Genomic investigations of unexplained acute hepatitis in children

Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children

Between Lines: A Critical Multimodal Discourse Analysis of Black Aesthetics in a Vocal Music Therapy Group for Chronic Pain

The purpose of this study was to gain an understanding of Black clients’ experiences within a music therapy context by exploring the discursive construction of aesthetics demonstrated by Black members of a vocal music therapy (VMT) group for chronic pain. For this purpose, the theoretical framework of critical race theories and Africana womanism guided this study, and a critical multimodal discourse analysis was employed as the primary methodological tool. Three primary research questions guided this study: What were the aesthetic experiences of the Black members of the VMT chronic pain group? What was the role of black lifeworlds (musical representations and cultural representations) in Black clients’ aesthetics experiences? What was the function of Black client aesthetics in the VMT group experience? Secondary data of another research study, namely video data obtained in a clinical trial on the effect of vocal music therapy (VMT) on core outcomes in chronic pain management, served as the primary data source for this analysis. The video data documented an eight-week group VMT treatment program, in which six Black individuals with chronic pain, five females and one male, and one white female participated in vocal music therapy techniques such as toning, group singing, vocal improvisation often accompanied with percussion instruments, song reflection, and deep breathing to address core outcomes of chronic pain. These sessions were facilitated by the white music therapist and principal investigator of the clinical trial and assisted by me, her Black research assistant. This analysis evidenced Black clients’ agency-driven aesthetic exploration of Black language and Black musical representations within a music therapy context. In so doing, the VMT group context is revealed as a racially patterned social activity marked by performances of alterity mobilized through Black participants’ aestheticization of personhood. The analysis detailed the social realities co-constructed by the Black participants vis-à-vis non-monolithic experiences of Black language and Black vernacular music as processed through cultural memory and the inherently subordinate nature of therapy. This was demonstrated in four aesthetic formations: (a) (pre)embodied pain aesthetics, evidenced by participants' portrayals of agency within the intersection of socio-historical, socio-structural, and socio-cultural systems of chronic pain and healthcare disparity discourse; (b) Black language aesthetics, revealed in mono- and cross-racial verbal and prosodic communication; (c) healing aesthetics, delineated by participants' spiritual negotiations within a model of medical music therapy; and (d) musicking aesthetics, detailed by the use and situated meaning of Black musical gestures referentially used within music therapy theory and praxis. These findings detailed Black verbal and musical iconicity, client face-saving practices, individual and collective responses to microaggressions and their impact on the therapeutic process exhibited verbally and nonverbally, in-group tensions, the protective function of spiritual coping, paraxial tensions between medical and culturally centered healing practices, and aesthetic relevance of ethnocentricity within the VMT program. The findings of this analysis detailed the sensorial, relational, imaginal, and political nature of aesthetic discourse and served as the first systematic exploration of aesthetic processes of Black participants in the field of music therapy. Furthermore, this research discussed the widely understudied experience of chronic pain by Black participants, as both physical and psychological phenomena. In so doing, it provided a synthesis of Black client narratives that further contribute to the growing knowledge of culturally responsive clinical practice within music therapy and related healthcare disciplines, as well as the collective discourse of Black bodies within cultural aesthetics, semiotic anthropology, and Africana studies. Given the nature of the findings, implications for future research, clinical practice, and music therapy cultural competence development are provided.Ph.D., Creative Arts in Therapy -- Drexel University, 201

A Call for Radical Imagining: Exploring Anti-Blackness in the Music Therapy Profession

This spotlight presentation explores the relationship between anti-Black violence and music therapy. Centering the recent deaths of Ahmaud Arbery, Breonna Taylor, Sean Reed, George Floyd, and Tony McDade, the speaker discusses protests taking place in the United States and throughout the world that demand justice for Black lives. In this presentation, the speaker discusses the interconnectedness of physical and social death as a continuum of oppression the field must contend with to meet social justice aims. Music therapy across the globe is situated within complex socio-political, socio-structural, socio-historical, and socio-cultural systems. It holds the vestiges of White European settler colonialism and is founded upon dominant cultural values and ideals that support its existence and simultaneously benefit and harm client communities. While, as a professional body, we aim to deepen music therapy access and conceptualize empowerment from a social justice frame, we must explore the various ways music therapy leverages proximations of power. Any calls for access and empowerment in music therapy amplify our existence within unjust systems and our participation in their perpetuation in education, theory, research, practice, and praxis. The speaker explores anti-Blackness from a Black feminist lens and discusses the radical repositioning of music therapy as we collectively strive to meet social justice aims

Freedom Dreams: What Must Die in Music Therapy to Preserve Human Dignity?

This commentary was written on the week of September 28, 2020, as grand jury decisions on the killing of Breonna Taylor in Louisville, Kentucky, United States, were publicly announced on news and media outlets. Six months after Breonna Taylor's brutal murder in Louisville, Kentucky (United States), justice for her life has not been actualized. The author reflects on this injustice and discusses its relationship to anti-Black violence and systemic oppression in music therapy culture and practice. &nbsp

Black Aesthetics

Editorial for Special Issu

Interview-Transkript von Black Music Matters und dem Black Messiah Album

Abstract  In einem Audio-Interview bespricht Adrian Dunn sein Album The Black Messiah mit Leah Gipson und Marisol Norris. Als Kommentar zum religiösen Leben in den USA wurde die Musik erstmals in dem Jahr aufgeführt, in dem Donald Trump zum Präsidenten gewählt wurde - als Widerstand gegen den vorherrschenden, weißen, christlichen Nationalismus und gegen Hassreden. Dunn versuchte, diese Geschichte in einem Album zu bewahren. Dunn erklärt, dass The Black Messiah die Befreiung und Gerechtigkeit der Schwarzen bestärkt und sieht die Verantwortung dafür bei jedem einzelnen als das Werk der humanen Gemeinschaft. Die Diskussion reflektiert über amerikanische Musiktraditionen, Narrative, schwarze Spiritualität und eine integrale Beziehung zwischen Musik und Freiheit. In an audio interview, Adrian Dunn, discusses his album, The Black Messiah, with Leah Gipson and Marisol Norris. As a commentary on religious life in the U.S., the music was initially performed the year that Donald Trump was elected president in resistance to dominant, white Christian nationalism and hate speech. Dunn sought to preserve this history in an album. Dunn explains that The Black Messiah affirms Black liberation and justice, and situates responsibility with all persons as the work of a shared humanity. The discussion reflects on American musical traditions, narratives, Black spirituality, and an integral relationship between music and freedom

Three Black Women’s Reflections on COVID-19 and Creative Arts Therapies

COVID-19 has revealed underlying social inequities that disproportionately impact Black communities. This commentary offers three different reflections by creative arts therapists on this critical moment of widespread protest, organizing and demands for justice led by Black activists worldwide.&nbsp

What are You All Going to Do to Keep Black Women in Art Therapy?

In this viewpoint, the authors describe their impressions of a 2018 conference and the significance of participating in a learning environment that centered on arts therapists of color. Collectively, two art therapy educators, a music therapy educator, one new professional art therapist, and one art therapy graduate student, question the maintenance of professional norms that have at times motivated BIPOC students and practitioners to leave the creative arts therapies in search of other professional places to thrive. The article concludes with a Womanist Manifesto for Arts Therapies Education.Abstract  In questa prospettiva, gli autori descrivono le loro impressioni su una conferenza del 2018 e l'importanza di partecipare a un ambiente di apprendimento incentrato sugli arteterapeuti di colore. Collettivamente, due educatori di arteterapia, un educatore di musicoterapia, un nuovo arteterapeuta professionista e uno studente laureato in arteterapia, mettono in dubbio il mantenimento di norme professionali che talvolta motivano studenti e professionisti BIPOC a lasciare le artiterapie creative in cerca di altre strade professionali in cui prosperare. L'articolo si conclude con un Manifesto ‘Womanist’ per le artiterapie educative. Abstract  In diesem Standpunkt beschreiben die AutorInnen ihre Eindrücke von einer Konferenz im Jahr 2018 und die Bedeutung der Teilnahme an einer Lernumgebung, die sich auf KunsttherapeutInnen of Color konzentrierte. Gemeinsam hinterfragen zwei Kunsttherapie-AusbilderInnen, ein/e Musiktherapie-AusbilderIn, ein gerade ausgelernte/r KunsttherapeutIn und ein/e Kunsttherapie-StudentIn die Aufrechterhaltung berufsbezogener Normen, die BIPOC*-Studenten und -Praktiker zeitweise motiviert haben, die künstlerischen Therapien auf der Suche nach anderen beruflichen Wegen zu verlassen, um Erfolg zu haben. Der Artikel schließt mit dem „Womanist Manifesto for Arts Therapies Education“.  * Black, Indigenous and People of Color (Schwarze und Indigene Menschen sowie Menschen of Color)&nbsp

Vocal Music Therapy for Chronic Pain Management in Inner-city African Americans: A Mixed Methods Feasibility Study

To date, research on music for pain management has focused primarily on listening to prerecorded music for acute pain. Research is needed on the impact of active music therapy interventions on chronic pain management. [PUBLICATION ABSTRACT

Are mHealth Interventions to Improve Child Restraint System Installation of Value? A Mixed Methods Study of Parents

Childhood death from vehicle crashes and the delivery of information about proper child restraint systems (CRS) use continues to be a critical public health issue. Safe Seat, a sequential, mixed-methods study identified gaps in parental knowledge about and perceived challenges in the use of appropriate CRS and insights into the preferences of various technological approaches to deliver CRS education. Focus groups (eight groups with 21 participants) and a quantitative national survey (N = 1251) using MTurk were conducted. Although there were differences in the age, racial/ethnic background, and educational level between the focus group participants and the national sample, there was a great deal of consistency in the need for more timely and personalized information about CRS. The majority of parents did not utilize car seat check professionals although they expressed interest in and lack of knowledge about how to access these resources. Although there was some interest in an app that would be personalized and able to push just-in-time content (e.g., new guidelines, location and times of car seat checks), content that has sporadic relevance (e.g., initial installation) seemed more appropriate for a website. Stakeholder input is critical to guide the development and delivery of acceptable and useful child safety education