There is a need for person-centred approaches and empowerment of staff within the residential care for older people; a movement called ‘culture change’. There is however no single path for achieving culture change. With the aim of increasing understandings about cultural change processes and the promotion of cultural values and norms associated with person-centred practices, this article presents an action research project set on a unit in the Netherlands providing care for older people with dementia. The project is presented as (...) a case study. This study examines what has contributed to the improvement of participation of older people with dementia in daily occupational and leisure activities according to practitioners. Data was collected by participant observation, interviews and focus groups. The results show that simultaneous to the improvement of the older people’s involvement in daily activities a cultural transformation took place and that the care became more person-centred. Spontaneous interactions and responses rather than planned interventions, analysis and reflection contributed to this. Furthermore, it proved to be beneficial that the process of change and the facilitation of that process reflected the same values as those underlying the cultural change. It is concluded that changes arise from dynamic, interactive and non-linear processes which are complex in nature and difficult to predict and to control. Nevertheless, managers and facilitators can facilitate such change by generating movement through the introduction of small focused projects that meet the stakeholders’ needs, by creating conditions for interaction and sense making, and by promoting the new desired cultural values. (shrink)

Democracy means rule by the people, but in practice even the most robust democracies delegate most rule making to a political class The gap between the public and its representatives might seem unbridgeable in the modern world, but Legislature by Lot examines an inspiring solution: a legislature chosen through “sortition”—the random selection of lay citizens. It’s a concept that has come to the attention of democratic reformers across the globe. Proposals for such bodies are being debated in Australia, Belgium, Iceland, (...) the United Kingdom, and many other countries. Sortition promises to reduce corruption and create a truly representative legislature in one fell swoop. In Legislature by Lot, John Gastil and Erik Olin Wright make the case for pairing a sortition body with an elected chamber within a bicameral legislature. Gastil is a leading deliberative democracy scholar, and Wright a distinguished sociologist and editor of the Real Utopias series, of which this is a part. In this volume, they bring together critics and advocates of sortition who have studied ancient Athens, deliberative polling, political theory, social movements, and civic innovation. Without obscuring its limitations, the contributors offer a wide variety of ideas for how to implement sortition and examine its potential for reshaping modern politics. Legislature by Lot includes sixteen essays that respond to Gastil and Wright’s detailed proposal. Essays comparing sortition to contemporary reforms see it as a dramatic extension of deliberative “minipublics,” which gather random samples of citizens to weigh public policy dilemmas without being empowered to enact legislation. Another set of essays explores the democratic principles underlying sortition and elections and considers, for example, how a sortition body holds itself accountable to a public that did not elect it. The third set of essays considers alternative paths to democratic reform, which limit the powers of a sortition chamber or more quickly establish a pure sortition body. With contributions by Arash Abizadeh, Tom Arnold, Terrill Bouricius, Deven Burks, Lyn Carson, Dimitri Courant, Donatella della Porta, David M. Farrell, Andrea Felicetti, James S. Fishkin, Brett Hennig, Vincent Jacquet, Raphaël Kies, Tom Malleson, Jane Mansbridge, Christoph Niessen, David Owen, John Pitseys, Min Reuchamps, Yves Sintomer, Graham Smith, Jane Suiter, and Pierre-Étienne Vandamme. (shrink)

Sensible people advise one not to expend one's strength on polemics. And sensible people are right, of course. But look at the history of social thought: there is no peace beneath the olives, and without the flames of social thought, even the pure light of science begins to flicker.

The Journal of Mind and Behavior, Winter 2003, Volume 24, Number 1, Pages 91–118, ISSN 0271–0137 This paper focuses on a logical systems flow-down of a set of consciousness requirements, which together with biological quantification of human brain anatomy sets limits on the neurological network in the cerebrum in order to produce the mind. It employs data to validate inferences, or when data do not exist, proposes methods for acquiring valid evidence. Many of these systems requirements will be imposed after (...) some fundamental assumptions are made. These assumptions are not new to theories on consciousness. However, their application as fundamentals may actually represent a new approach. Concurrent with these fundamentals, explicit periods of awareness while conscious are employed. Justification for their use is found in a theoretical process described as cerebral fusion. Additionally, storage of memory elements is postulated within local glia sites, proximal to synaptic nodes, and conductive transport through the astrocytes responsible for recall of data. The model permits variations in neural–glial interface physics and allows forecasts of mind/brain dysfunctions to be inferred. One key result from the model is hypothesized and expanded upon, and may have impact in certain types of dementia, such as Alzheimer’s disease. (shrink)

Genetic and environmental factors leading to Alzheimer's disease (AD) converge in a pathogenic pathway that leads to the accumulation of mis‐folded amyloid peptide (Aβ) in the brain. Removal of Aβ from the brain has thus been the focus of academic and industrial research in the last decade. The concept of immunization therapy could be proven in animal models mimicking amyloid pathology but a multicenter clinical trial in which AD patients were vaccinated with aggregated Aβ has resulted in somewhat unanticipated and (...) partially conflicting results. The occurrence of meningoencephalitis in 6% of vaccinated individuals forced the discontinuation of the clinical study, preventing the generation of sufficient data for an unequivocal statement about the effectiveness of such a therapy approach. This study, however, clearly showed that vaccination induced the production of antibodies against Aβ in some immunized patients. Moreover, circulating anti‐Aβ antibodies are found in healthy humans suggesting a protective role of such physiological antibodies. Nonetheless, the physiological role of the immune system in preventing AD is not fully understood. This article summarizes crucial animal and clinical data underscoring the potential of the immune system for AD treatment. BioEssays 29:927–932, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Objectives: The introduction of the living donation in organ transplantation introduces important new psychological conflicts and ethical questions in the transplantation process. Operation related risks, as well as dependencies in the family structure, generate considerable pressure on potential donors. The aim of the study was to reconstruct the determinants of willingness to donate before transplantation.Methods: Evaluation of 20 taped and transcribed interviews oriented to current approaches in qualitative interview research. The approach used is based on grounded theory, qualitative content analysis, (...) and the concept of the ideal type.Results: Before surgery, “openly motivated” donors push for an operation, leaving no room for ambivalence in the evaluation process. They idealise the relationship with the recipient, and link their donation with the individual—partly in subconscious expectations and wishes. In contrast, “openly ambivalent” donors formulate their anxieties and express arguments against donation.Conclusions: Statements that claim ambivalence towards donation or utterance of arguments against donation indicate earlier coercion. Before transplantation, potential donors should have the opportunity to discuss their emotional situation to help their decision making process. (shrink)

I suggest a description of the theory that I find applicable to understanding self-knowledge. The theory of its own complexity focuses on the structure of individual thoughts about themselves. Own complexity concerns two features of a person's self-determination: the number of social roles that a person has, and the ability of a person to differentiate among these roles. For example, I would be considered a weak bearer of the idea of ​​my own complexity if I considered myself as the bearer (...) of a relatively small number of roles and I would describe existing roles as similar to those that I carry out. I would have a greater degree of my own complexity if I looked at the number of roles I increased and made more distinctions between them. (shrink)

The Old Testament furnishes its readers with two pictures of Christ’s coming: his coming to earth as a servant in glorious apparel and his coming to earth as a king in glorious apparel. This has brought about bewilderment both to the Jews who expected only the kingly and glorious Christ and the 21st century Christian who are being misled by some preachers and teachers of the Gospel of Christ. The objective of this paper, therefore, is to unearth two forms of (...) Christ’s second coming: a secret coming – as a thief in the night, and public, universal coming, when every eye shall see him. Therefore through lexicosemantics analysis which reveals, its root-words and word-stems and the various possible semantic categories created by the human mind, this paper claims that the secret coming of Christ is what is called the rapture and the public coming is called the παρουσία. It conveys the idea that Christ’s return will be a definite and decisive action on his part. He will come himself, as surely as he came in the incarnation. (shrink)