Music As a Tool for Integration and Community Building

Music has long been recognized for its power to unite people, foster a sense of belonging, and serve as a tool for social inclusion. Community musicians use music to promote these qualities, but it is still a marginalized group of professionals that consciously include community work as a part of their skill set. Simultaneously, a Multicultural Center Gloria, located in Jyväskylä, Finland, faces challenges in including music and art education as a more solid part of their operations, a desire clearly expressed. Continuity in the programmes, gaining resources, and recruiting more volunteers and interns with relevant competences are topics, that the research strives to explore. The research-based development work was guided by the research questions: What kind of needs does Gloria have in terms of music, and how could the competences of local music educators be transferred to their use? Is there something applicable in the operating models of other organizations working towards social change through music? Relevant themes were researched in the knowledge base, and two thematic interviews were conducted. The research was commissioned by the Multicultural Center Gloria, and the output of the process was a list of themes, under which guidelines, ideas, and development proposals were described. The findings were constructed through an interview with a Gloria staff member, comparing the results with the knowledge of local music educators’ competences, and adding another perspective of social change through music from the data collected by interviewing a staff member of Musicians without Borders. The need for integrating music education as a part of multicultural community work became apparent in the findings, which are constructed in a way that they can be used by various relevant parties. The Multicultural Center Gloria and Jamk UAS can find ways to increase collaboration, and local music educators can develop their understanding of community work through music. In addition, motivated facilitators and participants of musical activities can find ways to boost the development of the impact in these initiatives

Masentuneen asiakkaan arvostava ja ammatillinen kohtaaminen

Opinnäytetyön tarkoituksena oli kuvata Kriisikeskus Mobilessa toimivien kriisityöntekijöiden näkemyksiä siitä, millaisista asioista masentuneen asiakkaan hyvä kohtaaminen muodostuu, ja millainen osaaminen sitä tukee. Opinnäytetyön tavoitteena oli tuottaa tietoa, jolla on mahdollista tukea asiakastyön laatua erityisesti sosiaali- ja terveysalan mielenterveyspalveluissa. Opinnäytetyön toimeksiantajana toimi Keski-Suomen alueella toimiva Kriisikeskus Mobile. Opinnäytetyö toteutettiin laadullisena tutkimuksena. Tutkimuksen kohderyhmä muodostui Kriisikeskus Mobilen työntekijöistä, ja tutkimusaineisto kerättiin teemahaastatteluina. Aineisto analysoitiin aineistolähtöisen sisällönanalyysin menetelmin. Aineisto käsitti yhteensä kolme noin puolentoista tunnin mittaista haastattelua. Tulokset osoittivat masentuneen asiakkaan hyvää kohtaamista tukevan osaamisen muodostuvan niin tietoon, vuorovaikutukseen, kuin tunnetyöskentelyyn liittyvistä ulottuvuuksista. Hyvää kohtaamista kuvattiin sellaisen vastavuoroisen ja luottamuksellisen suhteen muodostumisena, jonka puitteissa asiakas tulee kohdatuksi yksilöllisesti, ammatillisesti ja arvostavasti. Keskeisenä nähtiin asiakasta tukevien oivallusten syntyminen yhteisasiantuntijuutta tuottavassa ja ammattieettisesti vastuullisessa dialogissa. Masentuneen asiakkaan arvostava ja ammatillinen kohtaaminen edellyttää työntekijältä ammatillista itsetuntemusta, masennukseen liittyvien ilmiöiden ymmärtämistä, vuorovaikutusosaamista, sekä työtehtäväkohtaista substanssiosaamista. Opinnäytetyössä korostui työntekijän asenteiden sekä itsetuntemuksen, dialogisen vuorovaikutuksen, ja asiakkaan tilanteen kokonaisvaltaisen tarkastelun merkityksellisyys masentuneen asiakkaan hyvässä kohtaamisessa. Kiinnostavana nähtiin erityisesti työntekijän tunnetaitojen merkitys ja niiden kehittämiseen liittyvät mahdollisuudet asiakastyön laadun tukemisessa sosiaali- ja terveysalalla

Increased intestinal mucosal permeability and metabolic endotoxemia predict the risk of cardiovascular mortality

Abstract Background and aims: Low-grade chronic inflammation is a pathogenetic factor in atherosclerotic cardiovascular diseases (ASCVD), but the underlying mechanisms are not well understood. We aimed to explore the role of intestinal permeability and ensuing metabolic endotoxemia as risk factors for cardiovascular mortality. Methods: A random sub-cohort of home-living participants from the Helsinki Businessmen Study (HBS), born between 1919 and 1934 and followed since 1964, was recalled in 2003 (n = 632), 2011 (n = 316) and 2017 (n = 82). Six biomarkers representing intestinal permeability and endotoxemia were measured and the results were combined with extensive data on ASCVD prevalence, conventional risk factors, and mortality. Results: Correlation on the individual levels was observed for zonulin, lipopolysaccharide-binding protein (LBP), and intestinal fatty acid-binding protein (I-FABP) across the entire 15-year follow-up. These biomarkers are highly intercorrelated. Particularly zonulin, a marker of intestinal permeability, correlated with most of the conventional ASCVD risk factors. None of the biomarkers correlated with prevalent ASCVD, but higher levels of zonulin and LBP associated with 10-year risk of death from coronary artery disease (CAD, age-adjusted p < 0.001 and p = 0.006, respectively). Conclusions: The results support metabolic endotoxemia as a contributing pathogenetic factor in atherosclerotic cardiovascular disease with an adverse outcome. Of the surrogate biomarkers studied, zonulin was the most robust predictor of mortality in CAD. Levels of zonulin, LBP, and I-FABP remained relatively stable in individuals over the 15-year follow up, suggesting a potential role for them as biomarkers for ASCVD risk.Abstract Background and aims: Low-grade chronic inflammation is a pathogenetic factor in atherosclerotic cardiovascular diseases (ASCVD), but the underlying mechanisms are not well understood. We aimed to explore the role of intestinal permeability and ensuing metabolic endotoxemia as risk factors for cardiovascular mortality. Methods: A random sub-cohort of home-living participants from the Helsinki Businessmen Study (HBS), born between 1919 and 1934 and followed since 1964, was recalled in 2003 (n = 632), 2011 (n = 316) and 2017 (n = 82). Six biomarkers representing intestinal permeability and endotoxemia were measured and the results were combined with extensive data on ASCVD prevalence, conventional risk factors, and mortality. Results: Correlation on the individual levels was observed for zonulin, lipopolysaccharide-binding protein (LBP), and intestinal fatty acid-binding protein (I-FABP) across the entire 15-year follow-up. These biomarkers are highly intercorrelated. Particularly zonulin, a marker of intestinal permeability, correlated with most of the conventional ASCVD risk factors. None of the biomarkers correlated with prevalent ASCVD, but higher levels of zonulin and LBP associated with 10-year risk of death from coronary artery disease (CAD, age-adjusted p < 0.001 and p = 0.006, respectively). Conclusions: The results support metabolic endotoxemia as a contributing pathogenetic factor in atherosclerotic cardiovascular disease with an adverse outcome. Of the surrogate biomarkers studied, zonulin was the most robust predictor of mortality in CAD. Levels of zonulin, LBP, and I-FABP remained relatively stable in individuals over the 15-year follow up, suggesting a potential role for them as biomarkers for ASCVD risk

Visuaalisen neglectin tunnistamisen haasteet kognitiivisessa ajokykyarviossa: tapaustutkimus

Tämän tutkimuksen tarkoituksena oli selvittää, kuinka luotettavasti visuaalista vasemman puolen neglectiä ja ajokykyä pystytään arvioimaan kognitiivisilla kynä-paperitehtävillä kliinisessä yksilöarvioinnissa. Suoriutumista kynä-paperitehtävissä (Rey, Reyn välitön tahaton mieleenpalautus, BIT perinteiset osatehtävät, Vilkin viivat) verrattiin suoriutumiseen simulaattoriajossa. Lisäksi tarkasteltiin visuaalista havainnointia simulaattoriajon aikana silmänliikkeitä mittaamalla. Tutkimukseen osallistui kolme neglect-potilasta ja 17 tervettä verrokkia. Lopulliseen aineistoanalyysiin otettiin kymmenen verrokkia, koska seitsemän joutui keskeyttämään simulaattoripahoinvoinnin takia. Vasemman puolen havainnointi oli oikeaa puolta heikompaa ja ajaminen erittäin virhealtista siitä huolimatta, että kognitiivinen testisuoriutuminen ei antanut kahdella kolmesta neglect-potilaasta viitteitä neglect-oireista ja siten antanut aihetta epäillä heidän ajokykyään. Lisäksi neglect-potilaiden oiretiedostus näyttäytyi huomattavan heikkona. Tämä tutkimus antaa viitteitä siitä, että perinteiset kynä-paperitehtävät eivät ole riittävän herkkiä tunnistamaan visuaalista vasemman puolen neglectiä kliinisessä yksilöarvioinnissa 6–7,5 kuukautta aivoverenvuodon jälkeen eivätkä pysty luotettavasti ennustamaan potilaiden ajokykyisyyttä. Abstract The aim of this study was to clarify how reliably neglect symptoms and driving ability can be evaluated by cognitive paper and pencil tests in clinical assessment. Paper and pencil test performance (Rey, Rey immediate recall, BIT traditional subtests, Vilkki visual search for parallel lines) was compared to the driving simulator performance. Additionally, the visual search was recorded by eye-tracking device during simulator drive. Three neglect patients and 17 healthy controls participated in this study. Ten healthy controls were included in the final analyses. Seven healthy controls quit the study due to simulator sickness and their data was excluded from final analyses. Despite the fact that neglect was not revealed in the cognitive tests and thus there was no reason to doubt the driving ability of two out of three patients, neglect patients’ simulator drive was full of driving errors and perception of the left side was weaker than of the right side. Additionally, all the patients had clear anosognosia. This study suggests that traditional paper and pencil tests are not sensitive enough to recognize left visual neglect in clinical assessment 6–7.5 months after hemorrhage and cannot reliably predict the ability to drive. Keywords: neglect, hemi-inattention, driving, simulator, assessmen

The biological activity of serum bacterial lipopolysaccharides associates with disease activity and likelihood of achieving remission in patients with rheumatoid arthritis

Peer reviewe

The biological activity of serum bacterial lipopolysaccharides associates with disease activity and likelihood of achieving remission in patients with rheumatoid arthritis

Peer reviewe

Truncating <em>NFKB1 </em>variants cause combined NLRP3 inflammasome activation and type I interferon signaling and predispose to necrotizing fasciitis

\ua9 2024 The AuthorsIn monogenic autoinflammatory diseases, mutations in genes regulating innate immune responses often lead to uncontrolled activation of inflammasome pathways or the type I interferon (IFN-I) response. We describe a mechanism of autoinflammation potentially predisposing patients to life-threatening necrotizing soft tissue inflammation. Six unrelated families are identified in which affected members present with necrotizing fasciitis or severe soft tissue inflammations. Exome sequencing reveals truncating monoallelic loss-of-function variants of nuclear factor κ light-chain enhancer of activated B cells (NFKB1) in affected patients. In patients’ macrophages and in NFKB1-variant-bearing THP-1 cells, activation increases both interleukin (IL)-1β secretion and IFN-I signaling. Truncation of NF-κB1 impairs autophagy, accompanied by the accumulation of reactive oxygen species and reduced degradation of inflammasome receptor nucleotide-binding oligomerization domain, leucine-rich repeat-containing protein 3 (NLRP3), and Toll/IL-1 receptor domain-containing adaptor protein inducing IFN-β (TRIF), thus leading to combined excessive inflammasome and IFN-I activity. Many of the patients respond to anti-inflammatory treatment, and targeting IL-1β and/or IFN-I signaling could represent a therapeutic approach for these patients

Rizatriptan versus rizatriptan plus rofecoxib versus rizatriptan plus tolfenamic acid in the acute treatment of migraine

BACKGROUND: Rizatriptan is an effective and fast acting drug for the acute treatment of migraine. Some nonsteroidal anti-inflammatory drugs (NSAID) have also demonstrated efficacy in treating migraine attacks. There is evidence that the combination of a triptan and a NSAID decreases migraine recurrence in clinical practice. The primary aim of this randomized open label study was to assess the recurrence rates in migraine sufferers acutely treated with rizatriptan (RI) alone vs. rizatriptan plus a COX-2 enzyme inhibitor (rofecoxib, RO) vs. rizatriptan plus a traditional NSAID (tolfenamic acid, TO). We were also interested in comparing the efficacy rates within these three groups. METHODS: We assessed 45 patients from a headache clinic in Rio de Janeiro (35 women and 10 men, ages 18 to 65 years, mean 37 years). Patients with IHS migraine were randomized to one out of 3 groups, where they had to treat 6 consecutive moderate or severe attacks in counterbalanced order. In group 1, patients treated the first two attacks with 10 mg RI, the third and fourth attacks with RI + 50 mg RO and the last attacks with RI + 200 mg of TA. In group 2, we began with RI + TA, followed by RI, and RI + RO. Group 3 treated in the following order: RI + RO, RI + TA, RI alone. The presence of headache, nausea and photophobia at 1, 2 and 4 hours, as well as recurrence and side effects were compared. RESULTS: A total of 33 patients finished the study, treating 184 attacks. The pain-free rates at 1 hour were: RI: 15.5%; RI + RO: 22.6%; RI + TA: 20.3%(NS). Pain-free rates at 2 h were: RI: 37.9%; RI + RO: 62.9%, and RI + TA: 40.6% (p = 0.008 for RI vs. RI + RO; p = 0.007 for RI + RO vs. RI + TA, NS for RI vs RI + TA). At 4 h, pain-free rates were: RI: 69%; RI + RO: 82.3%; RI + TA: 78.1% (NS for all comparisons). The combination of RI + RO was superior to RI and to RI + TA in regard of the absense of nausea and photophobia at 4 hours. Recurrence (after being pain-free at 2 h) was observed in 50% of patients treated with RI, in 15,4% of those treated with RI + RO, and in 7,7% of those treated with RI + TA. CONCLUSIONS: Despite the methodological limitations of this study, the combination of RI and RO revealed a higher response rate at 2 hours. Recurrence was also clearly decreased with both combinations in relation to the use of RI alone. Controlled studies are necessary to provide additional evidence