Cancer related fatigue and self-care while undergoing chemotherapy: patients' perspectives

Background: Cancer related fatigue (CRF) is considered the most severe, debilitating and under-managed symptom of cancer. Patients receiving chemotherapy experience high levels of CRF which profoundly impacts on their lives. Aim: 1). To explore and measure CRF and determine the most effective self-care strategies used to combat CRF in a cohort of patients with a diagnosis of cancer (breast cancer, colorectal cancer, Hodgkin’s and Non-Hodgkin’s lymphoma) 2). To explore self-care agency and its relationship to CRF. Method: A mixed methods study which incorporated a descriptive, comparative, correlational design and qualitative descriptions of patients’ (n=362) experiences gleaned through open ended questions and use of a diary. The study utilised The Revised Pipers Fatigue Scale, the Appraisal of Self-Care Agency and a researcher developed Fatigue Visual Analogue Scale, Fatigue Self-Care Survey, and Diary. Findings: Having breast cancer, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma; using the strategies of counselling, taking a 20–30 minute nap, resting and sleeping, self-monitoring and complementary therapies were all associated with increased odds of developing fatigue. Increased self-care agency; being in the divorced / separated cohort; being widowed; increased length of time since commencement of chemotherapy; engagement in exercise, and socializing were associated with a reduced risk of developing fatigue. Females had 20% higher fatigue levels than males (p=<.001). Receiving support was the strategy used most frequently and rated most effective. Fatigue was very problematic and distressing, four key qualitative categories emerged: the behavioural impact, affective impact, the sensory impact, and the cognitive impact. Keeping a diary was considered very beneficial and cathartic. Conclusions: Fatigue severely impacted on the daily lives of patients undergoing chemotherapy. There are a range of self-care strategies that patients should be encouraged to use e.g. exercise, socializing, and enhancement of psychological well-being. The enhancement of self-care agency and use of diaries should also be considered.

TRADITION AND INNOVATION: ANALYSIS AND PERFORMANCE OF SELECTED COMPOSITIONS FOR VIOLONCELLO BY HEITOR VILLA-LOBOS

Brazilian composer Heitor Villa-Lobos (1887-1959) began his musical career as a cellist. When he was only twelve years old, it became imperativeupon the sudden and untimely death of his fatherthat the young Villa-Lobos earn money as a cellist to provide financial support for his mother and sisters. Villa-Lobos's intimate relationship with the cello eventually inspired him to compose great music for this instrument. This dissertation explores both the diversity of compositional technique and the evolution of style found in the music for cello written by Villa-Lobos. The project consists of two recorded recital performances and a written document exploring and analyzing those pieces. In the study of the music of Villa-Lobos, it is of great interest to consider the music's traditional European elements in combination (or even juxtaposition) with its imaginative and sometimes wildly innovative Brazilian character. His early works were greatly influenced by European Romantic composers such as Robert Schumann, Frédéric Chopin, and the virtuoso cellist/composer David Popper (whom Villa-Lobos idolized). Later, Villa-Lobos flourished in a newfound compositional independence and moved away from Euro-romanticism and toward the folk music of his Brazilian homeland. It is intriguing to experience this transition through an exploration of his cello compositions. The works examined and performed in this dissertation project are chosen from among the extensive number of Villa-Lobos's cello compositions and are his most important works for cello with piano, cello with another instrument, and cello with orchestra. The chosen works demonstrate the evolving range and combination of characteristic elements found in Villa-Lobos's compositional repertoire.

Sikh Sabad Kirtan as a Musical Construction of Memory

The performance of devotional music in India has been an active, sonic conduit where spiritual identities are shaped and forged, and both history and mythology lived out and remembered daily. For the followers of Sikhism, congregational hymn singing has been the vehicle through which text, melody and ritual act as repositories of memory, elevating memory to a place where historical and social events can be reenacted and memorialized on levels of spiritual significance. This dissertation investigates the musical process of Shabad Kirtan, Sikh hymn singing, in a Sikh musical service as a powerful vehicle to forge a sense of identification between individual and the group. As an intimate part of Sikh life from birth to death, the repertoire of Shabad Kirtan draws from a rich mosaic of classical and folk genres as well as performance styles, acting as a musical and cognitive archive. Through a detailed analysis of the Asa Di Var service, Shabad Kirtan is explored as a phenomenological experience where time, place and occasion interact as a meaningful unit through which the congregation creates and recreates themselves, invoking deep memories and emotional experiences. Supported by explanatory tables, diagrams and musical transcriptions, the sonic movements of the service show how the Divine Word as Shabad is not only embodied through the Guru Granth Sahib, but also encountered through the human enactment of the service, aurally, viscerally and phenomenologically.

THE PIANO MUSIC OF ROBERT SCHUMANN (1810-1856) AND JOHANNES BRAHMS (1833- 1897): A SURVEY OF CONCERTI, VARIATIONS, AND CHARACTER PIECES

Robert Schumann (1810-1856) and Johannes Brahms (1833-1897), in some ways Robert Schumann's artistic descendant, are the most important and representative German piano composers during the Romantic period. Schumann was already a mature and established musician in 1853 when he first met the young Brahms and recognized his talents, an encounter that had a long-lasting affect on the lives and careers of both men. After Schumann’s mental breakdown and death, Brahms maintained his admiration of Schumann’s music and preserved an intimate relationship with Clara Schumann. In spite of the personal and musical closeness of the two men, Schumann’s music is stylistically distinct from that of Brahms. Brahms followed traditions from Baroque and Classical music, and avoided using images and expressive titles in his music. Brahms extraordinarily intermingled earlier musical forms with multicolored tones of German Romanticism. In contrast, Schumann saw himself as a radical composer devoted to personal emotionalism and spontaneity. He favored programmatic titles for his character pieces and extra-musical references in his music. While developing their own musical styles as German Romantic composers, Schumann and Brahms both utilized the piano as a resourceful tool for self-realization and compositional development. To investigate and compare the main characteristics of Schumann and Brahms’s piano music, I looked at three genres. First, in the category of the piano concerto, I chose two major Romantic works, Schumann’s A minor concerto and Brahms’s B-flat major concerto. Second, for the category of piano variations I included two sets by Brahms because the variation framework was such an important vehicle for him to express his musical thoughts. Schumann’s unique motivic approach to variation is displayed vividly in his character-piece cycle Carnaval. Third, the category of the character piece, perhaps the favorite medium of Romantic expression at the piano, is shown by Schumann’s Papillons and Brahms’s sets of pieces Op.118 and Op.119. This performance dissertation consists of three recitals performed in the Gildenhorn Recital Hall at the University of Maryland, College Park. These recitals are documented on compact disc recordings that are housed within the University of Maryland Library System.

CABARET: MIRROR OF SOCIETIES

The basic definition of a cabaret is a café that offers live entertainment performed by singers, musicians and dancers and serves food and drink. It is generally housed in small, intimate spaces. Starting in the middle of the nineteenth century, artists, composers and writers met at Parisian cafés and salons to share their works. The cabaret was a suitable place for social activities. Artists could meet, discuss their opinions, and share their art in a relaxed setting. Even though cabaret music was often based on popular idioms, social and political commentary coupled with satirical settings represented the true soul of the genre. This trend flourished in the late nineteenth and early twentieth centuries. The first cabaret in Paris, Le Chat Noir inspired the growth of similar places in major cities throughout Europe besides Paris. The three recitals that comprise this dissertation project were performed at University of Maryland venues: the Robert & Arlene Kogod Theatre on 11 May 2011, Ulrich Recital Hall on 4 December 2011, and Gildenhorn Recital Hall on 4 March 2012. The repertoire for the first recital included works by Erik Satie with mezzo-soprano Monica Soto-Gil, Friedrich Hollaender with soprano Gabrielle DeMers, William Bolcom with baritone Ethan Watermeier and mezzo-soprano Stepanie Sadownik, and Poulenc with baritone Andrew McLaughlin. André Previn‘s Tango Song and Dance with violinist Jennifer Kim served as the instrumental interlude. The second recital included songs by Friedrich Hollaender with mezzo-soprano Monica Soto-Gil, Hanns Eisler and Viktor Ullmann with mezzo-soprano Stephanie Sadownik, and Mischa Spoliansky with soprano CarrieAnne Winter. Victor Hollaender‘s Romance and Albumblatt were the instrumental interludes with violinist Jennifer Kim. The last recital featured works for piano and violin, the Graceful Ghost Rag by William Bolcom with violinist Jenny Wu, Four Souvenirs by Paul Schoenfield with violinist Jennifer Kim, Cabaret Songs by Benjamin Britten with soprano Linda Mabbs, and Souvenirs for piano four-hands by Samuel Barber with pianist Rita Sloan. The recitals were recorded on compact discs and are archived within the Digital Repository at the University of Maryland (DRUM).

THE GREAT RUSSIAN PIANO TRADITION: SELECTED REPERTOIRE BY TCHAIKOVSKY, RACHMANINOFF AND PROKOFIEV

This dissertation explores representative piano music by three great Russian composers: Tchaikovsky, Rachmaninoff and Prokofiev. The areas of research include: 1) the short character piece; 2) the Russian piano transcription tradition; 3) the concerto and sonata cycle; 4) extra-musical imagery; 5) the influence of popular and dance music of the period. Perhaps the most important result of this research is learning how the art of incorporating a singing quality at the piano stands at the center of Russian pianistic heritage. The first recital features compositions by Sergei Prokofiev. The Seventh Sonata exhibits rebellious, uncompromisingly dissonant treatment of its musical content. Ten Pieces from “Cinderella” shows an ascetic approach to piano texture - a common characteristic in Prokofiev’s late works. The Third Concerto is Prokofiev’s masterpiece in the genre. One of the 20th century’s most performed concerti, it overflows with pianistic challenges. For my second dissertation recital, I have chosen Peter Ilich Tchaikovsky’s The Seasons. These short character pieces were inspired by literary sources. The text portrays Russian rural life, nature, moments of intimate reflection, and imaginary experiences and impressions. Tchaikovsky’s gift as a melodist and remarkable musical individualist is represented in his two Nocturnes as well as in the Nutcracker Suite, masterfully transcribed by Mikhail Pletnev. The final program features Sergei Rachmaninoff’s Ten Preludes, Op. 23, regarded as a culmination of the turn-of-the-century grand Russian pianistic style. The Fantasy Pieces helped establish Rachmaninoff’s reputation as a pianist-composer, a profoundly lyrical poet of the piano. The three Rachmaninoff transcriptions, the Minuet, the Hopak and the Polka de W.R. preserve the spirit of the Golden Era’s musical salon. These pieces were written to delight and dazzle audiences with their bold character, musical taste, virtuosic tricks and technical finesse. The three recitals comprising this dissertation were presented in Gildenhorn Recital at the University of Maryland School of Music on November 13, 2010, April 11, 2011 and February 27, 2012. The recitals were recorded on compact discs and are archived within the Digital Repository at the University of Maryland (DRUM).

OPERA IN AMERICA: MUSIC OF, BY, AND FOR THE PEOPLE­: A PERFORMANCE DISSERTATION

Opera in America: Music of, by, and for the people is a study of the relationship between American popular culture and opera in the United States. Four performance projects demonstrate the on-going exchange between the operatic community-including its composer, singers, and patrons-and the country's popular entertainment industry with its broad audience base. Numerous examples of artistic cross pollination between lowbrow and highbrow music will illustrate the artistic and social consequences created by this artistic amalgamation. Program #1, By George! By Ira! By Gershwin!, is a retrospective of Gershwin's vocal music representing a blending of popular and serious music in both style and form. The concert includes selections from Porgy and Bess, a work considered by many musicologists as the first American opera. Program #2, Shadowboxer, is a premiere performance of an opera by Frank Proto and John Chenault. For this newly commissioned work, I serve as Assistant Director to Leon Major. Shadowboxer provides a clear example of opera utilizing popular culture both musically and dramatically to tell the true story of American hero and legendary boxer, Joe Louis. Program #3, Just a Song at Twilight, is an original theatrical music piece featuring music, letters, diaries, and journals of the Gilded Age, an era when opera was synonymous with popular entertainment. Special attention is focused on tum-of­ the-century singers who performed in both opera and vaudeville. Program #4 is a presentation of Dominick Argento's Miss Manners on Music and illustrates the strong relationship that can exist between opera and American popular entertainment. Originally conceived as a song cycle, I have staged the work as a one-act opera sung and acted by soprano Carmen Balthrop. This piece is based on the writings of pop icon and newspaper columnist Judith Martin, otherwise known as Miss Manners. All four performances are recorded in audio and video formats.

THE GREAT RUSSIAN PIANO TRADITION: SELECTED REPERTOIRE BY TCHAIKOVSKY, RACHMANINOFF AND PROKOFIEV

This dissertation explores representative piano music by three great Russian composers: Tchaikovsky, Rachmaninoff and Prokofiev. The areas of research include: 1) the short character piece; 2) the Russian piano transcription tradition; 3) the concerto and sonata cycle; 4) extra-musical imagery; 5) the influence of popular and dance music of the period. Perhaps the most important result of this research is learning how the art of incorporating a singing quality at the piano stands at the center of Russian pianistic heritage. The first recital features compositions by Sergei Prokofiev. The Seventh Sonata exhibits rebellious, uncompromisingly dissonant treatment of its musical content. Ten Pieces from "Cinderella" shows an ascetic approach to piano texture - a common characteristic in Prokofiev's late works. The Third Concerto is Prokofiev's masterpiece in the genre. One of the 20th century's most performed concerti, it overflows with pianistic challenges. For my second dissertation recital, I have chosen Peter Ilich Tchaikovsky's The Seasons. These short character pieces were inspired by literary sources. The text portrays Russian rural life, nature, moments of intimate reflection, and imaginary experiences and impressions. Tchaikovsky's gift as a melodist and remarkable musical individualist is represented in his two Nocturnes as well as in the Nutcracker Suite, masterfully transcribed by Mikhail Pletnev. The final program features Sergei Rachmaninoff's Ten Preludes, Op. 23, regarded as a culmination of the turn-of-the-century grand Russian pianistic style. The Fantasy Pieces helped establish Rachmaninoff's reputation as a pianist-composer, a profoundly lyrical poet of the piano. The three Rachmaninoff transcriptions, the Minuet, the Hopak and the Polka de W.R. preserve the spirit of the Golden Era's musical salon. These pieces were written to delight and dazzle audiences with their bold character, musical taste, virtuosic tricks and technical finesse. The three recitals comprising this dissertation were presented in Gildenhorn Recital at the University of Maryland School of Music on November 13, 2010, April 11, 2011 and February 27, 2012. The recitals were recorded on compact discs and are archived within the Digital Repository at the University of Maryland (DRUM).

Expression, purification and X-ray crystallographic analysis of the Helicobacter pylori blood group antigen-binding adhesin BabA

Helicobacter pylori is a human pathogen that colonizes about 50% of the world's population, causing chronic gastritis, duodenal ulcers and even gastric cancer. A steady emergence of multiple antibiotic resistant strains poses an important public health threat and there is an urgent requirement for alternative therapeutics. The blood group antigen-binding adhesin BabA mediates the intimate attachment to the host mucosa and forms a major candidate for novel vaccine and drug development. Here, the recombinant expression and crystallization of a soluble BabA truncation (BabA^25-460) corresponding to the predicted extracellular adhesin domain of the protein are reported. X-ray diffraction data for nanobody-stabilized BabA^25-460 were collected to 2.25Å resolution from a crystal that belonged to space group P21, with unit-cell parameters a = 50.96, b = 131.41, c = 123.40Å, α = 90.0, β = 94.8, γ = 90.0°, and which was predicted to contain two BabA^25-460-nanobody complexes per asymmetric unit.

An unusually large phytoplankton spring bloom drives rapid changes in benthic diversity and ecosystem function

In 2012, the Western English Channel experienced an unusually large and long-lived phytoplankton spring bloom. When compared with data from the past 20 years, average phytoplankton biomass at Station L4 (part of the Western Channel Observatory) was approximately 3× greater and lasted 50% longer than any previous year. Regular (mostly weekly) box core samples were collected from this site before, during and after the bloom to determine its impact on macrofaunal abundance, diversity, biomass, community structure and function. The spring bloom of 2012 was shown to support a large and rapid response in the majority of benthic taxa and functional groups. However, key differences in the precise nature of this response, as well as in its timing, was observed between different macrofauna feeding groups. Deposit feeders responded almost instantly at the start of the bloom, primarily thorough an increase in abundance. Suspension feeders and opportunistic/predatory/carnivorous taxa responded slightly more slowly and primarily with an increase in biomass. At the end of the bloom a rapid decline in macrobenthic abundance, diversity and biomass closely followed the decline in phytoplankton biomass. With suspension feeders showing evidence of this decline a few weeks before deposit feeders, it was concluded that this collapse in benthic communities was driven primarily by food availability and competition. However, it is possible that environmental hypoxia and the presence of toxic benthic cyanobacteria could also have contributed to this decline. This study shows evidence for strong benthic–pelagic coupling at L4; a shallow (50 m), coastal, fine-sand habitat. It also demonstrates that in such habitats, it is not just planktonic organisms that demonstrate clear community phenology. Different functional groups within the benthic assemblage will respond to the spring bloom in specific manner, with implications for key ecosystem functions and processes, such as secondary production and bioturbation. Only by taking integrated benthic and pelagic observations over such fine temporal scales (weekly) was the current study able to identify the intimate structure of the benthic response. Similar studies from other habitats and under different bloom conditions are urgently needed to fully appreciate the strength of benthic–pelagic coupling in shallow coastal environments.

Teaching and cognitive outcomes in A-levels and Advanced GNVQ's: Case studies from Science and Business Studies Classrooms

The purpose of the paper is to demonstrate how a research diary methodology, designed to analyse A-level and GNVQ classrooms, can be a powerful tool for examining pedagogy and quality of learning at the level of case study. Two subject areas, science and business studies, are presented as cases. Twelve teachers and thirty-four students were studied over a four-week period in May 1997 and contrasts were drawn between lessons from three A-level physics teachers/three Advanced GNVQ science teachers and two A-level business/economics teachers/four Advanced GNVQ business teachers. Lessons were analysed within a cognitive framework which distinguishes between conceptual and procedural learning and emphasizes the importance of metacognition and epistemological beliefs. Two dimensions of lessons were identified: pedagogical activities (e.g. teacher-led explanation, teacher-led guidance on a task, question/answer sessions, group discussions, working with IT) and cognitive outcomes (e.g. structuring and memorizing facts, understanding concepts and arguments, critical thinking, problem-solving, learning core skills, identifying values). Immediately after each lesson, teachers and students (three per class) completed structured research diaries with respect to the above dimensions. Data from the diaries reveal general and unique features of the lessons. Time-ofyear effects were evident (examinations pending in May), particularly in A-level classrooms. Students in business studies classes reported a wider range of learning activities and greater variety in cognitive outcomes than did students in science classes. Science students self-rating of their ability to manage and direct their own learning was generally low. The phenomenological aspects of the classrooms were consistently linked to teachers' lesson plans and what their teaching objectives were for those particular students at that particular time of the year.

DFT and in situ EXAFS investigation of gold/ceria-zirconia low-temperature water gas shift catalysts: Identification of the nature of the active form of gold

A combined experimental and theoretical investigation of the nature of the active form of gold in oxide-supported gold catalysts for the water gas shift reaction has been performed. In situ extended X-ray absorption fine structure (EXAFS) and X-ray absorption near-edge structure (XANES) experiments have shown that in the fresh catalysts the gold is in the form of highly dispersed gold ions. However, under water gas shift reaction conditions, even at temperatures as low as 100 degrees C, the evidence from EXAFS and XANES is only 14 consistent with rapid, and essentially complete, reduction of the gold to form metallic clusters containing about 50 atoms. The presence of Au-Ce distances in the EXAFS spectra, and the fact that about 15% of the gold atoms can be reoxidized after exposure to air at 150 degrees C, is indicative of a close interaction between a fraction (ca. 15%) of the gold atoms and the oxide support. Density functional theory (DFT) calculations are entirely consistent with this model and suggest that an important aspect of the active and stable form of gold under water gas shift reaction conditions is the location of a partially oxidized gold (Audelta+) species at a cerium cation vacancy in the surface of the oxide support. It is found that even with a low loading gold catalysts (0.2%) the fraction of ionic gold under water gas shift conditions is below the limit of detection by XANES (<5%). It is concluded that under water gas shift reaction conditions the active form of gold comprises small metallic gold clusters in intimate contact with the oxide support.

Reflexive learning in pre-service training of primary school teachers: from experience to assimilation of contents

This article presents an educational experiment carried out in the Primary School Teaching Degree at the University of Barcelona. Specifically, the article analyses the application of the “Work Corners” approach in a core subject. In a three-year action research process, trainers put into practice an innovation which enabled them to boost cooperative work and reflexive learning among trainees. Firstly, the theoretical model underpinning the project and guiding many of the actions carried out by the training team is presented. After providing detailed information on the practical development of the experiment, the data-gathering process and its results are shown. Various information-gathering strategies were used in assessing the project, such as a questionnaire, participant observation, and teachers’ diaries. The results demonstrate, amongst other things, that “work corners” offer viable and appropriate educational conditions for the articulation of theoretical and practical knowledge, for building professional knowledge, and therefore, the beginnings of a reflexive teaching practice.