Stacy Garrop\u27s settings of sonnets by Edna St. Vincent Millay: a conductor\u27s analysis

Stacy Garrop is an emerging composer of choral and orchestral music. The focus of this research is to provide information on her career and compositional style and to provide a conductor’s analysis of six multi-movement a cappella works which set to music sonnets by Edna St. Vincent Millay. Works to be examined: Sonnets of Love and Chaos (2001) Sonnets of Vanity, Loss, and Rapture (2002) Sonnets of War and Mankind (2003) Sonnets of Desire, Longing, and Whimsy (2004) Sonnets of the Fatal Interview (2005) Sonnets of Beauty and Music (2006) The document is divided into nine chapters tracing the musical development of Stacy Garrop from the beginning of her musical education in elementary school to her current position as Associate Professor of Composition at Roosevelt University, and identifies influential musical moments in her career while providing insight into her compositional process. Furthermore, the document traces the career of Pulitzer Prize winning feminist American poet Edna St. Vincent Millay. The focus of the monograph is to analyze the aforementioned choral works with consideration to formal structure, style, interpretation, and rehearsal considerations. Garrop sonnet settings are composed with Millay’s texts in mind. Meter is typically altered to allow for proper syllabic stress of the English language. Within each movement, careful attention is given to musically express the words of the sonnet. Garrop’s harmonic language is largely chromatic and is constructed around anchor pitches, often tonicized by duration or repetition rather than traditional cadential figures

Ideologies and outcomes in temporomandibular disorders

Temporomandibular disorders (TIVID) are a group of relatively common chronic disorders that often result in pain affecting the face, specifically the temporomandibular joint and associated muscles. Treatment strategies are varied, with only a minimal evidence base. The psychosocial aspects of TIVID are generally recognised to be important and complex. The aim of this thesis is to understand the philosophies of care that underpin the professional management of TIVID, and to explore the patients ) experiences of their illness and its management. The ultimate purpose is to use this information to target future interventions at specific points in the care pathway. Qualitative studies of professionals' and individuals' experiences of managing and living with TIVID were undertaken. In depth interviews were conducted with eighteen professionals and twenty-nine individuals suffering from TIVID. The data were then analysed and used to develop a map illustrating the patients' journey through care. The results exposed the large variation in clinical practice and considerable professional uncertainty about optimum management. Patients' experiences reflected the professional uncertainty, and some of the psychosocial effects experienced on the journey through care appeared to have an impact on outcome. The uncertainty over diagnosis in primary care led to a lack of legitimisation of the sufferer's complaint, which had concomitant effects on their day-to-day functioning. This, in turn, perpetuated any psychological distress they might already be experiencing. In conclusion, this thesis highlights the experiential basis of TIVID management, and the underlying ideology of, "do no harm". In primary care the sufferers experience a lack of legitimacy in their complaint due, in part, to a lack of a diagnosis. There is a need for a targeted programme of education in primary care in the diagnosis and management of TMD. This might reduce the level of uncertainty and concomitant psychosocial effects that sufferers experience currently.EThOS - Electronic Theses Online ServiceNewcastle Healthcare CharityGBUnited Kingdo

“Well nobody reads learning outcomes do they?” – an evaluation of CAA and its feedback on directed student learning

Traditionally anatomy is taught to dental students in the first one or two years of their course and not revisited. The problem with separating this basic, discipline-specific knowledge from that needed for clinical practice is that students can view anatomy as a mass of facts, learnt for examinations and then forgotten. Such superficial learning can be partly overcome by using case-led or problem-solving approaches but the students do not have enough clinical experience to see these examples as anything more than vignettes. Therefore a collaborative project between an anatomist, dental surgeon and a learning technologist was funded by the LTSN-01 to develop six clinically relevant anatomy tutorials for final year students, running on the university’s virtual learning environment. Participation was voluntary in the first year of the project upon which this study is based. The vertical integration of basic and clinical science is one of the important principles adopted by the General Dental Council in its document that sets out the framework for dental education in the UK (ref here!). This integration is also of pedagogical importance as it provides a means to “link theoretical ideas with practice” (Ramsden, 2003) and thus can contribute to effective teaching, moving students further up the critical matrix of learning (Light and Cox, 2001). This issue of integrating factual content with professional practice throughout a professional programme (ie vertical integration) is faced by many subject areas, for example Law, Speech and Language Sciences and Medicine, and so it is hoped that the results of this initial study will be of interest to those beyond Dentistry

Dental Attendances to General Medical Practitioners in Wales: a 44 Year Analysis

One-third of the UK population is composed of problem-oriented dental attenders, seeking dental care only when they have acute dental pain or problems. Patients seek urgent dental care from a range of health care professionals, including general medical practitioners. This study aimed to identify trends in dental attendance at Welsh medical practices over a 44-y period, specifically in relation to dental policy change and factors associated with repeat attendance. A retrospective observational study was completed via the nationwide Secure Anonymised Information Linkage (SAIL) Databank of visits to general medical practice in Wales. Read codes associated with dental diagnoses were extracted for patients attending their general medical practitioner between 1974 and 2017. Data were analyzed with descriptive statistics and univariate and multivariable logistic regression. Over the 44-y period, there were 439,361 dental Read codes, accounting for 288,147 patient attendances. The overall attendance rate was 2.60 attendances per 1,000 patient-years (95% CI, 2.59 to 2.61). The attendance rate was negligible through 1987 but increased sharply to 5.0 per 1,000 patient-years in 2006 (95% CI, 4.94 to 5.09) before almost halving to 2.6 per 1,000 in 2017 (95% CI, 2.53 to 2.63) to a pattern that coincided with changes to National Health Service policies. Overall 26,312 patients were repeat attenders and were associated with living in an area classified as urban and deprived (odds ratio [OR], 1.22; 95% CI, 1.19 to 1.25; P < 0.0001) or rural (OR, 0.84; 95% CI, 0.83 to 0.85; P < 0.0001). Repeat attendance was associated with greater odds of having received an antibiotic prescription (OR, 2.53; 95% CI, 2.50 to 2.56; P < 0.0001) but lower odds of having been referred to another service (OR, 0.75; 95% CI, 0.70 to 0.81; P < 0.0001). Welsh patients’ reliance on medical care for dental problems was influenced by social deprivation and health policy. This indicates that future interventions to discourage dental attendance at medical practitioners should be targeted at those in the most deprived urban areas or rural areas. In addition, health policy may influence attendance rates positively and negatively and should be considered in the future when decisions related to policy change are made

Developing Effective and Efficient care pathways in chronic Pain: DEEP study protocol

Background Pain affecting the face or mouth and lasting longer than three months (“chronic orofacial pain”, COFP) is relatively common in the UK. This study aims to describe and model current care pathways for COFP patients, identify areas where current pathways could be modified, and model whether these changes would improve outcomes for patients and use resources more efficiently. Methods/Design The study takes a prospective operations research approach. A cohort of primary and secondary care COFP patients (n = 240) will be recruited at differing stages of their care in order to follow and analyse their journey through care. The cohort will be followed for two years with data collected at baseline 6, 12, 18, and 24 months on: 1) experiences of the care pathway and its impacts; 2) quality of life; 3) pain; 4) use of health services and costs incurred; 5) illness perceptions. Qualitative in-depth interviews will be used to collect data on patient experiences from a purposive sub-sample of the total cohort (n = 30) at baseline, 12 and 24 months. Four separate appraisal groups (public, patient, clincian, service manager/commissioning) will then be given data from the pathway analysis and asked to determine their priority areas for change. The proposals from appraisal groups will inform an economic modelling exercise. Findings from the economic modelling will be presented as incremental costs, Quality Adjusted Life Years (QALYs), and the incremental cost per QALY gained. At the end of the modelling a series of recommendations for service change will be available for implementation or further trial if necessary. Discussion The recent white paper on health and the report from the NHS Forum identified chronic conditions as priority areas and whilst technology can improve outcomes, so can simple, appropriate and well-defined clinical care pathways. Understanding the opportunity cost related to care pathways benefits the wider NHS. This research develops a method to help design efficient systems built around one condition (COFP), but the principles should be applicable to a wide range of other chronic and long-term conditions

Quality of life and mastication in denture wearers and cleft lip and palate adults

<div><p>Abstract The impact of oral rehabilitation on masticatory function and oral health-related quality of life (OHRQoL) may vary with the experience of the individual with tissue loss. Our hypothesis is that patient-centered outcomes vary among adults who have experienced large defects in the maxilla due to congenital or acquired conditions even after oral rehabilitation to restore aesthetics and function. This study compared OHRQoL, perceived masticatory ability, maximum bite force (MBF), and symptoms of pain and depression among subjects with acquired (edentulous maxilla) and congenital (cleft lip and palate) loss of oral tissues in the maxilla after dental treatment. A gender-matched sample (n = 60) of cleft lip and palate (CLP), maxillary denture wearers (DENT) and controls (CONT) was recruited. OHRQoL was assessed using OHIP-14. Chewing was evaluated through a masticatory ability questionnaire and by MBF. The RDC/TMD Axis II questionnaire was used to assess symptoms of pain and depression. Data were analyzed by Fisher's test, Kruskal Wallis test, and Spearman correlation coefficients. CLP showed higher OHIP-14 and depression scores than DENT and CONT (p < 0.05). Sub-analysis by OHIP-14 items (%FOVO) showed higher prevalence of psychological impact for CLP and of functional impacts for DENT. The number of foods difficult to chew, of food textures difficult to chew, and avoided foods were similar between CLP and DENT. OHIP-14, MBF, and depression scores showed significant correlation (p < 0.05). The results suggest that adults with treated CLP or maxillary DENT have chewing impairment and lower MBF than healthy subjects, with different psychological and functional impacts.</p></div

The effect of magnetic resonance imaging on mercury release from dental amalgam at 3T and 7T

Objectives To measure mercury release from standardised hydroxyapatite/amalgam constructs during MRI scanning and investigate the impact of static field strength and radiofrequency (RF) power on mercury release. Methods Amalgam was placed into 140 hydroxyapatite disks and matured for 14-days in artificial saliva. The solution was replaced, and samples split into five groups of 28 immediately prior to MRI. One group had no exposure, and the remainder were exposed to either a 3T or 7T MRI scanner, each at high and low RF power. Mercury concentration was measured by inductively coupled plasma mass spectrometry. Groups were compared using one-way ANOVA, and two-way ANOVA for main effects/ interaction of field strength/ RF power. Results Mercury concentration was increased in the 7T groups (high/ low: 15.43/ 11.33 ng mL−1) and 3T high group (3.59) compared to control (2.44). MRI field strength significantly increased mercury release (p < .001) as did RF power (p = .030). At 3T, mercury release was 20.3 times lower than during maturation of dental amalgam, and for the average person an estimated 1.50 ng kg−1 of mercury might be released during one 3T investigation; this is substantially lower than the tolerable weekly intake of 4,000 ng kg−1. Conclusion Mercury release from amalgam shows a measurable increase following MRI, and the magnitude changes with magnetic field strength and RF power. The amount of mercury released is small compared to release during amalgam maturation. Amalgam mercury release during MRI is unlikely to be clinically meaningful and highly likely to remain below safe levels

Blame framing and prior knowledge influence moral judgments for people involved in the Tulsa Race Massacre among a combined Oklahoma and UK sample

IntroductionHow an event is framed impacts how people judge the morality of those involved, but prior knowledge can influence information processing about an event, which also can impact moral judgments. The current study explored how blame framing and self-reported prior knowledge of a historical act of racial violence, labeled as Riot, Massacre, or Event, impacted individual’s cumulative moral judgments regarding the groups involved in the Tulsa Race Massacre (Black Tulsans, the Tulsa Police, and White Tulsans).Methods and resultsThis study was collected in two cohorts including undergraduates attending the University of Oklahoma and individuals living in the United Kingdom. Participants were randomly assigned to a blame framing condition, read a factual summary of what happened in Tulsa in 1921, and then responded to various moral judgment items about each group. Individuals without prior knowledge had higher average Likert ratings (more blame) toward Black Tulsans and lower average Likert ratings (less blame) toward White Tulsans and the Tulsa Police compared to participants with prior knowledge. This finding was largest when what participants read was framed as a Massacre rather than a Riot or Event. We also found participants with prior knowledge significantly differed in how they made moral judgments across target groups; those with prior knowledge had lower average Likert ratings (less blame) for Black Tulsans and higher average Likert ratings (more blame) for White Tulsans on items pertaining to causal responsibility, intentionality, and punishment compared to participants without prior knowledge.DiscussionFindings suggest that the effect of blame framing on moral judgments is dependent on prior knowledge. Implications for how people interpret both historical and new events involving harmful consequences are discussed

Oral splints for patients with temporomandibular disorders or bruxism : a systematic review and economic evaluation

This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 7. See the NIHR Journals Library website for further project information.Peer reviewedPublisher PD

Oral splints for temporomandibular disorder or bruxism : a systematic review

Funded by: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment Programme (Project number: 16/146/06). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.Peer reviewedPublisher PD