Musical Leadership and Societal Transformation: Inspiration and Courage in Action

Music is a form of leadership. Music-based interventions in organizations and society are being used throughout the world, including in situations of extreme conflict and consequence. Artists are going beyond the dehydrated language of economics, politics, and war to achieve goals that have eluded those using more traditional approaches. This article presents musical interventions in Bosnia-Herzegovina, Cyprus, Estonia, Northern Ireland, the Middle East, South Africa, the United States, and Venezuela, in which musicians have had the inspiration and courage to make a difference.T=The radical shift in the structure of the world begs for creativity; it asks us to rethink who we are as human beings… It may be that writers, painters, and musicians have an unprecedented opportunity to be co-creators with society’s leaders in setting a path. For art, after all, is about rearranging us, creating surprising juxtapositions, emotional openings, startling presences, flight paths to the eternal. —Rosamund and Benjamin Zander (1998, p. 7)2Art transforms apathy into action.3 Social scientist Ken Gergen (1999) invites us all to become “poetic activists” (p. 12). Perhaps there is no better label for the use of musical interventions in global and organizational crises than that of poetic activism. Activists, great artists, and great leaders share three fundamental perspectives (Adler, 2006, 2010, 2011, 2015). They all demonstrate the courage to see reality the way it is. They all exhibit the courage to imagine possibility—positivefutures—even when the world labels such imagination as naïve for daring to express optimism. And they all have the courage to inspire people to move from current reality back to possibility.Over the past half-century, with no singular organized movement or unifying philosophy to guide them, artists and artistic processes have attempted to transform reality in numerous contentious situations. In particular, music has been used to address extreme conflict and the threat of conflict, along with the dysfunction and degradation that conflict so often causes (see Tongeren, 1999; Urbain, 2008; Ippolito, 2008).4 Music, most often when combined with other approaches, appears to have produced generative outcomes in some, although not all, situations in which it has been introduced. In many circumstances, musical interventions have inspired the broader community (see Tongeren, 1999; Welch & LeBaron, 2006; Ippolito, 2008; Cohen, Gutiérrez Varea, & Walker, 2011). Such initiatives exemplify the frame-breaking perspectives and approaches that music has the potential to offer

Liderando com Maestria: Desenvolvendo a Capacidade de Contribuição Significativa

A liderança extraordinária nasce no líder como um todo e não apenas no somatório de suas estratégias e táticas aprendidas, não importa quão bem executadas. O século XXI coloca-nos numa época desafiadora — época que exige uma liderança extraordinária em nível global, nacional, organizacional e comunitário. Para aumentar as possibilidades de líderes empresariais influenciarem o mundo de forma a beneficiar a sociedade e a rentabilidade das empresas, a Universidade de McGill lançou um seminário sobre “A arte da liderança em 2003. O seminário já foi oferecido aos gerentes e executivos na Áustria, Canadá, Dubai, França, Índia, Israel, Japão, Coreia, Holanda, Nova Zelândia, Eslovênia, Suécia, Suíça e Estados Unidos. Resgatando as tradições e processos artísticos, o seminário vai além da gestão tradicional ao focar na compreensão mais profunda da nossa cultura e valorização do “possível”. O seminário foi concebido para desenvolver as capacidades dos participantes de criar, de apoiar e reforçar as organizações economicamente sustentáveis, ao mesmo tempo em que fomenta a criação de uma sociedade mais pacífica, solidária e saudável. Explicitamente, centra-se na liderança, ao invés da gestão, e sobre o desafio imperioso da construção de sentido, em vez da meta mais tradicional do sucesso. O seminário é projetado para aperfeiçoar o líder que há em cada indivíduo, ao invés de utilizar qualquer conjunto particular de técnicas ou ferramentas de liderança

Heterogeneity of diabetes outcomes among asians and pacific islanders in the US: the diabetes study of northern california (DISTANCE).

ObjectiveEthnic minorities with diabetes typically have lower rates of cardiovascular outcomes and higher rates of end-stage renal disease (ESRD) compared with whites. Diabetes outcomes among Asian and Pacific Islander subgroups have not been disaggregated.Research design and methodsWe performed a prospective cohort study (1996-2006) of patients enrolled in the Kaiser Permanente Northern California Diabetes Registry. There were 64,211 diabetic patients, including whites (n = 40,286), blacks (n = 8,668), Latinos (n = 7,763), Filipinos (n = 3,572), Chinese (n = 1,823), Japanese (n = 951), Pacific Islanders (n = 593), and South Asians (n = 555), enrolled in the registry. We calculated incidence rates (means ± SD; 7.2 ± 3.3 years follow-up) and created Cox proportional hazards models adjusted for age, educational attainment, English proficiency, neighborhood deprivation, BMI, smoking, alcohol use, exercise, medication adherence, type and duration of diabetes, HbA(1c), hypertension, estimated glomerular filtration rate, albuminuria, and LDL cholesterol. Incidence of myocardial infarction (MI), congestive heart failure, stroke, ESRD, and lower-extremity amputation (LEA) were age and sex adjusted.ResultsPacific Islander women had the highest incidence of MI, whereas other ethnicities had significantly lower rates of MI than whites. Most nonwhite groups had higher rates of ESRD than whites. Asians had ~60% lower incidence of LEA compared with whites, African Americans, or Pacific Islanders. Incidence rates in Chinese, Japanese, and Filipinos were similar for most complications. For the three macrovascular complications, Pacific Islanders and South Asians had rates similar to whites.ConclusionsIncidence of complications varied dramatically among the Asian subgroups and highlights the value of a more nuanced ethnic stratification for public health surveillance and etiologic research

Obesity and the food environment: income and ethnicity differences among people with diabetes: the Diabetes Study of Northern California (DISTANCE).

ObjectiveIt is unknown whether any association between neighborhood food environment and obesity varies according to individual income and/or race/ethnicity. The objectives of this study were to test whether there was an association between food environments and obesity among adults with diabetes and whether this relationship differed according to individual income or race/ethnicity.Research design and methodsSubjects (n = 16,057) were participants in the Diabetes Study of Northern California survey. Kernel density estimation was used to create a food environment score for each individual's residence address that reflected the mix of healthful and unhealthful food vendors nearby. Logistic regression models estimated the association between the modeled food environment and obesity, controlling for confounders, and testing for interactions between food environment and race/ethnicity and income.ResultsThe authors found that more healthful food environments were associated with lower obesity in the highest income groups (incomes 301-600% and >600% of U.S. poverty line) among whites, Latinos, and Asians. The association was negative, but smaller and not statistically significant, among high-income blacks. On the contrary, a more healthful food environment was associated with higher obesity among participants in the lowest-income group (<100% poverty threshold), which was statistically significant for black participants in this income category.ConclusionsThese findings suggest that the availability of healthful food environments may have different health implications when financial resources are severely constrained

The biological embedding of early-life socioeconomic status and family adversity in children's genome-wide DNA methylation.

AimTo examine variation in child DNA methylation to assess its potential as a pathway for effects of childhood social adversity on health across the life course.Materials & methodsIn a diverse, prospective community sample of 178 kindergarten children, associations between three types of social experience and DNA methylation within buccal epithelial cells later in childhood were examined.ResultsFamily income, parental education and family psychosocial adversity each associated with increased or decreased DNA methylation (488, 354 and 102 sites, respectively) within a unique set of genomic CpG sites. Gene ontology analyses pointed to genes serving immune and developmental regulation functions.ConclusionFindings provided support for DNA methylation as a biomarker linking early-life social experiences with later life health in humans

The Differential Effects of Sleep Quality and Quantity on the Relationship between SES and Health

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73341/1/j.1749-6632.1999.tb08162.x.pd

Hypoglycemia is More Common Among Type 2 Diabetes Patients with Limited Health Literacy: The Diabetes Study of Northern California (DISTANCE)

Little is known about the frequency of significant hypoglycemic events in actual practice. Limited health literacy (HL) is common among patients with type 2 diabetes, may impede diabetes self-management, and thus HL could increase the risk of hypoglycemia. To determine the proportion of ambulatory, pharmacologically-treated patients with type 2 diabetes reporting ≥1 significant hypoglycemic events in the prior 12 months, and evaluate whether HL is associated with hypoglycemia. Cross-sectional analysis in an observational cohort, the Diabetes Study of Northern California (DISTANCE). The subjects comprised 14,357 adults with pharmacologically-treated, type 2 diabetes who are seen at Kaiser Permanente Northern California (KPNC), a non-profit, integrated health care delivery system. Patient-reported frequency of significant hypoglycemia (losing consciousness or requiring outside assistance); patient-reported health literacy. At least one significant hypoglycemic episode in the prior 12 months was reported by 11% of patients, with the highest risk for those on insulin (59%). Patients commonly reported limited health literacy: 53% reported problems learning about health, 40% needed help reading health materials, and 32% were not confident filling out medical forms by themselves. After adjustment, problems learning (OR 1.4, CI 1.1-1.7), needing help reading (OR 1.3, CI 1.1-1.6), and lack of confidence with forms (OR 1.3, CI 1.1-1.6) were independently associated with significant hypoglycemia. Significant hypoglycemia was a frequent complication in this cohort of type 2 diabetes patients using anti-hyperglycemic therapies; those reporting limited HL were especially vulnerable. Efforts to reduce hypoglycemia and promote patient safety may require self-management support that is appropriate for those with limited HL, and consider more vigilant surveillance, conservative glycemic targets or avoidance of the most hypoglycemia-inducing medications

The rate of leukocyte telomere shortening predicts mortality from cardiovascular disease in elderly men

Telomere length (TL) has been proposed as a marker of mitotic cell age and as a general index of human organismic aging. Short absolute leukocyte telomere length has been linked to cardiovascular-related morbidity and mortality. Our aim was to test whether the rate of change in leukocyte TL is related to mortality in a healthy elderly cohort. We examined a subsample of 236 randomly selected Caucasian participants from the MacArthur Health Aging Study (aged 70 to 79 years). DNA samples from baseline and 2.5 years later were assayed for mean TL of leukocytes. Percent change in TL was calculated as a measure of TL change (TLC). Associations between TL and TLC with 12-year overall and cardiovascular mortality were assessed. Over the 2.5 year period, 46% of the study participants showed maintenance of mean bulk TL, whereas 30% showed telomere shortening, and, unexpectedly, 24% showed telomere lengthening. For women, short baseline TL was related to greater mortality from cardiovascular disease (OR = 2.3; 95% CI: 1.0 - 5.3). For men, TLC (specifically shortening), but not baseline TL, was related to greater cardiovascular mortality, OR = 3.0 (95% CI: 1.1 - 8.2). This is the first demonstration that rate of telomere length change (TLC) predicts mortality and thus may be a useful prognostic factor for longevity