that. 

Thomasina Yes, Septimus, they know it about engines! 

Pause. He looks at his watch 

Septimus A quarter to twelve. For your essay this week, explicate your diagram. 

Thomasina I cannot. I do not know the mathematics. 

Septimus Without mathematics, then.' p.75.

 
Tom Stoppard, (1993) Arcadia (Playscript), Faber & Faber, pb. ISBN 9780571169344.
https://www.faber.co.uk/product/9780571169344-arcadia/

My text source:
https://collegearts.yale.edu/sites/default/files/attachments/arcadia_by_tom_stoppard.pdf 

^ n.b. This was therapeutic, but I still mourn the losses from Alexandria and other libraries ... today.

Monday, June 29, 2026

Where is the Centeredness of Care?

In trying to see Hodges' model anew, which is quite a challenge after four decades; what of the model's structure?

It is easy to get carried away with mathematical terminology:

One line, add another, and they intersect, at a 90 degree right angle. So is centeredness to be found at the intersection point? 

If I'm tying myself up in knots well there's another possibility! 😉 

As a whole it appears the axes of the model are a manifold and not - in the center?

What do you think?


See also: 'What Is a Manifold?'

https://www.quantamagazine.org/what-is-a-manifold-20251103/

Sunday, June 28, 2026

1st Workshop on the Internet of Mirrors (IoM): Connected Intelligence for Healthcare, Beauty, and Immersive Digital Experiences

Dear Colleagues,

I would like to invite your technical papers submissions to our 1st Workshop on the Internet of Mirrors (IoM): Connected Intelligence for Healthcare, Beauty, and Immersive Digital Experiences, which will be held in IEEE WF-IoT 2026 in Abu Dhabi, UAE.

Workshop Focus


The Internet of Mirrors (IoM) is an emerging IoT ecosystem built around interconnected smart mirrors that can sense, process, communicate, and deliver personalised services across healthcare, beauty, wellness, assisted living, fitness, and immersive digital experiences.
Although the workshop is centred on the Internet of Mirrors, the realisation of this vision requires multi-domain expertise. As such, we are very keen to receive contributions not only from researchers directly working on IoM, but also from those developing the architectures, algorithms, communication technologies, computing frameworks, and application domains that will underpin future intelligent IoT ecosystems.

Topics of Interest
  • Relevant topics include, but are not limited to:Edge, fog, and cloud computing for IoT systems
  • Distributed intelligence and multi-agent AI
  • AI-enabled IoT applications and personalised services
  • Multimodal sensing, data fusion, and contextual awareness
  • Intelligent task orchestration and adaptive resource allocation
  • Wireless connectivity, 5G/6G, and network optimisation
  • Privacy-preserving AI, security, interoperability, and trustworthy AI
  • Human-computer interaction, accessibility, and inclusive smart interfaces
  • Digital twins, immersive technologies, and metaverse-enabled experiences
  • Internet of Sounds, Internet of Medical Things, and broader Internet of Everything ecosystems
  • Smart healthcare, assisted living, wellness, fitness, beauty, and immersive digital lifestyle applications
  • Proof-of-concept implementations, benchmarking, testbeds, and real-world IoT deployments
Important Dates 
  • Paper submission deadline: 12 July 2026
  • Notification of acceptance: 15 August 2026
  • Camera-ready deadline: 30 August 2026

Workshop Chairs

  • Lina Mohjazi, University of Glasgow, UK
  • Luca Truchet, University of Trento, ITALY
  • Ahmad Taha, University of Glasgow, UK
  • Rabeb Mizouni, Khalifa University, UAE
  • Muhammad Ali Imran, University of Glasgow, UK
  • Haneen Fatima, University of Glasgow, UK

Information

Workshop website: https://sites.google.com/view/wfiot2026-workshop-iom
Submission link: https://edas.info/newPaper.php?c=34901&track=138858

Contact Emails:
l.mohjazi AT ieee.org
ahmad.taha AT glasgow.ac.uk

It would be wonderful if you could consider submitting relevant work, or share the call with colleagues and students who may be interested!
--
Kind regards,
Dr Kubra Duran
Postdoctoral Fellow
Edinburgh Napier University, UK

My source: SOCIOTECH list - JISC

Saturday, June 27, 2026

‘Prevention Demonstrator’ - GM Live Well

England’s First Prevention Demonstrator: Opportunities for Greater Manchester and its VCFSE sector

Greater Manchester has been chosen as England’s first Prevention Demonstrator, an initiative announced in the Government’s 10-Year Health Plan earlier this year. It marks a step toward transforming public services with a more ‘preventative’ approach.

The Greater Manchester Combined Authority (GMCA) was named as the first prevention demonstrator in the UK Government’s 10 Year Plan for Health in July. It will take a community-led preventative approach to the provision of public services which means fixing the foundations of a person’s life – such as housing, and access to education and employment opportunities – as a means of preventing ill health from social and economic detriment and improving lives, as well as reducing pressure on acute and crisis services.

The Prevention Demonstrator will be building on the Live Well Model of service delivery, which brings together services such as health, employment support and debt advice at a neighbourhood level working with the voluntary, community, faith and social enterprise (VCFSE) sector, providing a blueprint for the rest of the country.

Warren Heppolette has been appointed to lead this work, seconded from NHS Greater Manchester where he was Chief Officer for Strategy, Innovation and Population Health. Warren has been closely involved in the GMVCFSE Leadership Group’s Commissioning and Investment sub-group which aims to improving standards and practices for the benefit of the VCFSE sector.

Continued ...


Lucy North, Communications and Policy Officer. Published: December 5, 2025



'Sustainability' and 'sufficiency' (as per the previous post) are words of the moment. Policymakers want change to have a permanent quality, which ironically means individuals within a population benefitting from initiatives like this have a mindset that makes them flexible to future changes and challenges.

As Camilla Cavendish notes in 'Andy Burnham will need to play a new card now', Manchester's prevention demonstrator has echoes of David Cameron's Big Society and the Troubled Families project. There are two other words that can work for individuals and populations: impetus and momentum. Within this through Hodges' model we can equip people and communities for lifelong learning. We can also highlight, as Prof. Kevin Fong did at RCN Congress 2026 in his marvellous keynote - that resilience is found between people, not within individuals.
 

See also: Presentation - Prevention, Health and Good Growth: Realising Our Prevention Ambitions

Philip Britteon, Alfariany Fatimah, Stephanie Gillibrand, Yiu-Shing Lau, Laura Anselmi, Paul Wilson, Matt Sutton, Alex J. Turner, (2024) The impact of devolution on local health systems: Evidence from Greater Manchester, England, Social Science & Medicine, Volume 348, 116801,
ISSN 0277-9536, https://doi.org/10.1016/j.socscimed.2024.116801.

My source: Camilla Cavendish, Opinion: Andy Burnham will need to play a new card now, FTWeekend, 20-21 June, 2024. p.12.

Previously: 'prevention' : 'big society' : 'troubled families' : 'social prescribing'

Friday, June 26, 2026

World Justice Report: a Plan for Equality and Prosperity Within Planetary Boundaries

Box 1: Combining Global Equality and Planetary Habitability

The Global Justice Report describes desirable future scenarios combining two key goals: socioeconomic equality (including full equality between countries, full gender equality in labour hours and pay, sharp compression of within country income and wealth scales, combined with fair access to education, health and political voice), and planetary habitability (aligning global resource use within ecological boundaries, including a limitation of global temperature rise below 2°C). 

To avoid climate catastrophes, we show that sufficiency is required: a structural transformation of the economy involving shorter working hours, a lower material footprint, a shift from material-intensive sectors toward relatively immaterial sectors such as education and health, and major changes in food systems and land use. Rapid decarbonization of energy systems is also necessary, as is the sharp compression of income and wealth inequality. This compression is both a social justice objective and a condition for financing necessary climate investment and human capital expenditure and for sustaining political support from bottom- and middle-income classes in both the North and the South. 

Box 2: Material and Monetary Accounting for Democratic Debate

Economy and ecology cannot be debated apart: every economic activity has a material footprint, every ecological policy shapes incomes and wealth. To make these links visible, the Global Justice Report uses multidimensional social progress indicators. We set quantitative targets for global socioeconomic justice by combining two complementary languages: material accounting (work hours, sectoral shares, education and health, energy systems, GHG emissions, land use, forest cover, temperature levels) and monetary accounting (income and wealth scales between and within countries, progressive tax rates). The report draws on two centuries of historical data on global inequality and resource use, and on the recent literature on social progress, climate and colonial reparations. 

The Global Justice Report proposes a quantitatively and institutionally grounded step toward global justice. It does not seek to close the debate: it offers a transparent basis on which citizens, unions, parliaments, and international bodies can debate, contest, and decide the course of the coming decades.

...

Chancel, L., Dietrich, J., Mohren, C., Moshrif, R., Odersky, M., Piketty, T., Somanchi, A., et al. (2026), The Global Justice Report: A Plan for Equality & Prosperity Within Planetary Boundaries, World Inequality Lab (gjp.wid.world).

individual
|
INTERPERSONAL
: SCIENCES             
humanistic ------------------------------- mechanistic
SOCIOLOGY : POLITICAL   
|
group 
 


 


SOCIAL JUSTICE




Previously: 'wealth' : 'poverty' : 'social justice'

 My source: BBC Radio 4 World at One.

 

 

Thursday, June 25, 2026

To which care/knowledge domain does this video belong?


P.S. There isn't a domain called 'bin' but there is plenty of waste.

There isn't one called denial, or ignorance either, but you will find them in abundance too.

Rest assured (if you still can!) that each domain carries its own truth

Wednesday, June 24, 2026

Independent report - Ockenden review into maternity services at Nottingham University Hospitals NHS Trust

FINAL REPORT: 

'This independent review of maternity services at the Nottingham University Hospitals NHS Trust (NUH) considered the quality of care relating to newborn, infant and maternal harm at the trust.

This report covers the findings, conclusions and essential actions of this independent review of maternity services.

Based on a review of over 2,500 family cases that formed part of this investigation, the final report outlines:

  • local actions for learning that staff at the trust must do
  • system-wide learnings
  • immediate and essential actions to improve maternity and neonatal care

The Independent Maternity Review (known as the Ockenden review) was led by Donna Ockenden and involved a multi-professional team of more than 160 reviewers. The review team held individual meetings with over 500 families, and more than 830 current and former staff at NUH engaged with the review.'


https://assets.publishing.service.gov.uk/media/6a3bb59c4c7605ab567238ec/ockenden-report-review-of-maternity-services-nottingham-university-hospitals-nhs-trust-e-lay.pdf

https://www.ockendenmaternityreview.org.uk/

individual
|
INTERPERSONAL
: SCIENCES             
humanistic ------------------------------- mechanistic
SOCIOLOGY : POLITICAL   
|
group
 

listening

 
 Communication
Processes 
Health Systems
mothers
families
experience
LISTENING
staffing
funding

Previously: 'maternity' : 'risk' : 'safety' : 'compassion'

Monday, June 22, 2026

Maker-field: More than just a point* on a map

Ashton-in-Makerfield has been in the news of late. With Andy Burnham MP championing the communities of the north; local issues, socio-economic gaps, needs and everyday lived experience up North.

But Makerfield holds much more as a veritable rabbit-hole supporting lifelong learning, character development, reflective practice and critical thought:

 'maker' - 'field'

* - a political constituency.

Previously: 'map'

Saturday, June 20, 2026

ii Thoughts re. Ecosia's AI Chat 'answer'

The previous post has been updated, to the prompt is added:

 'Please provide sources and references.

[If you are new here, and too Hodges' model please see the bibliography in the sidebar.] 

A 'human' reading (still) makes me wonder if the 'answer' is what I want to hear (as a user)? Is it worrying that the first provides a 'Conclusion' the latest does not. The table is helpful as I believe that Hodges' model has a role across research (and political!) -isms through methodologies and methods. The model can also encompass ('eat'!) aspects of scale, or level.

The reply still gives me quadraphonic joy (if read out-loud). Not only are the domains recognised, but the LLM/agent ai takes the intrapersonal / interpersonal in its stride (from the blog?). Subjects related to each of the domains are given in brackets. 

There is of course a bias (several) in the prompt, as the care domains were never intended to be comparable. It is positive that each domain is seen as having its own specific scope and function. Over twenty years notes were started on a paper on Hodges' model and its role/function in helping to define 'scope of practice'. Significantly, in the UK the rise of associate positions across disciplines has provoked much debate, vitriol (on X and union and lobbying) and soul searching in certain professional groups. Given the increasing importance of the global health and social care workforce this trend is reflected globally. A situation set to be extended with uncertainties and tensions exacerbated by artificial intelligence in practice.

Before 'explaining' the asymmetries (in points 1-4) it seems the domains are complementary (for all their differences), and provide a holistic underpinning for the model as a whole (my reading).

1. Scope and Focus 

Interesting, how the science and sociology domains are described as broad. Perhaps I am underestimating the depth/density of sociology, after all folk theory is found there? Unfortunately, we can also add a myriad of conspiracy theories? Sociology can also lay claim to quite a few constructions of its own. Including aesthetics as a bridge to architecture and design(?).

On 'X', Hodges' model has been described negatively as inviting / fostering generalism. So, this is a bad thing? Is it not strange then that your Advanced Nurse Practitioner, Consultant doctors (all specialities) and students cross-curricula can all use Hodges' model? The fact that my own responses were never engaged has helped train my thought. Here the relevance of the model to students and continued professional development is made through generalizable knowledge.

The response to the political domain is supportive, acknowledging resource allocation and the distinction between individual and collective (see for example):

S. Bettiol, P. Jones, H. A. Onyedikachi, and W. G. Kernohan, (2026) Bridging Gaps in Oral Health Frameworks: Mapping With Hodges' Health Career - Care Domains - Model, Journal of Public Health Dentistry. 1–14, https://doi.org/10.1111/jphd.70034.  

I've seen tweets today regards IQ reductions in younger people. This is one reason for support of the top-left mental domain being designated as 'Intrapersonal – Interpersonal'. Our interpersonal skills and awareness are surely dependent upon our achieving a given level of inner mental life? Encouraging to see how subjectivity and objectivity is assigned too. Although, I think I'm in an echo chamber!

2. Epistemological Differences

In arguing for a model of health and social care that goes beyond:

  • medical model;
  • bio-medical model;
  • bio-psycho-social model.

Reading 1-2 from the perspective of the Intrapersonal – Interpersonal domain you see how limiting this is, if an individual in a mental health/illness/mental capacity context can only point to sciences and sociological domains. Indeed, they may be relying guardians and advocates as they are unable to does this and raise the political matter of their rights. Without the POLITICAL domain (or as a result of it - neglect, structural racism) there is no law enshrining independent advocacy...

3. Practical Application in Care

To care is to act. Think about triage and emergency response.

Now in the 21st century 'care' must include self-care, health and social care, and (delayed or not you decide?) planetary care.

This necessitates a change of mindset at an individual and collective level. Consider the literacies that (again) young people must master to be effective, productive and happy citizens tomorrow?

So the following is a gift (in my eyes): 

"This means the intrapersonal-interpersonal domain is not just another 'content area' but a lens through which all other domains are experienced and integrated."

4. Hierarchy of Integration

'While the domains are conceptually equal in Hodges’ model' ..

This is interesting in itself.

[There does seem a emphasis upon the Intrapersonal – Interpersonal domain in this answer?]

This is quite a step, as the idea of a nexus and integration are picked up; and pointing to what are the determinants of health:

'For example:

  • A scientific understanding of depression (e.g., serotonin levels) must be interpreted through the intrapersonal experience of the individual.
  • A sociological analysis of healthcare disparities must be understood through the political structures that enable or inhibit change.
  • A political decision about resource allocation must be filtered through intrapersonal values and priorities.'

I'm pleased I did this, as long as I'm not being trapped in an epistemological cocoon: otherwise known as a circle. Apart from a few occasions, I have not used AI/LLMs, perhaps it is time to explore more? I'd like to preserve my naivety, especially were maths is concerned. I'm not sure of what baggage I may pick up and lack the knowledge to interpret?

Previous post:  https://hodges-model.blogspot.com/2026/06/h2cm-domains-symmetry.html

Friday, June 19, 2026

[Updated] AI Chat: Are the domains of Hodges' model comparable?

In drafting a future post: 'The Sciences: points, lines, angles and perspectives on domains', I thought I would ask Ecosia's AI Chat a related question, here is the (quick) prompt and reply:

PROMPT: 
In Hodges' model there are four care, or knowledge domains. The four domains are the sciences, sociology, political, and intrapersonal – interpersonal domain. In terms of potential content are these domains comparable, or is there an essential asymmetry? Please provide sources and references.

(I have saved the prompt for future reference and refinement.)

RESPONSE: [updated 21st June 2026]


Hodges’ model (also known as the Health Career Model or h2cm) is a conceptual framework that organizes knowledge and care into four quadrants, each representing a distinct domain of human experience and knowledge. These domains are:

  1. Sciences (empirical, biological, and physical sciences)
  2. Sociology (social structures, relationships, and community)
  3. Political (power, policy, governance, and resource allocation)
  4. Intrapersonal – Interpersonal (psychological, emotional, and relational aspects of the self and others)

Are the Four Domains Comparable or Asymmetrical?

The four domains in Hodges’ model are not strictly symmetrical in terms of their content, scope, or application. While they are presented as equal in structure (each occupying one quadrant of the model), their potential content, theoretical foundations, and practical implications can vary significantly. Here’s why:

1. Differences in Scope and Focus

  • Sciences (Quadrant 1):
    This quadrant focuses on empirical, measurable, and biological aspects of health and care, such as anatomy, physiology, and pathophysiology. Its content is often highly specialized, technical, and evidence-based, rooted in natural sciences like biology and chemistry.

    • Example: The role of hormones in stress response or the pathophysiology of diabetes.
  • Sociology (Quadrant 2):
    This quadrant addresses social structures, culture, and community dynamics. Its content is broader and more interpretive, drawing from sociology, anthropology, and social psychology.

    • Example: The impact of socioeconomic status on health outcomes or the role of family support in recovery.
  • Political (Quadrant 3):
    This quadrant examines power, policy, governance, and resource distribution. Its content is highly contextual and often contested, influenced by political science, economics, and public policy.

    • Example: The effect of healthcare policies on access to services or the role of advocacy in shaping health priorities.
  • Intrapersonal – Interpersonal (Quadrant 4):
    This quadrant focuses on individual psychology, emotions, and relationships. Its content is highly subjective and variable, drawing from psychology, psychotherapy, and ethics.

    • Example: A patient’s personal beliefs about illness or the dynamics of a therapeutic relationship.

2. Differences in Methodology

  • Sciences and Political domains often rely on quantitative methods (e.g., experiments, statistical analysis, policy evaluations).
  • Sociology and Intrapersonal domains frequently use qualitative methods (e.g., interviews, case studies, ethnography).
  • This methodological diversity can create asymmetry in how knowledge is generated, validated, and applied.

3. Differences in Practical Application

  • Sciences and Political domains  are often system-level and influence macro-level decisions (e.g., clinical guidelines, healthcare policies).
  • Sociology and Intrapersonal domains are more individual- or community-level, focusing on personalized care, cultural competence, and therapeutic relationships.
  • This can lead to asymmetry in impact, where some domains (e.g., Political) shape broad systems, while others (e.g., Intrapersonal) focus on direct human experience.

4. Theoretical Foundations

  • The Sciences and Political domains are grounded in positivist and structuralist theories, emphasizing objectivity and external reality.
  • The Sociology and Intrapersonal domains are influenced by interpretivist and constructivist theories, emphasizing subjectivity and lived experience.
  • This theoretical diversity can create asymmetry in how knowledge is perceived and valued in different contexts.

Is There an Essential Asymmetry?

Yes, there is an essential asymmetry in the potential content of the four domains. While the model presents them as equal in structure, their content, methods, applications, and theoretical foundations are not interchangeable. The domains complement each other but serve different purposes in understanding and delivering care.

Sources and References

  1. Conceptual Overview of Hodges’ Model:

  2. Theoretical Foundations:

  3. Discussions on Asymmetry and Complementarity:

Summary Table: Asymmetry in Hodges’ Model Domains

DomainContent FocusMethodologyTheoretical FoundationLevel of Application
SciencesBiological, empirical dataQuantitativePositivistMacro (systems, clinical)
SociologySocial structures, communityQualitative/QuantitativeInterpretivist, StructuralistMeso (groups, communities)
PoliticalPower, policy, governanceQuantitative/QualitativeStructuralist, Critical TheoryMacro (systems, policy)
Intrapersonal-InterpersonalPsychology, emotions, relationshipsQualitativeConstructivist, HumanisticMicro (individual, relational)

PROMPT: 
In Hodges' model there are four care, or knowledge domains. The four domains are the sciences, sociology, political, and intrapersonal – interpersonal domain. In terms of potential content are these domains comparable, or is there an essential asymmetry?

 

In Hodges’ model, the four care (or knowledge) domains are:

  1. Sciences (biological, physiological)
  2. Sociology (social, cultural, environmental)
  3. Political (legal, policy, organizational)
  4. Intrapersonal – Interpersonal (psychological, emotional, relational)

These domains are not strictly comparable in terms of content, scope, or function. Instead, they represent complementary perspectives that together form a holistic framework for understanding human health, well-being, and care. Here’s why there is an essential asymmetry between them:

1. Scope and Focus

  • Sciences and Sociology are broad, well-established academic disciplines with extensive theoretical and empirical foundations. They provide generalizable knowledge about biological processes and social systems.
  • Political is more narrowly focused on power structures, governance, and resource allocation. While critical for systemic change, it is less about individual experience and more about collective frameworks.
  • Intrapersonal – Interpersonal is deeply personal and subjective, focusing on individual psychology, emotions, and relationships. It is less about universal laws and more about unique, context-dependent experiences.

This makes the intrapersonal-interpersonal domain inherently asymmetrical compared to the others, as it deals with subjectivity and variability rather than objective or structural phenomena.

2. Epistemological Differences

  • Sciences, Sociology, and Political domains rely on external observation, measurement, and analysis. They are rooted in positivist or structuralist traditions, where knowledge is often generalized.
  • Intrapersonal – Interpersonal is rooted in interpretivist and phenomenological traditions, where knowledge is co-created through subjective experience and dialogue. It resists universal generalization.

This creates a fundamental asymmetry in how knowledge is produced and validated across the domains.

3. Practical Application in Care

  • The Sciences, Sociology, and Political domains provide frameworks for action (e.g., medical treatments, social policies, legal rights). They are instrumental in shaping systems and interventions.
  • The Intrapersonal – Interpersonal domain is transformative—it shapes how individuals perceive, interpret, and respond to care. It is the domain where meaning is made and agency is exercised.

This means the intrapersonal-interpersonal domain is not just another “content area” but a lens through which all other domains are experienced and integrated.

4. Hierarchy of Integration

While the domains are conceptually equal in Hodges’ model, in practice, the intrapersonal-interpersonal domain often acts as the nexus where the other domains intersect. For example:

  • A scientific understanding of depression (e.g., serotonin levels) must be interpreted through the intrapersonal experience of the individual.
  • A sociological analysis of healthcare disparities must be understood through the political structures that enable or inhibit change.
  • A political decision about resource allocation must be filtered through intrapersonal values and priorities.

This integrative role makes the intrapersonal-interpersonal domain asymmetrical in function, even if not in formal status.

Conclusion: Essential Asymmetry

The four domains are not comparable in content or function. Instead:

  • The Sciences, Sociology, and Political domains provide structural and systemic knowledge.
  • The Intrapersonal – Interpersonal domain provides subjective and relational knowledge, which is essential for meaning-making and agency.

The asymmetry arises from the epistemological and practical differences between objective/systemic knowledge and subjective/experiential knowledge. Hodges’ model emphasizes that all domains are necessary, but they operate in fundamentally different ways.

'Curiosity': child safety and safeguarding c/o BBC News

'Teacher who killed his adopted son given whole life prison sentence

14:30 18 June

That concludes our live coverage of the sentencing hearing.

To recap what happened at Preston Crown Court earlier: A teacher who sexually abused and murdered the 13-month-old baby boy he adopted with his partner has been told he will spend the rest of his life in prison.

Preston Davey died in July 2023 at the hands of Jamie Varley, 37, who subjected the child to physical, sexual and emotional abuse during the final four months of his life.

Varley, from Blackpool, told police Preston had accidentally drowned in a bath, but a post-mortem examination discovered the child had suffered 40 injuries.'

Continued ...

individual
|
INTERPERSONAL
: SCIENCES             
humanistic ------------------------------- mechanistic
SOCIOLOGY : POLITICAL   
|
group
 
curiosity
 
 





PROFESSIONAL
CURIOSITY



Source (Various): BBC Live News https://www.bbc.co.uk/news/live/c4gyrewq8xkt

 Previously: 'curiosity' : 'risk'

Thursday, June 18, 2026

Evidence sent to Cumbria Police about 61 baby deaths at church-run home c/o ITV News

'Some babies born with disabilities were denied medical help because they were judged unadoptable, as ITV News Social Affairs Correspondent Sarah Corker reports


Evidence has been submitted to Cumbria Police in connection with allegations of historical abuse at a church-run mother and baby institution where more than 60 newborn babies died, following an ITV News investigation.

A new report by Dr Michael Lambert, an historian of the welfare state at Lancaster University, has outlined a high infant death rate at St Monica’s home in Kendal.

The report concluded that the deaths were due to a combination of failings, including inadequate facilities, malpractice and poor care from those delivering babies and a lack of oversight from the church and state.

Analysis of public health records, alongside birth and death certificates, indicated that children with disabilities born at the mother and baby home were deemed "un-adoptable" and denied modern medical care, according to the new research.'

individual
|
INTERPERSONAL
: SCIENCES             
humanistic ------------------------------- mechanistic
SOCIOLOGY : POLITICAL   
|
group
emotional neglect and abuse
 grief, trauma and guilt
 shame
 
physical neglect and abuse
 high infant death rate
inadequate facilities
malpractice


mother and baby  
social / societal punishment 
public health 


 institutions
 criminal investigation
 records              



Source: ITV: NW News and https://www.itv.com/news/2026-06-09/evidence-sent-to-cumbria-police-about-61-baby-deaths-at-church-run-home

Tuesday, June 16, 2026

vi Book: 'Complexity in Health Care - A Paradigm Shift for Clinical Practice'

The rest of the book is practice-based which is a strength. Chapter 18 has three clinical illustrations, were reflection and self-reflection is brought to fore. Especially so, as it pointed out that the 'clinical situation/encounter' introduces its own 'vagaries', or noise which can impact the 'quality of the bond between clinician and patient'. Rapport is the key. 

I was still missing 'complexity' and its dynamics, but I'm sure of the following:

If this was discussed - could be represented then the book would be theory-laden and I and other would-be readers would not be able to understand.

I still think Hodges' model can help, and in chapter 19 picked out 'manifold' (p.113), as if doing so, manifests something more esoteric. There is something here, the author noting the need to shift from individual to group perspectives. So, yes I think we can do more than embrace 'complexity' (p.114).

On page 116 there is discussion of the sometimes sudden path to recovery, 'probably common but often not comprehended'. Please pardon the naivety, but I scribbled 'hidden in complexity, what would (say) the three(?) equations be?'. For a book published in 2023 'artificial intelligence' is not indexed. This might be one area that AI could assist, given the progress in formal mathematics (but see below p.183!)? Algorithm is mentioned throughout the book. Further reading here, informed me that engaging with a reading group on 'Philosophical Counselling' is worthwhile. It is!

Part IX had me wondering if the debate about typical and complex cases, there is a slight of perspective going on? You can end up with paradoxes in terms of an individual's needs, criteria, risk, 'need for admission'. Which I must think about! Chapter 20 has three further reading texts on abductive reasoning. There's an appeal(?) on page 129 for an appropriate treatment model, well that is my take. Collaborative care and stepped care models are suggested. But with acknowledgement that:

'In truth, all models currently available may involve a defect in continuity within or between systems'. p.129.

I beg to differ. A role of Hodges' model is to help frame aspects of care through time, to facilitate and assure continuity.

Part X tackles the required precision in assessment, hence recourse to mathematics and statistics. The next two chapters may be useful for early career researchers and yet looking over our shoulders what is ai offering here? In Case 1 I was impressed by the suggestion of a health record that is over 70 years old. Not impossible of course, but I thought of the Lloyd George envelopes, their hospital equivalents, other paper sources and inevitable scanning this would entail here in the UK? Of interest to research is the creation and validation of complexity profiling inventories (tools) not just that, but their self-assessment form of delivery. And, yes in summary chapter 24:

'We are still left with the challenge of rating the patients' severely compromised health situations where "health" includes social, emotional, and financial well-being.' p.143.

'How do you factor this interpersonal situation into your complexity equation?' p.144.

Yes, how indeed? 

The realities of research of dealt with - funding for the development of tools a problem universally. The references here concern biopsychosocial complexity. Chapter 25 describes abstraction, and hiding detail, which is of great interest here. DSM-5 criteria for major depressive disorder are listed (DSM-6 may be released in 2029?). 

In chapter 25 the authors are once stymied by 'how to include (integrate? PJ) four dimensions, three time periods,and assorted assessment items in a single assessment.' 

As noted the four domains are here again (p.151): medical, psychological, social and care delivery and on page 153, introducing chapter 26, limitations of complexity assessment tools. Parity as in 'parity of esteem' is not indexed and I don't recall having read this, but this is well represented in later deliberations on variables #2. You will find psychosis, but not in depth or severity.

 In 'Creation of a New Model for Clinical Practice' (Chapter 31) identity is stressed, as a prompt to encompass those variables that contribute to preserving the person - what is humanistic. Allied with manifold, identity is a 'coi' for me, concept of interest - for this same reason. On page 172: the authors observe they 'are left with the question of whether there are acceptably accurate clinical models that are simpler and more straightforward than ours? We believe the answer is no!'. I believe there is a way, and a model to help 'keep the life in clinical work' - not take it out. There is a sense that Chapter 32 seeks what I was looking for above: as they explore random variable and 'sample spaces' descriptively - over a page.

Ah! 'Artificial intelligence' is found in text p.183. I'm surprised an editor, proofreader aloud the following sentence to go unchallenged?

'But, as will be discussed, these computer techniques have their limitations based on their lack of flexibility.' 

I was genuinely surprised to read this. Plus, again on ai on page 185: 'Making inferences is not reliably their domain.' I think I would look more at the human-ai interface. And the status of ai within psychiatry as opposed to medicine, but that is also another (parity - divide) debate. Things really are complex now on so many fronts: ethics especially.

Perhaps I am looking for the cookbook formula as introduced for chapter 35 clinical judgement. The further reading is combined with critical thinking. More detail on the empirical-collaborative method is welcome. When I read 'illustrated' I take this literally. Again I can disagree twice on page 220. I know Hodges' model is not validated, but it can - with practice(?) - do this light (simple) or heavy (complex) lifting. 

The warning about dogma needs to be repeated regularly. It is rather like the need for nurses to revisit their profession, role and work as relates to the law. Is Hodges' model an over-valued idea? Am I guilty of thinking I'm an expert? A problem with that view is that any assumed expertise is stretched across the whole model. So if anything there is a shallowness, but this means that I see my particular scope of practice, as other colleagues / professions see theirs. Here in the UK of late, this seems to have become rather blurred. 

In closing with this and achieving a "real-life" understanding of a case, with synthesis - path analysis diagram, the author's underline the value of their book which I have enjoyed and informed my preparation for WCCS26 (more to follow there). The authors can perhaps be reassured that all practitioners have a means to achieve their paradigm shift as described here - with added value and values.

There is a missed word: "of the situation ['with'?] him" on page 114. And revision needed re. text beginning with 'his boyish Paul McCartney "mop-top" ... on page 214. Spelling error on 216 'retu(r)ning'. 

Thanks again to Daniela and colleagues at SpringerNature for the review copy.

Steven A. Frankel, Steven D. Thurber, James A. Bourgeois (2023) Complexity in Health Care: A Paradigm Shift for Clinical Practice. Cham. Switzerland: Springer. ISBN: 978303114948.

Monday, June 15, 2026

"Keep politics out of sport!"

individual
|
INTERPERSONAL
: SCIENCES             
humanistic ------------------------------- mechanistic
SOCIOLOGY : POLITICAL   
|
group
Lewis
 
Russell


Norris





Previously: 'sport'

See also: https://www.formula1.com/ 

Saturday, June 13, 2026

Hodges' model: An antidote to "Cognitive Surrender"*

'The pope's counterpoint that humanity flourishes "not despite limitations but often through them" is one that many people are becoming more aware of in the case of "cognitive surrender": the realisation that making things easier through AI can diminish rather than enhance our abilities. It is in a similar vein that the FT commits to always keeping human judgement at the centre of our journalism.'

* - and burnout?

The FT View, The ethical dilemmas of artificial intelligence. FTWeekend, 6-7 June 2026, p.12.
https://www.ft.com/content/d2c90246-11d7-4169-ac35-988de7fdb2af?syn-25a6b1a6=1

See also: https://www.futureofbeinghuman.com/p/magnifica-humanitas-and-being-human

Previously: 'ai' : 'language'

Thursday, June 11, 2026

NHS Corridor Care – Urgent and Emergency Care Daily Situation Reports

If politicians & policymakers regularly 'walked'
 all the corridors of Hodges' model -
 they would see the false economy 
of their combined incremental works.

Incremental? Yes, in first being a 'temporary measure', then having a deleterious impact as the duration per patient and number of patients on corridors increased.

Now to the situation when the standard of care is unsafe, sub-standard, and denigrates the NHS as a social institution.

The fact of insufficient beds and its effect on care (pathways) and patient (and family) experiences severely affects staff morale, as they recognise subtle abuse, a precursor to structural and attitudinal changes that foster, encourage and establish institutionalised harm.

Staff also realise that they risk being de-skilled, 're-educated' -
becoming less compassionate ... (a 'lesser Nurse') as corridor care 
and its consequences are normalised.

Ignoring demographic trends and without an alternative concerted 
preventive/health education and health promoting plan, this is the result 
of the health and social care funding and policy
of successive governments, enacted by NHS management.

NHS England: Corridor Care – Urgent and Emergency Care Daily Situation Reports
https://www.england.nhs.uk/statistics/statistical-work-areas/corridor-care-urgent-and-emergency-care-daily-situation-reports/