Journal articles on the topic 'Chopin Year 2010'

Although cultural tourism has been known since the very beginning of the European civilisation (the Ancient Greeks and Romans peregrines’), nowadays cultural events are a great attraction not only for a local community, but they are also a strong motivation for tourists to travel. It seems that one of the special research value is to consider how deeply cultural events, connected with ‘high art’ (museums, classical music, art events of superior quality), motivate a local community and tourists. Therefore, the main aim of our survey was to recognize the role and contribution of top cultural events (on the example of ‘the Chopin Year 2010’) in marketing a city’s image and to evaluate its significance as a tourist attraction and its meaning to the local community. To examine the cultural tourism from visitors and the local community perspective and to obtain primary data, we undertook the explanatory and evaluative research. We also used (as secondary data) an academic literature review results, statistic information and materials obtained from the Chopin Museum in Warsaw, the Fryderyk Chopin Association and the Fryderyk Chopin Institute. This paper describes the main outcomes of the survey conducted in 2011–2015. In the past, cultural activities were rarely regarded as part of the tourism industry in Warsaw. The International Fryderyk Chopin Festivals and the International Fryderyk Chopin Piano Competitions were considered as different. From the beginning, they were aimed to be widely recognised international events, rather than attractions organised to meet the needs of the residents and domestic tourists. However, ‘the Chopin Year 2010’ celebrations remained highly exceptional as many different events took place, including ‘street music.’ They were aimed broader than to satisfy only a rather narrow niche of professional musicians. In 2010 both the International Fryderyk Chopin Festival and the 16th International Fryderyk Chopin Piano Competition were events not only shaped for special groups of music lovers, but also for the local community who was able to actively participate in these two big festivals.

Abstract Some of Fryderyk Chopin’s letters were published individually or in groups already in the 2nd half of the 19th century. With the passage of time, more letters from and to Chopin were printed in monographs dedicated to his life and work. The first editions of Chopin’s collected letters come from the 1st half of the 20th century (by Scharlitt and von Guttry in Germany, Henryk Opieński – in Poland). B.E. Sydow’s Fryderyk Chopin’s Correspondence of 1955 continues to be used as the basic source edition by Chopin biographers. It has many strong points, but has become largely outdated. The research project dedicated to the new source edition of Chopin’s correspondence is implemented at the Institute of Musicology, University of Warsaw by Zofia Helman, Zbigniew Skowron and Hanna Wróblewska-Straus. It aims to edit and publish all the preserved letters written to and from Chopin. As a result of many historical cataclysms in the 19th and 20th centuries, some of Chopin’s letters have been lost or dispersed. Our edition consists of 3 volumes (Vol. I – Warszawa 2009, Vol. II – in print, Vol. III – in preparation). All the letters have been edited from sources: the preserved autographs by Chopin and other persons, autograph reproductions in various publications (if the original is now lost or inaccessible), and if reproductions are also unavailable – on the basis of a selected edition (not necessarily the first). Our edition is also the first to include summaries of lost letters to Chopin (based on Karłowicz’s publication of 1904). In comparison with earlier editions, the number of published letters has increased, and we added descriptions of the autograph sources that we used as the basis for our edition. Earlier dating of letters which contain no date in the manuscript has been verified, and some dates – changed or established for the first time. Commentaries and notes accompanying the letters are significantly more extensive in this edition than in any previous one, and they include: remarks on text edition, biographical notes for persons mentioned in the letters, explanations concerning places, identification of musical and literary works, theatrical plays and other works of art referred to in the letters; historical commentary on the events described; information concerning cultural life (concerts, opera and theatre performances). We have frequently had to confront confabulated material repeated for many years in musicological studies and deeply rooted in collective awareness. We have also corrected numerous misspelt surnames and thus pointed to the true identity of many hitherto unidentified figures. Our research on the letters has made it possible to establish or confirm some facts from Chopin’s life, such as new details of his stays in Munich and Stuttgart on the way to Paris in 1831, the exact date of his arrival in Paris (5th October 1831), details of Chopin and Hiller’s trip to Aachen to the music festival of the Lower Rhine, to Düsseldorf (in May 1834), as well as the definite date of the Polish concert in the Parisian Théâtre-Italien (4th April 1835).

Choking often occurs in people's lives. To be able to overcome this condition, a person's skills are needed to quickly and accurately provide help, in order to save victims from serious conditions, namely disability or even death. This study aims to collect and analyze the effect of education on the level of knowledge and ability of first aid in children who are choking. This research is a literature study by conducting a review of previous research using some relevant literature. Search for articles using search engines including Google and data bases such as Google Scholar, Research Gate, and PUBMED, with a limitation on the year of publication of articles for the last 10 years, starting from 2011-2020. Articles used in Indonesian and English are downloaded in full text in PDF format and are free articles. Based on the results of the analysis of relevant journals, it was found that education had an effect on the level of first aid ability for children who experienced choking. Simulation/demonstration is an effective method to educate family/community in providing first aid (airway management) for airway obstruction due to choking.

Choking on small parts remains one of the leading causes of death and injury in infants and toddlers. The current method of testing for small parts, created by the Consumer Product Safety Commission (CPSC), has become outdated and has yet to be changed despite the many deaths and injuries of children. The method uses a device called the small parts test fixture (SPTF) that is supposed to mimic the size of a fully expanded throat of a toddler. If a product does not fit inside the cavity of the SPTF, then it is deemed safe to play with because it “will not fit” in the esophagus of a child. The present study obtains a dataset of products recalled by the CPSC within the last twelve years due to choking hazards/incidents and discovers that a noteworthy amount of the children’s products have parts that are larger than the fixture size and are still capable of causing choking. This study indicates that a larger SPTF size must be implemented by the CPSC in order to prevent future choking incidents on small parts.

Qualification of winter wheat became more complex for Hungary, after the expansion of the EU. Use of Chopin alveograph is a general method in Western- and Southern Europe. This method is not traditional in Hungary, so determination of alveographic properties of Hungarian winter wheat varieties is very important. Artificial fertilization is one very important component of applied agricultural engineering, which effects winter wheat quality. The another factor is the weather or rather the cropping year, which effects winter wheat quality too. We examined both of them and the alveographic quality of GK Öthalom winter wheat variety between 1996 and 2003.We found that cropping year has significant effect on the alveographic quality of GK Öthalom winter wheat variety on each treatment of artificial fertilization. We found no connection between quantities of precipitations of vegetation periods and the W values of GK Öthalom.We found a strong connection in 1999 and 2003 as well as a very strong connection in 1996, 1997 and 2002, between the increase of fertilizer dose and W values of GK Öthalom. Treatments of artificial fertilization had a significant effect to W values of GK Öthalom in 2001 and 2002. The differences between the two methods are because of large standard deviation of the results.

Sudden respiratory distress in association with severe weight loss are unusual features of systemic sclerosis (SSc). We report the case of a 56-year-old Caucasian woman with a 9-year history of a diffuse form of SSc who presented with acute stridor due to vocal cord paralysis and required an emergency tracheostomy. She had sought medical attention only after 4 years of disease onset, presenting with a mask-like face, diffuse skin thickening, acro-osteolysis and severe interstitial lung disease. Even though skin tightness improved after immunosuppressive treatment, several spontaneous facial fractures and episodes of dysphagia and choking occurred in the years that followed. At the time of stridor, she was severely malnourished and a percutaneous endoscopic gastrostomy was required for feeding. Permanent vocal cord damage in combination with severe loco-regional bone resorption resulted in severe disability and impaired nutrition. We hereby highlight the features of SSc for which therapy remains challenging.

We present a case of Sandifer syndrome in a 3-year-old girl who initially presented with a history of recurrent paroxysmal head drops associated with ataxia-like symptoms and recurrent falls sustaining a clavicular fracture on one occasion. She was referred to and seen by the paediatric neurologist. Physical examination, electroencephalogram, MRI brain, electromyograph single fibre study and blood tests were all normal. With the history of hiccups and choking-like episodes she was referred to the speech and language therapist (SALT). SALT assessment did not reveal indications of swallowing impairment or possible aspiration. A barium swallow later showed small amount of reflux into the distal oesophagus. This prompted a trial of lansoprazole and she was referral to the gastroenterologists. Endoscopy and oesophageal manometry were essentially normal. However, the pH impedance study revealed severe gastro-oesophageal reflux disease. She continued with lansoprazole and dairy-free diet and her symptoms resolved.

A six-year-old girl presented to an emergency room after describing choking on a rubber band. She was in no distress and was discharged. Over the course of the next 9 months, she had numerous outpatient and emergency room visits due to intermittent stridor, difficulty breathing, and hoarseness. Eventually, dedicated airway films revealed a laryngeal foreign body. During rigid bronchoscopy, a two-centimeter rubber band was discovered in the larynx. It extended from the supraglottis, through the glottis, and into the subglottis. It was successfully removed. The patient was asymptomatic 24 hours later. This case highlights the appropriate evaluation and management of a child with stridor.

Tumor-to-tumor metastasis is extremely rare in the thyroid glands, and only seven cases of lung carcinoma metastasizing to thyroid tumors have been reported in the literature. We report another two cases of lung carcinoma metastasizing to thyroid neoplasms and review of the literature. The first case was a 64-year-old man presenting with neck mass, hoarseness, and easy choking for 2 months. Image studies showed several nodular lesions within bilateral thyroid glands. A histological examination after radical thyroidectomy revealed lung small cell carcinoma metastasizing to a thyroid follicular adenoma. The second case was a 71-year-old woman with a history of lung adenosquamous carcinoma. The PET/CT scan showed left lower lung cancer and a hypermetabolic area in the right thyroid lobe, highly suspicious for malignancy. Radical thyroidectomy and left lung lobectomy were performed, and the thyroid gland revealed lung adenosquamous carcinoma metastasizing to a papillary thyroid carcinoma.

Summary. Foreign bodies in esophagus are avoidable accidents that occur most often in children younger than 3 years. The most common presenting symptoms are dysphagia, drooling, and vomiting. Revelation by respiratory distress is a rare and unusual condition. Objective. We describe and discuss the case of an esophageal foreign body, in which the patient presented with respiratory distress. Case report. A two-year-old child was admitted to the emergency department for acute respiratory distress. He had no history of choking episodes or dysphagia. Nevertheless, he was brought by his parents several times for a persistent cough and wheezing that was treated as asthma for a month. Pulmonary examination had revealed polypnea, suprasternal recession, scattered snoring, and diffuse wheeze. As part of his assessment, a chest X-ray was demanded. It had shown, as unexpected, a nonmetallic foreign body in the upper thoracic esophagus. A clothing button was removed by hypopharyngoscopy under sedation without any incident. Subsequent follow-up had not shown any complications related to this episode. Conclusion. Large esophageal foreign bodies can impinge on the trachea causing upper respiratory tract signs. We alert clinicians on variation in the presentation of foreign body ingestion, and we emphasize the importance of an early diagnosis and management.

Abstract Hemangioma is the most common tumor of the vascular origin, benign, frequently observed in children, and with preference for head and neck, but rarely having a uvular origin. In this organ, it presents potential risk of local trauma, hemorrhage and it may produce great discomfort for the patient. In this article we present the cases of two patients (34 year-old and 44-year old) with uvular hemangiomas; patient 1 was admitted for dysphagia, salivation and choking and patient 2 was admitted for the swelling of the uvula, dysphagia, salivation and difficulty in speaking. They both presented a history of this symptoms, with acute episodes of dysphagia. They did not report bleeding, pain or fever. Hemangiomas were histopathologically confirmed, thus raising the awareness that hemangiomas are included in the differential diagnosis when a patient presents an elongated, swollen uvula or uvular masses.

Objective. To describe a rare case of an impacted large foreign body (chicken bone) in the laryngopharynx.Case Report. A 28-years-old man presented with pain in the neck of 5 days duration. The patient gave a history of severe choking sensation while eating chicken. Laryngoscopic examination revealed a linear whitish large chicken bone impacted in the left pyriform fossa. The bone was removed under local anesthesia with the guidance of telescopic laryngeal examination.Conclusion. This paper describes impaction of a large chicken bone in the hypopharynx in an adult male patient and its removal with guided telescopic laryngeal examination.

Frontal lobe seizures have a tendency to occur in sleep and in most cases occur exclusively insleep; these individuals are said to have nocturnal frontal lobe (NFLE). NFLE can be difficult to distinguish clinically from various other sleep disorders, particularly parasomnias, which also present with paroxysmal motor activity in sleep. Interictal and ictal EEG findings are frequently unremarkable or nonspecific in both parasomnias and NFLE making the diagnosis even more difficult. Nocturnal epilepsy should be suspected in patients with paroxysmal events at night characterized by high frequency, repetition, extrapyramidal features, and marked stereotypy of attacks. Here we present a 13-year-old female who was extensively worked up for choking episodes at night. On repeat video EEG she was found to have frontal opercular seizures. Once on Carbamazepine, her seizures completely resolved.

Purpose – The purpose of this paper is to provide a brief and partial overview of some of the issues and authors that have dominated British industrial relations research since 1965. It is cast in terms of that year being the astronomical Big Bang from which all else was created. It traces a spectacular growth in academic interest and departments throughout the 1970s and 1980s, and then comments on the petering out of the tradition and its very existence (Darlington, 2009; Smith, 2011). Design/methodology/approach – There are no methods other than a biased look through the literature. Findings – These show a liberal oppression of the Marxist interpretation of class struggle through trade unions, collective bargaining, strikes, and public policy. At first through the Cold War and later, less well because many Marxists survived and thrived in industrial relations departments until after 2000, through closing courses and choking off demand. This essay exposes the hypocrisy surrounding notions of academic freedom, and throws light on the determination of those in the labour movement and their academic allies to push forward wage controls and stunted bargaining regimes, alongside restrictions on strikes, in the name of moderation and the middle ground. Originality/value – An attempt to correct the history as written by the pro tem victors.

Abstract Introduction Professional societies recommend providers assess sleep symptoms in COPD, but it is unclear if this occurs. We aimed to evaluate OSA symptom assessment and documentation among patients with COPD, and the patient and provider characteristics associated with this assessment. Methods We conducted a cross-sectional study of adults aged ≥40 years with clinically diagnosed COPD and no prior diagnosis of OSA. We selected patients receiving care at two academic general internal medicine clinics between 6/1/2011 - 6/1/2013. We abstracted charts to assess how often OSA symptoms such as snoring, somnolence, witnessed apneas, or gasping/choking arousals were documented as present or absent. We performed multivariable mixed-effects logistic regression to assess associations of patient and primary care provider (PCP) factors with assessment of OSA symptoms. Patient factors included demographics, body mass index, comorbidities, healthcare utilization, and severity of COPD, and PCP factors including demographics, degree, and years of experience. Results Of 523 patients with COPD, only 26 (5.0%) had documentation of OSA symptom assessment within a one-year period. In mixed effects models, only referral to general pulmonary clinic was associated with the assessment of OSA symptoms (OR: 4.56, 95% CI 1.28-15.52). Among the 26 individuals who had OSA symptoms assessed, 9 (34.6%) reported snoring, 15 (57.7%) reported daytime somnolence, 2 (7.7%) reported gasping/choking arousals, and 5 (19.2%) reported witnessed apneas. Among those assessed for OSA symptoms, providers referred 11 (42.3%) for formal sleep consultation. Conclusion Providers rarely document OSA symptoms for patients with COPD in primary care clinic, but assessment is greater among those with pulmonary specialty consultation. Given time constraints in primary care, external facilitation of sleep symptom assessment may improve symptom recognition and receipt of appropriate services. Support NIH 5K23HL111116-05, VA Center of Innovation for Veteran-Centered and Value-Driven Care.

Foreign body aspiration is relatively rare in adults compared to children. In adults with delayed presentation, a history of choking is often absent, resulting in delayed diagnosis and significant morbidity. Common presenting features in adults include nonresolving cough with or without fever, hemoptysis, or wheezing and may mimic infectious, inflammatory, or neoplastic disorders. We present a case of a 64-year-old man with 80-pack-year smoking history who had a nonresolving left lower lobe infiltrate on chest radiograph after treatment for community-acquired pneumonia. His insidious-onset symptoms included cough, decreased exercise tolerance, and localized wheezing. Computed tomography of the chest showed a left lower lobe consolidation, with narrowing of the bronchus. Flexible bronchoscopy revealed a fleshy endobronchial mass, prompting endobronchial needle aspiration and biopsies, all of which revealed acute inflammation on rapid onsite evaluation. After multiple biopsies, a white pearly object with a detached brown cover was revealed; the object was found to be an aspirated almond. The almond and its peel were retrieved. The patient acknowledged that he had frequently eaten almonds in the supine position while recovering from a previous injury. His symptoms completely resolved at 3-month follow up, and he has ceased smoking and no longer consumes food while supine.

Purpose To evaluate the effect of major postoperative complications on health-related quality of life (HRQL) in 5-year survivors of esophageal cancer surgery. Patients and Methods This study was based on the Swedish Esophageal and Cardia Cancer register with almost complete nationwide coverage and data on esophageal cancer surgery collected prospectively between 2001 and 2005. Patients who were alive 5 years after surgery were eligible. HRQL was assessed longitudinally until 5 years after surgery by using the validated European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 and OES18. Linear mixed models were used to assess the mean score difference (MD) with 95% CIs of each aspect of HRQL in patients with or without major postoperative complications. Adjustment was made for several potential confounders. Results Of 153 patients who survived 5 years, 141 patients (92%) answered the 5-year HRQL questionnaires. Of these individuals, 46 patients (33%) sustained a major postoperative complication. Dyspnea (MD, 15; 95% CI, 6 to 23), fatigue (MD, 13; 95% CI, 5 to 20), and eating restrictions (MD, 10; 95% CI, 2 to 17) were clinically and statistically significantly deteriorated throughout the follow-up in patients with major postoperative complications compared with patients without major complications. Although problems with choking declined to levels comparable with patients without major postoperative complications, sleep difficulties and gastroesophageal reflux progressively worsened during follow-up. Conclusion The occurrence of postoperative complications exerts a long-lasting negative effect on HRQL in patients who survive 5 years after esophagectomy for cancer.

The hemodynamic compromise caused by a large aspirated food particle in the airway can become the focus of medical attention and a distraction from rare but fatal Heimlich maneuver related injuries after an incident of food aspiration. We herein present a case of an 84-year-old man who was brought to the emergency department after an episode of choking at a restaurant followed by several failed Heimlich maneuver attempts. Despite relieving the airway obstruction by extracting a large piece of steak from the airway, the patient remained hypotensive and required continued hemodynamic support. Repeated laboratory tests within 24 hrs of aspiration showed a significant decline in the hemoglobin level. A computed tomography (CT) scan of the abdomen and pelvis showed a lacerated liver with a large subcapsular hematoma draining into the pelvis.Conclusion. Hepatic rupture is a rare complication of Heimlich maneuver; this paper represents the second case report in the literature. It emphasizes the necessity of early identification and surveillance of fatal Heimlich maneuver complications in a high risk population.

ObjectivesTo investigate mortality in adults with intellectual disabilities: rates, causes, place, demographic and clinical predictors.DesignCohort study with record linkage to death data.SettingGeneral community.Participants961/1023 (94%) adults (16–83 years; mean=44.1 years; 54.6% male) with intellectual disabilities, clinically examined in 2001–2004; subsequently record-linked to their National Health Service number, allowing linkage to death certificate data, 2018.Outcome measuresStandardised mortality ratios (SMRs), underlying and all contributing causes of death, avoidable deaths, place, and demographic and clinical predictors of death.Results294/961 (30.6%) had died; 64/179 (35.8%) with Down syndrome, 230/783 (29.4%) without Down syndrome. SMR overall=2.24 (1.98, 2.49); Down syndrome adults=5.28 (3.98, 6.57), adults without Down syndrome=1.93 (1.68, 2.18); male=1.69 (1.42, 1.95), female=3.48 (2.90, 4.06). SMRs decreased as age increased. More severe intellectual disabilities increased SMR, but ability was not retained in the multivariable model. SMRs were higher for most International Statistical Classification of Diseases and Related Health Problems, 10th Revision chapters. For adults without Down syndrome, aspiration/reflux/choking and respiratory infection were the the most common underlying causes of mortality; for Down syndrome adults ‘Down syndrome’, and dementia were most common. Amenable deaths (29.8%) were double that in the general population (14%); 60.3% died in hospital. Mortality risk related to percutaneous endoscopic gastrostomy/tube fed, Down syndrome, diabetes, lower respiratory tract infection at cohort-entry, smoking, epilepsy, hearing impairment, increasing number of prescribed drugs, increasing age. Bowel incontinence reduced mortality risk.ConclusionsAdults with intellectual disabilities with and without Down syndrome have different SMRs and causes of death which should be separately reported. Both die younger, from different causes than other people. Some mortality risks are similar to other people, with earlier mortality reflecting more multimorbidity; amenable deaths are also common. This should inform actions to reduce early mortality, for example, training to avoid aspiration/choking, pain identification to address problems before they are advanced, and reasonable adjustments to improve healthcare quality.

This study summarizes 660 events involving captured, live-stranded and dead cetaceans in South Australia between 1881 and 2000. Emphasis is placed on records (n = 361) during 1985-2000 when an active necropsy programme was underway. Average number of events per year was 30.4 and the most common species were the short-beaked common dolphin (Delphinus delphis) and Indo-Pacific bottlenose dolphin (Tursiops aduncus). Records were assigned to nine categories of circumstance/cause of death. Summarizing the total database, 60% were unknown circumstance, 22% not obviously anthropogenic, 13% unintentional human-related and 5% intentional human-related. In the data set of records for 1985-2000, 50% were unknown, 25% were not obviously anthropogenic, 20% were unintentional humanrelated and 5% were intentional killings. Non-anthropogenic circumstances included neonatal deaths, live strandings, significant diseases, shark attacks and choking. Cornynebacterium ulcerans is recorded for the first time in a cetacean. Unintentional circumstances included entanglement in fishing and aquaculture equipment (17% of necropsied carcasses from 1985-2000) and boat strikes. Intentional human-related circumstances were captures for live display and illegal killing. Five percent of the necropsied carcasses during 1985-2000 were attributed to shootings or stabbings/spearings. There is need for a formal reporting procedure for marine mammal deaths and human interaction involving injury and for steps to be taken to reduce human impacts.

AbstractBackground: Neurofibromatosis type 1 is an autosomal dominant disorder associated with multiple neoplasms particularly those of ectodermal origin. Various endocrine pathologies are often present, among them, hyperparathyroidism and follicular thyroid lesion are very rare described and their coincidence in the same patient has not been described in the literature reviewed.Subject: A 59-years-old woman with clinical manifestation of neurofibromatosis type 1 developed dysphagia, dysphonia, choking sensation. Physical and imagistic examination revealed a multinodular goiter with microfollicular lesion on fine needle aspiration biopsy (FNAB), elevated parathormone levels and severe osteoporosis. The surgically removed thyroid contained a nodule with follicular architecture of uncertain malignant potential; the parathyroid tissue appeared normal.Discussion and conclusion: This case serves as a reminder to look for non-neurogenic tumors in patients with neurofibromatosis. Clinicians must be aware of the diverse clinical features of this genetic disorder.

Abstract A global problem of today is the large amount of waste in the seas and oceans, primarily plastic waste. It is estimated that every year 1.25 to 2.41 million tons of plastic material is being carried by rivers into the seas and oceans. Waste is a major problem for marine organisms, causing entanglement, choking, strangulation, malnutrition and death. In 1972 the problems caused by microplastics, particles smaller than 5 mm, were first observed. Such particles bind pathogenic microorganisms on to their surface. Increasing quantities of microplastics have been found in the stomachs of fish, and also in shellfish that feed by filtering sea water. Ingested by marine organisms, such plastics may eventually pass through the food web and can end up ingested by humans. In addition, plastic releases chemical compounds whose effect on marine organisms and humans has still not been studied. Many international and state organizations offer solutions through recycling plastic waste, as well as reducing the production of plastic materials and informing the public about the problem.

The anterior cervical spine surgery is a common procedure to stabilize vertebrae damaged by various diseases. The plates and screws are usually used in the spine fixation. This kind of instrumentation may detach from the bones which is a rare but well-known complication. A 77-year-old male presented to the otorhinolaryngology department with throat pain, choking, and dysphagia. At first the angioedema was diagnosed and he was treated conservatively. The endoscopy revealed laryngeal edema, being more defined on the right side with right vocal fold paresis. CT scans showed the stabilizing plate with two screws attached tightly and the back-out of the third screw toward soft tissue of the neck. In the meantime, his condition deteriorated and he needed tracheotomy. In few days the surgical removal of the dislocated screw was performed successfully. Although two-month follow-up reported no obstruction of the larynx, the vocal folds paresis with gradual functional improvement was observed. Long-term complication of anterior spine surgery sometimes may suggest laryngeal angioedema at first. If the conservative treatment is ineffective and there is a history of anterior spine surgery, the clinicians should consider the displacement of the plate or screws in differential diagnosis.

This study used qualitative methods to explore the stressors, appraisal mechanism, emotional response, and effective/ineffective coping strategies experienced by elite rugby union referees during pressurized performances. Participants included seven male rugby union referees from the United Kingdom (Mage = 27.85, SD = 4.56) who had been officiating as full-time professionals for between 1 and 16 years (M = 4.85, SD = 5.42). Data revealed that the referees encountered a number of stressors, which were appraised initially as a ‘threat’, and elicited negatively-toned emotions. The referees were able to maintain performance standards under pressure by adopting proactive, problem- and emotion-focused coping strategies which managed effectively the stressors and their emotions. However, the use of avoidance-coping, reactive control, and informal impression management were perceived as ineffective coping strategies, and associated with poor performance and choking. Recommendations are offered to inform the psychological skills training of rugby union referees.

Abstract In recent years, there has been a tendency toward creating innovative, easy to use and patient-friendly drug delivery systems suitable for every consumer profile, which would ensure safety, stability and acceptability of a drug. One of the relatively novel and promising approaches is the manufacture of orodispersible films (ODFs), which is an upcoming area of interest in drug delivery. They are defined as polymer thin films that disintegrate in the oral cavity within seconds, without drinking water or chewing, and eliminate the risk of choking. Gaining special usefulness in therapies of children and the elderly, ODFs seem to fill the gap in the range of preparations available for these groups of patients. As no detailed monography of ODFs including testing methods and uniform requirements has been presented in any of the pharmacopoeias to date, the aim of this article is to give an overview of the applied testing methods, their modifications and innovative approaches related to ODF quality assessment.

Application of chemical cues to manipulate adult sea lamprey (Petromyzon marinus) behavior is among the options considered for new sea lamprey control techniques in the Laurentian Great Lakes. A male mating pheromone component, 7α,12α,24-trihydroxy-3-one-5α-cholan-24-sulfate (3kPZS), lures ovulated female sea lamprey upstream into baited traps in experimental contexts with no odorant competition. A critical knowledge gap is whether this single pheromone component influences adult sea lamprey behavior in management contexts containing free-ranging sea lampreys. A solution of 3kPZS to reach a final in-stream concentration of 10−12 mol·L−1 was applied to eight Michigan streams at existing sea lamprey traps over 3 years, and catch rates were compared between paired 3kPZS-baited and unbaited traps. 3kPZS-baited traps captured significantly more sexually immature and mature sea lampreys, and overall yearly trapping efficiency within a stream averaged 10% higher during years when 3kPZS was applied. Video analysis of a trap funnel showed that the likelihood of sea lamprey trap entry after trap encounter was higher when the trap was 3kPZS baited. Our approach serves as a model for the development of similar control tools for sea lamprey and other aquatic invaders.

Many long-term care (LTC) residents have an increased risk for dysphagia and receive texture-modified diets. Dysphagia has been shown to be associated with longer mealtime duration, and the use of texture-modified diets has been associated with reduced nutritional intake. The current study aimed to determine if the degree of diet modification affected mealtime duration and to examine the correlation between texture-modified diets and dysphagia risk. Data were collected from 639 LTC residents, aged 62–102 years. Nine meal observations per resident provided measures of meal duration, consistencies consumed, coughing and choking, and assistance provided. Dysphagia risk was determined by identifying residents who coughed/choked at meals, were prescribed thickened fluids, and/or failed a formal screening protocol. Degree of texture modification was derived using the International Dysphagia Diet Standardization Initiative Functional Diet Scale. There was a significant association between degree of diet modification and dysphagia risk (P < 0.001). However, there was no association between diet modifications and mealtime duration, even when the provision of physical assistance was considered. Some residents who presented with signs of swallowing difficulties were not prescribed a texture-modified diet. Swallowing screening should be performed routinely in LTC to monitor swallowing status and appropriateness of diet prescription. Physical assistance during meals should be increased.

ObjectiveTo assess the prevalence of engagement in self-asphyxial (risk-taking) behaviour (SAB) (‘choking game’) and associated morbidity and mortality in children and young people up to age 20.DesignSystematic literature review.Search strategyElectronic database search of MEDLINE, Embase, PsycINFO, CINAHL, PubMed, Web of Science Core Collection, BIOSIS citation index and the Cochrane register with no language or date limits applied. References of key papers were reviewed, and experts were contacted to identify additional relevant papers.Eligibility criteriaSystematic reviews, cross-sectional, cohort and case–control studies, and case reports examining SAB with regard to individuals aged 0–20 years, without explicitly stated autoerotic, suicidal or self-harm intentions were included.ResultsThirty-six relevant studies were identified, and SAB was reported in 10 countries. In North America, France and Colombia, awareness of SAB ranged from 36% to 91% across studies/settings, and the median lifetime prevalence of engagement in SAB was 7.4%. Six studies identified the potential for SAB to be associated with engagement in other risk behaviours. Ninety-nine fatal cases were reported. Of the 24 cases described in detail, most occurred when individuals engaged in SAB alone and used a ligature.ConclusionsThe current evidence on SAB among young people is limited, and stems predominantly from North America and France. Awareness of SAB among young people is high, and engagement varies by setting. Further research is needed to understand the level of risk and harm associated with SAB, and to determine the appropriate public health response.

AbstractGlaucoma is an eye disorder in which the optic nerve is damaged over time due to a sustained elevation of the intraocular pressure (IOP). Being the second leading cause of blindness according to the reports of the World Health Organization, glaucoma is not only a serious ocular disease that threatens individuals, but also a community health problem. In recent years, great improvement has been achieved in the technology of implants used in the treatment of the disease. Despite the great effort dedicated to the design and implementation of the glaucoma drainage devices (GDD), they still have unsolved problems and weaknesses. Most of the currently employed GDDs are very simple and have major problems such as reversed flow, choking and a coarse interval of pressure control. Experiments must be devised to investigate the flow behavior inside these devices. In this study, an accurate microfluidics experimental setup is constructed to analyze and characterize the in-vitro performance of actively employed GDDs on the glaucoma treatment. Proposed setup includes a pressurized fluid reservoir, ELVEFLOW microfluidics flow rate measurement/control unit, microfluidics flow/pressure sensors, and data analysis system. In the setup, more precise measurements than experimental setups in literature is planned to be provided. It is estimated that the results showing consistency with in-vivo measurements will be obtained, behavior of the fluid passing through the GDDs will be observed and issues with design flaws will be addressed.

<p>Professor Beata Dąbrowska – a conductor, teacher, and organizer of musical life, highly merited for Lublin’s musical culture and Maria Curie-Skłodowska University (UMCS) – died on 14<sup>th</sup> March 2016. She was born on 5<sup>th</sup> January 1960 in Lublin, She attended the Karol Lipiński Music School in Lublin, and then studied at the Frederic Chopin Music Academy in Warsaw, from which she graduated in 1982 and received a Master of Music Degree in Choral Conducting. From 1982 until the end of her life she worked at the Institute of Music, Maria Curie-Skłodowska University (until 2000 it was the Institute of Arts Education). In 1992 she received the first-grade qualification (today – a PhD equivalent) in the artistic discipline of <em>conducting vocal and vocal-instrumental groups</em>; in 1999 she received her second-grade qualification (now – a postdoctoral degree: Habilitated Doctor). In 2003 she was appointed Associate Professor of UMCS. In 2005 she became Head of the Institute of Music. She held this function till her death, combining it with multiple academic activities. At the same time she pursued her artistic activity. In 1987, together with her husband Dariusz Dąbrowski, she founded the Chamber Choir of the Henryk Wieniawski Music Society of Lublin, whose conductor she was for almost 30 years. She and the Choir gave several dozen vocal-instrumental concerts and over 300 concerts a cappella; they took part in many festivals and competitions in other countries and won awards and honors. Most often she performed in Lublin at religious and official state ceremonies, various jubilees, or anniversaries; many times she took part in Lublin concert series (inter alia Ars Chori, Spotkania Chórów Akademickich [Meetings of Academic Choirs]), she also gave concerts in other towns ( e.g. in Gdańsk, Grudziądz, Olsztyn, Toruń, Wrocław). She was engaged in many initiatives of Lublin’s music culture and, at the same time, she improved her skills (in 1990 she completed Podyplomowe Studium Chórmistrzowskie [Postgraduate Choirmaster Training Program at the Feliks Nowowiejski Academy of Music in Bydgoszcz]). In 1995 she initiated in Lublin Międzynarodowe Dni Muzyki Chóralnej (International Days of Choir Music). She organized concerts in Lublin for many years. She was awarded many times for her dedicated and invaluable work, the formation of Lublin’s cultural image, and for the promotion of Polish culture in Poland and abroad.</p>

124 Background: The symptom burden faced by long-term head and neck cancer survivors could inform clinical decision making but it is not well understood. Methods: In 2016 we surveyed current enrollees of Group Health (an integrated health care delivery system in Washington State) who were aged ≥18 years when diagnosed with head and neck cancer in 2011 (n = 54). Symptoms experienced in the past 24 hours were assessed using the validated MD Anderson Symptom Inventory head and neck cancer module (MDASI-HN). Survivors were asked to report on a 10-point scale the severity of the problem at its worst (“not present” to “as bad as you can imagine”). Self-reported risk factor and demographic information were also collected. Results: Eighty percent of persons responded to the survey (n = 43) via web questionnaire (n = 12), mailed questionnaire (n = 26) or telephone interview (n = 5). One person who reported to have not been diagnosed with head and neck cancer was excluded, leaving 42 participants. Overall, 29% had no more than mild symptoms (all MDASI-HN symptoms rated <5 ), 43% had no more than moderate symptoms (all MDASI-HN symptoms rated <7 ), 57% had one or more symptoms rated as severe (at least one MDASI-HN symptom rated ≥7 ), and 45% had two or more symptoms rated as severe. The symptoms most commonly rated as severe were: dry mouth (38%), difficulty swallowing or chewing (17%), pain (17%), fatigue (17%), disturbed sleep (15%), feeling sad (15%), choking or coughing (15%), problems with tasting food (15%), problems with teeth or gums (15%), problems with mucus in the mouth or throat (12%), and feeling distressed (12%). Persons who rated one or more symptom as severe were more likely than those who did not to have had cancer recurrence (44% versus 6%), receipt of cancer treatment in the previous three years (36% versus 17%), age ≥65 years at diagnosis (63% versus 17%), non-white race (21% versus 6%), no more than high school education (33% versus 17%), current unemployment/disability/retirement (71% versus 44%), and annual household income <$100,000 (71% versus 56%). Conclusions: In the context of limited data on this topic, in this small study we found that it was not uncommon for five-year survivors of head and neck cancer to experience one or more symptoms which they rated as being a severe problem.

AimTo determine the feasibility of investigating the swallowability and acceptability of different sized placebo tablets in children and young people (CYP) aged 4–12 years and estimate consent/recruitment rates for a future study.MethodsParticipants were asked to swallow three different sized placebo tablets; 6mm, 8mm and10mm in a standardised order, smallest to largest. The recruitment target is 50 children, including both healthy children and NHS inpatients/outpatients. Following informed consent participants were shown a short video demonstrating how a tablet can be swallowed. The researcher observed and recorded the child’s facial expressions as they swallowed the tablet.1 Any tablet chewing, signs of choking and/or coughing during and after swallowing were recorded. After each administration, an internal inspection of the mouth was conducted by the researcher to identify any residue or non-swallowed tablet.2 The participants assessed the swallowability and acceptability of the samples using a questionnaire that included a 5-point hedonic facial scale and voluntary feedback was provided. Faces 1-3 on the hedonic scale were deemed acceptable to the participant. The process described above was repeated for swallowing the 8mm and 10mm tablets. Participants were offered all three different sized placebo tablets and were given the option to stop or continue at each stage. Children who successfully swallowed all three samples were asked if they would be willing to take part in the study again if the tablet administration order was randomised rather than in order of increasing size.ResultsTo date, 32 participants aged between 4-12 years have taken part in the study (mean age 7.7 years). Twelve children were aged 6 or under. All 32 participants attempted to swallow the 6mm tablet, 27 attempted the 8mm and 25 children attempted the 10mm tablet. 78.1% successfully swallowed the 6mm tablet and 85.2% successfully swallowed the 8mm and 10mm tablets. Participants were also asked about the most important factors when taking a tablet, data were available for 30/32 participants and the most important factor was deemed tablet size (17/30), followed by taste (7/30) responses. 87% of children who swallowed all three samples reported that they would be willing to take part in the study again if the tablet size order was randomised.ConclusionThe preliminary results show that tablets may be an acceptable dosage form for children from 4 years old. Tablet size was deemed to be the most important factor of swallowability/acceptability of tablets in children. The full data set should give further information about optimal tablet size for CYP which is currently unknown. This feasibility study will collate data on key variables which will inform the design of a larger, definitive study including the sample size based on observed recruitment/consent rates.ReferencesZeinstra GG, Koelen MA, Colindres D, et al. Facial expressions in school-aged children are a good indicator of ‘dislikes’, but not of ‘likes’. Food Quality and Preference 2009 December;20(8):620–624.Klingmann V, Spomer N, Lerch C, et al. Favorable Acceptance of Mini-Tablets Compared with Syrup: A Randomized Controlled Trial in Infants and Preschool Children. The Journal of Pediatrics 2013 December;163(6):1728–1732.e1.

Subject area The case specifically discusses the role of stakeholders and non-market forces and how they can potentially influence the strategic choices of firms. Participants need to have some basic understanding of non-market forces, and stakeholder theory. The case is suitable for courses on sustainable supply chain management, closed loop supply chain management, reverse logistics, green business, environmental management, strategic management and business in emerging economies. Study level/applicability The target audiences for the case are bachelor and first-year MBA students and trainees who are interested in learning the relevance of non-market forces in sustainable growth of an industry and the importance of stakeholder management in the smooth conduct of business. Case overview The case study details how the plastic industry in Kerala faces a non-market threat and how it affects the progress of the industry by using the example of Ashiyana Pipe. Though plastic is a unique material by virtue of its reusability and non-perishable characteristics, it has invited a lot of criticism, as there is a wide spread perception regarding its detrimental impact on the environment (such as choking drains, preventing the degradation of solid waste because of its impermeability, etc.). But the reason for experiencing the detrimental impact of plastic can also be attributed to the inability of the supply chain of the plastic industry to reach a closed-loop status, especially in developing countries such as India, as all categories of post-consumer plastic are not reaching recycling plants. Lack of awareness, lack of community participation in proper segregation and aggregation at the source, absence of incentive systems, weak regulations and poor monitoring are discussed as the common barriers hindering the achievement of closed loop status of plastic supply chain. Detailing the barriers, the case study explains the failure of informal and formal recycling markets in Kerala. Finally, the case study proposes a model with involvement of all the key stakeholders to reposition the hate toward plastic into love through recycling initiatives. Expected learning outcomes Expected learning outcomes of the case are listed below: illustrate the importance of stakeholder involvement in achieving a sustainable business and to stress the importance of a decentralized approach. Illustrate the relevance of non-market forces in sustainable growth of an industry that has significant impact on the surrounding environment and society. Critically analyze the existing business models (based on market mechanism) and suggest possible improvements and alternatives. Understand the challenges that will be faced while implementing an inclusive model with involvement of all stakeholders to reduce the negative impact of non-market forces. Supplementary materials Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes. Subject code CSS 11: Strategy.

Introduction. This paper deals with two sets of colour photographs of Mongolian tsam masks taken by Czechoslovak archaeologist Lumír Jisl (1921–1969) and art photographer Werner Forman (1921–2010) in Mongolia during the period of 1956–1963. Werner Formanʼs photographs appeared in Lamaistische Tanzmasken. This unpretentious, slim volume, with a text composed by B. Rinchen (with the apparent assistance of a former tsam ceremony master, giving it unequivocal authenticity) holds a unique position: it was published 32 years after the last eye-witness description of the Mongolian tsam given by Shastina in 1935 (including black-and-white photographs), and some two decades before the series of tsam mask photographs featured in Tsultemʼs Mongolian Sculpture and Iskusstvo Mongolii ʻMongolian Artʼ. In contrast, Lumír Jislʼs photographs, apart from the few that were published during his lifetime, were preserved in a family archive for more than fifty years. The goal of this paper is to describe the circumstances under which these colour photographs came into being. A brief account is given of the visits to Mongolia undertaken by Lumír Jisl and Werner Forman. The general background of Czechoslovak-Mongolian cooperation in its first decade after the establishment of diplomatic relations between the two countries is also sketched out. At that time, tsam masks were stored in the Choijin Lama Temple, one of the very few monastic complexes to survive the antireligious campaign of the late 1930s; the temple became shelter to many religious artefacts. In addition to photographing this temple complex, Lumír Jisl photographed the tsam masks during research trips to at least three regional museums. This paper also describes the different goals and visions of both Lumír Jisl and Werner Forman when photographing the tsam masks, resulting in differing modes of execution. In conclusion, I examine the changes in perspective of the Buddhist monks following the general atmosphere of mistrust and fear engendered by the antireligion campaigns and repressions of the late 1930s, as well as the subsequent partial easing of these repressions. Not only were Forman and Jisl both invited to take photographs of religious artefacts, but they also received assistance in doing so. The Mongolian monks who helped Forman and Jisl had to accept, however, the drastically changed status of these artefacts: once sacred items used in religious ritual dance, they were now objects of Mongolian artistic heritage.

Summary At the base of a steam-assisted-gravity-drainage (SAGD) steam chamber, a liquid pool is developed, which is a key component for bitumen production. A producer is placed in the liquid pool, and its production is mainly controlled by its liquid level and the temperature gradient across its depth. A “subcool control” or “thermodynamic steam-trap control” is a typical operating strategy to control steam coning to the producer. Part I of this study (Irani 2018) presented a methodology to evaluate the production rate for a given pressure drawdown and subcool in a SAGD liquid pool; and Part III (Irani and Gates 2018) modified such a formulation for a stability analysis of the Nsolv™ (Nenniger and Nenniger 2000, 2001) process that contained a large fraction of liquid butane. In this study, first, the effect of localized hot spots on well control is formulated as a virtual skin factor in the liquid-pool deliverability equation. The results of this work suggest that a longer hot spot will yield to lower differential pressure and make it more challenging to control the steam breakthrough by choking the well at a given rate. Another key finding is that the steam coning becomes less controllable for higher-permeability reservoirs. Flow-control devices (FCDs) have been used extensively in horizontal wells for conventional oil and gas production to prevent early water breakthrough or gas coning. Although FCDs are commonly installed to prevent steam coning after steam breakthrough and to manage hot spots as retrofit completions by SAGD operators, in recent years, FCDs have been often installed to improve SAGD well-pair performance as part of the initial completion. The benefits associated with this technology in the SAGD industry have been studied with reservoir simulations and validated with field experience, but a theoretical study that discusses the main factors for a correct FCD selection on the basis of operational conditions and reservoir heterogeneity is required. In this study, the liner-deployed FCD and liquid-pool systems are coupled, and two criteria are suggested for a design of liner-deployed FCDs on the basis of the pressure-drop ratio of the FCD relative to the liquid pool (ΔPFCD/ΔPpool) and the coefficient of variation (CoV) of inflow for the liner-deployed-FCD wellbore (CoVFCD). The results of this study show that in higher-permeability reservoirs, the ideal FCD design should have more ports to reduce the differential pressure to flow response. While FCDs will improve inflow conformance relative to completions without FCDs, the effect of permeability in this improvement is minimal. This improvement is larger in applications operating at lower target subcool values. Reducing the target-wellbore subcool value can improve well deliverability twofold: First, FCD-completed wells produce more at lower subcools and, second, reducing the subcool value helps to improve inflow uniformity along the length of the lateral. By effectively removing the fluids available to the producer, the growth of the steam chamber can be maximized through accelerated injection rates.

Abstract Abstract 695 Background Radotinib is a novel, selective Bcr-Abl tyrosine kinase inhibitor (TKI) developed by IL-YANG Pharm, South Korea. Radotinib showed a good efficacy and safety profile to chronic myeloid leukemia (CML) in preclinical and phase 1 clinical studies. To investigate the clinical efficacy and safety of radotinib 400 mg twice daily, data from CML patients treated during phase 2 clinical trial are reported. Methods Philadelphia chromosome (Ph+)-positive chronic phase CML (CP-CML) patients who failed or were intolerable to TKIs (imatinib and/or dasatinib and/or nilotinib) were enrolled between July 2009 and November 2011. Patients were treated with radotinib 400 mg twice daily for 12 cycles (1 cycle=4 weeks). The primary end point was an achievement of major cytogenetic response (MCyR, Ph+£35%) by 12 months. Safety parameters were also analyzed. Results A total of 77 CP CML patients (18 years of age or over) were enrolled from 12 sites in Korea, India, and Thailand. This analysis includes data from last enrolled patient who received at least 3 months of radotinib therapy. The median age of patients was 47 (range; 24–76) years, and 65 (84.4%) were imatinib-resistant and 12 (15.6%) were imatinib-intolerant. Four patients also had intolerance to dasatinib. With a median follow-up of 10.6 months, treatment with radotinib is ongoing in 46 patients (59.7%) and 31 patients (40.3%) discontinued the treatment including two deaths (2.6%). However, there were no CML-related deaths. Median duration of radotinib exposure was 296 (8–798) days. Overall MCyR rate was 63.6%, including 35 patients (45.4%) complete cytogenetic response and 14 patients (18.2%) partial cytogenetic response. The median time to MCyR was 2.8 months (85 days) and the median duration of MCyR was 315 (range; 5–726) days. Of patients achieving complete cytogenetic response, 37% (13/35) achieved major molecular response. Within follow-up durations, 44 patients (57.1%) required dose interruption and 41 patients (53.3%) had dose reduction. Most common grade 3/4 hematologic and laboratory adverse events (AEs) were thrombocytopenia (27.3%), neutropenia (10.4%), anemia (6.5%), and hyperbilirubinemia (31.2%). Common non-hematologic AEs were rash (29.8%), fatigue (14.3%), nausea/vomiting (14.3%), headache (13.0%), and pruritus (11.7%). The majority of AEs were easily manageable with temporal dose interruption and/or reductions. In all patients with CP-CML treated with second-line radotinib, estimated progression-free survival and overall survival rate at 12months was 84.9% (95% CI, 72.7–92.0%) and 97.4% (95% CI, 89.9–99.3% ), respectively. Conclusion Radotinib phase 2 trial confirmed the efficacy and safety of radotinib 400 mg twice daily in patients with CP-CML after failure to TKIs. Most of the AEs occurred in the early treatment period, were tolerable, and were easily controlled by dose interruption or reduction. Disclosures: Off Label Use: Radotinib, new BCR/ABL tyrosine kinase inhibitor, treatment for CML. Lee:IL-YANG Pharm.: Employment. Park:IL-YANG Pharm.: Employment. Woo:IL-YANG Pharm.: Employment. Kim:IL-YANG Pharm.: Employment. Lee:IL-YANG Pharm.: Employment. Cho:IL-YANG Pharm.: Employment. Shin:IL-YANG Pharm.: Employment. Kim:IL-YANG Pharm.: Employment. Kim:IL-YANG Pharm.: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau.

Background. The article is devoted to the creative activity of the outstanding Chinese composer, pianist, teacher and public figure Zhang Zhao (born in 1964). The musical heritage of Zhang Zhao covers a wide range of genres and includes symphonic, piano music, instrumental compositions, works for Chinese traditional instruments, vocal, chamber music, ballets, music of cinema and television programs, and music for large social events. Despite his notoriety in China, the United States, Canada and many European countries, Zhang Zhao is little known in Ukraine. Thus, Ukrainian musicians to date have been deprived of the opportunity to get acquainted with his work. Since the music of Zhang Zhao sounds in many countries of the world, it resonates powerfully in a variety of areas, and in particular, research. To date, the work of the composer is actively studied by Chinese musicologists. However, among the publications, small articles devoted to a narrow range of problems predominate. Large-scale studies devoted to any area of his music have not yet been created. One of the most important topics relating to the composer’s work is the study of his views on musical art. Zhang Zhao’s vision of the further development of Chinese piano art reveals the composer’s worldview, his creative credo. This question is decisive for studying the composer’s musical heritage, defining his genre-style priorities. Objectives. The purpose of the article is to reveal the peculiarities of Zhang Zhao’s artistic worldview in order to promote the fullest possible identification of the ideas of the composer, the disclosure of the artistic concepts of his works. Methods of research are based on a set of scientific approaches necessary for the disclosure of its theme. The complex approach, combining the principle of musical-theoretical, musical-historical and performing analysis, is taken as the basis of the methodology. Results. Important for the disclosure of the creative worldview of the composer is the study of his statements on the ways of further development of musical art. His attitude and vision of his role in this process, the Chinese musician has repeatedly stated in an interview with domestic journalists. According to Zhang Zhao, the main issue that should concern modern composers is the place of the musical art of their country in world culture. Zhang Zhao found in the face of the pianist virtuoso his Yundi Li adherent. The collaboration between the composer and the performer began in 2011. Zhang Zhao took part in a large-scale theatrical performance at the Third Congress of BRICS leaders in Sanya. Then Yundi Li performed on the stage of the concert hall of Zhang Zhao’s play “In the most remote place” and “Chinese piano dream”. Zhang Zhao is committed to the concept of inheritance and the promotion of a culture of national music. The Chinese compare Zhang Zhao with the outstanding leader of the Polish people Chopin, who dedicated his life to the transformation in piano music of various genres. Piano works by Zhang Zhao adorned the world culture with the introduction of Chinese national motives into it. The composer introduced listeners to the air melodic lines of original works and filled his works with a complex texture, making them attractive for acquaintance with the rich traditional culture of China. Developing national piano art, Zhang Zhao inscribes the Chinese chapter in the world culture with his inherent passion and love for life. In addition to studying composition, performing and teaching, Zhang Zhao, is active in public activities, being a music professor at the Central University for Nationalities. He pays great attention to the development of the artistic taste of students, shares his own musical ideas and aesthetic principles. The composer made great efforts and energy to create the “Chinese piano dream”. To popularize this work, they, together with Yundi Li and the Shanghai People’s Orchestra conducted nationwide tours, visited Taiwan, and outlined other projects. Despite the fact that Professor Zhang Zhao has a very tight work schedule, he nevertheless finds time to talk with his students about the place of national music and its prospects. In the “Chinese Piano Dream”, the composer sought to reflect the essence of the musical culture of the Chinese nation. He embodied the dreams of the older generation of pianist composers and performers about the perfection of the Chinese piano scene, set a high goal – to show the artistic value of the Chinese piano piece on the world stage, took on the mission to inherit the national culture and pass it on to the next generations. In the works of Zhang Zhao, the interests of the Chinese and global world level intersect. This is due to the amazing richness of the composer’s creative worldview, which is open to everything significant in life and art. On this basis, the composer came to important conclusions about the role of contemporary classical musical art in people’s lives in China and in the world. Conclusions. For more than twenty years, Zhang Zhao is in the creative search for his musical style. He carefully investigated the development of ethnic music, which enabled him to create his piano works, which are distinguished by a unique and mature language.

Background. George Gershwin is often considered as a composer who wrote mainly songs and musicals, but this is a misconception: beside the pieces of so-called “light” genres, among the composer’ works – two operas, as well as a number of outstanding instrumental compositions (“Cuban Overture” for a symphony orchestra, two Rhapsodies, Variations for piano and orchestra and Piano Concerto etc.). Gershwin had a natural pianistic talent, and there was almost not a single piece of his own that he did not perform on the piano, and most of them were born in improvisation (Ewen, 1989). The basis for the creation of this study was the desire to increase interest in the work of Gershwin as a “serious” composer and to draw the attention of domestic academic pianists to the value of his piano works, presented not only the “Rhapsody in Blue”, which has been mostly played lately. The purpose of our research is to prove the relevance of the performance of Gershwin’s instrumental works in the academic concert environment as the music of the classical tradition, tracing the formation of specific features of the composer’s instrumental creativity and their reflection in the cycle of “Three Preludes for Piano” in 1926. Studies of the life and work of G. Gershwin, illuminating a special path in music and the unusual genius of an outstanding musician, were created mainly in the 50–70s of the XX century. D. Ewen – the author of the most detailed biography of the composer (first published in 1956, the Russian translation – in 1989) – was personally acquainted with the great musician and his family, took numerous interviews from the composer’s relatives, friends and teachers, had access to his archives (Ewen, 1989: 3–4). The author of the book enters into the details of the life and creative work of the genius and creates a portrait of the composer as a person “in relationships” – as a son, brother, friend. A separate chapter devoted to the music of Gershwin is in the fundamental work of V. Konen (1965) “The Ways of American Music”, an extremely useful study of the folklore origins and musical foundations of jazz. Cognitive is the “popular monograph” by V. Volynskiy (1988) about Gershwin, carefully structured chronologically and thematically. The Internet-pages of A. Tikhomirov (2006–2020) on the resource “Classic Music News.ru” are also very valuable, in particular, thanks to retrospective photographs and audio recordings posted there. From the point of view we have chosen, the piano Preludes by G. Gershwin have not yet been considered by domestic researchers. Research methodology is based on comparative analysis and then synthesizing, generalization and abstraction when using data from biographical literature, and tested musicological approaches when considering musical samples and audio recordings of various versions of the Preludes (including the author’s playing). The results of reseaching. G. Gershwin, despite his Jewish-Slavic family roots (his parents emigrated to America from the Russian Empire at the end of the 19th century), is undoubtedly a representative of American culture. Outstanding artists have almost always turned to the folklore of their country. In Gershwin, this trait manifested itself in a special way, since American folklore, due to historical and political circumstances, is a very motley phenomenon. Indian, English, German, French, Jewish, African, Latin American melodies surrounded Gershwin everywhere. Their rhythms and intonations, compositional schemes were melted, transformed in professional music (Konen, 1965: 231–246). The first musical teacher of Gershwin was the sound atmosphere of New York streets. This is the main reason that the style of his musical works is inextricably linked with jazz: Gershwin did not encounter this purely American phenomenon, he grew up in it. Among the numerous other teachers of Gershwin who significantly influenced on the formation of his music style, one should definitely name the pianist and composer Charles Hambitzer, who introduced his student to the music of Bach, Beethoven, Chopin, Liszt, Debussy, Ravel (Ewen, 1989: 30–32). The most part of Gershwin’s creativity consisted of working on musicals, a typically American genre. The work with the musicals gave the composer the basis for writing his first jazz opera “Blue Monday“, 1922 (other name – “135th Street”), which became the predecessor of the famous pearl of the new genre, “Porgy and Bess” (1935). Following the production of “Blue Monday”, Gershwin began collaborating with the Paul Whiteman Orchestra, who was impressed by the piece. On the initiative of the latter, Gershwin created his masterpiece, “Rhapsody in Blue” (1924), which still remains a unique musical phenomenon, since the composer brought jazz to the big stage, giving it the status of professional music (Ewen, 1989: 79–85; Volynskiy, 1988: part 4). V. Konen (1965: 264–265) believes that Gershwin is a representative of symphonic Europeanized jazz, since he uses it in musical forms and genres of the European tradition. However, we cannot agree that Gershwin “used” jazz. For him, jazz was organic, inseparable from the author’s style, and this is what makes his music so attractive to representatives of both classical and pop traditions. For Gershwin, due to life circumstances, turning to jazz is not an attempt at stylization, but a natural way of expression. “Three Preludes for Piano” are significant in the composer’s work, because it is the only known concertо work for solo piano published during his lifetime. At first, Gershwin planned to create a cycle of 24 Preludes, but only seven were created in the manuscript, then the author reduced the number of works to five. A year after the creation of the Piano Concerto, in 1926, Gershwin presented this new opus. The pieces performed by the author himself sound impeccably technically and even austerely-strictly (audio recording has been preserved, see ‘Gershvin plays Gershvin 3 Preludes’, video on You Tube, published on 2 Aug. 2011). It can be noted that Gershwin is close to the European pianistic style with its attention to the accuracy of each note. The cycle is built on the principle of contrasting comparison: the first and third Preludes are performed at a fast pace, the second – at a slow pace (blues-like). The analysis of the cycle, carried out by the author of the article, proves that “Three Preludes” for piano reflect the main features of Gershwin’s creative manner: capriciousness of syncopated rhythms, subtle modulation play, improvisational development. Breathing breadth, volumetric texture, effective highlighting of climaxes bring the cycle closer to the composer’s symphonic works. Jazz themes are laid out at a high professional level, using traditional European notation and terminology. Thus, although Gershwin was a brilliant improviser, he made it possible for both jazz pianists and academic performers to master his works. Conclusions. The peculiarities of Gershwin’s development as an artist determined the combination of the jazz basis of his works with the compositional technique of European academic music. The versatility and musical appeal of the Preludes are the key to their long stage life. Plays are well received both in cycles and singly. Their perception is also improved by the fact that the original musical speech is combined in them with the established forms of academic music. The mastery of the Preludes by pianists stimulates the development of technical skill, acquaints with jazz style, sets interesting rhythmic problems. The pieces are bright and winning for concert performance. Thus, the presence of the composer’s piano pieces and other his instrumental works in the programs of classical concerts seems appropriate, useful and desirable.

IntroductionAccording to modern scholars (N. Maslova, B. Astafiev), one of the important reasons for the global planetary crisis, including modern educational system in particular, is violation of the conformity of nature principles in the process of perception and cognition of the world, which is conditioned by the advantages of the development of logical and rational thinking and insufficient development of figurative, spiritual-intuitive thinking in the contemporary school of all levels.The modern system of education at all levels (school, higher education, postgraduate studies, and doctorate) is aimed primarily at the development of mechanisms of the left hemisphere that are rational, logical thinking, and analytical perception of reality.Such a one-way orientation leads to inhibition of right-sided processes, does not contribute to the development of creativity, disclosure and activation of the spiritual and intuitive capabilities of the individual, as well as to alienation of individual from the World, loss of personal sense of integrity, unity with the World; that is, to the disharmony of individual with his/her own nature and environment.Personal development of an individual in modern conditions takes the form of "Homo technicus" ("technical person"), "Homo informaticus" (“informational and technogenic person”), "Нomо соnsumens" (“person who consumes”), "Reified man" ("material surplus person"), "Nomo Festivus" ("person who has fun") (Butenko, 2017). As a result, a person with a technocratic, rational thinking, pragmatic and consumer attitude towards the world is brought up, and as a consequence, harmony in the "man-man", "man-nature", "man-society", "man-universe" systems, and correspondingly, the equilibrium in the integrated information-energy system interaction "Man – Society – Earth –Universe" are violated.Approach In contemporary education of all levels, high ontological and existential goals are not set, and not enough attention is paid to the spiritual and mental health of the individual, in particular to problems of spiritual self-knowledge, self-development, self-regulation and self-realization, thus leading to the formation of consumer psychology, dominance of pragmatic values, loss of spirituality, upbringing of a human – destroyer, a soulless person, but not a creator.One of the ways out from the planetary global crisis in the area of a contemporary education in particular, is the noosphereization of education, the imperative task of which is formation of the noospheric individual, actualization of his/her spiritual and intuitive potential, training of the noosphere integral harmonious bioadequate environmentally healthy mindset, which is based on a conscious total ownership of logical (left cerebral hemisphere) and creative, spiritual-intuitive (right cerebral hemisphere) thinking that, due to correspondence with both huamn nature and the laws of the cosmoplanetary world, will provide the individual with possibilities to adequately and fully (at the information and energy levels) perceive and recognize the surrounding world, and to interact with it on a spiritual basis.Results and Discussion The problem of intuition always remains relevant throughout the history of mankind. Among the scholars of the late XX century - beginning of the XXI century the problem of intuition and harmonization of the activity of the left and right hemispheres of the brain has been studied by such researchers as G. Kurmyshev, N. Maslova, Osho Bhagwan Sri Rajneesh, I. Smokvina and others. Modern psychophysiological science explains the nature of intuitive thinking and cognition: the human mind combines the ability to integrate and develop both intellectual and intuitive knowledge that modern scientists associate with the activity of the left and right cerebral hemispheres. According to psychological science, the two hemispheres of the brain cognize and reflect the surrounding world differently and, thereafter transform information in their own ways. The left hemisphere "sees" objects as discrete, separated; it is responsible for logic and intellect, verbal thinking, application of sign information (reading, counting, language), and is characterized by the ability for logical, rational, mathematical, and scientific thinking. The right hemisphere binds objects into a single whole; it is responsible for emotions, creative thinking, intuition (unconscious processes). Thanks to the right hemisphere, a holistic image of the world is formed, and the left hemisphere gradually collects the model of the world from separate, but carefully studied details. "Left- hemisphered" thinking is associated with the ability for consistent, step-by-step cognition, which has respectively analytical rather than synthetic character. "Right- hemisphered" thinking is linked to the ability for integral, voluminous and complete cognition, space spatial immediate perception of the world in all of its information-energy interrelations and interactions.Logic and intuition, rational and intuitive paths – are different aspects of the unified process of cognition, and if the intellect can be regarded as the earthly beginning in humans, then intuition – is a spiritual primary source, a phenomenon of nonlinear, unearthly thinking, the logic of the Higher Being, the logic of the Almighty. As was very wittily pointed out by Osho Bhagwan Shree Rajneesh, logic – the way our mind cognizes our reality, intuition – is how the spirit passes through the experience of reality (Maslova, 2006). Therefore, logic and intuition are two mutually conditioned mechanisms of scientific cognition that supplement and do not exist in isolation from one another. If the function of intuition in this interaction lies in creative discoveries, inventions, awareness of the true essence of things and phenomena, then the task of the scientific method, acting as an assistant of intuition, is to endeavor to comprehend new ideas, explain them from the point of view of earth science at the logical level, and "adapt" to our reality.Given this, rational and intuitive paths must complement, enrich and explain each other, interact in sync, in synthesis.Intuition is an organic component of the spiritual and psychic nature of the individual. Therefore, the problem of the development of intuition and harmonization of the discourse-logical and spiritual-intuitive components of thinking is extremely important at all levels of contemporary education. This is especially true for student youth, since students are the future spiritual and creative potential of the country, and therefore it is extremely important to reveal and develop their spiritual and intuitive abilities, to harmonize their mental-spiritual sphere, which promotes spiritual self-healing of both the individual and the environment, and harmonization of relations in the world. In the context of the modern information and energy paradigm, intuition is considered as a special mental state of a highly spiritual person, in which he/she deliberately initiates informational and energetic contact with any object of the Universe, in the physical or subtle world, "connects" to its information field, "reads out", "decrypts" and analyzes necessary information. This information-energy interaction is perceived by the individual as the process of connection, merging with the object being studied, which enables instant cognition of its true essence (Smokvina, 2013). As the analysis of the literature on the research problem testifies, if the activity mechanisms of the left hemisphere of the brain are relatively studied in modern science, the problems of the individual’s intuitive updating potential and harmonization of the activity of logical and intuitive cognitive processes are being investigated.According to many scholars, the ability for intuition is inborn in every human; however, unfortunately, in most people it is in a latent state. And only due to intense conscious work of the individual regarding their own spiritual self–cognition and self–perfection, one can discover and develop personal spiritual and intuitive abilities.According to the results of our theoretical study the general conditions contributing to the disclosure and development of intuition are as follows: (Tyurina, 2017) • Ability to cope with one’s own passions, emotions, feelings, thoughts, and achievement of the state of internal silence, voicelessness;• Formed self-motivation for spiritual self–cognition and self–perfection;• Achievement by the individual of the corresponding spiritual level: the higher the spirituality of the human, the more clearly his/her ability is expressed to obtain a higher spiritual knowledge: information and energy interaction, contact with higher levels of psychic reality;• Conscious desire, willingness of the individual to use intuitive cognition that helps overcome information-power resistance, the barrier that exists between a subject and an object, helps create harmony, assonance, interaction with the object being studied;• Intuitive human confidence: deep inner belief in personal intuitive capabilities and ability for intuitive cognition and self-cognition;• Humanistic orientation of the individual and his/her internal psychological properties such as: altruism, active love for all living beings on the Earth, empathy, ability to express compassion, care, and self-consecration, conscious desire to live in harmony with oneself and the world;• Nonjudgmental practice, which consists of the ability of a person to abandon assessments, classifications, analysis, which creates favorable conditions for immersion into the information space around us, makes it possible to connect to the information-energy field (biofield) of the object being studied;• Sense of inner unity with the world, awareness of oneself as a part of mankind, of the Earth, of the Universe, and a feeling of deep responsibility for the world and for ourselves in the world;• Striving for personal self-realization for the benefit of the cosmoplanetary world.In our opinion, the ways of actualization of intuition and harmonization of the activity of logical and intuitive components of the process of cognition should be attributed to the following (Tyurina, 2018):• Concentration, concentration of human consciousness of the subject being studied, deep and thorough knowledge of it.Psychological mood, deep concentration, focus of human consciousness on the subject of research lead to intuitive penetration into its essence, comprehension of the subject of study as if "from within." An intuitive act of cognition is the result of a huge concentration of all human efforts on a particular problem, deep and thorough knowledge of it, mobilization of all its potencies. In particular, for almost 20 years, D. Mandeleev worked continuously on the systematization of chemical elements, and only after that he "saw" his periodic system of elements in his dream. At academician M. Shchetynin school students spend 21 days (6 lessons daily) studying only one academic discipline for the purpose of deep penetration into its essence - information-energy merger, connection with the subject being studied, into a single whole, that is, achieving an intuitive level of comprehension.• Spiritual practices (prayer, meditation).Prayer and meditation are effective ways of spiritualizing a person, awakening and activating his/her intuitive potential. Through prayer, meditation a person learns to adjust to nature and Cosmos, eternity and infinity, the World Harmony, reaches consonance with the World, and permeates its inner essential depth with the heart.It is believed that it is prayer that promotes the spiritual purification of both the human soul and the surrounding world. During a heart-warming prayer a human comes to enlightenment and spiritual enlightenment, intuitive enlightenment.In the process of prayer, meditation, the right and left hemispheres of the brain begin to work synchronously, which makes the brain function in resonance with the Field of Consciousness or the Field of Information - Noosphere.• Spiritual processing of the corresponding religious, spiritual and philosophical sources, fine arts, classical music, information-energy interaction which raises the spiritual level of an individual, awakens his/her intuitive abilities.Spiritual literature is an important way of discovering and developing intuition and harmonizing the activity of intuitive and logical components of thinking, since information and energy interaction with spiritual literature contributes to individual’s spiritual growth, disclosure and development of intuition, and harmonization of personal intuitional and intellectual sphere.It should be noted that various forms of art, in particular, visual and musical, play a special role in the process of disclosure and development, intuition, harmonization of the logical and figurative, spiritual and intuitive perception of reality.The spiritual potential of art is, first of all, that in itself, creating spiritual values, spiritualizes a person, and interprets personality as a phenomenon of a global planetary-cosmic nature. True art has an ecumenical, cosmic dimension. The best masterpieces of world art transfer the idea of unity of humans with the world, their harmonious interaction.The creativity of great artists contributes to the disclosure and development of the personality's spirituality, the heart's perception of the world, the cultivation of the Cosmic Worldview, and directs the person to high ideals.Musical art is one of the most important means of revealing and developing intuition, harmonizing its spiritual and intuitive basis.The results of research by modern scholars show that classical, spiritual music activates the spiritual-intuitive sphere, harmonizes the person, gives a sense of joy and rest, and helps to restore spiritual and mental balance.It has been scientifically proven that classical musical compositions based on the perfection of harmony and rhythm, especially the works of J. Bach, L. Beethoven, J. Brahms, A. Vivaldi, G. Handel, F. List, F. Mendelssohn, A. Mozart, S. Rakhmaninov, O. Scriabin, P. Tchaikovsky, F. Chopin, F. Schubert, R. Schumann and others have a positive effect on the individual on the spiritual, mental and physiological levels, since classical music relates mainly to the natural rhythms of the human body. This music causes not only positive emotions, but also represents a powerful energy force that inspires humans and the world: makes a person more perfect and the world more beautiful.Consequently, fine arts, classical music, contribute to the disclosure and development of the spiritual and intuitive potential of the individual, to harmonization of his/her intuitive-intellectual sphere; they help the person to grow spiritually and be filled with high spiritual energy, accordingly, to change, and improve the natural and social environment.- Bioadequate REAL-methodology of noosphere education (N. Maslova), in which stages of relaxation (accumulation of information, work of the right creative hemisphere in a state of rest), alternating with stages of activity (training of the left hemisphere: logic, analysis, synthesis of information) are presented. As a result, the work of the left and right cerebral hemispheres is synchronized, which promotes harmonization of consciousness, carries a beneficial influence on the spiritual, mental, social and physical health of the student's personality.The fundamental characteristics of the bioadequate method of noospheric education are:1. Health preserving - does not violate the nature of perception, processing and preservation of information.2. Corrective - restores the natural genetic sequence of work with the information and health of the student and the teacher.3. Developing - improves the body's reserves.4. Harmonizing - integrates all systems of the body and personality (Vernadsky, 2002).According to studies of the neuropathologist I. Smokvinova, PhD, bioadequate methods of noosphere education, taking into account the physiological and informational and energy resources of the individual, contribute to the harmonization of the work of the left and right cerebral hemispheres, awaken higher feelings, recharge with life energy, teach the ability to direct vitality to the realization of one’s own higher potential, which also has a beneficial effect on the spiritual, mental and physical health of the individual. Moreover, due to the application of a bioadequate technique, psychological and physiological stress is eliminated, and a positive emotional mood is created that heals the body and the student's psychics (Osho, 2000). According to N. Maslova, holistic thinking contributes to the acquisition of basic energy, biologically adequate to livelihoods programs (Kurmyshev, 2013).Many independent groups of scientists (teachers, psychologists, physicians, biologists) have proved that noosphere education, harmonizing the left and right hemispheres thinking, has a healing effect on the body of both the student and the teacher, contributes to the development of natural creativity.Practical valueResults of our study can be used in lectures and practical classes with students in medical psychology, psychology of creativity, social, general, pedagogical psychology, pedagogy (sections of didactics, spiritual and moral education), sociology, philosophy, etc.ConclusionsThus, the actualization of the spiritual and intuitive potential of the individual and the harmonization of the activity of the left and right cerebral hemispheres stimulates the disclosure of spiritual and creative abilities of the individual, fills the individual with spiritual energy, and the person becomes a source of spiritualization of himself/herself and the world, thus contributing to the spiritual and psychological improvement of society, humanity, and civilization in general, since at the information-energy level, "Man - Society - Earth - Universe" this is the only cosmoplanetary organism, all parts of which are mutually interconnected, interact and stipulate with one another. We consider that it is important in the future to develop appropriate special disciplines for all the sections of modern school and keep working in the direction of developing and incorporating into the content of the curricula, relevant pedagogical technologies aimed at the disclosure and development of the intuitive-mental sphere of the individual

ABSTRACT Background: Chemical weapons attacks during the recent conflict in Syria and Iraq highlight the need to better understand the changing epidemiology of chemical weapons use, especially among non-state actors. Public health professionals and policy-makers require this data to prioritize funding, training, chemical weapons preparedness, disaster response, and recovery. The purpose of this investigation is to provide descriptive data that can be used by policy-makers and public safety officials to better prepare for these potential attacks. Methods: A five-decade descriptive retrospective review of The Global Terrorism Database, maintained by the National Consortium for the Study of Terrorism and Responses to Terrorism, was conducted to understand trends in chemical agents, targets, and routes of exposure. We reviewed and analyzed data specific to these documented chemical attacks between 1970 and 2017. Results: 383 terror attacks involved chemical weapons over the study period. A specific agent was named in 154 incidents, while 124 incidents could be classified into traditional chemical weapons categories (eg, vesicant, choking agents). A route of exposure was identified in 242 attacks, with the most common routes of exposure being dermal-mucosal and inhalational. Caustic agents were used in the highest portion of attacks (25%) where the route of exposure was known. Explosive devices were used in 21% of attacks to deliver these chemical agents. Of particular note, private citizens and educational facilities were targeted in 25% and 12% of attacks, respectively. The average number of attacks increased from 6 per year between 1970 and 2011 to 24.9 per year between 2011 and 2017 (coinciding with the start of the Syria conflict). The most commonly utilized chemicals were chlorine (26.0%), tear gas (20.8%), and cyanide (15.6%). Blood agent incidents declined from 32.6% before the September 11, 2001 attacks to 13.6% after 2001, while nerve agent attacks fell from 9.3% to 1.2%. In contrast, choking (namely chlorine) and vesicant (mustard) agent use increased from 7% to 48.1% and from 2.3% to 6.2% of attacks, respectively. Conclusions: Chemical weapon use in global terrorism remains an increasingly common occurrence that requires better characterization. The average number of chemical terrorist attacks per year is increasing, with a large proportion resulting from the conflicts in Iraq and Syria. Choking (chlorine) and vesicant (mustard) agents have become the predominant chemical terror agent since 2001, with a decreased incidence of blood (cyanogenic) and nerve (sarin) agents. Future preparedness initiatives should focus on vulnerable targets such as private citizens and educational institutions. Improving blast injury response is essential, along with prioritizing disaster training focused on choking agents, vesicants, and caustics.

Abstract: Asphyxia is a condition characterized by the disturbance of gas exchange in the respiratory tract resulted in reduced oxygen accompanied by increased carbon dioxide in the blood. Mechanical asphyxia is suffocation that occurs when the airway was obstructed by various circumstances (which are mechanical), as follows: choking, smothering, strangulation by ligature, manual strangulation, and hanging. This study was aimed to obtain the profile of mechanical asphyxia cases at Forensic Department of Prof. Dr. R. D. Kandou Hospital period 2010-2015. This was a descriptive retrospective study. The results of the external examination and autopsy showed that there were 22 cases of death due to mechanical asphyxia. The highest percentage of asphyxia cases was in 2011 as many as 8 cases (36.5%). Most cases were in the age group of 17-25 years old (7 cases; 31.8%). Males (12 cases; 54.5%) were slightly more frequent than females (10 cases; 45.5%). The most cases of mechanical asphyxia were hanging (15 cases; 68.2%). The most common sign of asphyxia was congestion of the organs (19 cases; 86.4%).Keywords: asphyxia, mechanical asphyxia, forensic Abstrak: Asfiksia adalah suatu keadaan yang ditandai dengan terjadinya gangguan pertukaran udara dalam saluran pernapasan yang berakibat menurunnya oksigen dalam darah berkurang disertai dengan meningkatnya karbon dioksida. Asfiksia mekanik adalah mati lemas yang terjadi bila udara pernapasan terhalang memasuki saluran pernapasan oleh berbagai kekerasan (bersifat mekanik), yaitu pembekapan, penyumpalan, jeratan, cekikan dan gantung. Penelitian ini bertujuan untuk mengetahui gambaran kasus asfiksia mekanik di Bagian Forensik RSUP Prof. Dr. R. D. Kandou periode tahun 2010-2015. Jenis penelitian ialah deskriptif retrospektif menggunakan data hasil pemeriksaan luar dan autopsi. Hasil penelitian mendapatkan 22 kasus kematian akibat asfiksia mekanik. Kasus terbanyak pada tahun 2011 yaitu 8 kasus (36,5%). Kelompok usia terbanyak ialah 17-25 tahun dengan 7 kasus (31,8%). Jenis kelamin laki-laki sedikit lebih banyak yaitu 12 kasus (54,5%) dibandingkan perempuan yaitu 10 kasus (45,5%). Kasus asfiksia mekanik tersering ialah gantung dengan jumlah 15 kasus (68,2%). Tanda asfiksia yang sering ditemukan ialah pembendungan organ dalam yaitu 19 kasus (86,4%). Kata kunci: asfiksia, asfiksia mekanik, forensik

Introduction: Hypopharyngeal lipomas are rare tumors of head and neck which present with vague symptoms like dysphagia, foreign body sensation in throat, feeling of something coming to the throat or mouth, choking sensations or with symptoms of obstructive sleep apnea. These tumors can cause upper airway obstruction and even asphyxial deaths presenting as medical emergency. 
 Case report: We report one such case of a 38 year old female with hypopharyngeal lipoma who had presented to us with symptoms of dysphagia, choking episodes and foreign body sensation in throat.
 Discussion: Laryngoscopic examination in these cases is diagnostic to assess its size and site of attachment. Imaging studies like CT scan or MRI help in diagnosis.

Entering the new year of 2014 the Kingdom of Tonga had enough to worry about; a local economy choking to near death and a finance minister sacked and replaced in a political spectacle leaving the public baffled over what went wrong between him and the Prime Minister (Fayle, 2014; Lopeti, 2014c; Fonua, 2014b). People uttered they looked forward to the end of year election tentatively set for Thursday November 27th. The 2010 register of around forty thousand voters had increased at the 2014 intake by four thousand, mostly voters who had turned the age of suffrage at twenty one years old. The chorus call from the masses was simple, vote them out. Then Cyclone Ian struck on Saturday 11 January 2014 aggravating Tonga’s money shortage.
 Journalist Pesi Fonua wrote “the impact on the Tongan economy of the cyclone and the salary rise for civil servants at this point of time is a matter of great concern” (Fonua, 2014a). He was right. The state and taxpayers could not afford economic recovery from Tonga’s cruellest cyclone, a symptom of climate change, let alone paying for a 5% rise in the cost of living allowance for public servants. As the national debt distress sore became inflamed the Public Service Association decided it was the right time to fight cabinet for a 22% living allowance rise because 5% was not enough (Lopeti, 2014a). This essay asks a pointed question. Leading up to the general election of November 2014, how was cyclone politicking being manoeuvred to sway the way people would vote?

Binwa is a perennial hill stream of the Western Himalayan region of Himachal Pradesh. During the present investigation, four observation sites based on altitudinal differences were selected, i.e., Kharli(S1), Baijnath (S2), near Chobin (S3), and Triveni (S4) and water samples were analyzed for physico-chemical and biological parameters for one year (Mar.2011-Feb.2012). Water temperature, water current, dissolved oxygen, turbidity, T.D.S., electric conductivity, total Hardness, phosphate, and nitrate had played an essential role in determining the variations in planktonic and macroinvertebrate fauna of the stream.Species diversity indices such as Simpson, Shannon and Wiener, and Margalef’s diversity index of macroinvertebrates were worked out for all the observation sites. Based on the comparison of physico-chemical parameters of water samples with different standards prescribed for drinking water, water quality index for four stations calculated. Similarly, EPT taxa (Ephemeroptera, Plecoptera, Trichoptera) measured, and EPT index computed. The water quality of the stream deteriorates downstream from head to mouth due to different types of anthropogenic interferences. The findings revealed that stream has no pollution at S1, while it is oligotrophic from S2 to S3 and meso-oligotrophic at S4.

Foreign body aspiration is a potentially fatal occurrence, particularly in children less than 3 years of age. Predisposing factors include the tendency to put objects into the mouth, poor chewing ability, lack of posterior dentition and uninhibited inspirations when laughing or crying. Classically, the history opens with a witnessed choking episode which would raise a high level of suspicion in the clinician. Ideally, this would lead to an investigative cascade resultant in prompt diagnosis and removal of the object without significant sequelae. The clinical presentation, however, of an unwitnessed foreign body aspiration can be non-specific and subtle from acute shortness of breath and difficulty breathing to intractable cough, fever and chronic wheeze. It can masquerade as a reactive airway or primary infective pathology and delay crucial diagnosis. A high index of suspicion is therefore required when assessing a child with any of these complaints. Commonly aspirated substances include food particles, hardware and toys. Retained foreign bodies can lead to severe and dangerous long-term consequences including atelectasis, pneumothorax, pneumomediastinum or even death. The purpose of this case is to demonstrate the diagnostic dilemma when dealing with young children and the understated presentation of an unwitnessed aspiration of a foreign body.

In "Speed and Information: Cyberspace Alarm!", Paul Virilio claims that telecommunications are ushering in the "invention of a perspective of real time" which results in "some kind of choking of the senses, a loss of control over reason". As users of this new technology, as the receptors of the stream of computer-mediated information, we need to figure out the terms and conditions of our acceptance of cyberspace as a space and realtime as a form of time, to understand the implications of this new mode of communication, for "no information exists without dis-information". In "Speed and Information: Cyberspace Alarm!", Paul Virilio claims that telecommunications are ushering in the "invention of a perspective of real time" which results in "some kind of choking of the senses, a loss of control over reason". As users of this new technology, as the receptors of the stream of computer-mediated information, we need to figure out the terms and conditions of our acceptance of cyberspace as a space and realtime as a form of time, to understand the implications of this new mode of communication, for "no information exists without dis-information". Even Virilio proclaims apocalyptically that "our history will happen in universal time, itself the outcome of instantaneity -- and there only". In fact, time also governs narrative choices: their availability, viability, desirability, relevance. Despite the hype surrounding the instantaneity of virtual travel, narrative in cyberspace is inherently subordinate to connection speed and loadtime. This is why the "loading screen" has become the standard welcome on Shockwave-heavy sites, developing into a kind of mini-genre of low-bandwidth animation. The possiblity of using temporality as a narrative catalyst has been exploited in cinema, as in classic Hollywood dissolves and fades. Metaphors of the passing of time are a familiar cliche: the pages of a daily calendar fluttering away, the changing of the seasons. Stanley Kubrick's bold cut from a spinning bone to a space station in orbit in 2001: A Space Odyssey is an extreme and unusual example of this sort of metaphor. These all function as temporal ellipses. The passage of time can also function as plot, as in Warhol's Blow Job and Richard Linklater's Slacker, both of which are ostensibly about merely the passage of time. Slacker lacks a traditional narrative and instead progresses through a series of vignettes, each one following seemingly random characters through seemingly random events (an idea developed further by the recent Magnolia). The change from one vignette to the next is motivated simply by the camera's movement from one character or event to another. The camera is like a nosy passerby, a voyeur, showing noncommittal interest in one thing, then another, and the viewer must give up interest in each vignette without the satisfaction of narrative closure. As the filmmaker tells the cabdriver in the beginning, each turn of events, each decision made, results in all possibilities going on to live out their potential realities. We, the viewers, in turn, follow the camera's gaze with the frustrating knowledge that other, unresolved realities are continuing without that gaze. The recent Timecode uses the same hypertext-type approach with four simultaneous screens, each a single shot capturing one part of an interlocked world. These are all extreme, overt examples of Deleuze's time-image. Online, similar moves have been made in Mark Napier's Shredder and Maciej Wisniewski's Netomat interfaces. Both function as alternatives to conventional browsing, Netomat even labelled an "anti-browser" that engages "an Internet that is an intelligent application and not simply a large database of static files". The above-mentioned devices for manipulating the perception and understanding of time as represented in film (fade, dissolve, et al.) exploited an inherently filmic problem: simply put, that there is a serious discrepancy between time as it happens and its perception, much like the time it takes to enjoy a Website's multimedia content and the length of its download. In the case of the fade, for instance, an inherent problem of the medium has been internalised in a non-transparent way and used overtly to further the narrative meaning. Likewise, the "loading screen" offers a morsel of content typically focussed on its function ("loading... 5 seconds to go..."). The existence of these filmic conventions makes us aware of when they are broken, as in the "realtime" films Nick of Time, Blow Job, and Timecode, and also in instances of extended time, as in the classic shower scene in Hitchcock's Psycho. Think, too, of the last time you had to wait before you saw any of a Website's content. Just as filmic time is typically compressed for the sake of appearing real, navigational movement on the Web is in fact constrained while seeming free, and delayed while seeming instantaneous. The promise of instant access has instead been fulfilled by erratic connection speeds and server problems. Because Web time ostensibly passes almost in an instant (this is, after all, the industry in which a product might become passé while still at the beta phase), information ages just as quickly: "404 File not found" is a familiar sight, telling us that the link we followed may have been coded, not last year, but maybe even last week, or yesterday. Information loses relevance, even disappears, often in no time at all. These problems have been exploited by JODI, whose experimental online work foregrounds the nuts and bolts (and kinks) of the Web, instead of hiding it beneath a clean "other" design. The desirability of information over time is also the focus of Rhizome's Starry Night interface which, utilizing Java, shifts over time to emphasise popular links, eventually eradicating unpopular ones. In The Work of Art in the Age of Mechanical Reproduction, Walter Benjamin writes that "even the most perfect reproduction of a work of art is lacking in one element: its presence in time and space, its unique existence at the place where it happens to be" (220). But what of the Web art project, whose existence on a server somewhere does not need to be known for the work to be understood, whose duplication yields a copy that is indistinguishable from the original? What of the work that is both static and temporal, which is inherently mediated through time, including time (as in server and connection speed) which cannot be completely accounted for by the author? He goes on to say that technical reproduction "enables the original to meet the beholder halfway" (220), but what is the Website's point of departure? Its creator's computer? The server on which it lives? The end user's computer? How can we map the path from the "original" to its "reproduction" when the two are indistinguishable, when, in fact, there is no confirmable original? As if in response to Benjamin, Paul Virilio writes in "Speed and Information: Cyberspace Alarm!" that "the specific negative aspect of these information superhighways is precisely this loss of orientation regarding alterity (the other), this disturbance in the relationship with the other and with the world". Virilio is concerned with the problem of orientation, that is, of the lack of geographical, historical, and temporal specificity and point of reference when experiencing a Web-based narrative. Compare that to Deleuze's claim that, in the time-image, "the brain has lost its Euclidean co-ordinates, and now emits other signs" (278), a notion similar to the "loading screen", a bit of content which exists merely to inform that content is forthcoming. Virilio sees this as a crucial problem facing us today and adds that "there is talk of substituting the term 'global' by 'glocal,' a concatenation of the words local and global". The Internet yields both seeming temporal instantaneity and spatial compression. We can be everywhere all at once, all the time; but what of the inevitable slippage of time involved? The World Wide Web has created a life of dead moments, of moments spent waiting for the instantaneous to happen. References Baudrillard, Jean. "Radical Thought." Trans. Francois Debrix in CTheory. Collection Morsure. Eds. Sens and Tonka. Paris: 1994. Benjamin, Walter. Illuminations. New York: Shocken Books, 1968. Debord, Guy. The Society of the Spectacle. London: Rebel Press, 1992. Deleuze, Gilles. Cinema 2: The Time-Image. Minneapolis: U of Minnesota P, 1989. Napier, Mark. Shredder. 27 June 2000 <http://www.potatoland.org/shredder/>. Rhizome. 27. June 2000 <http://www.rhizome.org/>. Virilio, Paul. "Speed and Information: Cyberspace Alarm!" Le Monde Diplomatique Aug. 1995. Trans. Patrice Riemens in CTheory. Wisniewski, Maciej. Netomat. 27 June 2000 <http://www.netomat.net/>. Citation reference for this article MLA style: Maya Drozdz. "Waiting for Instantaneity." M/C: A Journal of Media and Culture 3.3 (2000). [your date of access] <http://www.api-network.com/mc/0006/instantaneity.php>. Chicago style: Maya Drozdz, "Waiting for Instantaneity," M/C: A Journal of Media and Culture 3, no. 3 (2000), <http://www.api-network.com/mc/0006/instantaneity.php> ([your date of access]). APA style: Maya Drozdz. (2000) Waiting for instantaneity. M/C: A Journal of Media and Culture 3(3). <http://www.api-network.com/mc/0006/instantaneity.php> ([your date of access]).

As perhaps most obviously evidenced in the political maneuverings that led up to the second Gulf War in 2003, the use of satellite imagery to document spatial terrain is often, and almost instantly, politicized. In the two images presented here, this politicization takes on a two-way relationship and is open to contrasting and inevitably dualistic readings. One way of describing their relationship is as “Target” and “Aftermath”. On the left, we have an image of the nuclear plant near the Iranian city of Qom, annotated in this version by the US security services to highlight ‘suspicious’ activity said to evidence the nuclear ambitions of the Iranian government. On the right, we are presented with an image of Tehran under heavy smog in 2013 released by the Iranian government itself. Although the official Iranian explanation for this smog is the general population density and industrialization of the city, it has now been acknowledged, or is at least extensively argued, that the pollution it documents is a direct result of the economic sanctions imposed by the United States in 2010 that banned the sale of refined fuel to the country. Facing a major energy crisis that would completely stall the economy, the Iranian government opted to produce a “bathtub mix” of far inferior quality oil that has been releasing deadly exhaust into the already dense air of Iran for the past three years. The “Target”, as the first image shows, is Iran’s nuclear program, which lies at the crux of complicated historical animosities currently evident between the US and Iranian governments. Taken at very high resolution (2.5 meters per pixel) from outer space, the image presents itself as tunnel-vision precision — each point is a piece of data and each piece of data details coordinates, date, and time. It is on the back of such supposed satellite precision that the crippling economic sanctions of the US’s policy of containment are justified. However, the aftermath of these sanctions has not been the cessation of Iran’s nuclear program, but rather the suffocation of Tehran. Indeed, it has been argued that the inhabitants of Tehran are almost literally “choking to death”. By the standards of the sanctions’ purported aims, the result seems more an egregious misfire than a successful piece of foreign policy. The reality behind these images and their conflicting ascribed narratives is far from clear. The effects on the people of Iran are also not only equally unclear, they are deliberately hazed. Employing Giorgio Agamben’s notions of the abstraction of the citizen to ‘bare life’ and its corollary of the ‘Camp’ as the 'Nomos' of the Modern, this paper attempts to decipher these images, their politicized readings, and the way in which the sites of human life in and near their locations – the occupants of the city of Qom in the first instance and those of Tehran in the second – have been conspicuously erased. It will argue that this visual erasure from spatial representation has fundamental implications for the human rights of the inhabitants of these cities and, by extension, Iran and a politicized world more generally. In doing so, it will suggest that as spaces and places of political conflict are ever more frequently presented through the medium of the satellite image, a deeply politicized reading of their structures, narratives and spatial representative techniques becomes ever more important.

Introduction The first “Aquarius Festival” came together in Canberra, at the Australian National University, in the autumn of 1971 and was reprised in 1973 in the small rural town of Nimbin, in northern New South Wales. Both events reflected the Zeitgeist in what was, in some ways, an inchoate expression of the so-called “counterculture” (Roszak). Rather than attempting to analyse the counterculture as a discrete movement with a definable history, I enlist the theory of cultural memes to read the counter culture as a Dawkinsian cluster meme, with this paper offered as “testimonio”, a form of quasi-political memoir that views shifts in the culture through the lens of personal experience (Zimmerman, Yúdice). I track an evolving personal, “internal” topography and map its points of intersection with the radical social, political and cultural changes spawned by the “consciousness revolution” that was an integral part of the counterculture emerging in the 1970s. I focus particularly on the notion of “consciousness raising”, as a Dawkinsian memetic replicator, in the context of the idealistic notions of the much-heralded “New Age” of Aquarius, and propose that this meme has been a persistent feature of the evolution of the “meme cluster” known as the counterculture. Mimesis and the Counterculture Since evolutionary biologist Richard Dawkins floated the notion of cultural memes as a template to account for the evolution of ideas within political cultures, a literature of commentary and criticism has emerged that debates the strengths and weaknesses of his proposed model and its application across a number of fields. I borrow the notion to trace the influence of a set of memes that clustered around the emergence of what writer Marilyn Ferguson called The Aquarian Conspiracy, in her 1980 book of that name. Ferguson’s text, subtitled Personal and Social Transformation in Our Time, was a controversial attempt to account for what was known as the “New Age” movement, with its late millennial focus on social and personal transformation. That focus leads me to approach the counterculture (a term first floated by Theodore Roszak) less as a definable historical movement and more as a cluster of aspirational tropes expressing a range of aspects or concerns, from the overt political activism through to experimental technologies for the transformation of consciousness, and all characterised by a critical interrogation of, and resistance to, conventional social norms (Ferguson’s “personal and social transformation”). With its more overtly “spiritual” focus, I read the “New Age” meme, then, as a sub-set of this “cluster meme”, the counterculture. In my reading, “New Age” and “counterculture” overlap, sharing persistent concerns and a broad enough tent to accommodate the serious—the combative political action of Students for a Democratic Society (SDS), say, (see Elbaum)—to the light-hearted—the sport of frisbee for example (Stancil). The interrogation of conventional social and political norms inherited from previous generations was a prominent strategy across both movements. Rather than offering a sociological analysis or history of the ragbag counterculture, per se, my discussion here focuses in on the particular meme of “consciousness raising” within that broader set of cultural shifts, some of which were sustained in their own right, some dropping away, and many absorbed into the dominant mainstream culture. Dawkins use of the term “meme” was rooted in the Greek mimesis, to emphasise the replication of an idea by imitation, or copying. He likened the way ideas survive and change in human culture to the natural selection of genes in biological evolution. While the transmission of memes does not depend on a physical medium, such as the DNA of biology, they replicate with a greater or lesser degree of success by harnessing human social media in a kind of “infectivity”, it is argued, through “contagious” repetition among human populations. Dawkins proposed that just as biological organisms could be said to act as “hosts” for replicating genes, in the same way people and groups of people act as hosts for replicating memes. Even before Dawkins floated his term, French biologist Jacques Monod wrote that ideas have retained some of the properties of organisms. Like them, they tend to perpetuate their structure and to breed; they too can fuse, recombine, segregate their content; indeed they too can evolve, and in this evolution selection must surely play an important role. (165, emphasis mine) Ideas have power, in Monod’s analysis: “They interact with each other and with other mental forces in the same brain, in neighbouring brains, and thanks to global communication, in far distant, foreign brains” (Monod, cited in Gleick). Emblematic of the counterculture were various “New Age” phenomena such as psychedelic drugs, art and music, with the latter contributing the “Aquarius” meme, whose theme song came from the stage musical (and later, film) Hair, and particularly the lyric that runs: “This is the dawning of the Age of Aquarius”. The Australian Aquarius Festivals of 1971 and 1973 explicitly invoked this meme in the way identified by Monod and the “Aquarius” meme resonated even in Australia. Problematising “Aquarius” As for the astrological accuracy of the “Age of Aquarius meme”, professional astrologers argue about its dating, and the qualities that supposedly characterise it. When I consulted with two prominent workers in this field for the preparation of this article, I was astonished to find their respective dating of the putative Age of Aquarius were centuries apart! What memes were being “hosted” here? According to the lyrics: When the moon is in the seventh house And Jupiter aligns with Mars Then peace will guide the planets And love will steer the stars. (Hair) My astrologer informants assert that the moon is actually in the seventh house twice every year, and that Jupiter aligns with Mars every two years. Yet we are still waiting for the outbreak of peace promised according to these astrological conditions. I am also informed that there’s no “real” astrological underpinning for the aspirations of the song’s lyrics, for an astrological “Age” is not determined by any planet but by constellations rising, they tell me. Most important, contrary to the aspirations embodied in the lyrics, peace was not guiding the planets and love was not about to “steer the stars”. For Mars is not the planet of love, apparently, but of war and conflict and, empowered with the expansiveness of Jupiter, it was the forceful aggression of a militaristic mind-set that actually prevailed as the “New Age” supposedly dawned. For the hippified summer of love had taken a nosedive with the tragic events at the Altamont speedway, near San Francisco in 1969, when biker gangs, enlisted to provide security for a concert performance by The Rolling Stones allegedly provoked violence, marring the event and contributing to a dawning disillusionment (for a useful coverage of the event and its historical context see Dalton). There was a lot of far-fetched poetic licence involved in this dreaming, then, but memes, according to Nikos Salingaros, are “greatly simplified versions of patterns”. “The simpler they are, the faster they can proliferate”, he writes, and the most successful memes “come with a great psychological appeal” (243, 260; emphasis mine). What could be retrieved from this inchoate idealism? Harmony and understanding Sympathy and trust abounding No more falsehoods or derisions Golden living dreams of visions Mystic crystal revelation And the mind’s true liberation Aquarius, Aquarius. (Hair) In what follows I want to focus on this notion: “mind’s true liberation” by tracing the evolution of this project of “liberating” the mind, reflected in my personal journey. Nimbin and Aquarius I had attended the first Aquarius Festival, which came together in Canberra, at the Australian National University, in the autumn of 1971. I travelled there from Perth, overland, in a Ford Transit van, among a raggedy band of tie-dyed hippie actors, styled as The Campus Guerilla Theatre Troupe, re-joining our long-lost sisters and brothers as visionary pioneers of the New Age of Aquarius. Our visions were fueled with a suitcase full of potent Sumatran “buddha sticks” and, contrary to Biblical prophesies, we tended to see—not “through a glass darkly” but—in psychedelic, pop-, and op-art explosions of colour. We could see energy, man! Two years later, I found myself at the next Aquarius event in Nimbin, too, but by that time I inhabited a totally different mind-zone, albeit one characterised by the familiar, intense idealism. In the interim, I had been arrested in 1971 while “tripping out” in Sydney on potent “acid”, or LSD (Lysergic acid diethylamide); had tried out political engagement at the Pram Factory Theatre in Melbourne; had camped out in protest at the flooding of Lake Pedder in the Tasmanian wilderness; met a young guru, started meditating, and joined “the ashram”—part of the movement known as the Divine Light Mission, which originated in India and was carried to the “West” (including Australia) by an enthusiastic and evangelical following of drug-toking drop-outs who had been swarming through India intent on escaping the dominant culture of the military-industrial complex and the horrors of the Vietnam War. Thus, by the time of the 1973 event in Nimbin, while other festival participants were foraging for “gold top” magic mushrooms in farmers’ fields, we devotees had put aside such chemical interventions in conscious awareness to dig latrines (our “service” project for the event) and we invited everyone to join us for “satsang” in the yellow, canvas-covered, geodesic dome, to attend to the message of peace. The liberation meme had shifted through a mutation that involved lifestyle-changing choices that were less about alternative approaches to sustainable agriculture and more about engaging directly with “mind’s true liberation”. Raising Consciousness What comes into focus here is the meme of “consciousness raising”, which became the persistent project within which I lived and worked and had my being for many years. Triggered initially by the ingestion of those psychedelic substances that led to my shocking encounter with the police, the project was carried forward into the more disciplined environs of my guru’s ashrams. However, before my encounter with sustained spiritual practice I had tried to work the shift within the parameters of an ostensibly political framework. “Consciousness raising” was a form of political activism borrowed from the political sphere. Originally generated by Mao Zedong in China during the revolutionary struggle to overthrow the vested colonial interests that were choking Chinese nationalism in the 1940s, to our “distant, foreign brains” (Monod), as Western revolutionary romantics, Chairman Mao and his Little Red Book were taken up, in a kind of international counterculture solidarity with revolutionaries everywhere. It must be admitted, this solidarity was a fairly superficial gesture. Back in China it might be construed as part of a crude totalitarian campaign to inculcate Marxist-Leninist political ideas among the peasant classes (see Compestine for a fictionalised account of traumatic times; Han Suyin’s long-form autobiography—an early example of testimonio as personal and political history—offers an unapologetic account of a struggle not usually construed as sympathetically by Western commentators). But the meme (and the processes) of consciousness raising were picked up by feminists in the United States in the late 1960s and into the 1970s (Brownmiller 21) and it was in this form I encountered it as an actor with the politically engaged theatre troupe, The Australian Performing Group, at Carlton’s Pram Factory Theatre in late 1971. The Performance Group I performed as a core member of the Group in 1971-72. Decisions as to which direction the Group should take were to be made as a collective, and the group veered towards anarchy. Most of the women were getting together outside of the confines of the Pram Factory to raise their consciousness within the Carlton Women’s Liberation Cell Group. While happy that the sexual revolution was reducing women’s sexual inhibitions, some of the men at the Factory were grumbling into their beer, disturbed that intimate details of their private lives—and their sexual performance—might be disclosed and raked over by a bunch of radical feminists. As they began to demand equal rights to orgasm in the bedroom, the women started to seek equal access within the performance group, too. They requested rehearsal time to stage the first production by the Women’s Theatre Group, newly formed under the umbrella of the wider collective. As all of the acknowledged writers in the Group so far were men—some of whom had not kept pace in consciousness raising—scripts tended to be viewed as part of a patriarchal plot, so Betty Can Jump was an improvised piece, with the performance material developed entirely by the cast in workshop-style rehearsals, under the direction of Kerry Dwyer (see Blundell, Zuber-Skerritt 21, plus various contributors at www.pramfactory.com/memoirsfolder/). I was the only male in the collective included in the cast. Several women would have been more comfortable if no mere male were involved at all. My gendered attitudes would scarcely have withstood a critical interrogation but, as my partner was active in launching the Women’s Electoral Lobby, I was given the benefit of the doubt. Director Kerry Dwyer liked my physicalised approach to performance (we were both inspired by the “poor theatre” of Jerzy Grotowski and the earlier surrealistic theories of Antonin Artaud), and I was cast to play all the male parts, whatever they would be. Memorable material came up in improvisation, much of which made it into the performances, but my personal favorite didn’t make the cut. It was a sprawling movement piece where I was “born” out of a symbolic mass of writhing female bodies. It was an arduous process and, after much heaving and huffing, I emerged from the birth canal stammering “SSSS … SSSS … SSMMMO-THER”! The radical reversioning of culturally authorised roles for women has inevitably, if more slowly, led to a re-thinking of the culturally approved and reinforced models of masculinity, too, once widely accepted as entirely biologically ordained rather than culturally constructed. But the possibility of a queer re-versioning of gender would be recognised only slowly. Liberation Meanwhile, Dennis Altman was emerging as an early spokesman for gay, or homosexual, liberation and he was invited to address the collective. Altman’s stirring book, Homosexual: Oppression and Liberation, had recently been published, but none of us had read it. Radical or not, the Group had shown little evidence of sensitivity to gender-queer issues. My own sexuality was very much “oppressed” rather than liberated and I would have been loath to use “queer” to describe myself. The term “homosexual” was fraught with pejorative, quasi-medical associations and, in a collective so divided across strict and sometimes hostile gender boundaries, deviant affiliations got short shrift. Dennis was unsure of his reception before this bunch of apparent “heteros”. Sitting at the rear of the meeting, I admired his courage. It took more self-acceptance than I could muster to confront the Group on this issue at the time. Somewhere in the back of my mind, “homosexuality” was still something I was supposed to “get over”, so I failed to respond to Altman’s implicit invitation to come out and join the party. The others saw me in relationship with a woman and whatever doubts they might have carried about the nature of my sexuality were tactfully suspended. Looking back, I am struck by the number of simultaneous poses I was trying to maintain: as an actor; as a practitioner of an Artaudian “theatre of cruelty”; as a politically committed activist; and as a “hetero”-sexual. My identity was an assemblage of entities posing as “I”; it was as if I were performing a self. Little gay boys are encouraged from an early age to hide their real impulses, not only from others—in the very closest circle, the family; at school; among one’s peers—but from themselves, too. The coercive effects of shaming usually fix the denial into place in our psyches before we have any intellectual (or political) resources to consider other options. Growing up trying to please, I hid my feelings. In my experience, it could be downright dangerous to resist the subtle and gross coercions that applied around gender normativity. The psychoanalyst D. W. Winnicott, of the British object-relations school, argues that when the environment does not support the developing personality and requires the person to sacrifice his or her own spontaneous needs to adapt to environmental demands, there is not even a resting-place for individual experience and the result is a failure in the primary narcissistic state to evolve an individual. The “individual” then develops as an extension of the shell rather than that of the core [...] What there is left of a core is hidden away and is difficult to find even in the most far-reaching analysis. The individual then exists by not being found. The true self is hidden, and what we have to deal with clinically is the complex false self whose function is to keep this true self hidden. (212) How to connect to that hidden core, then? “Mind’s true liberation...” Alienated from the performative version of selfhood, but still inspired by the promise of liberation, even in the “fuzzy” form for which my inchoate hunger yearned (sexual liberation? political liberation? mystical liberation?), I was left to seek out a more authentic basis for selfhood, one that didn’t send me spinning along the roller-coaster of psychedelic drugs, or lie to me with the nostrums of a toxic, most forms of which would deny me, as a sexual, moral and legal pariah, the comforts of those “anchorage points to the social matrix” identified by Soddy (cited in Mol 58). My spiritual inquiry was “counter” to these institutionalised models of religious culture. So, I began to read my way through a myriad of books on comparative religion. And to my surprise, rather than taking up with the religions of antique cultures, instead I encountered a very young guru, initially as presented in a simply drawn poster in the window of Melbourne’s only vegetarian restaurant (Shakahari, in Carlton). “Are you hungry and tired of reading recipe books?” asked the figure in the poster. I had little sense of where that hunger would lead me, but it seemed to promise a fulfilment in ways that the fractious politics of the APG offered little nourishment. So, while many of my peers in the cities chose to pursue direct political action, and others experimented with cooperative living in rural communes, I chose the communal lifestyle of the ashram. In these different forms, then, the conscious raising meme persisted when other challenges raised by the counterculture either faded or were absorbed in the mainstream. I finally came to realise that the intense disillusionment process I had been through (“dis-illusionment” as the stripping away of illusions) was the beginning of awakening, in effect a “spiritual initiation” into a new way of seeing myself and my “place” in the world. Buddhist teachers might encourage this very kind of stripping away of false notions as part of their teaching, so the aspiration towards the “true liberation” of the mind expressed in the Aquarian visioning might be—and in my case, actually has been and continues to be—fulfilled to a very real extent. Gurus and the entire turn towards Eastern mysticism were part of the New Age meme cluster prevailing during the early 1970s, but I was fortunate to connect with an enduring set of empirical practices that haven’t faded with the fashions of the counterculture. A good guitarist would never want to play in public without first tuning her instrument. In a similar way, it is now possible for me to tune my mind back to a deeper, more original source of being than the socially constructed sense of self, which had been so fraught with conflicts for me. I have discovered that before gender, and before sexuality, in fact, pulsing away behind the thicket of everyday associations, there is an original, unconditioned state of beingness, the awareness of which can be reclaimed through focused meditation practices, tested in a wide variety of “real world” settings. For quite a significant period of time I worked as an instructor in the method on behalf of my guru, or mentor, travelling through a dozen or so countries, and it was through this exposure that I was able to observe that the practices worked independently of culture and that “mind’s true liberation” was in many ways a de-programming of cultural indoctrinations (see Marsh, 2014, 2013, 2011 and 2007 for testimony of this process). In Japan, Zen roshi might challenge their students with the koan: “Show me your original face, before you were born!” While that might seem to be an absurd proposal, I am finding that there is a potential, if unexpected, liberation in following through such an inquiry. As “hokey” as the Aquarian meme-set might have been, it was a reflection of the idealistic hope that characterised the cluster of memes that aggregated within the counterculture, a yearning for healthier life choices than those offered by the toxicity of the military-industrial complex, the grossly exploitative effects of rampant Capitalism and a politics of cynicism and domination. The meme of the “true liberation” of the mind, then, promised by the heady lyrics of a 1970s hippie musical, has continued to bear fruit in ways that I could not have imagined. References Altman, Dennis. Homosexual Oppression and Liberation. Sydney: Angus & Robertson, 1972. Blundell, Graeme. The Naked Truth: A Life in Parts. Sydney: Hachette, 2011. Brownmiller, Susan. In Our Time: Memoir of a Revolution. New York: The Dial Press, 1999. Compestine, Ying Chang. Revolution Is Not a Dinner Party. New York: Square Fish, 2009. Dalton, David. “Altamont: End of the Sixties, Or Big Mix-Up in the Middle of Nowhere?” Gadfly Nov/Dec 1999. April 2014 ‹http://www.gadflyonline.com/archive/NovDec99/archive-altamont.html›. Dawkins, Richard. The Selfish Gene. Oxford: Oxford UP, 1976. Elbaum, Max. Revolution in the Air: Sixties Radicals Turn to Lenin, Mao and Che. London and New York: Verso, 2002. Ferguson, Marilyn. The Aquarian Conspiracy. Los Angeles: Tarcher Putnam, 1980. Gleick, James. “What Defines a Meme?” Smithsonian Magazine 2011. April 2014 ‹http://www.smithsonianmag.com/arts-culture/What-Defines-a Meme.html›. Hair, The American Tribal Love Rock Musical. Prod. Michael Butler. Book by Gerome Ragni and James Rado; Lyrics by Gerome Ragni and James Rado; Music by Galt MacDermot; Musical Director: Galt MacDermot. 1968. Han, Suyin. The Crippled Tree. 1965. Reprinted. Chicago: Academy Chicago P, 1985. ---. A Mortal Flower. 1966. Reprinted. Chicago: Academy Chicago P, 1985. ---. Birdless Summer. 1968. Reprinted. Chicago: Academy Chicago P, 1985. ---. The Morning Deluge: Mao TseTung and the Chinese Revolution 1893-1954. Boston: Little Brown, 1972. ---. My House Has Two Doors. New York: Putnam, 1980. Marsh, Victor. The Boy in the Yellow Dress. Melbourne: Clouds of Magellan Press, 2014. ---. “A Touch of Silk: A (Post)modern Faerie Tale.” Griffith Review 42: Once Upon a Time in Oz (Oct. 2013): 159-69. ---. “Bent Kid, Straight World: Life Writing and the Reconfiguration of ‘Queer’.” TEXT: Journal of Writing and Writing Courses 15.1 (April 2011). ‹http://www.textjournal.com.au/april11/marsh.htm›. ---. “The Boy in the Yellow Dress: Re-framing Subjectivity in Narrativisations of the Queer Self.“ Life Writing 4.2 (Oct. 2007): 263-286. Mol, Hans. Identity and the Sacred: A Sketch for a New Social-Scientific Theory of Religion. Oxford: Blackwell, 1976. Monod, Jacques. Chance and Necessity: An Essay on the Natural Philosophy of Modern Biology. New York: Alfred A. Knopf, 1970. Roszak, Theodore. The Making of a Counter Culture: Reflections on the Technocratic Society and Its Youthful Opposition. New York: Doubleday, 1968. Salingaros, Nikos. Theory of Architecture. Solingen: Umbau-Verlag, 2006. Stancil, E.D., and M.D. Johnson. Frisbee: A Practitioner’s Manual and Definitive Treatise. New York: Workman, 1975 Winnicott, D.W. Through Paediatrics to Psycho-Analysis: Collected Papers. 1958. London: Hogarth Press, 1975. Yúdice, George. “Testimonio and Postmodernism.” Latin American Perspectives 18.3 (1991): 15-31. Zimmerman, Marc. “Testimonio.” The Sage Encyclopedia of Social Science Research Methods. Eds. Michael S. Lewis-Beck, Alan Bryman and Tim Futing Liao. London: Sage Publications, 2003. Zuber-Skerritt, Ortrun, ed. Australian Playwrights: David Williamson. Amsterdam: Rodolpi, 1988.

I was born illegitimate. Born on an existential precipice. My unwed mother was 36 years old when she relinquished me. I was the fourth baby she was required to give away. After I emerged blood stained and blue tinged – abject, liminal – not only did the nurses refuse me my mother’s touch, I also lost the sound of her voice. Her smell. Her heart beat. Her taste. Her gaze. The silence was multi-sensory. When they told her I was dead, I also lost, within her memory and imagination, my life. I was adopted soon after but not told for over four decades. It was too shameful for even me to know. Imprinted at birth with a psychological ‘death’, I fell, as a Late Discovery Adoptee (LDA), into a socio-cultural and psychological abyss, frozen at birth at the bottom of a parturitive void from where, invisible within family, society, and self I was unable to form an undamaged sense of being.Throughout the 20th century (and for centuries before) this kind of ‘social abortion’ was the dominant script. An adoptee was regarded as a bastard, born of sin, the mother blamed, the father exonerated, and silence demanded (Lynch 28-74). My adoptive mother also sinned. She was infertile. But, in taking me on, she assumed the role of a womb worthy woman, good wife, and, in her case, reluctant mother (she secretly didn’t want children and was privately overwhelmed by the task). In this way, my mother, my adoptive mother, and myself are all the daughters of bereavement, all of us sacrificed on the altar of prejudice and fear that infertility, sex outside of marriage, and illegitimacy were unspeakable crimes for which a price must be paid and against which redemptive protection must be arranged. If, as Thomas Keneally (5) writes, “original sin is the mother fluid of history” then perhaps all three of us all lie in its abject waters. Grotevant, Dunbar, Kohler and Lash Esau (379) point out that adoption was used to ‘shield’ children from their illegitimacy, women from their ‘sexual indiscretions’, and adoptive parents from their infertility in the belief that “severing ties with birth family members would promote attachment between adopted children and parents”. For the adoptee in the closed record system, the socio/political/economic vortex that orchestrated their illegitimacy is born out of a deeply, self incriminating primal fear that reaches right back into the recesses of survival – the act of procreation is infested with easily transgressed life and death taboos within the ‘troop’ that require silence and the burial of many bodies (see Amanda Gardiner’s “Sex, Death and Desperation: Infanticide, Neonaticide, and Concealment of Birth in Colonial Western Australia” for a palpable, moving, and comprehensive exposition on the links between 'illegitimacy', the unmarried mother and child murder). As Nancy Verrier (24) states in Coming Home to Self, “what has to be understood is that separation trauma is an insidious experience, because, as a society, we fail to see this experience as a trauma”. Indeed, relinquishment/adoption for the baby and subsequent adult can be acutely and chronically painful. While I was never told the truth of my origins, of course, my body knew. It had been there. Sentient, aware, sane, sensually, organically articulate, it messaged me (and anyone who may have been interested) over the decades via the language of trauma, its lexicon and grammar cellular, hormonal, muscular (Howard & Crandall, 1-17; Pert, 72), the truth of my birth, of who I was an “unthought known” (Bollas 4). I have lived out my secret fatality in a miasmic nebula of what I know now to be the sequelae of adoption psychopathology: nausea, physical and psychological pain, agoraphobia, panic attacks, shame, internalised anger, depression, self-harm, genetic bewilderment, and generalised anxiety (Brodzinsky 25-47; Brodzinsky, Smith, & Brodzinsky 74; Kenny, Higgins, Soloff, & Sweid xiv; Levy-Shiff 97-98; Lifton 210-212; Verrier The Primal Wound 42-44; Wierzbicki 447-451) – including an all pervading sense of unreality experienced as dissociation (the experience of depersonalisation – where the self feels unreal – and derealisation – where the world feels unreal), disembodiment, and existential elision – all characteristics of Post Traumatic Stress Disorder (PTSD). In these ways, my body intervened, acted out, groaned in answer to the social overlay, and from beyond “the dermal veil” tried to procure access, as Vicky Kirby (77) writes, to “the body’s opaque ocean depths” through its illnesses, its eloquent, and incessantly aching and silent verbosities deepened and made impossibly fraught because I was not told. The aim of this paper is to discuss one aspect of how my body tried to channel the trauma of my secret fatality and liminality: my pre-disclosure art work (the cellular memory of my trauma also expressed itself, pre-disclosure, through my writings – poetry, journal entries – and also through post-coital glossolalia, all discussed at length in my Honours research “Womb Tongues” and my Doctoral Dissertation “The Womb Artist – A Novel: Translating Pre-verbal Late Discovery Adoption Trauma into Narrative”). From the age of thirty onwards I spent twelve years in therapy where the cause of my childhood and adult psychopathology remained a mystery. During this time, my embodied grief and memories found their way into my art work, a series of 5’ x 3’ acrylic paintings, some of which I offer now for discussion (figures 1-4). These paintings map and express what my body knew but could not verbalise (without language to express my grief, my body found other ways to vent). They are symptom and sign of my pre-verbal adoption trauma, evidence that my body ‘knew’ and laboured ceaselessly and silently to find creative ways to express the incarcerated trauma. Post disclosure, I have used my paintings as artefacts to inform, underpin, and nourish the writing of a collection of poetry “Womb Tongues” and a literary novel/memoir “The Womb Artist” (TWA) in an ongoing autoethnographical, performative, and critical inquiry. My practice-led research as a now conscious and creative witness, fashions the recontextualisation of my ‘self’ into my ‘self’ and society, this time with cognisant and reparative knowledge and facilitates the translation of my body’s psychopathology and memory (explicit and implicit) into a healing testimony that explores the traumatised body as text and politicizes the issues surrounding LDAs (Riley 205). If I use these paintings as a memoirist, I use them second hand, after the fact, after they have served their initial purpose, as the tangible art works of a baby buried beneath a culture’s prejudice, shame, and judgement and the personal cries from the illegitimate body/self. I use them now to explore and explain my subclinical and subterranean life as a LDA.My pre-disclosure paintings (Figures 1-4) – filled with vaginal, fetal, uterine, and umbilical references – provide some kind of ‘evidence’ that my body knew what had happened to me as if, with the tenacity of a poltergeist, my ‘spectral self’ found ways to communicate. Not simply clues, but the body’s translation of the intra-psychic landscape, a pictorial and artistic séance into the world, as if my amygdala – as quasar and signal, homing device and history lesson (a measure, container, and memoir) – knew how to paint a snap shot or an x-ray of the psyche, of my cellular marrow memories (a term formulated from fellow LDA Sandy McCutcheon’s (76) memoir, The Magician’s Son when he says, “What I really wanted was the history of my marrow”). If, as Salveet Talwar suggests, “trauma is processed from the body up”, then for the LDA pre-discovery, non-verbal somatic signage is one’s ‘mother tongue’(25). Talwar writes, “non-verbal expressive therapies such as art, dance, music, poetry and drama all activate the sub-cortical regions of the brain and access pre-verbal memories” (26). In these paintings, eerily divinatory and pointed traumatic, memories are made visible and access, as Gussie Klorer (213) explains in regard to brain function and art therapy, the limbic (emotional) system and the prefrontal cortex in sensorimotor integration. In this way, as Marie Angel and Anna Gibbs (168) suggest, “the visual image may serve as a kind of transitional mode in thought”. Ruth Skilbeck in her paper First Things: Reflections on Single-lens Reflex Digital Photography with a Wide-angled Lens, also discusses (with reference to her photographic record and artistic expression of her mother’s death) what she calls the “dark matter” – what has been overlooked, “left out”, and/or is inexplicable (55) – and the idea of art work as the “transitional object” as “a means that some artists use, conceptually and yet also viscerally, in response to the extreme ‘separation anxiety’ of losing a loved one, to the void of the Unknown” (57). In my case, non-disclosure prevented my literacy and the evolution of the image into language, prevented me from fully understanding the coded messages left for me in my art work. However, each of my paintings is now, with the benefit of full disclosure, a powerful, penetrating, and comprehensible intra and extra sensory cry from the body in kinaesthetic translation (Lusebrink, 125; Klorer, 217). In Figure 1, ‘Embrace’, the reference to the umbilical is palpable, described in my novel “The Womb Artist” (184) this way; “two ropes tightly entwine as one, like a dark and dirty umbilical cord snaking its way across a nether world of smudged umbers”. There is an ‘abject’ void surrounding it. The cord sapped of its colour, its blood, nutrients – the baby starved of oxygen, breath; the LDA starved of words and conscious understanding. It has two parts entwined that may be seen in many ways (without wanting to reduce these to static binaries): mother/baby; conscious/unconscious; first person/third person; child/adult; semiotic/symbolic – numerous dualities could be spun from this embrace – but in terms of my novel and of the adoptive experience, it reeks of need, life and death, a text choking on the poetic while at the same time nourished by it; a text made ‘available’ to the reader while at the same narrowing, limiting, and obscuring the indefinable nature of pre-verbal trauma. Figure 1. Embrace. 1993. Acrylic on canvas.The painting ‘Womb Tongues’ (Figure 2) is perhaps the last (and, obviously, lasting) memory of the infinite inchoate universe within the womb, the umbilical this time wrapped around in a phallic/clitorial embrace as the baby-self emerges into the constrictions of a Foucauldian world, where the adoptive script smothers the ‘body’ encased beneath the ‘coils’ of Judeo-Christian prejudice and centuries old taboo. In this way, the reassigned adoptee is an acute example of power (authority) controlling and defining the self and what knowledge of the self may be allowed. The baby in this painting is now a suffocated clitoris, a bound subject, a phallic representation, a gagged ‘tongue’ in the shape of the personally absent (but socially imposing) omni-present and punitive patriarchy. Figure 2. Womb Tongues. 1997. Acrylic on canvas.‘Germination’ (Figure 3) depicts an umbilical again, but this time as emerging from a seething underworld and is present in TWA (174) this way, “a colony of night crawlers that writhe and slither on the canvas, moving as one, dozens of them as thin as a finger, as long as a dream”. The rhizomic nature of this painting (and Figure 4), becomes a heaving horde of psychosomatic and psychopathological influences and experiences, a multitude of closely packed, intense, and dendridic compulsions and symptoms, a mass of interconnected (and by nature of the silence and lie) subterranean knowledges that force the germination of a ‘ghost baby/child/adult’ indicated by the pale and ashen seedling that emerges above ground. The umbilical is ghosted, pale and devoid of life. It is in the air now, reaching up, as if in germination to a psychological photosynthesis. There is the knot and swarm within the unconscious; something has, in true alien fashion, been incubated and is now emerging. In some ways, these paintings are hardly cryptic.Figure 3. Germination.1993. Acrylic on canvas.In Figure 4 ‘The Birthing Tree’, the overt symbolism reaches ‘clairvoyant status’. This could be read as the family ‘tree’ with its four faces screaming out of the ‘branches’. Do these represent the four babies relinquished by our mother (the larger of these ‘beings’ as myself, giving birth to the illegitimate, silenced, and abject self)? Are we all depicted in anguish and as wraithlike, grotesquely simplified into pure affect? This illegitimate self is painted as gestating a ‘blue’ baby, near full-term in a meld of tree and ‘self’, a blue umbilical cord, again, devoid of blood, ghosted, lifeless and yet still living, once again suffocated by the representation of the umbilical in the ‘bowels’ of the self, the abject part of the body, where refuse is stored and eliminated: The duodenum of the damned. The Devil may be seen as Christopher Bollas’s “shadow of the object”, or the Jungian archetypal shadow, not simply a Judeo-Christian fear-based spectre and curmudgeon, but a site of unprocessed and, therefore, feared psychological material, material that must be brought to consciousness and integrated. Perhaps the Devil also is the antithesis to ‘God’ as mother. The hell of ‘not mother’, no mother, not the right mother, the reluctant adoptive mother – the Devil as icon for the rich underbelly of the psyche and apophatic to the adopted/artificial/socially scripted self.Figure 4. The Birthing Tree. 1995. Acrylic on canvas.These paintings ache with the trauma of my relinquishment and LDA experience. They ache with my body’s truth, where the cellular and psychological, flesh and blood and feeling, leak from my wounds in unspeakable confluence (the two genital lips as the site of relinquishment, my speaking lips that have been sealed through non-disclosure and shame, the psychological trauma as Verrier’s ‘primal wound’) just as I leaked from my mother (and society) at birth, as blood and muck, and ooze and pus and death (Grosz 195) only to be quickly and silently mopped up and cleansed through adoption and life-long secrecy. Where I, as translator, fluent in both silence and signs, disclose the baby’s trauma, asking for legitimacy. My experience as a LDA sets up an interesting experiment, one that allows an examination of the pre-verbal/pre-disclosure body as a fleshed and breathing Rosetta Stone, as an interface between the language of the body and of the verbalised, painted, and written text. As a constructed body, written upon and invented legally, socially, and psychologically, I am, in Hélène Cixous’s (“To Live the Orange” 83) words, “un-forgetting”, “un-silencing” and “unearthing” my ‘self’ – I am re-writing, re-inventing and, under public scrutiny, legitimising my ‘self’. I am a site of inquiry, discovery, extrapolation, and becoming (Metta 492; Poulus 475) and, as Grosz (vii) suggests, a body with “all the explanatory power” of the mind. I am, as I embroider myself and my LDA experience into literary and critical texts, authoring myself into existence, referencing with particular relevance Peter Carnochan’s (361) suggestion that “analysis...acts as midwife to the birth of being”. I am, as I swim forever amorphous, invisible, and unspoken in my mother’s womb, fashioning a shore, landscaping my mind against the constant wet, my chronic liminality (Rambo 629) providing social landfall for other LDAs and silenced minorities. As Catherine Lynch (3) writes regarding LDAs, “Through the creation of text and theory I can formulate an intimate space for a family of adoptive subjects I might never know via our participation in a new discourse in Australian academia.” I participate through my creative, self-reflexive, process fuelled (Durey 22), practice-led enquiry. I use the intimacy (and also universality and multiplicity) and illegitimacy of my body as an alterative text, as a site of academic and creative augmentation in the understanding of LDA issues. The relinquished and silenced baby and LDA adult needs a voice, a ‘body’, and a ‘tender’ place in the consciousness of society, as Helen Riley (“Confronting the Conspiracy of Silence” 11) suggests, “voice, validation, and vindication”. Judith Herman (3) argues that, “Survivors challenge us to reconnect fragments, to reconstruct history, to make meaning of their present symptoms in the light of past events”. I seek to use the example of my experience – as Judith Durey (31) suggests, in “support of evocative, creative modes of representation as valid forms of research in their own right” – to unfurl the whole, to give impetus and precedence for other researchers into adoption and advocate for future babies who may be bought, sold, arranged, and/or created by various means. The recent controversy over Gammy, the baby boy born with Down Syndrome in Thailand, highlights the urgent and moral need for legislation with regard to surrogacy (see Kajsa Ekis Ekman’s Being and Being Bought: Prostitution, Surrogacy and the Split Self for a comprehensive examination of surrogacy issues). Indeed, Catherine Lynch in her paper Doubting Adoption Legislation links the experiences of LDAs and the children of born of surrogacy, most effectively arguing that, “if the fate that closed record adoptees suffered was a misplaced solution to the question of what to do with children already conceived how can you justify the deliberate conception of a child with the intention even before its creation of cruelly removing that child from their mother?” (6). Cixous (xxii) confesses, “All I want is to illustrate, depict fragments, events of human life and death...each unique and yet at the same time exchangeable. Not the law, the exception”. I, too, am a fragment, an illustration (a painting), and, as every individual always is – paradoxically – a communal and, therefore, deeply recognisable and generally applicable minority and exception. In my illegitimacy, I am some kind of evidence. Evidence of cellular memory. Evidence of embodiment. Evidence that silenced illegitimacies will manifest in symptom and non-verbal narratives, that they will ooze out and await translation, verification, and witness. This paper is offered with reverence and with feminist intention, as a revenant mouthpiece for other LDAs, babies born of surrogacy, and donor assisted offspring (and, indeed, any) who are marginalised, silenced, and obscured. It is also intended to promote discussion in the psychological and psychoanalytic fields and, as Helen Riley (202-207) advocates regarding late discovery offspring, more research within the social sciences and the bio-medical field that may encourage legislators to better understand what the ‘best interests of the child’ are in terms of late discovery of origins and the complexity of adoption/conception practices available today. As I write now (and always) the umbilical from my paintings curve and writhe across my soul, twist and morph into the swollen and throbbing organ of tongues, my throat aching to utter, my hands ready to craft latent affect into language in translation of, and in obedience to, my body’s knowledges. It is the art of mute witness that reverses genesis, that keeps the umbilical fat and supple and full of blood, and allows my conscious conception and creation. 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