(Confidential) Letter to self - and you, and you, and you... ?

Hi PJ,

I'm wondering if you can help with something that's been troubling me a bit...?

You know that as a nurse (and future patient!) confidentiality (which increasingly relies on the security of ICT systems) is of course vital to your profession and professionalism both in theory and practice. Quite rightly take this for granted and you could be in serious trouble, with your job in jeopardy.

I’ve been wondering about the way that Jo-public views their personal health information and clinical record and how these views have evolved over the past decade and how they will change in the next 5, 10 .... years? A change that will have major implications for definitions and the meanings of record, access, sharing, personalised, and professional. This is also one of those slippery slopes; since it will be very difficult to get that emerging genie back in the bottle. The clinical record even with new consent models will increasingly make it a currency for exchange within a *wider* community given the rise of electronic and personal health records, Health 2.0, 3.0…. By 'community' I mean one not just restricted to health and social care organizations, but one that could be much more extensive.

There are a lot of tools out there in the public domain that enable the creation of new portals, services to which other agencies can add value. This is not a problem: 'value-added services' is one definition of progress.

The problem is the pace of change and the extent.

Health has always been commodified. Recently on the news I heard that a kidney is probably worth 1.5 million dollars (https://www.newkerala.com).

Perhaps for the ‘professions’ given the sanctity of clinical records this is the ultimate trip?

Any thoughts or directions to references…?

Many thanks and best regards,

'Your other half'
P.S. People had better be careful when they mix personalised and professional - that's quite a potent concoction. I wonder if you can sell it?

Additional links / reading:

Viewpoint Paper
A Research Agenda for Personal Health Records (PHRs)
David C. Kaelber, Ashish K. Jha, Douglas Johnston, Blackford Middleton and David W. Bates
Journal of the American Medical Informatics Association, Volume 15, Issue 6, November-December 2008, Pages 729-736.
Abstract:

Patients, policymakers, providers, payers, employers, and others have increasing interest in using personal health records (PHRs) to improve healthcare costs, quality, and efficiency. While organizations now invest millions of dollars in PHRs, the best PHR architectures, value propositions, and descriptions are not universally agreed upon. Despite widespread interest and activity, little PHR research has been done to date, and targeted research investment in PHRs appears inadequate. The authors reviewed the existing PHR specific literature (100 articles) and divided the articles into seven categories, of which four in particular— evaluation of PHR functions, adoption and attitudes of healthcare providers and patients towards PHRs, PHR related privacy and security, and PHR architecture—present important research opportunities. We also briefly discuss other research related to PHRs, PHR research funding sources, and PHR business models. We believe that additional PHR research can increase the likelihood that future PHR system deployments will beneficially impact healthcare costs, quality, and efficiency.

From the above:

Markle Foundation http://www.markle.org

Robert Wood Johnson Foundation http://www.rwjf.org

Considering something ‘ELSE’: Ethical, legal and socio-economic factors in medical imaging and medical informaticsPenny Duquenoy, Carlisle George, Anthony Solomonides
Computer Methods and Programs in Biomedicine, Volume 92, Issue 3, December 2008, Pages 227-237.
Abstract:
The focus on the use of existing and new technologies to facilitate advances in medical imaging and medical informatics (MIMI) is often directed to the technical capabilities and possibilities that these technologies bring. The technologies, though, in acting as a mediating agent alter the dynamics and context of information delivery in subtle ways. While these changes bring benefits in more efficient information transfer and offer the potential of better healthcare, they also disrupt traditional processes and practices which have been formulated for a different setting. The governance processes that underpin core ethical principles, such as patient confidentiality and informed consent, may no longer be appropriate in a new technological context. Therefore, in addition to discussing new methodologies, techniques and applications, there is need for a discussion of ethical, legal and socio-economic (ELSE) issues surrounding the use and application of technologies in MIMI. Consideration of these issues is especially important for the area of medical informatics which after all exists to support patients, healthcare practitioners and inform science. This paper brings to light some important ethical, legal and socio-economic issues related to MIMI with the aim of furthering an interdisciplinary approach to the increasing use of Information and Communication Technologies (ICT) in healthcare.
 
Situation-Based Access Control: Privacy management via modeling of patient data access scenariosMor Peleg, Dizza Beimel, Dov Dori, Yaron Denekamp
Journal of Biomedical Informatics, Volume 41, Issue 6, December 2008, Pages 1028-1040.
Abstract:
Access control is a central problem in privacy management. A common practice in controlling access to sensitive data, such as electronic health records (EHRs), is Role-Based Access Control (RBAC). RBAC is limited as it does not account for the circumstances under which access to sensitive data is requested. Following a qualitative study that elicited access scenarios, we used Object-Process Methodology to structure the scenarios and conceive a Situation-Based Access Control (SitBAC) model. SitBAC is a conceptual model, which defines scenarios where patient’s data access is permitted or denied. The main concept underlying this model is the Situation Schema, which is a pattern consisting of the entities Data-Requestor, Patient, EHR, Access Task, Legal-Authorization, and Response, along with their properties and relations. The various data access scenarios are expressed via Situation Instances. While we focus on the medical domain, the model is generic and can be adapted to other domains.

Picker Inst. http://www.pickereurope.org/

World Health Day

"The pandemic is a portal.
We can walk through it with our dead ideas.
Or we can walk lightly,
ready to imagine another world."
Arundhati Roy

The pandemic represents five portals:

SOCIAL
SPIRITUAL
POLITICAL
INTRA- INTERPERSONAL
SCIENCES

On our respective journeys, 

we can reflect and think critically 

using the disciplinary-bridges provided to us:

socio-political
psycho-social
physico-political
psycho-political
socio-economic

socio-technical

bio-ethical

...

and through 
love, teamwork and perseverance
we see that ...

"Discipline is the bridge between
goals and accomplishment."
Jim Rohn.


individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

https://twitter.com/WHO/status/1247547729879891968?s=20

State of the World’s Nursing Report - 2020

Roy, A. (2020) The pandemic portal, Life&Arts, FT Weekend, 4-5 April, pp.1-2.

The Resurgence of - Soul Soil Society - in h2cm

On my travels into Manchester for Drupal NW and other monthly meetings I sometimes have time to call at the Cornerhouse (now HOME. It's an independent cinema and visual arts venue. The shop is open until about 7pm and amongst many interesting publications I discovered Resurgence which is now Resurgence & ECOLOGIST. It is a great read - as per its banner - on the environment, activism, social justice, arts and ethical living. The great read lies not just in the content, but the fact that it challenges your way of life.

The welcome in the latest issue Nov/Dec 2013 by Satish Kumar the editor-in-chief includes mention of two books, one by Satish Kumar himself: Soul Soil Society.

As technology races ahead and governments chase economic growth through capitalist-based socio-economic systems what stands out is the failure of political systems to keep up.

The question is not how soil is created through a natural process that takes time and is itself a vital variable in a complex ecosystem. The question is how hard can we push soil?

What are the global effects of giant excavators that can move mountains, cut swathes of tarmac through rain forests? What is the natural value of soil, of land for individual farmers against synthetic fertilisers, genetically modified seed, land grabs ...? Why do we call the rainforests - rainforests#? The impacts are local, global and glocal as this issue of Resurgence and others highlights.

Below I've transposed the book's title on to Hodges' model:

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

individual

Soul	Soil
Society	What is missing?

group - population

# See also: PHYSICS & THE RAINFOREST, Peter Bunyard, pp.12-14.

Additional book:
Jonathon Porritt, The World We Made

Call for Papers: Ethics, Health Data, and Bio-Citizenship

CFP: PhilosophicalNews, vol. 22, 2021

Ethics, Health Data, and Bio-Citizenship

http://www.moralphilosophy.eu/cfp/cfp-no-22/

Submission Deadline

Full paper: January 1st, 2021

Aims and Background

Adriana Petryna first introduced the term “biological citizenship” in her ethnography of the aftermath of the Chernobyl post-disaster emergency, Life Exposed [Petryna A. 2002. Life Exposed: Biological Citizens after Chernobyl. Princeton, NJ: Princeton University Press.]. As stated by Rose and Novas, biological citizenship can be defined as an active form of citizenship that produces new forms of belonging, claims to acknowledgement of experiences, and access to resources revolving around biological and medical claims. Within this frame, the “emergency” refers to those “emerging forms of life” and introduces a new element into the philosophical, ethical, and sociological reflection: something which arises from the intertwining of modes of theoretical thinking and moral agency pertinent to different areas – medical, legal, economic, political, moral – and is not directly postulated by any of them; something whose characteristics can be identifiable, but whose result cannot be predicted. Several factors have contributed to defining the concept of biological citizenship. These include:

1.         A gnoseological expansion leading to a proliferation of disease categories in the biomedical field;

2.          New forms of bio-sociality emerging in connection with the increase in rare diseases;

3.         The consolidation of new biopolitical systems and new forms of governance;

4.          The rise of new political and moral economies of hope;

5.          An increased relevance of patient associations in decision making.

However, biological citizenship should not be constructed merely as a resurgence of the medicalization of life (Foucault), or a form of liberalization and privatization of eugenics (Habermas). In this context, this special issue aims at investigating the multidisciplinary background of the expanding moral claim to bio-sociality and bio-citizenship. As a matter of fact, being a bio-citizen carries an underlying demand for more suitable public policies and socio-economic rights to shape the universalization of fragility and vulnerability as human conditions in contemporary society. On the one hand, bio-citizenship may therefore be viewed as a proactive proposition for patient-centred healthcare within an enlarged framework of cultural and political meanings: the patient is no longer a subject, who happens to suffer from a specific impairment at a specific moment in time; rather, being a patient is a universal condition, shared by all human beings. The idea is to move from a generally negative perception of the term “patient” to a neutral or positive perception of the same concept. On the other hand, however, biological citizenship also implies an underlying and constant connection between the patient status and the involvement of health data in order for patient-centred technologies to run efficiently. This entails new (cyber) risks and vulnerabilities that might not only impoverish the empathic and emotional quality of the care relationship, but also favour a concept of democratic citizenship based on Big-data-oriented sovereignty, thus paving the way from bio-citizenship to bio-data-citizenship. This idiosyncrasy is very evident in the ongoing global experience of the COVID-19 pandemic. We are learning how contingent the necessity is to rethink the link between ethics, Big data, patient empowerment, and healthcare technology.

Original contributions discussing issues such as gender, big data, biocitizenship, or any other relevant topic will be considered, subject to approval by the Editorial Board.

Submission Details

•             8000 words (spaces included)

•             Each text has to include an abstract written in English, 300 words max.

•             All material should be submitted via e-mail to the special issue’s editors Antonio Carnevale (a.carnevale AT cyberethicslab.com) and Emanuela Tangari (e.tangari AT cyberethicslab.com).

The volume will be published in June 2021.

For further information as well as the submission of the paper, please refer to the guidelines or visit http://www.moralphilosophy.eu/cfp/cfp-no-22/

Radical Health: Doing Medicine, Health Care, and Anthropology of the Good

Freie Universität Berlin (online), 24-27 June 2021

Convened by:

Medical Anthropology Working Group (German Anthropological Association DGSKA e.V.)

Association for Anthropology and Medicine (AGEM e.V.) 

Institute of Social and Cultural Anthropology, Freie Universität Berlin

In contemporary times of proliferating neoliberalization, augmenting socio-economic disparity, environmental degradation, and political struggles around identities and belonging, health and well-being are becoming increasingly fragile. Not least, COVID-19 illustrates how intimately entangled economic, ecological, social, cultural, and political factors can be, and how they affect people’s living environments, health, and health care provision. Our conference brings together the fields of medical anthropology, medicine, and public/global health to focus attention on how ‘healthy futures’ can be envisioned, theorized, and actually ‘done’ despite multiple constraints. We gather social scientists, medical professionals, health activists, and artists whose contributions will open up avenues toward an understanding of what is conducive to “good” health.

The conference begins on Thursday, 24 June 2021 at 14.30 CEST  (Central European Summer Time, UTC/GMT +2 hours)

Keynote address "Good for what: Radical health in the midst of an epidemic" by Professor Adia Benton (Northwestern University, Evanston, Illinois) on Thursday, 24 June 2021, 19-20 CEST.

For further information and free registration, please visit https://nomadit.co.uk/radical-health/

-- 
Dr. Dominik Mattes
Wissenschaftlicher Mitarbeiter | Research Associate
Freie Universität Berlin | Institut für Sozial- und Kulturanthropologie
DFG SFB 1171 "Affective Societies“
Teilprojekt C03 "Regieren religiöser Vielfalt in Berlin. Affektive Dynamiken der In- und Exklusion im urbanen Raum"

Habelschwerdter Allee 45 | 14195 Berlin | Raum JK30/203

ii 'GlobalMinds' - NHS study severe mental health problems

GlobalMinds has clearly stated goals and objectives. Three challenges that are highlighted:

1. Diagnosis can take years
2. Treatments target symptoms, not underlying causes
3. Half of the prescribed drugs cause severe side effects

These are, to put it mildly, highly contested issues. Diagnosis in mental health/illness is problematic in several respects, for example:

INDIVIDUAL

|

    INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

a) Lack of Theoretical, Practical and Philosophical(?) agreement between:  Psychology Psychiatry b) Individuals are self diagnosing c) Access to mental health services can be highly structure - single-point entry d) The evidence-base for treatment of mental illness is growing,but remains contested. e) Perhaps there is a phenomena of people getting stuck, with not just a label, but a mindset?	a) Loss of trust in classification/coding schemes: DSM b) Proposed alternatives in - Power Threat Meaning Framework HiTOP c) Data defined scientifically: existing diagnosis biomarker
a) Increased awareness of mental illness, ADHD.. b) Behavioural explanations for mental illness c) The determinants of mental illness (unlike, health?) are poorly researched (hence understood) d) The vocabulary of mental illness (psychiatry) is more widely disseminated, hence used; not necessarily with full contextual understanding e) Stigma associated with mental illness is nevertheless ongoing.	a) Reduced economic productivity b) The socio-economic phenomena of NEETs c) Increased demand on welfare benefits d) The role of primary care - GPs      - fit / sick notes      - 'functional assessors' (Who is best placed?) e) Loss of mental health beds, community compensations incomplete.

This will be a space to watch: and related (global) initiatives? 

Viewed from Hodges' health career - care domains - model, it appears an individual's life chances and expectations (family, and educational experience?) can result in their life chances being frozen?

Book: Social Information Technology: Connecting Society and Cultural Issues

Social Information Technology:
Connecting Society and Cultural Issues

Edited By:
Terry Kidd, Univ. of Texas Health Science Center, USA;
Irene Chen , Univ. of Houston Downtown, USA

Description:

An interdisciplinary field, technology and culture, or social informatics, is part of a larger body of socio-economic, socio-psychological, and cultural research that examines the ways in which technology and groups within society are shaped by social forces within organizations, politics, economics, and culture. Given the popularity and increased usage of technology, it is imperative that educators, trainers, consultants, administrators, researchers, and professors monitor the current trends and issues relating to social side of technology in order to meet the needs and challenges of tomorrow.

Social Information Technology: Connecting Society and Cultural Issues provides educators, trainers, consultants, administrators, researchers, and professors with a fundamental research source for definitions, antecedents, and consequences of social informatics and the cultural aspect of technology. This groundbreaking research work also addresses the major cultural/societal issues in social informatics technology and society such as the Digital Divide, the government and technology law, information security and privacy, cyber ethics, technology ethics, and the future of social informatics and technology, as well as concepts from technology in developing countries.

Jones, P. (2008) Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons, IN Kidd, T., Chen, I. (Eds.) Social Information Technology Connecting Society and Cultural Issues, Idea Group Publishing, Inc. Chap. 7, pp. 96-109.

Ecovisionaries: The Royal Academy - Nov 23 - Feb 23 2020

Late autumn I received news of an exhibition that sounded right-up my street - down in London.

Eco-Visionaries at The Royal Academy.

Without wishing to sound grandiose, I see myself as an 'eco-visionary' in several respects:

• yes, as a white, middle-class male and would-be environmental do-gooder;
• yes, as this is the perspective that Hodges' model fosters;
• yes, because now we all need to be eco-visionaries.

As this post's title shows, the exhibition had a short run. Probably a norm in London, but from the NW of England not straightforward but then there was great news and a golden opportunity.

The RA was organising a symposium:

Confronting a Planet in a State of Emergency: Eco-Visionaries Symposium

Sat 22 Feb, 10am-6pm

From futuristic visualisations of a world without humans, to innovative ways of measuring toxicity in cities, creative research into the climate crisis is proving essential for imagining solutions. Join us for a full day of presentations and discussions looking at how we can protect and understand our environment now and in the future. 

And! There was a call for abstracts. Just the thought of a symposium makes me go wobbly, so could I imagine this: actually being an eco-visionary and presenting at the RA! Goodness me.


On twitter I read of many people's efforts to present and publish. I've tried for the Planetary Health event and been unsuccessful but will try again. To those people who try, I say: If you've a message, a resource - keep trying.

Previously on W2tQ [ Waste not, want not ... ], I recycled an 'Item for discussion' that was not accepted last year for RCN Congress, so once again:

Abstract:

In healthcare we are and must be in permanent readiness for emergency situations. Education, continuing professional development, theory and practice are all predicated on lifelong learning and safety. Triage is applied in a practised, reflex manner. This paper will explain how we can better critique the climate emergency and debate solutions using a resource created in healthcare. Healthcare must not only respond to extreme levels of demand, but it is itself demanding. Practitioners and learners must provide safe, high quality care; which must be holistic to achieve a person-centred focus, a positive lived-experienced and integrated outcome. Health is a dedicated Social Development Goal (3), this paper reveals a map of all seventeen.

Despite the proclamations of technophiles, technology alone cannot deliver solutions, a socio-technical perspective is essential. Health and health care systems achieve this by being situated. The climate change emergency highlights not just the interdependency of people to the-ir environment, but the biosphere as a whole. We take health for granted until something goes 'wrong' and now the weather is 'wrong'. This paper addresses: “Creative approaches to conveying information on climate change, air pollution or other environmental issues” but can potentially represent all the symposium's themes. Does this matter? It does in terms of finding not only solutions, but reconciling socio-economic, political groups, global dependencies, issues and vested interests.

The environment needs nursing now.

Health professions will not take kindly to the 'system' placing the climate crisis at their feet and proclaiming “triage this!” Ironically, (bar mass-extinction events) since life emerged the 'system' that really matters is self-regulating. The first example of self-care is vested in Gaia. Eco-vision calls for vision of scale. This paper will share a care architecture worthy of eco-vision and the visionaries we must all aspire to be ...

Title:

A Unique Space: a Care Architecture for Person, Population and a Planet

I'm sure the above can be re-purposed, since alas, it was also unsuccessful. I knew the chances were slim. Hearing the speakers and panel discussions, this is clearly their forte and all very well qualified as Eco-Visionaries. The organisers were very gracious and encouraging, which helped to temper the disappointment. I was offered a complimentary place at the symposium and and was informed there would be Q&A, so I would have chance to highlight the model behind the abstract.

I arrived in London on the Thursday before and visited the exhibition Friday 21st - the last day. It was stimulating, challenging, thought-provoking and upsetting - a video of a giraffe being shot. If shock was the intention: it worked.

With a white rhino in the exhibition and an elephant in the lecture theatre called 'COVID' the symposium appeared full the day after.

I will defer to The Guardian's Oliver Wainwright's review of the exhibition:

Eco-Visionaries review – the salt flats will die and the jellyfish shall rise

I asked several questions / raised points at the symposium, but I suspect for many of us the weeks and months of disruption since disrupted the positive momentum that I at least left with - which is a pity.

I hope the RA Architecture team re-visit this theme. Not so much that I can try to submit again, but more to perfect the technique of framing Hodges' model within a question.

The exhibition and symposium were very good for learning and I really appreciate the opportunity to attend.

International Nurses Day - Closing the gap: My Project for a Global Conceptual Framework for Nursing

As International Nurses Day is celebrated tomorrow on the 12th May the emphasis and work here at W2tQ lies with Hodges' model. The project is to publicise h2cm's international potential in providing an avenue to help unify nursing theory, practice and assure future research.

Fawcett wrote of the metaparadigm of nursing - namely the inclusion of the concepts of person; environment; health; and nursing.

These concepts are incorporated into Fawcett's criteria on model validation which are listed in bold-italic below.

I have also ventured some reflections on the current status of h2cm when compared against these criteria.

Assumptions underlying the conceptual model are made explicit.

It is not sufficient, but the structure of Hodges' model renders the assumptions within the model explicit. The structure identifies eight initial key concepts:

INDIVIDUAL, GROUP (population); HUMANISTIC, MECHANISTIC; SCIENCES, POLITICS, SOCIOLOGY, INTERPERSONAL

A complete description of all four concepts of nursing's metaparadigm are presented.

Reflection soon reveals that several environments are suggested:

PHYSICAL, ORGANISATION, COMMUNITY, HOME, RESIDENCES, DWELLINGS, COGNITIVE (conceptual), SYMBOLIC, ABSTRACT, VIRTUAL, FORUMS, COLLEGES

Propositions of the conceptual model completely link the four meta-paradigm concepts. 

This is feasible, reasoning from the foundation of the model's structure.

The internal structure of the conceptual model is logically congruent.

This does need to be demonstrated. Initial recognition of logical congruence might be found through the conjoining of disciplines, that is frequently taken for granted: PSYCHO-SOCIAL; SOCIO-TECHNICAL; SOCIO-ECONOMIC.

The conceptual model is socially congruent, socially significant, and socially useful.

I have claimed on numerous occasions that the model is agnostic, universal, accessible, and has educational potential. These and other qualities need to be critically examined.

Empirical evidence in support of the model has accumulated from many derived theories.

The two final criteria are the most challenging. Empirical evidence supporting Hodges' model is available, but again must be tested through research. If someone has time - could you please compare the frequency of a set of political concepts in the nursing literature since 1985?* The emergence of health literacy and self-efficacy, threshold concepts, conceptual spaces, the rise of the semantic web and developments in software can all potentially support h2cm. Producing a roll-call of some of the latest trends in contemporary education, research and culture is not good enough, specific studies are needed.

The total contribution of the conceptual model to nursing knowledge. 

There is a long, long way to go, but the contribution has begun ... every journey ...

Of course, it is almost 20 years since publication of Fawcett's criteria. Has the concept of congruence changed in that time? What is socially significant and useful now? What should the social and political weighting of evaluative criteria be in 2012...? There is a body of critique upon Fawcett's and other evaluative tools within nurse education.

Perhaps a new set of criteria could be defined using h2cm itself? For a model of nursing (health and social care) to be fit for purpose, acceptable and viable across the globe, there are new concepts to be represented. While that would certainly close a gap, it does not seem a rigorous or valid way to proceed. I will seek out other more recent criteria and present them here at some point.

Fawcett J. Analysis and Evaluation of Conceptual Models of Nursing, 3rd ed. Philadelphia, Pa: FA Davis; 1995.

*Many thanks - if someone should pick this up, which ever axes, concept or issue.

Book: The Empathy Exams & Michel Serres Institute

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

group

The Empathy Exams Interpersonal Skills	The Natural Sciences
Local, Society & Socio-	-Economics Law

As recent posts reveal I'm overwhelmed with reading at present. Material that is essential for the TEL course and reading more tangential and yet potentially enjoyable titles. It will be a busy summer as all this is brought together(!?). Especially as I've a literature search in mind as a module submission - progress permitting.

The publication of Jamison's book this (N) spring sits well after the findings last year about the benefits of reading fiction in increasing empathy.

Since 2008-2009 I've lost touch with the work of Michel Serres:

Jones, Peter, Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons (Aug 15, 2007). SOCIAL INFORMATION TECHNOLOGY CONNECTING SOCIETY AND CULTURAL ISSUES. Available at SSRN: http://ssrn.com/abstract=1842504 or http://dx.doi.org/10.2139/ssrn.1842504

I only scratched the surface of Serres' oeuvre in the above paper and when time permits will revisit this work having just learnt of the Institute:

The resource-systems approach

"Reframing the conceptual and operational field of natural resources requires deep interdisciplinarity across fields encompassing legal and socio-economic studies, and life-sciences. And, it goes without saying, philosophy. The priorities at present are the aid to decision-making and a participative, pro-active civil society acting to (1) manage human activities while meeting the specific territorial potential and resource capacities and (2) ensure a fair re-allocation of such resources according to vital human needs and coherent public goods policies. Who are the members, what are the missions and the activities of the (...)."

Book cover image: c/o Author.

My source: The Empathy Exams
FT Weekend, June 7-8, 2014.

Paper: "How can we mainstream mental health in research engaging SDGs? -

A theory of change." i

This paper caught my eye on twitter, quite a while ago - the combination of mental health and SDGs:

Madill A, Bhola P, Colucci E, Croucher K, Evans A, et al. (2022) How can we mainstream mental health in research engaging the range of Sustainable Development Goals? A theory of change. PLOS Global Public Health 2(8): e0000837. https://doi.org/10.1371/journal.pgph.0000837

"The recently updated WHO Comprehensive Mental Health Action Plan 2013–2030 [1] concurs with this vision in that two of its six cross-cutting principles are: (i) a multi-sectoral approach, and (ii) action on social determinants. This acknowledges that “integrating mental health across wider sectors such as education, employment and social welfare helps address social determinants of mental health and ensures a comprehensive and holistic approach” [7 p12]. Shen, Eaton and Snowden [8] investigated mental health mainstreaming in 42 countries in terms of a shift towards providing mental health care from institutional to community settings. They concluded that “different countries have adapted deinstitutionalization in ways to meet idiosyncratic situations and population needs” [7 p313] and that more needs to be done with regard to management and implementation strategies. While the keyword for Shen, Eaton and Snowden [8] is ‘deinstitutionalisation’, for Gómez-Dantés and Frenk [9] it is ‘integration,’ and they provide a dimensional approach with regard to what is involved in mainstreaming mental health: “(i) incorporating mental disorders to the global and local agendas related to NCDs [non-communicable diseases]; ii) moving away both from the biological and sociological reductionisms around mental health prevalent in the past century; iii) addressing the whole range of conditions related to mental health; iv) migrating from the idea that mental diseases have to be treated in secluded clinical spaces; and v) expanding the use of a comprehensive approach in the treatment of these disorders, which includes medication, psychotherapy and other types of therapies” [9 p214]." p.2/23

Selected concepts are related to Hodges' model below. In addition to the 2x2 table below, it may be useful for visitors to consider the paper's figures against the model? There is no doubt an overlap across the care / knowledge domains of Hodges' model, but hopefully the 'holistic bandwidth' of the model and its potential as a generic conceptual framework will also be highlighted. 

Note for example the way mention of 'clinical' tends to attract care (understandably) to clinics, hospitals, institutions, controlled (mechanistic) spaces where resources can be controlled and concentrated. Additionally, to find appropriate concepts, we must appreciate how 'local' is applied not only geographically, regionally, but culturally also - within and across a community, or several.

Hodges' model provides several disciplinary bridges of relevance here:

• psycho-political
• psycho-social
• socio-economic
• socio-political
• bio-social

I will revisit the paper again soon ii.

INDIVIDUAL

|

INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

intra-personal - mental health  (contribution to individual's overall health status) self advocacy qualitative evidence mental health practitioners psychotherapy, counselling individual health literacy/education "Implications for researchers include: recognising the potential of their projects to have psycho-	quantitative evidence time, environment, geography - locale treatment resources (time and physical - space) digital technologies 'clinical' seclusion spaces multiple locally-appropriate concepts 'clinical spaces' seclusion/isolation
-social wellbeing impact"* "collaborating with local communities, researchers, and service providers to effect change." "developing a more inclusive and flexible language around mental health that bridges cultures and disciplines ..." multiple locally-appropriate concepts resources  - social, family, community	LMICs - 'workforce gap' shift from institutionalised to community settings security - conflict advocacy resources $$$ income/welfare/micro-finances/ banking/digital access legislation, policies, strategies and services

*The paper also refers to "psychosocial disabilities".

My source (twitter):

https://twitter.com/PLOSGPH/status/1565066449798205440?s=20

Madill A, Bhola P, Colucci E, Croucher K, Evans A, et al. (2022) How can we mainstream mental health in research engaging the range of Sustainable Development Goals? A theory of change. PLOS Global Public Health 2(8): e0000837. https://doi.org/10.1371/journal.pgph.0000837

Additional citation: IRMS Bulletin - November 2022

 Last May I presented Hodges' model at the IRMS Conference in Glasgow.

When I walked in to set up I had the room to myself. I was able to attend on the final day, that of my talk - travelling and staying at my own expense.

The concurrent - streamed format for the conference means you are competing for hearts, minds and existing conceptual frameworks, how well they are populated, what are the 'gaps' and delegate's curiosity and desire for lifelong learning. Next year's event is in Manchester, I'd encourage you to submit, attend if you can.

Five minutes before the start of my session, I counted 8-10 people. The Chair had arrived and suggested we wait a bit longer. 4-5 minutes later I was really pleased - all the seats were occupied and people still arrived by the door. Altogether there were over 30 people.

I'm probably better 1-1 - perhaps that's the 'nurse inside', but the session went well, as the Chair acknowledged and some questions afterwards.

At the end, I was also approached by Jonathan Fryer, in response to a slide showing how Hodges' model can conceptually encompass the various forms of literacy and schools and informatics (posted previously on W2tQ).

Jon immediately saw the relevance of the model, as at The British Library (Head of Corporate Information Management Corporate Information Management Unit) he was currently thinking about literacy.

IRMS Bulletin is a member-based publication, so not open access. I'm grateful that Hodges' model has some exposure and that Mr Fryer found it helpful:

"Information Literacies - Learning, to thrive in a digital age"

IRMS bulletin 230

"I am indebted to Peter Jones, who shared Hodges’ Health Career Model¹ with the 2022 IRMS conference in Glasgow. Although originally used in a healthcare setting, this simple, two-axis intellectual model can be readily used to analyse any complex interaction between the individual and their environment – in this case, information literacies.

The diagram² shows a number of distinct yet overlapping literacies that were potentially in play in our problem example, although there are likely to be many more – even emotional literacy played a part, with the frustrations of the young people in question causing them to dismiss potential solutions before they had been tried or even considered. Likewise, socio-political and socio-economic literacies may have been a factor – if you are unaware that something exists in the world due to blind-spots in your own cultural background then you cannot even begin to look for it."

Jon Fryer, "Information Literacies - Learning, to thrive in a digital age". IRMS Bulletin, Issue 230, November 2022.

[ I will add a detailed citation when obtained and add to the blog's bibliography. Apparently some details referring to Hodges' model were omitted from the published article, I understand IRMS editors are addressing this is a future issue. ]

See also:
https://hodges-model.blogspot.com/search?q=blind-spot

I am planning a submission to the bulletin myself in 2023.

Book: Rethinking Global Health - open access

Rethinking Global Health

INDIVIDUAL
  |

     INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

psy-disciplines:  intra- interpersonal domains subjectification - objectification  learning emotional labour burnout precarious researchers -  acknowledgement of contributions equity personal truth	ebola, cholera, HIV/AIDS, COVID-19, PTSD ... 'emergency', natural diasters climate crises: geography local - global - glocal remote - rural - urban (physical) systems tarmac bias data, information access (SDGs?) digital  divide, epistemic justice
collective 'truth' violence against the 'others' - women, children ... symbolic, structural and  collaboration, cooperation,  co-production, co-design, co-owned with communities socialisation - (into global health work) civil society mobilisation inclusion, empowerment social/cultural/ethnic history social - community - group:  psychology	POWER, poverty global - mental health - physical health (parity of health: determinants^) institutional violence co-ownership paternalism, colonialism humanitarianism NGOs - WHO - Institutions (political) systems decision-making (where, when, who, how ...?) finance - resources 'development' political history

^All of them...

Burgess, R.A. (2023). Rethinking Global Health: Frameworks of Power (1st ed.). Routledge. https://doi.org/10.4324/9781315623788

My source: Twitter

Please also note the inter- multi- transdisciplinary bridges provided by Hodges' model, including well established 'avenues' of psycho-social, socio-technical, psycho-political, geo-political, socio-economic and others.

#NHSMillion: From one quadrant to another three

The image below is from twitter and the #NHSMillion campaign which I've RT a couple of times on @h2cm. The graphic is repurposed here representing the NHS as an organisation with its Socialist founding. On twitter the arrow would point to the twitter account holder's name. In Hodges' model we can readily travel from the individual to the million and more; from personalised healthcare to population health:

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group-population

Within Hodges' model the arrow points to the INDIVIDUAL axis. The stress is placed on a person* and their experience of the NHS whether for themselves or a family member. Care should always encompass physical and mental health care, with emergency care prioritised firstly of course.

As an NHS employee I have been cocooned from many of the financial vagaries of the world. This does not mean I work for nothing, don't pay tax, have holes in my pockets ... On the contrary I'm frustrated and increasingly annoyed about austerity and the pay situation over the past 5 years and more. Interest rates, Brexit, the Euro, the $ ... all count here too. Healthcare does need to be paid for - one way or another. The cocoon refers to the effect of the founding core principles of the NHS:

• that it meet the needs of everyone
• that it be free at the point of delivery
• that it be based on clinical need, not ability to pay

As well as the four domains Hodges' model carries within its structure a series of interdisciplinary bridges as previous posts reveal; psycho-social, psycho-somatic - you get the picture.

A further tweet from @NHSMillion brings home the SOCIO-ECONOMIC and SOCIO-POLITICAL dimension of health and social care. The cocoon is ruptured, the vulnerability of the NHS's core principles and values is laid bare:

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group-population

We need to assure and ensure that the many can continue to make a difference to the one. Even as that gratitude is increasingly reframed as people learning how to stay well for longer and better look after themselves.

*The arrow is also pointing to the center of the model. Truly person-centered care should be able to demonstrate that full round of the four domains have been factored into any assessment, plan, intervention and evaluation with the spiritual also duly considered.

The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 2025

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group-population

'This year’s prize relates to the explanations for sustained growth based on technological innovation. Economic historian Joel Mokyr is rewarded with one half of the prize for his description of the mecha­nisms that enable scientific breakthroughs and practical applications to enhance each other and create a self-generating process, leading to sustained economic growth. Because this is a process that challenges prevailing interests, he also demonstrates the importance of a society that is open to new ideas and permits change.' 'The other half of the prize is awarded to the economists Philippe Aghion and Peter Howitt. In a joint publica­tion from 1992, they constructed a mathematical model of how companies invest in improved pro­duction processes and new, better-quality prod­ucts, while the companies that previously had the best products are outcompeted. Growth arises through creative destruction. This process is creative because it builds upon innovation, but it is also destructive because older products become obsolete and lose their commercial value.'

'It is apparent that, in the long run, sustained growth does not only have positive consequences for human wellbeing. First, sustained growth is not synonymous with sustainable growth. Innovations can have significant negative side effects. Mokyr argues that such negative effects sometimes initiate processes that uncover solutions to problems, making technological development a self-correcting pro­cess. Clearly, however, this often requires well-designed policies, such as in the areas of climate change, pollution, antibiotic resistance, increasing inequality and the unsustainable use of natural resources.'

Source: https://www.nobelprize.org/prizes/economic-sciences/2025/popular-information/

Previously on W2tQ: 'Nobel prize' : 'socio-economics'

Review ii - "Brainscapes: The Warped, Wondrous Maps Written in Your Brain―And How They Guide You"

Brainscapes

Now I know how Umami (p.87) an "example food magazine website to demonstrate some of the features of Drupal core" - got its name. I'm sure this was explained at a Drupal Meetup. Savoury indeed!

There had to be two! The brain has two strategies: brain maps and distributed codes.

"Representing information with a distributed code is entirely different from representing it with brain maps. In a brain map, neighboring neurons represent neighboring regions in space, frequency, time, and so forth. And brain maps essentially represent information using location, or where in the brain area the neurons are most active. In contrast, there is no consistent relationship between neighboring neurons in brain areas that use distributed codes. These areas represent information through the distributed pattern of activity across that entire region of the brain, rather than through the location of activity within it. This pattern of activity is a kind of code." pp.93-94.

This distinction is significant for Hodges' model, as the distributed codes act to deal with novelty, what is new - ongoing (lifelong) learning (p.95). Hodges' model can help distinguish between subjective and objective concerns. Schwarzlose unifies the two - via a catfish (also a goal here - but not necessarily with such an assistant).

"The map in the olfactory bulb is organised into odor zones based on molecular structure, an objective property of these compounds in the physical world. But the second map is organized into zones based on the significance of the odors to the animal." p.100.

Chapter 6 'On the Move: Brain Maps for Action' would have been useful as a student nurse at Winwick Hospital, the history in the book brings back many reminders - late 1970s. Epilepsy, then was less well understood, and managed. In describing the M1 brain map and movement I wondered about consent, but can see that is a distraction. Chapters -

6. On the Move: Brain Maps for Action | 107
7. Maps in the Making: How Brain Maps Develop and Adapt | 131
8. Knowing Again: Brain Maps for Recognition | 151

- offer much to relate to clinical encounters: movement, reaching, infant versus the brain in adults, the senses and catastrophic events such as cerebrovascular accident - stroke. Morphologically there is much still to learn (brain maps are 'primed' before birth), which perhaps is why we recognise the remarkable nature of gestation and birth. 'Maps in the Making' provides wondrous insights, including the need in hospitals to rethink the sensory environment and experience for premature infants.

While reading - I was struck at the experience of the newborn and mothers in Ukraine. The 'health career' model concerns life chances - from birth to later life...

As a community mental health nurse I have found subtle and less-subtle impacts on a person affected by semantic dementia (p.204) and their family. Given the ongoing invasion and war, I also thought about people living with dementia and having to flee their homes. The multiple contexts that pertain in such a crisis situation when considering 'maps' and sense-making. Especially, when the need for action is preemptive - preventive and so must be explained and justified, not once but perhaps repeatedly?

We are all innate mathematicians even if we feel we have no ability. 

https://www.google.com/search?client=firefox-b-d&q=mathematics+in+catching+a+ball

I take some succor in this (p.127).

There's a hodgepodge in here too (p.161 hb). The myriad of objects we encounter and their recognition calls for the combination of brain maps and distributed codes. Chapter 8 is more psychological, touching :-) how we categorise objects, dimensions and scales, size and animacy. Galton's contribution is discussed, his ideas on eugenics also acknowledged. Visual perception, mental imagery and visual learning style remain subjects of note for researchers. I'm not sure why figure 32 stood out ( :-) - please pardon the quality of the photo. Paul Kim's illustrations are an excellent support for the prose.):

FIGURE 32 A comparison of visual perception and mental imagery in
the V1 visual map. Paul Kim

Somewhere I've saved an article on mental imagery from New Scientist I think, about this ability - the mind's eye and how it is missing for some 'brilliant' people (p.182) and posted previously:

In my mind's eye I can picture care: Frame by Frame

I might read Chapter 9 again, attention, action and perception in combination. 

Chapter 10 had me thinking again about 'Conceptual Spaces' (quality dimensions) and threshold concepts (not in the book - but this is a positive!):

"Many of the concepts that rule our financial, social, and emotional well-being have no shape, no color, no odor or weight. How do we grasp these intangible concepts? As it turns out, we often do so by aligning abstract concepts with physical dimensions and then putting our brain maps to work." p.191.

There is a 'mental number line', vertical too, and culture is a factor in how we learn and the brain associates space and quantities, in which L-R, low-high are also brought into play. The question remains here: Is Hodges' model culturally neutral? 

Still with h2cm - mind reading, writing and 'drawing' perhaps? p.236. In "Fortune-Telling with the Brain" we read about how fMRI is allowing us to learn how the brain maps employ teamwork. There is an architecture whose stability can inform predictions of future abilities - reading is described. Reading this you see ethical implications (as Schwarzlose warns p.238), but it may help to target personalised learning, as an adjunct to personalised medicine? I double checked (index) and the connectome is not mentioned, but the benefits of this research is still to be realised. In 'prison health' here in the UK (and globally?) it is long overdue but it is encouraging to hear about the focus on investigation for previous brain injury within the prison population. Remember - lead in fuel and the socio-economic impacts of pollution (ongoing - air and plastic pollution)?

Corporations have literally only 'scratched the surface' of the future potential to 'read' us individually. Through Hodges' model I can qualify and justify the model's increasing relevance. Technology and science not only call for SOCIO-technical approaches. The brain-computer interface and AI (p.239) demands we also consider the several forms of literacy and informatics that are needed in the 21st century: bio-informatics, bio-political, psycho-political and more.

This is very informative and timely read - the diagrams too. This is a book for all. For student nurses specifically, it will enable them to maximize learning in their practical placements and throughout their course of study.

Writing this review I can also see the important messages in chapter 12 - recognition of infancy and the opportunities this affords.

Many thanks to Rebecca Schwarzlose and Profile Books for my review copy.

Schwarzlose, R. (2021) Brainscapes: The Warped, Wondrous Maps Written in Your Brain―And How They Guide You". London: Profile Books.