Approaching the Performance of Experimental Music on the Flute

This dissertation serves as a commentary to two recitals: a recital of chamber music which took place in July 2014, and a solo recital in June 2015. The first chapter looks at the definition of experimental music and its characteristics through the exploration of writings by composers and performers, considering the selection of repertoire that abides by these ideas, along with a brief look at performance practice. The second chapter serves as a performance commentary to the chamber works Why Patterns? by Morton Feldman and Flutist and Guitarist by Christian Wolff. The third chapter serves as a performance commentary to the works Headlong by Christopher Fox and 947 by Alvin Lucier. Both the second and third chapter examine the composer’s aesthetic concerns, along with recordings and writings around experimental music to inform the performance approach. Finally the conclusion looks at the significance of the experimental performer and how a performer may approach future works

A geostatistical study of socioeconomic status (SES), rurality, seasonality and index test results as drivers of free private groundwater testing in southern Ontario, 2012–2016

Approximately 12% of the Canadian population uses private wells for daily water consumption; however, well water testing rates are on the decline, resulting in an increased risk of waterborne acute gastrointestinal illness. To date, limited research has explored the determinants influencing well testing practices. Accordingly, the current study sought to investigate the drivers of “one-off” and repeat well water testing in southern Ontario during the 5-year period 2012–2016, using the worlds largest private groundwater testing data-frame. Data from \u3e400,000 wells were geospatially integrated with all tests conducted by the provincial laboratory in southern Ontario. The Ontario Marginalization Index (ON-Marg) was used as a proxy measure of socioeconomic status (SES), with rurality, based on population density, season, and index (1st) test results assessed as effect modifiers. Multivariate analysis was undertaken using log-binomial regression. Approximately 27.5% of wells (n = 417,406) were tested during the study period, 66.7% of which were sampled more than once; 3% of all samples tested positive for E. coli (\u3e0 colony forming unit/100 mL). In rural regions (\u3c150 people/km2), wells located in low SES areas were 13% more likely to be tested compared to high SES areas (95% CI: 1.11, 1.15). In urban (\u3e400 people/km2) and peri-urban regions (\u3e150 and \u3c400 people/km2), wells located in low SES areas were 14% (95% CI: 0.78, 0.95) and 15% (95% CI: 0.76, 0.94) less likely to be tested compared to high SES areas. Wells located in low SES areas were 6% more likely to be re-tested (95% CI: 1.04, 1.07). Positive index tests were associated with a 17% increased likelihood of repeat testing (95% CI: 1.16, 1.18). Accordingly, the authors conclude that location and SES are significant predictors of well water testing, with index test status being the most influential predictor of repeat well testing

Human papillomavirus (HPV) types 16, 18, 31, 45 DNA loads and HPV-16 integration in persistent and transient infections in young women

<p>Abstract</p> <p>Background</p> <p>HPV burden is a predictor for high-grade cervical intraepithelial neoplasia and cancer. The natural history of HPV load in young women being recently exposed to HPV is described in this paper.</p> <p>Methods</p> <p>A total of 636 female university students were followed for 2 years. Cervical specimens with HPV-16, -18, -31, or -45 DNA by consensus PCR were further evaluated with type-specific and β-globin real-time PCR assays. Proportional hazards regression was used to estimate hazard ratios (HR) of infection clearance. Generalized estimating equations assessed whether HPV loads was predictive of HPV infection at the subsequent visit.</p> <p>Results</p> <p>HPV loads were consistently higher among women <25 years old, and those who had multiple sex partners, multiple HPV type infections and smokers. HPV-16 integration was encountered only in one sample. Infection clearance was faster among women at lower tertiles of HPV-16 (HR = 2.8, 95%CI: 1.0-8.1), HPV-18 (HR = 3.5, 95%CI: 1.1-11.2) or combined (HR = 2.4, 95%CI: 1.8-6.2) DNA loads. The relationship between HPV-16 and HPV-18 DNA loads and infection clearance followed a clear dose-response pattern, after adjusting for age and number of sexual partners. GEE Odds Ratios for HPV persistence of the middle and upper tertiles relative to the lower tertile were 2.7 and 3.0 for HPV-16 and 3.8 and 39.1 for HPV-18, respectively. There was no association between HPV-31 or -45 DNA loads and persistence.</p> <p>Conclusions</p> <p>The association between HPV load and persistence is not uniform across high-risk genital genotypes. HPV-16 integration was only rarely demonstrated in young women.</p

Interventions to improve continence for children and young people with neurodisability: a national survey of practitioner and family perspectives and experiences.

Objective Describe families’ experiences of interventions to improve continence in children and young people with neurodisability, and health professionals’ and school and social care staff’s perspectives regarding factors affecting intervention use. Design Four online surveys were developed and advertised to parent carers, young people with neurodisability, health professionals and school and social care staff, via societies, charities, professional contacts, schools, local authorities, and national parent carer and family forums, who shared invitations with their networks. Survey questions explored: difficulties helping children and young people use interventions; acceptability of interventions and waiting times; ease of use and availability of interventions, and facilitators and barriers to improving continence. Results 1028 parent carers, 26 young people, 352 health professionals and 202 school and social care staff registered to participate. Completed surveys were received from 579 (56.3%) parent carers, 20 (77%) young people, 193 (54.8%) health professionals, and 119 (58.9%) school and social care staff. Common parent carer-reported difficulties in using interventions to help their children and young people to learn to use the toilet included their child’s lack of understanding about what was required (reported by 337 of 556 (60.6%) parent carers who completed question) and their child’s lack of willingness (343 of 556, 61.7%). Almost all (142 of 156, 91%) health professionals reported lack of funding and resources as barriers to provision of continence services. Many young people (14 of 19, 74%) were unhappy using toilet facilities while out and about. Conclusions Perceptions that children lack understanding and willingness, and inadequate facilities impact the implementation of toileting interventions for children and young people with neurodisability. Greater understanding is needed for children to learn developmentally appropriate toileting skills. Further research is recommended around availability and acceptability of interventions to ensure quality of life is unaffected

Implementing collaborative care for major depression in a cancer center: An observational study using mixed-methods.

OBJECTIVES: To describe the implementation of a collaborative care (CC) screening and treatment program for major depression in people with cancer, found to be effective in clinical trials, into routine outpatient care of a cancer center. METHOD: A mixed-methods observational study guided by the RE-AIM implementation framework using quantitative and qualitative data collected over five years. RESULTS: Program set-up took three years and required more involvement of CC experts than anticipated. Barriers to implementation were uncertainty about whether oncology or psychiatry owned the program and the hospital's organizational complexity. Selecting and training CC team members was a major task. 90% (14,412/16,074) of patients participated in depression screening and 61% (136/224) of those offered treatment attended at least one session. Depression outcomes were similar to trial benchmarks (61%; 78/127 patients had a treatment response). After two years the program obtained long-term funding. Facilitators of implementation were strong trial evidence, effective integration into cancer care and ongoing clinical and managerial support. CONCLUSION: A CC program for major depression, designed for the cancer setting, can be successfully implemented into routine care, but requires time, persistence and involvement of CC experts. Once operating it can be an effective and valued component of medical care

Public Interest Litigation and the Civil Society Factor

This article explores civil society organisations’ (CSOs) participation in judicial review proceedings. This became contentious when the Ministry of Justice announced that it intended to reform the judicial review process, and suggested changes to the law on standing and third party interventions (Ministry of Justice Judicial Review: Proposals for Further Reform London: TSO 2013, Cm 8703). Ultimately, the Criminal Justice and Courts Act 2015 did not amend the law in these areas, but has arguably made it more difficult for CSOs to engage in public interest litigation. Attempts to restrict the access of CSOs, to judicial review, need to be seen in the context of the shifting relationship between CSOs and the state, and differing perspectives on their function. If CSOs are to continue to take part in judicial review cases they need to justify their presence in terms of their expertise and on the ground knowledge. It is argued that deliberative, dignitarian, and more general theories about the nature of civil society may well establish a basis for CSOs’ continued presence in judicial review litigation

HIV Prevention in Care and Treatment Settings: Baseline Risk Behaviors among HIV Patients in Kenya, Namibia, and Tanzania.

HIV care and treatment settings provide an opportunity to reach people living with HIV/AIDS (PLHIV) with prevention messages and services. Population-based surveys in sub-Saharan Africa have identified HIV risk behaviors among PLHIV, yet data are limited regarding HIV risk behaviors of PLHIV in clinical care. This paper describes the baseline sociodemographic, HIV transmission risk behaviors, and clinical data of a study evaluating an HIV prevention intervention package for HIV care and treatment clinics in Africa. The study was a longitudinal group-randomized trial in 9 intervention clinics and 9 comparison clinics in Kenya, Namibia, and Tanzania (N = 3538). Baseline participants were mostly female, married, had less than a primary education, and were relatively recently diagnosed with HIV. Fifty-two percent of participants had a partner of negative or unknown status, 24% were not using condoms consistently, and 11% reported STI symptoms in the last 6 months. There were differences in demographic and HIV transmission risk variables by country, indicating the need to consider local context in designing studies and using caution when generalizing findings across African countries. Baseline data from this study indicate that participants were often engaging in HIV transmission risk behaviors, which supports the need for prevention with PLHIV (PwP). TRIAL REGISTRATION: ClinicalTrials.gov NCT01256463