Hodges' Model: Welcome to the QUAD

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Wednesday, January 30, 2008

Test page - CSS for the old content (and new)

The work to re-style - OK actually 'style' - the existing site content is ongoing.

There are two drop capital formats at present, still experimenting. The first gets upset in Netscape (although I gather NS is no longer supported beyond this or next month). There is much still to do -

  • Styles for TABLES
  • Quotes, cite and abbreviations
  • More work on the heading tags
  • Lists - ordered and unordered (I've used an image for a bullet)
    • hierarchy (as here)
  • I'd like to use a typewriter style font for the references.
  • (?Drupal)
    • Paging and navigation of the same
    • Accessibility
    • Printing
I wondered that although Brian's original notes and my original introduction are to be 'archived', whether I could punctuate the text with an 'update box' feature? The user would have a choice whether to omit this when printed or displayed.

The style sheet used above is a bit of a monster, as it includes all the elements for the Drupal theme. Constantly navigating this is helping with the wider aspects of styling to follow.

You may notice on the links pages, e.g.: SCIENCES I've deleted the existing column headings and added the 'th' tag to the main table. So, at present the column headers don't look very pretty. In truth they never have really. They will be much better.

I've been fairly pleased with much of my early HTML work, I can't believe that I never made proper use of the heading and so many other tags. In Dan Cederholm's book the advice is to sort the STRUCTURE first then the STYLING. Pretty sound me thinks - I better get on with both...

Tuesday, January 29, 2008

Halos, clouds and living ontologies

Simon TemplarIt would be nice to be blessed with a halo, but I guess I'd rather be elliptically challenged than possessed of a slipped disc.

Halo-less, succor is found imagining the concept cloud that follows me around. Of course we all have one:

A dynamic cognitive-virtual creation that would be a wonder of the universe if it could be seen. Maybe this is why the WWW is such a marvel?

Life is a comic book really, we just don't see the thought bubbles. ...

As of Jan 2008 - this blog's side bar has a sandpit listing tools in which I would love to fully immerse myself. One of these is Protégé. Like so many pieces of this (my) care informatics jig-saw, this - the keystone? - is yet to be picked up.

It is heavy, a specialist tool; built for knowledge engineering not for care engineers.

After decades of excellent work by researchers in expert systems and decision support systems... knowledge management tools like Protégé are making knowledge engineering much more accessible. Web 2 (and Web 3...) is using the semantic web as a foundation and the term semantic web seems to capture the concept cloud (that might be) instantiated in Hodges' model.

I know the links pages may seem a links-fest or even a links-farm, but in LINKS I intra-INTERpersonal the presence of knowledge management is neither incidental or accidental. Conceptual tools and Protégé in particular might provide a means to help thread together:

  • caring and learning: the 4Ps and care participants
  • informatics
  • records
  • Hodges' model

When I set about creating the website in 1997 this is what I had in - and out of - mind. Already familiar with Buzan's mind-mapping, Hodges' model was and remains a living ontology. A tool to capture and freeze concepts and reasoning at selected critical intervals. This living dynamic vision was just what I needed, to blow the dust off Brian's model, sat there languishing on the shelf. Better a living ontology than a model sleeping in the recessed cloisters of the more mature student's memory. As far as Protégé is concerned though, I've yet to fully raise my right foot, never mind complete the first step (and listen into the literature) perhaps I may never.

Maybe for living ontologies this is where communities come in - so please look after your halo!

Image source: http://www.simon-templar.de/

Sunday, January 27, 2008

Reflections on Drupal Denver theme

Customising Drupal themes is a central skill in the Drupal and other communities. The number of contributed and updated themes are a great testimony to the specific expertise people develop. In tackling a project Drupal developers put a team together across the spectrum of required skills and this includes someone proficient with themes.

I want the new site to look different and reflect the unique structure and content of Hodges' model, but I don't want to spend all my time grinding a mirror for the telescope. I want to be out there observing - even if that's just with binoculars and the naked eye.

I've found the Denver theme quite appealing in its simplicity and functionality:


If you click&check the above image in detail you'll see I need to sort the banner (transparent?) another image would be preferred. There are several menus too: the tabs, left and right side bars plus breadcrumb trails. I've finally defined a new site within Dreamweaver [MX], so I can also focus on the style sheet(s).

Wouldn't you know it - I just checked and Denver isn't currently listed as a Drupal 6 theme. Forever a realist - this is always going to be an issue so ....

Records 2: Flying the standard

'Records I' was posted last September, time to revisit this theme...

If I am a real champion of Hodges' model, convinced of the value and care-worthiness of this 21st century conceptual framework then why have I not been an agent of change@work?

Surely, I would not have stopped short of stepping on toes, or letting a lack of evidence get in the way of advocating the model as a solution to real problems? So why haven't I been the standard bearer where it really matters - on the shop floor? Excuses are many and include:

  • the personal - part-time nature of my combined nursing-informatics interest;
  • following local policy Care Programme Approach [CPA];
  • professional accountability - risk assessment and management and working as a CPA lead;
  • watching with interest as the Single Assessment Process joined the fray;
  • and even more recently the Common Assessment Framework;
  • plus, and this may be a cop out - I like people to decide/discover things for themselves.
Having been away from the clinical practice from Nov 2004 to last summer I was informed as to how much things had changed. After a short period of time I realised on the contrary how little things had changed.

We are still completing paper documentation designed for risk assessment, service engagement and case management of younger adults. Sometimes this focus and attention is justified with older adults, but this is rarely the case. Case files end up with pages of redundant white-space, white noise that slows what we might call conventional information retrieval.

It has been recognised for a long time that IT systems are key to unlocking multidisciplinary working and joining the dots of policy across health, social care and associated care sectors. The outcome of the CPA review is due later this month, it will be very interesting to see the direction this takes and what hooks there are for Hodges' model. The hooks I can see and well and truly intend to snag my lip upon here include:
  • "paperless working";
  • self-assessment;
  • e-working at the point of care;
  • collaborative working and treatment with education interventions;
  • individual budgets and new commissioning models;
  • social inclusion, social enterprise;
  • social capital and employment.
Ultimately, I do believe Hodges' model will find its niche - why? Clearly, the 4P's with records and policy in particular are becoming ever more complex. At times like this a tool to -

simplify and summarise : engage and educate

- must have a place in our curricula, paper and e-record systems, client's and carer's hands and our cognitive tool sets.

Ack: links Care Services Improvement Partnership.

Saturday, January 26, 2008

Drupal 5.2 - 5.6 - 6.0 (and back again...)

I still haven't upgraded Drupal to version 5.6 and so I thought - well let's see what going to 6.0 entails? Next step: download release candidate 2.

Reading the instructions - after backing up the database and files, I put the current 'site' off line, disabled all the modules, set the theme to a core offering and ran through the remaining steps. The Drupe 6 install screen is slick and shows quite a few changes that I look f/w to completing one day.

This time though - trying (foolishly) to upgrade I did not get very far.

Selecting 'English' as the install language then running update.php, the SQL complained and suffered one of those last-line kind of fatal errors.

I may have left one module - 'localisation' enabled and this amongst other things tripped me up.

Anyway, I managed to get back to my original 5.2 and learned quite a few things along the way.

Now at least I feel able to take a copy of what I have to the Drupal NW England user group in Manchester next month (Feb 20th) or whenever. The Drupal directories are a lot clearer in my head now, I even feel like going for a multi-site set up...?

I know this is dreary and at this rate there will be more 'Drupal' tags here at W2tQ than 'Hodges Model'; but as was mentioned at the start it's steep over here and well worth the time spent reading and planning. Another question is what will the database look like? Hence the possible benefits of a multi site set-up?

I've been clearing the existing website directory of redundant clutter, on my PC and at Demon. Reading my pages now, there is not an awful lot to archive. I'll start putting together the style sheets:
  • archive pages (existing content)
  • book pages (new)
  • links pages (existing - unsure about the future)
  • front page template?
The theme will be a contributed effort for now as I'd like to focus on the content and overall structure at this stage. I'll post a few more screen shot examples over the weekend.

(Need to photograph a jacket for that Apollo, Africa and E.T + a favourite book - post)

Monday, January 21, 2008

Free book, part-time enthusiasts and the damage done!

Using Dreamweaver I've been correcting more of the missing 'top of page' links. I'm still using 'top' as the name which is a no-no according to one book. Validating the HTML and all the 'font' tags showed up. What a mess!

Many people still include these tags in their web sites. My pages also include reference to a CSS-style file; so the 'font' tags really are superfluous. Some are there purely to add colour, but I want to strip the pages down, then assess the content:

  • Keep and revise/update
  • Keep but archive
  • Delete (quick!)
I've ordered jQuery in Action and had some good news regards another forthcoming book title next month:

Care of the good people at PACKT Publishing I'm in line for a free pre-order copy of David Mercer's new book:
Building powerful and robust websites with Drupal 6

In return I have to complete a review, which I'll post here and on Amazon. I'm really looking forward to this title and doing a review from the perspective of a Drupal beginner and with the new website for Hodges' model in mind.

Sunday, January 20, 2008

Missing the sun....

Rivington - July 2007

Peter Jones Copyright Photo
Really miss you Mr Sunshine
at least you are on your way back again
with your showers
just one or two -
in toe.


Photo copyright Peter Jones

The symbol '+'

Apart from a multitude of symbolic meanings the figure below also provides the structural foundation for Hodges' model and as symbols.com notes:
Cross from symbols.com

The cross with arms of equal length is an extremely old ideogram used in most cultures. It is also one of the basic gestalts in Western ideography (as opposed to the basic elements, which are derived entities). The cross is found in every part of the world, in prehistoric caves and engraved on rocks.
In my interview with Brian Hodges' over 10 years ago in May 1997, Brian provided an account for how he arrived at this structure (summarised below). As mentioned elsewhere on this blog, the website, symbols.com and other sources - the cross, or 2x2 matrix is a common device to explain and structure. The four elements, the four humours (or humors) yellow bile, black bile, phlegm and blood, the seasons; there are so many things that can be characterised in this way.

With '+' as a starting point for me to reflect on Hodges' model I see each line as an individual. This agent or subject could include patient (person) and health care worker; lecturer and student and many other examples.

The act of cros-sing, the intersection of the axes represents two human beings being in a situation.

Space and time brings people together:

and also forces us apart - physically and temporally.

Adding an arrow to one end of these axes creates the dynamic of communication.

The angular distance in the alignment of those arrows offers hope -
  • in our common humanity we are never in 180 degree opposition;
and yet acknowledges:
  • the isolation of the individual -
  • and the challenge.
The work that must done. Hence the primacy of communication skills and values; in order to bridge individual being, ti:me and space.

Perspective is helpful here as an extension:

While we may get close to another person, through relationships that entwine the lines - be they spun by professional obligations, friendship, family ties, or intimate sexual relationships - the two lines are always distinct: part of an elaborated knot.

Is it just the special ties that must forever seek to be one+



The best way to explain h2cm is to review the questions Brian Hodges originally posed.

To begin, who are the recipients of care? Well, first and foremost individuals of all ages, races and creed, but also groups of people, families, communities and populations. Then Hodges asked: what types of activities - tasks, duties, and treatments - do nurses carry out? They must always act professionally, but frequently according to strict rules and policies, their actions often dictated by specific treatments including drugs, investigations, and minor surgery. Nurses do many things by routine according to precise procedures, rather like the stereotypical matron with machine-like efficiency? If these actions are classed as mechanistic, they contrast with times when healthcare workers give of themselves to reassure, comfort, develop rapport and engage therapeutically.

This is opposite to mechanistic tasks and is described as humanistic; what the public usually think of as the caring nurse. In use this framework prompts the user to consider four major subject headings or care domains of knowledge. Namely, what knowledge is needed to care for individuals - groups and undertake humanistic - mechanistic activities? Through these questions Hodges’ derived the model axial structure.

Saturday, January 19, 2008

Nursing process: a lesson for interface developers

Back in the 1980s when the nursing process first appeared in the UK, amongst the pioneering early adopters there were nurses who were also worried. Would the nursing process with its mechanistic connotations lead to the person, the patient - literally being processed? There is a lesson here for nursing (health and social care) IT systems / interface developers ...

They really are star performers you know, regular high-wire runners. They have to make things simple, safe, efficient, fit for purpose and yet also deal with complexity as they juggle multiple contexts and second guess the psychological state of not just one user (crucial as that is), but several groups (disciplines, beginner-specialists, user roles and security...).

In Tidwell's Designing Interfaces the first chapter is more a psychology primer than pure IT text. The first pattern is safe exploration (and there's much more too).

This week someone e-mailed me and stated that the website and links (in particular) are 'daunting'. While for me the website and links pages have been an emergent pursuit, for 1st-xth time visitors .... well; I have to agree.

Thinking beyond a new site for an archive and book project - this is the trick, I suppose. How do you make a site or information system inviting and put the user at ease? How do you hide complexity until it is appropriate to do the non-trivial things? In order to capture data quickly and efficiently at the point of care how can those static check boxes and drop-down lists duck and weave the user's perception that:

1. They as a professional are being de-skilled;
2. or that the patient (person!) is indeed being 'processed'?

That's not just one tightrope, but several ...

Holistic care striking a balance: Dance halls and the steps we take

I was reminded recently of these research related terms:

NOMOTHETIC -

Of or relating to the study or discovery of general scientific laws.

IDIOGRAPHIC -

Concerned with establishing the uniqueness of a phenomenon:
an individual, a place, or a region, for example.

These words struck me due to the way that Hodges' model can encompass them courtesy of the INDIVIDUAL-GROUP and HUMANISTIC-MECHANISTIC axes.

You know those arcade and now home based interactive dance games where the player dances on a pad?: well if Hodges' model is a dance hall and the concepts we use (the semantic web) comprise the dance steps; then if we focus on one side only (self?) we would essentially be standing on one foot - dancing with one half of our body or may be even a quarter.

Come on.
Yes of course - "at your own risk".
Stand up, move the chair out of the way and do your groove thing!

Try it!

Do you feel a bit silly?

OK, OK, it's no use,

Alright!

I confess!

While I try to be holistic, that's how I dance...

Image source adapted from:
http://www.uniqlo.jp


Answers.com - definitions