bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Rhythm in Music Therapy Have an Organising Effect on the Agitated Behaviours of People with a Diagnosis of Dementia? An Investigation into Music Therapists' Current Practice
Authors: Allen-Williams Helen
Published: January 2016

While previous research on music therapy and dementia has shown the positive outcomes gained from interventions, it lacked specificity regarding techniques utilised by practising music therapists. Recent developments in music therapy and neuro-rehabilitation have shown rhythm to be an integral part of accessing remaining cognitive functioning following brain injury and deterioration.

This article is based upon a recent research project that investigates the potential of rhythm in music therapy to organise the internal chaos (mental and emotional) experienced by patients with dementia. It is speculated that such chaos is often expressed through agitated behaviours, and that rhythm can be used in such instances as a means to stimulate meaningful interaction. A literature review was conducted of studies of music therapy and agitated behaviour. Data was collected using semi-structured interviews with four music therapists and was coded and categorised in order to establish themes. Results showed that the use of individualised rhythmic interventions was functional as therapists noted reduced agitation, more organised physical movement and other communications, meaningful interaction and emotional reassurance.

The results also suggest that the Cochrane review's conclusion that no substantial evidence exists to support the use of music therapy with dementia patients might be challenged by further research.
A Potential Space: Approaching “Outsider Research” with Classroom Practitioners Working with Children with Complex Needs in Belarus
Authors: Margetts Lisa , Wallace Helen , Young Emily
Published: January 2016

This paper will discuss approaches to ethical issues encountered in the development of the proposal for a PhD research project, to be undertaken by the first author, entitled “Psychodynamic music therapy and the work of classroom practitioners working with children with complex needs in Belarus: A potential space”. This research will be based at Novi Dom, a special school in Minsk, Belarus, and follows two skills-sharing projects undertaken there during 2009 (Margetts, Wallace and Young 2010), which were requested initially to support person-centred teaching initiatives by one of the founding charities of Novi Dom. The positive outcomes of these first two projects led to a request for further music-therapy-based input. The impetus for the first author's PhD research project has therefore evolved in response to this locally identified need (Trimble and Fisher 2006: 6).

Writing and research around multicultural competency in music therapy have increased in recent years with commentators offering further consideration of the knowledge, skills and qualities needed by therapists, supervisors and trainers to work successfully with the complexities of the multicultural environment (Gilboa, Yehuda and Amir 2009; Wheeler and Baker 2010). The unique, rich sociocultural context of post-communist and modern Belarus offers an opportunity to explore fascinating areas of divergence and meeting of approaches to working with children with complex needs. A brief overview of geographical, historical, political and social factors which have contributed to this very specific context will be drawn from literature, as well as from both the experience of the authors, and that of fellow music therapists who have undertaken music-therapy-based skills-sharing projects in other post-communist countries (Quin 2004, 2007; Salcin-Watts 2007).

Fundamental ethical challenges of psychodynamic music-therapy-based research within special education in Belarus will be explored from the perspective of outsider research as defined by David Bridges (2001, 2009). This discussion will be illustrated with clinical material from the projects at Novi Dom in 2009.
“No Maths, No Physics (So I Spray My Bars with Lyrics)”: Rap/Music Therapy with Young Men at a Young Offender Institution
Authors: Short Helen
Published: January 2016

This paper describes work undertaken at a young offender institution, focusing on the therapeutic use of improvised or ‘freestyle’ and original rap. In particular it uses material and analysis pertaining to two individuals who formed part of a slow open group for outpatients detained in the main prison.

A background to the work sets the scene. Next the author details the role of this specific form of therapy within the institution addressing the aims of the work and the background of the clients. The main body of the paper examines the nature of this work from a psychodynamic perspective, incorporating concepts of Klein, Winnicott, Holmes and Bowlby. This relates to the setting, client group and the use of rap as a therapeutic intervention, with focus on original rap lyric-writing and the stylistic and cultural connotations of the genre. Original lyrics and therapeutic techniques specific to clients are drawn upon and discussed.
Embedding Innovation into the Counterpoint of Music Therapy Practice Today
Authors: Quin Alexia
Published: January 2016

When Alexia founded Music as Therapy International, the music therapy profession seemed very different. Who has changed? The author or the profession? Or both? The author will present her experiences of being a threat, a novelty and now a welcome contributor to practice, and consider the changing professional context against which (and within which) her work has unfolded.

The article will trace the development of Music as Therapy International's work in Romania, as the country's care system has progressed through dramatic reforms following the crisis in care revealed after the fall of Communism in 1989. The author will explore how the consequent portfolio of activities devised by the charity has since proven relevant in other countries and has become increasingly influential in the UK. Specific relevant projects will be presented, including the six-week introductory training project model (international), the distance learning programme (Romania), the training DVD (Rwanda), the UK continuing professional development seminars and interactive music-making (a university credit-rated course for UK practitioners working with under-5s). The paper will also refer to responses to these projects from the profession and the relevant practice of others over the years.
A Perspective on Music Therapy Research in Great Britain
Authors: Bunt Leslie G.K. , Hoskyns Sarah L.
Published: January 2016

Researching and writing about music therapy has evolved from an early anecdotal stage through a period of rigorous behavioural research — particularly in the United States — to the present position where many directions could be followed. Outcome research can contribute to the profession's external validity and research into music therapy processes to increased internal validity. This paper argues for a synthesis of these two approaches, implying an integration of quantitative and qualitative analysis. Links with other disciplines are explored but in relation to the development of a coherent individual theory of music therapy.
Towards Group Analytic Music Therapy
Authors: Woodcock John
Published: January 2016

Verbal material is inevitably encountered in adult psychiatry. This paper describes and discusses an approach to music therapy which admits of this, seeks to understand its significance and to use it in the service of therapy. The origins of the approach are considered and elements of theory and technique derived from group analysis and psychotherapy and their application are described and discussed. The therapist's verbal and musical role is considered in the light of this and conclusions are drawn as to the advantages and insights gained by the adoption of the approach.
Reflections on the Pre-Musical Moment
Authors: Pavlicevic Mercedes
Published: January 2016

Patients in hospitals frequently have little choice about attending music therapy sessions. This, in addition to the novelty of music therapy as a treatment, may make both patient and therapist uncomfortable. The patient is unsure as to what to expect, and the music therapist uncertain as to how much to say—or leave unsaid. This article draws on the author's experience as a music therapist in a small adult psychiatric hospital. It is an attempt at examining the pre-musical moment at the time when both the patient and the music therapist are engaged in sharing their expectations and anxieties, and in negotiating a resolution before the musical-therapeutic process can begin.
The Influence of Jung's Psychology on the Therapeutic Use of Music
Authors: Hitchcock Dorinda Hawk
Published: January 2016

This paper explores the work of two innovative music therapists and the way in which their individual approaches relate to the theories of C.G. Jung. Firstly, the author describes how Margaret Tilly, a concert pianist, once gave Jung a session of passive music therapy explaining that she begins to play composed music in rapport with the patient's dominant function, and gradually evokes the inferior function's qualities also using the ‘masculine’ and ‘feminine’ aspects of music. This convinced the otherwise sceptical Jung that ‘from now on music should be an essential part of every analysis’.

Secondly, she examines Mary Priestley's work in which the patient improvises with the therapist to make contact with feelings and unconscious material: e.g. in dreams.

The author speaks from direct experience of her analytical music therapy intertherapy training with Priestley. She quotes several passages from Jung's work to explain how this therapy accords with the need to contact the image behind the emotions, and to accept the ethical obligation presented by the dreams and the need to make concrete the experiences. She finishes with a call to musicians and therapists to be ‘more aware of the creative power of music to make us whole’.
Creative Music Therapy in a Hospital Setting: A Preliminary Research Design
Authors: Aldridge David , Verney Rachel
Published: January 2016

The aims of this study are to find ways of collecting appropriate clinical data consistently and to develop co-operative working relationships with clinical colleagues. Six hypotheses are generated from the relationship between the playing of improvised music and a person's health. The method of research is to collect quantitative and qualitative data, and use observations from several perspectives: the doctor, the therapist, the ward staff, the patient and the family. Data collection and observation would be closely linked to everyday clinical practice.
Music Healing
Authors: Wright Peter
Published: January 2016

There are two distinct traditions of Music Therapy. One is of ancient origin whilst the other is the modern approach. There are some major difficulties between them, but they have a great deal to teach each other. The older tradition, however, is not as well known to the modern approach as it should be, for it is based upon its own distinct assumptions. These have arisen from its foundations in shamanism and religious philosphy, which have produced a wide variety of techniques in helping to heal the ills of humanity.
Recreation and Music Therapy: An Experimental Study
Authors: Hooper Jeff , Lindsay Bill , Richardson Isobel
Published: January 2016

The paper outlines current trends in experimental research in music therapy and then presents an individual case study which examines the impact of recreational musical activities on the subject.
Issues in Working with Sexually Abused Clients in Music Therapy
Authors: Rogers Penny
Published: January 2016

This paper discusses some of the issues that arise when working with sexually abused clients. It highlights a number of factors that appear to be common to this client group's manipulation of the medium of music therapy; the symbolic use of the instruments; the preoccupations with mess and containers; the use of boundaries; and the power of the secret. Material from a number of case studies (both adults and children) is used to illuminate many of the points made. Many of the issues discussed are pertinent to a wider range of client groups — particularly those prone to eating disorders and substance abuse. It does not refer to the wealth of literature regarding work with abused clients with learning difficulties.
Music Therapy: A Description of Work with a Mentally Handicapped Young Man
Authors: Clough Jayne
Published: January 2016

This paper describes, chronologically, aspects of music therapy sessions with a 22-year-old man. Observations of Sean in other environments are included as well as some background details. The discussion section of the paper briefly examines the use of music in sessions, as well as the influence of psycho-dynamic informed thinking. All names have been changed.
Review of the Journal of British Music Therapy: 1987–91
Authors: Webster Judith
Published: January 2016

The last few years have seen a change in both the identity and format of the Journal of British Music Therapy. This review looks at the present Journal from 1987–91, attempting to identify changes and trends, and any areas which are not covered. Finally, it tries to assess what the profession needs from its Journal, what music therapists want, and to what extent this is being met in the JBMT.
Considerations of Development Issues in Choosing Interventions for Resistance in Music Therapy
Authors: Dvorkin Janice M.
Published: January 2016

It is the focus of this paper to look at the idea of resistance as providing information on the primary object experience. Using this information, the music therapist needs to assess his or her role in playing music during the session, in the same way that he or she assesses verbal interventions.
The Acknowledgement of Loss in Working through Depression
Authors: Davies Alison
Published: January 2016

In this paper, I would like to share some of my thoughts about work with depression and how aspects of loss are linked with depressive states. I will show how, through the use of music, patients stuck in the depths of a painful depression are able to begin to express feelings through an experience in music, and how this gives them access to feelings that can then be articulated in words. My theoretical basis for understanding depression comes from the field of psychoanalysis.
Music Therapy Research in Europe: A Context for the Qualitative/Quantitative Debate
Authors: Rogers Penny
Published: January 2016

Research in music therapy has proliferated over the past decade, some conducted by practitioner-researchers, some by academics. This research includes both clinical and non-clinical studies and encompasses a variety of research methodologies — qualitative, quantitative, new paradigm, and single case-studies. This paper reports a number of emerging trends in music therapy research across Europe. It focuses specifically on research conducted at PhD or post-doctoral level, and acknowledges the debate between the adoption of qualitative and quantitative methodologies in music therapy research in Europe.
Case Studies in Huntington's Disease: Music Therapy Assessment and Treatment in the Early to Advanced Stages
Authors: Magee Wendy
Published: January 2016

The purpose of this paper is to describe the different stages of Huntington's Disease (HD) and to present methods of music therapy assessment and treatment specifically related to the varying levels of abilities seen in the early to advanced stages of this illness. Whilst these methods are described here in relation to HD, they are also useful when working with clients with other forms of cognitive or neurological impairment.

Music therapy, unlike other treatments, provides an active outlet for a person living with HD even during the most advanced stages of the illness. Participation in music therapy can be facilitated for those people who are unable to take part in any other form of activity, thus providing a valuable assessment tool for other disciplines working with the HD client.

This paper will present a progressive picture of life for the HD client. Using case studies, it will suggest different music therapy treatment approaches for the varying stages of the illness. Special consideration will be given to assessment when working with clients experiencing cognitive degeneration, and methods for optimising clients' remaining skills within individual and group settings.
Is Music an Archaic Form of Thinking?
Authors: Lehtonen Kimmo
Published: January 2016

The central idea of this article is based on the assumption that there is a close parallel between the forms of music and ‘archaic’ forms of thinking. The article discusses the Piagetian developmental model of assimilation and accommodation processes and their resemblance to the increasing and decreasing inner tensions caused by music. At the most general, pervasive level, music can be viewed as being parallel to bodily experienced, non-verbal forms of meaning, and, as such, may be described as ‘archaic thinking’. This dimension of musical experience is common to all known cultures, and it is similar to the body schemas and ‘bodily forms of thinking’ of an infant.

Forms of ‘archaic thinking’ as a hierarchy are also discussed. Theories concerning the different developmental phases of thinking are considered. The cognitive and psychoanalytical theories of Eva Basch-Kahre shed new light on the phenomenon of music, as do the infant developmental research and writings of Daniel Stern. Basch-Kahre distinguishes different forms of thinking according to the different developmental stages of the individual, e.g. chaotic, emotional-sensomotoric and operational thinking processes. Stern considers developmental stages of the infant in an interpersonal dimension, the dynamic processes of which manifest ‘musically’, or in ‘musical’ forms. This author's thesis is that, by using music and musical symbols in the therapeutic situation, for example, it is possible to meet and address all these developmental stages within the individual.
Talking about Music Therapy
Authors: Ansdell Gary
Published: January 2016

This paper is designed as an introduction to a projected series on aspects of the meta-theory of music therapy. In common with pyschoanalysis (Mitchell 1993) and art therapy (Henzell 1995), music therapy inquiry is seeing an evolving reflexive trend which examines in several ways the nature of theory in the discipline — in order to clarify, contextualise and critically evaluate past and current trends (Aldridge 1990, 1993b; Aigen 1991, 1995; Ruud 1988). In the case of music therapy, meta-theory typically seeks to uncover the relationships between three domains: what music therapists do (praxis); what they say (discourse); and what they know (epistemology). This paper takes discourse as the starting-point and makes an introductory study of the nature of talking about music therapy. It centres its investigation on a simple qualitative-style experiment in which a group of listeners (of varying musical and music therapy experience) identify and describe a taped excerpt of music therapy. The results of this experiment are used to form the basis of a discussion about several commonly expressed ‘language problems’ in music therapy: the need for a ‘common language’; the verification of clinical data; describing musical behaviour and the boundary between description and interpretation.
Editorial
Authors: Robarts Jacqueline Z.
Published: January 2016

This 11th volume of BJMT appears in a new design, of which the Editors and the BJMT Management Board hope our readers will approve. Both the APMT and the BSMT were consulted in liaison with Nigel Taylor of Devious Designs. The redesign of the journal has involved fairly intensive intercommunication between individuals and committees over several months, after being on the ‘back-burner’ for three years or more. The Board and Jackie Robarts are particularly grateful to Nicky Barber for her skill and professional advice. Our limited budget has prevented any radical changes, and the A4 format has also been retained for reasons of economy. Flights of fancy (or ‘phantasy’) thus restrained, the BJMT's new design has focused first on creating a new distinctive cover (using laminated paper that will not show coffee rings and finger marks as readily as the former Astralux) and, secondly, on the overall ‘look’ of the inside pages which we hope will make the BJMT easier, clearer and more attractive to read.
When Having Means Losing: Music Therapy with a Young Adolescent with a Learning Disability and Emotional and Behavioural Difficulties
Authors: Walsh Ruth
Published: January 2016

This paper describes ten hours of music therapy work with a twelve-and-a-half-year-old girl, giving specific details of the process of events during sessions and the development of the therapeutic relationship. Central to the therapist's thinking about the work was the notion of the client's struggle between wanting, but being unable to bear, good feelings, and not wanting, but needing to hold on to, bad feelings. Turning good feelings into bad, in order to feel in control, was a predominant theme. The therapy was carried out within a broadly psychodynamic theoretical framework, with particular reference to the work of Melanie Klein in relation to the processes of splitting within the ‘paranoid-schizoid’ position (Klein 1946). The paper also refers to Anne Alvarez's notions (1992) of the importance of the aspirational aspects of play and the anticipation of identification with a ‘good object’, and thus, the possibility of reparation. This article is based on a paper presented at the first National Conference on Music and Disability, Maynooth, Republic of Ireland, in 1994.
‘Kinesis und Katharsis’: The African Traditional Concept of Sound/Motion (Music): Its Application in, and Implications for, Music Therapy — Part III
Authors: Mereni Anthony-Ekemezie
Published: January 2016

This paper falls into three broad sections, the first two of which were published in BJMT 10:1 (1996). The first section provided a brief introduction to the African philosophy of music and musical instruments and explored the reasons behind the therapeutic powers attributed to music; the second section considered the traditional African causal theory of ailments and the relevance of the different uses of music in almost all traditional medical interventions in African society.

This third and final section is an attempt to draw up an evaluative paradigm of some traditional music therapeutic practices and techniques in the light of modern music therapy. Mention is made of several traditional music therapy practices but, overall, the paper does not have an anthropological bias. This paper is a partial report of current research into traditional African music therapy and is motivated by the author's interest in identifying those aspects of African music therapy which may have correlations in Western music therapy methodology and practice.
Music Therapy with Adults Who Have Traumatic Brain Injury and Stroke
Authors: Purdie Heather
Published: January 2016

Following an overview of the epidemiology and clinical features of traumatic brain injury and stroke, standard rehabilitation programmes are discussed, with consideration of the therapeutic aims and outcomes of these interventions. The physical, cognitive, communicative, social and psychological consequences of neurological impairment are explained, and the role of music therapy in rehabilitation programmes is introduced. A review of the literature on music therapy and TBI and stroke from 1983–96 includes details of more recent developments and research in Europe and the United States of America. Models of intervention are discussed, such as rhythmic re-training of upper limb movements and gait; treatment of aphasia; and the treatment of the psychosocial effects of TBI and stroke. Links with theoretical frameworks such as environmental enrichment are considered.

The model of intervention for TBI and stroke developed recently in Scotland is discussed in detail. The value of improvisation in enhancing self-esteem and achievable outcomes is emphasised, as well as the importance of using familiar music to enhance reminiscence and motivation in people with intact musical memories. Case studies will demonstrate how a model of intervention has emerged. Research with people with stroke, recently completed in Scotland, is summarised, and future directions for music therapy provision and research in the UK discussed.
Group Analysis and Improvisation: A Musical Perspective
Authors: Towse Esme
Published: January 2016

The writings of S. H. Foulkes, founder of group analysis, abound with musical imagery. This paper describes how musical experience has contributed to the author's understanding of aspects of group analytic theory and practice, and is an attempt to put some of that understanding back into the development of a model of group music therapy.
Perspectives on Meaning in Music Therapy
Authors: Stige Brynjulf
Published: January 2016

In this article I discuss some questions on meaning in music therapy by taking as my point of departure the different perspectives of two British music therapists, Mary Priestley and Gary Ansdell. Since all discussions of meaning – even when considering ‘non-verbal phenomena’ – are based on an understanding of language, I have found the philosophy of Ludwig Wittgenstein an interesting port of entry to this topic. Following an introduction to Wittgenstein's concepts of ‘language game’ and ‘family resemblances’, I give a brief discussion of Wittgenstein's relevance for aesthetic understanding, highlighting the concept of ‘intransitive understanding’. These three concepts will then be used as a basis for examining the differences between Priestley's and Ansdell's perspectives, which may serve to expand our thinking about meaning in music therapy.
Communication, Heart Rate and the Musical Dialogue
Authors: Neugebauer Lutz , Aldridge David
Published: January 2016

This article is concerned with a physiological investigation into what happens when two people play music together in a situation that is similar to that of music therapy. Active music therapy is a process of dialogue, with both therapist and patient as part of one musical process. In evaluations of music therapy the musical process is often emphasised, although the question remains as to what effect this musical process has on the body of the patient. In this paper we take this question one step further by asking what effect the musical process has on both partners in the process of playing improvised music. Such a perspective is not trivial. We expect that the therapeutic contact influences both therapist and patient. At the end of this paper we will hypothesise about the ramifications of this idea for other clinical encounters.

It is important, in explaining the benefit of music therapy to others, to know what happens when people improvise music together. Our intention is to be able to demonstrate the influence music therapy has on the physiology of the patient and the therapist. This is to accept not only the ramifications music has for mental well-being but also the physical effect that music therapy has on the patient's body. While music can be demonstrated to have a direct physical effect on the body, it is organisation, the non-material aspect, that is vital to communication both within the person and between persons (Aldridge 1996a). However, the ground from which we will argue is that music has the ability to bring about physical changes in the human body, an understanding that has been in our culture since antiquity (Aldridge 1993).
Music Therapy in Acute Psychiatry: Our Experience of Working as Co-Therapists with a Group for Patients from Two Neighbouring Wards
Authors: Davies Alison , Richards Eleanor
Published: January 2016

This paper is an account of our work at Fulbourn Hospital, a psychiatric hospital in Cambridge, running an open group once a week for a year, and of our experience of working as co-therapists. To a lesser extent, we also draw on our experience as music therapists in other settings.

We have a particular interest in co-therapy. It is unusual in music therapy, in this country at least, for two music therapists to work together; it is a little more frequent in group analysis, and much of our thinking draws on that tradition. We will look at some examples of clinical material and consider the potential value of running a group of this kind. We will also examine the relationship of the group with the institution, particularly in its more recent history, as well as the dynamics of our continuing relationship as co-therapists.

At times throughout the paper we refer to ourselves by our initials: A (Alison) and E (Eleanor).
Finding a Balance between Psychological Thinking and Musical Awareness in Music Therapy Theory — A Psychoanalytic Perspective
Authors: Streeter Elaine
Published: January 2016

There is a growing body of literature which suggests that it is possible to provide safe therapeutic encounters without reference to non-music derived theory (Lee 1996), and that music therapy theory should preferably spring from an understanding of creative musical processes alone (Ansdell 1995). The writer sets down a number of critical objections to this ‘absolutist’ position (outlined by Pavlicevic 1996) and proposes that music therapy theory needs to derive as much from psychological thinking as it does from musical awareness and, indeed, from an understanding of the connections between the two. Psychoanalysis offers just one psychological perspective on which to draw. There are many equally useful perspectives, such as developmental theory which the writer first introduced to the music therapy literature (1979) as a result of her early research (1978). This paper focuses on basic psychoanalytic concepts in an attempt to identify how awareness of musical experience alone cannot provide the music therapist with the means to ensure safe, effective therapeutic practice. The practical application of these concepts is then illustrated with extracts from two case studies.
Creating a New Music Therapy Post
Authors: Moss Hilary
Published: January 2016

This paper describes a pilot project carried out as part of a newly created music therapy post in the NHS. It briefly sets out the circumstances surrounding the creation of the post, followed by a full description of the six-month research project. This includes a discussion of seven aims for music therapy in mental health, which form the basis of the research. The process of evaluation is presented, with an analysis of the involvement of the multi-disciplinary team in the work. Music therapy was carried out with six different client groups. Both clients and staff were involved in evaluating the service, and the benefits and difficulties of client-based evaluation are discussed. The results of this evidence-based research are presented in full. The paper also seeks to comment briefly on the experience of creating a new post within the NHS and the use of evidence-based research to justify the employment of a music therapist.
Some Thoughts on Music, Therapy, and Music Therapy
Authors: Brown Sandra
Published: January 2016

This article discusses points raised by Streeter's article ‘Finding a Balance between Psychological Thinking and Musical Awareness in Music Therapy Theory – a Psychoanalytic Perspective’ (Streeter 1999). Whilst agreeing that ‘psychological thinking’ is essential for the therapist fully to understand and contain the processes in the therapy room, it considers how music itself can bring about integral change within the therapy process. This is considered in terms of more recent developments in psychoanalysis and analytical psychology, as well as from an aesthetic perspective. Finally, it warns of the danger of moving from one ‘absolutist’ position to another within music therapy, and suggests that we as a profession need to be open to listening and learning from a wide range of disciplines, and from each other, in order to enrich our work.
Resident Reactions to Person-Centered Communication by Long-Term Care Staff
Authors: Savundranayagam Marie Y. , Sibalija Jovana , Scotchmer Emma
Published: January 2016

Long-term care staff caregivers who are person centered incorporate the life history, preferences, and feelings of residents with dementia during care interactions. Communication is essential for person-centered care. However, little is known about residents’ verbal reactions when staff use person-centered communication. Accordingly, this study investigated the impact of person-centered communication and missed opportunities for such communication by staff on resident reactions. Conversations (N = 46) between staff–resident dyads were audio-recorded during routine care tasks over 12 weeks. Staff utterances were coded for person-centered communication and missed opportunities. Resident utterances were coded for positive reactions, such as cooperation, and negative reactions, such as distress. Linear regression analyses revealed that the more staff used person-centered communication, the more likely that residents reacted positively. Additionally, the more missed opportunities in a conversation, the more likely that the residents reacted negatively. Conversation illustrations elaborate on the quantitative findings and implications for staff training are discussed.
In-vivo three-dimensional measurement of distal radioulnar joint translation in normal and clinically unstable populations
Authors: Pickering G. T. , Nagata H. , Giddins G. E. B.
Published: January 2016

Assessment of distal radioulnar joint instability is clinically difficult and subjective. The distal radioulnar joint is postulated to ‘tighten’ in ulnar/radial deviation and pronation/supination. Using a rig, we measured mean distal radioulnar joint translation in neutral forearm rotation and neutral wrist radial and ulnar deviation, as well as extremes of wrist radial and ulnar deviation and forearm rotation. We tested the rig on ten cadaver forearms to validate the measurements we made. We tested 50 normal adults and 50 patients with clinical distal radioulnar joint instability. Distal radioulnar joint stability in men and women and on contralateral sides were comparable. Distal radioulnar joint translation decreased significantly with wrist radial and ulnar deviation and forearm pronation and supination, matching clinical practice and further validating the rig. The data in normal patients is comparable with previous computed tomography-based studies. Translation in all positions was statistically increased within the clinical instability group and did not cross-over with the normal ranges. Distal radioulnar joint translation is a physically measurable phenomenon. Our device appears to be a valid test of distal radioulnar joint translation, establishing normal data in vivo.

Level of Evidence: III
The Efficacy of a Brief Nature Sound Intervention on Muscle Tension, Pulse Rate, and Self-Reported Stress
Authors: Largo-Wight Erin , O’Hara Brian K. , Chen W. William
Published: January 2016

Background:

There is a growing recognition that environmental design impacts health and well-being. Nature contact is a design feature or exposure that is especially important in public health and healthcare. To date, there are limited findings on the impact of nature sounds.

Objective:

This experimental study was designed to examine the effect of nature sounds on physiological and psychological stress.

Methods:

Participants were randomized into one of three groups—silence ( n = 9), nature sound ( n = 17), and classical music ( n = 14)—and listened to the assigned sound for 15 min in an office or waiting room-like environment. Pre- and postdata were collected including muscle tension (electromyogram), pulse rate, and self-reported stress.

Results:

With the exception of pulse rate, there were no statistical differences in baseline or demographics among groups. A paired t-test by group showed a decrease in muscle tension, pulse rate, and self-reported stress in the nature group and no significant differences in the control or the classical music groups. The significant reduction in muscle tension occurred at least by 7 min of listening to the nature sound.

Conclusion:

This study highlights the potential benefit of even very brief (less than 7 min) exposure to nature sounds. Brief nature sound “booster breaks” are a promising area for future research with important practical implications.
The unlikely encounter between von Foerster and Snowden: When second-order cybernetics sheds light on societal impacts of Big Data
Authors: Chavalarias David
Published: January 2016

Although information and communication technologies (ICT) have created hope for a shared pluralistic world, democratic principles are far from being respected in the public digital environment, and require a detailed knowledge of the laws by which they are governed. Von Foerster's conjecture is one of the early theoretical results that could help to understand these laws. Although neglected for a long time, the advent of the overlying layer of recommendation and ranking systems which is progressively occupying the web has given empirical evidences of this conjecture, which predicts the consequences of increasing inter-individual influences on social dynamics and the susceptibility of these latter to manipulation. With both von Foerster's conjecture and the Snowden revelations in the background, we analyse the impact of ICT on human societies and their governance, in view of the fact that they have a massive impact on the way in which people influence each other in their tastes and actions.
When Journalists Tweet: Disclosure, Participatory, and Personal Transparency
Authors: Hedman Ulrika
Published: January 2016

This article analyses transparency among groups of journalists by examining journalists’ tweets. It also answers a call from previous researchers on transparency on Twitter for further studies based on more representative samples of journalists. The study draws on a quantitative content analysis of Swedish journalists’ tweets during 1 week in spring 2014. The total number of tweets analyzed ( N) is 1,500. A total of 24% of the journalists’ tweets can be described as being explicitly transparent. However, the findings indicate that while journalists on Twitter indeed discuss how the news are produced (disclosure transparency), they show less personal transparency, and hardly ever invite the audiences to interact or take part in the process of making news (participatory transparency).
Severe Insulin Resistance Improves Immediately After Sleeve Gastrectomy
Authors: Sharma Rahul , Hassan Chandra , Chaiban Joumana T.
Published: January 2016

Introduction. Obese individuals exhibit insulin resistance often leading to adverse health outcomes. When compared with intensive medical therapy, bariatric surgery has shown better outcomes mainly in terms of insulin resistance and glycemic control. Using the Homeostasis Model Assessment of insulin resistance (HOMA-IR), we report herein a case illustrating a drastic improvement in severe insulin resistance after sleeve gastrectomy in the immediate postoperative period. Case Report. A patient with long-standing history of morbid obesity, type 2 diabetes, obstructive sleep apnea, hypertension, and severe insulin resistance (requiring approximately 2 units of insulin per kg per day) was enrolled in the medical weight management program for 6 months during which he lost 40 lbs and his insulin requirements decreased. He then underwent a sleeve gastrectomy and did not require insulin therapy as of postoperative day 1. His HOMA-IR improved by about 76% between day 1 and day 14 postoperatively. Conclusion. Sleeve gastrectomy leads to a drastic improvement in severe insulin resistance as early as the first postoperative day.
Anatomic and Biomechanical Comparison of Traditional Bankart Repair With Bone Tunnels and Bankart Repair Utilizing Suture Anchors
Authors: Judson Christopher H. , Charette Ryan , Cavanaugh Zachary , Shea Kevin P.
Published: January 2016

Background:

Traditional Bankart repair using bone tunnels has a reported failure rate between 0% and 5% in long-term studies. Arthroscopic Bankart repair using suture anchors has become more popular; however, reported failure rates have been cited between 4% and 18%. There have been no satisfactory explanations for the differences in these outcomes.

Hypothesis:

Bone tunnels will provide increased coverage of the native labral footprint and demonstrate greater load to failure and stiffness and decreased cyclic displacement in biomechanical testing.

Study Design:

Controlled laboratory study.

Methods:

Twenty-two fresh-frozen cadaveric shoulders were used. For footprint analysis, the labral footprint area was marked and measured using a Microscribe technique in 6 specimens. A 3-suture anchor repair was performed, and the area of the uncovered footprint was measured. This was repeated with traditional bone tunnel repair. For the biomechanical analysis, 8 paired specimens were randomly assigned to bone tunnel or suture anchor repair with the contralateral specimen assigned to the other technique. Each specimen underwent cyclic loading (5-25 N, 1 Hz, 100 cycles) and load to failure (15 mm/min). Displacement was measured using a digitized video recording system.

Results:

Bankart repair with bone tunnels provided significantly more coverage of the native labral footprint than repair with suture anchors (100% vs 27%, P < .001). Repair with bone tunnels (21.9 ± 8.7 N/mm) showed significantly greater stiffness than suture anchor repair (17.1 ± 3.5 N/mm, P = .032). Mean load to failure and gap formation after cyclic loading were not statistically different between bone tunnel (259 ± 76.8 N, 0.209 ± 0.064 mm) and suture anchor repairs (221.5 ± 59.0 N [ P = .071], 0.161 ± 0.51 mm [ P = .100]).

Conclusion:

Bankart repair with bone tunnels completely covered the footprint anatomy while suture anchor repair covered less than 30% of the native footprint. Repair using bone tunnels resulted in significantly greater stiffness than repair with suture anchors. Load to failure and gap formation were not significantly different.
Women, Mission, and Medicine: Clara Swain, Anna Kugler, and Early Medical Endeavors in Colonial India
Authors: Singh Maina Chawla , Gracey Mrs. J. T.
Published: January 2016

The recovery from disease is the kindliest exhibition of divine power, and the Christian medical missionary occupies a lofty vantage ground in his work.
Declaration on Creation Stewardship and Climate Change
Authors: Network Micah
Published: January 2016

We present here a recent declaration by the Micah Network, whose international president is C. René Padilla (office in Surry Hills, New South Wales, Australia). In the words of Padilla, an IBMR contributing editor, this declaration “may perhaps in time be regarded as the most significant document coming out of the evangelical movement on a subject that has hardly received in the past the attention it deserves from people who confess the triune God as the God of Creation.… Established in 1999, the Micah Network has grown into a worldwide movement of over 500 Christian relief, development and justice organizations, churches and individuals. It includes over 330 active members and 230 associate members from over 80 countries. Its primary objective is to encourage the practice that, according to the text from which it derives its name, God requires of his people: ‘To act justly and love mercy and to walk humbly with your God’ (Micah 6:8)“ (from foreword to the declaration; see www.micahnetwork.org/en/home ). —Editors
Pope Francis, Christian Mission, and the Church of Saint Francis
Authors: Bilocura Theodora
Published: January 2016

On March 13, 2013, Cardinal Jorge Mario Bergoglio was elected Bishop of Rome. A citizen of Argentina, Pope Francis is the first Latin American and the first Jesuit to become pope. We asked three friends of the Overseas Ministries Study Center, all members of the Roman Catholic Church, for an initial assessment of the significance Pope Francis's elevation holds for Christian mission.
Forty Years of North American Missiology: A Brief Review
Authors: Robert Dana L.
Published: January 2016

The following article is an abridgment of the author's plenary address “Forty Years of the American Society of Missiology: Retrospect and Prospect,” delivered at the American Society of Missiology annual meeting, Wheaton, Illinois, on June 21, 2013. The full address is available in Missiology: An International Review 42, no. 1 (January 2014), and online at http://mis.sagepub.com/content/42/1/6.full.pdf+html . (This URL was updated on December 31, 2013.) DOI: 10.1177/0091829613507026. —Editors
Diary of a Country Missioner—Manchuria, 1940
Authors: MacInnis Donald
Published: January 2016

Thanks to the foresight of Maryknoll's founders, the archives contain an estimated 90,000 pages of diaries and related materials from the China missions, dating from 1918 through 1952. The excerpts printed here were selected from the diaries of Father John A. Fisher who was assigned in 1940 as pastor of the parish of Ch'iao T'ou (Chiaotou), a market town south of Mukden (Shenyang) in Manchuria. Father Fisher was also responsible for the outstation of Pen Hsi Hu (Benxihu), and all Catholic families in neighboring villages. In contrast to the Maryknoll Sisters who always lived and worked in community, he was, like most Maryknoll Fathers, the one missioner in his station, assisted by Chinese catechists. With thirty American priests and twenty-eight Sisters in 1940, Maryknoll served a territory in Manchuria of 40,000 square miles with a population of 2.5 million.

Manchukuo (Manchuria) at that time was a frontier region under Japanese domination, only partially settled. Impoverished peasant families from China were migrating northward in search of livelihood. Father Fisher's diaries record their difficulties, some beggars, some poor farmers, and some who worked in the coal mines.

While Father Fisher helped the poor and needy as he could, his main tasks were pastoral—celebrating Mass, administering the sacraments, visiting the homes of the sick, the elderly, the lapsed members, arranging dispensations for mixed marriages, organizing catechumenates for new Christians and reaching out to non-Christians. One entry describes a funeral Mass held in a rural home, the first Christian service ever held in that village or entire district.

These diaries record both the special problems of his time and place, and the routine events of daily living. This was a time of inflation and rationing, a constant struggle to get flour, coal, and other necessities: Japan was at war with China. The church and rectory are prepared for winter, the stoves installed, coal laid in, storm doors mounted, and windows papered. An ironsmith makes basketball hoops. The pastor substitutes in the primary school when the teacher is sick, works in the vegetable garden, swims in the mountain streams, and plays basketball with the school-boys.

This was a lonely life; he had one American visitor during the period of these diaries. It was a dangerous time and place. Gerard Donovan, a fellow Maryknoller in the same vicariate, had been kidnapped, held for ransom, and finally murdered by strangulation just two years earlier.

As for the larger historical context, Father Fisher scarcely alludes to the heightened tensions that would bring his own country to war with Japan in just one more year, leading to arrest and imprisonment for all Americans in China. A single reference (October 11) reads: “News of the Americans being ordered to evacuate in all the newspapers today. Has the people wondering and a few of the local authorities more vigilant…. A load of materials arrived for building the hen-coop.”