What! Nursing reduced to objects! Do you realise what you're saying?

Wittgenstein to the rescue?

Revisting a theme, and while it is not new - as in use of objected oriented approaches in health informatics; as a nurse, to suggest there's a need to view the elements of care systems as a series of objects surely runs counter to nursing's theory, practice, professional standing and values.

Or, does Wittgenstein come to the rescue in his 'Tractatus Logico-Philosophicus'?

'2.01231 In order to know an object, I must know not its external but all its internal qualities'.

[My emphasis - and as ever high degree of selectivity.] 

In reading 'internal qualities' I can equate internal with a person; and qualities with subjectivism, what is inherently seen as humanistic, a set of characteristics, and properties. Can it be argued that in the context of healthcare and person-centredness we can also take 'internal' as potentially referring to what happens in the mind, an individual's mental life, for example? This can be applied physically too. To bodily properties, which ultimately are internal genetically, and influenced by - expressed in-part - by the external environment.

While I sort books, creating space, there is the small matter that Wittgenstein walked away from philosophy after the Tractatus was published. Then, realising he had not answered the questions concerning human language and reality, he returned to Cambridge and his studies, with Philosophical Investigations published after his death.

Does this invalidate the thoughts above?

Another post to follow drawing from the Tractatus. 

Previous posts:

Reflection: programming and caring II

Abstract [working] Hodges’ model as a mathematical object, a lens for social care and inclusion: category theory or category mistake?

Person to object: Surely you're joking* ...!

Bill Ross Memorial Workshop – BSP Special Event 2025

A workshop in memory of Bill Ross, and to celebrate the posthumous publication of his book Order and the Virtual: The Philosophy and Science of Deleuzian Cosmology (2024). 

Convened by the British Society for Phenomenology with the family and friends of Bill.

I never met Bill Ross, nor had I learned of his work prior to receiving news of this workshop. I attended today in Manchester; also realising I'd intended to post the details. It was well worth the effort in the (predictable!) rain. The speakers and sessions were as follows:

• Dan Smith (Purdue University): “Reality is a Problem: Deleuze’s Metaphysics of Manifolds”
• Michael Epperson (California State University, Sacramento): “Relational Realism and the Ontogenetic Universe: Subject, Object, and Ontological Process in Quantum Mechanics”
• Vera Bühlmann (Vienna University of Technology): “Cosmic splendour and signal messages, or the choice that will remain unmade”
• Kemal Tezgin (Virginia Tech): “The Virtuality of Space: A Deleuzian Reading of Quantum Fields”
• Robin Durie (University of Exeter) & Craig Lundy (London Metropolitan University): “What the imagination already knew: Science & Myth in the Genesis of Desert Islands”

Order and the Virtual (2024)

The sessions were informative and stimulating for studies here (category theory was noted).

With thanks to Carol at Edinburgh University Press, I have a review copy of Bill Ross's text.

Looking at the contents and index there are many fields in common, which I will share over the coming months.

As with the Laws of Form conference last year in Liverpool, here is another group of academics and scholars, welcoming and keen to share their expertise and learn.

So, thanks to Carol again for what looks an exciting book and the organisers and sponsors of this brilliant event acknowledging and commemerating the work of Bill Ross.

I will try to be more timely with news of related events, and developments. More to follow, but to close for now ...

'Bill Ross (1964 – 2022) had interests ranging widely across contemporary philosophy and culture, with a particular interest in the relations between science and philosophy. As managing editor, he was the driving force behind Clinamen Press, which in the early 2000s published new works by contemporary philosophers, and English translation of important works by continental philosophers such as Henri Bergson, Gaston Bachelard and Michel Serres. He completed his PhD in philosophy at Staffordshire University, where he taught on the MA in the Philosophy of Nature, Information, and Technology. Bill had a lifelong passion for the connections between science and philosophy, on which he had published several important articles. Bill was working on a monograph on the philosophy and science of Deleuzian cosmology, which was has been posthumously published by Edinburgh University Press. This event is to celebrate Bill’s book and his life, and to allow his friends, his colleagues, and anyone interested in his work or the topics and issues addressed by his work to continue the conversation that Bill’s work inspires.'

https://www.thebsp.org.uk/bill-ross-memorial-workshop-deleuzian-cosmologies/

ii SNAP! Abstract [working] Hodges’ model as a mathematical object, a lens for social care and inclusion: category theory or category mistake?

Snap! 

As suspected the elasticity in the holistic bandwidth of the working abstract just failed.

The abstract rejected, I'm not surprised.

[ Prev. https://hodges-model.blogspot.com/2023/03/category-theory-or-category-mistake.html ]

I hoped 'no news' ... might fuel progress for a little longer.

Clearly (again), holistic bandwidth is never enough - focus, focus.

I'm grateful to learn from the call however, that there is a need to address:

How can prevention in social care be better conceptualised?

So I've a start at least ...

Grateful too, in the call, for Wright Mills sociological imagination:

“Know that the human meaning of public issues must be revealed by relating them to personal troubles—and to the problems of the individual life. Know that the problems of social science, when adequately formulated, must include both troubles and issues, both biography and history, and the range of their intricate relations. Within that range the life of the individual and the making of societies occur; and within that range the sociological imagination has its chance to make a difference in the quality of human life in our time.” Wright Mills (1959:226). [My emphasis.]

Clearly the current and previous governments have not got a clue!

I have rarely felt the fury that I feel at todays @DHSCgovuk “announcement” on social care. A massive retreat from what was already bare minimum first steps in long term reform. So on top of previously announced delays to the cap and a better means test, here’s what we now have..

— Sally (@so_says_sally) April 4, 2023

Abstract [working] Hodges’ model as a mathematical object, a lens for social care and inclusion: category theory or category mistake?

There's a clearer idea now - an abstract - something to aim for in July:

Call for Papers - Community Development and Preventative Care With Older People:
New Values and Approaches

Not yet fully fledged, but then Spring [N] still beckons ...

Hodges’ model as a mathematical object, a lens for social care and inclusion:
category theory or category mistake?

Abstract

The health and social care sectors include disciplines that inevitably fall under the combined aegis of the sciences and humanities. This paper examines social inclusion across Snow’s ‘Two Cultures’. The method is interdisciplinary and descriptive utilising a generic conceptual framework known as Hodges’ model. Rather than Hodges’ model acting as a model of, and for care, here the model is used to investigate how social care can be better conceptualised. While mathematics is a mandated competency in healthcare, the subject, as for the general population, is one preferably left at school. The question posed is: What happens when Hodges’ model is treated as a mathematical object? A challenge for reader and author alike, the purpose is to seek new insights into social inclusion, value, values and development through a relational and dialectic strategy with diagrammatic support, also signposting future avenues of study.

Given ongoing demographic pressures for many nations, is there an additional danger of two intergenerational cultures? Is prevention enough; and can we improve understanding of what can be termed ‘legacy issues’ in health and social care? Can we simultaneously reduce the focus to Simmel’s ‘dyad’, and yet open new avenues for discourse and description? Can we expose the epistemological and ontological dimensions of social inclusion and the life (and death) experience of older adults? Inclusion and exclusion are implicit parameters within the model, its original purposes being person-centredness and recognition of health as political. References and resources, in the form of a template and bibliography are provided.

<>

Still much more to do ... heaven knows what the result will be - and do? Even as I keep the call 'in mind', it may not 'fit' the intended journal at all. Non-predatory, and no article processing charges is essential. Brevity, conciseness ... the order of the day. I can't even hide behind "A little knowledge is a ...": I know nothing - but I'm sure there is some-thing here and in #h2cm.

If anyone is interested in writing something quite different and challenging, then please get in touch. There may (realistically imho) be two-three papers here?

From the call:

"As Rapoport highlighted in the 1960s, however, translating the unified view of prevention associated with public health into social welfare is inherently problematic. This remains the case. Preventative social care and support necessarily operate in complex and dynamic systems, generally where knowledge of causation and the consequences are unclear, and an imaginative application of care needs and contexts is required.

Though current policy direction across many countries suggests opportunities for re-imagining how prevention may be best conceptualised, numerous studies have highlighted that there remains considerable confusion and disparity in how this plays out in practice."

I have held on to the following article from Computing, March 19th 1987 and still learning from Durham and colleagues' journalism:

 "Sometimes a highly abstract, unifying mathematical theory underlies a whole set of scientific or engineering subjects. ...

Category theory is one such subject. Sometimes described as an algebra of algebras, it plays a unifying role in discrete mathematics. Discrete mathematics is a general heading for all the mathematical subjects which deal with jumpy, lumpy entities. Most of the mathematics used in the theory of digital computing is of this kind.

Another unifying subject, homology theory or differential topology, is less well known to computer scientists ... Homology theory is a unifying theory in continuous mathematics, which is the name given to everything that deals with smooth and stretchy entities.

Durham, T. (1987) Over the Horizon.
Working out the algebra of algebras, Computing, 19 March. pp.28-29.

[According to Bowden,] 'category theory and homology theory are fairly close things. The big difference is that homology theory includes information about the topology of the space that it describes.

Category theory is just about information. Homology theory is about information and structure, the structure of something.'

Space itself is not something we usually think of as possessing structure. But space does impose limitations on the kinds of behaviour that can be exhibited by things like electric fields and currents, or electromagnetic waves." p.28.

Durham, T. (1987) Over the Horizon. Working out the algebra of algebras, Computing, 19 March. pp.28-29. (Sorry no issue / volume nos.).


See also:

Call for Papers (i) Community Development and Preventative Care With Older People: New Values and Approaches

Call for Papers (ii) Community Development and Preventative Care With Older People: New Values and Approaches

Call for Papers (ii) Community Development and Preventative Care With Older People: New Values and Approaches

 I drafted this with (i) but didn't want to distract from the call and journal itself.

 With three working titles in a 250 word abstract in response to:

"How can prevention in social care be better conceptualised?" - 

I am open here (as ever) to expressions of interest towards collaboration. Support (help) would be invaluable, whether advice/co-author - to develop ideas on Hodges' model as a mathematical object(?). Even if this includes telling me to stop the barking and leave the tree alone. That point aside, the reading and videos are a challenge, but really enjoyable too.

In reading the call, Quaternary prevention will be added to:

"While applied in the context of complex social problems, discourses of prevention are most coherent and established in the realm of public health (e.g., tertiary, secondary, and primary prevention). As Rapoport highlighted in the 1960s, however, translating the unified view of prevention associated with public health into social welfare is inherently problematic. This remains the case. Preventative social care and support necessarily operate in complex and dynamic systems, generally where knowledge of causation and the consequences are unclear, and an imaginative application of care needs and contexts is required."

The result will be abstract. With “'re-imagine' social care" taken literally. 

Since there are quinary industries ( 'ours' no less), is there, should there be - quinary prevention? I think so, and this - and several legacy issues encountered in my career and ongoing today (also accentuated in the future?) will form the basis of discussion. Early days, but also need to decide upon the manuscript type:

• Article: a paper containing original research results that has not been published elsewhere. Articles shall have a maximum length of 6,000 words (the word count limit includes title, abstract, tables, figures, and references list). During a potential revisions stage, after peer-review, authors can extend the article length to a maximum of 8,000 words to better address the reviewers and editors’ comments.
• Commentary: an opinion piece providing a critical evaluation of a published article or topic of interest to the readership of the journal. Letters to the Editor and replies should be submitted as Commentaries. Commentaries shall have a maximum length of 2,000 words (the word count limit includes title, abstract, tables, figures, and references list).
• Review: a paper which comprehensively sums up the current state of research on a particular topic. Reviews shall have a maximum length of 6,000 words (the word count limit includes title, abstract, tables, figures, and references list). During a potential revisions stage, after peer-review, authors can extend the article length to a maximum of 8,000 words to better address the reviewers and editors’ comments.

The completed draft may not be 'finished' by July, but the exercise will help develop ideas to further understanding and awareness of Hodges' model. I'm almost too close to Hodges' model and I can't discuss ideas on a daily - work basis. The other impediment, is standing on my foot, pressing me against the walls (whichever domain) is the fact that models of/for care, and nursing theory have little currency these days. Finally, having explained I have no funding, encouragement to write is appreciated. This effort is also informed by threads on (and off) the Spirit of 1848 ListServe.

Time - for care to commute [an appendum]

Addendum: Because we are (still) living in a post-Project 2000 World ...

"The whole thrust of nursing in the last decade [1981-91] has been directed towards seeing the patient as an integrated, individual human being rather than as a piece of malfunctioning anatomy. The patient is a person not 'the mastectomy in bed 3' or 'the man with the leg'. This means that any model of nursing must take into account the patient's psychological and social functioning as well as anatomy and physiology." p.53.

Ack. Walsh, M. (1991). Models in clinical nursing: The way forward. London: Bailliere Tindall.

[Book now bound for students.]

 INDIVIDUAL
|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

psychology	anatomy, physiology
social	employment, studying ... life chances / end of life choices

We need to consider concepts of care for a person, patient, and carer, not only in terms of their respective, or primary care domain [ e.g. leg, mastectomy; anatomy, physiology; sciences ] and associations with the academic disciplines; but in Hodges' model, focus upon the horizontal, vertical and diametric relation across and between care domains.

As described by Walsh, talk of  'the mastectomy in bed 3' or 'the man with the leg', is a dated trope; yet sadly it can signify the nature of staff (team) attitudes, the quality of care and experience of patients and their families. 

 

Technically, I see Hodges' model as a relational ontology. What this means basically, is that the model facilitates, encourages the user of the model to consider what they identify in a situation as objects (entities), events, concepts, relationships, data, and so on. An important assumption here is that what 'stands out' is what has salience (what the patient says - non-verbally too, what they mean, what they don't say?); that is, meaning and significance. 

 

Returning to Walsh's example: What does this event, diagnosis, prognosis (including anatomy and physiology) mean for this person as an individual? (If it means 'nothing' this may still - in a mental health context - be important.) What will it mean for the person's friends and family? What do the person it will mean to friends and family - significant other? What about their ability to work, and study? Can they resume their life plans and what of the person's life chances and those also affected? 

 

Crucially, there may not be a connection, a relation, across the care domains of Hodges' model. Asking the question is key, however; to go beyond what can be(come) task-based care. The ability of the model to assure and improve health care rests on this. The same applies for self-care too, with the model's support of reflection and critical thinking, essential to health and other forms of literacy.

Parity of esteem means we have to travel across the model. If we are 'collapse' the model's domains - four sets, into one that actually means something for the nurse, patient, manager, policy maker and researcher. This something, at least conceptually; is no less than person-centred, holistic and integrated care.

Q. Can care commute?

Designing for Changing Values (Event & Journal CfP)

I learned of the following research project via

Philos-L "The Liverpool List" Department of Philosophy, University of Liverpool
[ https://www.liverpool.ac.uk/philosophy/philos-l/ @PhilosL ]

- with news of a call for papers:

CFP: Corpus Analysis, Conceptual Change, and Socially Disruptive Technologies

Hodges' model is ideally to suited to critique of systems and socio-technical dimensions as previously described:

Jones, P. (2009) Socio-Technical Structures, the Scope of Informatics and Hodges’ model, IN, Staudinger, R., Ostermann, H., Bettina Staudinger, B. (Eds.), Handbook of Research in Nursing Informatics and Socio-Technical Structures, Idea Group Publishing, Inc. Chap. 11, pp. 160-174.

Plus, there are many posts tagged 'socio-technical' - hyphenated to emphasize the inter- multi- trans-disciplinary bridges that the model provides (some posts are also tagged 'sociotechnical').

The research project Designing for Changing Values provides encouragement here for the increasing relevance of Hodges' model:

How to Deal with Value Change in Sociotechnical System Design

"Not value neutral

A key insight from philosophy of technology is that technological artifacts and sociotechnical systems are not value neutral, but support or inhibit certain values. Several philosophical accounts for understanding the embedding of values in technological artifacts have been proposed and approaches like Value Sensitive Design, Design for Values and Responsible Innovation have been established for integrating values into technical design.

A theoretical blind spot

A blind spot is, however, the possibility of value change after a sociotechnical system has been designed. For example, when many of our current energy and transportation systems were designed sustainability was not yet a central value, and we are now struggling to incorporate this value into these systems. Progress in the field is currently inhibited by the lack of a philosophical theory of value change in sociotechnical systems.

Better design strategies

This project fills the gap by developing such a theory. It moves beyond the state of the art by proposing a dynamic rather than a static account of values, by developing insights in the dynamics of value change, by extending analysis about the embedding of values in technical artefacts to sociotechnical systems and by developing design strategies that aim at designing sociotechnical systems that can better deal with value change."

https://www.valuechange.eu/

I do wonder about the subjective-objective and qualitative-quantitative 'metrics' of value and values (and other metrics - change, complexity, emergence). In human and mechanistic terms there are marked differences too between value and values. Values are, should, must be, embedded in individual nurses and hence the domains of Hodges' model. This is how (in part) the model supports reflection, and critical thinking.

No surprise then being created for practice, Hodges' model is dynamic. The model can help capture and present an ongoing sequence of frames. Where were we? Where are we going? How have things changed? (This is

Hodges' model prompted the thought of 'holistic bandwidth', the call for papers on corpus analysis seeks examples of formal work. The model, initially blank provides a conceptual framework upon which to capture a conceptually situated corpus. The structure of Hodges' model is a foundation for a relational ontology that draws upon semantic distance between the model's two axes (as per the table below):

INDIVIDUAL <-> GROUP 

HUMANISTIC <-> MECHANISTIC

Not just that but the synonyms that may apply. So for 'individual': person, patient, client, self, client, 'I', 'me', Peter, Chi, student, teacher and whatever role is applicable. This point is vital as there is a potential and workflow that runs from:

1. Neutral, blank, non-judgemental (the model as a template): the content - empty, null state.

2. The model's essential structure.

With a potential for conceptual explosion - from a basic (very simplistic) inherent corpus, to one that is explicit:

3. A response to a situation, a context.

4. That then changes according to events, aims, objectives, strategies, philosophical perspective (recovery, strengths, self-care), policy emphasis ...

In health and social care as suggested above we would hope that the model is employed to shift from the general to the specific - person-centred approach.

 INDIVIDUAL
|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

value(S)	VALUE(S)
value(s)	VALUE(S)

This conceptual framework is not limited to strategy either, but can also encompass deliberation on operational and tactical concerns.


See also:

Soc. Philosophy & Technology Conf: Charleston, S.C. 8-11 July 2007

20/20 vision minus 1, 2, or 4 blind spots....

'corpus'

Jones, P. (2012). Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model. The Journal Of Community Informatics. 8(3). Retrieved from https://openjournals.uwaterloo.ca/index.php/JoCI/article/view/3034

Jones P. Exploring the relationship of threshold concepts and Hodges’ model of care from the individual to populations and global health. Rev Cuid. 2017; 8(3): 1697-720. http://dx.doi.org/10.15649/cuidarte.v8i3.464