What’s Love Got To Do With It? A Longitudinal Study of the Culture of Companionate Love and Employee and Client Outcomes in a Long-term Care Setting

From Administrative Science Quarterly, May 29, 2014:

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.

 

Polio in Cork: Patrick Cockburn’s “The Broken Boy”, reviewed in the Guardian 09/07/05

 

A review I wrote for the Guardian 13 years ago of an oddly titled book by the son of the “84th most dangerous red in the world.” As I wrote, it is not entirely a memoir of the 1956 polio epidemic, nor is it an thorough history of the outbreak, but nevertheless it is an interesting read.

The Broken Boy
by Patrick Cockburn
320pp, Cape, £15.99

Writing about the house in which he grew up in Youghal, East Cork, Patrick Cockburn says it “owed its vigorous personality to our lack of money, which ensured that it never saw the hand of a contractor and was reconstructed piecemeal by my mother”. Cockburn’s engaging and witty book itself has a vigorous personality. It is far from the straightforward memoir of his experience of the 1956 polio epidemic in Cork suggested by the title and cover.
While being taken to see child casualties after the American bombing of Baghdad in 1998, Cockburn – a foreign correspondent – began to wonder about his own childhood experience of polio, and the epidemic about which he knew so little. Hardly any written accounts existed. In 1999, he began to interview those who remembered the outbreak, but the Chechen war and the world situation after September 11 combined to prevent him from continuing his research for some years.

This perhaps contributes to the somewhat disjointed feel of the book. Six of its 14 chapters deal with the 1956 epidemic. It begins with a six-year-old Cockburn waking with a headache and sore throat. The local doctor is called and the sensation of the stethoscope on his skin is one of the few clear memories Cockburn retains from the time. Three months earlier, in July, the epidemic had arrived in Cork city.

Cockburn was taken by ambulance to St Finbarr’s hospital in Cork city. Although terrified and uncomprehending, his memories of St Finbarr’s are sunnier than those of Gurranebraher, where children were transferred after the acute phase of the illness. Cockburn’s father, the radical journalist Claud Cockburn, wrote that children in Gurranebraher “seemed to be largely in the hands of maids – young country girls with no special training at all”. One reason for this was that female nurses, like any woman working in the public service at the time, had to resign on marriage – a glimpse of a very different Ireland from today’s.

Although Cockburn quotes doctors and physiotherapists critical of the handling of the outbreak, he himself seems curiously detached. The Salk vaccine had been field tested the year before, but was still unavailable and not entirely trusted by doctors. Quarantine was pointless, given that the majority of carriers of polio are asymptomatic. Some agitated for sporting events to be cancelled and for a form of temporary apartheid to be implemented against Corkonians – but though some politicians indulged in similar rhetoric, such sanctions were avoided.

Paradoxically, the victims of the Cork epidemic largely came from the more prosperous areas. This was because, in places where hygiene was poor, exposure to the virus was near-universal, and infants would be protected by maternal antibodies, so tended to have mild or asymptomatic forms of the illness. Improved water supply and sewage systems led to the loss of this immunity. Indeed, Cockburn argues, the outbreak could be seen as an early marker of Ireland’s later prosperity.

Cockburn writes well about his Anglo-Irish childhood, the tangled lives of his mother’s forebears and what Olivia Manning called “the usual Anglo-Irish sense of belonging nowhere”. His father Claud, described by Senator Joseph McCarthy as “the 84th most dangerous red in the world”, is a benign, rather impish spirit hovering over the book. As well as the affectionate personal memories of his father, Cockburn describes the absurdly detailed file kept on his father by British intelligence. For 20 years, with dutiful pedantry, agents followed him around recording who he met, where he went and what he did there.

The title The Broken Boy is slightly mystifying, as Cockburn doesn’t seem to have thought much about his polio experience until 1998. He does refer to “emotional scar tissue from polio” that he was aware of from an early age, but the nature of this emotional scarring isn’t at all clear. Though he spent a lot of time in school reading by himself, he writes “I was not solitary and made friends easily.” In fact, this is an oddly uplifting book. It is refreshing to read a disease memoir that is far more focused on the lives of those around the author than on trying to whip up sympathy or outrage.

Are we winning the War on Sleeplessness?

Or, as the authors of this paper put it, are we seeing the “first signs of success in the fight against sleep deficiency?”

Abstract:

STUDY OBJECTIVES:

The high prevalence of chronic insufficient sleep in the population has been a concern due to the associated health and safety risks. We evaluated secular trends in sleep duration over the most recent 14-year period.

METHODS:

The American Time Use Survey, representative of US residents ≥15 years, was used to investigate trends in self-reported sleep duration and waking activities for the period 2003-2016 (N = 181335 respondents).

RESULTS:

Sleep duration increased across survey years both on weekdays (+1.40 min/year) and weekends (+0.83 min/year, both p < .0001, adjusted models). This trend was observed in students, employed respondents, and retirees, but not in those unemployed or not in the labor force. On workdays, the prevalence of short (≤7 hr), average (>7-9 hr), and long (>9 hr) sleep changed by -0.44% per year (p < .0001), -0.03% per year (p = .5515), and +0.48% per year (p < .0001), respectively. The change in sleep duration was predominantly explained by respondents retiring earlier in the evening. The percentage of respondents who watched TV or read before bed-two prominent waking activities competing with sleep-decreased over the same time period, suggesting that portions of the population are increasingly willing to trade time in leisure activities for more sleep. The results also suggest that increasing online opportunities to work, learn, bank, shop, and perform administrative tasks from home freed up time that likely contributed to increased sleep duration.

CONCLUSIONS:

The findings indicate first successes in the fight against sleep deficiency. Public health consequences of the observed increase in the prevalence of long sleep remain unclear and warrant further investigation

Here is the American Time Use Survey which the authors used for their study.

Institutional nominative determinism paper on therapeutic gold from the Gold Coast

Nominative determinism is the jocular notion that surnames determine destiny, to wit:

the term was first used in the magazine New Scientist in 1994, after the magazine’s humorous Feedback column noted several studies carried out by researchers with remarkably fitting surnames. These included a book on polar explorations by Daniel Snowman and an article on urology by researchers named Splatt and Weedon. These and other examples led to light-hearted speculation that some sort of psychological effect was at work.

I suppose the Gold Coast campus of Griffith University in Queensland is just where you would expect to find researchers publishing on therapeutic gold:

The application of gold in medicine is traceable for several thousand years and Au(i) compounds have been used clinically to treat rheumatoid arthritis since the last century. Recently research into gold-based drugs for a range of human diseases has seen a renaissance. Old as well as new Au(i) and Au(iii) compounds have been used and designed with an aim of targeting cellular components that are implicated in the onset or progression of cancers, rheumatoid arthiritis, viral and parasitic diseases. In addition, new disease targets have been found for gold compounds that have given insight into the mechanism of action of these compounds, as well as in the molecular pathophysiology of human diseases. Here we discuss the rationale for the design and use of gold compounds that have specific and selective targets in cells to alleviate the symptoms of a range of human diseases. We summarise the most recent findings in this research and our own discoveries to show that gold compounds can be developed to become versatile and powerful drugs for diseases caused by dysfunction of selenol and thiol containing proteins.

Article on bereavement and grief from the website of the Galway Diocese

I found this article (PDF) a good, clear, wise and down-to-earth piece on grief. There is no particular religious content to the article, aside from the framing device of the month of November being a month of remembrance – an association with secular as well as religious overtones.

The article is especially good on the limits of Kubler-Ross’ Four Stages:

 

In 1969, psychiatrist Elisabeth Kübler-Ross introduced what became known as the “five stages of grief.” Denial: “This can’t be happening to me.”Anger: “Why is this happening? Who is to blame?” Bargaining: “Make this not happen, and in return I will ____.” Depression: “I’m too sad to do anything.” Acceptance: “I’m at peace with what happened.”

If you are experiencing any of these emotions following a loss, it may help to know that your reaction is natural and that you’ll heal in time. However, not everyone who is grieving goes through all of these stages – and that’s okay. Contrary to popular belief, you do not have to go through each stage in order to heal. In fact, some people resolve their grief without going through any of these stages. And if you do go through these stages of grief, you probably won’t experience them in a neat, sequential order, so don’t worry about what you “should” be feeling or which stage you’re supposed to be in.

Kübler-Ross herself never intended for these stages to be a rigid framework that applies to everyone who mourns. In her last book before her death in 2004, she said of the five stages of grief, “They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grieving is as individual as our lives.

Mindfulness in the Classroom- Finger Labyrinth Meditation

For World Labyrinth Day, here are some ideas for using labyrinths with children … an activity I would encourage with or without the mindfulness banner attached!

Education's Voice

 lab1b

Labyrinths have been around for over 4,000 years with labyrinth stone wall carvings, clay tablets and coins dating back to the Bronze Age. Labyrinths have been featured in Greek and Roman mythology and, in the Middle Ages, they started to appear in churches and temples around the world. Labyrinths have been used by many different cultures and religions across time as they have been known to be used for relaxation, meditation and prayer that can bring spiritual and emotional well-being to the lives of those who used them.

Now, labyrinths can be found in hospital gardens, parks, schools and home gardens as they are known for their meditative properties.

What is a Labyrinth?

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A Labyrinth is not a maze; a maze has blind dead ends that are used to confuse and trick the mind. A labyrinth is a spiral course having a single, winding unobstructed path from the outside…

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Circadian rhythms Nobel Prize for Medicine or Physiology 2017

When I was young, the Oscars had an air of naffness, and the likes of the Golden Globes or Emmys even more so. One of the many many ways internet culture has failed to live up to its utopian hype   is the glorification of these sort of jamborees into moments of Great Cultural Significance, endlessly teased over by scolding columnists determined to weed out wrong think even about a glorified trade awards ceremony.

The Nobel Prizes haven’t quite reached the same point – indeed, as I wrote here before, their cultural impact may be somewhat diminished – but nevertheless, they are also subject to a strained search for important messages. The Nobel Prize in Physiology or Medicine 2017 was awarded jointly to Jeffrey C. Hall, Michael Rosbash and Michael W. Young “for their discoveries of molecular mechanisms controlling the circadian rhythm”

The video illustrates nicely what Circadian Rhythms are. 

 

Here is Robash’s lecture (with 5250 YouTube views) which is a good place to start a consideration of circadian rhythms:

And here is Young’s, which ties it all back to human circadian rhythms (just over 4000 views):

Here is Hall’s Nobel lecture, I note he is wearing a Brawndo hat from the film “Idiocracy”. I also note this video has just over 6000 views on YouTube (the Brawndo ad linked to above has over 3 million) Then again, it is a little hard going – Hall is not as funny as he thinks he is… and while there is some interest in his anecdotal style of various prior Drosophilia researchers it is not that effective an entry into this world (so while it is the first lecture given and includes the overall introduction, I have left it to last):

Slides of Robash’s and Young’s lectures are available on the Nobel site. Rather endearingly, they are basic PowerPoint slides replete with credits for everyone in the lab.

So there you go. 3 Nobel lectures on a subject of direct relevance to all our lives have a grand total of less than 15000 views on YouTube. I could easily find some ephemeral/trashy/obscene video with several multiples, but what is the point?

In the New Yorker, Jerome Groopman identified the “real message” of the prize as a rebuke to those who ignore or underfund basic science (in fairness his piece is also a decent introduction to this research).  While there may be some merit to this, it strikes me as more likely that the Academy recognised scientific work of genuine merit and enduring relevance.

And Groopman’s piece was one of the only ones I could find online that discussed the science and the issues related in some context (even though it was one I found slightly suspect) – most of the others essentially recycled the press releases from the Nobel Foundation and the US National Science Foundation

In my post “Why isn’t William C Campbell more famous in Ireland?” I discussed an excellent piece by Declan Fahy on “the fragile culture of Irish science journalism”. One wonders if this fragility is perhaps not only an Irish phenomenon.

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April 15th 1941: The Belfast Blitz, Brian Moore, and Errol Flynn’s father

Around the time of the 2010 IMF/ECB/EC bailout, I remember hearing it described as “the worst day in Irish history.” This struck me as hyperbolic at the time. Obviously, like best of lists, worsts are subjective. Surely however loss of life must count towards “worst days” than economic events. I am not aware of any day in the last hundred years of Irish history with a greater loss of life than April 15th 1941, the Belfast Blitz when over 900 people died.

Much of what I have heard about this focused on the Southern reaction, with fire brigades crossing the border. This is seen as a positive. To some degree, the sheer human cost of 900 lives lost (about a quarter of those lost in the Troubles in a single night) and thousands injured or made homeless is eclipsed by this. More generally, the narrative of the Second World War as “the good war” can blind a little to the suffering involved.

Here are the recollections of novelist Brian Moore (incidentally this piece captures how Moore’s death in 1999 led to near-invisibility in the digital age), who was working in the Mater Hospital at the time:

“In the stink of human excrement, in the acrid smell of disinfectant these dead were heaped, body on body, flung arms, twisted feet, open mouth, staring eyes, old men on top of young women, a child lying on a policeman’s back, a soldier’s hand resting on a woman’s thigh, a carter still wearing his coal-slacks, on top of a pile of arms and legs, his own arm outstretched, finger pointing, as though he warned of some unseen horror. Forbidding and clumsy, the dead cluttered the morgue room from floor to ceiling”.

One thing I didn’t know was that Theodore Flynn, father of Errol Flynn (and grandfather of Sean Flynn) was based in the Mater Hospital and “head of the casualty service” for Belfast:

“The rescue service felt the want of heavy jacks; in one case the leg and arm of a child had to be amputated before it could be extricated … [But] the greatest want appeared to be the lack of hospital facilities … At 2pm, on the afternoon of the 16th (9 hours after the termination of the raid) it was reported that the street leading to the Mater Hospital was filled with ambulances waiting to set down their casualties … Professor Flynn, [father of his more famous son, Errol], head of the casualty service for the city, informed me that the greater number of casualties was due to shock, blast and secondary missiles, such as glass, stones, pieces of piping, etc … There were many terrible mutilations among both living and dead—heads crushed, ghastly abdominal and face wounds, penetration by beams, mangled and crushed limbs, etc. … In the heavily “blitzed” areas people ran panic-stricken into the streets and made for the open country. As many were caught in the open by blast and secondary missiles, the enormous number of casualties can be readily accounted for. It is perhaps true that many saved their lives running but I am afraid a much greater number lost them or became casualties…During the day, loosened slates and pieces of piping were falling in the streets and as pedestrians were numerous many casualties must have occurred.”

It is evident from Theodore Flynn’s biography he was a zoologist rather than a medical doctor. It would be interesting to know how common this sort of thing was on the Home Front in wartime.

Silence and the limits of language

I have found that an interest in silence and its meanings transcends the divide between clincal/”medical” interest and wider concerns. The auld philosophy of silence bit will take a bit longer to tease out… if ever.

Séamus Sweeney

“That for which we find words in something already dead in our hearts. There always is a kind of contempt in the act of speaking.”

Nietzsche, The Twilight of the Idols

Some popular sayings about education and mastery reflect a intuition that what is remembered is not always the full truth, or even the essential. There is the saw that “education is what remains when you have forgotten what you learned in school”, one of those quotes ascribed to multiple authors from Einstein to Lord Halifax. There is near-taunt that, on topic X, “I have forgotten more than you will ever know”.

The Nietzsche aphorism above is the epigraph of Harold Bloom’s “Shakespeare the Invention of the Human”. In another translation, the full paragraph is as follows:

We no longer have sufficiently high esteem for ourselves when we communicate. Our true experiences are not at all…

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