Effectiveness of music therapy for autism spectrum disorder, dementia, depression, insomnia and schizophrenia: Update of systematic reviews

Background Music therapy (MT) aims at maintaining, restoring and furthering physical/emotional/mental health. This review assesses effectiveness of MT and its methods for autism spectrum disorder (ASD), dementia, depression, insomnia and schizophrenia. Methods A search for systematic reviews and health technology assessment reports was conducted and yielded 139 hits. Given the large amount, we focused on five frequent diagnostic groups with available Cochrane reviews. A second search was conducted in four databases. Two authors independently performed study selection, data extraction and assessed methodological quality. Only trials with moderate/low risk of bias (RoB) were selected. Results Ten randomized controlled trials (1.248 participants) met inclusion criteria. For schizophrenia, no studies with low/moderate RoB were found; therefore, updating was not possible. The Cochrane authors stated that quality of life (QoL), social functioning, global/mental state improved for schizophrenia, but not global functioning. For ASD, MT improved behaviour, social communication, brain connectivity and parent–child relationship. For depression, mood was enhanced, and for insomnia, sleep quality, stress, anxiety, total sleep time, disease severity and psychological QoL improved. MT positively affected mood, neuropsychiatric behaviour, apathy, communication and physical functions for dementia; behavioural/psychological symptoms improved only in severe, and memory and verbal fluency only in mild Alzheimer’s disease. Cognition improved for dementia in one of four studies. Both active (playing music) and receptive (listening to music) methods were used for dementia, whereas for ASD and depression, active methods were applied. For insomnia, only receptive methods were used. Conclusion These findings provide evidence that MT helps patients improving their physical/psychosocial health. More research investigating long-term effects is needed.publishedVersio

Social innovations in tourism: Analysing processes, actors, and tipping points.

Social innovations consist of new forms of cooperation of individ- uals or organisations and they provide new solutions to societal problems. they typically evolve along three phases and have the potential to solve region-specific challenges. in the operating phase, social innovations can overcome the so-called tipping point. the tipping point is an elusive moment at which the social inno- vation can begin to spread or at which it could also fail. to exam- ine the social innovation characteristics that contribute to overcome tipping points and to identify the role and motivations of actors to participate in the process of developing social innovations in tourism, we applied innovation biographies to seven social inno- vations in a swiss mountain region. Data were drawn from 29 interviews with the involved actors. Our results show that social innovations in tourism that overcame the tipping point fulfil three conditions: First, new actors join the social innovations in the operating phase. second, all the actors involved benefit from the social innovation for their own business strategy. third, the social innovation is accepted in the region and among the actors involved and therefore does not face strong headwinds. Furthermore, developers, supporters, and promoters are important throughout the entire social innovation process. the findings sug- gest the need for a more comprehensive understanding of inno- vations in tourism that incorporates the complexity of different actors involved

Personenzentrierte Pflege

Die vorliegende Arbeit geht der Frage nach, warum es schwierig ist psychosoziale Konzepte in die Praxis zu implementieren. Es wird dabei in den Gesundheits- und Krankenpflegebereich hineingegangen und geschaut, welche Störfaktoren eine Umsetzung erschweren oder verhindern können. Zu den zentralen Aussagen gehören, dass (a) das Pflegeparadigma und dessen geschichtliche Entwicklung, (b) die Gesundheits- und Krankenpflegeausbildung, (c) persönliche Ressourcen und Kompetenzen des Pflegepersonals, (d) klinische Rahmenbedingungen und (e) der Patient/die Patientin einen blockierenden Einfluss auf eine Implementierung nehmen können.The present thesis is trying to scrutinize why it is so difficult to put psychosocial conceptions into practice. I will investigate the specific field of nursing to look for aspects, which make it difficult or hinder an implementation. Central propositions are: (a) The care paradigm and its historical development, (b) nursing school, (c) personal resources and social skills of the nursing staff, (d) clinical conditions and (e) cases of patients’ implementation blockages

Lebensrettende Sofortmaßnahmen „neu”

Für das Überleben eines Herzstillstandes haben Ersthelfermaßnahmen eine entscheidende Bedeutung. Untersuchungen belegen wiederum, dass sich Ersthelfer häufig nicht zutrauen Erste Hilfe zu leisten. Das liegt zum einen an der Angst davor, bei fehlerhafter Hilfeleistung belangt zu werden, zum anderen daran, dass die Helfer Angst haben etwas falsch zu machen und dem Patienten dadurch Schaden zuzufügen (Völker, 2010). In einer verblindeten Studie wurde im Rahmen des Kurses „Lebensrettende Sofortmaßnahmen am Unfallort“ ein neues Kursdesign mit dem bisherigen Kursdesign verglichen. Sechs Monate nach dem Abschluss des Kurses wurden die fiktive Bereitschaft zur Hilfeleistung der Teilnehmer und ihre Fertigkeiten in der Herz-Lungen-Wiederbelebung, der Stillung einer starken Blutung und der stabilen Seitenlage evaluiert. An der Studie nahmen 66 Personen mit einem mittleren Alter von 22,0 ± 2,0 Jahren und einem männlichen Anteil von 48% teil. Die Teilnehmer der Interventionsgruppe schätzten ihr Sicherheitsgefühl hinsichtlich der Bewältigung einer realen Situation eines Atem-Kreislaufstillstandes signifikant höher ein als die Teilnehmer der Kontrollgruppe (VAS: 57 vs. 41 mm). Die Teilnehmer der Interventionsgruppe begannen signifikant früher (nach 25 vs. 36 Sekunden) mit der Herzdruckmassage. Die Zeit bis zur ersten Defibrillation war ebenfalls in der Interventionsgruppe signifikant kürzer (nach 86 vs. 92 Sekunden). Die Interventionsgruppe führte häufiger Schock- bekämpfungsmaßnahmen durch. Bei den übrigen Qualitätsmerkmalen der Herzlungenwiederbelebung ergaben sich keine signifikanten Unterschiede. Weder beim Szenario „starke Blutung“, noch bei der stabilen Seitenlage konnten signifikante Unterschiede zwischen den beiden Gruppen festgestellt werden. Das Projekt „Lebensrettende Sofortmaßnahmen neu“ hat gezeigt, dass ein verändertes Kursdesign Einfluss, sowohl auf die Motivation Erste Hilfe zu leisten, als auch auf die Qualität der geleisteten Maßnahmen hat. Ein wichtiger Schritt gute Ersthelfer auszubilden könnte es also sein, den Unterricht für Erste Hilfe zu überarbeiten. Hier scheint vor allem die Minimierung theoretischer Inhalte auf das Notwendigste bei gleichzeitiger Ausdehnung der praktischen Übungseinheiten wesentlich zu sein. Darüber hinaus könnte der Einsatz verschiedener Medien, eine lockere, professionelle Atmosphäre und positives Feedback die Lernerfolge verbessern.For the survival of a cardiac arrest, first aid measures have an essential role. Studies have shown that first aiders often do not rely themselves to give first aid. On the one hand this is due to the fear of being prosecuted for faulty performance, on the other hand to the fear of doing something wrong and harming the patient thereby. The blinded study was conducted as part of the course, "life-saving emergency measures at the scene of an accident" a new course design compared with the established course design. Six months after the completion of the course the notional willingness to assist the participants and their skills in cardiopulmonary resuscitation, the managing of severe bleeding and the recovery position has been evaluated. The study included 66 people, participated with a mean age of 22.0 ± 2.0 years and a male part share of 48%. The participants of the intervention group estimated their security feeling, concerning the coping of a real situation of a cardiac arrest significantly higher than the participants of the control group (VAS: 57 versus 41 mm). Participants in the intervention group started significantly earlier (by 25 vs. 36 seconds) with chest compressions. The time to first defibrillation was also significantly shorter in the intervention group (after 86 vs. 92 seconds). The intervention group performed more frequently by shock-control measures. For the other quality characteristics of cardiopulmonary resuscitation, there were no significant differences. Neither at the scenario "severe bleeding", nor the “recovery position”, significant differences between the two groups are found. The project „life-saving emergency measures new“ has shown, that a changed course design influence the motivation to give first aid, as well as on the quality of the performed measures. An important step to educate good first aiders could be the revision of the lessons for first aid trainings. Therefor the minimisation of theoretical contents on the most necessary seems to be essential, by concurrent expansion of practical units. In addition to the application of different media, a loose, professional ambience and positive feedback could amend the learner's results

Change agency in social innovation: an analysis of activities in social innovation processes

We examine the role of change agency in social innovations. Agency in social innovations can create new resources and capacities for transformative change in a region. To date, there is a lack of empirical studies investigating how agency manifests itself in social innovations. In particular, research has not yet investigated the detailed activities of social innovation actors throughout the phases of social innovation processes. In this paper we apply the concept of trinity of change agency to investigate the activities of social innovation actors. Using innovation biographies and data from 61 interviews for 11 case studies of social innovation in a peripheral mountain region in Switzerland, we analyse the social innovation process from an actor-oriented perspective. Our findings show that the various types of change agency are highly present in social innovations. The significance of change agency alters throughout the innovation process. Our analysis shows that all kinds of actors performed change agency during the social innovation process. Interestingly, same actors performed different types of change agency during the social innovation process. The findings suggest that change agency is as a significant element in social innovations and that we need to consider it as a transformative element of social innovation processes. When policymakers take change agency into account in creating an environment in which social innovations can flourish, there is a great chance that social innovations can contribute to changing regional development paths and perhaps even to regional transformation

Sunlight-powered kHz rotation of a hemithioindigo-based molecular motor

Photodriven molecular motors are able to convert light energy into directional motion and hold great promise as miniaturized powering units for future nanomachines. In the current state of the art, considerable efforts have still to be made to increase the efficiency of energy transduction and devise systems that allow operation in ambient and non-damaging conditions with high rates of directional motions. The need for ultraviolet light to induce the motion of virtually all available light-driven motors especially hampers the broad applicability of these systems. We describe here a hemithioindigo-based molecular motor, which is powered exclusively by nondestructive visible light (up to 500 nm) and rotates completely directionally with kHz frequency at 20 degrees C. This is the fastest directional motion of a synthetic system driven by visible light to date permitting materials and biocompatible irradiation conditions to establish similarly high speeds as natural molecular motors

Tocopherol and plastoquinone synthesis in spinach chloroplasts subfractions

Subfractions isolated from intact purified spinach chloroplasts are able to prenylate the aromatic moiety of -tocopherol and plastoquinone-9 precursors. The biosynthesis of -tocopherol and plastoquinone-9 is a compartmentalized process. The chloroplast envelope membranes are the only site of the enzymatic prenylation in -tocopherol synthesis whereas the thylakoid membrane is also involved in the prenylation and methylation sequence of plastoquinone-9 biosynthesis. A very active kinase which forms phytyl-PP is localized in the stroma. Phytol but not geranylgeraniol is the polyprenol precursor of the side chain of -tocopherol in spinach chloroplasts

A Non-Motor Microtubule Binding Site Is Essential for the High Processivity and Mitotic Function of Kinesin-8 Kif18A

BACKGROUND: Members of the kinesin-8 subfamily are plus end-directed molecular motors that accumulate at the plus-ends of kinetochore-microtubules (kt-MTs) where they regulate MT dynamics. Loss of vertebrate kinesin-8 function induces hyperstable MTs and elongated mitotic spindles accompanied by severe chromosome congression defects. It has been reported that the motility of human kinesin-8, Kif18A, is required for its accumulation at the plus tips of kt-MTs. METHODOLOGY/FINDINGS: Here, we investigate how Kif18A localizes to the plus-ends of kt-MTs. We find that Kif18A lacking its C-terminus does not accumulate on the tips of kt-MTs and fails to fulfill its mitotic function. In vitro studies reveal that Kif18A possesses a non-motor MT binding site located within its C-proximal 121 residues. Using single molecule measurements we find that Kif18A is a highly processive motor and, furthermore, that the C-terminal tail is essential for the high processivity of Kif18A. CONCLUSION/SIGNIFICANCE: These results show that Kif18A like its yeast orthologue is a highly processive motor. The ability of Kif18A to walk on MTs for a long distance without dissociating depends on a non-motor MT binding site located at the C-terminus of Kif18A. This C-proximal tail of Kif18A is essential for its plus-end accumulation and mitotic function. These findings advance our understanding of how Kif18A accumulates at the tips of kt-MTs to fulfill its function in mitosis

Prospective study on complications using different techniques for parotidectomy for benign tumors

OBJECTIVES: Long‐term prospective studies on procedure‐related complications after parotid surgery for benign neoplasms (BNs) are scarce. This is the first prospective study on the use of extracapsular dissection (ECD) for BNs, and it aimed to examine the incidence of postoperative complications after parotid surgery for BN. METHODS: We collected data obtained in a prospective study of parotidectomy for BN at a university hospital and analyzed the transient and long‐term complications. RESULTS: The incidence rates of transient facial palsy immediately and 18 months after surgery were 15.0% and 3.7%, respectively. The rates of immediate postoperative facial palsy in patients who underwent ECD, partial superficial, superficial, and total parotidectomy were 5.8%, 29.3%, 20.0%, and 44.1%, respectively. Significant risk factors for facial palsy included multiple and larger lesions as well as surgery duration and extension. CONCLUSIONS: Postoperative facial palsy remains a common complication after parotidectomy for BN and is associated with the extent of parotidectomy, presence of multiple neoplasms, and operative duration. The results of this study showed that ECD could be a safe technique for avoiding facial palsy. Level of Evidence: 2