Assistive and Augmentative Communication: Ethics and Possibilities in Music Therapy with Non-Speaking clients

Music therapy is a healthcare field wherein music experiences and the myriad relationships formed between client(s), board-certified music therapist(s), and music activates health-oriented changes (Bruscia, 2014). Within this field there are multiple facets that directly impact the client’s experiences; these include: arrangement of the therapy environment, role and function of music experiences, therapeutic relationships, and communication in verbal and non-verbal forms. However, there is a gap in the education and training of music therapists concerning alternatives to verbal communication, and the use of these alternatives in therapy. Through interviews and analysis, this thesis presents findings regarding the experiences of one non-speaking music therapy participant, and three board certified music therapists with relevant expertise, to empower professional and student music therapists to advance their engagement with non-speaking clients in music therapy

Social Media Polarization and the Ministry of Reconciliation

Online communication is becoming increasingly divisive. This dissertation argues that the best way for individuals to decrease social media polarization is for people to engage in the ministry of reconciliation in their social media interactions. Section One describes how social media polarizes because the medium promotes networked individualism, exaggerates dehumanizing “discarnate” communication and numbs humanity’s ability to form meaningful relationships. The left-brain focused argumentation, writing-centered communication and depersonalized nature of online interactions increase a lack of empathy in social media users and add to the polarizing chaos evident in many social media conflicts. Section Two examines how individuals have unsuccessfully tried to address the increased polarization of social media through employing non-relational, information-based solutions; engaging in increased argumentative partisan behaviors; embracing ideological segmentation and adopting conflict avoidance and disengagement practices. Section Three proposes how to facilitate social media reconciliation through (1) developing a Christ-centered theology of reconciliation; (2) advocating online reconciliation that addresses the unique challenges of the medium of social media and (3) utilizing Brenda Salter McNeil’s Roadmap to Reconciliation as a guide to internet conflict resolution. Section Four describes the artifact, a non-fiction book entitled, Angry, Polarizing People: Communicating Truth in the Social Media Age, that will help readers communicate in a way that promotes reconciliation. Section Five articulates the artifact’s specifications

Dionysus

The manuscript below is an amalgamation of farce with the purpose of exploring a character within an inescapable existence. Indeed, the narrator is so deep in the trench that he has been manipulated twice over at a two-fold distance from the thesis writer. First, the narrator’s story is being retold by the narrator himself from memory, then he employs the story-within-a-story cliché by placing this retelling in a narrative which he wrote on a collection of notecards. After this, the notecards themselves have been rearranged to an uncertain degree by a Professor of Philosophy somewhere in Florida after the notecards were delivered to the scholar’s office in Miami. It is possible that the professor, aptly named Apollo Bartholomew, has rewritten entire portions of the text considering he took the liberty of inserting himself into the epilogue and advertising for his own books throughout the text. When he completed his work—or, rather, when he gave-up, since he could no longer go on—he sent it all to the thesis writer who further edited the script for thesis submission. All this to exaggerate the first narrator’s sense of entrapment. There is no way out—not even from his existence within a text. Dionysus is a tricky character whose presence is never given the weight he would perhaps prefer to have. One finds that the mischievous puppet continually inserts himself in places in order to draw the attention of spectators—a desire which is understandable, coming, as he has, from the intense social setting of Ben Jonson’s play Bartholomew Fair where Dionysus (or Dionysius, as he is called in Jonson) achieved his audience. One can therefore assume Dionysus was, at one point, in search of this missing audience from which the thesis writer/Apollo/the narrator has so violently seized him. Now, with the understanding that this audience is no longer achievable—an Elizabethan audience? In today’s climate? History would not allow such a thing!—Dionysus contents himself like a spouse in a marriage full of resentment to play his games with the narrator as though to torture whose-ever genderless wrist he can get his skirt around (the narrator is quite keen on cutting off his own genitalia, though this is not the only reading in which gender inescapability possible in this text). It is unclear whether or not this was an original choice of the narrator, if Dionysus actually existed, if Apollo inserted him for proportion, or if the thesis writer included him so he had a reason to call the thesis Dionysus

Fenretinide induces autophagic cell death in caspase-defective breast cancer cells

The elimination of tumor cells by apoptosis is the main mechanism of action of chemotherapeutic drugs. More recently, autophagic cell death has been shown to trigger a nonapoptotic cell death program in cancer cells displaying functional defects of caspases. Fenretinide (FenR), a synthetic derivative of retinoic acid, promotes growth inhibition and induces apoptosis in a wide range of tumor cell types. The present study was designed to evaluate the ability of fenretinide to induce caspase-independent cell death and to this aim we used the human mammary carcinoma cell line MCF-7, lacking functional caspase-3 activity. We demonstrated that in these cells fenretinide is able to trigger an autophagic cell death pathway. In particular we found that fenretinide treatment resulted in the increase in Beclin 1 expression, the conversion of the soluble form of LC3 to the autophagic vesicle-associated form LC3-II and its shift from diffuse to punctate staining and finally the increase in lysosomes/autophagosomes. By contrast, caspase-3 reconstituted MCF-7 cell line showed apoptotic cell death features in response to fenretinide treatment. These data strongly suggest that fenretinide does not invariably elicit an apoptotic response but it is able to induce autophagy when apoptotic pathway is deregulated. The understanding of the molecular mechanisms involved in fenretinide action is important for the future design of therapies employing this retinoid in breast cancer treatment

Treatment Expectations for CAM Interventions in Pediatric Chronic Pain Patients and their Parents

Patient expectations regarding complementary and alternative medicine (CAM) interventions have important implications for treatment adherence, attrition and clinical outcome. Little is known, however, about parent and child treatment expectations regarding CAM approaches for pediatric chronic pain problems. The present study examined ratings of the expected benefits of CAM (i.e. hypnosis, massage, acupuncture, yoga and relaxation) and conventional medicine (i.e. medications, surgery) interventions in 45 children (32 girls; mean age = 13.8 years ± 2.5) and parents (39 mothers) presenting for treatment at a specialty clinic for chronic pediatric pain. Among children, medications and relaxation were expected to be significantly more helpful than the remaining approaches (P < 0.01). However, children expected the three lowest rated interventions, acupuncture, surgery and hypnosis, to be of equal benefit. Results among parents were similar to those found in children but there were fewer significant differences between ratings of the various interventions. Only surgery was expected by parents to be significantly less helpful than the other approaches (P < 0.01). When parent and child perceptions were compared, parents expected hypnosis, acupuncture and yoga, to be more beneficial than did children, whereas children expected surgery to be more helpful than did parents (P < 0.01). Overall, children expected the benefits of CAM to be fairly low with parents' expectations only somewhat more positive. The current findings suggest that educational efforts directed at enhancing treatment expectations regarding CAM, particularly among children with chronic pain, are warranted

Identification of a novel population of Langerin+ dendritic cells

Langerhans cells (LCs) are antigen-presenting cells that reside in the epidermis of the skin and traffic to lymph nodes (LNs). The general role of these cells in skin immune responses is not clear because distinct models of LC depletion resulted in opposite conclusions about their role in contact hypersensitivity (CHS) responses. While comparing these models, we discovered a novel population of LCs that resides in the dermis and does not represent migrating epidermal LCs, as previously thought. Unlike epidermal LCs, dermal Langerin+ dendritic cells (DCs) were radiosensitive and displayed a distinct cell surface phenotype. Dermal Langerin+ DCs migrate from the skin to the LNs after inflammation and in the steady state, and represent the majority of Langerin+ DCs in skin draining LNs. Both epidermal and dermal Langerin+ DCs were depleted by treatment with diphtheria toxin in Lang-DTREGFP knock-in mice. In contrast, transgenic hLang-DTA mice lack epidermal LCs, but have normal numbers of dermal Langerin+ DCs. CHS responses were abrogated upon depletion of both epidermal and dermal LCs, but were unaffected in the absence of only epidermal LCs. This suggests that dermal LCs can mediate CHS and provides an explanation for previous differences observed in the two-model systems

CELL DEATH AND AUTOPHAGY: CYTOKINES, DRUGS, AND NUTRITIONAL FACTORS

Cellsmay use multiple pathways to commit suicide. In certain contexts, dying cells generate large amounts of autophagic vacuoles and clear large proportions of their cytoplasm, before they finally die, as exemplified by the treatment of human mammary carcinoma cells with the anti-estrogen tamoxifen (TAM, ≤1 M). Protein analysis during autophagic cell death revealed distinct proteins of the nuclear fraction including GST- and some proteasomal subunit constituents to be affected during autophagic cell death. Depending on the functional status of caspase-3, MCF-7 cells may switch between autophagic and apoptotic features of cell death [Fazi, B., Bursch,W., Fimia, G.M., Nardacci R., Piacentini, M., Di Sano, F., Piredda, L., 2008. Fenretinide induces autophagic cell death in caspase-defective breast cancer cells. Autophagy 4(4), 435–441]. Furthermore, the self-destruction of MCF-7 cells was found to be completed by phagocytosis of cell residues [Petrovski, G., Zahuczky, G., Katona, K., Vereb, G., Martinet,W., Nemes, Z., Bursch,W., Fésüs, L., 2007. Clearance of dying autophagic cells of different origin by professional and non-professional phagocytes. Cell Death Diff. 14 (6), 1117–1128]. Autophagy also constitutes a cell’s strategy of defense upon cell damage by eliminating damaged bulk proteins/organelles. This biological condition may be exemplified by the treatment of MCF-7 cells with a necrogenic TAM-dose (10 M), resulting in the lysis of almost all cells within 24 h. However, a transient (1 h) challenge of MCF-7 cells with the same dose allowed the recovery of cells involving autophagy. Enrichment of chaperones in the insoluble cytoplasmic protein fraction indicated the formation of aggresomes, a potential trigger for autophagy. In a further experimental model HL60 cells were treated with TAM, causing dose-dependent distinct responses: 1–5 MTAM, autophagy predominant; 7–9 M, apoptosis predominant; 15 M, necrosis. These phenomena might be attributed to the degree of cell damage caused by tamoxifen, either by generating ROS, increasing membrane fluidity or forming DNA-adducts. Finally, autophagy constitutes a cell’s major adaptive (survival) strategy in response to metabolic challenges such as glucose or amino acid deprivation, or starvation in general. Notably, the role of autophagy appears not to be restricted to nutrient recycling in order to maintain energy supply of cells and to adapt cell(organ) size to given physiological needs. For instance, using a newly established hepatoma cell line HCC-1.2, amino acid and glucose deprivation revealed a pro-apoptotic activity, additive to TGF- 1. The proapoptotic action of glucose deprivation was antagonized by 2-deoxyglucose, possibly by stabilizing the mitochondrial membrane involving the action of hexokinase II. These observations suggest that signaling cascades steering autophagy appear to provide links to those regulating cell number. Taken together, our data exemplify that a given cell may flexibly respond to type and degree of (micro)environmental changes or cell death stimuli; a cell’s response may shift gradually from the elimination of damaged proteins by autophagy and the recovery to autophagic or apoptotic pathways of cell death, the failure of which eventually may result in necrosis