Dear Editorial Office,

Dear Dr. Jones,

My name is Editorial Office, and I am writing on behalf of the selected journal. I came across your article, "A Conceptual Mapping Exercise of Deprivation of Liberty Safeguards in Residential & Community Care Using Hodges' Model and Threshold Concepts". Its focus on deprivation of liberty safeguards, Hodges' model, older adults caught our attention. I would like to invite you to consider a new and unpublished contribution to the selected journal.

For this invited contribution, we are pleased to offer a Full APC Waiver. Invited manuscripts receive priority editorial handling, and we aim to provide an initial editorial decision within one week. This invitation does not imply acceptance, and editorial standards remain unchanged.

If you are interested, a working title or short abstract is enough for an initial discussion. If your current work is not closely aligned with this journal, you are also welcome to share your present research topic and we can check whether another journal in our portfolio may be more suitable.

I would be glad to answer any questions and look forward to hearing from you.

Best regards,
Editorial Office
the selected journal

Dear Editorial Office,

Re. 'the selected journal: Invited Contribution – Full APC Waiver'

Thank you for your communication and recognition of my recent paper.

Unfortunately you have not specified the 'selected journal'. Without this detail it is difficult to proceed at all, or ascertain what benefit is provided by the 'full APC waiver'. 

I am more troubled, however by your name. Is it really 'Editorial Office'?

Again the specific journal matters here. If it is materials science, chemistry, or quantum physics or related this is (slightly?) less of a problem. Otherwise, I do worry that with Hodges' model being person-centred your being de-personalised does not sit very well with the purposes and values of Hodges' model.

It is however reassuring to learn that I should not take your invitation to suggest acceptance, and that accordingly your editorial standards remain intact - especially in these times.

Again, even if I were interested, I am at a loss to provide either a working title, or abstract.

I do hope you understand my difficulty? 

Although perhaps I ask too much.

Can it be - this IS in fact the journal?

'The Selected Journal'?

Yours Faithfully,

Mr^ P Jones

^'Conceptual Surgeon' 4th class

(and not sent.) 

Writing - next project - parts 1 & 2 in search of titles

Currently, I'm pulling together what have become two drafts, that consider Hodges' model as a mathematical object. Part 1, put-down in the new year, and picked-up now; a good start as there is more than I thought. There's a cost of that, of course? Part 2 is a gathering of tatters. Well, it is an effort.

As I don't work in academia where connections may more readily follow, can I claim that Hodges' model also does work? That the model can help in finding potential collaborators and co-authors? Once the fundamentals are understood, and again - it's not rocket science - for some people thankfully, something clicks. It clicks absolutely where it is should.

The model can be quite addictive in a positive way, as one of many among the vast array of assessment, evaluation and other tools. It is complementary.

So, with much needed support to follow, including from previous publication (please see the bibliography in the sidebar), plus April's WCCS26 conference, I'm working away to share them in 12 days or so. Then the work really begins as I benefit from collegial input, new perspectives, views, critique and the reward of constructive debate, experience and knowledge of others. I hope the drafts reward the curiosity that's been displayed. It is still quite exciting. Hoping too that students and early career researchers might pick this up ...

Leapspace ii - References

Of the references listed by LEAPSPACE #6 stood out:

Merritt, M.K., Procter, N. (2010) Conceptualising the functional role of mental health consultation-liaison nurse in multi-morbidity, using Peplau's nursing theory. Contemporary Nurse. https://doi.org/10.5172/conu.2010.34.2.158 

Had I missed this? When I hear (read) of new citation for Hodges' model, it is added to the blog's bibliography. So, what about this one?

I could not access the full-paper initially, but did so at:

https://lmscontent.embanet.com/MVU/NURS600/Readings/W3_Peplau.pdf

I can see that Merrit and Proctor reference the following [#16 of 1-46]:

Jones, P. (1998). Hodges’ health career – Care domains – Model, nursing – Art or science? Retrieved October 4, 2009, from http://www.pjones.demon.co.uk/holsci.html

This additional cognitive and motivational nourishment is welcome. They are spot on with '1998', the year the former website (p-jones.demon.co.uk) went live. 

Pre-2015 and indicative of (what will increasingly follow) from AI, LLMs, agentic ai - LEAPSPACE found a page on the now archived website:

https://web.archive.org/web/20150409004111/http://www.p-jones.demon.co.uk/index.htm

While a positive, perhaps (again) we should worry about regurgitation? Although on another level perhaps the definition of 'grey literature' is also being (has been) redefined?

There is a positive in the author's acknowledgement of Hodges' model on several counts, being associated with:

• Highlighting the need for inclusion of mental health/illness (parity of esteem);
• Peplau's seminal work;
• A search to link mental health with other specialities (emergency, liaison, burns);
• Recognition of the inverse (psychological care within medicine); 
• The fact of being listed with Phil Barker (Tidal Model). 

Negatively, on the archived homepage (above) many links to content may not work:

The (rather short but referenced) page Merrit and Proctor list is available here:

https://web.archive.org/web/20111018204743/http://www.p-jones.demon.co.uk/holsci.html

I will insert this paper in the bibliographical listing; and revisit this.

This blog "Welcome to the QUAD" is 20 years old

Yesterday, this blog celebrated its 20th birthday. That first post seems an age away now -

Welcome to the Hodges Health Career - Care Domains Blog

https://hodges-model.blogspot.com/2006/04/

Back then, I was full-time and on a secondment with the NHS's National Programme for Information Technology:

Independent report: Making IT work: harnessing the power of health information technology to improve care in England. Published 7 September 2016

House of Commons Committee of Public Accounts - The National Programme for IT in the NHS: an update on the delivery of detailed care records systems - Forty-fifth Report of Session 2010–12

In that first post, several links take you to the former website which is now archived, as per the note in the sidebar. Similar links have been updated to the web.archive.org site, but some may have been missed. Other links may be plain broke.

The blog began as an acknowledgement of the former site's limitations, hence all the posts on Drupal the content management system.* The intention was to create a stop-gap. So much for that! I still have the 'new' site in my head.

Personally, there's been much change: as ever in life, a mix of sadness and great joy. Regards the former, a manager from 1985 into the 90s, colleague and friend David McKendrick died in 2009. And coinciding with personal bereavements, Brian Hodges in 2022. I do miss chats with both of them.

With periodic backups of the blog's content (and old website 1998-2015), there been one effort at a spring clean. Posts that are poor (what was I thinking?), or items that are clearly time-limited - event announcements have been deleted. Many more no doubt remain with images - banners - that will be removed at some point. With 3381 (inc.) posts published, it is quite an onerous, yet rewarding task.

During the two decades I would like to thank researchers who have discovered Hodges' model, recognised (either) its value, utility, relevance and cited the model in their studies/projects.

Thanks too to several co-authors whose patience and understanding in working with me, their recognition of the model and value in their work, and assistance to assure open access is invaluable to bring Hodges' model and this project to the attention of a global audience and community.

If I can help you with Hodges' model - acknowledgement not a requirement(!): please let me know.

The online presence has been about the model, not business, or commerce, so there's a lack of analytics. There's a project for someone, as I notice 'Blog Analysis' as an online research method. 

People occasionally email and provide encouragement regards the content.  In a way the blog is my thesis*. 

Amid the time-dependent content, there may be much here that can demonstrate:

• the holistic bandwidth of Hodges' model
• the scope of application of Hodges' model
• the transdisciplinary potential of Hodges' model 
• how to apply the model, or at least this practitioner's use
• the visual appreciative dimension through the model's presentation to reveal the relational nature of the situation / context at hand
• many remaining questions are also to be found.

Thank you for your visiting! Here's to another 20 years ;-) !?

*I still live in hope: it's called dreaming.

Bridging Gaps in Oral Health Frameworks: Mapping With Hodges' Health Career - Care Domains - Model

 ABSTRACT

Objectives

Despite decades of national and global strategies, persistent inequities in oral health outcomes, access, and service provision remain. Existing frameworks often fail to integrate clinical and behavioral factors with social, cultural, and political determinants. This study aimed to map and evaluate oral health frameworks using Hodges' Health Career—Care Domains-Model (HCM), a meta-framework that spans clinical, behavioral, sociological, and political domains. The goal was to identify conceptual gaps and opportunities for greater integration.

Methods

A structured scoping review was conducted using MEDLINE, CINAHL, EBSCO, and search engine Google Scholar (1995–2025) to identify oral health-related conceptual frameworks. Frameworks were eligible if they addressed oral health determinants, behaviors, policies, or interventions. Two reviewers independently screened records and analyzed full-text articles. Frameworks were categorized by theoretical orientation and mapped against the four HCM domains to identify patterns of emphasis or omission.

Results

Of 226 identified records, 21 frameworks met inclusion criteria. These were classified into three thematic groups: balanced (addressing all domains), clinically led (focused on clinical/behavioral aspects), and policy/public health-focused (emphasizing sociological/political factors). Seven cross cutting themes emerged, including health promotion, systems integration, social justice, and cultural safety. While many frameworks promoted equity and policy reform, few offered implementation guidance or had been empirically validated.

Conclusions

HCM proved useful for systematically comparing frameworks and revealed consistent underrepresentation of political and structural domains. It offers a practical tool for oral health professionals, educators, and policymakers developing integrated oral health models that align with equity, sustainability, and universal health coverage goals.

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

Nursing models of care: "There is another"!

It seems Star Wars forums continue to debate the meaning of Yoda's response to Obi-Wan that "There is another". 

The lack of practice-based debate in nursing and health education about 'nursing theory' and 'models of care, confirms that these academia sagas did indeed take place in a galaxy far, far away.

There is, as ever, positive and negative news too. The bibliography in the sidebar keeps growing. I'm hoping for news of additions dropping into the inbox before the end of the year. Not just prospective papers I know about (yes, there is another prospect!), but other work. In a way the latter is even more special. As these sporadics reveal that there are research heroes out there, on their own path and journey of discovery. Finding Hodges' model, they have applied it to their respective field.

Yesterday, searching for 'Activities of Daily Living' (first published in 1980) while writing the DASH post, on BMJ Careers I came across:

'What models do nurses use to guide their care?'

Is that 'models' plural?

Perhaps the response to the question says something about:

• nurse academia;
• how our medical colleagues view nursing;
• and more importantly - their understanding of nursing, the nursing profession, ongoing aspirations and relevance to self , health and social care in the 21st century?

In January, frustrated at the effort that is getting published (a shared experience then) and lack of attention to theory I posted:

Are you planning a health* study in 2025?

The literature trail for Hodges' model is not voluminous, but it is there:

• as a model of care, conceptual framework;
• person-centredness;
• integrated and holistic care;
• holistic bandwidth
• SDGs
• life chances, health career, prevention, life-style and literacies
• socio-technical approach
• global health;
• reflection and reflective practice;
• critical thinking
• mind-mapping;
• concepts, conceptual spaces, threshold concepts

- with much more to do, even in the above.

Please, call this a gentle nudge. Thank you.

Image: http://www.quickmeme.com/

Paper - (finally!) "A generic model and conceptual framework to prime curiosity across health and social care ..."

 It has been over a decade but at last the second* paper has been published in Journal of Evaluation in Clinical Practice:

Jones, P. (2025), A Generic Model and Conceptual Framework to Prime Curiosity Across Health and Social Care Disciplines to Facilitate Lifelong Learning. Journal of Evaluation in Clinical Practice, 31: e70252. https://doi.org/10.1111/jep.70252

ABSTRACT 

Rationale: The Corona virus pandemic highlighted the importance in continuity of the physical and emotional labour across all care sectors. Synergy between healthcare in hospitals, and community services must be allied with social care; and be central to integrated and efficient policy and service delivery. Services were found wanting in the pandemic and in recurring winter crises. The politics of funding for care delivered in rest and nursing homes remains contested, awaiting long‐promised governmental action. The workforce is recognised as dedicated, skilled, compassionate and yet under‐valued and under‐paid; managers face ongoing recruitment challenges, with a national shortage of staff, and high turnover of personnel. A National Care Service is awaited in England and Wales. 

Aims and Objectives: This study explores the ongoing care crisis, using the educational lens of threshold concepts, projected, analysed and synthesised of a generic conceptual framework, known as Hodges' model. Readers will understand Hodges' model and threshold concepts being equipped to explain both. 

Methods: The study is descriptive and uses a conceptual mapping approach supported by discussion and literature. Additional resources and avenues for ongoing study are also provided. 

Conclusion: In conclusion, Hodges' model is a pragmatic, practice‐based tool, that can support and sustain curiosity for workforce learning and development. 

Acknowledgements I would like to thank Messrs Mark Bird and Matthew Graham and the journal's reviewers for comments on drafts of this study; and acknowledge the effort of Dr Michael T. Flanagan in creating the informative threshold concepts resource (referred to above). 

https://onlinelibrary.wiley.com/share/author/IRPNBR2KHJNYJK8XUAW6?target=10.1111/jep.70252

*This paper was originally the first of a two-part work. Feedback from reviewers suggested the papers be standalone. United now, in one journal.

Many thanks to the reviewers, editor, editorial and publications team at JECP.

This paper has been added to bibliography in the blog's sidebar.

Citation of Hodges' model: 'Sustainable Health Model: Increasing Universal Access to Health Services in Remote Areas'

News received of another citation to add to the bibliography. It's just a sentence, but always welcome.

Noting the journal's title, Hodges' model incorporates a person's, family's, population's health career which is invariably impacted by a cascade of life chances. H2cm can also be applied temporally, longitudinally; taking in the past, current situation and future.

Good to see researchers discovering Hodges' model and considering it in respect of global health and sustainability also. If your purpose is to identify gaps, seek to reduce them, critique and evaluate change then again Hodges' model with the bridges it affords is an effective resource.

It's disappointing to see the journal - JoWFMHN list only the first author of referenced work. I must look at open access in the future, and remain grateful to Dr Wirnitzer - co-author in the cited paper - for assistance with writing and final publication, whose work includes:

The NURMI-Study (NURMI – Nutrition and Running high Mileage)
https://www.nurmi-study.com/en

Science 2 School: Nachhaltig gesund – bewegt & veggie
https://www.science2.school/

Abstract

Access to healthcare services in remote areas remains a significant global challenge, with many populations experiencing disparities in healthcare availability, quality, and affordability. Sustainable health models that ensure universal access to health services are essential for improving public health outcomes in underserved areas. This study investigates the potential for sustainable health models to increase healthcare access in remote regions, focusing on the role of telemedicine, mobile health clinics, and community health workers. The research employs a mixed-methods approach, combining qualitative interviews with healthcare professionals and quantitative data on healthcare access and outcomes in remote communities. The findings indicate that telemedicine platforms have improved healthcare delivery by 40%, while mobile health clinics and trained community health workers have expanded service reach, particularly in geographically isolated areas. Furthermore, community-based health interventions have led to a 30% reduction in preventable diseases in these regions. The study concludes that integrating technology with community-based solutions offers a scalable and effective approach to achieving universal health access in remote areas. However, challenges such as technology infrastructure, resource allocation, and healthcare workforce training need to be addressed to ensure the sustainability of these models.

Ardenny Ardenny, Le Hoang Nam, Pham Anh Tu (2025). Sustainable Health Model: Increasing Universal Access to Health Services in Remote Areas. Journal of World Future Medicine, Health and Nursing. 3. DOI: 10.70177/health.v3i1.1907

Time to revisit Wikipedia?

Yesterday morning an email from a mail list -

https://groups.google.com/g/bytesforall_readers/about

- regards a Wikipedia entry, prompted me to look back at some personal - 'local' history. In 2006 having started this blog, I'd noticed 'models of care', and nursing theories' on Wikipedia.

I posted an entry on Wikipedia about Hodges' model.

This included the now defunct url/domain - p-jones.demon.co.uk (See below).

A request followed to remove it:

https://en.wikipedia.org/wiki/Wikipedia:Articles_for_deletion/Hodges_Health_Career_Model

I must admit there is a repetitive 'spam' quality to emails, contributions, activity on twitter and posts here. I do try to keep things relevant, in context and seek what is salient. 

Given the digital divide and ethos behind the web the 'complaints' now seem exclusive.

From scribbled notes to a global revolution - the personal journey behind the World Wide Web’s invention and the unexpected turns along the way. It is both a history and my vision for what comes next.

This is for Everyone isn’t just a story about technology; it’s about… pic.twitter.com/gdUBmFCViG

— Tim Berners-Lee (@timberners_lee) April 23, 2025

After a brief problem with Blogger I also wrote a blog post:

'Thanks Google ... Wiki ... oh for more time ....':

https://hodges-model.blogspot.com/2006/05/thanks-google-wiki-oh-for-more-time.html

At the time I wrote: 'I agreed the submission should be deleted - another time.' 

In writing - 'Another time...', perhaps, I should try again - or leave it to someone else?

Following up, I found that the now archived POLITICAL care/knowledge links page -

original static website 1998-2015

https://web.archive.org/web/20140821191217/http://www.p-jones.demon.co.uk/index.htm

- is, ironically listed on Wikipedia. You'll find it under 'External links':

https://en.wikipedia.org/wiki/Outline_of_political_science 

[ Which is itself a useful 'collection' of resources. ]

Since 2006 the bibliography for Hodges' model has grown, please see sidebar:

http://hodges-model.blogspot.com/

Created in NW England higher education in the mid 1980s Hodges' model was intended for use within post-registered nursing courses - psychiatric and learning disability nursing, health visiting and district nursing. Hodges' model, is however, universal in scope and potential application.

As no doubt occurs in other professions/disciplines, advocates for tools, resources, theories, model that may also be simple, free - open access, 'neutral', pragmatic, supportive of lifelong learning, curiosity, literacy and informatics forms can be met with internal resistance - never mind external responses:

Raskin, Jef. "Humbug: Nursing Theory". Archived from the original on July 10, 2001. Retrieved December 14, 2015. (Wikipedia).

More recently the phrase 'Nursing eats its own' has resonated. A phenomena not limited to nursing no doubt?

Biblio - addition: Conceptual Mapping Exercise of DoLS in Residential & Community Care Using Hodges' Model and Threshold Concepts

After a great many years of on-off effort, radical revisions - from one to two papers - part 1 and part 2; and then finally two standalone papers, I received news this morning from ORCID and Wiley of online publication.

News of the second paper (part 1 - to me) is still to follow.

Many thanks to the individuals who read earlier drafts, the editor and team of JECP.

It is a real delight to add an item to the blog's bibliography in the sidebar.

Apologies in advance, the paper is not open access, I cannot personally cover the fees. Happy to assist with an earlier draft.

Once again, if you can add to the bibliography, or are interested in using Hodges' model please let me know. Or as several researchers have done: 'Just get on with it!'. Learning post-publication of a citation for Hodges' model, is a welcome surprise too.

Jones, P. (2025), A Conceptual Mapping Exercise of Deprivation of Liberty Safeguards in Residential & Community Care Using Hodges' Model and Threshold Concepts. Journal of Evaluation in Clinical Practice, 31: e70085. https://doi.org/10.1111/jep.70085

New citation for Hodges' model

It was a struggle obtaining a copy, as the paper is not open access, but more good news with Doyle & Jones (2013) being cited in:

Yasemin Güner, Bilge Delibalta, Melek Üçüncüoğlu, Sinan Paslı, Challenges encountered by emergency nurses in forensic case management: A qualitative study, Journal of Forensic and Legal Medicine, Volume 109, 2025, 102807, ISSN 1752-928X, https://doi.org/10.1016/j.jflm.2025.102807.(https://www.sciencedirect.com/science/article/pii/S1752928X25000083)

The above has been added to the blog's bibliography. 

The abstract reads:

Purpose/Aims: This study aimed to reveal the opinions of emergency room nurses regarding crime victims and the challenges they experience.
Design: This study was a qualitative descriptive study.
Methods: A convenience sampling method was used in the study. Data were collected through individual in-depth interviews using semi-structured questions lasting approximately 45 min. The interviews were audio recorded. In total, nine nurses individual interviews were held.
Results: The study was completed with nine nurses with approximately twelve years of experience in the emergency department. Four themes were identified: duties and responsibilities of nurses in crime victims management; maintaining well-being in challenging crime victims; education needs of emergency nurses for crime victims; and challenges experienced by nurses in crime victims management.
Conclusions: When contextualizing the findings of our study within forensic nursing theory, it becomes evident that nurses play a pivotal role in continuously informing, influencing, and advancing forensic nursing care to improve patient health, forensic evidence collection, and criminal justice outcomes. A key finding of our study was the impact of interaction with crime victims in the emergency department on nurses’ well-being. In this regard, implementing institution-supported education policies, establishing units dedicated to supporting wellbeing, and fostering a supportive organizational culture are essential measures to promote the resilience and effectiveness of nurses in this critical field.

I will read again, and reflect later in the month.

"Hi! I'm new to Hodges' model - and this blog - what's it about?"

INDIVIDUAL

|

   INTERPERSONAL : SCIENCES              

humanistic ------------------------------- mechanistic

 SOCIOLOGY : POLITICAL   

|

GROUP

The model was created in the early - mid 1980's with four purposes in mind - to facilitate: 1. reflection & develop reflective practitioners; 2. person-centred, integrated (holistic) care; 3. help bridge the theory-practice gap; 4. curriculum design, planning and development. This was prompted by the change in the UK to university-based nurse education, which was to commence in (Project) 2000. Learning and applying Hodges' model in 1987-88, and creating a website 1998-2015, I am clearly invested in Hodges' model and biased, questions and debate are welcome. Created by Brian E.

Hodges' model is a generic framework -  a conceptual framework. This model is situated, as 'generic' suggests which means of course it is universal. If you've a problem, scenario forthcoming project, or one that is nearing completion Hodges' model can assist in reflection and critical thinking to plan, scope, or evaluate as per your purpose. This blog has posts about papers, events that interest me (PJ), plus many posts using this two-by-two table approach that suggests how the model can be applied in a variety of contexts. This blog also has a bibliography and template in the sidebar.

Hodges^ As noted previously (and last month!), it is marvellous to hear news of a paper citing Hodges' model. If you are planning a piece of writing, research and believe that Hodges' model may be of help please get in touch. If you don't and can see merit in Hodges' model asit is presented, that is fine also. In fact, although I mention collaboration unique - untainted perspectives are probably much needed. Learning of a citation after publication is great news and encouragement. This could and should be an amazing community: Welcome to the QUAD Thank you for your visit and interest. Any questions pleased to try to help: h2cmng AT yahoo.co.uk

As a nurse who trained in learning disability, Brian Hodges was acutely aware of the political in health care, the role of the institutions and the aspiration of community-based and person-centred care. Yes, you can use the model. It is open source.  All we* ask is that you cite and credit the source. With the 'politics of health' much in mind there are many papers to write on the model that includes: reflection; person-centredness; integration of care; self care TO planetary health FROM ?; Inter- multi- transdisciplinary in Hodges' model; A model of healthcare viewed mathematically: Surely you're joking Mr Hodges? This blog started in 2006, the template is dated, comments are disabled. A new site - repository is needed.

*In Brian's memory too : Brian E. Hodges (1942-2022) RIP^

'New' citation of Hodges' model - Kennedy (2019)

This morning an alert from ResearchGate brought news of a further not so new citation of Hodges' model:

Kennedy, Harry G. (2019). National Forensic Mental Health Service (NFMHS) Model of Care. 10.13140/RG.2.2.30103.59041.

I've extending thanks to Prof. Kennedy, and have added the details to the blog's bibliography (in the sidebar). It is not as if Hodges' model played a key role in service design (care architecture?), but it is nonetheless marvellous to achieve this visibility.

This does make me wonder if there are others?

Any further news welcome.

Citation of Hodges' model IN "Application of the Threshold Concept Framework in Nursing: An Integrative Review"

This morning ResearchGate informed me of a further citation for Hodges' model:

Kistler KB, Tyndall DE. Application of the Threshold Concept Framework in Nursing: An Integrative Review. Nurse Educ. 2022 Mar-Apr 01;47(2):91-95. doi: 10.1097/NNE.0000000000001041. PMID: 34033613.

I have requested a copy and added Kistler and Tyndall to the bibliography listing in the blog's sidebar.

Here, I am still sitting on the two-part draft paper on threshold concepts, liberty protection safeguards, residential forms of care and Hodges' model.

Last week, during a break I received news of acceptance for another online conference. Details to follow, as I complete two abstracts this month.

CLOSE(D) CARE: Group climate in a secure forensic setting for individuals with mild intellectual disability

This morning ResearchGate alerted me to a new paper/thesis citing Hodges' model. 

I will add this to the bibliography and post again in the new year, relating selected conceptual content of Elien's thesis to Hodges' model.

Background

CLOSE(D) CARE

This study examines associations between group climate, aggressive incidents and coercive measures in adults with mild intellectual disability or borderline intellectual functioning (MID‐BIF) of a secure forensic setting.

Method Participants (N = 248) were interviewed about their perception of group climate utilizing the Group Climate Instrument. Data on aggressive incidents and coercive measures were retrieved from the facilities’ electronic database. A multilevel structural equation model was fitted in which variability in perception of group climate within and between living groups was examined.

Results An open and therapeutic group climate was associated with lower levels of aggression within and between groups. A higher number of aggressive incidents were significantly associated with a higher number of coercive measures.

Conclusions The findings have implications for the understanding of how group climate may play a role in reducing aggressive incidents at the living group in treatment of individuals with MID‐BIF in secure forensic settings.

Elien G Neimeijer (2021) "CLOSE(D) CARE: Group climate in a secure forensic setting for individuals with mild intellectual disability." Radboud University, ISBN: 978-94-6416-713-9
https://www.trajectum.nl/sites/default/files/proefschrift_e._neimeijer_pdf.pdf

Update on draft papers ;-)

Please excuse the intended irony, as need for an - 'update' could refer to far more than papers.*

Across the life of W2tQ (since April 2006...) there are many posts about papers by other people, papers planned and less frequently work published. 

A paper that started in 2017 has finally been accepted and we (not the Royal variety - which is a critical joy) await the proof. 

I'm really grateful to my co-author who stayed the course on what has been an utter roller-coaster and with COVID too. I look forward to sharing details and hence news of their ongoing research elsewhere - in Europe.

Another paper conceived in March has progressed more rapidly. With the initial draft well received, I'm addressing some revisions from editors, which are straightforward. 

I still need to 'see' these two birds in my hands, to believe: it will be worth it (I think?) to add these to the bibliography, as:

• SDGs are fundamental in global health and reveal the scope and relevance of h2cm;
  
• nutrition is critical in public (mental) health, policy and sustainability;
• there is more to follow from the 'mapping' that is exercised on W2tQ [2x2 HTML tables thus far], in these, and other papers;
• the psychoses constitute a severe mental health condition that can also illustrate the impact on individuals, friends, family and society;
• in health (and social) care we must address parity of esteem in and across theory, practice, management, policy, and research;
  
• how do (research) methods figure in Hodges' model (a mapping approach);
• what does a similar mapping of cardiovascular medicine and nursing reveal?
  

These bibliographical additions may help researchers in health, social care, and other fields find the model. While it is disappointing to find out about papers that reference h2cm 'after the writing' this still counts. It is a reference, not a collaboration! This is very welcome and a key purpose of the blog, and presence - @h2cm - on twitter. 

It would be validating, so 'me' [massaging ego] but it would also be contradictory. 

Hodges' model is simple, isn't it? 

In its basic form, blank and template - it presents virgin territory for the user(s) to overlay with their map according to context.

I'll post again about three remaining drafts papers, one dates back to 2012 (I was full-time then) and one that is in two parts. I've learnt a lot (again) with the two 'nearbies' and will post and list details when able. 

If I can help you, your project - I'd be pleased to do so.

*a website for example!

See also: the blog's bibliography in the sidebar, plus -

'New' citation: "Pratique en milieu de psychiatrie légale: proposition d’un modèle interdisciplinaire."

Reference [ii] "Practice in forensic psychiatry: A proposed interdisciplinary model"

Practice in forensic psychiatry:
A proposed interdisciplinary model

Expanding on the post about a further reference for Hodges' model:

Holmes, D. Perron, A. Jacob, J.D. Paradis-Gagné, É. & Gratton, S (2018). Pratique en milieu de psychiatrie légale: proposition d’un modèle interdisciplinaire. Recherche en soins infirmiers, (Practice in forensic psychiatry: A proposed interdisciplinary model). 134, 33-43. DOI: 10.3917/rsi.134.0033

Here, and on twitter I have sought to stress the limitations of the biopsychosocial model in healthcare, and I value Holmes et al. recognition of Hodges' model as politico-biopsychosocial. 

The authors also identify the structural nature of the model.

 

In comparing 'models of care' there is the question of whether Hodges' model is a model of care. As a generic conceptual framework Hodges' model can of course be used in the health care (as per its original design and creation) but it can be used to compare models of care.

Below, translated by Google are the models used in the paper.

I have altered the listing bringing the Tidal and Recovery model s together. Some I've 'mapped' in pairs, using formatting to indicate the differences.

Tidal Model

"The Tidal Model is a humanistic nursing model of recovery developed by Barker (12) with the premise that the person with mental disorder has strengths, abilities, personal priorities and a future ahead (13). This model of care, popular in forensic psychiatry circles, recognizes certain deficits of the hospitalized patient but it is especially interested in the meaning that the latter attributes to them. The sick person is the expert in his life and is therefore the one who contributes the most to his own recovery. This nursing perspective is therefore centered on the phenomenological experience (lived experience) of the patient and on the role of the staff, which is to allow healing and restore hope (12,14)."  

Recovery Model

"A popular model in mental health care, the recovery model is increasingly gaining ground in psychiatric care settings (28). The postulates of this humanistic model state that anyone, including those suffering from mental disorders, can aspire to a fulfilling future, participate in rewarding and inspiring activities, self-determination and finally, be able to live in an environment free of stigma and discrimination (29). The peculiarity of this model lies in the fact that recovery is part of a process where the person with mental illness can continue to show symptoms while being able to adapt to their condition (often chronic) and pursue their goals. life (30)."

Individual
|

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------ mechanistic

SOCIOLOGY : POLITICAL

|

Group

recovery strengths, abilities, personal priorities deficits healing and hope phenomenological - (lived experience) personal responsibility fulfillment - life goals patient as expert personal adaptation living with x,y,z... coping strategies	place as context my future deficits signs - symptoms chronicity Institutional settings clinical - hospital
humanistic - human qualities social expectations social contribution participation - social inclusion free from stigma deficits	Institutional settings politics of recovery free from discrimination forensic deficits

<>

Integrated Practice Model

"This model was developed by Virginia Lynch, a pioneer in forensic psychiatry, and it guides the role of practicing staff in this care setting (15). There are three main theoretical foundations: 1) the fields of expertise involved (nursing, criminal justice and forensic science), 2) the health system (victim and offender, health care and forensic nursing ) and 3) the social impact (social sanction, human behavior, crime and violence) (16). According to this model, patients should be cared for using an interdisciplinary and holistic approach (15)."

Individual
|

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------ mechanistic

SOCIOLOGY : POLITICAL

|

Group

nursing forensic psychiatry 2. health system interdisciplinary holistic OFFENDER	nursing theoretical foundations forensic science 1. fields of expertise 2. health system interdisciplinary holistic
VICTIM role of practitioners 2. health system 3. social impact (social sanction, human behavior, crime and violence)	criminal justice 2. health system

<>

Model of Nursing Interaction

"This model of care includes six categories of forensic nursing interaction with the goal of establishing a relationship with the patient: establishing and maintaining a relationship (relationship based on honesty, respect and trust), encouraging and support interactions (help the patient to recognize his qualities and use his resources), the learning of social skills (encourage the patient to do social activities and talk to others), reality orientation (help the patient patient to be aware of his way of being and of acting), reflective interactions (the perception of the patient and his problems) and the learning of practical skills (encouraging the patient to develop good lifestyle habits) ( 17,18)."

Individual
|

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------ mechanistic

SOCIOLOGY : POLITICAL

|

Group

patient qualities, resources reflective interaction self-perception of problems reality orientation awareness of way of being and of acting	practical skills develop lifestyle skills
reality orientation learn social skills develop lifestyle skills encourage social activities talk to others	encourage and support interactions reality orientation perception of patient and problems

<>

Healthy Living Program

"This model was developed in response to metabolic syndrome and physical illnesses that may develop in people with severe mental illness (19). It includes programs related to health promotion activities such as weight reduction, smoking cessation, physical exercise, etc. It is a voluntary approach that not only improves physical health, but also independence and recovery. For the program to work in the institution and to fit into its organizational culture, the approach must be flexible and systematically maintained by the entire interdisciplinary team."

[ PARITY OF ESTEEM ] 

mental health - metabolic syndrome physical illnesses

Individual
|

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------ mechanistic

SOCIOLOGY : POLITICAL

|

Group

independence recovery voluntary approach	(physical) health promotion activities such as weight reduction, smoking cessation, physical exercise,
independence recovery	voluntary approach for program to work in the institution and to fit into its organizational culture, the approach must be flexible and systematically maintained by the entire interdisciplinary team

<>

Holistic Model

"This model is used in forensic care in the assessment, health care and psychotherapy of patients with personality disorder (22). Holistic care includes the physical (diet and exercise), cultural, spiritual, and psychosocial needs of the patient. This model is based on problem solving, anger management and decision making. Caring is a central concept in the holistic model and is actualized in an emotional, psychosocial, constant and authentic caring response (23). It is for caregivers to be present for the patient, to respect his situation, to understand his experience and to demonstrate a desire to help."

Individual
|

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------ mechanistic

SOCIOLOGY : POLITICAL

|

Group

holistic care personality disorder [mental] health care psychotherapy assessment emotion problem solving, anger management decision making actualized psycho-	holistic care 'caring' assessment diet, exercise health care 'being present'
-social culture holistic care 'being present' constant and authentic caring understand person's experience respect person's situation desire to help	forensic care holistic care desire to help (also exemplified in the organisation?)

<>

Good Lives Model

"This model focuses on the offense committed by the mentally disordered offender, his recovery, the promotion of personal goals, the reduction of the risk of reoffending, and the treatment of mental illness (24,25, 26). The model favors an approach based on the strengths of the patient. In addition, mechanisms of change are present, that is to say that behaviors judged to be poorly adapted are replaced by adapted behaviors when the patient is equipped with the skills, resources and support provided by the nursing staff. This model contextualizes the offense, focuses on the symptoms of mental illness while conceptualizing both as inappropriate behaviors.This model helps to better understand the relationship between mental illness and crime in order to create an individualized plan of care."

Risk-Need-Responsivity Model

"This model (27) imported from the correctional environment was adapted to the psycho-legal context by the addition of the “mental illness” dimension. It was developed primarily to reduce the risk of recurrence. Care interventions are geared towards the identification and treatment of criminogenic factors. This model is based on three major principles: the risk principle (granting the highest level of resources to the group most at risk of crime), the needs principle (identifying dynamic criminogenic risk factors and targeting them in treatment) and the principle of receptivity (adjusting programs according to the characteristics of the person: learning style, motivation, strengths, etc.) (24,25)."

Individual
|

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------ mechanistic

SOCIOLOGY : POLITICAL

|

Group

mentally disordered (diagnosis) recovery characteristics of the person learning style (evidence?) motivation, strengths 3. principle of receptivity treatment: skills, resilience personal goals “mental illness” <-> crime recurrence individualized plan of care	1. risk principle -> resource allocation recurrence treatment 2. dynamic criminogenic risk factors  support of nursing staff
treatment [social determinants?] mechanisms of change adapted behaviours inappropriate behaviours recurrence	offense reoffending correctional environment contextualise the offence treatment principles [policy] recurrence

<>

Hodges' Health Career Model

"This model has a politico-biopsychosocial structure which is consistent with contemporary interdisciplinary practice (20); that is, it relies on a multidimensional critical approach, incorporating writings in sociology and politics, in order to understand the person in context. It is based on four objectives: measuring learning, providing holistic care, supporting reflective practice and closing the gap between theory and practice (21). This model is applicable in various clinical situations in a psycho-legal context. When this model is used as a frame of reference, it emphasizes the role of caregivers who must meet the patient's needs and focus on their problems. It also serves as a guide to assess and provide assistance to the patient vis-à-vis their physical, psychological and social needs as well as with the justice system in order to promote their recovery. The theoretical foundations call on four sources of knowledge: interpersonal, scientific, sociological and political (21)."

The PERSON in Context 

(situated)

Individual
|

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------ mechanistic

SOCIOLOGY : POLITICAL

|

Group

INTRAPERSONAL INTERPERSONAL reflective practice conceptual structure psychological needs measure of learning psycho-	SCIENTIFIC physical needs theory-practice gap
SOCIOLOGICAL reflective practice (develop self-awareness) social needs practice-theory gap	POLITICAL justice system (needs) -legal

[ all embedded within the SPIRITUAL ]

Not just 'problems' Hodges' model can incorporate any desired stance, perspective or philosophical approach - strengths, disease, skills, weaknesses or deficits, psychosocial for example.

I am not sure about explicitly 'measuring learning, but the model can be used by learners and teaching staff / mentors to demonstrate their understanding and justify their output - formulation.

There is an instrumental potential in Hodges' model as a whole. Hodges' model can illustrate the degree of holistic intent - whether this is realised could also be indicated using the model.

Once again I am grateful to the authors for their inclusion of Hodges' model. The reference is listed in the blog's bibliography (please see the sidebar for others) which includes:

Doyle, M., Jones, P. (2013). Hodges’ Health Career Model and its role and potential application in forensic mental health nursing. Journal of Psychiatric and Mental Health Nursing. 20, 7, 631-640.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2012.01961.x/abstract

Jones P. (2014) Using a conceptual framework to explore the dimensions of recovery and their relationship to service user choice and self-determination. International Journal of Person Centered Medicine. Vol 3, No 4, (2013) pp.305-311.

See also on W2tQ (with overlap):

https://hodges-model.blogspot.com/search?q=forensic

https://hodges-model.blogspot.com/search?q=justice

https://hodges-model.blogspot.com/search?q=interdisciplinary

'New' citation: "Pratique en milieu de psychiatrie légale: proposition d’un modèle interdisciplinaire."

Practice in forensic psychiatry:
A proposed interdisciplinary model

Checking through emails I missed a notification from ResearchGate about an additional citation for Hodges' model:

Holmes, D. Perron, A. Jacob, J.D. Paradis-Gagné, É. & Gratton, S (2018). Pratique en milieu de psychiatrie légale: proposition d’un modèle interdisciplinaire. Recherche en soins infirmiers, (Practice in forensic psychiatry: A proposed interdisciplinary model). 134, 33-43. DOI: 10.3917/rsi.134.0033

This is very welcome, even though in December 2021, I am 'late to the party'. This it seems is how news of potential additions to the bibliography are bound to arrive, which is a bit frustrating. It would be marvellous to learn of a project much earlier - while the work is 'live'. Not to jump on-board as a co-author necessarily, but to share the dynamism of work-in-process.

I continue to take encouragement from the fact that researchers appear able to find, understand and apply Hodges' model in their respective theoretical, practical and work context.

This is rewarding in itself so many thanks to the authors.

If I can access the English copy I will post again with any observations and comments that arise.

Translated by Google:

"Hodges' Health Career Model

This model has a politico-biopsychosocial structure which is consistent with contemporary interdisciplinary practice (20); that is, it relies on a multidimensional critical approach, incorporating writings in sociology and politics, in order to understand the person in context. It is based on four objectives: measuring learning, providing holistic care, supporting reflective practice and closing the gap between theory and practice (21). This model is applicable in various clinical situations in a psycho-legal context. When this model is used as a frame of reference, it emphasizes the role of caregivers who must meet the patient's needs and focus on their problems.It also serves as a guide to assess and provide assistance to the patient vis-à-vis their physical, psychological and social needs as well as with the justice system in order to promote their recovery. The theoretical foundations call on four sources of knowledge: interpersonal, scientific, sociological and political (21)."

In comparing several models of care please note how the authors here recognise how Hodges' model is not just bio-psycho-social; yes - it is politico-biopsychosocial.

See also on W2tQ (with overlap):

https://hodges-model.blogspot.com/search?q=forensic

https://hodges-model.blogspot.com/search?q=justice

https://hodges-model.blogspot.com/search?q=interdisciplinary

Info Smörgåsbord

Going through papers (again) I saved 'Infovore' from New Scientist back in 2006. Individually and collectively we are hungry for information (even when asleep - in the form of dreams?), hence we are infovores. The brief article explains work by Bierderman and Vessel, Perceptual Pleasure and the Brain. Information gives us a high via a "type of chemical receptor known as mu-opioid".

If time ever permits I would like to write again about 'information':

The pull quote reads: 

"Information that triggers the most memories causes the greatest pleasure"

Clearly from 2006 there may be further studies to consider, but revisiting this since 1996 a new paper would incorporate the informational dimensions of Hodges' model. The pull quote with its emphasis on memory and pleasure begs discussion of persons living with dementia.

Another saved newspaper concerned a book review from 2015 Why Information Grows: The Evolution of Order, from Atoms to Economies by César Hidalgo. Searching here on W2tQ there's no post about this text - hence why it's still gathering dust.

https://www.ft.com/content/36cad2c0-1038-11e5-ad5a-00144feabdc0in

Finally and related to 'information', data and knowledge are the way Hodges' model suggests and can make explicit disciplinary bridge as posted previously 

[ https://hodges-model.blogspot.com/2009/08/combining-h2cm-informing-science-and.html ].

For me, the FT is expensive, (as mentioned before) so I want to squeeze out all the value I can. Another page, by Gillian Tett (2014) discusses "How should we analyse our lives?" The book here is Alex "Sandy" Pentland's Social Physics.

This scratches the surface of papers [a few printed, the majority now on Zotero], other items from the quality press and science media I've kept.

I mention this as after this month all I will be posting [ and tweeting @h2cm ] are the remaining book reviews and other occasional items. A new citation is worthy of a post and celebration for Hodges' model - added already to the bibliography listing in the sidebar. Again if you can add to the bibliography, are interested in using Hodges' model and writing too please let me know. I'm conscious here and on twitter I feel I'm repeating myself and rather wasting my time. That said in mitigation and a blatant excuse the past 18 months has enforced a holding pattern on us all. When the pattern breaks I'd like to be 'elsewhere' in terms of any teaching opportunities, completing some writing and addressing the outstanding lack of a digital presence.

Thanks for your visit and time.

The Word, Infovore, New Scientist, 22 July 2006, p.56. (Sorry no more details).
https://www.newscientist.com/article/mg19125612-200-the-word-infovore/

Bierderman, I., Vessel, E. Perceptual Pleasure and the Brain, American Scientist. May-June 2006, Volume 94, Number 3, p.247. DOI: 10.1511/2006.59.247
https://www.americanscientist.org/article/perceptual-pleasure-and-the-brain

Gillian Tett (2014) "How should we analyse our lives?", FT Weekend, Magazine, January 14-15, p.46.

Jones, P. (1996) Humans, Information, and Science, Journal of Advanced Nursing, 24(3),591-598.

A new citation of Hodges' model: "A multi-agent system approach to dynamic ridesharing for older people" 2020

Given the volume of new research published each year and even daily, I am always looking for validation of Hodges' model and my belief (and time ...) in the model's generic utility.

An email from ResearchGate this morning prompted a search, revealing the following conference paper by Iris Lohja, Yves Demazeau and Christine Verdier. 

This a very rewarding read for me as the paper states that Hodges' is situated, person-centred, socio-technical and combines the individual and group.

"Situation Theory is a theoretical approach, according to which a system is defined as the composition of situation-related concerns. To collect information about these concerns and to address the user preferences BP, we use the Hodges’ Health Career Model (H2CM) [15]. It is a model centred around the person, based on the situation,considering all contexts (or as many as possible), and allows for simple modelling. One of the main reasons why this model is adapted to our context is that it allows for individualism and holism at the same time. We use H2CM to structure knowledge or features of older people around two axes – the vertical axis of individual and group and the horizontal axis of humanistic and mechanistic – which create four knowledge domains – Interpersonal, Sciences, Sociology, and Political. The vertical axis indicates our primary focus on the older person as an individual and as a group. The horizontal axis separates features into humanistic – related to the social aspect of the older person/people – and mechanistic – related to the technical aspects concerning the older person/people. Figure 1 shows the H2CM model for the passenger population, where we can see some features identified and classified into the four knowledge domains.

Modelling the passenger population with H2CM in IMOPOP helps to identify and include in the system their preferences and constraints, thus addressing the user preferences BP. A UML representation of a passenger agent is shown in Figure 2.

Table 1 compares the approaches we have considered for the modelling of the agents, according to our main criteria." p.54

I will post again and if possible with Figure 1 and Table 1 from the paper. 

Figure 1 could be extended and Table 1 is a very useful approach by the authors, contrasting Hodges' model with other approaches.

"In this paper, we discussed about various MAS techniques for dealing with the first two blocking points. Viewing our multi-agent system as componential, we considered various models for modelling each of its components. We used the socio-technical Hodges’ Health Career Model, which originates from the social care domain but we still described as it is crucial for IMOPOP. It is used to model the older people as the agents in the system, addressing the user preferences blocking point. Given that we consider ridesharing as activity-based, we discussed about activities and proposed modelling the urgency and importance of these activities in the system. In the environment, we modelled agents’ points of interest and the main players in the ridesharing market." p.57.

MAS: multi-agent systems (the MAS described is called IMOPOP)

Iris Lohja, Yves Demazeau, Christine Verdier. A multi-agent system approach to dynamic ridesharing for older people: State-of-the-art work and preliminary design. 18èmes Rencontres des Jeunes Chercheurs en Intelligence Artificielle, RJCIA’20, Jun 2020, Angers, France. pp.52-59. ⟨hal-02897446⟩

 See also from Aug. 2020:

a Paper: Hodges' model and mental health nursing in bushfire-affected communities