To supervise activities for patients with frontotemporal dementias presents major challenges to day programs typically equipped to care for more elderly, frail patients. In this article, we present the development and immediate outcomes of integrating a day program specialized for patients with frontal lobe disturbances into an already established day program. Planning required new collaborations between the ambulatory memory clinic and the day program staff. Immediate outcomes have included relief of burden for an under-served group of caregivers and behavioral management that more seamlessly combines strategies for medication titration, environmental adjustments, and activity participation.

ObjectivesThe aim of this study was to evaluate the pharmacokinetic (PK) profile, safety, and efficacy of gadopiclenol, a new high-relaxivity gadolinium-based contrast agent, in children aged 2 to 17 years.Materials and MethodsChildren scheduled to undergo contrast-enhanced magnetic resonance imaging of the central nervous system (CNS cohort) or other organs (body cohort) were included sequentially into 3 age groups (12–17, 7–11, and 2–6 years). Gadopiclenol was administered at the dose of 0.05 mmol/kg. A sparse sampling approach was applied, with 4 blood samples per child collected up to 8 hours postinjection. Population PK modeling was used for the analysis, including the CNS cohort and adult subjects from a previous study. Adverse events were recorded, and efficacy was assessed for all children.ResultsEighty children were included, 60 in the CNS cohort and 20 in the body cohort. The 2-compartment model with linear elimination from the central compartment developed in adults was also suitable for children. Pharmacokinetic parameters were very similar between adults and children. Terminal elimination half-life was 1.82 hours for adults and 1.77 to 1.29 hours for age groups 12–17 to 2–6 years. The median clearance ranged from 0.08 L/h/kg in adults and 12–17 years to 0.12 L/h/kg in 2–6 years. The median central and peripheral volumes of distribution were 0.11 to 0.12 L/kg and 0.06 L/kg, respectively, for both adults and children. Simulations of plasma concentrations showed minor differences, and median area under the curve was 590 mg·h/L for adults and 582 to 403 mg·h/L for children. Two patients (2.5%) experienced nonserious adverse events considered related to gadopiclenol: a mild QT interval prolongation and a moderate maculopapular rash. Despite the limited number of patients, this study showed that gadopiclenol improved lesion detection, visualization, and diagnostic confidence.ConclusionsThe PK profile of gadopiclenol in children aged 2 to 17 years was similar to that observed in adults. Thus, there is no indication for age-based dose adaptation, and comparable plasma gadopiclenol concentrations are predicted to be achieved with body weight–based dosing in this population. Gadopiclenol at 0.05 mmol/kg seems to have a good safety profile in these patients and could improve lesion detection and visualization, therefore providing better diagnostic confidence.

This thesis is situated within the paradigm of artistic research. It is a project in which the practice, processes and products of two-piano and piano duet performance constitute the research context, method and outcomes. The research was conducted through the activity of the Viney-Grinberg Piano Duo, of which the author is a member. The thesis is comprised of a folio of three artistic outputs in the form of recordings of musical performances, which are contextualised in a critical commentary.As a contribution to artistic knowledge, the thesis aims to "assemble" ideas and meanings around the recorded performances as a way of illuminating tacit knowledge embedded in the artistic objects, and to articulate implications of that knowledge for two-piano and duet performance. The research draws on the performative turn in musicology, construing performance as a creative rather than merely re-creative act, and recognising the ontological and epistemological potential of music performance as a knowledge outcome. The thesis makes a contribution to new music, duo pianism, two-piano music, piano duet music, and Australian music. The primary contribution lies in aesthetic, tacit and nonconceptual artistic knowledge in the form of the first recorded performances of twelve works, nine of which were commissioned by the duo. The commentary identifies certain types of knowledge particular to the performance acts, inscribed in the recorded performances, and contributes to thinking around the kinds of artistic and discursive knowledge performers can bring to the broader understanding of music. In the context of the history of two-piano and piano duet composition, the research suggests that each medium offers both performers and composers alike a unique outlet for performative and compositional innovation. The concept of the "metapiano" underpins both the collaborative relationship between the pianists, and the musical structures that are composed and performed. Finally, the study suggests that in the context of new music, the development and use of vivid imagery is particularly important in creating first interpretations.

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