Rewriting The Rep: Modernizing The Ensemble Experience Through Contemporary Media

In an effort to fight classism in music, composers of the past integrated recognizable folk tunes into “classical” performances, creating wildly successful pieces that drew people from all walks of life to the performing arts. Today, there is a new rift between “classical” and contemporary music, one that firmly separates what can and cannot be performed in wind ensemble settings. Consequently, music education rarely includes contemporary genres in its curriculum, leading music students to continue choosing only the same “classical” repertoire yearly. With arrangements of music from The Last of Us, Steven Universe, Phoebe Bridgers, Johnny Cash, Harry Styles, and Radiohead, I propose ways to modernize the ensemble experience through contemporary media. For this project, I created arrangements of six contemporary songs from pop, rock, indie, and country, as well as the music from television shows and video games. The main goal of this project was to experiment with arranging as a tool for education, and with how music from today’s contemporary media would sound formatted for wind bands. Other goals included increasing my personal knowledge of arranging techniques and softwares, as well as creating a product that showcases modern, recognizable songs formatted for the characteristic wind band sound

Examination of pharmacists’ support for implementation of syringe exchange programs in community pharmacies in North Carolina: a social ecological approach

Background: In the US, hepatitis C virus (HCV) infection is the leading bloodborne infection and injection drug use is the most common mode of transmission. North Carolina (NC) is one of the states with the highest rates of acute HCV infection. Syringe exchange programs are effective in the prevention of HCV infection in injection drug users. With only approximately 30 syringe exchange programs in North Carolina, access is limited. Implementation of syringe exchange programs in community pharmacies can increase access. Objective: This study examined NC community pharmacists’ support of implementation of syringe exchange programs in community pharmacies and the associated intrapersonal, interpersonal, and organizational factors. Factors represented constructs of the Social Ecological Model (SEM). Methods: This quantitative correlational, cross-sectional study was guided by the SEM. NC community pharmacists (N = 304) were surveyed using an online survey. Descriptive statistics, Somers’ d correlation coefficient, PLUM ordinal logistic regression modeling, and Chi-squared tests were used to answer 6 research questions. Results: Findings revealed that 68.6% of NC community pharmacists surveyed supported implementation of a syringe exchange program in their pharmacy to some extent, which included from a small extent to a great extent. Pharmacists’ support for syringe exchange programs was indicated at all three concept levels. Specifically, the major intrapersonal factors that validated support included the beliefs about the effectiveness of syringe exchange programs, practicing in an independent community pharmacy, male gender, and receiving education on syringe exchange programs. Receiving injection drug user cultural competency training was the interpersonal factor that indicated support. The major organizational factors that substantiated support were having a company/store policy that allows implementation of a syringe exchange program and receiving training on how to implement a syringe exchange programs. The belief about the effectiveness of syringe exchange programs at preventing HCV infection in injection drug users was the intrapersonal factor most strongly related to support. Concern about having increased numbers of injection drug users in the pharmacy was the interpersonal factor most strongly related to support. Receiving training on how to implement a syringe exchange program was the organizational factor most strongly related to support. Factors predicting support were type of community pharmacy, gender, and years of practice. Support and factors differed between chain and independent community pharmacists. Chain community pharmacists were 56.1% less likely to express support for implementation to a great extent compared to independent community pharmacists. Chain community pharmacists had fewer beliefs about the effectiveness of syringe exchange programs and more concerns associated with implementation. Conclusion: NC community pharmacists supported syringe exchange programs in community pharmacies to some extent. All three concept levels indicated support for syringe exchange programs among the pharmacists. A lack of knowledge of the overall potential public health impact of syringe exchange programs existed to some extent based on some responses to beliefs about syringe exchange programs. Stigmatization of injection drug users was suggested based on responses around the concern about having increased numbers of injection drug users in the pharmacy. Multilevel strategies to mitigate concerns and increase knowledge about syringe exchange programs including the public health impact and how to implement a syringe exchange program are warranted. Public health nurses are in a pivotal role to develop and implement these strategies. Implications for practice include the development and implementation of multilevel strategies through nurse-led interdisciplinary teams and consideration of chain and independent community pharmacists separately during strategy development. Implications for education include incorporation of injection drug user health information and the role of interventions such as syringe exchange programs into nursing, pharmacy, and other healthcare provider education curriculum, and provision of continuing education for current practitioners on these topics. Implications for research include conducting action or community-based participatory research with community pharmacists and other stakeholders such as pharmacy policy makers to determine best practices for implementing syringe exchange programs in community pharmacies. Implications for policy and community engagement include providing community awareness campaigns of syringe exchange program positive outcomes and contributions to decrease HCV infection and improve health of the community

Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy

BACKGROUND: Morgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies. METHODS: A descriptive study was conducted among persons at least 13 years of age and enrolled in Kaiser Permanente Northern California (KPNC) during 2006-2008. A case was defined as the self-reported emergence of fibers or materials from the skin accompanied by skin lesions and/or disturbing skin sensations. We collected detailed epidemiologic data, performed clinical evaluations and geospatial analyses and analyzed materials collected from participants' skin. RESULTS: We identified 115 case-patients. The prevalence was 3.65 (95% CI = 2.98, 4.40) cases per 100,000 enrollees. There was no clustering of cases within the 13-county KPNC catchment area (p = .113). Case-patients had a median age of 52 years (range: 17-93) and were primarily female (77%) and Caucasian (77%). Multi-system complaints were common; 70% reported chronic fatigue and 54% rated their overall health as fair or poor with mean Physical Component Scores and Mental Component Scores of 36.63 (SD = 12.9) and 35.45 (SD = 12.89), respectively. Cognitive deficits were detected in 59% of case-patients and 63% had evidence of clinically significant somatic complaints; 50% had drugs detected in hair samples and 78% reported exposure to solvents. Solar elastosis was the most common histopathologic abnormality (51% of biopsies); skin lesions were most consistent with arthropod bites or chronic excoriations. No parasites or mycobacteria were detected. Most materials collected from participants' skin were composed of cellulose, likely of cotton origin. CONCLUSIONS: This unexplained dermopathy was rare among this population of Northern California residents, but associated with significantly reduced health-related quality of life. No common underlying medical condition or infectious source was identified, similar to more commonly recognized conditions such as delusional infestation

124I-HuCC49deltaCH2 for TAG-72 antigen-directed positron emission tomography (PET) imaging of LS174T colon adenocarcinoma tumor implants in xenograft mice: preliminary results

<p>Abstract</p> <p>Background</p> <p>¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG-PET) is widely used in diagnostic cancer imaging. However, the use of ¹⁸F-FDG in PET-based imaging is limited by its specificity and sensitivity. In contrast, anti-TAG (tumor associated glycoprotein)-72 monoclonal antibodies are highly specific for binding to a variety of adenocarcinomas, including colorectal cancer. The aim of this preliminary study was to evaluate a complimentary determining region (CDR)-grafted humanized C_H2-domain-deleted anti-TAG-72 monoclonal antibody (HuCC49deltaC_H2), radiolabeled with iodine-124 (¹²⁴I), as an antigen-directed and cancer-specific targeting agent for PET-based imaging.</p> <p>Methods</p> <p>HuCC49deltaC_H2 was radiolabeled with ¹²⁴I. Subcutaneous tumor implants of LS174T colon adenocarcinoma cells, which express TAG-72 antigen, were grown on athymic Nu/Nu nude mice as the xenograft model. Intravascular (i.v.) and intraperitoneal (i.p.) administration of ¹²⁴I-HuCC49deltaC_H2 was then evaluated in this xenograft mouse model at various time points from approximately 1 hour to 24 hours after injection using microPET imaging. This was compared to i.v. injection of ¹⁸F-FDG in the same xenograft mouse model using microPET imaging at 50 minutes after injection.</p> <p>Results</p> <p>At approximately 1 hour after i.v. injection, ¹²⁴I-HuCC49deltaC_H2 was distributed within the systemic circulation, while at approximately 1 hour after i.p. injection, ¹²⁴I-HuCC49deltaC_H2 was distributed within the peritoneal cavity. At time points from 18 hours to 24 hours after i.v. and i.p. injection, ¹²⁴I-HuCC49deltaC_H2 demonstrated a significantly increased level of specific localization to LS174T tumor implants (p = 0.001) when compared to the 1 hour images. In contrast, approximately 50 minutes after i.v. injection, ¹⁸F-FDG failed to demonstrate any increased level of specific localization to a LS174T tumor implant, but showed the propensity toward more nonspecific uptake within the heart, Harderian glands of the bony orbits of the eyes, brown fat of the posterior neck, kidneys, and bladder.</p> <p>Conclusions</p> <p>On microPET imaging, ¹²⁴I-HuCC49deltaC_H2 demonstrates an increased level of specific localization to tumor implants of LS174T colon adenocarcinoma cells in the xenograft mouse model on delayed imaging, while ¹⁸F-FDG failed to demonstrate this. The antigen-directed and cancer-specific ¹²⁴I-radiolabled anti-TAG-72 monoclonal antibody conjugate, ¹²⁴I-HuCC49deltaC_H2, holds future potential for use in human clinical trials for preoperative, intraoperative, and postoperative PET-based imaging strategies, including fused-modality PET-based imaging platforms.</p

A comprehensive overview of radioguided surgery using gamma detection probe technology

The concept of radioguided surgery, which was first developed some 60 years ago, involves the use of a radiation detection probe system for the intraoperative detection of radionuclides. The use of gamma detection probe technology in radioguided surgery has tremendously expanded and has evolved into what is now considered an established discipline within the practice of surgery, revolutionizing the surgical management of many malignancies, including breast cancer, melanoma, and colorectal cancer, as well as the surgical management of parathyroid disease. The impact of radioguided surgery on the surgical management of cancer patients includes providing vital and real-time information to the surgeon regarding the location and extent of disease, as well as regarding the assessment of surgical resection margins. Additionally, it has allowed the surgeon to minimize the surgical invasiveness of many diagnostic and therapeutic procedures, while still maintaining maximum benefit to the cancer patient. In the current review, we have attempted to comprehensively evaluate the history, technical aspects, and clinical applications of radioguided surgery using gamma detection probe technology