Evolving Concepts in how Viruses Impact Asthma

Over the past decade, there have been substantial advances in our understanding about how viral infections regulate asthma. Important lessons have been learned from birth cohort studies examining viral infections and subsequent asthma and from understanding the relationships between host genetics and viral infections, the contributions of respiratory viral infections to patterns of immune development, the impact of environmental exposure on the severity of viral infections, and how the viral genome influences host immune responses to viral infections. Further, there has been major progress in our knowledge about how bacteria regulate host immune responses in asthma pathogenesis. In this article, we also examine the dynamics of bacterial colonization of the respiratory tract during viral upper respiratory tract infection, in addition to the relationship of the gut and respiratory microbiomes with respiratory viral infections. Finally, we focus on potential interventions that could decrease virus-induced wheezing and asthma. There are emerging therapeutic options to decrease the severity of wheezing exacerbations caused by respiratory viral infections. Primary prevention is a major goal, and a strategy toward this end is considered

Personality and the Quality of the Music Therapy Supervisor-Intern Relationship

The 6-month music therapy internship is the capstone experience of the music therapy degree in which a clinical music therapy supervisor works with an intern to build skills necessary for entry level into the music therapy field. During this time, the supervisor and intern build a relationship that solidifies university education with clinical experience in a professional setting. This final supervisor-intern relationship leaves a lasting impression on professional practice of the intern, which can impact the success of future practice. The purpose of this study was to examine the supervision attributes [i.e., safe base and commitment] of the relationship between music therapy supervisors and interns. Further, personality traits of supervisors and interns were identified and examined for their influence on the aforementioned attributes.&nbsp;Previous personality research has examined the personality preferences of music therapists, indicating that the 16 Personality Factor and The Myer’s Briggs Type Indicator are commonly utilized personality assessments. Results from previous research indicate that music therapists are creative and desire to make a positive impact on humanity. There has not yet been a research study that has examined the personality preferences of music therapists using the NEO-FFI Factor Personality Assessment.&nbsp;A sequential explanatory mixed method design was utilized in the study to examine the relationship between personality and supervision attributes of music therapy supervisors and interns. Data collection tools for quantitative portion of the study included the NEO-FFI Personality Assessment, a demographic survey, the Supervisory Relationship Measure (supervisors)/the Supervisory Relationship Questionnaire (interns). In addition, eight semi-structured interviews were conducted with supervisors and interns. A total of 69 (N = 69) participants completed the quantitative portion of the study and eight participants (n = 8) completed the qualitative interview portion of the study. The integration of the quantitative and qualitative data took place through the discussion, implication, and future research sections. Personality results of the supervisor indicates that the majority of supervisors scored low to average in Neuroticism, high in Openness to Experience, and high in Conscientiousness. A majority of the interns scored average to high in Neuroticism, high in Openness to Experience, and average to high in Conscientiousness.&nbsp;The correlational analysis indicated four significant results for supervisors, which included a significant inverse relationship between Neuroticism and safe base, a significant positive relationship between Conscientiousness and commitment, a significant positive relationship between Openness to Experience and commitment, and was a significant inverse relationship between Neuroticism and overall supervision score of the SRM. Two significant correlations were found for interns, a significant inverse relationship between Neuroticism and safe base and a significant inverse relationship between Neuroticism and total SRQ score. Both supervisors and interns with higher Neuroticism perceived the internship relationship as less safe and had less overall satisfaction in supervision. In addition, supervisors with high standards and organizational skills were perceived as having a high level of commitment to the intern and supervision experience. Also, supervisors that were more open to new ideas and experiences had higher levels of perceived commitment to the intern and were able to provide a constructive supervision experience.Several clinical implications stem from the results of the study. Personality assessments can be a useful tool in internships in that supervisors and interns can learn more about their personality preferences. Supervisors can use the personality assessments of their intern to learn how to motive their intern during the internship. Supervisors and interns with high Neuroticism should consider practicing mindfulness to mitigate symptoms of irrational perfectionistic beliefs.&nbsp;</p

A Preliminary Overview of Music Reimbursement Practice in the United States

Music therapy services are currently being reimbursed through state and private insurance funding streams, yet to date, there is no known systematic exploration on music therapy reimbursement practices. Such information would be helpful to include when com- municating with third-party payers and can assist in tracking reim- bursement trends. Thus, we sought to provide baseline information on how music therapy services are currently being reimbursed in the United States, with a focus on approved treatment parameters, re- ferral sources, Current Procedural Terminology (CPT) codes used, and types of music interventions and music therapy experiences imple- mented. Board-certified music therapists in private practice who had successfully obtained reimbursement for music therapy services be- tween 2012 and 2018 completed a 28-item online survey. In total, 7 respondents provided information on 55 unique reimbursement cases from 5 different states, most of which were based on Medicaid waiver programs. We conducted descriptive analyses to summarize music therapy reimbursement practices. Most of the clients were referred by doctors or physician’s assistants. The most common CPT code utilized was 97530 (Therapeutic Activities, one-on-one, each 15 minutes), and most of the International Classification of Diseases, 10th Revision (ICD-10) diagnostic codes were based on specific diagnoses rather than general clinical needs. In most of the cases, reimbursement of music therapy was ongoing, and services incorporated a variety of music therapy methods, with few specific music interventions identi- fied. Most notably, reimbursement practice varied by state; thus, we recommend the creation and dissemination of state-specific surveys

A PILOT STUDY INVESTIGATING VETERAN IDENTITY USING THE PHOTOVOICE TECHNIQUE IN A QUALITATIVE, COMMUNITY-BASED PARTICIPATORY ACTION RESEARCH FRAMEWORK**

Veteran identity has been defined as a veteran’s self-concept that derives from their military experience within a sociohistorical context. Reintegration into civilian life can be difficult, experiencing a “reverse culture shock” that can negatively impact many interpersonal relationships and result in experiencing negative feelings such as helplessness, isolation, and emotional disconnection. Understanding how veterans define themselves in their civilian lives can give us insight that could bridge the gaps between them and their available support systems. We utilized a qualitative, community-based participatory action research (CbPAR) model where veterans are empowered to use their voices to tell their stories and researchers serve to help communicate their stories to the community. We are using the photovoice technique where Veterans take pictures that represent the answer to the following prompt: What does being a veteran mean to you? This study is part of a larger project using photovoice and lyric analysis to help define the “sights and sounds” of veteran identity. Our Veterans will then be interviewed individually where they are asked questions to help the researchers understand the symbolism of the images relating to the prompt for them. Transcripts of the interviews are being analyzed to uncover common themes and elements that represent a definition of veteran identity. Preliminary results of these analyses will be discussed after completion of our member-checking process, which helps establish external validity within the community. Our next aim is to present the images and our results in an immersive, interactive gallery experience to allow for the veterans’ stories to be told. We argue that without more emphasis on qualitative, CbPAR methodologies, research with special and/or marginalized populations, like veterans, will continue to be more exploitative than beneficial and will further reinforce the distrust in scientists and clinicians already experienced by many in these populations

A PILOT STUDY EXPLORING VETERAN IDENTITY USING LYRIC ANALYSIS IN A QUALITATIVE, COMMUNITY-BASED PARTICIPATORY ACTION RESEARCH FRAMEWORK**

Researchers attempt to define what it means to be a veteran, but it is rare for that question to be directly asked of veterans. Traditionally, experimenters define variables and ask the community of interest (CoI) to provide responses without the CoI being included in the research process or reaping any direct benefit from participation. There is a high degree of distrust and disenfranchisement reflected in veterans towards the mental health care system and the scientific community. We aim to use the CbPAR model to amplify their voices and focus on what is important to them. We are seeking to allow veterans to define their identity in their own words. Researchers serve as messengers to help amplify veteran voices and disseminate their stories to the larger community. In the current study, we asked veterans to identify songs that answered the question, “What does being a veteran mean to you?” This study is part of a larger research project using both photovoice and lyric analysis to help define the “sights and sounds” of veteran identity. Veterans worked individually with researchers through the process of lyric analysis, which is a music therapy intervention in which the client and therapist listen to a song together and discuss the connection the lyrics have to the client’s life experiences. Transcripts of interviews will be analyzed to uncover common themes and elements that help researchers understand how they conceptualize their community identity as veterans. External validity is addressed through member checking, in which participants will review transcripts, discuss identified themes, and choose representative songs to present as a part of an immersive, interactive gallery experience for the community to allow for their stories to be told. We assert that more research should be done with the veteran community, not to them