The Reception of Plainchant A MUSICAL, PSYCHOLOGICAL AND THEOLOGICAL EXPLORATION

This thesis (describing an exercise in Qualitative Research) explores the reception of plainchant through the minds of 30 participants and other informants. The participants were sent three Tracks of recorded plainchant and asked to comment upon them in a structured way. The tracks are referred to in the thesis as Track A, Track B and Track C. The other informants, including published writers and other professional exponents gave their views on plainchant more generally, with reference to specific chants of their own choosing. A primary point is made: that the ‘ancestral home’ of plainchant is the Christian Church; it is therefore to be expected that the emphases are both musical and theological. The thesis is structured in such a way as to reveal the views of the participants and others in respect of (a) memory – the way in which this music takes them ‘back’ in time through their own memories and to a sense of the long history of the Church; (b) serenity (a word used by more than one participant) signifying the sense of ‘inner calm’ generated by the music; and (c) transcendence – the way in which this kind of music evokes in some people the awareness of a ‘higher reality’, and seems to take them ‘beyond the confines of daily life’. Reference is made to the ‘double hermeneutic’ which this type of research entails, as I (the researcher) seek to make sense of the way in which the participants and others make sense of the phenomenon of plainchant. Reference is also made to the notion of ‘invitational rhetoric’, as I (the writer) invite the reader to enter into the minds of the participants and others, and to see the phenomenon of plainchant as they see it – or, rather, to hear it as they hear it. An outline of the structure is as follows: - The Introduction includes some comments about the possible origins of plainchant, although, as I point out, the history is decidedly obscure. A review of relevant literature indicates that much recent work on plainchant is concerned with areas which are very different from the specific focus of this thesis; but the review also includes reference to work on my main subject areas of Memory, Serenity and Transcendence. The Methodology chapter defines the research method as Interpretative Phenomenological Analysis (IPA) with references to the ‘double hermeneutic’ and ‘invitational rhetoric’ as briefly described above. In the three ‘main’ chapters (4, 5 and 6, based on a, b and c above) there are numerous references to the philosophy of music, its links with theology, with emotions and even with cognitive science. The Conclusion focusses on the words of one informant about ‘the life of the Spirit’, and also takes up references (found at various earlier points) to one particular chant known as Tonus Peregrinus (the ‘wandering tone’): recent work has indicated a possible Hebrew origin for this tone; but the element of ‘peregrination’ is also present in the thesis itself, as I try to draw together the various strands of thought presented by my participants and informants, which lead us at some points well beyond the areas which might be expected, including mention of quantum physics and comments about ‘the nature of time’. Further work is clearly needed to develop these links in more detail. The reception of plainchant has proved to be a mine of unexpected treasures. My wording at times might seem florid; but music is an art with strong links to poetry and the visual arts; music also depends a good deal on repetition (as poetry sometimes does); and so ‘melismatic’ (rather than ‘minimalist’) language seems entirely appropriate in this context

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700