51 research outputs found
Interim Report
Full text linkAuthor: F. R. Rodgers for N. H. Taylor for Sage Improvement CommitteeReason: C. W. Farr reviewing for declassificationMemo regarding 1956 interim repor
The invisible artist: Arrangers in popular music (1950-2000): Their contribution and techniques
Full text linkThis thesis was submitted for the degree of Doctor of Philosophy and was awarded by Brunel University.This thesis is based on the research conducted by the author for the series,
Richard Niles' History of Pop Arranging, seven thirty-minute documentary
programmes for BBC Radio 2, researched, written and presented by the author and
broadcast in 2003. It also draws on interviews conducted by the author (and other
research) between 2002 and 2007 both for the radio series and for this thesis and on
the author's experience as a professional arranger in popular music working with
many of the genre's significant recording artists including Paul McCartney, Ray
Charles, Cher, Tina Turner, Westlife, Tears For Fears, Dusty Springfield, James
Brown, Pet Shop Boys, Kylie Minogue and producers including Trevor Hom, Steve
Lipson, Steve Mac and Steve Anderson.
It will be argued that the role of the arranger in popular music has often been
undervalued and that during a critical period of popular music history (1950-2000)
arrangers played a significant part in the evolution of musical content. This thesis is,
to the best of the author's knowledge, the first time (apart from the above mentioned
documentary) the subject has ever been examined. The arranger is "invisible" because musical arrangers are often un-credited on
record liner notes or in books or articles concerning popular music. A considerable
amount of research has been necessary to determine who wrote many of the
arrangements considered herein. Motown's Berry Gordy purposely kept the names of
musicians and arrangers off the records because he feared others might 'poach' the
trademark 'Motown Sound'. Other record labels considered the job of the arranger to
be reminiscent of an earlier era, diluting the Rock 'n' Roll image of emotion and
spontanaeity they wished to promote. Some producers and recording artists disliked
sharing credit for their work. Motown arranger David Van dePitte told the author that
arranging was "thankless and anonymous - a very service-oriented profession where
others often take credit for what you've done." Arranging has therefore remained an
intrinsically unseen art created by 'invisible' artists. By analyzing many recordings,
revealing the techniques and concepts they have used in their work to create popular
records, arrangers and their art will be made more 'visible'
Selected genes of Human herpesvirus-8 associated Kaposi’s sarcoma among patients with Human Immunodeficiency Virus-1 and Acquired Immunodeficiency Disease Syndrome
Full text linkIntroduction: Kaposi's sarcoma (KS) is a kind of cancer that causes flat or raised lesions containing Human herpes virus 8 (HHV8). The KS lesions are common among immunosuppressed HIV patients. Highly Active Antiretroviral (HHART) treats and prevents the development of KS. The objective of this study was to determine the presence of K1 and K15 (predominant alleles) genes in Kaposi's sarcoma-associated herpes virus (KSHV) among immunosuppressed patients due to HIV -1.
Methods: this was a cross-sectional descriptive study where consecutive sampling technique was adopted to pick archived tissue blocks from the Thematic Unit of Anatomic Pathology, Department of Human Pathology, College of Health Sciences, University of Nairobi and Department of Laboratory Medicine, Histology Section, Kenyatta National Hospital
Results: upon staining 81 tissue blocks with H & E, 84% (68/81) were diagnosed as KS and 16% (13/81) as KS-like. The K1 and K15 (P) genes were both detected at 88.9% (72/81) in the tissue blocks, with 95.8% (69/72) detection from KS and4.2% (3/72) from the KS-like.
Conclusion: the K1 and K15 (P) genes of KSHV were present among the immunosuppressed patients with Human Immunodeficiency Virus (HIV)-1. It is important to carry out K1 and K15 (P) genes detection on tissues that are diagnosed as KS or KS-like by histology techniqu
Association between transient receptor potential melastatin genotypes and the prostate surface antigen levels in BPH patients
Full text linkBackground: Benign Prostate Hyperplasia (BPH) is a prevalent condition among older males, characterized by an enlarged prostate gland leading to lower urinary tract symptoms and impacting quality of life. Transient receptor potential melastatin (TRPM) genes regulate various physiological processes.
Methods: We studied 194 BPH patients and 194 healthy controls, genotyping six selected TRPM gene SNPs. PSA levels were measured using the Cobas® e411 analyzer.
Results: Prostate-specific antigen (PSA) levels were significantly higher in BPH patients (135.76±578.03 ng/mL) than in controls (2.01±1.09 ng/mL). TRPM2 (rs168355) and TRPM7 (rs2362295) genotypes were significantly associated with elevated PSA levels. The TRPM2 GG genotype was associated with decrease in the likelihood of severe PSA levels (OR=0.34, 95% CI: 0.12-0.96, P=0.034), while the TRPM7 CC genotype showed increased odds for severe PSA levels (OR=1.48, 95% CI: 1.08-3.56, P=0.041).
Conclusions: Our findings suggest a potential link between TRPM gene variants and the severity of prostatic changes reflected in PSA secretions, indicating the need for further research to understand the underlying mechanisms and clinical implications
EFFECT OF COST LEADERSHIP STRATEGY ON PERFORMANCE BY KENYA SELECTED CAR RENTAL BUSINESS IN NAIROBI CITY COUNTY,
Full text linkPurpose of this study was to determine the effect of cost leadership strategyon performance of selected car rental business in Nairobi City County. Thisstudy was a cross-sectional descriptive study design where purposivesampling technique was used to select fifteen (15) car rental business inNairobi City County. Stratified and simple random sampling technique wasemployed in recruiting three categories of respondents. The three category ofstaff included, top level, middle level and bottom level management.Structured questionnaires were used to collect primary data which was thenanalyzed. Both descriptive and inferential statistics was used. The findings ofthe study revealed that cost leadership strategy was not statisticallysignificant in affecting the performance of Car hire firms in Nairobi CityCounty. Many of the car hire business in Nairobi City County charged sameas their competitor. Cost leadership strategy affected performance of carrental business in Nairobi City to a very large extend. This studyrecommends the need to evaluate other competitive strategies onperformance of car rental business in Nairobi City. This study findingsimplies that sustaining a cost leadership strategy an entrepreneur shouldbecome aware of the competitors offer and consider developing customerintimacy and focus on a narrow target market
A differentiated model for tertiary education: past ideas, contemporary policy and future possibilities
Full text linkUsing history as a policy tool, this report looks back at the binary system as well as its demise with the Dawkins reforms of the late 1980s to uncover the lessons learned.
Summary:
Australia’s education system has undergone many changes over the past 50 years — and it will continue to do so as governments change. The first major reform over this period was the introduction of a binary policy of higher education, which was subsequently replaced by a unified system with the Dawkins reforms. Today, potential changes to the system include the deregulation of student fees and the widening of government-supported university places to cover provision by private providers. The latter would open up the delivery of tertiary education — taken here to mean diploma and above — to traditional vocational education and training (VET) providers to an increased extent.
To enrich the current discussion on changes to tertiary education policy, the author has used history as a policy tool for uncovering trends, explaining institutional cultures and preventing the re-application of ideas already tested. While this particular report is contextualised through a rereading of the Martin Report (the report of the Committee on the Future of Tertiary Education in Australia, published in 1964—65), a companion piece What next for tertiary education? Some preliminary sketches (Beddie 2014) makes a number of somewhat radical suggestions for future directions to tertiary education, with the aim of stimulating discussion in this area
The agency of service user and carer engagement in health and social care education
No full textService user and carer involvement in health and social care education in the UK has gained momentum over the last two decades, largely driven by consumerist and democratic ideologies. This is reinforced by the health and social care regulatory bodies such as the Nursing and Midwifery Council (NMC) and the Health and Care Professions Council (HCPC).
This thesis presents a series of eight peer reviewed papers that have focussed on the agency of service user and carer involvement in health and social care education. The accompanying commentary draws the papers together and locates them within an overarching theoretical framework, ‘The Ladder of involvement’. This portfolio of evidence demonstrates a coherent approach that draws on underlying philosophies and theoretical underpinnings and displays contribution to knowledge in five distinct sections: Contribution to the literature with new findings, location of the findings within the current literature, location of the findings within the theoretical framework, contribution to the refinement and development of theory and contribution to dialogue and debate.
The key message from the studies undertaken as part of this portfolio of evidence is that service user and care involvement in health and social care education enhances student learning and influences their future practice. However, there must be a well-developed infrastructure within higher education institutions that recognises the complexities of user involvement for the key stakeholders. There is a pressing need for additional research to further substantiate the benefit of user involvement for all parties concerned, in order for user involvement to take its place as a core component of health and social care education
Bernard Brodie and the bomb: at the birth of the bipolar world
No full textBernard Brodie (1910-1978) was a leading 20th century theorist and philosopher of war. A key architect of American nuclear strategy, Brodie was one of the first civilian defense intellectuals to cross over into the military world. This thesis explores Brodie’s evolution as a theorist and his response to the technological innovations that transformed warfare from World War II to the Vietnam War. It situates his theoretical development within the classical theories of Carl von Clausewitz (1780-1831), as Brodie came to be known as “America’s Clausewitz.” While his first influential works focused on naval strategy, his most lasting impact came within the field of nuclear strategic thinking. Brodie helped conceptualize America’s strategy of deterrence, later taking into account America’s loss of nuclear monopoly, the advent of thermonuclear weapons, and proliferation of intercontinental ballistic missiles. Brodie’s strategic and philosophical response to the nuclear age led to his life-long effort to reconcile Clausewitz’s theories of war, which were a direct response to the strategic innovations of the Napoleonic era, to the new challenges of the nuclear age. While today’s world is much changed from the bipolar international order of the Cold War period, contemporary efforts to apply Clausewitzian concepts to today’s conflicts suggests that much can be learned from a similar endeavor by the previous generation as its strategic thinkers struggled to imagine new ways to maintain order in their era of unprecedented nuclear danger.acceptedVersionei tietoa saavutettavuudest
A systematic review of evidence on malignant spinal metastases : natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression
Full text linkBackground: Spinal metastases can lead to significant morbidity and reduction in quality of life due to spinal cord compression (SCC). Between 5% and 20% of patients with spinal metastases develop metastatic spinal cord compression during the course of their disease. An early study estimated average survival for patients with SCC to be between 3 and 7 months, with a 36% probability of survival to 12 months. An understanding of the natural history and early diagnosis of spinal metastases and prediction of collapse of the metastatic vertebrae are important.
Objective: To undertake a systematic review to examine the natural history of metastatic spinal lesions and to identify patients at high risk of vertebral fracture and SCC.
Data sources: The search strategy covered the concepts of metastasis, the spine and adults. Searches were undertaken from inception to June 2011 in 13 electronic databases [MEDLINE; MEDLINE In-Process & Other Non-Indexed Citations; EMBASE; Cochrane Database of Systematic Reviews; Cochrane Central Register of Controlled Trials (CENTRAL); Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED), HTA databases (NHS Centre for Reviews and Dissemination); Science Citation Index and Conference Proceedings (Web of Science); UK Clinical Research Network (UKCRN) Portfolio Database; Current Controlled Trials; ClinicalTrials.gov].
Review methods: Titles and abstracts of retrieved studies were assessed by two reviewers independently. Disagreement was resolved by consensus agreement. Full data were extracted independently by one reviewer. All included studies were reviewed by a second researcher with disagreements resolved by discussion. A quality assessment instrument was used to assess bias in six domains: study population, attrition, prognostic factor measurement, outcome measurement, confounding measurement and account, and analysis. Data were tabulated and discussed in a narrative review. Each tumour type was looked at separately.
Results: In all, 2425 potentially relevant articles were identified, of which 31 met the inclusion criteria. No study examined natural history alone. Seventeen studies reported retrospective data, 10 were prospective studies, and three were other study designs. There was one systematic review. There were no randomised controlled trials (RCTs). Approximately 5782 participants were included. Sample sizes ranged from 41 to 859. The age of participants ranged between 7 and 92 years. Types of cancers reported on were lung alone (n= 3), prostate alone (n= 6), breast alone (n= 7), mixed cancers (n= 13) and unclear (n= 1). A total of 93 prognostic factors were identified as potentially significant in predicting risk of SCC or collapse. Overall findings indicated that the more spinal metastases present and the longer a patient was at risk, the greater the reported likelihood of development of SCC and collapse. There was an increased risk of developing SCC if a cancer had already spread to the bones. In the prostate cancer studies, tumour grade, metastatic load and time on hormone therapy were associated with increased risk of SCC. In one study, risk of SCC before death was 24%, and 2.37 times greater with a Gleason score 7 than with a score of < 7 (p= 0.003). Other research found that patients with six or more bone lesions were at greater risk of SCC than those with fewer than six lesions [odds ratio (OR) 2.9, 95% confidence interval (CI) 1.012 to 8.35, p= 0.047]. For breast cancer patients who received a computerised tomography (CT) scan for suspected SCC, multiple logistic regression in one study identified four independent variables predictive of a positive test: bone metastases 2 years (OR 3.0 95% CI 1.2 to 7.6; p= 0.02); metastatic disease at initial diagnosis (OR 3.4, 95% CI 1.0 to 11.4; p= 0.05); objective weakness (OR 3.8, 95% CI 1.5 to 9.5; p= 0.005); and vertebral compression fracture on spine radiograph (OR 2.6, 95% CI 1.0 to 6.5; p= 0.05). A further study on mixed cancers, among patients who received surgery for SCC, reported that vertebral body compression fractures were associated with presurgery chemotherapy (OR 2.283, 95% CI 1.064 to 4.898; p= 0.03), cancer type [primary breast cancer (OR 4.179, 95% CI 1.457 to 11.983; p= 0.008)], thoracic involvement (OR 3.505, 95% CI 1.343 to 9.143; p= 0.01) and anterior cord compression (OR 3.213, 95% CI 1.416 to 7.293; p= 0.005).
Limitations: Many of the included studies provided limited information about patient populations and selection criteria and they varied in methodological quality, rigour and transparency. Several studies identified type of cancer (e.g. breast, lung or prostate cancer) as a significant factor in predicting SCC, but it remains difficult to determine the risk differential partly because of residual bias. Consideration of quantitative results from the studies does not easily allow generation of a coherent numerical summary, studies were heterogeneous especially with regard to population, results were not consistent between studies, and study results almost universally lacked corroboration from other independent studies.
Conclusion: No studies were found which examined natural history. Overall burden of metastatic disease, confirmed metastatic bone involvement and immediate symptomatology suggestive of spinal column involvement are already well known as factors for metastatic SCC, vertebral collapse or progression of vertebral collapse. Although we identified a large number of additional possible prognostic factors, those which currently offer the most potential are unclear. Current clinical consensus favours magnetic resonance imaging and CT imaging modalities for the investigation of SCC and vertebral fracture. Future research should concentrate on: (1) prospective randomised designs to establish clinical and quality-of-life outcomes and cost-effectiveness of identification and treatment of patients at high risk of vertebral collapse and SCC; (2) Service Delivery and Organisation research on magnetic resonance imaging (MRI) scans and scanning (in tandem with research studies on use of MRI to monitor progression) in order to understand best methods for maximising use of MRI scanners; and (3) investigation of prognostic algorithms to calculate probability of a specified event using high-quality prospective studies, involving defined populations, randomly selected and clearly identified samples, and with blinding of investigators
The safety and effectiveness of different methods of ear wax removal: a systematic review and economic evaluation
No full textEar wax (cerumen) is a natural secretion produced to protect the inner ear from dirt and other fragments by moving these particles towards the outer ear. If this process does not happen properly, wax may build up causing blockage in the ear canal and the possibility of impaction. People with a build up of ear wax may suffer from hearing loss, discomfort and, on occasions, infection. It may present problems in assessing hearing, blocking the view of the ear drum during medical examination and interfering with the fitting or function of hearing aids. Although it is thought to affect between 2% and 6% of the population in the England and Wales, some groups may be at a higher risk, such as those using hearing aids or with small ear canals and/or skin conditions. Recurrence is thought to be high among some of these groups. The consequences of the build up of ear wax in the ear canal are thought to be a common reason for consultation and cost in general practice with over 2 million consultations per year in the NHS.Methods of removal of ear wax include drops, flushing with water in general practice, and removal with suction or probes in specialist clinics. The relative safety and benefits of these different methods of removal remains uncertain. This research will systematically review published and unpublished evidence on the clinical and cost effectiveness of different methods for the removal of ear wax. Where appropriate, it will develop an economic model using data from this systematic review and other relevant sources to estimate the relative costs and benefits of different methods. In addition, the project will provide recommendations for future research to try to help answer any remaining areas of uncertainty
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