Toward a new Kurt Weill Reception: A Study of Influence in the Music Theater of Marc Blitzstein and Leonard Bernstein

Theodor Adorno verkündete, das Model von Kurt Weill lasse sich nicht wiederholen. Seine Bühnenwerke wurden trotzdem zum unvermeidlichen Präzedenzfall für Komponisten auf beiden Seiten des Atlantiks. Diese Promotionsarbeit erkundet insbesondere die Rolle seiner formalen Innovationen im Musiktheater von Marc Blitzstein und Leonard Bernstein. Dabei haben die Komponisten seinem ästhetischen Beitrag zur amerikanischen Tradition entweder wiederstanden oder ihn heruntergespielt. Komparative Analysen aufgrund von Harold Blooms „Anxiety of Influence“ und anderen intertextuellen Methoden decken auf, dass die Grundsätze von Weills Opernreform eine einheimische Bewegung von anspruchsvollem, sozial-engagierten Musiktheater katalysierten. Die folgende Studie richtet den Fokus auf Werke, die verschiedene Phasen seiner Mission vertreten, die Gattung der Oper zu erneuern, eine Entwicklung, die sich von der Urform in Die Dreigroschenoper bis zum Musical Play (Lady in the Dark) und zur Broadway Opera (Street Scene) erstreckt. Blitzstein und Bernstein wiederum überwanden die formalen Grenzen zwischen Oper und Musical mit The Cradle Will Rock, Regina, Trouble in Tahiti, Candide und West Side Story, teil einer kurzlebigen Bewegung in Amerika des zwanzigsten Jahrhunderts. Dieselbe überschnitt sich mit einer Renaissance für Weills deutschsprachige Werke im Anschluss an die Premiere von Blitzsteins Übersetzung The Threepenny Opera unter Bernsteins Leitung. Das unveröffentlichte A Pray by Blecht, für welches Bernstein sich an Stephen Sondheim und Jerome Robbins, seine Kooperationspartner in West Side Story, wieder angeschlossen hat, vertieft den Bezug von Bernsteins Musiktheater-Ästhetik auf Weill.Theodor Adorno famously proclaimed that the model of Kurt Weill could not be repeated. His stage works nevertheless set an inescapable precedent for composers on both sides of the Atlantic. My dissertation explores how Weill’s formal innovations in particular laid the groundwork for the music theater of Marc Blitzstein and Leonard Bernstein although they either resisted or downplayed his aesthetic contribution to American tradition. Comparative analysis based on Harold Bloom’s Anxiety of Influence and other modes of intertextuality reveal that the principles of Weill’s opera reform would catalyze an indigenous movement in sophisticated, socially engaged music theatre. The following study focuses on works that represent different phases of his mission to renew the genre of opera, evolving from the Urform (original or primitive form) in Die Dreigroschenoper to the musical play (Lady in the Dark) and Broadway Opera (Street Scene). Blitzstein and Bernstein in turn defied the formal boundaries between opera and musical theater with The Cradle Will Rock, Regina, Trouble in Tahiti, Candide and West Side Story, part of a short-lived movement in mid-twentieth century America that coincided with a renaissance for Weill’s German-period works following the premiere of Blitzstein’s translation, The Threepenny Opera, under Bernstein’s baton. The unpublished A Pray by Blecht, – for which Bernstein rejoined Stephen Sondheim and Jerome Robbins, his collaborators on West Side Story, – deepens the connection of Bernstein’s music theater aesthetic to Weill

Wachkoma - ein anderes Leben : Schmerzerfassungsinstrumente bei Kindern mit schweren, erworbenen Hirnschädigungen

Einleitung: Jährlich fallen schweizweit ungefähr 40 Kinder aufgrund schwerer, erworbenen Hirnschädigungen in ein Wachkoma (Donis & Trojer, 2015). Sie können sich nicht zu ihrem Befinden äussern und so bleibt für das betreuende Fachpersonal unklar, ob die gewählten Massnahmen zur Zustandsverbesserung der Kinder beitragen. Zur Überprüfung dieser Massnahmen verwendet man deshalb im Praxisalltag Verlaufsparameter, die objektive Aussagen ermöglichen. Ziel: Das Ziel ist, reliable, valide und für die Physiotherapie relevante Schmerzassessments für Kinder im Wachkoma zu finden. Solche Assessments helfen, eine bessere und zielorientierte Empfehlung für eine physiotherapeutische Behandlung zu geben und den Therapieverlauf objektiv festzuhalten. Methodik: Mittels einer Literaturrecherche wurden Assessments gesucht, welche für Kinder mit schweren, erworbenen Hirnschädigungen anwendbar sind. Die inkludierten Validierungsstudien wurden bezüglich Methodik und psychometrischen Eigenschaften nach Lienert und Raatz (1998) beurteilt und kritisch diskutiert. Ergebnisse: Für die Schmerzerfassung zeigt die NCS-R die höchsten Werte für Reliabilität und Validität. Offen bleibt die Frage, inwiefern die Ergebnisse dieser Arbeit für Kinder anwendbar sind. Schlussfolgerungen: Da Kinder ab 2 Jahren bereits über entwickelte Schmerzbewältigungsstrategien (Deutscher Hebammenverband, 2010) verfügen, wird empfohlen, den Entwicklungsstand der Kinder immer miteinzubeziehen (Ashwal, 2004). Dadurch könnte die Möglichkeit bestehen, Kinder ab einer gewissen Reife, mit Assessments für Erwachsene zu bewerten

A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol.

Background Disability is prevalent in individuals with multiple sclerosis (MS), leading to difficulty in care access, significant caregiver burden, immense challenges in self-care and great societal burden. Without highly coordinated, competent and accessible care, individuals living with progressive MS experience psychological distress, poor quality of life, suffer from life-threatening complications, and have frequent but avoidable healthcare utilizations. Unfortunately, current healthcare delivery models present severe limitations in providing easily accessible, patient-centered, coordinated comprehensive care to those with progressive MS. We propose a home-based comprehensive care model (MAHA) to address the unmet needs, challenges, and avoidable complications in individuals with progressive MS with disabling disease. Objective The article aims to describe the study design and methods used to implement and evaluate the proposed intervention. Method The study will use a randomized controlled design to evaluate the feasibility of providing a 24-month, home-based, patient-centered comprehensive care program to improve quality of life, reduce complications and healthcare utilizations overtime (quarterly) for 24 months. A transdisciplinary team led by a MS-Comprehensivist will carry out this project. Fifty MS patients will be randomly assigned to the intervention and usual care program using block randomization procedures. We hypothesize that patients in the intervention group will have fewer complications, higher quality of life, greater satisfaction with care, and reduced healthcare utilization. The proposed project is also expected to be financially sustainable in fee-for-service models but best suited for and gain financial success in valued-based care systems. Discussion This is the first study to examine the feasibility and effectiveness of a home-based comprehensive care management program in MS patients living with progressive disability. If successful, it will have far-reaching implications in research, education and practice in terms of providing high quality but affordable care to population living with severe complex, disabling conditions

Young women with breast cancer: how many are actually candidates for fertility preservation?

Purpose: There are no data regarding the actual need for fertility preservation (FP) in breast cancer (BC) patients. Our study provides a practical needs assessment for reproductive medicine by analyzing an unselected cohort of young BC patients. This assessment considers oncological factors as well as the patient's obstetrical and gynecological history and reproductive outcome after BC diagnosis. We aimed to identify how many patients are actually potential candidates for FP and how many patients might consequently use their cryopreserved gametes to achieve pregnancy. Methods: Based on a prospective BC database, we analyzed all patients who were≤40years at initial diagnosis (time period of diagnosis: 1990-2007; n=100; 7.7% of the entire BC cohort; median age: 35.9years). Results: Using an algorithm of exclusion criteria considering disease-specific, therapy-specific and family history characteristics, 36 patients who received chemotherapy were identified as potential "classical” candidates for FP. After 5years, 22 women were identified as potential candidates for using their cryopreserved gametes to achieve pregnancy; the majority of these patients were childless (n=16, 72.7%) and in their late reproductive years (n=12, 54.5%). Conclusions: Our study demonstrates that in a cohort of young BC patients only a minority of women are candidates for FP. Young BC patients who wish to have children in the future usually carry risk factors both from oncological and reproductive medicine perspective. Due to this high-risk profile, the rarity of BC in young age and the limited number of patients who might actually have opted for FP, these women must be offered timely and multidisciplinary counseling in highly specialized center

Reply to Sopek Merkaš, I.; Lakušić, N. Comment on "von Känel et al. Early Trauma-Focused Counseling for the Prevention of Acute Coronary Syndrome-Induced Posttraumatic Stress: Social and Health Care Resources Matter. J. Clin. Med. 2022, 11, 1993".

We thank Merkaš and Lakušić for commenting on our recently published paper; in the paper, we suggested that resources in a patient's social environment may moderate the benefit of one single-session trauma-focused counseling in the prevention of acute coronary syndrome (ACS)-induced posttraumatic stress disorder (PTSD) symptoms [...]

Reply to Sopek Merkaš, I.; Lakušić, N. Comment on “von Känel et al. Early Trauma-Focused Counseling for the Prevention of Acute Coronary Syndrome-Induced Posttraumatic Stress: Social and Health Care Resources Matter. J. Clin. Med. 2022, 11, 1993”

We thank Merkaš and Lakušić for commenting on our recently published paper; in the paper, we suggested that resources in a patient’s social environment may moderate the benefit of one single-session trauma-focused counseling in the prevention of acute coronary syndrome (ACS)-induced posttraumatic stress disorder (PTSD) symptoms [1]. Their comment gives a comprehensive summary on the topic of ACS-induced PTSD and its treatment [2]. We agree with the authors that guidelines and standards regarding the identification and treatment of patients at high risk for developing PTSD after ACS remain lacking. We designed the MI-SPRINT study to test whether trauma-focused psychological counseling is more effective than stress-focused counseling in preventing PTSD symptoms after acute ACS [3]. Our study showed no beneficial effect of trauma-focused counseling on PTSD symptoms; after 3 and 12 months, we found no difference in the severity of PTSD symptoms between patients with early trauma-focused counseling and those with stress-focused counseling in the total sample. However, our results suggested that psychological counseling in general might help distressed patients to prevent posttraumatic psychological responses compared with no intervention [4,5]. Importantly, PTSD symptoms that had developed after 3 months were shown to have been persistent up to 12 months after ACS, despite the delivery of one session of early psychological counseling [6]. Furthermore, as alluded to above, we showed that social support and cardiac rehabilitation act as moderators of the intervention; specifically, trauma-focused counseling was associated with fewer PTSD symptoms compared with stress-focused counseling in patients with high social support and with longer participation in cardiac rehabilitation [1]. Moreover, the data of MI-SPRINT showed that several factors contribute to identifying patients at risk for ACS-induced PTSD symptoms, such as high perceived distress during ACS [6], perception of higher harmful consequences of the illness [7], perception of a hectic hospital environment [8], sleep problems [9], and low trait resilience [10]. Screening for risk factors or specific symptoms—e.g., in the cardiac rehabilitation setting, as indicated by the Merkaš and Lakušić [1]—is important. However, we believe that screening alone may have little clinical benefit. It will be much more crucial to offer effective treatment to patients identified at high risk of developing PTSD or patients with established PTSD symptoms. In summary, further studies are needed to develop a standardized approach for the screening of patients at risk of clinically relevant, ACS-induced PTSD symptoms and to establish efficacious interventions that can be applied in a clinical setting. For instance, multisession early counseling could be elaborated and tested based on our findings to prevent the development of PTSD symptoms in patients at risk

Early Trauma-Focused Counseling for the Prevention of Acute Coronary Syndrome-Induced Posttraumatic Stress: Social and Health Care Resources Matter.

BACKGROUND A one-size-fits-all approach might explain why early psychological interventions are largely ineffective in preventing the development of posttraumatic stress disorder (PTSD) symptoms triggered by acute medical events. We examined the hypothesis that social and health care resources are moderators of an intervention effect. METHODS Within 48 h of hospital admission, 129 patients (mean age 58 years, 83% men) with acute coronary syndrome (ACS) self-rated their social support and were randomized to one single session of trauma-focused counseling (TFC) or stress-focused counseling (SFC) (active control intervention). Clinician-rated PTSD symptoms, use of cardiac rehabilitation (CR) and use of psychotherapy were assessed at 3 and 12 months. Random mixed regression multivariable models were used to analyze associations with PTSD symptoms over time. RESULTS TFC did not prevent ACS-induced PTSD symptom onset better than SFC; yet, there were significant and independent interactions between "intervention" (TFC or SFC) and social support (p = 0.013) and between "intervention" and duration of CR in weeks (p = 0.034). Patients with greater social support or longer participation in CR had fewer PTSD symptoms in the TFC group compared with the SFC group. The number of psychotherapy sessions did not moderate the intervention effect. CONCLUSIONS Early psychological intervention after ACS with a trauma-focused approach to prevent the development of PTSD symptoms may be beneficial for patients who perceive high social support or participate in CR for several weeks

Relationship between a Self-Reported History of Depression and Persistent Elevation in C-Reactive Protein after Myocardial Infarction.

BACKGROUND Elevated levels of C-reactive protein (CRP) are associated with both an increased risk of cardiovascular disease (CVD) and depression. We aimed to test the hypothesis that a self-report history of depression is associated with a smaller decrease in CRP levels from hospital admission to 3-month follow-up in patients with acute myocardial infarction (MI). METHODS We assessed 183 patients (median age 59 years; 84% men) with verified MI for a self-report history of lifetime depression and plasma CRP levels within 48 h of an acute coronary intervention and again for CRP levels at three months. CRP values were categorized according to their potential to predict CVD risk at hospital admission (acute inflammatory response: 0 to <5 mg/L, 5 to <10 mg/L, 10 to <20 mg/L, and ≥20 mg/L) and at 3 months (low-grade inflammation: 0 to <1 mg/L, 1 to <3 mg/L, and ≥3 mg/L). Additionally, in a subsample of 84 patients showing admission CRP levels below 20 mg/L, changes in continuous CRP values over time were also analyzed. RESULTS After adjustment for a range of potentially important covariates, depression history showed a significant association with a smaller decrease in both CRP risk categories (r = 0.261, p < 0.001) and log CRP levels (r = 0.340, p = 0.005) over time. CONCLUSIONS Self-reported history of depression may be associated with persistently elevated systemic inflammation three months after MI. This finding warrants studies to test whether lowering of inflammation in patients with an acute MI and a history of depression may improve prognosis

Relationship between a Self-Reported History of Depression and Persistent Elevation in C-Reactive Protein after Myocardial Infarction

Background: Elevated levels of C-reactive protein (CRP) are associated with both an increased risk of cardiovascular disease (CVD) and depression. We aimed to test the hypothesis that a self-report history of depression is associated with a smaller decrease in CRP levels from hospital admission to 3-month follow-up in patients with acute myocardial infarction (MI). Methods: We assessed 183 patients (median age 59 years; 84% men) with verified MI for a self-report history of lifetime depression and plasma CRP levels within 48 h of an acute coronary intervention and again for CRP levels at three months. CRP values were categorized according to their potential to predict CVD risk at hospital admission (acute inflammatory response: 0 to <5 mg/L, 5 to <10 mg/L, 10 to <20 mg/L, and ≥20 mg/L) and at 3 months (low-grade inflammation: 0 to <1 mg/L, 1 to <3 mg/L, and ≥3 mg/L). Additionally, in a subsample of 84 patients showing admission CRP levels below 20 mg/L, changes in continuous CRP values over time were also analyzed. Results: After adjustment for a range of potentially important covariates, depression history showed a significant association with a smaller decrease in both CRP risk categories (r = 0.261, p < 0.001) and log CRP levels (r = 0.340, p = 0.005) over time. Conclusions: Self-reported history of depression may be associated with persistently elevated systemic inflammation three months after MI. This finding warrants studies to test whether lowering of inflammation in patients with an acute MI and a history of depression may improve prognosis