Symptom burden in individuals with inflammatory bowel disease: a mixed methods study

To investigate the symptom burden experiences of individuals with inflammatory bowel disease (IBD). An explanatory sequential mixed methods study was conducted. A cross-sectional, correlational survey was first undertaken. Symptom burden was measured using a modified disease specific version of the Memorial Symptom Assessment Scale, which was administered to a consecutive sample of individuals with IBD (n = 247) at an IBD Outpatients department in one urban teaching hospital in Ireland. Disease activity was determined using clinical disease activity indices, which were completed by the consulting physician. A sequential qualitative, descriptive study was then conducted aimed at explaining noteworthy quantitative findings. A criterion-related purposeful sample of seven participants from the quantitative study was recruited. Semi-structured face to face interviews were conducted using an interview guide and data were analysed using content analysis. Findings revealed that participants experienced a median of 10 symptoms during the last week, however as many as 16 symptoms were experienced during active disease. The most burdensome symptoms were lack of energy, bowel urgency, diarrhoea, feeling bloated, flatulence and worry. Total symptom burden was found to be low with a mean score of 0.56 identified out of a possible range from 0 to 4. Participants with active disease (M = 0.81, SD = 0.48; n = 68) had almost double mean total symptom burden scores than participants with inactive disease (M = 0.46, SD = 0.43; n = 166) (p < 0.001). Mean total psychological symptom burden was found to be significantly greater than mean total physical symptom burden (rho = 0.73, n = 247, p < 0.001). Self-reported disease control, gender, number of flare ups in the last two years, and smoking status was found to be significant predictors of total symptom burden, with self-reported disease control identified as the strongest predictor. Qualitative data revealed tiredness, pain, bowel symptoms, worry and fear as being burdensome. Furthermore, symptom burden experiences were described in terms of its impact on restricting aspects of daily activities, which accumulated into restrictions on general life events. Psychological symptom burden was revealed as more problematic than physical symptom burden due to its constant nature, with physical and psychological symptoms described to occur in a cyclical manner. Participants revealed that disease control was evaluated not only in terms of symptoms, but also in terms of their abilities to control the impact of symptoms on their lives. This study highlights the considerable number of symptoms and the most burdensome symptoms experienced by individuals with IBD, both during active and inactive disease. This study has important implications on symptom assessment in terms of the need to encompass both physical and psychological symptoms. In addition, greater attention needs to be placed on psychological aspects of IBD care.

GABRIEL URBAIN FAURÉ, THE UNSUNG MODERNIST: A PERFORMANCE SURVEY OF SELECTED LATE WORKS WRITTEN AFTER 1892 FOR PIANO SOLO, AND PIANO IN COLLABORATION WITH VIOLIN, VIOLONCELLO, AND VOICE

Gabriel Urbain Fauré lived during one of the most exciting times in music history. Spanning a life of 79 years (1845-1924), he lived through the height of Romanticism and the experimental avant-garde techniques of the early 20th century. In Fauré's music, one can find traces of Chopin, Liszt, Mendelssohn, Debussy and Poulenc. One can even argue that Fauré presages Skryabin and Shostakovich. The late works of Gabriel Fauré, chiefly those composed after 1892, testify to the argument that Fauré holds an important position in the shift from tonal to atonal composition and should be counted among such transitional composers as Gustav Mahler, Claude Debussy, Erik Satie, Richard Strauss, and Ferruccio Busoni. Fauré's unique way of fashioning harmonic impetus of almost purely linear means, resulting in a synthesis of harmonic and melodic devices, led me to craft the term mélodoharmonique. This term refers to a contrapuntally motivated technique of composition, particularly in a secondary layer of musical texture, in which a component of harmonic progression (i.e. arpeggiation, broken chord, etc.) is fused with linear motivic or thematic development. This dissertation seeks to bring to public attention through exploration in lecture and recital format, certain works of Gabriel Fauré, written after 1892. The repertoire will be selected from works for solo piano and piano in collaboration with violin, violoncello, and voice, which support the notion of Fauré as a modernist deserving larger recognition for his influence in the transition to atonal music. The recital repertoire includes the following--Song Cycles: La bonne chanson, opus 61; La chanson d'Ève, opus 95; Le jardin clos, opus 106; Mirages, opus 113; L'horizon chimérique, opus 118; Piano Works: Prelude in G minor opus 103, No. 3; Prelude in E minor opus 103, No. 9; Eleventh Nocturne, opus 104, No.1; Thirteenth Nocturne, opus 119; Chamber Works: Second Violin Sonata, opus 108; First Violoncello Sonata, opus 109; Second Violoncello Sonata, opus 117.

THE EFFECT OF A PROGRAM OF PORTABLE ELECTRONIC PIANO KEYBOARD EXPERIENCE ON THE ACQUISITION OF SIGHT-SINGING SKILL IN THE NOVICE HIGH SCHOOL CHORUS

The problem was to determine whether a method of aural and visual vocal training that included a program of portable electronic piano keyboard experience would be more effective in teaching sight-singing skills to novice high school chorus students than a method that included only aural and visual vocal training. A sub-problem was to determine whether novice chorus students enjoyed playing electronic keyboards in chorus as a reinforcement experience in sight-singing training. Students were randomly assigned to two treatment groups, tested with the Musical Aptitude Profile, Tonal Imagery, part A, and then trained separately. The experimental group sang repetitions of melodic patterns and utilized techniques associated with the Kodály Method while simultaneously playing keyboard. The comparison group received a similar treatment without using keyboards. The students were pre- and post-tested in sight-singing using the Vocal Sight-Reading Inventory. Results of the Analysis of Covariance using MAP scores as the covariate revealed no significant difference (p<.05) between post-test scores of the two groups. Improvement was noted in 96% of students from pre-test to post-test regardless of grouping. The repeated measures ANOVA revealed a significant relationship (p<.006) between aptitude group and post-test score. High aptitude students in both groups were found to benefit more from the training than low aptitude students. High aptitude keyboard group students achieved an average gain score that was 8.67 points higher than the comparison group. Of the total experimental group, 92% enjoyed playing keyboards in chorus. It is recommended that future research be undertaken to study the use of keyboards with advanced high school choruses and with uncertain singers in the high school chorus. Research is also needed to develop graded, valid, and reliable sight-singing tests for use in high school chorus. Techniques of the Kodály Method should be further investigated for use in high school sight-singing training.

All This the World Well Knows: a symphonic cantata in Sonnets and Proverbs for mixed chorus, four solo voices, and orchestra

All This the World Well Knows is a 30-minute symphonic cantata for mixed chorus, four solo voices (soprano, mezzo-soprano, tenor, and baritone), and orchestra. The libretto, adapted by the composer, weaves together texts from Shakespeare's Dark Lady sonnets and from the King James Bible's book of Proverbs in a loose narrative of love, betrayal, and reconciliation. The composition's pitch material includes microtonality that arises from the just intonation of sonorities derived from the harmonic series. In passages in which the solo voices express this microtonality, they are amplified in order to allow precise, non vibrato intonation. The modest size of the orchestra, which includes pairs of winds and only two percussionists, makes the composition practical for a wide range of performing groups.

USE OF VARIATION AND FUGUE IN PIANO MUSIC FOLLOWING THE CLASSICAL PERIOD

The variation and fugue originated from the 15th and 16th centuries and blossomed during the Baroque and Classical Periods. In a variation, a theme with a particular structure precedes a series of pieces that usually have the same or very similar structure. A fugue is a work written in imitative counterpoint in which the theme is stated successively in all voices of polyphonic texture. Beethoven’s use of variation and fugue in large scale works greatly influenced his contemporaries. After the Classical Period, variations continued to be popular, and numerous composers employed the technique in various musical genres. Fugues had pedagogical associations, and by the middle of 19th century became a requirement in conservatory instruction, modeled after Bach’s Well-Tempered Clavier. In the 20th century, the fugue was revived in the spirit of neoclassicism; it was incorporated in sonatas, and sets of preludes and fugues were composed. Schubert's Wanderer Fantasy presents his song Der Wanderer through thematic transformations, including a fugue and a set of variations. Liszt was highly influenced by this, as shown in his thematic transformations and the fugue as one of the transformations in his Sonata in b. In Schumann’s Symphonic Études, Rachmaninoff's Rhapsody on a Theme of Paganini and Copland’s Piano Variations, the variation serves as the basis for the entire work. Prokofiev and Schubert take a different approach in Piano Concerto No. 3 and Wanderer Fantasy, employing the variation in a single movement. Unlike Schubert and Liszt's use of the fugue as a part of the piece or movement, Franck’s Prelude Chorale et Fugue and Shchedrin’s Polyphonic Notebook use it in its independent form. Since the Classical Period, the variation and fugue have evolved from stylistic and technical influences of earlier composers. It is interesting and remarkable to observe the unique effects each had on a particular work. As true and dependable classic forms, they remain popular by offering the composer an organizational framework for musical imagination.

Aqueous solution of anionic surfactants mixed with soils show a synergistic reduction in surface tension

Water retention and transport in soils is dependent upon the surface tension of the aqueous phase. Surfactants present in aqueous solution reduce the surface tension of aqueous phase. In soil–water systems, this can result in water drainage and reductions in field capacity and hydraulic conductivity. In this investigation, the surface tension of surfactant solutions mixed with soil—in a constant fixed ratio—was measured as a function of surfactant concentration. Two anionic surfactants were used: sodium dodecyl sulphate and sodium bis (2-ethylhexyl) sulfosuccinate. Two soils were also used—a clay soil and a sandy soil. The key observation made by this investigation was that the addition of soil to the surfactant solution provided a further component of surface tension reduction. Neither soil sample reduced the surface tension of water when surfactant was absent from the aqueous phase, though both soils released soil organic matter at low surfactant concentrations as shown by measurement of the chemical oxygen demand of the supernatant solutions. Furthermore, both surfactants were shown to be weakly adsorbed by soil as shown by the use of a methylene blue assay. It is therefore proposed that the additional reduction in surface tension arises from synergistic interactions between the surfactants and dissolved soil organic matter.

The Mixed Fortunes of Irish Unions: Living with the Paradoxes of Social Partnership

We assess the fortunes of Irish unions since 1980 and, in particular, focus on the period of national social partnership since 1987. We argue that, structurally, unions have been weakened by a sharp decline in union density levels. In addition, labor law reform has not been as permissive as unions desired. However, on the other hand, we highlight that union membership in Ireland has never been higher and unions exert a strong influence over many areas of government policy. In conclusion, we argue that continuing with social partnership is the most viable option for Irish unions, though significant gains in union power are unlikely to happen.

CsF and alumina: A mixed homogeneous-heterogeneous catalytic system for the transesterification of sunflower oil with methanol

The activity and nature (i e heterogeneous and/or homogeneous) of catalysts based on CsF supported on alpha-Al2O3 were investigated for the transesterification of vegetable oil with methanol. The effect of the activation temperature, CsF loading and the reusability in a recirculating reactor were first studied CsF/alpha-Al2O3 exhibited the highest activity for a CsF loading of 0 6 mmol/g and when activated at 120 degrees C An important aspect of this study is the effect of CsF leaching into the reaction mixture, which is attributed to the high solubility of CsF in methanol, leading to a complete loss of activity after one run It was Identified that the activity of the catalyst resulted from a synergy between alumina and dissolved CsF, the presence of both compounds being absolutely necessary to observe any conversion The use of an alumina with a higher surface area resulted in a far greater reaction rate, showing that the concentration of surface site on the oxide (probably surface hydroxyl) was rate-limiting in the case of the experiments using the low surface area alpha-Al2O3 This work emphasizes that combined homogeneous-heterogeneous catalytic systems made from the blending of the respective catalysts can be used to obtain high conversion of vegetable oil to biodiesel. Despite the homogeneous/heterogeneous dual character, such a catalytic system may prove valuable in developing a simple and cost-effective continuous catalytic process for biodiesel production (C) 2010 Elsevier B V All rights reserved

Modification of Ag nanoparticles with mixed thiols for improved SERS detection of poorly adsorbing target molecules: detection of MDMA

Here we report an example of a mixed thiol monolayer on the surface of Ag nanoparticles which promotes adsorption and quantitative SERS detection of 3,4-methylenedioxymethamphetamine (MDMA, “Ecstasy”); the thiols in the mixed monolayers act synergistically since MDMA does not adsorb onto colloids modified with either of the thiols separately.

Agency or Dependency?: The Mixed Peppers Theatre Arts Training Project for young people with disabilities

This article provides a reflection on my past practice as Creative Director of The Mixed Peppers Theatre Arts Training Programme. Drawing upon discourses of Disability Studies it considers how this ostensibly emancipatory project that sought to provide access to theatre activity for young people with physical disabilities living in Northern Ireland was flawed, and was eventually disbanded, partly due to a failure on the part of its non-disabled leadership to address imbalances of power in its relationship with its young disabled constituency. The article is framed within a survey of recent debates that focus upon the historical lack of a sustained, indigenous, disability-led theatre activity in Northern Ireland and the recent efforts by non-disabled professional arts practitioners to establish such activity in the region. It offers, as an exemplar to current discussion, an analysis of how the choice and agency of the young members of The Mixed Peppers were compromised by the well-meaning but potentially oppressive practices of its leadership. It questions whether the project was unduly influenced by parental desire to see their disabled children `normalized' in a high-profile theatrical production. Finally, it considers how The Mixed Peppers' institutional situation, as a project controlled and administered by a disability charity, was implicated in the premature demise of the initiative.