ABSTRACT
Crick and Koch's 1990 "neurobiological theory of consciousness" sparked the race for the physical correlates of subjective experience. 30 years later, cognitive sciences trend toward consideration of the brain's electromagnetic field as the primary seat of consciousness, the "to be" of the individual. Recent advancements in laboratory tools have preceded an influx of studies reporting a synchronization between the neuronally generated EM fields of interacting individuals. An embodied and enactive neuroscientific approach has gained traction in the wake of these findings wherein consciousness and cognition are theorized to be regulated and distributed beyond the individual. We approach this frontier to extend the implications of person-to-person synchrony to propose a process of combination whereby coupled individual agents merge into a hierarchical cognitive system to which they are subsidiary. Such is to say, the complex mammalian consciousness humans possess may not be the tip of the iceberg, but another step in a succeeding staircase. To this end, the axioms and conjectures of General Resonance Theory are utilized to describe this phenomenon of interpersonal resonant combination. Our proposal describes a coupled system of spatially distributed EM fields that are synchronized through recurrent, entraining behavioral interactions. The system, having achieved sufficient synchronization, enjoys an optimization of information flow that alters the conscious states of its merging agents and enhances group performance capabilities. In the race for the neurobiological correlates of subjective experience, we attempt the first steps in the journey toward defining the physical basis of "group consciousness." The establishment of a concrete account of the combination of consciousness at a scale superseding individual human consciousness remains speculation, but our suggested approach provides a framework for empirical testing of these possibilities.
ABSTRACT
OBJECTIVE: To explain the current delivery of healthcare to residents living in UK care homes. DESIGN: Qualitative interview study using a grounded theory approach. SETTING: 6 UK care homes and primary care professionals serving the homes. PARTICIPANTS: Of the 32 participants, there were 7 care home managers, 2 care home nurses, 9 care home assistants, 6 general practitioners (GPs), 3 dementia outreach nurses, 2 district nurses, 2 advanced nurse practitioners and 1 occupational therapist. RESULTS: 5 themes were identified: complex health needs and the intrinsic nature of residents' illness trajectories; a mismatch between healthcare requirements and GP time; reactive or anticipatory healthcare?; a dissonance in healthcare knowledge and ethos; and tensions in the responsibility for the healthcare of residents. Care home managers and staff were pivotal to healthcare delivery for residents despite their perceived role in social care provision. Formal healthcare for residents was primarily provided via one or more GPs, often organised to provide a reactive service that did not meet residents' complex needs. Deficiencies were identified in training required to meet residents' needs for both care home staff as well as GPs. Misunderstandings, ambiguities and boundaries around roles and responsibilities of health and social care staff limited the development of constructive relationships. CONCLUSIONS: Healthcare of care home residents is difficult because their needs are complex and unpredictable. Neither GPs nor care home staff have enough time to meet these needs and many lack the prerequisite skills and training. Anticipatory care is generally held to be preferable to reactive care. Attempts to structure care to make it more anticipatory are dependent on effective relationships between GPs and care home staff and their ability to establish common goals. Roles and responsibilities for many aspects of healthcare are not made explicit and this risks poor outcomes for residents.