The purpose of this study was to examine correspondence schools of music in the early twentieth century. Advertisements in widely circulated household and music periodicals and archival copies of courses from Siegel-Myers Correspondence School of Music, United States School of Music, American College of Music, and others were examined. Research questions focused on course offerings, faculty, recruitment, and reputation of the schools. The study also examined the advantages and disadvantages of this first generation of distance education and implications for current distance education practices today. Results revealed that correspondence schools of music had more breadth and, in some cases, depth than previous research had indicated. Instruction at numerous schools was offered on a wide variety of instruments, including voice, as well as in music history, music theory, and music teacher education. One of the prominent teacher education resources was Frances Elliott Clark's Course in Public School Music offered through Siegel-Myers Correspondence School of Music. Instruction reached a wide demographic, including segments of the population without alternate access to music education. This rich history shows that distance education has been and will remain a viable and valuable option for accessing music education.
Complicated flexor tendon injuries are classified into lacerations, avulsions, ruptures, and defects. They are often a challenge for hand surgeons and frequently they present unsatisfactory functional results postoperatively. Lacerations and avulsions are usually treated by pull-out sutures and suture anchors. In ruptures, the causality should be sought. Tendon-linking, transposition and tenodesis/arthrodesis are the domain of rheumatoid arthritis. The primary transplantation of tendons is rarely indicated, ideally in non-contaminated flexor tendon defects in zones III-V with an uninjured surrounding soft tissue situation. Postoperative rehabilitation programs are very the same as in normal flexor tendon injuries.
ZusammenfassungEs gelang durch eine Reihe von Forschungsarbeiten die wenig verstandene und teilweise ignorierte Problematik von Schmerzen bei bewusstseinsgestörten Patienten ein Stück weit zu erhellen. Funktionelle Bildgebungsstudien zeigen, dass die früher definitionsgemäß erwartete vollkommende Unfähigkeit Schmerzen zu empfinden für Patienten mit einem Syndrom reaktionsloser Wachheit nicht generell zutrifft. Die Nociception Coma Scale versucht, die Schmerzwahrnehmung bewusstseinsgestörter Patienten zu objektivieren und deren Schmerztherapie zu verbessern. Allerdings kann diese Skala nur ansatzweise die Frage nach einer tatsächlich erhaltenen Schmerzwahrnehmung beantworten. Schmerztherapie sollte auch Patienten ohne äußere Anzeichen für Bewusstsein nicht vorenthalten werden. Allerdings muss die Sinnhaftigkeit einer solchen Therapie immer gut hinterfragt werden, um Nebenwirkungen der Medikation und Behinderung von Rehabilitationsfortschritten durch Sedierung zu vermeiden. Spastik stellt eine häufige potenzielle Schmerzursache bei schwer betroffenen neurologischen Patienten dar. Neben intrathekalem Baclofen bietet die Botulinumtoxininjektion eine relativ nebenwirkungsarme und wirkungsvolle Therapiealternative.
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