BackgroundIndividuals with early phase cognitive impairment are frequently affected by existential distress, social avoidance and associated health issues. The demand for efficient psychological support is crucial from both an individual and a societal perspective. We have developed a novel psychological intervention manual for providing a non-medical path to enhanced psychological health in the cognitively impaired population. The current article provides specific information on the randomized controlled trial -design and methods. The main hypothesis is that participants receiving PIPCI will increase their (...) psychological flexibility compared to participants in the active control group and the waiting list control group. The secondary hypotheses are that participants receiving PIPCI will improve psychological health compared to participants in the active control group and the waiting list control group.Materials and MethodsThis three-arm RCT will recruit participants from the cognitive centers at Karolinska University Hospital in Stockholm and randomize approximately 120 individuals in the early phase of cognitive impairment to either an experimental group, an active control group or a waiting list control group. Intervention outcome will be evaluated with self-report questionnaires on physical and psychological aspects of health, cognitive assessment, biological markers and health care costs. Assessments will be performed at pre- and post-intervention, as well as at a 6-month follow-up.DiscussionThe development of a potentially feasible and effective psychological intervention tailored for early phase cognitive impairment has the potential to advance the non-pharmacological intervention field. This is especially important given the extensive burden for many affected individuals and their families and the current lack of effective treatments. If the psychological intervention discussed here shows feasibility and efficacy, there is potential for far-reaching healthcare implications for patients with early cognitive impairment at risk of developing dementia.Clinical Trial RegistrationClinicalTrials.gov: NCT04356924. Date of registration: April 22, 2020. URL: https://clinicaltrials.gov/ct2/show/NCT04356924. (shrink)

What do houses do to the people who live with them? In what sense are houses themselves living things? If they live and act, how to conceive of the relationship between built and natural landscapes, and between environment and life more broadly? This article considers three moments at which human geographers have attempted to answer these questions without submitting to visions of environmental causation and constraint favoured by determinists, who dominated the discipline into the early 20th century. The article begins (...) with the work of Carl Sauer, by 1925 the major American figure refuting environmental determinism at a theoretical level and recommending the study of housing as an articulate transcript of human action. It then looks back to the American writings of Friedrich Ratzel, one of several German scholars Sauer canonized, to illuminate a more vitalistic ontology of domestic architecture, and an urbanism, untapped by Sauer when filing his dissent. It then looks ahead to mid-century studies of vernacular architecture – by those of Sauer’s students friendlier to urban life than he was, and by the critic and publisher J. B. Jackson – to assess how this inheritance informed critiques of industrial modernity in the post-war United States. The article observes certain continuities, despite manifest tensions, between ‘old’ and ‘new’ cultural geographies. It also routes a long-standing set of debates concerning the relationship of materiality to meaning – and of spatial to social form – through the case of human geography, a peculiar interstice in the broader constellation of disciplines. (shrink)

Emotions are viewed as having evolved through their adaptive value in dealing with fundamental life-tasks. Each emotion has unique features: signal, physiology, and antecedent events. Each emotion also has characteristics in common with other emotions: rapid onset, short duration, unbidden occurrence, automatic appraisal, and coherence among responses. These shared and unique characteristics are the product of our evolution, and distinguish emotions from other affective phenomena.

The editors of this unique volume have brought together 24 leading emotion theorists with a wide variety of perspectives to address 12 fundamental questions about the subject.

Emotions are discrete, automatic responses to universally shared, culture-specific and individual-specific events. The emotion terms, such as anger, fear, etcetera, denote a family of related states sharing at least 12 characteristics, which distinguish one emotion family from another, as well as from other affective states. These affective responses are preprogrammed and involuntary, but are also shaped by life experiences.

Person‐centred care is founded on ethics as a basis for organizing care. In spite of healthcare systems claiming that they have implemented person‐centred care, patients report less satisfaction with care. These contrasting results require clarification of how to practice person‐centred ethics using Paul Ricoeur's ‘Little ethics’, summarized as: ‘aiming for the good life, with and for others in just institutions’. In this ethic Kantian morality is at once subordinate and complementary to Aristotelian ethics because the ethical goal needs to be (...) critically assessed and passed through the examination of the norm in each care situation. This paper presents examples that describes a person‐centred care practice that balance a critical review of care activities based on a conviction of aiming for patients' wellbeing. In contrast to patients' experiences of person‐centred care in real life, research projects have shown that if the clinical performers comprehend and apply the practice of person‐centred ethics, patients report positive outcomes. The implementation of person‐centred care therefore demands that stakeholders and managers enables and requires that healthcare staff study ethics in the same way as studying for example pharmacology is required when handling patients' medicines. (shrink)

Reviewing the literature on political participation and civic engagement, the article offers a critical examination of different conceptual frameworks. Drawing on previous definitions and operationalisations, a new typology for political participation and civic engagement is developed, highlighting the multidimensionality of both concepts. In particular, it makes a clear distinction between manifest “political participation” (including formal political behaviour as well as protest or extra-parliamentary political action) and less direct or “latent” forms of participation, conceptualized here as “civic engagement” and “social involvement”. (...) The article argues that the notion of “latent” forms of participation is crucial to understand new forms of political behaviour and the prospects for political participation in different countries. Due to these innovations it contributes to a much-needed theoretical development within the literature on political participation and citizen engagement. (shrink)

In this paper it is shown that addition of certain reductions to the standard cut removing reductions of deductions in prepositional logic makes prepositional logic non-normalizable. From this follows that some provable propositions in prepositional logic has no direct proof.

This brief article presents the everyday cultural use of the Snapchat instant messaging application for video chats as an exemplary case of the challenges confronting studies of cinematics in an epoch marked by the rise in network societies of ubiquitous mobile and social media and technics. It proffers and begins to detail the argument that snap video chats cannot be denigrated as mere ‘shorts’ but must be approached as spatiotemporally and experientially complex.

Tape-recorded semi-structured interviews were conducted with 21 nursing aides and enrolled nurses in the geriatric clinic in Umeå, Sweden. The interviews focused on the difference between the care of demented and non-demented patients and ethical conflicts in dementia care. The results indicate that caregivers have problems in providing the demented patients with opportunities to act autonomously in everyday matters on the ward, mainly due to the difficulty of understanding what the patients wish and the fact that their wishes, when understood, (...) often seem irrational. Measures to provide the demented patients with more opportunities to act autonomously in everyday matters are suggested. (shrink)

The purpose of this study was to explore how one person experienced the early years of dementia as she was living through the pre-clinical and earlyclinical stages of Alzheimer’s disease. Interviews were held onfour occasions over a period of three years. The data were analyzed usingthe descriptive phenomenological psychological method, in which theresearcher approached the data from a caring perspective. The livedexperience of early-stage Alzheimer’s disease showed to be acomplex transitional phenomenon that involves a dynamic process of personaladjustment. The process (...) is set in motion as the participant receives thediagnosis and will eventually lead her towards a state of increased opennessand receptiveness toward the disease. The results describe this process asit unfolds in the context of the overall experience, and the variousadjustments that the participant undertakes. Some reflections concerning theplausible needs of patients with early-stage Alzheimer’s diseaseare included in the discussion. (shrink)

This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations, when the patient was regarded as an individual, when the patient's knowledge was recognized by staff, and when the patient made decisions based on knowledge and needs, or performed self-care. Thus, to provide conditions for (...) true patient participation, professionals need to recognize each patient's unique knowledge and respect the individual's description of his or her situation rather than just inviting the person to participate in decision making. (shrink)

Women wishing hospital admission for childbirth are asked to sign very general pre-admission consent forms. The use of such forms suggests that women in labor are considered incompetent to give informed consent. This paper explores some of the problems with advance directives and general consent, and argues that since women in labor are not generally incompetent, it is not appropriate to require this kind of consent of them.

Despite the much-discussed court cases in the 1970s that permitted some sibling-to-sibling kidney donations from minors,1 principles that can guide parental, medical, or judicial decisionmaking are neither clearly articulated nor uncontroversial.