The purpose of this study was to examine the effects of song-based music therapy interventions on psychosocial factors for people who have had Acquired Brain Injuries (ABI) or Spinal Cord injuries (SCI) and their caregivers during acute rehabilitation. The psychosocial factors in this study involve mood states, caregiving experiences, and dyadic relationships. The study also examined the correlation between care recipients and caregivers on mood states and the dyadic relationship. A quasi-experimental, two-group pretest-posttest design without a control group was used to investigate the psychosocial factors. A total of 10 dyads were recruited for the study. Group A in this study were care recipients; Group B were caregivers of Group A. The dyad attended four individual music therapy sessions of approximately 45-minute duration over a period of 14 days. During the song-based music therapy protocol, the participants were empowered to choose between singing along or listening to their preferred music. Caregiver participants had the option to participate in either in-person or virtual sessions. Three measures were used to investigate psychosocial factors: Visual Analogue Mood States (VAMS), Positive Aspects of Caregiving (PAC), and Dyadic Relationship Scale (DRS). VAMS was used pre and post each intervention while PAC and DRS were only used before the first session and the last session. All statistical analyses were conducted in R, a statistical program. The Wilcoxon test and Kendall’s rank correlations were used to examine the pre- and post-intervention changes and the correlation between Group A and Group B on mood states and the dyadic relationship. The findings of the study indicated that there were significant changes in mood states for both Group A and Group B. There were four strong correlations in the dyadic relationship between caregivers and care recipients, including feeling closer to each other, feeling angry toward the other, having more patience than they have had in the past, and feeling relationships with each other were strained. Implications for music therapy practice and recommendations for the field and future research are also presented. / Music Therapy

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24133号 / 医博第4873号 / 新制||医||1059(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 生田 宏一, 教授 濵﨑 洋子, 教授 森信 暁雄 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Music therapists have utilized technology in their clinical work for decades. Yet music therapy delivered in a telehealth model – telemusic therapy – has rarely been described in the literature until recently. This study stems from telemusic therapy services the researcher-interventionist was contracted to provide to adult acquired brain injury (ABI) survivors. The existing literature has primarily reported on synchronous telemusic therapy conducted via internet-based videoconference platforms with individual clients or groups who were colocated but not face-to-face with the clinician. Technological issues were cited as limitations. Only one article described small group telemusic therapy where participants were each located at their individual homes; no literature was found for large groups of non-colocated participants. Further, the telemusic therapy literature very rarely reports empirical data. This thesis presents the results of a pilot study exploring the feasibility and effectiveness of telemusic therapy on well-being for adult brain injury survivors who participate independently from their homes. This retrospective study utilized a quasi-experimental, pre/post-session repeated measures design to examine data from a 20-session, 10-week, group telemusic therapy program (N = 15). Clinician-developed pre/post measures of well-being were administered each session. A Qualtrics Likert scale survey exploring audiovisual quality, emotional support, the therapeutic relationship, and social-emotional connection between participants was issued during the 5th and 10th weeks. Results: Mean and median difference of pre/post measures were significant for increasing well-being at α = 0.5. Frequency distributions of the survey ratings of more than or very much adequate for quality of audio and video: 78.6% – 85.7%; ratings of more than or very much adequate for emotional support, formation of a therapeutic relationship and creating connections with other participants, respectively: 85.7%, 78.6%, 92.9 %. The results support the feasibility and effectiveness of group telemusic therapy for increasing well-being in adult ABI survivors who attend from their individual homes. Study limitations include small N, low return rate for surveys, and unvalidated measures.It is noteworthy that in each session, the music therapy group successfully engaged in real-time active music making with all members playing and all microphones on. No audio delay was detected. This phenomenon has been described in the literature as improbable. The cause of such low latency is unknown. These findings demonstrate that participants using personal computers or laptops and residential broadband Internet experience the audio and visual components of synchronous music therapy as more than adequate. A real-time telehealth model is a viable means for providing group music therapy. / Music Therapy

No description available.

Salicylic acid is a plant hormone that accumulates with plant-pathogen interaction. This accumulation corresponds to the plant being resistant to infection and without it the plant is susceptible. In this study, primers of genes involved in the normal synthesis of SA were used in RT-PCR to compare gene expression levels in susceptible and resistant plants challenged with tobacco mosaic virus. Because SA synthesis shares chorismate as a common substrate with the synthesis of aromatic amino acids, HPLC was used to determine whether the increase in SA could be attributed to a decrease in amino acid levels. The results suggest that genes of the shikimate pathway are up-regulated in both plant lines but much more quickly in the resistant plant, making differential gene expression a possible cause of SA accumulation. Additionally, results showed a more pronounced decrease in amino acid levels in resistant plants compared to susceptible plants.

No description available.

Patients infected with the human immunodeficiency virus (HIV+) are living longer and at heightened risk for developing cardiovascular events (CVEs). Commonly used prediction tools appear to misrepresent their CVE risk to varying degrees and in varying directions. Inclusion of markers of cellular infection, chronic immune activation and/or systemic inflammation into risk models might provide better predictive accuracy. Observational studies assessing the relationship of high-sensitivity C-reactive protein (hs-CRP) to CVE in HIV+ patients have reported inconsistent findings. This review of published studies attempted to determine if the available evidence supports its potential use in new models for stable, treated HIV+ patients. We searched the PubMed database using keywords and combinations of "HIV" AND "cardiovascular risk" AND "CRP". Papers presenting original analyses, associating hs-CRP concentration as an independent variable to hard cardiovascular outcomes (myocardial infarction and cardiovascular death), or to hard CVE as part of a composite endpoint, were included. Five observational studies met inclusion/exclusion criteria for review. Three papers identified an association between elevated hs-CRP and CVE, while two others failed to find any significant association. All reports were heterogeneous in terms of independent variables, controls, and designs. The larger and more rigorous studies, employing higher rates of confounder controls and more objective endpoints in their composites, showed positive associations. Though not conclusive, the preponderance of the evidence at this time supports CRP as a potentially valuable factor to be studied in prospective cardiovascular risk prediction investigations in HIV+ patients.

Traumatic brain injury (TBI) contributes to global mortality and disability more than any other traumatic injury. Individuals who sustained a TBI undergo profound changes in their cognitive, physical, and emotional functions. Noticeable behavioral changes include irritability, aggression, low self-awareness, impulsivity, rumination, and more. These contribute to the individual's inability to control emotions and thus participate in interactions and activities, naturally influencing the person, their environment, and the community. While traditional therapy approaches are beneficial for some of the mentioned challenges, extensive evidence shows that emotional regulation is not effectively addressed, often resulting in behavioral outcomes in the therapeutic environment alone. Mindfulness interventions focus on the present moment's thoughts, sensations, and surroundings with an open and curious mindset, helping participants cope with stressors that often lead to anxiety and problematic behavioral patterns. Nevertheless, the standard Mindfulness does not accommodate the TBI-related challenges. Cultivating Awareness by Living Mindfully (CALM), is a Mindfulness-based group intervention for adults who sustained a TBI. It aims to increase self-awareness and improve emotional regulation by practicing mindfulness techniques and implementing them in everyday activities and interactions. This 12-week program is low-cost and easily applicable to a variety of practice and community settings. The program incorporates principles from the latest evidence-based therapy approaches and is designed specifically to accommodate TBI-related challenges. The theoretical foundations consist of complementing knowledge bases including Mindfulness, the occupational therapy framework - the multi-context approach, and brain-based learning, which are principles from the latest research on optimizing learning for this population. This combination of frameworks aims to makes Mindfulness and its many associated health benefits accessible for individuals post-TBI. This doctoral paper includes a plan for program evaluation, funding, and dissemination

Healthcare-associated infections present an escalating worldwide issue, further intensified by the emergence of antimicrobial resistance and the spread of pathogens on surfaces. Current infection prevention methods have shown limited effectiveness, leading to several health issues, an overuse of antibiotics, and a continuous threat of surface recontamination. In response, extensive research has focused on bioinspired omniphobic smart coatings that effectively reduce the contact area available for pathogen attachment, achieved through an increase in surface roughness and apparent surface energy. This thesis introduces a new class of an omniphobic spray-coating, featuring hierarchical structured polydimethylsiloxane (PDMS) microparticles coated with gold nanoparticles, encompassing primary microscale (~0.23 𝜇m) and secondary nanoscale (~5 nm) buckyball and labyrinth wrinkles. This substrate-independent coating efficiently repels a wide range of liquids, including pathogens, even under harsh conditions like high temperatures, ultraviolet (UV) exposure, and abrasions. Repellency tests comparing coated and uncoated gloves revealed that uncoated gloves spread contamination to 50 secondary surfaces, while coated gloves transferred fewer bacteria and viruses to just three and two surfaces, respectively. The investigation extended to the coating's biocidal capabilities, incorporating gold nanoparticles functionalized with mercapto-silane to create a "Repel and Kill" coating. This process initiates chemisorption through thiol-gold bonding, allowing for the formation of diverse surface structures, including three-dimensional self-assembly, multilayers, and island structures. These modifications significantly enhance the roughness and hydrophobicity of the gold nanoparticles, amplifying their biocidal effectiveness. The wrinkled structure of PDMS contribute to repellency, while the functionalized gold nanoparticles play a crucial role in the antimicrobial property. This enhancement was evident in the antibacterial tests, which exhibited an immediate 99.90% reduction in bacterial adhesion for both MRSA and Pseudomonas aeruginosa (P. aeruginosa), followed by an additional 99.70% and 99.90% reduction in bacterial growth after 8 hours for MRSA and P. aeruginosa, respectively. Moreover, the coating's antiviral properties were confirmed, demonstrating a 98% reduction in the transfer of the bacterial virus Phi6. Recognizing the role of hospital fabrics as potential reservoirs for infection transmission, primarily due to their ability to sustain bacterial growth for extended periods, especially in the presence of bodily fluids, we took further steps to modify the wrinkled PDMS microparticles. This involved the incorporation of silver nanoparticles, capped with a positively charged ligand known as branched polyethyleneimine (bPEI). Additionally, we integrated a colorimetric sensor, giving rise to the "Repel, Kill, and Detect" smart coating. The transition of color from blue to green-yellow provided a tangible indicator of contamination detection based on the acidic mileu of the biofilms. To evaluate its realworld effectiveness, we conducted simulations of infection transmission in hospital environments, resulting in a remarkable reduction in pathogen adhesion from urine and feces by 99.88% and 99.79%, respectively, compared to uncoated fabrics. To further enhance the validation of our results, we employed a powerful deep learning network architecture, that determined whether the surfaces are contaminated or safe. In the face of evolving health challenges, this coating emerges as a resilient and adaptable solution, promising to enhance overall safety and alleviate the burden of infectious diseases. / Thesis / Doctor of Engineering (DEng) / The prolonged survival of pathogens on surfaces, significantly highlighted by the COVID-19 global pandemic, has intensified the urgency of addressing contamination on high-touch surfaces. Engineered surface coatings with repellent properties have emerged as a long-lasting and health-conscious solution for infection prevention and control. In this thesis, we introduce a new class of multifunctional engineered coatings featuring hierarchical structures adorned with biocidal nanoparticles and an integrated colorimetric sensor. We comprehensively investigate these coatings' multifunctional capabilities to repel, exterminate, and detect contaminants. Through specific characterization tests involving a wide range of pathogens, including viruses, bacteria, and fungi, within complex biological fluids like urine and feces, this research culminates in the development of surface coatings equipped with both antimicrobial and pathogen-sensing capabilities. In addition to advancing our understanding of surface hierarchy and chemical modifications for repellency and biocidal activity, this thesis yields insights into the dynamics of biofouling and pathogen transfer, with the overarching goal of reducing pathogen transmission via surfaces.

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem nationwide, threatening to develop into an epidemic. Many of these patients are presenting to their primary care clinics with skin and soft tissue infections (SSTIs). The CDC has reported that in 2005, MRSA was responsible for an estimated 94,000 life-threatening infections and 16,650 deaths. The purpose of this study is to estimate the incidence of CA-MRSA within a specific family practice in Florida and to identify epidemiologic factors, classify antibiotic susceptibility patterns, and evaluate patient education in regard to disease management and prevention. This study was a descriptive, epidemiologic, three-year retrospective medical record review of all wound cultured skin and soft tissue infections that presented to a family practice between January 2007 and December 2009. Sixty-two medical records met the inclusion and exclusion criteria for the study. Of these 62 SSTIs, 44 cultures grew one or more bacterial organisms. The incidence of CA-MRSA was 66% (n=29). The mean age of those with CA-MRSA was 40 years old, with a range from 7 to 90 years old. Sixty-two percent (n=18) were male and 38% (n=11) were female; additionally 69% (n=20) lived within a 10 mile radius from the family practice, while 31% (n=9) lived in a surrounding suburb. The most frequent race was Caucasian 83% (n=24), with African American at 10% (n=3) and Hispanics 7% (n=2). Risk factors associated with CA-MRSA was obesity 41% (n=10), diabetes mellitus 24% (n=7), and a previous history of MRSA infection 24% (n=7). Skin and soft tissue infections were diagnosed as either an abscess 62% (n=18), boil 24% (n=7), pustule 10% (n=3), or cellulitis 4% (n=1). CA-MRSA isolates were susceptible to trimethoprim-sulfamethoxazole 100% (n=29), doxycycline 93% (n=27), and rifampin 100% (n=14). Clindamycin susceptibility was 65% (n=15) with resistance at 30% (n=7) and 5% (n=1) intermediate. Both cephalexin and erythromycin were 100% resistant. Documentation in the medical record on wound care was found in 45% (n=13) of the records. The incidence of CA-MRSA SSTI was 66%, which identifies this suburban community at high risk for this bacterial infection. Risk factors associated with CA-MRSA included obesity (BMI > 30), history of previous MRSA infection, and diabetes mellitus. There were no clinical characteristics that helped distinguish MRSA infection from other bacterial SSTIs. Most SSTI were treated with incision and drainage and a susceptible antibiotic. Judicious use of antibiotics not only provides appropriate treatment, but is also critical in prevention of antibiotic resistance. Lastly, patient education in adequate hygiene is essential in preventing the spread of CA-MRSA