Leapspace? Why not ...?

Referred to a paper in an email: https://doi.org/10.1016/j.jclinepi.2026.112401.

- I noticed an invitation to try Leapspace. 

So I leapt (with much editing - for formatting here). ...

 

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("Hodges' model" OR "Hodges model" OR "Hodges' health career model" OR "health career model" OR "care domains model") AND (nursing OR healthcare OR "health care" OR education) AND (domain* OR component* OR framework OR concept* OR definition*)

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What are the conceptual definitions, domains, and components of Hodges' model in nursing and healthcare education?

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("Hodges' model" OR "Hodges model" OR "care domains") AND (diagram* OR figure* OR visual* OR schema) AND (teach* OR education OR curriculum OR learning) AND (critique OR adaptation* OR application*) AND (method* OR framework OR discussion)

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How is Hodges' model represented, taught, and adapted in nursing or healthcare education, including diagrams and critiques?

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("Hodges' model" OR "Hodges model" OR "care domains framework") AND (application* OR use OR implementation OR practice) AND (critique* OR limitation* OR adaptation* OR evaluation*) AND (nursing OR healthcare OR "health care")

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What applications and critiques of Hodges' care domains framework have been reported in nursing and healthcare practice?

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Hodges' health career - care domains - model

Hodges’ Health Career – Care Domains – Model is a generic, practice-based conceptual framework for health and social care that organizes thinking into four knowledge/care domains: science, political, sociology, and interpersonal. It is presented as broadly applicable across healthcare contexts and is used to structure reflection, critical thinking, and care planning. [1] [2] [3]

Core domains

Domain	What it covers	How it is used
Science	Cause and effect, evidence, costs, benefits, and trade-offs	Helps frame the “hard” evidence side of care and service decisions. [1]
Political	Policy, systems, and structural influences on care	Helps connect care to wider health and social policy contexts. [1] [4]
Sociology	Social context, culture, stigma, and relationships	Helps explain how social factors shape health and illness experiences. [1] [5]
Interpersonal	Therapeutic relationships, patient/carer engagement, and human interaction	Supports person-centred and relational practice. [1] [2] [6]

What the model is for

• It is described as universal in structure and adaptable to many healthcare settings, including informatics, dementia/palliative care, forensic mental health, and oral health. [2] [3] [4] [7] [8]

• It helps practitioners map concepts into domains, build a mind-map-like structure, and support reflective practice and critical thinking. [3] [9]

• In forensic mental health nursing, it is proposed as a way to guide assessment, decision-making, and recovery-oriented practice. [2]

Bottom line

Hodges’ model is best understood as a four-domain lens for integrating clinical evidence, policy, social context, and relationships into one framework for care and reflection. Its main value is not in prescribing a single care process, but in helping users think more holistically and systematically about health problems and care systems. [1] [2] [3]

Confidence level: High — multiple sources consistently describe the model’s four domains, generic structure, and broad healthcare applications.

References

1. Fox, Siobhán, FitzGerald, Carol, Harrison Dening, Karen, (...), Timmons, Suzanne (2017) Better palliative care for people with a dementia: summary of interdisciplinary workshop highlighting current gaps and recommendations for future research. BMC Palliative Care. https://doi.org/10.1186/s12904-017-0221-0

2. 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. https://doi.org/10.1111/j.1365-2850.2012.01961.x

3. Jones, P., Wirnitzer, K. (2022) Hodges' model: The Sustainable Development Goals and public health - Universal health coverage demands a universal framework. BMJ Nutrition, Prevention and Health. https://doi.org/10.1136/bmjnph-2021-000254

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

5. Jones, P. (2008) Exploring serres' atlas, Hodges' knowledge domains and the fusion of informatics and cultural horizons. Social Information Technology: Connecting Society and Cultural Issues. https://doi.org/10.4018/978-1-59904-774-4.ch007

6. 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

7. Jones, P. (2009) Socio-technical structures, 4Ps and hodges' model. Nursing and Clinical Informatics: Socio-Technical Approaches. https://doi.org/10.4018/978-1-60566-234-3.ch011

8. Jones, P. (2011) Socio-technical structures, 4Ps and hodges' model. Clinical Technologies: Concepts, Methodologies, Tools and Applications. https://doi.org/10.4018/978-1-60960-561-2.ch215

9. 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. https://doi.org/10.1111/jep.70252

Follow-up Suggestions 

What are the key components of Hodges' health career care domains model?

How does Hodges' model apply to interdisciplinary health care practices?

What are the implications of Hodges' health career care domains model for patient-centered care?

ERCIM News No. 145 Special theme: "E-Values - Statistical Testing for the 21st Century"

ERCIM NEWS No. 145 -

Dear ERCIM News reader, ever heard of e-values?

If not, you're probably not alone. 

Michael I. Jordan opens this issue with a keynote introducing the concept:

What is an “e-value” and why has it become an object of intense study in statistics and in the allied fields of machine learning, signal processing, and econometrics? To briefly introduce the basic idea, let us consider one of the core problems in statistics – the “hypothesis testing problem” of deciding whether observed data is consistent with some particular data-generating mechanism (often referred to as a “null hypothesis”) or is better explained by another mechanism (referred to as an “alternative hypothesis”). This problem is addressed by defining some function of the data (a “statistic”) whose distribution is as different as possible under the null and the alternative. Given an observed value of such a statistic, one then makes a choice between the two distributions, doing so in a way that minimizes the probability of errors. Classical statistical theory provides a unifying framework – the “p-value” – by which the choice between the null and alternative hypotheses reduces to a thresholding procedure.

Guest editors Peter Grünwald (CWI and Leiden University), Wouter Koolen (CWI and University of Twente) and Johanna Ziegel (ETH Zurich) guide readers through this emerging framework for quantifying statistical evidence. 

The articles in this special theme demonstrate how it is already finding applications across many areas of scientific research, from clinical trials and microbiome studies to political polls, AI evaluation and financial risk backtesting.

 

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I must admit when I read 'e-values', I thought of an e-rendering of ethics - humanities and sciences (qualitative-quantitative : subjective-objective : ...), but as always a welcome resource.

Includes:

p.6 Introduction to the Special Theme - E-values Statistical Testing for the 21st Century
by the guest editors Peter Grünwald (CWI and Leiden University), Wouter Koolen (CWI and University of Twente) and Johanna Ziegel (ETH Zurich) 

p.8 On Testing by Imaginary Betting^
by Glenn Shafer

'Cournot’s principle does a lot of work. We predict events that have very high probability. We use the happening of events with very small probabilities to discredit theories that attribute the small probabilities to them. (Here the small probabilities are called p-values.)'. p.8.

p.37 Large Language Models as Design Partners: Automating Graphical Mockups to Refine Requirements
by Giovanna Broccia, Maurice H. ter Beek (CNR-ISTI), and Alessio Ferrari (University College Dublin and CNR-ISTI) 

p.39 Challenges in Small-Scale Medical Data Exchange Platform Development
by Hubert Schölnast, Peter Kieseberg, Patrick Kochberger and Henri Ruotsalainen (University of Applied Sciences St. Pölten) 

p.42 SCIANCE: AI for Scientific Discovery in Europe
by András Benczúr, Edina Nemeth (SZTAKI), Jonas L'Haridon (European Science Foundation) and Magdalena Brus (EGI Foundation)

My source: Peter Kunz c/o ERCIM News

^As a community mental health nurse I have a problem with the betting and gambling industries. Yes, many participants 'gamble responsibly', they know when to take a break. They understand the house rules. For a significant number of the population, they are vulnerable. Bitcoin is another example. There the 'house' is continually re-built after successive collapses. But the mathematics here in p-values, v-values and in clinical reasoning is also significant as a crucial element whether naive or formal research.

I have always thought that -

1. Hodges' model presents an implicit theory (as per many models - given their purpose).
2. It follows, that Hodges' model can also do a lot of work.

'Proper domain' c/o Machery 2017

On a visit to London 4-7th, in Foyles on Charing Cross Road amongst many desirable titles I came across:

Machery, Edouard, Philosophy Within Its Proper Bounds (Oxford, 2017; online edn, Oxford Academic, 24 Aug. 2017), https://doi.org/10.1093/oso/9780198807520.001.0001, accessed 24 June 2025.

Philosophy and knowledge are in constant play: hide and seek. So the title's 'proper bounds' piqued my interest. I found a previous paper by Machery, also cited in the book:

MACHERY, E. (2011). THOUGHT EXPERIMENTS AND PHILOSOPHICAL KNOWLEDGE. Metaphilosophy, 42(3), 191–214. http://www.jstor.org/stable/24439937

The paper is technical (as 'metaphilosophy' suggests) with discussion of thought experiments, parity defence, but there is utility here:

'If we have reason to suspect that a physical skill or a psychological capacity is applied outside its proper domain, our confidence in the success of this application should decrease. If we have no further information about the circumstances in which the skill or capacity is applied or about how these circumstances impact its reliability, then, for all we know, the reliability of the skill or capacity in this particular application might be almost as high as it is in its proper domain, or it might be very low: that is, we have a reason to believe that its reliability is lower than in its proper domain, but we do not know how low it is. In these conditions, we should be reluctant to express much confidence in the success of the application of the skill or capacity'. p.201.

I'm hoping for an e-copy of the book, which avoiding even more screen-time, I won't read through (review - as I call it...) but I will search, read selectively and post again.

Alliance for Responsible Citizenship

Last month on two occasions, I came across the Alliance for Responsible Citizenship (which is a registered company). 

In the Sunday Times, "Philippa Stroud: ‘Everyone’s moaning — I think humanity can sort things out’":

https://www.thetimes.com/uk/politics/article/philippa-stroud-alliance-responsible-citizenship-km8z26b8b

and Financial Times "'Part megachurch, part political rally: inside London’s ‘rightwing Davos’".

https://www.ft.com/content/7ff1614c-38a2-4b5c-81d3-80cea1196dad 

Apparently, a right wing, conservative movement with a three-day conference, one commentary suggested it has struggled to define itself, which is understandable given the ongoing (increasing?) prompts for its creation.

You recognise early on in your nursing career and not just as a student (pre-Project 2000 UK), but as a Nursing Assistant that character is a key element in your professional development. By the time you qualify, you more accurately see that without a doubt it is your formative education that is a critical factor. That and your 'home' circumstances - and not necessarily the two-parents good, one bad formulation. This is why with students excluded from school, society is taking a wrong turn. There is obviously a problem but what is the 'correct' approach?

An 'alliance' already suggests a given level of organisation. By definition 'grassroots movements' must struggle to establish and retain their identity.

This is a project Hodges' model can help address - with a balanced but not necessarily a neutral output.

Individual

|

      INTERPERSONAL    :     SCIENCES               

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

 SOCIOLOGY  :    POLITICAL 

|

Group

identity personality attitude aptitude character faith individual beliefs religious engagement courage hope threshold concepts my destiny well-being trust	future physical thresholds  waste climate change circular economy AI truth - information disorder science technology PAST - work - FUTURE our future destiny - (what does the clock say?) future generations?
grassroots social movement arts family community culture - diversity social - cultural identity society - support social change social capital social contract social values our shared destiny our children's children welfare - living wage employment - leisure quality of life	power political systems past policy UK: 'Troubled Families' economics organisations, institutions corporations political (manifest! - colonialism ) destiny policy systems political engagement health of leaders trust international law - justice control of fraud, corruption, crime human rights political thresholds

Forgotten Rationales ... ?

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

"One of the earliest attempts to systematically classify disease began with John Graunt’s mid-seventeenth-century examination of London’s Bills of Mortality (1939[1662]). London’s series of bubonic plague outbreaks in the first half of the seventeenth century served as the backdrop for Graunt’s statistical analysis. His primary objective was to develop a more comprehensive picture of London’s mortality in order to construct a disease-incident baseline from which to better understand the effects of plague, which tended to overshadow other causes of death. Essential to these objectives were the broader concerns for creating "population profiles through a study of causes of death" (Alter and Carmichael 1999, 121), which Graunt accomplished by estimating London’s population through a geographical analysis, allowing him to calculate crude mortality rates." p.96.

UK coronavirus: care providers allege Covid-19 death toll underestimated Care operators warn coronavirus may  already be in more than 50% of nursing homes (Robert Booth and Rowena Mason, Wed 15 Apr 2020 07.09 BST. The Guardian)

"Sydenham designed his nosology with the needs of the physician rather than those of the statistician in mind. Accordingly, Sydenham and Graunt produced different classification systems based on the distinct purposes for which they were intended. This distinction (clinical vs. demographic) played a more significant role in the nineteenth century, foreshadowing some of the tensions and cross-purposes that informed the development of modern classification systems. As Alter and Carmichael (1999, 121) note: 'The problematic relationship between causes of morbidity and causes of mortality thus presented an ideological barrier between the concerns of physicians and the interests of statisticians. ...one group were lumpers, the other splitters.'" p.97.

Beemer, Jeffrey Keith, "Social Meanings of Mortality: The Language of Death and Disease in 19th Century Massachusetts" (2011). Open Access Dissertations. 428.
https://scholarworks.umass.edu/open_access_dissertations/428

Q. Is the state of social care and the applicable policy and legislation under which it operates an example of an 'inverted ring-fence'? Discuss & debate, justifying key policy and legislation as you see it and the implications amid the COVID-19 crisis and future (health and social care) policy.
https://twitter.com/h2cm/status/1250405469929328647?s=20

Remember(?) also:
Forgotten Streams ...  

BREXIT: On the Border

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

	Medicines, Medical products Time - Logistics
	"Border Delivery Group" import - export checks BREXIT DEAL :: NO DEAL REFERENDUM #2 ELECTION (crunch) Commons Vote (deferred)  ?

Source: Hughes, L. (2018) NHS faces risk of reduced drug access for six months, FT Weekend, 8-9 December, p.2.

#EndPJparalysis - NHS 70

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

For people who are agitated and living with dementia their carers may learn to remove such cues as hat, coat and shoes. Seeing these may cause increased agitation as a need to be elsewhere. For #EndPJparalysis perhaps we can reverse this and use the sight clothes and footwear as a cue for 'get up & try to go'.	Required: decent research on hypoactive delirium and sleep (need to engage Prof Anita Simonds at the Brompton for this), and how to #endPJParalysis70 in hypoactive delirium. — shibley rahman (@dr_shibley) April 16, 2018

My source:

Please retweet
One week to go and the #endPJparalysis70 challenge begins. Right now, we need as many clinicians to download the #endPJparalysis app as possible so we can reach 14,286 patients a day for 70 days to reach our goal.
Here, the inimitable @Sonia_Sparkles shows us how pic.twitter.com/U8D5R663ui

— Brian Dolan RMN, RGN (@BrianwDolan) April 10, 2018