Ravel’s Gaspard de la Nuit: Extra-musical subtext, and its role within interpretive performance

Few works within the realm of the piano repertoire have amassed a reputation as formidable as Gaspard de la Nuit. These three pieces, each unique in character and pianistic requirements, arguably represent a pinnacle of early 20th-century French piano music. This paper seeks to illuminate points for consideration for the pianist who wishes to embark upon studying the work for performance, and for the musicologist.

I shall first consider the three character poems of Aloysius Bertrand that inspired the suite, as an understanding of these Diabolic creations is essential to understanding the piece analytically and programmatically. I shall then explore the subtitle of Bertrand’s Gaspard de la Nuit: ‘Fantaisies À La Manière De Rembrandt Et De Callot’, as an acknowledgement of these artists helps us better to engage with Bertrand’s poetry, and provides us with a direct link to the visual stimuli for Ravel’s compositions.

Finally, using Ondine as a case study, I shall explore how the composer unifies his inspirations to paint a musical portrait of both the character and the content of Bertrand’s poem. I shall focus on three particular aspects of Ravel’s style: the refined textures that create washes of watery colour, subtle rhythmic variations that imply the ‘deep, rolling currents of the sleeping lake’, and the simple melodic lines sung by the water nymph in the manner of a French air. Each element plays its part in the thematic development that illustrates Ondine’s seductive powers.

DESCRIBING SLEEP AND SEDATION PRACTICES IN THE ICU: A MULTINATIONAL SURVEY

Introduction Sleep disturbances are common in critically ill patients treated in the intensive care unit (ICU) with the potential for serious consequences and long-term effects on health outcomes and patient morbidity.
Objectives Our aim was to describe sleep management and sedation practices of adult ICUs in ten countries and to evaluate roles and responsibilities of the ICU staff in relation to key sleep and sedation decisions.
Methods A multicenter, self-administered survey sent to nurse managers of adult ICUs across 10 countries. The questionnaire comprised four domains: sleep characteristics of the critically ill; sleep and sedation practices; non-pharmacological and pharmacological interventions used to improve sleep; and the autonomy and influence of nurses on sleeping practices in the ICU.
Results Overall response rate was 66% (range 32% UK to 100% Cyprus), providing data from 522 ICUs. In all countries, the most frequent patient characteristic perceived to identify sleep was lying quietly with closed eyes (N=409, 78%) (range 92% Denmark to 36% Italy). The most commonly used sedation scale was the Richmond Agitation-Sedation Score (RASS) (N=220, 42%) (range 81% UK to 0% Denmark, Cyprus where most ICUs used the Ramsay score). In most ICUs, selection of sleep medication (N=265, 51%) and assessment of effect (N=309, 59%) was performed by physicians and nurses based on collaborative discussion. In a minority of ICUs (N=161, 31%), decisions and assessments were made by physicians alone. The most commonly used (in all countries) non-pharmacological intervention to promote sleep was reducing ICU staff noise (N=473, 91%) (range 100% Denmark, Norway to 78% Canada). Only 95 ICUs (18%) used earplugs on a frequent basis (range 0% Greece, Cyprus, Denmark to 57% Sweden). Propofol was the drug used most commonly for sedation (N=359, 69%) (range 96% Sweden to 29% Canada). Chloral hydrate was used by only 63 (12%) ICUs (range 0% Greece, Cyprus, Denmark, Italy to 56% Germany). Sedation scales were used on a routine basis by 77% of the 522 ICUs. Participants scored nursing autonomy for sleep and sedation management as moderate; median score of 5 (scale of 0 to 10), range 7 (Canada, Greece, Sweden) to 4 (Norway, Poland). Nursing influence on sleep and sedation decisions was perceived considerable; median score 8, range 9 (Denmark) to 5 (Poland).
Conclusions We found considerable across country variation in sleep promotion and sedation management practices though most have adopted a sedation scale as recommended in professional society guidelines. Most ICUs in all countries used a range of pharmacological and non-pharmacological interventions to promote sleep. Most units reported inter-professional decision-making with nurses perceived to have substantial influence on sleep/sedation decisions.

Cooperative Proxying: An Approach to Reduce Network Energy Waste

A network connected host is expected to generate/respond to applications and protocols specific messages. Billions of Euro of electricity is wasted to keep idle hosts powered up 24/7 just to maintain network presence. This short paper describes the design of our cooperative Network Connectivity Proxy (NCP) that can impersonate sleeping hosts and responds to packets on their behalf as they were connected and fully operational. Thus, NCP is in fact an efficient approach to reduce network energy waste.

Non-contact Pressure-based Sleep/Wake Discrimination

Poor sleep is increasingly being recognised as an important prognostic parameter of health. For those with suspected sleep disorders, patients are referred to sleep clinics which guide treatment. However, sleep clinics are not always a viable option due to their high cost, a lack of experienced practitioners, lengthy waiting lists and an unrepresentative sleeping environment. A home-based non-contact sleep/wake monitoring system may be used as a guide for treatment potentially stratifying patients by clinical need or highlighting longitudinal changes in sleep and nocturnal patterns. This paper presents the evaluation of an under-mattress sleep monitoring system for non-contact sleep/wake discrimination. A large dataset of sensor data with concomitant sleep/wake state was collected from both younger and older adults participating in a circadian sleep study. A thorough training/testing/validation procedure was configured and optimised feature extraction and sleep/wake discrimination algorithms evaluated both within and across the two cohorts. An accuracy, sensitivity and specificity of 74.3%, 95.5%, and 53.2% is reported over all subjects using an external validation
dataset (71.9%, 87.9% and 56%, and 77.5%, 98% and 57% is reported for younger and older subjects respectively). These results compare favourably with similar research, however this system provides an ambient alternative suitable for long term continuous sleep monitoring, particularly amongst vulnerable populations.

Att leva med kroniska sår En litteraturöversikt

Bakgrund: Kroniska sår innefattas av bensår, fotsår, trycksår, diabetessår, sårskada, tumörer, reumatiska sår och vårdskador vid komplikationer efter kirurgiska ingrepp, som inte har läkt inom 6 veckor. Forskning visar att trots att förebyggande strategier används, utvecklas det sår som kräver behandling. I mötet med vården är en god omvårdnad och en god vårdrelation viktig. Bristen på dessa leder ofta till ett lidande som individen måste kämpa emot med copingstrategier. Syfte: Syftet med denna litteraturstudie var att belysa personers erfarenhet av att leva med kroniska sår. Metod: En litteraturöversikt gjordes i denna studie med 15 vetenskapliga artiklar, som bestod av både kvantitativ och kvalitativ metod. Resultat: 3 huvudkategorier identifierades: begränsningar, lidande samt coping. Deltagarna ansåg att en brist på information samt begränsningar i vardagen påverkade individens sociala umgänge och fysiska aktivitet. Smärta, skam och rädsla ledde till depression. För att hantera detta använde individerna sig av familjen och stöd av vårdpersonalen Slutsats: Det framkom att individernas dagliga liv påverkades av det kroniska såret. Den konstanta smärtan orsakade sömnsvårigheter hos individen, vilket ytterligare försvårade hanteringen av smärtan och vardagen. Kontinuitet hos vårdpersonal och i behandlingen gav personerna en trygghet och en ökad förståelse för sitt tillstånd. Det belystes att det var viktigt att vårdpersonalen ser individen bakom såret, och inte bara lägger sitt fokus på sårläkningen och behandlingen.

Qualidade Subjetiva do Sono, Sintomas Depressivos e Sentimentos de Solidão em Idosos Institucionalizados e Não Institucionalizados

Parece existir uma associação entre solidão e uma pobre qualidade subjetiva do sono. Em reforço desta ideia, alguns estudos mostraram que os sentimentos de solidão se associam a uma menor satisfação do sono, mesmo que a sua duração não esteja diminuída. Outros mostraram que a solidão se associa a sintomas depressivos. Sabe-se que na institucionalização são frequentes os problemas de sono, depressão e solidão. No entanto, falta saber o que se passa nas respostas sociais portuguesas. Assim foram os nossos principais objetivos descrever a qualidade subjetiva do sono e analisar a intensidade dos sintomas depressivos e dos sintomas de solidão em idosos institucionalizados, comparar com uma subamostra de idosos não institucionalizados e analisar a relação entre estas variáveis nas duas subamostras. Cento e quarenta idosos, com 70 institucionalizados e 70 não institucionalizados foram emparelhados por idade, sexo, escolaridade, estado civil e sem défice cognitivo. A média de idades foi de 76,58 (DP = 6,10), sendo 104 mulheres e 36 homens. Como instrumentos para a análise utilizámos um Questionário Sociodemográfico, o Questionário sobre o Sono na Terceira Idade, o Inventário de Depressão Geriátrica e a Escala de Solidão da Universidade da Califórnia, Los Angeles. Verificou-se que os idosos institucionalizados apresentavam mais sentimentos de solidão do que os não institucionalizados. Contudo, não se verificaram diferenças entre as duas subamostras em relação aos sintomas depressivos e à qualidade subjetiva do sono. Através de uma análise correlacional verificou-se nas duas subamostras que quanto pior a qualidade subjetiva do sono mais sintomas depressivos se observavam e quanto mais sintomas depressivos, mais sentimentos de solidão. Concluímos que não houve diferenças na qualidade subjetiva do sono pelo tipo de resposta social ainda que haja mais sintomas depressivos e sintomas de solidão nos idosos institucionalizados. Não encontrámos também relação entre o sono e a solidão nos idosos institucionalizados. / There seems to be an association between loneliness and poor subjective sleep quality. In support of this idea, some studies have shown that feelings of loneliness are associated with less satisfaction sleep, even if your life is not diminished. Others have shown that loneliness is associated with depressive symptoms. It is known that in the institutionalization are frequent problems with sleeping, depression and loneliness. However, lack know what is happening in the Portuguese social responses. So were our main objectives describe the subjective quality of sleep and analyze the intensity of depressive symptoms and loneliness symptoms in institutionalized elderly, compared with a non-institutionalized elderly subsample and analyze the relationship between these variables in both subsamples. One hundred and forty older adults, with 70 institutionalized and 70 non-institutionalized were matched by age, sex, education, marital status and without cognitive impairment. The average age was 76.58 (SD = 6.10), including 104 women and 36 men. As tools for the analysis we used a sociodemographic questionnaire, the Questionnaire About Sleep in the Older Adults, Geriatric Depression Inventory and the Loneliness Scale of the University of California, Los Angeles. It was found that the institutionalized older adults had more feelings of loneliness than noninstitutionalized. However, there were no differences between the two subsamples in relation to depressive symptoms and subjective sleep quality. Through a correlational analysis it was found in the two subsamples that the worse the subjective sleep quality more depressive symptoms were observed and the more depressive symptoms, more feelings of loneliness. We concluded that there no differences in subjective sleep quality by the type of social response even though there are more depressive symptoms and symptoms of loneliness in the elderly. Also we did not find relationship between sleep and loneliness in the elderly.

Socioeconomic Status and Health Behavior in Nepal

Thesis (Master's)--University of Washington, 2016-07

A utilização das análises cefalométricas no diagnóstico dos distúrbios do sono

A Síndrome da Apneia e Hipopneia Obstrutiva do Sono (SAHOS) é uma doença crónica, de carácter progressivo, que atinge cerca de 4% da população adulta. A obstrução parcial ou total das vias aéreas superiores durante o sono pode provocar quadros de hipopneia (uma redução do fluxo aéreo) ou apneia (cessação completa do fluxo aéreo). Os pacientes queixam-se de sonolência diurna excessiva, ronco durante a noite e além destes problemas sociais a preocupação pela redução de funções cognitivas que se podem desencadear, como memória, atenção, hipertensão pulmonar e insuficiência cardíaca. O Médico Dentista está habilitado para avaliar o espaço aéreo oro e nasofaringeo e diagnosticar, além da necessidade de correções dentárias, a presença de obstruções das Vias Aereas Superiores (VAS) orientando assim o seu tratamento. Além do exame clínico, o diagnóstico de distúrbios respiratórios do sono é baseado na história clínica, exame físico e confirmado através da polissonografia e da análise cefalométrica. Esta tem sido considerada como um método importante no diagnóstico, fornecendo características craniofaciais que permitem verificar a existência de pré-disposição de SAHOS. As avaliações com cefalometrias obtidas em telerradiografias em norma lateral é um recurso essencial para realizar o diagnóstico de distúrbios respiratórios do sono, desde que o profissional tenha domínio da técnica e da sua interpretação. Estes distúrbios são caracterizados por diferentes graus de diminuição do espaço das vias aéreas superiores, causado por factores anatómicos e funcionais, que podem ser analisados pelo profissional. A intervenção precoce torna-se crucial, pela diminuição da morbilidade, melhores resultados no tratamento, diminuição de gastos nos serviços de saúde e melhor qualidade de vida do paciente. O presente trabalho teve por objectivo realizar uma revisão bibliográfica sobre a importância da avaliação das vias aéreas superiores através da análise de grandezas cefalométricas obtidas de telerradiografias em norma lateral como padrão de diagnóstico para a identificação de distúrbios respiratórios do sono.

Relógios biológicos, apetite e sono

Um ritmo circadiano normal, hábitos alimentares saudáveis, prática de exercício físico regular e uma boa higiene de sono constituem fatores imprescindíveis para o bom funcionamento do organismo e para a prevenção de diversas doenças. Os universitários constituem uma população bastante vulnerável a ritmos circadianos anormais, hábitos alimentares pouco saudáveis, sedentarismo e problemas de sono, provenientes das alterações no seu estilo de vida bem como alterações a nível comportamental. O objetivo deste estudo é identificar o cronótipo (matutino, intermédio ou vespertino), os hábitos alimentares e de sono dos alunos universitários. Neste sentido utilizou-se uma amostra de 302 estudantes da Universidade Fernando Pessoa, no qual 238 são do sexo feminino e os restantes 64 são do sexo masculino. Com a finalidade da recolha de dados foi elaborado um questionário através do Formulários do Google. Para avaliar o tipo de cronótipo dos universitários aplicou-se o Morningness-Eveningness Questionnaire (MEQ) e os hábitos de sono foram avaliados a partir do Pittsburgh Sleep Quality Index (PSQI) e da Epworth Sleepiness Scale (ESS). Para avaliar os hábitos alimentares dos participantes formulou-se um conjunto de questões tendo em conta este objetivo. Estes dados foram recolhidos on-line, tendo sido enviado o questionário a todos os alunos da Universidade Fernando Pessoa através do respetivo correio eletrónico institucional. No final desta investigação, foi possível concluir que a maioria dos alunos universitários apresenta um cronótipo intermédio (50 pontos ± 9,43), hábitos alimentares saudáveis e equilibrados e apresenta ainda uma má qualidade de sono (8 pontos ± 2,86) e padrões de sono irregulares, no entanto, não exibem sonolência diurna excessiva (8 pontos ± 3,96).

O processo de luto em pessoas idosas defilhadas e a CIF: um estudo exploratório

Introdução: O luto provocado pela morte dos filhos, o defilhar, desperta fortes sentimentos de raiva, culpa e de censura, sendo estas mortes vividas como uma falha na capacidade de dar e proteger a vida. Superar uma perda desta magnitude implica reestruturar psicologicamente e socialmente. Ainda são muito poucos os estudos realizados para identificar e caraterizar estratégias de superação do luto e menos ainda quando dizem respeito ao defilhar. Objetivos: O objetivo deste estudo é analisar numa amostra de mulheres que perderam um filho (defilhadas) com idade igual ou superior a 60 anos, as narrativas de superação do seu processo de luto e mapeá-las à Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Métodos: Foi elaborado um protocolo com os seguintes instrumentos: Short Portable Mental Status Questionnaire (SPMSQ), informações sociodemográficas (idade, género, estado civil, nível educacional, localização geográfica, quantos filhos tem, quando faleceu o filho(a), se foi morte súbita ou esperada, se toma medicação antidepressiva, soníferos ou ansiolíticos e se sim, há quanto tempo), Inventário de Luto Complicado (ILC) e uma entrevista semiestruturada. O protocolo foi administrado a uma amostra de 8 mulheres. Resultados: Os resultados globais sugerem que apesar de grande parte do processo de superação do luto ser bastante emocional, foi possível classificá-lo utilizando o referencial CIF. Dentro do componente ’Funções do Corpo‘, verificou-se o predomínio das funções emocionais nas categorias ‘o que mudou na sua vida’, ‘superação da dor’ e ‘estratégias adotadas’; no componente ‘Atividades e Participação’ destacaram-se aquelas associadas à religião e espiritualidade, nas categorias ‘superação do luto’, ‘estratégias adotadas’ e ‘o que mais gosta de fazer’; no componente ’Fatores Ambientais‘ (‘apoio e relacionamentos’) sobressaiu o apoio proporcionado pela família próxima nas categorias ‘superação da dor’, ‘estratégias adotadas’, apoios físicos ou humanos recebidos’ e ‘o que mais gosta de fazer’. Conclusão: Foi possível mapear à CIF o processo de superação do luto por defilhadas idosas. No entanto, para se obterem dados mais conclusivos, são necessários mais estudos em amostras com maiores dimensões, que abranjam ambos os géneros e com faixas etárias mais amplas. Também é necessário adaptar o protocolo ao referencial CIF de forma a obterem resultados mais precisos.

Caught in the dance : dream poems, experiential narrative, and the continuity hypothesis

This thesis explores the efficacy of the dream poem as a narrative device and is the outcome of practice-led research. The creative component, a novella, includes significant dreams of the main characters in the form of lyric poetry. The author’s own dream reports are used as source material for the poetry, and are contextualised within a prose fiction framework. Caught in the Dance is an experiment in combining prose with dream poetry and in investigating the experiential power of dreams on the formation of character identity. The exegesis discusses dreaming as an experience and the place of that experience in the context of identity narratives. Central to this discussion is the continuity hypothesis regarding the symbiosis of waking and sleeping life. Fludernik’s theory of experiential narrative is applied to dreaming and to the composition of poetry. This theory moves the emphasis of narrativity from events and the action of telling to ‘grounding narrativity in the representation of experientiality’ (Fludernik 1996:20). Ricoeur’s theories on identity and narrative are also applied to the reading of dreams, and experiences in general. He calls the system through which we ‘read’ life the ‘semantics of action’ (Ricoeur 1991b:28). Fludernik’s and Ricoeur’s approaches build on each other and they are brought together in the context of theories of the self, consciousness, and the processing of experience. Lyric poetry, as a creative product of that same consciousness, is discussed as experienced narrative moment. Furthermore, those moments are identified as defining elements in the identity narratives of characters. By combining the experience of dreaming with the experience imparted through lyric poetry, this thesis argues that the continuity hypothesis serves effectively as a demonstration of the wider narratological importance of experiential narrative.

Współczesne rytuały przejścia z dzieciństwa do dorosłości: baśń o Śpiącej Królewnie

In the paper, I make references to the psychological process of passing from childhood to adulthood. In contemporary times, this process is spread in time, its boundaries are blurry and it is difficult to find in it the primordial initiation rituals known among primitive tribes. I call these phenomena the Sleeping Beauty syndrome, and compare the contemporary rites of passage from childhood to adulthood to this very fairy tale, in particular to its psychological readings. The theoretical framework for my considerations is based on a selection of anthropological rite concepts and elements of methodological concepts of studying fairy tales, such as structural and psychoanalytical approaches. My psychopedagogical analysis of the Sleeping Beauty fairy tale through the category rite of passage thus begins with defining this category underlining the possibility of using it in various sciences and referring to the fairy tale as a contemporary space for ritual initiation experience.

Role of cytokines in Trypanosoma brucei-induced anaemia: A review of the literature

Background Anaemia is an important complication of trypanosomiasis. The mechanisms through which trypanosomal infection leads to anaemia are poorly defined. A number of studies have implicated inflammatory cytokines, but these data are limited and inconsistent. In this article, we reviewed the published literature on cytokines associated with Trypanosoma brucei infections and their role in the immunopathology leading to anaemia. Methodology Articles were searched in PubMed through screening of titles and abstracts with no limitation on date of publishing and study design. Articles in English were searched using keywords “African trypanosomiasis”, “sleeping sickness”, “Trypanosoma brucei”, in all possible combinations with “anaemia” and/or “cytokines”. Results Twelve articles examining cytokines and their role in trypanosomeinduced anaemia were identified out of 1095 originally retrieved from PubMed. None of the articles identified were from human-based studies. A total of eight cytokines were implicated, with four cytokines (IFN-γ, IL-10, TNF-α, IL-12) showing an association with anaemia. These articles reported that mice lacking TNF-α were able to control anaemia, and that IFN-γ was linked to severe anaemia given its capacity to suppress erythropoiesis, while IL-10 was shown to regulate IFN-γ and TNF-α, providing a balance that was associated with severity of anaemia. IFN-γ and TNF-α have also been reported to work in concert with other factors such as nitric oxide and iron in order to induce anaemia. Conclusion IFN-γ, IL-10, and TNF-α were the three major cytokines identified to be heavily involved in anaemia caused by Trypanosoma brucei infection. The anti-inflammatory cytokine, IL-10, was shown to counter the effects of proinflammatory cytokines in order to balance the severity of anaemia. The mechanism of anaemia is multifactorial and therefore requires further, more elaborate research. Data from human subjects would also shed more light.

Sleep quality and stress levels among higher education students

A good night sleep enables to achieve physical and mental wellbeing (Paiva, 2015). The preservation of sleep quality is paramount as who sleeps well has a high adaptation capacity to adverse circumstances such as stress and anxiety, amongst others. There is an impacting relationship between reduced sleeping hours and high levels of anxiety, depression and stress (Pinto et al., 2012). Measure the sleep quality and stress levels amongst higher education students.Quantitative study with a descriptive-correlational and transversal design. A socio-demographic record, the Pittsburgh Sleep Quality Index (PSQI) from Ramalho (2008) and the Anxiety, Depression and Stress Scale (EADS-21) from Ribeiro, Honrado and Leal (2004) were applied. The sample included 358 students. 54% of the students present a bad sleep quality, go to bed on average at 1am, take about 19 minutes to fall asleep and sleep on average 7 hours effectively. Female students have a 48% higher probability of having bad sleep quality. Stress, anxiety and depression levels were considered disperse with stress presenting the higher average. The majority of the students that refer having a bad sleep quality present an average score of 6.57 on the stress scale being approximately double of the students that refer having a good sleep quality (3.35). Stress, anxiety and depression are positively and with statistic signiicance correlated to the sleep quality index where a higher score means worse sleep quality.

Cayler Cardio-Facial Syndrome: An Uncommon Condition in Newborns

Introduction: Cayler cardio-facial syndrome is a rare syndrome associated with asymmetric crying faces with congenital heart disease. We report a newborn that was diagnosed as case of Cayler Cardio-facial syndrome based on clinical features and was confirmed with FISH analysis. Case Presentation: A term male baby, born to non-consanguineous couple through normal vaginal delivery was diagnosed to have asymmetric crying faces with deviation of angle of mouth to left side at the time of birth. The baby had normal faces while sleeping or silent. Mother was known case of hypothyroidism and was on treatment. Baby was diagnosed as case of Cayler Cardio-facial Syndrome and was investigated with echocardiogram, brain ultrasound, total body X-ray examination, X-ray of cervico-thoracic vertebral column and fundus examination. Echocardiogram showed muscular VSD, brain ultrasound was normal and fundus examination showed tortuous retinal vessels. Whole body X-ray and lateral X-ray of cervico-thoracic vertebral column were not suggestive of any skeletal abnormalities. The other associated malformation was right ear microtia. Baby FISH karyotype analysis showed deletion of 22q11.2 deletion. Baby was discharged and now on follow-up. Conclusions: Cayler syndrome is a rare syndrome which must be suspected if a baby has asymmetrical cry pattern and normal facies when baby sleeps. Patient must be evaluated with echocardiography to find out associated cardiac malformations. These infants should undergo FISH analysis for 22q11.2 deletion syndrome.