The endless search for SA: spiritual ideology in Hindustāni music

This dissertation centres on philosophical attitudes presented by North Indian classical musicians in relation to the concept and experience of rāga improvisation. In Hindustāni music, there is a dynamic tension ideology and pragmatism, devotion and entertainment, fixity and improvisational freedom, and cognition and visceral experience. On one hand, rāga is an embodied methodological template for the creation of music. On the other hand, rāga improvisation is conceptualised as a path to metaphysical experience and as an evocation of an ineffable divine presence. A masterful rendition of rāga is both a re-enactment of a systematic prescribed formula and a spontaneous flow of consciousness. This study presents these apparent dichotomies to highlight ideological concerns, while simultaneously contextualising philosophical idealism in relation to pragmatic realities. A central paradigm is the manner in which pragmatic concerns are elevated in status and given spiritual significance. The dissertation begins with a view into historical and religious context. The discussion continues with a speculative investigation positing co-relations between Hindustāni music and central tenets of Indian philosophy, considering how rāga improvisation may manifest as a philosophy of sound. The study then explores the concept of rāga, a modal and conceptual construct that forms the heart of Indian classical music. The final three sections ground the subject of spiritual ideology within the life experience of Hindustāni musicians: ‘Transmission’ looks at the learning and enculturation process, which encapsulates values intrinsic to the ethos of Hindustāni music culture. ‘Practice’ explores the discipline, science and experience of musical practice, revealing core ideological concerns connecting spirituality to musical experience; and ‘Performance’ examines the live presentation of rāga improvisation, and the relationship between music as ‘entertainment’ and music as ‘devotion’. Both ethnographic and musicological, this research is the culmination of various fieldtrips to India, extensive interviews with Hindustāni musicians, fifteen year’s sitār training, and the study of relevant musicological and philosophical texts.

A spiritual perspective on loss and bereavement

This article investigates the experience of loss and bereavement from the point of view of a spiritual perspective on the phenomenon. It also looks at the experience of holding a marginalized viewpoint within an academic and professional community and adopts an autoethnographic approach to the inquiry. Some conclusions are drawn from the study in terms of its implications for theory and professional life.

Devotional Culture in Late Medieval England and Europe: Diverse Imaginations of Christ’s Life

Christ’s life, as related through the Gospel narratives and early Apocrypha, was subject to a riot of literary-devotional adaptation in the medieval period. This collection provides a series of groundbreaking studies centring on the devotional and cultural significance of Christianity’s pivotal story during the Middle Ages.

The collection represents an important milestone in terms of mapping the meditative modes of piety that characterize a number of Christological traditions, including the Meditationes vitae Christi and the numerous versions it spawned in both Latin and the vernacular. A number of chapters in the volume track how and why meditative piety grew in popularity to become a mode of spiritual activity advised not only to recluses and cenobites as in the writings of Aelred of Rievaulx, but also reached out to diverse lay audiences through the pastoral regimens prescribed by devotional authors such as the Carthusian prior Nicholas Love in England and the Parisian theologian and chancellor of the University of Paris, Jean Gerson.

Through exploring these texts from a variety of perspectives — theoretical, codicological, theological — and through tracing their complex lines of dissemination in ideological and material terms, this collection promises to be invaluable to students and scholars of medieval religious and literary culture.

The spirit of palliative practice:A qualitative inquiry into the spiritual journey of palliative care physicians

Objective: Much is known about the important role of spirituality in the delivery of multidimensional care for patients at the end of life. Establishing a strong physician-patient relationship in a palliative context requires physicians to have the self-awareness essential to establishing shared meaning and relationships with their patients. However, little is known about this phenomenon and therefore, this study seeks a greater understanding of physician spirituality and how caring for the terminally ill influences this inner aspect. Method: A qualitative descriptive study was used involving face-to-face interviews with six practicing palliative care physicians. Results: Conceptualized as a separate entity from religion, spirituality was described by participants as a notion relating to meaning, personal discovery, self-reflection, support, connectedness, and guidance. Spirituality and the delivery of care for the terminally ill appeared to be interrelated in a dynamic relationship where a physician's spiritual growth occurred as a result of patient interaction and that spiritual growth, in turn, was essential for providing compassionate care for the palliative patient. Spirituality also served as an influential force for physicians to engage in self-care practices. Significance of results: With spirituality as a pervasive force not only in the lives of palliative care patients, but also in those of healthcare providers, it may prove to be beneficial to use this information to guide future practice in training and education for palliative physicians in both the spiritual care of patients and in practitioner self care. Copyright © Cambridge University Press 2010.

The last word:Family members' descriptions of end-of-life care in long-term care facilities

A postal survey was used to collect data from family members of deceased residents of six long-term care (LTC) facilities in order to explore end-of-life (EOL) care using the Family Perception of Care Scale. This article reports on the results of thematic analysis of family member comments provided while completing the survey. Family comments fell into two themes: 1) appreciation for care and 2) concerns with care. The appreciation for care theme included the following subthemes: psychosocial support, family care, and spiritual care. The concerns with care theme included the subthemes: physical care, staffing levels, staff knowledge, physician availability, communication, and physical environment. This study identified the need for improvement in EOL care skills among LTC staff and attending physicians. As such, there is a need to implement continuing education to address these issues. © 2006 Centre for Bioethics, IRCM.

Enhancing family physician capacity to deliver quality palliative home care:An end-of-life, shared-care model

PROBLEM BEING ADDRESSED: Family physicians face innumerable challenges to delivering quality palliative home care to meet the complex needs of end-of-life patients and their families. OBJECTIVE OF PROGRAM: To implement a model of shared care to enhance family physicians' ability to deliver quality palliative home care, particularly in a community-based setting. PROGRAM DESCRIPTION: Family physicians in 3 group practices (N = 21) in Ontario's Niagara West region collaborated with an interprofessional palliative care team (including a palliative care advanced practice nurse, a palliative medicine physician, a bereavement counselor, a psychosocial-spiritual advisor, and a case manager) in a shared-care partnership to provide comprehensive palliative home care. Key features of the program included systematic and timely identification of end-of-life patients, needs assessments, symptom and psychosocial support interventions, regular communication between team members, and coordinated care guided by outcome-based assessment in the home. In addition, educational initiatives were provided to enhance family physicians' knowledge and skills. CONCLUSION: Because of the program, participants reported improved communication, effective interprofessional collaboration, and the capacity to deliver palliative home care, 24 hours a day, 7 days a week, to end-of-life patients in the community.

Optimizing Research on End-of-Life Care for Seniors:The Collective New Emerging Team on End of Life Care for Seniors University of Ottawa, Institute of Palliative Care

Background: End-of-life care for seniors is an important and neglected area of research. The University of Ottawa Institute of Palliative Care has expanded its research capacity by developing a Canadian Institutes of Health Research (CIHR) funded new emerging team on end-of-life care for seniors. This initiative brings together an interdisciplinary team of researchers from palliative care and geriatrics to develop a comprehensive program of research. Methods: 1) A variety of investigators from the fields of palliative care and geriatrics and disciplines of epidemiology, medicine, nursing, psychology and social work will collaborate on the development of a research agenda focussed on end-of-life care for seniors. 2) The conceptual model for the research program consists of 4 broad interrelated domains that are congruent with the CIHR themes of health services, clinical issues, population health and psychosocial, cultural, spiritual and ethical issues; this framework will guide the research program and all studies emanating from the program. 3) Research studies will focus on 5 areas of inquiry that are central to end-of-life care for seniors: palliative end-of-life care for rural seniors, care settings, burden, role of volunteers, and delirium. Results: This new team has the potential to obtain peer-reviewed funding, recruit and train a new generation of researchers, and build a network of concerned researchers. Conclusions: The new team should ultimately contribute to an improved quality of care for seniors who are approaching death.

Life after Stroke: Coping mechanisms among African Caribbean Women

In the UK stroke is the third most common cause of death for women and the incidence in African Caribbean women is higher than the general population. Stroke burden has major consequences for the physical, mental and social health of African Caribbean women. In order to adjust to life after stroke individuals affected employ a range of strategies which may include personal, religious (church) or spiritual support (i.e. prayer), individual motivation, or resignation to life with a disability. This study explored these areas through the coping mechanisms that African Caribbean women utilised post stroke in the context of stroke recovery and lifestyle modification efforts needed to promote healthy living post stroke. A qualitative approach using Interpretative Phenomenological Analysis was adopted. Eight women were recruited into the study. Semi structured in-depth interviews were audio recorded and were transcribed verbatim. Data were analysed using a four-stage framework: familiarisation, sense making, developing themes and data refinement and analysis. Three main themes on coping emerged: the need to follow medical rules to manage stroke, strength and determination, and the use of religion and faith to cope with life after stroke. These findings illustrate both a tension between religious beliefs and the medical approach to stroke and highlight the potential benefits that religion and the church can play in stroke recovery. Implications for practice include acknowledgement and inclusion of religion and church based health promotion in post stroke recovery.

The Turtle Garden: Tan Kah Kee’s last spiritual world

This paper explores the role of diasporic subjects in China’s heritage-making through a case study of the Turtle Garden built by Tan Kah Kee in Xiamen, China. Tan is the first person with Overseas Chinese background who built museums in the P.R. China and has been regarded as a symbol of Overseas Chinese patriotism. This paper argues that the Turtle Garden, conceptualised as a postcolonial ‘carnivalesque’ space, is more than a civic museum for public education. It reflects the owner’s highly complex and sometimes conflicting museum outlook embedded in his life experience as a migrant, his encounter with (British) colonialism in Malaya, and integrated with his desire and despair about the Chinese Communist Party’s nation-building project in the 1950s. Rather than a sign of devotion to the socialist motherland as simplistically depicted in China’s discourse, the garden symbolises Tan’s last ‘spiritual world’ where he simultaneously engaged with soul-searching as a returned Overseas Chinese and alternative diasporic imagining of Chinese identities and nation. It brings to light the value of heritage-making outside centralised heritage discourses, and offers an invaluable analytical lens to disentangle the contested and ever shifting relationship between diasporic subjects, cultural heritage and nation-(re)building in the Chinese context and beyond.

A Clinical Support System Based on Quality of Life Estimation

Quality of life is a concept influenced by social, economic, psychological, spiritual or medical state factors. More specifically, the perceived quality of an individual's daily life is an assessment of their well-being or lack of it. In this context, information technologies may help on the management of services for healthcare of chronic patients such as estimating the patient quality of life and helping the medical staff to take appropriate measures to increase each patient quality of life. This paper describes a Quality of Life estimation system developed using information technologies and the application of data mining algorithms to access the information of clinical data of patients with cancer from Otorhinolaryngology and Head and Neck services of an oncology institution. The system was evaluated with a sample composed of 3013 patients. The results achieved show that there are variables that may be significant predictors for the Quality of Life of the patient: years of smoking (p value 0.049) and size of the tumor (p value < 0.001). In order to assign the variables to the classification of the quality of life the best accuracy was obtained by applying the John Platt's sequential minimal optimization algorithm for training a support vector classifier. In conclusion data mining techniques allow having access to patients additional information helping the physicians to be able to know the quality of life and produce a well-informed clinical decision.

The relationship between religion, spirituality, psychological adjustment, and quality of life among people with multiple sclerosis

The present research was comprised of two studies that aimed to explore the role of religious and spiritual variables in the psychological adjustment and quality of life of people with Multiple Sclerosis (MS). In study 1, religious behavior and objective levels of spirituality and religiosity were not significantly related to psychological adjustment or quality of life among people with MS. Positive religious coping was negatively related to psychological adjustment and quality of life. In study 2, Intrinsic religious orientation and Quest religious orientation were related to poor psychological adjustment. Implications of the present research for people with MS and other chronic illnesses are discussed.

Changes in quality of life and coping among people with multiple sclerosis over a 2 year period

There is a need to investigate the impact of different coping strategies on quality of life (QOL) of people with multiple sclerosis (MS), in order to better inform intervention programs for this population. This study evaluated the relationship between QOL and coping over a 2 year period among people with MS. Participants were 382 people with MS (144 male, 238 females) and 291 people without a neurological or other chronic illness from the general population (101 males, 190 females). People with MS experienced lower QOL than the control group in the domains of global QOL, independence, social and spiritual QOL scales, as well as the problem solving and social/emotional support coping scales. Interestingly, people with MS experienced higher psychological QOL than the general population, and higher detachment and focusing on the positive coping. Over time, people with MS demonstrated increases in their global QOL as well as in their social/emotional support coping. Women demonstrated higher levels than men of global QOL and Social/emotional support coping. The results of these findings have implications for information and intervention programs for people with MS.

'Friend of my soul' : constructing spiritual friendship in the autobiography of Mary Fletcher

Mary Bosanquet Fletcher (1739-1815) was a leading early English Methodist, active throughout her adult life as a preacher, author, spiritual director and head of a large household. She was also part of a largely unexamined network of intense and intimate friendships between Methodist women across England. This article analyses the ways in which Fletcher represented friendship in her autobiography, a text that was widely published and read throughout the nineteenth century. Fletcher's autobiography shows how religious conviction could shape a distinctive construction of female friendship, at a time when such friendships had growing social and cultural significance.