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Facey M, Baxter N, Hammond Mobilio M, Moulton CA, Paradis E. The ritualisation of the surgical safety checklist and its decoupling from patient safety goals. SOCIOLOGY OF HEALTH & ILLNESS 2024. [PMID: 38300726 DOI: 10.1111/1467-9566.13746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/08/2023] [Indexed: 02/03/2024]
Abstract
Patient harm, patient safety and their governance have been ongoing concerns for policymakers, care providers and the public. In response to high rates of adverse events/medical errors, the World Health Organisation (WHO) advocated the use of surgical safety checklists (SSC) to improve safety in surgical care. Canadian health authorities subsequently made SSC use a mandatory organisational practice, with public reporting of safety indicators for compliance tied to pre-existing legislation and to reimbursements for surgical procedures. Perceived as the antidote for socio-technical issues in operating rooms (ORs), much of the SSC-related research has focused on assessing clinical and economic effectiveness, worker perceptions, attitudes and barriers to implementation. Suboptimal outcomes are attributed to implementations that ignored contexts. Using ethnographic data from a study of SSC at an urban teaching hospital (C&C), a critical lens and the concepts of ritual and ceremony, we examine how it is used, and theorise the nature and implications of that use. Two rituals, one improvised and one scripted, comprised C&C's SSC ceremony. Improvised performances produced dislocations that were ameliorated by scripted verification practices. This ceremony produced causally opaque links to patient safety goals and reproduced OR/medical culture. We discuss the theoretical contributions of the study and the implications for patient safety.
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Affiliation(s)
- Marcia Facey
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Nancy Baxter
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Melanie Hammond Mobilio
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- The Wilson Centre, University Health Network, Toronto, Ontario, Canada
| | - Carol-Anne Moulton
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- The Wilson Centre, University Health Network, Toronto, Ontario, Canada
| | - Elise Paradis
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- The Wilson Centre, University Health Network, Toronto, Ontario, Canada
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Wolf W, Tomasello M. A Shared Intentionality Account of Uniquely Human Social Bonding. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023:17456916231201795. [PMID: 37883801 DOI: 10.1177/17456916231201795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Many mechanisms of social bonding are common to all primates, but humans seemingly have developed some that are unique to the species. These involve various kinds of interactive experiences-from taking a walk together to having a conversation-whose common feature is the triadic sharing of experience. Current theories of social bonding have no explanation for why humans should have these unique bonding mechanisms. Here we propose a shared intentionality account of uniquely human social bonding. Humans evolved to participate with others in unique forms of cooperative and communicative activities that both depend on and create shared experience. Sharing experience in these activities causes partners to feel closer because it allows them to assess their partner's cooperative competence and motivation toward them and because the shared representations created during such interactions make subsequent cooperative interactions easier and more effective.
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Affiliation(s)
- Wouter Wolf
- Department of Developmental Psychology, Utrecht University
- Department of Psychology and Neuroscience, Duke University
| | - Michael Tomasello
- Department of Psychology and Neuroscience, Duke University
- Department of Developmental and Comparative Psychology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
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Dunbar R. Why did doctrinal religions first appear in the Northern Subtropical Zone? EVOLUTIONARY HUMAN SCIENCES 2023; 5:e15. [PMID: 37587936 PMCID: PMC10427489 DOI: 10.1017/ehs.2023.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 08/18/2023] Open
Abstract
Doctrinal religions that involve recognised gods, more formal theologies, moral codes, dedicated religious spaces and professional priesthoods emerged in two phases during the Neolithic. Almost all of these appeared in a narrow latitudinal band (the northern Subtropical Zone). I suggest that these developments were the result of a need to facilitate community bonding in response to scalar stresses that developed as community sizes increased dramatically beyond those typical of hunter-gatherer societies. Conditions for population growth (as indexed by rainfall patterns and the difference between pathogen load and the length of the growing season) were uniquely optimised in this zone, creating an environment of ecological release in which populations could grow unusually rapidly. The relationship between latitude, religion and language in contemporary societies suggests that the peculiar characteristics of the northern (but not the southern) Subtropical Zone were especially favourable for the evolution of large scale religions as a way of enforcing community cohesion.
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Affiliation(s)
- R.I.M. Dunbar
- Department of Experimental Psychology, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK
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Blackburn R, Jim C, Paltoglou AE. A “random group of misfits” or being “part of something bigger”? Exploring experiences of attending a non-religious congregation. Int J Qual Stud Health Well-being 2022; 17:2021618. [PMID: 35257631 PMCID: PMC8925926 DOI: 10.1080/17482631.2021.2021618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose Religion is an important part of many people’s lives and there is some evidence that attending church or other religious congregations is positively associated with psychological well-being. However, religious participation is declining in Western Europe and North America. Sunday Assembly is a non-religious gathering that intends to provide a similar communal experience and a sense of spirituality to the church, but without the religious element. In the current study, we aimed to explore the experiences of and motivations for attending a non-religious congregation in relation to well-being. Methods A qualitative approach was taken, gathering data through semi-structured interviews with participants from Sunday Assembly congregations across England. Results Thematic analysis was used and three key themes were found: (1) searching for meaning and community, (2) Sunday Assembly as protective of mental health, and (3) loneliness in a crowd. Conclusions Sunday Assembly can provide a sense of belonging and improvement in mental health through shared experience and spirituality, and it can act as a coping mechanism during difficult times. Further research could explore the benefits of Sunday Assembly upon attendee’s mental health, test the effectiveness of Sunday Assembly as a coping mechanism, and whether continued attendance improves mood over time.
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Affiliation(s)
- Rowena Blackburn
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Carly Jim
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
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Bending and bonding: a randomized controlled trial on the socio-psychobiological effects of spiritual versus secular yoga practice on social bonding. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04062-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Dunbar RIM. Managing the stresses of group-living in the transition to village life. EVOLUTIONARY HUMAN SCIENCES 2022; 4:e40. [PMID: 37588930 PMCID: PMC10426039 DOI: 10.1017/ehs.2022.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/16/2022] [Accepted: 08/16/2022] [Indexed: 11/07/2022] Open
Abstract
Group living is stressful for all mammals, and these stresses limit the size of their social groups. Humans live in very large groups by mammal standards, so how have they solved this problem? I use homicide rates as an index of within-community stress for humans living in small-scale ethnographic societies, and show that the frequency of homicide increases linearly with living-group size in hunter-gatherers. This is not, however, the case for cultivators living in permanent settlements, where there appears to be a 'glass ceiling' below which homicide rates oscillate. This glass ceiling correlates with the adoption of social institutions that allow tensions to be managed. The results suggest (a) that the transition to a settled lifestyle in the Neolithic may have been more challenging than is usually assumed and (b) that the increases in settlement size that followed the first villages necessitated the introduction of a series of social institutions designed to manage within-community discord.
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Affiliation(s)
- R. I. M. Dunbar
- Department of Experimental Psychology, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK
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Gabriel R. Affect, Belief, and the Arts. Front Psychol 2021; 12:757234. [PMID: 34925160 PMCID: PMC8674731 DOI: 10.3389/fpsyg.2021.757234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
The cultural project is a therapeutic melding of emotion, symbols, and knowledge. In this paper, I describe how spiritual emotions engendered through encounters in imaginative culture enable fixation of metaphysical beliefs. Evolved affective systems are domesticated through the social practices of imaginative culture so as to adapt people to live in culturally defined cooperative groups. Conditioning, as well as tertiary-level cognitive capacities such as symbols and language are enlisted to bond groups through the imaginative formats of myth and participatory ritual. These cultural materializations can be shared by communities both synchronically and diachronically in works of art. Art is thus a form of self-knowledge that equips us with a motivated understanding of ourselves in the world. In the sacred state produced through the arts and in religious acts, the sense of meaning becomes noetically distinct because affect infuses the experience of immanence, and one's memory of it, with salience. The quality imbued thereby makes humans attentive to subtle signs and broad “truths.” Saturated by emotions and the experience of alterity in the immanent encounter of imaginative culture, information made salient in the sacred experience can become the basis for belief fixation. Using examples drawn from mimetic arts and arts of immanence, I put forward a theory about how sensible affective knowledge is mediated through affective systems, direct perception, and the imagination.
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Affiliation(s)
- Rami Gabriel
- Research Group in Mind, Science, and Culture, Department of History, Humanities, and Social Sciences, Columbia College Chicago, Chicago, IL, United States
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The evolution of music as artistic cultural innovation expressing intuitive thought symbolically. Behav Brain Sci 2021; 44:e91. [PMID: 34588019 DOI: 10.1017/s0140525x20001260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Music is an artistic cultural innovation, and therefore it may be considered as intuitive thought expressed in symbols, which can efficiently convey multiple meanings in learning, thinking, and transmission, selected for and passed on through cultural evolution. The symbolic system has personal adaptive benefits besides social ones, which should not be overlooked even if music may tend more to the latter.
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Dunbar RIM, Pearce E, Tarr B, Makdani A, Bamford J, Smith S, McGlone F. Cochlear SGN neurons elevate pain thresholds in response to music. Sci Rep 2021; 11:14547. [PMID: 34267302 PMCID: PMC8282857 DOI: 10.1038/s41598-021-93969-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022] Open
Abstract
The C-tactile (CLTM) peripheral nervous system is involved in social bonding in primates and humans through its capacity to trigger the brain’s endorphin system. Since the mammalian cochlea has an unusually high density of similar neurons (type-II spiral ganglion neurons, SGNs), we hypothesise that their function may have been exploited for social bonding by co-opting head movements in response to music and other rhythmic movements of the head in social contexts. Music provides one of many cultural behavioural mechanisms for ‘virtual grooming’ in that it is used to trigger the endorphin system with many people simultaneously so as to bond both dyadic relationships and large groups. Changes in pain threshold across an activity are a convenient proxy assay for endorphin uptake in the brain, and we use this, in two experiments, to show that pain thresholds are higher when nodding the head than when sitting still.
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Affiliation(s)
- R I M Dunbar
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, OX1 6GG, UK.
| | - Eiluned Pearce
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, OX1 6GG, UK.,Division of Psychiatry, University College London, London, WC1A 4AA, UK
| | - Bronwyn Tarr
- Institute of Cognitive and Evolutionary Anthropology, University of Oxford, Banbury Road, Oxford, OX2 6PE, UK
| | - Adarsh Makdani
- Research Centre Brain and Behaviour, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Joshua Bamford
- Institute of Cognitive and Evolutionary Anthropology, University of Oxford, Banbury Road, Oxford, OX2 6PE, UK
| | - Sharon Smith
- Research Centre Brain and Behaviour, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Francis McGlone
- Research Centre Brain and Behaviour, Liverpool John Moores University, Liverpool, L3 3AF, UK.,Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
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Simpson FM, Perry G, Thompson WF. Assessing Vocal Chanting as an Online Psychosocial Intervention. Front Psychol 2021; 12:647632. [PMID: 34140914 PMCID: PMC8203819 DOI: 10.3389/fpsyg.2021.647632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/30/2021] [Indexed: 01/22/2023] Open
Abstract
The ancient practice of chanting typically takes place within a community as a part of a live ceremony or ritual. Research suggests that chanting leads to improved mood, reduced stress, and increased wellbeing. During the global pandemic, many chanting practices were moved online in order to adhere to social distancing recommendations. However, it is unclear whether the benefits of live chanting occur when practiced in an online format. The present study assessed the effects of a 10-min online chanting session on stress, mood, and connectedness, carried out either in a group or individually. The study employed a 2 (chanting vs. control) × 2 (group vs. individual) between-subjects design. Participants (N = 117) were pseudo-randomly allocated across the four conditions. Before and after participation, individuals completed the Spielberg’s State Trait Anxiety Inventory, the Positive and Negative Affect Schedule, the Social Connectedness Scale and Aron’s Inclusion of Self in Other Scale. Online chanting led to a significant reduction in stress and an increase in positive affect when compared to the online control task. Participants who took part in group chanting also felt more connected to members of their chanting group than participants in the control group. However, feelings of general connectedness to all people remained similar across conditions. The investigation provides evidence that online chanting may be a useful psychosocial intervention, whether practiced individually or in a group.
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Affiliation(s)
- Felicity Maria Simpson
- School of Psychological Sciences, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Gemma Perry
- School of Psychological Sciences, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - William Forde Thompson
- School of Psychological Sciences, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, NSW, Australia
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