Does additional support by nurses enhance the effect of a brief smoking cessation intervention in people with moderate to severe chronic obstructive pulmonary disease? A randomised controlled trial

Background: Smoking cessation is the primary disease modifying intervention for chronic obstructive pulmonary disease (COPD).

"Thought-Tormented Music": Joyce and the Music of the Irish Revival

"In this special issue's opening essay, Martin Dowling devotes almost half of "'Thought-Tormented Music': Joyce and the Music of the Irish Revival" to what he calls "the situation of music in the Irish literary revival." He focuses chiefly on 1904, which was both an intensely productive period for the revival movement and a year chock-full of crucial events and decisions for Joyce. Drawing on the works of Pierre Bourdieu and Jaques Lacan, Dowling explores the revivalists' efforts to "de-anglicize" Irish music, to remove foreign influences that distorted the "pure tradition of Irish song," and to achieve an improbable harmony between the music favoured by the disappearing Anglo-Irish aristocracy and the Irish-speaking peasantry. Inevitably, disputes occurred over what constituted "authentic" Irish music. Factions quarrelled over whether pristine Irish music existed in the Atlantic seaboard or more inland; whether "authentic" songs were sung with or without instrumental accompaniment; and whether the piano, rather than the traditional harp, was a legitimate instrument of accompaniment. Having delineated the historical and theoretical context, Dowling offers a richly detailed analysis of Joyce's story "A Mother." He reveals how almost every element in the story--from the Eire Abu Society to the Antient Concert Rooms, from the conflict between Mrs. Kearney and Hoppy Holohan to the plight of Kathleen Kearney--is charged with meaning by the subtextual conflicts of the revivalists' agenda. Dowling explains also the "authenticity" in Joyce's depiction of vocal performances of "The Lass of Aughrim" in "The Dead" and "The Croppy Boy" in "Sirens," which he calls two "true gems" of authentic Irish music." --Introduction by Charles Rossman and Alan W. Friedman, Guest Editors, pp. 409-410

Cluster randomised controlled trial of an infection control education and training intervention programme focusing on meticillin-resistant Staphylococcus aureus in nursing homes for older people

The aim of this cluster randomised controlled trial was to test the impact of an infection control education and training programme on meticillin-resistant Staphylococcus aureus (MRSA) prevalence in nursing homes. Nursing homes were randomised to intervention (infection control education and training programme; N¼16) or control (usual practice continued; N¼16). Staff in intervention homes were educated and trained (0, 3 and 6 months) in the principles and implementation of good infection control practice with infection control audits conducted in all sites (0, 3, 6 and 12 months) to assess compliance with good practice. Audit scores were fed back to nursing home managers in intervention homes, together with a written report indicating where practice could be improved. Nasal swabs were taken from all consenting residents and staff at 0, 3, 6 and 12 months. The primary outcome was MRSA prevalence in residents and staff, and the secondary outcome was a change in infection control audit scores. In all, 793 residents and 338 staff were recruited at baseline. MRSA prevalence did not change during the study in residents or staff. The relative risk of a resident being colonised with MRSA in an intervention home compared with a control home at 12 months was 0.99 (95% con?dence interval: 0.69, 1.42) after adjustment for clustering. Mean infection control audit scores were signi?cantly higher in the intervention homes (82%) compared with the control homes (64%) at 12 months (P<0.0001). Consideration should be given to other approaches which may help to reduce MRSA in this setting.

The cost-effectiveness of the SPHERE intervention for the secondary prevention of coronary heart disease

Objectives: The Secondary Prevention of Heart disEase in geneRal practicE (SPHERE) trial has recently reported. This study examines the cost-effectiveness of the SPHERE intervention in both healthcare systems on the island of Ireland. Methods: Incremental cost-effectiveness analysis. A probabilistic model was developed to combine within-trial and beyond-trial impacts of treatment to estimate the lifetime costs and benefits of two secondary prevention strategies: Intervention - tailored practice and patient care plans; and Control - standardized usual care. Results: The intervention strategy resulted in mean cost savings per patient of 512.77 (95 percent confidence interval [CI], 1086.46-91.98) and an increase in mean quality-adjusted life-years (QALYs) per patient of 0.0051 (95 percent CI, 0.0101-0.0200), when compared with the control strategy. The probability of the intervention being cost-effective was 94 percent if decision makers are willing to pay €45,000 per additional QALY. Conclusions: Decision makers in both settings must determine whether the level of evidence presented is sufficient to justify the adoption of the SPHERE intervention in clinical practice. Copyright © Cambridge University Press 2010.

Spatial Perception and Cognition in Multichannel Audio for Electroacoustic Music

Listeners experience electroacoustic music as full of significance and meaning, and they experience spatiality as one of the factors contributing to its meaningfulness. If we want to understand spatiality in electroacoustic music, we must understand how the listener’s mental processes give rise to the experience of meaning. In electroacoustic music as in everyday life, these mental processes unite the peripheral auditory system with human spatial cognition. In the discussion that follows we consider a range of the listener’s mental processes relating space and meaning from the perceptual attributes of spatial imagery to the spatial reference frames for places and navigation. When considering multichannel loudspeaker systems in particular, an important part of the discussion is focused on the distinctive and idiomatic ways in which this particular mode of sound production contributes to and situates meaning. These idiosyncrasies include the phenomenon of image dispersion, the important consequences of the precedence effect and the influence of source characteristics on spatial imagery. These are discussed in close relation to the practicalities of artistic practice and to the potential for artistic meaning experienced by the listener.

Meaning in Electroacoustic Music and the Everyday Mind

The key question posed here is how listeners experience meaning when listening to electroacoustic music, especially how they experience it as art. This question is addressed by connecting electroacoustic listening with the ways that the mind constructs meaning in everyday life. Initially, the topic of the everyday mind provides a framework for discussing cognitive schemas, mental spaces, the Event schema and auditory gist. Then, specific idioms of electroacoustic music are examined that give rise to artistic meaning. These include the creative binding of circumstances with events and the conceptual blending that creates metaphorical meaning. Finally, the listener's experience of long-term events is discussed is relation to the location event-structure metaphor.

Government intervention in a dynamic economy

From the late 1970s onwards, the view that government intervention could provide a means of overcoming market failure in advanced was increasingly questioned. For some, intervention was to be discouraged because it interfered with individual liberty. For others, what was problematic was the welfare economist's assumption of an autonomous state acting in the public interest. Finally, there was the issue of the state's ability to achieve what it set out to do. Government failure it was argued was just as pervasive as market failure and no antidote to it. This paper critically evaluates such arguments in relation to competition, industrial change, innovation, and competitive advantage in production.

Juxtaposition and Non-Motion: Varese Bridges Modernism and Electroacoustic Music

Edgard Vare` se’s Poe` me e´ lectronique can be viewed as a bridge between early twentieth-century modernism and electroacoustic music. This connection to early modernism is most clearly seen in its use of musical juxtaposition, a favoured technique of early modernist composers, especially those active in Paris. Juxtaposition and non-motion are considered here, particularly in relationship to Smalley’s exposition of spectromorphology (Smalley 1986), which in its preoccupation with motion omits any significant consideration of non-motion. Juxtaposition and non-motion have an important history within twentieth-century music, and as an early classic of electroacoustic music, Poe` me e´ lectronique is a particularly striking example of a composition that is rich in juxtapositions similar to those found in passages of early modernist music. Examining Poe` me e´ lectronique through the lens of juxtaposition and non-motion reveals how the organisation of its juxtaposed sounds encourages the experience of sound structure suspended time.