A Model of Dance/Movement Therapy for Resilience-building in People Living with Chronic Pain: A Mixed Methods Grounded Theory Study

Awareness of pain as a multifaceted phenomenon is growing and more people are seeking complementary and alternative medicine or psychotherapeutic approaches for chronic pain management. Furthermore, the significance of positive health concepts focusing on individuals’ strength within the context of adversity, such as resilience, has been recognized in chronic pain management. However, contemporary pain management strategies as well as existing resilience models have largely been neglecting a fundamental component of the experience of chronic pain and its rehabilitation, namely embodiment. This study aimed at examining how Dance/Movement Therapy (DMT), an embodiment and enaction-based psychotherapeutic approach, may help people living with chronic pain to foster resilience through the corporeal experience of the moving body. To answer the question, “What theoretical model grounded in qualitative and quantitative data may explain the therapeutic factors and mechanisms of DMT for resilience building in people living with chronic pain?” an innovative multiphase Mixed Methods Grounded Theory (MM-GT) study was developed and conducted. In phase I, a substantive model was generated based on the findings from two sets of data collection and analysis processes, namely meta-modeling and reflexive GT. Based on these findings, a 10-week group DMT intervention was designed and appropriate quantitative outcome measures were determined. In phase II, the substantive model was tested quantitatively and qualitatively during the clinical intervention. The quantitative and qualitative findings were then compared and integrated to generate a clinical model. Through integrating the models from the two phases, a refined final composite model was constructed. The quantitative findings showed that there was statistically significant change in resilience (p <. 001), kinesiophobia (p=. 031), attention regulation, a subscale from body awareness (p=. 016), and pain intensity (p=. 03) after the 10-week intervention. The Patient’s Global Impression of Change score indicated that about 70% of the participants felt moderately to a great deal better after the treatment. The immediate effect of DMT sessions on mood, stress, relaxation, and pain was also tested significant with p <. 001 for all outcomes. Correlation analysis confirmed that there is a statistically significant relationship between body awareness and self-efficacy (p <. 0001). The final GT model shows that the DMT process involves dynamic interactions between various factors that facilitate the intricate mechanisms of DMT to foster resilience resources for chronic pain management. The overall phenomenon is a process of breaking free from the rigidity and imprisoned state created by the overpowering impact of chronic pain toward regaining control over pain and one’s life. DMT provides a novel environment for creative self-exploration and interactions, and mobilizes people to loosen up at all levels – physical, cognitive, emotional, and social. Key therapeutic mechanisms include activating self-agency, connecting to self, connecting to others, enhancing emotional intelligence, and reframing. Several moderator factors were identified namely person factors (i.e., peer support and therapist support) and therapy factors (i.e., self-directive structure, optimal level of challenge, music, and home practice). A set of contextual conditions were also identified namely activity level, alexithymia, % of time in pain, social support, other life stressors, and engagement with the psychotherapeutic aspects of the treatment. Therapy outcomes include being in-control, integration, emotional health, plasticity, and readiness to engage with outside world. As a result, people experienced new ways of living in their body and being in the world. Based on the findings, several theoretical, clinical and methodological implications as well as suggestions for future research are proposed. The process and outcome of the study confirmed that MM-GT is an effective research method for generating and testing a theoretical model that can describe complex data.Ph.D., Creative Arts Therapies -- Drexel University, 201

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

Attenuating Effects of Dieckol on Endothelial Cell Dysfunction via Modulation of Th17/Treg Balance in the Intestine and Aorta of Spontaneously Hypertensive Rats

Disruptions of the Treg/Th17 cell balance and gut barrier function are associated with endothelial dysfunction. Dieckol (DK) obtained from Ecklonia cava and E. cava extract (ECE) decreases blood pressure by reducing inflammation; however, it has not been elucidated whether DK or ECE modulates the Treg/Th17 balance, changes the gut epithelial barrier, or decreases endothelial cell dysfunction. We evaluated the effects of ECE and DK on gut barrier and the Treg/Th17 balance in the intestine and aorta, with regard to endothelial dysfunction, using the spontaneously hypertensive rat (SHR) model. The level of Th17 cells increased and that of Treg cells decreased in the intestine of SHRs compared to normotensive Wistar Kyoto (WKY) rat. These changes were attenuated by ECE or DK treatment. Additionally, the serum IL-17A level increased in SHRs more than WKY; this was decreased by ECE or DK treatment. The level of Treg cells decreased and that of Th17 cells increased in the aorta of SHRs. These changes were attenuated by ECE or DK treatment. The NF-κB and IL-6 levels were increased in SHRs, but these changes were reversed by ECE or DK treatment. Endothelial cell dysfunction, which was evaluated using peNOS/eNOS, nitrate/nitrite ratio, and NADPH oxidase activity, increased in the aorta of SHRs, but was decreased by ECE or DK treatment. The Treg/Th17 balance in the intestine and aorta of SHRs was attenuated and endothelial cell dysfunction was attenuated through the Th17/NF-κB/IL-6 pathway by ECE or DK

Hepatic Infarction Caused by Portal Vein Thrombophlebitis Misdiagnosed as Infiltrative Hepatic Malignancy with Neoplastic Thrombus

Portal vein thrombosis (PVT) is a form of venous thrombosis that usually presents in chronic form without any sequalae in patients with hepatocellular carcinoma (HCC) or liver cirrhosis. Accurate differential diagnosis of bland PVT from neoplastic PVT is an important step for planning treatment options, but the acute form can be challenging. Here we present a case of acute hepatic infarction caused by acute bland PVT combined with pylephlebitis, which was misdiagnosed as infiltrative hepatic malignancy with neoplastic PVT owing to the perplexing imaging results and elevated tumor markers. (Korean J Gastroenterol 2016;68:156-160

A 65-nm CMOS 2 x 2 MIMO Multi-Band LTE RF Transceiver for Small Cell Base Stations

This paper presents a 680 MHz-6 GHz 2 x 2 multiple-input and multiple-output (MIMO) long-term evolution (LTE) RF transceiver in 65-nm CMOS for low-cost and multi-band capable femtocell base stations. The transceiver integrates two receivers (RXs), two transmitters (TXs), and two frequency synthesizers, for the 2x 2 MIMO operation to support both the frequency division duplex (FDD) and the time division duplex (TDD) modes. Each pair of an RX and a TX features eight single-ended low noise amplifiers (LNAs), and eight TX outputs that extensively share active and passive circuits with minimal performance degradation. In the measurement, each RX illustrates the noise figure (NF) from 2.9 to 5.2 dB, the input-referred third-order intercept point (IIP3) of more than -2 dBm, and the IIP2 of more than 48 dBm, over the entire frequency range at the maximum gain. Each TX achieved the adjacent channel leakage ratio (ACLR) that was less than -54 dBc at -5-dBm output power with -157-dBc/Hz phase noise at the RX band, while achieving an error-vector-magnitude (EVM) of less than 2.8%, over the entire frequency range. The transceiver, packaged in a flip-chip chip-scale package (fcCSP), is mounted on the board of the commercial femtocell of the LTE Band5, along with a commercial duplexer, power amplifier, and modem. The femtocell achieved -100-dBm reference sensitivity without the use of an external LNA. It also achieved -51-dBc TX ACLR and 1.68% TX EVM at 20-dBm output power in the LTE 10-MHz mode with the 2 x 2 MIMO configuration, without applying a digital pre-distortion (DPD) technique

Authentication of <i>Zanthoxylum</i> Species Based on Integrated Analysis of Complete Chloroplast Genome Sequences and Metabolite Profiles

We performed chloroplast genome sequencing and comparative analysis of two Rutaceae species, <i>Zanthoxylum schinifolium</i> (Korean pepper tree) and <i>Z. piperitum</i> (Japanese pepper tree), which are medicinal and culinary crops in Asia. We identified more than 837 single nucleotide polymorphisms and 103 insertions/deletions (InDels) based on a comparison of the two chloroplast genomes and developed seven DNA markers derived from five tandem repeats and two InDel variations that discriminated between Korean <i>Zanthoxylum</i> species. Metabolite profile analysis pointed to three metabolic groups, one with Korean <i>Z. piperitum</i> samples, one with Korean <i>Z. schinifolium</i> samples, and the last containing all the tested Chinese <i>Zanthoxylum</i> species samples, which are considered to be <i>Z. bungeanum</i> based on our results. Two markers were capable of distinguishing among these three groups. The chloroplast genome sequences identified in this study represent a valuable genomics resource for exploring diversity in Rutaceae, and the molecular markers will be useful for authenticating dried <i>Zanthoxylum</i> berries in the marketplace

Art as Research : Opportunities and Challenges

"Art as Research addresses how artistic enquiry has always been a preferred method of investigating the most complex human problems. The book combines two special issues from the Journal of Applied Arts & Health on art-based research which has emerged from applied arts disciplines and is now being used in all situations where the arts can further research. Authors from the arts in therapy are joined by colleagues in philosophy, history, education, social relations, business and organizational studies." - p. [4] of cover