Teaching the way we learnt: a study in popular music education

Popular music education in the UK, and worldwide, has seen a significant expansion in the last two decades. As this new subject matures, scholars are beginning to fashion a new and more student-centred approach to learning and teaching: drawing on the informal learning practice found in popular music. Green (2006) defined the key characteristics of informal learning: allowing learners to choose the music; learning by listening and copying recordings; learning in friendship groups, with minimum adult guidance; learning in personal, often-haphazard ways; and integrating listening, playing, singing, improvising and composing. Informal musical learning is also facilitated through the use of recording as a technique for reflecting on, and improving one’s own performance. These novel approaches to music education have begun to be applied by music educators, in a diverse range of contexts. Karlsen (2010) has correspondingly linked informal learning with ideas of authenticity, and communities of practice: social networks that provide individuals with access to learning through interaction with experienced ‘old-timers’ as described by Lave and Wenger (1991). This thesis examines the way that seven musicians, teaching in one private UK Higher Education popular music institution, learnt their craft: firstly as musicians and subsequently as teachers. It asks how the way that these individuals acquired their skills and beliefs might impact on the way that they teach their students, and if this impact might be more effective if teachers were encouraged to reflect on their own learning, using that reflection to research, inform, and modify their own teaching practice. This work is particularly situated in small and medium size group teaching rather than the one to one teaching model found in classical music programmes, or in peripatetic music teaching. Furthermore, my work takes a structural-constructivist approach using the ideas of Bourdieu (1977, 1990a, 1993) as a theoretical lens, and drawing on the constructivist learning theory developed from the principles established by Vygotsky in the 1920’s and 1930’s (1930/1978).1 I argue that a hybrid approach to Bourdieu’s notion of habitus (1990a, p.53) or the dispositions we adopt to the social world is crucial to understanding the way that we become musicians. Moreover, that the situatedness of musical and educational practice and the identity practices of learners and teachers are fundamental to the process of learning as a process of becoming (Lave and Wenger, 1991). Ergo, by recognising this process of learning as situated in social, cultural, historical, and technological contexts we may also facilitate metacognition (Flavell, 1979). By metacognition, I mean the ability to be reflexive2 as a learner or teacher; understanding the way that learning works, our beliefs about learning, and how those beliefs affect one’s own learning and thus agency. Additionally, that notions of authenticity and creativity are vital to the effectiveness of musical learning practices, and the accumulation of social and cultural capital for popular musicians. My research methods include the use of open ‘semi structured’ interviews (Leech, 2002) alongside observation in the classroom3 to generate empirical data. The primary research presented here is an Action Research Study: enabling the teachers in the study to retrieve their own experience of informal learning in order to facilitate informal learning practice in the music classroom. I suggest that these individuals recognise the importance of their own experience and are able to utilise, and learn from those experiences in developing approaches that are relevant, creative, and also authentic to their students. What this work also aims to do is establish links between theory and practice, and to identify potential mechanisms for engaging with our students’ entire learning experience, whilst allowing them to understand the social and cultural process of musical learning. 1 This text is a collection of Vygotsky’s work originally published in the 1920’s and 1930’s. 2 Reflexivity is a word used in sociology to describe how much agents are able to recognise the forces of social structure and therefore affect agency. 3 By classroom teaching, I mean small group (10-20 students) and exceptionally, larger group (40-60) teaching, as is the model for delivery at my institution

Polymerized bovine hemoglobin solution as a replacement for allogeneic red blood cell transfusion after cardiac surgery: Results of a randomized, double-blind trial

AbstractBackground: Blood loss leading to reduced oxygen-carrying capacity is usually treated with red blood cell transfusions. This study examined the hypothesis that a hemoglobin-based oxygen-carrying solution can serve as an initial alternative to red blood cell transfusion. Methods: In a randomized, double-blind efficacy trial of HBOC-201, a total of 98 patients undergoing cardiac surgery and requiring transfusion were randomly assigned to receive either red blood cell units or HBOC-201 (Hemopure; Biopure Corporation, Cambridge, Mass) for the first three postoperative transfusions. Patients were monitored before and after transfusion, at discharge, and at 3 to 4 weeks after the operation for subsequent red blood cell use, hemodynamics, and clinical laboratory parameters. Results: The use of HBOC-201 eliminated the need for red blood cell transfusions in 34% of cases (95% confidence interval 21%-49%). Patients in the HBOC group received a mean of 1.72 subsequent units of red blood cells; those who received red blood cells only received a mean of 2.19 subsequent units (P =.05). Hematocrit values were transiently lower in the HBOC group but were similar in the two groups at discharge and follow-up. Oxygen extraction was greater in the HBOC group (P =.05). Mean increases in blood pressure were greater in the HBOC group, but not significantly so. Conclusion: HBOC-201 may be an initial alternative to red blood cell transfusions for patients with moderate anemia after cardiac surgery. In a third of cases, HBOC-201 eliminated the need for red blood cell transfusion, although substantial doses were needed to produce this modest degree of blood conservation.J Thorac Cardiovasc Surg 2002;124:35-4

Research cardiac magnetic resonance imaging in end stage renal disease - incidence, significance and implications of unexpected incidental findings

Objectives: Left ventricular mass (LVM) at cardiac magnetic resonance imaging (CMR) is a frequent end point in clinical trials in nephrology. Trial participants with end stage renal disease (ESRD) may have a greater frequency of incidental findings (IF). We retrospectively investigated prevalence of IF in previous research CMR and reviewed their subsequent impact on participants. Methods: Between 2002 and 2006, 161 ESRD patients underwent CMR in a transplant assessment study. Images were used to assess LV mass and function. In the current study a radiologist reviewed the scans for IF. Review of patient records determined the subsequent clinical significance of IF. Results: There were 150 IF in 95 study participants. Eighty-four (56 %) were new diagnoses. One hundred and two were non-cardiac. Fifteen were suspicious of malignancy. There was a clinically significant IF for 14.9 % of the participants. In six cases earlier identification of an IF may have improved quality of life or survival. Conclusions: Without radiology support clinically important IF may be missed on CMR. Patients undergoing CMR in trials should be counselled about the frequency and implications of IF. Patients with ESRD have a higher prevalence of IF than reported in other populations. Nephrology studies require mechanisms for radiologist reporting and strategies for dealing with IF

Anomalies in the review process and interpretation of the evidence in the NICE guideline for chronic fatigue syndrome and myalgic encephalomyelitis

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a disabling long-term condition of unknown cause. The National Institute for Health and Care Excellence (NICE) published a guideline in 2021 that highlighted the seriousness of the condition, but also recommended that graded exercise therapy (GET) should not be used and cognitive-behavioural therapy should only be used to manage symptoms and reduce distress, not to aid recovery. This U-turn in recommendations from the previous 2007 guideline is controversial.We suggest that the controversy stems from anomalies in both processing and interpretation of the evidence by the NICE committee. The committee: (1) created a new definition of CFS/ME, which 'downgraded' the certainty of trial evidence; (2) omitted data from standard trial end points used to assess efficacy; (3) discounted trial data when assessing treatment harm in favour of lower quality surveys and qualitative studies; (4) minimised the importance of fatigue as an outcome; (5) did not use accepted practices to synthesise trial evidence adequately using GRADE (Grading of Recommendations, Assessment, Development and Evaluations trial evidence); (6) interpreted GET as mandating fixed increments of change when trials defined it as collaborative, negotiated and symptom dependent; (7) deviated from NICE recommendations of rehabilitation for related conditions, such as chronic primary pain and (8) recommended an energy management approach in the absence of supportive research evidence.We conclude that the dissonance between this and the previous guideline was the result of deviating from usual scientific standards of the NICE process. The consequences of this are that patients may be denied helpful treatments and therefore risk persistent ill health and disability

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Anomalies in the review process and interpretation of the evidence in the NICE guideline for chronic fatigue syndrome and myalgic encephalomyelitis

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a disabling long-term condition of unknown cause. The National Institute for Health and Care Excellence (NICE) published a guideline in 2021 that highlighted the seriousness of the condition, but also recommended that graded exercise therapy (GET) should not be used and cognitive-behavioural therapy should only be used to manage symptoms and reduce distress, not to aid recovery. This U-turn in recommendations from the previous 2007 guideline is controversial.We suggest that the controversy stems from anomalies in both processing and interpretation of the evidence by the NICE committee. The committee: (1) created a new definition of CFS/ME, which 'downgraded' the certainty of trial evidence; (2) omitted data from standard trial end points used to assess efficacy; (3) discounted trial data when assessing treatment harm in favour of lower quality surveys and qualitative studies; (4) minimised the importance of fatigue as an outcome; (5) did not use accepted practices to synthesise trial evidence adequately using GRADE (Grading of Recommendations, Assessment, Development and Evaluations trial evidence); (6) interpreted GET as mandating fixed increments of change when trials defined it as collaborative, negotiated and symptom dependent; (7) deviated from NICE recommendations of rehabilitation for related conditions, such as chronic primary pain and (8) recommended an energy management approach in the absence of supportive research evidence.We conclude that the dissonance between this and the previous guideline was the result of deviating from usual scientific standards of the NICE process. The consequences of this are that patients may be denied helpful treatments and therefore risk persistent ill health and disability