4 research outputs found
Musicology and Mediation: an examination of the cultural materialisms of Raymond Williams and Pierre Bourdieu in relation to the fields of contemporary music and musicology, with a case study of Arvo Part and ECM
Merged with duplicate record 10026.1/2795 on 06.20.2017 by CS (TIS)This thesis examines the usefulness of the work of Pierre Bourdieu and Raymond Williams
for discussions of material mediation in musicology. In part I, I focus on Bourdieu's discussions
of cultural production as set out in The Rules of Art and "The Field of Cultural Production", and
reconstruct the terms of Williams's late theoretical project. In establishing the terms of these
projects, I draw a parallel between their attempts to materialize the categories of Marx's
superstructure - noting in Williams's subsequent use of a revised Marxist production paradigm
a proximity to the work of Adorno - before noting the differences imposed by the pressures
and limits of their respective intellectual cultures. The tensions between these two models are
therefore identified as the opportunity for dialogue between theoretical traditions.
In part 2, these reflections are tested through a discussion of Arvo Pärt's music and the
record label Edition of Contemporary Music (ECM). Using data from musical scores, CDs,
reviews, critical essays, magazine articles, interviews, and so on, Part's emergent field position
in the late 1970s and early 1980s is reconstructed and ECM's function as both institution and
artistic formation is argued. These instances of musical practice remain rhetorically committed
to the ideals of autonomy while spanning the opposition of autonomy and heteronomy. This
ambiguity puts strain on Williams's and Bourdieu's readings of cultural production, allowing for
a critical approach to this range of debate. In this sense, the method becomes part of the
subject matter, and the discussions combine both theoretical and musical reflection
Extended adjuvant intermittent letrozole versus continuous letrozole in postmenopausal women with breast cancer (SOLE): a multicentre, open-label, randomised, phase 3 trial
Background In animal models of breast cancer, resistance to continuous use of letrozole can be reversed by withdrawal and reintroduction of letrozole. We therefore hypothesised that extended intermittent use of adjuvant letrozole would improve breast cancer outcome compared with continuous use of letrozole in postmenopausal women. Methods We did the multicentre, open-label, randomised, parallel, phase 3 SOLE trial in 240 centres (academic, primary, secondary, and tertiary care centres) in 22 countries. We enrolled postmenopausal women of any age with hormone receptor-positive, lymph node-positive, and operable breast cancer for which they had undergone local treatment (surgery with or without radiotherapy) and had completed 4\u20136 years of adjuvant endocrine therapy. They had to be clinically free of breast cancer at enrolment and without evidence of recurrent disease at any time before randomisation. We randomly
assigned women (1:1) to treatment groups of either continuous use of letrozole (2\ub75 mg/day orally for 5 years) or
intermittent use of letrozole (2\ub75 mg/day orally for 9 months followed by a 3-month break in years 1\u20134 and then
2\ub75 mg/day during all 12 months of year 5). Randomisation was done by principal investigators or designee at respective centres through the internet-based system of the International Breast Cancer Study Group, was stratified by type of previous endocrine therapy (aromatase inhibitors only vs selective oestrogen receptor modulators only vs both therapies), and used permuted block sizes of four and institutional balancing. No one was masked to treatment assignment. The primary endpoint was disease-free survival, analysed by the intention-to-treat principle using a stratified log-rank test. All patients in the intention-to-treat population
who initiated protocol treatment during their period of trial participation
were included in the safety analyses. This study is registered with ClinicalTrials.gov, number NCT00553410, and EudraCT, number 2007-001370-88; and long-term follow-up of patients is ongoing.
Findings Between Dec 5, 2007, and Oct 8, 2012, 4884 women were enrolled and randomised after exclusion of patients at a non-adherent centre, found to have inadequate documentation of informed consent, immediately withdrew consent, or randomly assigned to intervention groups in error. 4851 women comprised the intention-to-treat population
that compared extended intermittent letrozole use (n=2425) with continuous letrozole use (n=2426). After a median follow-up of 60 months (IQR 53\u201372), disease-free survival was 85\ub78% (95% CI 84\ub72\u201387\ub72) in the intermittent letrozole group compared with 87\ub75% (86\ub70\u201388\ub78) in the continuous letrozole group (hazard ratio 1\ub708, 95% CI 0\ub793\u20131\ub726; p=0\ub731). Adverse events were reported as expected and were similar between the two groups. The most common grade 3\u20135 adverse events were hypertension (584 [24%] of 2417 in the intermittent letrozole group vs 517 [21%] of 2411 in the continuous letrozole group) and arthralgia (136 [6%] vs 151 [6%]). 54 patients (24 [1%] in the intermittent letrozole group and 30 [1%] in the continuous letrozole group) had grade 3\u20135 CNS cerebrovascular ischaemia, 16 (nine [<1%] vs seven [<1%]) had grade 3\u20135 CNS haemorrhage, and 40 (19 [1%] vs 21 [1%]) had grade 3\u20135 cardiac ischaemia. In total, 23 (<1%) of 4851 patients died while on trial treatment (13 [<1%] of 2417 patients in the intermittent letrozole group vs ten [<1%] of 2411 in the continuous letrozole group).
Interpretation In postmenopausal women with hormone receptor-positive breast cancer, extended use of intermittent letrozole did not improve disease-free survival compared with continuous use of letrozole. An alternative schedule of extended adjuvant endocrine therapy with letrozole, including intermittent administration, might be feasible and the results of the SOLE trial support the safety of temporary treatment breaks in selected patients who might require them