Transcendence at the Table: a Transfigurational Experience for Ecclesia while Breaking Bread Together

The Church has been slowly losing its identity. This loss of identity has a strong connection to the failure of the church to tend and till faith relationships, as well as pass the faith story on to children and others. There has been a loss of emphasis on the table as a place of significance in church, community, and home. To break bread together is to reclaim the spoken story of Jesus’ transfigurational power. The hope for growth in a stronger identity lies in believing in the Truth of a present and powerful Jesus who could transfigure lives, offer forgiveness and hope, and for those who allow him to live his life through them, the power to experience healing, joy, and peace. The Christian faith is the gathering of those anointed by the Holy Spirit and committed to Jesus, the ecclesia, the Church. The early church was a community of ecclesia, a Holy Spirit infused, worshiping community with a strong identity and a certain mission in the world, to proclaim the power and salvation hope of Jesus

Language of leadership

This thesis takes a critical approach to dominant ways of understanding leadership. The context for the study is UK local government where leadership has been popularised as a key feature of the latest phase of public sector modernisation. By drawing on the linguistic turn inherent in poststructuralism, and in particular the work of Jacques Derrida, the thesis challenges the orthodox assumption that leadership is a neutral and stable pre-linguistic phenomenon. In contrast it suggests that any given 'truth' of leadership can be seen as an attempt to control a linguistic system that is inherently undecidable. It is an attempt to 'write' the world in a particular way, which is then forgotten. The thesis begins by considering orthodox approaches to the role of language in theorising organising in general, and also reviews a range of alternative perspectives that have gone some way towards engaging more fully with its epistemological, ontological and normative-ethical deficits. It then justifies the distinctive contribution to these debates made by the radicalised view of language found in poststructuralism in general, and the work of Jacques Derrida in particular. A review of the leadership literature suggests that it is dominated by an assumption that language is representational. Leadership is also depicted unquestioningly as an individualistic and impartial phenomenon. It is thus argued that the field is ripe for a more detailed focus on the politics of the language of leadership. The implications of Derrida's work for reading and writing texts, and the (im)possibility of a poststructuralist methodology, are discussed in some detail. In particular, I highlight the need to reflexively problematise the textuality of the truth of this thesis. This is addressed by means of a deconstruction of the assessment criteria for a PhD thesis, which is included in the Appendix. An analysis of the linguistic decisions I made in order to stage an exemplary chapter betrays the discipline exerted by the academy. The main empirical work is based on a variety of texts from the case study organisation, including interviews with putative leaders, and formal documentation, such as a statement of leadership competences. These are subject to close reading in the spirit of what has been termed 'deconstruction', focusing on how and with what consequences the popularised truth of leadership is organised through language. Each reading concentrates in turn on one aspect of the leadership truth being promoted in the case study organization, namely leadership that is 'visible', 'strong', 'understanding' and 'shared'. I suggest that 'leadership' is an unsuccessful attempt to stabilize the play of language around individualism, specific aspects of which serve to privilege the productive power of the person of the office holder as part of local government modernisation. The study concludes by suggesting that the very instability of the truth offers opportunities for rethinking both leadership and public sector reform, in ways that are more open to the other.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

A clinical algorithm for wound biofilm identication

Broj publiciranih referenci koje ukazuju na prisutnost biofi lma u kroničnim ranama je u porastu. Sve je veći broj dokaza koji potvrđuju da biofilm značajno sudjeluje u nezacijeljivanju rane i u bakterijskim infekcijama. Iz navedenih razloga postavlja se pitanje nedostatka postupnika o dokazima prisutnosti biofilma u rani. Namjera je ovog rada specifi cirati vidljive dokaze i indirektno dati kliničke smjernice tretmana biofilma u rani, te predložiti određeni postupnik za olakšanje kliničkog prepoznavanja biofi lma da bi se potom promijenilo ciljano liječenje vrijeda.Recognition of the existence of biofilm in chronic wounds is increasing among wound care practitioners, and a growing body of evidence indicates that biofilm contributes significantly to wound recalcitrance. While clinical guidelines regarding the involvement of biofilm in human bacterial infections have been proposed, there remains uncertainty and lack of guidance towards biofilm presence in wounds. The intention of this report is to collate knowledge and evidence of the visual and indirect clinical indicators of wound biofilm, and propose an algorithm designed to facilitate clinical recognition of biofilm and subsequent wound management practices

Aspects of the anaerobic digestion of wattle tannins

The aqueous extract from the bark of the black wattle tree, (Acacia mearnsii De Wild)(1), is used extensively in the tanning industry for the production of sole and other heavy leathers as well as in lighter leathers and skins. The commercial extract is available in an easily dissolvable spray dried form and in deference to its genus name Mimosaceae is referred to in the trade as Mimosa(3). Mimosa extract consists primarily of high molecular weight polymeric flavonoid units which also constitutes the active tanning ingredient. Lower phenolics, gums and sugars or the so called "non-tannins" are present as impurities and contribute up to 40% to (3 ) the total mass of the extract

Language of leadership

This thesis takes a critical approach to dominant ways of understanding leadership. The context for the study is UK local government where leadership has been popularised as a key feature of the latest phase of public sector modernisation. By drawing on the linguistic turn inherent in poststructuralism, and in particular the work of Jacques Derrida, the thesis challenges the orthodox assumption that leadership is a neutral and stable pre-linguistic phenomenon. In contrast it suggests that any given 'truth' of leadership can be seen as an attempt to control a linguistic system that is inherently undecidable. It is an attempt to 'write' the world in a particular way, which is then forgotten. The thesis begins by considering orthodox approaches to the role of language in theorising organising in general, and also reviews a range of alternative perspectives that have gone some way towards engaging more fully with its epistemological, ontological and normative-ethical deficits. It then justifies the distinctive contribution to these debates made by the radicalised view of language found in poststructuralism in general, and the work of Jacques Derrida in particular. A review of the leadership literature suggests that it is dominated by an assumption that language is representational. Leadership is also depicted unquestioningly as an individualistic and impartial phenomenon. It is thus argued that the field is ripe for a more detailed focus on the politics of the language of leadership. The implications of Derrida's work for reading and writing texts, and the (im)possibility of a poststructuralist methodology, are discussed in some detail. In particular, I highlight the need to reflexively problematise the textuality of the truth of this thesis. This is addressed by means of a deconstruction of the assessment criteria for a PhD thesis, which is included in the Appendix. An analysis of the linguistic decisions I made in order to stage an exemplary chapter betrays the discipline exerted by the academy. The main empirical work is based on a variety of texts from the case study organisation, including interviews with putative leaders, and formal documentation, such as a statement of leadership competences. These are subject to close reading in the spirit of what has been termed 'deconstruction', focusing on how and with what consequences the popularised truth of leadership is organised through language. Each reading concentrates in turn on one aspect of the leadership truth being promoted in the case study organization, namely leadership that is 'visible', 'strong', 'understanding' and 'shared'. I suggest that 'leadership' is an unsuccessful attempt to stabilize the play of language around individualism, specific aspects of which serve to privilege the productive power of the person of the office holder as part of local government modernisation. The study concludes by suggesting that the very instability of the truth offers opportunities for rethinking both leadership and public sector reform, in ways that are more open to the other

What determines duration of palliative care before death for patients with advanced disease? A retrospective cohort study of community and hospital palliative care provision in a large UK city

Objective For patients with advanced cancer, several randomised controlled trials have shown that access to palliative care at least 6 months before death can improve symptoms, reduce unplanned hospital admissions, minimize aggressive cancer treatments and enable patients to make choices about their end of life care, including exercising the choice to die at home. This study determines in a UK population the duration of palliative care before death and explores influencing factors. Design This retrospective cohort study analysed referrals to three specialist palliative care services; a hospital based inpatient palliative care team, and two community based services (hospices). For each patient referred to any of the above services we identified the date of first referral to that team and calculated the median interval between first referral and death. We also calculated how referral time varied by age, sex, diagnosis and type of palliative care service. Participants 4,650 patients referred to specialist palliative care services in Leeds UK between April 2012 and March 2014. Results Median age of the sample was 75 years. 3,903 (84.0%) patients had a diagnosis of cancer. Age, diagnosis and place of referral were significant predictors of duration of palliative care before death. Age was independently associated (J = 2672078, z = -392046.14, r = .01) with duration of palliative care regardless of diagnosis. Patients over 75 years have 29 fewer days of palliative care than patients under 50. Patients with non-cancer diagnoses have 13 fewer days of palliative care than patients with cancer. Additionally, patients referred to hospital palliative care receive 24.5 fewer days palliative care than those referred to community palliative care services. Conclusions The current timing of referral to palliative care may limit the benefits to patient in terms of improvements in end of life care, particularly for older patients and patients with conditions other than cancer

Long-Term Effectiveness of the Community-Based Complete Health Improvement Program (CHIP) Lifestyle Intervention: A Cohort Study

Objective: To examine the long-term (three or more years) effectiveness of the volunteer-delivered CHIP intervention. Design: Cohort study Setting: Hawera, New Zealand Participants: Of the total cohort of 284 individuals who self-selected to complete the CHIP lifestyle intervention between 2007 and 2009, 106 (37% of the original cohort, mean age = 64.9±7.4 years, range 42-87 years; 35% males, 65% female) returned in 2012 for a complimentary follow-up health assessment (mean follow-up duration = 49.2+10.4 months). Intervention: 30-day lifestyle modification program (diet, physical activity, substance use and stress management) delivered by volunteers in a community setting. Main outcome measures: Changes in body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TG). Results: After approximately 4 years, participants with elevated biometrics at program entry maintained significantly lowered BMI (-3.2%; 34.8±5.4 versus 33.7±5.3 kg/m2, p=0.02), DBP (-9.4%; 89.1±4.1 versus 80.8±12.6 mmHg, p=0.005), TC (-5.5%; 6.1±0.7 versus 5.8±1.0 mmol/L, p=0.04) and TG (-27.5%; 2.4±0.8 versus 1.7±0.7 mmol/L, p=0.002). SBP, HDL, LDL and FPG were not significantly different from baseline. Participants with elevated baseline biometrics who reported being compliant to the lifestyle principles promoted in the intervention (N=71, 67% of follow-up participants) recorded further reductions in BMI (-4.2%; 34.8±4.5 versus 33.4±4.8 kg/m2, p=0.02), DBP (-13.3%; 88.3±3.2 versus 77.1±12.1 mmHg, p=0.005) and FPG (-10.4%; 7.0±1.5 versus 6.3±1.3 mmol/L, p=0.02). Conclusions: Individuals who returned for follow-up assessment and entered the CHIP lifestyle intervention with elevated risk factors were able to maintain improvements in most biometrics for more than three years. The results suggest that the community-based CHIP lifestyle intervention can be effective in the longer-term, even when delivered by volunteers