The Sciences: Points, lines, angles and perspectives on Domains

In Hodges' model the axes are presented - by convention - as perpendicular. From this it follows that the resulting four domains, or quadrants appear as equivalent in terms of the space they each occupy. There are many posts on the blog that present a 2x2 table. When in template form Hodges' model is also a potential corpus, empty apart from its structure, then there must surely be a gross asymmetry in the SCIENCES domain compared with the others, including the SPIRITUAL. Discuss?

#simplicity #complexity #folktheory #humanities #arts #humanistic #emotion #balance

See also: https://hodges-model.blogspot.com/2026/06/h2cm-domains-symmetry.html

iii Picking up sticks: when axes matter

It is one thing for us to break the stick, but quite another from a concept's perspective. They are accustomed to the dynamics at work, when as search terms they are exploded, or not. And, not just any concept but one that can be unique. Consider the concept, and how or where it finds itself [ in Hodges' or another model ]? Let us use the intra-INTERPERSONAL domain, as an example, and ask:

1. Is 'mood' fixed by the I-axis alone?
2. Does the humanistic axis have a role in where in the doomain the user of Hodges' model places 'mood'?
3. Acknowledging person-centredness, if the patient/client had a view, to what extent would this agree (with annonymity assured) with the professional's judgement, or a relatives / guardian?
4. What is as a result, 'mood' has become 'very low mood'? (To continue in this vein , invites complication, but we will continue.)
5. Introducing the 'Other' whatever their role and relationship, pushes us to the humanistic, but whether this is achieved in a person-centred manner (triage excluded) is a matter of opinion and judgement (evaluation).

If mood is fixed by the I-axis then if we determine the issue is 'low mood' are we introducing a combined quantitative and qualitative dimension, a continuum, at the selected point in the interpersonal domain? Writing previously about threshold concepts, I wondered, and proposed compound threshold concepts. There is a progression from the patient's subjective self-assessment, to in all likelihood of an objective measure being introduced, so spanning two domains. Definition of 'compound' aside; there is a compound structure at work.

What points 1-5 above reveal is triangulation. When it is argued that Hodges' model facilitates navigation as per my presentation on 21st April, this is a strategy from mixed-methods research in practice. Many years ago, Hodges' model was described as a 'cognitive periplus', reflecting the way ancient mariners initially charted the coastlines creating the first map, as per their culture and dispora. In the west more recently the value of social approaches and activities, especially in mental health. Care navigation is a role. Literally sign-posting to individually suited (which must be stressed) activities, resources, and agencies. So, in Hodges' model what are our three triangulation points? They are:

1. Axial;
2. Intra- InterDomain; 
3. Person-centred. 

Perhaps, we can describe 1-2 as conceptual anchors at least when dealing with a concept, while #3 is more about approach, values and philosophy. So, there is something of a 'cheat' going on, because each one is compound:

1. Axial: The axial is comprised of four points. The axes create a Cartesian plane (figure). And, as far as a patient is concerned, they mark off a point on the respective Individual and Humanistic-Sciences parts of the axes. This form of triangulation point can claim a general conceptual precision (language) in the applied terminal labels; but what happens in-between can be patently fuzzy. A mix of what may be objective and subjective.

2. Intra- Interdomain: This may be the most imprecise triangulation point. It appears the axes of Hodges' model are composite (figure). They have two-sides as a boundary. To be pedantic, in our example, one plays to the interpersonal domain, the other the sciences.

[The relationship between the axis and the domains in Hodges' model, is far from unique; but I wonder if there is something else here?]

2. Person-Centred: There is a paradoxical nature to person-centred(ness). It is also nebulous in nature, and yet in care it is definitive in practice (safety, purposes, values, professionalism, competency, ...).  It forms locus which can also be classed as a traingulation point, at the centre of the model. This is the point around which Hodges' model is built. This captures the individual's (life, care) context and situation, all influenced by their life chances as consequent health - and other - careers. Salience and our attention^ is key. Is it possible to frame our purpose(s)?

^A focus for [N] autumn.

Marrakech, Le Jardin Secret. 24th April. 1000-1830.

Picking up sticks: when axes matter ii

This past week at WCCS26, I've put Hodges' model itself on the work-, or more properly the inspection bench. Now, referring back to the - 'Our broken sticks' c/o Roger Lewin "Complexity: life at the edge of chaos" post, perhaps a theatre table is required. That is, as I try to examine the model, take it apart, have a look at the bits - as far as they are. And, what about the question posed in the above post?

'If we take the axes of Hodges' model, and break them at twenty-five points, I wonder what we end-up (or start) with?'

If there are twenty-six sticks, well, amongst other things - we've made quite a mess. But, there's more going on.

There may be some kind of idealised symmetry, or is it equality between the necessary, or projected length of the I-G axis. That is, as it extends for the INTERPERSONAL and SOCIOLOGICAL domains. But is there equivalence, in a default sense, for the SCIENCE and POLITICAL domains? Or am I (once again) overthinking? If medicine, health and by implication social care are bio-psycho-social, then surely we have a structural problem? Not only that, but we see a boundary, partition ... axis - in action. In Hodges' model the axes have two parts, two sides, so they are in effect composite. If the bio-psycho-social model is true, in whatever senses we wish to declare, derive or pursue in research (the literature, logic, practice, political expediency, or realism ...), then the group axis is incomplete. 

Hodges' model: Structure and Content - Axes and Domains

Is this literally why health care systems are so difficult to design, develop, establish and sustain? Think about that too, please. Is this why we as individuals rely on a functioning (caring) society and political systems? Is this why health care systems can suddenly be faced with collapse, as geopolitics has revealed. Vulnerability, becomes more than an individual characteristic and experience; when nations are dependent upon others for their funding, organisation, logistics, personnel, continuity and more. As a result, many understandably want to break with this socio-political and coloanial legacy.

Is there something in the sentence above in italics, that we can actually utilise to help define the foundation of Hodges' model? Again, not wanting to sound grandiose, but is there an axiom hidden in there? Even as 'health' is the inevitable election issue. The irony of this! Even if the politics of health and health in politics is not so much hidden as often denied. History reveals the influence of triage on the battlefield on the emergence of medicine and surgery. The future is here now. There is a political fight to follow for health in all its manifest forms. So here is another post to return to.

'Our broken sticks' c/o Roger Lewin "Complexity: life at the edge of chaos"

Chapter 4 Explosions and Extinctions

  'Is Stu being led astray? I asked. "There's something called the broken stick model in statistics," said Dave. In this trick, a random number generator "breaks'' a stick a hundred inches long at twenty-five points, and produces twenty-six short sticks. Measure them, count the number that are one inch long, the number two inches long, and so on, and draw a histogram. You get a skewed distribution, toward the short end, just like many natural phenomena, including the distribution of sizes of U.S. cities, for instance. "One thing you have to remember about extinctions is that some species are more likely than others to die out, just because they exist as small, isolated populations,'' explained Dave. "This sort of statistical quirk can skew your results, easily." So, you would be suspicious of anything that looks like a power law? "I would, because it's common, just in the nature of statistics. It may tell you that a system is poised at a critical point, whatever that means, but it may not. In any case, when Stu says that the curve he gets from my data is close to a power law, he knows that there are many other mathematical models that could fit equally well."
  Clearly, there were many reasons to be cautious about drawing the conclusion that global ecosystems are poised at the edge of chaos, using just the extinction data.' p.80.

 

Hodges' model: Axes (structure) and Domains (content)

If we take the axes of Hodges' model, and break them at twenty-five points, I wonder what we end-up (or start) with?

 

Lewin, Roger. (1993) Complexity: life at the edge of chaos. London : Phoenix [Dent, 1993] ISBN: 1857990285.

Previously: 'complexity' : 'system'

ii Learn your lines and the hyperplanes will follow

With these lines, partitions, axes and domains in mind, when a clinical practitioner is presented with a new person, whether as a patient, client, or carer ... they can, using Hodges' model (and other tools!) approach their assessment in an open and receptive manner.

This means that the information provided by the 'patient' can be readily fielded, captured whatever the context and situation.

As noted previously, my study of Hodges' model began in the late 1980s. Application in my work as a community mental health nurse, with an interest in informatics followed quite naturally(?). Primed as I was, for various reasons to carry this forward, I also carried a mathematical learning disability. At the risk of getting bogged down in my thought, use and approach to Hodges' model I need a challenge.

Mathematics is the challenge for me. It's fascinating how we have in-built 'calculators' that can help us catch a ball, and judge fairly well where to throw a ball for interception. There seems then to be an informal or naïve  mathematics, at work unconsciously. Does the same apply to Hodges' model? If so, how can I isolate, and identify it?

• Is it represented somewhere, implicit in Hodges' model itself?
• Is it (once again) to be found in the user of the model?
• Is it (more likely, and obviously) a combination of these two?
• Or, is it a product of the system, or a series of systems? 

I was reminded of what is a Sober toy, several years ago:

Is Hodges' model a selection machine?

All four original purposes of Hodges' model:

1. Person-centred, integrated and holistic care;
2. To bridge the theory - practice gap;
3. To facilitate reflection and reflective practice;
4. To support curriculum development;

- are concerned with conjunction and choice, selection. So is life itself through distinction, difference, and differentiation.

Hodges' model is a selection machine, that is both fhuman and machine driven.

A clinician may obtain the referral information through an email, a history of previous contacts can be retrieved from a clinical information system; the context and purpose supporting access to the information.   

A whole series of blog posts describe the role of Hodges' model to help assure parity of esteem across mental and physical health. What does this mean in practice?

For the practitioner, they take selected data from the referral, a history - if available, an initial telephone contact, a conversation with a colleague who remembers the person re-referred and starts to populate Hodges' model. What are the psychological concepts that arise? What are the physical?

If a referral in whatever form, or a database record can be viewed as a bag-of-words, then Hodges' model is a collection of care concepts. Four bags then. Sets or classes. An experienced user of Hodges' model may position care concepts that throws attention on the INDIVIDUAL↔GROUP axis. Lying between the INTRA- INTERPERSONAL and SCIENCES domains, this axis (like all the others) earns its keep. There is work to be done that is also of interest in machine learning:

'A support vector machine (SVM) is a supervised machine learning algorithm that classifies data by finding an optimal line or hyperplane that maximizes the distance between each class in an N-dimensional space.

SVMs were developed in the 1990s by Vladimir N. Vapnik and his colleagues, and they published this work in a paper titled "Support Vector Method for Function Approximation, Regression Estimation, and Signal Processing"¹ in 1995.' 

https://www.ibm.com/think/topics/support-vector-machine

Strange to think that perhaps the VERTICAL axis and others in Hodges' model are not precisely S-N-E-W in their bearing? There may also be several vectors at work in fact?

Image: c/o https://www.ibm.com/think/topics/support-vector-machine

The word 'naïve' has been bubbling away for a good-many years. A close colleague Silvana Bettiol, Univ. of Tasmania kindly read my draft on Hodges' model as a mathematical object, and mentioned the introduction points to Bayes theorem even if informally. Even in those initial 'clinical' encounters (and social meetings, that attend to empathy, rapport and engagement...) complex judgements are being made, beliefs tested, from what is often partial and disparate sources of information.

Checking other leads led to Frequentist and Bayesian Approaches

'Statistical inference is a series of methods used to make decisions and draw conclusions based on available data. There are two primary approaches for inference: Frequentist and Bayesian. Each framework relies on a different philosophical perspective on probability and modeling, leading to different techniques and interpretations. Each has its own strengths and drawbacks, so understanding the distinctions between them is vital for researchers, data scientists, and statisticians who aim to choose the most suitable approach for their specific analysis.'
https://www.statology.org/comparing-frequentist-and-bayesian-approaches/

More reading required and threads to run.

Earlier this week I posted re. Cromer's book -

Cromer, A. (1997) Connected Knowledge: Science, Philosophy, and Education, Oxford: Oxford University Press

Before passing the book on, p.198, Chapter 8 notes, #4:

'"Understanding" is a commonly used English word which has no precise meaning. It's sometimes taken to mean the ability to apply knowledge to new situations. In this sense, it is a very high-level skill. Benchmarks for Science Literacy says, "Learning to solve problems in a variety of subject-matter contexts, if supplemented on occasion by explicit reflection on that experience, may result in the development of a generalized problem-solving ability that can be applied in new contexts' (American Association for the Advancement of Science, 1993)." The key word here is "may." 'We really don't know how to help students develop a generalized problem-solving ability, or whether there is such an ability apart from mere knowledge of many different problem-solving strategies. Whatever the case, since we do know how to teach students to solve specific, problems. this should be the primary focus of science education' p.198.

Ack. IBM.

Learn your lines and the hyperplane will follow i

Take an empty [rectangular] space (A4 paper in landscape)

Blank! Isn't it?

Take a line. Yes, call it that.

Divide the space vertically, and equally, in two. 

Do this again but horizontally.

You can call these lines, partitions if you wish?

Or, as per adopted convention here, axes.

Now, there are four empty spaces.

These spaces can be called quadrants, planes, or domains. The latter term usually adopted here.

Labels can be decided, and assigned to the axes and the resulting domains.

Given a purpose, in practice (initially) the 'empty' spaces have the ability to assign significance to what may be placed within them.

Such decisions are non-trivial, in the sense that context and situation determine what follows, influenced by objective and subjective considerations.

The domains can contain concepts, or keywords with decisions driven by categorical reasoning.

The content of the domains can also be viewed as classes and sub-classes.

ii to follow (with revision here?)

ii Big Mind: How Collective Intelligence Can Change Our World

'Everything we know is knowledge from the past, which may not apply in the future - the problem repeatedly stumbled on by models, algorithms, economic theories, and geopolitical dispositions, which made sense in one era, but then become dysfunctional in another. As social science has repeatedly discovered, the more you use a model, the less likely you are to question it. What starts as a pragmatic tool to answer a question becomes a truth in itself.

And so the models we use to think can also become traps. A model is held on to because it provides meaning and reassurance. Police forces notoriously cling to evidence they collect early in a case in the face of powerful contrary evidence that emerges later, and thus extraordinary miscarriages of justice result. The middle-aged cling to the theories they learned as undergraduates. Organizations become attached to models that become comfortable through use. I remember once meeting the planning team of a government that admitted that their forecasts had been no better than random guesses, but argued that the detailed forecasts were still needed to help with planning. The model became a comfort, even though it had no real use. 

Familiarity also breeds blindness. ...

Expertise can equally entrap. ...

 

The implication, as the Buddha pointed out, is that intelligence has to be at war with and suspicious of itself to be truly intelligent.' pp.120-121.

FIVE FUNDAMENTAL PRINCIPLES FOR EFFECTIVE COLLECTIVE INTELLIGENCE

'The first is the extent of what I call (1) autonomous commons of the intelligence in the system. By this I mean how much the elements of intelligence are allowed free rein, and not subordinated too easily to ego, hierachy, assumption, or ownership.' p.66. Chap. 5. Organizing Principles.

2. Balanced use of the capabilities of intelligence

3. Focus and the right granularity

4. Reflexivity and learning

5. Integration for action

 

'So a group is a we, but it is not just a scaling up of an I. How, then, should we think about the character of this we?' p.102. Chap. 9. The Collective.

 

Individual

|

      INTERPERSONAL    :     SCIENCES               

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

 SOCIOLOGY  :    POLITICAL 

|

Group

EGO	HIERARCHY
ASSUMPTION	OWNERSHIP

  

n.b. With my emphasis.

 

Geoff Mulgan (2017) Big Mind: How Collective Intelligence Can Change Our World, Princeton University Press.

Image: Princeton University Press.

See also: 'AI' : 'group' : 'axes' : 'individual'

 Previously:
Big Mind: How Collective Intelligence Can Change Our World

Bourdieu: systems, axes, maps, practical logics

I have checked these quotes and am fairly sure they are accurate. The first, I feel, improves with re-reading, and presents a clearing at the end? 

The clearing could be a template, and as per the second it may be old; but retains its practical function.

'Intellectualism is inscribed in the fact of introducing into the object the intellectual relation to the object, of substituting the observer's relation to practice for the practical relation to practice. Anthropologists would be able to escape from all their metaphysical questioning about the ontological status or even the 'site' of culture only if they were to objectify their relation to the object, that of the outsider who has to procure a substitute for practical mastery in the form of an objectified model. Genealogies and other models are to the social orientation which makes possible the relation of immediate immanence to the familiar world, as a map, an abstract mode of all possible routes, is to the practical sense of space, a "system of axes linked unalterably to our bodies, which we carry about with us wherever we go", as Poincaré put it.' p.34.

The Logic of Practice

'The logical [kinship] relations he constructs are to 'practical' relations - practical because continuously practised, kept up and cultivated - as the geometrical space of a map, a representation of all possible routes for all possible subjects, is to the network of pathways that are really maintained and used, 'beaten tracks' that are really practicable for a particular agent. The family tree, a spatial diagram that can be taken in at a glance, uno intuitu and scanned indifferently in any direction from any point, causes the complete network of kinship relations over several generations to exist in the mode of temporal existence which is that of theoretical objects, that is, tota simul, as a totality in simultaneity. It puts on the same footing official relationships, which, for lack of regular maintenance, tend to become what they are for the genealogist, that is, theoretical relationships, like abandoned roads on an old map; and practical relationships which really function because they fulfil practical functions.' p.35.

My source:

Bourdieu, P. (1990). The Logic of Practice. Stanford University Press. https://doi.org/10.1515/9781503621749 [and image source].

Bourdieu, Pierre, "The Logic of Practice (1990)" (1990). eTextbooks for Students. 875.
https://stars.library.ucf.edu/etextbooks/875

See also: https://hodges-model.blogspot.com/search?q=bourdieu

Interesting ... 'Incidence structure(s)'

Unsurprising, in studying 'Hodges' model, I've been aware of Wilfrid Hodges and model theory for many years.

Now, trying to look at (Brian) Hodges' model using maths, I've wondered about possible connections with Wilfred Hodges' work.

Dr W. Hodges was listed in searches on lines, axes, and structure:

'Algebraists and geometers like to classify structures by the laws which they obey. A typical law for incidence structures reads:

"For any two different lines L and M, there is exactly one point which lies on both L and M."'

My imagination may be getting the better of me, but there seems something profound in the intersection of the model's two axes and the care - knowledge domains that are created (proposed - adopted..)?

So, is Hodges' model a form of 'incidence structure', or does it contain several incidence structures? 

Hodges, W. (1985). Truth in a Structure. Proceedings of the Aristotelian Society, 86, 135–151. http://www.jstor.org/stable/4545041

Hodges' model - Locus of Care & Control?

Draft notes:

There are obvious geometric features (Stewart, 1981) in Hodges’ model. Application of the model is a holistic affair. The centre of the model is its centre (as a template), but in application it is not fixed. There are several degrees of freedom, determined by the context of application. Consider figures 4a, 4b and 4c. Perhaps it can be argued there is what amounts to a care locus? As Persons (2025) notes:

‘Primary care is considered the first line of defense in health care, and it is the locus of the maintenance of both individual and population health.‘ p. 15.

 Emphasis can be placed on selected domains, as the situation dictates:

Stewart, I. (1981) Concepts of Modern Mathematics, Harmondsworth: Penguin Books.

Persons, G. A. (2025). Health Care Safety Nets: Vital Participant Roles and Varying Policy Contexts. Phylon (1960-), 62(1), 5–30. https://www.jstor.org/stable/27396595

The INDIVIDUAL ↔ GROUP axis

Looking at the axes of Hodges' model, specifically the INDIVIDUAL ↔ GROUP axis, I realise (as ever) there's more than meets the eye. 

The labels for the axes are placeholders. To a certain degree they are open, flexible. In the template (link and figure in the sidebar), the what should now be familiar labels are provided for guidance, and convenience.

The care, knowledge domains can be viewed as giant - compound placeholders, even as an opportunity to abstract away a lot of detail. In care delivery, as we concentrate on patient care, , clinical interactions, procedures ... we tend to do this in political terms. Until that is, we are jolted to the wider situation and the true realities of policy, law, and practice.

While the HUMANISTIC ↔ MECHANISTIC labels are fixed, I've often shown how the I ↔ G is itself situated, so you could variously have (titles & names to follow...):

person, self, I, individual, client, patient,
carer, student, nurse x, dr y, allied health z ..

|

nurse .., husband, wife, partner, kin, couple, guardian, friend, family, team, group, community, region, nation, populations, Planet

Usually, what we have is a ONE-TO-MANY relationship, that is 1:N.

In Hodges' model can we also say that the team is the 'individual' and the organisation the group?

Another thought regarding self-care. ... Some times this state might be concurrent with being a patient.

Part of the journey in a patient's recovery. But at some point the person does not need a professional and is indepedently self-caring. Care episodes are not what they used to be. Although when 'true' self-care is achieved, it might appear One-to-None, but this is not correct. Not correct, that is, if we can credit society acting as a safety net. Usually, it would be One-to-Family; if there is no family, then the One-to-Community should (must) be the placeholder of choice.

On self-care, and the vertical axis of Hodges' model, is this also a way to define sustainable health and social care?

See also: https://hodges-model.blogspot.com/2025/10/l-shaped-model.html

On models, gaps, deficits, neglect

This a.m. I responded to an email from -

the SDOH Listserv at https://listserv.yorku.ca/cgi-bin/wa?SUBED1=SDOH&A=1

- about a forthcoming book (news to follow). 

I replied, with thoughts (edited) that link to the post earlier today:

On the 'front' - or behind the line(s)?

As a community mental health nurse, I've always recognised (as best I can) the critical, power relation of psychiatry.

This is why I study - champion Hodges' model, because the -

• medical model
• bio-medical
• bio-psycho-social models 

- are all inadequate (in the 21st C. and supposedly post-Institutional care?).*

Inclusion of the 'Political' domain in Hodges' model, is critical in the negotiation between the person and collective.

This is what opens up the wide, expansive 'front' in Hodges' model, where relations can be explored in abstract and concrete terms.

A point I'm currently working through (post - paper?): is it ironic that that education and health have acknowledged and try to mitigate(?) the 'deficit model', but in the very conceptual frameworks / models that these disciplines & professions deploy (esp. medicine?), there is a deficit* - manifest in were we are and how we Care today and tomorrow. This is further aggrevated as capitalism clearly has its way (counter-lobbying the health and care professions)?

*tantamount to neglect?

Despite the pioneering efforts and work of several leaders e.g. Virchow, and fields of medical sociology and public (mental) health.

See also - Joe Wicks: Licensed to Kill Channel 4 UK. 2000hrs 6th October 2025.

'Cereal'

On the 'front' - or behind the line(s)?

In many sources on socio-economics, politics, health policy ... I still note the challenge to represent the INDIVIDUAL and COLLECTIVE within a figure. Of course the author's subject, purpose, the context all influence the final depiction and the message to be conveyed. 

I wonder if Hodges' model can provide a starting point to explore relationships, oppositions, arguments and synergies?

Hodges' model provides an 

expansive and potentially powerful 'front' 

through its horizontal axis 

[ HUMANISTIC ↔ MECHANISTIC ].

This axis - drawn across and through the model vertically, may make it easier(?) to analyse and synthesize the relations at work and produce a diagram?

Individual

|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC =========================  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

INDIVIDUAL	INDIVIDUAL
GROUP - POPULATION	GROUP - POPULATION

Nothing new under the Sun . . .

"The quadrangle is the token of a new humanity. The square is to us what the cross was to the early Christians". 

Theo van Doesburg

Tate Liverpool visit 13th June 2008.

Book: 'Health and Health Care Inequities' iv

Fittingly, chapter 4 brings us to Political Power and Policy Advocacy. In Hodges' model you can both have your cake; and gratefully receive the cake you're given. This is the health in politics and the health in politics (as, for example, revealed in the health status of political leaders).

As a framework structure, the axes of Hodges' model initially give rise to four symmetric domains (spaces). There is an invitation to begin where you choose. Chapter four reveals some truths, as the 'nexus' - center of the model is mobile (unlike many citizens!) as the 2x2 rendition below suggests, if not illustrates. Borras takes us through health politics, political participation and representation, unequal power and politics, and policy change approaches with illustrative cases.

In an institution (like the NHS), bureaucracy, aka an organisation, the workforce are often acutely aware of policy and procedure. It is like the Force. It permeates everything - the meetings - and yet is remote. Borras seek to shed light on unequal resources and policy influence. Again Borras's literature informed discussion and argument, includes some historical gems, such as Lasswell (1958).

Individual

|

      INTERPERSONAL    :     SCIENCES               

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

 SOCIOLOGY  :    POLITICAL 

|

Group

	Political Power and Policy Advocacy

In chapter 5 on evidence and ideas, discussion of Katherine Smith's 'under 'Six Travelling Ideas' is an excellent resource, with several references including:

Smith, Katherine E (2013) Institutional filters : the translation and re-circulation of ideas about health inequalities within policy. Policy and Politics, 41 (1). pp. 81-100. ISSN 0305-5736 (https://doi.org/10.1332/030557312X655413).

I love the image of ideas as and on a journey, some successful, others fractured, weak, re-contextualised, even non-journeys (falling - 'dead from the press' - I suppose?). At least the journey of Hodges' model is ongoing. A baton for our times. As I wrote in post i, chapter 5 tackles 'evidence' (there's a post or two). It does so in relation to information, ideology, and interests:

• 
  Book: 'Health and Health Care Inequities' i

If you've read many posts on W2tQ, you may see: I've a chip on my shoulder. Evidence for the safety, benefits, theoretical underpinning ... of Hodges' model is still to be realised. To the satisfaction, that is: of course to the powers that be. Speaking of which: the axial (for me) subtitles arise again in chapter 6; capitalism-imperialism-colonialism-racism nexus (p.87).

To demonstrate the utility of Hodges' model, this is significant.

Please feel free to search for these terms - capitalism-imperialism-colonialism-racism in the search bar above.

I've been interested in drama since playing the part of Francis Nurse in Miller's The Crucible. It took some 50 years to go from armchair to treading the boards again. I played Ken, supported by his wife, trying to run a post office, amid a chaotic and injurious IT system. An 8-9 minute sketch which was part of a Living Newspaper. Interested in writing - as previous posts may reveal, I also keep trying get to the theatre. With the themes of chapter 6, Liberation was thought provoking.

Mind-Body, Private-Public, Socialist-Conservative, Borras adds the global health North-South schism. A prompt for suggesting a brief glossary is expropriation and exploitation^ (p.88). Four stages of capitalism too. This chapter - A critical political economy approach is essential reading for me (and you!?) - a path to a critical care economy (self-care to planetary health).

^There is a note #3 about these on page 99.

See also: Post i : Post ii : Post iii : Post v (to follow)

Merelman, R. M. (1981). Harold D. Lasswell’s Political World: Weak Tea for Hard Times. British Journal of Political Science, 11(4), 471–497. http://www.jstor.org/stable/193766

Arnel M. Borras. (2025) Health and Health Care Inequities - A Critical Political Economy Perspective. Fernwood Publishing.

Liberation image: The Agency

https://theagency.co.uk/news/cast-announced-for-ntombizodwa-nyonis-liberation-at-royal-exchange/

Book: iii 'Health and Health Care Inequities'

This book, or similar should be read by 3rd year student nurses and other healthcare learners. I wondered if, for students, a brief glossary might be useful. But key terms are explained and clearly, with typologies numbered and expanded when needed. There seems an aversion in nursing academia to avoid the acutely 'political'. Even though of course in psychiatry, the need for considersation of human rights, consent, capacity, law, personal and public safety, risk is inevitable. Should we only learn of the politics of our role on a post-registration/license course of learning? As mentioned in post i, Borras duly notes the asymmetric impact COVID. The disproportinate deaths of frontline healthcare workers from ethnic minority groups (UK). A sign of the impact, is reflected in COVID recurring through the text.

The device of using axes, e.g. Class-Gender-Health (p.11) rightly draws in commentary on nutrition, pay gaps - heterosexual white men, terms of employment, and design and occupational health for woman. Gender politics is also reflected in the text. The relational dimensions of this discussion also stands out. The Class-Race-Health axis (had me return to the question of parity, but beyond the mental - physical divide. 

These axes employed by Borras seemingly traverse a path and are extensible (across pages). Briefly, in Hodges' model the domains and axes act as stepping stones: 

We can ‘walk’ the model:

Humanistic INTERPERSONAL Individual SCIENCES Mechanistic: adding - Humanistic SOCIOLOGY Group POLITICAL Mechanistic 

A global perspective is matained, even though the focus is Canadian health, government, policy and policy. The press have often highlighted the global nature of the housing crisis. Canada is not immune; as discussed in chapter 2. For what is in many nations a 'housing disaster', Borras covers the history too. Reflecting on: 

'Around the world, neoliberal programs have resulted in over a billion people living in slums (Davis 2017, 23). In wealthier countries, there was rampant privatization of social housing units.' p.25. 

- you feel like a nodding dog toy. Where is the leadership, the strategy and integrity to provide housing for all? Arnel also stresses the link between mental health status and housing. The SDGs place emphasis on security (yes, at the level of what is happening in Ukraine, Gaza, South Sudan...), then housing follows. And with climate refugees to follow ...! I have seen gentrification, and listened to an account in 2007 as Manchester started to experience high-rise growth. I used to try to walk to community visits with students when possible. Observational skills come in many forms, safety still depends upon them. With no place to call home, safety and security is a stark issue for people. A foundation for health, wellbeing and ironically productivity. The rise of foodbanks is also damning. 

Gambling is not indexed, but there appears a denial in the UK government, with other nations 'folding' to the influence of lobbying and corporate influence reducing or removing restrictions in gambling and crucially: advertising. What's the denial you say? Yes, well governments seem to be in denial that there are vulnerable groups in their respective populations. It is laudable that they bestow upon the citizenry the freedom of choice, but that can spell trouble.

If Canada - Ontario has its housing scandal:

'Housing insecurity and homelessness occur because the state and its goencies support real estate and banking corporations that continuously increase housing prices. This setup is a huge problem because these enti- ties focus on generating profit and capital accumulation. The Greenbelt Scandal in Ontario revealed how the government made decisions that served the interests of big companies instead of the public (McGrath 2023; Office of the Auditor General of Ontario 2023). This scandal is an example of neoliberalism and a corrupt style of governance (Moscrop 2023). We need to stop using neoliberal strategies and focus on socialized housing.' p.27.

So does the UK: Grenfell Tower Inquiry No doubt, other nations have their tragic examples. It seems 'international Standards', quality, integrity can never be taken for quality. They too are precarious, vulnerable. Borras's work in chapter 2 on housing security, and differenciation of core housing need is laudable, informative and welcome. Re-reading Arnel's point: 'There is no doubt that housing insecurity affects health'. p.28. His book as a whole makes the point that of course more evidence will always be needed. In healthcare for decades the basics of public health have been identified, studied, established, placed in models and frameworks. Yet we find we are found wanting (UK - Awaab's Law) dragged back to the first steps; and despite the urgent issues we now face.

"Universal health care" is not exactly new:

The Canadian Association of Social Workers. (1961). The Social Worker, Volume 29, Numbers 1 to 2. 29(1to2), 1to78. The Canadian Association of Social Workers. The Social Worker - Le travailleur social. Canadian Association of Social Workers. https://jstor.org/stable/community.39672572.

Borras is correct to write of 'The Continuing Private War against Universal Health Care' (p.36). Looking at NGRAM it appears the private sector has been winning in recent decades. Working previously as a community mental health nurse for older adults, chapter 3 explores Canada's health care systems. Table 3.1 compares the ownership of long-term care homes in figures. The discussion deals with the quality of care and variation. Policy intentions, plans, research and what follows in practice is also debated. Is there any comfort  in learning that Canada is not alone in being skilled at kicking-can-down-the-road. To be fair many developed nations face the same demographic cliff (whichever way you it!), just one of the urgent issues noted above. The contribution of informal carers is also highlighted.

Here in the UK the commissioner - provider split and models of care at the finance level are a maze: amazing in their bureaucracy. Borras does a marvellous job, in providing enough detail without weighing the narrative flow, and losing the reader. The close of chapter 3 offers hope that Hodges' model will continue to be found:

'Therefore, shifting away from neoliberalism toward a new societal system where health care is seen as a fundamental human need and a universal right, not a profit-driven commodity, is crucial. This alternative system requires a new societal framework built on solidarity, fairness, and humanity, prioritizing health over financial and personal gain.' p.50.

See also: Post i : Post ii : Post iv : Post v (to follow)

Arnel M. Borras. (2025) Health and Health Care Inequities - A Critical Political Economy Perspective. Fernwood Publishing.

In addition:

Messing, K., & de Grosbois, S. (2001). Women Workers Confront One-Eyed Science: Building Alliances to Improve Women’s Occupational Health. Women & Health, 33(1–2), 125–141. https://doi.org/10.1300/J013v33n01_08  (Borras - pp.11-12).

https://nhsrho.org/news/tender-maternal-and-neonatal-image-library/

Previously: "Invisible Women" on International Women's Day

The 'animal' in Hodges' model ii

The two pairs of eyes in Hodges' model are provided through the model's two axes

HORIZONTALLY: the humanistic and mechanistic.

VERTICALLY: the individual and the group.

Hodges' model: Axes & Domains
Structure AND Content :: Fight OR Flight

Before delving into this though, let's revisit the model as a template.

Structure aside, Hodges' model acts as a conceptual blank sheet. Overall, the model is also an aide-mémoire. It can prompt us to 'where' we've been, where we need to go in our data gathering, assessment, planning, interventions, evaluations: personal history, family, work and leisure. In an interview how does the patient, client, carer, student ... negotiate the domains of Hodges' model? The model can guide us in what is said, what is omitted - for whatever reason, what is significant within all this; AI-assisted or not.

These two 'horizontal' eyes prompt us to attend to safety, your own, the patient / client and other people in the vicinity. In terms of responding to 'fight', obviously this does not mean you are looking for a fight, but of course you have to be able to defend yourself. Metaphorically, Hodges' model can represent the sword and shield. We are in a fight for justice to secure health services for individuals, families, and the population.

On the side - vision for flight, what is humanistic and mechanistic.

Then, in the vertical axis, there is vision for fighting, for the individual, and the group - population.

In this interplay of person and collective, I'm reminded of Odysseus and the shout "Nobody did it!" (with other sources). It never ceases to amaze, the frequency of this conclusion throughout local, national and global politics?

The individual nightmare of Cyclops; and collective nightmare of the Panopticon.

In mental health nursing you quickly learn about the anatomy^, physiology and psychology of anxiety. Not necessarily simultaneously, but the jig-saw is there to be completed, at least as far as you can as a 1st year student - whatever your health discipline. The pieces that matter (literal keys to action) are provided by the patient, client, carer. ...

In a way it is too late when people are referred to mental health services. Too late for prevention, but given the incoherence between:

• health systems (as usually found & founded)
• government policy -
• state of nutrition - food
• advertising of foods, beverages
• life style choices
• education - health literacy
• individual
• family
• community
• national (curricula)
• NHS? National Health Illness/Disease Service

- this isn't a surprise.

Whatever an individual's sensory capacities and abilities we need to do better. With tools to facilitate situational awareness, and realise an individual's and community's potential to learn and prosper.

^Anatomy? How many of us take for granted our limbs are 'there': ready to react?

Previously: The 'animal' in Hodges' model i

Original source - prompt:
Doniger, Wendy. The Rise and Fall of Warhorses. The New York Review of Books. April 10, 2025. Volume LXXII, Number 6. pp.17-19.

The 'animal' in Hodges' model i

The New York Review of Books

'The fact that a horse has his eyes on the sides of his head identifies horses as animals of flight rather than fight, in contrast with animals like tigers, who have their eyes in the front.' p.17.

Hodges' model has two pairs of 'eyes'.

Can you see them?

Hodges' model: Axes & Domains
Structure AND Content :: Fight OR Flight

Doniger, Wendy. The Rise and Fall of Warhorses. The New York Review of Books. April 10, 2025. Volume LXXII, Number 6. pp.17-19. https://www.nybooks.com/issues/2025/04/10/

Joint-carving - 'The First Cut is the Deepest' c/o Traldi

Last Friday I joined in another online session of the Argumentation network c/o Andrew Aberdein and Kat Stevens. 

The subject was “The Epistemology and Politics of Redefinition” by Oliver Traldi.

As ever, it was interesting, technical, relevant and a prompt to concepts new, briefly encountered previously. I can't remember if in the talk, or Q&A, but mention was made of 'joint-carving' but I checked some sources:

'Because properties are so abundant, they are undiscriminating. Any two things share infinitely many properties, and fail to share infinitely many others. That is so whether the two things are perfect duplicates or utterly dissimilar. Thus properties do nothing to capture facts of resemblance. That is work more suited to the sparse universals. Likewise, properties do nothing to capture the causal powers of things. Almost all properties are causally irrelevant, and there is nothing to make the relevant ones stand out from the crowd. Properties carve reality at the joints -- and everywhere else as well. If it's distinctions we want, too much structure is no better than none.' p.346.

Lewis, D. 1983. New Work for a Theory of Universals, Australasian Journal of Philosophy, 61(4): 343–377. doi:10.1080/00048408312341131

'Though the facts or truths that the realist judges mind-independent are most commonly put in terms of a kind’s ‘naturalness’ (or lack thereof), they may be formulated in alternative locutions, such as the ‘reality,’ ‘non-reality,’ or ‘artificiality’ of a kind or kinds. For example, that human races are not real, or that protons form a natural kind, both express such facts. Equivalently, Plato’s famous carving metaphor may be used to do so, as when it is asserted that the classifications of the DSM-5 do not carve nature at the joints. For the sake of expository simplicity I will exclusively use the language of ‘naturalness’ here, but translations into alternative terminology are straightforward.'

Franklin-Hall, L. 2015. Natural kinds as categorical bottlenecks. Philosophical Studies 172 (4):925-948.

Further, Sass writes:

'The goal is to have a consistent and informative test for what counts

as a realist versus an anti-realist view about natural kinds. Bird’s(2018) taxonomy,

building on Hawley and Bird(2011), focuses on the questions of whether natural

kinds exist, and if so, what sort of entity kinds are. Franklin-Hall’s (2015) taxonomy

focuses instead on whether kinds are individuated by a mind-independent principle,

or whether kinds “carve at the joints”.1 This paper focuses mainly on the issues raised

by Bird’s (2018) taxonomy.' p.11862.

Sass, R. 2021. An ontology of weak entity realism for HPC kinds. Synthese, 198(12), 11861–11880. https://www.jstor.org/stable/48692794 [ homeostatic property cluster (HPC) theories of kinds ].

In the past, I've written about the (nursing, IT, psychological...) models muddle. At the risk of adding to my muddle, Traldi's presentation is a timely prompt. Timely, because trying to looking at Hodges' model as a mathematical object, it needs to be stripped down to its bare components (and purposes?). Is redefinition the order of the day? I will leave defining the components to one-side at present (in drafted notes). But even from Hodges' model as a template, with its (two) axes and (four) domains we can (must) consider:

1. The two axes taken as a whole - do they intersect, or not?*

Relationally, the axis between:

INTERPERSONAL | SCIENCES

SOCIOLOGY | POLITICAL

INTERPERSONAL - SOCIOLOGY

SCIENCES - POLITICAL

2. Each axis (treated independently) to the centre of Hodges' model. (See 1.)

The conjoining of axes (do they?):

The INDIVIDUAL - HUMANISTIC and INDIVIDUAL - MECHANISTIC.

The HUMANISTIC - GROUP and GROUP - MECHANISTIC.

                                

Hodges' model

I won't continue now, but I have wondered if one axis is primary? Which one comes first? Faced with a blank piece of paper, or flipchart ... which axis gets drawn first?

In guided discovery workshops, teaching sessions I have been directed by the context and duty of care. Given that this is clinical then the I-G is where I start, or lead the discussion.

Perhaps, (as per the previous post) there is a safety dividend in having to consider this question more formally (forcibly)?

I remember Rod Stewart's rendition of  'The First Cut is the Deepest' - even as governments work to make this cut as shallow as possible.

The INDIVIDUAL - GROUP cut: has it every time.

Previously: 'argumentation'

Hornberger (1989) 'Continua of Biliteracy'. Review of Educational Research

The axes of Hodges' model present a problem in:

• theory
• practice
• evidence - research terms (data!).

The easiest to resolve is practice, which is were Hodges' model can lay claim to being a pragmatic solution. Of course, it isn't the axes that are the difficulty, it is the labels that Brian Hodges originally applied in the early-mid 1980's, followed by other users of the model since. From:

INDIVIDUAL <> GROUP - variations here in 'Welcome to the QUAD' [W2tQ] Patient <> Carer - Family : Client <> Health professional. You can progress to the "patient zero" and a population in an pandemic.

These are fundamental elements in clinical encounters, whether face-to-face, online, and across settings.

The same applies to the horizontal axis: HUMANISTIC <> MECHANISTIC.

As presented - in the sidebar, and the two-by-two table found in many posts - the model has a distinct dichotomous quality. It seems to set up, or invite opposition, or polarities. Sometimes I've viewed the axes as continua, but they are not graduated, incremental in a quantitative sense.

Do the axes of Hodges' model serve a need (do their work) by allowing the user to differentiate through opposition and relational appraisal (testing)? Perhaps, qualified in a respective profession / subject area, the user of Hodges' is employing other axes?

This brings us to intersectionality and the cognitive work of placing the person (couple, family, community ... biosphere) at the centre of our deliberations.

In biliteracy studies, Hornberger (1989) is perhaps more accurate in seeing a series of multidimensional and interrelated continua (p.273) which form a framework.

There are three figures in this paper and many other points of use:

"Contexts of biliteracy are defined, then, by these three continua. Any particular instance of biliteracy is located at a point of intersection among the three." p.280.

In health care this is readily understood given the varied contexts of the centre, the nexus of Hodges' model. When we say Hodges' model is situated, the centre of the model is the sweet and sour spot. For Hornberger, the context determines the use and significance of the continua.

This opens up Hodges' model as a potential tool to better understand the dimensions of diversity, inclusion and intersectionality.

Hornberger, N. H. (1989). Continua of Biliteracy. Review of Educational Research, 59(3), 271–296. https://doi.org/10.2307/1170183

No! This post hasn't been in draft since 1990. ;-)