iii Picking up sticks: when axes matter

It is one thing for us to break the stick, but quite another from a concept's perspective. They are accustomed to the dynamics at work, when as search terms they are exploded, or not. And, not just any concept but one that can be unique. Consider the concept, and how or where it finds itself [ in Hodges' or another model ]? Let us use the intra-INTERPERSONAL domain, as an example, and ask:

1. Is 'mood' fixed by the I-axis alone?
2. Does the humanistic axis have a role in where in the doomain the user of Hodges' model places 'mood'?
3. Acknowledging person-centredness, if the patient/client had a view, to what extent would this agree (with annonymity assured) with the professional's judgement, or a relatives / guardian?
4. What is as a result, 'mood' has become 'very low mood'? (To continue in this vein , invites complication, but we will continue.)
5. Introducing the 'Other' whatever their role and relationship, pushes us to the humanistic, but whether this is achieved in a person-centred manner (triage excluded) is a matter of opinion and judgement (evaluation).

If mood is fixed by the I-axis then if we determine the issue is 'low mood' are we introducing a combined quantitative and qualitative dimension, a continuum, at the selected point in the interpersonal domain? Writing previously about threshold concepts, I wondered, and proposed compound threshold concepts. There is a progression from the patient's subjective self-assessment, to in all likelihood of an objective measure being introduced, so spanning two domains. Definition of 'compound' aside; there is a compound structure at work.

What points 1-5 above reveal is triangulation. When it is argued that Hodges' model facilitates navigation as per my presentation on 21st April, this is a strategy from mixed-methods research in practice. Many years ago, Hodges' model was described as a 'cognitive periplus', reflecting the way ancient mariners initially charted the coastlines creating the first map, as per their culture and dispora. In the west more recently the value of social approaches and activities, especially in mental health. Care navigation is a role. Literally sign-posting to individually suited (which must be stressed) activities, resources, and agencies. So, in Hodges' model what are our three triangulation points? They are:

1. Axial;
2. Intra- InterDomain; 
3. Person-centred. 

Perhaps, we can describe 1-2 as conceptual anchors at least when dealing with a concept, while #3 is more about approach, values and philosophy. So, there is something of a 'cheat' going on, because each one is compound:

1. Axial: The axial is comprised of four points. The axes create a Cartesian plane (figure). And, as far as a patient is concerned, they mark off a point on the respective Individual and Humanistic-Sciences parts of the axes. This form of triangulation point can claim a general conceptual precision (language) in the applied terminal labels; but what happens in-between can be patently fuzzy. A mix of what may be objective and subjective.

2. Intra- Interdomain: This may be the most imprecise triangulation point. It appears the axes of Hodges' model are composite (figure). They have two-sides as a boundary. To be pedantic, in our example, one plays to the interpersonal domain, the other the sciences.

[The relationship between the axis and the domains in Hodges' model, is far from unique; but I wonder if there is something else here?]

2. Person-Centred: There is a paradoxical nature to person-centred(ness). It is also nebulous in nature, and yet in care it is definitive in practice (safety, purposes, values, professionalism, competency, ...).  It forms locus which can also be classed as a traingulation point, at the centre of the model. This is the point around which Hodges' model is built. This captures the individual's (life, care) context and situation, all influenced by their life chances as consequent health - and other - careers. Salience and our attention^ is key. Is it possible to frame our purpose(s)?

^A focus for [N] autumn.

Marrakech, Le Jardin Secret. 24th April. 1000-1830.

Draft: Table 3 What about this one - should it stay or...?

 Table 3 Features of Hodges' model related to Threshold Concepts [TCs]

This is, I think, a more obvious element of a paper on Hodges' model and threshold concepts than Table 2 which has now been removed from the draft. Despite the inclination to relate the main features of one to the other at 5449 words it looks like this table will also be dropped. I'm not working to a word limit for a given journal, but 5-6000 words including references seems a more disciplined figure at this stage.

While I've just explained a rationale for it, the purpose of table 3 does not seem very clear within the paper. At 90 words the table is hardly lengthy, but it is the main text and ideas it relates too. Without fooling myself, I'm sure the draft is now much improved continuing to sort the wheat from the chaff as it were. Now I've placed the emphasis on explaining the example 'Deprivation of Liberty'. There is an interloper in the table: can you spot it?

Yes, that's it - Compound TCs [CTCs]. In this I'm questioning whether there are hybrid conceptual structures in Hodges' model? I'm proposing that 'Deprivation of Liberty' (must) be considered as a compound TC, for reasons (care requirements actually) of integrated, person-centered and holistic care. I also intend to argue that these are legacy issues (based on a 40 year career - practitioner research?) in terms of quality of care and quality of teaching / learning which also call for measurement. In addition to CTCs, I also see Hodges' model as a means to precontextualisation.

So, Table 3 thanks for hanging out with me: you will be revisited at some point, but for now it looks like your rows and columns are numbered!

Once again if needed this invaluable introduction and bibliography on threshold concepts may help with the meaning of the threshold concepts features.

Hodges' model Feature	TC Features and additional points
Care Domains	Liminality, Transformative, Troublesome, Irreversible, Integrative, Bounded, Discursive, Reconstititive Disciplinary and contextual way-finding and sign-posting precontextualisation
Health Career	Transformative, Reconstititive, Irreversible
H-M axis	Integrative, Reconstititive, subjective-objective, qualitative-quantitative Personal, Collective, 4Ps purposes, processes, policies, practises,  Effectiveness, Efficiency
I-G axis	Integrative, Reconstititive, Personal, Collective, 4Ps purposes, processes, policies, practises Equity, Efficacy, Equality
Hodges' model – as a whole	Holistic, Person and Student-centredness, Troublesome Idealisation, being person-centred, precontextualisation, transtheoretical
Compound TCs	Troublesome, Integrative, Discursive, Reconstititive, Liminality Situated learning, Person centredness, Reflection on experiences, Reflexivity

See also - Draft: Table 2 ... 

Threshold Concepts: Pre-conference Health and Social Care

Yesterday afternoon there was a video-linked workshop between Glasgow, Halifax, Nova Scotia - Dalhousie University and an interest group member in Plymouth. This was to try to further thinking on threshold concepts in healthcare and one of two pre-conference workshops at:

6TH BIENNIAL THRESHOLD CONCEPTS CONFERENCE

Our agenda:

Workshop: To disaggregate or not? The dilemma of complex threshold concepts

• What do we mean by complex thresholds?
• Is this particularly relevant to healthcare and if so how?
• Can we identify some examples in health and social care?
• What problems do complex thresholds bring for teachers, learners, the curriculum?
• Is disaggregation helpful (and how) or unhelpful/reductionist/simplification?
• Do we have any evidence or theories that can help us?

We did not cover all the points in depth, but in respect of the first point I could define 'complex thresholds' with recourse to Hodges' model. The paper I'm working on includes a table that alludes to this. I could take this question more literally in that draft.

Thinking about complexity and aggregation, by complex is this the same as compound? Compound suggests something that can be taken apart (it is composite), but complex involves the whole (domain-based?) situation / context?

The example I have in mind is learner's recognition, appreciation and understanding of:

• mental capacity
• best interest
• deprivation of liberty

By learner's I am thinking of student nurses (plus other disciplines), healthcare assistants and future associate practitioners. In the era of lifelong learners, public engagement and patient involvement/engagement I have include others (despite the academic demands for specificity).

Philosophy Now 113

On the last question - Do we have any evidence or theories that can help us? - I still feel evidence can be found in Hodges' model. As ever: data, data, data!

Feelings are never enough (until they are all we are left with).

Discussion included the curriculum as the questions indicate, and again one of the original purposes for the model was in curriculum development. but in addition the position and role of the 'big picture'.

Issue 113 of Philosophy Now featured New Realism. I'm cherry picking from pragmatism, idealism and realism. New realism questions whether a unified picture (in philosophy) is available (p.7). While this is a damaging critique to Hodges' model, it might also be an opportunity.

Steinbauer, A. (2016). Interview: Markus Gabriel, Philosophy Now, Apr/May, 113; pp.6-10.

"Integrated - care": What's in a word, or two?

This blog post was sat in 'drafts' since 28/01/2007 (yes, I know what that suggests). It concerns an issue, or more properly a theoretical and experiential aspiration in health AND social care that should in truth have provoked many papers for Hodges' model by now.

In the almost 18 years since, I wonder about the total number of papers devoted to this subject, the service's delivery, policy, outcomes, reviews and reports on integrated care? In nursing theory, philosophy and the start of many 'learned papers', it is customary to begin with a definition of terms. What happens when we divide 'integrated care' and first treat integrated and care separately? Does this aid our understanding? Do we divide and conquer? Is there a difference in results? Conceptual analysis would see us do both, and conduct a literature search.

In practice, (and clinical - especially) we often use words in rather lackadaisical way. Not surprising really, after all we've got a job to do! When pronouncements are made regards health and social policy I hear it as good intentions. I also reach for my soap box. It is often hyperbole, rhetoric. The same applies to the related idea and ideal(?) of holistic care, and person-centredness. I'm biased, of course, but I believe that Hodges' model can help to scope, and define these idealised features of health and social care (and education). As noted, people don't have the luxury of time to stop and deliberate on the precise meaning of the language they routinely use. As noted, at the end of the day - if it gets the job done then that's sound.

In a poll of words that are both much used and the meaning taken for granted integrated must be near the top for several reasons:

• its seniority: it has been around for decades.
• its scope across sectors and day-to-day life.
• our dependence on its fulfillment.

N-Gram suggests some possible insights into integrated and related forms of care:

https://books.google.com/ngrams/graph?content=integrated+care,holistic+care,person-centered+care&year_start=1800&year_end=2022&corpus=en&smoothing=3 

[Trying to embed, results in 1/3 white space at the bottom?]

It seems that integrated care [IC] has been a standing agenda item in health and social care media, education, the workforce, conference, exhibition and policy for several decades. Perhaps, things have calmed somewhat? So either IC is either very important, complex, a hard thing in practice or maybe it's all of these and more besides? IC is a undeniably a compound concept. Is this a cop-out though? You declare something 'compound' then sit back - job-done? I've suggested the same of threshold concepts in health (and probably other contexts?). Time will tell. In the meantime I have reflected on 'integrated care' across the domains of Hodges' model:

self

|

INTERPERSONAL : SCIENCES              

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

SOCIOLOGY : POLITICAL   

|

other

INTEGRATION OF: PRACTITIONER; Team; service; org... Philosophy* assessments threshold for acceptance into service (referral criteria) patient experience & engagement health education / literacies programmes spiritual research involvement	INTEGRATION OF: health record (e- or paper) location - team base care disciplines geographical area referral sources assessments - tools/scales data and statistics research involvement
INTEGRATION OF: HEALTH & SOCIAL CARE public engagement hospital  carer (parent/guardian) experience community services social care - NHS family experience public engagement in research Patient / Public Community Advocacy Treat demand :: Support prevention	INTEGRATION OF: funding leadership / management accountability - complaints (not the same thing!) outcome measures ILLNESS - PREVENTION / education self-care <> planetary care -  Sustainability assisted dying! palliative care! Public - Private - Voluntary Sectors Provider :: Purchaser [Systems] All-Party Parliamentary Groups^

*ethics, values.

^One aspect of so-called 'joined-up government'.

Book review: "After Ethnos" iv

After Ethnos

The nurse literature has drawn attention to transcultural nursing and ethnography in nursing theory and practice. There are books, conferences, societies, journals - papers, dedicated posts and a history derived from Madeleine Leininger's model. While tempted, I'm not about to go off-topic, suffice to emphasize the initial point about nurses being 'anthropologists' and the conceptual scope of Hodges' model.

Rees provides reassurance in this respect. As mentioned, be it lines, contours (p.41), theory, practice or concepts all play a part in avenues to disrupt, break away, escape. 

 Within this (for me) movement and moment are equivalent - leading to surprise, discovery, recognition, observation ...

"Put in a formula, the idea is to render visible ruptures and mutations of established conceptions of the human (an analysis of movement) by way of bringing into view how instances in the here and now derail and defy the normative conceptions of the human (or other things, really) that are silently transported by the analytical concepts on which anthropology thus far has relied (in terms of movement).

The form such analysis of movement / in terms of movement would take is what I refer to as exposure: the exposure of oneself, of one's analytical categories, of the established conceptions of the human that are built into these categories, in one's fieldwork/research. The task would consist in immersing oneself into scenes of everyday life in order to let the chance events that make up fieldwork/research give rise to an unanticipated, unforeseen difference." p.41

"... I mean a discovery of a space/a realm, the dynamic of which - its speed, its velocity, its logic of composition - is no longer reducible to this conceptual history, that escapes it." p.42.

I'm sorry to interpret this text in terms of Hodges' model, but I noted; "h2cm as a carrier for the 'human'". Perhaps this book can prove as pivotal and thought provoking for you?

From a health perspective I see irony in Rees's talk of new concepts and their emergence. (The book is about finding this opportunity and if not creating the opportunity?) In healthcare at present we seem to be suffering 'conceptual churn' as terminology (concepts) is called into question. Perhaps this is facet of (academic?) and the everyday life to which Rees refers. This is why and how Hodges' model can help assure 'carriage' and person-centredness that is experiential (clinically and ethnography?).

Yes, the center of Hodges' model can be a scary place too. Research in the 'open' (p.51). I'd like to think some people may find this blog and my 'take' of Hodges' model somewhat abstract if not theory-laden (I do make things more complicated than necessary). I know I need data, data, data in order to propose Hodges' model as evidence-based (with a theoretical underpinning). Rees differentiates (somewhat) between theory and theoretical and admits due to the mission to a certain disregard - disrespect for theory (p.52). This is music to the four (five -- spiritual) domains: Foucault (1972) - the echo, 'theory as a prison.'. The paradox - 'after ethnos' as a theory - is recognised too.

Rees signposted to specificity within anthropology and books on bees, insects, and cheese. This reminded me of the extracts I had heard of Sheldrake's 'Entangled Life' on fungi (roots, biomass volumes Vs human-made). I noted 'compound' but added 'compound fracture'. Philosophers may enjoy the discussion on epistemology with emphasis upon ontology. Health and medicine figures here too: public health, Pasteur, microbes, malaria (evidence back in time: the bones often have it?). Ethnoi also; what is the unit of analysis in Hodges' model (single concept, conceptual space, threshold concept, pattern, schema ...?

Rees quotes Descola (2013, xx) that includes:

"Anthropology is faced with a daunting challenge: either to disappear as an exhausted form of humanism or else to transform itself by rethinking its domain and its tools in such a way as to include in its object far more than the anthropos: ..."

 On page 65, "Latour is exemplary here. ... the distinction between nature and culture has, insofar as it runs diagonal to how the world is, ..."

Very diagonal:

 individual 

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

modernity (individualism...?)	nature
culture	modernity (capitalism...?)

The present to follow Latour early in the book, is reference to Michel Serres (p.85). This really warmed me. Ensembles - assemblages are clearly structures, forms to add as units of analysis in Hodges' model..

Despite my initial rock onto the back-foot, there is so much I can still draw upon here (bio-politics). Chapters 4 and 5 deserve re-reading. This is a brilliant book. Clear typology, comprehensive index. Prescient too, even though pre-COVID: with SARS and reference to avian and swine flu.

I hope to return to the notes at some point in the future.

Thank you again to Duke University Press for the review copy.

 

Book review: "After Ethnos" i 

Book review: "After Ethnos" ii 

 

Book review: "After Ethnos" iii

 

After Ethnos - acknowledgements 

 

What's in a word - 'hysteric-al'?

 INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

Hysterical: Exploding the Myth of Gendered Emotions Pragya Agarwal	"Rolling resistance is a compound of two factors: hysteric and dampening losses. Hysteric loss is the energy surrendered when a soft tyre deforms; as pressure rises, deformation decreases, therefore diminishing hysteric loss." p.17.

Sources:

Book - various.

Bates, D. How time lords win race against clock. Sport, Cycling, The Times, 17 September 2022, p.17.

Cycling image: c/o @DavidSBates

https://twitter.com/_DavidSBates/status/1570789552985632771?s=20&t=KPyb7YjvVHMZhuvtAFDa7A

"Global Mechanism - Your analysis and ideas?" c/o COMMINIT.com

I have posted some items c/o The Communication Initiative Network previously, but that was quite a while ago. Having just contributed to an ongoing discussion I thought it might help me and readers new to COMMINIT to post some background and add to my comment over coming weeks. The topic begins on COMMINIT:

UNICEF, with Rafael Obregon (Chief, Communication for Development, UNICEF New York) leading and The Communication Initiative, through Warren Feek (Executive Director) are holding a series of consultations, to gather views, opinions and ideas on what kind of global mechanism could be helpful for supporting advancements in the scale, sustainability, relevance and influence of programmes, strategies and organisations that develop and implement initiatives rooted in communication and media development, social and behaviour change. 

Background
The global development tapestry has seen the growth of a series of such mechanisms seeking to advance particular fields of work. For example, WASH for All; the Global Partnership for Education and, the Global Partnership on Violence Against Children, amongst others.
As we have reviewed these mechanisms it is clear that there are a range of differing goals and roles including:

• Raising technical standards;

• Advocating value and impact;

• Engaging in policy debates and dialogue;

• Coordinating action;

• Accrediting data;

• Expanding funding levels; and,

• Acting as a legitimate global point of contact for policymakers, funders and other major global players in development.

What kind of mechanism - priority, strategy, structure?
The major question for the social and behaviour change, communication and media for development field of work is what kind of mechanism – focus and structure - could help to advance our field of work. Consequently, there will be 3 major themes to the consultation that we will be holding. From your perspective and experience:

1. What priority goals and themes would you propose as the focus of such a possible mechanism?
2. What strategic approach should such a possible mechanism take to work towards those goals?
3. How would you recommend that such a mechanism be structured and organised?

continued... 


There was a meeting last year in London but I could not attend. I was prompted to write following a brief comment by Lorenzo Vargas...

Communication... also as a right (and more in Hodges' model)

I have copied and will further develop my ramblings as follows...

Dear Lorenzo and All,

'Communication' needs to be considered as not just a com-plex concept (process, social, practice, research, purpose, policy, reality...) but a com-pound phenomena too.

I have raised the potential of Hodges' model previously and in your few lines Lorenzo you also highlight how this (open) model might help integrate and provide a generic foundation for the whole health care agenda, locally, globally and glocally - through technology and culture.

First I quite agree to 'communication' being a Right: definitely and even when claims of rights has been described as a 'rights-fest'. In some contexts communication is a privilege, when cultural and historical structures accord a speaker - the 'stage'. Communication as much an innate ability. So the work of Paul Watzlawick needs to taken into account. The primacy of communication is made explicit in the first of Watzlawick's axioms of communication: "One cannot not communicate." Stepping over several axioms, number five brings us to the health context: "Inter-human communication procedures are either symmetric or complementary." This communication dynamic is the pivotal point of entry for communication as a right. The politics of axiom 5 is why we focus so closely on advocacy, engagement, safeguarding, guardianship, best interests, translation services and other measures that might include others acting as a proxy. If these are legal so much the better, if recourse to law if needed is accessible and affordable for example. In health, gender and development contexts a mix (compound) of qualities, characteristics and outcomes must be taken into account:

• being heard (physically, linguistically, politically, educationally - literacy, culturally ...)
• and being able to hear (physically, politically, language, environment, educationally - literacy ...)

We must also include choosing not to communicate (verbally, non-verbally, vote) and such acts ?

I'm sure we can all add our own experiential, personal, and professional emphases on the above.

The link below (should... ) outline Hodges' model - a generic conceptual framework.

Hodges' model - Structure and Care Domains

What is 'spiritual' encompasses the whole model.

As a 'right' like human rights we can place this conceptually in the POLITICAL domain. The scope of 'communication' and its dimensions can then be reflected upon and made more explicit. 

There are a number of 'gifts' in your comment beyond the obvious one in C4D :-)

We are aware of the skills needed in the sciences and many clinical treatments in handling instruments. The history of science is full of them through to the fact of robots deftly and with mm accuracy (and less) assisting in surgery.

For communication to be a right, this should necessitate a series, or at least one 'policy instrument'. 

In Hodges' model the SCIENCES and POLITICAL domains are associated with what is usually considered MECHANISTIC (physical).

This is not merely word association, but a tool that imho can help this and related communities.

With communication as a right, Hodges' model can help stress the need for the many identified and debated literacies to be made a reality. Or if they are not realised, then those who control axiom 5 (and other key factors - social media?) can be held to account?

Just to close I am presenting Hodges' model in London on the 18 May - there is a link on the blog's sidebar.

Thank you for your comment Lorenzo.

I hope this helps your deliberations?

Kind regards,

Peter Jones

Jones, P. (1996). Do we need an overarching theory of health communication? Health Informatics Journal, 2,1,28-34.

The INDIVIDUAL ↔ GROUP axis

Looking at the axes of Hodges' model, specifically the INDIVIDUAL ↔ GROUP axis, I realise (as ever) there's more than meets the eye. 

The labels for the axes are placeholders. To a certain degree they are open, flexible. In the template (link and figure in the sidebar), the what should now be familiar labels are provided for guidance, and convenience.

The care, knowledge domains can be viewed as giant - compound placeholders, even as an opportunity to abstract away a lot of detail. In care delivery, as we concentrate on patient care, , clinical interactions, procedures ... we tend to do this in political terms. Until that is, we are jolted to the wider situation and the true realities of policy, law, and practice.

While the HUMANISTIC ↔ MECHANISTIC labels are fixed, I've often shown how the I ↔ G is itself situated, so you could variously have (titles & names to follow...):

person, self, I, individual, client, patient,
carer, student, nurse x, dr y, allied health z ..

|

nurse .., husband, wife, partner, kin, couple, guardian, friend, family, team, group, community, region, nation, populations, Planet

Usually, what we have is a ONE-TO-MANY relationship, that is 1:N.

In Hodges' model can we also say that the team is the 'individual' and the organisation the group?

Another thought regarding self-care. ... Some times this state might be concurrent with being a patient.

Part of the journey in a patient's recovery. But at some point the person does not need a professional and is indepedently self-caring. Care episodes are not what they used to be. Although when 'true' self-care is achieved, it might appear One-to-None, but this is not correct. Not correct, that is, if we can credit society acting as a safety net. Usually, it would be One-to-Family; if there is no family, then the One-to-Community should (must) be the placeholder of choice.

On self-care, and the vertical axis of Hodges' model, is this also a way to define sustainable health and social care?

See also: https://hodges-model.blogspot.com/2025/10/l-shaped-model.html

Re. 'Population mental health in England, 2003–2022: Teasing apart psychological distress, mental illness and activity limitation'

Last month I was struck reading John Burn-Murdoch's regular opinion piece 'Data Points' in the FTWeekend.

This one 'What's really going on with mental health around the world?' concerned a report:

Henking, C. and Baumberg Geiger, B. (2026), 'Population mental health in England, 2003–2022: Teasing apart psychological distress, mental illness and activity limitations'. ESRC Centre for Society and Mental Health, King's College London.
https://osf.io/preprints/socarxiv/8ygrz_v2

Below I have mapped some points to Hodges' model and added others. 

By accident or not, Mr Burn-Murdoch continued this theme last weekend, discussing pandemic lockdowns and how they never ended for some people (citations below):

individual

|
INTERPERSONAL : SCIENCES             

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

SOCIOLOGY : POLITICAL   

|

group

Getting stuck in a psychological minima. Becoming fixed in mindset, lack of self-development through others - empathy, rapport.  Subtle self-harm becoming more serious. What is character in the 21st C? Lack of measures. ^Lack of coherence - parity in health policy. Lack of assertiveness, self-advocacy, prone to self-stigma (non-help seeking!) Qualitative lived experience becomes self-reinforcing (and other - family?)

Getting fixed with a physique, posture - shaped by technology. Physical equivalent-complement  of 'mindset'. Getting stuck in a physical minima 'long-term'. Subtle self-harm becoming more serious. 'Systems medicalisation' PROCESSES Convenience (POLITICAL) of binary responses, e.g.  DISABLED -------- NOT DISABLED Search for 'answers' - diagnosis Search for 'solutions' interventions

Early effect of lack of external play, risk-taking with others, friends - testing - trust. Lack of social skills. Impact of social and other media - reduction of stigma. Social roles models - father-figure?  Lack of 'real' socialisation - meeting peers. Socio-Political Power, hence resort to 'sick role'. Social media - contribution to self-diagnosis.  Support inc. Social prescribing: "You're not listening! How dare you suggest walking, gardening, volunteering, discussion group .. as a way to deal with this!"

'It's life - get on with it!'  The compound effect of 'World News' on young people: cost of living; housing; cost of/access to education; employment options - related to AI; geopolitical events; climate change, state of economics since birth; COVID; housing; and isolation. 'Jobs' for teenagers? (I had a 7-day paper-round)  ^Parity of esteem (see above) Welfare traps -  especially by age xx Realisation of the importance of outdoors play. Streets being protected for children. Early Start Nursery

Imagine four characters called Harlequin meet for dinner. Halfway through another Harlequin gatecrashes the party, called spirit, then add psychiatry, anti-psychiatry, psychology, service users, policy-makers, the pharma-industry and education to the guest list and you are set for a marvellous time.

My source: John Burn-Murdoch, What's really going on with mental health around the world? FTWeekend, 11-12 July 2026, p.10.

John Burn-Murdoch, Pandemic lockdowns never ended for some people. FTWeekend, 15-16 August 2026, p.8.

Previously: 'young people' : 'mental illness' : 'behaviour' : 'Serres'

Dualistic- thinking checks and balances [II]

Continuing from Thinking checks and balances [I] how can Hodges' model help us understand and provide ready access to three forms of thought: these being -

1. Dualist
2. Multiplistic
3. and Relativistic thinking?

To recap, resort to dualist thinking might be a pathway to evidence for Hodges' model building the case for the model in education, healthcare theory, practice and policy making ... Taking each form of thinking in turn, dualist thinking in Hodges' model can be identified in six ways. Before discussing these, there are some general observations to make.

The axes provide an initial compass for differentiation.

The model is first situated (as per B.E. Hodges).

Situation precedes person but should not subvert the latter when the model is applied.

Upon arrival in any context it is what we draw in the sand.

The most obvious influence on thinking is in what the model gives to us through its structure - the two axes. Firstly, the individual - group axis can stand for the many variations of self and other: from patient - health care team; patient - family; citizen - civil society; person - friends (work colleagues); child - parents (or guardian - a status vested legally by others); clinical case - demographic (world) population. This might be considered a compound view, potentially incorporating scope and roles (as per the context).

Secondly, the individual aspect of the vertical axis also serves the reductive requirement of movement between many-one. Reductivism is a fundamental approach in scientific enquiry and quantitative research. There is in the above the reduction to the individual in the intra- interpersonal domain. Reductive descriptions and phenomena from the sciences can then be ascribed to the individual as per the conceptual content of the sciences domain.

The third factor is derived from the first and is evolutionary and developmental. It has a certain irony in also being a child's developmental milestone - the so-called 'terrible twos'. Whatever age an infant starts to assert their independence, establishing, coming to terms with their difference from the adult figures in their lives - this is a pivotal moment. As they set out to become them-selves, we can say that developmentally they, this nascent individual is drawn out of this particular axis. The axis is first of all then not dualist. The self is always a product of the group (even if the latter is absent). The individual, the self emerges from the other. This is an extended dynamic action, through our first 2-3 years. Self flows from otherness.

Illness, disease disruptions what should be the expected relation, crises whether of temperature or emotion places self-other in contention on a temporary or more permanent basis. The ‘health career’ in the full title of Hodges’ model is also pertinent, as this refers to life chances and the life course.

Perhaps, to borrow a term from genetics / chemistry the vertical axis represents a bivalent quality? The vertical axis has that telescopic property. The vertical axis is reflective the individual sees the group; the group sees the individual. Even as we contemplate the patient in person-centred care, what, who are we - the observers?

The fourth cognitive prompt utilises the model's horizontal axis which spans dualist thinking defined by the categories of humanistic and mechanistic. This can also be viewed as human - machine. This axis also gives an indication for the final, fourth type of dualistic thought. Since the 1960s this axis can also be described as the social - technical, or socio-technical (Baxter and Sommerville, 2011). The notion of machine logic then suggests objectivity and the contrast with subjective types of knowledge. This is a fundamental dualism that is debated by philosophers.

The fifth type a dualistic thinking could be described as replacing the axes above and inviting a free-for-all. Is this where creativity and innovation lie? Does this dualistic form open up conceptual probes and avenues to insight (association and relation)? There are a great many dualities, dichotomies, polarities that can (literally) be shot through the model. Through the centre, between adjacent care domains, within domains: consider, for example; demand-supply, mind-body, public sector-private sector-third sector and voluntary admission-sectioned.

Finally and sixth there is a translation, a progression from the axial duality to the epistemological background of the care domains. This can be constructed from the founding (root) disciplines of Hodges' model:

• Psycho-Social
• Psycho-Somatic
• Physico-Political
• Socio-Political

Superimposed on Hodges' model there is then another set of axes. This could be a means to explain Hodges' model. These trace out the domains of Hodges' model. Is this self-referential quality a coincidence or evidential towards making the case for Hodges' model? These axes act as either, or both a bridge and a brace. Since structure is all about geometry we can close at this point by noting that the strength of the triangle. In Hodges' model there are several diametrical dualities (oppositions), for example:

medicine - society*

individual - political involvement

a society's engagement in - the sciences

individual (demand) Political - health services (supply)

the individual who is mentally ill and the State, Mental Health Act legislation

As we see in this post in addressing dualities Hodges' model is concerned with DISCIP-LINES.

*Medicine and society represent a duality and an established discipline in medical sociology? Socio-technical is not a discipline in this sense and might provide a theoretical contrast - marker?

(The above and posts to follow are a work in progress and will form a larger - referenced - whole in terms of studies.)

Baxter, G. Sommerville, I. (2011) Socio-technical systems: From design methods to systems engineering. Interacting with Computers, 23 (1): 4-17 doi:10.1016/j.intcom.2010.07.003
http://iwc.oxfordjournals.org/content/23/1/4.full

Abstract translation (100 words): Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model

I need to produce translations of an abstract into French, Spanish and Russian with a 100 word limit. At present I'm relying on Google translate; any suggestions to improve what follows (the English too!) greatly appreciated. 'Glocal' should prove a bit of a test. (h2cmng at yahoo.co.uk):

Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model

Abstract
This paper introduces Hodges’s model a conceptual framework as a means to explore the  concept glocal and the more familiar terms local and global. Actual and speculative definitions of glocal are offered. Discussion will also deliberate on the compound meanings of these terms. The model's four knowledge (care) domains facilitate discussion of the physical, social, political and individual dimensions of local, global and glocal. The paper draws upon health, anthropology, history, science, informatics and geopolitics – especially the themes of globalization, literacy,  information technology and communication (voice). The purpose is exploratory with additional resort to philosophical reflection.

Explorar varias dimensiones de locales, globales y glocales utilizando el modelo conceptual genérico Hodges marco de

abstracto
Este trabajo presenta un nuevo modelo Hodges es un marco conceptual como un medio para explorar el concepto glocal y los términos más familiares locales y globales. Definiciones reales y especulativos de glocal se ofrecen. El debate también se tratará sobre el significado de estos términos compuestos. El modelo de cuatro conocimiento (atención) dominios de facilitar la discusión de las dimensiones físicas, sociales, políticos e individuales de los locales, globales y glocales. El documento se basa en la salud, la antropología, la historia, la ciencia, la informática y la geopolítica - especialmente los temas de la globalización, la alfabetización de tecnología de la información y la comunicación (voz). El objetivo es exploratorio con recurso adicional para la reflexión filosófica.

Exploration des dimensions de plusieurs locaux, mondiaux et glocal utilisant le modèle générique de cadre conceptuel Hodges

Résumé
Cet article présente le modèle Hodges un cadre conceptuel comme un moyen d'explorer le concept et le glocal termes plus familiers local et mondial. Définitions réelles et spéculative de glocal sont offerts. La discussion portera également délibérer sur les significations composé de ces termes. Les quatre modèle de connaissances (soins) domaines de faciliter la discussion de la physique, les dimensions sociales, politiques et individuels des locaux, mondiaux et glocal. Le document s'appuie sur la santé, anthropologie, histoire, sciences, informatique et de la géopolitique - notamment les thèmes de la mondialisation, de l'alphabétisation technologies de l'information et de communication (voix). Le but est exploratoires avec station supplémentaire à la réflexion philosophique.

Изучение нескольких размеров локальных, глобальных и глокальные использованием модели общих концептуальных рамках Ходжеса

абстрактный
В данной статье рассматривается модель Ходжеса концептуальную основу в качестве средства для изучения концепции и глокальные Наиболее известные термины локальные и глобальные. Фактические и спекулятивных определений глокальные предлагаются. Обсуждения будут также обсуждать соединения смысл этих терминов. Четыре модели знаний (ухода) области содействия обсуждению физических, социальных, политических и индивидуальных размеров локальных, глобальных и глокальные.Статья основана на здоровье, антропологии, истории, науки, информатики и геополитика - особенно темы глобализации, распространения грамотности, информационных и коммуникационных технологий (голос).Цель поисковой дополнительные прибегать к философской рефлексии.
 

Being all things to all people: and virtually 2nd

I don't ever want to be like 'jam', as that may indicate that one has also become a statistic. In IcT though it's very difficult to spread yourself as completely as you might like. The desire and apparent need to 'multi-webtech' is profound. So it is gratifying (if that's the right word?) when news comes through that the grass is not always greener being an 'early adopter' and in with the in-crowd. For me this missed opportunity and news comes c/o Second Life.

As with the philosophy dialogue there is a virtual effort that dates back to 1991. I realised ages ago that if you are going to build a community dedicated to the compound conceptual space that is Hodges' model then virtual - augmented reality is the space to Be. I have long thought of the model as the ideal portal for a virtual learning environment. So here is news that actually indicates a trend, a shift in the maturity of the web as the established newspaper media also takes stock of traditional journalism, its investment in web content and how to monetise. The latest sign of change is today's news of a possible NewsCorp and Microsoft alliance against Google in The Independent. Here's the Second Life news item:

Subject: [NetBehaviour] Second Life To Remove Free Content From Web Search.

"In a move that continues to shake the Second Life community of content creators, merchants, and consumers, Linden Labs has declared that free virtual content will no longer be searchable without listing payments on their website portal - (formerly at:)
(http://wiki.secondlife.com/wiki/Linden_Lab_Official:Managing_Freebies_on_Xstreet_SL_Roadmap_FAQ);
and additional fees will be added with the intention of discouraging content listed for inexpensive selling prices. The move is particularly troubling because the online Web listing service is the de facto search engine for virtual content in Second Life, since the in-world search tools are unable to provide information about an object beyond name and location - basic textual descriptions, pictures, or descriptions of licensing, size, or content-category are not possible. While initially the change was explained as a response to community feedback, the residents involved in this feedback process were revealed to be fewer than 100 in number, primarily larger merchants among a community of millions. Within 24 hours of the announcement, the feedback thread (https://blogs.secondlife.com/message/38923#38923) has swelled to over 1,000 overwhelmingly negative responses. Additionally, in-world protests have erupted throughout the day, and over 20,000 objects have been voluntarily removed from the online store by angered merchants."

Read on for more details on the brouhaha.

Adding to the controversy are the officially stated justifications in the FAQ
(http://wiki.secondlife.com/wiki/Linden_Lab_Official:Managing_Freebies_on_Xstreet_SL_Roadmap_FAQ),
such as 'They [free content listings] hinder the shopping experience because a "sort by price" puts all freebies first,' and the perplexing statement 'They [free listings] garner so much attention that Residents are driven toward the freebies instead of quality, fairly priced items.'

Various independent virtual content listing sites have been proposed, such as Meta-life.net and Slapt.me, but attempts to post this information on the Second Life forums has been met with aggressive administrative censorship of these links.

Found originally on slashdot.org
My source: CI list and marc garrett (FurtherField)

Additional links:
FurtherField
NetBehaviour for networked distributed creativity

Healthcare & Nursing: A select sport

Ed Smith: ‘We can’t risk stars’ mental health by playing too much’

Gruelling summer proved to England selector that player welfare is critical

Apparently, cricket is a late arrival to team building around a strong core and leader and then using a selection strategy. According to Wilde (below*), cricket is playing catch up with baseball (1880) football (1990) and rugby in 2010s. Even with a squad and substitution some players can play too much with physical and mental impacts. Delivery of healthcare is no 'game' even though certain aspects are open to gamification. Everyone understands the need to stay 'fresh' and avoid injury (burnout too). Nurses are not the only professionals and team players to experience the paradox of a break. On the one hand it's like you've never been away; on the other it is great to pick up the threads of cases, caseloads, referrals old and new. Key here too is the cover provided by colleagues while you were temporarily 'off the field'.

"Eddie Jones was asked after England's quarter-final
win over Australia if he felt vindicated in his decision
 to drop George Ford. He said, we didn't drop him, we
changed his role - welcome to modern rugby."

In health, the appliance of sport's 'win ratio' is not in dispute. We can test this! What is the satisfaction rating of the patient and family? But, let's broaden things to include the tax-payer and the patient's recovering, staying that way and becoming self-caring as far as possible. What has to be considered is the context, for example, palliative, end-of-life care and the aims of care.

Nurses have no choice but to 'play'. Sometimes an astute manager will recognise that a specific staff member is best suited to deal with a specific referral, or re-referral even.

As you guessed it, 'selection' does not end there. 

If Hodges' model is the compound field of play, then the selection of care concepts is the vital strategy to assure -

• person-centredness;
• integrated care;
• parity of esteem;
• reflective practice;
• critical thinking;
• a learning encounter;
• preventive approaches
• addressing health and other literacies ?
• teamwork ...

Yes, care assessment, evaluation can be a team effort. The significant care concepts (social determinants ... ), associations and priorities, risks and opportunities can be identified by an individual practitioner and also as a collective effort (group case discussion) and always with the patient / carer - guardian.

So, let Play commence  - and congratulations South Africa!

INDIVIDUAL

|

INTRA- INTER-PERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

GROUP

Simon Wilde, Cricket correspondent, The Big Interview. ‘We can’t risk stars’ mental health by playing too much’. The Sunday Times. October 27 2019. p.9.

https://www.thetimes.co.uk/article/ed-smith-interview-risk-mental-health-cricket-brw2t8lxk

c/o Gärdenfors: "Events and Causal Mappings Modeled in Conceptual Spaces"

Personal circumstances mean that over the past decade I've given up on several memberships and hence the benefits that were to be had. The British Computer Society was invaluable, and I'm sure still is even at the 'Associate' level. In addition to the Nursing Specialist Group, the Expert Systems Group, Medical Informatics, SocioTechnical and a Methods group have proved an engrossing distraction and a more remote source of ongoing interest. I'm not sure if this is persistence, or stubbornness, but it surely qualifies as sustainable - as I hope this blog demonstrates.

Following the workshops in 2012, and 2016 on Conceptual Spaces I checked online for developments. Amongst the results a paper (added to Zotero):

"Another field of learning that is required for robotic reasoning
about causation and for communicating, for example in a
planning situation, is action categorization. Representations of
actions in terms of conceptual spaces, such as those proposed
by, for example, Chella et al. (2001), Gärdenfors (2014), and
Gharaee et al. (2017a,b), provide a potentially fruitful method for
implementations. Simulating an action and then using the event
mapping that has been learned to predict a result vector, can then
be used to generate plans and to reason about complex situations.
In this way, simulations can provide the robotic system the power
to imagine events that is needed to understand the physical, social
and, eventually, the emotional world we live in.

The event structure has not yet been implemented in any
concrete system. However, a cognitively motivated architecture
for holistic AI systems, including robotic ones, that integrates
machine learning and knowledge representation has been
proposed in Gärdenfors et al. (2019). The central idea of the
proposal is to use ‘event boards’ representing components of
events as an analogy to blackboards that formed the backbone
in some earlier AI systems." p.8. [with my emphasis].

For years - ever since learning and applying Hodges' model I've been carrying a requirement - a project. As Prof. Gärdenfors notes blackboards were an approach artificial intelligence systems, plus frames, cases, neural networks and others. The Health Career Model can be viewed as a series of boards, frames, conceptual spaces and compound threshold concepts. With so many purported forms of informatics and literacy, h2cm can ultimately represent the general state of affairs. It is situated (previously):

h2cm = 'GI - General Intelligence'?

'general problem'

Englemore, Robert; Morgan, Tony (1988). Blackboard Systems.
Addison-Wesley. ISBN 978-0-201-17431-1.
McCord Nelson, Marilyn / W.T. Illingworth
(1990) A Practical Guide to Neural Nets.
Addison-Wesley, ISBN 10: 0201523760.

Over the years, I've been asked about the number of books on shelves and boxed. This week on BBC Radio 4 or Times Radio(?), I caught a snippet of how we hold on to books and why. Your library: can be part of your identity. 

Knowing the life story of a resident in a nursing home, they may be comforted carrying a book; if staff can manage their anxiety about its potential use as a weapon in the event of an altercation. Having several books on a window sill [they do have a window?], can help. The light damage to the book pales in contrast to the reduced anxiety.

I realise what books mean to me - on 'display' even though nobody else sees them and even as I try to reduce the count. I still hold on to some cherished titles, and will return to those above. Originally, I picked up the Health Career Model and created the now archived website, so it would not gather dust on the shelf. Without action now though - there isn't much difference.

Gärdenfors P (2020) Events and Causal Mappings Modeled in Conceptual Spaces. Front. Psychol. 11:630. doi: 10.3389/fpsyg.2020.00630

Defining e-Health

E-Health is a compound and dynamic term for people, health (and social) care education and delivery, organisations, information and communications technologies (ICT), infrastructures, policies and means combined to facilitate, measure and improve the intentions, actions and outcomes of health (and social) care.

In a nursing context people refers to patients, carers, nurses and public; means refers to partnerships plus funding ranging from the macro level of the public sector to personal budgets; intentions, actions and outcomes covers education, the nursing process, records, quantitative and qualitative metrics.

To be holistic metrics must incorporate safety, access, personal outcomes, benefits, integrated informatics and economics.

1st draft: (c) Peter Jones

Millikan's Unicepts and Unitrackers

An underpinning theory of Hodges' model must help us make sense of what is happening within the care domains, between the domains, and possibly say something about what may be significant relation[s]-ships that are diametric. Arriving at threshold concepts I wondered in Hodges' model about there being compound threshold concepts. Consider, when 2-3 thresholds are (b)reached in one (the sciences) domain? Contrast this then, with 4-5 thresholds across care domains? There may also be care concepts applicable that are for example, person-centred: that is, patient, carer, 'management', or policy defined? These concepts while not threshold related per se, are nonetheless relevant.

I came across the work of Ruth G Millikan in London, several years ago as I followed 'epistemology' around the shop. It is time to pick this up and earlier work:

Millikan, Ruth Garrett. “Biosemantics.” The Journal of Philosophy 86, no. 6 (1989): 281–97. https://doi.org/10.2307/2027123

https://www.researchgate.net/publication/235734046_Biosemantics 

INTRODUCTION TO PART I

0.4 Unicepts and Unitrackers

'Neither the clusters in the world nor their properties are found at the sensory surfaces. The properties characterize distal objects and events. They are manifested in diverse and irregular ways through signs impinging on the sensory surfaces, energy patterns that are contingent on shifting intervening circumstances.' ...

'A unitracker is a mechanism or faculty for same-tracking something, for recognizing when incoming information concerns it, then linking and storing this information together as information about one and the same thing. Only then can it can be brought to bear together on inference and action. The link connecting stored information about the same thing together is a "unicept." The information is recognized, paradigmatically,by the initiation or strengthening of an intentional attitude of credence, which we tentatively model as a temporary or enduring connection between the unicept and unicepts for other things.'

'Both unicepts and unitrackers are particulars. You and I do not have any of the same unicepts or unitrackers. What we have in common is unicepts and unitrackers for many of the same things.' ...

'Unitrackers are same-trackers used for collecting knowledge about their targets.' pp.7-8.

Millikan, Ruth Garrett, Beyond Concepts: Unicepts, Language, and Natural Information (Oxford, 2017; online edn, Oxford Academic, 19 Oct. 2017), https://doi.org/10.1093/oso/9780198717195.001.0001, accessed 16 Feb. 2026.