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 ...

Thursday, June 22, 2017

There's finding home and then there's Finding Home...

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population

Home
is
where
the
heart
is

Finding home

HOME




powerless power powerful


My source: Bloomberg

Tuesday, June 20, 2017

Pointing to the gap: Social Determinants of Health in Hodges' model

Recent discussion on a HIFA forum included mention of the Social Determinants of Health SDH and inequality. Revising the draft paper on h2cm and threshold concepts (abstract to follow soon) social determinants arose in references there also (Aronsson, 2016).

I realised that I have not stressed enough how readily (and obviously) Hodges' model facilitates reflection and critical thinking about SDH. Hodges' model can really come into its own in this particular application.

So, just in case I take Hodges' model for granted in its potential utility, below I have drawn on the following figure (the findings within will no doubt vary over time and with further research).

By Jsonin - Created this open source diagram for our research into standard human data elements Previously published: http://determinantsofhealth.org, CC BY 4.0, Link
I have mapped the main percentage items to Hodges' model below. Clearly there is great deal of overlap; what for example, is the effect of the physical environment upon individual behaviours? Medicine and medical care does not just rest upon several sciences, but it is inherently political and about power.

Throughout my career and many others I am sure, there is an accompanying gap. It follows us around from the initial educational encounters through to our very latest mandatory training and CPD exercises. Whilst educational in being the theory-practice gap, applying SDH to Hodges' model reveals a much greater gap that politically is still being fought over...

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population
38%
individual behaviour


7% 
physical environment
11%
medical care
21% 
genetics and biology

SOCIAL DETERMINANTS OF HEALTH

23%
social
circumstances



As if we needed to be 'told':

This space suggests that there really is 
still much more to do.

To those who would say: 
"We have done so much!" 
I would say: 
"But, we have only 
scratched the surface of 
the three 'easiest' care domains."



The 38% attributed to an individual's behaviour is a further source of evidence for Hodges' model as a resource for education and personal change.

Aronsson, J. (2016). Transformative sustainability learning within the undergraduate nursing curriculum. Community Practitioner, 89(1), 20-21.



Monday, June 19, 2017

Health Inequality: TB, Trauma and Technology - c/o BBC Radio 4

One of the joys of working in the community is that while travelling I can often catch the radio. Being on a 10-6 today I was even better placed to listen to 'Start the Week'. Even though there's the web iPlayer ... sometimes maybe it's a case of real time - real thinking...

It is a very engaging conversation that - as I listened - spoke directly to Hodges' model: but I would say that (not sure about the real thinking though..!).

BBC Radio 4 Start the Week (19 June 2017) Health Inequality: TB, Trauma and Technology


BBC Radio 4 Start the Week:

In reference to a book there is mention of organisational justice, which I will add to the post on the Grenfell Tower disaster.

I've a related post to follow after midnight UK on social determinants of health. Thank you for your ongoing interest.

Additional tags:
#psychiatry #information #basic needs #shelter #authority #uncertainty #friends #community #location #crisis #war #globalhealth #book #resilience #care #stigma #neglect #institution #community #technology #outcomes #research #services #internet

Saturday, June 17, 2017

The Compartmentalisation of Grief and Tragedy: RIP

INDIVIDUAL
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
POPULATION



a person

A LOVED ONE

(timeframe: grief)

(timeframe: Why)

(timeframe: answers)
to questions that should not need be asked 
(again and again....)

'problem'

Fear

uncertainty

advice

flight OR fight

values

ethics

morality

PSYCHO-

a house
a house
.
.
.
a house
a house
Fire a house fighting
Fire a house fighting
.
.
Fire a house fighting
Fire a house fighting
||||||||||||||||||

strength of towers
cladding - facade

material science

introducing: dead space

"probably"
'problem'

property: transparency vs opaque

(time-frame: risk, evidence)

-PHYSICAL
SOCIO-

a HOME

a group of people

family friends

social housing

a community

the most terrible of good-byes

Towers of Strength

SPIRITUAL

(timeframe: social justice)

D.ANGER

'problem'

introducing: a 'new' home

-POLITICAL

property

material evidence

facade - cladding

cost
££ value $$

Health & Safety Law

Building regulations

(timeframe: Public Inquiry)
(timeframe: ACTION)

GOV.UK

'problem'

'political correctness'?

local-regional-national

introducing: another Public Inquiry


Some reflections on the tragic event at Grenfell Tower, London, UK.

Personal note: In posting this, of course, I do not wish to trivialise the enormity of what has happened, the point is that even in disasters - across the world, tools are needed to reflect, think critically, to support learning in order to ultimately assure a safer future for all...


Tuesday, June 13, 2017

Boxing 'II'

As young children we may encounter 'boxing' quite early on. This first experience, which we may or may not wholly remember is undoubtedly critical to our personality and subsequent psyche. Such early experiences influence our ability to 'look after ourselves', how we deal with bullies, anxiety, the potential for conflict and develop assertiveness skills. When a 'scrap' happens it can be quite sudden, that total impact of everything out of control, sheer danger and literal impacts. The environment might be nursery, playground, cloak room and the presence of peers as onlookers can be another key factor.

In the late 1960s early 70s I found some old boxing gloves under the stairs at my nan's. I had a handful of uncles on mum's side (just two now - Uncles Tom and Ken!) and the gloves had clearly been swung and jabbed down the line. I don't count myself as a fighter, unless someone tries to push their beliefs - without invitation - down my throat. Then it will be more a case of a reflex action. The 'arc' being comprised of vomit. In the school playground I learned to talk my way out of trouble, resorting to humour at times; as you learn to deploy whatever intellect you might have judiciously. Legs are essential to a boxer:

“First your legs go. Then you lose your reflexes. Then you lose your friends”
Willie Pep

My legs helped me a time or two.

Not too many years ago, so a new generation is in the frame and a nephew had boxing gloves of his very own. He trained with a local club and had some fights. I didn't go watching, but didn't make too big a big fuss either. He doesn't box now as it happens; he's married with family and busy earning a living. Over four decades I've cared for several gentleman, former boxers who developed dementia. Hence, my lack of enthusiasm. (Although the selective literature listed below does not reflect it, women's boxing is of course also well established.) The extent to which boxing caused their dementia is not the point here. It's trying to acknowledge the ongoing debate: the risks, the history (Ancient Greece 688BC), the discipline, sense of belonging and self-respect it can instill. Of course a great many sports can do this. Of course, I listened very attentively as one gent could still relate how perhaps he had been 'used' in terms of the fights and purses back in the 50s-60s. Vulnerable adults of today and yesteryear. Today American Football is concerned about head injuries, in football heading the ball repeatedly is in the news. Technology should be able to reduce the risks even more and protect individuals from injury that is obvious and more insidious in nature.

Some of these points I've considered in Hodges' model as follows:

individual
|
INTERPERSONAL : SCIENCES
humanistic ---------------------------------------  mechanistic
SOCIOLOGY : POLITICAL
|
group

SELF

self-awareness
Identity
self-belief

way-finding

dementia - cognitive damage

personality change

aggression

tactics  strategy

motivation training attitude

self-discipline

ethics

mental health - mental capacity
emotions

mood

Personal safety

boxing technique

reflexes speed movement balance

punching fitness

weight, reach, statistics

THE RING

stamina nutrition hydration

concussion
sub-concussive

exposure models

unconscious knockout

Head - Brain injuries

physics: force time (duration) momentum

technology - sensor equipped gloves

Sports Medicine Research
Headgear
Safety - Evidence

Medical risks

OTHER

Ethnographics
Coaches <-> Boxers
Mentors

Support network

THE STREET

personal history-family
History
sports history

trainer friends club

Sporting behaviour

family friends
Socio-
Rules (changes)

Conflict Power

promotion media finance

codification rules

Amateur Professional

Refereeing

Regulating bodies

Governance

Law

Contracts

Economics


Selective reading:

Sacha, J. (2017). Fighting Feelings. Sociological Perspectives, 60(1), 77-94.

Erlanger, D. (2015). Exposure to sub-concussive head injury in boxing and other sports. Brain Injury, 29(2), 171-4.

Falvey, &., & Mccrory, P. (2015). Because not all blows to the head are the same. British Journal of Sports Medicine, 49(17), 1091.

Mcintosh, A., & Patton, D. (2015). Boxing headguard performance in punch machine tests. British Journal of Sports Medicine, British Journal of Sports Medicine, 14 July 2015.

http://www.welshboxers.com/quotes/

See related post 2016: 'Boxing' I


Thursday, June 08, 2017

The Care Domains: Where numbers count...

INDIVIDUAL
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
POPULATION
1:1
Intra- Interpersonal Skills


"All the monoliths, though they vary greatly in size, were fashioned to the exact proportions of 1:4:9, the squares of the integers 1, 2, and 3."


"The rise of capitalism in China resulted in the demise of the "iron rice bowl", under which the state-owned industries provided pensions. Retirees now have to fend largely for themselves or rely on their children, but the collapsing fertility rate has led to the infamous "1-2-4" problem in which a single working-age adult will eventually have to support two parents and four grandparents." p.219.

"2 for 1 offer"
Naylor Report


So let's listen to the wisdom of the four elders...

Sources:
2001: A Space Odyssey Wiki

Ford. M. (2015) Rise of the Robots: Technology and the Threat of a Jobless Future, London: Oneworld Publications. p.219.

Sunday, June 04, 2017

A UK Charter for Health

Dear PoHG supporter

A UK Charter for Health

During this election campaign the NHS and its financial cost are quite rightly of enormous significance. People clearly care about the principles on which the NHS is founded – fairness, equity and public provision. It’s time to broaden the debate and apply those principles to the wider social and economic causes of ill health.

Now we have a tool with which you can work to get health equity onto the political agenda during this final week of the election campaign. We are attaching the UK Charter for Health, developed by PoHG, The Equality Trust and Birmingham City University over the last twelve months. Please use it to ask your local candidates to support the goals of this charter and compare their party's manifesto proposals to the policy suggestions in Figure 1.

It is only by shifting policy upstream towards prevention of illness and promotion of health that the financial cost of treatment through the NHS will be brought under control.

But don’t stop when the election is over! Please promote the charter amongst your networks and colleagues – put it up in your workplace, talk about it with your friends and fellow workers, press your local health authorities and councils to adopt it. For our part PoHG will continue to refine, develop and promote the charter nationally.

With best wishes

Sue Laughlin and Alex Scott-Samuel
(Co-chairs of PoHG)

Politics of Health Group Mail List Messages
Visit the PoHG website for lots of interesting links and publications: http://www.pohg.org.uk/
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