Music Therapy for Young Adolescents Who Have Experienced the Death of a Loved One

The purpose of this study was to explore the effects of a music therapy based support group on depressive and grief symptoms in young adolescents who have experienced the death of a loved one. Participants were 3 middle school students, ages 11-12. Measures utilized to determine the effects of music therapy on grief symptoms were the Texas Revised Inventory of Grief (Faschingbauer, et al. 1987) scores on which range from 13 (low grief) to 65 (high grief) and the Depression Self-Rating Scale (Birleson, 1981), on which scores range from 0 (low depression) to 36 (high depression). Music therapy in the form of a “grief rock band” was used to facilitate the expression and processing of grief in adolescents. Group sessions included songwriting as the primary tool for expression and processing, along with other music therapy experiences to increase group cohesion, facilitate expression and awareness of feelings, and reinforce coping mechanisms. The thematic topics for this study were (1) feelings, (2) memories, (3) support, and (4) moving forward. Each session, participants engaged in discussion, developed song lyrics, and formed the music of songs to represent the thematic topic. Songs were video recorded and given to the participants at the end of the session series. Data were analyzed as multiple case studies. Scores from the DSRS and Part II of the TRIG at pretest and posttest were examined for each participant in order to observe for changes across time. For each of the participants, posttest scores showed an improvement in both depressive symptoms and grief symptoms. Music therapy in the form of a grief rock band may offer a creative and engaging means for young teens to express and move through grief

Champion of two worlds : a phenomenological investigation of North Carolina early college liaisons' leadership experiences

American high school reform has gone through many configurations during the past three decades. Dual enrollment, in which high school students access college courses for credit that can be applied toward high school and college transcripts simultaneously, is one of the more prevalent types of high school reform (Community College Research Center [CCRC], 2012). During the 2010-2011 academic year, there were slightly more than 2 million dual-credit enrollments in the United States, an astounding 67% increase nationwide in such enrollments since 2002-2003 (CCRC; Collins, 2012; Thomas, Marken, Gray, Lewis, & Ralph, 2013). One form of dual enrollment is early college, a secondary institution, typically located on a college campus, which allows dual-enrolled students the opportunity to earn a college degree while still in high school. In North Carolina, early colleges are initially funded by grants that are awarded by a private-public partnership called the North Carolina New Schools Project (NCNSP) (NCNSP, 2004a). Part of the grant funding pays for the salary of an early college liaison, a community college employee who, among other things, (a) assists in the development of programs of study; (b) coordinates high school and college schedules and calendars; (c) aids in the registration of students; and (d) develops college policies and procedures related to high school students (NCNSP, 2004b). Despite a significant amount of empirical research focused on the early college model, there is a paucity – indeed, a seeming nonexistence – of literature related to the early college liaison. This qualitative phenomenological study filled a gap in the early college and educational partnership literatures by investigating the leadership experiences of early college liaisons – “boundary-spanners” who are tasked with navigating the differing cultures and curricula of K-12 and community college systems. Fourteen early college liaisons provided written reflections and documents for this study, and engaged in recorded interviews that focused on the leadership skills, social traits, and relationships that are required for maintaining student advocacy in a political educational environment. Data showed that early college liaisons (a) form professional relationships and communicate extensively with a wide variety of stakeholders; (b) collaborate closely with faculty and executive leadership on both “sides” of the partnership; (c) engage in diplomacy in a highly political environment; (d) possess knowledge of K-12 and community college cultures and academic requirements; and (e) advocate for students in times of conflict. Because dual enrollment has grown at such a rapid rate in the past decade (CCRC; Collins; Thomas et al.), and the American Association of State Colleges and Universities has recommended an increase in the amount of personnel who can bridge K-12 and higher education (Eddy, 2010), it is imperative that future research be conducted that examines the professional relationships, leadership skills, and social traits that this study unearthed, to explore how they can be applied to forthcoming educational partnerships. Such partnerships are bound to increase as state funding declines and institutions of learning create new avenues for maintaining effectiveness while decreasing financial burdens (Azinger, 2000; Eddy). Such research would lend itself to the dearth of experiential studies focusing on how educational partnerships are planned, initiated, and developed (Miller & Hafner, 2008)

Electroanalytical point-of-care detection of gold standard and emerging cardiac biomarkers for stratification and monitoring in intensive care medicine - a review

Determination of specific cardiac biomarkers (CBs) during the diagnosis and management of adverse cardiovascular events such as acute myocardial infarction (AMI) has become commonplace in emergency department (ED), cardiology and many other ward settings. Cardiac troponins (cTnT and cTnI) and natriuretic peptides (BNP and NT-pro-BNP) are the preferred biomarkers in clinical practice for the diagnostic workup of AMI, acute coronary syndrome (ACS) and other types of myocardial ischaemia and heart failure (HF), while the roles and possible clinical applications of several other potential biomarkers continue to be evaluated and are the subject of several comprehensive reviews. The requirement for rapid, repeated testing of a small number of CBs in ED and cardiology patients has led to the development of point-of-care (PoC) technology to circumvent the need for remote and lengthy testing procedures in the hospital pathology laboratories. Electroanalytical sensing platforms have the potential to meet these requirements. This review aims firstly to reflect on the potential benefits of rapid CB testing in critically ill patients, a very distinct cohort of patients with deranged baseline levels of CBs. We summarise their source and clinical relevance and are the first to report the required analytical ranges for such technology to be of value in this patient cohort. Secondly, we review the current electrochemical approaches, including its sub-variants such as photoelectrochemical and electrochemiluminescence, for the determination of important CBs highlighting the various strategies used, namely the use of micro- and nanomaterials, to maximise the sensitivities and selectivities of such approaches. Finally, we consider the challenges that must be overcome to allow for the commercialisation of this technology and transition into intensive care medicine. Graphical abstract: [Figure not available: see fulltext.

Nano-molecularly imprinted polymers for serum creatinine sensing using the heat transfer method

Serum creatinine concentration is an important clinical measure of kidney function. However, standard methods of detection, such as the Jaffe method or enzymatic assays, suffer several disadvantages, including non-specificity and procedural complexity, or high cost, respectively. In this work, we propose the use of nano-molecularly imprinted polymers (nMIPs) in conjunction with the novel Heat Transfer Method (HTM) as a promising alternative sensing platform to these existing methods for measuring serum creatinine concentration. More specifically, it is shown that creatinine-imprinted nMIPs can be produced using a solid-phase templating method, and that simple drop-casting onto a cheap, disposable substrate can be used in conjunction with HTM to detect creatinine with a limit-of-detection of (7.0 ± 0.5) μM in buffer solutions. Furthermore, the nMIPs are shown to selectively bind creatinine in comparison to several similar molecules, and the sensing platform is demonstrated to be able to detect changes in creatinine concentration in complex blood plasma samples

Toward the Rapid Diagnosis of Sepsis: Detecting Interleukin-6 in Blood Plasma Using Functionalized Screen-Printed Electrodes with a Thermal Detection Methodology

This paper reports the detection of the inflammatory and sepsis-related biomarker, interleukin-6 (IL-6), in human blood plasma using functionalized screen-printed electrodes (SPEs) in conjunction with a thermal detection methodology, termed heat-transfer method (HTM). SPEs are functionalized with antibodies specific for IL-6 through electrodeposition of a diazonium linking group and N'-ethylcarbodiimide hydrochloride (EDC) coupling, which was tracked through the use of cyclic voltammetry and Raman spectroscopy. The functionalized SPEs are mounted inside an additively manufactured flow cell and connected to the HTM device. We demonstrate the ability to detect IL-6 at clinically relevant concentrations in PBS buffer (pH = 7.4) with no significant interference from the similarly sized sepsis-related biomarker procalcitonin (PCT). The limit of detection (3s) of the system is calculated to correspond to 3.4 ± 0.2 pg mL-1 with a working range spanning the physiologically relevant concentration levels in both healthy individuals and patients with sepsis, indicating the sensitivity of the sensor is suitable for the application. Further experiments helped provide a proof-of-application through the detection of IL-6 in blood plasma with no significant interference observed from PCT or the constituents of the medium. Due to the selectivity, sensitivity, straightforward operation, and low cost of production, this sensor platform has the potential for use as a traffic light sensor for the multidetection of inflammatory biomarkers for the diagnosis of sepsis and other conditions in which the rapid testing of blood biomarkers has vital clinical application

Implementation fidelity of a nurse-led falls prevention program in acute hospitals during the 6-PACK trial

Background: When tested in a randomized controlled trial (RCT) of 31,411 patients, the nurse-led 6-PACK falls prevention program did not reduce falls. Poor implementation fidelity (i.e., program not implemented as intended) may explain this result. Despite repeated calls for the examination of implementation fidelity as an essential component of evaluating interventions designed to improve the delivery of care, it has been neglected in prior falls prevention studies. This study examined implementation fidelity of the 6-PACK program during a large multi-site RCT. Methods: Based on the 6-PACK implementation framework and intervention description, implementation fidelity was examined by quantifying adherence to program components and organizational support. Adherence indicators were: 1) falls-risk tool completion; and for patients classified as high-risk, provision of 2) a ‘Falls alert’ sign; and 3) at least one additional 6-PACK intervention. Organizational support indicators were: 1) provision of resources (executive sponsorship, site clinical leaders and equipment); 2) implementation activities (modification of patient care plans; training; implementation tailoring; audits, reminders and feedback; and provision of data); and 3) program acceptability. Data were collected from daily bedside observation, medical records, resource utilization diaries and nurse surveys. Results: All seven intervention components were delivered on the 12 intervention wards. Program adherence data were collected from 103,398 observations and medical record audits. The falls-risk tool was completed each day for 75% of patients. Of the 38% of patients classified as high-risk, 79% had a ‘Falls alert’ sign and 63% were provided with at least one additional 6-PACK intervention, as recommended. All hospitals provided the recommended resources and undertook the nine outlined program implementation activities. Most of the nurses surveyed considered program components important for falls prevention. Conclusions: While implementation fidelity was variable across wards, overall it was found to be acceptable during the RCT. Implementation failure is unlikely to be a key factor for the observed lack of program effectiveness in the 6-PACK trial. Trial registration: The 6-PACK cluster RCT is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000332921 (29 March 2011)

Using enhanced number and brightness to measure protein oligomerization dynamics in live cells

Protein dimerization and oligomerization are essential to most cellular functions, yet measurement of the size of these oligomers in live cells, especially when their size changes over time and space, remains a challenge. A commonly used approach for studying protein aggregates in cells is number and brightness (N&B), a fluorescence microscopy method that is capable of measuring the apparent average number of molecules and their oligomerization (brightness) in each pixel from a series of fluorescence microscopy images. We have recently expanded this approach in order to allow resampling of the raw data to resolve the statistical weighting of coexisting species within each pixel. This feature makes enhanced N&B (eN&B) optimal for capturing the temporal aspects of protein oligomerization when a distribution of oligomers shifts toward a larger central size over time. In this protocol, we demonstrate the application of eN&B by quantifying receptor clustering dynamics using electron-multiplying charge-coupled device (EMCCD)-based total internal reflection microscopy (TIRF) imaging. TIRF provides a superior signal-to-noise ratio, but we also provide guidelines for implementing eN&B in confocal microscopes. For each time point, eN&B requires the acquisition of 200 frames, and it takes a few seconds up to 2 min to complete a single time point. We provide an eN&B (and standard N&B) MATLAB software package amenable to any standard confocal or TIRF microscope. The software requires a high-RAM computer (64 Gb) to run and includes a photobleaching detrending algorithm, which allows extension of the live imaging for more than an hour

Heat stress causes spatially-distinct membrane re-modelling in K562 leukemia cells

Cellular membranes respond rapidly to various environmental perturbations. Previously we showed that modulations in membrane fluidity achieved by heat stress (HS) resulted in pronounced membrane organization alterations which could be intimately linked to the expression and cellular distribution of heat shock proteins. Here we examine heat-induced membrane changes using several visualisation methods. With Laurdan two-photon microscopy we demonstrate that, in contrast to the enhanced formation of ordered domains in surface membranes, the molecular disorder is significantly elevated within the internal membranes of cells preexposed to mild HS. These results were compared with those obtained by anisotropy, fluorescence lifetime and electron paramagnetic resonance measurements. All probes detected membrane changes upon HS. However, the structurally different probes revealed substantially distinct alterations in membrane heterogeneity. These data call attention to the careful interpretation of results obtained with only a single label. Subtle changes in membrane microstructure in the decision-making of thermal cell killing could have potential application in cancer therapy

Device-assessed sleep and physical activity in individuals recovering from a hospital admission for COVID-19: a multicentre study

Background The number of individuals recovering from severe COVID-19 is increasing rapidly. However, little is known about physical behaviours that make up the 24-h cycle within these individuals. This study aimed to describe physical behaviours following hospital admission for COVID-19 at eight months post-discharge including associations with acute illness severity and ongoing symptoms. Methods One thousand seventy-seven patients with COVID-19 discharged from hospital between March and November 2020 were recruited. Using a 14-day wear protocol, wrist-worn accelerometers were sent to participants after a five-month follow-up assessment. Acute illness severity was assessed by the WHO clinical progression scale, and the severity of ongoing symptoms was assessed using four previously reported data-driven clinical recovery clusters. Two existing control populations of office workers and individuals with type 2 diabetes were comparators. Results Valid accelerometer data from 253 women and 462 men were included. Women engaged in a mean ± SD of 14.9 ± 14.7 min/day of moderate-to-vigorous physical activity (MVPA), with 12.1 ± 1.7 h/day spent inactive and 7.2 ± 1.1 h/day asleep. The values for men were 21.0 ± 22.3 and 12.6 ± 1.7 h /day and 6.9 ± 1.1 h/day, respectively. Over 60% of women and men did not have any days containing a 30-min bout of MVPA. Variability in sleep timing was approximately 2 h in men and women. More severe acute illness was associated with lower total activity and MVPA in recovery. The very severe recovery cluster was associated with fewer days/week containing continuous bouts of MVPA, longer total sleep time, and higher variability in sleep timing. Patients post-hospitalisation with COVID-19 had lower levels of physical activity, greater sleep variability, and lower sleep efficiency than a similarly aged cohort of office workers or those with type 2 diabetes. Conclusions Those recovering from a hospital admission for COVID-19 have low levels of physical activity and disrupted patterns of sleep several months after discharge. Our comparative cohorts indicate that the long-term impact of COVID-19 on physical behaviours is significant

Device-assessed sleep and physical activity in individuals recovering from a hospital admission for COVID-19: a multicentre study

Availability of data and materials: The protocol, consent form, definition and derivation of clinical characteristics and outcomes, training materials, regulatory documents, information about requests for data access, and other relevant study materials are available online https://www.phosp.org/.Background: The number of individuals recovering from severe COVID-19 is increasing rapidly. However, little is known about physical behaviours that make up the 24-h cycle within these individuals. This study aimed to describe physical behaviours following hospital admission for COVID-19 at eight months post-discharge including associations with acute illness severity and ongoing symptoms. Methods: One thousand seventy-seven patients with COVID-19 discharged from hospital between March and November 2020 were recruited. Using a 14-day wear protocol, wrist-worn accelerometers were sent to participants after a five-month follow-up assessment. Acute illness severity was assessed by the WHO clinical progression scale, and the severity of ongoing symptoms was assessed using four previously reported data-driven clinical recovery clusters. Two existing control populations of office workers and individuals with type 2 diabetes were comparators. Results: Valid accelerometer data from 253 women and 462 men were included. Women engaged in a mean ± SD of 14.9 ± 14.7 min/day of moderate-to-vigorous physical activity (MVPA), with 12.1 ± 1.7 h/day spent inactive and 7.2 ± 1.1 h/day asleep. The values for men were 21.0 ± 22.3 and 12.6 ± 1.7 h /day and 6.9 ± 1.1 h/day, respectively. Over 60% of women and men did not have any days containing a 30-min bout of MVPA. Variability in sleep timing was approximately 2 h in men and women. More severe acute illness was associated with lower total activity and MVPA in recovery. The very severe recovery cluster was associated with fewer days/week containing continuous bouts of MVPA, longer total sleep time, and higher variability in sleep timing. Patients post-hospitalisation with COVID-19 had lower levels of physical activity, greater sleep variability, and lower sleep efficiency than a similarly aged cohort of office workers or those with type 2 diabetes. Conclusions: Those recovering from a hospital admission for COVID-19 have low levels of physical activity and disrupted patterns of sleep several months after discharge. Our comparative cohorts indicate that the long-term impact of COVID-19 on physical behaviours is significant.UK Research and Innovation and National Institute of Health Research (grant references: MR/V027859/1 and COV0319