Ethics in Music Therapy: a Programmed Text.

The purpose of this study was to develop a programmed text to teach the subject of professional ethics to music therapy students and professional music therapists. This study was undertaken in response to a mandate from the National Association for Music Therapy requiring the inclusion of professional ethics in the undergraduate music therapy curriculum. Data from four surveys were utilized in the development of the text. For the first survey, a questionnaire was sent to all university music therapy directors in the United States. Questionnaire items concerned how the subject of ethics is taught, materials used, and course titles. Analysis of thirty-nine questionnaires returned indicated that the subject of ethics was most frequently taught as part of another course. Also, respondents indicated a need for educational materials on professional ethics in music therapy. Survey II involved the eliciting of codes of ethics from 181 education and health care organizations. Sixty codes of ethics were received and utilized in the development of the text. In survey III, fifty music therapists, who had been selected at random, were asked to choose the best solution to fifty-six ethical problem situations. They were asked also to rate the importance of each situation on a scale from one (unimportant) to seven (extremely important). Ethical areas considered most important by respondents included client welfare, client-therapist relationships, and confidentiality. In survey IV, eleven experts on professional behavior in music therapy received 291 ethical problem situations. They were asked to select the best solution to each problem, and rate the importance of each of a scale from one (unimportant) to seven (extremely important). Respondents agreed unanimously 25% of the time on choices of solutions to problem situations. The programmed text consisted of ninety problem ethical situations drawn from surveys III and IV. Each situation was followed by four possible solutions to the problem, or four judgments concerning the problem. The best solutions to the problem situations followed each in a programmed text format. Excerpts from codes of ethics were used to support the choice of solutions. A discussion section was also included for each situation. The situations were grouped according to content and placed in one of four categories dealing with organizational and interprofessional relationships; clinical relationships; educational and training relationships; and research precautions and publication credits. Conclusions and recommendations included an assertion regarding the need for frequent update and review of educational materials on professional ethics in music therapy

Neuronal Effects of Listening to Entrainment Music Versus Preferred Music in Patients With Chronic Cancer Pain as Measured via EEG and LORETA Imaging

Previous studies examining EEG and LORETA in patients with chronic pain discovered an overactivation of high theta (6–9 Hz) and low beta (12–16 Hz) power in central regions. MEG studies with healthy subjects correlating evoked nociception ratings and source localization described delta and gamma changes according to two music interventions. Using similar music conditions with chronic pain patients, we examined EEG in response to two different music interventions for pain. To study this process in-depth we conducted a mixed-methods case study approach, based on three clinical cases. Effectiveness of personalized music therapy improvisations (entrainment music – EM) versus preferred music on chronic pain was examined with 16 participants. Three patients were randomly selected for follow-up EEG sessions three months post-intervention, where they listened to recordings of the music from the interventions provided during the research. To test the difference of EM versus preferred music, recordings were presented in a block design: silence, their own composed EM (depicting both “pain” and “healing”), preferred (commercially available) music, and a non-participant’s EM as a control. Participants rated their pain before and after the EEG on a 1–10 scale. We conducted a detailed single case analysis to compare all conditions, as well as a group comparison of entrainment-healing condition versus preferred music condition. Power spectrum and according LORETA distributions focused on expected changes in delta, theta, beta, and gamma frequencies, particularly in sensory-motor and central regions. Intentional moment-by-moment attention on the sounds/music rather than on pain and decreased awareness of pain was experienced from one participant. Corresponding EEG analysis showed accompanying power changes in sensory-motor regions and LORETA projection pointed to insula-related changes during entrainment-pain music. LORETA also indicated involvement of visual-spatial, motor, and language/music improvisation processing in response to his personalized EM which may reflect active recollection of creating the EM. Group-wide analysis showed common brain responses to personalized entrainment-healing music in theta and low beta range in right pre- and post-central gyrus. We observed somatosensory changes consistent with processing pain during entrainment-healing music that were not seen during preferred music. These results may depict top–down neural processes associated with active coping for pain

NleG Type 3 Effectors from Enterohaemorrhagic Escherichia coli Are U-Box E3 Ubiquitin Ligases

NleG homologues constitute the largest family of type 3 effectors delivered by pathogenic E. coli, with fourteen members in the enterohaemorrhagic (EHEC) O157:H7 strain alone. Identified recently as part of the non-LEE-encoded (Nle) effector set, this family remained uncharacterised and shared no sequence homology to other proteins including those of known function. The C-terminal domain of NleG2-3 (residues 90 to 191) is the most conserved region in NleG proteins and was solved by NMR. Structural analysis of this structure revealed the presence of a RING finger/U-box motif. Functional assays demonstrated that NleG2-3 as well as NleG5-1, NleG6-2 and NleG9′ family members exhibited a strong autoubiquitination activity in vitro; a characteristic usually expressed by eukaryotic ubiquitin E3 ligases. When screened for activity against a panel of 30 human E2 enzymes, the NleG2-3 and NleG5-1 homologues showed an identical profile with only UBE2E2, UBE2E3 and UBE2D2 enzymes supporting NleG activity. Fluorescence polarization analysis yielded a binding affinity constant of 56±2 µM for the UBE2D2/NleG5-1 interaction, a value comparable with previous studies on E2/E3 affinities. The UBE2D2 interaction interface on NleG2-3 defined by NMR chemical shift perturbation and mutagenesis was shown to be generally similar to that characterised for human RING finger ubiquitin ligases. The alanine substitutions of UBE2D2 residues Arg5 and Lys63, critical for activation of eukaryotic E3 ligases, also significantly decreased both NleG binding and autoubiquitination activity. These results demonstrate that bacteria-encoded NleG effectors are E3 ubiquitin ligases analogous to RING finger and U-box enzymes in eukaryotes