Self-organization

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Self-organization 

Self-organization in micron-sized Nb₃O₇(OH) cubes during a hydrothermal treatment at 200 °C. Initially amorphous cubes gradually transform into ordered 3D meshes of crystalline nanowires as summarized in the model below.

Self-organization, also called spontaneous order in the social sciences, is a process where some form of overall order arises from local interactions between parts of an initially disordered system. The process can be spontaneous when sufficient energy is available, not needing control by any external agent. It is often triggered by seemingly random fluctuations, amplified by positive feedback. The resulting organization is wholly decentralized, distributed over all the components of the system. As such, the organization is typically robust and able to survive or self-repair substantial perturbation. Chaos theory discusses self-organization in terms of islands of predictability in a sea of chaotic unpredictability.

Self-organization occurs in many physical, chemical, biological, robotic, and cognitive systems. Examples of self-organization include crystallization, thermal convection of fluids, chemical oscillation, animal swarming, neural circuits, and black markets.

Overview

Self-organization is realized in the physics of non-equilibrium processes, and in chemical reactions, where it is often characterized as self-assembly. The concept has proven useful in biology, from the molecular to the ecosystem level. Cited examples of self-organizing behavior also appear in the literature of many other disciplines, both in the natural sciences and in the social sciences (such as economics or anthropology). Self-organization has also been observed in mathematical systems such as cellular automata. Self-organization is an example of the related concept of emergence.

Self-organization relies on four basic ingredients:

1. strong dynamical non-linearity, often (though not necessarily) involving positive and negative feedback
2. balance of exploitation and exploration
3. multiple interactions among components
4. availability of energy (to overcome the natural tendency toward entropy, or loss of free energy)

Principles

The cybernetician William Ross Ashby formulated the original principle of self-organization in 1947. It states that any deterministic dynamic system automatically evolves towards a state of equilibrium that can be described in terms of an attractor in a basin of surrounding states. Once there, the further evolution of the system is constrained to remain in the attractor. This constraint implies a form of mutual dependency or coordination between its constituent components or subsystems. In Ashby's terms, each subsystem has adapted to the environment formed by all other subsystems.

The cybernetician Heinz von Foerster formulated the principle of "order from noise" in 1960. It notes that self-organization is facilitated by random perturbations ("noise") that let the system explore a variety of states in its state space. This increases the chance that the system will arrive into the basin of a "strong" or "deep" attractor, from which it then quickly enters the attractor itself. The biophysicist Henri Atlan developed this concept by proposing the principle of "complexity from noise" (French: le principe de complexité par le bruit) first in the 1972 book L'organisation biologique et la théorie de l'information and then in the 1979 book Entre le cristal et la fumée. The physicist and chemist Ilya Prigogine formulated a similar principle as "order through fluctuations" or "order out of chaos". It is applied in the method of simulated annealing for problem solving and machine learning.

History

Further information: Spontaneous order

The idea that the dynamics of a system can lead to an increase in its organization has a long history. The ancient atomists such as Democritus and Lucretius believed that a designing intelligence is unnecessary to create order in nature, arguing that given enough time and space and matter, order emerges by itself.

The philosopher René Descartes presents self-organization hypothetically in the fifth part of his 1637 Discourse on Method. He elaborated on the idea in his unpublished work The World.

Immanuel Kant used the term "self-organizing" in his 1790 Critique of Judgment, where he argued that teleology is a meaningful concept only if there exists such an entity whose parts or "organs" are simultaneously ends and means. Such a system of organs must be able to behave as if it has a mind of its own, that is, it is capable of governing itself.

In such a natural product as this every part is thought as owing its presence to the agency of all the remaining parts, and also as existing for the sake of the others and of the whole, that is as an instrument, or organ... The part must be an organ producing the other parts—each, consequently, reciprocally producing the others... Only under these conditions and upon these terms can such a product be an organized and self-organized being, and, as such, be called a physical end.

Sadi Carnot (1796–1832) and Rudolf Clausius (1822–1888) discovered the second law of thermodynamics in the 19th century. It states that total entropy, sometimes understood as disorder, will always increase over time in an isolated system. This means that a system cannot spontaneously increase its order without an external relationship that decreases order elsewhere in the system (e.g. through consuming the low-entropy energy of a battery and diffusing high-entropy heat).

18th-century thinkers had sought to understand the "universal laws of form" to explain the observed forms of living organisms. This idea became associated with Lamarckism and fell into disrepute until the early 20th century, when D'Arcy Wentworth Thompson (1860–1948) attempted to revive it.

The psychiatrist and engineer W. Ross Ashby introduced the term "self-organizing" to contemporary science in 1947.^[7] It was taken up by the cyberneticians Heinz von Foerster, Gordon Pask, Stafford Beer; and von Foerster organized a conference on "The Principles of Self-Organization" at the University of Illinois' Allerton Park in June, 1960 which led to a series of conferences on Self-Organizing Systems. Norbert Wiener took up the idea in the second edition of his Cybernetics: or Control and Communication in the Animal and the Machine (1961).

Self-organization was associated with general systems theory in the 1960s, but did not become commonplace in the scientific literature until physicists Hermann Haken et al. and complex systems researchers adopted it in a greater picture from cosmology Erich Jantsch, chemistry with dissipative system, biology and sociology as autopoiesis to system thinking in the following 1980s (Santa Fe Institute) and 1990s (complex adaptive system), until our days with the disruptive emerging technologies profounded by a rhizomatic network theory.

Around 2008–2009, a concept of guided self-organization started to take shape. This approach aims to regulate self-organization for specific purposes, so that a dynamical system may reach specific attractors or outcomes. The regulation constrains a self-organizing process within a complex system by restricting local interactions between the system components, rather than following an explicit control mechanism or a global design blueprint. The desired outcomes, such as increases in the resultant internal structure and/or functionality, are achieved by combining task-independent global objectives with task-dependent constraints on local interactions.

By field

Convection cells in a gravity field

Physics

See also: Self-assembly and Self-assembly of nanoparticles

The many self-organizing phenomena in physics include phase transitions and spontaneous symmetry breaking such as spontaneous magnetization and crystal growth in classical physics, and the laser, superconductivity and Bose–Einstein condensation in quantum physics. Self-organization is found in self-organized criticality in dynamical systems, in tribology, in spin foam systems, and in loop quantum gravity, in plasma, in river basins and deltas, in dendritic solidification (snow flakes), in capillary imbibition and in turbulent structure.

Chemistry

The DNA structure shown schematically at left self-assembles into the structure at right

Self-organization in chemistry includes drying-induced self-assembly, molecular self-assembly, reaction–diffusion systems and oscillating reactions, autocatalytic networks, liquid crystals, grid complexes, colloidal crystals, self-assembled monolayers, micelles, microphase separation of block copolymers, and Langmuir–Blodgett films.

Biology

Further information: Biological organization

Birds flocking (boids in Blender), an example of self-organization in biology

Self-organization in biology can be observed in spontaneous folding of proteins and other biomacromolecules, self-assembly of lipid bilayer membranes, pattern formation and morphogenesis in developmental biology, the coordination of human movement, eusocial behavior in insects (bees, ants, termites) and mammals, and flocking behavior in birds and fish.

The mathematical biologist Stuart Kauffman and other structuralists have suggested that self-organization may play roles alongside natural selection in three areas of evolutionary biology, namely population dynamics, molecular evolution, and morphogenesis. However, this does not take into account the essential role of energy in driving biochemical reactions in cells. The systems of reactions in any cell are self-catalyzing, but not simply self-organizing, as they are thermodynamically open systems relying on a continuous input of energy. Self-organization is not an alternative to natural selection, but it constrains what evolution can do and provides mechanisms such as the self-assembly of membranes which evolution then exploits.

The evolution of order in living systems and the generation of order in certain non-living systems was proposed to obey a common fundamental principal called “the Darwinian dynamic” that was formulated by first considering how microscopic order is generated in simple non-biological systems that are far from thermodynamic equilibrium. Consideration was then extended to short, replicating RNA molecules assumed to be similar to the earliest forms of life in the RNA world. It was shown that the underlying order-generating processes of self-organization in the non-biological systems and in replicating RNA are basically similar.

Cosmology

In his 1995 conference paper "Cosmology as a problem in critical phenomena" Lee Smolin said that several cosmological objects or phenomena, such as spiral galaxies, galaxy formation processes in general, early structure formation, quantum gravity and the large scale structure of the universe might be the result of or have involved certain degree of self-organization. He argues that self-organized systems are often critical systems, with structure spreading out in space and time over every available scale, as shown for example by Per Bak and his collaborators. Therefore, because the distribution of matter in the universe is more or less scale invariant over many orders of magnitude, ideas and strategies developed in the study of self-organized systems could be helpful in tackling certain unsolved problems in cosmology and astrophysics.

Computer science

Phenomena from mathematics and computer science such as cellular automata, random graphs, and some instances of evolutionary computation and artificial life exhibit features of self-organization. In swarm robotics, self-organization is used to produce emergent behavior. In particular the theory of random graphs has been used as a justification for self-organization as a general principle of complex systems. In the field of multi-agent systems, understanding how to engineer systems that are capable of presenting self-organized behavior is an active research area. Optimization algorithms can be considered self-organizing because they aim to find the optimal solution to a problem. If the solution is considered as a state of the iterative system, the optimal solution is the selected, converged structure of the system. Self-organizing networks include small-world networks self-stabilization and scale-free networks. These emerge from bottom-up interactions, unlike top-down hierarchical networks within organizations, which are not self-organizing. Cloud computing systems have been argued to be inherently self-organizing, but while they have some autonomy, they are not self-managing as they do not have the goal of reducing their own complexity.

Cybernetics

Main article: Self-organization in cybernetics

Norbert Wiener regarded the automatic serial identification of a black box and its subsequent reproduction as self-organization in cybernetics. The importance of phase locking or the "attraction of frequencies", as he called it, is discussed in the 2nd edition of his Cybernetics: Or Control and Communication in the Animal and the Machine. K. Eric Drexler sees self-replication as a key step in nano and universal assembly. By contrast, the four concurrently connected galvanometers of W. Ross Ashby's Homeostat hunt, when perturbed, to converge on one of many possible stable states. Ashby used his state counting measure of variety to describe stable states and produced the "Good Regulator" theorem which requires internal models for self-organized endurance and stability (e.g. Nyquist stability criterion). Warren McCulloch proposed "Redundancy of Potential Command" as characteristic of the organization of the brain and human nervous system and the necessary condition for self-organization. Heinz von Foerster proposed Redundancy, R=1 − H/H_max, where H is entropy. In essence this states that unused potential communication bandwidth is a measure of self-organization.

In the 1970s Stafford Beer considered self-organization necessary for autonomy in persisting and living systems. He applied his viable system model to management. It consists of five parts: the monitoring of performance of the survival processes (1), their management by recursive application of regulation (2), homeostatic operational control (3) and development (4) which produce maintenance of identity (5) under environmental perturbation. Focus is prioritized by an alerting "algedonic loop" feedback: a sensitivity to both pain and pleasure produced from under-performance or over-performance relative to a standard capability.

In the 1990s Gordon Pask argued that von Foerster's H and Hmax were not independent, but interacted via countably infinite recursive concurrent spin processes which he called concepts. His strict definition of concept "a procedure to bring about a relation" permitted his theorem "Like concepts repel, unlike concepts attract" to state a general spin-based principle of self-organization. His edict, an exclusion principle, "There are No Doppelgangers" means no two concepts can be the same. After sufficient time, all concepts attract and coalesce as pink noise. The theory applies to all organizationally closed or homeostatic processes that produce enduring and coherent products which evolve, learn and adapt.

Sociology

Main article: Spontaneous order

Social self-organization in international drug routes

The self-organizing behavior of social animals and the self-organization of simple mathematical structures both suggest that self-organization should be expected in human society. Tell-tale signs of self-organization are usually statistical properties shared with self-organizing physical systems. Examples such as critical mass, herd behavior, groupthink and others, abound in sociology, economics, behavioral finance and anthropology. Spontaneous order can be influenced by arousal.

In social theory, the concept of self-referentiality has been introduced as a sociological application of self-organization theory by Niklas Luhmann (1984). For Luhmann the elements of a social system are self-producing communications, i.e. a communication produces further communications and hence a social system can reproduce itself as long as there is dynamic communication. For Luhmann, human beings are sensors in the environment of the system. Luhmann developed an evolutionary theory of society and its subsystems, using functional analyses and systems theory.

Anarchism can advocate self-organization as one of its basic principles.

Economics

The market economy is sometimes said to be self-organizing. Paul Krugman has written on the role that market self-organization plays in the business cycle in his book The Self Organizing Economy. Friedrich Hayek coined the term catallaxy to describe a "self-organizing system of voluntary co-operation", in regards to the spontaneous order of the free market economy. Neo-classical economists hold that imposing central planning usually makes the self-organized economic system less efficient. On the other end of the spectrum, economists consider that market failures are so significant that self-organization produces bad results and that the state should direct production and pricing. Most economists adopt an intermediate position and recommend a mixture of market economy and command economy characteristics (sometimes called a mixed economy). When applied to economics, the concept of self-organization can quickly become ideologically imbued.

Learning

Enabling others to "learn how to learn" is often taken to mean instructing them how to submit to being taught. Self-organized learning (SOL) denies that "the expert knows best" or that there is ever "the one best method", insisting instead on "the construction of personally significant, relevant and viable meaning" to be tested experientially by the learner. This may be collaborative, and more rewarding personally. It is seen as a lifelong process, not limited to specific learning environments (home, school, university) or under the control of authorities such as parents and professors. It needs to be tested, and intermittently revised, through the personal experience of the learner. It need not be restricted by either consciousness or language. Fritjof Capra argued that it is poorly recognized within psychology and education. It may be related to cybernetics as it involves a negative feedback control loop, or to systems theory. It can be conducted as a learning conversation or dialog between learners or within one person.

Transportation

Main article: Three-phase traffic theory

The self-organizing behavior of drivers in traffic flow determines almost all the spatiotemporal behavior of traffic, such as traffic breakdown at a highway bottleneck, highway capacity, and the emergence of moving traffic jams. These self-organizing effects are explained by Boris Kerner's three-phase traffic theory.

Linguistics

Order appears spontaneously in the evolution of language as individual and population behavior interacts with biological evolution.

Research

Self-organized funding allocation (SOFA) is a method of distributing funding for scientific research. In this system, each researcher is allocated an equal amount of funding, and is required to anonymously allocate a fraction of their funds to the research of others. Proponents of SOFA argue that it would result in similar distribution of funding as the present grant system, but with less overhead. In 2016, a test pilot of SOFA began in the Netherlands.

Criticism

Heinz Pagels, in a 1985 review of Ilya Prigogine and Isabelle Stengers's book Order Out of Chaos in Physics Today, appeals to authority:

Most scientists would agree with the critical view expressed in Problems of Biological Physics (Springer Verlag, 1981) by the biophysicist L. A. Blumenfeld, when he wrote: "The meaningful macroscopic ordering of biological structure does not arise due to the increase of certain parameters or a system above their critical values. These structures are built according to program-like complicated architectural structures, the meaningful information created during many billions of years of chemical and biological evolution being used." Life is a consequence of microscopic, not macroscopic, organization.

Of course, Blumenfeld does not answer the further question of how those program-like structures emerge in the first place. His explanation leads directly to infinite regress.

In short, they [Prigogine and Stengers] maintain that time irreversibility is not derived from a time-independent microworld, but is itself fundamental. The virtue of their idea is that it resolves what they perceive as a "clash of doctrines" about the nature of time in physics. Most physicists would agree that there is neither empirical evidence to support their view, nor is there a mathematical necessity for it. There is no "clash of doctrines." Only Prigogine and a few colleagues hold to these speculations which, in spite of their efforts, continue to live in the twilight zone of scientific credibility.

In theology, Thomas Aquinas (1225–1274) in his Summa Theologica assumes a teleological created universe in rejecting the idea that something can be a self-sufficient cause of its own organization:

Since nature works for a determinate end under the direction of a higher agent, whatever is done by nature must needs be traced back to God, as to its first cause. So also whatever is done voluntarily must also be traced back to some higher cause other than human reason or will, since these can change or fail; for all things that are changeable and capable of defect must be traced back to an immovable and self-necessary first principle, as was shown in the body of the Article.

Grassroots

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Grassroots

A grassroots movement uses the people in a given district, region or community as the basis for a political or social movement. Grassroots movements and organizations use collective action from volunteers at the local level to implement change at the local, regional, national, or international levels. Grassroots movements are associated with bottom-up, rather than top-down decision-making, and are sometimes considered more natural or spontaneous than more traditional power structures.

Grassroots movements, using self-organisation, encourage community members to contribute by taking responsibility and action for their community. Grassroots movements utilize a variety of strategies, from fundraising and registering voters, to simply encouraging political conversation. Goals of specific movements vary and change, but the movements are consistent in their focus on increasing mass participation in politics. These political movements may begin as small and at the local level, but grassroots politics, as Cornel West contends, are necessary in shaping progressive politics as they bring public attention to regional political concerns.

The idea of grassroots is often conflated with participatory democracy. The Port Huron Statement, a manifesto seeking a more democratic society, says that to create a more equitable society, "the grass roots of American Society" need to be the basis of civil rights and economic reform movements. The terms can be distinguished in that grassroots often refers to a specific movement or organization, whereas participatory democracy refers to the larger system of governance.

History

The earliest origins of "grass roots" as a political metaphor are obscure. In the United States, an early use of the phrase "grassroots and boots" was thought to have been coined by Senator Albert Jeremiah Beveridge of Indiana, who said of the Progressive Party in 1912, "This party has come from the grass roots. It has grown from the soil of people's hard necessities".

In a 1907 newspaper article about Ed Perry, vice-chairman of the Oklahoma state committee, the phrase was used as follows: "Regarding his political views, Mr. Perry has issued the following terse platform: 'I am for a square deal, grass root representation, for keeping close to the people, against ring rule and for fair treatment.'" A 1904 news article on a campaign for a possible Theodore Roosevelt running mate, Eli Torrance, quotes a Kansas political organizer as saying: "Roosevelt and Torrance clubs will be organized in every locality. We will begin at the grass roots".

Since the early 1900s, grassroots movements have been widespread both in the United States and in other countries. Major examples include parts of the American Civil Rights Movement of the 1950s and 1960s, Brazil's land equity movement of the 1970s and beyond, the Chinese rural democracy movement of the 1980s, and the German peace movement of the 1980s.

A particular instantiation of grassroots politics in the American Civil Rights Movement was the 1951 case of William Van Til working on the integration of the Nashville Public Schools. Van Til worked to create a grassroots movement focused on discussing race relations at the local level. To that end, he founded the Nashville Community Relations Conference, which brought together leaders from various communities in Nashville to discuss the possibility of integration. In response to his attempts to network with leadership in the black community, residents of Nashville responded with violence and scare tactics. However, Van Til was still able to bring blacks and whites together to discuss the potential for changing race relations, and he was ultimately instrumental in integrating the Peabody College of Education in Nashville. Furthermore, the desegregation plan proposed by Van Til's Conference was implemented by Nashville schools in 1957. This movement is characterized as grassroots because it focuses on changing a norm at the local level using local power. Van Til worked with local organizations to foster political dialogue and was ultimately successful.

The Brazilian Landless Workers Movement (MST) was founded in the 1970s and has grown into an international organization. The MST focused on organizing young farmers and their children in fighting for a variety of rights, most notably the right to access land. The movement sought organic leaders and used strategies of direct action, such as land occupations. It largely maintained autonomy from the Brazilian government. The MST traces its roots to discontent arising from large land inequalities in Brazil in the 1960s. Such discontent gained traction, particularly after Brazil became a democracy in 1985. The movement focused especially on occupying land that was considered unproductive, thus showing that it was seeking overall social benefit. In the 1990s, the influence of the MST grew tremendously following two mass killings of protestors. Successful protests were those in which the families of those occupying properties received plots of land. Although the grassroots efforts of the MST were successful in Brazil when they were tried by the South African Landless People's Movement (LPM) in 2001, they were not nearly as successful. Land occupations in South Africa were politically contentious and did not achieve the positive results seen by the MST.

The National People's Congress was a grassroots democratic reform movement that came out of the existing Chinese government in 1987. It encouraged grassroots elections in villages all around China with the express purpose of bringing democracy to the local level of government. Reforms took the form of self-governing village committees that were elected in a competitive, democratic process. Xu Wang from Princeton University called the Congress mutually empowering for the state and the peasantry in that the state was given a renewed level of legitimacy by the democratic reforms and the peasantry was given far more political power. This manifested itself in increased voting rate, particularly for the poor, and increased levels of political awareness, according to Wang's research. One example of the increased accountability from the new institutions was a province in which villagers gave 99,000 suggestions to the local government. Ultimately, 78,000 of these were adopted, indicating a high rate of governmental responsiveness. This movement is considered grassroots because it focuses on systematically empowering the people. This focus manifested itself in the democratic institutions that focused on engaging the poor and in reform efforts that sought to make the government more responsive to the will of the people.

Another instance of a historical grassroots movement was the 1980s German peace movement. The movement traces its roots to the 1950s movement opposing nuclear armament, or the "Ban the Bomb" Movement. In the 1980s, the movement became far bigger. In 1981, 800 organizations pushed the government to reduce the military size. The push culminated in a protest by 300,000 people in the German capital , Bonn. The movement was successful in producing a grassroots organization, the Coordination Committee, which directed the efforts of the peace movements in the following years. The committee ultimately failed to decrease the size of the German military, but it laid the groundwork for protests of the Iraq War in the 2000s. Further, the movement started public dialogue about policy directed at peace and security. Like the Civil Rights Movement, the German Peace Movement is considered grassroots because it focuses on political change starting at the local level.

Another example of grassroots in the 1980s was the Citizens Clearinghouse for Natural Waste, an organization that united communities and various grassroots groups in America in support of more environmentally friendly methods of dealing with natural waste. The movement focused especially on African American communities and other minorities. It sought to bring awareness to those communities and alter the focus from moving problematic waste to changing the system that produced such waste. The movement is considered grassroots because it utilized strategies that derived their power from the affected communities. For example, in North Carolina, African American communities lie down in front of dump trucks to protest their environmental impact. The success of these movements largely remains to be seen.

Strategies of grassroots movements

Grassroots movements use tactics that build power from local and community movements. Grassroots Campaigns, a non-profit organization dedicated to creating and supporting grassroots movements in America, says that grassroots movements aim to raise money, build organizations, raise awareness, build name recognition, to win campaigns, and deepen political participation. Grassroots movements work toward these and other goals via strategies focusing on local participation in either local or national politics.

Grassroots organizations derive their power from the people, the community; thus their strategies seek to engage ordinary people in political discourse to the greatest extent possible. Below is a list of strategies considered to be grassroots because of their focus on engaging the populace:

• Hosting house meetings or parties
• Having larger meetings—AGMs
• Putting up posters
• Talking with pedestrians on the street or walking door-to-door (often involving informational clipboards)
• Gathering signatures for petitions
• Mobilizing letter-writing, phone-calling and emailing campaigns
• Setting up information tables
• Raising money from many small donors for political advertising or campaigns
• Organizing large demonstrations
• Asking individuals to submit opinions to media outlets and government officials
• Holding get out the vote activities, which include the practices of reminding people to vote and transporting them to polling places.

Use of online social networks

Social media's prominence in political and social activism has skyrocketed in the last decade. Influencers on apps like Instagram and Twitter have all become hot spots for growing grassroots movements as platforms to inform, excite and organize.

Hashtags

Another influential way media is used to organize is through the use of hashtags to group together postings from across the network under a unifying message. Some hashtags that stirred up larger media coverage include the #MeToo movement, started in 2017 in response to sexual assault allegations against prominent figures in the American entertainment industry. Grassroots movements also use hashtags to organize on a large scale on social media. Some examples include:

• BlackLivesMatter, this hashtag demonstrates how what starts as a media campaign can take footing to be a form of embodying an entire movement.
• LoveWins. After the Supreme Court of the United States ruled in favor of legalizing same-sex marriage, supporters used the hashtag #LoveWins.
• Resist: This hashtag, used in cities throughout America, is another example of the power of organization through media platforms. It was used by event planning sites like Meetup.com to bring together members of a community who wanted to get involved politically. It was used in the case of #Resist:Dallas for such purposes.

Examples

Barry Goldwater 1964 presidential campaign

Main article: Barry Goldwater 1964 presidential campaign

The junior senator from Arizona and standard-bearer of conservative Republicans, Barry Goldwater announced his candidacy on January 3, 1964. Goldwater focused on goals such as reducing the size of the federal government, lowering taxes, promoting free enterprise, and a strong commitment to U.S. global leadership and fighting communism, which appealed strongly to conservatives in the Republican Party.

Despite vehement opposition from the leaders of his party's dominant moderate-liberal wing, such as New York governor Nelson Rockefeller and Michigan governor George Romney; Goldwater secured the Republican nomination. He sparked a grassroots movement among young conservatives by presenting himself as honest, committed, and a genuine politician. The majority of his campaign donations were made by individual supporters; and only one-third of donations were greater than $500.

Earth Hour

Earth Hour is a world wide movement aimed to bring awareness to environmental issues.  The grassroots movement started in Sydney, Australia in 2007.  The World Wild Life (WWF) also has an Earth Hour , WWF has more than just the electrical stoppage for the hour in March. While the day for the outage does change it typically lands anywhere from March 20th to March 31th.  Many countries take part of Earth Hour ranging all over the globe. Corporations and governments have also taken part in Earth Hour. The movement is also online as well, using #EarthHour on social media platforms.  Earth Hour is also focused on more local efforts in climate advocacy in different countries.  Earth Hour is still on going to date with no visible plans of slowing campaigning.

UK grassroots aid movement

In 2015, the refugee crisis became front-page news across the world. Affected by images of the plight of refugees arriving and travelling across Europe, the grassroots aid movement (otherwise known as the people-to-people or people solidarity movement), consisting of thousands of private individuals with no prior NGO experience, began in earnest to self-organized and form groups taking aid to areas of displaced persons. The first wave of early responders reached camps in Calais and Dunkirk in August 2015 and joined forces with existing local charities supporting the inhabitants there. Other volunteers journeyed to support refugees across the Balkans, Macedonia, and the Greek islands. Grassroots aid filled voids and saved lives by plugging gaps in the system between governments and existing charities.

The Axis of Justice

The Axis of Justice (AofJ) is a not-for-profit group co-founded by Tom Morello and Serj Tankian. Its intended purpose is to promote social justice by connecting musicians and music enthusiasts to progressive grassroots ideals. The group appears at music festivals; the most prominent being Lollapalooza in 2003. The Axis of Justice most regularly appears whenever the bands System of a Down or Audioslave are performing. The group also has a podcast on XM Satellite radio and KPFK (90.7 FM), a Pacifica Radio station in Los Angeles, California. The AofJ's mission is to connect local music fans to organizations, local and global, aimed at effectively working on issues like peace, human rights and economic justice within communities.

Criticism

Top-down vs. bottom-up processing

There is an ongoing debate as to whether a bottom-up or top-down approach is better suited to address the problems facing communities. Top-down processing involves large-scale programs or high-level frameworks, often driven by governmental or international action. Top-down processing is great for tracking large-scale causal relationships in environmental systems, and it has better funding. Top-down processing is typically designed by outsiders who can only perceive a community's needs, and so community needs are often only marginally addressed or not addressed at all. By contrast, bottom-up processing is defined as "observing or monitoring efforts defined and undertaken at the local scale and brought forward to higher-level bodies, often with a focus on supporting outcomes desired by a local community." Bottom-up processing has "local residents and [POC] co-facilitate the trainings and workshops"—this "empowers participants." Bottom-up approaches are often not impactful beyond local settings. Grassroots organizations take on a bottom-up approach as they often allow for direct community participation.

Issues with horizontal movements

Grassroots movements are usually criticized because the recent rise in social media has resulted in leaderless and horizontal movements. Some argue that social movements without a clear hierarchy are far less effective and are more likely to die off.

Astroturfing

Main article: Astroturfing

Astroturfing refers to political action that is meant to appear to be grassroots, that is spontaneous and local, but in fact comes from an outside organization, such as a corporation or think tank. It is named after AstroTurf, a brand of artificial grass. An example of astroturfing was the ExxonMobil Corporation's push to disseminate false information about climate change. ExxonMobil was largely successful both in disseminating the information through think tanks and in disguising the true nature of the think tanks.

More controversial examples of astroturfing often exhibit some characteristics of a real grassroots organization, but also characteristics of AstroTurf. Many of President Obama's efforts, for example, have been deemed grassroots because of their focus on involving the electorate at large. Critics of Obama have argued that some of these methods are, in fact, astroturfing because they believe that Obama faked the grassroots support. For example, the Reason Foundation has accused Obama of planting AstroTurf supporters in town hall meetings. Many movements and organizations must be placed on a continuum between grassroots and AstroTurf instead of being labeled entirely as one or the other. For example, Australia's Convoy of No Confidence, a movement seeking to force an early election in 2011, incorporated elements of grassroots infrastructure in its reliance on the anger and discontentment of the participants. It also had elements of AstroTurf, namely the large extent to which it relied on support from political elites in the opposition party.

The Tea Party, a conservative force in American politics that began in 2009, is also a controversial example of astroturfing. Critics, notably including Former President Barack Obama and Speaker of the House Nancy Pelosi, dismissed the Tea Party as Astroturf. They say that the movement purports to represent large swaths of America when in reality it comes from a select few billionaires seeking policies favorable to themselves. The Tea Party has defended itself, arguing that it comes out of broad popular support and widespread anger at the Democratic Party and disenchantment with the GOP. Defenders of the Tea Party cite polls that find substantial support, indicating that the movement has some basis in grassroots politics. Critics point to the corporate influence on the Tea Party, which they believe indicates that the movement is more top-down than the grassroots rhetoric would suggest. The Tea Party can be considered grassroots to the extent that it comes from the people, but it is considered astroturfing to the extent that it is shaped by corporations and particularly wealthy individuals.

Current examples

• Earth Hour International - Created by WWF Australia and advertising agency Leo Burnett Sydney and Fairfax Media, has described itself as "the world's largest grass roots movement".
• Bernie Sanders presidential campaign, 2016: this has been deemed by some as a grassroots campaign because of its focus on small donations, massive rallies and other grassroots style politicking methods.
• Momentum in the United Kingdom: it has been described as a grassroots movement supportive of Jeremy Corbyn and the Labour Party.

Use in sport

The term "grassroots" is used by a number of sporting organizational bodies to reference the lowest, most elementary form of the game that anyone can play. Focusing on the grassroots of a sporting code can lead to greater participation numbers, greater support of professional teams/athletes and ultimately provide performance and financial benefits to the organization to invest into the growth and development of the sport^[ Some examples of this are FIFA's Grassroots Programme and the Football Federation Australia's "Goals for Grassroots" initiative.

Patient advocacy

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Patient_advocacy 

Patient advocacy is a process in health care concerned with advocacy for patients, survivors, and caregivers. The patient advocate may be an individual or an organization, concerned with healthcare standards or with one specific group of disorders. The terms patient advocate and patient advocacy can refer both to individual advocates providing services that organizations also provide, and to organizations whose functions extend to individual patients. Some patient advocates are independent (with no conflict-of-loyalty issues) and some work for the organizations that are directly responsible for the patient's care.

Typical advocacy activities are the following: safeguarding patients from errors, incompetence and misconduct; patient rights, matters of privacy, confidentiality or informed consent, patient representation, awareness-building, support and education of patients, survivors and their carers.

Patient advocates give a voice to patients, survivors and their carers on healthcare-related (public) fora, informing the public, the political and regulatory world, health care providers (hospitals, insurers, pharmaceutical companies etc.), organizations of health care professionals, the educational world, and the medical and pharmaceutical research communities.

Nurses can perform a de facto role of patient advocacy, though this role may be limited and conflicted due their employment within an organization. Patients can advocate for themselves through self-advocacy and the ability for this self-advocacy can be learnt or improved through training.

History

Patient advocacy, as a hospital-based practice, grew out of this patient rights movement: patient advocates (often called patient representatives) were needed to protect and enhance the rights of patients at a time when hospital stays were long and acute conditions—heart disease, stroke and cancer—contributed to the boom in hospital growth. Health care reformers at the time critiqued this growth by quoting Roemer's law: a built hospital bed is a bed likely to be filled. And more radical health analysts coined the term health empires to refer to the increasing power of these large teaching institutions that linked hospital care with medical education, putting one in the service of the other, arguably losing the patient-centered focus in the process. It was not surprising, then, that patient advocacy, like patient care, focused on the hospital stay, while health advocacy took a more critical perspective of a health care system in which power was concentrated on the top in large medical teaching centers and a dominance of the medical profession.

Patient advocacy in the United States emerged in the 1950s in the context of cancer research and treatment. In those early days of cancer treatment, patients and their families raised ethical concerns around the tests, treatment practices, and clinical research being conducted. For instance, they expressed concern to the National Institute of Health (NIH) about the cruelty of the repeated collection of blood samples (for blood marrow examination) and raised questions about whether this was more harmful than beneficial to the patient. Sidney Farber, a Harvard physician and cancer researcher, coined the term total care, to describe the treatment of children with leukemia. Under total care, a physician "treated the family as a whole, factoring in its psychosocial and economic needs", rather than focusing purely on physical health concerns. Previous researchers had dealt with concerns raised by families, because physicians emphasized patient physical health rather than the inclusion of bedside manners with the families. The practice of patient advocacy emerged to support and represent patients in this medico-legal and ethical discussion.

The 1970s were also an important time in the US for patient advocacy as the Patient Rights movement grew. As a major advocacy organization during the time, the National Welfare Rights Organization's (NWRO) materials for a patient's bill of rights influenced many additional organizations and writings, including hospital accreditation standards for the Joint Commission in 1970 and the American Hospital Association's Patient Bill of Rights in 1972. The utilization of advocates by individual patients gained momentum in the early 2000s in the US, and Australia 10 years later, and the profession is now perceived as a mainstream option to optimize outcomes in both hospital- and community-based healthcare.

Self-advocacy

See also: Patient participation and Patient and public involvement

Communication skills, information-seeking skills and problem-solving skills were found to correlate with measures of a patient's ability to advocate for themselves. Conceptualizations of the qualities have defined self-knowledge, communication skills, knowledge of rights, and leadership as components of advocacy.

A number of interventions have been tried to improve patients' effectiveness at advocating for themselves. Studies have found peer-led programs where an individual with a condition is taught interview skills were effective in improving self-advocacy. Writing interventions, where people with conditions received training and practiced writing essays advocating for themselves, were shown to improve self-advocacy.

Patient advocacy processes

At a conceptual level patient advocacy consists of three processes: valuing, apprising and interceding. Valuing consists of understanding the patient's unique attributes and desires. Apprising consists of informing the patient and advising the patient. Interceding consists of interacting with processes to ensure that the patient's unique attributes and desires are represented in these processes, and may include interceding in family interactions as well as healthcare processes.

Examples of patient advocacy include:

• Educating and walking patients through the management of their disease or chronic illnesses. The social determinants of health can vary significantly from patient to patient. It is the role of the patient advocate to cater to the patient's needs and assist with these factors, such as where to find treatment to manage their illness, assisting with healthcare access due to socioeconomic barriers, or helping find additional health services. Assistance with the management of their illnesses or disease can also include assisting with cooperative purchases of health care materials.
• Support with sourcing and navigating second opinions where patients seek input about diagnosis, treatment options and prognosis.
• Establishing a network of contacts. Examples of contacts patient advocates can assist in connecting patients to include: in the public sector (political and regulatory), in public and private health insurance, in the sector of medical service providers, with medical practitioners, and with pharmaceutical and medical research to provide patients with help in the care and management of their diseases.
• Providing emotional support in dealing with their health concerns, illnesses, or chronic conditions. According to the National Institute of Mental Health, individuals with chronic illnesses are at a higher risk of depression of than patients with other mental health conditions. When managing their illnesses, patients and survivors experience the direct effect of the consequences their disease has on their quality of life, and may also go through difficult phases of adaptation of their daily routine and lifestyle to accommodate the disease. Part of the role of patient advocates can include providing emotional support for patients or connecting them to mental health resources.
• Attending appointments with a patient. Patients can find doctor's appointments intimidating, but also difficult to understand. Issues may stem from differences in language proficiency, educational background, or background in health literacy. A patient advocate's presence can ensure that patient's concerns are highlighted and adequately addressed by physicians. Patient advocates may also be responsible for assisting with scheduling additional appointments as well.
• Assisting with health insurance and other financial aspects of healthcare. The Institute of Medicine in the United States says fragmentation of the U.S. health care delivery and financing system is a barrier to accessing care. Within the financing system, health insurance plays a significant role. According to a United Health survey, only 9% of Americans surveyed understood health insurance terms, which presents a significant issue for patients, given the importance of health insurance in terms of providing access to healthcare. The patient advocate may help with researching or choosing health insurance plans.

Nurse advocacy

The American Nurses Association (ANA) includes advocacy in its definition of nursing:

Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.

Advocacy in nursing finds its theoretical basis in nursing ethics. For instance, the ANA's Code of Ethics for Nurses includes language relating to patient advocacy:

• The nurse's primary commitment is to the patient, whether an individual, family, group, or community.
• The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.

Several factors can lead a patient to use nurses for advocacy, including impairments in their ability to express wishes due to speech impairments or limited consciousness, lack of independence due to illiteracy, sociocultural weakness, or separation from friends or family caused by hospitalization. Nurses are more able to advocate if they are independent, professionally committed, and have self-confidence as well as having legal and professional knowledge, as well as knowing a patient's wishes. The act of patient advocacy improved nurses' sense of professional well-being and self-concept, job motivation and job satisfaction, and enhances the public image of nurses; however, advocating for a patient could have social and professional consequences.

Conflict of interest between a nurse's responsibilities to their employer and their responsibilities to the patient can be a barrier to advocacy. Additionally, a nurse is concerned about all of the patients they care for rather any individual patient. Gadow and Curtis argue that the role of patient advocacy in nursing is to facilitate a patient's informed consent through decision-making, but in mental health nursing there is a conflict between the patient's right to autonomy and nurses' legal and professional duty to protect the patient and the community from harm, since patients may experience delusions or confusion which affect their decision-making. In such instances, the nurse may engage in persuasion and negotiation in order to prevent the risk that they perceive.

Private advocacy

Main article: Health advocacy

Private advocates (also known as independent patient/health/health care advocates) often work parallel to the advocates that work for hospitals. As global healthcare systems started to become more complex, and as the role of the cost of care continues to place more of a burden on patients, a new profession of private professional advocacy began to take root in the mid-2000s. At that time, two organizations were founded to support the work of these new private practitioners, professional patient advocates. The National Association of Healthcare Advocacy Consultants was started to provide broad support for advocacy. The Alliance of Professional Health Advocates was started to support the business of being a private advocate. Some regions require that those detained for the treatment of mental health disorders are given access to independent mental health advocates who are not involved in the patient's treatment.

Proponents of private advocacy, such as Australian advocate Dorothy Kamaker and L. Bradley Schwartz, have noted that the patient advocates employed by healthcare facilities frequently have an inherent conflict of interest in situations where the needs of an individual patient are at odds with the corporate interests of an advocate's employer. Kamaker argues that hiring a private advocate eliminates this conflict because the private advocate "…has only one master and very clear priorities."

Kamaker founded patientadvocates.com.au in 2013 and, in partnership with Alicia Dunn, followed with disabilityhealthsupport.com.au in 2021 when research revealed that vulnerable groups achieved sub-optimal outcomes and encountered barriers and prejudice in the mainstream health and hospital systems in Australia. "Based on the limited data available, we know that the overall health of people with disabilities is much worse than that of the general population", with "people with disabilities rarely identified as a priority population group in public health policy and practice". Patients supported by advocates have been shown to experience fewer treatment errors and require fewer readmissions post discharge. In Australia there has been some movement by private health insurers to engage private patient advocates to reduce costs, improve outcomes and expedite return to work for employees.

Schwartz is the founder and president of GNANOW.org, where he states, "Everyone employed by a health care company is limited to what they can accomplish for patients and families. Hospital-employed patient advocates, navigators, social workers, and discharge planners are no different. They became health care professionals because they are passionate about helping people. But they have heavy caseloads and many work long hours with limited resources. Independent Patient Advocates work one-on-one with patients and loved ones to explore options, improve communication, and coordinate with overworked hospital staff. In fact, many Independent Patient Advocates used to work for hospitals and health care companies before they decided to work directly for patients."

Patient advocacy organizations

See also: Health policy, Health advocacy, and Patient participation § Formation of health policy as stakeholders

Patient advocacy organizations, PAO, or patient advocacy groups are organizations that exist to represent the interests of people with a particular disease. Patient advocacy organizations may fund research and influence national health policy through lobbying. Examples in the US include the American Cancer Society, American Heart Association, and National Organization for Rare Disorders.

Some patient advocacy groups receive donations from pharmaceutical companies. In the US in 2015, 14 companies donated $116 million to patient advocacy groups. A database identifying more than 1,200 patient groups showed that six pharmaceutical companies contributed $1 million or more in 2015 to individual groups representing patients who use their drugs, and 594 groups in the database received donations from pharmaceutical companies. Fifteen patient groups relied on pharmaceutical companies for at least 20 percent of their revenue in the same year, and some received more than half of their revenue from pharmaceutical companies. Recipients of donations from pharmaceutical companies include the American Diabetes Association, Susan G. Komen, and the Caring Ambassadors Program.

Patient opinion leaders, also sometimes called patient advocates, are individuals who are well versed in a disease, either as patients themselves or as caretakers, and share their knowledge on the particular disease with others. Such POLs can have an influence on health care providers and may help persuade them to use evidence-based therapies or medications in the management of other patients. Identifying such people and persuading them is one goal of market access groups at pharmaceutical and medical device companies.

Organizations

Professional groups

Solace

Solace is an American professional organization where private advocates can list their business and allow consumers to book conversations with advocates directly.

Alliance of Professional Health Advocates

The Alliance of Professional Health Advocates (APHA) is an international membership organization for private, professional patient advocates, and those who are exploring the possibility of becoming private advocates. It provides business support such as legal, insurance and marketing. It also offers a public directory of member advocates called AdvoConnection. Following the 2011 death of Ken Schueler — a charter member of the APHA, described as "the Father of Private Patient Advocacy" — the organization established the H. Kenneth Schueler Patient Advocacy Compass Award. The award recognizes excellence in private practice including the use of best practices, community outreach, support of the profession and professional ethics.

Dialysis Patient Citizens

Dialysis Patient Citizens is an American patient-led, non-profit organization dedicated to improving dialysis citizens' quality of life by advocating for favorable public policy. One of DPC's goals is to provide dialysis patients with the education, access and confidence to be their own advocates. Through their grassroots advocacy campaigns, Patient Ambassador program; Washington, D.C. patient fly-ins; conference calls and briefings, DPC works to train effective advocates for dialysis-related issues. Membership is free.

National Association of Healthcare Advocacy Consultants

National Association of Healthcare Advocacy Consultants (NAHAC) is an American nonprofit organization located in Berkeley, California. Joanna Smith founded NAHAC on July 15, 2009, as a broad-based, grassroots organization for health care and patient advocacy. To that end, it is a multi-stakeholder organization, with membership open to the general public.

National Patient Advocate Foundation

The National Patient Advocate Foundation is a non-profit organization in the United States dedicated to "...improving access to, and reimbursement for, high-quality healthcare through regulatory and legislative reform at the state and federal levels." The National Patient Advocate Foundation was founded simultaneously with the non-profit Patient Advocate Foundation, "...which provides professional case management services to Americans with chronic, life-threatening and debilitating illnesses."

Patient Advocates Australia

Patient Advocates Australia, founded by Dorothy Kamaker, is a support option for consumers of aged, health and disability care in Australia. For the elderly, an emerging need has arisen for patient advocacy in residential aged facilities. The Aged Care Royal Commission Report published in 2021 has made recommendations regarding a need for vigilant advocacy for residents of nursing homes to protect them against rampant abuse and neglect, with one submission calling for the routine provision of independent patient advocates. For the disabled, funding for support to overcome healthcare barriers is available through the National Disability Insurance Scheme.

Greater National Advocates (GNA)

Greater National Advocates is a non-profit organization with the goal of raising Americans' awareness of the lifesaving benefits of independent patient advocacy and to provide patients and loved ones with immediate online access to a trusted network of qualified practitioners. GNA uses fact-based media to spread awareness and steer patients and their loved ones to GNANOW.org where they can learn more and find the professional support they need.

Center for Patient Partnerships

Founded in 2000, the interprofessional Center for Patient Partnerships (CPP) at University of Wisconsin–Madison offers a health advocacy certificate with a focus on either patient advocacy or system-level health policy advocacy. The chapter "Educating for Health Advocacy in Settings of Higher Education" in Patient Advocacy for Health Care Quality: Strategies for Achieving Patient-Centered Care describes CPP's pedagogy and curriculum.

Government agencies

United States

In the United States, state governmental units have established ombudsmen to investigate and respond to patient complaints and to provide other consumer services.

New York

In New York, the Office of Patient Advocacy within the New York State Office of Alcoholism and Substance Abuse Services (OASAS) is responsible for protecting the rights of patients in OASAS-certified programs. The office answers questions from patients and their families; provides guidance for health care professionals on topics related to patient rights, state regulations, and treatment standards, and intervenes to resolve problems that cannot be handled within treatment programs themselves.

California

In California, the Office of the Patient Advocate (OPA), an independent state office established in July 2000 in conjunction with the Department of Managed Health Care, is responsible for the creation and distribution of educational materials for consumers, public outreach, evaluation and ranking of health care service plans, collaboration with patient assistance programs, and policy development for government health regulation.

Such state government offices may also be responsible for intervening in disputes within the legal and insurance systems and in disciplinary actions against health care professionals. Some hospitals, health insurance companies, and other health care organizations also employ people specifically to assume the role of patient advocate. Within hospitals, the person may have the title of ombudsman or patient representative.