Schenker, Schubert, and the Subtonic Chord

A close reading and critique of Heinrich Schenker’s treatment of the subtonic chord (for example, B♭-D-F in C major or C minor) serves as the foundation for a detailed assessment of the diverse contexts in which it was employed by Franz Schubert. Numerous analyses of musical excerpts by Schubert help to reveal the relationship between the subtonic chord and the dominant Stufe (scale-step) and to demonstrate various linear contexts in which it may arise. Although the chord often is labeled as VII in C minor or as ♭VII in C major, its subsidiary role within the projection or connection of more foundational Stufen warrants a less overtly harmonic interpretation. This article is part of a special, serialized feature: A Music-Theoretical Matrix: Essays in Honor of Allen Forte (Part II)

Intellectual Property Rights and the GATT: United States Goals in the Uruguay Round

The pursuit of protection of IP rights is a valuable goal both for the United States and the rest of the world community. Such rights promote creativity and the advancement of knowledge, as well as fuel the domestic economy and improve the position of the United States vis-a-vis the other trading nations of the world. With the growing interdependence of the global economy, there is no time like the present to lay the foundation for a system of dispute settlement of such trade matters. Economic interdependence will continue to increase, and the problems of international trade in, and piracy of, high technology IP will increase alongside. As one of the most powerful IP exporters, it is vital for the United States to gain greater international protection for its high technology IP. At present, the GATT is the best forum for the United States to show the world community that it is serious about IP protection and is committed to curbing the piracy of what has become an important element in the United States economy

Pediatric Teleheath: Opportunities Created by the COVID-19 and Suggestions to Sustain Its Use to Support Families of Children with Disabilities

Aims: Telehealth is being rapidly adopted by physical and occupational therapists in pediatrics as a strategy to maintain services during the COVID-19 crisis. This perspective presents a mix of theoretical and practice perspectives to support the implementation of telehealth. Although research evidence is just emerging, there is sufficient indication to believe telehealth is effective. However, which telehealth strategies are best for which children and families, and which intervention goals, are not yet clear. Methods: We discuss how different telehealth strategies (e.g. videoconferencing, emails, phone calls, online programs) are being used to address specific intervention goals. Comments from therapists using telehealth and examples of practices in different context and with different populations are provided. We discuss how newly adopted telehealth practices could be included in future hybrid service delivery models and programs, as well as factors influencing the decision to offer face-to-face or online interventions. Conclusion: Although telehealth has been implemented quickly as a response to a health care crisis, and is not a one-size-fits-all intervention, we believe it offers great opportunities to increase the accessibility, cost-effectiveness and family-centredness of our services, to best support families of children with disabilities

The Essential Value of LGBT Resource Centers

Through the voices and experiences of LGBTQ+ students on three campuses, this study provides evidence of the essential value of LGBT Centers as they advocate for and empower LGBTQ+ students. Grounded in theories of college student development, identity development, and Queer theory, the qualitative study draws on 35 semi-structured interviews with students and staff involved with LGBT Centers on three campuses that broadly reflect the diversity of higher education in the United States. In particular, the study answers the following questions: What are historical and current contexts of LGBT Centers? What is the nature of campus climate contexts for LGBTQ+ students? Who are the Centers for and what purposes do they serve? What are the policies, programs, services and daily practices around advocacy and identity affirmation? What skills and strategies are taught through Center interaction that help LGBTQ+ students mitigate microaggressions, obstacles and barriers related to identity? The study explores campus climate for LGBTQ+ students, and campus spaces that reflect inclusionary and exclusionary practices. Participantsâ?? experiences of microaggressions and their perceptions of critical counterspaces are described. The study further describes the policies, programs, services and daily practices that embody the value that Centers contribute to campuses. Serving multiple simultaneous and congruent purposes on campus, the data revealed that Center activities fall into two themes: those that primarily support core institutional practices of instruction, education, learning and research: advocacy, ally development, fostering visibility, and assessment; and those that primarily further individual student outcomes: community and counterspace, specialized expertise, advising, leadership development, and providing information, referral and resources. Beyond those activities specifically related to LGBTQ+ identity and the support of those marginalized based on sexual orientation and gender identity, Centers contribute significantly to the development of capacities and skills in students that transcend identity work and development. In particular, participants discussed ways that Center participation fostered professionalism and the ability to work with others in productivity environments. Participants also explored the development of resilience, or strategies that they employ to overcome obstacles to their achievement of desired goals and outcomes. Finally, participants discussed the ways Center involvement cultivated a social justice lens, which participants used to buffer, interpret and understand encounters and interactions with other individuals and experiences of the world. Finally, the study provides additional observations, conclusions and recommendations for future inquiry. Asserting that future Center efforts must coalesce around emerging sexual and gender identity understandings to maintain Center value, purpose and relevance, the author calls on researchers to consider the ways that Centers can and do broaden their influence and impact beyond active users or students whose primary identity development trajectory relates to sexual identity or gender identity. The study also challenges that identity alone may be a less valuable unit of analysis in parsing and understanding participants, their experiences and contributions to research

Implementation and evaluation of the VA DPP clinical demonstration: protocol for a multi-site non-randomized hybrid effectiveness-implementation type III trial.

BackgroundThe Diabetes Prevention Program (DPP) study showed that lifestyle intervention resulted in a 58% reduction in incidence of type 2 diabetes among individuals with prediabetes. Additional large randomized controlled trials have confirmed these results, and long-term follow-up has shown sustained benefit 10-20 years after the interventions ended. Diabetes is a common and costly disease, especially among Veterans, and despite strong evidence supporting the feasibility of type 2 diabetes prevention, the DPP has not been widely implemented. The first aim of this study will evaluate implementation of the Veterans Affairs (VA) DPP in three VA medical centers. The second aim will assess weight and hemoglobin A1c (A1c) outcomes, and the third aim will determine the cost-effectiveness and budget impact of implementation of the VA DPP from a health system perspective.Methods/designThis partnered multi-site non-randomized systematic assignment study will use a highly pragmatic hybrid effectiveness-implementation type III mixed methods study design. The implementation and administration of the VA DPP will be funded by clinical operations while the evaluation of the VA DPP will be funded by research grants. Seven hundred twenty eligible Veterans will be systematically assigned to the VA DPP clinical demonstration or the usual care VA MOVE!® weight management program. A multi-phase formative evaluation of the VA DPP implementation will be conducted. A theoretical program change model will be used to guide the implementation process and assess applicability and feasibility of the DPP for VA. The Consolidated Framework for Implementation Research (CFIR) will be used to guide qualitative data collection, analysis, and interpretation of barriers and facilitators to implementation. The RE-AIM framework will be used to assess Reach, Effectiveness, Adoption, Implementation, and Maintenance of the VA DPP. Twelve-month weight and A1c change will be evaluated for the VA DPP compared to the VA MOVE!ProgramMediation analyses will be conducted to identify whether program design differences impact outcomes.DiscussionFindings from this pragmatic evaluation will be highly applicable to practitioners who are tasked with implementing the DPP in clinical settings. In addition, findings will determine the effectiveness and cost-effectiveness of the VA DPP in the Veteran population

An Iterative, Low-Cost Strategy to Building Information Systems Allows a Small Jurisdiction Local Health Department to Increase Efficiencies and Expand Services

Objective and Methods: The objective of this case study was to describe the process and outcomes of a small local health department\u27s (LHD\u27s) strategy to build and use information systems. The case study is based on a review of documents and semi-structured interviews with key informants in the Pomperaug District Health Department. Interviews were recorded, transcribed, coded, and analyzed. Results and Conclusions: The case study here suggests that small LHDs can use a low-resource, incremental strategy to build information systems for improving departmental effectiveness and efficiency. Specifically, we suggest that the elements for this department\u27s success were simple information systems, clear vision, consistent leadership, and the involvement, training, and support of staff

A pilot Internet "Value of Health" Panel: recruitment, participation and compliance

Objectives To pilot using a panel of members of the public to provide preference data via the Internet Methods A stratified random sample of members of the general public was recruited and familiarised with the standard gamble procedure using an Internet based tool. Health states were perdiodically presented in "sets" corresponding to different conditions, during the study. The following were described: Recruitment (proportion of people approached who were trained); Participation (a) the proportion of people trained who provided any preferences and (b) the proportion of panel members who contributed to each "set" of values; and Compliance (the proportion, per participant, of preference tasks which were completed). The influence of covariates on these outcomes was investigated using univariate and multivariate analyses. Results A panel of 112 people was recruited. 23% of those approached (n = 5,320) responded to the invitation, and 24% of respondents (n = 1,215) were willing to participate (net = 5.5%). However, eventual recruitment rates, following training, were low (2.1% of those approached). Recruitment from areas of high socioeconomic deprivation and among ethnic minority communities was low. Eighteen sets of health state descriptions were considered over 14 months. 74% of panel members carried out at least one valuation task. People from areas of higher socioeconomic deprivation and unmarried people were less likely to participate. An average of 41% of panel members expressed preferences on each set of descriptions. Compliance ranged from 3% to 100%. Conclusion It is feasible to establish a panel of members of the general public to express preferences on a wide range of health state descriptions using the Internet, although differential recruitment and attrition are important challenges. Particular attention to recruitment and retention in areas of high socioeconomic deprivation and among ethnic minority communities is necessary. Nevertheless, the panel approach to preference measurement using the Internet offers the potential to provide specific utility data in a responsive manner for use in economic evaluations and to address some of the outstanding methodological uncertainties in this field

Exploring what lies behind public preferences for avoiding health losses caused by lapses in healthcare safety and patient lifestyle choices

© 2013 Singh et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been made available through the Brunel Open Access Publishing Fund.Background: Although many studies have identified public preferences for prioritising health care interventions based on characteristics of recipient or care, very few of them have examined the reasons for the stated preferences. We conducted an on-line person trade-off (PTO) study (N=1030) to investigate whether the public attach a premium to the avoidance of ill health associated with alternative types of responsibilities: lapses in healthcare safety, those caused by individual action or lifestyle choice; or genetic conditions. We found that the public gave higher priority to prevention of harm in a hospital setting such as preventing hospital associated infections than genetic disorder but drug administration errors were valued similar to genetic disorders. Prevention of staff injuries, lifestyle diseases and sports injuries, were given lower priority. In this paper we aim to understand the reasoning behind the responses by analysing comments provided by respondents to the PTO questions. Method: A majority of the respondents who participated in the survey provided brief comments explaining preferences in free text responses following PTO questions. This qualitative data was transformed into explicit codes conveying similar meanings. An overall coding framework was developed and a reliability test was carried out. Recurrent patterns were identified in each preference group. Comments which challenged the assumptions of hypothetical scenarios were also investigated. Results: NHS causation of illness and a duty of care were the most cited reasons to prioritise lapses in healthcare safety. Personal responsibility dominated responses for lifestyle related contexts, and many respondents mentioned that health loss was the result of the individual’s choice to engage in risky behaviour. A small proportion of responses questioned the assumptions underlying the PTO questions. However excluding these from the main analysis did not affect the conclusions. Conclusion: Although some responses indicated misunderstanding or rejection of assumptions we put forward, the results were still robust. The reasons put forward for responses differed between comparisons but responsibility was the most frequently cited. Most preference elicitation studies only focus on eliciting numerical valuations but allowing for qualitative data can augment understanding of preferences as well as verifying results.EPSRC through the MATCH programme(EP/F063822/1 and EP/G012393/1) and HERG within Brunel University

Crystallization and preliminary X-ray diffraction analysis of the complex between a human anti-interferon antibody fragment and human interferon α-2A

Crystals of the complex between the Fab fragment of a human anti-interferon α therapeutic antibody and human interferon α-2A have been obtained and diffracted to 3.0 Å resolution