It’s what you’ve been waiting for (though you may not have realised it) – in the ho-ho-ho opening lede of IdeaConnection’s story: “the comfortably smart underwear from Skiin takes a bottoms-up approach to health monitoring.”
All sounds fantastic, but I don’t quite find much information on how effective it is in the more traditional role of underwear … how many pairs would one need?
It’s been a while since I posted anything on this blog, a longer while since I posted anything that wasn’t just a link to something else here, and an even while since I posted anything all that medical education related.
Anyone who has learnt a musical instrument knows that countless hours of practice are needed to achieve success. As a musician who has performed as an individual and as part of a group, I have spent many hours practicing before competitions and performances. It becomes apparent that how one practices is a skill in itself and the type or quality of practice is often more important than the quantity of practice. Ericsson formally described this phenomenon as deliberate practice after studying violinists in a music academy in Berlin. Rather than monotonous repetition of a skill or task, deliberate practice involves breaking the task up into chunks, identifying which ones need improvement, and performing focused practice on this chunk or task until a goal is achieved.
As a surgical educator, I can also see a role for deliberate practice in surgical training. As in music, complex tasks (e.g. percutaneous screw placement in fracture surgery) can be broken up into basic steps or “chunks,” such as image intensifier positioning, appropriate screw entry point identification, and trajectory planning. Trainees can then practice the steps they are deficient in under supervision. Here trainers provide critical feedback by identifying the troublesome parts of a technique that an individual trainee is struggling with. Simulation in particular can provide a safe environment for deliberate practice where trainees can practice tasks repeatedly without risk to patients.
Read the whole thing, as they say.
From Paula and Andrew’s Travels – a visit to Burghley House which is full of entertaining detail , especially this:
I have posted at times speculating as to the long term impact of collective traumas I may have a personal motivation for this. On my other blog I have often re-posted from the excellent blog of Adam deVille, Eastern Christian Books. On this blog deVille considers recent books relevant to the broad theme of Eastern Christianity – along with his own always perceptive and thought-provoking reflections.
He has a post on a recent book on transgenerational trauma and the Armenian Genocide:
To my mind one of the most important and far-reaching insights Freud first helped us to understand, and many analysts–as well as other psychologists, sociologists, historians, and churchmen–have deepened in the years after Freud (and in particular after the Holocaust) is the long-lasting nature of major trauma, and the very real ways in which something of those traumatic memories will shape later generations who did not experience the trauma directly.
In this instance, Eastern Christians have first-hand experience, starting in 1915 (though, of course, actually much earlier, given a centuries-long trail of blood and tears among Armenian Christians, subject to periodic mass slaughters under the Ottomans) with the Armenian, Assyrian, and Greek genocides. The first of these was the largest, and has attracted a good deal of attention in the last two decades. Now that a century and more has passed, and all survivors are dead, the memories and effects of the genocide are not, as a new book reminds us: Anthonie Holslag, The Transgenerational Consequences of the Armenian Genocide: Near the Foot of Mount Ararat (Palgrave Macmillan, 2018), 291pp.
About this book the publisher tells us:
This book brings together the Armenian Genocide process and its transgenerational outcome, which are often juxtaposed in existing scholarship, to ask how the Armenian Genocide is conceptualized and placed within diasporic communities. Taking a dual approach to answer this question, Anthonie Holslag studies the cultural expression of violence during the genocidal process itself, and in the aftermath for the victims. By using this approach, this book allows us to see comparatively how genocide in diasporic communities in the Netherlands, London and the US is encapsulated in an historic narrative. It paints a picture of the complexity of genocidal violence itself, but also in its transgenerational and non-spatial consequences, raising new questions of how violence can be perpetuated or interlocked with the discourse and narratives of the victims, and how the violence can be relived.
Karl von Vierordt has a relatively short Wikipedia bio (compared, for instance, to this) for someone who pioneered the measurement of blood pressure, the measurement of lung function and – the activity that would link his name with a “law” for posterity, the experimental study of the time sense. Indeed, he seems to have been one of the first experimental psychologists.
This excellent set of slides gives an overview of Vierordt’s career and a very detailed discussion of the time experiments, their methodology, context, and implications. So what is Vierordt’s Law? As stated by Wearden in the talk:
the proposition that short intervals
of time are judged as longer than they are,
whereas long intervals are judged as
shorter, with an indifference point, where
intervals are judged correctly, somewhere
between the two
In 1868, Vierordt published Der Zeitsinn nach Versuchen
– “The Time Sense According to Experiments.” This was not the first study of time perception, but by had by far the most data. Wearden describes Vierordt’s experimental methodology:
–
The data collected in Der Zeitsinn come from
experimental studies in which Vierordt himself,
or sometimes his pupil Höring, was the sole
experimental participant
• Höring [Vierordt’s student] not only carried out time perception
studies to qualify for a medical degree, but his
thesis work has the oddity that Höring was the
participant and not the experimenter (who was
Vierordt)
• The data were derived from very extensive
experimentation, often involving hundreds of
experimental trials carried out over many daysTwo taps (on a glass plate) define a target
time interval and the participant must
make a response so that the time between
the second tap and the response is equal
to the time between the two taps
A very full account of the Vierordt effect (perhaps a better term than “law”) is given in Wearden’s paper linked to above. Wearden has an intriguing conclusion:
A potential conclusion is that the Vierordt effects
shown in different tasks don’t actually have any
common cause, and that different processes are
responsible in the different cases• Here, unusually, theoretical analysis seems to
suggest that things that look the same aren’t
really the same at all, a kind of theoretical
“disintegration” rather than the usual theoretical
“integration” of different phenomena within the
same theoretical framework
He ends with two points that should give pause to those who see the science of today as inherently superior to the science of the past:
You can see that this 19th. Century work, in spite
of some peculiarities, not only produced reliable
data, but also has posed some problems which
are unsolved (and, it seems, quite difficult to
solve) even today in the light of many recent
advances in our understanding of time
perception
• More generally, Vierordt seems to be a pioneer
of experimental Psychology who is unjustly
neglected….until now
From here
Sober Minds [2017] Short Documentary Trailer from Zimmerhands Films on Vimeo.
OFFICIAL SELECTIONS 2017
Flickers Rhode Island International Film Festival US (World Premiere)
Fingal Film & Arts Festival IRE (Irish Premiere)
DocUtah International Documentary Film Festival US.
Website: CharloJohnson.com/SoberMinds
Facebook: facebook.com/SoberMindsFilm
This trailer looks really interesting – even the trailer powerfully depicts the power of nature connection and suggests that nature can be a source of connection that more mainstream education (for instance) misses out on
I have blogged before about on the tendency to grandiosity of neuroscience, or rather (very often) how the science media portray neuroscience. This phobia of neurohype is not the same as a suspicion of neuroscience. The ingenuity of the methodology of studies like this is staggering. I don’t have access via my usual library sources to recent issues of NeuroReport so I’m afraid that I can’t assess the study directly (in so far as as I am at a certain stage of clinical practice, and the consequent distance from what personal study of relevance I have done)
Fetal rhythm-based language discrimination: a biomagnetometry study
Minai, Utakoa; Gustafson, Kathleenb; Fiorentino, Roberta; Jongman, Allarda; Sereno, JoanaNeuroreport: 5 July 2017 – Volume 28 – Issue 10 – p 561–564
AbstractUsing fetal biomagnetometry, this study measured changes in fetal heart rate to assess discrimination of two rhythmically different languages (English and Japanese). Two-minute passages in English and Japanese were read by the same female bilingual speaker. Twenty-four mother–fetus pairs (mean gestational age=35.5 weeks) participated. Fetal magnetocardiography was recorded while the participants were presented first with passage 1, a passage in English, and then, following an 18 min interval, with passage 2, either a different passage in English (English–English condition: N=12) or in Japanese (English–Japanese condition: N=12). The fetal magnetocardiogram was reconstructed following independent components analysis decomposition. The mean interbeat intervals were calculated for a 30 s baseline interval directly preceding each passage and for the first 30 s of each passage. We then subtracted the mean interbeat interval of the 30 s baseline interval from that of the first 30 s interval, yielding an interbeat interval change value for each passage. A significant interaction between condition and passage indicated that the English–Japanese condition elicited a more robust interbeat interval change for passage 2 (novelty phase) than for passage 1 (familiarity phase), reflecting a faster heart rate during passage 2, whereas the English–English condition did not. This effect indicates
that fetuses are sensitive to the change in language from English to Japanese. These findings provide the first evidence for fetal language discrimination as assessed by fetal biomagnetometry and support the hypothesis that rhythm constitutes a prenatally available building block in language acquisition.
I have blogged before about the relationship between morale and clinical outcomes. From 2014 in Administrative Science Quarterly , a paper which links this with another interest of mine, workplace friendships .
In this longitudinal study, we build a theory of a culture of companionate love—feelings of affection, compassion, caring, and tenderness for others—at work, examining the culture’s influence on outcomes for employees and the clients they serve in a long-term care setting. Using measures derived from outside observers, employees, family members, and cultural artifacts, we find that an emotional culture of companionate love at work positively relates to employees’ satisfaction and teamwork and negatively relates to their absenteeism and emotional exhaustion. Employees’ trait positive affectivity (trait PA)—one’s tendency to have a pleasant emotional engagement with one’s environment—moderates the influence of the culture of companionate love, amplifying its positive influence for employees higher in trait PA. We also find a positive association between a culture of companionate love and clients’ outcomes, specifically, better patient mood, quality of life, satisfaction, and fewer trips to the emergency room. The study finds some association between a culture of love and families’ satisfaction with the long-term care facility. We discuss the implications of a culture of companionate love for both cognitive and emotional theories of organizational culture. We also consider the relevance of a culture of companionate love in other industries and explore its managerial implications for the healthcare industry and beyond.
Few outcomes are as “hard” – or as appealing to a certain strand of management – than “fewer trips to the emergency room.” The authors squarely and unashamedly go beyond the often euphemistic language of this kind of paper to focus on love:
‘‘Love’’ is a word rarely found in the modern management literature, yet for more than half a century, psychologists have studied companionate love— defined as feelings of affection, compassion, caring, and tenderness for others—as a basic emotion fundamental to the human experience (Walster and Walster, 1978; Reis and Aron, 2008). Companionate love is a far less intense emotion than romantic love (Hatfield and Rapson, 1993, 2000); instead of being based on passion, it is based on warmth, connection (Fehr, 1988; Sternberg, 1988), and the ‘‘affection we feel for those with whom our lives are deeply intertwined’’ (Berscheid and Walster, 1978: 177). Unlike self-focused positive emotions (such as pride or joy), which center on independence and self- orientation, companionate love is an other-focused emotion, promoting interdependence and sensitivity toward other people (Markus and Kitayama, 1991; Gonzaga et al., 2001).
Companionate love is therefore distinct from the romantic love which so dominates our thought when we think about love. As is often the case, we moderns are not nearly as new in our thinking as we would like to see ourselves:
Considering the large proportion of our lives we spend with others at work (U.S. Bureau of Labor Statistics, 2011), the influence of companionate love in other varied life domains (Shaver et al., 1987), and the growing field of positive organizational scholarship, which focuses on human connections at work (Rynes et al., 2012), it is reasonable to expect that this basic human emotion will not only exist at work but that it will also influence workplace outcomes. Although the term ‘‘companionate love’’ had not yet been coined, the work of early twentieth-century organizational scholars revealed rich evidence of deep connections between workers involving the feelings of affection, caring, and compassion that comprise companionate love. Hersey’s (1932) daily experi- ence sampling study of Pennsylvania Railroad System employees, for example, recorded the importance of caring, affection, compassion, and tenderness, as well as highlighting the negative effects when these emotions were absent, particularly in relationships with foremen. Similarly, Roethlisberger and Dickson’s (1939) detailed study of factory life provided crisp observations of companionate love in descriptions of workers’ interactions, describing supervisors who showed genuine affection, care, compassion, and tenderness toward their employees.
There is nothing new under the sun. In subsequent decades this kind of research was abandoned. The authors go on to describe the distinctions between strong and weak cultures of companionate love:
Like the concept of cognitive organizational culture, a culture of companio- nate love can be characterized as strong or weak. To picture a strong culture of companionate love, first imagine a pair of coworkers collaborating side by side, each day expressing caring and affection toward one another, safeguarding each other’s feelings, showing tenderness and compassion when things don’t go well, and supporting each other in work and non-work matters. Then expand this image to an entire network of dyadic and group interactions so that this type of caring, affection, tenderness, and compassion occurs frequently within most of the dyads and groups throughout the entire social unit: a clear picture emerges of a culture of companionate love. Such a culture involves high ‘‘crystallization,’’ that is, pervasiveness or consensus among employees in enacting the culture (Jackson, 1966).
An example of high crystallization appears in a qualitative study of social workers (Kahn, 1993) in which compassion spreads through the network of employees in a ‘‘flow and reverse flow’’ of the emotion from employees to one another and to supervisors and back. This crystallization of companionate love can cross organizational levels; for example, an employee at a medical center described the pervasiveness of companionate love through- out the unit: ‘‘We are a family. When you walk in the door, you can feel it. Everyone cares for each other regardless of whatever level you are in. We all watch out for each other’’ (http://auroramed.dotcms.org/careers/employee_ voices.htm). Words like ‘‘all’’ and ‘‘everyone’’ in conjunction with affection, caring, and compassion are hallmarks of a high crystallization culture of companio- nate love.
Another characteristic of a strong culture of companionate love is a high degree of displayed intensity (Jackson, 1966) of emotional expression of affec- tion, caring, compassion, and tenderness. This can be seen in the example of an employee diagnosed with multiple sclerosis who described a work group whose members treated her with tremendous companionate love during her daily struggles with the condition. ‘‘My coworkers showed me more love and compassion than I would ever have imagined. Do I wish that I didn’t have MS? Of course. But would I give up the opportunity to witness and receive so much love? No way’’ (Lilius et al., 2003: 23).
In weak cultures of companionate love, expressions of affection, caring, compassion, or tenderness among employees are minimal or non-existent, showing both low intensity and low crystallization. Employees in cultures low in companionate love show indifference or even callousness toward each other, do not offer or expect the emotions that companionate love comprises when things are going well, and do not allow room to deal with distress in the workplace when things are not going well. In a recent hospital case study, when a nurse with 30 years of tenure told her supervisor that her mother-in- law had died, her supervisor responded not with compassion or even sympathy, but by saying, ‘‘I have staff that handles this. I don’t want to deal with it’’ (Lilius et al., 2008: 209). Contrast this reaction with one from the billing unit of a health services organization in which an employee described her coworkers’ reactions following the death of her mother: ‘‘I did not expect any of the compassion and sympathy and the love, the actual love that I got from co-workers’’ (Lilius et al., 2011: 880).
This is obviously a paper I could simply post extracts from all day but at this point I will desist. Perhaps rather than “What’s Love Got to Do With It? the authors could have invoked “All You Need is Love?”
I have blogged both here and on my other blog quite a few quotes from novels and other literature on sleep. I have found these passages capture a sort of phenomenology of sleep as effectively as any clinical text. In this post I use a quote from Jorge Luis Borges as the starting point for a more general, although ultimately quite personal, discussion of literature and sleep and other altered states of consciousness.
Sleeping, as we all know, is the most secret of our acts. We devote a third of our lives to it, and yet do not understand it. For some, it is no more than an eclipse of wakefulness, for others, a more complex state spanning at one and the same time past, present, and future,; for still others, an uninterrupted series of dreams. To say that Mrs Jáuregui spent ten years in a quiet chaos is perhaps mistaken; each moment of those ten years may have been a pure present, without a before or after. There is no reason to marvel at such a present, which we count by days and nights and by the hundreds of leaves of many calendars and by anxieties and events; it is what we go through each morning before waking up and every night before falling asleep. Twice each day, we are the elder…
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A Medical Education 