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1

Santos, Alciomar Oliveira. "Un répertoire de musique brésilienne adapté à l’enseignement collectif du trombone." Doctoral thesis, Université Laval, 2016. http://hdl.handle.net/20.500.11794/26852.

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Cette thèse, complémentaire à deux récitals donnés dans le cadre de la réalisation d’un doctorat en études pédagogiques et pratiques musicales instrumentales, a comme fil conducteur l’enseignement collectif du trombone au Brésil et examine le trombone sous trois angles : historique, pédagogique et dans une perspective d’interprétation musicale. Bien que le sujet ne soit pas nouveau, le projet présente une réflexion, sur le trombone et son enseignement, encore inexplorée en raison principalement du répertoire sélectionné pour la présente étude. En effet, à notre connaissance, le répertoire populaire brésilien n’a jusqu’à maintenant pas fait l’objet d’arrangements musicaux écrits, en vue d’une exploitation non seulement en contexte de représentation publique, mais aussi avec des visées pédagogiques. Les morceaux choisis ont été retenus en raison de leur contenu, qui présente un vocabulaire musical lié à la culture régionale de quatre des cinq régions géographiques du Brésil. Dans le processus de réalisation du projet, les morceaux choisis ont fait l’objet d’arrangements dans la perspective qu’ils servent comme outil pédagogique pour la formation en trombone, en contexte de musique brésilienne. Les arrangements ont été conçus pour des ensembles réduits, où le trombone tient fréquemment le rôle de soliste. Ainsi, au-delà des concepts et techniques issus de la formation traditionnelle reçue, l’interprétation des arrangements a été une occasion pour le doctorant et soliste de présenter, à travers l'improvisation dans le langage de la musique populaire brésilienne, les résultats de processus développés au cours des deux dernières années. Les partitions sont annexées au texte de la thèse, afin d'illustrer certains propos et avec l’objectif de soutenir les recherches futures dans ce domaine. La thèse est divisée en quatre chapitres lesquels, bien que présentés séparément, possèdent entre eux d’étroites relations. Le premier chapitre donne un aperçu général de l'histoire de l'instrument, à travers les cinq siècles de son existence. Le deuxième chapitre s’articule autour de l'histoire de la musique brésilienne et de la présence du trombone au Brésil. Le troisième chapitre présente d’abord un aperçu de l’enseignement artistique et musical au Brésil au 20e et 21e siècle, poursuit en abordant la situation de l'enseignement du trombone au Brésil et aboutit à une proposition favorisant l’apprentissage du trombone en contexte d’enseignement musical collectif. Finalement, le quatrième chapitre fait un retour sur l’expérience musicale vécue dans le premier volet du projet, celui se rapportant à la pratique musicale instrumentale, établit des liens et trace des pistes dans une perspective d’enseignement et d’apprentissage du trombone.
This thesis, in conjunction with two recitals given toward fulfillment of a doctoral degree in pedagogical studies and instrumental musical practices, addresses collective teaching of the trombone in Brazil and examines the trombone from three perspectives: historical, educational and that of musical performance. Although the topic is not new, the project offers a reflection, on the trombone and how it is taught, unexplored mainly due to the repertoire selected for this study. Indeed, to our knowledge, written musical arrangements of the Brazilian popular repertoire have, until now, not been undertaken with a view both toward public performance as well as with pedagogical aims. The chosen pieces were selected because of their content, which presents a musical vocabulary related to the regional cultures of four of the five geographic regions of Brazil: the Northeast, the Midwest, the Southwest and the South. During the course of this project, the selected pieces were arranged such that they could serve as pedagogical tools for trombone training in the context of Brazilian music. The arrangements were designed for small ensembles, in which the trombone often plays the role of soloist. Thus, beyond the concepts and techniques gained through traditional training, performing the arrangements gave the doctoral student and soloist the opportunity to present, through the language of Brazilian popular music improvisation, the outcomes of processes developed over the past two years. Scores are appended to the text of the thesis, in order to illustrate certain remarks and with the goal of supporting future research in this area. The thesis is divided into four chapters, which, although presented separately, are closely related. The first chapter provides an overview of the history of the instrument through the five centuries of its existence. The second chapter focuses on the history of Brazilian music and on the presence of the trombone in Brazil. The third chapter begins with an overview of the artistic and musical education in Brazil in the twentieth and twenty-first centuries, then addresses the situation of teaching the trombone in Brazil, ultimately leading to a proposal to promote learning the trombone in the context of collective music education. Finally, the fourth chapter looks back at the musical experiences of the first part of this project, as an account of instrumental music practice, establishing links and following lines of thought with the perspective of teaching and learning the trombone.
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2

De, Oliveira Alves Rui Pedro. "The trombone in Portugal before 1850." Thesis, University of St Andrews, 2014. http://hdl.handle.net/10023/16353.

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This thesis examines the use of the trombone in Portugal between the first references to its use in the early sixteenth century and the mid nineteenth century. It is primarily based on archival research and supplemented by literary and iconographical references. This material is presented in calendar form in Volume II as Appendix 1. Volume I consists of a series of chapters that analyse and contextualise material from the Calendar. For the earlier period the thesis focuses on the use of the trombone in royal service, and in doing so provides a detailed survey of the Portuguese royal shawm band. The use of the trombone outwith royal service it is also examined. Issues relating to terminology and instrument making in Portugal are discussed. By examining sixteenth century iconographical sources with links to Portugal, this study addresses questions concerning aspects of trombone technique that have not previously been considered and have implication elsewhere in Europe. It considers the decline of the trombone during the second half of the seventeenth century and its resurgence in the later years of the eighteenth century. It identifies the earliest orchestral repertoire containing trombones that emerges in Portugal during the last decade of the eighteenth century, as well as the first trombone players of the beginning of the nineteenth century in military bands and orchestras in Lisbon. Finally, the thesis considers the class of brass instruments of the Royal Conservatoire of Lisbon and its professors, and examines the earliest surviving trombone methods in Portugal, which introduce aspects of performance practice that are not mentioned in other contemporary sources.
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3

Pinson, Donald Lynn. "History and current state of performance of the literature for solo trombone and organ." connect to online resource, 2008. http://digital.library.unt.edu/permalink/meta-dc-9050.

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Thesis (D.M.A.)--University of North Texas, 2008.
System requirements: Adobe Acrobat Reader. Accompanied by 4 recitals, recorded Mar. 1, 2004, Jan. 31, 2005, Jan. 30, 2006, and Apr. 21, 2008. Includes bibliographical references (p. 50-64), and discography (p. 41-49).
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4

Pinson, Jr Donald Lynn. "History and Current State of Performance of the Literature for Solo Trombone and Organ." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9050/.

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More than 200 compositions have been written for solo trombone and organ since the nineteenth century, including contributions from notable composers such as Franz Liszt, Gustav Holst, Gardner Read, Petr Eben, and Jan Koetsier. This repertoire represents a significant part of the solo literature for the trombone, but it is largely unknown to both trombonists and organists. The purpose of this document is to provide a historical perspective of this literature from the nineteenth century to the present, to compile a complete bibliography of compositions for trombone and organ, and to determine the current state of performance of this repertoire. This current state of performance has been determined through an internet survey, a study of recital programs printed in the ITA Journal, a study of recordings of this literature, and interviews and correspondence with well-known performers of these compositions. It is the intention of this author that this document will serve to make the repertoire for trombone and organ more accessible and more widely known to both trombonists and organists.
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5

Samball, Michael L. (Michael Loran). "The Influence of Jazz on French Solo Trombone Repertory." Thesis, North Texas State University, 1987. https://digital.library.unt.edu/ark:/67531/metadc331843/.

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This lecture-recital investigated the lineage of French composers who were influenced by jazz during the first half of the twentieth century, with a focus on compositions from the solo trombone repertory. Historically, French composers, more than those of other European countries, showed an early affinity for the artistic merits of America's jazz. This predilection for the elements of jazz could be seen in the selected orchestral works of Les Six and the solo compositions of the Paris Conservatory composers. An examination of the skills of major jazz trombonists early in the twentieth century showed that idioms resulting from their unique abilities were gradually assimilated into orchestral and solo repertory. Orchestral works by Satie, Milhaud, and Ravel works showing jazz traits were investigated. Further, an expose of the solo trombone works emanating from the Paris Conservatory was presented. Although written documentation is limited, comparisons between early recorded jazz trombone solos and compositions for orchestral and solo trombone was established. These comparisons were made on the basis of idiomatic jazz elements such as high-tessitura ballad melodies, blue tonalities and harmonies, syncopated rhythms, and many of the aspects of style associated with improvisation. All major French solo trombone repertory to mid-century was surveyed and examined.
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6

Callison, Hugh A. "Nineteenth-century orchestral trombone playing in the United States." Virtual Press, 1986. http://liblink.bsu.edu/uhtbin/catkey/474196.

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The nineteenth century was a time of musical and cultural growth in the United States. Six of the major orchestras which exist today were established during this time. From the birth of the New York Philharmonic in 1842 through the founding of the Philadelphia Orchestra in 1900, audiences that valued orchestral music provided an impetus for professional orchestral development.A comprehensive review of the events leading up to the establishment of the New York Philharmonic, Boston Symphony, Chicago Symphony, Cincinnati Symphony, and Philadelphia Orchestras provides a basis for understanding the nature of professional orchestral trombone playing in the United States before 1900. It was found that orchestras were established in a common manner though growth was often retarded by social and economic factors. The Civil War, especially, was an event which momentarily hindered the growth of American symphony orchestras.Biographical data about the orchestral trombone players of the nineteenth century is very incomplete in the standard texts for American music history. A registry of orchestral trombonists in the United States during this period identifies 65 trombone players who were active in major symphony orchestras. An examination of the lives of some of the better-known orchestral trombonists shows that most of these musicians immigrated from Germany. The largest number of these musicians seem to have immigrated during a period from about 1870 to 1900. These capable musicians were leaders in the development of orchestras whose personal performance was reported to be of high quality. Especially influential was Frederick Lesch, a trombonist in the Theodore Thomas Orchestra and the New Philharmonic, who served as a principal player, bass trombonist, and soloist. His performance of Ferdinand David's Concertino for Trombone and orchestra is a landmark in the growth of orchestral trombone playing.A review of literature which includes a listing of all pieces performed by major orchestras during the nineteenth century establishes the repertoire of the orchestral trombonist of the period. Through analysis of this repertoire, the technical requirements for orchestral trombone playing are established. Technique, pitch range, and dynamic range were areas where the greatest demands were made upon the players. The orchestral trombonists of the nineteenth century were indeed pioneers who set the stage for today's orchestral trombone players.
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7

Moore, Donald Scott. "The Concerto for Bass Trombone by Thom Ritter George and the Beginning of Modern Bass Trombone Solo Performance." University of Cincinnati / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1258476563.

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8

Flanigan, Sean Gerard. "From Deux Danses to Fluctuations: Compositional components and innovations in two solo trombone works of Jean-Michel Defaye." Thesis, connect to online resource, 2006. http://www.unt.edu/etd/all/Aug2006/flanigan%5Fsean%5Fgerard/index.htm.

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Thesis (D.M.A.)--University of North Texas, 2006.
System requirements: Adobe Acrobat Reader. Accompanied by 4 recitals, recorded June 28, 1999, Jan. 24, 2000, Jan. 29, 2001, and Apr. 10, 2006. Includes bibliographical references and discography (p. 66-70).
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9

Aldag, Daniel J. "The influence of jazz on timbre in selected compositions for solo trombone." Thesis, connect to online resource, 2002. http://www.library.unt.edu/theses/open/20023/aldag%5Fdaniel/index.htm.

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10

Lewis, Michael E. (Michael Edward) 1952. "Solo Trombone Performances at the Gewandhaus in the Nineteenth Century: a Lecture Recital, Together with Three Recitals of Selected Works of G. Jacobs, S. Sulek, E. Bloch, C. Wagenseil, W. Ross, G. Pergolesi, T. George, F. Hidas, J. Albrechtsberger and Others." Thesis, University of North Texas, 1989. https://digital.library.unt.edu/ark:/67531/metadc331410/.

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This study investigates and documents tenor/bass trombone solo performances at the Gewandhaus, Leipzig, East Germany, between 1821 and 1876. Included is the discussion of a newly discovered composition, the Concertino fur Bassposaune und Orchester, by Carl Heinrlch Meyer, which is the earliest concerto for the tenor/bass trombone. Its performance at the Gewandhaus in 1821 marked the beginning of the solo tradition for the tenor/bass trombone, and the Leipzig Gewandhaus became one of the leading centers of solo trombone performance for the next fifty years. The study includes background information on the rise of the virtuoso soloist in nineteenth-century Germany. It specifically focuses on Friedrlch August Belcke and Carl Traugott Queisser and their performances at the Gewandhaus. All solo trombone performances at the Gewandhaus in the nineteenth century have been documented, and specific information has been provided regarding the soloists, dates of performances and repertoire performed on the concerts. The paper includes a discussion of performance reviews from the Allgemeine Musfkalische Zeitung. The conclusion discusses the importance of solo trombone performance at the Gewandhaus, and the reason for its sudden decline after 1876.
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11

Bogle, James Michael. "Gunther Schuller and John Swallow: Collaboration, Composition, and Performance Practice in Eine Kleine Posaunenmusik, with Three Recitals of Selected Works by Berio, Bogle, Gregson, Pryor, Suderburg and Others." Thesis, University of North Texas, 2000. https://digital.library.unt.edu/ark:/67531/metadc2479/.

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Gunther Schuller is credited with coining the term Third Stream, meaning compositions where twentieth-century art music forms exist simultaneously with jazz. Furthermore, Schuller specifically states in the liner notes to the debut recording of Eine Kleine Posaunenmusik "The work is not a Third Stream piece." Yet the concerto alludes to jazz through a multitude of slide glissandi and plunger mute effects, Solotone mute passages, specific references to the jazz trombone styles of Tommy Dorsey and Lawrence Brown, musical quoting or indirect reference, and the use of a walking bass line in Movement V, Finale. What makes one piece Third Stream and another simply a modern composition with jazz implications? Is Third Stream primarily a compositional designation or a performance practice stipulation? How does a celebrated trombone soloist inspire and collaborate with a distinguished composer in the creation of a major work? The somewhat conspicuous title, Eine Kleine Posaunenmusik, seems to point towards Mozart's famous string serenade Eine Kleine Nachtmusik. What connection to Mozart, if any, does Schuller's title suggest? All of these questions are elucidated in this study through careful investigation and research of Gunther Schuller's Eine Kleine Posaunenmusik. New interviews with John Swallow and Gunther Schuller are included.
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12

SANTOS, Mário Ribeiro dos. "Trombones, tambores, repiques e ganzás: a festa das agremiações carnavalescas nas ruas do Recife (1930-1945)." Universidade Federal Rural de Pernambuco, 2010. http://www.tede2.ufrpe.br:8080/tede2/handle/tede2/4815.

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Esta dissertação tem como objetivo o debate em torno do Carnaval vivenciado nas ruas do centro do Recife, em especial as agremiações carnavalescas, partindo do pressuposto que esses grupos incluem o Carnaval em suas práticas cotidianas, o que nos permite pensar numa configuração dos espaços da cidade pelos foliões. Discute ainda a atuação do Estado e demais autoridades na organização da festa, sobretudo no período de 1930 -1945, quando a documentação é observada. Uma época marcada por medidas normativas de prevenção da moral e dos bons costumes, e, em contraponto, pela imposição do ideário da modernidade. O estudo, portanto, percorre caminhos que nos levam a analisar um momento específico no contexto político, social e ideológico do país, caracterizado pelo discurso autoritário do Estado e pela mudança na perspectiva do olhar das elites, que passa a perceber a organização e a força política da classe pobre trabalhadora. Nesse sentido, identificamos uma valorização da cultura mestiça e de suas práticas lúdicas pelas autoridades. Essa mudança de pensamento, de atitude e de aproximação em relação aos populares, vincula-se aodiscurso estado-novista de que “toda política nasce do povo.” O trabalho está divido em três capítulos: o primeiro dedica-se a percorrer os diferentes trajetos do circuito da folia no Recife, especialmente, os bairros centrais, analisando o cotidiano da cidade e seus conflitos, os bastidores de preparação da festa e as posturas de ordem que circulam entre os foliões; o carnaval organizado pelos moradores nas ruas, nos clubes, o corso, entre outras experiências. No segundo capítulo, destacamos dois pontos: em primeiro lugar, uma caracterização do carnaval do Recife que o torna original, criado na sua paisagem urbana, isto é, o FREVO, síntese das várias tradições étnicoculturais. A segunda questão diz respeito à discussão de como aparece a presença da cultura afro-brasileira, sobretudo, a religiosidade, nas agremiações ligadas ao frevo (clubes, troças e blocos). Por fim, no terceiro capítulo, questionamos como o frevo, considerado até o início do século XX, como sinônimo de atraso, por uma elite obcecada por valores europeus, transforma-se em elemento genuinamente pernambucano, exemplificando o orgulho de uma identidade mestiça propagada pelo Estado em praticamente todos os acontecimentossociais, sobretudo, no Carnaval.
Esta dissertação tem como objetivo o debate em torno do Carnaval vivenciado nas ruas do centro do Recife, em especial as agremiações carnavalescas, partindo do pressuposto que esses grupos incluem o Carnaval em suas práticas cotidianas, o que nos permite pensar numa configuração dos espaços da cidade pelos foliões. Discute ainda a atuação do Estado e demais autoridades na organização da festa, sobretudo no período de 1930 -1945, quando a documentação é observada. Uma época marcada por medidas normativas de prevenção da moral e dos bons costumes, e, em contraponto, pela imposição do ideário da modernidade. O estudo, portanto, percorre caminhos que nos levam a analisar um momento específico no contexto político, social e ideológico do país, caracterizado pelo discurso autoritário do Estado e pela mudança na perspectiva do olhar das elites, que passa a perceber a organização e a força política da classe pobre trabalhadora. Nesse sentido, identificamos uma valorização da cultura mestiça e de suas práticas lúdicas pelas autoridades. Essa mudança de pensamento, de atitude e de aproximação em relação aos populares, vincula-se aodiscurso estado-novista de que “toda política nasce do povo.” O trabalho está divido em três capítulos: o primeiro dedica-se a percorrer os diferentes trajetos do circuito da folia no Recife, especialmente, os bairros centrais, analisando o cotidiano da cidade e seus conflitos, os bastidores de preparação da festa e as posturas de ordem que circulam entre os foliões; o carnaval organizado pelos moradores nas ruas, nos clubes, o corso, entre outras experiências. No segundo capítulo, destacamos dois pontos: em primeiro lugar, uma caracterização do carnaval do Recife que o torna original, criado na sua paisagem urbana, isto é, o FREVO, síntese das várias tradições étnicoculturais. A segunda questão diz respeito à discussão de como aparece a presença da cultura afro-brasileira, sobretudo, a religiosidade, nas agremiações ligadas ao frevo (clubes, troças e blocos). Por fim, no terceiro capítulo, questionamos como o frevo, considerado até o início do século XX, como sinônimo de atraso, por uma elite obcecada por valores europeus, transforma-se em elemento genuinamente pernambucano, exemplificando o orgulho de uma identidade mestiça propagada pelo Estado em praticamente todos os acontecimentossociais, sobretudo, no Carnaval.
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13

Scott, Deb. "Supplemental Studies for Mastering Extended Techniques in Three Late Twentieth-Century Works for Solo Trombone: Luciano Berio's Sequenza V, Folke Rabe's Basta and Mark Phillips' T. Rex, Together with Three Recitals of Selected Works by Wagenseil, Grøndahl, Gotkovsky, and Others." Thesis, University of North Texas, 2004. https://digital.library.unt.edu/ark:/67531/metadc5544/.

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Many, if not most, student trombonists have perhaps had little or no previous experience with "extended techniques"-novel or unconventional modes of sound production. To address this deficiency of experience, this document sets forth a progressive sequence of descriptive explanations and supplementary studies, which are specifically designed to assist trombonists in mastering the particular extended techniques that will prepare them to perform three of the most popular late Twentieth-Century pieces for trombone that include extended techniques-Luciano Berio's Sequenza V, Folke Rabe's Basta, and Mark Phillips' T.Rex. Following the introductory chapter, the body of the document consists of three chapters, each of which deals with one of the three solos, presenting descriptive explanations of relevant extended techniques interspersed with performance commentary (solicited from prominent trombonists) and supplementary studies (composed by the author). The studies presented in each chapter are specifically geared toward mastering the extended techniques as they relate to the music of each particular solo. They are also especially focused toward learning the more difficult passages of music in each solo.
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Wolfinbarger, Steve M. "The Nineteenth-Century German Tradition of Solo Trombone Playing: A Lecture Recital, Together with Three Recitals of Selected Works of E. Bozza, W. Hartley, A. Frackenpohl, A. Pryor. G. Frescobaldi. L. Grondahl, P. Bonneau and Others." Thesis, University of North Texas, 1989. https://digital.library.unt.edu/ark:/67531/metadc331705/.

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This study deals with trombone soloists and music of nineteenth-century Germany. Much of the discussion is based on the influence of two trombone virtuosos, Carl Traugott Queisser (1800-1846) and Friedrich August Belcke (1795- 1874) . Finally, a style and form analysis is given of several representative trombone compositions of the period. These include Ferdinand David's Concertino. Op. 4, Friedebald Grafe's Concerto. and Josef Serafin Alschausky's Concerto No. I.
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Wood, James J. "A Historical and Analytical Examination of the Stravinsky Octet for Wind Instruments, with a Guide to Performance Preparation of the Two Trumpet Parts." Thesis, connect to online resource, 2007. http://digital.library.unt.edu/permalink/meta-dc-3593.

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Thesis (D.M.A.)--University of North Texas, 2007.
System requirements: Adobe Acrobat Reader. Accompanied by recitals, recorded Mar. 22, 1999, Nov. 29, 1999, and Sept. 11, 2006. Includes bibliographical references (p. 52-53).
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"Introduction of Soviet Trombone Literature to Western Trombone Repertoire." Doctoral diss., 2015. http://hdl.handle.net/2286/R.I.36460.

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abstract: The canon of music performed in recitals by American trombonists contains very few works for trombone by composers from Russia and the Soviet Union. Trombonists in the United States periodically perform trombone solos by Nikolai Rimsky-Korsakov, Alexei Lebedev, Vladislav Blazhevich, Gregory Kalinkovich, Alexander Tcherepnin, and Eugene Reiche. But these works represent a very small percentage of trombone solos performed in recitals in the United States, and compositions written after 1960 by composers in the U.S.S.R. are completely absent from recital programs. The purpose of this project is to identify several Soviet-era compositions for trombonists that are worthy of introduction into trombone recital programs in the West. To support the thesis that Soviet-Russian trombone music has been disproportionally under-represented in American recital programs, a survey of over 3300 trombone recitals given in the United States from 1972 to 2013 was conducted. Once a body of significant works that had previously not been performed on American trombone recitals was identified, they were acquired, analyzed, and several were performed. The following compositions represent a list of Soviet-Russian solos not programmed on any of the 3300 recitals: German Grigoryevich Okunev, Adagio and Scherzo; Gregory Markovich Kalinkovich, Concertino for Trombone; Pavel Davidovich Saliman-Vladimirov, Concertino for Trombone; Vadim Veniaminovich Kulyov, Concertino for Trombone; Vladislav Alexanderovich Uspensky, Concertino for Trombone and Orchestra; Sergei Vasilyev and Vladimir Robertovich Enke, Concerto for Trombone and Orchestra; Sergei Borisovich Chebotaryov, Rondo for Tuba; Victor Nikolaevich Smirnov, Scherzo; Alfred Garievich Schnittke,“Schall und Hall”;and Tatyana Alexseyevna Chudova, Sonata for Trombone.
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Doctoral Dissertation Music 2015
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Ferreira, Carlos Alberto Costa de Noronha. "Nontumoral portal vein thrombosis in patients with and without cirrhosis : clinical significance, natural history of varices and efficacy of anticoagulation." Doctoral thesis, 2019. http://hdl.handle.net/10451/48542.

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A cirrose caracteriza-se por um estado de hipercoagulabilidade. A incidência de trombose da veia porta (TVP) aumenta na cirrose avançada. O impacto da TVP na história natural de cirrose não é claro. A segurança de anticoagulação na cirrose avançada e TVP não é clara e o seu impacto na sobrevida livre de transplante hepático ortotopico (THO) na cirrose avançada e TVP é controverso. Em doentes com trombose da veia porta não-cirrótica e não-tumoral (TVPNCNT) crónica, existe escassa evidência sobre a história natural de varizes esófagogastricas que são habitualmente manejadas como na cirrose. Não existe evidência relativa à eficácia desta estratégia. No primeiro estudo desta tese, uma coorte de 241 doentes com cirrose sem TVP foi seguida prospectivamente e verificamos que a descompensação prévia de cirrose e trombocitopenia foram factores independentes predizentes de desenvolvimento de TVP. A TVP não foi factor predizente independente de descompensações de cirrose ou de sobrevida livre de THO. No segundo estudo, uma análise retrospectiva duma coorte prospectiva de 178 doentes com TVPNCNT crónica, verificamos que o curso natural de varizes esofagogástricas é semelhante ao de doentes com cirrose. No terceiro estudo, uma análise retrospectiva de 80 doentes com cirrose e TVP não-tumoral, constatamos que a anticoagulação, embora não melhorasse a sobrevida global livre de THO, associou-se a melhoria de sobrevida apenas em doentes com cirrose avançada. A anticoagulação aumentou significativamente a recanalização da TVP e deverá ser mantida para prevenir a retrombose. Em conclusão, a descompensação prévia de cirrose e trombocitopenia predizem independentemente, maior risco de desenvolvimento de TVP. A TVP não influenciou independentemente, descompensações de cirrose ou a sobrevida livre de THO. A anticoagulação foi segura e aparenta melhorar a sobrevida livre de THO na cirrose avançada. Na TVPNCNT crónica a mesma estratégia terapêutica como na cirrose associou-se a um baixo risco de hemorragia e mortalidade.
Cirrhosis is considered a hipercoagulable state and there is strong evidence that the incidence of nontumoral portal vein thrombosis (PVT) increases in advanced cirrhosis. There is conflicting data regarding the impact of PVT on the natural history of cirrhosis. The safety of anticoagulation especially in patients with advanced cirrhosis and PVT is unclear. The impact of anticoagulation in patients with cirrhosis and PVT on orthotopic liver transplant (OLT) free survival is controversial. There is scant data regarding natural history of gastroesophageal varices in patients with chronic noncirrhotic nontumoral PVT (NCNTPVT), which are usually managed as in cirrhosis. There is no evidence regarding efficacy of this policy. In the first study of this thesis, a cohort of 241 patients with cirrhosis without PVT at study inclusion were evaluated prospectively and we found that prior decompensation of cirrhosis and thrombocytopenia independently predicted development of PVT. PVT did not independently predict higher risk of cirrhosis decompensations and lower OLT free survival. In the second study, a retrospective analysis of a prospective cohort of 178 patients with chronic NCNTPVT, we found that the course of esophagogastric varices appears to be similar to that in cirrhosis. In the third study, a retrospective analysis of 80 patients with cirrhosis with nontumoral PVT, although anticoagulation did not improve OLT free survival of the entire study cohort, it was associated with significantly higher survival in advanced cirrhosis. Anticoagulation was safe, significantly increased PVT recanalization and should be maintained to avoid rethrombosis. In conclusion, prior decompensation of cirrhosis and thrombocytopenia predicted higher risk of developing PVT. PVT did not independently influence cirrhosis decompensations or OLT free survival. Anticoagulation appears to improve OLT free survival only in advanced cirrhosis. In chronic NCNTPVT using the same therapeutic approach as for cirrhosis was associated with a low risk of bleeding and death.
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